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0	CDC-2022-0024-0006	https://api.regulations.gov/v4/comments/CDC-2022-0024-0006	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As long as there are things like an OARRs report around, this suggested change is just a bunch of nonsense. If Doctors have the penalty of losing one’s physicians license, decided by a bunch of politicians who have no training in medicine, pharmacy, chemistry, physiology, etc., the Doctor will have to act to protect their own self interest, not their patients best interest. This is submitted by a 66 year-old man who came very close to killing himself due to intractable nerve pain. I tried everything recommended, but my Doctor would only prescribe Gabepentin. Check Pfizer’s history about sending out lawyers to warn prescribing physicians against prescribing Gabepentin off-label, namely for never pain. This drug was developed for epilepsy. Chronic-pain sufferers are dying all over because they will not be treated for their condition, because of your incredibly short-sighted legislations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484f69987	Arter	None	2022-02-10T14:46:16Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Arter, Richard	kzh-39ny-3m4a	False	None	False	2022-04-12 01:53:30.276	[]
1	CDC-2022-0024-0007	https://api.regulations.gov/v4/comments/CDC-2022-0024-0007	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to begin by thanking you for readdressing this issue. I personally am a chronic pain sufferer, having had a botched neck surgery several years ago that leaves me with extreme pain down my right arm. I went through physical therapy which only exacerbated the problem. My regimen of hydrocodone gave me back my life and gives me the ability to function everyday, and therefore I contribute to the workforce and am not on disability. I see my Dr. every single month for this, we have had a years long relationship and he knows me well. When the rules changed in the last administration, I was forced to go back to physical therapy (by my insurance company) and had to go through a very difficult reauthorization process. My insurance company does not know what I need, my Dr. does. I follow all the rules and do not abuse my prescription. As of this month, my insurance company saw fit to send me a specific letter that they have now put this medication on tier 3 which takes it from $15 per month to $45 per month which I feel is targeted and incendiary. I hope that this can be addressed as well.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006484f69931	Mann	None	2022-02-10T14:46:24Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Mann, Robin	kzh-3337-z756	False	None	False	2022-04-12 01:53:30.777	[]
2	CDC-2022-0024-0008	https://api.regulations.gov/v4/comments/CDC-2022-0024-0008	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please leave doctoring to highly educated and caring doctors who are actually treating real people… people like your mother, grandmother, or your children. Every patient is different. Patients are individuals, not the statistical averages or Bell Curve inhabitants of your studies, studies that don’t apply to any one individual. Please stop with arbitrary regulations that prioritize numbers and protocols over what is really important… care for the patient. Please prioritize caring… of every person, Not just those that fit within two standard deviations. The rules and regulations haven’t worked. Try something different. Give doctors the freedom to treat each patient as the individual that they are. Nothing less will ever work. NOTHING.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Matthew	None	None	0900006484f69a5b	Willenkin	None	2022-02-10T15:08:22Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Willenkin, Matthew	kzh-3zl6-t7ri	False	None	False	2022-04-12 01:53:30.991	[]
3	CDC-2022-0024-0009	https://api.regulations.gov/v4/comments/CDC-2022-0024-0009	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 66 year old male with diagnosed atrial fibrillation. I had an atrial catheterization to deliver radiofrequency ablation to the right atrium for atrial flutter. I take 5mg of apixaban twice a day. I also have chronic pain from damaged cervical discs and vertebrae and osteoarthritis that affects both knees and hips as well as hands and elbows. I am currently waiting for a TKR of the right knee that is largely devoid of cartilage. It's been bone-on-bone for all three joints for years. The left knee has had two orthoscopic surgeries. The first trimmed the torn lateral meniscus, an injury sustained during Survival School while serving as a USAF pilot. The second trimmed a torn medial meniscus ten years after the first surgery. <br/><br/>Due to the apixaban I cannot take NSAID medications. Four 50mg doses of Tramadol each day have been the keys to better daily function. More importantly, this medication allows me to have regular restorative sleep. The physical pains always intensify in the evening. I have taken this same dosage of Tramadol for several years now, thanks to my competent and compassionate primary care physician in the VA Health Care System where I receive excellent medical care. There is no downside or negative side effects of the Tramadol use that I can detect. I personally believe that natural and synthetic opioids deliver meaningful pain relief with fewer risks and side effects than many of the alternatives. There remains an irrational fear and aversion to these useful medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484f69b05	Bell	None	2022-02-10T15:30:36Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bell, Steven	kzh-4nle-yxz8	False	None	False	2022-04-12 01:53:31.214	[]
4	CDC-2022-0024-0010	https://api.regulations.gov/v4/comments/CDC-2022-0024-0010	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC’s 2016 guidelines are hurting patients. As a hospice/palliative care RN, my patients are suffering! Please rescind the MME guidelines, they are not evidence based, and are truly junk science.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheri	None	None	0900006484f69b3b	Wells	None	2022-02-10T15:35:26Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Wells, Sheri	kzh-4uru-bvdz	False	None	False	2022-04-12 01:53:31.420	[]
5	CDC-2022-0024-0011	https://api.regulations.gov/v4/comments/CDC-2022-0024-0011	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 opioid guidelines caused harm to millions of us chronic pain pts. We have had enough. Let's do the right thing and treat pain appropriately. With no made up dose limits. Tolerance is expected and adjustments in dose are necessary and normal. Lets do the right thing please. No more suicides due to undertreated pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anthony	None	None	0900006484f69b6a	Pulcini	None	2022-02-10T15:36:28Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Pulcini, Anthony	kzh-5008-w9xk	False	None	False	2022-04-12 01:53:31.635	[]
6	CDC-2022-0024-0012	https://api.regulations.gov/v4/comments/CDC-2022-0024-0012	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a very close family member under the age of 40 that has a genetic condition that results in her suffering with unrelenting chronic pain. She is in pain every single moment of every single day and will likely continue to be for the rest of her life. She has a strong medical team that we have spent years building. Her medical team includes a very well-trained and highly-regarded pain management specialist that is extremely knowledgeable regarding her genetic condition. She has monthly visits with him where he closely monitors her as a human, including her general health, her pain, her pain management, and her medications. One tool, among many others, in their pain management arsenal is opioids. Her doctor and his holistic pain management program have literally saved her life and have vastly improved her quality of life. Without her doctor and her medication she would be bedridden and/or potentially lost the will to live long ago.<br/><br/>Patient care should be handled solely between caring and knowledgeable doctors and their patients. Politicians (although usually well-meaning) should have exactly no input in how my family member is treated. They cannot be interlopers between patients and their doctors<br/><br/>While guidelines can be helpful, when they are misinterpreted and taken as a rule of law or used spuriously as a "shield" by states and insurance companies, they can be extremely damaging to patients. Patients that suffer with chronic pain are among the most vulnerable Americans. They should be supported and treated compassionately with due care.<br/><br/>I support the revision of the guidelines to remove caps on dosages and to put back control of patient care in the hands individual doctors. Those doctors should not fear losing their medical licenses or being fined, just for prescribing what they believe in their medical opinion is best for their patients. Further, insurance companies should not be erroneously using these guidelines as the basis of denying coverage or increasing the price to patients for doctor prescribed opioids.<br/><br/>The fact that I have chosen to only sign this with initials (instead of my full name) out of fear of retribution from employers, insurance companies, or others is an example of the misunderstanding, confusion, and stigma that still exists in 2022 around opioids.<br/><br/>In short, leave the doctoring to the doctors! We look forward to when these guidelines are finally fixed and patients and doctors can focus on treatment and healing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484f6a0e8	C	None	2022-02-10T17:53:13Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from C, A	kzh-9l5f-shms	False	None	False	2022-04-12 01:53:31.858	[]
7	CDC-2022-0024-0013	https://api.regulations.gov/v4/comments/CDC-2022-0024-0013	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 20-year chronic pain patient, who has tried every non-opioid treatment available, I strongly support these revisions. <br/><br/>The existing 2016 guidleines have cause immeasurable harm to people in pain. Lives have been lost because patients weren't able to access medication for some of the most painful conditions known to man. People have had to give up jobs and quality of life because of an arbitrary limitation on their medication by an agency who knows nothing about them or their medical history. <br/><br/>I can only hope the CDC will further work to correct their grievous error by supporting the revision of state prescribing laws that we're made based on the 2016 guidelines. This revision is a huge step toward giving people with chronic pain back their dignity, and their lives, but it's just the first step. <br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jessica	None	None	0900006484f6a0e5	Layman	None	2022-02-10T17:54:15Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Layman, Jessica	kzh-9kjd-gt1a	False	None	False	2022-04-12 01:53:32.077	[]
8	CDC-2022-0024-0014	https://api.regulations.gov/v4/comments/CDC-2022-0024-0014	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am one of “those” patients that felt like a junky when filling my prescribed pain medication. Ordered from my Pain Management Physician who monitored me every 3 months. After having my pain “tolerable” enough to work for 7 years following a serious debilitating work injury, and failed surgeries only to slowly have that opportunity to basically live my life taken away from me by the CDC. My meds were restricted, changed, lowered and other dangerous treatment modalities that caused more harm than good were implemented. Slowly but surely I lost all function and am now home bound. Many people sought relief from drug dealers and sadly died trying to obtain some relief to be able to work and live. I’m an RN and used to work in Surgery. I’ve seen women status post double mastectomies sent home with a prescription for extra strength Tylenol. I’ve seen total knee replacement patients leave with a prescription for Meloxicam. Stage 4 cancer patients, military members with an arm and both legs blown off desperately searching for drug dealers and dying alone from an overdose taking a street drug that was laced with Fentanyl. Suicides, destroyed families, people struggling to stay alive in a society that looked at them like the lowest piece of scum. What happens when you take a persons basic human right away? They will find it, obtain more of it and it creates a ever ending cycle of suicides, overdoses, illegal activity, and complete disability. It’s negligence at a minimum. There should be no place in healthcare where the government decides what’s best for a patient. Ever. Especially from a group that has one motive. Take it away at all costs and they know nothing about the domino effect they created. Sadly I agree this is a little too late but I pray for a day where a patient can have pain medications when their physician and they discuss all aspects of treatment good and bad. Everyone has been affected negatively by this and will be affected by it if doesn’t change soon. Sitting at the bedside of your parent when they’re dying from Stage 4 cancer and all they have is Toradol. Calm an 18 month old baby that has children’s Tylenol for post op adenoidectomy. Pain delays healing and has the potential to cause other serious health issues, takes people out of the workforce and society completely to become shut ins and prisoners in their own homes. This NEVER should’ve happened and needs to be corrected immediately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JacquelynJacquelyn	None	None	0900006484f6a0e3	Hansford	None	2022-02-10T17:56:54Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Hansford, JacquelynJacquelyn	kzh-9jyb-r3sx	False	None	False	2022-04-12 01:53:32.317	[]
9	CDC-2022-0024-0015	https://api.regulations.gov/v4/comments/CDC-2022-0024-0015	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s high time the CDC stop its mindless attacks on Americans with chronic pain.<br/>When I think of the unnecessary trials and tribulations the government has visited upon millions of innocent people, I just shudder. The fact that doctors (who, in large part, are responsible for -creating- chronic pain with botched surgeries) haven’t worked harder to redress this horrendous situation, is equally as troubling. The AMA should be ashamed.<br/>Well, better late than never, I suppose.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f6a0a0	Rader	None	2022-02-10T17:58:46Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Rader, Michael	kzh-9943-3wjk	False	None	False	2022-04-12 01:53:32.537	[]
10	CDC-2022-0024-0016	https://api.regulations.gov/v4/comments/CDC-2022-0024-0016	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is Barbara Gianelli. I am a 65 year old married woman, with two children and 3 grandchildren. I am also a chronic pain patient who has gone through hell in the past 10 years trying to get the medication I required to purposely live my life. (Before I retired, I was an RN and FNP for over 20 years, volunteered 1 day per week in my kids’ classrooms for 10 years, ran a pizza business and our home, as well as being an avid jogger.) I have severe back pain and have used numerous types of opioids in the past 18 years, but the one that allowed me to function most normally in my life was OxyContin ER. Since your guidelines to stop opioid treatment for chronic pain, my already painful life has become immeasurably more painful, humiliating and depressing. The first difficulty that I encountered was trying to find a pain doctor. None of the doctors in my rural hometown felt comfortable any longer prescribing the opioids that the pain specialists in San Francisco, Ca had prescribed for me. This forced me to “shop” for doctors who would prescribe the medication that had allowed me to continue living my life. (I HAD tried physical therapy numerous times, as well as every other holistic form of pain management available to help manage my back pain, such as: acupuncture, chiropractic, massage, Myofascial release, meditation, counseling, reiki, TENS stimulation, and almost every other modality that held any promise of pain relief). Once I found a pain doctor, I now had to drive 3 hours for each appointment (riding in a car always causes my back pain to flare up). Unfortunately, getting the prescription for OxyContin ER was just the beginning of the difficulties and humiliations. Going to the pharmacy that I had always used for my family and myself, I found out that many pharmacies no longer wanted to deal with the increase in paperwork and regulations that were needed if they dispensed OxyContin ER, so I had to pharmacy shop. Once I found a pharmacy that would fill my prescription, I was shocked by the outrageous cost of the medication…..because all of the insurance companies had moved OxyContin ER to a TIER of medications that were barely covered. I also found that I had to plan all of our family vacations around the date that I needed to pick up my medication, because I could no longer get a three month supply of pain medication, and no pharmacy would fill an OxyContin ER prescription written by a doctor from out of town.<br/>Even picking my prescription for OxyContin ER up each month from the same pharmacy has become a nightmare. EVERY MONTH there is a new excuse as to why my medication can NOT be picked up on the correct day. In the past few months I have been told that the pharmacy is out of stock of OxyContin ER, or that they are out of stock of the generic drug that I usually get. I have been told that I need to get Prior Authorization of this same medication as often as 4 times in the same year….(when each Prior Authorization is good for a year). Even after going to the same pharmacy every month for over 5 years, almost every month there is some mix-up at the pharmacy or insurance company that makes picking up the 30 day supply of my pain medication a question……what type of road block will be thrown up this month? It is incredibly stress provoking, maddening and ultimately depressing.<br/>I have never smoked, used illicit drugs, or used overused alcohol (I haven’t used any alcohol in almost 20 years), and yet, EVERY MONTH, I feel like I am treated like I am breaking the law, just to get medication to help me live a productive life. This is not right. I think that the reason that we have had so many deaths from opioid overdose is because you, the CDC, took pain medication away from so many people who suffer daily with chronic pain. Unfortunately, the only way those people could get something that they thought was pain medication to ease their pain, was to use an illicit drug. <br/><span style='padding-left: 30px'></span>I beg you, as a chronic pain sufferer, as an RN and FNP, and as a human being, please change your stance on opioids for chronic pain. Your education program about opioids has been great. Everyone should know about the abuse potential of opioids, but no one should have to live in severe chronic pain when medicine DOES have the means to improve their lives. When I was practicing as a Nurse Practitioner, I don’t know how many elderly folks told me that they had been taking opioids for 20 years or more…..the same dosage. They all told me some form of the same story….”if I am able to talk my 2 or 3 pills a day, I can get outside and garden, or walk my dog, or play with my grandkids, etc”…..but without the opioids, they were stuck inside on a heating pad. Unfortunately, I have had the same experience. I do NOT need more and more opioids each month or year to lead a productive life, but I DO need the dosage that I am on now…..even though it is over your suggested dosage.<br/>Thank you, <br/>Barb Gianelli	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484f6a030	Gianelli	None	2022-02-10T18:03:11Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Gianelli, Barbara	kzh-8uja-8n1y	False	None	False	2022-04-12 01:53:32.742	[]
11	CDC-2022-0024-0017	https://api.regulations.gov/v4/comments/CDC-2022-0024-0017	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	So many have suffered unnecessarily for years. A lot of us have lost dear friends and family members. They couldn't handle the pain and not being heard. CPP are being treated as less then human. I am cautiously optimistic about the changes being made here. I will continue to pray that help will arrive. I hope a clearer picture has been painted here as we see overdoses still rising. It's not CPP! Correct use doesn't equal abuse. Also most of the alternatives that CPP have been forced into are far worse. Like early onset of dementia from Gabapentin. My mother is forever changed. I can't get that back. We need to keep the DEA, government, pharmacists, and insurance out of our medical treatments. If found medically necessary by my doctor than it should be between me and my doctor. Thank you for listening to the CPP community. I hope you will find it in your hearts and logic to make humane decisions with chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f69fb8	Anonymous	None	2022-02-10T18:09:19Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-8ee9-nyac	False	None	False	2022-04-12 01:53:32.982	[]
12	CDC-2022-0024-0018	https://api.regulations.gov/v4/comments/CDC-2022-0024-0018	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've had 27 surgeries and/or hospital procedures to help me manage my syndrome called Ehlers Danlos. It's a failure of the body to produce sturdy collagen. I'm bendy. I'm stretchy. I'm in constant pain. Sometimes light, sometimes so unbelievable that I don't understand why my heart doesn't burst. People ask what I do to get better. I don't have a disease. I have a syndrome. Like Down's. Would you ask as Down's person when they're going to get better? I'm not going to get better. I'm on liquid morphine now and what a struggle it was to get doctors to work with me. Every 90 days I report in with whatever remains in my prescription and I fill out a pain chart that has no relevance to what I'm dealing with. I'm fortunate that morphine gives me a little relief. Most EDs folks can't take it. Please, continue to make strong pain relief available for those of us who need it. For those of us who have proven we are responsible patients maybe a yearly visit with a phone check up every 90 days would be enough. And for Ehlers Danlos folks, work up a new pain chart that goes from 1-20 instead of 1-10. Sadly, many of us go years and years being told there is nothing wrong with us. By the time a good diagnosis is made severe damage to our body has already taken place. For me a good day is one where I don't feel like chewing a limb off. Without morphine I don't think I could get out of bed. And I'm one of the lucky ones.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	0900006484f69f25	Lagorio	None	2022-02-10T18:13:57Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Lagorio, Catherine	kzh-7w85-gacw	False	None	False	2022-04-12 01:53:33.183	[]
13	CDC-2022-0024-0019	https://api.regulations.gov/v4/comments/CDC-2022-0024-0019	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a much needed change from the 2016 guidelines which destroyed quality of life for so many people. Our medical professionals are educated and qualified to determine the best treatment for each of their patients and should be trusted to do so. As a migraine sufferer, I as well as family members, have been unable to obtain medications that we need. We have suffered days and weeks of unrelieved pain due to the current oppressive guidelines. I look forward to the proposed guidelines being put in force.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peggy	None	None	0900006484f69f1e	Wilson	None	2022-02-10T18:14:35Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Wilson, Peggy	kzh-7vbv-frxm	False	None	False	2022-04-12 01:53:33.398	[]
14	CDC-2022-0024-0020	https://api.regulations.gov/v4/comments/CDC-2022-0024-0020	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic back pain for over 30 years. The pain prevents me from living a normal life. It is excruciating. I finally found relief from a pain management and spinal specialist who prescribed Suboxone for my pain. It gave me immediate relief and allowed me to resume normal activities. I lived a normal almost pain free life for about ten years. Then I moved from the state of Florida to the state of Wisconsin. Opioid use is so strictly regulated here that no pain doctors will prescribe them, for fear of losing their licenses. I could no longer get Suboxone and returned to an excruciating state of chronic pain. I rarely left the house, stopped socializing and could no longer pursue my art making. I was 78 years old at that time. After spending six months in agony, I finally persuaded a non pain doctor to look into Suboxone . He agreed to and took a workshop in prescribing it. He told me that his eyes were opened and he obtained a license to prescribe it. I am now almost pain free again and living a wonderful life filled with family, friends and the art community. For a long time some states mistakenly took CDC recommendations for prescribing opioids as rigid mandates instead and stopped prescribing them at all. So the new suggested guidelines will come as a great relief to thousands of patients that suffer excruciating pain and hopefully remove the fear of prescribing opioids from those doctors involved in pain management . It will put the decision for treatment back into the hands of doctors as it should be.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bonnie	None	None	0900006484f69d65	Bohn	None	2022-02-10T18:17:39Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bohn, Bonnie	kzh-6gqz-yesi	False	None	False	2022-04-12 01:53:33.657	[]
15	CDC-2022-0024-0021	https://api.regulations.gov/v4/comments/CDC-2022-0024-0021	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At present many cases of extreme and or chronic pain are insufficiently treated because of pressure on the medical community to limit the use of opioid pain killers. Physicians and other health care providers should not have to be afraid to prescribe appropriate doses. In addition, many elderly people, myself included, would use massage and acupuncture and other alternative, well-proven treatment modalities both for preventive care and strengthening to prevent injury, as well as recuperation, if they were paid for by Medicare.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484f69d06	Van Sickle	None	2022-02-10T18:19:13Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Van Sickle, Janet	kzh-66fh-5nwi	False	None	False	2022-04-12 01:53:33.877	[]
16	CDC-2022-0024-0022	https://api.regulations.gov/v4/comments/CDC-2022-0024-0022	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For many long term opioid treatment is integral to palliative care <br/>Giving a one legged man crutches and then taking them away a very apt analogy of current policy	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484f698b8	Sepulveda	None	2022-02-10T18:22:31Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Sepulveda, Daniel	kzh-60ej-ut00	False	None	False	2022-04-12 01:53:34.093	[]
17	CDC-2022-0024-0023	https://api.regulations.gov/v4/comments/CDC-2022-0024-0023	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank God the pendulum is swinging back towards the center! In my lifetime I've seen wild swings on this issue - either rules are too lenient or way too restrictive - but the latest over-reaction to the "opioid crisis" was far too restrictive. Fifteen years ago I was prescribed Lyrica, Oxycodone and a Fentynyl patch after major back reconstruction for severe scoliosis. There was a lot of physical therapy involved and there was no way I could have done it without those prescriptions. I began to taper myself off after the 4th month and by the 5th month I was off all meds and back at work. I am about to have more surgery done (also for my scoliosis) but this time, even the Pain Specialists are unwilling to prescribe anything even though I've already gone through all the other options (physical therapy, acupuncture and Tylenol 2-3 times a day for months). I would not advocate for another Fentynyl patch this time, but oxycodone WORKS when nothing else does but the doctors are petrified of prescribing it! My family depends on me, as my husband is unable to do much anymore. I go for surgery again later this month, and they're telling me they'll give me a few days of pain meds. . . I hope that will be enough. <br/>Physicians should be able to prescribe these medications if they think they are warranted. Thank you for trying to bring a little more common sense to this issue. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484f69886	Byron	None	2022-02-10T18:24:11Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Byron, Judith	kzh-5x09-938a	False	None	False	2022-04-12 01:53:34.299	[]
18	CDC-2022-0024-0024	https://api.regulations.gov/v4/comments/CDC-2022-0024-0024	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a caregiver for my fiancé who has experienced multiple car and motorcycle acccidents in his 61 years of life. We have been together for almost seven years and I have observed his devolution over this time period. His MRIs can attest to his chronic pain, but the current regulations are so strict, that he is not eligible for opiate therapy. <br/>He utilized prescribed opiates for years until the 2016 regulations were implemented. At that time, his dosages were greatly reduced through a pain management facility, to the point that they weren’t helping to reduce his pain. He resorted to finding unregulated street drugs to allay his pain, which resulted in his exclusion from subsequent pain management facilities. I called our councilman, the Department of Health and countless pain management establishments, all to no avail; at present, he is on methodone for his pain and he had to get that by saying that he is an addict in need of therapy. When we have mentioned his methodone use to medical professionals, police officers, court officials, etc., he is judged to be a useless drug addict. His methodone use has negatively affected his custody rights, not to mention the daily, now weekly, trips to the methodone clinic to stand in line with the actual drug addicts.<br/>I have always believed in the healthcare system and its willingness to care for people in need. I find it incredible and appalling that a person living in the United States in 2022 should be treated so inhumanly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f6986e	Sibley	None	2022-02-10T18:28:19Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Sibley, Lisa	kzh-5v7z-l8h4	False	None	False	2022-04-12 01:53:34.541	[]
19	CDC-2022-0024-0025	https://api.regulations.gov/v4/comments/CDC-2022-0024-0025	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 35 and have had chronic pain for 8 years. I have done physical therapy, OTC meds, and many other types of therapies. Nothing works except opioids. I dont want to be on them the rest of my life, but I can’t even get out of bed without them. I have kids and I need to be able to function. However my doctors are not allowed to prescribe what will actually help because of regulations made by someone who does not know my case. I can’t heal because I am always in pain. My body gets just enough relief to function, but not to do normal activities or heal. I’d love to be able to function like a normal mom and wife and not get barely enough relief to get out of bed and do minimal work. Please give professionals who spent years in school and know their patients personally the ability to prescribe what will actually be help. They pledged an oath to protect us and keep us safe. They want to help us, but can’t. And they will be safe since they are the ones who know the risks and benefits best.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashley	None	None	0900006484f6a639	J	None	2022-02-10T18:30:15Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from J, Ashley	kzh-bcfh-jcrz	False	None	False	2022-04-12 01:53:34.744	[]
20	CDC-2022-0024-0026	https://api.regulations.gov/v4/comments/CDC-2022-0024-0026	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	OH MY, I'm so elated that some progress is finally being made. I'm an elderly legacy patient living in Florida and, after losing my PCP , I have searched for acceptable PM. It seems all want to make bucks and offering steroid injection rather than pain medications. It's become a money grab. I do not have OUD and resent being put in that category. I'm a chronic pain patient who wants to, at least, be a bit mobile in my later years. Wonderful that we are finally being heard and there is a positive reaction. Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	cindy	None	None	0900006484f6a549	caron	None	2022-02-10T18:31:53Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from caron, cindy	kzh-a5fi-0do4	False	None	False	2022-04-12 01:53:34.965	[]
21	CDC-2022-0024-0027	https://api.regulations.gov/v4/comments/CDC-2022-0024-0027	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting concerning my husband who has chronic pain in his back he has been on opioids for about 5 years or longer as his dosage keeps getting cut because of laws in place his pain has increased significantly because of this he can barely walk or enjoy any activities because of the pain it would be wonderful to see him be able to go back to his regular dose and be able to enjoy everyday things again so please put back in place for him to be prescribed back up to a higher dose where he can enjoy normal everyday activities again thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484f6a532	Aguilar	None	2022-02-10T18:33:10Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Aguilar , Pamela	kzh-a061-bo2t	False	None	False	2022-04-12 01:53:35.177	[]
22	CDC-2022-0024-0028	https://api.regulations.gov/v4/comments/CDC-2022-0024-0028	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am on SSDI. I am a 58 year old female who is not overweight. I consume no alcohol, and never have smoked. I am on Medicare and Medi-Cal. I have chronic pain from Small Fiber Neuropathy, and significant Osteoarthritis throughout my body. I had two Medtronic Neuromuscular Stimulators installed and then removed for chronic pain. I would absolutely love acupuncture, biofeedback, and or massages. However, my insurance does not pay for those items. I do take a large dose of Mobic. I also take 90MG of Gabapentin. The Gabapentio. affects my cognition if I take a larger dose. I also stretch, take hot baths, and go to a local pool when I can find a ride.<br/>I do take a moderate dose of a short acting opiate to sleep, in addiction to 100 MG of Trazodone. Otherwise I toss and turn in pain. I could really use the above mentioned treatments! Because my pain is significant I have to lie down and rest every afternoon. This means I am unable to to cook for my family or babysit grandchildren all day without assistance. I just had an ankle/foot surgery. I still need the other foot operated on, a knee replacement, and a shoulder replacement. But, that doesn't stop the arthritis pain in hands and feet or neuropathy pain. Since my insurance won't pay for the above mentioned treatments I need an opiate dose in the afternoon so I can be a productive member of my family. The opiate guidelines are too strict.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rhonda	None	None	0900006484f6a525	Brand-Cross	None	2022-02-10T18:35:14Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Brand-Cross , Rhonda	kzh-9y5l-ecb1	False	None	False	2022-04-12 01:53:35.382	[]
23	CDC-2022-0024-0029	https://api.regulations.gov/v4/comments/CDC-2022-0024-0029	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While it seems to head in a better direction the destruction to the medical care of pain needs to be reinstated. However without reversing the DOJ's DEA policing, raiding, and jailing of so many pain doctors nothing will change. So many PM doctors no longer prescribe due to the long arm of the law and until this is rectified how doctors operate will not change. Also, the alleged fraud by PROP and medical boards needs immediate addressing. All this must be done first before any remaining doctor will write a script. Government agencies and anti-opioid people must address and confront the greed and power plays that have occurred. These areas need fixing now before releasing new guidelines. While the new guidelines are an improvement over the 2016 ones I'll tell you that on their release not one thing will change. While you dropped the ridiculous MMEs there will be few, if any doctors that will change their very restrictive and inhumane treatment plans. I bet after these are released and if I wait 6 more months I could see a PM doctor and run into the same issues I had before. I was on pain meds from 1992 till 2016 at the same dosage. I only had to change my pain med in 2011 because Aetna refused to pay for what I was prescribed. I was scripted the equivalent of what I was on and remained on that until I saw a pain clinic in Michigan where I was over what their limit was. Still I carried on only to find myself without any pain meds or 2 other controlled meds for another life changing post op complication. All I can hope for is these hurdles are resolved, our doctors released from the chains of guidelines and medical boards which have caused and will continue to cause major problems in caring for anyone in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peggy	None	None	0900006484f6a51d	Oconnor	None	2022-02-10T18:45:16Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Oconnor, Peggy	kzh-9x0t-bpz9	False	None	False	2022-04-12 01:53:35.594	[]
24	CDC-2022-0024-0030	https://api.regulations.gov/v4/comments/CDC-2022-0024-0030	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello I'm 68 years old I'm still trying to work I'm at work have crying most of the time because I'm in so much pain I need something to help me make it through the day while I'm working.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6a66b	Anonymous	None	2022-02-10T18:46:07Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-blyk-tcy4	False	None	False	2022-04-12 01:53:35.833	[]
25	CDC-2022-0024-0031	https://api.regulations.gov/v4/comments/CDC-2022-0024-0031	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I welcome the proposed guidelines for prescribing opioids. I have had chronic pain for 15 years, and the prescribed pain meds do very little to alleviate my suffering and OTC meds do nothing. The stigma of opioids have always prevented me from asking my doctor about getting such medications. I know they work, because I have leftover hydrocodone from a surgery 5 years ago. When the pain gets excruciating I take one, and it's a miracle, I am pain free for a few hours. If I was an addict, those pills wouldn't have lasted a week post operatively.<br/>I hope doctors will pay attention to those guidelines and stop treating people like potential substance abusers if they ask for pain relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heidi	None	None	0900006484f69857	Schram	None	2022-02-10T19:42:40Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Schram, Heidi	kzh-5u2d-572u	False	None	False	2022-04-12 01:53:36.036	[]
26	CDC-2022-0024-0032	https://api.regulations.gov/v4/comments/CDC-2022-0024-0032	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is definitely the right thing to do. One size does not fit all, and as a patient who suffers from chronic pain, I can tell you that applying one rule or standard to everyone across the board, regardless of circumstances, is not working and can be inhumane. I applaud the decision to allow physicians to make determinations regarding prescription of pain medications based on the condition of the patient, and this must include the patient’s quality of life. Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6982b	Anonymous	None	2022-02-10T19:46:47Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-5rca-k7cf	False	None	False	2022-04-12 01:53:36.242	[]
27	CDC-2022-0024-0033	https://api.regulations.gov/v4/comments/CDC-2022-0024-0033	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic migraine sufferer, I commend your efforts to revisit these regulations. I am a highly educated adult with a close relationship with my primary care provider. For years, I was able to refill the single effective prescription medication I use twice a month. That was a perfect match for my needs, providing necessary relief without overmedication. With the stricter restrictions, I am only able to access this medication once a month. The product I rely on, butorphanol, is already significantly limited in dosage, making one refill a month ineffective for my needs. I have been left with chronic, debilitating pain, causing me to miss work repeatedly. <br/>Please trust providers to determine the best course of action for their patients. If certain over-prescribers cause an issue, deal with those individuals. As a teacher, I don't punish the whole class for the misdeeds of one student. The same principle should apply here.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f697e2	Anonymous	None	2022-02-10T19:48:27Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-5m1n-yv2g	False	None	False	2022-04-12 01:53:36.445	[]
28	CDC-2022-0024-0034	https://api.regulations.gov/v4/comments/CDC-2022-0024-0034	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for 22 years. I was a chiropractic physician that treated chronic patient patients and worked with the Oregon Pain Center. It started with a lower back disc injury that progressed into nerve impingement. Initiallty I needed vicoden to control the pain. Unfortunately, after several failed attempts to treat my injury, my lower back and radicular pain never resolved. The next recommendation was to start oxycontin and see if that could control my pain. I refused that treatment knowing what happens to chronic pain patients that start down that road. So i continued to treat my condition with chiropractic care, acupuncture, massage, and Tramadol. I tried a procedure called an IDET that caused a lower back nerve injury that made my nerve pain worse. So i elected to go forward with a neurostim implant. That turned out to significantly reduce my pain. So for the last 20 years, I have continued to manage my chronic pain with exercise, massage, occational chiropractic manipulation,Tramadol(300-400mg/day) and the neurostim. I also had the advantage of my health care experience to make good medical decisions. Unfortunately, many patients are pushed though an overburdened medical system where opiods are a quick and easy way to treat complex chronic pain conditions. Many patients with addictive personalities need to be treated with more of a team approach and avoid using strong narcotics long term. My experience working with the Oregon Pain Center showed me the destructive nature of long term use of strong opiods on patients. So i don't see this changing much unless doctors have other options for chronic pain patients other then opioids. If doctors do run out of options then patients should be treated with any combination of medicines including opioids to control pain. Good luck finding the sweet spot on opiod use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Craig	None	None	0900006484f69be1	Balter	None	2022-02-10T19:52:49Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Balter, Craig	kzh-5hoq-n5u3	False	None	False	2022-04-12 01:53:36.685	[]
29	CDC-2022-0024-0035	https://api.regulations.gov/v4/comments/CDC-2022-0024-0035	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a physician, and occasionally a patient...A couple of things. Most insurance plans do not pay for "massage", and physical therapy is not often the same thing. PT addresses function, not pain. Second, Ibuprofen should not be used in elderly patients, or even patients over 50. It can cause renal damage and cardiac damage. It's bad for people with high blood pressure. Next, medical marijuana is VERY USEFUL, and it works. But it's not legal. And in states where it is legal on the state level, it is very expensive and also NOT COVERED BY INSURANCE. So only people with money can access medical grade marijuana. A very good way out of this dilemma is to legalize marijuana, and make medical marijuana legal and therefore covered by insurance. Please, it's safe, it's past time. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f69bbe	Dranginis-Shulman	None	2022-02-10T20:00:10Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Dranginis-Shulman, Patricia	kzh-5apl-fegb	False	None	False	2022-04-12 01:53:36.892	[]
30	CDC-2022-0024-0036	https://api.regulations.gov/v4/comments/CDC-2022-0024-0036	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person that has been suffering from chronic osteoarthritis for the last 20+ years, had 2 horse accidents and a major car accident and recently gone through a complete shoulder replacement procedure, I can assure you that the recommended adjustments to the opioid epidemic are welcome from my prospective. <br/>Every time I need to get my prescription refilled; I feel like a criminal going for another fix. My doctor is afraid to increase my prescription because of Federal Regulations and I have been limited to (2) Norco-5 per day. If I travel anywhere, I need to schedule my trips around the refill date of my prescription because I cannot have another drug store fill my prescription other than the store that the original prescription that the Doctor called the medical in for refill to, not even with the same chain of drugstores. EX: Walgreen's. My only other option is to try to get my doctor's office to call my prescription to a pharmacy where I think I may be on the 21st of each month. <br/>I am a 59-year-old man who has worked hard all my life and now forced into early retirement because of Covid and arthritis. I don't drink, I don't smoke anything like tobacco or marijuana or use any other drugs besides Hydrocodone, Gabapentin and Acetaminophen to control my pain. When I exert myself around the house or drive long distances, my pain increases, but with a limit of 2 tablets a day, I need to limit my activity, hence my weight gain over the last few years. <br/>My point is that I am a responsible member of society that always follows my doctor's direction, uranate's in a cup for random drug tests and do all I can to follow the law. Why am I treated like a criminal?<br/>Remember that a drug addict is going to get drugs one way or another. Some of these recent laws only keep the honest people honest. The criminals will get their drugs one way or another. Why punish the law abiding, tax paying, responsible citizens who truly need medication to endure a chronic debilitating disease like chronic osteoarthritis? <br/>Please allow my prescribing doctor to treat my pain and allow me to have to dignity to not be treated like a common criminal. <br/><br/>Thanks, RF	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484f6a6c2	Fuller	None	2022-02-10T20:02:13Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Fuller, Steven	kzh-c2y6-o3q1	False	None	False	2022-04-12 01:53:37.101	[]
31	CDC-2022-0024-0037	https://api.regulations.gov/v4/comments/CDC-2022-0024-0037	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a social work researcher in mental health and as a person with a family member living with Multiple Sclerosis, these changes cannot come soon enough. Persons living with chronic pain often have difficulty finding a pain management clinic, accessing timely appointments, and the needed medications. I have often heard person living with chronic conditions being treated as “a drug addict” by pain management providers. Reform is needed to provide individually-centered services.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alice	None	None	0900006484f6a6cd	Boyd	None	2022-02-10T20:02:51Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Boyd, Alice	kzh-c4tj-gjuw	False	None	False	2022-04-12 01:53:37.333	[]
32	CDC-2022-0024-0038	https://api.regulations.gov/v4/comments/CDC-2022-0024-0038	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Centers for Medicare & Medicaid Services (CMS) released its 2018 Call Letter on April 3, 2017. In addition to the traditional information included in the annual Call Letters, the 2018 Call Letter included significant changes in CMS’s opioid overutilization criteria that mandate considerably heightened scrutiny of opioid prescriptions; the new criteria more than double the number of beneficiaries “whose opioid use may require focused care management.” Healthcare Fraud Prevention Partnership (HFPP), which addresses opioid-misuse issues, operates largely in the dark, in violation of the Federal Advisory Committee Act (FACA). According to minutes from the meeting, HFPP designs federal policy on opioid prescribing and “encourage practices that connect patients to the level of care best suited to their needs…while avoiding unnecessary services or opioid prescriptions.” HFPP encourages pharmacists to “deny payments for (opioid) prescriptions that do not conform to general prescribing practices” and to profile doctors and patients to identify “problematic actors and schemes.” HFPP’s most recent set of policy recommendations is contained in a January 2017 “White Paper” entitled “Healthcare Paper Strategies to Reduce the Harms of Opioids.” A final version of the White Paper drafted by HFPP’s Executive Committee was circulated at an October 20, 2016 “Special Session” of HFPP’s general membership. At that session, HFPP members reviewed the draft White Paper and recommended various changes to the US Department of Justice (USDOJ). HFPP issued its White Paper in final form a few months later. Notice of this Call Letter was first given on February 2, 2017, when the draft was published on CMS’s website, and the comment period closed on March 3, 2017. That truncated 30-day comment period did not foster transparency or allow the affected parties to submit informed comments with reasonable notice.<br/>On January 5, 2017, months after drafts of the White Paper were first made available to CMS, CMS adopted its own “Opioid Misuse Strategy” that largely mirrored recommendations contained in the White Paper funded by General Dynamic Information Technology (GDIT) Trusted Third Party (TTP) and HFPP.<br/>The HFPP and the USDOJ implemented Dr. David Rein of NORC Chicago, published white paper, “Healthcare Payer Strategies to Reduce the Harms of Opioids” presented at the Healthcare Fraud Prevention Summit in Woodlawn, MD at the CMS Center for Program Integrity (CPI) Command Center. <br/>CMS prevented other stakeholders in healthcare, such as physicians, pharmacists, hospitals, or patients, to assist in developing appropriate guidelines at the October 20, 2016 meeting which was called by CMS, organized by CMS, funded by CMS, and held on federal property at the CMS Command Center in Woodlawn, Maryland.<br/>Blue Cross Blue Shield Association (BCBSA) Office of Policy and Representation influenced CMS to align its Medicare Advantage and Part D prescription drug plans with the CDC guideline soon after receiving the HFPP white paper recommendations. BCBSA Office of Policy and Representation interfered and restrain trade with respect to all interchangeable products and services as advocated by the Pain Management Best Practices Inter-Agency Task Force (Task Force) which was established to propose updates to best practices and issue recommendations that address gaps or inconsistencies for managing chronic and acute pain.<br/>The charter for the Task Force was approved by the Secretary of Health and Human Services on October 24, 2017, and sunset on July 22, 2019. The U.S. Department of Health and Human Services oversaw this effort with the Task Force with the U.S. Department of Veterans Affairs and the U.S. Department of Defense. The Task Force, which was authorized by section 101 of the Comprehensive Addiction and Recovery Act of 2016, and also provided the public with an opportunity to comment on any proposed updates and recommendations and developed a strategy for disseminating information about best practices. The Task Force consisted of representatives from relevant HHS agencies, the Departments of Veterans Affairs and Defense, and the Office of National Drug Control Policy. Non-federal representatives included individuals representing diverse disciplines and views, including experts in areas related to pain management, pain advocacy, addiction, recovery, substance use disorders, mental health, minority health, and more. Members also included patients, representatives from veteran service organizations, the addiction treatment community, and groups with expertise in overdose reversal, including first responders, medical boards, and hospitals.<br/>The Center for Disease Control should consider adopting all the recommendations of the Pain Management Best Practices Inter-Agency Task Force and disregard recommendations of Dr. David Rein, BCBSA Office of Policy and Representation, and HFPP GDIT TTP.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Neil	None	None	0900006484f6a6e3	Anand	None	2022-02-10T20:10:58Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anand, Neil	kzh-bw8q-yd64	False	None	False	2022-04-12 01:53:37.554	[]
33	CDC-2022-0024-0039	https://api.regulations.gov/v4/comments/CDC-2022-0024-0039	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am not a chronic pain sufferer in the sense that I receive pain management. But over the past 10 years, I can recollect the times that opiods were what I needed to find relief from from acute conditions. Your proposed draft intends to give the guidance of using OTC drugs or non proven medical "relief" like accupuncture as a solution to what you deem as "acute" problems (back pain, etc). I can attest that if I or many go to a doctor for back pain, it is because I have exhausted my OTC options or junk science homeopathic remedies. This past year, after being sick for a month coughing, something popped in my back. Awful, searing, take your breath away pain that no OTC drug or heating pad relieved. Chiropractor did nothing. Exercise made worse. What worked: opiods and time. Managing the pain until my back healed. I had to go to a hospital, get a CAT scan, stays, spend thousands of dollars to get a fee gours of relief and be told I pulled a muscle. You see, I can't take NSAIDs because a hospital put me into kidney failure for fear of giving me opiates. They overdosed me on ibuprofen after foot surgery. I cant take steroids because of my diabetes. There are no other options for me, and your misguided attempt at fixing a this "epidemic" has more than hurt many of us. Similarly, after my c-section, a fear of opiod prescribing, left me in unimaginable pain after the epidural wore off with no pain management in place. I have been on the end of this fear of prescribing and its consequential light handed medicating from major surgery to acute pain. Trust me, as someone who has spent almost a lifetime in medical debt, I dont go to a doctor unless I have exhausted all my options. Most of the United States is this way because our healthcare system is broken and unaffordable. I'm tired of being in pain with no way to remedy it, and your proposed changes only fix this for chronic pain sufferers. It doesn't help those of us that slip and fall, tear a muscle, break a bone, etc. The acute patients that just need enough relief to heal. Shame on you for telling me to lay on a heating pad and take a tylenol to fix something that is so painful. Obviously, no one who has drafted this new proposal has ever been denied relief while being in pain, or almost died because doctors overdosed you on NSAIDs because they feared giving you opiods. You are nearly the same as those that tell patients nothing is wrong with them because you can't see they're symptoms. Shame on you. Change your guidance to what it should always have been, prescribe what you as a doctor think is reasonable for this patient based off of thier particular ailment. They are doctors. Let them do their job.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484f6a6f9	Griffith	None	2022-02-10T20:14:24Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Griffith, Nancy	kzh-cb01-69fn	False	None	False	2022-04-12 01:53:37.765	[]
34	CDC-2022-0024-0040	https://api.regulations.gov/v4/comments/CDC-2022-0024-0040	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You don't and can't understand 24\7 pain until it hits you.. Every day the first thought in your mind is can I take this curse 1 more day. While I understand the dilemma you have nudged doctors to get out of pain management and force people who simply want to live and enjoy the bare minimum of life to the streets. You cannot possibly understand that pain management is the last resort before you do 1 of 2 things and as usual government over corrects and this is a good first step as people's misery under the past guidelines cannot be described. Until it happens to you, no words can explain. Mind you most of us work because we don't want to be leaches on the system and be nudged to sell drugs to pay for the doctors, medication, mandatory drug tests, and constantly going to other doctors in the meantime either trying to solve the issue or proving to the pain management doctors that you are suffering. Its obvious you don't actually talk to people because you can't predict the side effects of your actions. I absolutely urge people to contact me and I am not afraid like most people to send you their information	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jared	None	None	0900006484f6a6fc	Bennett	None	2022-02-10T20:16:01Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bennett, Jared	kzh-cb6y-fea8	False	None	False	2022-04-12 01:53:37.973	[]
35	CDC-2022-0024-0041	https://api.regulations.gov/v4/comments/CDC-2022-0024-0041	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm not sure where to start as I've never voiced my opinion on anything like this. Doctors. PA's, NP's, go to Medical school for a reason, and that reason is to make a difference in people's lives. They take an oath to protect, and to treat each patient with their best knowledge, and judgment. Each person's journey is different, and should be treated as such. Each person's pain is different, and should be treated as such. I've had doctors not want to treat me how I should've because of not wanting to deal with opioids. It's a true saying that it always takes one bad apple to ruin it for the rest. I've had pain for many years from the trauma done to my body. I've fought hard to be the person I am, and to show I'm not someone with an addiction problem. I'm someone's mother who tries every day to be the best version of myself, and to put on a brave tough face to not let the ones I love know how much pain I live in daily. I take an opioid medication daily. I hate that I feel judged for having to do so, I hate that nothing else will ease the pain just enough to be able to live life normally. It doesn't take my pain away, it barely eases it enough to function without hurting. I don't ask for a strong dose because I know how people, and doctors act whenever it is talked about. Everyone's pain and their treatment plan should be individualized. I shouldn't be treated like someone else because they frequently hurt themselves to get pain killers. I should be treated as how my bodies trauma - which isn't from burns, cancer, ect and the many times my medical provider has had to go through all the different routes of care to find one that has helped. Hippocrates has said so many great things, but these two go well with this,<br/> "As to diseases, make a habit of two things — to help, or at least, to do no harm." <br/>"Declare the past, diagnose the present, foretell the future."<br/>Medical providers are a gift, and many of them are brilliant enough to make a habit of their best judgment call.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6a723	Anonymous	None	2022-02-10T20:18:12Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-ch18-9rdz	False	None	False	2022-04-12 01:53:38.173	[]
36	CDC-2022-0024-0042	https://api.regulations.gov/v4/comments/CDC-2022-0024-0042	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain and due to the current regulations I’m treated as a ex con on parole. I have to submit to quarterly urine analysis tests which is ridiculous. I have tried every medication, physical therapy and surgery and yet still suffer from crippling pain. The only thing that works is opioid pain relievers. Because I am able to get some medication I am able to conduct basic functions in life. Without my pain medication I wouldn’t be able to leave my bed. <br/>It’s time to stop treating chronic pain suffers like criminals and allow them to have access to the medication we need. The CDC/DEA making doctors terrified to prescribe drugs that can substantially increase the quality of life for those living with chronic conditions is wrong and misguided. <br/>More people die from alcohol related accidents/disease/abuse than opioids. It’s time to stop the double standard and allow the quality of care in this country to take care of those of us that need pain medications to be healthy members of our community, family and workforce.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jason	None	None	0900006484f6a751	A	None	2022-02-10T20:27:13Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from A, Jason	kzh-cqbz-rgch	False	None	False	2022-04-12 01:53:38.389	[]
37	CDC-2022-0024-0043	https://api.regulations.gov/v4/comments/CDC-2022-0024-0043	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I am so happy and relieved that you listened to chronic pain patients and pain clinic physicians. As a chronic pain sufferer I applaud you for making reasonable pain practices for Physicians and patients to have open and honest conversations about pain management and what is right for them. I hope this change can be implemented soon. I have a connective tissue disease and my bones and joints sublux and come out of joint frequently. The pain is so terrible, sometimes even the Emergency Department cann ot put the joint back in to place for a very long time. With a lifetime of constant pain my view of my future for pain management was very bleak and looked rather unlivable. This provides those of us hope that we can manage some semblance of a better future and life.<br/>Thank you,<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6a754	Anonymous	None	2022-02-10T20:28:03Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-cqr2-w202	False	None	False	2022-04-12 01:53:38.604	[]
38	CDC-2022-0024-0044	https://api.regulations.gov/v4/comments/CDC-2022-0024-0044	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Medical personnel should be able to prescribe medication based on the patient’s needs, without government constraints. Each patient is on a different situation and has different needs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6a791	Anonymous	None	2022-02-10T20:28:31Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-d1tn-di16	False	None	False	2022-04-12 01:53:38.879	[]
39	CDC-2022-0024-0045	https://api.regulations.gov/v4/comments/CDC-2022-0024-0045	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a young adult, 24, who is a mom and wife I fully support adjusting the pain management guidelines. Between 2020 and 2022 I have been admitted to the hospital 26 times specifically for pain management because I could not get the meds at doses I needed due to the 2016 guidelines. I suffer from chronic pancreatitis due to a birth defect in my pancreas. I have extreme pain when I eat, even with the pain meds I can have Currently which is the max 90 mme. Each patient within every condition has different symptoms and severity of symptoms and should be able to have an individualized care plan. Most of us chronic pain patients just want to feel normal and have a normal life. I hope these new guidelines will allow that for us. I also hope clinicians will be open to adjusting and accommodating the new guidelines. I have heard so many stories of patients being under treated and then they go to the street and end up with fentanyl on accident and die. Or even worse they take their own life due to the extreme pain they suffer. Pain management is a human right. Countries with proper pain management have shown to have less OD, less illegal drugs and less addiction. People also need to remember dependence does not equal addiction. Most people who do something daily, like drink coffee, would have withdrawal symptoms when stopped immediately but no one accuses them of being a coffee addict same thing with antidepressants. In today's day and age we shouldn't have patients suffering from extreme pain. We have spent to much time demonizing opiates and less time Recognizing their importance in care management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cassandra	None	None	0900006484f6a7b0	Gaines	None	2022-02-10T20:36:49Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Gaines, Cassandra	kzh-d6vn-4301	False	None	False	2022-04-12 01:53:39.114	[]
40	CDC-2022-0024-0046	https://api.regulations.gov/v4/comments/CDC-2022-0024-0046	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern,<br/><span style='padding-left: 30px'></span>I am a licensed medical professional who was working in Rheumatology when all the opioid rules changed.<br/>The damage done to these patients who were in DIRE need of pain control is irreparable and most of those I had to cut off and send to pain clinics, were then treated SO TERRIBLY and accused of being a drug seeker? Well, a lot of those people are now gone and suffered terribly by not being adequately treated or even treated humanely, as they once were, as they contorted and shriveled in pain to their demise at the hands of "officials" making decisions for all based on data from drug abuse from these same drugs without consideration of those in actual need. FOR SHAME! Lumping all into one. Deciding for all because abuse by some dictates that well then,,,,aren't these "bad drugs?" NO! And strict guidelines by an agency that I truly admire, that frighten doctors into NOT treating patient's pain as they once DID and should STILL be so that many doctors, including my own, opted to retire knowing the government would not allow them to actually help their patients any longer at the risk of losing their licenses!!! My doctor did not want to retire but she also did not want to NOT be able to "doctor!" The federal government has lost many great docs because of making rules without knowing or considering patient's needs. Other doctors would however, take their place, send them to pain clinics and call it a day. These negative affectations about pain are not overly attractive because pain is not overly attractive and destroys people's lives. These are throw-away patients now. Most of them do not seek out help now because they have been turned down so many times and made to feel "less than" because they must live with pain so extreme it has broken them where they can longer work, no longer dress themselves, cook, drive, feed, sleep, think and seemingly, simply exist, in a loop of pain, until they succumb, one way or another.....and there IS medicine.<br/>But you, the patient, cannot have it now, even if it has been prescribed and has helped tremendously before, if the doctor prescribes it or what others may think is too much, the doctor will get in trouble or be reviewed or lose their license....and the patient is obviously a "druggie."<br/>Again....FOR SHAME.<br/>Now let's move on to alternative drugs being given instead of the appropriate opioid treatment without fear of retribution or labeling.....go ahead,,,,say it!<br/>Opioid treatment without fear of retribution or labeling! Doesn't that feel good!? Like a breath of fresh air! Was that the sound of HOPE!?<br/><br/>I absolutely could, and WOULD, go into every NON-applicable drug that has been thown into the gammit of attempted nonapplicable/ nonappropriate<br/>treatment options given to patients to keep doctors out of trouble and give it the old "let's see if this one works therapy. I know because I was forced to write srcipts for probably every one of them for patients who simply wanted to continue their current therapy that was being fine-tuned or was working or at least working well enough to keep them a functional part of society. I was the bad guy, the doctor was the bad guy, the patients calling in tears or in so much pain begging for their prior prescriptions that our office could no longer give. Many times I explained about the new guidelines that even I did not agree with and I soon left this practice for a teaching position. It was an opportunity, but it was also a chance to get out of the line of fire the CDC had created. Like many great doctors, I retired from medical rather than not be able to help with the correct treatment, the correct meds, the correct mindset about good patient care and working to assure the best possible outcomes. This ability was taken away by the federal government by way of the CDC by taking the voice away from the patient and giving it over to an agency that doesn't know them, recognize their needs, or treat with appropriate medicine without fear of retribution or labeling.<br/>Just one mention however, Gabapentin is the WORST and is being used the most. It is a radiculopathic drug - radicul/o = spinal nerve root, and the thinking here is that if the pain can be stopped at the nerve root it will not travel or possibly even occur beyond this point in the patient. This is so wrong and in the elderly population this drug is extremely dangerous, yet doctors continue to prescribe it because "it's all they have left." The options for the doctor to treat appropriately are no longer available, the patient suffers and loses faith. This leads to a very downward spiral in some instances. <br/>Did anyone at the CDC really think the same treatment, categorization, thoughtless care and consideration from a government agency who seems to think patient outcomes are unimportant?<br/>Please think again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f6a7d1	Beilach	None	2022-02-10T20:46:32Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Beilach, Amy	kzh-dbi9-dwkm	False	None	False	2022-04-12 01:53:39.325	[]
41	CDC-2022-0024-0047	https://api.regulations.gov/v4/comments/CDC-2022-0024-0047	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to tell u my story. My Dr dropped my meds to just 1/4 of what I had been taking for 20 yrs. I broke my neck in 88. The reduction of my meds has caused many issues. At first I was just sick from withdrawal then the pain began to get worse with everyday. As of now I’m still in much I’m just a lump in the bed and can’t even do my home maintenance or anything. The pain has taken over my life at this point. I have considered suicide many times but really don’t want to leave my family. I’m very happy to see that they finally realized what they have done to us CPPs. I can’t wait for it to go in effect. Thank u for hearing us finally	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484f6a72d	Brawley	None	2022-02-10T20:49:36Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Brawley, Kevin	kzh-cita-gfln	False	None	False	2022-04-12 01:53:39.532	[]
42	CDC-2022-0024-0048	https://api.regulations.gov/v4/comments/CDC-2022-0024-0048	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>As the spouse and caregiver of someone with chronic pain -- residual from a tumor on his pituitary gland, that was eventually removed, but did not resolve the headache pain due to damage as the tumor grew, now in its 11th year -- it is painful and frustrating to watch and advocate for him to have his prescribed dose of opioid pain killer meds. He's tried ALL sorts of pain meds, but the one medication that works to give him SOME relief is a overly controlled and highly stigmatized. He has never abused the medication. Yet he is treated like a "drug seeking addict". They do not use this highly judgmental and prejudicial language for persons living with the disease of substance use disorder, yet it is apparant in their behavior. His primary physcian abruptly decided to no longer prescribe it because of the many restrictions now required in our state (Ohio). He now must see a "pain doctor" in his network which adds a new level of frustrating healthcare regulations and requirements. He now must make a monthly appointment to receive a refill, costing us more money in copays for a chronic pain condition. Even the Pharmacists now get in on the act. Randomly deciding if he can fill the prescription the day of or the day before, or the day after the refill date. All persons who use opioids for pain relief do not have the disease of substance use disorder. I understand that a response to opioid abuse and deaths needed action. But your recommendation and the subsequent actions taken by the medical and governmental establishment made life extremely difficult for people like my husband who live with chronic, daily pain. It is my contention, as a person who works in the mental health and addiction recovery arena, that these regulations, making no allowance for people like my husband, has had an unintentional consequence of creating circumstances where people, merely seeking pain relief, are sent into potentially addictive and dangerous practices, or worse. Thank you for re-examing and reconsidering your recommendation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Juliet	None	None	0900006484f6a79f	D-W	None	2022-02-10T20:49:58Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from D-W, Juliet	kzh-d3sx-lgq2	False	None	False	2022-04-12 01:53:39.740	[]
43	CDC-2022-0024-0049	https://api.regulations.gov/v4/comments/CDC-2022-0024-0049	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For years I've had painful health problems and 15 plus surgeries. When oxytocin came out, I was the 1st woman to be prescribed them. I didn't know and neither did my doctor know just how addictive they were. After years of being prescribed oxytocin, methadone, fentynel, roxycodone, and others. My doctors (regular and pain management) cut me off cold turkey and I truly thought I was going to die. Now 6 years later I was diagnosed with osteoporosis, osteoarthritis, and osteopenia. I have broken my pelvis, back also my spine has 3 more extremely places including my neck, wrist, shoulder, knee, and both feet. My bones are of a 90 year olds. My doctor said I shouldn't leave the house and I can't get pain medication s. I suffer everyday of my life. I believe there should be laws in place but sadly they are treating REAL patients who have REAL PAIN and putting us in the same group of those who abuse them. They definitely need to be aware of those (me-us) who TRULY need the medications. I also believe there's people who abuse this. I'm just giving my personal opinion. I also know that ALOT of the overdoses come from the streets. Other countries, which ruin it for us the real patients who desperately need them. Thank you for your time and if I can be of any more help, please reach out to me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f6a7dc	Durr	None	2022-02-10T20:52:34Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Durr, Kimberly	kzh-ddw6-2t0k	False	None	False	2022-04-12 01:53:39.949	[]
44	CDC-2022-0024-0050	https://api.regulations.gov/v4/comments/CDC-2022-0024-0050	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was dropped on 2016 from my doctor for an illegal urine test that read me negative of my meds I was prescribed. I cannot go one day without my meds I explained to him so his wife that had no business running the front desk threatened me to call the police. I feel his license was getting threatened by the cdc because he was dropping so many patients. I was doing great with the medication I was on until he dropped me . My new doctor will not prescribe me the same meds . I now live miserable in pain . The MME should be lifted so our doctors won’t feel threatened to prescribe us the strong enough meds that we need to live a normal life. I was doing great from 2010-2016 . Now My MME is at 200 and I am miserable when my old doctor had me at 400 MME and very productive. Now I can’t move out of my bed to recliner. Please fix these guidelines & get the word out to all pain management doctors. I need my mobility back .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6a7ef	Anonymous	None	2022-02-10T21:00:52Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-dhqs-517r	False	None	False	2022-04-12 01:53:40.199	[]
45	CDC-2022-0024-0051	https://api.regulations.gov/v4/comments/CDC-2022-0024-0051	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 53 yr old female that has CHF as well as psoriatic authorities. I am in chronic pain everyday. I can not take NSAIDS , Ibuprofen or anything else because of my heart problems. My doctor has me on Hydrocodone. He has prescribed 1 tablet every 8 hours. I never take more than prescribed. I have to see him once a month for my prescription. While I am in his office he gives me a urine test to make sure I am not taking any other drugs. Doctors are the only ones that need to determine if their chronic pain patients should be prescribed an opioid or any other pain medicine. The CDC has no idea what kind of pain the patient is in and should stay out of it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f6a80c	Walker	None	2022-02-10T21:03:12Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Walker, Deborah	kzh-dncu-da9f	False	None	False	2022-04-12 01:53:40.422	[]
46	CDC-2022-0024-0052	https://api.regulations.gov/v4/comments/CDC-2022-0024-0052	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient, that suffers from 4 debilitating pain conditions, I’m pleased to see the CDC revising the 2016 guidelines. I know first hand that these guidelines caused unnecessary suffering. In 2019 I had my entire colon removed, for the 1st hours after my surgery I was tortured. In spite of going over the plan to manage by post-op pain with my surgeon prior to my surgery, she left orders for me to receive only IV Tylenol. I can clearly remember my first words when I woke up “pain, I’m in pain”. I was giving IV Tylenol which did absolutely nothing not even to dull the pain, how could it, my entire colon had just been recovered. My surgeon was on “holiday” within hours of leaving the operating room. So there I was with my husband and myself begging for proper pain management. <br/><br/>Nothing made me more upset, than the 160 degrees shift in attitude by this hospital after my insurance company demanded they give me the proper care or they would have me airlifted to another hospital that would provide proper treatment. From that point on they were pushing morphine on me without me having to ask for it. I only took morphine when I needed it, as soon as it was no longer needed I asked to be given Percocet. The message I got from their new approach once their money was threatened was that their concern was more about money and not the safety and my welfare. I pray no one will ever experience what I did.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bernadette	None	None	0900006484f6a833	Marcelus-Johnson	None	2022-02-10T21:04:53Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Marcelus-Johnson, Bernadette	kzh-dtr1-sxfj	False	None	False	2022-04-12 01:53:40.626	[]
47	CDC-2022-0024-0053	https://api.regulations.gov/v4/comments/CDC-2022-0024-0053	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As chronic pain patient with MS I am happy to see removal of maximum opioid recommendations. I have been on them for more than ten years and have developed tolerance. <br/>Also, as a Medicare patient it would help minimize my opioid use if massage therapy were covered.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joanne	None	None	0900006484f6a84b	Molz	None	2022-02-10T21:07:43Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Molz, Joanne	kzh-dwx6-o6c2	False	None	False	2022-04-12 01:53:40.837	[]
48	CDC-2022-0024-0054	https://api.regulations.gov/v4/comments/CDC-2022-0024-0054	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern. I am a 61 year old chronic pain patient. I’ve had four spinal surgeries two in which left me worse of than before. I’ve been on meds almost 20 years and was leading a somewhat good quality of life. Last year my Dr forced tapered my breakthrough pain medication due to the CDC guidelines. As a result of that my blood pressure has increased and so has my pain. It’s totally unethical. I am now almost bed bound from all of it. These guidelines should not even effect legacy pain patients. It’s like I’m living in a third world country. Please revise the guidelines and protect people from this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6a877	Anonymous	None	2022-02-10T21:08:22Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-e3eq-8rp8	False	None	False	2022-04-12 01:53:41.044	[]
49	CDC-2022-0024-0055	https://api.regulations.gov/v4/comments/CDC-2022-0024-0055	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person on a limited income opioids are affordable while massage therapy is not. A thought for Medicare.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joanne	None	None	0900006484f6a885	Molz	None	2022-02-10T21:09:03Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Molz, Joanne	kzh-e651-ydaz	False	None	False	2022-04-12 01:53:41.260	[]
50	CDC-2022-0024-0056	https://api.regulations.gov/v4/comments/CDC-2022-0024-0056	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I experience chronic pain from fibromyalgia. I take Lyrica and Cymbalta for nerve pain, but I also use a muscle relaxer and the pain narcotic dilaudid. There are moments every day that I experience pain so bad that I can barely stand it. It's at those times that the pain medicine comes in handy to help decrease my pain for a while. I just want to say that my pain management doctor does a wonderful job of monitoring me. I do my best to mix up when I use Ibuprofen instead of opiods. I believe pain management opiods should be monitored closely. Physicians can easily see how fast someone is burning through their opiods. It is a Physician's job to slow a patient down if necessary, but taking them away would make life more miserable and intolerable leading to depression and suicide. I am so thankful that I have the option if I need it. You cannot comprehend what is going on with chronic pain, unless you yourself experience it! Keep opiods available for chronic pain. It's a nightmare having to live with it! Keep allowing doctors to make the decisions they need to make for their patients. Opioids are not a cure but a tool and a physician should in no way be hindered by too strict of regulations. Thank you for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Augusta	None	None	0900006484f6a8e0	Mendenhall	None	2022-02-10T21:10:40Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Mendenhall, Augusta	kzh-eiws-vzwh	False	None	False	2022-04-12 01:53:41.469	[]
51	CDC-2022-0024-0057	https://api.regulations.gov/v4/comments/CDC-2022-0024-0057	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for over 17 years and have been on opioids for pain relief for 16 of those years, all with the same doctor, who is very good about helping me fight these diseases with proper pain treatment. Once my dr got my pain leveled out about 12+ years ago I have not had to go up in dose. I consider myself very lucky that I have been this stable, sure I have bad days where I have to do a lot to take care of the pain, like hot baths, additional medications like anti-inflammatories and bengay, and my use of heating pads has left marks all over my back like a zebra, but I also worry that if things get worse in the future I will have to fight to get an increase in dose, even though I'm not near the max that the CDC has erroneously set years ago. Drs are just too scared to increases doses, let alone prescribe them to being with. (a friend just had major hip replacement surgery and his dr refused to give him pain killers afterward! Another had a bad tooth extraction (with a large cyst) and wouldn't even give them 1-2 days of pain killers and they almost wound up i the ER due to the pain!) This is doing actual harm to patients! I'm also VERY VERY worried about finding another dr who will take me on as a patient since my current dr is nearing retirement age. Drs all see these medications on your chart and automatically refuse to see you! Have have never taken even 1/2 a pill above my prescribed amount in all these years. I did try to take a "vacation" from them just to see where my baseline pain level is, and my spouse was ready to drag me to the ER I was in so much pain, I was almost blacking out due to the severity of that pain! I was off them for 30 days just to see the level and to be brutally honest, it was suicidal. There is no way I could ever live with that much pain. These medications are life saving for me and many others. They allow people to live their lives, care for their children, even just get out of bed. Please, don't treat us like addicts, they need treatment too, but with this opioid crisis you're just causing another crisis of under-treated pain patients. I can't even count on my fingers, there are so many, how many people I knew on community boards online who had their prescriptions lowered or cut all together, only due to dr fear, not anything that they did, and then after failing to try to find another dr to take them on as a patient, they ended their lives because they just couldn't live with their pain. These were people who had jobs, families and ok lives despite living in pain, but then had it all ripped out from under them. It was their only way out. Between making something like vicodin a schedule II instead of it's old III, which will now not allow my dr to give me 2 refills, now costs me $50 a visit with him, a LOT more frequently, and increases my yearly costs by a great deal, and basically is wasting his time just doing a quick med check instead of seeing a patient who really needs to see him, it also cause me horrific anxiety with trying to get refills every single month. I worry that this month will be the month the CDC/FDA/whoever decides what my dr and I have been very successfully doing is wrong and it'll just be taken from me. These agencies say these drugs don't work for chronic use, if that's true then why are so many people so successfully living their lives due to these drugs? Then can and do work very well for chronic patients. Please don't do more harm then has already been done to us, and consider reversing your previous stance and leave our care to us and our drs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484f6ad21	Bowen	None	2022-02-10T21:14:15Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bowen, Chris	kzh-esf6-9ems	False	None	False	2022-04-12 01:53:41.681	[]
52	CDC-2022-0024-0058	https://api.regulations.gov/v4/comments/CDC-2022-0024-0058	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First off, let me start by saying this proposal seems to be a step in the right direction. Thank you.<br/><br/>As a chronic pain patient the impacts of the 2016 recommendations being turned into strict policies used by states, doctors, and insurance providers had a terrible impact for me and other chronic pain patients. To manage chronic pain I was on daily opioid treatment, until that became no longer available due to providers covered by my insurance being unwilling to prescribe them. Honestly, If I hadn't been in a state that allows regulated medical cannabis I have no idea what I would have done. Even with medical cannabis available, I strongly considered looking to unregulated sources of opioids. Fortunately, I was able to mostly replace opioids with medical cannabis while I continued using alternative therapies to manage my pain. Pain patients being forced to find treatment outside of the medical system is a failure of the system. Had I been forced to find pain medication from street providers I would have never known what I was actually getting. Considering many street drugs contain fentanyl I would have been at significantly higher risk from overdose than I ever was taking prescribed opioids. Without any pain management options suicide would have been more strongly considered just to make it stop. While it is impossible to ever know the numbers, the 2016 guidelines killed pain patients across the country and made many more of us criminals.<br/><br/>In my particular case, other medicines were either not terribly effective or had side effects that made them intolerable. Gabapentin eventually caused such issues that I was unable to work and needed physical therapy to recover from it. Opioids, for all the supposed risks, had minimal side effects. Opioids simply made it so that I could function. I understand opioids are abused by some people for the high. There is no high for me or many other pain patients I've spoken with at appropriate doses; there is simply less pain. For me, the lack of feeling high is one of the things that makes opioids preferable to medical cannabis. I was definitely more functional utilizing opioids at an effective level.<br/><br/>I appreciate the interest in alternative therapies. Diet changes, exercise, tai chi, qui gong, acupuncture, and massage have all been a part of my pain journey. They helped. They were in no way the full solution. Most of them had limited benefit by themselves. If I hadn't had opioids and then cannabis to help manage the pain while I was working on these some of them wouldn't have even been possible to do. These should be encouraged to be part of a holistic approach to healing and pain management not gates a patient needs to pass through before they are prescribed opioids. Attempting to use movement and exercise while in so much pain they are difficult to do is discouraging. It is difficult to consider going back to try these things later when they were ineffective or painful to do when pain is unmanaged. Additionally, these therapies/practices are generally not covered by insurance. When you're already having difficulty working, adding additional expenses for things that may or may not work is a hard decision. Even dietary changes, which seems like a simple thing, increases food costs. Cheap, calorie dense foods are, in my experience, the worst for health and managing pain, but moving away from them increases a food budget and generally adds to the time necessary to shop for and prepare them.<br/><br/>I do appreciate that the worst impacts of the disastrous 2016 guidelines are starting to be addressed. Additionally, I hope that efforts will be made to encourage governments and organizations that enshrined the 2016 guidelines in law and policy to adopt these less restrictive guidelines. It would also be nice if patients legitimately using scheduled medications were not treated like criminals by the medical system. Deaths from opioid abuse are a national tragedy, but the solutions for these deaths have nothing to do with abusing pain patients. Actual solutions for opioid abuse are much broader and more systemic such as addressing poverty, the horrifying increase in medical costs, and improved assess to mental health services and addiction treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f6ad45	Alley	None	2022-02-10T21:21:44Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Alley, James	kzh-ezcx-u6ic	False	None	False	2022-04-12 01:53:41.922	[]
53	CDC-2022-0024-0059	https://api.regulations.gov/v4/comments/CDC-2022-0024-0059	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Guidelines for prescribing opiates should definitely be updated. Current guidelines are far too restrictive. Despite the fact that opiates are addictive, they remain the best treatment practice for many conditions. Addition is a treatable condition. The long term liver damage and other effects of nsaids <br/>and other treatments are not.<br/><br/> Due to the fact that doctors are refusing to prescribe the most effective treatment due to their current application of opiate guidelines, many patients are turning to illegal supplies to treat legitimate medical concerns. If doctors felt able to prescribe opiates, patients would not turn to illegal channels. By being forced to obtain medication illegally, patients çan end up getting opiates that are laced with other drugs and of inconsistent strength. Therefore, making overdose more likely. Patients would be much less likely to overdose if they were able to obtain the medication that they need through legitimate channels.<br/><br/>I recently fell 15 feet onto concrete. I broke my pelvis in two places, my back in five places, and broke three ribs. Despite the fact that I was clearly in severe pain, doctors were extremely hesitant to prescribe opiates due to current guidelines. Every doctor that I saw stated that they did not agree with these policies and that opiates would be my best treatment option. However, they were fearful to provide what they felt would be the best treatment option for me due to their understanding of the current guidelines. Due to their interpretation of opiate guidelines, I have suffered significantly more pain than I would have if doctors had felt free to prescribe what they felt was the best option for me.<br/><br/>Please update this policy to allow doctors to make decisions as professionals and allow them to prescribe opiates whenever they feel it is in the best interests of the patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484f6ad61	Stambaugh	None	2022-02-10T21:23:41Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Stambaugh, Jennifer	kzh-f5lt-exl7	False	None	False	2022-04-12 01:53:42.144	[]
54	CDC-2022-0024-0060	https://api.regulations.gov/v4/comments/CDC-2022-0024-0060	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient since 2008 with 4 cervical and lumbar fusions, as well as a stimulator implanted. I suffer chronic migraines as well as chronic neck and back pain. I am under the medical supervision of a primary care physician and pain management. I am prescribed a low dose pain medication which I (responsibly) take every 12 hours. I have been to physical therapy for pain management but even with that, have no quality of life without my meds. Over the counter medications are not helpful in managing my pain and I don't believe my doctor's should have the treatment options limited because others choose to misuse prescriptions. Most days I can function even without my walker. That is 100% related to my continued ability to take my pain medication as it is prescribed. I see pain management every month. Pain patients already have to jump through multiple hoops (urine testing, pill counts, restrictions on refill dates, lowering accepted therapeutic medication levels) to continue of needed and prescribed medications. Policy should be created to help all patients and not further restricted to save drug abusers from themselves. For many, these drugs are the lifeline to quality of life and ability to function in society. I have never misused my meds, and never would. My access to a treatment that has worked for years should not be determined by anyone but my physicians and me. Cruel drug restrictions to protect "others" should not determine my care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Noelle	None	None	0900006484f6ad74	Kahn	None	2022-02-10T21:30:35Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Kahn, Noelle	kzh-f8yu-nfu9	False	None	False	2022-04-12 01:53:42.350	[]
55	CDC-2022-0024-0061	https://api.regulations.gov/v4/comments/CDC-2022-0024-0061	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Unless the greater flexibility in the guidelines offer more legal protections for physicians & pharmacies, the current practice of substituting pseudo science for medical practice will continue. Doctors are so fearful of criminal repercussions that they simply deny care to patients presenting with pain. One would expect acute pain symptoms to be diagnosed and treated, yet patients are merely referred to psychological therapists or told to simply live with the pain without the benefit of diagnostic tests or treatment options. Medical conditions are allowed to irreversibly deteriorate due to fear by health care providers of arrest or charges by the Drug Enforcement Agency. Also, the guidelines do not address the use of unverified, proprietary law enforcement predictive algorithms adapted to predict patient drug abuse to determine permissibility of opioid pain relief. The solution to overdose deaths from the use of illicit, synthetic opioids sold on the black market is not to deprive patients of medically indicated pain relief, and convoluting the two is making both worse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Spine	None	None	0900006484f6adb1	Damaged	None	2022-02-10T21:32:06Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Damaged, Spine	kzh-fhtk-rz99	False	None	False	2022-04-12 01:53:42.557	[]
56	CDC-2022-0024-0062	https://api.regulations.gov/v4/comments/CDC-2022-0024-0062	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to tell u my story. My Dr dropped my meds to just 1/4 of what I had been taking for 20 yrs. I broke my neck in 88. The reduction of my meds has caused many issues. At first I was just sick from withdrawal then the pain began to get worse with everyday. As of now I’m still in much I’m just a lump in the bed and can’t even do my home maintenance or anything. The pain has taken over my life at this point. I have considered suicide many times but really don’t want to leave my family. I’m very happy to see that they finally realized what they have done to us CPPs. I can’t wait for it to go in effect. Thank u for hearing us finally	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484f6a72e	Brawley	None	2022-02-10T21:40:32Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Brawley, Kevin	kzh-citk-h34a	False	None	False	2022-04-12 01:53:42.766	[]
57	CDC-2022-0024-0063	https://api.regulations.gov/v4/comments/CDC-2022-0024-0063	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to be able to do my day to day activities but as of right now I can’t do anything because I am in so much pain.. I would love to be able to get the pain medication I need to be able to work and not go onto disibility so please lift the guidelines so my doctor is able to give me a quality of life I deserve to have. I will be in pain for the rest of my life and I don’t want to suffer no more than I am right now. Please hear my voice and help me a pain patient with life time injuries… I don’t want to suffer anymore and I pray these guidelines change to help the pain community…	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6adcc	Anonymous	None	2022-02-10T21:44:51Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-fnw1-jt3c	False	None	False	2022-04-12 01:53:42.969	[]
58	CDC-2022-0024-0064	https://api.regulations.gov/v4/comments/CDC-2022-0024-0064	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>This voluntary clinical practice guideline provides recommendations and does not require mandatory compliance; and the clinical practice guideline is intended to be flexible so as to support, not supplant, clinical judgment and individualized, patient-centered decision-making. As a retired Social Worker and Nurse I support this wholeheartedly. As a pain patient I hope that there might be a little less of negativity, mislabeling and discrimination which has resulted in under medicating a large population of chronic pain patients leading to increased suicide.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pattricia	None	None	0900006484f6adf7	Myers	None	2022-02-10T21:45:32Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Myers, Pattricia	kzh-fuxy-q6vu	False	None	False	2022-04-12 01:53:43.182	[]
59	CDC-2022-0024-0065	https://api.regulations.gov/v4/comments/CDC-2022-0024-0065	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The Guideline Committee should be applauded for beginning to rectify a document that facilitated an appalling disregard of patient suffering from severe chronic pain that extended to acute trauma pain, post-surgical and cancer pain. However, physicians remain fearful of the DEA and state medical boards, which along with the US DOJ maintains surveillance of opioid prescribers via PDMPs. Pharmacists have been unilaterally deputized by DEA and state pharmacy boards to report “inappropriate” opioid prescriptions. Unless CDC works closely with these and other actors to remove coercion of physicians into opioid deprescribing, I don’t see how patients requiring opioids for analgesic control will gain improved access.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484f6ae11	Rose	None	2022-02-10T21:46:43Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Rose, Mark	kzh-g03d-66fi	False	None	False	2022-04-12 01:53:43.391	[]
60	CDC-2022-0024-0066	https://api.regulations.gov/v4/comments/CDC-2022-0024-0066	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since 1998. I have never abused medication, nor been tempted to. The last six years have been hell on earth for myself and everyone like me. The suicides are astronomical and most of the pain patients I know have switched to street drugs because they are easier to get than legitimate pain medications. Do you have a plan for letting those people back into the fold? Making it possible for them to return to a legal system? Because you need one that is humane and not discriminatory and I bet you haven't even thought of it. <br/><br/>As for the rest? My advice is what it has always been. LET THE DOCTORS WHO KNOW THEIR PATIENTS DECIDE WHAT THE PATIENT NEEDS AND IS BEST FOR THEM. LET THEM PRESCRIBE IT. <br/><br/>You also need to quit stigmatizing opioid use because even being able to get them, I can't find other doctors to treat me: No one wants me as a patient because YOU, YES YOU THE CDC has made pain patients toxic and doctors don't want to touch us. I've been trying to find humane treatment since 2018 and haven't found any yet. But I got bounced into a detox program without even being drug tested because I was on opioids. <br/><br/>Everything about the 2016 guidelines was a disgrace. There was no research to back it up, there was no reason to do it, and all it did was kill people. Limiting legal Bupenorphine didn't do a single thing to stop Fentanyl use on the streets. For that you need the DEA to get serious about patrolling the ports and inspecting Chinese container ships. <br/><br/>The CDC has killed people. This policy is one tiny baby step toward making things right. But it is not a fix. Until you work against the stigma and quit demonizing opioids, we're still going to be treated like dirt by the medical establishment. <br/><br/>And while you're at it, QUIT COUNTING STREET FENTNYL ODs AS PRESCRIPTION OVERDOSE YOU KNOW THEY AREN'T.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484f6ae85	Theaker	None	2022-02-10T21:49:00Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Theaker, Julie	kzh-gipo-gh9k	False	None	False	2022-04-12 01:53:43.597	[]
61	CDC-2022-0024-0067	https://api.regulations.gov/v4/comments/CDC-2022-0024-0067	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. I am a legacy pain patient. I became disabled at age 25, from 3 serious car accidents. I have had surgeries on my back and neck. I have done everything from getting nerves burned, facet blocks, nerve blocks, and epidurals. I received about 40% relief and it did not last long. I have been on opioid therapy for 23+ years. It helps me maintain some quality of life, as I am wife and mom of three. I have been with the same practice for years. Now they have decreased my meds and to fully take me off one of them and only left me with my breakthrough medicine. When I ask my doctor, he says his hand are tied because of the CDC. And says "I'm not losing my license". I have been under the 90mme and still be cut. I have had to choose my pain meds over my anxiety medication also. I am afraid everytime I go to the doctors, they might cut me off everything. I have always complied, never broke the pain contract or failed a drug test. This is not fair. It's not the prescribed meds that are causing these od's, but the illicit drugs like fentanyl. Yet we are treated like drug addicts. There is a horrible stigma on pain patients and it must stop. DO BETTER CDC!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6aea2	Anonymous	None	2022-02-10T21:58:25Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-h3ev-z8mi	False	None	False	2022-04-12 01:53:43.813	[]
62	CDC-2022-0024-0068	https://api.regulations.gov/v4/comments/CDC-2022-0024-0068	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hopefully this correction in policy will be a relief for those of us in chronic pain continually. Most of us are under medicated in order to comply with old policy. Also within pain clinics , patients are interacting with the same way criminals on probation are treated. Would be a great blessing if policies were in place to prevent such a culture. I broke my neck and back, I didn’t rob a liquor store.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tim	None	None	0900006484f6aef0	Drinkard	None	2022-02-10T22:00:17Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Drinkard, Tim	kzh-htxn-rhfh	False	None	False	2022-04-12 01:53:44.020	[]
63	CDC-2022-0024-0069	https://api.regulations.gov/v4/comments/CDC-2022-0024-0069	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to suggest that the CDC and doctors also consider patients who have been prescribed the opioid medication daily since 2003 for breakthrough pain. I don't use the medication everyday because I don't have pain that would cause me to use daily. I mostly have gotten use to being in this pain over the years and I also have a high tolerance for pain.<br/>Patients who are in the same category as me should also be taking into consideration in all instances just as those who have a low or very low tolerance for pain and drug abuse and addiction. <br/><br/>Finally, I trust that the decisions made by the CDC are always in the best interest of the public as a whole and NEVER in the best or worst interest of any political party or individual.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6aef2	Anonymous	None	2022-02-10T22:06:14Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-hv15-ffru	False	None	False	2022-04-12 01:53:44.241	[]
64	CDC-2022-0024-0070	https://api.regulations.gov/v4/comments/CDC-2022-0024-0070	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Ehlers Danlos, a genetic disorder causing chronic pain, subluxations, and also carries a lot of painful and disabling comorbidities. For many years, I have seen every kind of specialist, physical therapist, holistic treatment practioner, have tried alternative medicines, therapy, and OTC medications in an attempt to manage the symptoms. I have had some of my most dark and difficult days with doctors and a system overlooking the pain of Ehlers Danlos, and multiple diagnoses verifying the condition referred me to Mayo Clinic for a full workup, ending in another diagnosis of Ehlers Danlos and a suggestion to try yoga. <br/><br/>Not everyone has access to these methods and resources, which are costly and time consuming in the US, and unfortunately they were not effective for my needs and I was still in pain, and unable to function. Only long term opioid therapy has allowed me to regain my independence and ability to function with minimal pain. I can include physical therapy and other tools like mindfulness or counseling and compression garments into this plan without having to spend time or money on resources searching for a way to manage my symptoms that consistently fail. Disabled and chronically ill patients' time is challenging to manage as it is, so frankly no one wants to spend it on half-measures. <br/><br/>I am stable, responsible, and contribute to my family and society under the care of my physician who monitors my medications. I am able to work and be productive. Yes, there is unfortunately stigma associated with opioids and opioid use related to the opioid crisis. However, it's of the utmost importance the CDC consider the possibility of benefit for patients with chronic, intractable pain and the need for individualized patient care. <br/><br/>I hope the CDC will recognize long-term opioid therapy can be successful, and patients with chronic conditions and disabilities gaining function, independence, and the ability to manage our lives with less pain is a valuable tool in accessibility. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6af03	Anonymous	None	2022-02-10T22:07:58Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-hyz7-nvku	False	None	False	2022-04-12 01:53:44.455	[]
65	CDC-2022-0024-0071	https://api.regulations.gov/v4/comments/CDC-2022-0024-0071	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 51 yr old chronic pain patient with No history of any illicit drug or alcohol use ever; however the U.S.A. Health care system treats me as if I'm a drug addict. I'll explain, I've had debilitating arthritis and spinal cord issues since I was a child; I managed to graduate H.S. & College, become a Licensed Social Worker for nearly 20 years until I couldn't stand or walk without severe pain that I stopped working in 2017. I've been on opiate pain medicine over 10 years now. Each month I have to go to the pain clinic to talk to the Dr. to verify I'm still in pain; then on the exact day my prescription is due to be filled I have to call the pharmacy and ask to speak to the pharmacist so I can fill my prescription. Now any other medicine you can use an app or automatic phone system, but since the 2016 guidelines went into effect I no longer can get my medicince via mail order, which is cheaper per my insurance plan and I'm meant to feel as if I have to phone a drug dealer i.e. pharmacist every month just to get a legitimate prescription. My Dr. in 2016 took the guidelines literally and took me off morphine after being on it for 13 years at that point. I was in horrible pain, not to mention feeling physically ill. I went to a new pain clinic who resumed my meds, but at lower lose. I had trouble getting injections authorized by my insurance so I really suffered. I went for a 2nd opinion and was offered antidepressants versus opiates for my chronic pain. I declined and never returned. The clinic I was going to for 4 years closed & the Dr. opened another clinic, but I've been told "things are only going to get worse" after I asked for my Rx to be sent to mail order vs. local pharmacy as I'm having financial problems with the number of copays for Rx. This way of guidelines and physicians afraid to prescribe opioids is humiliating and demoralizing that this chronic pain patients are still being done today. I have had multiple surgeries and I have significant MRI'S to back up my condition, but if Docket No. CDC-2022-0024 is misinterpreted once again my healthcare will be directly affected. Chronic pain patients are not the ones causing the opiate crisis, but rather those with substance abuse issues. The guidelines need to be separated for chronic pain patients so we receive the quality healthcare we deserve.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jamie	None	None	0900006484f6af27	Heise	None	2022-02-10T22:10:44Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Heise, Jamie	kzh-i6rm-jmlz	False	None	False	2022-04-12 01:53:44.686	[]
66	CDC-2022-0024-0072	https://api.regulations.gov/v4/comments/CDC-2022-0024-0072	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These rules , please, must change! Too many severe pain patients are suffering and even bedridden because they cannot get medication their doctor wants them on! Medication that gave them a quality of life. Please!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy Bram	None	None	0900006484f6af42	Cast	None	2022-02-10T22:11:09Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Cast , Judy Bram	kzh-idz9-fkbo	False	None	False	2022-04-12 01:53:44.895	[]
67	CDC-2022-0024-0073	https://api.regulations.gov/v4/comments/CDC-2022-0024-0073	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who was force tapered. I have diabetes spondylitis and there are days I can't get out of bed or stand for more than 5 minutrs. Please consider chronic pain patients and the impact taking away my pain meds have made on my daily life. My children are the only reason I can do even day to day things like shower or do dishes or housework. Please don't punish me any longer. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f6af63	McDonnell	None	2022-02-10T22:11:36Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from McDonnell, Mary	kzh-inez-v900	False	None	False	2022-04-12 01:53:45.097	[]
68	CDC-2022-0024-0074	https://api.regulations.gov/v4/comments/CDC-2022-0024-0074	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 74 year old man who has been living with chronic pain from a spinal accident fifty years ago and a deterioration of my shoulder over the last few years. My doctor has me on the previous recommended maximum quantities of oxycontin and percocets. But the pain has increased over the years, yet we have been unable to raise even slightly the level of opioids prescribed. In order to control the pain, we are also using Gabapentane and Meloxicam, as recommended. I've been taking the same dosage of opioids for the last ten years or so. But lately these meds are not reaching the worst of the pain. It would be a blessing if we could increase the dosage of opioids to counter this debilitating pain. After all, given my age and past history, I am not a candidate for abusing drugs in any way and never have been. I believe the new proposed guidelines would be life-saving for me. Thank you for letting me comment here.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484f6afba	Doe	None	2022-02-10T22:12:48Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Doe, John	kzh-izg5-7r7u	False	None	False	2022-04-12 01:53:45.348	[]
69	CDC-2022-0024-0075	https://api.regulations.gov/v4/comments/CDC-2022-0024-0075	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This article says it well. Doctors presctibing for people in constant Pain, who cannot live a functional life without meds, is NOT the source of the problem! I have known at least 6 people who have committed suicide because they could not tolerate the pain they were left in when their Drs. were told to stop prescribing. STOP PUNISHING PAIN !!!!!<br/>https://www.theguardian.com/commentisfree/2017/nov/07/truth-us-opioid-crisis-too-easy-blame-doctors-not-prescriptions	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kat	None	None	0900006484f6b026	Bunker	None	2022-02-10T22:13:46Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bunker, Kat	kzh-j7h4-k30o	False	None	False	2022-04-12 01:53:45.563	[]
70	CDC-2022-0024-0076	https://api.regulations.gov/v4/comments/CDC-2022-0024-0076	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The original guidelines put out in 2016 have harmed many people. Veterans and civilians alike. The main component that caused the harm was the dose limit recommendations. The dose limits of morphine milligram equivalent or MME have caused the greatest harm. Many cpp on long term opioid therapy were thriving and doing well on doses higher than the recommended dose limits. That is why the tapering happened in the first place. Unless the cdc takes the dose limits out of the guidelines people will continue to suffer and die from pain untreated. The dose limits have given the dea a gage and a number to unfairly close down pain management clinics that had many patients on doses above those limits. For many people on opioid therapy the recommended dose limits are NOT therapeutic for many patients that suffer from chronic pain. If the cdc is going to undo the mess they have created they will have to take the dose limits out of the guidelines to accomplish that goal. I am very concerned with my future and the future of so many people that live in chronic pain and need opioid medication to live a life where they have some type of pain relief. I would like to point out the fact that putting these dose limits on pain meds, tapering people off of pain meds and shutting down pain management clinics have not decreased the number of overdose deaths from illicit fentanyl analogs. So there is nothing to gain by continuing these dose limits but there is so much to continue to lose. Lose of life. Lose of quality of life for so many patients as the limits in the GL restrict physicians from properly treating their patients. These limits have tied their hands. Even if the physician does not follow the dose limits then they run the serious risk of having the dea shut them down as the dea is using these dose limits as a gage to arrest physicians. So telling the physicians not to “ misapply” the guidelines like the cdc did 3 years ago won’t accomplish anything. The dea is using those limits as law. Just like an officer uses the number listed on a speed limit sign to reprimand someone driving over that number. It is passed time for the cdc to correct this wrong. Thank you for allowing me to voice my concerns. This is a critical situation that requires immediate attention and correction. Please take the dose limits out.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f6b083	Crumpler	None	2022-02-10T22:16:23Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Crumpler, Lisa	kzh-jf74-4n94	False	None	False	2022-04-12 01:53:45.766	[]
71	CDC-2022-0024-0077	https://api.regulations.gov/v4/comments/CDC-2022-0024-0077	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 72 year woman who has suffered from fibromyalgia and complex regional pain syndrome for over 20 years. For about seven years I have also developed neuropathy. My pain is severe in both hips, left leg and both feet. I’m treated in a pain clinic with a provider that understands all of these ailments with prescription opioids. I’ve become dependent upon these meds to help control the pain. I still have many days where the pain is unbearable. I’ve had injections, physical therapy, nerve blocks, and a spinal cord stimulator. None of these treatments have been successful. I did have a ketamine infusion that gave me some relief for several weeks but I also have asthma which adds another complication to the mix of talking opioids. I’m am thrilled to hear that the guidelines are being reaccessed for dosing requirements. I look forward to discussing this matter with my provider.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	B	None	None	0900006484f6b0d7	Lovelle	None	2022-02-11T04:15:20Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Lovelle, B	kzh-jm4d-52u1	False	None	False	2022-04-12 01:53:46.018	[]
72	CDC-2022-0024-0078	https://api.regulations.gov/v4/comments/CDC-2022-0024-0078	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a part of my job as a science journalist I have interviewed dozens of people who have had various, severe chronic pain conditions who have been thrown off their opioid medication. Many of them were very close to suicide. Many have discovered kratom, containing mitragynine, a partial opioid agonist which is poorly regulated and not standardized, so they have to navigate a grey market where it's sometimes difficult to find a quality product. But at least they haven't had to turn to a black market. I've interviewed nurses who have cared for terminal cancer patients in their 70s whose doctors refused to prescribe them pain medication. This is no less than torture. And I believe the overdose crisis, occurring overwhelmingly on the black market via illicit fentanyl, is a direct result of treating pain like a crime rather than a medical condition, and treating opioid use as a sin rather than a response to pain. It's really time we come out of the dark ages and stop the torture, and help people who develop problem use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484f6b0fc	Gallagher	None	2022-02-11T04:16:23Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Gallagher, Brian	kzh-jnu1-0su3	False	None	False	2022-04-12 01:53:46.222	[]
73	CDC-2022-0024-0079	https://api.regulations.gov/v4/comments/CDC-2022-0024-0079	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	$105 billion is the annual cost of medication non-adherence. 1<br/>$696 billion is the annual cost of treating opioid use disorder (OUD) from opioid non-adherence. 2 Astonishingly, there are also 3.3 billion unused postoperative opioid pills that enter society every year 3 and 6.8 million opioid units lost in the supply chain. 4<br/><br/>Opioids are triple locked in the hospital and securely dispensed by nurses, yet these same opioids are sent home with patients only to be left on the kitchen table. 1 in 4 opioid overdoses today involves children and teens 5 because there is no medication adherence monitoring and no secure storage of opioids in the home. What is needed at home for opioids is secure storage with medication adherence monitoring, active control dispensing, & destruction of unused pills upon tampering and prescription end, just as if they were being used in the hospital. OUD doesn't start in the hospital; OUD starts at home.<br/><br/>Many see the opioid crisis as problem with illicit opioids. Opioid prescriptions have dropped 44% in the last decade but the opioid overdose rate rose by 30.4% primarily due to illicit opioids. 6 39 Americans still overdose every day from prescription opioids and are not to be forgotten. 7 5,200 people per day aged 12 or older initiated misuse of prescription pain relievers for the first time in the past year. 8<span style='padding-left: 30px'></span>86% of Heroin users report abusing prescription opioids as teens. 9 Given the large number of nonmedical users, even a small percentage who initiate heroin use translates into several hundred thousand new heroin users”. 10 Applying the 3.9 percent incidence rate to the 25 million Americans who ever initiated NMPR use between 2002 and 2011 11 indicates that the prescription opioid epidemic created nearly 1 million new heroin users in this 10-year time frame, or roughly 100,000 annually. Given underreporting, the correct number may be considerably higher still.<br/><br/>Treatment of OUD has not been successful. It is difficult to access. OUD clinics overcrowded and under-funded have long wait times for intake. Insurance coverage is sparse. The relapse rate is hovers between 40%-60% and reported as high as 91%. The dropout rate in OUD treatment is on average 75% for the general population and higher for minorities. 12 Suboxone/Methadone in medication-assisted treatment (MAT) reduces opioid overdose deaths by 50% yet only 1/3 of OUD clinics prescribe it. 13Physicians are hesitant to prescribe MAT therapy. Pharmacies are reluctant to stock MAT drugs due to DEA scrutiny. <br/><br/>Telehealth has improved access to OUD providers and the Ryan Haight Act allows for opioid prescribing online but medication therapy management is non-existent. How can we ask a patient holding an opioid bottle of opioids not to take too many? We must be able improve access to and improve treatment of OUD. We must be able to monitor medication adherence and address individual cravings to reduce the relapse.<br/><br/>1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221544/<br/>2. https://www.whitehouse.gov/articles/full-cost-opioid-crisis-2-5-trillion-four-years/<br/>3. https://www.pacira.com/sites/default/files/inline-files/USND_Stats_FINAL.pdf<br/>4. https://www.dea.gov/sites/default/files/2018-11/DIR-032-18%202018%20NDTA%20final%20low%20resolution.pdf<br/>5. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2719580 <br/>6. https://end-overdose-epidemic.org/wp-content/uploads/2021/09/AMA-2021-Overdose-Epidemic-Report_92021.pdf<br/>7. https://www.cdc.gov/drugoverdose/data/analysis.html<br/>8. https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf<br/>9. https://www.drugabuse.gov/publications/research-reports/relationship-between-prescription-drug-heroin-abuse/prescription-opioid-use-risk-factor-heroin-use<br/>10.https://pubmed.ncbi.nlm.nih.gov/26760086/<br/>11.https://www.samhsa.gov/data/sites/default/files/Revised2k11NSDUHSummNatFindings/Revised2k11NSDUHSummNatFindings/NSDUHresults2011.htm<br/>12. https://substanceabusepolicy.biomedcentral.com/track/pdf/10.1186/s13011-021003894.pdf#:~:text=Individuals%20with%20opioid%20use%20disorders%20%28OUD%29%20report%20oneof,indifferent%20types%20of%20services%20%28e.g.%2C%20methadone-%20andcounseling-based%20treatment%29.<br/>https://www.drugabuse.gov/publications/effective-treatments-opioid-addiction	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6b0ff	None	None	2022-02-11T04:19:26Z	iPill inc	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from iPill inc	kzh-jogc-dp6u	False	None	False	2022-04-12 01:53:46.428	[]
74	CDC-2022-0024-0080	https://api.regulations.gov/v4/comments/CDC-2022-0024-0080	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a someone who lives everyday in pain, I have since I was 26 years old...I have chronic conditions that there is no cure for and when I was 1st diagnosed, the physician I had at the time prescribed medication that allowed me to lead a fairly normal life, I could work full-time, I was able to enjoy my life outside of work...I felt like someone was actually listening and cared about me and how I was feeling everyday, but then the new guidelines came into play and I was taken off of these medications completely. My physician retired and my life is a living hell!! One of my conditions includes several surgeries in my future for the rest of my life, there's no cure...I'm 51 years old and feel like a prisoner to my illnesses, it's very depressing. I no longer work full-time because my body is in constant pain, my joints are painful everyday and some have been replaced already and will continue to be as they deteriorate. Each person's case should be looked at individually and not thrown in with everyone else, what works for one doesn't work for another. The ones who abuse these medications make the ones that don't suffer and that's extremely unfair...there are many of us out there that are hurting constantly and motrin, Tylenol, gabapentin etc, is not helping!! I want my life back!! I understand there are certain regulations in place for many reasons but you can't put everyone in the same category and expect everyone to have the same results...it's not possible...each individual is unique and their conditions are different...it would be nice to feel that we are being treated like someone actually is paying attention...allow our doctors to do their jobs and treat their patients, we are all human beings who trust our doctors to do what's best for us on an individual basis, we're seen one at a time so, why can't they treat us and prescribe medication to relieve our discomfort and have as normal life as possible...we, as well as our doctor's are well aware of the risks of these medications and I feel we have a right to decide to take these risks...our doctors have gone to school and have been trained to take care of their patients...treatment plans are for the doctors and their patients, not for insurance companies or government to decide or determine whether or not these medications are right for them, especially when they have never met us and do not know our medical conditions or know us personally, we are human beings not a number!!! If I seem a bit angry, I apologize but I'm so tired of living everyday feeling the way I do...thank you for allowing us to be heard finally!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484f6b519	Snide	None	2022-02-11T04:25:22Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Snide, Tracy	kzh-jsq2-izke	False	None	False	2022-04-12 01:53:46.639	[]
75	CDC-2022-0024-0081	https://api.regulations.gov/v4/comments/CDC-2022-0024-0081	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who was force tapered bc of these guidelines and am in pain everyday so severe from a spinal diagnosis that I can't get out of bed. On the days I can get up I can't even do the littlest of house chores or shower as I can't stand for more than 10 minutes due to pain. If not for my children I couldn't even shower. I have done shots and everything recommended and the only thing that made my life livable was my pain meds. Please give the pain patients consideration when you do the guidelines or just leave it up to our doctors who monitor us. My life has been horrible without the pain meds making me an invalid stuck inside every day. Please help me get my life back. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maryann	None	None	0900006484f6b53b	Jablonski	None	2022-02-11T04:28:47Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Jablonski, Maryann	kzh-jyv0-fsmg	False	None	False	2022-04-12 01:53:46.924	[]
76	CDC-2022-0024-0082	https://api.regulations.gov/v4/comments/CDC-2022-0024-0082	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am truly tired of living in pain while knowing that there is a medication out there that 100% will help me. The 2016 guidelines have done more harm then good for me. One size fits all should not have any place in the medical community. If your mother was in pain, you would do anything to make her pain go away. Why are you forcing so many other moms to suffer? I will never understand how this could be happening in America.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monica	None	None	0900006484f6b545	M	None	2022-02-11T04:29:37Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from M, Monica	kzh-jzqh-7w03	False	None	False	2022-04-12 01:53:47.127	[]
77	CDC-2022-0024-0083	https://api.regulations.gov/v4/comments/CDC-2022-0024-0083	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioid laws and current pain management guidelines are actively harming chronic pain patients every day. In the past ten years, I’ve undergone 5 spine surgeries with limited success to treat my conditions. Over the last three years I made an attempt to manage my pain without opioids unsuccessfully. It has been impossible for me to obtain any meaningful pain management as providers are afraid to prescribe anything. <br/><br/>I, along with many others, feel abandoned by healthcare. What are chronic pain patients supposed to do? I’ve exhausted all of the non opioid options and continue to grind painfully through as much physical therapy as I can tolerate. I have severe depression and recurrent suicidal episodes because I’m in pain 24/7. Six weeks post a two level cervical fusion (5th spine surgery), I have no pain management plan in place. Medicaid in the state of TN prevents my Pain Management clinic from prescribing any opioid medication. I’m 47 and have lived with severe chronic pain for 11 years at this point. Though I’m in a good place now, if I cannot get some percentage of my pain managed moving forward I doubt I want to live beyond 50. Legitimate opioid prescriptions are not a factor in the opioid crisis. There also needs to be support, funding and research for non-opioid alternatives like Ketamine and THC.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f6b576	Barclay	None	2022-02-11T04:30:36Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Barclay, Michael	kzh-k8bt-54yx	False	None	False	2022-04-12 01:53:47.342	[]
78	CDC-2022-0024-0084	https://api.regulations.gov/v4/comments/CDC-2022-0024-0084	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t understand !!! Why all of use chronic pain patients have to suffer!!! How dare you make us out to be bad people because we suffer from PAIN like it’s our faults!! <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f6b57e	Hartman	None	2022-02-11T04:30:55Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Hartman, Amy	kzh-k9ua-ths7	False	None	False	2022-04-12 01:53:47.548	[]
79	CDC-2022-0024-0085	https://api.regulations.gov/v4/comments/CDC-2022-0024-0085	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient with spinal cord and other damages and significant sequelae from a car accident I asked a pain medicine specialist I was referred to 10 hears ago what he recommends if I became tolerant in the future to the meds I was on. He recommended “opioid rotation”. After many years on same dose I then years later asked my primary care physician about it as I think I am now tolerant and he was not eager to try that. I have always followed the prescribed dose and instructions the last 10 years but now find myself tolerant to the dose I have been on which is 50 morphine equilivants but my primary care doctor said if he increased my dose it would not help and he feels there is no need for me to ho back to the pain specialist I was referred to 10 yrs ago.<br/>I feel afraid to bring the issue that I think I am tolerant to my long standing dose again to my primary care physician’s and feel his reluctant to increasing dose leaves me under treated. I think there needs to be better recommendations to primary care physicians to realize some patients become tolerant of long standing doses and an increase may be warranted in compliant patients. There remains great hesitancy on the part of treating MDs to do that. I as a patient am hesitant to even bring the subject up again for fear that it would incorrectly appear to be drug seeking behavior.<br/>Better education regarding tolerance is needed. Thank you.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Adam	None	None	0900006484f6b59e	Petras	None	2022-02-11T04:32:07Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Petras, Adam	kzh-kesw-ol9q	False	None	False	2022-04-12 01:53:47.751	[]
80	CDC-2022-0024-0086	https://api.regulations.gov/v4/comments/CDC-2022-0024-0086	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear NCIPC,<br/><br/>Thank you for the release of the new CDC opioids guidelines proposal. The reforming opioid use for chronic pain patients and acute care is greatly appreciated. Removing the MME threshold is a crucial step that could potentially save many lives. Also appreciated is how you've removed the three-day limit for opioid prescriptions for patients with acute pain needs. I also appreciate you putting stronger wording regarding forced tapering. For all these changes I thank you.<br/><br/>What is less appreciated is the note that opioids should not be for migraine episodes. That opioids should never be first-line treatment. Well, that is undoubtedly true. There is a good chance that language will be translated as code as the CDC is still moving against prescribing opioids. <br/><br/>Considering the pressure sent your way by pain medicine prohibitionists and the grifts in the media, you will need to either put stronger language defending pain medicine practices for patients; or be willing to push back hard against those drug warriors.<br/><br/>On a personal note, I thank you for listening to chronic pain patients' concerns and reading our articles and media. Thank you for paying attention to my work and the work of other journalists fighting for medical freedom and common decency. That took guts. Even if this is a small step, I know this took a lot of courage. Thank you for that,<br/><br/>Sincerely,<br/>Journalist	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484f6b5aa	Pischke	None	2022-02-11T04:34:15Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Pischke, Peter	kzh-kh9d-tbju	False	None	False	2022-04-12 01:53:47.955	[]
81	CDC-2022-0024-0087	https://api.regulations.gov/v4/comments/CDC-2022-0024-0087	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long-term chronic pain patient, I applaud this proposed rule change. My pain comes from multiple physical causes that are well documented and easily visible through imaging. However i have had some difficulty in the past obtaining prescriptions for opioid pain medication and have lived with the pervasive concern that mine might suddenly be cut off by some bureaucratic fiat. This proposed rule goes a long way towards easing that concern. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gregg	None	None	0900006484f6b5ba	Bender	None	2022-02-11T04:34:40Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bender, Gregg	kzh-kmp1-hq7u	False	None	False	2022-04-12 01:53:48.161	[]
82	CDC-2022-0024-0088	https://api.regulations.gov/v4/comments/CDC-2022-0024-0088	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When the 2016 guidelines came out, MANY states swiftly created task forces, implementation of PDMP, and STATE PRESCRIBING LAWS specifically aligning with the CDC guidelines. THIS revision specifically lays out this clinical practice guideline is NOT intended to be applied as inflexible standards of care across patient populations by healthcare professionals, health systems, third-party payers, organizations, or governmental jurisdictions. Regarding government jurisdictions, basically those laws won't be rolled back, and that's the problem. How do you unring a bell ? NCCP will not be made whole by this revision 6 years later. We will continue being collateral damage on the war on opioids. <br/><br/>The guidelines that not only saw an INCREASE of overdose deaths, but MILLIONS of NCCP patients stripped of medication that helped them function. We were never the problem, but everyone can agree, we are the ones that paid for it. And still will. We didn't CHOOSE our journeys. I predict many statements in the near future from State AG's that will be firmly on the side of keeping the "laws" in place. Which state will be first? <br/><br/>I wish I was more optimistic. But LASTLY, not every BODY is the same. Genetic polymorphisms should taken into consideration, ACCESS to these genetic screenings should be a priority in not only future studies, but access for the current population. A test that's too expensive for most, but would be a tremendous tool in treating CP more effectively.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn	None	None	0900006484f6b638	Moreno	None	2022-02-11T04:36:09Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Moreno, Dawn	kzh-l1bc-1fab	False	None	False	2022-04-12 01:53:48.366	[]
83	CDC-2022-0024-0089	https://api.regulations.gov/v4/comments/CDC-2022-0024-0089	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We need to drop minimum me<br/>Get rid of guidelines altogether. We are not addicts! We are people in chronic pain and we didn't choose this it chose us. Stop punishing and shaming us for being human. We deserve compassion and understanding!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484f6b654	Parsons	None	2022-02-11T04:36:33Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Parsons, David	kzh-l3tg-npvi	False	None	False	2022-04-12 01:53:48.576	[]
84	CDC-2022-0024-0090	https://api.regulations.gov/v4/comments/CDC-2022-0024-0090	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the CDC’s “guidelines” on Opioids came out in 2016, you have made life impossible for legitimate pain patients. Dictating to doctors who see patients day in and day out how to treat patients is a recipe for disaster and has been. Not every person responds to the same medications at the same dosages so that needs to be at the discretion of the physician seeing patients and not some MD’s who sit behind desks and haven’t seen pain patients in decades, if at all. Your “guidelines” have made it so patients who functioned well on specific dosages either had their medications removed all together or drastically reduced. Patients can no longer function in their every day lives and many have had to quit their jobs due to their pain not being managed any longer. <br/><br/>The majority of opioid overdoses are ILLEGAL drugs…..not prescription opioids….which you know is the case. So please stop torturing everyone who uses legal, prescription pain medication. It’s gotten so out of hand that dr’s are scared to prescribe opioids even after surgery. Have you or a family member ever had invasive, painful surgery and then been told to take Tylenol?!? If not, consider yourselves extremely lucky because your “guidelines” are causing this torture. That’s what it is….it’s like mid evil torture that you are directly behind for Americans. We have tools (opioids) that are extremely effective and have very few side effects. <br/><br/>As a legitimate pain patient, it should be my right as an American to get whatever FDA approved medication my doctor seems necessary without federal government interference. I should have the same rights as someone who has diabetes and not be treated worse than a drug addict. Really, you need to rescind these “guidelines” or at the very least specifically exclude chronic pain, cancer and surgical patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6b656	Anonymous	None	2022-02-11T04:38:12Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-l46y-lhm2	False	None	False	2022-04-12 01:53:48.781	[]
85	CDC-2022-0024-0091	https://api.regulations.gov/v4/comments/CDC-2022-0024-0091	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My concern is that the DEA, insurers, and physicians will now use the mentioned "50 mme" rather than 90 mme as a stopping point for "allowed" amounts of opiods prescribed. How will this be addressed?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Johnnie	None	None	0900006484f6b68f	Ward	None	2022-02-11T04:40:28Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Ward, Johnnie	kzh-lc98-51u7	False	None	False	2022-04-12 01:53:49.003	[]
86	CDC-2022-0024-0092	https://api.regulations.gov/v4/comments/CDC-2022-0024-0092	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guidelines have put so much pain and undue stress on pain patients and their Doctors. These guidelines need to be removed. No one person should be treated as every other person. People are definitely different, their pain is definitely different and the medication they take to help them be productive is definitely different. The CDC and the “authors” of the 2016 guidelines should not be allowed any input into these new 2022 guidelines. My opinion is there should be no guidelines at all. Our Doctors and patients have a relationship and it is usually when the patient is at the most vulnerable dealing with something that has caused these patients to live with a form of pain for the rest of their lives. So many people have died due to suicide after the 2016 guidelines. The CDC and everyone who participated in forming these guidelines should be held accountable for these deaths! These deaths were undeniably the fault of Doctors not prescribing medication people had been using, legally, because the DEA wanted to put their nose where it didn’t belong either; between doctor and patient!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	CameronSharon	None	None	0900006484f6b75e	Schweitzer	None	2022-02-11T04:41:34Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Schweitzer, CameronSharon	kzh-m2r3-55w4	False	None	False	2022-04-12 01:53:49.222	[]
87	CDC-2022-0024-0093	https://api.regulations.gov/v4/comments/CDC-2022-0024-0093	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I broke my leg and in the emergency room I had the presence of mind to look at my blood pressure and heart rate. Both were higher than I had ever seen them before. The emergency personnel first checked to see if I had any drugs in my system. Finding none, they gave me a shot to relieve my pain. As the pain left me, my heart rate and my blood pressure were down to almost normal. I cannot help but feel sorry for the people who have had to endure much more pain than I did and for a lot longer due to physicians being strong armed by the CDC. I cannot help but think that many of these people probably had stress related heart attacks and strokes due to the intense pain that their bodies endured. Who is counting those deaths?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6b7a9	Anonymous	None	2022-02-11T04:42:21Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-metq-5jgx	False	None	False	2022-04-12 01:53:49.426	[]
88	CDC-2022-0024-0094	https://api.regulations.gov/v4/comments/CDC-2022-0024-0094	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not take away medications that help folks do their everyday life. Some people function in pain as bad as other people would go to the ER over. Strict regulations are already in place. Keep those and leave it alone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kc	None	None	0900006484f6b7b0	B	None	2022-02-11T04:42:48Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from B, Kc	kzh-mgk6-pvn4	False	None	False	2022-04-12 01:53:49.629	[]
89	CDC-2022-0024-0095	https://api.regulations.gov/v4/comments/CDC-2022-0024-0095	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 56 year old woman who lives with Fibromyalgia, failed spinal fusion, and neurological pain that Iam being evaluated for for possible MS. Without opiods I would not have any quality of life. I work with a pain clinic, use the lowest possible dose, do pt, yoga, and a healthy lifestyle. I did not choose this and was suicidal until I was finally treated. There is a big difference between an addict and someone who takes pain medication to manage unmanageable pain. It has not been fair to be treated like an addict, to pee in a cup, or to count my pills. Until there are better treatments out there for chronic pain, please be humane to those of us who suffer in silence. Untreated pain is a big cause of suicide. People can only tolerate so much pain day in and day out and still find life worthwhile. I sometimes feel we treat our pets better. I only request that my pain docs and the medical team I work with decide how to best treat my pain, not the government. I should not have to pay the price because of some people that abuse their medication. Opiods are not perfect but for tough to treat intractable pain it can be a life saver.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6b384	Anonymous	None	2022-02-11T04:44:02Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-mums-eo3b	False	None	False	2022-04-12 01:53:49.830	[]
90	CDC-2022-0024-0096	https://api.regulations.gov/v4/comments/CDC-2022-0024-0096	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am relieved to see the softening of these guidelines. My late husband, committed suicide in Oct 2016 after having his opioids ( for chronic pain ) abruptly withdrawn . He suffered greatly as have many others. It is my hope to see the suffering of numerous chronic pain patients in the country brought back under control.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammi	None	None	0900006484f6b3e8	Morse	None	2022-02-11T04:48:08Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Morse, Tammi	kzh-n5pj-suyg	False	None	False	2022-04-12 01:53:50.050	[]
91	CDC-2022-0024-0097	https://api.regulations.gov/v4/comments/CDC-2022-0024-0097	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support the CDC guidelines being changed!!! The 2016 guidelines made it impossible for chronic pain patients!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484f6b417	Gadd	None	2022-02-11T04:48:20Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Gadd, Cheryl	kzh-n8gf-i9xb	False	None	False	2022-04-12 01:53:50.277	[]
92	CDC-2022-0024-0098	https://api.regulations.gov/v4/comments/CDC-2022-0024-0098	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75 year old female suffering from severe back pain resulting from arthritis up and down my spine and degenerative loss of vertebrae in the lower part of the spine. I also have issues with my knees which are extremely painful. Both issues result in a decreased ability to function normally with spine being the worst. Presently I am taking Tramadol up to three times a day as needed. This does not ease or stop the excruciating back pain. It only takes the edge off fir a matter of minutes. I am not a drug addict now, nor have I ever been. I cannot take arthritis meds because of chronic kidney disease. My doctors are so regulated and quite frankly uncomfortable due to regulations, that they hesitate not to increase the doseage or try a more potent drug. So I suffer daily when I shouldn't have to. I also personally know someone with MS who struggles daily with pain for the same reason, regulation of pain meds and doctors who prescribe it. I have tried therapy several times and also used alternative avenues such as natural or holistic meds plus meditation. Nothing gives me any relief. So I am encouraged to see the CDC considering changes to its recommendations. Our governments, both local, state, and national should be more concerned with drug addicts and drug dealers than what an ordinary person like me takes. If you need a stronger pain medicine my doctor should be allowed to prescribe what he thinks is best for me without having his hands tied by regulations ( state or local). By the way pain management centers are pretty much a joke for my kind of pain. Thank you for allowing me to comment on this issue. Thank you, the CDC , for recognizing a problem and being bold enough to try and correct it. Yes, I am in favor of these regulation changes. Thank you again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Frreddie	None	None	0900006484f6b465	Moore	None	2022-02-11T04:49:50Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Moore, Frreddie	kzh-ne67-7sb0	False	None	False	2022-04-12 01:53:50.489	[]
93	CDC-2022-0024-0099	https://api.regulations.gov/v4/comments/CDC-2022-0024-0099	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 66 hear old woman with Rheumatoid Arthritis AND an aggressive form of Osteoarthritis. I have had the same rheumatologist since 2007 (save for 2 years in the interim) and he and I have worked closely to control my diseases. Because of these conditions, I endure chronic pain. If you haven't lived with chronic pain, you cannot understand the exhaustion, etc. Pain aside, just dealing with it is exhaustive. I keep running into issues with even getting my meds. I take Norco (Hydrocodone) and do not take many but do take at least one each day. I have tried pain management and through them, other drugs (Tramadol, Methodone). None of these 'alternative' treatments worked for me. I am SO tired of all the gauntlets that get thrown down each year by regulations and insurance companies. Many people in this country have legitimate reasons to be on these drugs and we are not drug seekers. We do, obviously, have a problem in the country, but the answer is not to restrict access to these therapeutics to the point where they are basically unavailable. (Don't you think that will send even more people to the streets?). I have NEVER sold my meds nor purchased them from anyone other than a pharmacy (nor would I ever). There are a lot of us in this boat and we're tired of all the prior authorizations, etc. that get in the way of us and our doctors and our attempts to treat our paint. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6b972	Anonymous	None	2022-02-11T04:52:19Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-nwg4-ntz4	False	None	False	2022-04-12 01:53:50.708	[]
94	CDC-2022-0024-0100	https://api.regulations.gov/v4/comments/CDC-2022-0024-0100	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My son, age 41, has had chronic pancreatitis for 10 years. He lives in SC. It is a debilitating chronic condition. Without his proper prescription pain medication he cannot function. With proper medication he is able to work, and support his family. Pay taxes and contribute to society. The goverenment should not come between the patient and his doctor. Pain patients don't get high, the meds relieve their pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f6bb32	Scanlan	None	2022-02-11T04:55:32Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Scanlan, Patricia	kzh-oul7-u35f	False	None	False	2022-04-12 01:53:50.987	[]
95	CDC-2022-0024-0101	https://api.regulations.gov/v4/comments/CDC-2022-0024-0101	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for removing the 90 MME threshold. Thank you for cutting the red tape in these updated guidelines and letting doctors be doctors and do individualized care as they are the ones with the medical knowledge to do so depending on many factors with the individual patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6bb65	Anonymous	None	2022-02-11T04:55:51Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-p36b-pbo5	False	None	False	2022-04-12 01:53:51.194	[]
96	CDC-2022-0024-0102	https://api.regulations.gov/v4/comments/CDC-2022-0024-0102	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since this is just "voluntary" nothing is going to change. You have to add language that says the 2016 guidelines are being rescinded & replaced with this 2022 version. The horrific damage caused by the 2016 guidelines will not be changed by this version without that added language. Too many statutes; practices and such have been put in place that are harming CPPs & IPPs who absolutely need opioids and this will change nothing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6bbc9	Anonymous	None	2022-02-11T04:56:19Z	None	None	1	None	2022-02-10T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-peka-1nxg	False	None	False	2022-04-12 01:53:51.408	[]
97	CDC-2022-0024-0103	https://api.regulations.gov/v4/comments/CDC-2022-0024-0103	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is good news. Finally. Now there must be a Senate Oversight Committee to reign in the DEA. They are dangerously out of control. Talk about harm!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484f6bc92	Grener	None	2022-02-11T05:02:01Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Grener, Kathleen	kzh-q1et-0txo	False	None	False	2022-04-12 01:53:51.625	[]
98	CDC-2022-0024-0104	https://api.regulations.gov/v4/comments/CDC-2022-0024-0104	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your "Guidelines" while being a recommendation have become legislative policy. With that being said, knowing you are a scientific organization, I don't see the science in the MME policy. Pharmaceutical application of medication is based on a patients health, genetics, and degree of symptoms. You haven't applied science to your MME policy because you haven't used a bell-curve approach to understanding the application of opioids to the broad spectrum of patient medical science. You can do this by testing opioid blood titration levels to prove safe and effective dosing in a lab. Any other medication is studied extensively and science is applied to the broad spectrum of patient responses. For example, if you used an arbitrary MME policy for cardiac, infection, diabetes, etc...as you do with opiods then what do you think will happen? Yes, people would die and I know that is not what the CDC is for. If you believe that the MME policy is controlling an overdose crisis then look at what you have created in the marketplace for cartels. The current death rate from illicit fentanyl overdose is entirely the fault of denying people effective pain management and sending them to the streets for relief. It is a failed policy and should be course corrected by scientific efforts so that our children stop dying. It is not only a scientific issue but one of morality and even humanitarian proportion. I understand that there are politics involved with the CDC but the basic facts are now a matter of relieving suffering and death by doing the right thing. Prove that this is what the CDC is about while you still have the chance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lee	None	None	0900006484f6bc96	Egger	None	2022-02-11T05:03:29Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Egger, Lee	kzh-q1vg-mkg8	False	None	False	2022-04-12 01:53:51.870	[]
99	CDC-2022-0024-0105	https://api.regulations.gov/v4/comments/CDC-2022-0024-0105	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Being the husband of a chronic pain patient has been a long haul. Our trip started with a injury sustained 38 or more years ago. No one could find out what was wrong and no one could believe that her pain was real. After struggling with this for more than 20 years, we finally found a doctor who could help and found the root of the injury. However by this time the root cause had blossomed into a host of other problems from lack of treatment from previous Dr.s'. once the issue was found treatment was started that involved surgery, medication, physical therapy, and a host of other treatments and remedies, all under super vision of dr.s. The big issues with meds was the side affects and to often allergic reactions to this that and the other meds that where tried. The only long term relief was found in opioids on a regular basis. This was working great then along come the reconditions of 2016! Now suddenly my sweet wife who has followed prescriptions to the letter is a "drug addict" and what has worked fine is now an severely controlled substance and has to fight to obtain what is needed to control her constant pain. This has been a fight that so many of the folk I have meet have had to struggle with. It has been a crime of no small proportions that you have inflicted on so many people that NEED this help so desperately. <br/>I welcome the changes that are proposed in this document, I believe that doctors should not be trapped into a box of what works and what does not work, by a group of people that have no history of the patients life, medical back round or extent of their injuries. You must also be careful that the wording does not come across as if a doctor does not follow you guide lines that their license to practice medicine would come under scrutiny for failure to follow your outlines. again I state that treatment should be left in the hands of medical doctors in the cases and they need to be done on a one on one basis. the Hippocratic oath states "do no harm". I believe that a lot of harm has been done by the previous guidelines.<br/>On a personal note: I have seen my wife of 42 years struggle to get relief of constant pain and the worst part is not being able to do anything about it. As a man this is a horrible place to be. watching my loved one writhe in pain because some *** said that the meds that work she can no longer have why? because they are addictive.... she has to be on these to have some semblance of a life, other wise it is bed ridden and writhing in pain that is uncontrolled, yes I realize that there many who abuse these drugs and are addicted to them, but for many like her they are the only way that they can get out of bed, shower and put cloths on, fix food for their family or even be able to earn a living. These folk need the support of doctors family and communities to live a reasonably normal life. My hope is that the purposed changes will be looked at by the medical community that treats these people and suggest even more changes to better treat all people with chronic pain and diseases that require long term opioid use. Thank you for letting me express my hopes fears and pains on this issue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roger	None	None	0900006484f6bcfe	Burns	None	2022-02-11T05:18:15Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Burns, Roger	kzh-qe6b-nonz	False	None	False	2022-04-12 01:53:52.073	[]
100	CDC-2022-0024-0106	https://api.regulations.gov/v4/comments/CDC-2022-0024-0106	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel the guidelines need to be updated due to the fact that pain didn't disappear. I have a couple of friends that recently passed due to cancer and died in pain. Doctors no longer help patients with pain due to these guidelines. Please make changes to the opoid guidelines and allows patients to die in comfort.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f6d1ec	Frey	None	2022-02-11T13:30:19Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Frey, James	kzi-fwxw-ev4k	False	None	False	2022-04-12 01:53:52.528	[]
101	CDC-2022-0024-0107	https://api.regulations.gov/v4/comments/CDC-2022-0024-0107	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to share my experience in regard to the CDC updating opioid prescribing guidelines. I am a chronic pain patients. In one way, I am fortunate that opioids do not have any affect on my primary pain source. However, on the flip side of that, I must rely on other methods of pain management (spinal cord stimulator and muscle relaxers primarily). But I also have another source of pain that is steadily progressing: degenerative disc disease. To date my doctor and I are trying to manage that pain with injections and radiofrequency ablations. The pain control is often ineffective, but I still am required to wait 90 days before another attempt can be made. I fear that at some point, opioids will be a necessary part of my treatment plan. In the meantime, even though I currently take zero opioids for pain, the only exceptions being surgical and major dental procedures, yet I am still subjected to both routine and random drug testing. I am treated like a suspected drug seeker, even though none of my doctors prescribe any pain medications and I have never had a positive for any substance I was not prescribed. This treatment also extends to the muscle relaxers I have filled at my local pharmacy. Recently I was singled out (and subjected to embarrassment) because I was picking up a prescription for one of my muscle relaxers. One of the technicians called the pharmacist over (never bothering to talk to me first). The pharmacist proceeded to interrogate me as to why I took both those medications and asked if I ever took them at the same time. I was in put in the position of having to make a split second decision: lie and say "no, of course not" or reply that I take the as prescribed by my doctor (one doctor prescribes both, plus another muscle relaxers that is filled via mail order pharmacy), which requires, as my doctor is aware, taking them at the same time. I lied. If I hadn't, I would not have been given the prescription. I stopped to pick up another prescription two days ago. This time it was antidepressants. My doctor is taking me off one and replacing it with another. This time the (same) tech quizzed me about that and I explained that I was being taken off the one and starting on the new one, adding that the former medication needed to be archived (which I had already requested via their online app). Again, she called the (same) pharmacist over and I was again interrogated. I repeated what I had just told the tech. As it turns out, even though I had requested the first med to be archived and told the tech I wasn't taking it anymore, it was sitting in the bag having already been filled anyway. Again, a long wait and embarrassment as a very long line had now formed behind me. It's bad enough that I'm treated like a suspected criminal by my doctors (it's the same with every doctor I've seen since the "war on opioids" began), but now I'm also being treated like a criminal at the pharmacy. I have friends who are also chronic pain patients. They are treated far worse than I am. They are required to take their medications to their appointments for a "pill count." These are legitimate pain patients with documented histories of years of correct use. The CDC needs to focus their resources on the illicit sale of opioids on the street. Heroin and fentanyl would be a perfect place to start. I am not suggesting that pain patients necessarily be given anything and everything they ask for. But I am suggesting that pain management physicians have the absurdly stringent requirements that all too often leave their patients in sheer and utter agony. Pain patients aren't expecting 100% pain relief. We just want to be able to function and have some semblance of a normal life. Please review the current guidelines and stop making the innocent suffer. It is barbaric and inhumane. We don't even allow our pets to suffer needlessly. We have them euthanized before it gets to that point. Should people not be treated at least as well as we treat animals?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Edwin	None	None	0900006484f6d1d2	Giddens	None	2022-02-11T13:32:23Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Giddens , Edwin	kzi-frmn-z7rb	False	None	False	2022-04-12 01:53:52.757	[]
102	CDC-2022-0024-0108	https://api.regulations.gov/v4/comments/CDC-2022-0024-0108	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The changes in the guidelines are a must. Intractable/Chronic Pain Patients deserve medical treatment without judgement. Prior recommendations which have been taken as law has caused irreparable damage to those who could no longer live in pain and their families. The supposed guidelines have created a divide between Dr's and their patients, Pharmacies, and Insurance. Those forced to live in pain are now considered suspect, malingerers, fakers even when medical tests prove otherwise. We ask that that regulations be modified to stop the persecution of all being monitored by the DEA. Law Enforcement does not have a medical degree nor do they have a place in treatment. Allow Dr's to treat patients according to their specialty as no two patients are the same.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kym	None	None	0900006484f6c257	Vance	None	2022-02-11T13:46:41Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Vance, Kym	kzh-t2wv-j18f	False	None	False	2022-04-12 01:53:52.997	[]
103	CDC-2022-0024-0109	https://api.regulations.gov/v4/comments/CDC-2022-0024-0109	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors should not be second guessed about prescriptions. If an addict lies to the doctor, that's not the doctor's fault. Unless there is a very clear case of a pill mill, let the doctor use his professional judgment about his prescriptions. Don't prevent patients in pain from being helped.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484f6ca4b	Morgan	None	2022-02-11T15:45:30Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Morgan , Charles	kzh-y226-a3t8	False	None	False	2022-04-12 01:53:53.211	[]
104	CDC-2022-0024-0110	https://api.regulations.gov/v4/comments/CDC-2022-0024-0110	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What can you at the Govt. do, to stop Pharmacies and Physicians from being afraid to prescribe and dispense pain med relief when it is obviously needed? So many pain sufferers with injury or illness were previously stable and not abusing or misusing medication, and were completely taken off because of the rules made, when there was a very small percentage who actually abused their prescription. It is now well known that usually overdoses were from illegally obtained drugs often tainted with Fentanyl or used in combinations with (legal) alcohol and other drugs. It has exacerbated to drs being afraid to prescribe Opioid pain meds after trauma and surgery which is equal to medieval torture, unbelievable this enlightened age. Now use of Hallucinogenic drug Ketamine is recommended to keep from using Opioids even as Anesthesia; this was used as a party drug <br/>and illegal because of serious side effects and flashbacks after use. That's how desperate this Anti-Opioid Hysteria has become, and it needs serious voices to turn it into a reasonable regulation that allows treatment when needed with effective pain medication. Please do more than give a recommended MME, realizing more specific guidance is needed to allow Drs to prescribe, and Pharmacies to willingly dispense without fear. We who are victims of painful conditions, post op and trauma patients, ask you sincerely to respond in a substantial action.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006484f6cada	Stitt	None	2022-02-11T15:47:13Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Stitt, Robin	kzh-z74z-qrcq	False	None	False	2022-04-12 01:53:53.423	[]
105	CDC-2022-0024-0111	https://api.regulations.gov/v4/comments/CDC-2022-0024-0111	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been on opioids for 25yrs in the last almost 2yrs I’ve been hit by a truck while in crosswalk and 2 subsequent car accidents and I can’t get enough meds from shock trauma nor any drs to make my pain bearable complete thoracic spine needs to b repaired along with my top 2cervical discs my jaw ribs and feet mind ya it happened right before virus lockdown the pain I endure on 60mg morphine and 40mg oxycodone doesn’t touch my daily pain now same meds I was takin before all this but no one seems to care bout what has happened or what it’s doin to me just let me suffer which isn’t good for BP heart or dealin with the pain tryin to keep goin was treated better more effectively yes ago cause the drs listened and took care of me and I’ve never become addicted to my meds I’ve self detoxed every time a dr left	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charmaine	None	None	0900006484f6c6b7	Holmes	None	2022-02-11T15:48:02Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Holmes , Charmaine	kzi-02ko-0476	False	None	False	2022-04-12 01:53:53.642	[]
106	CDC-2022-0024-0112	https://api.regulations.gov/v4/comments/CDC-2022-0024-0112	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please get rid of the old guidelines as they have done irreparable harm to Chronic Pain Patients and people with cancer. Even many surgeries are no longer gotten due to no pain medication post op. Pain cannot be treated the same for everyone therefore the MME limit is torture for some. I’ve been tapered and due to increased pain, no longer have an active life. Nobody should be allowed to suffer like we all are. Please fix this entire problem and let people live a free and fair life. The DEA needs to stay out of healthcare and focus on where we all know the problems are…..illegal fentanyl pouring in across our borders Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6d0d9	Anonymous	None	2022-02-11T16:03:10Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-joj4-in03	False	None	False	2022-04-12 01:53:53.869	[]
107	CDC-2022-0024-0113	https://api.regulations.gov/v4/comments/CDC-2022-0024-0113	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While this perspective is a welcome departure from the rigid harms of the 2016 Opioid Prescribing Guidelines, we need to go further. As a disabled chronically ill patient and writer /advocate of over eight years I have experienced personally the stigma and misinformation about opioids that most physicians carry. I’ve watched as at least two chronic pain patients in the online community we have created have committed suicide weekly since the 2016 guidelines. There are three main issues that need to be addressed by the workgroup. The first is that the majority of patients on Long Term Opioid Treatment (LTOT) have “Rare and Incurable Diseases.” These are things like CRPS, EDS, chronic pancreatitis, and many more. Because these kinds of illnesses have been left out of the guidelines, it is assumed that patients either have Cancer, low back pain, or are acutely injured and will improve with time. This is not the case. Second, it’s important to emphasize that palliative care physicians learn a different “MME conversion,” which means that these are all lose approximations and should be treated as such. Different medications are processed very differently in different patients, and the amounts that may be “a lot” for one patient might be very ineffective and too low a dose for others. Last, because of the stigma and harms that have been imposed upon patients, and because doctors fear for their licensure when prescribing pain meds, it is extremely important that instructions on how to treat patients who require opioids safely (without having to fear DEA wrath for simply helping patients) be created. Stigma, shame, and puritanical morals based thinking that paints patients with pain as “having character flaws” only inflicts more harm, and makes it more difficult for patients to get help and doctors to provide it. This was a small step in the right direction, but patients and doctors need more. This is a bandaid for a stab wound.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Emily	None	None	0900006484f6c431	Ullrich	None	2022-02-11T16:10:41Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Ullrich, Emily	kzh-va8f-som5	False	None	False	2022-04-12 01:53:54.113	[]
108	CDC-2022-0024-0114	https://api.regulations.gov/v4/comments/CDC-2022-0024-0114	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have found current guidelines personally and professionally cruel and inhuman. I have had to treat elderly patients with crush injuries to the spine and only getting APAP with the excuse of current guidelines. I personally am about to loose a 30 year career as a nurse due to pain because I cannot get adequate relief. I have herniated disk. Degenerative disk disease and arthritis. But I don't qualify evidently under current guidelines to continue opiods for chronic pain. The Big Lie needs to stop. You are hurting your citizens. Street drugs should have NEVER been considered when imposing these guidlines. And should not be included to continue the hype. Doctors should be allowed to practice within their scope. And the Centers of DISEASE Control should stay in their lane. They have absolutely hurt more people, caused more fear and death by these guidelines than Covid. The reason Fentynl and Carafentynl are illegally coming across US borders like it is is because of the CDC guidelines and people desperate to not be in pain.<br/>There is a huge difference between addiction and dependance.<br/>Remember: PAIN IS A MEDICAL DIAGNOSIS!!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6d015	Anonymous	None	2022-02-11T16:12:55Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-i6ut-zup6	False	None	False	2022-04-12 01:53:54.364	[]
109	CDC-2022-0024-0115	https://api.regulations.gov/v4/comments/CDC-2022-0024-0115	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please acknowledge the number of suicides since 2016 by chronic pain patients who were denied adequate medication for their suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christl	None	None	0900006484f6d592	Miller	None	2022-02-11T16:15:47Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Miller, Christl	kzi-kv4o-j9o9	False	None	False	2022-04-12 01:53:54.577	[]
110	CDC-2022-0024-0116	https://api.regulations.gov/v4/comments/CDC-2022-0024-0116	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am pleased to see that the very harmful 2016 guidelines have been revised to become more flexible for pain patients. My physician, although wonderful, has kept me on a very low—almost ineffective dosage of pain medication. Some days it’s hard to function at a normal level due to my pain. It’s my hope and prayer that after the revision of these guidelines some flexibility will allow my doctor to feel more comfortable prescribing myself and other patients opioids at an affective dose. The majority of the overdoses are from heroin and illicit fentanyl. Furthermore, the grand majority of chronic opioid patients such as myself take their medicines as prescribed and do not take them to get high. We take our medicines to function normally in society and I feel relieved that the updated guidelines may give my doctor and others the confidence to be able to prescribe appropriate dosages of opioids to myself and other legitimate patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484f6d5cd	Kraft	None	2022-02-11T16:16:12Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Kraft, Marie	kzi-laug-8vep	False	None	False	2022-04-12 01:53:54.800	[]
111	CDC-2022-0024-0117	https://api.regulations.gov/v4/comments/CDC-2022-0024-0117	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Something Must be done tohrlp chronic pain sufferers, post operative patients and people who are suffering. The "opiate crisis" was not brought on by pain patients rather, illegal drugs. The DEA, prosecutors and the government has too much control. What happened to doctor's being able to treat patient's needs properly? Doctor's must answer to the medical board and are trained to care for people. The government shouldn't put the fear of God into doctors and pharmacies, to the point of jeopardizing medical care. I pray for revision of these guidelines. Focus on the real problem, illegal narcotics and not the true pain sufferers. Please!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6d5fd	Anonymous	None	2022-02-11T16:16:53Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-lna4-uoky	False	None	False	2022-04-12 01:53:55.057	[]
112	CDC-2022-0024-0119	https://api.regulations.gov/v4/comments/CDC-2022-0024-0119	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC and many providers exceeded pulling back on prescriptions for intractable pain relief. Not enough has been done to address helping patients who have no other choice for pain relief. Even low grade opioids like Tramadol have not been prescribed. That's very short sighted and forces many folks to go off label for pain relief with many negative results. I support lessoning the ban on prescriptions to benefit many patients that don't have other options.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ray	None	None	0900006484f6b872	Antonelli	None	2022-02-11T16:31:47Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Antonelli, Ray	kzh-rg3h-nd44	False	None	False	2022-04-12 01:53:55.280	[]
113	CDC-2022-0024-0120	https://api.regulations.gov/v4/comments/CDC-2022-0024-0120	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for a great start to addressing this issue. With 2 failed spinal surgeries, degenerative disc disease, several herniated discs, nerve damage as well as a few other conditions, I have been fighting for my life for the greater part of my adulthood. The ONLY reason I am able to function in the limited capacity I do is because of opioid treatment. It allows me to work, drive, and do the most basic household chores that most people take for granted. Traveling, concerts and most social functions are still not possible due to the price I have to pay. What energy I do have is focused on being able to continue working.<br/>Even though I still have many days where the pain keeps me at home, I fight with all I have to remain a productive member of society. The existing guidelines resulted in my med being decreased last year. I told myself I'd be fine: my body will adjust, I told myself. I was wrong. My abilities and productiveness have been significantly limited by this reduction. Like others I have never failed a urine test, never missed an appt, never took more than prescribed, yet I was "punished" because of misinformed leaders who made decisions based on erroneous data. <br/>I still believe I am one of the lucky ones though. I know that the fact I am still even being treated with opioids at all is a small miracle. Like others, (because I keep myself informed on everything that has been happening) I live in constant fear of being cut off forever. The current climate surrounding opioid use has made all of us live in daily anxiety and panic. Perhaps this step will begin to allow us to hope again.<br/>I would also like to suggest that you also re-examine the rx combination restrictions that many drs and pharmacies have put in place. Having to choose between pain meds, psyche or anxiety meds should not be acceptable. Anxiety and depression are extremely common with chronic pain. These conditions go hand in hand and Drs should be able to treat the whole, not just part. <br/>Again thank you for continuing to search for the facts and make sound decisions based on those facts, not on unwarranted hysteria. We are chronic pain patients, NOT addicts.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484f6c1c2	Sheridan	None	2022-02-11T16:32:24Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Sheridan, K	kzh-sjgi-g6gr	False	None	False	2022-04-12 01:53:55.494	[]
114	CDC-2022-0024-0121	https://api.regulations.gov/v4/comments/CDC-2022-0024-0121	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a good start in reversing the 2016 CDC guidelines for treatment for chronic pain patients and Doctors who treat them. It is vital that the DEA and other government agencies, HHS, DOD, Pharmaceutical organizations, Insurers are informed and obidide the new guidelines. Many medical professionals have been threatened by the misjustice, misinformed and harassed because of the poorly written and execution of the 2016 guidlines. Lifting a one size fits all and reducing prosecution to Doctors will save lives and definitely will help chronic pain patients have a better quality of life that the have been denied for the past 6 years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tori	None	None	0900006484f6c23e	Dorsey	None	2022-02-11T16:32:57Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Dorsey, Tori	kzh-synm-375d	False	None	False	2022-04-12 01:53:55.710	[]
115	CDC-2022-0024-0122	https://api.regulations.gov/v4/comments/CDC-2022-0024-0122	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a retired registered nurse, healthcare consultant and medical coder and a chronic pain sufferer I’ve experienced the narcotic epidemic from both sides. I’ve worked in substance abuse and psychiatry as well as critical care and public health. After falling during a small southern California earthquake in 1988 in which I fractured my spine and required a spinal fusion. I was given Tylenol with Codeine #3 and eventually #4’s for well over 15 years for my disabling pain. I was also on Social Security Disability from 1992 to 1995 when I returned to the work force but still on same pain med. I was eventually switched to Kadian SR tabs and now use Buprenorphine patches with Oxycodone 5/325 for breakthrough pain. In all these years i’ve been prescribed these drugs I never abused them as most chronic pain sufferers do not abuse their life line to a normal life. I’ve never veered outside of my prescribed regime. Do not cause additional harm to those who require these medications? Having been involved in government investigations for the OIG as a healthcare consultant I recommend more frequent scrutiny of physician prescribing practices by monitoring pharmacy filling practices.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jules	None	None	0900006484f6d542	Enatsky	None	2022-02-11T16:36:45Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Enatsky, Jules	kzi-kebl-ucm3	False	None	False	2022-04-12 01:53:55.925	[]
116	CDC-2022-0024-0124	https://api.regulations.gov/v4/comments/CDC-2022-0024-0124	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It may be indicated to recommend a visit with a patient who gets opioids for acute pain 1. A few days prior to when their last anticipated dose should be so they can be "checked" on regarding their opioid use, pain and their level of concern for dependence/tolerance/withdrawal at time of discontinuation. 2. Followed by another visit a week or two after the Rx is anticipated to wear out to check on the pt and see again how they are doing by way of pain as well as if any continued opioid use continued after the allotted time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jordan	None	None	0900006484f6d699	Spencer	None	2022-02-11T16:45:07Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Spencer, Jordan	kzi-mim3-ecr2	False	None	False	2022-04-12 01:53:56.140	[]
117	CDC-2022-0024-0125	https://api.regulations.gov/v4/comments/CDC-2022-0024-0125	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand there is a current issue with opioids. But this is not the way to solve it. there is also an issue with ones who have constant pain that makes life unbearable to function. I am one who deals with severe pain everyday. I have EDS and my joint constantly dislocate. I was also in a severe car accident where I broke my pelvic, hips, tailbone and leg. I have arthritis and pain in my hips, back, fingers and feet. I do not take opioids everyday, but on days I cannot get out of bed, I do. It was mentioned to have doctors first go to NSAID’s. Well this was done with me at first, and the NSAIDs have now caused many ulcers in my stomach, which has caused additional medical issues. Most doctor do not understand what it is like to wake up everyday in severe pain, nor do I believe the people voting on this do. I am for educating the patient and follow them closely, but not making patients out to be a drug seeker because you suffer from severe pain. Constant urine tests as you are not trusted and being accused of overusing. I know there are people who are abusing opioids, but they will find another way to get them and this is only adding more hardship for the ones who already battle with hardship everyday and that is pain. Maybe have a formulary for ones who have identifiable diseases or conditions that warrant opioids as treatment. Either way, I am a sufferer with severe pain. I have learned to do 5 days on and 5 days off as I know my body can build a tolerance, it it was my primary doctor who took the time to educated me. It was my doctor who helped me because unlike most primary physicians, they are to scared now to even proscribe opioids because of regulations such as this one. They are scared and send patients off to clinics. Yet a primary physician should be the ones to be able to keep close contact with their patient. I have had someone close to me pass away from drug overdose, but I can tell you he was able to get it easily elsewhere and not from a prescribed doctor. So while I know there is to many lives lost to opioids.. money and time would be spent better on getting ones access to the help, and educating doctors on what to look for with ones who are suffering from drugs or abusing opioids. Requiring primary physician to see there patients regularly and educate doctors on what to looks for physically and also mentally, before it gets bad. So I say no to regulating even more on opioids when all it really does is make it harder for the ones who actually need it. I appreciate your time reading this, as it is from my own personal experience.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c442	Anonymous	None	2022-02-11T16:46:56Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-vcz0-al45	False	None	False	2022-04-12 01:53:56.357	[]
118	CDC-2022-0024-0126	https://api.regulations.gov/v4/comments/CDC-2022-0024-0126	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient I have been on the receiving end of the 2016 Guidelines which cruelly harmed so many people, including myself. I am relieved to see that the CDC has begun understanding the voice of reason with these guidelines. They are a momentous step in the right direction. Much more work to do…to “call off” the DEA and their unfair and unjust persecution of doctors, to roll back state laws that remove the doctor patient relationship when prescribing the necessary meds and restoring the faith that doctors will adequately treat pain. Thank you for beginning the process that hopefully will bring relief to so many millions suffering unnecessarily.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shara	None	None	0900006484f6c344	Danziger	None	2022-02-11T16:51:41Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Danziger, Shara	kzh-u741-1l8v	False	None	False	2022-04-12 01:53:56.584	[]
119	CDC-2022-0024-0127	https://api.regulations.gov/v4/comments/CDC-2022-0024-0127	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I do think some people would benefit from alternate therapies other than opioids. However, I know many cases where pain medicine is denied to people who have legitimate severe chronic pain. Most importantly, I think it's ironic that the alternative therapies you describe are not paid for by insurance companies. The result is simply there will be no treatment at all for many people. Once again, insurance companies define who gets treatment and you are enabling them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c816	Anonymous	None	2022-02-11T16:52:36Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-amk3-yujs	False	None	False	2022-04-12 01:53:56.849	[]
120	CDC-2022-0024-0128	https://api.regulations.gov/v4/comments/CDC-2022-0024-0128	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a very rare autoimmune disease that is called Adult Onset Still's disease and it is literally RA and Lupus combined. When the new guidelines came out, I knew it was going to affect my life for the worse. Actually, it was my nightmare that came true. I had a heart attack in 2016 and I very much attribute that to being denied my pain medication. I no longer was the grandma I wanted to be, nor the mother or daughter. Pain has stolen my life, literally. I can't play with my toddler grandkids, I can't babysit them, I can't even pick them up because I have severe spine injuries. My nerve pain medications do not help the kind of pain I have with Still's disease. Yes, you really do feel pain with destructive arthritis. You know what is sad? I only took one, maybe two hydrocodones a day when my script said 3 a day. You will find that people with real chronic pain do not abuse their meds. You want to know why suicide rates are up? Its called being denied our pain meds. Pain steals out lives away. Don't you see? I have known 3 who committed suicide last year from being denied their meds. What happens when one of them gets illegal Fentanyl off the streets because they are desperate for relief and then they die because of your harmful guidelines?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ada	None	None	0900006484f6c8ba	Wilson	None	2022-02-11T16:59:14Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Wilson, Ada	kzi-e3za-z76v	False	None	False	2022-04-12 01:53:57.094	[]
121	CDC-2022-0024-0129	https://api.regulations.gov/v4/comments/CDC-2022-0024-0129	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I welcome the changes proposed in this 2022 CDC Guideline, as it directly affects my health and quality of life. I am 49, and have suffered from debilitating headache pain for 42 years. A consistent and carefully monitored daily dose of opioids over 10+ years has made it possible for me to function, work, and take care of my family. The 2016 CDC rule/gudeilines made it harder for me to get the medication I need, required more doctor visits and drug testing (=higher costs), and higher costs for my medicine, because the insurance company will only pay for a supply that is less than what I needed. I have been with the same doctor, a pain specialist and board certified anesthesiologist, for more than 12 years, and trust him with my care. I applaud this changed guideline that allows my doctor to provide me with the care that his professional training and experience determines that I need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c8c1	Anonymous	None	2022-02-11T17:00:47Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-e8lh-dekc	False	None	False	2022-04-12 01:53:57.308	[]
122	CDC-2022-0024-0130	https://api.regulations.gov/v4/comments/CDC-2022-0024-0130	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop leaving out the fact that about 70% of people with AIDS, long term sufferers of 20 to 40 years of living with HIV have chronic pain.. not only does it go untreated,, we cannot enjoy basic living, family or part time work. Many stuck at home , alone, secluded and unable to walk far. Please add us to chronic pain suffers like cancer. Drs lump PWAs as addicts. That is discrimination and not true. Most who acquired AIDS or HEP C in the begining, the 1980s was through sex, tatoos, surgery. I was in excruciating pain. Many drs and tests. Was doing tob102 pounds! Took 2 years to get treatment. I did so much better yet took years to gain weight and muscle 117 lbs. I was able to pack and sell home and move closer to my son. Then pain meds taken away in new place new dr..was taken away for no reason. I lost enough of my life to this disease, now the antiretrovirals deem me healthy but I can't get out of bed or eat in pain. Loosing weight.. I am 60 and alone.. on meds I was able to drive, go fishing, sew, visit friends...Allow us low dose short acting oxycodone again. Cymbalta does not work fir me. Gabapentin and Lyrica harm my already damaged kidneys. Drs keep pushing the stronger long acting suboxone. I do not do well on the long acting opiods. Most of us elder are not addicts. We lived clean lives, took toxic HIV meds to survive 40 years for our families... now in our 60s and suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484f6c84a	Denby	None	2022-02-11T17:01:47Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Denby , Diane	kzi-burk-m87y	False	None	False	2022-04-12 01:53:57.525	[]
123	CDC-2022-0024-0131	https://api.regulations.gov/v4/comments/CDC-2022-0024-0131	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioid restrictions only cause patients to turn to the street or alcohol if someone has an addictive trait they will either learn to overcome it or perish, there is a term for this=natural selection. I should be able to decide how much and what type of pain medicine I consume. No one else, the treatment I received since my spinal fusions has been barbaric and inhumane. Treated like a junky because I wanted relief and more than to. Lie in bed and cry.shame on anyone who stands between me and my pursuit of happiness....anyone	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Casey	None	None	0900006484f6beb9	Atwood	None	2022-02-11T17:09:00Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Atwood, Casey	kzh-qwlt-v6j6	False	None	False	2022-04-12 01:53:57.797	[]
124	CDC-2022-0024-0132	https://api.regulations.gov/v4/comments/CDC-2022-0024-0132	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am pleased to see that the current guidelines established in 2016 are being considered for revision, however, I feel those guidelines have done irriparable harm to so many, especially chronic pain patients within the VA system. Currently pain management doctors at the VA are pushing patients off of opioid therapy that works to control pain into unproven and unprovable therapies such as "battlefield accupuncture" also known as "auricular acupuncture." Studies have been done proving that it does not effectively help with chronic pain to the degree that opioids do. As a VA paitient, who has service connected back and ankle injuries, and having been on multiple NSAIDS, other pain receptor blockers, as well as neuropathy medications, these guidelines set by the CDC were interpreted as law, and VA doctors started forcing veterans with verified long term injuries off of medications that work to control their pain and being treated like addicts, by requiring frequent urinalysis, "pain contracts" and unnecessary suffering because the doctors have been told they have to get their paitents off of opioids unless they are in end of life care or have cancer. <br/><br/>I spent years on Tramadol for both ankle and back pain associated with my injuries incurred during my time in the military. The tramadol helped minimally with the ankle pain but as my back continued to deteriorate, it did not control the pain radiating down my legs from my back injury. I had surgery to repair ligament damage in my ankle after 25 years of dealing with it, when I finally got an orthopedic surgeon at the VA who said he could repair it and help with the instability. I had the surgery in 2011, and was required to be non-weight bearing for 3 months. I was given percocet for post op pain. That was the first time in years I felt relief in my back. Once recovery was done on my ankle, and discussing it with my primary care physician at the VA, she switched me to Tylenol 4, an Opioid with Tylenol. Then I had an allergic reaction to the nicotine patch that had me at the ER thining it was a heart attack. It turned out to be an allergy to the adhesive in the patch. This ER visit caused my doc to order tests on my heart, including an echocardiogram. During that, it was discovered that my liver had fatty infiltration. My doctor knew I did not drink, but she also knew that I had been using NSAIDS for decades due to my injuries. She was concerned and took me off all NSAID medications and told me not to take them unless absolutely necessary. She changed my pain medication to oxycodone. I have been on that since 2012. I have been on varying doses of it, eventually reaching 10mg every 6 hours, while I waited to find a solution for the bone on bone L5-S1 vertebrae. I was sent to a neurology offfice in 2016, underwent medial nerve ablation, along with multiple rounds of physical therapy, chiropractic visits, and was taking Lyrica for radiculopathy in my feet. I finally underwent a discogram test in 2019, to see what condition the disc material left was in. It was not good. I was scheduled for surgery in December 2019, and had a titanium wedge placed between the vertebrae, held in place by screws going up into the L5 vertebra, and down into the S1. The radiculopathy was relieved enough to discontinue the Lyrica immediately. I was still on a total of 40mg oxycodone daily, for about a month post-op, but was able to decrese the dose on my own to 60mg 6 weeks after surgery. Unfortunately, the surgery only repaired part of my problem, and have been unable to decrease it further and still maintain quality of life and continue to do my part time job as well as things like stand at the sink to do dishes, cook, and keep my house clean. (Some days it is still a struggle, and I have breakthrough pain, but I do not want to increase my dose, so I just put some things off until I feel up to them.) The fact is, without those meds, I would likely need someone to do everything for me and I would not be able to even make a trip to the store. <br/><br/>I think the biggest mistake the 2016 guidelines made was lumping "opioid deaths" in with prescribed medications and taking medical decisions away from doctor and patient. The numbers do not add up when you separate prescribed pain medication from illicit fentanyl and heroin overdoses. People who have chronic pain don't get high from opioids, and that is evidenced by them taking meds as prescribed. Chronic pain patients are simply able to limit pain enough to still have quality of life and participate in normal daily activites. <br/><br/>Steps need to be taken to return medication decisions to doctors and patients, and not set my some arbitrary number decided on by someone who doesn't suffer from chronic pain, and is not familiar with every patient's medical condition. <br/><br/>Thank you for your time and consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D.	None	None	0900006484f6bf11	Brown	None	2022-02-11T17:09:56Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Brown, D.	kzh-qzx6-kgqr	False	None	False	2022-04-12 01:53:58.009	[]
125	CDC-2022-0024-0133	https://api.regulations.gov/v4/comments/CDC-2022-0024-0133	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello!<br/>I have been a chronic pain patient for 25+ years. I have several debilitating syndromes/disease. <br/>I needed and took narcotic analgesics for 20 years without negative incident! <br/>Since my doctors retired in 2020, NOBODY will treat me!<br/>The result is Literally Killing Me.<br/>On top of many Severe pain syndromes, osteopathic and neuropathic problems, I have bleeding ulcers, IBS-D and Chron's Disease; all with severe diarrhea and inability to absorb nutrients. The only Logical solution was specific opiods. They Saved My Life. <br/>Since they were taken away from me in 2020, I have lost 45 pounds that I didn't have to lose.<br/>I have been bedridden and weak, resulting in Wasting and Heart Palpitations. I also suffer from anxiety/panic disorders and CPTSD.<br/>I almost died 3 times from the GI afflictions and the first 2 times, I was Logically and Responsibly Treated. It stopped the GI afflictions, and with a tried and true "cocktail" of medication, I was able to take care of myself, home and animals. I could drive, shop, clean, cook, bathe, walk and occasionally visit with friends and family. I HAVE LOST EVERYTHING AND EVERYONE because of this. I'm Wasting Away, my teeth have been ruined from Oral Chron's Disease Outbreaks and I cannot care for myself. I don't have anyone who can help me. I lost my entire family just before I lost my doctors and medications. <br/>If a physician doesn't help me, Soon, I will continue to die in this Horrific pain. I'm fighting to live because I'm just under 50 years old. I should be having a great life at this time. However, I keep getting weaker and the pain gets worse. If I were in palliative care, I would have medication for the Agony of slowly dying! <br/>All I need is my medication back! <br/>It will allow me to eat, gain weight and regain muscle, not to mention easing my other severe pain. I am a fighter and I want to Live. I Deserve To LIVE! <br/>It's Common Sense Medicine. At least, it Used to be! <br/>I am suffering and slowly dying over Not Having Correct, Legal Medication! HOW IS THIS OKAY?!? It's NOT.<br/>In the meantime, I see abusers doing more drugs. Dangerous, Illegal Drugs. There are more hospitalizations and deaths from street drugs Because of pain patients being denied.<br/>I refuse to take illicit drugs and wouldn't even know how to get them, much less afford them. I Cannot Work! Not for years, but I am also Denied SSD! Again, I see people getting SS aid with fake disability! I'm a law abiding citizen. I have No idea How these people get away with scamming the government. I have no idea how people get street drugs. I Don't Want To, Either!<br/>I JUST WANT TO LIVE MY BEST LIFE AND BE A PRODUCTIVE CITIZEN. <br/>I Deserve That Much! <br/>Needless to say, me wasting away has caused me to lose family who needed me. I lost all friends. I lost my dogs and I Lost My Love! <br/>You see, no matter how much someone may love you, 99% will Not Help You! Who wants to deal with a sick person? <br/>I'm Not Old Enough To Have Lost My Life! Thankfully, I can be treated, IF someone would help me! I'm not dying of cancer or other definitively deadly disease. <br/>I AM DYING FROM NEGLECT. <br/>SHAMEFUL, IGNORANT NEGLECT!!!<br/>I Beg of whomever is in control of this; PLEASE HELP ME by way of aforementioned Common Sense! Doctors have been dumping me in circles for a year and a half! NOT ONE WILL HELP ME, out of Fear and Misinformation about Treatment with Reasonable Narcotic Analgesics!!!<br/>PLEASE. CHANGE AND EDUCATE NEW/YOUNG PHYSICIANS!!! They have given me several "Acceptable" medications that have added severe problems and almost killed me Again! <br/>I CANNOT KEEP WAITING. <br/>I. WILL. DIE. INHUMANLY. PAINFULLY. <br/>Such an Easy fix, yet I am going to lose my life over Misinformation and Fear Mongering that has been Taught to the Newest Generation of Physicians! <br/>This is Degradation and Neglect on an Extreme Level.<br/>SOMEONE MUST STAND UP FOR PEOPLE LIKE ME!<br/>Our voices fall on deaf ears and I can't physically get to the "musical chair" of repetitive doctors, much less seek help elsewhere. <br/>PLEASE, PLEASE, PLEASE HELP ME and others like me! <br/>Thank You for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6bd8c	Anonymous	None	2022-02-11T17:11:41Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-qm30-t33w	False	None	False	2022-04-12 01:53:58.239	[]
126	CDC-2022-0024-0134	https://api.regulations.gov/v4/comments/CDC-2022-0024-0134	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in my thirties. I was a college athlete. I have had 3 back surgeries due to my sports injuries. My first surgery was at the age of 21. I live in pain every single day. You can’t take 4 advil every 6 hours for the rest of your life. My other option is to have surgery number 4 that will fuse 3 levels of my lower spine together. My 3rd surgery left me with no feeling from my left knee down. I’m not even 40 and I wake up every day in excruciating chronic pain. Some form of this reform needs to be passed. There are patients out there that TRULY have tried everything and NOTHING works except opioids. I have been in physical therapy 20+ times. I have done water therapy. Nerve blocks. Cortisone injections. Tens units. I would love to be able to start living again with less pain. And opioids are the ONLY thing that works at this point. Not all of us abuse drugs. I’ve been on and off opioids for 20<br/>Years and not once have I abused them. I use when needed. Which is often. PLEASE make it a primary care/patient decision and NOT and insurance decision or NOT by some big wig at CDC or opioid activists to make decisions about MY pain and MY needs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracey	None	None	0900006484f6bd8d	Silver	None	2022-02-11T17:13:04Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Silver , Tracey	kzh-qm3i-2k09	False	None	False	2022-04-12 01:53:58.457	[]
127	CDC-2022-0024-0135	https://api.regulations.gov/v4/comments/CDC-2022-0024-0135	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm very much hoping the recommendation to use non-opioids is not presented in a threatening or punitive way, but truly allows for the prudent use of these meds. They provide the BEST relief for millions of pain patients, including me.<br/><br/>I have several painful chronic conditions. I've taken essentially the same prescription for 25 years, under quality supervision. My liver and kidneys are fine (I don't take a lot), my cognition is stable, and since I'm being treated for central sleep apnea via variable cpap, my doctor is a bit more relaxed about respiratory depression. In other words, I am an excellent candidate for opioid use for the use of chronic pain when nothing else works. Some days I only need Excedrine.<br/><br/>I discovered buprenorphone. It works well for me in place of hydrocodone. <br/><br/>I'm not sure if it's considered an opioid like morphine.<br/><br/>It doesn't present risk of respiratory depression, is practically impossible to overdose on, is evidently less addiction-provoking than other opioids, and doesn't contain the acetaminophen in my current prescription. Sublingual, easy to swallow. Takes ~30 min to work.<br/><br/>The wonderful doctor who recognized it was not only useful for MAT and introduced me to it has, unfortunately, passed. My rheumatologist refuses to get the "X" to prescribe it. I've seen two other pain specialists who just widen their eyes and treat me as a drug-seeker for mentioning it. Of course there are shady practitioners who would prescribe it (ironic!), but they cost $450 a visit, and that has to happen once a month. AND they treat me like a drug-seeker. No thanks!<br/><br/>All I know is it has a lower risk profile than hydrocodone and it works really well for me. I also know it's been studied and found to be a safe and effective option for pain. https://pubmed.ncbi.nlm.nih.gov/30051169/<br/><br/>I would greatly appreciate it if BUPRENORPHONE could be addressed as a different kind of drug that works well (for me anyway) and might be a decent alternative to the opioids that freak doctors out and have led to an epidemic of addiction, suffering, and death.<br/><br/>Oh, and maybe a line or two directed at the DOJ re Purdue / the Sackler family. We see you and the damage you continued to allow with a pittance of a fine and NO JAIL TIME for the perpetrators of our current disaster of "prescription" street drugs that contain fentanyl and kill people. In fact, nothing in this new guidance is likely to prevent doctors from prescribing what they believe to be a 12-hour painkiller that makes patients frantic because it only actually lasts 8. I don't have personal experience with it but I've certainly read enough articles and one excellent book to know exactly what DOJ let these monsters get away with it. It was only people who became addicted or worse who were affected; it was legit pain patients whose legit doctors were scared out of their minds by CDC rules that were in direct response to what that company and family KNOWINGLY did. For shame.<br/><br/>Also, if there's any way for the CDC to do so, I would like physicians to feel free to try different meds and different combinations with individuals. We don't all respond the same to any given drug. I know of a woman whose quality of life was saved by tramadol, which her doctor will no longer prescribe. Meanwhile it didn't do a thing for me. Fortunately I was able to work with my rheumatologist and pain specialist who, together, helped me discover a good regimen with minimal side effects. (Buprenorphine and Norco are both reported to CURES, which they each scrupulously check.) I wish all doctors felt free to do so (and, of course, caring enough to help patients methodically experiment). <br/><br/>Final thing: A lot of the first-line suggestions don't work for a lot of people. Personally I can use a 91-degree therapy pool for an hour, or use a Pilates reformer until I feel like a normal person does when they're done with a workout. If I walk more than 20 minutes, though, I might be down with body pain all over for a week. Sometimes I push it just because it's pleasurable and I'm feeling pretty good; sometimes (very rarely) I don't have to pay heavily for going for 45 minutes. I meditate; it doesn't reduce pain, I do it for other reasons. Biofeedback made me worse. Gabapentin doesn't help too many folks and the side effects are bad, yet it seems docs are pressured to continue prescribing it bc they're scared to try something else. I've done intensive warm pool, CBT, and yoga therapy (4 hrs, 3x/week, 6 weeks off work). I enjoyed and tolerated the water, I enjoyed but didn't well tolerate the yoga, and for me CBT made things worse, as the techniques have never helped me, and I had to sit upright in a bad chair to do it. Yet I know others in the program had different experiences.<br/><br/>Again, please, I'm asking you allow docs who are on the up and up to relax enough to hear people. Don't threaten their livelihoods. And together with the patient, let them explore what truly works, for each individual.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6bde4	Anonymous	None	2022-02-11T17:17:21Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-qo8m-rghe	False	None	False	2022-04-12 01:53:58.689	[]
128	CDC-2022-0024-0136	https://api.regulations.gov/v4/comments/CDC-2022-0024-0136	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My life was taken away at 34, though until PROP, I could almost have some quality of life. Since 2016 Super Bowl to know for my own thanks to prof I am severely under medicated I have no quality of life at all, as I have to lay on my heating pad 16 hours a day because I can’t move. You guys are not helping something to me now I am so tall my life being stuck in my bedroom crying all the time. Please give me my life back!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006484f6ca6c	D Dicino	None	2022-02-11T17:29:28Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from D Dicino , Maria	kzh-y9hx-abhd	False	None	False	2022-04-12 01:53:58.903	[]
129	CDC-2022-0024-0137	https://api.regulations.gov/v4/comments/CDC-2022-0024-0137	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am going to start by saying I'm happy and optimistic about this issue being looked at and considering changes. I have been in chronic pain for 20 years and have been on pain medication for 15 years I tried everything possible before getting on opioids and nothing worked well enough to live a normal life and I was always a healthy active person with nothing but life and energy I was into health and fitness training and loved to help others feel better about themselves and live healthier lives. My life has changed drastically in the last 12 years from being a happy energetic person who loved to do everything, to being the person who doesn't want to get out of bed most days. After being able to treat my pain and live my life again and worked on finding the right treatment for my pain management with my Dr. Who has been the same for all 20 years and knows my health and pain issues as well as I do only to then let politics getting involved and allowing a few people's opinions on what is good for everyone and deciding what I can or cant continue to do or managing how my healthcare provider can provide for me the care that worked perfectly fine for me, and kept me able to do my day to day tasks and take care of my family's needs aswell as go to work every day and be capable of caring for my family going to work and manage my pain well enough to do so that just made life for many people very hard to deal with and many of us had thoughts of suicide over living with the pain we once had under control. Not to mention now because of opiod issues mostly heroin illegal drug use the idea that a panel of people should make it a rule now they know better than the MD and the patient how they should be treated never knowing anything about either of them. The idea that making a rule a Dr. Has now got to stop or cut a patients prescribed medication in half and lower the managed pain relief or they can loose a medical license if not followed has to be the worst thing thought up. Especially if it was suppose to be helping an opioid epidemic. Now resulting in a opioid epidemic close to 3 times what it was before this passed. The people who have never even thought of doing anything illegal have been denied the medical treatment they have had for long enough to live ok with pain now are pushed to suicide or taking drugs from places they never would of thought to and as a result there are so many more deaths overdoses and drug addicts who just had to see a doctor every few months for them to live a almost pain free life. But drug testing patients every time they need a refill wasn't enough now we have to take less or get nothing like some patients who been cut off completely because a MD can't prescribe any pain medication without fear of losing his medical license and that then makes it very hard for both to come to any possible management of the patients pain. So the only option for the patient is live with pain go through the withdrawals of years of opioid use for pain management NOT abuse or to be told to head to the nearest methadone clinic if your state has one. And that is just inhumane and completely irresponsible of the government to let happen. The Dr. Patient relationship and experience an knowledge is more important more useful and more beneficial for the patient and the Dr. Once that is ruined everything has to start all over again and that should never have had to happen to anyone who's living with enough pain without all the extra stress that's been put on us all. Not to mention the way insurance companies took advantage of this and used it to control how much more a prescription will cost or if they would even cover it now because of the stigma that goes along with anyone who takes pain meds. Everyone has their opinions but when it comes to people and how they live or what they may need to do the simplest of things like go to the store to get food and cook. Should not have that option taken away from them by any one. This should be re written and give the Dr. Permission to use his/her own discretion without any reason to worry it may be a issue for them later because they helped a person live with less pain. I understand the one out of a thousand that should not have his license that has prescribed 20 times the amount to every patient under the care of that Dr. But don't stop the chance for people to live with out pain because of the few bad apples. I hope this is truly looked at and understood that the changes that were made are the reason for the rise in suicides, overdoses deaths aswell as fentanyl being sold in counterfeit pills sold as vicodin or percocet etc. becoming the worst thing that hit the streets in America more than half of those are old patients who had nowhere to go because the only help they had for pain was taken from them that's the direct result of a very deadly and wrong choice to make a foolish rule that kept MDs from doing their jobs an putting patients first. Now its license first.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Josh	None	None	0900006484f6c70c	Yuran	None	2022-02-11T17:31:29Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Yuran, Josh	kzi-115d-u2ov	False	None	False	2022-04-12 01:53:59.149	[]
130	CDC-2022-0024-0138	https://api.regulations.gov/v4/comments/CDC-2022-0024-0138	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Now somehow get the message of what the CDC started back in 2016 out to physicians, nurses and pharmacists (not to mention doctors in training) that prescribing opioids was never a bad thing and to not fear prescribing them again, especially to legacy patients.<br/>So many lives were lost, damaged and ruined by the words written, and then misinterpreted by the DEA, that to undo that damage is impossible. But you need to get out a campaign telling the world that excruciating pain does not have to be endured and to stop the persecution of physicians for “high prescribing.” Has it never occurred to you that GP’s dumped their patients on pain specialists? That baby boomers are aging and developing painful conditions which sent them to the doctor’s office? Taking opioids responsibly is what millions were doing for quality of life. Of all the things I had to worry about, being able to control my pain was not one of them until you interfered in the doctor/patient relationship. I have been living with unnecessary painful conditions because of those words and been made to feel as though I had an addiction problem because I sought a source of relief for my pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	I.L.	None	None	0900006484f6c743	Mitchell	None	2022-02-11T17:32:09Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell , I.L.	kzi-1tg7-fy6u	False	None	False	2022-04-12 01:53:59.368	[]
131	CDC-2022-0024-0139	https://api.regulations.gov/v4/comments/CDC-2022-0024-0139	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First, please remove pain exemptions! There are many diseases that cause excruciating pain. No specific disease should be singled out for exemption over others. So unfair and biased.<br/><br/>Secondly, I have debilitating spine degeneration in my lower back. When a doctor sees in your "Checklist" evidence section:<br/><br/>"Insufficient evidence for long-term benefits in low back pain, headache, and fibromyalgia".<br/><br/>What do you think said doctor is likely to do when considering my treatment? These terms are over generalizations and many diseases can result in back pain, headache etc. A person could have muscle tension or a brain tumor. Both cause headache! Remove this bullet point. In fact, remove the entire "Evidence" bullet points section. They are suspiciously shoehorned in, my guess is by psychiatrist recommendation (?) to create an anti opioid bias. So irresponsible!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M	None	None	0900006484f6c778	Robinson	None	2022-02-11T17:37:58Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Robinson, M	kzi-2of6-1vjt	False	None	False	2022-04-12 01:53:59.580	[]
132	CDC-2022-0024-0140	https://api.regulations.gov/v4/comments/CDC-2022-0024-0140	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines still prioritise reduction and tapering of opioids and reduce the recommended numbers - it pays lip service alone to the fact that there are those of us for whom opioids are the best or only remaining option. Of particular concern is the suggestion that long-term use in itself justifies tapering (2543 - the current risk balance will be unknown to any clinician at that point as they are unlikely to have been with the patient through their whole experience with pain...) and that a clinician should push tapering even when a patient is NOT AT RISK (2574-2575). This section really needs to emphasise also that maintaining a dose and maintaining current function are valid goals to have and more space given to the section on continuing opioids in order to give at least the impression of providing guidance and support for doing so. <br/>It's already been shown that the guideline will be weaponised as a rule by many, and saying 'don't do it' now is not going to make anyone undo the rules they have in place or take action to reverse the harm done, especially when it's the same few sentences copy pasted and sprinkled throughout..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c795	Anonymous	None	2022-02-11T17:39:41Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-3a47-y6s8	False	None	False	2022-04-12 01:53:59.803	[]
133	CDC-2022-0024-0141	https://api.regulations.gov/v4/comments/CDC-2022-0024-0141	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a former healthcare worker, RN and a chronic pain patient of 10 years. Prior to multiple spine surgeries, I was an active wife and mother. I enjoyed running and ran half and full marathons. With each surgery my ability to function decreased due to pain. I was fortunate to have a wonderful PM Dr. who treated me over those 10 years. Recently, this Dr left his practice and I had to find a new PM Dr. My new Dr and his clinic have a “rule”, based on CDC guidelines, of not prescribing over 60 MME. I was at 80 MME. I feel fortunate to find a Dr that will prescribe at all in this climate. I’ve spoken to many that will absolutely not prescribe opioids. One Dr actually told me, “there’s no money in prescribing pain meds and it’s not worth the risk”. Being in chronic pain is bad enough but having to deal with all the uncertainty of getting a medication that helps you function/live life is almost unbearable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6d245	Anonymous	None	2022-02-11T17:47:00Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-g8dw-8xvp	False	None	False	2022-04-12 01:54:00.037	[]
134	CDC-2022-0024-0142	https://api.regulations.gov/v4/comments/CDC-2022-0024-0142	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband was cut off cold turkey when a urine test showed positive for morphine! He never ever has had a failed urine test or a pill count that was off in over 8 years. Why not repeat the test?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6d271	Anonymous	None	2022-02-11T17:48:20Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-gmww-mx84	False	None	False	2022-04-12 01:54:00.386	[]
135	CDC-2022-0024-0143	https://api.regulations.gov/v4/comments/CDC-2022-0024-0143	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for this as someone that has tried everything and this is the only thing that helps to some extent. Been on for years and never abused and yet because some have abused this it makes people that really need it feel like criminals or a junkie. It is not perfect but if never abused I'm glad this has come out from the cdc for people with chronic pain to try and lead a somewhat normal life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6cff1	Anonymous	None	2022-02-11T17:49:22Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-hw3t-penf	False	None	False	2022-04-12 01:54:00.597	[]
136	CDC-2022-0024-0144	https://api.regulations.gov/v4/comments/CDC-2022-0024-0144	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm glad to see this review is happening, however, I hope more attention to detail is addressed. For instance, the original 2016 guidelines were intended for PCPs concerning opioid naive patients. This is far from what it transformed into!! No longer, in most states, are PCPs even allowed to prescribed. One must go to a PM clinic or doctor where one is tapered, without consent, and/or pushed to have epidural shots, even with documentation of prior administration has either not helped, or, indeed, harmed. Also, the 2016 guidelines were not supposedly intended for legacy chronic pain patients. The harm that has been done is immeasurable- many suicides, the elderly and patients with diseases who live in pain 24/7 have been irretrievably harmed, not to mention our veterans!! The outstanding issues of authorship is another faux pax that most people don't even know about. The AMA has been up in arms for years about this abuse and neglect of patients. Many studies have proven that there is not a prescription drug problem, but an illicit Fentany problem. Are our government agencies afraid to address the source- being the Mexican cartels, and the flow of ingredients from China?! I find it outrageous that our population, most too ill, weak, and disheartened, have been used as the scapegoat for the country's drug problem!! The DEA has NO place harassing doctors!! After so many lives loss, I don't see redemption for what has been inflicted on our chronic pain population. A doctor/patient relationship used to be one of trust. Now, those doctors who insisted on treating their patients have been incarcerated and/ or forced to shut down their businesses! I wonder if those writing the guidelines have any idea that most CPP's and their doctors can read, even though pertinent information is purposefully hidden within the many pages. We are not ignorant- we are in PAIN!!! I propose that these guideline reverse to what might have been the original idea- PCP's being aware that opioid naive patients should be started on a low dose.<br/>This is, and has been a Human and Disability Rights disaster!! Fix it- Please!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	brian	None	None	0900006484f6d7c4	bine	None	2022-02-11T17:51:20Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from bine, brian	kzi-ocl1-bxkb	False	None	False	2022-04-12 01:54:00.811	[]
137	CDC-2022-0024-0145	https://api.regulations.gov/v4/comments/CDC-2022-0024-0145	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It seems that the proposed updated guidelines will not be of much benefit to patients undergoing significant surgery, such as open heart surgery, significant back or neck surgery.<br/><br/>The surgeons consider this type of pain as "acute" although it likely will exceed one month in duration. The surgeons know this, but are limited to prescribing for acute pain. In my state (Ohio), I was given a 7-day supply of opioids following major heavy-duty back surgery because the pain was 'acute.' Of course the surgeon knew the pain would last longer than 7 days but he stated he could only prescribe 7-day's worth of pain meds. Now imagine someone postop 7 days heavy-duty back surgery going to the pharmacy to get another 7-day supply of opioids.<br/><br/>Perhaps it would be better to separate acute pain into nonsurgical and surgical acute pain. At least the physicians would be able to use their judgment as to how much pain medication to give following heavy-duty painful surgery with a healing time longer than 7 days.<br/><br/>There is another issue of import. Physicians are well versed in whether or not other modalities are likely to alleviate the pain enough for the patient to have a functional life. One should not expect the patient to undergo chiropractic, physical therapy and various other modalities to alleviate pain when those modalities take most of the patient's time. There should be some ratio of modalities to pain relievers in order for the patient to have a life.<br/><br/>Please stop scaring the providers to death. They are really scared to prescribe the appropriate amount and duration of pain medications. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6bdea	Anonymous	None	2022-02-11T17:54:28Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-qoz6-mghf	False	None	False	2022-04-12 01:54:01.027	[]
138	CDC-2022-0024-0146	https://api.regulations.gov/v4/comments/CDC-2022-0024-0146	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer for the last decade who was tapered to zero meds 5 years ago I have very strong opinions on this subject. My daily pain is much worse, as is my quality of life. My only options somedays are not get out of bed, buy street drugs, or kill myself. I refuse to kill myself, and I refuse to buy street drugs, so I just don't get out of bed. Advil and Aleve are NOT substitutes for Opioids. That is a ridiculous suggestion, clearly made by someone who does not suffer from chronic pain.<br/><br/>In my opinion, the CDC and the DEA have completely ruined my life by making it impossible for me to get the meds I need in a safe way. <br/><br/>You should be ashamed of yourselves. How dare you determine what's is best for me without talking to me or considering the living hell that my constant pain makes my life.<br/><br/>SHAME on you for pushing desperate patients to buying street drugs and then overdosing.<br/><br/>Shame on you for allowing the over-perscription of opioids for years and then over correcting so much that you've ruined hundreds of thousands or people's lives.<br/><br/>Shame on you for thinking you know what is best for me and my body.<br/><br/>Shame on you for taking away the medication that helped me the most..<br/><br/>Shame on you.<br/><br/>Someday you'll be in pain and realize how awful you've made peoples lives.<br/><br/>I hope you all end up with chronic pain so you can crawl a mile in my shoes.<br/><br/>SHAME ON YOU ALL!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6b83f	Anonymous	None	2022-02-11T17:57:28Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-r87k-tr5q	False	None	False	2022-04-12 01:54:01.241	[]
139	CDC-2022-0024-0147	https://api.regulations.gov/v4/comments/CDC-2022-0024-0147	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When I was prescribed pain meds I could actually get out of bed and do things. Then y’all decide we don’t need them, so I quit getting them. Stopped taking them without any type of problems as withdrawals or anything. Now without them I can’t take care of my family. Luckily my youngest is 17 so they can all basically take care of themselves. I can not do my normal everyday evening walk around the neighborhood and barely get out of bed due to pain. Therefore I have gained more weight than I was when I was pregnant. I’ve never been a big girl. I miss my walks with friends around the neighborhood, I miss baking with my kids, I miss having bbq’s in the backyard and grilling while enjoying the company of my neighbors. Please think of people like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tabatha	None	None	0900006484f6c7f8	Carter	None	2022-02-11T18:01:44Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Carter, Tabatha	kzi-9pho-lxg1	False	None	False	2022-04-12 01:54:01.482	[]
140	CDC-2022-0024-0148	https://api.regulations.gov/v4/comments/CDC-2022-0024-0148	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's both sad and disgusting what the laws have done to people dealing with chronic pain. Lives have been destroyed. People who could at one time function somewhat normally with the aid of opioids are now stuck living with pain and misery. The current laws are cruel, inhumane and unfair! Change them!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6dc14	Anonymous	None	2022-02-11T18:09:10Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-plou-ek0q	False	None	False	2022-04-12 01:54:01.696	[]
141	CDC-2022-0024-0150	https://api.regulations.gov/v4/comments/CDC-2022-0024-0150	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	finally, you have started to fix the mistake of the 2016 "guidelines", which had horrible effect on the chronic pain patients and cancer patients. leaving them in pain and unnecessary suffering, sadly leaving many to commit suicide to relieve the horrible pain they suffered daily. I really hope this is a turning point and gives the power back to the doctors. nothing should interfere with a doctor patient relationship and care/treatment plan that is decided by BOTH doctor and patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	lisa	None	None	0900006484f6c317	aguilar	None	2022-02-11T18:13:56Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from aguilar , lisa	kzh-tzq2-0ky8	False	None	False	2022-04-12 01:54:01.920	[]
142	CDC-2022-0024-0151	https://api.regulations.gov/v4/comments/CDC-2022-0024-0151	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hopefully this is the right step in getting our quality of life back but I fear damage has been done and physicians will still worry about being sanctioned. You have to treat patients not policy’s as every patient is different. How did they expect 90 MME to receive a 400 Lb patient? My hope is they take the next step an assure the physicians they won’t be sanctioned for prescribing. My quality of life declined by 70 per scent when I was lowered to the 90MME. I have been on opiate therapy for 18 years so through the years my dose of course had to be increased to get the same level of relief I got when I first started therapy. Now I’ve been on the same dose for the last 8 years, never needing an increase because it’s the dose my body can function and be productive in society at however every month it’s a fear “is this the month their gonna lower me or cut me off” I get so full of anxiety every month right before my appointment and I shouldn’t have to live this way, I didn’t ask for a disease that keeps me in constant pain, I did not ask for this !! Please find a way to assure physicians it’s okay to prescribe accordingly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JEANNE	None	None	0900006484f6c85b	PETERSON	None	2022-02-11T18:17:20Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from PETERSON, JEANNE	kzi-c8a3-a42o	False	None	False	2022-04-12 01:54:02.137	[]
143	CDC-2022-0024-0152	https://api.regulations.gov/v4/comments/CDC-2022-0024-0152	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the guidelines were implemented it has been difficult to say the least on chronic pain patients to maintain adequate treatment. Most CPPs have not had any adequate treatment for years. Thousands have died in pain due to the adverse effects of the 2016 guidelines. This serves as a good start in directing physicians and law makers in an appropriate direction to treat pain fairly and adequately. As a CPP my life was severely hindered by the reaction to the original guidelines, and maybe now it won't be.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6dc83	Anonymous	None	2022-02-11T18:20:06Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-pyjm-a7hq	False	None	False	2022-04-12 01:54:02.349	[]
144	CDC-2022-0024-0153	https://api.regulations.gov/v4/comments/CDC-2022-0024-0153	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife is a chronic pain patient she was percribed opoids and took them for over 18 years with no ill effect<br/>She was not addicted to them nor did she get any euphoric feeling from them.<br/>A year and a half ago her dr retired and her new dr cut her off of all the meds that were helping her.<br/>The drs are now so paranoid of gov action that they are letting patients suffer needlessly. <br/>My wife is now bedridden and unable to do anything for herself and is literally down to 85 pounds <br/>She is only 49 years old<br/>The government needs to lay off the drs and go after the real problem street drugs that are killing people	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6b84b	Anonymous	None	2022-02-11T18:28:59Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-r9r6-w7bc	False	None	False	2022-04-12 01:54:02.559	[]
145	CDC-2022-0024-0154	https://api.regulations.gov/v4/comments/CDC-2022-0024-0154	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Chronic pain paitent, undertreated I have been a Chronic Pain Paitent since 1995, I have not been to pm since 2014 for fear of being violated and traumatized even more. My doctor forced tapered me. I told him for 6 months something was wrong. No Testing Done, He refused to give me doctors notes for work, told me to suck it up. I lost my job May 2014, I was still under his care he continued to be little me an treated me inhumanely I cannot stress this enough the barbaric treatment I received. My Rights Were Violated. July 2014 I had a heart attack. I then fired him, then in September 2014 I attempted suicide. I'm disabled an have no quality of life. I fear going to doctors. I cannot keep living this way. We have had are rights violated and we have been traumatized by the so called medical institutions that are supposed to help us. I think the civil liberties union should be involved. The CDC guidelines and the DEA locking up doctors is doing further damage to all of us chronic pain paitents. The regulations need to change before more damage is done . We can't hang on much longer. untreated chronic pain paitent at the end of the line.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronda	None	None	0900006484f6c807	Williams	None	2022-02-11T18:34:32Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Ronda	kzi-aag0-cybs	False	None	False	2022-04-12 01:54:02.776	[]
146	CDC-2022-0024-0155	https://api.regulations.gov/v4/comments/CDC-2022-0024-0155	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a CPP since January 2008, which is also when I had my first spine fusion at L5-S1. I didn’t fuse so it had to be redone in September 2008. I did fuse, however, my pain didn’t resolve and actually got worse. I was able to control the pain and have a semi normal life with 45mgs of ER Morphine twice a day & 15mgs of IR morphine every 4-6 hours. In mid 2015 that dosage wasn’t giving me the relief it had for the previous 7 years so I had another of many MRI’s to follow. It showed that there was no disc space at L4 so I have a revision fusion in August of that same year. Sadly, that fusion failed and high dose opioids still left me at a pain level of 7 90% of the time. I then had another of many CT’s that showed I didn’t fuse, so my surgeon removed all of the hardware and redid the fusion at L4-S1. My medication regimen was switched to 30mgs of ER Morphine every 8 hours and 15mgs of Oxycodone every 6 hours which again allowed me to live a semi normal life and kept my pain levels at a 4 90% of the time. In early 2019 I started having severe pain in my mid/upper back so again had to have another MRI and CT. Both showed that I had no disc space at levels T10-L1. I had every injection pain management offers with no relief so my surgeon fused me from T10-L1 in January 2020. My pain was actually worse and an MRI and CT showed that the screws at level L1 were backing out and that I wasn’t fusing. Because of the 2016 guidelines on opioid prescribing I have put off having that fusion redone. I now live with severe chronic pain and permanent neuropathy in my left leg. I am only 52, but feel like I am 92. I also have too many diagnoses to list. Although these “guidelines” were meant for PCP’s and acute pain, my pain management doctor, who I adore, is terrified of raising my opioid dosage above the 90 MME recommendation so my daily regimen is now 15mgs of ER Morphine every 8 hours and 7.5mgs of Oxycodone every 6 hours. I can no longer live a normal life and stay bedridden 80% of the time. The only time I leave my house is for my monthly pain management appointment and important family events. I can no longer cook meals, clean my house, or perform normal daily activities. I want my life back! I want my old daily regimen/dosage of opioids back. I have never abused my medication or taken more than prescribed. The “opioid crisis” was not caused by me or any other CPP that I know, yet we have been punished because of people overdosing on illicit fentanyl, and your inhumane guidelines. Also, I consider myself one of the lucky CPP’s because my doctor still prescribes opioids, however, he is restrained by your 90 MME dosage cut off. This has to stop! You have to let doctors treat chronic pain without restraints and fear of being shut down. Like I said, I am only 52 years old. I have two adult children who will eventually give me the gift of being a grandmother. I want to be the grandmother that my grandmother was able to be. I want to be the wife to my husband that I was prior to 2008. My husband will be able to retire in a few years and I want to enjoy that with him. I can’t and won’t be able to do any of these things if you don’t loosen the chokehold you have on doctors who treat chronic pain. Again, THIS INHUMANE TREATMENT OF CHRONIC PAIN PATIENTS HAS TO END!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Schree	None	None	0900006484f6e3cf	Rusevlyan	None	2022-02-11T18:41:22Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Rusevlyan, Schree	kzi-r360-ec4m	False	None	False	2022-04-12 01:54:03.007	[]
147	CDC-2022-0024-0156	https://api.regulations.gov/v4/comments/CDC-2022-0024-0156	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's about time! Although I feel the government has no business regulating what we put in our bodies, the tight restrictions have made things extremely difficult for those of us who depend on pain medication to function at least somewhat normally from day to day. We shouldn't be punished for the actions of others.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484f6e3a1	Burdett	None	2022-02-11T18:42:08Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Burdett, Eric	kzi-r1k7-rcbo	False	None	False	2022-04-12 01:54:03.247	[]
148	CDC-2022-0024-0157	https://api.regulations.gov/v4/comments/CDC-2022-0024-0157	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think that relaxing the guidelines is a must and sooner than later. So many people I hear are committing suicide for lack of pain medication. They are forced to go out to the streets to seek pain relief and they are getting medication pills that are laced. This is just so crazy that people have to live like this. I myself have had three major spine surgeries within the last three years. I suffer at home daily and live on an ice machine. The relaxed guidelines looks fair. Please don’t leave chronic pain patients suffering like this. This is inhumane and scary. I am going through torturous injections and having nerves burned. Sadly the only thing that helps is opioids. I have tried all of the others that did nothing at all. I have gone to many Pain clinics in my state where they told me they don’t prescribe. I still have hope that this is going to get better and I won’t need to be on anything but right now it’s pretty bad. <br/>When people go to the emergency room you’re treated like a drug addict or drug seeker even if they see that your blood pressure is sky high and you’re in agony. They still will not treat you for pain. It has gotten very bad.<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6e385	Anonymous	None	2022-02-11T18:42:28Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-r0c5-mftc	False	None	False	2022-04-12 01:54:03.461	[]
149	CDC-2022-0024-0158	https://api.regulations.gov/v4/comments/CDC-2022-0024-0158	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 10 year chronic pain patient with 7 vertebral fractures and Both Humerus and femur compound fractures and repair, it’s refreshing to see these absurd 90mme limit “recommendations” being taken off the table and placed back in the hands of Physicians.<br/>While I don’t require higher than that, many CPPs do. Every patient has a different physiology, absorption, tolerance, and daily pain levels that need to be treated on an Individual basis by their Dr. who can feel free with his/her expertise and specialized knowledge of each of their individual patients without fear of govt oversight interpretation.<br/>Would love to see some formal CDC statement with new recommendations pointed directly at practitioners so that they know it’s ok once again to “treat” their pain patients as they would treat their own mother or spouse in post opp or long term chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484f6e235	Miles	None	2022-02-11T18:42:46Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Miles, Chris	kzi-qvhh-x9ku	False	None	False	2022-04-12 01:54:03.696	[]
150	CDC-2022-0024-0159	https://api.regulations.gov/v4/comments/CDC-2022-0024-0159	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As stated by many professionals I too appreciate the more compassionate tone of these revised guidelines. My wife and myself have been suffering with chronic pain caused by two different failed back/spine surgeries. Her surgeon nicked the dura of the spinal cord and this was not recognized and diagnosed for 7 weeks. At that time a second surgery was needed to repair the nicked spinal cord cover. However by that time the scare tissue had already developed into Adhesive Arachnoiditis, an incurable condition. She is currently on an intrathecal pain pump and is dosing at 1mg per day. In addition her pain provider is trying to get an optimal dose of Fentanyl patches in order to get away from quick acting oral meds.<br/>During the same period in 2017 the same surgeon did some spinal fusion work on me at l1 to l5. However during this surgery he drove one of thoses 2 inch screws into a nerve root. After many examinations and imaging and other tests to diagnose the problem a second surgery was required to remove the screw. However like my wife the damage was already done. <br/>We both suffer with chronic pain daily, my primary care provider is managing my pain with 600 mg Tylenol, 500mg daily of Pregagalin and Percocet 10/325 4 tablets daily, however after 3 years of prescribing Percocet 10/325 he now for some reason wants to decease the dose. I'm 74 years old and if I become addicted to opioids as my age what does it matter. I would rather be addicted than suffer daily with the neuropathic pain I now have in both legs and feet.<br/>I know 100,000 people died last year from opioid overdoses, and it's a tragedy. But don't make your CPGs for Opioids cause either my wife's or my physician to prescribe less just to meet guidelines put in place by the management of their practices which are directly modeled after your recommendations of 2016. I'm off the belief that a majority of the opioid deaths were related to illicit and illegal street drugs, not those prescribed by the nations primary care or pain management providers.<br/>I've been in the healthcare industry for 40 years and watched the guidelines move from compassionate to policing and back again more times than I can count. Leave room in your guidelines for compassionate opioid care for those with chronic pain so they may enjoy at least some of the life they have left and this shouldn't just apply to terminal cancer patients. Like I said if my wife and I die addicted to some Opioid at age 79 who cares, at least we were able to partially enjoy the years we had and were not left disabled because of uncontrolled pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f6e1e7	Hendry	None	2022-02-11T18:43:41Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Hendry, Michael	kzi-qv1f-isau	False	None	False	2022-04-12 01:54:03.910	[]
151	CDC-2022-0024-0160	https://api.regulations.gov/v4/comments/CDC-2022-0024-0160	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had 17 craniotomies, three skin grafts, and when my surgery site wouldn't close they removed a muscle from my leg and back to cover the wound. I have been in pain for 11 years now, without noticeable relief. Doctors have given me nerve medicine, but nothing for pain. Over the counter meds do not work for my everyday headaches, and burning leg scar. I might never be pain free, but I would like to lead a normal life where I can clean the house, go shopping, etc... without having to limit myself, or my movements. Opioid overdoses are usually not the people who have real need, have medical proof, and those who follow their prescriptions exactly. Please let doctors be less nervous about prescribing, and give relief to all those who have chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather	None	None	0900006484f6d7b2	M Davis	None	2022-02-11T18:44:00Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from M Davis, Heather	kzi-oan8-me1a	False	None	False	2022-04-12 01:54:04.131	[]
152	CDC-2022-0024-0161	https://api.regulations.gov/v4/comments/CDC-2022-0024-0161	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was excited to read several weeks ago that you all work looking at revising the 2016 GUIDELINES. The revision does not go far enough. When doctors and states that implemented the GUIDELINES as REGULATIONS, that is when this whole thing went wrong. A GUIDELINE is not a REGULATION! You have stated doctors and states do not have to make any changes; therefore nothing will change. Chronic pain patients, such as my husband, will continue to be under medicated because doctors fear the DEA coming in and doing an investigation. At one point my husbands meds were so cut back that he attempted to take his own life. How sad that we as a nation have the ability to give someone good quality of life but refuse to allow that. You know have added the language of 50 MME; heaven help us. The 50 MME will become the new normal and doctors will be cutting patients medications back once age to get them in line with the 50 MME. When will you all realize each persons body reacts to pain differently, metabolizes medications differently. Please let the doctors be the doctors without fear of losing their license or having the DEA raid their office. Like I said at the beginning, I was glad to read this was going to be revised, but I fear you have just once again added to the problem.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6d73e	Anonymous	None	2022-02-11T18:44:42Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-nj9n-9hbw	False	None	False	2022-04-12 01:54:04.341	[]
153	CDC-2022-0024-0162	https://api.regulations.gov/v4/comments/CDC-2022-0024-0162	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a 55 year old totally disabled marine veteran with chronic pain in my back and legs since 1993. 5 years ago I was kicked off my pain medication indiscriminately in response to the alleged opiate crisis. The government killed many people I know, including family, with this policy. Myself, I am left with 5 new health problems directly related to my pain medication being shut off. It is a miracle I am still here to tell of it. I think the CDC has outlived its usefulness if this is the kind of policy they choose for the American people. And the government wonders why folks choose not to trust in government? Do Better!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Don	None	None	0900006484f6d6ee	Reitmeyer	None	2022-02-11T18:45:03Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Reitmeyer, Don	kzi-n004-jw23	False	None	False	2022-04-12 01:54:04.555	[]
154	CDC-2022-0024-0163	https://api.regulations.gov/v4/comments/CDC-2022-0024-0163	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Several years ago, I took opioids continuously for pain management due to a rare form of breast cancer that was very painful. Then I had healing troubles after surgery and remained on these pain meds for more than 3 months. When I was finally out of pain, I was overjoyed and had absolutely no desire to continue taking taking them<br/>. <br/>A few months ago, I finally had reconstruction surgery. After a couple of nights in the hospital with IV and opioid pain meds, I was sent home with a 3 day supply of hydrocodone. Luckily I still had some leftovers from years previous, and got the surgeon's NP to call in another 3 day supply, but I had to ration this because it definitely was not enough. After a miserable 4 weeks, I was finally at a point where I did not need them, but it is ridiculous that I had to suffer when pain medication was readily available.<br/><br/>While I know (or at least know of) people who abuse opioids, these are all people who have serious addictions to other drugs as well. The opioids are just an addition to the many things they abuse. And they take significantly higher doses than a normal therapeutic dose that is normally prescribed. I do not know a single person who got addicted from taking a typical dose of these meds after a surgery or trauma. Quite the opposite--it's a happy day when pain subsides and meds are no longer necessary.<br/><br/>My nurse friend, who worked many years in the ER for several hospitals, knows the drug problem well. When I was taking opioids long term, she went with me to ask the oncologist to prescribe the extended release meds as well as the regular for breakthrough pain. For the immediate release, she requested the type without Tylenol. According to her, the druggies don't want either of these because they can't get high as easily from them and she believes they are less addictive. All I know is that they worked well for me and I was nothing even similar to addicted after 3 months of using them 24/7. If she is right, it seems a fairly simple solution to the addiction problem. Maybe some studies of historical data could determine if she is correct? <br/><br/>I had to have the scripts filled at the cancer hospital because my local CVS and Walgreens don't stock them. I assume this is because they are rarely prescribed, which makes me wonder why that is the case. After all, it seems it should be the other way around as someone could take Tylenol in addition if needed. So why automatically include it? It makes me think it was part of the marketing plan. So was it just a happy accident or did the manufacturers know the addition of Tylenol made them more addictive?<br/><br/>In one of my cancer support groups, it is often noted that we should not ask for pain meds by name because we will be labelled as drug seekers. This is a crazy mixed-up world where even cancer patients have to worry about this in addition to the pain and other burdens of the disease.<br/><br/>So I am very pleased that CDC is revising the guidelines so that cancer patients and others in pain will not have to suffer as much. And hopefully the labels will end eventually--although that damage will be hard to reverse. It is the bad behavior of a minority of patients that messed this up for the rest of Americans. We need access to good pain meds without being treated as though we are an addict just for asking.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	NANCY	None	None	0900006484f6d6e5	COPE	None	2022-02-11T18:46:09Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from COPE, NANCY	kzi-my3k-yby7	False	None	False	2022-04-12 01:54:04.767	[]
155	CDC-2022-0024-0164	https://api.regulations.gov/v4/comments/CDC-2022-0024-0164	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I fell ill during my first year of college. The next 4-years were spent merely searching for an answer while my life completely fell apart from chronic pain. At age 22, my doctors were considering implanting an intrathecal morphine pump. Having opted to not go that route at such a young age, the daunting task of finding the right pain medication began. I have been a chronic pain patient since the beginning of what's considered the 'opioid epidemic' back in the late 90's. Many of the first pain medications I was on are no longer considered safe. Many other pain meds at that time weren't meant to be taken long term. For several years I was prescribed fentanyl and dilaudid. And while they worked to control the pain, there was no quality of life, as I slept days of my life away in a stretch. When I finally asked to be taken off of both meds, I was swapped to methadone. Holy cow, the social stigma attached to telling people you were prescribed methadone was astounding. Everyone assumed I was a recovering heroin user. And while the methadone worked in the beginning, it eventually became abundantly clear that I was allergic and it was causing me far more harm than good. So again I was swapped, this time to oxycontin. Finally I had found a medication that worked. In addition to my implanted neuromodulation device, I was prescribed 165mg of oxycodone per day to help control my pain. And for a couple of years I had some measure of a life again. I was even considering finding a job for the first time in over 20-years. Then came the CDC guidelines that changed everything for chronic pain sufferers. Almost overnight I was forced by new hospital policies into a forced taper. And once more my life was sent into disarray. For me, one of the hardest parts of dealing with prescribing guidelines over these past two decades is that there is never any stability for the patient. No sooner than we get into a regiment, the rules are changed and we're again trying to adjust to a new normal, possibly on new medications. And the stigma around oxycodone is so bad now. Being a chronic pain patient is difficult enough. Remove the limits and let our doctors be doctors. Don't treat us like we're the problem, though I fear that the doctrine being taught in medical schools with regard to opioid use is a damage that can't easily be undone. It's reached a point here in my state that simply finding a pain doctor is a tedious task.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484f6ccf0	Vance	None	2022-02-11T18:46:32Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Vance, Daniel	kzi-5q9q-2hzx	False	None	False	2022-04-12 01:54:04.984	[]
156	CDC-2022-0024-0165	https://api.regulations.gov/v4/comments/CDC-2022-0024-0165	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am one of the many intractable pain patients who's life has been annihilated by the 2016 CDC guidelines. I was grateful to be chosen to speak with the OWG via Zoom in 2020, I felt that they listened and had compassion. I was also present on the Zoom meeting this past July 2021. While grateful changes in the guidelines are being worked on, I am still bedridden in pain much of the time and the only reason I have not taken my life is because of my son and husband, and because I'm hoping to get the pain management back that I was doing so well with in 2015. My PCP did a better job than a pain specialist I was forced to go to after the guidelines were published. In 2015 I was on well above 120 MME, but I was functional, alert and not "doped up", sedated or a proverbial "zombie." My pain specialist abandoned me after multiple expensive ineffective procedures and told me "you can say you're an addict and go to a methadone clinic." When I responded ,"no, because you know I'm not an addict and I don't want that on my medical records" he replied "just joking." I was abandoned as a patient and my PCP took back over. My PCP has tried to refer me to other specialists, they're all scared. My PCP is scared to treat my pain adequately until he feels assured he won't be persecuted. To that end, I feel the CDC needs to participate in undoing the regulations and defacto laws in each state that were instituted due to the guidelines. My doctor is still afraid of the state medical board and DEA. My health records support my need for opioids and the fact that I've tried every non opioid venue possible to no avail. I would like what semblance of life I had in 2015 back. I've never abused RXs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Misty	None	None	0900006484f6c7d3	Hoffman	None	2022-02-11T18:51:29Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Hoffman, Misty	kzi-8hhg-kjuy	False	None	False	2022-04-12 01:54:05.201	[]
157	CDC-2022-0024-0166	https://api.regulations.gov/v4/comments/CDC-2022-0024-0166	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have dealt with chronic back pain, chronic sciatic nerve pain and chronic neck pain for over 10 years now. I've went through the recommended shots in the neck and back, physical therapy, acupuncture, and non opiod prescriptions with no relief. Now I will be going through breast reduction surgery and a possible tens unit surgically implanted, all suggested by my PCP. So I've went through all of this or am going to in the near future just to see if it will help with my chronic pain. And because no one of the three pain management specialists will not prescribe any opiod containing drugs including my PCP. I know there are for worse people walking around with pain but who has the right to put a number on anyones pain level? One Dr. asked me to tell him truefully if there was anything that actually helped me and I said yes. It was when I had took a bad fall and injured my shoulder and was put on Oxycodone. I could finally be pain free everywhere. I have a had time doing the things that I love to do like sew on my sewing machine, clean house, work in the garden, and just doing random crafting projects. But when I was taking opiods for that short time I didnt have much trouble at all doing those things. I was told once that there is not hope of being on opiods unless youre dying. So I hope the law changes, not just for me but for many.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Trina	None	None	0900006484f6c828	Knouse	None	2022-02-11T18:52:41Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Knouse, Trina	kzi-b6rt-orla	False	None	False	2022-04-12 01:54:05.414	[]
158	CDC-2022-0024-0167	https://api.regulations.gov/v4/comments/CDC-2022-0024-0167	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	That the revised Guideline draft is rife with recommendations for non-opioid therapy is, in and by itself, a positive. However, the authors neglect to explain how insurers' will be convinced to pay for non-opioid options, which make the recommendations moot. As a pain clinician and researcher, I'm quite aware of the brilliant benefits of multimodal approaches, and certainly advocate for their use. Compounding the issue is that regulatory agencies will pay no attention to the new Guideline, choosing to cite the original 2016 document (generally out of context) in developing their progressively more draconian anti-opioid policies. It's nice to see CDC acknowledge the shortcomings of their original Guideline; however, they fail to do anything to reverse the havoc that they have wreaked, and pain patient suffering will needlessly continue. We didn't need a new opioid prescribing Guideline; we need a new PAIN CARE Guideline, looking at individualized care including opioids (when necessary) but reaching farther than that.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f6d035	Schatman	None	2022-02-11T18:56:03Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Schatman, Michael	kzi-ihjc-qdd9	False	None	False	2022-04-12 01:54:05.623	[]
159	CDC-2022-0024-0168	https://api.regulations.gov/v4/comments/CDC-2022-0024-0168	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was under pain management for 5 years when the attempts at limiting opioids started. I live in Florida where it was a huge issue. When the restrictions we're not happening as quickly as some wanted our pharmacists were threatened with loss of their license and jail. That created an immediate situation where even if you had a licensed pain physician you often could not fill your prescription. One pharmacist did not allow the DEA or police to scare him so they attacked his business and arrested a patient in the parking lot and charged him. This attack has lead to more deaths now than at the height of what is referred to as the opioid epidemic. I agree with restrictions on people who have never been in pain management but for all the people that already were taking away the ability to get medicine we had been on for years was not the answer. Trying to live with chronic pain gives very low quality of life. Science proved significant brain changes after long periods on medication like that. It should have been obvious that people would turn to street drugs and isn't that a bigger problem. No one wanted to chose that but when you can't do basic daily functions like bathing, dressing or even going to the bathroom on your own and you know there is something that changes that you don't feel you have much choice. Depression and anxiety are a constant factor. Please listen to people that have lived it. Your facts show what the new restrictions have done. Educate providers but also listening to patients is just as important.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f6d258	Fogle	None	2022-02-11T19:25:31Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Fogle, Amy	kzi-gcss-zotd	False	None	False	2022-04-12 01:54:05.840	[]
160	CDC-2022-0024-0170	https://api.regulations.gov/v4/comments/CDC-2022-0024-0170	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>My previous dr of 4 years left Kaiser and i had to chose a new dr. I have gone through 3 drs and they are all too scared to continue to prescribe me the pain medication. <br/><br/>I broke my leg in 2004 and it got infected with osteomyelitis. It took 16 months to heal. I have been told many times that im lucky to still have a leg. I was relatively pain free until 2015 when the pain came back. It was so bad i was in bed 23 hours a day. I got realy depressed and wanted to die. <br/><br/>I started taking a low does of hydrocodone and i was able to get out of bed and be productive. I have tried every non narcotic pain med as well as physical therapy chiropractic acupuncture nothing works like opioids. unfortunately my dr left kaiser so i had to chose a new dr. I have been through 3 drs and they are all to scared to continue to prescribe me pain medication. Next month i will be forced to taper off of the pain medication. For no reason. I didnt break any rules in the contract. I have used the medicine safely for years withouth increasing the dose. The drs a just scared. They dont say i shouldnt take it. They say they will lose there medical license and cant risk it. I feal like im being attracted for somthing i didnt say or do.<br/><br/> After im cut off i will have no pain relief and will not be able function. Unfortunately if im not able to obtain the meds from a dr i will have to use other unsafe exspinsive street drugs or alcohol to numb the pain. I dont want to do that. I will not live with this much pain. I would rather die<br/><br/>Please lay off the drs and let them do there job	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Winston	None	None	0900006484f6c74e	Bellant	None	2022-02-11T19:28:11Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Bellant , Winston	kzi-1zok-bupl	False	None	False	2022-04-12 01:54:06.124	[]
161	CDC-2022-0024-0171	https://api.regulations.gov/v4/comments/CDC-2022-0024-0171	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered nearly 60 yrs. now I am not getting much for pain because of age I guess. I know I am not living I am just existing. Only go for medical appointments. Pain level not low enough to go any where anymore. CDC has left us out to dry!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f6c9ed	McCutcheon	None	2022-02-11T19:30:03Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from McCutcheon, Linda	kzh-xk4f-nmfr	False	None	False	2022-04-12 01:54:06.340	[]
162	CDC-2022-0024-0173	https://api.regulations.gov/v4/comments/CDC-2022-0024-0173	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thanks to to old guidelines, I have no quality of life. My family has suffered! I can not be the mother I need to be because of the opioid crisis. No doctor where I live in Pa will precise anything at all to help my numerous conditions. I will definitely have a shorter life if these guidelines don’t change to help chronic pain patients. I will eventually have a heart attack from all of the pain. I have black out because of the intensity of the pain I am in and doctors do not care because of these selfish laws	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6ebc4	Anonymous	None	2022-02-11T19:39:03Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-smhc-6opa	False	None	False	2022-04-12 01:54:06.556	[]
163	CDC-2022-0024-0169	https://api.regulations.gov/v4/comments/CDC-2022-0024-0169	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6d270	None	None	2022-02-11T20:32:39Z	None	None	0	None	2022-02-11T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from Brescia , Kelley	None	True	None	False	2022-04-12 01:54:06.773	[]
164	CDC-2022-0024-0174	https://api.regulations.gov/v4/comments/CDC-2022-0024-0174	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024 <br/>As a person myself who suffers daily from chronic pain due to scoliosis, it's just a matter of how bad it is today versus if have pain at all. <br/><br/>In my case I have been told by my neurologist and scoliosis Specialist it will only get worse as I age. <br/><br/>I agree and believe there has been a huge overreach and chronic pain sufferers like me have paid an awful price. <br/><br/>Fentanyl isn't a real “opioid” and unfortunately is being included in the death count under real opioids. <br/><br/>People who die of fentanyl should be classified as poisoning not overdose in my opinion. <br/><br/>I also think people addicted to heroine and overdose should also be counted as a separate category. Chronic pain are all drug addicts. <br/><br/>Please eliminate the road blocks that stand in the way from chronic pain sufferers being allowed this Irreplaceable treatment option. <br/><br/>It allows me to live a life worth living. <br/><br/>This should be a decision between doctors and their patients. <br/><br/>Respectfully,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelley	None	None	0900006484f6d28e	Brescia	None	2022-02-11T21:09:07Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Brescia , Kelley	84f6d28e	False	None	False	2022-04-12 01:54:06.984	[]
165	CDC-2022-0024-0118	https://api.regulations.gov/v4/comments/CDC-2022-0024-0118	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6d5ee	None	None	2022-02-11T21:15:06Z	None	None	0	None	2022-02-11T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from hillman, frank	None	True	None	False	2022-04-12 01:54:07.200	[]
166	CDC-2022-0024-0175	https://api.regulations.gov/v4/comments/CDC-2022-0024-0175	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is ... and have been practicing pain management in Oregon since 2007. <br/>My comments on the proposal are listed below:<br/>Emphasizing non-opioid therapies are not only the right therapies but the most curative and restorative. They should be the gate-keeper to opioids as they regularly stop the need for opioids. I am first to agree that access to non-medication treatments have many barriers, but this does not mean aggressive opioids are the answer. After acute injury, use of low dose opioids should be allowed, but then tapered within a few months. After that much time, the opioids typically lose efficacy quickly and lead to increased demand for higher, more dangerous doses and rarely leads to improved long term recovery of function.<br/>Misapplication of 2016 guidelines – The CDC’s recommendations were acted upon by industry and some clinicians too abruptly, but the outcomes of slow, considerate opioid tapers have improved long term pain management while improving safety as well. Without strong guidance, I strongly believe we will slide back to dangerous, ineffective treatment with aggressive opioid therapies. As to concerns about poor patient-caregiver relations due to these changes, those clinicians should evaluate what kind of relationship they had with those patients as improving patient health and safety should always be the goal. I enjoy long term positive relationships with my patients and that includes treating them as I would a friend or loved-one. I would never recommend to a family member they should use aggressive opioids.<br/>Comment regarding Urine testing - Toxicology testing is a major tool in the management of opioid use in our patients. They have improved the safety of my patients countless times, as reporting their medication and alcohol use is usually terrible. I am aware the cost of testing can be high, although it is much lower lately, it frequently pales in comparison to drug costs and should not be used as reason to avoid testing.<br/>Recommendation #5 regarding collaboration of clinicians and patients on how to manage high opioid doses- We should be always be caring for the whole patient. As such, rapid opioid tapers are rarely a good idea as they can lead to disruption of life and mood and lead to death. That said, many patients are unable to understand how opioids are causing them harm and need to slowly reduce their doses. Thus, clinicians still need to mandate change to promote best outcomes for the patient. <br/>Something that should definitely be added to the CDC recommendations is the use of Buprenorphine for pain as this regularly solves the problem of balancing the need for opioid therapy versus safety.<br/>Overall, the gentle pursuit of lower opioid doses does produce better outcomes for patients in regards to pain, function, mood and safety. Please do not make your new recommendations to weak as to endorse returning to more dangerous use of opioids.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	frank	None	None	0900006484f6d28f	hillman	None	2022-02-11T21:17:43Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from hillman, frank	84f6d28f	False	None	False	2022-04-12 01:54:07.409	[]
167	CDC-2022-0024-0123	https://api.regulations.gov/v4/comments/CDC-2022-0024-0123	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6d08c	None	None	2022-02-11T21:18:53Z	None	None	0	None	2022-02-11T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from Reilly, Laura	None	True	None	False	2022-04-12 01:54:07.632	[]
168	CDC-2022-0024-0176	https://api.regulations.gov/v4/comments/CDC-2022-0024-0176	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe if Doctors could Treat me correctly, I could have some Quality of life. This is the glimmer of light I needed. 8 months ago, when i was taken off my 2nd Pain Med that WORKED, I found myself back where I started. In pain, on Bed 20 hours a day on lacerating pain and not eating. I weigh 110 pounds and pain makes me sick and unable to consume anything. I have Takayasu Arteritis , Fibromyalsia, sciatic neuropathy, 3 bulging discs, osteoarthritis and degrading discs up into my neck. The pain meds helped me make a dinner and eat it. Walk my dog is is very active. I was walking anywhere from 3 to 7 miles a day. Now I do a quarter mile if that. Do my shopping. Get up for appointments, clean my house.... Now I feel useless. Before taking away my medication, I contemplated going back to work. Part time to start, but that is impossible right now. I have 2 adult sons living at home with me, one with a Severe Mental Illness, but its under control and one who just recently got hit by a Car walking to get coffee for his next shift. My hands are full , yet they are not getting lighter without the Life Saving, Life Giving meds I had that where taken away from me. I didmt dare go to a Hospital ER. No need to be labeled "Drug Seeking" when I would have been " Pain Relief" Seeking. I participated in Nerve Ablation after many Epidermals, only to Have New Nerve Damage in tje Better Leg causing much more discomfort. I hope you are going to PUSH these Doctors to follow the new updated guideliness. Tell States there is No Opioid Epidemic, there is a Fentynal Epidemic. Please Stop Punishing Chronic Pain Patients. My name Is ... and I am a Legacy Pain Patient. Correct Use, Doesnt Equal Abuse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484f6d290	Reilly	None	2022-02-11T21:20:33Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Reilly, Laura	84f6d290	False	None	False	2022-04-12 01:54:07.842	[]
169	CDC-2022-0024-0172	https://api.regulations.gov/v4/comments/CDC-2022-0024-0172	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6d587	None	None	2022-02-11T21:21:21Z	None	None	0	None	2022-02-11T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from Gilbert-Theriot, Katherine	None	True	None	False	2022-04-12 01:54:08.062	[]
170	CDC-2022-0024-0177	https://api.regulations.gov/v4/comments/CDC-2022-0024-0177	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024:<br/>The rule limiting opiod use for patients with documented pain issues -- particularly chronic -- must be revised. Case in point: My husband has a neuromuscular condition that causes great pain, for which he did have a pain killer. Unfortunately, in the past 8 months, the pain ratcheted up to a level where, having taken the painkiller (Norco), he would try to transition from the bed to the wheelchair - and pass out from the pain. Clearly, something had to be done. While working with doctors to try to find a remedy, I asked for a stronger pain killer. Two solid weeks, countless telephone calls between patient advocate, two doctors (neither of whom disagreed with the need), insurance company and my employers' advocate finally overcame the denial for Nalocet 2.5 mg for what medical documentation called an "urgent" need to try to restore some level of quality of life. Injections were then scheduled to calm the nerves in lower half of the body, and four months later, he has just returned home from spinal surgery to relieve nerves being "squished" in two places in the lower spine -- on the left side ONLY -- and a prescription for Percocet 7.5 mg (which we did not request) without a question by anyone; we learned about it after returning home through a telephone call from our pharmacy. We'll have to return to the surgeon to potentially address the right side, which is causing quite a bit of pain and lack of mobility. Now, four days out from surgery, we fully expect to be able to dial back the Percocet use within a few days. Treating patients with known medical conditions should not be so difficult; if those who write the regulations would be in similar positions for themselves or be the caregiver, perspective would be quite different.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484f6fb8e	Gilbert-Theriot	None	2022-02-11T21:27:43Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Gilbert-Theriot, Katherine	84f6fb8e	False	None	False	2022-04-12 01:54:08.281	[]
171	CDC-2022-0024-0149	https://api.regulations.gov/v4/comments/CDC-2022-0024-0149	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6d7ed	None	None	2022-02-11T21:29:58Z	None	None	0	None	2022-02-11T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from Berthiaume, Deborah	None	True	None	False	2022-04-12 01:54:08.501	[]
172	CDC-2022-0024-0178	https://api.regulations.gov/v4/comments/CDC-2022-0024-0178	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE CHANGE YOUR RULINGS!!!! I am a chronic pain patient who also suffers from c-PTSD.<br/>I was forced off my benzodiazapines because I take pain meds.<br/>I had a seizure (luckily pulled the car over in time), and daily panic attackS. I spent my Christmas holiday on the suicide line 24th and the 25th. I was in the ER 3 times in Dec. for panic attacks my blood pressure SKYROCKETED, migraines have been uncontrolled.<br/>Please, for the love of everything sacred. Don't make our hard lives even more unbearable!!<br/>Do you even realize how many of us live under the poverty line on disability??<br/>We CAN'T AFFORD alternative treatments!! I cannot function without Both my benzodiazepines And my pain meds.<br/>Please. I have no quality of life without both.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f6fb8f	Berthiaume	None	2022-02-11T21:31:38Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Berthiaume, Deborah	84f6fb8f	False	None	False	2022-04-12 01:54:08.711	[]
173	CDC-2022-0024-0179	https://api.regulations.gov/v4/comments/CDC-2022-0024-0179	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient with chronic pain who was forced to discontinue using the most effective pain medicine for a lifelong issue that resulted from a service connected disability, I can state very clearly that this totally upended my life. For a total of over a year I was unable to take tramadol because the VA decided that the CDC and FDA would not allow it.... During that time I went from being able to walk with minimal pain to barely being able to get out of bed because my knees were going out due to the pain. There was constant back pain which disrupted my sleep to the point that I was only getting maybe an hour of sleep before being awake and from the pain... I was unable to bend without extensive pain and this limited my ability to do the work that I was required to do. I also was unable to set for more than 10 or 15 minutes without paying in my legs and my lower back. And the problem list is even longer. Now that the VA have decided that they will allow me to start taking the tramadol again I am now I get able to walk, sit, and bend with nominal pain... My sleep has gotten up to 2 and 1/2 hours prior to pain disruption. And I've only been back on the medicine 2 months. I am not an addict and I know that chronic pain can get so debilitating that a person would actually consider suicide... So when you all decide people can't have treatment simply because it's an opiate, you are eliminating the human factor that results in quality of life altering events when you take away the one option for actually being a productive citizen. I hope you all reach the decision that opiates can be abused but that chronic pain patients are not the ones doing the abusing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robyn	None	None	0900006484f69bc5	Winter-Sky	None	2022-02-11T21:31:39Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Winter-Sky, Robyn	kzh-5byp-l2ft	False	None	False	2022-04-12 01:54:08.925	[]
174	CDC-2022-0024-0180	https://api.regulations.gov/v4/comments/CDC-2022-0024-0180	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just wanted to let you know that I am a person with the rare disease of Chronic Regional Pain Syndrome/Reflex Sympathetic Dystrophy. I have suffered with this for almost 30 years. I was misdiagnosed for many of those years, and treated conservatively with physical therapy for a very long time. Insurance does not pay very well for physical therapy, so it financially strapped me for most of my life. Due to the extreme pain, I had a hard time working and trying to get an education. My affected limb is my right dominant arm. I was only prescribed NSAIDS, and I took the highest dose possible for years. Now I have upper GI problems due to this, and am told to never take NSAIDS again. I take a fairly high dose of Gabapentin, and I am allowed only 50mg of Tramadol a day. I know it is because of the fear of my providers office getting in trouble. I do have a spinal cord stimulator placed as well. All together only about 20% of my pain is helped. This is only regarding my arm pain, and allodynia. The original injury comes from my cervical spine, and I had a fusion and disc replacement in 2016. I have chronic lower back pain as well, and have had a series of epidural injections, and injections into my left bursa as well as injections into my piriformis muscle. Unfortunately, my lower back pain has increased in the last year and a half, and I can barely walk, but my pain provider does not increase my pain medicine to help that. I have also had years of physical therapy, acupuncture and myofascial release massage to help, but it's not affordable for someone who makes 35K a year. My pain is now ingrained due to the amount of years I have had it. I am asking that you please consider the trauma and torture people with my condition have to face everyday with this type of chronic pain, when considering opioid medication doses. I am very upset with the fear that has been instilled in providers and how insurance companies also decide for providers what is acceptable to treat a patient. Please consider the McGill pain scale when deciding on what is needed for people with chronic pain. I am so tired of having this suicide disease, and need my provider to feel safe in trying different opioid medications to help me. .Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f6985f	Edmons	None	2022-02-11T21:32:31Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Edmons, Mary	kzh-5uoo-ya2l	False	None	False	2022-04-12 01:54:09.139	[]
175	CDC-2022-0024-0181	https://api.regulations.gov/v4/comments/CDC-2022-0024-0181	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a user of opioids your restrictions already limit what I can take to control pain which makes it hard to walk or do simple tasks and trying to sleep is an adventure hoping on I get 4 manybe 5 hours to of sleep. I also belong to a support group for Ankylosing Spondylitis and can't tell you how many other people in pain I've had to talk to because they are suicidal because they cannot get anything that works to control the pain. So by limiting people that actually need it you are putting them at risk for depression and suicide. Stop punishing the people that actually need it and start punishing the criminals who are using them for recreation to get high.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	christopher	None	None	0900006484f69df8	Tyler	None	2022-02-11T21:34:37Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Tyler, christopher	kzh-6wpw-f9ah	False	None	False	2022-04-12 01:54:09.389	[]
176	CDC-2022-0024-0182	https://api.regulations.gov/v4/comments/CDC-2022-0024-0182	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m so relieved that the restrictions on opioid use for chronic pain has been reviewed by such a large community of specialists. I have had chronic pain foe 15 years. It has been getting worse despite two neck surgeries and soon I’ll be getting a reverse shoulder replacement. I also get terrible headaches from a nerve in my C2 and C3. Every morning I wake up to pain. It’s my alarm of sorts. If I didn’t have a way to get out of pain I’m not sure if I would want to live. I’ve done all the right things. Epidurals, anti inflammatory drugs , but I can’t tolerate them. I’m seriously afraid of addiction, so I walk a fine line of being in pain a little bit. I was afraid to have my shoulder replaced if I had to worry about the pain afterwards or if it’s not entirely successful what would I do then. I will never be a “ addict”, possibly dependent on opioids. But at least I have my life back.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laurie	None	None	0900006484f69f7a	Canty	None	2022-02-11T21:36:27Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Canty, Laurie	kzh-7sbt-21qi	False	None	False	2022-04-12 01:54:09.644	[]
177	CDC-2022-0024-0183	https://api.regulations.gov/v4/comments/CDC-2022-0024-0183	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in Chronic pain for years. I have severe arthritis, I have had a spinal fusion, a partial shoulder replacement, arthroscopic surgery for a full thickness tear in my rotater cuff, and I have no cartilage left in my joints. Exercise has been a regular part of my life for over 50 years, I am 62 years old. Three years ago I had to stop exercising because the pain is too much. I can barley do my job anymore, I just look forward to the "sweet release of death" life is not worth living when you are in the much pain and misery. I have been to doctors several times seeking pain relief. I was told in each of these doctor visits that I can not be prescribed opioids because my pain is chronic. After reading the cdc guidelines I find out I have been lied to. Doctors are afraid to prescribe them to me because they are afraid of consequences for themselves. So I suffer in misery and can not get help because of those who have abused them, the people who need them can not get them. SHAME on all those who took an oath to help their patients and refuse to out of fear. I know I am not the only one there are probably hundreds of thousands like me. Health care in this country is a joke.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Greg	None	None	0900006484f6a015	Feather	None	2022-02-11T21:42:46Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Feather, Greg	kzh-8q1y-gxoh	False	None	False	2022-04-12 01:54:09.856	[]
178	CDC-2022-0024-0184	https://api.regulations.gov/v4/comments/CDC-2022-0024-0184	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic, debilitating pain is REAL. It takes away your life. You pray for death, just to get out of pain. I have severe jaw, bone , gum and tongue pain and burning from a dental surgery that went wrong. Nerves and bone were cut and grinded. Permanent damage to my tongue from an improper maxillary implanted teeth plate, etc. I was unable to speak or eat and sleep. Became malnourished, the stress on my body from the pain and malnutrition gave me back my breast cancer, stage 4 . After being cancer free for 18 years! After 14 monthsof begging for pain management, I finally got some meds. Very minimal dose, but it helps. Please consider we need our pain meds to function. We are not addicts. We don't use them to get high. We just want to live with some quality. People take their own lives . I never understood that until I walked in those shoes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484f6a0dd	Damiani	None	2022-02-11T21:43:12Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Damiani, Cheryl	kzh-9j3s-o41e	False	None	False	2022-04-12 01:54:10.069	[]
179	CDC-2022-0024-0185	https://api.regulations.gov/v4/comments/CDC-2022-0024-0185	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a pain patient of 38 years. I wasn’t put on opiates until everything else failed. When the guidelines came out I was taken off benzodiazepines and my opiates were lowered to were they did very little. I lost function,gained 50lbs and developed high blood pressure. The suffering is horrible and thoughts of suicide are pretty regular now. My problem with your new guidelines is that I doubt it will make a difference. You’ve already destroyed the practice of pain management and doctors aren’t willing to put themselves in danger to save our lives. There aren’t any therapies left for me to try. Unless you add that outcomes for the patients are more important than covering for themselves they still won’t help us. PROP,the CDC and the DEA are directly responsible for the suffering and deaths of legitimate patients,elderly, disabled and Vets. Outcomes should have been important in the guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jackie	None	None	0900006484f6a7e0	Melcher	None	2022-02-11T21:43:59Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Melcher , Jackie	kzh-df4u-o6ma	False	None	False	2022-04-12 01:54:10.280	[]
180	CDC-2022-0024-0186	https://api.regulations.gov/v4/comments/CDC-2022-0024-0186	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s so crucial to clarify the earlier guidelines so that clinicians and HMOs are not afraid to provide pain relief to chronic pain patients. I am permanently disabled from spinal stenosis and have had three surgeries. Before the 2016 guidelines I was able to manage my pain with daily 2mg of Dilaudid. Because of the guidelines my doctor told me that he HAD to cut my prescription from 30 pills per month to 30 pills per year. Most recently I was cut to 6 pills PER YEAR, which is utterly useless. I tried to find another doctor at my HMO (Kaiser Permanente). One told me that she only prescribed opioids for terminal cancer! I have years of documentation of appropriate use of these drugs in my Kaiser record, including supporting blood tests, opiate contracts, chronic pain classes, and a history of reducing medication levels as soon as the acute episode subsided; nevertheless I was treated like an addict for seeking pain relief. Kaiser told me repeatedly that these changes were the result of government changes that no longer allowed them to prescribe. I know my spine surgeon thinks this is wrong, but has been powerless to change Kaiser policy. Prescribing should be based on the relationship between clinician and patient, and the documented compliance of the patient and not on a blanket prohibition of use of these essential medicines. Because of these restrictions I have had to resort to cannabis use, which interferes with my mental functioning far more than the opioids did, and also stop exercising because I can’t count on pain relief afterwards. For many of us chronic pain patients opioids keep us functioning, even employed. I know many who have been close to suicide because the pain is so excruciating. Please change the recommendations. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amanda	None	None	0900006484f6a7e2	Claiborne	None	2022-02-11T21:44:37Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Claiborne , Amanda	kzh-dg14-wv5j	False	None	False	2022-04-12 01:54:10.507	[]
181	CDC-2022-0024-0187	https://api.regulations.gov/v4/comments/CDC-2022-0024-0187	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How is this helping the millions of people that are already suffering? I lost a dear friend ten days ago due to renal failure that I'm convinced was brought about by UNTREATED pain! She lost what little pain care she had because of a bogus urine test...baloney, they just wanted to get rid of her!<br/>My own experience? I'm down to the absolute minimum pain medication, and my so-called pain management doctor wants to cut that...he actually screams at me! My quality of life has hit rock bottom. I can't even sit up to eat, and I'm diabetic! I've had 14 back surgeries and am fused, with hardware, from T-2 down to my pelvis.<br/>I would love to see these sanctimonious idiots TRY to walk in my shoes for just twelve hours... They'd be screaming for opioids!<br/>I'm done... I hope that I die tomorrow, no...make that tonight!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f6a7f2	Williams	None	2022-02-11T21:46:52Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Susan	kzh-diyw-b2fw	False	None	False	2022-04-12 01:54:10.753	[]
182	CDC-2022-0024-0188	https://api.regulations.gov/v4/comments/CDC-2022-0024-0188	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	That both the CDC and Federal Government have chosen to bury and hide these recommendations is appalling. Asking for comments on a document that is nowhere to be found is typical of federal standards. How nice that the opioid crisis, which was started by FDA negligence and CMS payment policies, will be so nicely maintained by the same agencies. Thanks for nothing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	0900006484f6adc6	Katz	None	2022-02-11T21:47:55Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Katz, Jeffrey	kzh-fld6-relp	False	None	False	2022-04-12 01:54:10.975	[]
183	CDC-2022-0024-0189	https://api.regulations.gov/v4/comments/CDC-2022-0024-0189	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guideless have been devastating to chronic pain patients. I suffer from Arthritis, Fibromyalgia, postoperative nausea and vomiting, Diverticulitis, Endometriosis, Back pain, neuromuscular disorder, Diverticulitis of large intestine with perforation and abscess, Thoracic radiculopathy, 2 failed SPINE Surgeries, Spinal stenosis, thoracolumbar region with neurogenic claudication, Abdominal wall pain in left flank post back surgery ,chest pain, Neuropathy, degenerative disc disease pretty much my whole spine. I was forced tapered to below 50MMEs and no matter how bad my health is getting the doctors will not help. I have done, Physical therapy, Medications many different kinds( both pain meds, nerve meds, and antidepressants), Lumbar Spine Surgery 8/22/2016 Lumbar Spine Surgery 5/4/2017 2 times, Epidural steroid injections, Spinal Cord Stimulation trial, Back brace, Exercises, Pain, management specialist ,Pain creams, Pain patches ,Heating pad, Ice packs, Hot baths with salt and oils, New bed with adjustable base, Hand held massager ,Nerve root block, Tens unit , acupuncture, and chiropractors. The only thing that has given me some relief is Oxycodone above the 90MMEs. These guidelines should not be for chronic pain patients. Taking a shower is almost impossible and often skipped do to pain. My quality of life has disappeared, most days I want to die from the pain. My health has gotten a lot worse sense they lowered my pain medications. My blood pressure is out of control, I got blood clots from lack of movement, swollen legs, more pain, chest pain, fatigue, depression, stressed, can’t sleep, mental health crisis, and I could go on. Please stop treating pain patients like drug addicts, urine test are so embarrassing. The urine drug test is not reliable either, false positives happen all the time, because of over the counter meds, some foods, vitamins and etc.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6b0cf	Anonymous	None	2022-02-11T21:48:38Z	None	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-jkkf-97ll	False	None	False	2022-04-12 01:54:11.210	[]
184	CDC-2022-0024-0190	https://api.regulations.gov/v4/comments/CDC-2022-0024-0190	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We must treat pain. Treating pain with an opioid and treatment opioid use disorder (OUD) with opioid replacement is evidenced based.  For OUD, Suboxone/Methadone used in MAT reduces opioid overdoses by greater than 50% yet only 1/3 of OUD clinics use it.  Additionally, there is a golden hour in OUD treatment. When a person with OUD calls, telemedicine enables a fast response.  Getting medication-assisted treatment (MAT) drugs to that person quickly can reduce withdrawal symptoms and cravings that can reduce relapse.  We can get MAT drugs to that person even if they are in a remote rural location. For pain, there is no better alternative for acute pain than opioids.  91% of patients who suffer a nonfatal opioid overdose are returned back on opioids with 2 weeks.  The restrictions on prescription opioid access left patients in pain with no options.  It may come down to either illicit opioids or suicide.  Before The Covid pandemic, life expectancy dropped for 3 straight years. During the Covid Pandemic, the opioid death rate rose over 30%.  Over 75,000 people died of illicit and prescription opioids. The unintended consequence of untreated pain is death.<br/>Many believe the opioid crisis is now an illicit opioid overdose crisis. 5,200 people initiate pain reliever misuse every day. While 2/3 of overdoses are widely known to be from illicit opioids, 28% are from prescription overdose and that means 39 people a day still overdose and die from prescription opioids.  We must not forget them.   <br/>There is a 4-6% incidence of prescription opioid misuse leading to illicit opioids but 86% of Heroin addicts report first abusing prescription opioids as teens.  The real telling evidence is that although believe the small number of prescription opioid overdoses as insignificant, given the large number of non-medical users, even a small percentage who initiate heron use translates into several hundred thousand new heroin users. Applying a 3.9% interest rate to 25 million Americans who abused opioids between 2000 and 2011 indicates that the prescription opioid epidemic created nearly 1,000,000 heroin users in this 10-year timeframe, or roughly 100,000 annually. Given under reporting the correct number may be considerably higher. <br/>Opioids are triple locked in the hospital yet these same opioids are sent home with patients without and security. Our ecosystem aims to extend the safe use of opioid use in the hospital to the home so only the person prescribed has access and only the prescribed him some time. That’s not just treat the opioid crisis let’s prevent it. <br/><br/>Our ecosystem - an app connected to a secure storage device for cloud-based medication adherence monitoring, active control dispensing, & destruction of unused pills upon tampering and prescription end.  We can improve home access to and home treatment of opioid use disorder.  Telehealth digital OUD treatment is risky without the ability to monitor medication adherence in the home.  We are using the same Class III FDA master file used in 200 million insulin pumps sold in the last 10 years for cloud dispensing of insulin for cybersecurity and connection of IoT "things".<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6b50f	None	None	2022-02-11T21:49:21Z	iPill	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from iPill	kzh-jr55-hmgy	False	None	False	2022-04-12 01:54:11.510	[]
185	CDC-2022-0024-0191	https://api.regulations.gov/v4/comments/CDC-2022-0024-0191	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am afraid that the focus on reducing opioids may actually make the opioid crisis worse. What was not highlighted is the 44% reduction prescription opioids in the last decade and the 30.4% rise in opioid overdoses, illicit opioids. https://pubmed.ncbi.nlm.nih.gov/22412106/ The big more obvious target is now illicit opioids. <br/><br/>Unfortunately, there are no alternates to opioid for pain. 91% of people surviving an opioid overdoses are prescribed more opioids in 2 weeks by their physician. https://arstechnica.com/science/2015/12/91-of-patients-that-survive-opioid-overdose-are-prescribed-more-opioids/. Reduction of opioid access leaves patients in severe pain with no options but illicit drugs or suicide. Life expectancy dropped 3 straight years before Covid. https://drugabusestatistics.org. With the Covid pandemic, we record greater than 100,000 drug overdoses. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm<br/><br/>We must still treat pain.<br/><br/>One study of millions of medical records, which compared the timing of state opioid regulations and reductions and could therefore suggest causality, found that opioid reductions actually led directly to increased disability, decreased productivity, rising medical costs and more pain. https://dspace.mit.edu/handle/1721.1/107321. Another study found that among veterans who had their opioids stopped involuntarily, 9 percent became suicidal and 2 percent actually tried to take their own lives. Even worse, other research shows that rather than minimizing overdose risk, cutting access to medical opioids nearly triples the odds of overdose death among people in pain. https://link.springer.com/article/10.1007/s11606-019-05301-2<br/><br/>The root of the problem is ironically a policy issue. Opioids or triple locked in the hospital and dispensed under supervision by nurses. Yet the same opioids are sent home with patients without any type of security or dispensing controls. One in four opioid overdoses today involves children and teens. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2719580. For those who say that prescription opioid are not the problem, 86% of Heroin and illegal fentanyl users report first abusing prescription opioids as teens<br/>https://www.doh.wa.gov/Portals/1/Documents/2300/2017/AnnalsInternalMed.pdf. Prescription opioid abundance then restricted access has lead to a 7-fold increase in Heroin overdose deaths. https://www.cdc.gov/drugoverdose/deaths/heroin/index.html<br/><br/>We hide our money at home from spouses and children. We don't hide up our opioids at home though opioids can kill. <br/><br/>We need to extend the safe use of opioids in the hospital to the home. After all opioid use disorder doesn’t start at home; opioid use disorder starts at home.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6b51a	None	None	2022-02-11T21:50:28Z	iPill inc	None	1	None	2022-02-11T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from iPill inc	kzh-jt2v-41p9	False	None	False	2022-04-12 01:54:11.720	[]
186	CDC-2022-0024-0192	https://api.regulations.gov/v4/comments/CDC-2022-0024-0192	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>I struggle with upper and lower back pain. The upper is ankylosing spondylitis, and random numbness and tingling. My lower back pain is from a bulged disk between L4-L5. I was cut off from my Norco when the Opioid changes occurred, and now life a miserable life. I have tried physical therapy, massage, injections of steroids, and chiropractic treatments but those do not help. I have contemplated taking my own life because the pain is intense most of the day, but I have kids and a wife whom I don't want to leave or put through that tragedy. If you could release the Drs from the risk of losing their license they might be more open to prescribing me the medication I desperately need, which would improve my quality of life. As it stands I cannot play with my kids like they want me to, and my hobbies have been limited greatly. I plead with you to revamp the requirements.<br/><br/>Thanks!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patrick	None	None	0900006484f6a83a	Thiel	None	2022-02-13T15:08:21Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Thiel, Patrick	kzh-duvp-182p	False	None	False	2022-04-12 01:54:11.937	[]
187	CDC-2022-0024-0193	https://api.regulations.gov/v4/comments/CDC-2022-0024-0193	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I do hope they reconsider the guidelines. I live in constant, severe pain, due to the amount of chemotherapy I was on. I am only 42. The amount of pain I am in sad. I am on a low dose of pain medication. The one and ONLY time I mentioned changing my dose, my doctor began asking me questions like, do I enjoy taking my pills because of how they make me feel, etc.. I began to cry. They are barely enough to keep me from jumping off the nearest bridge. It is so hard to get the proper care that I need. I pass all of my drug tests. I do what I am supposed too. It really isn't fair.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amie	None	None	0900006484f6b935	Gerard	None	2022-02-13T15:08:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Gerard, Amie	kzh-nrqp-bblz	False	None	False	2022-04-12 01:54:12.162	[]
188	CDC-2022-0024-0194	https://api.regulations.gov/v4/comments/CDC-2022-0024-0194	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is ... I am small business owner (and mom) in Colorado. I grew up in Cheyenne, Wyoming in a nice family with a hard-working dad, a stay-at-home mom, and 5 siblings. We were a very normal and healthy family. There was no drug or alcohol use in our home at all growing up.<br/>My younger sister ... died Nov. 1st, 2017 of a prescription drug overdose. She left behind three little boys. She had been approved for housing assistance and moved into her own apartment just 4 weeks before. Her 7-year old son was in the apartment with her when she died, and he managed to call his Grandma when his mom wouldn't get up off the floor after several hours. My mother found her daughter dead in the kitchen.<br/>She became addicted to prescription painkillers when she was 21 years old, after being prescribed them to manage kidney stone pain. She was pregnant and couldn't have the treatment to remove the stones without endangering the baby, and the best option was to treat the pain until the stones could be broken up and pass. It started there. One prescription to help with pain for a set amount of time. But it turned out that her body kept making more stones, and she needed more pain medication. What began as a real need for pain medication turned into an addiction. She had taken some nursing classes and had some basic knowledge about her body. She was also very smart and able to figure out a lot by doing research online. She managed to fool a lot of people for a long time. Eventually it got to the point where she had been given too many CT scans, and so they started testing her blood to see if she had blood in her urine as a sign of a kidney infection. She would prick her finger and put blood in her urine (she admitted to this in a diary she wrote in during rehab). During one stay at rehab, she made it to the step where she had to tell the doctors in her area that she was an addict. She was put on the "red list" at the hospital she informed and they would no longer send her home with pain medication prescriptions. So she started going to other nearby hospitals in surrounding states. Addicts are very convincing when they need drugs. Eventually she got set up with a pain management specialist in another town, who gave her a 2-week supply at once. She would take all the drugs she was given for a 2 week time frame in 4-5 days, and then have withdrawals for a few days, and then sometime during the second week get desperate enough to drive to a hospital somewhere and convince them she had a kidney infection and get pain medication in the hospital for a few days. She was taken to the hospital multiple times in an overdose state and her heart had to be re-started.<br/>She lived with my parents during most of this time. I would call and ask my mom who her pain management specialist was, and call and inform them that she was a self-professed addict, and to please check with the hospital where she lived, and begged them to stop giving her so many drugs. They would drop her as a patient, and she would find a new one. I don't know how many I called. One too few. I didn't catch the last one. He gave her 100 pills at once. 100 pills. It was supposed to be a 30 day supply. One week later when she died, the bottle was empty. <br/>There's a lot more to the story, but you get the picture. A young person with her whole life ahead of her, very bright; a mother of three adorable kids; a loving, supportive family who did EVERYTHING they could to stop this from happening and get her help. I'm telling her story to show you that it can happen to anyone.<br/>She was just one person. But, one very important person to me, to my family. And EVERY person out there, who may become addicted to prescription painkillers, is important. The rules that were put in place before helped save thousands of lives, because they helped prevent people becoming addicted by limiting the amount of time someone could be on the drugs, and it limited the potency levels (from what I understand) for long-term care. I know that most doctors are doing their very best to make good decisions for their patients. They can continue to do that with the old guidelines in place. It just makes them pause for a moment if they need to not follow the guidelines, to make sure they are doing so in the best interest of the patient. Please, PLEASE do not make it easier for people to begin drug addictions. Lay it heavy on a doctor's mind when they choose to not follow the guidelines. <br/>I'm guessing the majority of the people who have an issue with the tighter guidelines are long-term pain patients. I understand they need care, and I am empathetic to their situation. Keeping the previous guidelines forces physicians to keep pain management medications at a reasonable level and look for additional things to help with pain management, which often are much less harsh on their body and have less negative side effects.<br/>Thank you for your time and consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amber	None	None	0900006484f6bea0	DelGrosso	None	2022-02-13T15:15:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from DelGrosso, Amber	kzh-qw19-ke80	False	None	False	2022-04-12 01:54:12.415	[]
189	CDC-2022-0024-0195	https://api.regulations.gov/v4/comments/CDC-2022-0024-0195	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an ER nurse I have seen many, many drug overdoses. Some lives we save, some we don’t. All are because of illegal drug use. ALL. 100%. All are under age 35. <br/>Why is CDC/DEA micromanaging treatment for thousands of diseases that present differently depending on genetics, gender, age, environment, and stage of the disease? It is very complicated for smart, well trained, specialized doctors. <br/>CDC/DEA are ignoring the illegal drug crisis killing so many AND have created an untreated pain crisis. Why? Are drug dealers paying off DEA agents? Are insurance companies influencing CDC decisions to save money? Why is CDC paying $750/hr to loser doctors? “Experts” with dementia, poor patient ratings, and no compassion?<br/>I have severe Crohn’s disease with 2 ileal resections. From 1995-2017 I took opioid pain medication. Same dose. It helped with pain and explosive diarrhea that Crohn’s disease causes. In 2017 my doctor said, “we have an opioid crisis and I cannot prescribe opioids any longer”. I asked how to taper and the doctor replied, “I don’t know”. <br/>For the past 4+ years, as I have worked in the ER, easing human suffering and saving lives, I have constant pain and often soil myself because of the CDC/DEA. <br/>CDC/DEA are human torture agencies that do not represent the American taxpayers who fund them. <br/>I dare you to come to the ER and explain to a parent why their child just died of an illegal drug overdose. I dare you to explain why illegal drugs are widely available. I dare you to explain to patients, with severe diseases and pain 24/7, why they are forced to suffer. <br/>Get out of your plush offices and come join me on the front line…..or continue to harm Americans young and old. <br/>(Imagine assisting with conscious sedation for a dislocated shoulder and feeling the diarrhea running down your legs into your shoes. That’s my life.)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484f6b855	Bradford	None	2022-02-13T15:19:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bradford, Jeanne	kzh-rble-nlke	False	None	False	2022-04-12 01:54:12.632	[]
190	CDC-2022-0024-0196	https://api.regulations.gov/v4/comments/CDC-2022-0024-0196	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am now bed bound due to the harsh regulations and have been criminalized by the same medical community I worked in for years as an occupational therapist. <br/>I was never addicted to opiates and would not expect to be should I be able to resume them. I am seventy yrs old and would like more from life than constant nerve pain from traumatic injury.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suzanne	None	None	0900006484f6b858	LeaveyLeavey	None	2022-02-13T15:20:11Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from LeaveyLeavey, Suzanne	kzh-rbqo-3mkq	False	None	False	2022-04-12 01:54:12.845	[]
191	CDC-2022-0024-0197	https://api.regulations.gov/v4/comments/CDC-2022-0024-0197	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Changes to the 2016 guidelines cannot come soon enough as I'm severely broken and very close to just being done. The "misapplications" simply must be addressed. Perhaps (read: PLEASE!) include something very much like "Any laws or rules that were made by any and all USA states, territories and/or Native American tribes that were written and enacted as a result of the flawed and misunderstood CDC 2016 guidelines should be repealed immediately." In fact, IMHO, that should be the first line of the revised 2016 guidelines. The DEA should be made acutely of this as well as it'd be great if our physicians weren't living in fear for doing their jobs. This dark stain on the US healthcare system needs to be erased promptly! <br/>Thank you for your time and consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christopher	None	None	0900006484f6c17d	Lawson	None	2022-02-13T15:21:55Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Lawson, Christopher	kzh-s8te-eodv	False	None	False	2022-04-12 01:54:13.062	[]
192	CDC-2022-0024-0198	https://api.regulations.gov/v4/comments/CDC-2022-0024-0198	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been a chronic pain sufferer most of my life following a horrific car accident that I barely survived when I was just 3 years old. Since then I have suffered many life-threatening complications, repeat surgeries, and devastating scarring on the inside and outside of my body. I had most of my abdominus rectus muscle removed due to necrotizing fasciitis, sepsis, and peritonitis at the age of 16 from a bowel torsion from the scar tissue that became necrotic. This left me in chronic pain that no one would treat until I was 28 and couldn't walk or work anymore because the pain was so intense. There aren't any surgical procedures or physical therapies available for me and my unique and complex case. I was lucky to find a primary care doctor who recognized that opiates would give me a better quality of life and thus began the process of trial and error to find the right combination of medications that would control my pain safely and effectively. He prescribed me fentanyl transdermal patches and short-acting oxycodone after I signed a pain patient contract. Once the dosage was perfected for my needs, I was finally able to live my life and walk without sobbing in agony or collapsing to the ground. I was even able to start gardening in my backyard to help provide food for my family. For years I was stable at that dosage, followed every letter of my contract, never ran out early and my doctor even said I was a perfect and compliant patient. But then the CDC set an arbitrary dosing maximum and everything changed. He could no longer continue to prescribe me the dose that I was stable with and had drastically improved my quality of life. Suddenly he told me we had to slash my dose by half over the course of a couple of months or risk being denied all pain medications. I had no choice in this or alternative avenue to seek, so I took what he gave me. Now I am at a dose that barely helps mitigate my pain and I can barely function. I can barely get out of bed now and most days I'm back to crying myself to sleep in agony. I did nothing wrong but I am continually punished at your hands. I get treated like I am subhuman or a dirty drug addict by pharmacists when I go to fill my prescriptions because of your rhetoric. I am constantly having to fight to get the medications that keep me from taking my own life because the pain is that severe and pervasive. I know my doctor will never be allowed to prescribe me again the dose that allowed me to live some semblance of a normal life because of the damage your organization has done. The stigma you imposed on opiates and chronic pain patients has ruined what little hope I had at not being in intractable pain every waking moment of my life. Now, whenever I am sick and have to go to the emergency room I am treated like a drug seeker and they dismiss me without really examining me or ordering tests. You demonized me and the medications that I take. I will continue to suffer in abject agony for the rest of my life because of your careless and fearmongering actions and words. But at this point, my mental health has taken such a beating that I doubt it will be a long life, it certainly won't be a good life. Sadly my story isn't unique. The harm you caused is going to be with us for a very long time. My only hope now is that retracting your previous guidelines might mean that others won't be made to suffer the way I and so many others have. I deserve a chance at life with as little physical pain as possible with the current tools the medical field has at its disposal, but you took that chance away. You should be ashamed of the consequences of your actions in taking lawful medications away from people who are suffering and need them for basic functioning. You need to do better and make right what you broke. I pray that none of you reading this will ever have to suffer the way I have, I wouldn't wish this existence on my worst enemy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f6c2c9	Egeland	None	2022-02-13T15:25:24Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Egeland, Elizabeth	kzh-tlta-ae7y	False	None	False	2022-04-12 01:54:13.320	[]
193	CDC-2022-0024-0199	https://api.regulations.gov/v4/comments/CDC-2022-0024-0199	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Just want receive the news.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c2eb	Anonymous	None	2022-02-13T15:25:44Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-tq6x-dmak	False	None	False	2022-04-12 01:54:13.534	[]
194	CDC-2022-0024-0200	https://api.regulations.gov/v4/comments/CDC-2022-0024-0200	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer due to being hit by a car in 1995. I was crossing the street. I had 34 surgeries in ten years. I finally got on Tramadol. I also had a TBI and a broken humeral neck. I also had as a result C-PTSD. I take Xanax. In 2016 I either had to get off of the Benzos or get off the Tramadol. I went cold turkey from the Tramadol, as I know how hard it is to get off Benzos. My internist said to try ASA, or Acetaminophen. I also have traumatic trigeminal neuralgia from a patient punching me in the face while waking up from anesthesia. I finally started on Gabapentin. It has helped but finally my internist got certified in medical marijuana. I now smoke pot for pain relief. I wish I could take the Tramadol again, but they won't prescribe it anymore. If CDC is going to say how much pain relief, I get is wrong. At least take marijuana off of the Schedule 1 narcotics.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484f6c334	Schultz	None	2022-02-13T15:26:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Schultz, Jennifer	kzh-u4bf-1stm	False	None	False	2022-04-12 01:54:13.749	[]
195	CDC-2022-0024-0201	https://api.regulations.gov/v4/comments/CDC-2022-0024-0201	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am just an ordinary person. I work, I'm a mom, and I'm a wife. It was the scariest time when my spine broke and then was denied surgery three times by insurance for 13 agonizing months. Now, because of those 13 months I have permanent nerve damage. To say my ordinary life has changed is an understatement. I became a chronic pain patient in 2014. Two years before the 2016 guidelines. I was told to go on disability but I work at my family's business. Quitting or retiring wasn't an option. The anxiety I deal with just trying to do my regular daily things is bad enough, but the extra stuff I have to face has caused much more harm. I feel like I have PTSD just going to the pain management doctor every 28 days. Fear that their office will be shut down by the DEA. Fear that my doctor will retire, get sick, close down. The monthly drug tests and pill counts make me feel like I am a bad person even though I understood why they are needed. My BP is always elevated at these appointments. Once the appointment is over my fear follows me as I go to the pharmacy. Previously, when I went to the chain store pharmacys, I have received nasty comments. I have been told they do not have enough pills to fill my script. I have been told it will take a week to fill my script. Why should I have to suffer though withdrawals just because the pharmacy does not have my medication? Yet, with all the national data information and flagging patients, we are scared to go to a different pharmacy. I switched to a mom and pop pharmacy and no longer have any issues, but the damage has been done. As a CPP, I have so many obstacles in my life. Receiving proper medical care should not be another one. It is time to fix this problem. I pray for the day that I can actually get the amount of medication I really need, instead of being grateful for the minimum I do receive. I also pray for the day I don't have to choose between getting pain medication versus getting anxiety medication. I never had anxiety until the 2016 guidelines became the law of the land and I can't even get treatment for how all this has harmed me mentally.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f6c401	Moce	None	2022-02-13T15:26:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Moce, Debbie	kzh-v2kb-xxqw	False	None	False	2022-04-12 01:54:13.973	[]
196	CDC-2022-0024-0202	https://api.regulations.gov/v4/comments/CDC-2022-0024-0202	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You have no idea how much damage the current CDC “guidelines” have caused. I’ve gone all the way with my spinal injury to having the “ultimate surgery”, which left me in worse condition. I’m at a dead end with constant, excruciating pain, for the past 12 years. Before the DEA got involved in the practice of medicine, I was afforded a level of opiate treatment that allowed me to function somewhat and practice self care. Because of the strict enforcement of CDC RULES that were treated as LAW, I’ve been force tapered to a point that I live in either my bed or my recliner, unable to take care of myself, or even feed myself properly because I cannot stand up long enough to practice activities of daily living! Every time I ask my Pain Management Doctor to increase my medication, just a little bit, his response is that he can’t because of the DEA. The DEA needs to focus on the illicit drug trade that continues to kill people in astonishing numbers. I’m a 65 year old, compliant patient, at no risk of addiction or diversion. My pain levels have been so out of control, that I actually picked out a highway overpass to jump off of, thus ending my suffering. When I think about living this way for another 10 years, it doesn’t sit well with me. But too many Chronic Pain Patients have already committed suicide and I decided that I’m not going out that way! I’m a fighter. I’m a pain warrior! And I’m not taking this sitting down! And the fact that acute, post operative pain is being treated with OTC medications, is an assault on humanity in general! The old guidelines are WRONG and must be declared NULL AND VOID! If I had a terminal illness, I would not like to think that the DEA nor the CDC knows what is best for me! They are doing major surgeries, joint replacements and abdominal surgeries without pain medication! We’ve had “milk of the poppy” for thousands of years, and now the LAW says that Doctors cannot manage our pain properly, individually? What is wrong with this picture?! Some people are discharged through no fault of their own, with no other option, but to seek black market medicine, so YOU PEOPLE are driving people to the black market because they cannot get legitimate medical care, because Doctors are afraid of the DEA, stripping them of their professions and livelihood. The CDC has no right to practice medicine. The DEA most certainly has NO RIGHT TO PRACTICE MEDICINE! Stop it! NOW! Admit your mistakes, focus on the street trade, and leave legitimate medicine alone. You have committed CRIMES against humanity and it’s NOT YOUR PLACE to do so! Stop the madness NOW and forever desist.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomasina	None	None	0900006484f6c494	Ferguson	None	2022-02-13T15:27:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Ferguson, Thomasina	kzh-vq48-mm0v	False	None	False	2022-04-12 01:54:14.217	[]
197	CDC-2022-0024-0203	https://api.regulations.gov/v4/comments/CDC-2022-0024-0203	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to be able to have relief from the chronic pain I deal with daily. I was one of the first people cut off pain pills with the changes. I still work and take more ibuprofen and Tylenol then I should	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melody	None	None	0900006484f6c4bb	McKnight	None	2022-02-13T15:28:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from McKnight , Melody	kzh-vvvi-uqz1	False	None	False	2022-04-12 01:54:14.439	[]
198	CDC-2022-0024-0204	https://api.regulations.gov/v4/comments/CDC-2022-0024-0204	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for almost a decade now. The perception that people have of chronic pain is deplorable. The current laws and treatment of doctors who treat chronic pain patients has pushed a lot of people I know to the black market for medication. It’s time for bureaucracy to take a backseat to effective treatment. Fentanyl from China that is used in illegal pain meds is the enemy, not legitimate treatment of pain patients. Please remove the overly restrictive language and allow patients like me to receive the care and treatment that allows us to function and maintain a normal quality of life. Please stop penalizing law abiding patients seeking relief and the doctors who are brave enough to treat.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f6c9f0	Ambrose	None	2022-02-13T15:29:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Ambrose, James	kzh-xkuq-qyro	False	None	False	2022-04-12 01:54:14.654	[]
199	CDC-2022-0024-0205	https://api.regulations.gov/v4/comments/CDC-2022-0024-0205	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People with chronic pain need to be heard im a 66 year old man who served his country in the army ive raised a family me and my wife of 48 yrs are retired i have neuropathy in my feet and <br/>Restless leg syndrome<br/><br/>And would you go to a doctor they wanna prescribe you psycho tropic drugs. That turn you into a zombie and they have serious side effects. I dont want to take any medication but if i have to i would like to make those decision with a doctor who not afraid Prescribe opioids.im not going to abuse my medication. I need my life back i dont need some doctor telling me i need some Psycho tropic drugs they use those to treat depression And Anxiety.<br/>Please listen to us when we say we need help . STOP TREATING US LIKE DRUG ADDICTS and listen to us ! Dont make us suffer for the deeds of other who abuse drugs !!!! Please listen to us and treat us with dignity and respect were not drug addicts were chronic pain sufferers!!!! Thank you!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6ca1c	Anonymous	None	2022-02-13T15:29:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzh-xrrw-5faf	False	None	False	2022-04-12 01:54:14.879	[]
200	CDC-2022-0024-0206	https://api.regulations.gov/v4/comments/CDC-2022-0024-0206	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank You for giving the public the opportunity to speak on this matter.<br/>As a US Navy Veteran, a chronic pain patient and a patient advocate for other chronic pain patients, I have been deep in this issue for Decades. I, fortunately, have been under the care of an educated and compassionate doctor for many of my chronic pain years. He agrees that there are instances where Long Term Opioid prescribing is necessary and produces positive outcomes. I am one of his examples. I will be attempting to get him to come here and comment also.<br/>But, for myself, I have seen, first hand the damage the original guidelines of 2016 have done to so many Chronic Intractable Pain Patients. Especially my fellow Veterans. I recall the afternoon that a YOUNG Navy Veteran, who had his pain control medications stopped, went to his car in the parking lot, called his Mom and sister and took his life. I was there but was unaware of his situation, or I might have been able to intervene. Ten of Thousands of GOOD Americans have made that ultimate decision the last 5 years. All due to the misguided thoughts that opioids were bad and everyone must stop using them NOW! Many of these people are a matter of public record in certain pain advocacy groups on social media. From not being able to handle the Severe pain to not wanting to put their loved ones through the terrible life of a chronic pain sufferer. I have, personally, talked several out of that "Ultimate Decision". All the while, having a close understanding of why they made the choice they did. Unless you have PERSONALLY experienced the HELL of pain that can ONLY be controlled with Opioid Pain Therapy, you really do not have any idea of it's effects on the entire human body. <br/>Studies have proven that pain KILLS. It destroys many organs in the human body. Not to mention what it does to the brain. Heart attacks have been attributed to pain. High Blood Pressure is another common result of untreated pain. I know that one myself. When my pain gets to a certain level, my blood pressure shoots up dramatically. I am not talking about a sore back from a hard day at work. Or that finger you smashed with the hammer. But, imagine that pain lasting 24/7/365. NEVER letting up, NEVER stopping. Until you are able to get a good dr. to sit down with you and work up an opioid pain management therapy. It takes time to find the level and consistency of the medication, just as most other medications have to be changed around to find the right dosage and strength for a particular patient. EVERY human reacts to all medications differently. There is NO WAY in this World that the "One Size Fits All" "MME" limits, put in play by the original CDC guidelines, are anywhere near intelligent way to treat pain. We all metabolize medications differently. And, left alone, most dr.s and their patients will work together to find the appropriate dosing for the patient. Believe me, I know of NO chronic pain patient that is trying to get "HIGH" off their medications. I have never, in 30 years gotten "Euphoric" from my medications. We just want enough to do what it is meant to do. Which is in allowing the person to function without the Agonizing pain and be able to get back to some semblance of "LIFE". Which is what MILLIONS were doing, prior to the 2016 Misguided Guidelines! Opioids have been an effective treatment for the relief of pain for THOUSANDS and THOUSANDS of years. I have been baffled by the new idea that they are, all of a sudden, "BAD and EVIL"! <br/>I know I am not the most scientific or most articulate person that will place comments here. BUT, I am VERY Sincere when I say, PLEASE allow the dr patient relationship to return to the exam room. <br/>One thing I will say is that before the dr. is going to feel comfortable prescribing opioid pain medication again, you or whomever in our govt. that can control this, is the DEA MUST be removed for the equation ALL TOGETHER! As long as good dr.s are afraid of losing everything they have and going to prison, they will never go back to the treatment that many know is appropriate. Just because a patient abuses his medication or mixes it with something else, it is NOT the dr's fault. As long as he has been taking the necessary precautions and education his patients on what MIGHT happen, then it is on the patient. I call it "PERSONAL RESPONSABILITY"! I do not know of a single DEA Agent that is a pain management trained physician. Therefore, they need to worry about the illegal Heroin and Fentanyl analogues coming across our borders. NOT rushing in on dr. offices and pharmacies that are just doing their jobs.<br/>Thank you again for the opportunity to comment on the adjustment of the 2016 Opioid Prescribing Guidelines. If we all work together, and you LISTEN to the chronic pain patients and their families, we can Stop Torturing people and get back to treating the pain that disables. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R Michael	None	None	0900006484f6ca1f	Maddox	None	2022-02-13T15:30:27Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Maddox, R Michael	kzh-xs8c-1gov	False	None	False	2022-04-12 01:54:15.266	[]
201	CDC-2022-0024-0207	https://api.regulations.gov/v4/comments/CDC-2022-0024-0207	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for finally listening to Chronic Pain patients. Much harm has been done to our community over the last 6 years, and I fear that these changes have come too late for some. I am also concerned that getting the message out to doctors is going to take time. Many doctors have become too scared to support patients that suffer from chronic pain, making it difficult for patients to even find a provider. Please ensure that, along with these changes, you are also actively sending the message out to doctors that Chronic Pain Patients are not "drug seekers", or "difficult patients", or any of the other labels that have been applied to the community. Fixing the awful mess of the 2016 "guidelines" is more than just changing the guidelines, there has to be active work to undo the harm that has been done to a community of patients who have done nothing to deserve the kind of targetting and abuse that they have been subjected to over recent years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Caroline	None	None	0900006484f6c758	Lay	None	2022-02-13T15:30:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Lay, Caroline	kzi-251b-2aac	False	None	False	2022-04-12 01:54:15.479	[]
202	CDC-2022-0024-0208	https://api.regulations.gov/v4/comments/CDC-2022-0024-0208	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I have chronic pain with flare-ups. I have a true allergy to Nsaids with anaphylactic reactions. I have Small fiber neuropathy, C4-C5 fractures, T12 fracture, and L1 fractures of the spine. I am unable to use Prednisone a steroid for these flare-ups due to Osteopenia. I have a history of Guillan-Barre Syndrome in 2 different episodes. I also have Osteoarthritis and Fibromyalgia. I can tolerate pain to a 6 on a scale of 1-10 on a daily basis with Tylenol. However, flare-ups higher than 7 can be intolerable. For this I need an Opioid. For traumatic injury or post operative pain higher doses or stronger medications are required. The changes in the CDC rules of 2016 where the Providers followed the suggestion of not prescribing opioids as "the law" was terrifying to say the least. I was concerned that I would not be able to control the pain. I have tried alternative therapies with limited success. I am thankful for the change in the CDC's guidelines. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c7e0	Anonymous	None	2022-02-13T15:32:31Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-8o0t-l4ph	False	None	False	2022-04-12 01:54:15.685	[]
203	CDC-2022-0024-0209	https://api.regulations.gov/v4/comments/CDC-2022-0024-0209	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer, I understand there needs to be oversight when it comes to addictive medications. However, the strictness of the rules negatively impacts people like me who only take their medications as prescribed by a licensed medical provider. I have a primary care physician who prescribes all but my opioid and go to a certified pain clinic for the opioid medication, as well as pain-relieving procedures. I use a wheelchair when i leave the house and the urine tests are difficult to do every month. My mother is a senior citizen. I have a neurological disease that prevents my driving and due to the pandemic, we're not sure it's safe for people at high risk for covid complications to use public transport when many people refuse to wear masks and/or get vaccinated. Loosening the rules around opioids would allow us to perhaps go out less. It would definitely allow me access to medication I need. Though I've used opioids for some time, I take pain medication so that I can function. At no point is all of my pain gone completely and I am ok with that so long as I am able to have access to medication that keeps my pain at a relatively manageable level.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	sally	None	None	0900006484f6c819	lee	None	2022-02-13T15:33:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from lee, sally	kzi-aupn-v1kj	False	None	False	2022-04-12 01:54:15.932	[]
204	CDC-2022-0024-0210	https://api.regulations.gov/v4/comments/CDC-2022-0024-0210	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I still don't see much change for chronic pain patients! We are tired of suffering, we are tired of not having no quality of life! Tired of watching people suffer and hearing about suicides! Tired of doctors being scared to prescribe cause of the Dea! What if it was somebody in your families suffering? Do you all realize how many people have surgeries and have to suffer afterwards? Wouldn't be safer for a doctor to give pain meds then someone getting desperate and going to the streets for relief? I have multiple pain issues and can't work now cause I can't get any pain meds to help. I just wish everyone making these decisions could spend a week feeling real pain with no way to get relief! That's the only way I will think any of you could understand!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c825	Anonymous	None	2022-02-13T15:33:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-b4ku-8iat	False	None	False	2022-04-12 01:54:16.135	[]
205	CDC-2022-0024-0211	https://api.regulations.gov/v4/comments/CDC-2022-0024-0211	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am ... a victim of chronic pain from Fibromyalgia that began in 2017 with full body pain, fatigue and severe allergy problems. I took Norco 10 MG opioids as prescribed for Chronic pain from 2014-2017 and did not get addicted or have a need to up my dosage where I was able to exercise, work, lose weight or do physical therapy. In 2016 Congress enacted the CARA Act mandating States to also make dogmatic regulations for opioids removing the discretion of educated physicians into the hands of government. Now I (like millions of other Americans who suffer from chronic pain) live in misery every day with constant pain unable to work, exercise, lose weight or do physical therapy more than once a week. While taking opioids I maintained the weight of 220 lbs. After being denied opioids I gain weight constantly now weighing over 300 lbs., which increases my daily pain. I quit taking NSAIDS because they cause stomach damage which makes you eat more and gain more weight which equals more pain. Opioids do not harm my stomach. Your regulations to be realistic must offer physicians discretion to prescribe opioids so the patient is able to move enough to do alternative methods of pain relief such as exercises or physical therapy. Otherwise you are mandating victims of chronic pain torture treatments that they are not going to be able to do so it will not be effective. A more important question is why are about 50 million Americans about a 6th of our population (if that statistic is accurate) suffering from chronic pain. Congress should never make a law taking discretion away from educated physicians and the Executive should not be putting physicians in prison for simply being humane. The CDC should review chatrooms or whiteboards of the victims of chronic pain and the many stories of people being able to function living a dignified life by taking their opioids as prescribed. I believe the study claiming opioids are not an effective strategy for pain needs to reviewed again because the amount of people who actually abuse opioids, attempts suicide or gets addicted to them are likely a much smaller number. Opioids are effective and are the only therapy that relieves pain - they work. Fentynil needs to be greatly reduced in potency or outlawed if it is responsible for so many deaths just for touching the substance obviously being too potent a substance. Now all opioids such as NORCO are being falsely blamed for many deaths. One lawyer suggested opioids are not the reason for so many suicides, it is abuse of government power that makes our lives miserable which is the actual cause for the epidemic of suicide, the opioids are just an easy way to exit tyranny.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dale	None	None	0900006484f6c838	Adams	None	2022-02-13T15:35:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Dale	kzi-bch8-cjci	False	None	False	2022-04-12 01:54:16.338	[]
206	CDC-2022-0024-0212	https://api.regulations.gov/v4/comments/CDC-2022-0024-0212	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am on pain medication I have been on it for years if it wasn't for my pain medication I could not do daily activities if I could not do them I would have to get someone to help me every day not sure if my insurance would pay for that so I would be in a mess trying to get my normal things done every day I have done all the things before being put on pain medication physically therapy only made me hurt worse the shots in my back almost paralyzed me I think that our doctors who know our health concerns should have more of a say in what they do to help us though to do what is best for us I am aware of out comes of taking pain medication but it works for me now and if it is taken away who will help take care of me is my concern being independent is something I want to do I am 63 and taking care of myself is always a concern I only have a son so with this being said I hope you allow our doctors to made the best choice for us they know us my doctor did not just put me on pain medication we tried things for years that didn't work and it just got to the point I couldn't stand the pain and the older I get I now have arthritis, deteriorating disc and ruptured disc I am afraid of back surgery I have seen the bad outcomes of having it but with my pain medication I don't need to risk it thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6c8d8	Anonymous	None	2022-02-13T15:35:24Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-ee0f-7s56	False	None	False	2022-04-12 01:54:16.550	[]
207	CDC-2022-0024-0213	https://api.regulations.gov/v4/comments/CDC-2022-0024-0213	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At 54 years old, I am beginning to lose my independence because of my undertreated, chronic pain. I face a bleak future as a burden to my family. I'll need to start receiving Social Security Disability benefits. My life matters and I deserve some comfort and dignity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484f6c8db	Doe	None	2022-02-13T15:35:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Doe, Jane	kzi-ef1k-rem2	False	None	False	2022-04-12 01:54:16.754	[]
208	CDC-2022-0024-0214	https://api.regulations.gov/v4/comments/CDC-2022-0024-0214	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from Hashimoto's Encephalitis (HE) and one of the associated symptoms is extreme nerve pain in my extremities (neuropathy). The pain is constant, unrelenting, and severe. <br/>I have been working successfully with a pain physician for several years and his guidance combined with the opioids prescribed are the only minor relief I have. A constant concern he shares with me is the threat of Federal regulations changing that would prohibit my access to the drugs that I require for my illness. Any changes to the approach of the regulations concerning opioids that would place more decision-making power in the hands of the physician-patient relationship is welcome.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f6d143	Baugher	None	2022-02-13T15:35:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Baugher, Mary	kzi-f8ce-anlq	False	None	False	2022-04-12 01:54:16.955	[]
209	CDC-2022-0024-0215	https://api.regulations.gov/v4/comments/CDC-2022-0024-0215	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low dose naltrexone is a good alternative for long term use. Most clinics and hospitals have written policies now because of these guidelines to not prescribe opioids at all. This needs to be changed. Even pain clinics have policies forbidding doctors from prescribing opioids. This despirately needs to change for those who need opioids and alternatives will not work or the combination are needed. Low dose naltrexone only helps to a certain degree. It is as good as Norco but no stronger.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristina	None	None	0900006484f6d244	Cattrell	None	2022-02-13T15:36:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Cattrell, Kristina	kzi-g83l-f9or	False	None	False	2022-04-12 01:54:17.222	[]
210	CDC-2022-0024-0216	https://api.regulations.gov/v4/comments/CDC-2022-0024-0216	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines defiantly need to change. My father who broke his neck 8 years ago at age 70 was prescribed a fairly high dose of oxycodone by pain management. He was recovering well and able to get out and function. In 2016 they cut him back to 1/6th of what they were giving him due to the chained in government guidelines. He started going down hill faster because he won’t able to get up due to the pain. This has been extremely hard to watch. The pain management doctors would just apologize and say the couldn’t give him any more. They finally upped his dose to 1/3 of what he was originally getting. While he was doing a little better he was still in extreme pain. He’s been bedridden for the last year because the pain is to great for him to get up. I just don’t understand why anyone cares how much is prescribed to someone who is at the end of their life. He’s currently 78 and I doubt he will survive the year. If the opioids reduce someone’s life by 6 months or a year then who cares. At least they were in less pain. It’s not like we’re talking about a 25 or 40 year old that other methods may work on. Even then, properly trained pain management doctors who are seeing the patient should be able to desire what the patient needs. Don’t force people who are in the final years of their life to be in excruciating pain all the time, let people live the final years of their life with manageable pain what ever that takes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrew	None	None	0900006484f6cfd0	Freed	None	2022-02-13T15:36:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Freed, Andrew	kzi-hm7b-gyjk	False	None	False	2022-04-12 01:54:17.430	[]
211	CDC-2022-0024-0217	https://api.regulations.gov/v4/comments/CDC-2022-0024-0217	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m writing this today to let you know my experience as a pain management patient. I’ve been A pain patient for 15 years. I suffer from degenerative disc disease, DISH Disease, osteoarthritis, auto immune arthritis, fibromyalgia and calcification of many of my joints. I suffer every day. I had good pain management up until about 2016. I was a volunteer at my church cleaning the preschool classrooms, setting up the Sunday school lessons and helping cook for church member funerals. I actually had a life. I would take myself fishing for five times a week and I got some exercise. My pain was managed wonderfully. Even though I was on high doses, I never was disoriented, fading out, I’ve never been an accident or even had a speeding ticket. I had a life. I would be called in for random pill counts at the drop of a hat to an empty office during lunchtime. The nurses at that pain management center what come into the room and one of them will try to distract me while the other one try to “count“ my medication. I always counted my medication before I went in, and when I was out in back in my vehicle I counted it again. The nurses took 10 to 12 pills every time I went in for their random pill counts. They call me and say we are trying to build trust with you you need to be here within an hour or we will drop you as our pain patient. So I always went with such anxiety and apprehension because I didn’t know what was going to happen next. In 2016 My pain management doctor started lowering my medications very quickly. One day I asked if I could be lowered a little slower. He got angry, started yelling, Face red and veins bulging out of his neck and screamed “ I’m not losing my license for anybody”. He made me cry. That was the first time in 15 years of pain management that I had actually brought my daughter in with me for my appointment. She witnessed this and she was absolutely disgusted with his behavior Two days later I got a letter in the mail saying I was dismissed as his patient for being too emotional. That was the beginning of three months of torturous hell. I managed to get my primary care to bridge me for a month and then I couldn’t get another pain management doctor. I went through horrendous withdrawls. It was a week after my 60th birthday. I was in more pain those five days of withdrawal than all the painful episodes in my whole life combine together. I thought I was going to die and I almost wish I did it that time. It was awful. I went to the hospital to get help and they gave me two pain medications after seeing my blood pressure was 212/11010 and then sent me home. I felt like my blood was on fire like my blood was lava, I could feel the adrenal gland‘s above my kidneys spitting out cortisol, My muscles spasmed, I pooped, puked, shook, sneezed, and was in excruciating pain. I writhed in bed for five days. I finally was able to get a pain management doctor but was on such low doses that it wasn’t even touching my pain. To this day I am practically bedbound and when I get out I have to make sure that I have a scooter available in the store. I have always been a compliant pain management patient. My monthly and or random UAs always were correct, my pill counts were always correct, I never filled early or asked to be refilled early, I never argued with the doctor or disrespected anybody in the offices. I would just like to have my life back. I’m almost 63 now and I would like to spend some quality time with my six-year-old grandson. I can’t do anything enjoy myself because I’m just in so much pain. I implore you Please leave it up to the doctors to prescribe as they see fit. They know their patients, and their patients and of their own body. A persons body can go through only so many injections, oblations, surgeries, being poked and prodded. I would just like to live the rest of my life comfortable and enjoy the things that I should be able to enjoy in my old age. Thank you for your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484f6d008	Tallant	None	2022-02-13T15:38:07Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Tallant, Teresa	kzi-i1y5-1twc	False	None	False	2022-04-12 01:54:17.654	[]
212	CDC-2022-0024-0218	https://api.regulations.gov/v4/comments/CDC-2022-0024-0218	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a 66 year old female. I suffer 24/7 with chronic pain. I’ve told my story and explained my pain so my times I’m totally exhausted. My knee at this point no longer works, all the cartlidge is gone so it locks. Forcing my knee to bend/unlock is beyond pain, yesterday I almost passed out. I live by a certain belief of “do the least harm “ so I’m having a very hard time understanding why doctors are being forced to do that very thing “harm” patients..who do I go to for help? My knee is the least of my problems I only mentioned it because I hoping who ever reads this might understand. My quality of life is so bad. I can’t play n enjoy my grandkids or my grown children. People (even family) tire of hearing/dealing with someone with chronic pain. I pray not just for myself but all that need care with pain. Government needs to deal with the illegal street drugs like heroin, methamphetamine, cocaine, and the big one fenytanyl. Listen I’ve never even on my worst day taken an illegal drug. Nor have I found myself behaving like people that are taking illegal drugs. I suffer from Charcot Marie Disease, Rheumatoid arthritis, Degenerative bone disease. I’m a chronic pain patient only one there are millions of senior citizens just like me that need help. I appreciate the opportunity to express our need for our primary care physician to treat our pain n conditions. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eva	None	None	0900006484f6e449	Ferreira	None	2022-02-13T15:38:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Ferreira, Eva	kzi-ranp-slul	False	None	False	2022-04-12 01:54:17.871	[]
213	CDC-2022-0024-0219	https://api.regulations.gov/v4/comments/CDC-2022-0024-0219	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	II applaud these changes . I suggest a press confrence to further make these changes public knowledge. Thousands of chronic pain patients have lost their lives to suicide due to being forced tapered/ cut off without cause. Making these changes need to be followed by informing doctors on a mass scale. Also, a platform must be added to erase DOJ harressment of doctors in the face of said changes. You have a great chance to get this right for all patients suffering chromic pain. You cannot bring back the lives lost to the 2016 cdc travesty,. Keeping them in mind please move forward aggressively.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	PattiBlue	None	None	0900006484f6e70a	Hicks	None	2022-02-13T15:38:59Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Hicks, PattiBlue	kzi-rqe5-iuck	False	None	False	2022-04-12 01:54:18.079	[]
214	CDC-2022-0024-0220	https://api.regulations.gov/v4/comments/CDC-2022-0024-0220	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I am a 33 year old chronic pain patient suffering from permanent damage from Endometriosis. I have suffered through years of under treated pain because of opioid limits and lack of awareness of Endometriosis. This condition is so severe that I had to have a total hysterectomy at 32 years old and have been put in surgical induced menopause so that I no longer suffer from under treated monthly severe period pain. This condition has robbed me of my fertility. To experience the devastating reality that goes with infertility as well as debilitating pain monthly, it can take a huge toll on your life so I knew I could not go on continuing to have my period come monthly and cause me to suffer 2-3 weeks out of the month every month. I was in so much pain that I had no choice but to get the hysterectomy and gave up any possibility of having a pregnancy ever. I was blessed with a baby girl whom I adopted in 2018 so I was very fortunate to become a mom in spite of my infertility. However, my pain has not gone away and I must continue painful pelvic floor physical therapy indefinitely to help ease the damage that has been done from prolonged diagnosis of Endometriosis and under treated pain. I am constantly questioned when I have severe pain flares and need further treatment. Every time I get a virus I need further pain management because the endometriosis flares are off the charts when I’m fighting a virus that can even be painful by themselves with fever and body aches. I have been verbally abused and yelled at by doctors in Emergency Departments who refuse to review my chronic pain and prescription history and treat my pain with narcotics that do help me function, not suffer, and live a semi normal life. Once doctors have all the facts and are willing to treat my pain they then tell me that their hands are tied with regulations and restrictions on opioids. I have been threatened by doctors all types of ways and given excuses as to why they can’t treat my severe pain. One time I had a doctor tell me that the DEA was going to come after me just for being on pain medication so I should consider going off of opioids because of that but then they will give them to me, my response is always was that I would be happy to show the DEA my medical files and submit to drug tests and searches because I have nothing to hide. Please give doctors the freedom to prescribe opiates for chronic pain patients with documented conditions such as Endometriosis that require multiple surgeries and continued care. As a patient who is willing to submit to urine screenings anytime and willing to schedule frequent appointments to monitor prescription use I am frustrated that people have the right to tell me my pain is not significant enough to treat when the documentation of my painful condition is overwhelming. Stop punishing chronic pain patients for other people’s addictions. I recognize that there is addiction but that must be handled as a separate issue and on an individualized basis. Please remove prescribing limits on opioids for chronic pain patients and allow doctors to treat women's pelvic pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kayleigh	None	None	0900006484f6e737	Carlin	None	2022-02-13T16:56:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Carlin, Kayleigh	kzi-rt9t-1k9b	False	None	False	2022-04-12 01:54:18.325	[]
215	CDC-2022-0024-0221	https://api.regulations.gov/v4/comments/CDC-2022-0024-0221	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live with SLE, stenosis, osteoarthritis with all comes pain. Changes by weather, hourly, exhaustion and extreme fatigue	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f6e982	krieger	None	2022-02-13T16:58:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from krieger, Susan	kzi-s6q4-9eb3	False	None	False	2022-04-12 01:54:18.546	[]
216	CDC-2022-0024-0222	https://api.regulations.gov/v4/comments/CDC-2022-0024-0222	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a patient with multiple areas and causes for (of) Chronic Pain! I have been on Opioids for over 15 years and am being denied much pain relief (not to mention being treated like and called a "dope head and criminal" by doctors) since the 2016 guidelines which were used by doctors to reduce my medication by about two thirds.<br/>My life consists of terrible pain, braces, crutches and I am homebound all the time now except to see doctors! My Pain Dr. continually insists I have major surgery for every area of severe pain, which is knee to neck, or he will stop seeing me as a patient. Most of the surgeons he sends me to won't do surgery because they don't feel I will get much pain relief and I am a surgical risk. I have had years of injections in my joints and spine that they don't work at all anymore! Still, I am getting cut even more because the Dr. is afraid he will be investigated!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary Ann	None	None	0900006484f6e9e7	Supernaw	None	2022-02-13T17:01:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Supernaw, Mary Ann	kzi-sg7i-ep4d	False	None	False	2022-04-12 01:54:18.762	[]
217	CDC-2022-0024-0223	https://api.regulations.gov/v4/comments/CDC-2022-0024-0223	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate the CDC taking a more humane approach to the guidance on prescribing opioids. Too many people have suffered needlessly due to the restrictions on who can receive and the amount prescribed since the restrictions were imposed in 2016. I am one of those people. I have a chronic, neurological disease that necessitates my use of opioids. I hate having to take them, but have learned that if I don't manage the pain early, it will force a trip to the ER. I am not alone as you know. My neighbor committed suicide 2 years ago because he could not obtain the medication he needed to control the pain of rheumatoid arthritis. He left his wife, 2 sons, and 3 grandchildren wondering why it had to be this way. They understood the pain he was in and so frustrated and angry that he could not get the help he needed because of some arbitrary rule. Those of us who are able to function in what we consider a "normal" life feel like criminals. Pharmacies treat you like you are the crack pipe junky on the corner. Physicians force unnecessary random drug tests on us, even though our tests routinely are within range of all our previous tests. We are not the criminals the press makes us out to be, nor are we standing on the corner selling our medications. We can barely get enough medication to get us through the month and sometimes we run out and have to suffer until the next prescription cycle. I hate that I am one of the many who has to take these drugs and trust me, I have tried every alternative treatment there is with no relief. I realize that there are those who abuse the system and those who lie about their pain, but I contend they are few in numbers. You are punishing many to solve a problem that addicts and cartels will find a way around. You are punishing people who live in daily pain and that is inhumane. I appreciate you taking the time to read my comment and applaud you for seeing that there is a problem worth fixing from the previous regulations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeannie	None	None	0900006484f6ea0f	Evans-Van Hoff	None	2022-02-13T17:03:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Evans-Van Hoff, Jeannie	kzi-sk6j-fuox	False	None	False	2022-04-12 01:54:18.965	[]
218	CDC-2022-0024-0224	https://api.regulations.gov/v4/comments/CDC-2022-0024-0224	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My primary physician carefully monitors my use of low-dose opioids for chronic pain. They work very well for me. I am very careful about their use. I only take prescribed opioids, not diverted ones.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484f6ea76	Thompson	None	2022-02-13T17:03:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Thompson, Paul	kzi-smm1-7rxo	False	None	False	2022-04-12 01:54:19.170	[]
219	CDC-2022-0024-0225	https://api.regulations.gov/v4/comments/CDC-2022-0024-0225	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow doctors to evaluate and prescribe as they deem necessary. There are too many restrictions on opioids for people with certain problems. I have psoriatic arthritis and see a rheumatologist, dermatologist, as well as driving 5 hours round trip to a pain clinic once a month because the other doctors are unable to prescribe them. It is extremely difficult to get through the day. All of my joints hurt and are in flamed. I do physical therapy from time to time when needed and have tried everything else before breaking down and going to a pain clinic. I feel ashamed to have to take the medicine, but it is literally the only way I can make it through my day and get anything done. I have no problem being drug tested. I just need to have a voice and the only way to have my life in any normal capacity is with opioids. I live in a small town and our local pharmacies are all closed on Sunday. This means if i run out Saturday then I am in misery until Monday and usually later Monday afternoon as the pharmacies are so busy it takes most of the day to be filled. I have also gone on vacation to the beach. Just to lay at the beach is good for my psoriasis but if I don't plan my trip on just the perfect couple of weeks then good luck getting an opioid prescription filled across state lines. It won't happen and then you will have to suffer on something that should be helpful to your physical and mental state of being Opioids do have a place in our society and I for one am tired of being made to feel like a druggie. My rheumatologist should be allowed to prescribe this medication for his patients, If he feels it is a benefit to their life. Please reconsider lifting these restrictions. Thank you.<br/><br/>Best Regards,<br/>...<br/>Tennessee	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shannon	None	None	0900006484f6eb24	Williams	None	2022-02-13T17:04:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Shannon	kzi-stbf-sohk	False	None	False	2022-04-12 01:54:19.396	[]
220	CDC-2022-0024-0226	https://api.regulations.gov/v4/comments/CDC-2022-0024-0226	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient with neck, back, Fibromyalgia nerve disorders. I’m in constant Chronic pain. I can’t get my pain under control. I’ve been abandoned ,dosed down, dosed off opioid medications without my consent and even been without theses medications which causes side effects. These medications help so much I had a life was able to do daily task but now I can’t I don’t have a quality of life anymore. I barely leave my house barley can do daily tasks since the change of 2016 guidelines and the “Opioid Crisis”. I’m on low doses , I’m having a hard time finding a pharmacy that has these medications or will fill theses types of medications for me. I’ve be discriminated by pharmacies because I take these medications. Please re evaluate these guidelines. Chronic Pain/Cancer patients are going to the streets or even committing suicide.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6eb8c	Anonymous	None	2022-02-13T17:05:09Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-sw88-wvmi	False	None	False	2022-04-12 01:54:19.601	[]
221	CDC-2022-0024-0227	https://api.regulations.gov/v4/comments/CDC-2022-0024-0227	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My pain continues to get worse. My doctor only gives me 30mme when I should be around 50 or 60 at least! My mri warranted enough cause to be referred to a neurosurgeon in which I'm sure he will only offer surgery or injections. Ive been given so many injections in the past that fid not work and only made things worse. If my pain is that justified, to see a neurosurgeon, I should be given an increase. My record from the past 6 years of being in pain management is spotless.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chantae	None	None	0900006484f6ec89	Gustafson	None	2022-02-13T17:05:22Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Gustafson, Chantae	kzi-t9z7-stxk	False	None	False	2022-04-12 01:54:19.824	[]
222	CDC-2022-0024-0228	https://api.regulations.gov/v4/comments/CDC-2022-0024-0228	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting about CDC-2022-0024-0001 / National Center for Injury Prevention and Control, Centers for Disease Control and Prevention<br/><br/>I am the caregiver for a female who is 60 years old and has had four back surgeries, some unsuccessful; stage three breast cancer with treatment of chemotherapy, radiation, and a double mastectomy; and a recent diagnosis of Lewy body dementia and vascular dementia.<br/><br/>My loved one walks with use of a walker in the home, and we use a wheelchair outside of the home.<br/><br/>I fully support flexible standards of care in prescribing opioid treatments for chronic pain that resulting in improved function and quality of life for patients experiencing pain.<br/><br/>My loved one suffers acute, debilitating and chronic pain. She has never abused her medications. I oversee her dosages.<br/><br/>I urge you to make additional changes to the way those with chronic pain are treated, both personally and medically. You should not require that my loved one make frequent visits to both her primary care physician and to a pain management specialist. This imposes a financial burden, as the pain management doctor (she seldom sees the doctor, but sees a physician assistant and a nurse) requires a higher insurance co-pay. Similarly, you should allow doctors who treat chronic pain for familiar and documented patients the authority to prescribe opioids for chronic pain in amounts for more than 30 days. My loved one is feeble, and I must get her into the car and to the pain management clinic once a month just to have her pills counted. Give physicians the authority and support to prescribe my loved one’s pain killers in 90 day increments, to avoid repeated pain and difficulty in just getting into the car and travel, and to reduce our out of pocket co-pay expense.<br/><br/>You must also make changes that take into account the relationship between chronic pain and dementia. Studies suggest that those with dementia feel pain more profoundly or more frequently, ( https://www.nia.nih.gov/news/dementia-linked-increased-pain-years-before-diagnosis ). Published medical studies also suggest that the medical establishment’s unwillingness to accurately treat my loved one’s chronic pain may actually be responsible for the onset of her dementia ( https://rapm.bmj.com/content/early/2021/08/02/rapm-2021-102733 ).<br/><br/>I appreciate what you are doing with these proposed changes, but I urge you to more aggressively help people like my loved one better address their pain. Also, please consider specific rules for doctors to prescribe appropriate levels of opioids for those with chronic pain exacerbated and elevated by dementia. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jonathan	None	None	0900006484f6eda3	Austin	None	2022-02-13T17:06:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Austin, Jonathan	kzi-toiq-8h9o	False	None	False	2022-04-12 01:54:20.031	[]
223	CDC-2022-0024-0229	https://api.regulations.gov/v4/comments/CDC-2022-0024-0229	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a young 62 year old. Unfortunately I have had severe osteoarthritis since 50. I suffered for 11 years(taking Lortab) before I asked my doctor for Morphine ER 15mg. I was also taking Xanax 0.25 twice a day for anxiety(one of my children had died and the other was paralyzed in an accident). I went to the doctor every 3 months. On one visit he said he could no longer give me both medicines. He said I had to Choose! He said I might stop breathing! I had been on these medicines for over a year without problems. So now I have an anxiety disorder which is not being treated. My doctor was not scared I would quit breathing. He was sacred of losing his license! He also cannot give me refills on the pain medication. I have to call every month to get refills. I am willing to take drug tests. Why does it have to be so hard? Go after doctors who obviously are running pill mills. Decisions should be between a patient and their doctor, not a bureaucracy that has never seen me!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	tamra	None	None	0900006484f6edd0	kelly	None	2022-02-13T17:07:00Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from kelly, tamra	kzi-trvt-knl5	False	None	False	2022-04-12 01:54:20.236	[]
224	CDC-2022-0024-0230	https://api.regulations.gov/v4/comments/CDC-2022-0024-0230	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who has several chronic pain injuries and medical conditions resulting from my military services, I am 100% in support of relaxing the CDC Opioid prescribing guidelines. The current guidelines have created inequity in timely access to pain management medications. In addition, the current CDC guidelines have created an additional financial burden to those living in Chronic/irretractable pain because the current guidelines force legitimate pain sufferers to go to the doctor more often to obtain a script. Between additional out of pocket expenses for having to see prescribing physicians more often, patients also accrue additional expenses due to travel and time. Further, I am now subjected to drug tests 1-2X per year which I have to pay for due to the CDC's current opioid guidelines. Before the opioid guidelines were put forth, I would only have to go see my pain specialist doctor every 5-6 months. Now I have to go every 2 months simply to obtain my prescription. These added visits and drug testing creates a financial burden, especially in light of rising inflation costs, and this leads to disparities, inequality and discrimination in healthcare. Responsible Chronic Pain Sufferers are being penalized and demonized for needing pain management medications and it is becoming financially unfeasible to meet are medical health needs because of the economic burden and the stigma the CDC's opioid policy has created. The CDC MUST soften the opioid guidelines ASAP. Otherwise, these guidelines will continue to cause systemic inequity, discrimination and financial burden for this living in chronic pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f6ee4c	None	None	2022-02-13T17:09:37Z	Veteran Voices For Fibromyalgia	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Veteran Voices For Fibromyalgia	kzi-tzus-drsa	False	None	False	2022-04-12 01:54:20.440	[]
225	CDC-2022-0024-0231	https://api.regulations.gov/v4/comments/CDC-2022-0024-0231	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone living with several chronic pain medical conditions, I am 100% in support of relaxing the CDC Opioid prescribing guidelines. The current guidelines have created inequity in timely access to pain management medications. In addition, the current CDC guidelines have created an additional financial burden to those living in Chronic/irretractable pain because the current guidelines force legitimate pain sufferers to go to the doctor more often to obtain a script. Between additional out of pocket expenses for having to see prescribing physicians more often, patients also accrue additional expenses due to travel and time. Further, I am now subjected to drug tests 1-2X per year which I have to pay for due to the CDC's current opioid guidelines. Before the opioid guidelines were put forth, I would only have to go see my pain specialist doctor every 5-6 months. Now I have to go every 2 months simply to obtain my prescription. These added visits and drug testing creates a financial burden, especially in light of rising inflation costs, and this leads to disparities, inequality and discrimination in healthcare. Responsible Chronic Pain Sufferers are being penalized and demonized for needing pain management medications and it is becoming financially unfeasible to meet are medical health needs because of the economic burden and the stigma the CDC's opioid policy has created. The CDC MUST revise and loosen the opioid guidelines ASAP. Otherwise, these guidelines will continue to cause systemic inequity, discrimination and financial burden for this living in chronic pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristal	None	None	0900006484f6ee95	Kent	None	2022-02-13T17:10:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Kent, Kristal	kzi-u372-3oyg	False	None	False	2022-04-12 01:54:20.655	[]
226	CDC-2022-0024-0232	https://api.regulations.gov/v4/comments/CDC-2022-0024-0232	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC 2016 guidelines ruined my life as a chronic pain patient denied access to opioid pain medication. While I appreciate this revision, I fear it will do little to change the mess that was created by the guidelines. Many of us are being and will still be denied treatment with opioid pain medication, even those of us who had quality of life for a decade or more with opioids, and for whom other treatments have failed. That is not justice! I think this revision is too little, too late. It's definitely too late for me, because I can't bear my untreated pain any longer and have been preparing my exit plan. I pray before I go that at least a few pain patients will now be treated with dignity and compassion going forward.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandy	None	None	0900006484f6ef0c	McKenzie	None	2022-02-13T17:11:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from McKenzie, Sandy	kzi-u9q3-qwnu	False	None	False	2022-04-12 01:54:20.897	[]
227	CDC-2022-0024-0233	https://api.regulations.gov/v4/comments/CDC-2022-0024-0233	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People like me with CHRONIC pain that has been adequately treated with high doses of opioids for over a decade are still being FORCED to taper. My doctor of 12 years quit. It took me WEEKS with no medication, in severe pain and withdrawals to find ONE doctor who would take me. The rest answered the phone saying “we do not give pain meds.” I LOST MY JOB, I lost my home, I had to move back with my parents in my early 40’s with two young adult kids. My whole life was turned upside down because of the prescribing limitations. Then, when I found a doctor, he would ONLY take me if I tapered. I had no choice. Now every month I get less and less pain medicine and NOTHING else helps. I have filed for disability. How can I work getting less and less pain medicine monthly? I was a working, home owning, functioning person before. Now I lay in bed most days. I don’t sleep because of pain, I don’t cook, clean, I do nothing. My husband is ready to leave me. Without him I will be without insurance and homeless. Your prescribing guidelines have ruined the lives of so many tax paying, working Americans. We just want to have what works. I follow the rules, I don’t drink alcohol, I don’t do anything illegal. Why am I being punished? My life was over at FORTY THREE. I am now 46 with ZERO will to live. Why would anyone want to live when they cannot function? When just showering, using the bathroom, or getting dressed is excruciating? Take away the guidelines. Tell doctors they can do what they feel is right. Add more rules for patients to follow, something… anything. It’s not working now. ILLEGAL drugs caused the opioid epidemic and we all know it. How? Because us pain patients talk. And NONE of us know ANYONE who’ve died from prescribed pain medicine. Thousands upon thousands of us, or more, use them correctly. Yet we are paying for the few who don’t. Our lives are over because of a few bad apples. Because of illegal narcotics coming here from other countries. WE DONT HAVE ANYTHING TO DO WITH ANY OF THAT. But WE alone are paying for it. Please help us. Before we finally smarten up and just end our miserable lives. Because that is ALL we have to look forward to now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6ef10	Anonymous	None	2022-02-13T17:14:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-uad4-wje8	False	None	False	2022-04-12 01:54:21.098	[]
228	CDC-2022-0024-0234	https://api.regulations.gov/v4/comments/CDC-2022-0024-0234	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is ... and I am a chronic intractable pain patient. My medications have been cut drastically over the last 6 years and it has had many negative affects on my life including depression, weight gain, inability to do things I could do for myself before the reductions, high blood pressure and more. I have been on opioids for more than 15 years and I’ve never had any problems with my medications, never failed a drug test or needed emergency treatment due to my medications, but I like millions of others have been treated like an addict by healthcare professionals and pharmacies because of the 2016 CDC guidelines. I have never used illigal drugs or broken laws, I was just unfortunately born with crippling disease. I am begging the CDC to allow doctors to treat patients with care the way they see fit. Many people like myself have no other options, my progressive disease will only get worse, there is no cure or treatment other than pain management and I’ve tried everything before ending up on opioids. Over the counter meds, steroid injections, Spinal cord implants, PT, OT, pain management counseling, you name it, but nothing has helped me cope with the pain better than daily medication. Please consider rescinding the 2016 opioid guidelines as they are hurting people like me. <br/>Thank you for listening. <br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484f6f199	Bierens	None	2022-02-13T17:18:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Bierens, Brenda	kzi-v8uz-xmoq	False	None	False	2022-04-12 01:54:21.305	[]
229	CDC-2022-0024-0235	https://api.regulations.gov/v4/comments/CDC-2022-0024-0235	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is my wife's experience of how there is NO PAIN MANAGEMENT. Now at 75, she has severe chronic pain from congenital defects and since 1985 had ongoing Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). In 2010 she was put on a 50mcg/h transdermal fentanyl patch until about 2019. It worked fairly well to knock the high pain down to a more manageable level. There was never any euphoric effect. But the downside was that she experienced worsening brain fog, which she believed was from the opioids. And still I would hear her in the middle of the night sometimes, half asleep, crying out with pain. <br/>Due to her PCP suddenly withdrawing from prescribing opioids in 2018, she was referred over to a pain doctor who continued the treatment. However, her concerns for the tightening government restrictions on opioids in 2019 and concern that they may suddenly be prohibited led her to ask her pain doctor to guide her and wean off the patches over several months, which she achieved. Thereafter, with her regular PCP, she has stumbled along with less effective pain control drugs. To listen to her in her semi-sleep crying out with pain is saddening. But carry on, she has. <br/>In January 2022 she fell. For 10 days she toughed it out bedridden, and finally gave in and went by ambulance to the ER due to the immense pain. It was confirmed that she had broken her pelvis in multiple places. They said there is no repair and the pain will continue for 4-6 weeks and another 4-6 weeks to heal. In the hospital she was on reasonably adequate pain meds, namely intravenous hydrocodone, getting 120mg over a 24hr period. After an overnight stay, she was discharged with a pathetic 3 day prescription of 5mg Hydrocodone-325 mg Acetaminophen (amounting to 30mg of hydrocodone/24hrs) and told that was the max they could prescribe and to see her PCP. IT WAS CONSIDERED PROPER CARE TO IMMEDIATELY CUT THE PAIN DRUGS TO ¼? Upon discharge, she came home to bed and continued to be virtually bedridden due to pain. Her pain doctor said it had been more that 2 years since last visit, so she had to come in as a new patient, but physically, that was impossible. Her regular PCP, by a video appointment, said he could not dispense hydrocodone and said the best my wife could have was a brief Robaxin prescription and to use OTC Tylenol. IN OTHER WORDS, TOTAL DENIAL THAT THE PAIN NEEDS TO BE MANAGED. My wife has now consumed about 500 Tylenol pills over 4 weeks, probably damaging her liver in the process. I hear her yelling out in pain when she tries to slowly become ambulatory with PT help. In the night, I hear her often crying out in pain in her sleep. THIS IS HEALTH CARE? We treat animals better than that. <br/>This a 75 year old woman. I can see how younger adults in similar situations are being driven to buy illegal pain killers on the street. It is an absurd situation.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R	None	None	0900006484f6f252	S	None	2022-02-13T17:19:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from S, R	kzi-vjvm-9201	False	None	False	2022-04-12 01:54:21.513	[]
230	CDC-2022-0024-0236	https://api.regulations.gov/v4/comments/CDC-2022-0024-0236	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 69 year old chronic pain patient for 13 years. I’ve tried all alternatives for my medical issues without success. My doctor and I went through remedies other than prescribed opioids at first then different strengths. I finally was able to have a quality of life with a therapeutic dosage of prescribed opioids I was on the same dosage for 7 years, never needed an increase. Then the CDC guidelines came out. I was force tapered 2/3 of my pain medications and have since been in constant pain I am in bed 90% of the time. I have no life. I just exist. There have been no studies on long term use of prescribed opioids that gives enough information on the outcomes. The doctors need to be able to take care of their pain patients appropriately without fear. My doctor said it was fear not medical reasons. The mmes need to completely be withdrawn. There is no reason in America people in horrific pain should have to suffer they ways they have been because of the guidelines. Statistically I have 10 maybe 15 years left in my life and to know I have to live them in terrible pain when there are FDA approved medications that will help me but can’t get them because a doctor is scared is blatant discrimination. You will never know what it’s like to have chronic pain if you’ve never had it It is life changing and millions are suffering because of these guidelines. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dian	None	None	0900006484f6f27a	Barnard	None	2022-02-13T17:20:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Barnard, Dian	kzi-vmxy-plho	False	None	False	2022-04-12 01:54:21.725	[]
231	CDC-2022-0024-0237	https://api.regulations.gov/v4/comments/CDC-2022-0024-0237	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a medical social worker and care coordinator in the Northern Colorado area. I work with Medicaid clients that are medically complex clients that experience chronic pain concerns. There are several of these clients that have or are being prescribed opioids for pain management, and most of these clients are interested and aligned with exploring alternative options including chiropractic treatment, massage therapy, and acupuncture. One of the biggest barrier they run into is that many of these alternative options do not accept insurance, let alone Medicaid. Initiatives to address insurance coverage for these other options for treatment that are oftentimes just as, if not more, effective than solely managing with medications seems a critical piece of supporting success in implementing these practice guidelines. It would reduce barriers to care and increase ability of clients with Medicaid that experience chronic pain concerns and socioeconomic barriers to care to access these options, and I am curious as to what can be or is being done about this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslee	None	None	0900006484f6f2be	C.	None	2022-02-13T17:20:36Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from C., Leslee	kzi-vp4y-xgdd	False	None	False	2022-04-12 01:54:22.019	[]
232	CDC-2022-0024-0238	https://api.regulations.gov/v4/comments/CDC-2022-0024-0238	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a Crohn's disease patient for 32 years. I experience severe pain on a regular basis due to complications from this disease. I wholeheartedly agree with the new CDC guidelines for pain that were just released. We haven't chosen to have our lives interrupted with diseases and conditions causing chronic pain, yet we have to deal with doctors being afraid to treat our pain. We are labeled "drug seekers" even when we are completely transparent and follow every detail given to us by doctors. I'm fortunate in that I don't need to take pain meds daily, but when my Crohn's flares, I'm grateful I have such meds. The pain is debilitating. Please allow doctors to treat patients who suffer from chronic pain. We simply want to live our lives the best we can.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484f6f5a1	Schopp	None	2022-02-13T17:21:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Schopp, Julie	kzi-w6ae-6asm	False	None	False	2022-04-12 01:54:22.302	[]
233	CDC-2022-0024-0239	https://api.regulations.gov/v4/comments/CDC-2022-0024-0239	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a midlevel working with chronic pain patients specializing in pain medicine. I treat many different conditions that have lead patients to live with debilitating pain. With that said, I would like to voice my opinion on care, treatment, options and guidelines. I care deeply for my patients and their functional capabilities. I feel that I am nothing but another doctors appointment if I don't do my due diligence to keep them safely stable while still maintaining their quality of life. I frequently research different conditions to determine beneficial OTC medications, conservative therapies and medical equipment amongst other possible treatments. I routinely request updated imaging and testing to follow disease progression and evaluate for treatment changes. I do request blood work to ensure that prescribed medications are not causing detrimental harm to internal organs and all patients are required to undergo urine tox screens and pill counts for compliance purposes. <br/>I see many workers compensation patients as well and have limitations of treatment options due to medical treatment guidelines and formulary medications. This makes caring for my patients harder because safer choice medications are not listed within their formulary guidelines thus I am limited to change of treatments. <br/>Every person is different with regards to what their optimal pain relief is. Patients are always educated that I cannot fully rid them of pain but instead we work together with a goal to maintain a proper functioning level. I will also evaluate drug metabolism. Pending age and functional capabilities it sometimes does not make sense to change treatment especially if their regimen allows them to maintain independence and an acceptable quality of life as the benefits out weight the risks of changing medications due to age related decreased metabolism. This could lead to increased risks of potential falls which in turn could further exacerbate or worsen injury or complicate disease progression. I always review medications and interactions as well as assess other medical conditions and lab work evaluating different panels to ensure symptoms are not exacerbated by vitamin or mineral deficiencies. <br/>With all of this said as a provider who truly wants to do what's best for my patients and keeping in within the MME parameters of NYS guidelines, I feel that the opioid problems take away the ability to live by the oath that all prescribes and medical professionals take which is to do no harm. This oath also means to me that by not properly treating a patients condition, whether acute or chronic is essentially breaking that oath. Like many other medical professionals, I have completed all required schooling, clinicals, pharmacology courses and continue to learn about different options but feel that as I have earned the opportunity to help those in need that unless my treatment choices or recommendations are out of context that prescribers should not be limited to treatment options because of fear. <br/>I have also worked many many years in an emergency department where I have both successfully and unsuccessfully resuscitated overdose victims. I understand the opioid crisis and respect that it exists. I have discharged patients from the practice that have failed to screens, pill counts or show aberrant behavior. I take it into account that anyone can fall victim to opioid misuse or abuse. This is why requiremtns for pain management exist. I would love to see patients off opioids and functioning but realistically that is not always possible. Those who choose to abuse medications or misuse medications should not determine a declination in care for those who don't. A decline in functioning can further worsen pain, increase stress, a decline in mental health increasing depression, potentiate suicide ideation and cause weight gain which in turn just progresses pain even further due to increase stress on joints. <br/>I am by no means expressing an opinion that prescribers have a free for all with prescribing opioids, but what I am l expressing concerns about those who truly do need specific regimens to maintain there livelihood by helping reducing pain.<br/>Furthermore, health insurances aside from workers compensation do not always allow patients to receive better care or options due to denial of coverage or out of pocket expenses from copays/deductibles. The Healthcare in this country is backwards where I feel that people are viewed as a business transaction allowing for others within the insurance companies to authorize or decline coverage as opposed to the providers who regularly evaluate, assess and treat the patients. <br/>Again, by no means is this comment looking for changes to validate open access to over prescribing but rather the opportunity to treat based of regularly monitoring and evaluation within reason.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6f68f	Anonymous	None	2022-02-13T17:24:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-wctv-rsmq	False	None	False	2022-04-12 01:54:22.545	[]
234	CDC-2022-0024-0240	https://api.regulations.gov/v4/comments/CDC-2022-0024-0240	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support having new regulations for opioids. I had surgery for breast cancer in April 2020. My breast surgeon refused to give me a narcotics prescription. After the surgery, I am not exaggerating when I say that I didn't sleep for three nights. I had to have a second surgery two weeks later. I told my doctor that I needed a small number of narcotics because I knew the pain would be unbearable. She begrudgingly gave me a prescription for 10 pills. I still have 4 left- I did not become addicted- I just slept better. Opioids are necessary for surgery. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	T	None	None	0900006484f6fa5d	S	None	2022-02-13T17:25:41Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from S, T	kzi-wwo9-eebw	False	None	False	2022-04-12 01:54:22.766	[]
235	CDC-2022-0024-0241	https://api.regulations.gov/v4/comments/CDC-2022-0024-0241	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 62 year old nurse. I have lived and worked through the shift on prescribed opioids for pain. I believe that it is about time for this change. There are many patients with chronic pain who were made to suffer even more when doctors were made to reduce their meds to 90 per day. Then also added to their pain and suffering made to go to pain clinics in order to get prescribed meds. Pharmacy staff treating people with chronic pain like drug addicts. This has gone on long enough. Please change the rules and attitude. Treating chronic pain is humane. Senior citizens have been especially effected. Doctors have been afraid to treat patients. People are suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f6ffa6	Anonymous	None	2022-02-13T17:26:15Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-xi30-85bw	False	None	False	2022-04-12 01:54:22.975	[]
236	CDC-2022-0024-0242	https://api.regulations.gov/v4/comments/CDC-2022-0024-0242	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in chronic pain from Rheumatoid Athritis, Fibromyalgia, Chronic Pain Syndrome and bone pain. I have been on opiate medication for over 8 years. I never abused my medication. I have a hard time getting it every month. The pharmacy people are mean after they see my medication list. It causes my anxiety and depression to become worse when pharmacy staff makes me tell them every month why I get these meds. My pain management provider has me take a Urine test to be sure i take my meds properly and I can only walk to the restroom because I am able to get my pain medication. Without my medicine my quality of life would greatly suffer. I still have bad days with my medicine. Medi-cal also will not cover the amount of meds I need to have a good quality of life, but it covers enough so I am not constantly laying in bed in pain in a fetal position. At least I'm able to move even if it's still painful. It is not fair for pain patients to suffer because addicts overdose. The pain patients who take their medicine as prescribed should not have to I have such a hard time getting the medication they need that is prescribed to them by their doctor who knows they need it and works with them to figure out the best course of action for them. Please do what you can to make sure pain patients are not suffering for people who abuse drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f700ef	Anonymous	None	2022-02-13T17:27:10Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-xuk2-ebfz	False	None	False	2022-04-12 01:54:23.184	[]
237	CDC-2022-0024-0243	https://api.regulations.gov/v4/comments/CDC-2022-0024-0243	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a LPN who has worked in pain management, a mother of a severely disabled child, a patient who has had multiple surgeries, an endometriosis patient who was on daily opioid therapy for 18 months and a current CRPS patient who is very under treated for pain, I appreciate that you are taking another look at the 2016 Opioid Prescribing Guidelines that hurt so many chronic and acute pain patients.<br/>However, dropping the recommendation to ~50MME/day will serve only to continue to worsen the treatment of chronic pain patients. Additionally, simply stressing these are “guidelines” will not aid in undoing the damage from the 2016 Guidelines.<br/>There are people who have had total hysterectomies and mastectomies that were given nothing but acetaminophen for their pain. Surgery is painful, not a discomfort. You would serve the public well to ensure practitioners recognize that and treat pain accordingly. To that end, working in collaboration with the DEA to ensure practitioners who are properly treating pain are not unjustly punished.<br/>As a chronic pain patient, we recognize our pain will not get to “0”. We simply want our pain treated to a functional level. My personal goal is to be able to shower without crumbling in pain to the shower floor. Hydrocodone/APA 5/325 twice daily as needed does not even come close to helping me achieve that goal. Yet, due to the 2016 Guidelines, that’s where I am. The first opioid prescribed for my pain in 7 years. I have zero history of OUD and a diagnosed chronic pain condition. 5mg hydrocodone is all my doctor feels comfortable prescribing as a result of the 2016 Guidelines. Instead, I’ve been offered a plethora of “off-label” antidepressants/anticonvulsants that have done nothing except contribute to additional chronic diagnoses. Pain needs to be able to be treated with FDA approved medication whose specific & primary use is analgesia.<br/>I implore you to comb over the 2022 Proposed Opioid Prescribing Guidelines again with pain patients at the forefront.<br/>Thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paige	None	None	0900006484f7025c	Engle	None	2022-02-13T17:27:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Engle, Paige	kzi-y20l-ju5p	False	None	False	2022-04-12 01:54:23.392	[]
238	CDC-2022-0024-0244	https://api.regulations.gov/v4/comments/CDC-2022-0024-0244	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have two severely painful disorders. complex regional pain syndrome(crps)- considered to be one of if not THE most painful chronic pain disorder around. I also have ehler danlos syndrome(eds), a hereditary condition i have had since birth- this causes me to dislocate my joints frequently, have premature arthritis in my spine, hips, ankles, knees, shoulders and fingers. in addition I am prone to tearing ligaments when Ive partially or fully dislocated and I heal very poorly. lidocaine doesn't do anything, even at the dentist- thanks to EDS. I've been on max doses of gabapentin, pregabalin, Tylenol, ibuprofen, ketorolac, diclofenec. at different times through the years to attempt to manage my pain. antidepressants too.<br/><br/>had multiple spinal injections that didn't help because doctors ignored that -caine anesthetics do nothing for me. I even have a permanent spinal cord stimulator to attempt to treat my CRPS pain in my legs. for which I have had numerous complications from including partial paralysis of my lower legs, and my scoliosis went from 3 degrees to more than 15 after my spinal surgery. <br/><br/>unable to receive any other therapies than what I described, in desperation I turned to medical marijuana. which helped more significantly than any previous therapy I've listed. I still had/have very signifigant breakthrough pain on a frequent basis. especially when I tore my rotator cuff. none of which I have received any analgesia for other than what I have described above<br/><br/>by the time doctors even started to consider opioids for me- i was 21. despite having been seeing pain management for my conditions since the age of 12. I am 23 now and still not on a meaningfully helpful therapy despite over a decade of surgeries, procedures and desperation. <br/><br/> i was honest about using medical marijuana- obtained in my legalized state at the time (arizona) and very willing to cease using it if offered anything with at least a similar or better level of pain control<br/><br/> the most anybody was willing to do was 50mg tramadol once a day, or buprenorphprine patches- stopping marijuana and being only on either of these left me LITERALLY bedbound. tramadol did barely more than tylenol, and then I tried bupe- which I had side effects from including an inability to orgasm and new onset panic attacks- with only slightly more relief than tramadol. <br/><br/>my doctor then encouraged me to go back on marijuana if neither of those worked for me, they were unwilling to try any other therapies on me and encouraged me to discharge myself as a patient. repeatedly. said there wasn't a point in coming in since they weren't going to prescribe anything or do any more procedures- I was getting nowhere and I couldn't even see a different clinic for evaluation without discharging myself- so I did. (& have since moved to NC because life happens)<br/><br/>for a complex patient like me- the desperate attempts to avoid opioids at all costs have taken the use of my ankles. has deformed my spine further. have caused so much harm in my ability to trust doctors. it shouldn't have ended with "we can't help, discharge yourself" after over a DECADE when they were only willing to try very weak opioids. <br/><br/>ive had surgeries- multiple of them. ive been on stronger medications for very short durations of time after surgery, with massive success in not only treating the current surgical pain but what I deal with every single day of my life and with exacerbations like dislocation. instead of even considering helping me in that way, or going low and slow and trying different medications- I've been left stranded. <br/><br/>I hope these guidelines change more to include more specific conditions like crps<br/>and eds- for some conditions there needs to be a limit in the amount of non opiate therapies you need to exhaust before opioids are considered, some conditions cary an increased risk of surgical complications. like my eds does. other medications should be tried- but permanent body altering& scarring medical procedures (eds= more complications from scarring) should not be required for every single kind of patient. having to exhaust every conceivable option leaves people in severe pain for years and years. it's wrong and I am glad this change will put forth some changes that are desperately needed for people like me to live life, not just survive it. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cecelia	None	None	0900006484f70339	E Arroyo	None	2022-02-13T17:29:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from E Arroyo, Cecelia	kzi-ycb7-4dwu	False	None	False	2022-04-12 01:54:23.602	[]
239	CDC-2022-0024-0245	https://api.regulations.gov/v4/comments/CDC-2022-0024-0245	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. I have chronic lumbar pain that includes degenerative disc disease, herniated dics and nerve damage. I am in constant pain. My opioids have already been reduced from the last ruling that was pasted and now I am barely getting by day by day. If my pain management gets reduced even more my quality of life will be even reduced more than it already has been from chronic pain. I have been dealing with chronic pain since 2005 and since I have had chronic pain, life has not been the same. I haven't been able to enjoy life and do things with my children like I should. If my pain medication gets reduced even further the little I can still do with my family will cease as I know it. Why should the patients that follow all the rules and use our medication properly get punished because of those few that don't. Instead you should be making laws for those that don't follow the rules instead of punishing the patients that do follow the rules. The only thing you will create by reducing the amount is more people on permanent disability because they lost the amount of medication they can get and are now in to much pain to work. Then social security will become even more overloaded with clients and the government will be in even more debt because of what they created versus leaving things alone for those that already follow the rules that are in place.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70376	Anonymous	None	2022-02-13T17:30:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-yema-c88u	False	None	False	2022-04-12 01:54:23.821	[]
240	CDC-2022-0024-0246	https://api.regulations.gov/v4/comments/CDC-2022-0024-0246	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines are killing people. The only thing these guidelines affect are legit pain patients who do not abuse medications. Overdose rates are steadily rising despite the efforts made with these guidelines because prescription medication was never the problem. It is street drugs. Which you are pushing more and more every day people who would never touch street drugs into to get relief from the relentless pain they live with. You are pushing people into the decision to use street drugs or suicide.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lindsey	None	None	0900006484f703eb	Kenney	None	2022-02-13T17:30:37Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Kenney , Lindsey	kzi-yir2-hmkw	False	None	False	2022-04-12 01:54:24.053	[]
241	CDC-2022-0024-0247	https://api.regulations.gov/v4/comments/CDC-2022-0024-0247	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	All MME limits need to be removed, 50MME is only going to hurt even more people and cause more suicide due to pain. It will also cause more caring and compassionate doctors to be unlawfully raided and arrested.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70445	Anonymous	None	2022-02-13T17:30:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-ymh3-ns7r	False	None	False	2022-04-12 01:54:24.258	[]
242	CDC-2022-0024-0248	https://api.regulations.gov/v4/comments/CDC-2022-0024-0248	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wanted to encourage the CDC to consider the stories of pain patients when reviewing these guidelines. <br/>My story : I was denied appropriate pain relief after surgery, twice within a years time. I had to travel nearly 3 hours to find a doctor who would treat my pain for a rare, disabling condition. I was refused pain treatment by a pain specialist for supposedly not having my medication in a urine test, when I'd been taking the medicine as prescribed. When I contested, he said "we don't treat postop pain anyway... your surgeon is legally required to treat your pain." My surgeon then told me he will not treat my pain beyond 2 weeks postop. My condition can require months of pain treatment postop. I was abandoned, and no one would help me. <br/>My 82 year old grandmother. who had taken ONE single Norco a day for many years to treat her severe pain and allow her to do housework and play with grandkids, had it taken away from her "so she didn't become an addict.' She now spends most days on the couch. She's depressed, and suffering for no reason. <br/>There are many of us also, who do not metabolize certain medications as "expected" and require higher doses of medicine. This should not label as as addicts! But it does! <br/>These guidelines and crackdowns have broken down the trust between doctor and patient. Patients are afraid to tell their doctors something isn't working or even if it IS working, we are afraid that we will be punished for sharing our concerns. Doctors appointments become a source of incredible stress. Will they ask me to take a urine test? Will the test be accurate? Is this the appointment where they force me off my medication? Will they dismiss me as a patient? The refusal of doctors ro give patients the right to choose their own treatments is insane! There are pain specialists, who force you to have risky injections or surgeries in order to give you medicine. They are refusing to treat you if you don't submit to these procedures! <br/>I know of several middle class, law-abiding citizens who have been forced to the streets to treat their own pain. Removing the legal supply of pain medication has only resulted in a deep distrust of the medical profession but also an entire generation of good people who are suffering, immensely. <br/>The stories I've read in patient advocacy groups would break your heart. <br/>Finally, even addicts deserve pain treatment. Just because a person may have a history of addiction, that person does not deserve to suffer. There are a very small percentage of people who will overdose on their prescribed medication... doctors cannot be responsible for every action a patient takes outside of their office. Will some people become dependent? Yes. But no one cares about people becoming dependent on Zoloft or Paxil or these godawful Gabapentin-type drugs. Dependency does not = addiction. If people are taking their pain medication without negative consequences, addiction cannot even be considered. Addiction and dependence are not the same.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacqui	None	None	0900006484f70476	Mills	None	2022-02-13T17:31:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Mills , Jacqui	kzi-yp72-2dij	False	None	False	2022-04-12 01:54:24.467	[]
243	CDC-2022-0024-0249	https://api.regulations.gov/v4/comments/CDC-2022-0024-0249	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have trigeminal neuralgia type 2, which means I have constant pain on top of extremely painful flares. This is something I've been dealing with for over 15 years now, although the constant pain only started 10 years ago.<br/><br/>I was prescribed Percocet as a stand-by while we tried to find something that would help long-term. I have been through what feels like every nerve medication option and experienced bad or life threatening side effects. I have almost exhausted the non-medication options - surgeries aren't recommended because of my age and nature of the pain, ketamine infusions could maybe help (50% success rate) but would be a huge financial and time burden. I have had doctors refuse to take me on as a patient which resulted in me not having a doctor for years at a time.<br/><br/>Pain medication is the only treatment that's allowed me to stay functional. I could think clearly and the constant pain is kept in the background. Flares still happened, but if caught early with an extra dose, could be largely avoided.<br/><br/>But then my doctor left my HMO, and the new doctors were unwilling to prescribe pain medications. I was sent through pain management for the third time on the promise the GP would honor their decision - if pain medication was what worked, she would prescribe it. I found out later that she told them in the referral I wanted to come off the Percocet. Pain management didn't offer viable solutions (e.g., ketamine infusions), so I was stuck. In an appointment with my husband present (because that's seemingly the only way me and my pain are taken seriously), the doctor told us that she was taking me off the only thing that worked for me because continuing to be on it would result in our divorce, I would overdose, and she would get sued. She didn't want that. I was referred to a neurologist who read my file, agreed that it seemed like it was my only real option, and spoke to my doctor. But that resulted in no change to her stance.<br/><br/>I have been on a reduced dose schedule with the intent to get me off the pain medication. As the dose has gone down, so has my quality of life and ability to work/live. I live in a state where THC/CBD is legal, but to get to an equivalent level of managed pain I am at a point where it's difficult to think.<br/><br/>I am very pessimistic about my future. I'm barely into middle age and am looking at another couple decades of pain. Pain that's either ignored, downplayed, or results in me being passed around between medical professionals because I'm a problem no one wants to deal with. It seems like everyone who isn't in a position to help me are outraged at what I've been through (including MD friends outside the US), but those who are responsible for my treatment are more concerned about minimizing their opioid prescriptions than treating me. I would have given up on everything if it weren't for my husband.<br/><br/>This is being submitted under initials because I am afraid of reprisal.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C	None	None	0900006484f70479	E	None	2022-02-13T17:31:36Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from E, C	kzi-ypen-7hhx	False	None	False	2022-04-12 01:54:24.676	[]
244	CDC-2022-0024-0250	https://api.regulations.gov/v4/comments/CDC-2022-0024-0250	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing on behalf of my husband who is disabled with several spine issues inculdeing stenosis of the lumbar spine. He is under the care of an amazing pain management doctor who has done a great job of helping to control my husband's pain through a varied approach of pain management. Some of that inculdes prescribing opioids for pain. I know from dealing with all of the issues as a caregiver for my husband that he could not function physically on a daily basis without these paid meds. The clinical guidelines need to keep in mind that while opioids are addictive they are sometime necessary and it should be up to the doctor and the patient to make those decisions that will best manage chronic pain and any side effects from treatment of that pain. Guidelines should be just that and not rules or have the ability to override what the doctor and patient decide together is the best course of treatment for each circumstance. Thank you ..., West Jordan, UT	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monique	None	None	0900006484f7051d	Foust	None	2022-02-13T17:32:11Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Foust, Monique	kzi-yy9x-u127	False	None	False	2022-04-12 01:54:24.901	[]
245	CDC-2022-0024-0251	https://api.regulations.gov/v4/comments/CDC-2022-0024-0251	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prior to the retirement of my primary care physician (PCP) of over 40 years, I was prescribed Norco 10/325 for severe chronic arthritis pain. When I finally found a new PCP I was immediately sent to a pain management clinic. He refused to manage my pain. <br/><br/>Pain “management” is a joke. I was treated more like an addict than a patient. I was required to make monthly visits (very expensive), submit frequent urine tests & answer multiple questions about drug use & abuse. I used opioids for my pain very effectively & without any problems for over 20 years with the guidance of my doctor. I cannot take NSAID pain relievers as they cause me to bleed internally. Given the expense & degrading requirements of “pain management” & refusal of my PCP to treat my pain effectively I have stopped seeking treatment for my pain. <br/><br/>My life now is basically limited to using my hands only for basic life functions. I cannot do the many things I had planned in retirement. I used opioids responsibly & effectively & feel that I was stigmatized, penalized & finally driven into a life of pain by the knee-jerk response of government & medical communities to a problem that should never have been allowed to happen in the first place & was completely ineffectively managed by CDC, DEA, Congress & a general alphabet soup of agencies when it was finally addressed. <br/><br/>I’m hoping that the stigma & expense of “pain management” is banished & PCP’s are encouraged to treat their patients in the most effective & responsible ways they can.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terry	None	None	0900006484f70527	Lochmann	None	2022-02-13T17:32:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Lochmann , Terry	kzi-yyst-x45a	False	None	False	2022-04-12 01:54:25.109	[]
246	CDC-2022-0024-0252	https://api.regulations.gov/v4/comments/CDC-2022-0024-0252	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is getting out of control. The new guidelines need to change that make sense. If it needs to go back you have to have a hand written script so be it. If someone is hurting bad enough they will get into the Dr office or hospital. People that are abusing the medication or selling it. Need to be responsible. Not punished us. Pain is a real medical condition. And there is always a medical reason behind it. I wish the people that are pushing this. Have the same thing happen to them as happened to us. And get refused to get anything to relieve the pain. We can talk till we’re blue in the face. They think they know better because they went to college and what ever else. People don’t know until they Live it !! What’s next people?? The people that put them in this position needs to take them back out of their hands. If it was only that easy. I just know next week when I go to fill my Oxycodiacetamin either my doctor can’t write it or the pharmacy is out and won’t be getting anymore in. It has gotten that bad a family member went to get their fill and CVS didn’t have it and wouldn’t be getting anymore in. What is happening to are country is so SAD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f7063b	clemons	None	2022-02-13T17:32:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from clemons, Elizabeth	kzi-zkm2-zywk	False	None	False	2022-04-12 01:54:25.317	[]
247	CDC-2022-0024-0253	https://api.regulations.gov/v4/comments/CDC-2022-0024-0253	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank God, Yahvah!! It’s about time!! Yes, your stupid 2016 guidelines have caused myself much harm!! For no reason except my Dr’a we’re afraid of you and the DEA, you caused me to become a house hermit! I went from functioning at 60% to 30%, because my meds were cut by 2/3 thirds!!! I have CRPS. -!+Deg disc disease, 12 spine surgeries, incomplete spinal cord damage, neurogenic bladder, Gastro paresis, you have made my life and too many a nightmare! I went from being a special Ed teacher to 100% disabled!! What I don’t understand is that your operation is for the prevention of disease? What are you doing telling Doctors how to treat their patients? Your 2016 was not Dr.Driven or patient driven! You caused so much damage, chronic pain disease is not that the patient s are addicted drug seeking addicts? We are sick, in massive burning pain , and we can’t even have a relationship, partner with our Doctors. I pray that the Doctors aren’t afraid to do no harm; I pray you will really allow our Physicians to do what they know us best without being afraid of loosing their practice. Or worst, jail, etc!! I pray we all get our lives back some now!! We appreciate you doing the right thing! Now clean up the fetynal coming in at the s borders!! It isn’t a case of overdose. It’s poisoning the American people.. also use your power to stop supplying real addicts with crack pipes?? Is everyone loosing their minds?? Get those people help and not support their addiction, they are the addicts not the pain patient.. Thank you, don’t every punish the pain patient again, aymen <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f706c3	Anonymous	None	2022-02-13T17:33:31Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzi-zuxu-iozv	False	None	False	2022-04-12 01:54:25.522	[]
248	CDC-2022-0024-0254	https://api.regulations.gov/v4/comments/CDC-2022-0024-0254	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please return the authority to determine whether a patient needs higher doses of opioid medications for chronic pan to the doctors who treat them. I was forced off an effective dose for my severe chronic pain in 2019. It has cost me and my family so much. I cannot work, exercise, go to church regularly, or even shower daily. There is no part of my life that this has not tainted. The current guidelines are immoral, unjust, and are driving honest, law-abiding people to make drastic decisions. There are, for sure, people with legitimate need of these medicines who turned to illicit dugs because they are suffering in agony at the hands of the current guidelines. Others had to claim to be an addict because despite the intentions of the current guidelines, high doses of Methadone are given to treat addiction. It shouldn't be the case that the law-abiding patient that never abused these drugs is being punished and yet those who did abuse them can still get them. Give those of us who have need of this care access to it!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	john	None	None	0900006484f706f6	rollins	None	2022-02-13T17:33:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from rollins, john	kzj-00hz-6ed1	False	None	False	2022-04-12 01:54:25.740	[]
249	CDC-2022-0024-0255	https://api.regulations.gov/v4/comments/CDC-2022-0024-0255	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	1. Thank you for providing clarification on the issue of NOT withholding MOUD in patients who use concurrent CNS depressants, such as benzodiazepines. 2. Thank you for emphasizing the critical role that multimodal and multidisciplinary approaches play in treatment 3. Please also consider a stronger endorsement of buprenorphine as a chronic pain treatment option. Many currently think of it as a third-line treatment for patients failing chronic opioid analgesic therapy (COAT) with typical, full mu agonist agents. Based on the superior safety profile (well documented in these proposed guidelines), buprenorphine should be a preferred treatment for chronic pain over any full mu agonist form of COAT. 4. Also, please consider discussing (acknowledging with comment that more research is needed) the patient population that falls into the category describes as Complex Persistent Opioid Dependence (Manhapra 2021), which describes a large part of the population treated within the specialty of chronic pain, who have largely been excluded from identification and treatment recommendations, due to a paucity of exploration about their condition which doesn't clearly fall into the DSM OUD diagnosis or a simple chronic pain model. I feel they need to be at least mentioned in this document to increase this document's clinical relevance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marcelina Jasmine	None	None	0900006484f7074d	Silva	None	2022-02-13T17:48:11Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Silva, Marcelina Jasmine	kzi-zvp9-qx0a	False	None	False	2022-04-12 01:54:25.948	[]
250	CDC-2022-0024-0256	https://api.regulations.gov/v4/comments/CDC-2022-0024-0256	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired physician who has been on a regimen of opioids for over twenty years to control my chronic and severe leg pain. I was operated on in January 1997 to release compression on my left sciatic nerve that caused foot drop. After the laminectomy, my surgeon informed me that my nerve was badly damaged and would never return to normal. I was paralyzed for forty days after the surgery and slowly began the long road to recovery. I have been living my life since that day with severe radiculopathy that affects the motor, sensory, and proprioceptive fibers of my left leg. I thankfully was able to walk again with the help of both physical therapy and a combination of Oxycontin and Amytriptylin. It took a five-year titration period with my doctor to arrive at the correct dose of opioids that made my pain tolerable, and I have been on the same doses of Oxycontin and Amytriptylin for over twenty years. During the course of my titration period I tried many other non-opioid pain management treatments that either did not work or gave me severe side-effects including Lyrica, increasing the dose of Amytriptylin, steroid injections, TENS stimulation, acupuncture, etc. <br/><br/>I fully support the new guidelines from the C.D.C. that remove the previous recommended ceiling on opioid doses for patients with chronic pain. A minority of patients, like myself, require doses that exceed the daily 90 milligram morphine equivalency. The last few years have been a horror show of being bounced from doctor to doctor, with drastic reductions in my dosage which left my in excruciating pain, unable to exercise or even walk unassisted. The damage done to my left sciatic nerve due to the complications of my surgery has left me with chronic weakness in my left foot and a lack of balance, and therefore exercise is extremely important for me to keep my left leg muscles strong so that I don’t fall when I walk. Without the correct dosage of opioids, exercise is impossible due to the severe pain, my left leg muscles atrophy, and I am much more susceptible to falling and injuring myself. <br/><br/>Allowing patients to work with their doctor to find the correct dosage of opioids, after other nonopioid therapies have been attempted, should not be unreasonably withheld if the patient is compliant. A one-size-fits-all approach dictated by the government has been a recipe for misery and suffering for many patients that are living with chronic pain. I am relieved the C.D.C now understands that pain care needs to be individualized, and that there are some cases of severe, chronic pain that are best treated with higher doses of opioids. These patients should not be treated like criminals or forced to live in unbearable pain due to a failed surgery. If an opioid treatment regimen works, especially if the patient has maintained a stable dose for years, then the pain management doctor should be allowed to continue prescribing that regimen without fear of government reprisal. <br/><br/>It is my hope that the proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids will pass, allowing myself and other patients to live out our lives in dignity with a pain management regimen that works. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacqueline	None	None	0900006484f70759	Khoury	None	2022-02-13T18:19:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Khoury, Jacqueline	kzj-09m4-qm3w	False	None	False	2022-04-12 01:54:26.706	[]
251	CDC-2022-0024-0257	https://api.regulations.gov/v4/comments/CDC-2022-0024-0257	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please give doctors back the right to decide who is in need of pain medication. My brother has been in severe pain ever since his motorcycle wreck in 2009 leaving his arm paralyzed. With the last restriction implemented he now has more pain than ever with no relief because of the restrictions in place. I ask that you please consider the need of people like my brother who do not abuse the medication and allow the doctors to decide. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f707db	Rollins	None	2022-02-13T18:20:07Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Rollins , Michael	kzj-0o27-1ux3	False	None	False	2022-04-12 01:54:26.915	[]
252	CDC-2022-0024-0258	https://api.regulations.gov/v4/comments/CDC-2022-0024-0258	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s just obnoxious when doctors who don’t have chronic pain and experts who don’t have chronic pain weigh in on how people with chronic pain should be treated. You should treat the individual. If the individual needs a higher level of narcotics to address their pain and can handle it they should be able to have it. If you’re somebody who’s been on pain medication for decades and you’re doing OK and it’s helping you live a normal life then who are these people to say you should only receive a certain amount. And experts have been wrong over and over again. Why should they be given any credence on this?? The government is setting up drug injection sites and handing out crack pipes to addicts. So those people can shoot up whenever they want? But the every day people who have to go to the drugstore for their drugs should be limited by their doctor and the experts. One of my best friends has multiple conditions that cause severe chronic pain and the limitations have caused her quality of life to plummet for absolutely no reason other than some expert said she should not receive the treatment she needs because some people become addicts. Stop painting with such a broad brush, get the government out of medicine and let doctors treat their patients. So freaking backwards!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70807	Anonymous	None	2022-02-13T18:33:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-0s8c-a5lo	False	None	False	2022-04-12 01:54:27.161	[]
253	CDC-2022-0024-0259	https://api.regulations.gov/v4/comments/CDC-2022-0024-0259	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please let the choice of medication and dosage be between the patient and the doctor. Please inform en masse to doctors that the DEA will not come after them for prescribing necessary proper treatment for their patients even outside of the MME 90 “suggestion” . Doctors are terrified to prescribe it must be addressed loudly, firmly and clearly many great doctors have already left after being relentlessly hassled for properly treating patients and many patients have died due to just cold turkey stopping patients medication and suicide from forced tapering. Get the DEA out of the doctors office and to the streets where the illicit fentanyl is killing so many. Bring the Hippocratic oath back to life. Please let doctors treat their patients and not be managed by fear and the unreasonable overreaching 2016 guidelines. This lunacy must stop	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70809	Anonymous	None	2022-02-13T18:33:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-0set-yuob	False	None	False	2022-04-12 01:54:27.393	[]
254	CDC-2022-0024-0260	https://api.regulations.gov/v4/comments/CDC-2022-0024-0260	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I broke my neck in 88 and have been on pain meds for over 20 yrs but recently I was dropped to 1/4 of my previous meds. This has pretty much ruined what little life I did have. The CDC needs to understand that there r folks that need their meds to just get by daily. I don’t think u guys understand just what I have done to the chronic pain patients. This needs to change immediately. Thank u. ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484f70811	Brawley	None	2022-02-13T18:34:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Brawley, Kevin	kzj-0tj5-1kzh	False	None	False	2022-04-12 01:54:27.599	[]
255	CDC-2022-0024-0261	https://api.regulations.gov/v4/comments/CDC-2022-0024-0261	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You guys have no right to tell someone who is in serious pain that they can't have the medicine they truly need. I know others have abused the power and died but that was their choice. Please give our rights back so many people truly need the medication! Thank you .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f70833	None	None	2022-02-13T18:34:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Self	kzj-0w0g-ikpy	False	None	False	2022-04-12 01:54:27.802	[]
256	CDC-2022-0024-0262	https://api.regulations.gov/v4/comments/CDC-2022-0024-0262	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a brother of mine who in desperate need for relief from an accident he had a while back and nothing is touching it. Please please give the doctors back the need for them to treat and have the decision what their patient needs. Thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484f7086b	Johnson	None	2022-02-13T18:35:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Stephen	kzj-11r0-7v8s	False	None	False	2022-04-12 01:54:28.029	[]
257	CDC-2022-0024-0263	https://api.regulations.gov/v4/comments/CDC-2022-0024-0263	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since buprenorphine is arguably the safest opioid analgesic, its use instead of full agonist opioids to treat both acute and chronic pain should be explored and encouraged. It should even be considered for reversing full agonist overdose as it has a longer duration of action than naloxone and can be more easily carried in sublingual form in one's wallet.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Berry	None	None	0900006484f70874	Edwards	None	2022-02-13T18:35:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Edwards, Berry	kzj-12g4-4wgc	False	None	False	2022-04-12 01:54:28.268	[]
258	CDC-2022-0024-0264	https://api.regulations.gov/v4/comments/CDC-2022-0024-0264	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have intractable pain secondary to rsd, multiple crushed and herniated disks, and several torn ligaments in my leg. I cannot have the disks or ligaments repaired due to the rsd, my doctor has been under treating my pain for many years now saying the government will not allow him to treat it with higher dosages. He has told me that if it were up to him that he absolutely would treat me with a more adequate dosage and that my situation certainly needs to be treated with a higher dosage. now today I talked to him about these cdc guideline corrections and he said that it did not matter. He says that even if the cdc guidelines are changed the dea will still pull his license if he prescribes more than 90mme to any patient.so, can someone please help me? when I was prescribed adequate pain meds, I held a full time job, had a wife, home and could interact with my children. now I have lost everything and am bedridden 90% of my waking hours in horrible unending pain.... Please help me!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70896	Anonymous	None	2022-02-13T18:35:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-17l8-szkk	False	None	False	2022-04-12 01:54:28.486	[]
259	CDC-2022-0024-0265	https://api.regulations.gov/v4/comments/CDC-2022-0024-0265	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 40 year old disabled chronic pain patient. In 2017, I was abruptly dropped from my doctor's office and cut off cold turkey from opiates, which were giving me a much improved quality of life. Over the last 5 years I went from working a full time job and being productive, to now being completely bound to my bed. I'm confined to a wheelchair permanently. I've tried every type of non-opioid treatment available, including PT, painful injections, nerve blocks, and medications like gabapentin that did nothing but make me gain 50 lbs. Then, I was told by my pain management doctor that I just needed to lose weight and I'd feel better. The only treatment that ever helped me was opiates. I've had 5 vertabrae fused together, I have autoimmune diseases, and a very rare arteriovenous fistula in my spinal cord, and there isn't a doctor who will help me get my quality of life back due to the incredibly harmful 2016 CDC guidelines. I'm told I'm too young to be in pain, so I can't get help. I am just one of many pain patients who have been treated in this manner. I've contemplated ending my own life because the pain is unbearable. It's unfair and inhumane to make people suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f708bd	Anonymous	None	2022-02-13T18:36:34Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-1bia-546k	False	None	False	2022-04-12 01:54:28.693	[]
260	CDC-2022-0024-0266	https://api.regulations.gov/v4/comments/CDC-2022-0024-0266	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I notice that the draft discusses personalized decision making in terms of balancing "benefits" and "risks". This language implies that benefits are certain and harms are only possible- the preferred language should use the equivalent terms of "benefits" and "harms". Alternatively, you can discuss balancing the likelihood of benefit against the likelihood of harm.<br/><br/>To foster clearer thinking among clinicians and better shared decision-making with patients, it is important to use precise language.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f708c7	Korenstein	None	2022-02-13T18:38:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Korenstein, Deborah	kzj-1cax-mz7i	False	None	False	2022-04-12 01:54:28.908	[]
261	CDC-2022-0024-0267	https://api.regulations.gov/v4/comments/CDC-2022-0024-0267	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I strongly believe the CDC should give doctors back the power to decide whether their patients have need for high doses of opioids to treat chronic pain. The doctors have a more personal relationship with their patients and know what’s best for them. It is necessary for some people to have a good quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f708f9	Anonymous	None	2022-02-13T18:39:07Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-1gu1-c5hy	False	None	False	2022-04-12 01:54:29.118	[]
262	CDC-2022-0024-0268	https://api.regulations.gov/v4/comments/CDC-2022-0024-0268	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I welcome an improvement in guidance towards prescribing opioids but the CDC guidance sadly still discriminates against many disabled individuals. They clearly specify that conditions like cancer and sickle cell anemia are exempt from the guidance and I agree with this clarification but the same should also extend to individuals with non-idiopathic pain. People with severe chronic pain that is backed by scientific evidence proving their condition(s) should have safe access to medications that reduce their suffering safely under the supervision of a doctor the same as individuals with cancer and other serious painful medical conditions. I am personally in severe pain and have been for 28 years after a severe spine injury that went misdiagnosed by doctors for the majority of my life. I was forced to turn to illegal sources of marijuana to ease my pain before any states had legalized use, medically or recreationally, and had to relocate to another state in order to get safe, legal access to medical marijuana when it was legalized. I never wanted to take pain management into my own hands but the my government and the healthcare system failed me and left me to suffer without legal options for pain relief. Despite moving to a state with legal access to medical marijuana, most doctors were too afraid to prescribe it due to its schedule 1 drug status and the few that were willing to help patients like myself were attacked by politicians, law enforement, and the state medical board. The doctor helping me was literally raided by the DEA who cut a hole in the wall of his records room, seizing all records inside, and pushed the state medical board to suspend his license and they did. They doctor got his license back and continue to fight for patients like myself but his reputation was constantly attacked by those previosuly mentioned. I never did get access to my medical records seized by the DEA. Once the state legalized marijuana for recreational use, which I opposed, state lawmakers made it illegal for me to drive so I opted for safe access to opioids so I could continue to be under the care of a physician. Opioids are proven to have more analgesic properties so the change ended up being better for my healthcare but it has honestly been more difficult to obtain prescribed opioids, a schedule 2 drug with known medical uses, from the healthcare system than it was to obtain marijuana, a federally illegal schedule 1 drug. As a chronic pain patient it is honestly easier to obtain deadly illicit opioids laced with fentanyl from the black market than it is to get them safely through the heqlthcare system. This issue for patients suffering is absurd. I have had to fight for access to pain management and medical imaging such as MRIs to confirm my severe health condition that doctors wanted to ignore since chronic pain is often incurable. Now that I have a clear cause of my severe pain which has been confirmed as severe by multiple radiologists and subsequently many doctors I am thankfully able to find a rare compassionate doctor willing to ease my suffering via opioids and nerve blocks. The healthcare system, especially pain management, needs improved significantly. The government trying to criminalize opioid use and removing safe access for individuals is directly causing individuals to obtain illicit sources of medicines which can be fatal and this is clearly why opioid deaths continue to rise, directly correlating with harsher government laws and policies towards drugs. I am personally opposed to recreational use of alcohol, marijuana, and opioids, but people with medical conditions should have safe access to the medicines they need to live and individuals truly suffering are either going to find a way to get the medication they need to survive or they will parish, similar to how a starving person or animal will fight for survival. I personally am below the 2016 CDC recommended 90 MME daily limit for patients seeing general practitioners and have been stabilized on my dosage for quite some time yet most general practitioners tell me they used to prescribe my medications but no longer will out of fear of the federal government and it is incredibly sad. I understand why doctors rightly fear the DEA and the federal government because being compassionate enough to help patients in need can literally ruin their life and this is where the problem is. Change your stance and end your discrimination towards disabled individuals. If you must stigmatize medical drug use, at least treat use as a medical issue instead of a crime. Patients like myself just want to increase our function and reduce our pain levels and the public servants that are tasked with helping the public should quit enacting guidance that results in harming them. Please, exempt non-idiopathic chronic pain from the guidelines and encourage states to roll back their discriminatory state laws and policies that resulted from the harmful 2016 CDC opioid guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70957	Anonymous	None	2022-02-13T18:40:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-1u71-2jqh	False	None	False	2022-04-12 01:54:29.323	[]
263	CDC-2022-0024-0269	https://api.regulations.gov/v4/comments/CDC-2022-0024-0269	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please have a federal registry that that all opioid prescriptions cannot be filled without:<br/>Patient's photo ID<br/>Automatically links to all patient's prescriptions that are dangerous to mix with opioids, e.g. zanax<br/>Prevents the filling of the rx until all doctors are informed of the dangers of mixing opioids and zanax, e.g. and pharmacy receives their written approval<br/><br/>My 24 year old grandson died - not from overdose, but from the mixing of oxycotin and zanax, rxs written by 2 different doctors but filled at the same pharmacy - <br/>PLEASE<br/>from a grieving grandmother.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ardis	None	None	0900006484f7098f	Jerome	None	2022-02-13T18:40:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Jerome, Ardis	kzj-21x0-zz9p	False	None	False	2022-04-12 01:54:29.533	[]
264	CDC-2022-0024-0270	https://api.regulations.gov/v4/comments/CDC-2022-0024-0270	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a current business executive that spends a great amount of time traveling on business, which is being hindered by severe chronic pain. You see, I'm a chronic back, neck, and restless leg syndrome pain sufferer who's had 3-4 back surgeries and numerous nerve studies in the course of 14 years. I've tried PT, massages, OTC pain meds, high doses of gabapentin, Lyrica, muscle relaxers, and more, resulting in no relief from my pain. In October of 2018, I had a fusion (360) and ended up with no relief from pain; rather spent five months on a wound vacuum due to no healing. Surgery is no longer an option because I am prone to post-op infections. Currently, I'm under a pain management program and forced to (1) run out of pain meds each month or (2) go days without meds to prevent early depletion. I have a great pain management physician in cypress, texas; however, he is forced by law to restrict what he can prescribe me that will last month over month. I realized some abusers make it bad for legitimate pain sufferers. Still, I do believe, at least, my provider can determine if an individual is abusing pain meds or not. Leave that decision to the qualified professionals. I'm not a good candidate for more spinal surgeries, and there is currently no cure for restless leg syndrome nerve pain. I strongly support this new law and hope this comment is a positive deciding factor in this ruling	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f709db	Sayles	None	2022-02-13T18:41:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Sayles, James	kzj-29xt-lv8m	False	None	False	2022-04-12 01:54:29.736	[]
265	CDC-2022-0024-0271	https://api.regulations.gov/v4/comments/CDC-2022-0024-0271	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe scoliosis which has caused me pain for over 50 years. <br/>I wore a Milwaukee Brace 23 hours a day for a year to try to keep the curvature from worsening. At the age of 18 I had a Harrington rod placed on my spine. It immobilized my upper spine and served me well for many years. <br/>Because my low back bore the brunt of all movement, I suffer from debilitating back pain particularly in my low back and now need opioids to maintain any form of normalcy. I take my pain meds as prescribed because I barely get enough to keep the pain under control. <br/>Taking away my pain medication would leave me bed ridden. Unable to go to the store, visit a friend, stand and prepare dinner, etc. <br/>I would be left with no quality of life. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f70a05	Lakatos	None	2022-02-13T18:42:00Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Lakatos , Linda	kzj-2di0-hj3c	False	None	False	2022-04-12 01:54:29.991	[]
266	CDC-2022-0024-0272	https://api.regulations.gov/v4/comments/CDC-2022-0024-0272	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with chronic pain most of my life as I broke my neck when I was young and its effects only get worse the older I get. By properly using pain medication I am able to function and live happily. I understand there are issues with unchecked prescriptions for this kind of medication but the government should in no way get between a competent doctor and their patient in terms of proper care because of other people and or doctors that are out of control.<br/><br/>Allow doctors to treat their patients to the best of their ability without concern of government officials creating problems in the name of "concern for citizens being".	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allen	None	None	0900006484f70a4c	Bongard	None	2022-02-13T18:42:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Bongard, Allen	kzj-2m3l-ik0u	False	None	False	2022-04-12 01:54:30.215	[]
267	CDC-2022-0024-0273	https://api.regulations.gov/v4/comments/CDC-2022-0024-0273	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Once again I will have to fear my doctor getting afraid to write a prescription for pain medication I have been taking for years. I have tried many different medications over the years and this one helps me most daily functions. The CDC rules harms people who do not abuse their meds, and we are treated worse then a street junkie by pharmacists that are told anyone who uses opiates is bad. It's impossible for me to ever get a prescription filled locally so my legible now comes across state lines in jersey cause my local pharmacist could not get it for me in NY.<br/>Same goes for Pennsaid, I had to write a letter stating why I get this medication<br/>. My pharmacist had to call my doctor also for a letter. <br/>Please do not cause more worry and anxiety to chronic pain suffers, we are dealing with enough life issues and having my doctor scared isn't good. <br/>Yes there are abuses but with computers it should be simple to find a bad apple without new changes. <br/>Thank you<br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	susan	None	None	0900006484f70b13	silverstein	None	2022-02-13T18:43:15Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from silverstein, susan	kzj-394k-ae68	False	None	False	2022-04-12 01:54:30.422	[]
268	CDC-2022-0024-0274	https://api.regulations.gov/v4/comments/CDC-2022-0024-0274	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I do hope the right to exercise professional judgement about pain control is given back to the physician where it belongs. For some patients with issues of chronic pain, the prescriptions of physical therapy and life style changes have been tried and failed. Their quality of life can be greatly improved by proper use and oversight of pain medications. While of course, the government agencies know what is good for us and "feel our pain"; I prefer to trust my doctor to help me when I am hurting.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70b28	Anonymous	None	2022-02-13T18:44:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-3ci0-0w03	False	None	False	2022-04-12 01:54:30.642	[]
269	CDC-2022-0024-0275	https://api.regulations.gov/v4/comments/CDC-2022-0024-0275	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Data and word of mouth confirm involvement of DEA and CDC in prescribing revaluations has resulted in escalating suicides, decreased quality of life & increased suffering for patients, and their loved ones, increased overdoses from synthetic non-prescribed opiates. my father is forced to live in agony every minute of every day, from sun up to sun down. My sons know no difference in how he plays. Grandpa fitches, he groans, he squints his eyes and bits his lip in an attempt to conceal his pain. however I remember the man my father was, just a few years ago. who my Father was before the government took his quailty of life away.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R	None	None	0900006484f70b9c	C	None	2022-02-13T18:45:23Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from C , R	kzj-3rbm-f4aq	False	None	False	2022-04-12 01:54:30.883	[]
270	CDC-2022-0024-0276	https://api.regulations.gov/v4/comments/CDC-2022-0024-0276	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer (I had major back surgery 11 years ago, but it was 10 years too late) I had had shots of cortisone, had a simulator implanted and removed, have had my nerves ablated, been to numerous chiropractors, had physical therapy, MRI's, CAT Scans and been on every single non-opioid pain medicine known to man and nothing helps my pain as well as opioids. The medication is not something anyone takes lightly and I am so lucky I have a doctor who trusts and believes me when I tel her about my pain. I will always have some level of pain, I haven't been pain free since I can remember (I have many other issues besides my back but they pretty much all stem from there) and I have excepted that. I can live with being mostly pain free, which allows me to have a little bit of a life - I can drive, I can sit up, I can walk and I can live. I strongly urge the CDC to loosen these guidelines as most of the opioid deaths are NOT from chronic pain patients, but from people who use street drugs or have illegally obtained the drug; us chronic pain folks want to LIVE which is why we take the medication. Personally, I have never heard of a chronic pain patient, someone who has been in pain for years, die from an overdose. While I certainly agree that there needs to be some guidelines, the amount of people that have been abruptly taken off their medication due to doctors fearing repercussions from the CDC and the law is staggering - people are killing themselves due to this practice, why aren't those deaths taken into consideration?? There is so much I want to say, I could write a book, but I think this is sufficient. I hope I got my point across and thank you for reconsidering the current guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christi	None	None	0900006484f70b9f	C	None	2022-02-13T18:46:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from C, Christi	kzj-3rsf-tscp	False	None	False	2022-04-12 01:54:31.084	[]
271	CDC-2022-0024-0277	https://api.regulations.gov/v4/comments/CDC-2022-0024-0277	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was unable to walk or stand any longer than 5 minutes because of an unidentified issue. Pain medicine gave me back so much of my life. Not only could I walk and stand again without need for breaks, but I could enjoy activities I loved once again. I am dependent on my medicine to get adequate sleep and do simple things like clean my home, cook meals, and get my degree.<br/><br/>Everyone should be allowed the chance to enjoy their life. For most, they’re just asking to be able to live without excruciating pain. Please don’t punish pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amanda	None	None	0900006484f70ba6	Heise	None	2022-02-13T18:46:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Heise, Amanda	kzj-3saj-gw12	False	None	False	2022-04-12 01:54:31.290	[]
272	CDC-2022-0024-0278	https://api.regulations.gov/v4/comments/CDC-2022-0024-0278	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been practicing pain management for over 20 years and have encountered multiple patients using high doses of opioids that produce side effects such as erectile dysfunction and falls that were not discussed by the original prescribers before initiating the regimen. I believe that all risks should be discussed before commencing chronic opioids. In addition, I have another set of elderly patients receiving high doses of opioids MME 200 and using benzodiazepines and habit forming hypnotics. This particular population is exquisitely sensitive and any intended or accidental dose increase can lead to a tragedy. So, we are working on decreasing the dose and therefore the risk. I would like to request that no elderly patient ( >65 year of age) exceed the set limits. Lastly, I like to say that the faculty teaching the safe opioid courses seem to endorse the use of opioid agonists with proper documentation. In my opinion, there are no safe opioids and all of them require close monitoring. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	0900006484f70bbb	Kiltinen	None	2022-02-13T18:46:45Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Kiltinen, Anne	kzj-3u9g-dl8t	False	None	False	2022-04-12 01:54:31.499	[]
273	CDC-2022-0024-0279	https://api.regulations.gov/v4/comments/CDC-2022-0024-0279	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am opposed to softening the opioid guideline recommendations. As a recovering addict, a person who worked for years as a therapist at inpatient addiction hospitals, and a person who has a family member who is a heroin/fentanyl addict stemming from an initial opioid prescription for legitimate pain, I would like to appeal to the CDC to continue to recommend prescription of such medications with an abundance of caution and monitoring. My opinion is that the majority of pain docs and surgeons that are concerned about such guidelines are primarily concerned about their own personal inconvenience and inability to educate patients about the dangers of pain meds and manage through patient concerns or complaints. Many such docs have historically been of the opinion that "you can't get addicted if you're really in pain", and although this has been proven incorrect to the tune of hundreds of thousands of deaths, many continue to cling to this notion, even if they have amended it a bit. The bottom line is that no one that isn't hospitalized needs more than 3 days of reasonable strength opioids without additional monitoring. Being completely free of pain isn't a reasonable goal for some patients, and they should be educated on this. Making pain manageable with the least amount of addictive meds should always trump any other goals, as these are life and death medication decisions and should be treated with the seriousness that this implies. I'm concerned that any softening of guidelines is the beginning of a slippery slope of not taking this crisis seriously at a macro level. There are no indicators that we should ever loosen up, as even if the crisis abates, it is lying in wait to occur again if attitudes, guidelines, and regulations soften.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484f70bde	Cordera	None	2022-02-13T18:47:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Cordera, Laura	kzj-3yd8-k9h6	False	None	False	2022-04-12 01:54:31.701	[]
274	CDC-2022-0024-0280	https://api.regulations.gov/v4/comments/CDC-2022-0024-0280	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Don't limit how much pain medication my doctor can prescribe. My doctor knows what's best for me. You don't.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484f70bed	Merfeld	None	2022-02-13T18:47:29Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Merfeld , Paul	kzj-40nn-19fd	False	None	False	2022-04-12 01:54:31.920	[]
275	CDC-2022-0024-0281	https://api.regulations.gov/v4/comments/CDC-2022-0024-0281	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	WHile fighting cancer after your guideline of 2016, it became impossible to get pain relief. I had already been kicked out of a pain clinic for fibromyalgia pain due to them no longer allowing pain medication as the only step in pain relief. (It was all I needed as opposed to nonworking shots in my neck) I had to figure out how to deal with fibro related pain on my own as dr after dr stopped helping me thanks to your guidance.<br/>I got cancer in 2018 and then pain from the cancer drugs. I had to switch oncologist after oncologist as they were also using your guidance-which is to not treat pain adequately (or at all for most). I was starting to think about stopping cancer treatment entirely. I was becoming suicidal. I am only here and on my cancer drugs thanks to my oncologist (number 4) who did not follow your guidance.<br/>Your guidance should be to let drs use their judgment and not get between a patient and their dr.<br/>You nearly cost me my life, and your guidance cost many people their lives through suicides that occurred when they could no longer get pain help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70bf7	Anonymous	None	2022-02-13T18:47:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-425y-kjvw	False	None	False	2022-04-12 01:54:32.125	[]
276	CDC-2022-0024-0282	https://api.regulations.gov/v4/comments/CDC-2022-0024-0282	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	FR Doc. 2022-02802<br/><br/>I have Flat Back Syndrome with limited treatment pathways that affect me for the rest of my life. Only four doctors, in the U.S., provide definitive treatment for this Syndrome and the process can leave a patient in worse condition due to extent of the devices required for stabilization.<br/><br/>This condition cause the spine to exert force downward on the pelvis causing a fracture of S2. The treatment for fracture included support the spine with plates and screws involving two five inch screws place into the pelvis. I had three different surgeries during this process with two just one month apart due to the fracturing of S2.<br/><br/>I was under treatment by a pain specialist until January 2019 when the FBI and DEA misused 2016 CDC guidelines involving treatment facilities treating addicts and opioid abusers. Since that date, I have had little treatment for the massive pain caused by deterioration of my condition.<br/><br/>The 2019 and the proposed 2022 guidelines will not be successful unless the ability of pain specialist are returned to their license suspended by such misuse of the 2016 CDC guidelines.<br/><br/>The loss of pain medication has caused major changes to life style and the ability to interact with friends and family. I have grandchildren that participate in youth sports and the pain has forced me to forego watching such sports activities.<br/><br/>Proper treatment is a must to regain function and the ability to interact in daily routines.<br/>Any guidelines must return prescribing for chronic suffering from such misuse by enforcement by agencies applying the 2016 chronic pain guidelines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	0900006484f70c03	Maxwell	None	2022-02-13T18:48:02Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Maxwell, Shirley	kzj-43m9-dpdh	False	None	False	2022-04-12 01:54:32.333	[]
277	CDC-2022-0024-0283	https://api.regulations.gov/v4/comments/CDC-2022-0024-0283	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The way Pain Management is treated is wrong. Yes there are several out there doing things with pain medicine that they shouldn't be doing but there are several who actually need the medication to function a normal life such as having a chronic disease that hampers them in there daily functions or sleeping at night. I have Multiple Connective Tissue Disease and Pulmonary Fibrosis and the pain mgmt physician that was handling my 1 pain pill a day got jumped on from the DEA and made her surrender her license and said it was effective immediately no taper down no giving to another physician just didn't even take in to consideration of what it will do to all the patients she was treating. She also would do toxicology screens at random and had Drug contracts with the physician but they didn't care about any of that they just wanted her to be done and the patients can fend for themselves. I luckily was not taking anything to heavy and another one of my care physicians is willing to step up to the plate for now but it is unfair to do this to patients that really do have conditions and need for help with pain. To just say everyone out there should get the same dosages or should not be taking anything is just wrong. I fully hope that anyone setting these rules out there never sees anyone with real pain or have to deal with it themselves because every person is a individual and should be treated as an individual person and diagnosis. Please fix this broken system. Stop blaming innocents and Physicians for a broken system.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70c25	Anonymous	None	2022-02-13T18:48:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-481r-3mq6	False	None	False	2022-04-12 01:54:32.566	[]
278	CDC-2022-0024-0284	https://api.regulations.gov/v4/comments/CDC-2022-0024-0284	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think that you are really playing with fire. We have an epidemic on our hands. What makes you think doctors will abide by this? We got into the situation because there were doctors who just prescribed and weren't held accountable. There has to be some accountability. We cannot just assume all doctors are good doctors. Some will abuse this. I understand that people require pain meds and that there has to be a way fir those who need them to get them . It's up to you to find the right way to do it. This isn't it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70c2f	Anonymous	None	2022-02-13T18:49:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-48zv-lyfa	False	None	False	2022-04-12 01:54:32.797	[]
279	CDC-2022-0024-0285	https://api.regulations.gov/v4/comments/CDC-2022-0024-0285	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make a clear and definable distinction between illegal drug users, addicts seeking medication for the purpose of pleasure effects, and legitimate patients who are in chronic pain. I do not believe opioids should be prescribed for short term pain (Less than 3 months duration) unless that use is strictly monitored and limited in duration. Patients who are genuinely chronic pain sufferers should be allowed access to supervised treatment with opioid medications provided they are not: Addicted to any other substance which may interfere with the opioid medication, clearly using illegal substances for pain or pleasure, at high risk of overdose due to an impaired mental state such as severe depression, suicidal ideation, or other judgement impairing states, or live with others in a household where the security of the drugs for pain may be at risk of abuse. A questionnaire should be implemented by trained psychologists to determine current and ongoing risk factors or impediments to the prescribing of opioid medicines for safety purposes. Periodic review of the patient's condition, response to treatment, opportunities for new treatment, or suitability for other currently available treatments should be conducted at intervals in the duration of treatment. In addition, patient's with chronic pain could be categorized according to levels established concerning whether their pain is permanent and cannot be resolved, currently permanent but resolution is possible, chronic but treatable with current or future alternative treatments, chronic and recommended alternative treatments exist, and chronic with alternative resolution likely. Depending on the category of condition in which the pain sufferer is placed, the same level of monitoring, follow-up, and suggestion for alternate treatment should be conducted. In any case, counseling as well as psychological therapy should be available to patients so that they are not in any case treated by medications alone, due to the effect of chronic pain on mental outlook, status, and the possibility that the pain sufferer may decide that living with the pain, even if treated, is not in their best interest. It is my opinion, and only my opinion, that many deaths and overdoses occur involving prescription opioid use because of suicidal tendencies of the patient, so this must be ruled out for effective treatment. In addition, a national hotline should be set up for chronic pain sufferers who may or may not be prescribed opioids, in order for them to call in the case that pain medications are not working, that pain seems too burdensome to bear at the moment, and for anyone who has run out of answers or optimism regarding their pain condition or will to continue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70c51	Anonymous	None	2022-02-13T18:49:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-4cel-ocbq	False	None	False	2022-04-12 01:54:33.002	[]
280	CDC-2022-0024-0286	https://api.regulations.gov/v4/comments/CDC-2022-0024-0286	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Gabapentin as well as Duloxetine have a long list of side effects including seizures & increased thoughts of suicide. Also require a proper taper plan when discontinuing to limit withdrawal. these should be explained and understood prior to prescribing and pros and cons should be considered in comparison to opiate therapy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70c5b	Anonymous	None	2022-02-13T18:50:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-4d4r-5uja	False	None	False	2022-04-12 01:54:33.208	[]
281	CDC-2022-0024-0287	https://api.regulations.gov/v4/comments/CDC-2022-0024-0287	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a person who benefits from daily opioid therapy after a severe automobile accident and years of surgery and rehabilitation.<br/>The stigma associated with using opioids has hurt those who have a better quality of life with their use. Luckily I found a doctor who sees me as a person rather than a statistic. <br/>I would like nothing better than to not need the medication, but it is also one thing that makes my life more livable and more active and more worthwhile.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lois	None	None	0900006484f70cb3	Foster	None	2022-02-13T18:51:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Foster, Lois	kzj-4l3y-v5df	False	None	False	2022-04-12 01:54:33.413	[]
282	CDC-2022-0024-0288	https://api.regulations.gov/v4/comments/CDC-2022-0024-0288	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic intractable disease patient that utilizes Long term opioid therapy. I have chronic intercystial cystitis with hunners lesions. Chronically. I have utilized this medication responsibly and worked and supported my family the entire time. There is no cure for my condition, there is very limited treatment options. And the ones that are involve an over abundance of money that would never afford me to live any quality of life other than paying for procedures, it was difficult accepting this as life but with will and opioid therapy I continue on. However, since 2016 I've been called a controlled drug addict, I've been told the cdc has limited my care by my provider, I've been treated like a criminal instead of a tax paying, law abiding citizen. I do not wish anyone including myself be treated this way by professionals which are supposed to have the job of helping you. I pray you take this into consideration, my children don't want to go to doctors or trust a doctors judgement because of this. Which is a terrible shame. A lot of money wasted for an education and a license that is useless without trust. Please think about what you've allowed to happen. The labeling, the distrust, and beyond all, the pain. We are working, we are surviving, we are not out here killing stealing, and destroying, but we are being classified as such. I will not assume a label other than a God fearing, hard working American that uses a medication to survive. Please allow us to do this, stop punishing people that are ill but still trying to live a good quality of life for our families, our jobs, as people do depend on us to still be here. And maybe you too might be in this same situation one day. Please have compassion and stop the judgement. This is all I have to say. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70cfe	Anonymous	None	2022-02-13T18:52:24Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-4u4c-12h7	False	None	False	2022-04-12 01:54:33.655	[]
283	CDC-2022-0024-0289	https://api.regulations.gov/v4/comments/CDC-2022-0024-0289	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The conversation needs to a private conversation between the patient and their doctor. We should trust that NO HARM should be done from our doctors. "Correct Use Doesn't Equal Abuse" quoted from a dear friend who also advocates for the patient's pain. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484f70d02	P	None	2022-02-13T18:52:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from P, K	kzj-4um2-tra1	False	None	False	2022-04-12 01:54:33.857	[]
284	CDC-2022-0024-0290	https://api.regulations.gov/v4/comments/CDC-2022-0024-0290	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My son was injured in a motorcycle accident in 2009. As a result his right arm is paralyzed and he is in constant agony. Through the work of his doctors he was finally able to function with the right medication. He was able to attend college, be on the dean's list. But now after graduating with a degree in computer coding he is unable to work due to his pain. He never abused his medicine, not did his doctor ever abuse his position to prescribe the medicine<br/> Please consider this in your decision<br/> Not all doctors break rules and not all people who take pain medicine abuse it. Even with break through pain he would be able to work and contribute to his family's income. We're just asking for a chance at somewhat normal life for him, and we appreciate any assistance you can give us. Thank you for your time.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484f70d08	Rollins	None	2022-02-13T18:52:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Rollins, Sandra	kzj-4v5x-279u	False	None	False	2022-04-12 01:54:34.075	[]
285	CDC-2022-0024-0291	https://api.regulations.gov/v4/comments/CDC-2022-0024-0291	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Giving safe places and clean needles to heroin users<br/>Taking away quality of life for some people<br/>These things are the opposite of eachother<br/>I personally know people who have seriously<br/>Debilitating pain, who, even with opioids<br/>And non-opioid pain relievers, still just <br/>Get by.<br/>This is a biased proposal, the rule followers<br/>Will be punished. Rule-breakers, scam<br/>Artists will be rewarded.<br/>This makes no sense. How could you possibly<br/>Want to disrupt the lives af good people<br/>That need this medicine. Additionally,<br/>If Suboxne is free to heroin users<br/>Shouldn't that be regulated or have hard<br/>Limits. If you're going to make good people<br/>Live with extrodinary pain, should't heroin,<br/>Users have to go cold turkey. It would be<br/>Only fair.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70d1a	Anonymous	None	2022-02-13T18:53:16Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-5058-jkhe	False	None	False	2022-04-12 01:54:34.292	[]
286	CDC-2022-0024-0292	https://api.regulations.gov/v4/comments/CDC-2022-0024-0292	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My life has been decimated since the CDC GUIDELINES !! I have been tortured 4 1/2 years, living in bed most day everyday. I never needed a particular high dose of Oxycodone. I needed 15mg / 4 @ day . It’s a very long story. I’m 61 and a widow, no children & live alone. It’s both of my shoulders I am on SS Disability for. My Primary prescribed my pain meds until the 2016 guidelines. Pain management is un-pain management!! They don’t listen, don’t care and treat me like a Criminal !! I’m not an addict !! I’ve always followed their ridiculous guidelines yet currently I’m on 3/ 5mg @ day !! It’s woefully insufficient !! My Mother 84 w dementia, would be alive today if I had sufficient care. Since I can barely function I couldn’t bring her to live with me. She passed away February 9-22. I can tell you as an absolute FACT, she would be alive if I could have cared for her. The CDC GUIDELINES have ruined my life , and now my Angel mother. Please, I beg you .. I just want my quality of life and function back !! I’ve tried everything $$$$$$ an $8.00 prescription of Oxycodone works like a miracle. 4,500 humans have used opioids for pain !! Please stop the inhumanity to man .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	0900006484f70d85	Turner	None	2022-02-13T18:53:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Turner, Anne	kzj-55ji-rmdl	False	None	False	2022-04-12 01:54:34.542	[]
287	CDC-2022-0024-0293	https://api.regulations.gov/v4/comments/CDC-2022-0024-0293	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I lost my sister who was only 52 years old when she passed from an opiate overdose that was prescribed by doctors we have an epidemic in this country that we need to deal with and we need to forget about the greed and the glory and the money and worry about the human nature of people who need to live without doctors getting rich and killing people... For them to take away those guidelines I think is horrific and they ought to be ashamed of themselves come over and look at the pictures of my sister and tell me how they can live with themselves and sleep at night knowing that they're killing tens and thousands of people every year with their opioid addictions... And pill Mills and doctors handing out pills like they're nothing come on America wake up it's time we stand up and do something...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joel	None	None	0900006484f70da3	Taborsky	None	2022-02-13T18:54:09Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Taborsky, Joel	kzj-57wn-t995	False	None	False	2022-04-12 01:54:34.756	[]
288	CDC-2022-0024-0294	https://api.regulations.gov/v4/comments/CDC-2022-0024-0294	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is ... I had a debilitating accident in 2012. I have been on pain medication since that time. I have had many surgeries since then. As of this date there is nothing that can be done for any further treatment to resolve my pain. I will be on medication the rest of my life. It is soo very difficult to find a Dr that can or will prescribe the medication needed to help me. The stiff guidelines make it very hard to live pain free	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f70dd0	Sanders	None	2022-02-13T18:54:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Sanders, James	kzj-5c6d-ux47	False	None	False	2022-04-12 01:54:34.959	[]
289	CDC-2022-0024-0295	https://api.regulations.gov/v4/comments/CDC-2022-0024-0295	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband age 47 who I have been with 13 year was in a serious car accident back in 2016. In the words of his surgeon "it looks like a pro wrestler tried snapping his neck and stopped at the last second". This happened when a 55 year old woman rear ended us and my husband's concern for our daughter in the back seat and the seatbelt with force of impact. After going through physical therapy and massage therapy both in which was documented as making things worst. His doctor and surgeon agreed to put him on pain meds. Without them he couldn't even get out of bed. With all the problems with government trying to control a doctor's opinion on who should get them and who shouldn't even after being told he will be meds the rest of his life there's no getting better only worst in time, he's treated like a parolee, pays cash for his pain management appointment every month just to go in take pee test just so he can get his script. He misses his appointment due to illness or any reason he doesn't get his meds. His tolerance is increasing and condition is getting worst and yet they won't increase the dosage of his meds due to government guidelines. I wish some of these people would walk one day in the shoes of someone who has to deal with the chronic pain everyday for the rest of their life	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beth	None	None	0900006484f70dfb	Chase	None	2022-02-13T18:56:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Chase, Beth	kzj-5fzm-i1rw	False	None	False	2022-04-12 01:54:35.164	[]
290	CDC-2022-0024-0296	https://api.regulations.gov/v4/comments/CDC-2022-0024-0296	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The only person that will safely know if 50mme, 90mme or higher will reduce their pain, is the patient themselves. Nobody knows what our pain levels are on a daily basis, or even hourly basis. With lupus, fibromyalgia, Sjogrens, raynaulds, CRPS, osteoarthritis, right hip dysplasia from birth, 3/4 rotator cuff tear, total hysterectomy, total colectomy, IC, 3 failed spinal fusions, 1 leaving me with an inoperable spinal fluid leak, etc etc “I AM THE ONLY ONE” that knows what works and what does not. Is it this bad that we have to suffer in pain daily, or suffer being a wife, mother or grandmother when all I/we want is a quality of life, to be able to do the simplest tasks, be able to get our mail, take a shower, plant a rose bush, cook dinner without suffering in severe pain. Let alone the chronic fatigue, physical exhaustion, mental emotions, and feeling like a complete failure? I use to be a firefighter and also worked for the school board. I had to medically retire in 2015 because I could not continue to do my job. When your doctors say that my medical disabilities will only get worse as I get older and there is no cure, reading these cdc guidelines has me extremely worried…will I ever live pain free……nope!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484f70e19	Heinbaugh	None	2022-02-13T18:57:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Heinbaugh , Cheryl	kzj-5jjs-dxhy	False	None	False	2022-04-12 01:54:35.406	[]
291	CDC-2022-0024-0297	https://api.regulations.gov/v4/comments/CDC-2022-0024-0297	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a person that has chronic pain. I do not like taking medication, but if I couldn’t get the from my pain doctor; I would not be able to get out of bed. I have pain every single day. The medication helps me to be able to get up, work, clean, and go to church. I am able to do things with my grandkids. If there was another way to help chronic pain without medication (opioids), it would be great. I hate feeling like I am doing something wrong or made to feel like a drug addict. I hate it when my insurance makes me get a PA to get medication. I want to have some quality of life without feeling bad about it. Most overdose is from fentanyl from the streets. Something needs to be done about that situation. People that are in pain constantly suffer enough without needing to be afraid of having the only help they can get being threatened.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70e33	Anonymous	None	2022-02-13T18:59:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-5n90-sjgo	False	None	False	2022-04-12 01:54:35.611	[]
292	CDC-2022-0024-0298	https://api.regulations.gov/v4/comments/CDC-2022-0024-0298	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a lupus patient who is also battling pancreatic cancer. My pain journey began with the severe joint damage caused by lupus. The inconsiderate and overbearing actions of the government caused my medication (and many others like me) to be cut nearly in half and I was sent home to suffer. I truly believe that treating our pain should be between the doctors we’ve formed relationship with, not organizations who generalize pain in broad strokes. Doctors hands have been tied and we are the ones who suffer. I get that there is allegedly an opioid crisis. But the rates of suicide have also increased among the chronic pain community. Something has to give and I am grateful that pain sufferers are FINALLY being heard and our quality of life considered.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ebony	None	None	0900006484f70e6a	Vemford	None	2022-02-13T18:59:29Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Vemford , Ebony	kzj-5uw5-be6o	False	None	False	2022-04-12 01:54:35.825	[]
293	CDC-2022-0024-0299	https://api.regulations.gov/v4/comments/CDC-2022-0024-0299	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make the changes for chronic pain patients. It’s horrifying to watch my 88 year old husband suffer and beg. He can’t get the meds refilled because the dr wrote the prescription “take every 6 hours for pain for 30 days. Quantity 30. ( He has neuropathy in his feet.)<br/>He usually only takes one a day but now has a back and hip condition. But can’t get more than 1 a day. It is inhumane. He’s already taking gabapentin and cymbalta. <br/>He can only go to the ER. What a waste of resources for and 88 year old. Let him fill his prescription early.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cecily	None	None	0900006484f70e8d	Badding	None	2022-02-13T18:59:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Badding, Cecily	kzj-5zgh-goyi	False	None	False	2022-04-12 01:54:36.087	[]
294	CDC-2022-0024-0300	https://api.regulations.gov/v4/comments/CDC-2022-0024-0300	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a pain specialist, I believe these revisions seem appropriate. However, while a point is made of who these guidelines are intended for, everyone seems to be lumped into the same category of skill level and hence potential harm to the patient, practically speaking. Therefore, I would like to suggest that explicit language be added that reflects how these guidelines are not intended for pain specialists that as you know are already well versed in caring for some of those medically complex patient populations. Prescribing of opioids is safest in the hands of pain specialists who are well-versed in contraindications, drug-drug interactions, risk mitigation strategies and more, to provide safe and effective relief of pain for our chronic pain sufferers. Thanks for considering this addition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70ec0	Anonymous	None	2022-02-13T19:00:15Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-61fg-e4c0	False	None	False	2022-04-12 01:54:36.304	[]
295	CDC-2022-0024-0301	https://api.regulations.gov/v4/comments/CDC-2022-0024-0301	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The current CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016 were a knee-jerk reaction to a rising overdose crisis which the government was not equipped to address. It is understandable that HHS- CDC felt like they needed to start regulation the rates in which opioid medication were prescribed in the community. Indeed, pill mills were a real thing and the exorbitant practices of a few prescribing physicians did play a role in the opioid epidemic.<br/><br/>However, there are unintended consequences. By demonizing and stigmatizing the prescribing of opioid medication, it is almost impossible for an individual to treat acute or chronic pain through a standard medical facility. Prescribers are hesitant to prescribe any amount of opioid and often, instead prescribe Tramadol, as a stop gap to address an individual's chronic pain. Some people live in pain. Some people have pain so debilitating that without opioid pain medication, they cannot function. These individuals should not be subject to urinalysis testing, prior authorizations, and all of the additional precautions someone needs to now go through to have their healthcare needs addressed.<br/><br/>The regulation of opioid prescribing did NOT solve the epidemic. We now have a fentanyl epidemic and individuals are overdosing and dying at a greater rate than ever before. The "crackdown" on prescribing practices did not solve anything and has only impacted individuals with chronic pain who do NOT have an opioid use disorder. I am tired of having to jump through hoops and for being treated like an "Addict" and criminal just because I have chronic pain and the only thing that helps me function on a daily basis are opioid medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484f70ef2	Walton	None	2022-02-13T19:00:37Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Walton, Paul	kzj-62vc-0hk8	False	None	False	2022-04-12 01:54:36.509	[]
296	CDC-2022-0024-0302	https://api.regulations.gov/v4/comments/CDC-2022-0024-0302	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am grateful you've revised the 2016 CDC opioid prescribing guidelines. Thank you. There are more revisions necessary. For me to be able to live my best life, I require uninterrupted access to all of my medications, including the opiate. I have no trouble keeping a constant stock at home (or on the road) of every medication I take, with exception to the opiate. The opiate is one of the top 3 important medications in my regimen. I suffer with a failed right hip replacement, Fibromyalgia (likely brought on by the trauma of the hip replacement surgery per my Rheumatologist), degenerative joint disease, osteoarthritis, chronic kidney disease, PTSD. Pain medication is essential in my life. I landed on pain medication as a last resort. The Rheumatologist tried several medications, Some of these conditions I suffer are painful. They are lifelong and/or do not have a cure. They are expected to deteriorate. I do everything I can do to live my best life. Aquatic therapy has been a big part of my life since 2015. I use resistance tools in the water now, which give me an even better work out, one that helps me build muscle again like my workouts at the gym used to! Previous to aquatic therapy in 2015 I sat. That's pretty much it. After having tried more physical therapy, steroid injections, medications with horrific side effects and I mean horrific. 3 years of just sitting, I got weaker. Had to see the Dr one day, and he said Cindy you're getting weaker and weaker, you've got to find a way to exercise. I went to pain mgmt, was prescribed opioids, and it changed my life. Soon I began therapy in a heated pool. I hadn't driven since 2012, and I started driving again within 6-8 months of aquatic therapy and the proper medication. My life was worth living again. 11/2016 the pain mgmt Dr told me eff 1/1/2017 he would no longer be writing scripts for opioids for anyone. I started new pain mgmt 1/1/2017. After a few times I hated these appointments, the treatment was not characteristic of a knowledgeable, caring Dr. Instead I was made to feel ashamed for requiring pain medication. Finally, 12/2017 the Dr. accused me of selling my pain medication. I was speechless. He said the last drug screen I took came back negative for the pain medication he prescribes me and the only explanation is I must be selling it. Which I most certainly was not! He discharged me. I didn't have much medication left. I couldn't speak. When I finally got a copy of the drug screen result 2 weeks later, I could see the Dr did not ask the lab to test for the drug I take! Wow, boy, I KNEW there was an explanation. When I tried to see the Dr again to show him what I found, he would not see me or return my calls because I was no longer his patient. 4/2018 I found another Dr who would see me. It took 4 months to find another Dr who would see me. Those 4 months were horrible. My primary care provider who knows me and my conditions wrote 1 prescription for me during that time, but told me it could only be this one and never again because he could lose his license to practice medicine. He was angry this was happening to me and thought it was wrong. He told me he actually tried to call Governor Ducey about it. By 6/2018 my new Dr demanded I stop taking the benzodiazepine I require for the PTSD or she would not continue to prescribe the opiate to me. She was fine with it 2 mos prior 4/2018 when she started seeing me. My psychiatrist had been fine also with the combination for me personally. About 25 years I've been taking this very necessary medication. My life spirals again. I have severe PTSD symptoms and this medication is necessary. About 10/2018 this DR loses her prescribing authority because the DEA had finally found fault with her somewhere. New doctor again then, 6/2019 she's gone. My next Dr of 6/2019 lasted until recently. She just left the practice 1/1/2022 she's going into something completely different. She expressed to me on numerous occasions her concern and frustration with the State Medical Board and the DEA, that no matter how careful she is they could still always find something to make you go away. I'm a strong person but what you have done has brought me to my knees. It's hard enough to clear the kitchen table while using a cane and keeping my thumbs out of everything I do (try it, very difficult)but when you throw medication insecurity into the mix I have been driven to my literal edge. I've always figured it out, how to live with this failed hip replacement, how to carry glasses and plates or get dressed without using my thumbs. Everything I do is difficult for me, everything takes more time than the average person, yet I persevere because I have no choice. If we don't see changes out here soon I am defeated. I've already started bargaining with myself. "It's not so bad to stay in all the time is it"? "You don't really need to see people". Those kinds of thoughts are not healthy yet this is what I've been driven to.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484f70fac	Colbert-Hock	None	2022-02-13T19:03:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Colbert-Hock, Cindy	kzj-6a2u-liyy	False	None	False	2022-04-12 01:54:36.717	[]
297	CDC-2022-0024-0303	https://api.regulations.gov/v4/comments/CDC-2022-0024-0303	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My comment is that the gov. or <br/>insurance companies should not have a say in who gets opioids. There are people who have very bad pain and medical conditions that should be treated with some opioids that give them some relief. Yes there are people who do abuse these drugs and ruin it for people that really need these medications. It should all be looked at with what the problem the person has and let them have the opioids that help them get through the day without pain that is hampering the way they live their lives. I wonder if these people that say we can’t have opioids if they are in very bad pain or if members of their families would be in such pain what they would do about this, just let them keep hurting?<br/>Let’s all take a good look at what the real problem is and that is the people in government and insurance telling us what to do and take for our health.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f70fae	Anonymous	None	2022-02-13T19:03:16Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-6ab3-xlfz	False	None	False	2022-04-12 01:54:36.930	[]
298	CDC-2022-0024-0304	https://api.regulations.gov/v4/comments/CDC-2022-0024-0304	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a person that suffers from the lack of treatment required to control chronic and lifelong pain. I have attached my statement.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Scott	None	None	0900006484f70ff7	Maxwell	None	2022-02-13T19:10:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Maxwell, Scott	kzj-60xq-t3gv	False	None	False	2022-04-12 01:54:37.132	[]
299	CDC-2022-0024-0305	https://api.regulations.gov/v4/comments/CDC-2022-0024-0305	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been diagnosed with MS, fibromyalgia, spinal stenosis, RA and OA! I was dismissed by my doctor abruptly and can no longer work! The reason given was that I did not have enough medicine in my system when tested! This was because my bottle said “as needed” so if I had a good day I could take less, or so I thought. I have absolutely no quality of life and haven’t had for seven years! I can no longer work or do any of the things I used to enjoy! I do not claim disability as I have been denied multiple times for this benefit! After beginning work when I was fourteen and working for the same company for almost 25 years! Since this happened to me I have lost everything. I’ve had to live off the good graces of others, not being able to support myself. I could as for a referral to a pain clinic but after hearing all the horror stories from people who go to “pain clinics” I have not asked to be referred. I live in Kentucky now and all I receive for pain is gabapentin and I have to see a doctor every month just to get this medication. I look forward to updates to these laws. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71183	Anonymous	None	2022-02-13T19:11:23Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-6pyc-kpao	False	None	False	2022-04-12 01:54:37.571	[]
300	CDC-2022-0024-0306	https://api.regulations.gov/v4/comments/CDC-2022-0024-0306	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From a Pharmacist perspective, I believe there’s really an opioids disaster in this country. However, we can’t treat our patients based on this fact alone. Real patients with true chronic pain who are not responding to other safer regimen, should get their quality of life improved. That should be achieved based on their prescribers’ clinical review after establishing the right medical opinion of the treatment based on risks vs benefits consideration. In other words, the rule of thumb can’t be a plan fits all but rather a case by case basis. Chronic pain without alleviation can be so frustrating that patients may commit suicide or lose their jobs. Please reconsider that medical practitioners who are on the scope of their practice should have their free medical Judgment to decide what’s the best option for the patients that has more benefits than risks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71189	Anonymous	None	2022-02-13T19:11:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-6r6j-rm96	False	None	False	2022-04-12 01:54:37.819	[]
301	CDC-2022-0024-0307	https://api.regulations.gov/v4/comments/CDC-2022-0024-0307	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is ... I have had 3 back surgeries and I have done all the therapies I also have an internal stimulator to help with the pain the batteries always stop so I have to go and have surgery again to get a new battery again. Sometimes it helps but most times it doesn’t I have legitimate chronic back pain and because of the laws I cannot get any pain medication to help elevate the pain just to get through my days I have a 3 year old granddaughter I would love to do more with but I cannot because I cannot even move around long enough to play it’s ridiculous that people that really need help with pain cannot get help because all these people want to abuse the medicine so it’s ruined for the people who really need help something has to be done about this, another thing why do you think all these people are dying 300x more now because they get the crap off the streets now because doctors won’t help that’s why all these drugs are coming across the border because they know people are desperate for pain relief but instead they die Thanks CDC think about that!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	christie	None	None	0900006484f71197	davis	None	2022-02-13T19:12:11Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from davis, christie	kzj-6s6o-wsbr	False	None	False	2022-04-12 01:54:38.049	[]
302	CDC-2022-0024-0308	https://api.regulations.gov/v4/comments/CDC-2022-0024-0308	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain relief for patients with degenerative joint disease and lumbar spine problems even rheumatoid arthritis and other types of arthritis need the this medication not all people are abusing medications for pain we are being held responsible for people that are abusing it so we have to suffer because they are abusing the medication you make it hard for doctors to help the people who really need it the good doctors who do there job to really make sure you need it by doing all the right steps and have proof that there patients need it don’t punish the people who really need the medication there are some doctors that don’t care about passing it out so they can get paid but there is a lot of real doctors that really car about there patients are are afraid to help them because of your guidelines stop being so hard on people that need it .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f711ce	Anonymous	None	2022-02-13T19:12:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-704p-h8yi	False	None	False	2022-04-12 01:54:38.285	[]
303	CDC-2022-0024-0309	https://api.regulations.gov/v4/comments/CDC-2022-0024-0309	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long term severe chronic pain patient I was greatly harmed by the 2016 Guidelines my Doctor cut my meds way back instantly and now I am depressed due to being in so much more pain.I am wishful that when it is updated I can go back to my old dose and a better quality of life I have been miserable for a long time due to doctors being afraid to prescribe what a patient really needs	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484f711e7	Fugitt	None	2022-02-13T19:12:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Fugitt, Brenda	kzj-72jq-lm8i	False	None	False	2022-04-12 01:54:38.541	[]
304	CDC-2022-0024-0310	https://api.regulations.gov/v4/comments/CDC-2022-0024-0310	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Enough is enough already! End the suffering! It's time to go back to allowing doctors to treat their patients as they see fit! <br/>It's not up to the government, insurance companies, medical boards, pharmacies or any other entity to decide what the correct dose is for everyone. We are individuals and need to be treated that way.<br/><br/>We are being tracked by the PDMPs, forced to have Narcan on hand (if we are lucky enough to even have a doctor willing to treat our pain) & it has been proven time & again that we & our doctors are not the problem with the "Opioid Crisis " (nor are the manufacturers).<br/><br/>Put the CARE back in healthcare! Eliminate the restrictions and allow for appropriate, adequate & individualized care for each & every one of the millions who have suffered for so long!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashley	None	None	0900006484f711f6	Rodgers	None	2022-02-13T19:13:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers, Ashley	kzj-74ry-qios	False	None	False	2022-04-12 01:54:38.819	[]
305	CDC-2022-0024-0311	https://api.regulations.gov/v4/comments/CDC-2022-0024-0311	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic back pain for 3 years. Have done multiple back injections. With no relief. My doctor cut me off from opiates he doesn’t want to be held accountable. I was told to take Suboxone for pain. It doesn’t provide me relief like the opiates did. I feel like I’m a drug user because I have to do a pee test to get them. I’m in so much pain. I can’t stand it please rethink your policies. I have even thought of killing myself because of the pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484f71207	Eoute	None	2022-02-13T19:13:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Eoute, Steve	kzj-77ig-zpa7	False	None	False	2022-04-12 01:54:39.059	[]
306	CDC-2022-0024-0312	https://api.regulations.gov/v4/comments/CDC-2022-0024-0312	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Obtaining proper management of my pain hasn't been achieved in many years. There has been no accounting to tolerance and no accommodation for genetic differences in metabolism of opioid medications. I have an appointment on Monday and I can only hope for an appropriate change in medications. I can say I an not disrespected with my current physician, but I have had awful encounters with pain management doctors who have accused me of selling my medications and another who said I was truly mentally ill and shouldn't have any pain medications; he was patently false in his assessment (outside of his expertise) and also it is immoral to deny a person pain medication because they also have a mental illness. I've been subjected to testing for compliance which were incorrect and I demanded another UDS. I was relieved when I was informed that they had changed companies because they had had other errors. My experience have been mild compared to some friends who are subjected to a "pill count" with 3 hours notice and if they can't leave work, are out of town, or further than 3 hours away from the office, they are terminated from physicians cate. This is barbaric and inhumane. We all have to worry if we will have our medications filled each month. Will the physician reorder? Will the pharmacist refuse to fill it. I've been refused medication for a 7 day supply in advance so I could go on vacation; I had a miserable time, because I had to ration my medications to have some comfort and not have Withdrawal symptoms. I have q change in medications and the pharmacist refused to fill the medication until I was out of the previous medication. Pharmacists treat chronic pain patients wretchedly, with contempt and as if an addict or a criminal. All of these experiences are uncalled for and stem from politicians attempting to manage medical conditions and treatment, and the horrid CDC Guidelines which were used by prosecutors, police, the AMA and any other agency which monitors physicians. Insurance companies have been barriers to appropriate care, as well. We do not have an opioid crisis, but we do have illicit drugs as a problem, and woefully inadequate pain management of patients who then seek illicit drugs to manage their pain. I've never abused my medication, nor had any sort of "buzz" or thrill. I look forward to more appropriate pain management. I hope I have a better quality of life. I am treated with dignity and respect with my current pain management physician, but if he were to relocate or retire, then I am subject to the whims of whatever physician were to take his place. The stress is tremendous and negatively impacts my quality of life, as well. I will likely never be without pain until I die, but I'm not here to suffer and I deserve medically-driven care without arbitrary limitations which might be appropriate for a physician who doesn't routinely take care of patients with chronic pain. And heaven forbid that anyone of us have acute on chronic pain, because we are treated as "drug-seeking." I went to the ER with GI distress and frank blood in liquid stool; my pain medications were "exiting" intact. I was unable to have my baseline pain managed at home and certainly not the intestinal pain. I should have been provided IV pain medications since the other route wasn't longer working and I was not. I was talked to as if I were stupid and drug-seeking. I was given Carafate. It did nothing to treat any of the issues. What has passed as medical care in the realm of acute and chronic and acute on chronic pain has been a national disgrace. The CDC issued irresponsible guidelines and they were treated as LAW by insurance companies, physicians, and the DEA and prosecutors. We can only hope that these new guidelines allow physicians to be physicians and insurance companies to pay for the medications and the DEA monitor for true "pill mills" which can be an issue and leave prosecutors with nothing to do except for rare occasion. <br/><br/>I have to have hope that our lives will improve, our quality of life will improve, the offensive threats of being discharged from care, the condescension and refusal to fill prescriptions from pharmacists. I have to have hope. That's all I got.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ann Marie	None	None	0900006484f7120d	Kennedy	None	2022-02-13T19:14:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Kennedy, Ann Marie	kzj-78eo-0ltn	False	None	False	2022-04-12 01:54:39.303	[]
307	CDC-2022-0024-0313	https://api.regulations.gov/v4/comments/CDC-2022-0024-0313	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	#2 should include addiction risk.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheryl	None	None	0900006484f7122c	Suppan	None	2022-02-13T19:14:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Suppan, Sheryl	kzj-7bwl-f2yr	False	None	False	2022-04-12 01:54:39.543	[]
308	CDC-2022-0024-0314	https://api.regulations.gov/v4/comments/CDC-2022-0024-0314	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who lives with constant pain in my neck, lower back, both shoulders have partial thickness tares, carpel tunnel in both hands I have recently been denied a renewal of prescription that was outdated by 3 years. Why outdated? Because I do not like taking pain pills or any medicines at all. <br/><br/>I only take a pain pill(out dated keep in mind) is when most people would be in an emergency room. I recently had an elbow operation for ulnar nerve decompression. They prescribed me what I requested which was Tramadol because I do not need stronger drugs to help with pain. <br/><br/>I have had a spinal fusion and had bone shaved off my hip to use in the fusion and did not use pain pills once I was released from the hospital.Let me tell you that was the worst pain I have ever been through.<br/><br/>I spent a week in the hospital for a week do to a gull bladder that needed to be removed after the infection was decreased. Once I was released from the hospital I did not take any pain meds for that either.<br/><br/>When like i said I felt i needed a renew of the Tramadol because we found that it was 3 years outdated I requested a 1 time supply so that I would not be taking outdated medicine. The doctor told me she could not renew it do to new rules. My doctor knows that 1 I do not like taking medicnes and I only take a pain pill when I feel I really need it or as I say when the pain reaches the point I can no longer tolerate it. In which case most people go the the emergency room, I do not I take 1 pain pill and see if it will lower the pain level to where I can tolerate it. If I can great I don't take any more unless it continues 99.9% of the time I get through it and it subsides. Rarely do i have to ever take a second pill.<br/><br/>People like me should not have to save outdated medications that are prescribed to them from other things in my case the elbow surgery which I new I would not need the pain pills for that but i filled them just because I did not want to take outdated meds unless i have too. <br/><br/>Please fix the system so people like me can get the meds they need and not be forced to take outdated pills.<br/><br/>Thanks,<br/><br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jerry	None	None	0900006484f71235	Pennington	None	2022-02-13T19:15:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Pennington, Jerry	kzj-7d9u-b6am	False	None	False	2022-04-12 01:54:39.754	[]
309	CDC-2022-0024-0315	https://api.regulations.gov/v4/comments/CDC-2022-0024-0315	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Currently I find many providers are now under treating pain. Even for chronic non malignant pain, opiods can be an excellent tool, especially when someone has multiple pain generators not amendable to a single interventional pain procedure. However the stigma and media pressure has caused many providers to not trial low dose opioids in those judged to be clinically appropriate. As an ACGME trained pain medicine provider I find that primary care physicians are unwilling to manage patients on low OME (less than 20). This causes increased healthcare costs by requiring patients to see a specialist which costs them more money and time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Darren	None	None	0900006484f71243	Smither	None	2022-02-13T19:15:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Smither , Darren	kzj-7gj6-7l7t	False	None	False	2022-04-12 01:54:39.968	[]
310	CDC-2022-0024-0316	https://api.regulations.gov/v4/comments/CDC-2022-0024-0316	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having chronic migraine and severe back issues over the course of decades I have used opioids as a part of my pain regimen, not the sole means of pain control. Since the guidelines were put into place I have been vilified by my doctor at the pain clinic for needing these meds, not to be anywhere near out of pain but enough pain relief just to keep me functioning during the day. This mentality, when this doctor is running a pain clinic made me feel like a horrible person for needing pain relief. I’ve tried all the other non-opioid options and still use things like heating pad, ibuprofen and Tylenol but when you can’t afford the time or no way to take off 1-2 months for back surgery, pain meds make it so I can physically get out of my bed. My pain meds only give me maybe 25% pain relief but to me that’s better than nothing. I’m terrified to ask for anything stronger as I will be looked at as a drug seeker. That should never happen to someone who has documented X-rays, MRIs, CT Scans who have tried other therapies. I hope these new guidelines stop doctors from feeling like they can’t treat pain in patients who truly need it. I also hope it stops doctors from making patients feel bad for needing these meds to begin with.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484f7124d	Daenzer	None	2022-02-13T19:16:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Daenzer, Michelle	kzj-7ij2-ih7u	False	None	False	2022-04-12 01:54:40.196	[]
311	CDC-2022-0024-0317	https://api.regulations.gov/v4/comments/CDC-2022-0024-0317	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain since 2010. I had to be employed and would cry on lunch and my whole life suffered. I wasn't able to enjoy life. My physician would not take my pain seriously. I have had to use otc medicine. I continued to work until my 2nd back surgery and still at that time, no opiods or very limited. In 2016 since the CDC guidelines, my physician said I needed pain management. I also had very many painful spinal injections which didn't help. Also went to another pain management that had me stop all medications and with no medication inserted a 2nd trial of spinal stimulation. Imagine? I was told I needed a pain pump and researched it. It was snail venom. Yes, imagine? No, I was getting to the bottom of this. Not one physician knew why I was in so much pain. Here, finally went to a new neurosurgeon. Tests ordered showed I needed both hips replaced and another fusion in my back. A deteriorating spine with a terrible curve. Then, more pain management, another practice because the last one just was trying to get money. This one addressed the pain with the correct medication but just not enough to function or have any kind of life outside of bed. It cost my insurance way to much money and my out of pocket was 100 a month with monthly urine tests. Finally I had to take my husband and fight to up my dosage of oxycodone. Still not very high, but I could actually function. Somewhat, still many daylight hours in bed. This isn't the end, my hip replacement caused permanent nerve damage and drop foot. At 58 yrs old, I am very limited but actually found a PCP that cared enough to take me as a new patient and prescribe. Saving me so much heartache and money. Now I have to urine test every 3 months for my prescription. This I am grateful.<span style='padding-left: 30px'></span>But there are many things I haven't mentioned as trying to keep it fairly short but...I have worse news. My 35 year old nephew turned to heroin because his physician cut his small pain medication off, cold Turkey. He died 2 years ago, fentanyl instead of heroin. His mother found him dead. This has happened all across america and if the CDC wants to change overdoses it needs to solve the illegal importation of fentanyl. These guidelines have caused more deaths than stopping them. Thank you for finally doing something by changing the guidelines. Can the CDC concentrate on illegal fentanyl?<span style='padding-left: 30px'></span>Sincerely ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katie	None	None	0900006484f71254	Hilderbrand	None	2022-02-13T19:19:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Hilderbrand , Katie	kzj-7k56-ac0f	False	None	False	2022-04-12 01:54:40.417	[]
312	CDC-2022-0024-0318	https://api.regulations.gov/v4/comments/CDC-2022-0024-0318	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand the need for guidelines but doctors are so terrified now theyre not even using it as guidelines! I have a severe spinal cord injury. I’ve had numerous surgeries & continue to have more. You’ve made it so hard on the doctors it’s hard to find anyone to even treat me! I’m on an internal pain pump. I WAS using the fentanyl citrate for my break through pain. Now only cancer patients can receive them. So now I have nothing. My pump keeps me from my main suffering but I needed the lollipops if I did anything. Even showering would require a lollipop. So now I have to increase my pump to give me more than I actually need all the time. This is ridiculous. I understand I can use bolos with my pump but we’ve had complications with that. It’s taken 5 years to find something that worked for me. 5 years! I was completely bedridden for 2 years before my pain pump. Nothing helped. Nothing worked. I suffered. I honestly considered suicide. I’ve tried it all. Homeopathics, acupuncture, medications, opioids, etc. We finally get me dialed in so I have some type of quality of life & now I’m back to just my pump. I’ve always made sure I have enough pain. Even with my pump. I keep myself at a level 6 on the pain scale with my pump. Pain medication is not supposed to take away the pain. As long as I stay at home & relax I’m fine but if I need to go to the doctor, shower, go to the store, that’s what I need break through medication for. I was told to move to a warmer state to help with my pain. So I did. Then the doctors in this state tell me that I’m too young for a pump & want to remove it! I refuse to suffer like that again. Therefore I must travel back to where I moved from to continue to see my doctor there for treatment. This is all paid for by me! No one wants to treat someone like me with my pain. Your own representatives force doctors to cut off medication because patients don’t have cancer! These are supposed to be guidelines. Guidelines!! No two people are the same. My condition is rare. I understand that but you’re making it impossible to have ANY quality of life! No wonder suicide rates amongst people with chronic pain is up over 300% but I guess there aren’t enough of us killing ourselves because you’re so worried about the overdoses. Don’t punish us for their mistakes & issues! There are a lot of people like me. We suffer every day. We try & find a reason to even wake up every day. We don’t abuse our medication. I’m drug tested to make sure I’ve got the right amount in my system. I’m required to see a pain psychologist. I do my part! Stop interfering with our care! More suicides will happen because you’re making it harder & harder for us to get treatment. I’m headed in for yet another surgery on my spinal cord & now I have nothing for break through pain. My last spinal cord surgery at least my medication stayed the same. Meaning I suffered through after surgery with nothing additional!! That’s like you having surgery & not being prescribed anything to help with your post surgical pain. Do you know how painful spinal cord surgery is? Have you ever had cervical spinal cord surgery? It’s one of the worst surgeries by the way. I’m going in for my 3rd for that one. I don’t have a choice. It’s a myelopathy. If I don’t have surgery I will eventually die. And now I have a pump with no bolos & no lollipops. Thanks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f71260	Neal	None	2022-02-13T19:20:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Neal, Patricia	kzj-7mvm-5d3l	False	None	False	2022-04-12 01:54:40.676	[]
313	CDC-2022-0024-0319	https://api.regulations.gov/v4/comments/CDC-2022-0024-0319	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had back problems for decades. I’ve had a surgery that didn’t take and on top of 2 fractured vertebrae , herniated discs, bulging discs, scoliosis, degenerative disc disease, arthritis and a list of other back problems and a bad hip, I have tried the useless injections being forced on us and they do NOT HELP. My doctor was investigated and closed his practices without warning and we can’t even get our records. My medication was cut off completely and my primary refused to help because he’s afraid of the DEA. All of this after my daughter was diagnosed with cancer. My entire life has changed and I’m stuck in bed 99% of the time now. Before, I was able to get around and was doing yoga and water exercises, now that’s out of the question. <br/>I feel like the politicians are so clearly out of touch with the TRUTH of those of us with chronic pain go through. So many are now contemplating or actually committing suicide rather than live with the immense pain we have and NOBODY CARES. Politicians realized their war on drugs was stagnant and decided to take on opioids when it was not opioids that caused all of this nonsense, it was always fentanyl. Many good doctors have been imprisoned or lost their livelihood because of a political agenda…. The WRONG political agenda. Millions have been forced to lose their quality of life because of decisions made without thought to who were going to be affected . I understand that punishing those who are doing wrong happens… but when innocent peoples lives are destroyed while punishing those doing wrong… clearly something is wrong with that picture. It’s disheartening to realize I won’t be able to do the things I used to do, I can’t sleep very well, I can’t move well at all and my life has been reduced to my bed most days because it hurts too much to move. I read the 2016 hearing transcripts and I’m appalled at how blatantly many lied and did the opposite of what was said…. Chronic pain patients were never supposed to be affected… and in fact… nearly all have been and continue to be daily.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71270	Anonymous	None	2022-02-13T19:21:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-7s57-l4tf	False	None	False	2022-04-12 01:54:40.905	[]
314	CDC-2022-0024-0320	https://api.regulations.gov/v4/comments/CDC-2022-0024-0320	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife was struck by 2 consecutive vehicles in 2012. Many surgeries, and a decade of chronic pain. She was unable to get out of bed to even do the most menial daily tasks. Asked for a few hydrocodone tablets per day but all drs will prescribe her is suboxone. She never had a drug problem. It only makes her high. Foggy minded. She can move around now. But still hurts. Just high enough it doesn't matter. Only other option is methadone. My best friend was working with me out of state and couldn't get to his dr for his prescribed methadone. Had a heart attack from withdrawals. So I won't allow her to take it. All the people I run across with pain now rely on illicit heroin or fentanyl, suboxone or methadone. Truth be known they all are about the same strength and equally as addictive with just as bad withdrawals. Its crazy. Responsible prescription with reasonable doses of lesser opiates is a must. Don't turn having pain into having to abandon hope or become a criminal the only options an otherwise normal law building citizen has to choose between. Suboxone is a horrible substitute. And yes the withdrawals are horrendous. I've seen them first hand too many times she wants to be off them. Its not the miracle its Marketed as...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f71297	Smith	None	2022-02-13T19:21:55Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, James	kzj-82jq-3qxm	False	None	False	2022-04-12 01:54:41.126	[]
315	CDC-2022-0024-0321	https://api.regulations.gov/v4/comments/CDC-2022-0024-0321	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 72 year old 100% disabled vet who was just taken off my Morphine and Hydrocodone pills. The VA cut me down over and over and I have suffered with it. I buy pot edibles to help which cost me a fortune. I really need my meds and would buy them somewhere if I could. <br/>If this helps me get my pills back thank you so very much. I have had to have 4 different joints replaced and need more operations. My neck and back both need to be operated on and other joints replaced. The pain I have daily is really bad. At my age the doctors should let me have my pills <br/><br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alice	None	None	0900006484f712cb	Wells	None	2022-02-13T19:22:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Wells, Alice	kzj-89yb-kto3	False	None	False	2022-04-12 01:54:41.338	[]
316	CDC-2022-0024-0322	https://api.regulations.gov/v4/comments/CDC-2022-0024-0322	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why not just do away with the "guidelines"? When they were issued initially, doctors became so afraid of backlash from violating the guidelines that many of them stopped prescribing opiates all together. The guidelines were not looked at as guidelines. As a result of this countless chronic pain patients (and surgery patients) suffered needlessly and many turned to illicit drugs and/or committed suicide. The guidelines in place did absolutely nothing to stop opiate overdoses and it has been proven that the opioid epidemic is being caused by illicit drugs such as street fentanyl. I am afraid, even with the revised guidelines, they still will not be looked at as such and won't do anything to help doctors be more comfortable prescribing opiates to those who need them. The damage has already been done. The only way to start repairing that damage is to do away with the guidelines entirely.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484f712eb	Collier	None	2022-02-13T19:22:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Collier , S	kzj-8gxx-az38	False	None	False	2022-04-12 01:54:41.563	[]
317	CDC-2022-0024-0323	https://api.regulations.gov/v4/comments/CDC-2022-0024-0323	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make it easier for physicians to prescribe opioids to their patients that are in pain that cannot be addressed or lessened by any other medications. Most patients are not candidates to become addicted to the opioids. I myself suffered greatly and was constantly counting the Norco that was prescribed to me. Thankfully I have recovered ( sciatica) but during the four months that I was unable to move no amount of ibuprofen, acetaminophen, or muscle relaxers even affected my pain in any way. I actually found some very old Vicodin and supplemented my current prescription to make it through. I am now pain fre and off all medications- and I believe this is true for most people. Many days s and nights the pain was soul crushing. Why did I have to endure when I needed some relief. Please adjust your criteria. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f712f0	Anonymous	None	2022-02-13T19:23:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-8hpr-pp1c	False	None	False	2022-04-12 01:54:41.778	[]
318	CDC-2022-0024-0324	https://api.regulations.gov/v4/comments/CDC-2022-0024-0324	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please relax the guidelines! Presently many of us with chronic pain are undermedicated and suffering due to physicians’ strict adherence to the previous draconian guidelines. It’s time to stop punishing pain! <br/><br/>Most of the overdoses that are occurring in the US are due to illegal Fentanyl in the heroin supply and in fake “pressed” pills. This has nothing to do with chronic pain patients, and thus chronic pain patients should not bear the brunt of the fallout. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71337	Anonymous	None	2022-02-13T19:23:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-8shs-9jq0	False	None	False	2022-04-12 01:54:42.012	[]
319	CDC-2022-0024-0325	https://api.regulations.gov/v4/comments/CDC-2022-0024-0325	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is good news for me. I was a RN for 30 years and now suffer with multiple issues. One is chronic pain. I have physically and mentally been drained to the point that I cannot function normally on a daily basis. I also suffer from anxiety and that is a constant battle with being encouraged not to take klonipin at a very low dose. What happens if you have the problem and can't get help??	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71340	Anonymous	None	2022-02-13T19:23:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-8uvy-dupb	False	None	False	2022-04-12 01:54:42.225	[]
320	CDC-2022-0024-0326	https://api.regulations.gov/v4/comments/CDC-2022-0024-0326	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t like the change. It feels like backtracking. I think it will be interpreted as the agency previously being wrong, and as “permission” to go back to higher opioid use. I think that if we are to get our rate in line with most of the rest of the world, we need to keep the focus up on limiting opioid prescribing. Patients have come to know that there are limits, and when this comes out, I anticipate there will be increased demand.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristi	None	None	0900006484f71346	Gagne	None	2022-02-13T19:24:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Gagne , Kristi	kzj-8uzd-7omt	False	None	False	2022-04-12 01:54:42.447	[]
321	CDC-2022-0024-0327	https://api.regulations.gov/v4/comments/CDC-2022-0024-0327	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from Rheumatoid Arthritis,Fibromyalgia,Osteoarthritis.I gave up opioids before they took them.I have RA in my feet especially bad cannot stand some days.Along with all other joints.I am a 65 yr old great grandmother, and feel as though treated as a drug addict if you even ask for opioids.I have been on no med for RA in weeks waiting for insurance to approve new drug.The pain has been unbearable!!I have taken soo many Tylenol I am sick to my stomach!I Myself and others with chronic illness should not be treated like bad children.<br/><br/>Regards <br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sonjia	None	None	0900006484f71356	Montgomery	None	2022-02-13T19:24:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Montgomery, Sonjia	kzj-8w3y-saj3	False	None	False	2022-04-12 01:54:42.719	[]
322	CDC-2022-0024-0328	https://api.regulations.gov/v4/comments/CDC-2022-0024-0328	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I injured my entire back yet mostly my cervical and lumbar after two helicopter crashes in the 60's. <br/><br/>I was initially prescribed all different types of medications in the 60-70's then my back pain increased to a moderate level in 1988, but I was moving from the west coast to the south to help our mother.<br/><br/>In 1990 an x-ray diagnosed me with Intervertebral Disc Syndrome [IVDS] sometimes called a DDD condition in the lumbar area of my back. I was prescribed Ibuprofen, so I took them for several years and some other NSAID's prescribed until 2000.<br/><br/>In 2000 I developed Osteoarthritis [OA] in both hips and I was prescribed all types of medications for pain and mental conditions. In 2004 I was referred to a pain management doctor who prescribed me Hydrocodone, 7 mg to be taken three times a day. In 2007 an MRI diagnosed my lower back with a bulging disc at L5-S1. I visited another Pain management doctor in 2006 who gave me a CT-scan then offered injections, but I accepted more Hydrocodone except it was only 5mg to be taken three times a day. <br/><br/>Arthritis developed in my right-hand thumb, my right wrist and crepitus in my left knee.<br/><br/>In 2006 Arthritis developed in my sternum Costochondritis. I was referred to a Rheumatologist for several years who began prescribing me the Hydrocodone 5mg twice a day until 2010. <br/><br/>In 2012 I began to fall, or it was diagnosed with a loss of balance caused by more IVDS in my cervical area in almost all disc. <br/><br/>I have been taking the one Hydrocodone twice a day even after I developed Peripheral Neuropathy in both my upper and lower extremities until to this day in 2022 and I swim for most exercise, but I would like to set up my workout bench again to exercise some.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carl	None	None	0900006484f7135d	Watson	None	2022-02-13T19:25:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Watson, Carl	kzj-8y3j-23qg	False	None	False	2022-04-12 01:54:42.933	[]
323	CDC-2022-0024-0329	https://api.regulations.gov/v4/comments/CDC-2022-0024-0329	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It would be very helpful to extend these recommendations to those of us who are faced with the aftermath of the surgeon’s prescribing, or the pain specialist refusing to care for a patient who failed their urine tox screen, or the new patient who has chronically been prescribed opioids in doses that we consider to be inappropriate.<br/><br/>As an internist, I almost daily deal with patients who do not want to be tapered off controlled substances or have these agents changed to something safer but invariably perceived to be less effective. We did not cause the problem, but we are expected to solve it. No amount of quoting the scientific data will persuade most of these patients who have been on opioids for months or years or decades. <br/><br/>This is the practice guideline we really need. Emergency room doctors and surgeons can easily tell patients to see their PCP when they are still in pain and the controlled substance prescription for oxycodone every 4 hours is gone. Pain specialists are not widely available and do not like to take on these tasks. Health plan administrators forward patient complaints for us to address in detail when we try to taper or stop these agents. There is little support for those of us who are trying to do what is thought to be best for the patient and rectify the mistakes of the past.<br/><br/>I am the medical director and full time clinician in a community clinic where mental health, socioeconomic determinants, and cultural norms all factor into how patients deal with pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diana	None	None	0900006484f7135f	Marquardt	None	2022-02-13T19:25:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Marquardt, Diana	kzj-8yde-3l6e	False	None	False	2022-04-12 01:54:43.179	[]
324	CDC-2022-0024-0330	https://api.regulations.gov/v4/comments/CDC-2022-0024-0330	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dr. ... had me on 400 MME for 6 years. Now dropped after CDC threats . I am no where near that amount and living with excruciating discomfort. How can we fix this because my surgeon Dr. ... says he can’t fix my fused spine . Sorry .... What’s done is done & I will have to live with pain the rest of my life . So a SSI disability Judge disables me at the age of 38 . Who’s in charge of filling my prescriptions is my question ?? For Life .. I am 54 years old now . Recently recovering from two knee surgeries and triple bypass surgery. Living with chronic back pain .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rudy	None	None	0900006484f71396	Chavez	None	2022-02-13T19:27:07Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Chavez, Rudy	kzj-97pm-kxfq	False	None	False	2022-04-12 01:54:43.490	[]
325	CDC-2022-0024-0331	https://api.regulations.gov/v4/comments/CDC-2022-0024-0331	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I will comment more formally at a later time. This update is an improvement which is necessary but insufficient to reverse the damage the CDC and Federal government has done to pain management in the United States. For starters, the CDC lacks statutory authority to regulate food and drugs, which belong to the FDA, not the CDC. Our tax dollars should be spent once, not twice, on redundant and conflicting regulations like CDC imposed. FDA should be writing this, and CDC should be working on disease control like COVID-19, not interfering with another federal agency, which even the American Medical Association has criticized. Second, you selectively exclude sickle cell anemia patients, but didn't include autoimmune disease patients who have incurable and equally or more disabling conditions. In order to not be selectively racist, pandering to only black citizens, change "sickle cell anemia" to "intractable pain patients" so everyone is given the same consideration. Third, the new guideline has an even lower limit of 50 MME buried and hidden deep in the guidelines, which is actually worse than the 90 MME guideline. States have already proven they will take any number you publish and make it a law, and the same applies to health insurers, so the 50 MME needs to be removed. Fourth, you repetitively suggest NSAIDS while the FDA has published reports of how dangerous these drugs are, as if they are safer than analgesics. This is wrong and harmful to the health of everyone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f713cb	Anonymous	None	2022-02-13T19:27:27Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	kzj-9h6c-ppy2	False	None	False	2022-04-12 01:54:43.703	[]
326	CDC-2022-0024-0332	https://api.regulations.gov/v4/comments/CDC-2022-0024-0332	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a concerned citizen and I believe that doctors should be the one who decides whether a patient needs high doses of opioids for chronic pain. I have seen how this has caused problems for people and their marriages. I believe that doctors should make this decision not someone that doesn’t even know the patients or what they are going through.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f713dd	Anonymous	None	2022-02-13T19:27:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-9k10-2iyb	False	None	False	2022-04-12 01:54:43.946	[]
327	CDC-2022-0024-0333	https://api.regulations.gov/v4/comments/CDC-2022-0024-0333	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m 26 & have small fiber neuropathy, hypermobile Ehlers Danlos Syndrome, and have pudendal neuralgia. I was prescribed opiates for 2 yrs along with a benzodiazepine, previously prescribed for an unrelated condition. Opiates allowed me to graduate college top of my class and work simultaneously despite feeling as though I was burning alive due to the allodynia & nerve pain in my back. Opiates allowed me to put on a T shirt without feeling it was peeling off the skin on my back. I decided to have multiple RFA (ablations). The 3rd RFA eliminated all of my nerve pain & I decided to get a 4th. The 4th triggered an onset of severe POTS (postural orthostatic tachycardia syndrome) & was subsequently bedridden for 3 months. My neurologist said that if I ever have a surgery, it is always a risk my body will react after with severe POTS again. I went for years pain free although, later on, after a, ER visit due to a fecal impaction, I developed unrelenting pudendal neuralgia. I proceeded with expensive injections which wore off quickly and I'm, now, unable to sit due to pudendal neuralgia. Instead of my pain being treated, I have been told to take LDN, which has little evidence of efficacy and as a result, I’ve developed insomnia & twitches as a side effect. I spend my days bedridden along with going to physical therapy, which does nothing for the electric shock-like, fiery, burning pains that are in my most private parts of my body (genitals, rectum, groin). Instead of being prescribed an opiate to function as I took for years before I received RFAs, I am confined to my bed and rely on family members for care, in my 20s. I would be grateful to be able to sit long enough to work and enjoy more time with my friends again. <br/><br/>Please change the current 2022 recommended draft for to accommodate patients, such as me, with documented conditions, who possess the ability to responsibly take opiates for their neuropathy, and to also not be force patients to stop taking a benzodiazepine prescription, prescribed by another specialist, as a consequence of responsibly taking an opioid. Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71439	Anonymous	None	2022-02-13T19:28:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-9zap-4o2m	False	None	False	2022-04-12 01:54:44.161	[]
328	CDC-2022-0024-0334	https://api.regulations.gov/v4/comments/CDC-2022-0024-0334	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When are you going to tell the DEA to stop persecuting doctors who prescribe doses above 90 MME? When are you going to tell all the states who used your 90 MME to write state laws forbidding prescribing above 90 MME that you messed up and they need to remove any such laws? When are you going to tell all state medical boards who pulled physician licenses due to your 2016 90 MME guidelines to restore the medical licenses for doctors who stood up for patients and continued prescribing against CDC recommendations? How will the federal government now remove the 90 MME reference in the SUPPORT of community act? Finally, when are you going to compensate 25 million chronic pain victims for all the pain and sufferring you have inflicted irresponsibly for 6 years, when you admitted on April 10,2019 that your guidelines were being widely misinterpreted and misapplied, yet it took 3 more years for you to correct your mistakes?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7144a	Anonymous	None	2022-02-13T19:30:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-a20x-6mfb	False	None	False	2022-04-12 01:54:44.386	[]
329	CDC-2022-0024-0335	https://api.regulations.gov/v4/comments/CDC-2022-0024-0335	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I personally think that the guidelines should be lifted for chronic pain patients. They should be closely monitored, but given a chance at a better performance at life. Without opioids chronic pain patients would be in excruciating pain all of the time. Patients should not be treated as drug addicts. Pain should be assessed on an individual basis. Pain management physicians should treat their patients as individuals instead of groups based on diagnosis. Physicians should consider individual needs and diagnosis. Patient education on opioids should be a must. Pain should be assessed before, during, and after opioids are given. End of life patients should be able to use opioids more freely in order to keep them comfortable. Lessen the restrictions because correct use of opioids does not always equal abuse.<br/>Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tobi	None	None	0900006484f71454	Rauh	None	2022-02-13T19:30:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Rauh, Tobi	kzj-a3w6-xzqx	False	None	False	2022-04-12 01:54:44.670	[]
330	CDC-2022-0024-0336	https://api.regulations.gov/v4/comments/CDC-2022-0024-0336	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic intestinal, back and shoulder pain while the world looks at one prospective we suffer the most, I can’t even work because of extreme pain and all that people think about is that someone’s an addict, you’re wrong. When the table turns on assholes that don’t suffer from extreme pain they will remember what is written because the people making these decisions haven’t experienced extreme pain day and night. If it wasn’t for kratom a lot of us will suffer severely. The people you should target is the people that line there pockets, lobby and bribery instead of listening to the people that suffer from extreme pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71455	Anonymous	None	2022-02-13T19:30:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-a3wt-28ya	False	None	False	2022-04-12 01:54:44.898	[]
331	CDC-2022-0024-0337	https://api.regulations.gov/v4/comments/CDC-2022-0024-0337	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors overprescribed opioids for many years. Drug companies assured the doctors that the drugs were not addictive. Now people with chronic pain must suffer. How is this situation justified by the AMA and the CDC? I am a retired RN with 27 years of service. I have arthritis and chronic back pain from 27 years of bedside nursing. I am made to feel like I am a drug addict when I request pain medication from my doctor. This is not a patient problem, this stems from an overprescribing issue by doctors, encouraged by drug companies. Now people with legitimate chronic pain must suffer.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chuck	None	None	0900006484f714ce	Berry	None	2022-02-13T19:31:09Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Berry, Chuck	kzj-anog-x2sr	False	None	False	2022-04-12 01:54:45.130	[]
332	CDC-2022-0024-0338	https://api.regulations.gov/v4/comments/CDC-2022-0024-0338	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had spinal fusion revision surgery December 29th. It's now February 11th. My surgeon told me all I need is Tylenol. I'm healing well. That shouldn't keep me from getting a prescription during physical therapy to help me function every day. Patients that aren't addicts shouldn't be treated as such because we ask for help!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melisa	None	None	0900006484f714f5	White	None	2022-02-13T19:32:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from White, Melisa	kzj-atko-vzov	False	None	False	2022-04-12 01:54:45.352	[]
333	CDC-2022-0024-0339	https://api.regulations.gov/v4/comments/CDC-2022-0024-0339	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I appreciate the CDC’s effort to expand options available for chronic pain patients, the Guidelines are flawed because they still fail to distinguish among opioids – lumping Tylenol 3 with Oxycontin. <br/><br/>I have been taking Tylenol 3s for 40 years after a necessary spinal surgery left me with spinal instability and chronic neuropathy. That may be coming to an end, as some pain management physicians and their medical groups in my mid-sized city are now restricting them to patients with extreme, and acute, pain. <br/><br/>The proposed Guidelines will not change that because they still make all opioids a last resort. How many physicians will risk the wrath of the DEA to prescribe such a maligned medication? <br/><br/>I am also concerned that the CDC is about to “do harm” by irrevocably supplanting low-level opioids with medications that are flat-out dangerous. Side effects from low-level opioids are generally limited to constipation and nausea except for polypharmacy risks. (Note: nobody suggests banning Tylenol because taking it with alcohol can destroy your liver.)<br/><br/>I cannot emphasize this next point enough: most side effects from low-level opioids are readily, and immediately, apparent to the patient and physician alike – allowing substitution of other medicines. Not so for the medications mentioned in the Guidelines as substitutes. (See pages 75-76.)<br/><br/>For example, the Guidelines acknowledge that risks from long-term NSAID use range from kidney failure to potentially fatal gastric bleeding. These effects are often not apparent until permanent, irreversible damage has resulted. (Yes, these can occur even in the absence of the excluding conditions such as pre-existing renal failure noted on page 76.) Yet, NSAIDs are recommended as safer than Tylenol 3. And I may be forced to take my chances with them every night so I can sleep.<br/><br/>Pregabalin can cause rapid weight gain in some. It did with me, and those 25 pounds remain 10 years later. Yet it is recommended in preference to Tylenol 3.<br/><br/>The Guidelines even nod favorably toward Gabapentin (Neurontin), even though neither its mechanism of action nor its long-term effects are well understood. In 2007, the maker was fined over $500 million for marketing its use off-label for -- yes -- pain. Does the CDC see a problem here in declaring it less risky than Tylenol 3?<br/><br/>Again, low-level opioids pose a risk, but compared to what? When stripped away of concerns over side effects, including polypharmacy, the Guidelines sound but one, insistent, note: the risk of addiction outweighs the benefits – for all opioids, at all times.<br/><br/>Addiction is a horrible thing, but so are the results of using a meat ax instead of a scalpel when suggesting rules for practicing medicine. We have all heard about the post-surgical patient hooked on an extra supply of Oxycontin. But those stories are about extremely potent painkillers, not Tylenol 3s and their ilk. <br/><br/>Decades ago I asked my father, an M.D., about whether I was risking addiction by taking opioids. He asked how much I was taking. I replied that I took one Tylenol 3 a day. He looked at me, and said “I spill more than that.” <br/><br/>My audience here is mostly physicians – what do you, personally, use for pain relief? <br/><br/>Is Tylenol 3 addictive? Not when used appropriately, per the Mayo Clinic:<br/>When codeine is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.<br/>https://www.mayoclinic.org/drugs-supplements/acetaminophen-and-codeine-oral-route/description/drg-20074117<br/><br/>By failing to recognize that certain low-level opioids are relatively safe, at least when compared with the alternatives, the CDC is consigning many of us to more difficult and painful lives. You can – and must – do better.<br/><br/>Please consider including this recommendation in the Guidelines:<br/>“Low-strength opioids [e.g. Tylenol 3s, perhaps Tramadol for adults only – you can come up with a definition and/or list – the Mayo Clinic’s list in the above link may suffice] prescribed by a primary care physician who has received training in this area, a physiatrist, or a pain management physician are safe, effective, and recommended analgesics for those suffering from long-standing and properly documented chronic pain when accompanied by appropriate counseling concerning addiction.” <br/><br/>Thank you for considering my suggestion.<br/><br/>Signed: A chronic pain patient – name withheld to allow discussion of personal medical history.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	chronic pain patient	None	None	0900006484f7151c	Anonymous	None	2022-02-13T19:34:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, chronic pain patient	kzj-b1tn-uswd	False	None	False	2022-04-12 01:54:45.585	[]
334	CDC-2022-0024-0340	https://api.regulations.gov/v4/comments/CDC-2022-0024-0340	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain is an awful thing to live with. It takes way your ability to enjoy everyday life. It takes away your ability to concentrate of simple tasks. Everything become a long hard chore for you. You just want the endless nightmare to end. You can’t sleep. Nothing makes you happy. You get more depressed. Everything gets on your nerves. Simple tasks become major ordeals. You can’t handle the simplest thing because all you can think about is the excruciating pain you constantly feel. You get a small amount of relief from you pain medication but it is short lived. Then your life is back to horrible pain and wanting to just be able to enjoy the simplest thing. They treat you like a criminal when you go to get it filled. You have to jump through hoops to get the medicine prescribed and then when you get it filled you have to jump through more hoops and they treat you like a criminal. They make you turnover your persona data to prove who you are to get it. Pain patients are not criminals but the stress you get put through makes you more anxious causing you to have to get more tense and get more pain. It’s not the opioids that is the problem, it’s the drug dealers that caused the problem. Patients need the medicine to ease the suffering. The hoops pharmacies have to go through to fill a script cause them to put off filling it for hours at a time. Causing the patient more stress. While the patient suffers the pharmacist fill scripts that are just as dangerous without a care in the world dreading filling that opioid script because of all the regulatory steps they have to go through. Most of the Pain pills sold on the illegal market do not come from pain patients because the fact is they need every little bit they get to ease just a portion of the pain they have. Most doctors only prescribe enough to ease your pain down a few notches, you are never pain free. The drug tests that you have to take cost almost $500 every three months. The then pain doctor charges you out of the roof. We have to stop punishing the suffering patient and go after the cartels bringing them into the US. Have you ever wonder how much comes through shippers instead of across the border, yes some does but I would bet you most comes through shippers from other countries. It’s not the suffering patients who are selling the only thing that gives them that tiny bit of relief from a horrible debilitating pain that they feel around the clock, so stop punishing them by making it so hard for the to get their medicine they need. I would be glad to testify in front of the US Senate or House to help them understand what a patient goes through to get relief in this country if we could make meaningful Changes for the suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484f715d5	Greer	None	2022-02-13T19:36:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Greer, Steve	kzj-c2me-bagq	False	None	False	2022-04-12 01:54:45.810	[]
335	CDC-2022-0024-0341	https://api.regulations.gov/v4/comments/CDC-2022-0024-0341	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and almost committed suicide because my doctor was afraid to raise my dose thanks to all the pressure created on physicians created by your 2016 CDC guideline. I have multiple severe health conditions that are incurable and all cause severe pain, and you have been a threat to my life and have caused me so much unnecessary pain and suffering I'd like to see all of you held accountable for the torture and multiple suicides you've created. How many of you have MD degrees including residencies in anesthesiology and pain management? Let me guess. None. You relied on outside people with a political agenda to destroy the Sacklers and the same pharmaceutical companies you now depend on for COVID vaccinations. We should end the CDC and since universities perform the real research as you add no value. I hope you can't sleep at night for all the evil you have done, including thousands of suicides and millions of people who sufferred.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71631	Anonymous	None	2022-02-13T19:37:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-ckuk-1cjd	False	None	False	2022-04-12 01:54:46.050	[]
336	CDC-2022-0024-0342	https://api.regulations.gov/v4/comments/CDC-2022-0024-0342	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Change your stance and end your discrimination towards disabled individuals. If you must stigmatize medical drug use you should at least treat any use as a medical issue instead of as a criminal matter. Realize that any guidance you issue will be used by lawmakers and law enforcers to harm those that need opioids to live so please have compassion and err on the side of grace. Patients like myself just want to increase our function and reduce our pain levels and the public servants tasked with helping the struggling citizens should quit enacting guidance that results in irreparable harm to those they claim they are trying to help. Please, exempt non-idiopathic chronic pain in addition to cancer from the guidelines and encourage states to roll back their discriminatory state laws and policies that resulted from the harmful 2016 CDC opioid guidelines. Please realize that, while opioids should not the primary go to tool for treating people with serious health issues that they are a good secondary tool and they are sometimes used to help people before doctors understand what the underlying issue. A cancer patient should still have access to opioids even though they are undergoing radiation or chemotherapy and a non-idiopathic chronic pain patient like myself still needs access to opioids even though I am receiving nerve blocks and epidurals because none of these individually are the solution to easing a person's suffering but all of them together work to help make a suffering person's life just a little less miserable. Please realize it can take decades for a patient to find a competent doctor that can give an accurate hypothesis/diagnosis and confirm it with irrefutable evidence through scientific tests and in the meantime people still need help and pain relief regardless of whether the doctors know the source...no evidence to confirm a hypothesis does not mean the hypothesis is false, it simply means more research and medical care is needed, not less. Idiopathic pain does not mean the pain has no cause, it just means the cause is unknown. Surely you see that at a minimum, non-idiopathic chronic pain should be excluded from the guidelines. The CDC opioid guidelines should apply only to idiopathic, acute, and sub-acute pain.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f716af	Anonymous	None	2022-02-13T19:38:13Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-dh8u-g5yt	False	None	False	2022-04-12 01:54:46.282	[]
337	CDC-2022-0024-0343	https://api.regulations.gov/v4/comments/CDC-2022-0024-0343	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The healthcare system, especially pain management, needs improved significantly. The government trying to criminalize opioid use and removing safe access for individuals is directly causing patients with severe health issues to obtain medicines through illicit sources which can be fatal and this is clearly why opioid related deaths which are largely due to illegal sources of fentanyl continue to rise, directly correlating with harsher government laws and policies towards drugs. I am personally opposed to recreational use of alcohol, marijuana, and opioids, but people with serious medical conditions should have safe access to the medicines they need to live and individuals truly suffering are either going to find a way to get the medication they need to survive or they will parish and suffer harm, similar to how a starving person or animal will find the food needed for survival. I am below the 2016 CDC recommended 90 MME daily limit for patients seeing general practitioners and have been stabilized on my dosage for quite some time yet most general practitioners tell me they used to prescribe my medications but no longer will out of fear of the federal government and it is incredibly sad and a constant struggle to get adequate healthcare. I understand why doctors rightly fear the DEA and the federal government because being compassionate enough to help patients in need can literally ruin their life and this is the problem and it needs to stop and the CDC needs to quit attacking those already suffering.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f716b6	Anonymous	None	2022-02-13T19:38:28Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-die5-h5wr	False	None	False	2022-04-12 01:54:46.507	[]
338	CDC-2022-0024-0344	https://api.regulations.gov/v4/comments/CDC-2022-0024-0344	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This issue for patients suffering is absurd. I have had to fight for access to pain management and medical imaging such as MRIs to confirm my severe health condition that doctors wanted to ignore since chronic pain is often incurable as in my case. Now that I have a clear cause of my severe pain which has been confirmed as severe by multiple radiologists and subsequently by many doctors I am thankfully able to find a rare compassionate doctor willing to ease my suffering legally via opioids and nerve blocks but I know from experience that it is just a matter of time until those in power try to take away my medicine again because I am weak and disabled and an easy target.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f716bc	Anonymous	None	2022-02-13T19:38:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-djff-xxv1	False	None	False	2022-04-12 01:54:46.737	[]
339	CDC-2022-0024-0345	https://api.regulations.gov/v4/comments/CDC-2022-0024-0345	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I welcome an improvement in guidance towards prescribing opioids but the CDC guidance sadly still discriminates against many disabled individuals. The new guidelines clearly specify that conditions like cancer and sickle cell anemia are exempt from the guidance and I agree with this clarification but the same should also extend to individuals with non-idiopathic pain. People with severe chronic pain that is backed by scientific evidence proving their condition(s) should have safe access to medications that reduce their suffering safely under the supervision of a doctor the same as individuals with cancer and other serious painful medical conditions.<br/><br/>I am personally in severe pain constantly and have been for 28 years after a severe spine injury that went misdiagnosed by doctors who refused to order needed medical imaging for the majority of my life. After more then 10 years of suffering so much that I considered suicide often, I was forced to turn to illegal sources of marijuana to ease my pain before any states had legalized use, medically or recreationally, and eventually relocated to another state in order to get safe, legal access to medical marijuana when it was legalized. I never wanted to take pain management into my own hands but the my government and the healthcare system failed me and left me to suffer without legal options for pain relief. Unfortunately, I ended up having to grow my own medicine since the medical marijuana system was new and operating poorly and since the system was unable to provide safe, reliable access to the medicine I needed. Despite moving to a state with legal access to medical marijuana, most doctors were too afraid to prescribe it due to its schedule 1 drug status and the few that were willing to help patients like myself were attacked by politicians, law enforcement, and the state medical board. I would have gladly taken prescribed Sativex which has both THC and CBD to help ease my pain but the federal government unexplicably still has not approved this medication.<br/><br/>The doctor helping me with medical marijuana recommendations, Dr. ..., was literally raided by the DEA who cut a hole in the wall of his records room, seizing all records inside, and pushed the state medical board to suspend his license and succeeded. The doctor eventually got his license back and continued to fight for patients like myself but his reputation was constantly attacked by those previously mentioned and DEA agents which stand around his waiting room with their badges on beaded chains around their necks as they chewed on unlit cigars, staring intimidatingly at patients waiting to see the doctor.<br/><br/>Once the state legalized marijuana for recreational use, which I opposed, state lawmakers made it illegal for me to drive so I opted to see doctors for safe, legal access to opioids so I could continue to be under the care of a physician. Opioids are proven to have more analgesic properties and is FDA approved and more extended release formulas were being released which tritrate the medicine consistently so the change ended up being better for my healthcare but it has honestly been more difficult to obtain prescribed opioids, a schedule 2 drug with known medical uses, from the healthcare system than it was to obtain marijuana, a federally illegal schedule 1 drug. When the 2016 CDC guidelines for opioids were released, doctors started requiring costly urinalyses every few months and became less compassionate and more judgemental, worrying about the liability to their business and medical license, putting their concerns over the needs of the patient. Pharmacists also began to deny filling prescriptions overtly, calling people addicts in front of others waiting for their medications, or through covert actions such as repeatedly claiming to be unable to order the medication or perpetually forgetting to place opioid orders. Insurance companies started to use similar tactics, requiring excessive criteria to be met by the doctor and patient before covering opioid medications or even by excluding many opioids from coverage. In some cases insurance companies would pay doctors more for procedures and surgery if they refused to prescribe opioids to suffering patients which is beyons cruel and inhumane. As a chronic pain patient it is actually easier to obtain deadly illicit opioids laced with fentanyl from the black market, which I have never done, than it is to get them safely through the healthcare system.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f716ca	Anonymous	None	2022-02-13T19:43:07Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-dkhk-3g93	False	None	False	2022-04-12 01:54:46.949	[]
340	CDC-2022-0024-0346	https://api.regulations.gov/v4/comments/CDC-2022-0024-0346	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024.<br/>MY NAME IS .., FOR 25 YRS IVE BEEN DEALING W/CHRONIC & ACUTE PN. IT TOOK 13 YRS BEFORE I FOUND A DR WHO DIAGNOSED WHAT MY MAIN ISSUE WAS. I KNEW I HAD PSORIASIC ARTHRITIS W/NAROTOPY OSTO/RA, FIBER MYALGIA ENDOMETRIOSIS SCIATICA RYNODES, INTERCYCTIAL CYCTISIS. HAD SEVERAL SURGERY ON BLADDER EVEN HAD A PACEMAKER PUT ON BLADDER, I WAS IN PN MNGT BUT OVER THE YRS ALL OF THAT GOT WORSE, I STOPPED GOING TO DR'S & ER TO FIGURE OUT WHAT WAS WRONG, DR'S HAD SUCH RUDE & MEAN BEDSIDE MANNER, HAD DR TELL ME I HAD SYNTHETIC LUPUS BUT DUD PERSCRIBE ANYTHING OR MAKE FOLLOW UP. BUT ONEDAY HAD NO CHOICE HAD TO FIND A DR, I CALLED A DISEASE SPECIALIST/RHEMOTOLIGST, I BROUGHT HIM SOME REPORTS I HAD, HE DID SPECIFIC BLOOD TEST & FOUND OUT I HAD WEGNERS GRUMOLSOLTOIS VASCULITIS, HE IMMEDIATELY STARTED ME ON MEDICINE. THE ISSUE WAS GETTING WORSE, SO HE STARTED CHEMO, WHICH WORKED OFF&ON, 5 YRS AFTER BEING DIAGNOSED I ENDED UP ON LIFE SUPPORT & INDUCED FROM JUNE-AUG. NOW IVE BEEN ON OPIADS FIR 25 YRS, OFF&ON, THE LAST 3 YRS HAVEN'T BEEN IN THEM, I NEVER GOT ADDICTED, NEVER TOOK MORE THEN PERSCRIBED IF I DIDNT NEED I DIDNT TAKE. NOW LAST 3 YRS IVE BEEN IN AGONY I TAKE GABAPENTIN WHICH IVE BEEN ON FOR 10 YRS. I RECENTLY ASKED MY NEW DR OF 2 YRS FOR PN MEDS DIDNT EVEN RESPOND. WHATS UPSETTING IS THAT DR'S DONT SEEM TO GIVE THE MEDS TO PATIENTS WHO ACTUALLY NEED THEY GIVE THEM TO THE PPL W/ FAKE PAIN, PPL WHO REALLY DONT NEED, PPL WHO ABUSE. EVERYONE SAYS BECAUSE IF THE OPIATE CRISIS PPL ARE ABUSING HEROIN OR FENTYNAL BUT I TRULY BELIEVE THE PPL WHO ARE USING STREET DRUGS ARE BEING FORCED BECAUSE DR'S AREN'T HELPING PATIENTS W/ REAL PAIN ISSUES. IVE BEEN ON ALL KINDS OF MEDS FOR ALL MY HEALTH CONDITIONS, HAVE HAD SEVERAL DIFFERENT SURGERIES THAT WERE ONLY TEMPORARY FIXES SOME PATIENTS ACTUALLY NEED THE OPIATE PN MEDS, & BECAUSE OF ALL THESE DR'S GIVING IT AWAY LIKE CANDY TO THE WRONG PATIENTS, ITS PPL LIKE ME WHO ARE SUFFERING WHO HAVE TO FIND OTHER WAYS TO DEAL WITH OUR PAIN, EVERY AM I AWAKE TO SUCH NERVE PAIN, WHERE LEGS GO NUMB, CANT WALK, HAVE TO CRAWL TO BATHROOM SOMETIMES & THEN TRY HEAT, LEG COMPRESSORS, ETC FOR HOURS PPL LIKE ME WE DEAL WITH SO MUCH PAIN AND CANT FIND ANY HELP, SO WHAT ARE PATIENTS LIKE ME SUPPOSE TO DO? I HOPE EVENTUALLY TO BE ABLE TO GET OPIATES AGAIN, BUT IF REGULATIONS GET ANY STRICTER THEN THE ONLY HOPE FOR PPL LIKE ME IS GOING TO ,THE STREETS BECAUSE WE ARE GOING TO BR FORCED TO GO THERE. YES OPIATES ARE ADDICTING, BUT THERE HAS TO BE A COMMON GROUND WERE THEY CAN BE PERSCRIBED IETHER GIVE A HIGHER DOSE WHERE YOU GIVE LESS AND BREAKTHROUGH PAIN YOU CAN PRESCRIBE OTHER TYPES OF MEDS OR PRESCRIBE THE OPIATE W/ GABAPENTIN OR HIGHER MG OF IBPROHEN SO MEDS LAST LONGER, YOU CAN EVER MAKE IT SO A PATIENT ONLY TAKES WHEN NEEDED & WHEN PN LEVELS ARE LOW THEY TAKE NON OPIATE PN MEDS. UNFORTUNATELY ALOT OF DR'S HAVE NO IDEA WHAT REAL PAIN IS THEY ONLY STUDY IT BUT DONT EXPERIENCE PAIN.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484f716e9	Parady	None	2022-02-13T19:47:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Parady, Nicole	kzj-dt9k-v8cw	False	None	False	2022-04-12 01:54:47.184	[]
341	CDC-2022-0024-0347	https://api.regulations.gov/v4/comments/CDC-2022-0024-0347	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024.<br/>MY NAME IS ..., FOR 25 YRS IVE BEEN DEALING W/CHRONIC & ACUTE PN. IT TOOK 13 YRS BEFORE I FOUND A DR WHO DIAGNOSED WHAT MY MAIN ISSUE WAS. I KNEW I HAD PSORIASIC ARTHRITIS W/NAROTOPY OSTO/RA, FIBER MYALGIA ENDOMETRIOSIS SCIATICA RYNODES, INTERCYCTIAL CYCTISIS. HAD SEVERAL SURGERY ON BLADDER EVEN HAD A PACEMAKER PUT ON BLADDER, I WAS IN PN MNGT BUT OVER THE YRS ALL OF THAT GOT WORSE, I STOPPED GOING TO DR'S & ER TO FIGURE OUT WHAT WAS WRONG, DR'S HAD SUCH RUDE & MEAN BEDSIDE MANNER, HAD DR TELL ME I HAD SYNTHETIC LUPUS BUT DUD PERSCRIBE ANYTHING OR MAKE FOLLOW UP. BUT ONEDAY HAD NO CHOICE HAD TO FIND A DR, I CALLED A DISEASE SPECIALIST/RHEMOTOLIGST, I BROUGHT HIM SOME REPORTS I HAD, HE DID SPECIFIC BLOOD TEST & FOUND OUT I HAD WEGNERS GRUMOLSOLTOIS VASCULITIS, HE IMMEDIATELY STARTED ME ON MEDICINE. THE ISSUE WAS GETTING WORSE, SO HE STARTED CHEMO, WHICH WORKED OFF&ON, 5 YRS AFTER BEING DIAGNOSED I ENDED UP ON LIFE SUPPORT & INDUCED FROM JUNE-AUG. NOW IVE BEEN ON OPIADS FIR 25 YRS, OFF&ON, THE LAST 3 YRS HAVEN'T BEEN IN THEM, I NEVER GOT ADDICTED, NEVER TOOK MORE THEN PERSCRIBED IF I DIDNT NEED I DIDNT TAKE. NOW LAST 3 YRS IVE BEEN IN AGONY I TAKE GABAPENTIN WHICH IVE BEEN ON FOR 10 YRS. I RECENTLY ASKED MY NEW DR OF 2 YRS FOR PN MEDS DIDNT EVEN RESPOND. WHATS UPSETTING IS THAT DR'S DONT SEEM TO GIVE THE MEDS TO PATIENTS WHO ACTUALLY NEED THEY GIVE THEM TO THE PPL W/ FAKE PAIN, PPL WHO REALLY DONT NEED, PPL WHO ABUSE. EVERYONE SAYS BECAUSE IF THE OPIATE CRISIS PPL ARE ABUSING HEROIN OR FENTYNAL BUT I TRULY BELIEVE THE PPL WHO ARE USING STREET DRUGS ARE BEING FORCED BECAUSE DR'S AREN'T HELPING PATIENTS W/ REAL PAIN ISSUES. IVE BEEN ON ALL KINDS OF MEDS FOR ALL MY HEALTH CONDITIONS, HAVE HAD SEVERAL DIFFERENT SURGERIES THAT WERE ONLY TEMPORARY FIXES SOME PATIENTS ACTUALLY NEED THE OPIATE PN MEDS, & BECAUSE OF ALL THESE DR'S GIVING IT AWAY LIKE CANDY TO THE WRONG PATIENTS, ITS PPL LIKE ME WHO ARE SUFFERING WHO HAVE TO FIND OTHER WAYS TO DEAL WITH OUR PAIN, EVERY AM I AWAKE TO SUCH NERVE PAIN, WHERE LEGS GO NUMB, CANT WALK, HAVE TO CRAWL TO BATHROOM SOMETIMES & THEN TRY HEAT, LEG COMPRESSORS, ETC FOR HOURS PPL LIKE ME WE DEAL WITH SO MUCH PAIN AND CANT FIND ANY HELP, SO WHAT ARE PATIENTS LIKE ME SUPPOSE TO DO? I HOPE EVENTUALLY TO BE ABLE TO GET OPIATES AGAIN, BUT IF REGULATIONS GET ANY STRICTER THEN THE ONLY HOPE FOR PPL LIKE ME IS GOING TO ,THE STREETS BECAUSE WE ARE GOING TO BR FORCED TO GO THERE. YES OPIATES ARE ADDICTING, BUT THERE HAS TO BE A COMMON GROUND WERE THEY CAN BE PERSCRIBED IETHER GIVE A HIGHER DOSE WHERE YOU GIVE LESS AND BREAKTHROUGH PAIN YOU CAN PRESCRIBE OTHER TYPES OF MEDS OR PRESCRIBE THE OPIATE W/ GABAPENTIN OR HIGHER MG OF IBPROHEN SO MEDS LAST LONGER, YOU CAN EVER MAKE IT SO A PATIENT ONLY TAKES WHEN NEEDED & WHEN PN LEVELS ARE LOW THEY TAKE NON OPIATE PN MEDS. UNFORTUNATELY ALOT OF DR'S HAVE NO IDEA WHAT REAL PAIN IS THEY ONLY STUDY IT BUT DONT EXPERIENCE PAIN.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484f716ea	Parady	None	2022-02-13T19:48:31Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Parady, Nicole	kzj-dt9l-cpxj	False	None	False	2022-04-12 01:54:47.457	[]
342	CDC-2022-0024-0348	https://api.regulations.gov/v4/comments/CDC-2022-0024-0348	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024.<br/>MY NAME IS ..., FOR 25 YRS IVE BEEN DEALING W/CHRONIC & ACUTE PN. IT TOOK 13 YRS BEFORE I FOUND A DR WHO DIAGNOSED WHAT MY MAIN ISSUE WAS. I KNEW I HAD PSORIASIC ARTHRITIS W/NAROTOPY OSTO/RA, FIBER MYALGIA ENDOMETRIOSIS SCIATICA RYNODES, INTERCYCTIAL CYCTISIS. HAD SEVERAL SURGERY ON BLADDER EVEN HAD A PACEMAKER PUT ON BLADDER, I WAS IN PN MNGT BUT OVER THE YRS ALL OF THAT GOT WORSE, I STOPPED GOING TO DR'S & ER TO FIGURE OUT WHAT WAS WRONG, DR'S HAD SUCH RUDE & MEAN BEDSIDE MANNER, HAD DR TELL ME I HAD SYNTHETIC LUPUS BUT DUD PERSCRIBE ANYTHING OR MAKE FOLLOW UP. BUT ONEDAY HAD NO CHOICE HAD TO FIND A DR, I CALLED A DISEASE SPECIALIST/RHEMOTOLIGST, I BROUGHT HIM SOME REPORTS I HAD, HE DID SPECIFIC BLOOD TEST & FOUND OUT I HAD WEGNERS GRUMOLSOLTOIS VASCULITIS, HE IMMEDIATELY STARTED ME ON MEDICINE. THE ISSUE WAS GETTING WORSE, SO HE STARTED CHEMO, WHICH WORKED OFF&ON, 5 YRS AFTER BEING DIAGNOSED I ENDED UP ON LIFE SUPPORT & INDUCED FROM JUNE-AUG. NOW IVE BEEN ON OPIADS FIR 25 YRS, OFF&ON, THE LAST 3 YRS HAVEN'T BEEN IN THEM, I NEVER GOT ADDICTED, NEVER TOOK MORE THEN PERSCRIBED IF I DIDNT NEED I DIDNT TAKE. NOW LAST 3 YRS IVE BEEN IN AGONY I TAKE GABAPENTIN WHICH IVE BEEN ON FOR 10 YRS. I RECENTLY ASKED MY NEW DR OF 2 YRS FOR PN MEDS DIDNT EVEN RESPOND. WHATS UPSETTING IS THAT DR'S DONT SEEM TO GIVE THE MEDS TO PATIENTS WHO ACTUALLY NEED THEY GIVE THEM TO THE PPL W/ FAKE PAIN, PPL WHO REALLY DONT NEED, PPL WHO ABUSE. EVERYONE SAYS BECAUSE IF THE OPIATE CRISIS PPL ARE ABUSING HEROIN OR FENTYNAL BUT I TRULY BELIEVE THE PPL WHO ARE USING STREET DRUGS ARE BEING FORCED BECAUSE DR'S AREN'T HELPING PATIENTS W/ REAL PAIN ISSUES. IVE BEEN ON ALL KINDS OF MEDS FOR ALL MY HEALTH CONDITIONS, HAVE HAD SEVERAL DIFFERENT SURGERIES THAT WERE ONLY TEMPORARY FIXES SOME PATIENTS ACTUALLY NEED THE OPIATE PN MEDS, & BECAUSE OF ALL THESE DR'S GIVING IT AWAY LIKE CANDY TO THE WRONG PATIENTS, ITS PPL LIKE ME WHO ARE SUFFERING WHO HAVE TO FIND OTHER WAYS TO DEAL WITH OUR PAIN, EVERY AM I AWAKE TO SUCH NERVE PAIN, WHERE LEGS GO NUMB, CANT WALK, HAVE TO CRAWL TO BATHROOM SOMETIMES & THEN TRY HEAT, LEG COMPRESSORS, ETC FOR HOURS PPL LIKE ME WE DEAL WITH SO MUCH PAIN AND CANT FIND ANY HELP, SO WHAT ARE PATIENTS LIKE ME SUPPOSE TO DO? I HOPE EVENTUALLY TO BE ABLE TO GET OPIATES AGAIN, BUT IF REGULATIONS GET ANY STRICTER THEN THE ONLY HOPE FOR PPL LIKE ME IS GOING TO ,THE STREETS BECAUSE WE ARE GOING TO BR FORCED TO GO THERE. YES OPIATES ARE ADDICTING, BUT THERE HAS TO BE A COMMON GROUND WERE THEY CAN BE PERSCRIBED IETHER GIVE A HIGHER DOSE WHERE YOU GIVE LESS AND BREAKTHROUGH PAIN YOU CAN PRESCRIBE OTHER TYPES OF MEDS OR PRESCRIBE THE OPIATE W/ GABAPENTIN OR HIGHER MG OF IBPROHEN SO MEDS LAST LONGER, YOU CAN EVER MAKE IT SO A PATIENT ONLY TAKES WHEN NEEDED & WHEN PN LEVELS ARE LOW THEY TAKE NON OPIATE PN MEDS. UNFORTUNATELY ALOT OF DR'S HAVE NO IDEA WHAT REAL PAIN IS THEY ONLY STUDY IT BUT DONT EXPERIENCE PAIN.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484f716eb	Parady	None	2022-02-13T19:48:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Parady, Nicole	kzj-dt9n-5nvi	False	None	False	2022-04-12 01:54:47.721	[]
343	CDC-2022-0024-0349	https://api.regulations.gov/v4/comments/CDC-2022-0024-0349	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024.<br/>MY NAME IS ..., FOR 25 YRS IVE BEEN DEALING W/CHRONIC & ACUTE PN. IT TOOK 13 YRS BEFORE I FOUND A DR WHO DIAGNOSED WHAT MY MAIN ISSUE WAS. I KNEW I HAD PSORIASIC ARTHRITIS W/NAROTOPY OSTO/RA, FIBER MYALGIA ENDOMETRIOSIS SCIATICA RYNODES, INTERCYCTIAL CYCTISIS. HAD SEVERAL SURGERY ON BLADDER EVEN HAD A PACEMAKER PUT ON BLADDER, I WAS IN PN MNGT BUT OVER THE YRS ALL OF THAT GOT WORSE, I STOPPED GOING TO DR'S & ER TO FIGURE OUT WHAT WAS WRONG, DR'S HAD SUCH RUDE & MEAN BEDSIDE MANNER, HAD DR TELL ME I HAD SYNTHETIC LUPUS BUT DUD PERSCRIBE ANYTHING OR MAKE FOLLOW UP. BUT ONEDAY HAD NO CHOICE HAD TO FIND A DR, I CALLED A DISEASE SPECIALIST/RHEMOTOLIGST, I BROUGHT HIM SOME REPORTS I HAD, HE DID SPECIFIC BLOOD TEST & FOUND OUT I HAD WEGNERS GRUMOLSOLTOIS VASCULITIS, HE IMMEDIATELY STARTED ME ON MEDICINE. THE ISSUE WAS GETTING WORSE, SO HE STARTED CHEMO, WHICH WORKED OFF&ON, 5 YRS AFTER BEING DIAGNOSED I ENDED UP ON LIFE SUPPORT & INDUCED FROM JUNE-AUG. NOW IVE BEEN ON OPIADS FIR 25 YRS, OFF&ON, THE LAST 3 YRS HAVEN'T BEEN IN THEM, I NEVER GOT ADDICTED, NEVER TOOK MORE THEN PERSCRIBED IF I DIDNT NEED I DIDNT TAKE. NOW LAST 3 YRS IVE BEEN IN AGONY I TAKE GABAPENTIN WHICH IVE BEEN ON FOR 10 YRS. I RECENTLY ASKED MY NEW DR OF 2 YRS FOR PN MEDS DIDNT EVEN RESPOND. WHATS UPSETTING IS THAT DR'S DONT SEEM TO GIVE THE MEDS TO PATIENTS WHO ACTUALLY NEED THEY GIVE THEM TO THE PPL W/ FAKE PAIN, PPL WHO REALLY DONT NEED, PPL WHO ABUSE. EVERYONE SAYS BECAUSE IF THE OPIATE CRISIS PPL ARE ABUSING HEROIN OR FENTYNAL BUT I TRULY BELIEVE THE PPL WHO ARE USING STREET DRUGS ARE BEING FORCED BECAUSE DR'S AREN'T HELPING PATIENTS W/ REAL PAIN ISSUES. IVE BEEN ON ALL KINDS OF MEDS FOR ALL MY HEALTH CONDITIONS, HAVE HAD SEVERAL DIFFERENT SURGERIES THAT WERE ONLY TEMPORARY FIXES SOME PATIENTS ACTUALLY NEED THE OPIATE PN MEDS, & BECAUSE OF ALL THESE DR'S GIVING IT AWAY LIKE CANDY TO THE WRONG PATIENTS, ITS PPL LIKE ME WHO ARE SUFFERING WHO HAVE TO FIND OTHER WAYS TO DEAL WITH OUR PAIN, EVERY AM I AWAKE TO SUCH NERVE PAIN, WHERE LEGS GO NUMB, CANT WALK, HAVE TO CRAWL TO BATHROOM SOMETIMES & THEN TRY HEAT, LEG COMPRESSORS, ETC FOR HOURS PPL LIKE ME WE DEAL WITH SO MUCH PAIN AND CANT FIND ANY HELP, SO WHAT ARE PATIENTS LIKE ME SUPPOSE TO DO? I HOPE EVENTUALLY TO BE ABLE TO GET OPIATES AGAIN, BUT IF REGULATIONS GET ANY STRICTER THEN THE ONLY HOPE FOR PPL LIKE ME IS GOING TO ,THE STREETS BECAUSE WE ARE GOING TO BR FORCED TO GO THERE. YES OPIATES ARE ADDICTING, BUT THERE HAS TO BE A COMMON GROUND WERE THEY CAN BE PERSCRIBED IETHER GIVE A HIGHER DOSE WHERE YOU GIVE LESS AND BREAKTHROUGH PAIN YOU CAN PRESCRIBE OTHER TYPES OF MEDS OR PRESCRIBE THE OPIATE W/ GABAPENTIN OR HIGHER MG OF IBPROHEN SO MEDS LAST LONGER, YOU CAN EVER MAKE IT SO A PATIENT ONLY TAKES WHEN NEEDED & WHEN PN LEVELS ARE LOW THEY TAKE NON OPIATE PN MEDS. UNFORTUNATELY ALOT OF DR'S HAVE NO IDEA WHAT REAL PAIN IS THEY ONLY STUDY IT BUT DONT EXPERIENCE PAIN.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484f716ec	Parady	None	2022-02-13T19:49:15Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Parady, Nicole	kzj-dt9o-4ym8	False	None	False	2022-04-12 01:54:47.951	[]
344	CDC-2022-0024-0350	https://api.regulations.gov/v4/comments/CDC-2022-0024-0350	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You failed. The 2016 guidelines did nothing to slow the drug overdose crisis. Prescriptions are down 70%, and overdoses up 1000%. You need to withdraw the entire guideline and not even attempt an update. There is zero correlation and in fact some believe the CDC worsened the crisis by driving innocent law abiding citizens to street drugs. I personally know two people who now take heroin for pain thanks to you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71705	Anonymous	None	2022-02-13T19:49:27Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-e0co-8755	False	None	False	2022-04-12 01:54:48.264	[]
345	CDC-2022-0024-0351	https://api.regulations.gov/v4/comments/CDC-2022-0024-0351	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If it weren't for my intelligent, compassionate doctor recognizing the advantages of medication for my particular issues, I would have very little quality of life. I had a doctor prior to 2016 who prescribed me medication (after YEARS of searching for help), and finally for 1 solid year i was thriving! Then the guidelines came down and she cut me off cold turkey and left me crying in the office alone with no recommendations,taper, other meds.Nothing! I was devastated! <br/>It took me years of agony to find the one I have now. Hes an angel and he saved my life.<br/>Prior, I was always crying or angry, isolating, losing jobs because I couldnt get out of bed, I had strained relationships with loved ones, in a cycle of weight gain over inactivity and depression. <br/>Chronic pain feels like slowly dying in agony while everyone walks by laughing or judging you or ignoring your suffering. <br/>I have painful muscle and nerve issues, immune disorders and ongoing pain from previous severe injuries. Because of the proper medication and doses, I was able to go back to college, get a better paying job, become more active, overcome a lot of anxiety and severe depression and isolation from being in pain. It vastly changed my life. I look forward to living.<br/>I had many doctors, (mostly male), laugh in my face, say to just lose weight, tell me it was in my head, say I "looked" fine. I've been told "I don't prescribe pain meds" before we even had a conversation, or "your issue isnt real", "You just need to exercise more", and even after a double hand surgery I was crying and was told "It cant possibly hurt that bad", AFTER SURGERY!! That's become way more common, lack of proper care after surgery. How disgusting!<br/>I was prescribed so much Naprosyn and ibuprofen i got kidney infections just so they could avoid pain relief. They even give out horrible dangerous psych meds with terrible side effects instead of treating pain. <br/>The injections being pushed now are a whole other problem. <br/> Ive been forced to do painful injections while "awake" by pain management doctors who REQUIRE injections before any medication. Its in their contracts and they absolutely will not see you without scheduling injections by your 2nd visit. These are painful, invasive injections in spines, necks, joints, knees. Even biopsies for womens cervix and breast cancer are done awake with no pain relief! Do you want to lay naked and scared and be told to stay still while 7" needles are put into your spine or neck or cervix? Do you want your mom or daughter experiencing that? Unbelievable. That needs to change!!<br/>And btw, if you do that they give you pain medication after the injections, its 1 tablet a day. Then you have to decide what 4 hours of your day you deserve that pain relief, because 1 pill a day does absolutely nothing. You get no time to actually heal your body, get any therapeutic restorative rest, get any relief from the horrific stress and tension that makes you physically ill. Pain never takes a day off. ...how can you at the CDC NOT see issues with all these thousands of stories of denial, suffering, ignoring, suicide, loss of function, weird treatments, painful procedures, botched injections, people turning to the streets, people suffering after surgeries, or during painful procedures including biopsies, dentists, day surgeries, etc. and NOT realize you're making HUGE mistakes in putting caps or sanctions on care?<br/> It's really pretty gross when you take the time to consider how people in pain are treated. Your also subject to urine tests like you're on parole, the nurses pat you down, confiscate your jacket and purse, lift your shirt to make sure your not trying to cheat a test. You're looked at like an addict, the pharmacies are rude and police your activity, you can't travel near a refill time, you can't transfer medication even if you move without a bunch of scrutiny. I've known people with chronic painful issues, cancer, dementia, day surgery, C sections, ER injuries who were all denied pain relief. I know doctors and nurses denying pain medication for people on hospice, because they might get addicted. Yes, you read that right.<br/>It's time to stop policing responsible doctors and patients when their not the issue. There should be no pushing of "alternative" treatment not covered by insurance or expensive required injections. There should be no "guideline" for types or doses because you don't know what will work for every single case. People are suffering and dying for no reason! This isn't enough, it leaves all the original guidelines in place, doctors are still afraid of sanctions and the DEA needs to butt out of patient care.<br/>Why is there is no compassion for REAL people with REAL pain. Time to use your compassion and common sense to fix this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kris	None	None	0900006484f71737	Jenkins	None	2022-02-13T19:50:02Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Jenkins, Kris	kzj-eact-4ipf	False	None	False	2022-04-12 01:54:48.498	[]
346	CDC-2022-0024-0352	https://api.regulations.gov/v4/comments/CDC-2022-0024-0352	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just wanted to let you know I was affected by your 2016 guidelines. I have been opiods for years. This has helped me function at home and at work. I never abused my meds or took any street drugs. <br/> About a year and a half ago my Pain management practice told me they were cutting by dosage down significantly due to the guidelines, then pretty much to nothing. <br/>I ended up switching clinics and everything was going well until I was failed for a drug tear for a substance I have never taken in my life,failed by almost undetectable traces according to the NP. I was cut off completely and given the choice of suboxone and treated like an addict. I took my own drug test through work the sane day and passed for what I was failed for, but they refused those results. Ever since then no one will treat my pain with the meds that helped with my pain for years. The only thing anyone will prescribe now is buprenorphine, which is not good for pain and more addictive than the oxycodone I was on . The doctors have said my pain is not bad enough and only cancer patients are allowed those meds or scared they will get arrested. I can bary work or function due to my pain without the medications. What other choice do I have now? I have had 2 failed surgeries and even my post op pain was not treated properly. <br/> At the end of my rope	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Luis	None	None	0900006484f71739	Salmon	None	2022-02-13T19:50:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Salmon , Luis	kzj-eako-l4ox	False	None	False	2022-04-12 01:54:48.851	[]
347	CDC-2022-0024-0353	https://api.regulations.gov/v4/comments/CDC-2022-0024-0353	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioid use needs to be monitored extremely closely, and should never be over used in any circumstance. I am a public school teacher and have seen first hand how prescribed drug use can quickly become out of hand and ruin families.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484f71784	Wilson	None	2022-02-13T19:50:55Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Wilson, Christina	kzj-ewmx-nxls	False	None	False	2022-04-12 01:54:49.101	[]
348	CDC-2022-0024-0354	https://api.regulations.gov/v4/comments/CDC-2022-0024-0354	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was injured on the job back in the late 1990's and due to injury was prescribed opioids due to none of the over the counter meds helping with the pain. When I was first injured I was sent for all sorts of test and treatments and even having to see a psychologist. Since injury I have been on opioids prescribed by my primary dr. & dr. going over my MRI's, reports and records showing everything I have already done.. I even sent my MRI's to a spine specialist which concurred that opioids would help the pain but eventually without 2 back surgeries I would be permanently disabled. I opted to not get back surgery being that there was a huge chance that I would come out worse regarding the pain and movement. I was getting the right dose of pain meds when I was seeing my primary doctor then 2 years ago my primary stopped prescribing pain medication due to the 2016 guidelines, CDC and DEA forcing primary care doctors to stop prescribing pain medications. <br/><br/>I was forced to go to pain management clinic and the nurse practitioner said that I had to get injections even though I had already had them and they did not work and being on a pension I did not have the money to pay for treatment I had already had and did not work. I was forced to make an appointment for the injections otherwise I would not get my pain medication. I made the appointment but then cancelled and when I saw a different nurse practitioner the following month I explained again that I had already had ALL the treatments that they wanted me to do, none worked and I did not have the money to waste on doing the treatments again. This nurse practitioner changed my medications and lowered my dosage so much that for a month I was in so much pain and hardly got out of bed, my quality of life had decreased immensely. The following months pain management appt I was literally in tears explaining how bad the pain was the previous month from lowering my dosage so much. My medication was increased but not to my normal dosage. Having to go to pain management EVERY month, pee in a cup just to get a prescription has been costly and then to top things off having your medication lowered so much to the point that your quality of life goes way down is down right cruel and inhumane.<br/><br/>These pain management places act like they are God and if you do not do what they say you are threatened with not getting your pain medication. Every month I went in there was NEW rules. My last appointment the nurse practitioner told me that when the weather warmed up she was reducing my medication down to 60mme, which would be 2 pills a day. I told her again, 3 pills aren't enough for a 24 hour period and you're going to drop me down to 2 pills for a 24 hour period? Her reply, yes, 90mme is too much. Then she proceeds to tell me that I had to see their psychologist for a risk assessment, which really was a psych evaluation disguised as risk assessment. I asked why, I follow ALL your rules, my urine test have never come back dirty, I don't drink or use any other drugs (cbd, pot) and was told NEW RULE. I did not want a psych evaluation in my records when I did not need a psych evaluation in the first place.. I was told I had to see their psychologist before my next appt. The nurse practitioner had told me several times in past appts that eventually they, the pain management clinic would not be allowed to prescribe opioids and would need to start weening me off. <br/><br/>It's awful how these so called pain management clinics treat chronic pain patients and the power they hold over us. Taking our primary doctor out of the picture was wrong, they are doctors too and can read reports from specialist too!. What happened to the oath all dr's take, to do no harm? Pain mgt clinics, CDC & DEA have caused so much harm to chronic pain patients with the 2016 GUIDELINES (not a law) to the point that so many chronic pain patients have taken their lives, there's no empathy or compassion for chronic pain patients, just treated like a criminal and pain mgt clinics profiting while primary care dr's. are closing right and left. How many more chronic pain patients have to die because can't get pain medication needed to have somewhat quality of life? <br/> I hope the newly revised guidelines put an end to the torture as well as allow primary care doctors to prescribe opioids w/o the threat of their license being revoked and put in jail for doing their job. Thank you for finally revising!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7178f	Anonymous	None	2022-02-13T19:51:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-f0nd-jfl9	False	None	False	2022-04-12 01:54:49.375	[]
349	CDC-2022-0024-0355	https://api.regulations.gov/v4/comments/CDC-2022-0024-0355	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	THE HISTORICAL CDC ARBITRARY OPIOID RECOMMENDATIONS SUGGESTING OPIOID PRESCRIBING BE LIMITED TO 50 MME, RARELY 90 MME, HAS SEVERELY PROHIBITED LEGITIMATE PRESCRIBING OF EFFECTIVE SAFE ANALGESICS FOR OUR PATIENTS SUFFERING FROM CHRONIC PAIN. DESPITE THE COMMENT THAT YOUR RECOMMENDATIONS ARE GUIDELINES, THE GUIDELINES ARE BEING GIVEN FORCE OF LAW, MAKING PRESCRIBING LEGITIMATE OPIOIDS PROBLEMATIC. AS A RESULT OF THE PREVIOUSLY PUBLISHED GUIDELINES OPIOIDS ARE BEING AVOIDED, BEING REPLACED BY NSAID's WHICH HAVE SERIOUS, POTENTIALLY FATAL, SIDE EFFECTS, AS WELL AS ACETAMINOPHEN WHICH HAS BLEEDING AND HEPATIC NEGATIVE EFFECTS TOO. THE PANEL MUST ALSO BE AWARE THAT MORPHINE HAS NO SEALING LEVEL, ALLOWING ADJUSTMENT IN ANALGESIC DOSE TO ALLOW IMPROVED FUNCTION. DUE TO STIGMA RELATED TO THE CDC's PREVIOUS GUIDELINES HAS EVEN IMPACTED PAIN MANAGEMENT AND ER TREATMENT OF APPARENT GENUINE CHRONIC PAIN. CDC MUST BE AWARE THAT THEIR GUIDELINES HAVE REALLY NOT REDUCED OPIOID RELATED DEATHS, MOSTLY ATTRIBUTED TO ILLEGAL FENTANYL. THE CDC GUIDELINES MAKE SUBOXONE PRESCRIBING DUE TO ITS MME OF 30X. MY PAIN SUFFERING PATIENTS HAVE BEEN NEGATIVELY IMPACTED AS A DIRECT RESULT OF YOUR GUIDELINES. FINALLY, NON-NAIVE PATIENTS FAMILIAR TO PRACTITIONERS, ESPECIALLY FM/IM PHYSICIANS, SHOULD NOT BE RESTRICTED ON LIMITING THE SUFFERING OF OUR PATIENTS IN PAIN. ADDITIONALLY, BENZODIAZEPINE PRESCRIBING ALONG WITH OPIOIDS SHOULD NOT BE CRITICIZED SO STRONGLY, SINCE ANXIETY FREQUENTLY ACCOMPANIES CHRONIC PAIN.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f717ad	Anonymous	None	2022-02-13T19:52:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-fbx5-f3uv	False	None	False	2022-04-12 01:54:49.594	[]
350	CDC-2022-0024-0356	https://api.regulations.gov/v4/comments/CDC-2022-0024-0356	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In my opinion doctors shouldn't be prescribing opioids or any narcotics at first hand what's so ever to any patient. They may think that this is the right treatment to help with the unbearable pain but in reality when prescribing narcotics to patients you are harming them more then helping them. You may ask yourself why I think this way, well to begin with a year in a half ago my husband had an injury at his job. From that moment forward he had to have a surgery because the right thumb of his had was broken. The doctor who undertook the surgery prescribed him with narcotics and told him to take it when the pain was unbearable. My husband had pain every day because the more he tried to move his hand the worst it got. So he took the medication the doctor gave him every chance he got. I was to blind and unaware to realize that this would bring such an effect on him. My husband who is 26 years old who had a whole life ahead of him is now a drug addict and I've been fighting to help him stay clean for a year in half. After the narcotics that his doctor prescribed him ran out in his mind he still felt this pain and still feels this pain till now and his only solution is to find pills that will help him cope with this feeling. I've put him on detox places including rehabs but nothing works because every time he comes back home he relapses and last week on Monday was the second time he overdosed. If it wasn't because I beged and pleaded 911 to come and help my husband I would have lost him. This experience hasn't been easy for me and our son and to be honest I'd never expected to go through something like this. I dont wish this on anyone but I would like to share my experience with all of you. No doctor should prescribe opioids at first hand because you don't know what affect it will have in someone's life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f717ae	Anonymous	None	2022-02-13T19:52:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-fc86-54tk	False	None	False	2022-04-12 01:54:49.822	[]
351	CDC-2022-0024-0357	https://api.regulations.gov/v4/comments/CDC-2022-0024-0357	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think medication issues for those of us with chronic pain should be left to physicians. As usual the government is applying a one size fits all approach. The result of this recommendation will lower the quality of life for all chronic pain patients. I only have one life to live on this earth and the quality of that life is largely dependant on my pain medications. Please reconsider instituting such drastic recommendations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71983	Anonymous	None	2022-02-13T19:52:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-ge0h-sqq0	False	None	False	2022-04-12 01:54:50.057	[]
352	CDC-2022-0024-0358	https://api.regulations.gov/v4/comments/CDC-2022-0024-0358	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain all of the time I have h.s which is a skin condition which is very painful and causes other chronic conditions such as arthritis among others, I also suffer from a herniated disc and within the last year or so I have lost many days at work and I have tried first and second line treatments with no improvement and my doctors are too afraid to prescribe anything but muscle relaxers and ibuprofen I'm also on antibiotics and have been for at least 7 years or more. I have tried everything please consider relaxing the guidelines, I have had to take the rest of February off because I can't stand for more than an hour thank you for your time and consideration	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Devin	None	None	0900006484f719a1	Jean	None	2022-02-13T19:53:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Jean, Devin	kzj-grio-ovbo	False	None	False	2022-04-12 01:54:50.298	[]
353	CDC-2022-0024-0359	https://api.regulations.gov/v4/comments/CDC-2022-0024-0359	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I sufferered an Aortic Aneurysm after the birth of my twins 20 years ago. I am now 60 years old. I needed to have open heart surgery and a Dacron graft of 12 inches placed in the descending aorta of my heart. During the surgery, they also needed to take out one of my ribs. I was left with chronic pain and have been to rehabilitation therapy for three years following this surgery. It has taken me 10 years to find the best way to live my life while raising my children . My husband and family have been beyond wonderful. I had reduced my pain medication to 4 oxycontin (4o mg) and was swimming in a town pool to keep my body at the best I could. I have tried all forms of additional therapies and can not take nsaids due to my heart condition. I have exhausted other forms of pain medications due to side effects and only oxycontin was effective in giving 80% relief. I pay $400 out of pocket each month for this life saving medication that permits me to get out of bed and move. Without it, I can't get out of bed because of the stabbing pain and I finally established a routine that worked for me and I visited with my primary physician once a month to discuss. Since 2016 when the new opioid guidelines came out my life was turned upside down. My primary doctor would no longer prescribe narcotics to any patients but put me in touch with a Pain Clinic. The clinic would only prescribe 2 (40mg) tablets a day (I had been on 4(40mg) and I have laid in bed to this day wondering how unfair, unjust and wrong this system is for those who never abused it. I have only used one pharmacy and one doctor throughout this 20 year period and now I only have relief from unbearable pain for half the day. For anyone reading this, realize this could be you. It took me a good 10 years after trying every type of treatment ( Acupuncture, CBT, Hypnotherapy, herbs, Tumeric, relaxation therapy, massage, guided imagery therapy) to try to eliminate or alleviate the constant pain, and for whatever reason, my body only responds to this one medication that works for me. The expense alone has been a challenge but also a godsend because I get relief, Thank God. I can not tell you how many times I lay in pain knowing there is a better way yet society has determined I can not have access to this better way of living the best quality of life for me as an individual on this earth. I have all the MRI's, Cat scans and x-rays that show my issues at hand to substantiate my medical issues and I have been to over 20 Drs and specialists for advice. Most of them tell me I am lucky to be alive and I truly feel I am when I am not in the debilitating pain that I have without the proper dosing of medication needed for my body. Thank you for listening and providing this space to hear our individual situations that deserve individualized medications and therapies for chronic pain patients. I truly hope there will be the proper needed guidelines in place to help all individuals who live in chronic pain without the restrictions that are presently being followed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484f719cf	Kwiat	None	2022-02-13T20:00:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Kwiat, Christine	kzj-hfkv-aj5b	False	None	False	2022-04-12 01:54:50.519	[]
354	CDC-2022-0024-0360	https://api.regulations.gov/v4/comments/CDC-2022-0024-0360	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67 year old male that has been getting periodic headaches since I was 8 or 9 years old. At age 37, I began pursuing medical treatment, since aspirin, tylenol and motrin were ineffective. The neurologist I went to diagnosed the headaches as migraines, and I tried several drugs aimed at migraines. None worked. Eventually, I tried vicodin, and that worked well. I have been taking (2) 5-300mg pills at a time, when I get a headache, since then (30 years). I take them not to exceed the the daily maximum, until the headache is tolerable or goes away. I typically get headaches about once every few weeks, and they are of variable severity, and I use the vicodin sparingly on the worst of them only. I find that (1) bottle of 30 pills lasts about (1) year. THERE IS NO WAY TO GET ADDICTED ON THAT SMALL OF A SUPPLY. I think that over 30 years, I have proven myself to not be an addictive personality, and I have not abused the drug. But a few years back it has become increasingly difficult to get my doctors to prescribe it, and my pharmacist to fill it. It has gotten ridiculous. My regular doctor was unwilling to prescribe it, not because she thought it was ill advised, nor because she felt it was being abused, nor because it wasn't effective, but because it was too difficult for her to do so, and headaches weren't her area of expertise. So I went to a neurologist again, and after trying several new drugs and other therapies, he wanted to go back to the vicodin, but he said he was unable to write prescriptions for it. This was a doctor practicing at ... in Los Angeles, a worldwide recognized and highly esteemed hospital, and he was unable to write a prescription for it. That's insane. So at my next visit to my regular doctor, I practically begged for it. She wrote the prescription. Without it, when I get a headache, I am incapacitated for 3-4 days with pain. PLEASE FIX THIS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	paul	None	None	0900006484f71a01	reinstein	None	2022-02-13T20:07:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from reinstein, paul	kzj-ig84-67t7	False	None	False	2022-04-12 01:54:50.736	[]
355	CDC-2022-0024-0361	https://api.regulations.gov/v4/comments/CDC-2022-0024-0361	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do consider adopting these revised guidelines. My husband and I (68 and 62)both have chronic pain and our Dr keeps decreasing our dosages which affects our quality of life drastically.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484f71a03	Mahan	None	2022-02-13T20:07:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Mahan, Cindy	kzj-iguj-qqf8	False	None	False	2022-04-12 01:54:50.956	[]
356	CDC-2022-0024-0362	https://api.regulations.gov/v4/comments/CDC-2022-0024-0362	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to the initial anti opiate push my doctor dropped me. I now suffer 24/7 from intractable chronic pain in my groin. Although it’s a step in the right direction, the damage will be, most likely, irreversible for myself and many others.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484f71a2d	Justino	None	2022-02-13T20:08:06Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Justino , Thomas	kzj-j4x2-dp9f	False	None	False	2022-04-12 01:54:51.218	[]
357	CDC-2022-0024-0363	https://api.regulations.gov/v4/comments/CDC-2022-0024-0363	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These new guidelines are a step forward in making life better for those of us who live with Chronic pain. Changing guidelines will also help Dr's who have wrongly been prosecuted for helping their patients as well as helping the cost of medications I tried soo many times to get my insurance to cover my mrds they always gave me problems covering as I took what they saw as a high dose of meds but when you have neuropathy pain its the only thing that gives you Any quality of life living with pain is the worst kind of hell.. I'd never wish on anyone. So many judge others like myself thinking we are just pill seekers until you end up in my shoes it's a hard thing to understand. I hope that our government etc starts recognizing how many of us live with pain and we do not choose this life it's the illicit drugs on the streets that are creating overdoses not the patients suffering and physicians just trying to help them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484f71a3f	Hanner	None	2022-02-13T20:08:23Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Hanner, Karen	kzj-jgv6-1mbt	False	None	False	2022-04-12 01:54:51.433	[]
358	CDC-2022-0024-0364	https://api.regulations.gov/v4/comments/CDC-2022-0024-0364	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person with chronic severe pain emanating from both fibromyalgia, nerve pain from degenerative vertebral disintegration and severe osteoarthritis of the knees, I was prescribed a standing dose of both oral and patch administered olives in the early 2010s. In addition to spinal surgery and the adjunctive use of NSAIDs , I am able to live an agony free life. I have never used more than my prescribed amounts and have worked with 2 different physicians who have trusted my judgement and responded to my input. Suddenly, in 2016, I morphed from a patient who required medical pain management, to a drug seeking criminal., forced to sign agreements indicating that I was wrong for both needing and using these medications. My pharmacist was suddenly constrained to lecture me on the dangers of the medications each time I fill them, and I live in constant fear that my prescriptions will be summarily discontinued. I am unable to fill my prescriptions until exactly 30 days have passed even though it is difficult for me to get to the pharmacy and have been told to return a mere 10 hrs later to satisfy these draconian requirements. It is victim blaming and these actions by prescribers, pharmacists and government, have caused me both shame and increased difficulty and are now known to have been an overreaction based on the misinterpretation of a flawed study. Both my grandfather and my father in law were physicians and they swore to relieve suffering. I am a retired clinical social worker and registered nurse and have observed the multiple types of pain increased bthe US hysterical overreaction to one misunderstood study.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484f717e2	Richardson-Henley	None	2022-02-13T20:09:28Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Richardson-Henley, Karen	kzj-kcd8-w8x9	False	None	False	2022-04-12 01:54:51.644	[]
359	CDC-2022-0024-0365	https://api.regulations.gov/v4/comments/CDC-2022-0024-0365	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Sirs,<br/>My wife, ..., sustained permanent injuries as a result of an operation that used a product approved by the CDC, transvaginal mesh, to lift her bladder. This is a common operation in women who have had children. However, in my wife's case, the mesh grew through the flesh of her bladder and caused blood in her urine. She has had another five operations to correct the problem, the last two (unsuccessful) done at Stanford in an attempt to alleviate chronic pain caused by the mesh and attempts to remove it by cauterizing the nerves to the bladder.<br/>Until the CDC began regulating opioid prescriptions, her physician was able to give her enough medication to alleviate her pain and still function well. She was able to work and enjoyed life. I loved our life together! We traveled extensively, visited family and friends, and generally were very happy.<br/>Since the new regulations went into effect, her physician is hamstrung by regulation into limiting the amount of drugs he can prescribe. She now suffers constant, low level and sometimes intense pain for hours each day. Our family doctor is understandably reluctant to exceed the current guidelines, and the pain doctor she has been seeing will only use pain pumps to alleviate pain (these come with a whole new set of problems). She has tried meditation, hypnosis, and physical therapy, with limited success. However, for her, using opioids to control pain seems to be the most successful and effective strategy. <br/>The effect on our lives together has been dramatic! We are tied to the local pharmacy. Our family doctor is totally paranoid about loosing his license if he prescribes a few pills too many. We worry every time we travel that she might run out or her prescribed medication and a pharmacy in a strange town will refuse to fill our doctors prescription. My wife has turned from a happy, outgoing, social ball of energy to a sometimes recluse. It has affected my own mental and physical health as well!<br/>My wife is not alone in her pain. Thousands of people suffering chronic pain, who are NOT malingerers or addicts, find their lives circumscribed by their pain, unable to travel, socialize, or enjoy life. Many of them turn to street drugs, with disastrous results, as you well know. I STRONGLY urge the CDC to ease your restrictions. I believe that your own data shows that you overshot the mark and condemned thousands to a life of suffering and pain. Please help us by allowing our physician more discretion to prescribe opioids!<br/>If you have any questions, would like to see documentation, or speak to our physician, please contact me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f717f3	Morin	None	2022-02-13T20:10:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Morin, Michael	kzj-ky18-4vaq	False	None	False	2022-04-12 01:54:51.912	[]
360	CDC-2022-0024-0366	https://api.regulations.gov/v4/comments/CDC-2022-0024-0366	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was recently my state's opioid epidemiologist and am in the medical profession, though I do not write on behalf of any agency or employer. I write in strong support of the draft amended guideline. I commend those who gathered stakeholder feedback and put together these thoughtful proposed changes. I know many chronic pain patients who have suffered unnecessarily since 2016, and hopefully these changes will ease provider burden and providers will quickly adapt to taking care of their patients according to their level of need again. I commend not just the loosening of prescribing limits, but also the careful consideration of other treatment options to try before opioids or as adjuncts. I urge you to approve this document.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashleigh	None	None	0900006484f7180e	Faulstich	None	2022-02-13T20:10:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Faulstich, Ashleigh	kzj-lmil-gg17	False	None	False	2022-04-12 01:54:52.130	[]
361	CDC-2022-0024-0367	https://api.regulations.gov/v4/comments/CDC-2022-0024-0367	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had three back surgeries one neck 2 carpull tunnel.and. at 59 iam so sick and tired it has killed some of my will to live I'm in pain 24/7 sometimes I feel like committing suicide cuz I can't just take this pain no more yes I have pain meds but they helped tremendously but if I did not have them I dontknow what I would do.I pray to God that we fix this problem its a living hell .let the doctor.s do there job...go after the big drug dealers that are killing the people in the streets.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sam	None	None	0900006484f71823	Flores	None	2022-02-13T20:11:09Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Flores, Sam	kzj-mg6t-cv96	False	None	False	2022-04-12 01:54:52.348	[]
362	CDC-2022-0024-0368	https://api.regulations.gov/v4/comments/CDC-2022-0024-0368	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As so many others have mentioned here, I am a chronic pain patient and am very thankful that you have readdressed these guidelines. Just today I was explaining to a friend the difficulty I have getting pain management and relief and she was appalled since she witnesses the pain I'm in. The opioids I am prescribed and have been on for 12 yrs at roughly the same dose, allow me to play with my kids and function as a mom and wife. There is no "high", only the ability to function, yet I, a highly educated (in medical sciences no less), successful, upper middle class mother of two, am treated like a drug seeking junkie if I try to refill my prescription one day early. And God forbid something happens to cause me acute pain above my daily baseline pain level. A pinched nerve in my neck got me a lecture in the ER about how they won't give me narcotics. Keep in mind <br/>1. I never asked for them <br/>2. My pain level was a 9/10 <br/>3. I was clutching the railing on the bed in tears <br/>4. I had my pill case with me with my narcotics in it, clearly they weren't enough. But they still treated me like I was there simply to get drugs. And I was sent home with no additional pain relief for a pinched nerve radiating pain up the back of my head.<br/>Random drug tests, drug contracts and snide remarks are commonplace now making legitimate pain patients with diagnosed pain conditions feel like criminals for wanting a better quality of life. <br/>These recommendations and policies need to change. The number of overdose deaths has gone up astronomically while opioid prescriptions have gone way down. Clearly we are not the problem yet we are the ones being punished. Because my Drs are scared to prescribe me any more pills there are times I cry myself to sleep in pain. That is wrong and frankly unethical. I have three autoimmune diseases that cause chronic pain as well as numerous bolts in my spine from two spine surgeries. I am not faking my level of pain. <br/><br/>I understand there are risks associated with these medications, as does everyone else on them for chronic pain, but as with any treatment there has to be a risk/benefit assessment. There are so many other treatments and medications that are way riskier but the benefit outweighs the risk. <br/>Plus ultimately it should be our choice to take the risk in order to enjoy our lives, inform us of risks and let us decide. There are risks in not having these medications also. With no pain relief suicides would increase dramatically and mental health as a whole would suffer greatly. <br/>You are playing with our lives with these restrictions and "recommendations", please be mindful of the individual lives you are either helping or damaging. Sometimes irreparablly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mik	None	None	0900006484f71847	Franks	None	2022-02-13T20:11:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Franks, Mik	kzj-njcl-okzp	False	None	False	2022-04-12 01:54:52.563	[]
363	CDC-2022-0024-0369	https://api.regulations.gov/v4/comments/CDC-2022-0024-0369	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am happy to see this. I am a chronic pain survivor and it has been a total nightmare. I not only have had but I’ve seen first hand the awful treatment we all have received! The care is sub par bar far! My sister fell and broke her back and didn’t receive anything at all. They never even did anything to repair it. I know people who have had surgery and didn’t have pain control. I was in my 20’s when my twin and I started having ne k trouble and I have had 6 surgeries just on my neck but total I have had 27 different surgeries. I know chronic pain all to well and it’s no way to have to live. I can’t even mention the fact that the dose I’m on isn’t helping for fear I’ll have my medicine taken from me. When I’ve been on the same dose for 3 years. My ra and neck is getting worse despite all treatment. Not anything anyone can help but why must I suffer because people are overdosing on illegal fentanyl! We are adults. We are supposed to be a free country but we are being told we have to live in fear and life in pain. No quality of life at all. I am so so tired of worrying about my pain all day everyday! I want to walk my dog and wash dishes for my boyfriend because he has to do it all. It’s not fair. I’m sick of going to the ER and being treated like I’m there for pain meds because of some score that goes high because I have 5 different specialists only one pain doc but I am judged I am judged because one of my 5 docs will call the wrong pharmacy and if I pick up anything from another pharmacy we’ll point against you so you look like an addict but you can’t make them all understand you need one pharmacy for all medications opioid or not. I think it is absolutely outrageous that we as a community (chronic pain end of life or major trauma / surgical patients) have been treated with such judgments and non caring or plain scared of you people doctors. I am so outraged that you as a group can decide what I The owner of my body is allowed to have. I should be able to have a quality of life as much as the next. I want a life I am just sick of hearing of people having horrific pain but no help. I hate that old men and women have turned to the street or killled them selves because they couldn’t get help. This madness must end. The doctors and doctors let them be the doctor. Let us be free and let us make a informed decision with our doctors on what is best for us. Come on stop all this madness.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7184e	Anonymous	None	2022-02-13T20:12:31Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-np4b-02d5	False	None	False	2022-04-12 01:54:52.865	[]
364	CDC-2022-0024-0370	https://api.regulations.gov/v4/comments/CDC-2022-0024-0370	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank y’all for realizing that we were all left on a ledge. Our pain is real and terrible to live with. I would like for the cdc to check opioid use for fibromyalgia because it is the only thing that helped mine. Even though it caused nausea it helped so much it is with having to take the anti nausea medication. I also think that marijuana should be taken off the list of drug tests. Marijuana helps different symptoms of this awful painful condition and helps with being able to take a smaller dose of the opioids. Suicide is 10% higher in fibromyalgia patients for a big reason because I no one will treat it properly. We need help fast I have seen so many people losing hope in the fibromyalgia world. Without help or hope I am sure you will find that perfect much higher. Most of us long time suffers are at our wits end. This is NOT life. It is living in hell every day. Please try to help more. I understand there are addicts but they get all kinds of help suboxine and many others so they don’t have to withdraw, meantime we are dying each day and it really seems no one cares. Where can we go for help I know of no where at all that will help us. I hope this encourages you to make some special recommendations due to the difficulty of managing this illness. Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dianna	None	None	0900006484f7185a	Henderson	None	2022-02-13T20:13:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Henderson , Dianna	kzj-o36b-gfaz	False	None	False	2022-04-12 01:54:53.086	[]
365	CDC-2022-0024-0371	https://api.regulations.gov/v4/comments/CDC-2022-0024-0371	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You have no idea of how bad the struggle is when dealing with chronic pain. I was in a car wreck January 2005 that ended up rupturing my L5-S1 disc. I have not had a pain free day since. I have had 7 back surgeries including a fusion from L4 down in hopes of helping. That only made things worse. I have debilitating pain including the worse nerve pain in my left foot that has only gotten worse since Dec. 2014. I have been on the same dose of medicine since January 2015. I even under went a rhizotomy of my entire SI joint. Still nothing. I have long since been use to my dosage but my pain management specialist will not increase my dosage or add anything else because of the ridiculous laws and regulations. I also suffer from SLE Lupus, fibromyalgia, rheumatoid arthritis, and psoriatic arthritis. My quality of life has gone down severely and I am only 38 years old. Those of us who suffer daily deserve so much better. Please please I am begging you to change the recommendations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christy	None	None	0900006484f7186e	Vetter	None	2022-02-13T20:15:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Vetter, Christy	kzj-ovcp-assg	False	None	False	2022-04-12 01:54:53.314	[]
366	CDC-2022-0024-0372	https://api.regulations.gov/v4/comments/CDC-2022-0024-0372	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I apologize for submitting this comment anonymously, but I own a business as a well-respected strategic consultant, I have a family, I own a home). I was a functional addict for 9 years, however I now clean and have not abused drugs since 2017. None of my family, co-workers, friends know any of this about me; only my husband knows. <br/><br/>Back in the days of pill mills, I abused opioids. I was able to get tons of roxicodone (30mg oxycodone pills) and I ate them like Tic Tacs. At one point I needed 13 pills (you read that right) to feel even the slightest hint of the drug-- that is 390mg of oxycodone taken in one gulp. That dose would truly kill most people, but for me, it would give me a little boost of energy to clean the kitchen and do the laundry.<br/><br/>Thankfully the pill mills got shut down and I was too afraid to buy medication from the street, so I weaned myself off (it was living hell) and I have been clean ever since-- since 2017. I never want to go through that again, and I am determined not to. <br/><br/>However, my opioid tolerance will never be that of other people's. I am in my early 50s, and I have put off necessary surgeries and procedures because I am too fearful of the judgment of doctors or having "addict" in my medical chart like a red A. I also know that when I do eventually need surgery for something, they will have a challenging time not only keeping me sedated for surgery, but keeping me comfortable post-procedure due to my insane tolerance. <br/><br/>Yes, I did this to myself. Yes, I am a giant idiot. Yes, my stupid actions have consequences and eventually you have to pay the piper-- I get it. But should those consequences be "Sorry lady, bite this wallet, because you can only get 90 MME." <br/><br/>I might be able to somehow get off easier because I'm a well-dressed white lady with an NPR tote bag. But 90MME is absolutely inhumane to the thousands of people who are now addicted and accustomed to street fentanyl. 90 MME will never touch their tolerances. You must be prepared to serve that population, too. <br/><br/>Also, please, please, PLEASE allocate some funding to continue Dr. ...'s research into ibogaine therapy. If we have the ability to medically reset the addict's brain to a pre-addictive state and even reset their opioid tolerance, shouldn't we? <br/><br/>Thank you for reading. Your time, care, and compassion are truly appreciated.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71873	Anonymous	None	2022-02-13T20:18:15Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-p1is-hji3	False	None	False	2022-04-12 01:54:53.593	[]
367	CDC-2022-0024-0373	https://api.regulations.gov/v4/comments/CDC-2022-0024-0373	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have autoimmune disorders that have caused me pain most of my life. As a child, I took aspirin until I could no longer take them, and in my late twenties, thirties and forties, I took ibuprofen. I eventually developed ulcers and my stomach still cannot tolerate either of those meds. I started on pain meds in 2006 and these allowed me to work. Amazingly, my work was in the field of drug education and prevention. When the CDC made such a sweeping statement of condemnation of narcotics for pain control, my life took a nosedive. I retired from my job and spent two years just planning my death. I was angry. I knew that the issue wasn’t the narcotic and I watched as recovery experts I worked with develop this new model - taking personal responsibility out of the equation. Incredulously, someone can still go to a store and fill their cart with alcohol then return the next day and fill it again. No one will ever say “we can’t sell it to you because we are afraid you could become an alcoholic”. <br/><br/>I watched the news as overdose deaths continued to increase and faux fentanyl was everywhere. Manufactured in China, it seemed to becoming in barrels to the US. Did your shortsighted guidelines lead to more people dying from this chemical? <br/><br/>Now you have issued a revision. Now, after states have made your ‘recommendations’ into laws. Mention pain to any doctor and you literally hear their anus tighten up. The exclusion being a pain specialist which I won’t go to because I don’t need monthly drug screens as I have never been convicted of any drug or alcohol charge in my life. My primary doctor told me “all my other patients smoke pot”. How nice. I live in a state where it is not legal but I wouldn’t smoke it anyway.<br/><br/>I have cursed your agency on a daily basis as I face my days with stomach pain - continuously - because I am back with the damn ibuprofen again. Tell me, is taking 800-1200 mgs of this stuff daily not causing harm to my body? Doubt it. So don’t tell me you are concerned for my health. Just waiting for an ulcer.<br/><br/>But you have revised your stance. How long will it take for the states to change their laws and this change to trickle down to patient care? Will the DEA back off on their prosecutions of doctors? Will they get the memo?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484f71883	Thacker	None	2022-02-13T20:18:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Thacker, Donna	kzj-pvzd-fplq	False	None	False	2022-04-12 01:54:53.854	[]
368	CDC-2022-0024-0374	https://api.regulations.gov/v4/comments/CDC-2022-0024-0374	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Physician has chronic pain patients, who they have treated for over a year, has documented injuries, PMP is clean. They make the patient see them every month, or patient doesn't get prescription.<br/>This is so they can bill for office visit.<br/>Other MD's is every 3-6 mths visit, but will prescribe medication every month.<br/>Waiting in MD office every month for script is creulty in itself. You can wait up to 2 hours in pain so they can make extra money on you. You are their hostage.<br/>Can guidelines be set for this if pt is compliant?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynn	None	None	0900006484f7188c	Gurtner	None	2022-02-13T20:18:55Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Gurtner, Lynn	kzj-qarp-5yhl	False	None	False	2022-04-12 01:54:54.068	[]
369	CDC-2022-0024-0375	https://api.regulations.gov/v4/comments/CDC-2022-0024-0375	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has lived with chronic pain for years. He is currently on medicine that has gave him his life back. Before he started on his medicine he was not working and barely doing anything else but now he is able to work and even gets out and does what he can outdoors. His quality of life has greatly improved because of his caring doctor and his medicine. Thank you for considering a change for people who suffer daily from chronic pain. They can live their lives the best they can with the best care they can get. I think we forget sometimes that some people are not seeking drugs but just want to have their life back the best way they can	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f718d4	Anonymous	None	2022-02-13T20:19:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-rztq-wla8	False	None	False	2022-04-12 01:54:54.304	[]
370	CDC-2022-0024-0376	https://api.regulations.gov/v4/comments/CDC-2022-0024-0376	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First off to all who have lost loved ones due to overdose I am very sorry. Taking any medication comes with responsibility and awareness of side effects.Finally I have been waiting 5 years for the CDC to realize that the regulations put in place over reached reasons for such regulations.While yes the brakes did need to be hit to bring the pill mills to a halt and bring awareness to the dangers of taking opiod meds and I think they made their point.I dont think it should take 5 years to do so though .So much harm has been done to the ones who live with agonizeing persistent pain.Quality of life should be at the top of priorty list when it comes to regulating medications and vaccines .Now that the ones who are in control of our quality of life have confessed they made mistakes by the one size fits all approach will consider that everyone is different and the doctors are the ones trained to manage patients health care. With the pdmp in place over perscribing will not go on unnoticed which is a good thing but who is the one who gets involved and causes a person who has cancer and makes getting their meds difficult to fill and dont know of their health conditions should a person with cancer have to explain why they are perscribed certain medications to pharmacist doesnt that violate hippa laws.Anyway while suffering 24/7 with my destroyed body from doing heavy lifting hard work for my country for over 40 years and being a good citizen I pray constantly that my pain level doesnt go to 8 and I live with a level of 5 on the pain scale.My current perscribed generic unregulated pain medication thats made in india is my only hope for a small sted towards quality of life .Until big pharma is allowed to make name brand meds again and insurance will help pay again we are are all still stuck in the suffer rut.Generic meds make me feel sick and dont help control the pain I have from Lumbosacral Radiculopathy,Degeneration of L3L4L5S1Intervertebral disc arthritis of sacroiliac joints Lumbosacral Spondylosis .I am tired of living in pain and yes I have considered suicide only because my pain overwhelmed me and considered it as result to escape the pain The support i recieved from my children and their love has saved my life for the past 8 years not guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joel	None	None	0900006484f718d8	Scott	None	2022-02-13T20:20:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Scott, Joel	kzj-s3uo-nmx8	False	None	False	2022-04-12 01:54:54.527	[]
371	CDC-2022-0024-0377	https://api.regulations.gov/v4/comments/CDC-2022-0024-0377	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have sciatica and chronic upper and lower back pain for over 6 years. I am currently in physical therapy. I have taken every alternative treatment from water exercises, insulin shots for weight loss, years of ibuprofen/tramadol/naproxen etc. I have live in NC, VA, SC which doesn’t even give opioids to Black Americans. This study is egregious to say the least. You have patients exhausting their insurance benefits to keep from prescribing pain medications. I only get a set number of physical therapy sessions with Federal Blue Cross and Blue Shield, however I am expected to pay large amounts for alternative treatments when my set number of treatments are exhausted with insurance when I could be prescribed pain meds to function. The doctor/patient relationships are waned due to doctors being scared to prescribe pain medication consistently. My spine doctor expected me to purchase a $200 belt not covered by insurance. I don’t think the CDC is even considering how these amendments and the prior guidelines are not discriminatory.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa Jones	None	None	0900006484f71aa6	James	None	2022-02-13T20:21:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from James, Lisa Jones	kzj-v2nq-rwpb	False	None	False	2022-04-12 01:54:54.741	[]
372	CDC-2022-0024-0378	https://api.regulations.gov/v4/comments/CDC-2022-0024-0378	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your Honor, I am hoping for an upgrade to the opioid prescribed guidelines. I have suffered for years with chronic pain and destroyed joints. I was removed from my medication in 2019. I was able to function at 75 percent when I had pain control. I have been through unnecessary and painful epidural spine injection that does not help. I've been to therapy many times. I've had 4 joint replacements. I need spine surgery, which I have canceled due to this illicit drug problem and no pain treatment available. I am 67 years old with degenerative joint disease. I now live in bed 80 percent of the time now. I want my life back to be able to get up and take care of my home and live my life again. No one and I repeat, no one, should have to suffer like millions of chronic pain sufferers have been doing because junkies are buying illegal substances on the streets. Many of which are chronic pain people trying to get much-needed relief that were harmed due to the illegal drug trade. Legitimate pain sufferers were being harded through this. We need relief and it is a human right to have treatment for suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484f71aad	McMahon	None	2022-02-13T20:21:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from McMahon, Sandra	kzj-v6cu-nmnz	False	None	False	2022-04-12 01:54:54.970	[]
373	CDC-2022-0024-0379	https://api.regulations.gov/v4/comments/CDC-2022-0024-0379	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Guidelines created to control cost not control pain.Americans are not stupid we all know why the guidelines came about to control cost and with no concern of outcome it would have on us all.With chronic pain having a price tag on insurance companys and uncle sam up in the billions quess what someone had a bright idea behind closed doors lets just called it a crisis and fix cost problem well looks like someone figured out that the low hanging fruit does have a voice finally thats whats wrong in the usa today corruption greed dark money politics zero in on timing of implementation of guidelines and determine for yourself who the one with orange face had anything to do with the harm caused greed greed greed I feel that anyone who knew they was gonna cause as much harm as they have to the ones suffering in pain or any other serious health condition should consider themselves a black hearted individual.With all the technolgy we have today its really sad to make humans suffer.Guess its better to let the sick die than to spend fiat money to help them feel better and have just a little dignity Dear God please instill humanity in the hearts of the ones in control Love you all Hang in There maybe our lives will be healing soon .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71ab4	Anonymous	None	2022-02-13T20:22:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-vmfh-tpc8	False	None	False	2022-04-12 01:54:55.194	[]
374	CDC-2022-0024-0380	https://api.regulations.gov/v4/comments/CDC-2022-0024-0380	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescribed opiates for acute pain should be the for lowest effective dose and for the shortest duration to avoid dependence. A maximum of three days should be the norm with reassessment for further treatment should be made on an as needed basis. We now have alternative non opiate medications to supplement the treatment of acute pain and minimize the use of addictive opiates.<br/><br/>Opiates for acute pain should be minimized and alternated with NDAIDs and acetaminophen along with other pain control modalities. There are potent over the counter non opiates available for acute pain which are highly effective. Dosing should be spaced out. As we have seen from the opiate crisis with hundreds of thousands destroyed lives, the misuse use of opiates has deadly consequences. <br/><br/>The DEA should regulate the maximum prescribed opiate/schedule III/IV drugs to 3 days. Patients who have left over opiates should be instructed to return them to the pharmacy or dispose of them safely.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doreen	None	None	0900006484f71ab5	Wray Roth, M.D.	None	2022-02-13T20:25:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Wray Roth, M.D., Doreen	kzj-vn3a-jqbu	False	None	False	2022-04-12 01:54:55.418	[]
375	CDC-2022-0024-0381	https://api.regulations.gov/v4/comments/CDC-2022-0024-0381	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	my daughter has RSD/CRPS, rheumatoid arthritis with interstitial lung disease, fibromyalgia and stiff person syndrome. since the forced tapering she has spent more days in bed than out of bed, because whenever she tries to engage in normal life activities it flares her pain and she has not been able to get adequate pain control. in 2021 she advocated for change by organizing a rally in front of the DEA's office in Los Angeles and then meeting with them face-to-face. she and others deserves to live life instead of existing in intractable pain. these changes are imperative to chronic pain patients for any quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dee Kaye	None	None	0900006484f71ac7	RN BS MSHS	None	2022-02-13T20:26:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from RN BS MSHS, Dee Kaye	kzj-wnk4-lp07	False	None	False	2022-04-12 01:54:55.635	[]
376	CDC-2022-0024-0382	https://api.regulations.gov/v4/comments/CDC-2022-0024-0382	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have endometriosis.In 2001 after surgery, pain was still chronic. My woman's dr sent me to pain management. The doctor prescribed me (30) 30mg pure oxycodone, (30) break thru pain pure oxycodone, (from a compounding pharmacy) then (60) 10/650 percocet. A MONTH. Now you tell me who was irresponsible here. This began an addiction of 15 years. I think giving the doctors no choice but to prescribe steroids is irresponsible & cruel. I am a much older woman now so my endometriosis isn't as prevelant. But In 2021 I had carpal tunnel syndrome & for pain I was given steroids before the operation. Which opioids wouldn't have worked on my pain anyway - not carpal tunnel. I was prescribed sufficient opioid pain relief after surgery by my doctor & didn't even finish the prescription. These opioids work, but restricting the amount a doctor prescribes is hindering his/her/they work. I would ask that you make it a very tough crime for the doctors that overprescribe, not restrict the doctor.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Danielle	None	None	0900006484f71afd	Thacker	None	2022-02-13T20:26:31Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Thacker, Danielle	kzj-x1ov-aox0	False	None	False	2022-04-12 01:54:55.851	[]
377	CDC-2022-0024-0383	https://api.regulations.gov/v4/comments/CDC-2022-0024-0383	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After using my meds for norcos and ultrams for 14 years, my dr suddenly took 3/4 of them away without offering me any alternatives to control my pain, because of these guidelines. I developed Anemia of Inflammation. After 8 months of begging him for relief, I ended up going to the emergency room because I was crashing. I ended up getting 3 blood transfusions and an iron drip. I went back on my next visit. I saw the PA and told him what happened. He went to tell the Dr. Dr wouldn't change my doses so PA did. He slowly gave them all back. In August of 21, Dr came in and took all my ultrams. Again! After knowing what happened the first time. I'm in PAIN!!! I'm now seeing my 4th specialist in the 20 years I've had my issues with pain. Nothing else has helped me so far. I have true, authentic reasons to keep my meds. I've never had a problem with them. I have special circumstances. I have malabsorbtion, that the Dr won't research. I can't use weed. I believe YOUR RULES ARE TO TIGHT! TELL THE DOCTORS TO GIVE OUR MEDICINES BACK! MAKE DRS AWARE! WE ARE PEOPLE TO! EVEN THOUGH WE ARE LOW INCOME. BY-THE-WAY, DRS HAVE STATED THEY DONT LIKE MY INSURANCE, INCLUDING THIS ONE. DISCRIMINATION! YEAH, I THINK SO.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jo'ette	None	None	0900006484f71b07	Reno	None	2022-02-13T20:26:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Reno, Jo'ette	kzj-x56h-6tzo	False	None	False	2022-04-12 01:54:56.087	[]
378	CDC-2022-0024-0384	https://api.regulations.gov/v4/comments/CDC-2022-0024-0384	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Did a computer come up with this algorithm? Or just from a very few human beings who have little to no experience with medicine let alone real live human beings. People cannot be categorized like the produce the "health care system" treats them. <br/><br/>What about those of us whose doctor dumped them, after years of medically warranted and responsible use of pain medication? No one will even provide PCP care here in Maine, let alone even discuss the diagnosis, a MEDICAL issue, 0f chronic pain. If you even tell a "provider" here you have chronic pain, the label of "drug seeker" is plastered on your chart, and the "providers" kick you to the curb.<br/><br/>Never once in my 65 years have I asked anyone for pain medication. The life long search for help and the use of narcotic pain medication was a decision my doctor and I reached after 30 years of trying everything else.<br/><br/>But now, after years illness, I am the worse kind of person you can be in the USA: poor. And the medicaid insurance I have means that I am obviously a life<br/>long scumbag, liar, addict, and I am obviously trying to establish a drug empire, starting with you, today.<br/><br/>Funny how when I had my gold plated insurance, none of these things happened and I manage to actually get pain relief after a life of trauma and constant pain. The things "providers" have said to me are reprehensible and insulting along with the statement, "I'm not giving you any drugs," when I never asked and I thought I was seeing a doctor, not a drug dealer. You are doing a terrible job, and this is not an answer.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484f71b54	Grover	None	2022-02-13T20:27:16Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Grover, Katherine	kzj-xpjk-e13l	False	None	False	2022-04-12 01:54:56.300	[]
379	CDC-2022-0024-0385	https://api.regulations.gov/v4/comments/CDC-2022-0024-0385	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prior to becoming disabled. I was the architect of the Official New York State Prescription Program. The initiative was signed into law by Governor Pataki and was designed to curb illegal drug diversion and eliminate prescription fraud. The NY State Bureau of Narcotics Enforcement estimated $100 million in fraud losses prior to implementation. However, their estimate was low as the program saved $150 million in its first year 2004. The program still functions today and has saved not only dollars but lives by identifying individuals who could benefit from rehabilitation. I personally traveled throughout the US, meeting with decision makers in numerous States. However, all future efforts failed, which is hard to digest when you consider governments obligation to reduce fraud for taxpayers as well as other obvious benefits. Ultimately it was Big Pharma who put up strong resistance to these programs. Big Parma doesn’t want to solve this problem. They prefer to operate in the grey areas as we do currently- never truly solving the problem. Because of my experience, I am confident the so-called opioid crisis could be totally solved as far as doctors and their practices. All that needs to be done is to mandate that each state set up and maintain a Prescription Drug Monitoring Program in each state. Once a real time data base is established, each State should establish a bureau to look up each and every patient - no exceptions. Doctors should not be tasked to execute the searches themselves, rather just contact the Stare Bureau as the patient is registered for their visit. The Bureau then executed the search and transmits the results back to the doctor before the patient even leaves the building. In this manner, criminal drug diverters can be identified and apprehended on the spot. As far as patients with legitimate conditions that warrant treatment for chronic pain - each patient is also run through a table populated with qualified diagnosis codes (such as severe spinal stenosis or pancreatic cancer). If a patient is qualified and deemed a legitimate pain patient, that patient is free to work with their doctor and qualified for opiate pain medication if that’s the best solution for the qualified patient. As far as I’m concerned, this is the ONLY VIABLE SOLUTION. What is being done today is a joke. It is causing patient harm. But Big Pharma is undoubtedly happy to avoid a definite solution. They sell more dugs if we continue to operate in the grey. They are not interested in identifying the patient actors who function as Doctor shoppers. <br/>I am perhaps the only person in the US who is both a certified expert in drug diversion prevention as well as being severely injured and a long term chronic pain patient. I would be an excellent resource for any government agency trying to solve this problem once and for all. But sending threatening letters to doctors, as was done by the CDC at the end of the Obama administration will never work and created serious injustice for large groups of people suffering with pain. What’s unique about me is that I am an expert in drug diversion prevention while, at the same time, suffering with chronic pain. I’m also the co inventor of the world’s first secure prescription printer. The Star Micronics TSP 800 secured both the device itself and highly secure prescription itself. I have tried for years to offer assistance on this matter but never had any luck with my State Senator or trying to contact the White House Directly. This problem will never be solved in the current configuration. Never. All you have accomplished by threatening doctors is injustice and harm. I ask, have all the restrictions implemented since 2016 reduced hospital admissions for overdose? No they haven’t. Just the opposite. Why is that? Because the individuals that were shut off by their doctors operating in fear, still have pain all day long. It’s as if the patients suffering in pain were never consulted or considered. But since these patients have been abandoned and the effective treatments curtailed, these sufferers have no alternative but to seek a solution on the street where heroin is dirt cheap and readily available. To be blunt, poorly designed governments regulations have caused increasing consumption of street drugs by individuals abandoned by their doctors. My long term GP dropped me and all his patients he ever prescribed opiates to. This NY Doctor knew me quite well. I was a long term patient. And he knew my role working with the NY State Bureau of Narcotics Enforcement. He was also a member at my country club. I was zero diversion risk.I thought we were friends. But none of that mattered. All that mattered was that he might get investigated. That he might lose his practice and livelihood. So he threw out his oath to his patient and turned every single patient away that had prescribed opiates. This happened to millions of patients and is wrong. I ran out of space. I can help	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roger	None	None	0900006484f71b71	Bigelow	None	2022-02-13T20:30:47Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Bigelow , Roger	kzj-xvjm-ink7	False	None	False	2022-04-12 01:54:56.521	[]
380	CDC-2022-0024-0386	https://api.regulations.gov/v4/comments/CDC-2022-0024-0386	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This means so much to me and people like me. I've been dealing with chronic pain for over 20 years, with the worst of it being the past 10 years. When the previous guidelines came out, within a year, my meds were reduced and I had to stop working. I used to have a much more involved role in my kids' lives and in my community.... now, with doctors being able to be doctors, and treating evidence-based pain appropriately, perhaps I can start working again. Take a shower more than once a week. Go on an outing with my kids more than once a month... This brings more than just the possibility of physical relief. And affects more than just the patient. Thank you to the teams that have been advocating for such care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71b88	Anonymous	None	2022-02-13T20:31:00Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-y2kk-b8jh	False	None	False	2022-04-12 01:54:56.762	[]
381	CDC-2022-0024-0387	https://api.regulations.gov/v4/comments/CDC-2022-0024-0387	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been in constant pain since August, 2016. I'm almost 52 years old, and I absolutely dread another 30+ years of life like this. I'm fortunate enough to be a housewife, so I don't have to hide my pain from many people, but my duties at home have become more and more difficult, leaving my husband to help out after working 40+ hours a week. My pain has taken so much away! I rarely go anywhere, and I don't really have much of a quality of life. Car rides, walking, sitting, standing are all extremely uncomfortable, and they become very painful if I can't change position every couple of minutes. I'm on a fairly low dose of Oxycodone, 3x a day and I've been on the exact same dose for over 3 years. My conditions are degenerative, I won't be free of this, ever, and I've read so many horror stories about people being 'booted out' of pain management that I'm afraid to push for an increase in the number of pills I take a day. We've tried other opioids, but they left me in complete agony. In addition to my 3 oxycodone pills I'm allowed to take a day, I get trigger point injections every 4 weeks, I have lidocaine patches, I've tried several muscle relaxers, I take between 6-8 Advil duals, I have several heating pads and a heated mattress pad. Even with all these things, I'M IN CONSTANT PAIN. This is no way to live a life, and if I were offered surgery tomorrow to fix me, I'd do it in a heartbeat. I don't drink, my urine tests have always come up positive for opioides, ONLY, and I don't abuse my medication, yet I'm treated as if I do. I don't want to get high, I want to live my life without having to fake a smile, without having to hide an 'OUCH!', without having to force back tears, without having to pretend that I'm not in pain. I just want to truly enjoy something, anything, without my pain taking life's beauty away.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71b90	Anonymous	None	2022-02-13T20:31:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-y5rs-j9h8	False	None	False	2022-04-12 01:54:57.004	[]
382	CDC-2022-0024-0388	https://api.regulations.gov/v4/comments/CDC-2022-0024-0388	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	An entire country of chronic pain patients has been disparaged & abandoned. Our lives are not exciting enough for reality tv shows - we don't get exposure or compassion. We're unable to advocate for ourselves, as most of us have no energy to clean our houses much less campaign for fair treatment. You could not create a more perfect group of people to marginalize.<br/><br/>Most chronic pain patients have integrity & don't abuse their meds bc they're a need to function daily. It is not the psychological reward of addiction - it's the ability to load the dishwasher that day - & it's offensive to every patient who NEVER needed the ER due to abuse, misuse, or overdose to be treated as a problem rather than a human in need. <br/><br/>You did nothing to grandfather in the compliant patients with 13 inch thick medical records & multiple spine surgeries. My 7th spine surgery is on deck as I type this. And I was forced to 1/10 the dosage I was previously allowed - titrated by 3 military medical specialists, inpatient, after my 4th spine surgery due to injury while serving. Back when quality of life mattered.<br/><br/>I've literally had a pain doc brag he doesn't use other dr notes to make assessments- totally abandoning 14 years of trauma I endured. Then everyone followed HIS notes "it's all in my head" - until ONCE AGAIN, it's discovered I'm a critical paralysis risk bc my spinal cord is being crushed. Ironic isn't it. For this reason I won't be sending any records but if you'd like to see my proof, I'll mail you all 22 years since I lost my Navy career. The medevacs in Japan might be good reading, yeah?<br/><br/>Maybe you're not aware of the pain specialists who lie & say your guide or recommendation is THE ABSOLUTE LAW they must follow, when their faith in our valid need is what was needed.<br/><br/>Maybe you're not aware of the doctors who tell women their stretch marks must be HEROIN TRACKS. Or the doctors who refuse to see the people who need the help the most. The "heroin track" dr. also refused to prescribe morphine sulfate for me - the pain med my LIVER SPECIALIST said is safe for me, but he'd give me the Fentanyl patch instead. I walked out of his office. <br/><br/>Overdoses are on the rise, idk how you think blocking people in pain from valid help has had any impact on the WAR ON DRUGS. The only people on the other side of your battle field are the pain patients who have NO LIFE.<br/><br/>I need you to see me as a human being who is suffering. I need you to balance the pendulum swing, & to stop viewing the limiting of chronic pain treatment as some kind of victory on your war against drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marianne	None	None	0900006484f71b93	Huynh	None	2022-02-13T20:36:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Huynh, Marianne	kzj-y706-sukj	False	None	False	2022-04-12 01:54:57.234	[]
383	CDC-2022-0024-0389	https://api.regulations.gov/v4/comments/CDC-2022-0024-0389	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good, but not good enough. You have unnecessarily caused thousands of people to suffer because of your previous strictures. I could rant for pages however, I know your “review” will toss out anything unfavorable to your organization. In short, let me just say, we do not the vast over reach you have in our health care! My health should be between my doctor and me. Get out of our business.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Asa	None	None	0900006484f71d56	Rodgers	None	2022-02-13T20:36:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers, Asa	kzj-yefk-9lnn	False	None	False	2022-04-12 01:54:57.563	[]
384	CDC-2022-0024-0390	https://api.regulations.gov/v4/comments/CDC-2022-0024-0390	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m concerned about the lack of emphasis and nuance in the taper portion of the 2016 guideline. Forced tapers can be extremely traumatic for patients. Increased depression, hopelessness, self medication with riskier non-prescribed opioids, and risk of suicide is described in the literature with physician compelled tapers. A more patient centered guideline would include significant nuance on how to adjust taper rates when patients are not doing well, offer options and support harm reducing strategies such as switching to buprenorphine, and a discussion of how to manage pharmacokinetics of short and long acting opioids to manage a taper. In prevention portion of guideline emphasis should be placed on how to counsel patients on discontinuing opioids when starting. This task requires considerable skill and experience, and high quality CME should be offered for all opioid prescribers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brent	None	None	0900006484f71de0	Thiel, MD	None	2022-02-13T20:37:09Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Thiel, MD, Brent	kzj-z1bk-ndpb	False	None	False	2022-04-12 01:54:57.819	[]
385	CDC-2022-0024-0391	https://api.regulations.gov/v4/comments/CDC-2022-0024-0391	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I receive my oxycodone from the VA health system. I often run out, while waiting on a new prescription. They constantly are after me about taking urine tests. I feel I am treated rudely by health staff. I get 84 at a time. I am told to take 3 per day every 6-8 hours as needed. If pain is worse I can take 2 per dose every 8 hours. I practice good pain control. I have other medicines that help relieve the pain. However, I am never pain free. If I call and ask for more every 20 days or or so, then ask to have them mailed to me. I often run out. They often refuse to refill my medicine earlier. I don't ask for more nor an increase in dosage. I try very hard to take the minimum amount for me. Which is one every six to eight hours. This mean I am out every 25-28 days. I often have to wait 30 or more and they act like they are doing me a favor. I suffer from chronic pain. I have had several surgeries, pain counseling, seen specialist. I can go without the medicine and have sometimes I am out for weeks. Based on "guidelines" I am not allowed more for whatever reason. <br/><br/>The medicine doesn't make the pain go magically away. What it does for me is allow me to function and interact with life in a more normal and comfortable way. I do my pee tests and the drug is there. I see my doctor annually or more often. I take all my meds that help reduce my chronic pain as prescribed yet I am treated at times as a lesser person. The "rules" they "enforce" are draconic and chaotic. Just because a individual has chronic pain and Oxycodone helps their life (without addiction) does not mean they are lesser. The rules should be better matched to what a doctor and patient feel is needed to help solve a chronic pain issue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71de3	Anonymous	None	2022-02-13T20:37:27Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzj-zegn-al08	False	None	False	2022-04-12 01:54:58.059	[]
386	CDC-2022-0024-0392	https://api.regulations.gov/v4/comments/CDC-2022-0024-0392	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 68yo female with unrelenting bone pain for 15 years. I have been on morphine since soon after it started. Without the relief I get from opioid analgesics I would have no life, no ability to move past the pain. I feel the CDC is making a move in the right direction for people with chronic pain by leaving the decision to prescribe these meds up to their own discretion. Getting most of my care through VA I know how hesitant their doctors are to go against ANY recommendation of the CDC. I have many drug sensitivities and have tried every other option for pain management. I have not been able to tolerate any other pain meds, or hardly any other therapeutic medications either. There are many others like me. We do not abuse or misuse the valuable tool of opioid medication. I am extremely grateful it exists and that I HAVE been able to get it prescribed. I know from news sources that most drug related deaths recently are from fentanyl, especially when combined with other substances. I understand fentanyl is a synthetic opioid, and that THAT is what drug seekers look for. Therefore, the biggest reason for limiting prescription opioids is null and void. Please continue to be more open minded about doctors discretion with their patients in ALL areas, but particularly regarding the saving grace of pain medications that actually work.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484f71e03	Johns	None	2022-02-13T20:39:21Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Johns, Julie	kzj-zlhn-kwgz	False	None	False	2022-04-12 01:54:58.275	[]
387	CDC-2022-0024-0393	https://api.regulations.gov/v4/comments/CDC-2022-0024-0393	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mother has lived with chronic pain for the last 45 years. Aside from being misunderstood for so many years, she has also often not been given adequate medication to help manage her pain. Her doctor(s) hands have been tied as well. At the moment, she is slowly recovering from a fractured pelvis from a fall and the doctor will not give her stronger pain meds because of all the rules governing opioid treatment. She is 75 years old, lying in bed with a fractured pelvis. She is not a drug addict and needs help managing pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484f71e18	Scott	None	2022-02-13T20:43:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Scott, S	kzj-zqcg-qj9f	False	None	False	2022-04-12 01:54:58.497	[]
388	CDC-2022-0024-0394	https://api.regulations.gov/v4/comments/CDC-2022-0024-0394	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who has been treated for chronic pain during the last 20 years of my life, everything changed for me in 2017. I'm not sure what caused the change, but I believe it was an upcoming law change in the state of Missouri involving opioid treatment regulations for doctors, and my long time physician of 15 years suddenly did not wish to treat chronic pain. From there, I was suddenly without medication treatment of any kind. I tried my best to deal with this situation, trying to treat my pain with OTC medicines, anything that would help, but nothing helped. I finally tried a new doctor who treated me with oxycontin 15mg time release, 2 per day. That was the best he could do, until January 2018, he stopped treating patients for chronic pain and I was referred to a local pain clinic. Anyone who has ever been treated by a pain clinic, I came to find, knows you can wait all day among many other patients, waiting your turn, the doctor I ended up seeing did not treat me with dignity, nor did he offer much in the way of any relief, but I tried everything he suggested, including a nerve burn that did nothing to alleviate the pain I was experiencing. I currently have a pain management doctor who does treat me with dignity, but the treatment is buprenorphine Belbuca buccal film, timed release. It is causing me severe headaches and has many bad side effects and does not work the way percocet helped me for many many years. I DO understand why doctors do not want to jump through the hoops that involve opioid treatment, but I DO NOT understand the humility, pain and suffering, even mentally that I, and many others, have to endure and still never get the treatment that can help. Current medicine cost, with goodrx help, cost $617 month, percocet = no where close to that cost. When does it end???	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71ec3	Anonymous	None	2022-02-13T20:44:43Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-0fot-ppvz	False	None	False	2022-04-12 01:54:58.782	[]
389	CDC-2022-0024-0395	https://api.regulations.gov/v4/comments/CDC-2022-0024-0395	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/><br/>I favor updating the guidelines for prescribing opioid medications for certain types of pain management. <br/><br/>I do not take this lightly as I have had relatives, friends, and acquaintances with drug addictions and have seen first hand the devastation drug addictions cause. I have fibromyalgia and have even debated with other fibromyalgia patients against the use of opioid pain medications for fibromyalgia citing the research indicating it’s ineffectiveness and the heightened possibility of addiction (as opposed to dependence) with the long-term use of opioid medications. <br/><br/>Even so, I believe there are times, especially in short-term severe pain management, when the use of opioid medications is appropriate and are not being prescribed. <br/><br/>An example come from my own history. Despite my family history, I have little risk of addiction because, knowing my family history, I have been vigilant in never over using any medications or even overusing alcohol. When I have been prescribed opioid medications for something in the past, I have not even finished the prescription and I have never abused any prescribed or illicit drugs or even been drunk. <br/><br/>I did, though, wish I could have been prescribed a short-term prescription for an opioid medication last year. I had surgery on my tongue and was told to use over-the-counter pain relief. I cannot use NSAIDS due to stomach issues and I can only take 500 mg of acetaminophen every 6 hours because more will interfere with the performance of my CGM. Having fibromyalgia means that I feel all pain to a greater degree than other people. My recovery from the surgery was brutal. I was in severe tongue pain. Had I been prescribed something akin to oxycodone for about 5-7 days, my recovery would have been so much easier. <br/><br/>I know other people who I would not, if I were a physician, ever prescribe an opioid prescription for because of their history and the likelihood of abuse. <br/><br/>Prescribing of medications such as opioids is best done by the physician who knows the patient best, under appropriate CDC guidelines that take into account both potential abuses and individual patient needs. <br/><br/>I hope that you will indeed update the guidelines. <br/><br/>Thank you. <br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelly	None	None	0900006484f71f00	Haack	None	2022-02-13T20:46:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Haack, Kelly	kzk-0lqb-ffl5	False	None	False	2022-04-12 01:54:59.036	[]
390	CDC-2022-0024-0396	https://api.regulations.gov/v4/comments/CDC-2022-0024-0396	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guidelines for pain treatment has caused deadly and medical neglect to millions of patients. I personally have been horribly effectived by the forced reduction of my pain medication that I was functional on for over 10 years. When the 2016 guidelines were made my dosage was reduced and my quality of life is now mostly bed ridden, in horribly pain. I can not stand for longer than 10 minutes, I struggle with basic personal hygiene due to excruciating pain. Before this I could brush my teeth without having to take breaks, I could grocery shop, visit family on holidays but the forced reduction of my medication have negatively impacted my life causing depression, anxiety, high blood pressure, it's been terrible. My Doctor is afraid to return me to my effective milligram dosage because the DEA and other government law enforcement agencies have threatened their licenses, their medical practices, their professional lives. Six years of medical neglect for millions of people has been the most inhumane treatment I have ever seen in a country who considers itself an advanced, fair country. Please change theses barbaric guidelines, stop law enforcement from targeting Doctors and stop the real problem illegal fentanyl coming across our southern border. Thank you for reading my letter and please do the morally right action to allow the pain patients to get proper medical treatment. <br/>Sincerely, <br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	tori	None	None	0900006484f71fc8	Dorsey	None	2022-02-13T20:47:44Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Dorsey , tori	kzk-1juo-9gf8	False	None	False	2022-04-12 01:54:59.253	[]
391	CDC-2022-0024-0397	https://api.regulations.gov/v4/comments/CDC-2022-0024-0397	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I applaud the new proposed clinical guideline for opioid prescribing. As a primary care physician who retired in 2018, I helped manage numerous patients with chronic debilitating pain using cautious opioid prescribing, as well as other approved modalities. It helped many improve their function and continue employment requiring physical stamina. <br/><br/>Also, I personally have suffered from Chronic Radicular Low Back Pain from osteoarthritis and Spinal Stenosis as a result of Scheuermann's Disease and previous very active recreational and an exertional sport lifestyle. Morphine helped me extend my clinical practice some 7 years and as a retiree my ability to walk vigorously and engage in home keeping and care of young Grandchildren. I had been through numerous NSAIDs, PT, Steroid injections, Spinal Nerve Rhizotomy, and a recent implanted Spinal Stimulator trial without any relief. <br/><br/> I loathe having to be on Chronic Opioid therapy, and still have some pain. However, it has allowed me to be productive, continue moderate Cardio activity, avoid slipping into Depression as well as developing other potential physical ailments related to a sedentary lifestyle.<br/>Sincerely, <br/>... MD, St. Paul, MN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484f71fe0	Pebler	None	2022-02-13T20:51:44Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Pebler, Richard	kzk-1m9r-2axk	False	None	False	2022-04-12 01:54:59.484	[]
392	CDC-2022-0024-0398	https://api.regulations.gov/v4/comments/CDC-2022-0024-0398	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The strict regulations that have been put on doctors have made it almost impossible to get pain relieving medications that work. This caused many people to resort to getting pain-relieving medications (if you want to call it that) from the streets. It starts out harmless, trying to control pain, then when the person can’t get the "drug" they sampled anymore they move to the next thing available. This is how the addictions start. If only they could get medication from the doctor in controlled dosages, they would have never sunk into buying from dealers, taking uncontrolled amounts of various street drugs. If you look to the death toll, you will find it has increased substantially since the 2016 guidance. *See attached Overdose Death Rates data from the National Institute on Drug Abuse. This approach is not working. Please, it is beyond time to rethink this policy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Concerned	None	None	0900006484f71fe4	Mother	None	2022-02-13T20:53:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Mother, Concerned	kzk-1a1e-urkp	False	None	False	2022-04-12 01:54:59.716	[]
393	CDC-2022-0024-0399	https://api.regulations.gov/v4/comments/CDC-2022-0024-0399	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, My name is ... I am a 51 year woman living with chronic pain. I was diagnosed with Adhesive Arachnoiditis at age 39. Before that time I was an active full-time mother of 4 children. I have tried everything to try to control this horrible pain I have everyday. Multiple injections, surgeries, physical therapy many times, hypnosis, spinal cord stimulator and many medications. At the beginning of my journey I was prescribed 2 different pain medications (opana er and dilaudid for breakthrough pain) Topamax for nerve pain. I do not ever misuse my medication, ask to refill to soon, sell or abuse in any way. The Opana er was stopped amidst the "opiod crisis". For those that abused and misused, so many, myself included, have and are currently suffering severe pain and lack of quality of life. I am stretching out 30 pills a month. That is 2 pills a day 2 mgs each. With one of the most painful unbearable diseases you could not even imagine unless your living it. I hope there is "hope" for everyone suffering, those who honestly need these pain medications and cannot get them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f71ff1	Gatien	None	2022-02-13T20:56:32Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Gatien, Amy	kzk-1oyh-p4rr	False	None	False	2022-04-12 01:54:59.931	[]
394	CDC-2022-0024-0400	https://api.regulations.gov/v4/comments/CDC-2022-0024-0400	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a pain and addiction medicine physician. PLEASE MAKE SURE THE FOLLOWING IS INCLUDED IN YOUR RECOMMENDATIONS.<br/><br/>Narcotics are a God send and should be used BUT ONLY TO PREVENT SUFFERING FROM PAIN. A patient with pain should be able to rest assured that they will never have to suffer from pain. <br/><br/>Narcotics should be avoided at all costs because of their potential for causing OD, physical dependence, addiction, and TOLERANCE. <br/><br/>EXAMPLE: You don't give narcotics to treat the sever pain in a 10 year old with tonsillitis and cannot even swallow. You first address the underlying pathology and then if needed treat the pain. <br/><br/>NARCOTICS SHOULD NOT BE GIVEN ON A TIMED BASIS: Only give when suffering and the patient has done everything else they are supposed to be doing and never more than one. Wait 45min and if still suffering take another one. Repeat until your allotted daily dose is reach and then if still suffering have patient go to the ER to have suffering stopped while looking for other underlying pathologies. If this was just a flare up then the patient will be discharged from the ER without additional narcotics. Patient should always be seen every two weeks while in pain management so the patient would be seen for followup within 14 days and any flare up could be addressed. <br/><br/>Cancer or dying patients ARE THE ONLY ONES WHERE A BACKGROUND continuously blood level of narcotic is justified. All other chronic pain patients should learn how to manage their pain and suffering AND THAT IS WHY THEY CALL IT CHRONIC.<br/><br/>TO ACCOMPLISH THIS APPROACH:<br/>YOU MUST TRY TO FIND NON-NARCOTIC APPROACHES TO MANAGING THE PAIN SO IT DOESN'T GET SO BAD THAT THE PATIENT SUFFERS AND NEEDS NARCOTICS.<br/><br/>An MULTI-MODAL TREATMENT APPROACH IS NECESSARY and THE PROVIDERS NEED TO TALK WITH EACH OTHER REGULARLY ABOUT THEIR TREATMENTS therefore WE MUST PROVIDE an INTEGRATED MULTIDISCIPLINARY APPROACH. <br/><br/>YOUR TREATMENT MUST ADDRESS THE WHOLE PERSON: BIO-PSYCHO-SOCIAL-SPIRITUAL <br/><br/>Non-Narcotics that are also NON-ADDICTIVE should be sought that help, even a little, with the patients pain. Muscles relaxants, NSAID's, Pentins, Antidepressants, MMJ, whatever helps.<br/><br/>MYOFASCIAL COMPONENTS OF PAIN MUST ALWAYS BE SOUGHT and TREATED: Physical Therapy with MYOFASCIAL RELEASE. This does not have to be a Licensed Physical Therapist. Massage would work fine. HOME STRETCHING/HEAT/ICE SHOULD BE TAUGHT TO THE PATIENT AND DONE DAILY.<br/><br/>Therapeutic and Diagnostic injections should be applied where applicable. <br/><br/>Catastophizing, Pain Acceptance, Patient Empowerment, Behavioral Health should be applied by every provider in the treatment team and NOT RELEGATED TO JUST LICENSED BEHAVIORAL THERAPISTS. <br/><br/>Social Work to help with living conditions and work requirements and other social issues that are impeding treatment should be addressed.<br/><br/>YOU SHOULD HAVE THE IDEA HERE -- I AVAIL MYSELF TO TALK WITH YOU AT ANY TIME. .... <br/><br/>Please take the time to watch this 3 minute video to get a better idea on how to treat chronic pain. https://mdhealthclinics.com/videos/MDHCvideoFinal.mp4<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f72002	Kutzner	None	2022-02-13T21:00:21Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Kutzner, Robert	kzk-1va9-179y	False	None	False	2022-04-12 01:55:00.154	[]
395	CDC-2022-0024-0401	https://api.regulations.gov/v4/comments/CDC-2022-0024-0401	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who lives with chronic pain, I can tell you that trying to live with it isn’t working. I have had to find alternatives to prescribed medications to control my pain. I know from speaking to many others in my situation that I am not alone. Why do you think that sales of alcohol are up? Why do you think so many people are dying of overdoses? When there aren’t pain medications available, one has to find their own ways to treat it. For me, that has been whiskey. I do not like how it makes me feel, but sometimes I need the pain to be less than what it is. I have fibromyalgia and Rheumatoid Arthritis. Both are painful conditions. I also have a compressed spinal cord and bulging discs n my back. I used to have a provider who would prescribe 80 hydrocodone/APAP for me. Those would last about TEN MONTHS. Now I have nothing because providers tell me “narcotics don’t help my kind of pain”. I beg to differ. When the pain gets so bad that you feel like you’re going to vomit, a pain pill does help. They also kept me from missing work due to pain. I hope you seriously reconsider the horrible restrictions that are now in place. Patients shouldn’t be forced into searching the streets and/or liquor store for pain relief. <br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f72023	Santee	None	2022-02-13T21:00:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Santee, Lisa	kzk-27f5-fl5w	False	None	False	2022-04-12 01:55:00.372	[]
396	CDC-2022-0024-0402	https://api.regulations.gov/v4/comments/CDC-2022-0024-0402	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic Pain From Humira<br/>I have severe pain It's not my fault a doctor put me on humira for Arthritis and he was wrong I don't even have it My point is It's not my fault I didn't ask to live on pain medication My pain is a 9 without medication It's a 6 with it.I can't function at all without medication I don't think people understand how hard it is to try and function as a chronic pain patient. I cry every day all of the time. I had to cut my hair because my showers were over 10 minutes and I can't stand that long. My main problem is because I'm on a narcotic I'm not allowed to have my sleep medication valium which is classified as a benzodiazephine My choices are limited I have some pain relief but hardly any sleep Or I could be in severe pain and have sleep That is if I would even be able to fall asleep in this much pain. Please read our letter's very carefully It's our lives that you are dealing with <br/><br/>Thank you for taking the time to read all of the letter's<br/>...<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Molly	None	None	0900006484f7204a	Donnelly	None	2022-02-13T21:01:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Donnelly, Molly	kzk-2k85-hazn	False	None	False	2022-04-12 01:55:00.622	[]
397	CDC-2022-0024-0403	https://api.regulations.gov/v4/comments/CDC-2022-0024-0403	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been stable on a fentanyl patch 50 MCG and breakthrough medication for over 20 years now. Also part of UCSD pain clinic who put me on this combination of drugs over years of trial and error. Now after three fusions, chronic SI joint problems, AS, PAGET'S DISEASE. THE DOCTORS ARE TITRATING ME DOWN AND I AM SUFFERING GREATLY. I am going downhill and it scares me I need to be able to function I've always been able to take care of myself. Now I live in pain 24/7 and I have tried to communicate with this doctor and Nevada and his response is always the same I quote this is the plan it's 2022 and this is what we're going to do. I just don't have it in me to keep going from Doctor to doctor. I have tried to find doctors who are compassionate and willing to look at you as a person and deal with your personal condition. They all are afraid I believe of losing their licenses now from what I've been learning. Pain suffering is real and people with chronic pain who have been compliant on their medications should not be collateral damage from a piece of legislation which has nothing to do with us. You're allowing illegal drugs to cross the border, giving out drugs in California and San Francisco to drug addicts but the needs of chronic pain patients are ignored. This is wrong. Please allow doctors to do with their train to do evaluate people and treat them accordingly. you have no idea what many of us are going through.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72050	Anonymous	None	2022-02-13T21:06:13Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-2loo-rnde	False	None	False	2022-04-12 01:55:00.834	[]
398	CDC-2022-0024-0404	https://api.regulations.gov/v4/comments/CDC-2022-0024-0404	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I myself suffer from chronic pain from a back injury as a child and also suffer from fibromyolga. The guidelines that were offered in 2016 have made so many peoples lives a living hell, and also the lives of the doctors trying to control our pain. There are always going to be abusers of drugs which is becoming an unfortunate fact in our modern life. Penalizing chronic pain sufferers to lesser the abuse from drug abusers has only added to the hardships that chronic pain sufferers deal with. I'm not sure what the solution is,but believe this revision is a good start.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverly	None	None	0900006484f72077	Kingsbury	None	2022-02-13T21:08:29Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Kingsbury, Beverly	kzk-31hx-ea7u	False	None	False	2022-04-12 01:55:01.067	[]
399	CDC-2022-0024-0405	https://api.regulations.gov/v4/comments/CDC-2022-0024-0405	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Those who work for CDC/DEA have caused enormous harm and suffering to millions of Americans. Creating an illegal drug crisis and an untreated pain crisis simultaneously. No soul, no compassion,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gwen	None	None	0900006484f72079	Mower	None	2022-02-13T21:08:41Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Mower, Gwen	kzk-325u-5wuy	False	None	False	2022-04-12 01:55:01.491	[]
400	CDC-2022-0024-0406	https://api.regulations.gov/v4/comments/CDC-2022-0024-0406	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC, <br/>I am a Chronic pain patient and have had several back Durand procedures to try and reduce the problems but even after surgeries I have been left with chronic pain and new conditions make for acute pain too, morphine and ocycodone are the only thing that has helped my pain to be reduced to a manageable level where I can function. I have been on these same meds and same doses for 20 years and they were working well. In 2016 when my pain medicine was reduced because of that law I have been I. Much more pain and have no relief. I can no longer function as well for most of my day I am in too much pain. I can’t sleep well for my night time doses were taken away. I would be so grateful as a 60 year old women to have enough pain control and meds once again so I can live a full life once again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484f7207d	Payzant	None	2022-02-13T21:08:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Payzant, Diane	kzk-34p6-jrgi	False	None	False	2022-04-12 01:55:01.699	[]
401	CDC-2022-0024-0407	https://api.regulations.gov/v4/comments/CDC-2022-0024-0407	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the wife of a chronic pain patient. After several years of trips to the ER for pain control, he was finally placed on buprenorphine. He has been on the same low dose, 8 mg a day in divided doses. His pain specialist won't raise the dose out of fear. While I understand a physicians need to protect the license she worked so hard to get, I think it's a shame that my husband's quality of life is dictated by bureaucracy. He is never going to get better. He is 60 years old and should be able to enjoy the time he has left. I sincerely hope that the new guidelines will benefits patients like him. Chronic pain patients are committing suicide because they can't get adequate pain control. First do no harm?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gloria	None	None	0900006484f72098	Howell	None	2022-02-13T21:09:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Howell, Gloria	kzk-3gf6-7wui	False	None	False	2022-04-12 01:55:01.930	[]
402	CDC-2022-0024-0408	https://api.regulations.gov/v4/comments/CDC-2022-0024-0408	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	allow Our Doctor's to freely Prescribe Opioids when and as needed, without fear of the Government (DEA), Federal and state licensing boards, and Pharmacist objecting. NONE of your fear tactics have saved lives, looking at your OWN data, MORE people have died of opioids EVERY single year in the USA, with a increase! 90,000 DEATHS IN 2020<br/><br/>THE PROBLEM IS NOT DOCTORS<br/><br/>ALLOW ALL U.S. DOCTORS TO PRESCRIBE WHEN THEY FEEL IT IS NEEDED. <br/><br/>***** see CDC attachment!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f720a6	Anonymous	None	2022-02-13T21:10:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-382k-1ivx	False	None	False	2022-04-12 01:55:02.228	[]
403	CDC-2022-0024-0409	https://api.regulations.gov/v4/comments/CDC-2022-0024-0409	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long term chronic pain patient using opioids for 10 years I cannot take NSAIDS--which I will explain later. I welcome the proposed change to the 2016 guidelines. It is time to put pain management treatment back in the hands of doctors and patients and get the government out of the business of interfering with the doctor patient relationship in a misguided effort to control "problematic" opioid misuse and abuse.<br/><br/>I am 70 and have taken corticosteroids my entire adult life. I have osteoarthritis of my entire spine, degenerative disc disease, and severe (steroid induced) osteoporosis. I have suffered non traumatic compression fractures of 9 spinal vertebrae. I have undergone kyphoplasty that only partially restored the height of 6 vertebrae resulting in loss of 2 inches of height. I have had 2 spinal fusions in the last 4 years, but have scoliosis and kyphosis that cannot be treated with surgery. This has left me with severe pain that significantly impairs my ability to lead anything near a normal life. I have tried multiple non-opioid modalities to treat pain: laser acupuncture, ultrasound, hot-cold therapy, massage, multiple spinal injections and nerve ablations, all to no avail. I have clear objective pathologies causing severe pain including compressed nerve roots and compressed facet nerves throughout my spine. I have had 2 blood clots in the last 4 years and now need to take blood thinners--for the rest of my life according to hematology experts who have also advised me not to take any any NSAIDS--ever. Opioid treatment allows me to be able to move and live a reasonably worthwhile life.<br/><br/>One of the primary problems with the 2016 guidelines is their use by state legislatures to adopt draconian and obnoxious laws that interfere with a doctor's independent judgment in treating patients with opioid medications. Some states have built an entire bureaucratic structure to track every opioid prescription of every doctor. The data collected is used to "score" doctors annually on the gross amount of pain meds prescibed with the goal of intimidating doctors to "lower" the amount of opioids prescribed. The state monitors doctors continually and comments on their prescribing habits. I have spoken to many doctors including experienced, well credentialed and respectable doctors who receive communications from state oversight boards commenting on specific patients and reminding doctors that they are being watched.<br/><br/>I am required by law to meet with my doctor once every 30 days and provide a urine sample. This is demeaning. I am a retired lawyer and resent being treated like a common criminal. I have never had a problem with opioids. Most patients who are watched over by experienced doctors never have a problem. We are not the problem. Others taking illegal fentanyl, heroin and other drugs are the problem. Unscrupulous doctors who operate "pill mills" are the problem---my doctors are quite obviously not in that category. The result of this outrageous interference in the the doctor patient relationship is a profound "chilling" effect that has resulted in many doctors from even taking on pain patients. If anything the new guidelines should, in the strongest language possible, advise state lawmakers to avoid trying to practice medicine by adopting legislation that interferes with the sacred doctor patient relationship.<br/>I cannot live anything approaching a normal life without opioid pain medications. Please do not take that away.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nunzio	None	None	0900006484f720ae	Radogno	None	2022-02-13T21:11:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Radogno, Nunzio	kzk-3n98-0b44	False	None	False	2022-04-12 01:55:02.446	[]
404	CDC-2022-0024-0410	https://api.regulations.gov/v4/comments/CDC-2022-0024-0410	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern,<br/>Hello my name is ... I'm a patient that suffers from a deadly disease called systemic scleroderma. This is a very painful aggressive disease that causes extreme fatigue,joint pain,and limb disfigurement. I live with very painful ulcers that don't heal. My ONLY relief from my pain was opioids. This gave me the ability to do some daily life activities. The past six years have been ... From the way the horribly insensitive guidelines were written. I was cut back on my meds and my doctor made me come to his office every thirty days. This added so much difficulty and pain in my life. My doctor STOPPED listening to my pain complaints. The pharmacy started treating me like a drug addict. Looking for any excuse to deny my pain medicine. This was humiliating and unacceptable. I have never taken more than prescribed and always been very responsible with my pain medicine. I was punished for being sick. PLEASE change these dangerous and CRUEL policies from the 2016 poorly written guidelines. Thank you.<br/>Best regards, ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tylyn	None	None	0900006484f721b1	Aviles	None	2022-02-13T21:12:13Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Aviles, Tylyn	kzk-41f2-y5x3	False	None	False	2022-04-12 01:55:02.657	[]
405	CDC-2022-0024-0411	https://api.regulations.gov/v4/comments/CDC-2022-0024-0411	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Yes I deal with chronic pain and other health issues. Under the current rules we are treated like we are addicts. You can get your pain meds but if you need to take a muscle relaxer or anti anxiety medication. Your pain medication would get lowered due to some scoring system. So somewhere your overall we’ll being would be effected. Then you have dropping of urine at anytime and if your like me where you injured your spinal cord and since have trouble urinating at a moments notice you are threatened to be kicked out of the practice. I’ve sat in the pain clinic for 3-4 hours trying to give a sample. If rules where changed to help the patients who truly don’t take advantage of being prescribed the necessary medication would mean a lot. Not being able to take a medication due to some scoring system setup from someone is truly hard. <br/>I just hope we can get back to a patient and Doctor relationship to where the patients needs are meet according to there pain levels. Plus there are medications that we can’t even take due to Medicare/Medicaid deciding they won’t pay form them. <br/>Pharmacy’s also have guidelines and at times never have the medication you need, I used to get one medication and they always had to order it. But you always got your medication on the 29/30 day do you didn’t have time to wait for delivery of the medication and most times you’d go without and suffer in severe pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anthony	None	None	0900006484f721c8	Martinez	None	2022-02-13T21:13:10Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Martinez, Anthony	kzk-45kk-rioe	False	None	False	2022-04-12 01:55:02.881	[]
406	CDC-2022-0024-0412	https://api.regulations.gov/v4/comments/CDC-2022-0024-0412	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pleased to see the opioid quidelines updated, but I do not feel the revised quidelines will change the situation for chronic pain patients without stronger CDC <br/> wording or outreach to the medical community. The first CDC opioid recommendations were taken as law by physicians and are now hard-baked into the medical system as well as by Medicaid and other health insurers. <br/>Without the CDC openly admitting.that they were wrong in their first directive by sending out notices to physicians and emergency rooms to disregard those first erroneous guidelines. Also to offer redress to the many patients tapered or abandoned by physicians. To take patients back into their practices and to reverse their now widespread practice of not treating pain patients at all. Otherwise nothing will change back and chronic pain patients will continue to be under treated and mistreated.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72226	Anonymous	None	2022-02-13T21:18:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-4o5e-q4r0	False	None	False	2022-04-12 01:55:03.103	[]
407	CDC-2022-0024-0413	https://api.regulations.gov/v4/comments/CDC-2022-0024-0413	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines need to be change back how they was befor 2016 and put back too physicians.My urine was a false positive for morphine and I never had morphine in my life I am unable to find a physician to treat my pain with opioid that did give me a quality of life now I am unable to barley function it has cause harm inhumane torture and death to so many untreated pain people and force injections for your pain relief is also another issue that has to stop all of it immediately	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Siegfried	None	None	0900006484f72229	Shirley	None	2022-02-13T21:22:44Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Shirley, Siegfried	kzk-4pi7-m8dr	False	None	False	2022-04-12 01:55:03.312	[]
408	CDC-2022-0024-0414	https://api.regulations.gov/v4/comments/CDC-2022-0024-0414	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a victim of the 2016 CDC and have lived a live of doing nothing because of the pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cary	None	None	0900006484f722a7	Sabanty	None	2022-02-13T21:26:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sabanty, Cary	kzk-5hcs-ar9e	False	None	False	2022-04-12 01:55:03.548	[]
409	CDC-2022-0024-0415	https://api.regulations.gov/v4/comments/CDC-2022-0024-0415	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC, lets not unleash the beast of Opioids again. The 2016 guidelines were reasonable and sensible. Use opioids as a last resort, and use within a certain limit. If someone needs more than 90 MME of opioids to get out of bed and function, I doubt they are treating just chronic pain. It more than that. Chronic Depression, Anxiety, or other behavioral problems. We all know Opioids provide a sense of calm, hence the likelihood of addiction. <br/><br/>Do you have any data suggesting that Opioids at more than 90 MME per day are absolutely required for pain control and are safe to be used? Especially when majority of patients do not have access to Chronic Pain counseling. <br/><br/>Who is going to be liable for adverse outcomes such as addiction, respiratory depression, with sky high Opioid doses? <br/><br/>Have we made functional assessment and behavioral assessment as a mandatory part of treatment of chronic pain, before allowing chronic opioid treatment at any dose?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f722b6	Anonymous	None	2022-02-13T21:27:45Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-5lsy-zmcb	False	None	False	2022-04-12 01:55:03.759	[]
410	CDC-2022-0024-0416	https://api.regulations.gov/v4/comments/CDC-2022-0024-0416	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good afternoon, <br/>I am a chronic pain patient and have been for many years now. Throughout the years my pain medication has been force tapered down to practically nothing. I've been under treated left to suffer daily, epidurals, nerve blocks and ablations have all failed. <br/>Here's a little background about me. My current pain management doctor has started to decrease my medications when I told him I wanted to hold off on the stimulator trial. <br/>I've been suffering from chronic pain for most of my life. I started getting debilitating migraines as a young teenager which caused me to miss out on so much of life, kids events and so much more. In 2005 I was diagnosed with 2 herniated disc's in my cervical spine which eventually led to a fusion of the c5/6-6/7. I still had debilitating neck and head pain and that continued until late 2018 which my current surgeon discovered loose screws and a shifting metal plate that caused a lot of bone damage. December 2018 I had a revised cervical fusion to fix the problem and at that time my first lumbar surgery, a decompression of 3-5. The cervical fusion didn't heal which led to my 3rd cervical fusion, this time going into the back of the neck putting spacers and rods to secure everything. In 2020 I had my second lumbar surgery a decompression/fusion due to level 4/5 collapsing, they used spacers and rods to everything. Fast forward to now, I still suffer from debilitating migraines, neck pain, severe thoracic and lumbar pain with pain radiating into both legs. I've been through a lot and need to find something to reduce my pain so I can be a functional person. I used to have dreams and goals of going into the medical field. I went to school and became a licensed phlebotomist and EKG technician. I did very well in school but, do to all of my injuries I had to give it all up.. Now I'm just looking for a way to be functional enough to do daily tasks.Thank you for taking the time to read my life story. Have a great day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484f722e8	Piselli	None	2022-02-13T21:30:47Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Piselli, Denise	kzk-5xqn-kkip	False	None	False	2022-04-12 01:55:03.978	[]
411	CDC-2022-0024-0417	https://api.regulations.gov/v4/comments/CDC-2022-0024-0417	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has Multiple Sclerosis. No doctor will treat his pain because his will be life long and as time goes by will increase in dosage. He is brushed off because of these guidelines. He’s human! He matters! Do better for people who will be suffering the rest of their lives. MS goes by no guidelines. It’s destructive to a persons life. You have now reduced any quality of life he could or can have.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484f722fe	Childress	None	2022-02-13T21:31:27Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Childress, Kim	kzk-63gk-42wx	False	None	False	2022-04-12 01:55:04.229	[]
412	CDC-2022-0024-0418	https://api.regulations.gov/v4/comments/CDC-2022-0024-0418	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should focus on the mission and not continue to issue guidance in areas already effectively addressed by professional medical authorities. Clinicians and research done within professional organizations already publish extensive guidelines based on evidence, operating with less political bias and influence. Clinicians treat patients and patients do not need another governmental agency issuing extraneous, unnecessary guidance. The CDC should focus on epidemiology of specific related infectious diseases. <br/>Dr. ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f72365	McCormick	None	2022-02-13T21:32:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from McCormick, Susan	kzk-6vht-4iuv	False	None	False	2022-04-12 01:55:04.453	[]
413	CDC-2022-0024-0419	https://api.regulations.gov/v4/comments/CDC-2022-0024-0419	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a disabled Pediatric Nurse Practitioner. I have been a patient at a university based pain management clinic for the last 22 years after a freak accident left me with permanent spinal cord damage. During those years in addition to opioid medications I tried numerous steroid and Botox injections, physical therapy, acupuncture, surgically implanted peripheral nerve and spinal cord stimulator devices. I survived NHL after a year of chemotherapy and radiation treatments with the help of opioid medications. After 10 years I was finally diagnosed with Systemic Lupus and Sjogrens Syndrome requiring daily prednisone medication. Prednisone caused even more damage to my spinal structure. Since the 2016 “guidelines” were published I was forced to wean my opioid medications. Last year I was given the choice to continue weaning opioids or I would be sent to a rehab facility. I now spend 22 hours a day in my bed. I am in constant pain on my current medications.The university based pain management center and its physicians refuse to acknowledge quality of life over the 2016 “guidelines.” I strongly encourage the CDC to change these guidelines and urge lawmakers to punish those doctors and pharmaceuticals that break our laws for profit instead of punishing the patients that require opioid medications to live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Theresa	None	None	0900006484f723b7	Hands	None	2022-02-13T21:32:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Hands, Theresa	kzk-7i78-fdn9	False	None	False	2022-04-12 01:55:04.670	[]
414	CDC-2022-0024-0420	https://api.regulations.gov/v4/comments/CDC-2022-0024-0420	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a step in the right direction, but as it stands, it is merely a step in the long miles needed to travel in order to fix what you and others have broken. My mother, a vet, was a victim of the hysteria. She was undertreated for pain leading up to and after two surgeries (shoulder and spine). What little she had received the VA took away, cold-turkey, and offered nothing in the terms of support. They took away not only the opioid but her anti-anxiety medication and left her to face withdrawals alone. She was told to practice mindfulness and yoga. Laughable, considering she couldn’t even participate in physical therapy after her back surgery given her uncontrolled pain. <br/>Her life shrank to the couch when she did manage to pull herself out of bed. She tried, really tried to get better, to claw back some semblance of the life she had prior to the VA and their blunder. In the end, she began to self-medicate, first with sleep aids before graduating to alcohol. What little health she had left to her was completely, and utterly destroyed. She will now spend the rest of her days confined to a nursing facility where ironically at least they are treating her pain.<br/>People, like my mother, a woman in her 70s with very real, painful issues, were not the cause of the opioid crisis. They, however, paid for and are paying for it still. Opioids are a tool amongst many and in many cases it is a very important tool. How can you expect people to participate in PT, take up yoga, practice mindfulness, and the litany of items suggested if their pain is so poorly controlled all they can focus on is the pain? The anti-opioid movement in this country went too far and a great deal of damage has been done. As stated at the beginning of this comment, this is a step in the right direction, but you, as the CDC must start coming out in force against practices that harm patients.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484f723c8	Warthen	None	2022-02-13T21:34:43Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Warthen, Judith	kzk-7n6p-7uwg	False	None	False	2022-04-12 01:55:04.877	[]
415	CDC-2022-0024-0421	https://api.regulations.gov/v4/comments/CDC-2022-0024-0421	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Changing the daily mme to lower than it already was is absolutely absurd. How is this better? Pain people already are dying because they aren’t getting their pain controlled and now you want to lower the number it was already at. This MME needs to go. Let the doctor be a doctor again! It’s not the governments job to help us. We want our quality of life back!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f723ef	Anonymous	None	2022-02-13T21:36:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-7wr8-utxc	False	None	False	2022-04-12 01:55:05.094	[]
416	CDC-2022-0024-0422	https://api.regulations.gov/v4/comments/CDC-2022-0024-0422	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer DEBILIATING PAIN, DUE TO CENTRAL PAIN SYNDROME after large right brain stroke that affected my thalamus. The pain is 24/7 and excruciating. Docs have tried every anti-convulsant, epileptic meds, as well as Gabapentin etc... the only relieve I get is from low dose hydrocodone (5-325 BID) Because of the stigma my neurologist will only give me 2 a day. Which gives me about 7 hours of relieve. I'm in a constant 8/10 pain level, the Vicodin reduces to 5/6. My disorder is a rare complication of stroke, so naturally no research is being done (no money to be made) my point.. Without the benefit of opioids, I would not be alive today, nor have any quality of life, as minimal as it is. IT IS TIME! the CDC and the tyrannical government recognize there are many of us with legitimate "NEED" of opioids, we are not addicts we are not abusing our meds, we are not selling our meds. We are victims, who deserve respect, and acknowledgement that our lives matter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f72414	Flovin	None	2022-02-13T21:37:34Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Flovin, Michael	kzk-85pb-62o2	False	None	False	2022-04-12 01:55:05.304	[]
417	CDC-2022-0024-0423	https://api.regulations.gov/v4/comments/CDC-2022-0024-0423	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just want to say that I have chronic pain due to degenerative disc disease spondylolysis spinal stenosis and neck (have metal cage in neck)and back surgery’s . My Dr. stopped prescriptions of my pain meds 2years ago because he was scared of what the cdc could do to him. I don’t blame him. He is a good dr. I took this pain meds for over 15 years which gave me quality of life. I was able to do so much more than I can today. I am unable to do a lot of things that healthy individuals take for granted. Example, walk, sit or stand for more than 15 minutes at a time or sit or ride in a car with out changing positions a multitude of times.I could go on.. these are just a few every day life things. I was never addicted to my meds. Alway took them as needed and never abused them. I am 69 years old and wish I could have a better quality of life to do every Day things or just grocery shop without being in so much pain on a daily basis. Some days are so bad I think about unaliveing myself to stop my suffering. I’m so sick of this. Why were we bundled with the rest of the idiots that abuse drugs and die of illegal substance abuse. That’s not me. If it wasn’t for pain meds I wouldn’t have been able to work my job when I worked for as long as I did. Please help us get back to normal. What most don’t understand is the opioids I was taking did not get me “high” as they say they just took the pain away.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72422	Anonymous	None	2022-02-13T21:37:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-874z-95fk	False	None	False	2022-04-12 01:55:05.543	[]
418	CDC-2022-0024-0424	https://api.regulations.gov/v4/comments/CDC-2022-0024-0424	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Finally!! I get that it was unintentional, but the 2016 guidelines were used as if they were law... and really hurt a lot of people. I am 62 years old. I don’t drink. I do have a hormonally induced anxiety disorder and I’ve taken Xanax for over 30 years.... it controlled my anxiety, and unlike others in its class, it never made me feel drugged. I just felt like myself. <br/>8 years ago, I underwent a TKR that has made my life hell. My leg is about 85 percent functional, but it is 100xs more painful than before the surgery. It is unbearable.. it still gets “ fevered” and the surgeons say there is nothing they can do... enter pain management... I had injections in my back to “ put the nerve to sleep” so when it woke, it wouldn’t remember a foreign object was there. Did not work. Had injections to “ numb” the knee... ( all without novacaine or lidocaine.. as I am very allergic to either). <br/>My pm put me on a couple of non opioid meds that did not help. One made me feel like a zombie... and no pain relief.... another, I vomited continuously.... so he put me on Opana ER. It did not take away all the pain, but it made it bearable. In 2017 he was audited by the DEA.... he said it was the scariest thing ever.... they gave him the highest marks and noted “ if all drs were like him, there’d be no problem.” <br/>A few months later, he received a very threatening letter from the states US attorney.... I read it. It was extremely threatening... so he stopped prescribing. Period. He says he knows that I need to be treated both fir the anxiety and the pain but every doctor here is terrified to prescribe because of what the justice dept and the DEA are doing ( using the cdcs 2016 guidelines) to scare drs out of using their own judgement....<br/>The DEA does not belong in my drs office, unless he is a pill mill... which he is not. The insurance companies are also sending threatening info to drs. It should not be happening!!! Please, not only should these guidelines be corrected, but a distinctive letter should go out letting these drs know that it’s ok to do their jobs and that there IS a place for opioid treatment. I have gained over 50 lbs since I cannot walk without pain help. Taking aleve and then aspirin caused my always kiwis blood pressure to go through the roof!! <br/>I have been hospitalized in the past two years in hypertensive crisis bc of not being able to get pain care... so I can MOVE my body!! <br/>I do not drink alcohol. Never have. I don’t do anything wrong.<br/>I don’t think it’s unreasonable to ask pain pts to have a bolted safe for controlled medication.... but other than that, it is wrong to punish people who are in constant pain because of addicts that have misused or abused. <br/>To pain patients , pain medication is a medication.... to an addict, it is a drug<br/>If someone robbed a bank, would we shut down the banks?? Would we arrest EVERYBODY that ever wished they had more money?? No. Because that doesn’t pass the sanity test right? <br/>Well, keeping real pain patients from medication that allows us to live a functioning life doesn’t pass the sanity test either. Thank you for listening, but please go a step further and advise that the DOJ and DEA need to back off good drs. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kari	None	None	0900006484f72423	Hicks	None	2022-02-13T21:40:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Hicks, Kari	kzk-87db-gp5j	False	None	False	2022-04-12 01:55:05.757	[]
419	CDC-2022-0024-0425	https://api.regulations.gov/v4/comments/CDC-2022-0024-0425	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This "guideline" doesn't go far enough to reverse the damage of arbitrary MME dosages. No one should be regulating a blanket statement of how many pain meds a person needs to feel relief. By placing ANY numbers, you negate the patient's pain saying "well at 50mme, that's the best I can do".... but what if it's isn't enough? <br/>Yall have gone MUCH too far in assigning numbers for MMEs. That should be between me and my doctor. <br/><br/>My father recently broke his tibia. He was offered TYLENOL in the ER. That's unacceptable! Sadly, a few months layer, he has had now 3 lumbar compression fractures... again he was offered TYLENOL. That was terrible! He CLEARLY had fractures and any sort of movement made the pain excruciating... and Tylenol was offered... because of the horrid guidelines. It's just WRONG on so many levels! <br/><br/>In my own pain journey, I'm being forced to taper. I didn't ask for this and have been told that the powers that be, in the system my pain doc is in, have given a "..." to pain patients. They don't care if you're in pain, they don't care if your treatment isn't working... you MUST comply with their, again, randomly assigned MME counts. It's just MESSED UP! I can't go anywhere else, bc there really isn't anywhere TO go. I have been put in a HORRIBLE place where I need the meds to have any sort of quality of life... but my doc is saying "well.. good luck with that". What are we supposed to do? <br/><br/>Finally, y'all need to address the over stepping of boundaries, by the DEA and DOJ. These entities are barking up all the wrong trees. As a reminder.....scripts have been decreased by 38%, while fentanyl deaths have risen by 75% - by your own numbers. So.... remind me again why pain patients - who get their meds from approved pharmacies - not back bedrooms - are being punished? <br/><br/>PLEASE fix this horrible damage that has been done!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f7242c	Andy	None	2022-02-13T21:42:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Andy, Linda	kzk-88mj-7v0x	False	None	False	2022-04-12 01:55:05.966	[]
420	CDC-2022-0024-0426	https://api.regulations.gov/v4/comments/CDC-2022-0024-0426	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain as long as I can remember. One thing about pain is that you have to get in front of it. It's easier to prevent pain than to stop it. These guidelines do not take into account that nerves learn pain signals.<br/><br/>Therapies such as pt, massage, gabapentin, can work wonders. But they all take TIME. It can take weeks or months to see the effects. And during that time the patient is in pain, sometimes worsening pain, and their nerves are getting better at learning those signals. When OTC meds aren't enough opioids should be given as a stop gap during this time to give those alternatives time to work. It is unethical it leave them in pain in the interim.<br/><br/>These guidelines also don't take into account that many of the recommendations are not covered by insurance. I cannot get massages, acupuncture, etc even though they might help because they aren't covered and I can't can't afford them out of pocket. If a patient cannot access an alternative treatment the most important thing should be ending their pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tasha	None	None	0900006484f7242d	Schmidt	None	2022-02-13T21:43:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Schmidt, Tasha	kzk-88ul-5431	False	None	False	2022-04-12 01:55:06.176	[]
421	CDC-2022-0024-0427	https://api.regulations.gov/v4/comments/CDC-2022-0024-0427	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We are in desperate need of completely revising the 2016 opioid prescribing guidelines as they’ve become LAW in the eyes of DEA. RXing of opioids has gone down WAY TOO MUCH leaving innocent patients to suffer & die. The DEA has arrested innocent Drs & pharmacists & they’re sitting in prison for helping their patients while the death toll from OD’s has dramatically risen because patients are being forced to the streets for relief instead of being closely monitored by their Drs as they’ve had for decades. I’ve had my opioid therapy cut off suddenly for over 2yrs & once bk to a minimum dose, the DEA threatened my Dr & told them not to Rx my migraine meds because of my very low dose pain meds. I was a very active part of society with my pain under control as well as my migraines for over 20yrs w/out any problems at all & suddenly I’m being watched by the DEA & they’ve become my PMP. They are NOT licensed physicians & shouldn’t be allowed to go thru our PERSONAL med records. I’m suffering because of the guidelines as are 50 million others. No one should be denied individual care & relief from pain & agony. We’re begging for our basic rights back & the ability to live a pain free life again. Addiction from illicit poisonous drugs & the OD from Rx meds have all been counted together which is grossly inaccurate. The percentage of patients that get addicted are less than 2% of the over 50mil that have taken Rx opioids for 2wks-25yrs. We’re finding far more illicit drugs on the streets now as the 2016 guidelines has truly nourished the black market of illicit drugs. Opioid dependence is NOT addiction. We count on Rx opioids to relieve our pain. There’s been WAY TOO MANY deaths & suicides from what was just supposed to be a guideline. I Pray you can reverse this & stop the DEA from destroying more lives & careers & many’s freedom. Those innocent Drs need to be released from prison. I understand mistakes were made but now that you see the tremendous damage that’s been done, the only way to correct it all is to rescind the 2016 guidelines asap & get proper data from only patients Rx opioids & stress over & over that it’s NOT a law but rather meant for awareness & guidelines ONLY. Thank you for reading this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72457	Anonymous	None	2022-02-13T21:44:02Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-8ez5-suxs	False	None	False	2022-04-12 01:55:06.396	[]
422	CDC-2022-0024-0428	https://api.regulations.gov/v4/comments/CDC-2022-0024-0428	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who has lived with chronic pain from the age of 25 due to equestrian related injuries as well as others, there are days where I have been able to keep working only because of these medications. They are NOT my only course of treatment. I am now 62 with arthritis throughout my body, including my spine, cervical to sacral. I have scoliosis and suffer from migraines dou to head injuries sustained in the same activity. I force myself to keep go I g and could not do so some days without C II's. The ONLY people who have suffered from your plans and restrictions are the people who truly need and correctly use these medications. I spent 18 years as a nationally certified pharmacy tech in a hospital setting. I am well educated on the pros and cons. Never have I abused them. I have also had a total hip replacement done and now need another. I still work full time. I have also had expensive tx denied by my insurance companies that work and are not narcotic. i.e. botox injections for cervical dystonia. People with no insurance, lousy insurance or insurance that refuses tx do not help anyone. Until you all get it together and start doing the right things for those in need, nothing will change. A drug addict will always find illegal drugs. You, being the brilliant souls that you are and knowing that fentanyl is a synthetic drug should have seen the fentanyl problem coming from miles away. You cannot put a band-aid on a hemorrhage. The plan has to be coherent, all inclusive and address all aspects of the problem. Just for the record, my go to for stopping almost all pain would be high doses of prednisone because it works, but unless you are a complete idiot, you know that is not feasible. It will cause as many problems as it treats.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	CORREEN	None	None	0900006484f72466	SPECE	None	2022-02-13T21:46:55Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from SPECE, CORREEN	kzk-8hhs-swge	False	None	False	2022-04-12 01:55:06.631	[]
423	CDC-2022-0024-0429	https://api.regulations.gov/v4/comments/CDC-2022-0024-0429	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don't agreed with the way doctors are treating chronic pain. I am a 60 year old woman and I am living with chronic pain due to surgeries that I was told would give me a better quality of life, but while I was taking the pain medication my quality of life was better I had my mobility back. One day they said they wouldn't prescribed them for long term care, so now I'm suffering in agony because of others misuse of the medication. If there is a good reason to use this type of medication shouldn't it be up the individual. Taken properly this medication helps to eliminate pain so I can get back to being a productive citizen. As of right now I'm crippled with servere pain and there's nowhere to turn. The doctor's are reluctant to prescribe pain medication because of the government. I propose that the CDC allow doctors to give medication like this to patients the know who are suffering with chronic pain that's what it was made for.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f724c7	Anonymous	None	2022-02-13T21:48:49Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-8umb-jyck	False	None	False	2022-04-12 01:55:06.840	[]
424	CDC-2022-0024-0430	https://api.regulations.gov/v4/comments/CDC-2022-0024-0430	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What everybody forgets, is the older generation that has chronic pain, needs help. When you are in your 70's, and have no quality of life. Pain restricts all of the plans for exploring in the September years of your life. The younger generation has a problem with addiction. When there is chronic pain in the older generation, with a life expectation of 77 to 79 years of age, why give them a hard time trying to have a reduction in pain, where they can function enough to enjoy their final years.Travel with reduced space in Airplanes, driving in the beautiful U.S.A.<br/> The Rocky Mountains, the Grand Canyon, etc.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484f724ca	LaBine	None	2022-02-13T21:49:10Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from LaBine, Thomas	kzk-8vkq-25it	False	None	False	2022-04-12 01:55:07.050	[]
425	CDC-2022-0024-0431	https://api.regulations.gov/v4/comments/CDC-2022-0024-0431	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patients like myself that are suffering due to lower dosage of the 90 MME daily. We had lives, We worked and we had families to take care of. Since lowering medications doses we have no quality of life and are suffering. Many have gone to the streets to just relieve their pain some have over dosed due to laced fentanyl from the streets also died.Some committing suicide.Please reevaluate the 90 MME. Us Chronic pain patients already deal with a lot.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f724f5	Anonymous	None	2022-02-13T21:49:45Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-94l3-3hjg	False	None	False	2022-04-12 01:55:07.279	[]
426	CDC-2022-0024-0432	https://api.regulations.gov/v4/comments/CDC-2022-0024-0432	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a psychiatrist, I have many complex cases of biopsychosocial related pain syndromes, where opioids play a crucial role in pati3ent functioning. Many of my patients report stresses in getting their medication where pharmacists rigidly adhere to limited dosages, question changes in dosages, or refuse to fill bridge Rxs due to fear of DEA shutting them down or penalizing them. As a physician, my Rxs are often declined, requiring me to use alternate pharmacies.<br/><br/>The hyper-regulation increased patient stress and mistrust in pharmacies.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Phillip	None	None	0900006484f724fa	Romero MD	None	2022-02-13T21:59:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Romero MD, Phillip	kzk-96xv-8z0y	False	None	False	2022-04-12 01:55:07.504	[]
427	CDC-2022-0024-0433	https://api.regulations.gov/v4/comments/CDC-2022-0024-0433	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Finally you’re going to rectify what was wrong with your regulations put forth in 2016, and make provisions for people with cronic pain. <br/>Prior to 2016, I had a great quality of life where my pain was tolerable enough for me to enjoy doing what I love and spending time with friends and family. <br/>Beginning in 2017, when my Pain Management Dr had no choice, he started tapering down my pain meds. The further down they went, the less I was able to do anything including exercise and physical therapy and other means of pain management. <br/>I was extremely excited to finally have hopes of getting my life back when this publication came out. <br/>My life now is in my jammies and in my recliner and in pain. I’m afraid to move which increases my pain. <br/>Before 2017, the year my Dr started tapering my pain meds, I had the best quality of life possible. <br/>I weighed 60 lbs less, I was able to be active and involved. Now I spend every day by myself and can’t do much of anything.<br/>Myself and my house used to be clean, organized and always company ready.<br/>Now I take a shower only when absolutely necessary, I spend my days and nights in my jammies so that I don’t generate laundry, my health is deteriorating because I can’t eat the way I should because my body won’t let me do any kind of cooking and my house is full of stuff all over because I’m in too much pain to put things away let alone do any cleaning. <br/>I’ve always been involved with crafting in several different areas. When I was able to work, I bought all kinds of craft supplies for when I retired. However, I haven’t been able to play with them since my pain meds were drastically reduced. <br/>I’m going to have to give up my forever home I bought because I can’t take care of it anymore at all.<br/>Granted being on 3x more pain meds prior to your 2016 guidelines, I still had a substantial amount of pain. <br/>However, I had a quality of life that I could live with and be happy. <br/>I’ve been seeing a pain mgmt Dr for several years now where I’m drug tested and my meds counted every 2-3 months. <br/>I have no issues with addiction at all and am always good with my med counts and screenings.<br/>I highly recommend that all patients on opioids be monitored this way. <br/>Daily I put aside my allotted amount of pain meds so that I don’t take too many. <br/>If not for this, and the Dr’s monitoring I would take more than I’m supposed to in order to be pain free.<br/>My pain goal has always been a 3 out of 10 and that works perfectly for me and did for many years.<br/>The reductions in my pain meds makes it impossible to do the things I need to in order to be somewhat functional. <br/>I can’t do the things that I used to that helped my pain such as walking, swimming and simple exercises. <br/>My weight has been unmanageable because I can’t get out of my jammies and my chair. <br/>Very simply, I want my life back! The life I had before you ruined it in 2016.<br/>It’s not a pain free life, but getting my pain meds back to where they used to be would allow me to do the things that I need to do in order to be healthy and happy. Lose weight, exercise and get back to my most favorite things to do which is crafting <br/>I’m a social person who’s stuck in my chair and stuck in my jammies <br/>I’ve been praying for this day to come when you’re finally going to recognize people with cronic pain.<br/>My biggest fear now is that the language of what you’re proposing isn’t clear enough to prompt Drs to treat their cronic pain patients as individuals and will still refuse to give us what we need to have quality of life. <br/>I have a very years long record of compliance, need and non-addictive behavior that I hope will be considered. <br/>My Dr knows very well that I have a serious need for pain medication, backed by over 15 surgeries and several health issues. <br/>However, I have a feeling that my health care system will make rules that apply to everyone, rather than individually. <br/>Recently I was in the hospital for a week for a severe MRSA abscess. It took 3 days to have surgery and another 3 days of recovery. Prior to surgery my pain was not managed at all and when PT came to get me for walks. I could barely walk a few feet. Then they asked me what I needed for better pain control, and gave it to me. Because of being on the pain meds I needed, I walked way up and down the hallways.<br/>I hope you will consider stronger language to prompt Dr’s to treat us as individuals and give us the pain meds we need based on factors such as; what’s causing the pain, what worked well before 2016, what will give us an acceptable quality of life, what will enable us to do the things they want us to do such as losing weight and exercise? Do we have addiction tendencies, what’s our track record with pain meds, what kinds of non-movement therapies have we tried? It’s all relative and relative. <br/>Thank You for finally righting a wrong! I’m hoping and praying to get my life back!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynn	None	None	0900006484f7251f	Broadbent	None	2022-02-13T21:59:36Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Broadbent , Lynn	kzk-9j1z-vkpt	False	None	False	2022-04-12 01:55:07.734	[]
428	CDC-2022-0024-0434	https://api.regulations.gov/v4/comments/CDC-2022-0024-0434	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 55 year old working woman that suffers with chronic neck pain and back pain from a car wreck. I also have Trigeminal Neuralgia. I used te prescribed Opana (opioid) then it was taken away due to the opioid crisis. I now have trouble doing everything including working. I have gained weight due to little activity and high blood pressure. If I was able to be prescribed opioids again I could continue working, exercise to lose weight which would also lower my blood pressure	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484f72569	LeblueLeblue	None	2022-02-13T21:59:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from LeblueLeblue, Brenda	kzk-a6jv-v31g	False	None	False	2022-04-12 01:55:07.954	[]
429	CDC-2022-0024-0435	https://api.regulations.gov/v4/comments/CDC-2022-0024-0435	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC Clinical Practice Guideline for Prescribing Opioids–United States, 2022<br/><br/><span style='padding-left: 30px'></span>My comments and opinions, are based from my experiences of nearly 52 yrs as a licensed pharmacist, and married to a woman who has been a intractable chronic pain pts for some 30+ yrs and who personally is dealing with activity induced high intensity pain. I advocate for chronic pain pts and over the last decade I have communicated with tens of thousands of pts.<br/><br/><span style='padding-left: 30px'></span>The CDC needs to plainly state that it is revoking/rescinding the 2016 opiate dosing guidelines and discard this proposed opiate dosing guidelines and put out a statement that any entity that created laws/rules/regulations/policies and procedures that used the CDC 2016 opiate dosing guidelines should be rescinded, revoked, repealed and/or reversed. <br/><br/><span style='padding-left: 30px'></span>Because they were only guidelines, that were based on faulty studies and conclusions and anything created from those guidelines are - at best - of questionable quality.<br/><br/><span style='padding-left: 30px'></span>The 2016 guidelines gave too many well meaning bureaucrats, politicians and executives in various large healthcare corporations, but with little/no medical background to become “middlemen” in the fabricated war on pharma opiates and create their own version(s) of trying to restrict/restrain pharma opiates from being prescribed to legit chronic pain pts.<br/><br/><span style='padding-left: 30px'></span>The 2022 proposed guidelines mentions MME - TEN TIMES - MME’s are inaccurate and antiquated process that were used in the 80's - or earlier - when opiate rotations were in vogue - when it was perceived that a pt had developed a tolerance to the medication. <br/><br/><span style='padding-left: 30px'></span>These opiate equivalents were developed by using opiate naive pts with acute pain induced mechanically (heat or cold) and given a SINGLE DOSE of a opiate. Those resulting outcomes, have little/no relationship to treating chronic pain. Since this study was based on the OBJECTIVE FEELINGS of pts, with unknown different rates of opiate metabolism because CYP-450 opiate metabolism tests were yet to be discovered. They are CRUDE ESTIMATES AT BEST and the footnotes of most all MME conversion programs will plainly state that.<br/><br/><span style='padding-left: 30px'></span>I did a word scan of the 211 pages and searched for CYP-450, PGx, Pharmacogenomics and did not find one mention of these very important DNA testing to determine the opiate metabolism of a individual pt. Without at least one of these DNA tests being done on a chronic pain pt - especially a pt that is labeled as a intractable chronic pain pt - any practitioner attempting to provide adequate pain management using opiates, is IMO, still practicing medicine like was done in the mid-20th century.<br/><br/><span style='padding-left: 30px'></span>The CDC - and all these meddling middlemen - need to get out of the practice of medicine and leave the practice of medicine to the FDA and the various state Medical Licensing Boards.<br/><br/><span style='padding-left: 30px'></span>Since the 2016 guidelines were released, I can’t count all the pts that have told me that they have had their pain meds reduced - or cut entirely - have become bed/chair/house confined. Living/existing in a torturous level of pain, their blood pressure is in stroke range and even taking up to 4 different BP meds .. Does not reduce their BP back to a normal range. Pt that have taken too many NSAID’s and/or Acetaminophen and end up having liver or kidney failure. (Graphic attached) Their unmanageable high blood pressure, has caused eye damage, kidney damage, a stroke, heart attack, committed suicide or died prematurely from the complications of their comorbidity issues from under/untreated pain... (chart attached) . And everyone involved, gets to “wash their hands clean” because their death certificate read “natural causes”<br/><br/><span style='padding-left: 30px'></span>I have attached two different charts showing OD’s starting after the Decade of Pain Law was not renewed in 2010. One chart shows the OD’s from individual legal and illegal drugs and a second one shows the number of total OD’s from all opiates and I have marked on each chart when the 2016 CDC guidelines started and when the current administration opened our SW border. Both show a dramatic increase in OD’s from illegal substances and recently the CDC or DEA stated that 75% of OD’s involved a illegal Fentanyl analog. Regional variations have been stated to be between 73% to 87% illegal Fentanyl analog involvement.<span style='padding-left: 30px'></span><br/><br/><span style='padding-left: 30px'></span>It would appear that the CDC in stating that this proposal is VOLUNTARY, NOT MANDATORY, GUIDELINES appears to be admitting that they have NO ENFORCEMENT POWER over these guidelines and may not even have statutory authority to even create and publish them.<br/><br/><span style='padding-left: 30px'></span>The CDC needs to WITHDRAW this proposal, withdraw, rescind, revoke the 2016 guidelines and get out of the business of the practice of medicine and quit putting out “cook book recipes” in how to treat subjective disease(s), that has no means of measuring the intensity of the disease on the pt’s QOL.<br/><br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484f72580	Ariens	None	2022-02-13T22:01:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Ariens, Steve	kzk-a54f-rlvf	False	None	False	2022-04-12 01:55:08.165	[]
430	CDC-2022-0024-0436	https://api.regulations.gov/v4/comments/CDC-2022-0024-0436	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the changes to guidelines that allow doctors to use their best judgement. There is no one size fits all. I suffer from fibromyalgia, CRPS, osteoarthritis, osteoporosis, spinal stenosis, scoliosis of the spine, several herniated disk,IBS, tremors,and chronic fatigue syndrome. Those conditions led me to have to use a spinal stimulator,and get a total knee replacement this past August. I am 55 years old. I have tried all kinds of treatments, to no avail. The only thing that has worked for me, is pain medicine. I have to take, what might be seen as high doses, because the way my body metabolizes food and medication due to gastric bypass surgery. I have to see a psychiatrist because of the depression, PTSD, panic attacks, and suicidal thoughts I have due to being in fear of losing access to my medication, and being left in unrelenting pain that is like being slowly tortured to death. Please help! I have a beautiful family! I want to live to see my 6 grandchildren grow up! Again, thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484f7258d	Wilson	None	2022-02-13T22:02:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Wilson, Nancy	kzk-akqq-ceg8	False	None	False	2022-04-12 01:55:08.398	[]
431	CDC-2022-0024-0437	https://api.regulations.gov/v4/comments/CDC-2022-0024-0437	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Still looks to be more heavily influenced by law enforcement than a true medical doctors perspective. Those with chronic pain being differentiated from those with sickle cell disease, cancer and those requiring palliative care is wrong. If a person has severe pain why should it matter the cause? You have to be of a certain genetic make up or dying in order to receive opioids? Unless you have suffered from severe pain chronically you just cannot understand what it is like. Also putting in language that those on higher doses should be weaned done is misleading. If one is one a certain dose it works, they have no side effects (ok constipation but that is expected almost regardless of the dose) and is functioning well why should it matter the dose? If it was too high then they would have side effects. You might argue tolerance can develop. I argue unless one develops a new source or arrebates a current source of pain then if properly treated then in my experience I have in having had treated perhaps ten thousand patients tolerance to develop. You would not tell a sickle cell or cancer patient to wean their dosing! So why with chronic pain? Why because it appears to me that those with chronic pain are in many so called experts minds a step away from becoming addicted! I argue you cannot make a person who is not addicted to opioids addicted despite all the movies and TV shows purporting it to happen. It is a myth. Addicts typically are those who have a untreated mental health disease that had started self medicating with illicit drugs. When initiated as adolescence the brain develops being dependent on these substances thus making it extremely difficult to abstain from their use. So if a patient as a adolescence is started on opioids and has a untreated mental health disease it is possible they become addicted! So if one is going to start adolescence on opioids for chronic pain they need a full mental health evaluation, preferably before starting if possible. If not ASAP and be treated for any mental health issues they have concurrently!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judson	None	None	0900006484f725bf	Somerville MD	None	2022-02-13T22:05:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Somerville MD, Judson	kzk-b1mt-kfc3	False	None	False	2022-04-12 01:55:08.623	[]
432	CDC-2022-0024-0438	https://api.regulations.gov/v4/comments/CDC-2022-0024-0438	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a young individual that's disabled, chronically ill and chronically in pain, the opiod regulations are extremely harmful to me. I've had numerous surgeries in which I've had to fight to get adequate treatment and control of my pain. It is a daily battle to fight through the pain. Every person is different and deals with things differently. <br/>It shouldn't be this difficult to survive. <br/>Stop hurting chronic pain patients!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Megan	None	None	0900006484f71bde	Anonymous	None	2022-02-13T22:06:09Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Megan	kzk-bc2d-thsw	False	None	False	2022-04-12 01:55:08.860	[]
433	CDC-2022-0024-0439	https://api.regulations.gov/v4/comments/CDC-2022-0024-0439	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These new guidelines are a step in the right direction but have not gone far enough. As physicians we may inherit patients who have been on relatively high doses of opioids for many years because the pain doctor has retired or left practice. These physicians may have to continue prescribing for these patients provided that the patients show that they are functional, and their quality of life is improved with the use of the opioids. Likewise, pain management physicians may also have legacy patients who have been on opioids for many years and are followed carefully for any signs of opioid abuse behavior. It needs to be stated clearly in the guidelines that physicians should not be investigated by medical boards just for prescribing opioids above the 50 MME guideline. This is an arbitrary number and has no value when treating neuropathic pain or other chronic pain conditions that respond to opioid therapy but at a dose above the 50 MMEs. Medical Boards are using these guidelines not as guidelines but as Standards of Practice and it should be clearly stated in the opening lines of the Guidelines that they are in fact only guidelines and should not be used as Standards for judging medical care and practice.<br/>..., Keck School of Medicine of USC.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jack	None	None	0900006484f71bf0	Berger	None	2022-02-13T22:07:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Berger, Jack	kzk-bid8-dn7p	False	None	False	2022-04-12 01:55:09.069	[]
434	CDC-2022-0024-0440	https://api.regulations.gov/v4/comments/CDC-2022-0024-0440	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain is not an infectious disease, so a taxpayer might wonder why pain management is any concern of the Centers for Disease Control. CDC hasn’t exactly covered itself with glory performing its intended duties lately. So save the mission creep for another day. And keep bureaucrats out of the doctor-patient relationship. <br/><br/>ISSUE NO GUIDELINE REGARDING OPIOIDS. Not your job, CDC.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Les	None	None	0900006484f71c06	Waldron	None	2022-02-13T22:08:36Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Waldron, Les	kzk-bqft-am3i	False	None	False	2022-04-12 01:55:09.316	[]
435	CDC-2022-0024-0441	https://api.regulations.gov/v4/comments/CDC-2022-0024-0441	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long term stable opioid user who has been severely impacted by the rules and regulations that have made it almost impossible to procure my medications I would be very interested in giving you my thoughts.<br/>The last two years have been a pain in the ... I was stable for 17 years and then you ... things up.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kurt	None	None	0900006484f71c09	Spain	None	2022-02-13T22:09:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Spain , Kurt	kzk-brw7-qqpl	False	None	False	2022-04-12 01:55:09.522	[]
436	CDC-2022-0024-0442	https://api.regulations.gov/v4/comments/CDC-2022-0024-0442	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This will change nothing, just words, damage done, Drs still feel forced to cut off pts in pain. You have crucified innocent pts with lifetime painful conditions whom are 100% compliant, obey law, and are on lowest possible dosage to be abandoned to suffer! While serving up narcotics (free methadone, free suboxone, even free needles etc and saving these noncompliance group over and over with free narcan), addicts that illegally purchase street drugs (illicit heroin/fentanyl causing crisis) . They are not in pain, pain patients are. Yes they need help but do not punish innocent people in chronic pain! Do better, many pts turn suicidal because abandoned due to your "guidelines" to live until death in horrific pain. Stop misusing resources like FBI/DEA to raid innocent Drs instead of finding the real culprits, drug dealers! Street fentanyl killing and TRENDING up despite less prescribed pain meds, make it make sense! End this nonsense. Unethical! Don't punish the wrong people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71bff	Anonymous	None	2022-02-13T22:12:07Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-bo3s-kp94	False	None	False	2022-04-12 01:55:09.736	[]
437	CDC-2022-0024-0443	https://api.regulations.gov/v4/comments/CDC-2022-0024-0443	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are a serious problem in healthcare no doubt and must be clearly viewed as such by providers. Thus, I support revisions to guidelines. My thoughts:<br/>1. Anxiety becomes a high issue with both acute and chronic pain. Acute pain is "short" lived and no examination of anxiety needs to be completed for a patient. For those with chronic pain, anxiety must be screened and dealt with in the plan. It is shown that most can decrease pain pill needs by decreasing their own personal anxiety. So, maybe note that in the plan guideline and heavily suggest SSRI or such to decrease anxiety response.<br/>2. People do have chronic pain and must have needs met. However, once the diagnosis is established in a stated time limit as chronic pain--maybe then have two physicians consulted to agree to and sign off on the needed amount of opioids and patients overall treatment plan within a certain time limit. Then have two physicians sign off on the ongoing matter every 1-3yrs. Will also make sure all steps have been done or considered. <br/>Might also consider a required medical team approach for chronic pain patients.<br/>Can ultimately push for more sole chronic pain providers who just deal with and are responsible the serious matter.<br/>Yet, till then the plan must begin to become rigid on chronic pain steps and rules for physicians to curtail the personal and national problems opioids are causing.<br/>3. Might give epidural injections a researched and supported view as a step in part of a plan for most chronic pain. <br/>In same light might give marijuana a researched and supported view as a step. <br/>4. Might also seek to control prices or lower pain pill prices for those with chronic pain diagnosis to keep patient from seeking street drugs to meet their needs.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tony	None	None	0900006484f71c5b	Hussey	None	2022-02-13T22:12:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Hussey, Tony	kzk-cj4z-y8ht	False	None	False	2022-04-12 01:55:10.050	[]
438	CDC-2022-0024-0444	https://api.regulations.gov/v4/comments/CDC-2022-0024-0444	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 70 Year Old Man Who Has Suffered A TBI with 2 Craniotomies in 2008. I have suffered low back and thoracic back pain for more than 40 years. It was exacerbated by the trauma in 2008.<br/><br/>I have adult onset scoliosis with 19%+ Cobb Angle and Vertebral Fractures Due to Osteopenia and Hypogonadism.<br/><br/>I have been able to avoid a double interbody fusion since I was 47 years old by losing weight and managing my pain with low dose (50mg) Tramadol as needed. I take SOMA and Tizanadine as needed.<br/><br/>Although I do not take the well known controversial Opioids I strongly believe that choice should be left to the Patient and Patient's Doctor.<br/><br/>Not every person suffering Implacable Chronic Pain is a drug abuser and should not be treated by the Government as one.<br/><br/>Regulation of Opioids is appropriate but draconion measures the encompass punishing the prescriing doctor and the patient is not the way to address the Opioid Crisis.<br/><br/>With computerization and tracking today the abuse of these drugs is easily tracked. But those safeguards in at the Manufacturing, Distributor, Insurance, Drug Store and Prescriber Level and do not interfer in the Patient Doctor Relationship.<br/><br/>No one should be denied medical care and relief from intractable chronic pain and I can attest for many of us this is a very real issue.<br/><br/>Thank you for considering my position.<br/><br/>Regards,<br/><br/>...<br/>..., Florida<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Randy	None	None	0900006484f71c82	Roberts	None	2022-02-13T22:14:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Roberts, Randy	kzk-cx0u-kbkp	False	None	False	2022-04-12 01:55:10.277	[]
439	CDC-2022-0024-0445	https://api.regulations.gov/v4/comments/CDC-2022-0024-0445	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 96 year old mother in law fell and broke her ribs a couple months ago. She currently gets a prescription for one hydrocodone a day. The doctor refused to give her any additional pain medicine to help her cope with the pain saying his hands were tied, he wasn’t allowed to give her any more. We watched her suffer for months unnecessarily. There is no reason to make people suffer like this. She was never at risk of becoming a drug addict. The doctor knew that.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L.	None	None	0900006484f71ced	Wallace	None	2022-02-13T22:15:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Wallace, L.	kzk-dz8v-dmyi	False	None	False	2022-04-12 01:55:10.483	[]
440	CDC-2022-0024-0446	https://api.regulations.gov/v4/comments/CDC-2022-0024-0446	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	On behalf of my patients:<br/><br/>In response to the recent proposal from the CDC on opioid prescribing, I am encouraged by the attentive response from the CDC to cancer pain patients and long-term chronic pain suffers. The initial 2016 guidelines were much needed at the height of the opioid epidemic to put the brakes on unsafe opioid prescribing patterns that were endangering our vulnerable chronic pain patients. Now that the alarm has been sounded, the new guidelines will offer levity and salience to opioid prescribing.<br/> <br/>As an interventional pain physician, I do have some serious concerns of the new proposed guidelines. <br/><br/>The document clearly indicates the need for consideration of non-opioid options prior to engaging in long term opioid therapy. While ongoing funding for opioid addiction treatment is necessary, the only viable solution to ending unnecessary suffering should also rely on minimally invasive, safe, and scientifically proven interventional treatment options such as radiofrequency ablation, minimally invasive spinal decompression, peripheral nerve stimulation and spinal cord stimulation. Contrary to the proposed guidelines, these treatment options have overwhelming positive results from large randomized controlled trials offering level I clinical evidence for efficacy and safety. I have dedicated my career to helping patients with chronic pain and maintain that we should cautiously include opioids in select patients as part of a comprehensive treatment algorithm. The limited attention to interventional pain treatment options in this proposed guideline is critically flawed and will limit access to care. In the spirit of evidence-based medicine, I like to bring to your attention a small sample of peer reviewed publications that have reported efficacy, safety, reduction of opioid intake, and improved functional outcomes utilizing peripheral nerve stimulation and spinal cord stimulation. <br/><br/>..., M.D.<br/>Regional Medical Director,<br/>Premier Pain Centers<br/>An Affiliate of National Spine and Pain (NSPC)<br/>...<br/>Tel:...<br/>Fax: ...<br/>Adjunct Clinical Associate Professor, <br/>Department of Anesthesiology, Rutgers New Jersey Medical School, Newark, New Jersey<br/>President, New Jersey Society of Interventional Pain Physicians (NJSIPP)<br/>Director at Large, American Society of Pain and Neuroscience (ASPN)<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sean	None	None	0900006484f7290e	Li	None	2022-02-13T22:17:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Li, Sean	kzk-dw7c-de0b	False	None	False	2022-04-12 01:55:10.693	[]
441	CDC-2022-0024-0447	https://api.regulations.gov/v4/comments/CDC-2022-0024-0447	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient— I have been one for over 15 years. I suffer from chronic pain from Osteoarthritis, Spinal Stenosis, Degenerative Disc Disease, Cervical and Lumbar neuropathy, Radiculopathy, and have several spinal fusions in neck and back. The horribly applied, and MIS-guided, 2016 CDC opiate 90MME guidelines, has severely impacted my quality of life! I have been force tapered from a dosage that was controlling my pain, allowing me to work, play, and be a normal happy living person with Chronic Pain! I am cut down so low now and suffer horrible pain. I have no quality of life, and these changes/updates, are extremely important to me and the millions of chronic pain patients! Please allow the pain management doctors and the patient decide the best course of medical treatment! We are the ones in pain, we are U.S. Tax paying citizens, who want to be treated like any other illness and receive proper pain control. Please help all of us in horrible pain get access and proper pain management! We have suffered enough!!! We are forced tapered or cut off and treated like criminals! Many of us have died from the 2016 CDC guidelines… it’s a false narrative and propaganda. Please help! Don’t put a limit on MME and pain medication use and access!! Thanks again, your fellow chronic pain patient, American citizen, tax payer. Mr. ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gabriel	None	None	0900006484f7292e	Beadle	None	2022-02-13T22:18:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Beadle, Gabriel	kzk-eifb-ncp3	False	None	False	2022-04-12 01:55:10.908	[]
442	CDC-2022-0024-0448	https://api.regulations.gov/v4/comments/CDC-2022-0024-0448	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I welcome an improvement in guidance towards prescribing opioids but the new CDC guidance sadly still discriminates against many disabled individuals. Cancer is exempt from the guidance and the same should also extend to all non-idiopathic pain conditions. Anyone with severe chronic pain backed by scientific evidence proving their condition(s) should have safe access to medications that reduce their suffering safely under the supervision of a doctor.<br/><br/>I am in severe pain constantly after a severe spine injury that went misdiagnosed for decades by doctors who refused to order medical imaging. After years of suffering I was forced to turn to illicit sources of marijuana to ease my pain before any states had legalized use, medically or recreationally, and eventually relocated in order to get safe, legal access to medical marijuana when it was legalized. I never wanted to take pain management into my own hands but the government and healthcare system left me to suffer. Despite moving to a state with legal access to medical marijuana, most doctors were too afraid to prescribe it due to its schedule 1 drug status and the few doctors helping patients like myself were attacked by politicians, law enforcement, and the medical board. The doctor recommending my medical marijuana was literally raided by the DEA and they pushed the state medical board to suspend his license. My doctor eventually got his license back and continued to fight for patients like myself but his reputation was constantly attacked and DEA agents would frequently stand around his waiting room with their badges on beaded chains around their necks as they chewed on unlit cigars, staring intimidatingly at patients waiting to see him.<br/><br/>Later my state legalized marijuana for recreational use, which I opposed, then lawmakers made it illegal for me to drive so I opted for safe, legal access to opioids under the care of a physician. Opioids are proven to have more analgesic properties and is FDA approved and more extended release formulas were being released which titrate the medicine consistently so the change ended up being better for my healthcare but it is more difficult to obtain prescribed opioids, a schedule 2 drug, from the healthcare system than it was to obtain marijuana, a federally illegal schedule 1 drug. When the 2016 guidelines for opioids were distributed, it harmed patients who depended on opioids and prescriptions declined largely because federal and state government(s) used the guidelines to initiate a war against opioids attacking patients, manufacturers, distributors, pharmacies, and doctors. As a result it is clearly easier to obtain deadly illicit opioids laced with fentanyl from the black market, which I have never done, than it is to get them safely via the healthcare system.<br/><br/>I have had to beg for access to pain management and medical imaging such as MRIs to confirm my severe health condition which, according to doctors, is incurable and I depend on opioids and nerve blocks to function. The government trying to criminalize opioid use and removing safe access for individuals is directly causing patients with severe health issues to obtain medicines through illicit sources which can be fatal and this is clearly why opioid related deaths, due largely to illegal sources of fentanyl, continue to rise. I am personally opposed to recreational use of alcohol, marijuana, and opioids, but people with serious medical conditions need safe access to medicines they need to live. I am below the 2016 CDC recommended 90 MME daily limit and have been stabilized on my dosage for quite some time yet most practitioners tell me they used to prescribe my medications but no longer will because they rightly fear the federal government and it is a constant struggle to get adequate healthcare.<br/><br/>The CDC needs to quit attacking those suffering and end discrimination towards disabled individuals. Guidance issued will be used by lawmakers and enforcers to harm those that need opioids to live so please have compassion. Patients want to increase function and reduce pain levels and public servants should quit enacting rules that result in irreparable harm to those they claim they are trying to help. At a minimum, exempt all non-idiopathic chronic pain from the guidelines and encourage states to roll back their discriminatory state laws and policies that resulted from the harmful 2016 CDC opioid guidance. While opioids perhaps should not be the primary go to tool for treating people with non-idiopathic chronic pain, they are a good secondary tool just as they are for a cancer patient who is undergoing radiation or chemotherapy and a patient like myself still needs access to them. Opioids come with risks as do many medicines but numerous people depend on this tool to survive and you should not condemn it merely because you personally are privileged enough to be free of severe, intractable pain.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72942	Anonymous	None	2022-02-13T22:19:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-eov0-m3jc	False	None	False	2022-04-12 01:55:11.160	[]
443	CDC-2022-0024-0449	https://api.regulations.gov/v4/comments/CDC-2022-0024-0449	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Me and my husband are both sickly people that are in palliative care we are asking u to please removed the 50 mme off of the new guidelines .I know the 90 mme was removed but if the 50mme is not removed Dr s and pharmacist will go by that .these drs and pharmacist are using these guidelines saying it's the law when it s not .I want to give an example .my husband pharmacy called him yesterday and told him she had to many people on pain meds she had to drop some he just lost both of his legs he has cirrohios to the liver and is dieing he is on palliative care but I went to 30 different pharmacy s and none would take him in Martinsburg WV they said 120 meds a month was too high or I can't fill out of state scripts which is not true there in no Dr in Berkeley county that will give him the meds that he needs he has been on this meds for 25 years and now he can't find a pharmacy to fill because all pharmacy s are blaming the DEA .please up us sick people ..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484f72948	Guthrie	None	2022-02-13T22:20:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Guthrie, Melissa	kzk-es4s-faa3	False	None	False	2022-04-12 01:55:11.371	[]
444	CDC-2022-0024-0450	https://api.regulations.gov/v4/comments/CDC-2022-0024-0450	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/>When I had my spine fused from T-10 to my pelvis, I had a very difficult time obtaining pain control. My oxycodone was being titrated up carefully until I managed to find relief. Unfortunately, that took 3 weeks of dose adjusting. I was discharged right before Christmas 2019 and when I needed more medication, the holidays interfered. For example, I could not get a new prescription filled until 2 days later. However, the pharmacy would be closed. How was that fair.<br/><br/>As soon as I found that level of pain relief, I also did not want to take it forever. So, I worked with my surgeon to titrate down. It was agonizing! There was a point that I had recovered from surgical pain, but my body did not want to be off of the oxycodone. I struggled with the withdrawals, sweats, nightmares, deep depression. But I did get off of them.<br/><br/>Let doctors work closely with their surgical patients. Have pain management doctors work with professionals that help patients get off the opioids without so much withdrawal effects. It is clear why some get addicted as that is easier than dealing with the withdrawals. There is not enough resources for the patient to take themselves off of them by themselves.<br/><br/>However, until the Southern U.S./Mexico Border is closed and Bordie Pattol freed up to catch drug smugglers, you are NEVER going to get a handle on opioid overdoses. The reason overdoses were so fatal in 2021 is due to Fentanyl being mixed with every other medication people are getting online illegally. <br/><br/>The CDC will be just spinning their wheels when the bigger issue of illegal Fentanyl is killing people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484f72968	Lloyd	None	2022-02-13T22:26:31Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Lloyd, Karen	kzk-f34h-2v7z	False	None	False	2022-04-12 01:55:11.578	[]
445	CDC-2022-0024-0451	https://api.regulations.gov/v4/comments/CDC-2022-0024-0451	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What ever happened to not all one size shoe fits all? that goes the same for every single chronic pain patient. I can't do 50mme just like I can't do 90mme. my normal mme was 255mg and I had a life. I'm actually moving out of the country because I as a chronic pain patient for 21 years and a mother of a toddler cannot take another 7 years of torture that you bestowed upon us. I cry for my future and I cry for my child's future without her mom and I can't stand what you continue to do to us. you have blood on your hands and you certainly owe us and our families a good explanation for why you continue to go after the chronic pain patients and doctors and not go after the real opioid crisis which is illegal fentanyl and heroin on our streets. We need and deserve better from our country and you certainly need to abolish the MME completely for chronic pain patients, cancer patients and end of life care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72970	Anonymous	None	2022-02-13T22:29:41Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-f7wc-fzoh	False	None	False	2022-04-12 01:55:11.786	[]
446	CDC-2022-0024-0452	https://api.regulations.gov/v4/comments/CDC-2022-0024-0452	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had been on opioids for over 15 years. It was controlling my pain sufficiently so I could function, take care of my family, participate in my hobbies, etc. I was living a happy life. Exactly one year ago the clinic I was being seen at decided they would no longer write for any pain medication for anyone, any reason. It was not up for discussion. If I tried to talk to the doctor, she would give a curt reply and walk out of the room. I was cut by 1/3 of my dose then abruptly stopped. This past year has been a living hell. My pain is off the charts, I barely make it through the day. No one in my area will perscribe pain meds, not even post surgery, after an acute injury, nothing. Have been told to take tylenol. There are days I don't feel like going on, but I do because of my family. I don't sleep due to pain, can't eat much, the list goes on. I allso have a heart problem and my cardiologist was not happy. The constant pain has caused blood pressure problems as well as affecting heart function. The oath doctors take states, among other things, DO NO HARM! Taking away pain medication has done so much harm to so many including me. My kids have instructions that if anything happens to me due to losing my pain meds, they are to file law suits against as many doctors, clinics, gov. agencies as possible. We should not have to live our lives in complete agony!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f729b4	Anonymous	None	2022-02-13T22:30:23Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-g01i-zmqb	False	None	False	2022-04-12 01:55:12.004	[]
447	CDC-2022-0024-0453	https://api.regulations.gov/v4/comments/CDC-2022-0024-0453	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Chronic Pain patient due to work related injury in 2018 I have been made to suffer due to these guidelines that have made Drs feel unsafe prescribing opiod medications to the point that the ER I went to when my injury occurred prescribed me steroid for a ruptured disc impinging my sciatic nerve root, due to this and many other regulations that need changed, I am now permanently disabled and will continue to deteriorate! Had these guidelines not been in place I probably would have been prescribed opioids that would have allowed me to get up and walk, move around and stretch to get the disc off my nerve root! I spent 2 months unable to walk because of the excruciating pain. Had I been able to walk I most likely wouldn’t have permanent damage I’ve most likely wouldn’t be losing the ability to use my right leg, I most likely wouldn’t be almost completely bedbound at this point in my life. I am 43 years old and now due to my pain I have to take opioids for the rest of my life, or until a better treatment method is discovered! Due to the stringent restrictions and guidelines that you guys put into place in 2016 my doctors don’t want to prescribe pain medication due to fear that they will lose their license end up in prison, and that’s not OK I need and I deserve a quality pain control medication without the Excessive restriction on opioid medication’s I have panic attacks and severe anxiety anytime I have to get out of bed because I know it’s going to hurt! The failure of the CDC in these guidelines to recognize and acknowledge the difference between prescription medication and illicit opioid products, as well as lumping together illicit overdoses with prescription overdoses has made Chronic pain patients suffer to the point we are treated like we are criminals! The stringent guidelines need to be clarified as well as removing illicit drug use lumping with pain management opioid treatment!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484f729bd	Robinson	None	2022-02-13T22:32:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Robinson , Sharon	kzk-g4ol-q82q	False	None	False	2022-04-12 01:55:12.224	[]
448	CDC-2022-0024-0454	https://api.regulations.gov/v4/comments/CDC-2022-0024-0454	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think this is a positive turn of events. A lot of people with chronic pain, including myself, lost a degree of their quality of life after 2016. As someone that lives with chronic pain, I value empathy and relief from human suffering. I hope more positive changes occur, to guarantee that people in pain are well taken care of by the American medical system and their doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jaime	None	None	0900006484f729e3	Flor	None	2022-02-13T22:34:43Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Flor, Jaime	kzk-gngj-bbq2	False	None	False	2022-04-12 01:55:12.435	[]
449	CDC-2022-0024-0455	https://api.regulations.gov/v4/comments/CDC-2022-0024-0455	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for this guideline. Here’s my thoughts. I’ve used a pain management dr for 6 yrs. Every visit is documented from the clinic. It includes all my treatments, invasive, radiology and conditions. The opioid meds saved my quality of life. Sadly my new dr refused to check my records, called me an addict, that my pain isn’t real, my previous dr is unqualified and irresponsible. You see every ‘body’ is unique regarding chronic pain. I lost a kidney to cancer and every dr that’s treated me since then urged no NSAID use. My dr now doesn’t believe they are correct. He stopped all of my opioids with no weaning (post emergency spinal neurosurgery) and insists I return to NSAIDS and provide weekly lab results for him to monitor my kidney function. Since June 2021 I have suffered terribly. I cannot grocery shop, clean my home, go for a walk or enjoy a decent shower. In my state there is one large health care monopoly. Almost every dr is on that team. They share all medical records. Even the pain clinic I visited suggested an invasive procedure and told me they never use opioids for pain. I’m 65 and can’t even find a palliative care dr to help me. The content regarding the upcoming guideline revision does not offer significant education for medical professionals regarding chronic progressive painful conditions. Nor do the guidelines assure drs there will be no fear of losing licenses to practice or over used criminal prosecution and there is no explanation that drs are the experts to treat chronic pain as they/patient agree upon. Most will read and apply the suggestion that no patient should use opioids as therapeutic treatment. I don’t see a silver lining for chronic pain patients or fearful drs that want to help. Also it should contain a reference to pharmacies making decisions for customers such as, stigmatizing opioid patients, disposing of electronic prescriptions, taking pills from filled prescriptions and general bias for pain customers. Perhaps a stand alone section regarding chronic pain will benefit everyone. The Opiod Cris is misnamed. It should be referred to The Use of Illegal Narcotics Crisis.UINC. Chronic pain patients have practically zero involvement. And the fact that real honest to goodness addicts get free methadone, needles and now Crack Kits… well that is very hurtful and quite frankly irresponsible. Sincerely, C. PS I am willing to meet/zoom and speak on behalf of the millions of chronic pain patients who are suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C	None	None	0900006484f729e7	T	None	2022-02-13T22:36:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from T, C	kzk-goqw-onsn	False	None	False	2022-04-12 01:55:12.658	[]
450	CDC-2022-0024-0456	https://api.regulations.gov/v4/comments/CDC-2022-0024-0456	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We clearly have not stopped drug addiction by forcing everyone else to suffer in pain. We tried it and we found it made the problem worse. It has created more addicts than ever. People who were able to get pain medicine before the 2016 guidance were forced to get it from the streets. Overdose rates have exploded since the new rules have been implemented. Why are we forcing people to suffer? The answer is to let people get medicine from doctors in controlled amounts and dosages, not to force them to get it from dealers who will always work to create an addiction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L.	None	None	0900006484f729ea	W.	None	2022-02-13T22:38:31Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from W., L.	kzk-gr24-rbbm	False	None	False	2022-04-12 01:55:12.870	[]
451	CDC-2022-0024-0457	https://api.regulations.gov/v4/comments/CDC-2022-0024-0457	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic headaches and fibromyalgia for 35+ years, tried just about anything going to help. I took a low dose of Lorcet for years that helped me to keep going. In 2016 that all changed, had to go to a pain clinic to even consider getting Lorcet. The one I got in to was a disgrace! You had to go every month to get a prescription which cost me $100 because it was not in network with my insurance. Every 2 months had to have a urine test which cost another $100 to see if you were taking the medicine. The bathroom was at the end of the waiting room, so had to walk through the waiting room with your specimen. Humiliating! I cried every time I went. The doctor was finally arested for giving illegal prescriptions! Bad experience. Now the pain management clinic I go to does not even consider giving pain meds. I have tried numerous treatments and the Lorcet was the only thing that ever helped me. The only people that the new law hurt was the ones that need help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484f72a11	Mendenhall	None	2022-02-13T22:38:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Mendenhall, Brenda	kzk-h6dm-6wb7	False	None	False	2022-04-12 01:55:13.083	[]
452	CDC-2022-0024-0458	https://api.regulations.gov/v4/comments/CDC-2022-0024-0458	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who has lived with chronic pain for over 20 years, due to a surgical error, I have suffered more in the last five years than in any period previously. My state took the 2016 Guidelines and converted them, almost word-for-word, into policies for doctors who prescribe opioids. As a result, my pain has increased dramatically without a corresponding response in treatment. This has led to thoughts of suicide and weekly psychotherapy sessions to help me manage from one day to the next. Although I am older (62), I'd like to have some quality of life even if my disability continues. More importantly, there are far too many young people who are faced with a lifetime of suffering from chronic pain without this change in the Guideline, many of whom will make a more final and tragic choice in managing their pain. Although I've lost a tremendous amount as a result of my condition (job, marriage, friends), this change is much bigger than me. Not only is it an opportunity to change the physical wellbeing of tens of thousands of those of us in constant pain but it is also has the added benefit of addressing the mental anguish that accompanies it. Just imagine what it would be like to live with debilitating pain every minute of every day of every week of every year, knowing a solution was available but being withheld. Now imagine if that person in pain was your spouse or child or parent. Wouldn't you want to make every treatment option available (medical marijuana also falls in that category but that's a different federal rule)? Of course you would. We trust our medical professionals to individualize our personal care every day. Pain should be no different and this revised guideline, while it won't give me the last twenty years of my life back, will do so much to help thousands of others every day. Thank you for the opportunity to comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erik	None	None	0900006484f72a16	Engberg	None	2022-02-13T22:39:34Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Engberg, Erik	kzk-gwz7-k1kv	False	None	False	2022-04-12 01:55:13.379	[]
453	CDC-2022-0024-0459	https://api.regulations.gov/v4/comments/CDC-2022-0024-0459	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m 32 yr old female. I’ve been physically active all my life. Active hiker, running 5ks multiple times a year, taking physically laborious jobs, chopping wood for hours at a time. I injured my lumbar/sacral spine in 2010 at work, at 20 yrs old from repetitive heavy lifting. I’ve done 3 rounds of physical therapy on lower spine, years with a chiropractor, live with a back brace wrapped around me when I’m not wrapped in the heated back massager, I’ve used lavender and valerian oils diffused to help sleep. I’ve taken a dozen rounds of steroids orally and shot. I’ve had the steroid epidural injection which exacerbated my pain and landed me on muscle relaxers for a bit trying to get my body to calm down. Now a decade later enrolled in physical therapy for cervical spine. My L4/L5 is herniated, my L5/S1 is ruptured, completely desiccated, with degenerative disc disease, some height loss in the spine, lumbar radiculopathy, venous insufficiency, and neuropathy of the lower extremities. I was put on the lowest dose of Norco in 2019 when I went to PCP saying I couldn’t take the pain anymore. <br/>The first pain management Dr treated me like a drug addict and didn’t want to keep prescribing the pain meds unless I did more epidural injections. They would put me through withdrawals every two months for 2-3 weeks at a time before refilling the prescription. I didn’t want to go through withdrawals anymore so I changed pain management Dr’s. I’ve been seeing this one for 6 months. Every visit he says we’ll start weaning me off the pain killers while offering no other pain relief alternative. He has also decreased me from 3xs a day to 2xs a day which means I’m having to decide which part of the day I want to be pain free and which part I’ll survive the pain, since 2 a day doesn’t keep me pain free a whole 24 hrs. I haven’t had a good nights sleep in years because of frantically squirming in pain all night other than when I was on Norco 3xs a day. Being extremely tired throughout the day only makes life and the pain even worse. <br/><br/>I’ve had several consultations with neurosurgeons and I can’t figure out how to get the surgery on my spine that I need. One has told me my only option is fusion and decompression, & a 3rd surgery which I don’t remember. But he says they just don’t do these surgeries on people so young. A second neurosurgeon has also told me I’m too young for the surgery and prescribed a back brace. <br/><br/>My quality of life has declined dramatically over the years, I can’t even prepare a meal in the kitchen, when I do I have to gather everything and sit on a stool to cook. I can’t even stand in the line at the grocery store without squiring in pain. Nobody will give me a handicapped placard even though I can’t even walk from my bedroom to my bathroom without being in serious pain. My daily routine consists of me going to work, having a microwaved dinner and then laying in bed in pain from 6pm until I wake up and do it again. I don’t even have friends anymore because I just can’t even move, I have zero interest in anything anymore. I do laundry once every two weeks because it hurts too bad to carry my laundry up and down the stairs. <br/><br/>The opioids are the only thing that relieve my back pain enough to make me want to get out of bed, but the discrimination from the dr’s, then constantly trying to take them away has only added to my anxiety and frustration. I’m now considering switching to a 3rd pain management Dr who will hopefully understand how beneficial the medicine is to my wellbeing. I already know I won’t want to live in the kind of pain that my body is in. Life isn’t even worth living if you’re doing nothing but laying around in excruciating pain. <br/><br/>Please teach dr’s to stop treating their patients on opioids so poorly. I understand the dangers, and that they’re addictive, and dangerous. But many people like me are already going through enough ... on earth we don’t need the constant negative judgement and threats of taking away the only thing that helps us get out bed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stevi	None	None	0900006484f72a29	Travis	None	2022-02-13T22:42:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Travis, Stevi	kzk-hh1b-8rtj	False	None	False	2022-04-12 01:55:13.604	[]
454	CDC-2022-0024-0460	https://api.regulations.gov/v4/comments/CDC-2022-0024-0460	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	speaking from perspective of 36 years in medicine, with a fair number of chronic pain patients in my practice for 20 years+:<br/><br/>getting rid of the cap in morphine equivalent dosing seems like swinging the pendulum too far in the other direction?<br/><br/>I am glad to see that deaths from prescription opioids have decreased from their peak (while fentanyl/ street drug deaths continue to plague us), and the cap probably had some helpful effect on that.<br/><br/>rather than completely abandon the cap, would prefer to see language that still mentions a specific number where risk rises more steeply (120 MED would be my suggestion), but also includes strong support for flexibility in dosing for some cases, especially when the prescribing provider is following good practice habits (written controlled med agreements, checking CURES database at refill times, regular follow up appointments, etc.).<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484f72a2a	Zepf	None	2022-02-13T22:43:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Zepf, William	kzk-hh1j-f2y5	False	None	False	2022-04-12 01:55:13.816	[]
455	CDC-2022-0024-0461	https://api.regulations.gov/v4/comments/CDC-2022-0024-0461	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2004, I was diagnosed with bilateral Neurogenic Thoracic Outlet Syndrome and forced into early retirement on disability. As a fully compliant chronic pain patient with no addiction issues whatsoever, I was stable on the same low dose of ER pain meds for over a decade and was functioning reasonably well. I keep medications locked in a safe that’s bolted to a shelf, I never ran out early or asked for an increase strength. But after the 2016 CDC Guidelines came out, it started becoming harder to fill legitimate pain prescriptions in a timely manner. These delays, which were completely out of my control, caused horrible withdrawal symptoms because my body was physically dependent even though I was not psychologically addicted to them. The mail order pharmacy that my insurance required caused these delays and slow mail service does not help. <br/><br/>I am also the primary caregiver for my husband. He had end-stage COPD and recently underwent a double lung transplant. I need to be alert and active to help him when he needs me, not wracked with pain or doubled over because my meds weren’t delivered on time. These types of unnecessary hardships are unacceptable to those of us facing chronic illness. Arbitrary guidelines and one-size-fits all strategies have no place coming between the patient and doctor relationship.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pgh	None	None	0900006484f72a2b	Pammy	None	2022-02-13T22:44:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Pammy, Pgh	kzk-hhhd-w50v	False	None	False	2022-04-12 01:55:14.035	[]
456	CDC-2022-0024-0462	https://api.regulations.gov/v4/comments/CDC-2022-0024-0462	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The proposed new guidelines for prescribing opioids for chronic pain is a welcome relief. Since enacting the current guidelines in 2016, I have experienced an increase in physical and emotional pain. I have experienced chronic pain for the last 20 years from Fibromyalgia and Osteoarthritis in my knees, hips, joints, and in recent years, my entire spine. Before enacting the current guidelines, my primary care physician managed my pain through a combination of Tramadol, Gabapentin, and Norco. During the day, while at work, I took low doses of Tramadol and Gabapentin to mitigate the pain and allow me to perform well. Norco was reserved until just before bedtime if I needed it to sleep through the night. In addition to Fibromyalgia and Osteoarthritis, I also have Sleep Apnea (I use my CPAP every night) and Idiopathic Hypersomnolence. Therefore, a good night's sleep is essential for pain reduction and countering my sleep disorders' effects. <br/><br/>The 2016 CDC guidelines for prescribing opioids for chronic pain removed my primary care physician's ability to manage my pain effectively. Without the prescription support of Tramadol during the day, the dosage and frequency of Gabapentin have been increased without mitigation of my pain. No longer do I take one Norco, if needed at bedtime; I take one as soon as I get home from work and two a bedtime. Most nights, I cry myself to sleep from the pain. The number of nights I cannot sleep due to pain has increased from rarely to 3-4 times a week. The interruption of my ability to sleep has made my Sleep Apnea and Idiopathic Hypersomnolence worse.<br/><br/>Over the years, I have participated in several non-prescription means to manage my pain, including physical therapy, meditation, and exercise. While these therapies worked for a time, as the Osteoarthritis progressed, so did my pain. Today I cannot stand straight, and I can barely walk. The progression of Osteoarthritis and the associated pain has limited my life to work and home.<br/><br/>Since the 2016 guidelines took effect, the pain I have endured is not limited to physical pain. Many of my professional colleagues have solely focused on the damage of Opioids when abused and feel that even having them available causes the abuse. Some see my need for pain relief through Opioids as contributing to the abuse of these drugs, even while witnessing my physical decline. In addition, the social stigma of using Opioids to relieve my physical pain is emotionally painful. <br/><br/>I support the proposed 2022 CDC Clinical Practice Guidelines for Prescribing Opioids and urge its adoption. Thank you for hearing the voices of those who suffer from chronic pain. Thank you for looking for a new way to address both the abuse of Opioids and the use of these drugs to provide relief to those who suffer from chronic pain effectively.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Clinton	None	None	0900006484f72a4c	Copus II	None	2022-02-13T22:46:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Copus II, Clinton	kzk-hu5h-4koh	False	None	False	2022-04-12 01:55:14.277	[]
457	CDC-2022-0024-0463	https://api.regulations.gov/v4/comments/CDC-2022-0024-0463	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a CPP for 15 years. I am 47 years old. My days are spent deciding what activities I can do and what I can’t bc I am limited to 3 pain pills a day-that are supposed to last 8 hours. It brings my level of pain from a 9 or 10 to a 7 or 8 for approx 2 hours. I still have 6 hours before I can take another. I haven’t been able to work for the last 10. I still have young children that I cannot enjoy to the fullest bc of the extreme pain! PLEASE-PLEASE allow my dr to treat my pain adequately so I can have SOME quality of life. I’ll sign a waiver releasing drs, pharmacists & pharmaceuticals from responsibility of any harm it may cause. Patients are ending their own lives bc the pain is too much to live with. I beg you to reconsider, allowing us to have more power over our pain. Imagine it being your mother or child in excruciating, agonizing pain every day all day with little to no relief. I don’t sleep, I now have anxiety, have developed diabetes due to high cortisol levels from the pain, and not being able to be as mobile bc it hurts to move, high blood pressure that improves with proper pain management. Let us release anyone and everyone from liability and give us the freedom to choose to live a life that only adequate pain management can provide us. Imagine your quality of life being diminished simply bc a group of people THINK we don’t need it. It’s inhumane. Please, please-help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72a60	Anonymous	None	2022-02-13T22:46:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-i56g-exs9	False	None	False	2022-04-12 01:55:14.518	[]
458	CDC-2022-0024-0464	https://api.regulations.gov/v4/comments/CDC-2022-0024-0464	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since 2002. I was injured on the job and my injury resulted in three major lumbar spine surgeries from 2002-2004. The trauma from these failed surgeries resulted in me being diagnosed with Adhesive Arachnoiditis a extremely painful disease that has no cure and results with many complications. After trying many different treatment options opioid therapy treatments provided the most relief from my around the clock pain. I was prescribed opioids from 2002 thru 2018 at which time in 2018 I was told I would have to be weaned off my pain medications due to CDCguidlines and the subsequent opioid crisis. I was given numerous urine samples during my use of opioids and was always found to be compliant. The stoppage of my pain medication created a tremendous hardship for me and my family whom I had to rely on for more help and support during this time. I am frustrated and disappointed by the CDC guidelines. I was allowed to suffer for nothing I had done but these guidelines scared off pain management doctors from writing the prescriptions that afforded me a better quality of life. I am pleased that the agency is rethinking this obvious over reach. I remain concerned that doctors will still refuse to write these prescriptions. There have been many needless suicides due to this poor decision. Please make the necessary changes to allow chronic pain patients a better quality of life. Thank you for the opportunity to express my opinion on this subject.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f72a68	Chumbley	None	2022-02-13T22:49:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Chumbley, James	kzk-i822-zc50	False	None	False	2022-04-12 01:55:14.732	[]
459	CDC-2022-0024-0465	https://api.regulations.gov/v4/comments/CDC-2022-0024-0465	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From Common Sense! It’s ridiculous that people with legitimate pain issues are being told to take Tylenol or Ibuprofen! These type meds over the counter do nothing for things such as carpal tunnel syndrome, sciatic nerve pain, and much more! I agree with not over prescribing but the quality of daily life is a struggle with legitimate pain issues! It’s also ridiculous to punish all for the actions of a few. People who need pain meds are suffering! It’s also a guarantee not to be elected to any office when one promotes such laws!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Common	None	None	0900006484f72a75	Sense	None	2022-02-13T22:49:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sense, Common	kzk-ibxm-8vbj	False	None	False	2022-04-12 01:55:14.941	[]
460	CDC-2022-0024-0466	https://api.regulations.gov/v4/comments/CDC-2022-0024-0466	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s) I recently successfully defended my doctoral dissertation examining and identifying existing gaps between recommended guidelines for prescribing opioids while also understanding the personal and professional influences impacting the orthopedic provider's decision to prescribe opioids. <br/><br/>This study could lead to the improvement of existing evidence-based prevention strategies or the development of new strategies <br/><br/>These strategies could further close the gaps and decrease the staggering number of Delawareans impacted by opioid abuse, misuse, and overdose. <br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Krista	None	None	0900006484f6e73e	Hitchens	None	2022-02-13T22:50:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Hitchens, Krista	kzi-rgt1-bvhg	False	None	False	2022-04-12 01:55:15.155	[]
461	CDC-2022-0024-0467	https://api.regulations.gov/v4/comments/CDC-2022-0024-0467	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From Common Sense! It’s ridiculous that people with legitimate pain issues are being told to take Tylenol or Ibuprofen! These type meds over the counter do nothing for things such as carpal tunnel syndrome, sciatic nerve pain, and much more! I agree with not over prescribing but the quality of daily life is a struggle with legitimate pain issues! It’s also ridiculous to punish all for the actions of a few. People who need pain meds are suffering! It’s also a guarantee not to be elected to any office when one promotes such laws!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Common	None	None	0900006484f72a77	Sense	None	2022-02-13T22:50:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sense, Common	kzk-ibxs-sq3m	False	None	False	2022-04-12 01:55:15.372	[]
462	CDC-2022-0024-0468	https://api.regulations.gov/v4/comments/CDC-2022-0024-0468	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From Common Sense! It’s ridiculous that people with legitimate pain issues are being told to take Tylenol or Ibuprofen! These type meds over the counter do nothing for things such as carpal tunnel syndrome, sciatic nerve pain, and much more! I agree with not over prescribing but the quality of daily life is a struggle with legitimate pain issues! It’s also ridiculous to punish all for the actions of a few. People who need pain meds are suffering! It’s also a guarantee not to be elected to any office when one promotes such laws!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Common	None	None	0900006484f72a78	Sense	None	2022-02-13T22:50:32Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sense, Common	kzk-ibxu-u8uq	False	None	False	2022-04-12 01:55:15.591	[]
463	CDC-2022-0024-0469	https://api.regulations.gov/v4/comments/CDC-2022-0024-0469	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From Common Sense! It’s ridiculous that people with legitimate pain issues are being told to take Tylenol or Ibuprofen! These type meds over the counter do nothing for things such as carpal tunnel syndrome, sciatic nerve pain, and much more! I agree with not over prescribing but the quality of daily life is a struggle with legitimate pain issues! It’s also ridiculous to punish all for the actions of a few. People who need pain meds are suffering! It’s also a guarantee not to be elected to any office when one promotes such laws!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Common	None	None	0900006484f72a7a	Sense	None	2022-02-13T22:50:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sense, Common	kzk-iby0-5gpf	False	None	False	2022-04-12 01:55:15.801	[]
464	CDC-2022-0024-0470	https://api.regulations.gov/v4/comments/CDC-2022-0024-0470	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	So appreciate the CDC for revising the current guidelines. I didn’t think I would ever see this happen. I have been off pain medication since the guidelines were issued. I think the DEA really went too far in enforcements and terrorized patients and doctors. How many times I thought of suicide. I was on different drugs at different times for approximately 40 years for Chronic pain. I had a life but things changed and my life changed drastically to the worst. This is a long time coming!!! I could send you so many files and as I sit here in terrible pain from a broken crushed spine and not being able to get the proper medicines because of prescribing restrictions, I just bemoan the lost of my life at 72. I just prayed for some hope to live my last years being able to get out and enjoy what is left for me. I think the guidelines were abusive and insanely cruel when medicines could have helped me. It took so long but I thank you and everyone that worked tirelessly to finally see some hope for so many.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484f6efbc	Berry	None	2022-02-13T22:50:55Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Berry, Carol	kzi-ujwg-jtoz	False	None	False	2022-04-12 01:55:16.013	[]
465	CDC-2022-0024-0471	https://api.regulations.gov/v4/comments/CDC-2022-0024-0471	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024:<br/>The rule limiting opiod use for patients with documented pain issues -- particularly chronic -- must be revised. Case in point: My husband has a neuromuscular condition that causes great pain, for which he did have a pain killer. Unfortunately, in the past 8 months, the pain ratcheted up to a level where, having taken the painkiller (Norco), he would try to transition from the bed to the wheelchair - and pass out from the pain. Clearly, something had to be done. While working with doctors to try to find a remedy, I asked for a stronger pain killer. Two solid weeks, countless telephone calls between patient advocate, two doctors (neither of whom disagreed with the need), insurance company and my employers' advocate finally overcame the denial for Nalocet 2.5 mg for what medical documentation called an "urgent" need to try to restore some level of quality of life. Injections were then scheduled to calm the nerves in lower half of the body, and four months later, he has just returned home from spinal surgery to relieve nerves being "squished" in two places in the lower spine -- on the left side ONLY -- and a prescription for Percocet 7.5 mg (which we did not request) without a question by anyone; we learned about it after returning home through a telephone call from our pharmacy. We'll have to return to the surgeon to potentially address the right side, which is causing quite a bit of pain and lack of mobility. Now, four days out from surgery, we fully expect to be able to dial back the Percocet use within a few days. Treating patients with known medical conditions should not be so difficult; if those who write the regulations would be in similar positions for themselves or be the caregiver, perspective would be quite different.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484f6d291	Gilbert-Theriot	None	2022-02-13T22:52:02Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Gilbert-Theriot, Katherine	84f6d291	False	None	False	2022-04-12 01:55:16.236	[]
466	CDC-2022-0024-0472	https://api.regulations.gov/v4/comments/CDC-2022-0024-0472	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I went through 6 surgeries after the 2016 CDC guidelines and almost committed suicide because you even scared them enough to give post OP meds. Stay out of our doctor's appointments!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Zachary	None	None	0900006484f70715	Hamm	None	2022-02-13T22:52:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Hamm, Zachary	kzj-038f-k9qw	False	None	False	2022-04-12 01:55:16.508	[]
467	CDC-2022-0024-0473	https://api.regulations.gov/v4/comments/CDC-2022-0024-0473	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern, <br/><br/>I’m writing in regards to myself and tens of thousands of other patients with chronic illness resulting in intractable pain. <br/><br/>I have been an advocate for myself and others suffering since the CDC came out with guidelines in 2016. <br/><br/>I have learned a lot about these guidelines which mostly scares me. First, I learned the guidelines were written in secrecy with no pain specialists or pain patients on the committee. Secondly, I learned these guidelines where adopted by the Veterans Administration as rules. When this happened it hurt so many of our men and women who put their lives on the line for our country. Patients who were doing well with pain management were either cut off completely or tapered to less than 90 MMEs. Right away we began to see an increase of suicide due to untreated pain.<br/><br/>The CDC’s Prescribing Guidelines clearly communicate a threat to physicians who prescribe opioid pain medications. Those who continue treating their pain patients with appropriate and necessary opioid medications are at risk of legal action and possible loss of their medical licenses. <br/><br/>Physicians are terrified to practice pain management and many simply closed their practices with no warning to the patient. This is very inhumane yet I do not blame these Doctors as they were in jeopardy. The unintended consequence is tens of thousands of chronically ill patients who are literally kicked to the curb. They had no proper tapering and their pain returned with a vengeance causing even more suicides by untreated pain. <br/><br/>So now we have the DEA raiding doctors offices and even showing up at patients homes. I believe this is because it’s much easier for the DEA to find a doctor than a street dealer. But our Doctors are not the problem nor is pprescribed opiates. The real epidemic is the illicit fentanyl/heroin epidemic. The amount of prescribed legitimate opiate pain medication has gone down yet the overdoses are still increasing. <br/><br/>The right thing to do is a re-write of the CDC guidelines. And have the professionals who practice in this field be a part of the process. Get feedback from legitimate pain patient advocates like myself. It is down right barbaric what is happening to the chronically ill with intractable pain. We need to have compassion for these individuals and not take their life giving medication away. <br/><br/>On a proper dosage of opiate pain medication people with intractable pain can work, they can enjoy family time, and have some quality of life. <br/><br/>Since this guidelines suggesting 90 MMEs or less I have self gone from being an active dog trainer to being couch bound. Ive lost quality of life and am severely depressed. There is no one size fits all! And whomever came up with this arbitrary 90 MMEs makes no sense! Each patient is individual and 90 MMEs May work for one individual but not another. I personally function best around 250 MMEs but am being tapered every month. And this is all due to “guidelines” I suppose that’s how the CDC is able to not take responsibility. <br/><br/>Please look at the facts. What is happening in America is an illicit drug problem not a legal prescription problem. It’s so unfortunate as the the media has portrayed this epidemic as if our Drs are drug dealers and that is just not the case. <br/><br/>To be honest I feel like the government is trying to cull the chronically ill. We cost too much money and if the government continues to put extreme pressure on our good doctors they will leave and what will be left is “pain refugees” people who cannot get out of bed and have no quality of life! And then there will be a “Suicide Epidemic” it’s already happening. <br/><br/>In summary I just ask that the government stay out of our doctors offices. The DEA does not have the credentials to practice medicine. And realize every pain patient is individual and enforcing a 90 MME limit makes no sense. <br/><br/>Thank you for reading my statement. I suffer with MS, severe Crohn’s disease, Complex Regional Pain Syndrome also known as the suicide disease. I also deal with all the complications of these diseases. I have tried alternatives such as epidural steroid injections and I ended up with a severe infection in my spine. Im still recovering from a multi level spinal fusion as a result of this alternative treatment. I do very well with the proper dosage of opiate pain medication. I do not abuse my medication and I follow all the rules. <br/>My only crime is I have 3 chronic incurable diseases. <br/><br/>Sincerely, <br/><br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f72aac	Davidson	None	2022-02-13T22:52:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Davidson, Patricia	kzk-j6co-53jw	False	None	False	2022-04-12 01:55:16.737	[]
468	CDC-2022-0024-0474	https://api.regulations.gov/v4/comments/CDC-2022-0024-0474	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am retired. My hips became very arthritic after receiving a steroid for some damaged lungs. My life came to a halt because of the constant pain I found oxycodone to eliminate it I could be very active. Then suddenly they cut me off I went to about 15 doctors they all handled it different but they were all brutal. The remainder of my life could improve if somebody would just use common sense. I've always requested a low dose which to me is 15 mg to 20 mg tablets every 6 hours I know the drug companies had some doctors recommending patches and backup pain reliever and etc but for arthritic hips that was way overkill so even though I used good common sense those that provided me care did not it would be great if you would change the rules it would make my life better I never broke a rule or did anything stupid. Some pharmacists are absolute Nazis and some routinely deny a prescription your doctor wrote you and the pharmacy board here in North Carolina is the headquarters of the Nazis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bedford	None	None	0900006484f70fb1	Teague	None	2022-02-13T22:53:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Teague, Bedford	kzj-6atc-1diq	False	None	False	2022-04-12 01:55:16.952	[]
469	CDC-2022-0024-0475	https://api.regulations.gov/v4/comments/CDC-2022-0024-0475	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is sad druggies use ERs and other establishments to get drugs. It is sadder when professionals start treating everybody as a drug seeker. Sometimes opiods are the only thing to treat the pain. Most people have already gone through all the other innovative ways to hide pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DAVID	None	None	0900006484f72ab2	Parsons	None	2022-02-13T22:53:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Parsons, DAVID	kzk-j7pw-o6zq	False	None	False	2022-04-12 01:55:17.165	[]
470	CDC-2022-0024-0476	https://api.regulations.gov/v4/comments/CDC-2022-0024-0476	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please start treating people more humanely. It sucks to suffer from chronic pain and no one is willing to help you.. they are scared to do so	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72ad9	Anonymous	None	2022-02-13T22:54:16Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-jte4-4svv	False	None	False	2022-04-12 01:55:17.382	[]
471	CDC-2022-0024-0477	https://api.regulations.gov/v4/comments/CDC-2022-0024-0477	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had lumbar radiculopathy pain down my leg for over 30 years. Slow release morphine and later fentanyl patches greatly helped reduce the pain. Then, suddenly one day, the doctors where I was receiving the medications for approximately 10 years refused to renew the opioid prescriptions based on the new CDC guidelines. I had almost no problems fazing the medication out, probably because I was not psychologically addicted. Suddenly there was no way to relieve the pain and no alternatives.<br/><br/>I am extremely angry with the "throw the baby out with the bath water" philosophy of the CDC back then. Yes, many people were abusing the opioids. However, many, many more did not.<br/><br/>I appreciate the new CDC proposals. I believe it to be rational and fair. Please, please pass the new proposed clinical practice guideline.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484f725aa	Levine	None	2022-02-13T22:55:49Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Levine, Steve	kzk-aumi-us9a	False	None	False	2022-04-12 01:55:17.594	[]
472	CDC-2022-0024-0478	https://api.regulations.gov/v4/comments/CDC-2022-0024-0478	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain doesn't care what your regulations are; it will continue impacting lives regardless. In intractable cases where opioids are the most effective, or only effective treatment, the 2016 guidelines essentially told sufferers that their only options were heroin or a bullet. Neither of those options are good, and it leads very obviously to the statistics we are now seeing.<br/><br/>The new guidelines are better and should be adopted, even if I would prefer even more authority to be given to the actual doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f71c5c	Anonymous	None	2022-02-13T22:56:10Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-cjvn-akf5	False	None	False	2022-04-12 01:55:17.802	[]
473	CDC-2022-0024-0479	https://api.regulations.gov/v4/comments/CDC-2022-0024-0479	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have dealt with chronic pain for 25 years. In the past few years, I have had 4 major neck and back surgeries which didn’t help. In that time, I have had very little medication that helped even a little bit. I have been tested, and my body metabolizes the opioids faster, and I need higher doses….none of which has happened…. Despite the written results. I live in Delaware, and most pain docs don’t want to prescribe any opioids….. just a bunch of non-addictive drugs that haven’t worked, and supplements that don’t touch my pain. I have had every injection, procedure, and therapy that’s available…. With very limited or zero affect on my pain. At my lowest point, I even thought about ending my life (as have many others who went through with it, and are no longer with us. I never want to feel that way again. With the right drugs, at the right doses, I may actually be Abe to work, again (I have been on disability for 3+years). It’s about time guidelines are changing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484f71cac	Martin	None	2022-02-13T22:56:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Laura	kzk-da62-i1cq	False	None	False	2022-04-12 01:55:18.019	[]
474	CDC-2022-0024-0480	https://api.regulations.gov/v4/comments/CDC-2022-0024-0480	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From Common Sense! It’s ridiculous that people with legitimate pain issues are being told to take Tylenol or Ibuprofen! These type meds over the counter do nothing for things such as carpal tunnel syndrome, sciatic nerve pain, and much more! I agree with not over prescribing but the quality of daily life is a struggle with legitimate pain issues! It’s also ridiculous to punish all for the actions of a few. People who need pain meds are suffering! It’s also a guarantee not to be elected to any office when one promotes such laws!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Common	None	None	0900006484f72a76	Sense	None	2022-02-13T23:00:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sense, Common	kzk-ibxp-iqfa	False	None	False	2022-04-12 01:55:18.225	[]
475	CDC-2022-0024-0481	https://api.regulations.gov/v4/comments/CDC-2022-0024-0481	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From Common Sense! It’s ridiculous that people with legitimate pain issues are being told to take Tylenol or Ibuprofen! These type meds over the counter do nothing for things such as carpal tunnel syndrome, sciatic nerve pain, and much more! I agree with not over prescribing but the quality of daily life is a struggle with legitimate pain issues! It’s also ridiculous to punish all for the actions of a few. People who need pain meds are suffering! It’s also a guarantee not to be elected to any office when one promotes such laws!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Common	None	None	0900006484f72a79	Sense	None	2022-02-13T23:01:02Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sense, Common	kzk-ibxz-tvav	False	None	False	2022-04-12 01:55:18.449	[]
476	CDC-2022-0024-0482	https://api.regulations.gov/v4/comments/CDC-2022-0024-0482	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please don’t limit our ability to continue to live our lives! We do not abuse the medicine that helps. We have tried the shot, we have had the surgery, you name it we have done it. We get treated worse then dogs in puppy mills. The problem is not the people you are punishing it’s the people selling an making fentanyl. Please stop punishing cpp. When you take our only source of going to work everyday an living a half way normal life then what are people supposed to do! And please don’t limit us on mme that’s not fair! Correct use doesn’t equal abuse	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dixie	None	None	0900006484f72adb	Allman	None	2022-02-13T23:02:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Allman, Dixie	kzk-jtlf-ja3r	False	None	False	2022-04-12 01:55:18.661	[]
477	CDC-2022-0024-0483	https://api.regulations.gov/v4/comments/CDC-2022-0024-0483	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's past time we went back to the physician/patient relationship. The interference of the CDC, FDA and other beaurocratic organizations have caused harm. All we chronic patients wanted was some semblance of a normal life. We deal with chronic pain from the time we wake up to the time we go to sleep. We cannot attend family functions, our grandchildren's sports activities or any social gatherings because our pain is uncontrolled since we have been cut back to a one size fits all regime. We are barely able to go to the grocery store and keep our doctors appointments. Walk in my shoes for one day and you will see. We are not the cause of any epidemic. We only want to live our life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484f7264e	Gilbreath	None	2022-02-13T23:04:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Gilbreath, Cheryl	kzk-k7sm-5d5n	False	None	False	2022-04-12 01:55:18.881	[]
478	CDC-2022-0024-0484	https://api.regulations.gov/v4/comments/CDC-2022-0024-0484	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Pain management is one of our society’s ethical obligations, hence we dictate that physicians provide anesthesia prior to surgery. Unfortunately, our Federal Government for reasons not related to medical science, has prohibited the use of analgesics that are used safely in other jurisdictions, including many States in the Union.<br/>Rather than focus on currently sanctioned potentially lethal opiods, I suggest that the Federal Government cast aside decades of political and cultural arrogance and prejudice to allow professional examination of alternate pain management compounds/techniques that have little or no lethal potential and have served humanity for thousands of years.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dr.	None	None	0900006484f7393a	Livingston	None	2022-02-13T23:04:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Livingston, Dr.	kzl-h3mx-5hu2	False	None	False	2022-04-12 01:55:19.109	[]
479	CDC-2022-0024-0485	https://api.regulations.gov/v4/comments/CDC-2022-0024-0485	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No MME restrictions!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7265f	Anonymous	None	2022-02-13T23:05:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-kfix-83gq	False	None	False	2022-04-12 01:55:19.318	[]
480	CDC-2022-0024-0486	https://api.regulations.gov/v4/comments/CDC-2022-0024-0486	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a healthcare worker, I would like to tell you that most providers that I know try to avoid opioid use if possible. They also try these recommendations already. You are making it hard for providers and staff to treat a patient who is needing help. As a patient you should not have the right to tell my physician what she or he can give me for acute or chronic pain. I know that there are patients that are on chronic pain medications and they may not need to be. But, these patients are going to get pain medication one way or another. But you putting restrictions on the providers in order to help control the problem is not causing nothing but more of a problem. You need to come up with a better solution.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484f7347b	Bellomy	None	2022-02-13T23:05:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Bellomy, Katherine	kzl-gegs-sdn8	False	None	False	2022-04-12 01:55:19.524	[]
481	CDC-2022-0024-0487	https://api.regulations.gov/v4/comments/CDC-2022-0024-0487	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lumbar spine And thoracic chronic pain issues that I’ve had for 15+ years. From 2012-2016 I found a treatment plan that addressed my needs, made me feel human, and though I still had some pain I was able to function, able to work, I was myself. Since then due to the CDC prescribing guidelines my dr cut me down to bare bones treatment and I have suffered due to it. I am looked at like a criminal questioned like a criminal at both the Dr’s office and pharmacy for purely trying to live a pain tolerable life. It’ll never be pain free, but with the help of a great doctor free to practice nude to his experience vs gov oversight, it can vastly improve. Even after surgeries I’ve had my pain under treated due to the Physicians fear of regulations and prescribing only 3 days of medication for major surgeries! We need to change this, drug test everyone, and have a reasonable system and I think that is in reach. Please let Dr’s do their jobs and regulate when needed but unless a dr is a bad player in the system<br/> And doing bad things or and using patients or selling drugs, please let them do what they do best. Thank for you taking the time to read. I think it’s huge of you to have a forum to accept such comments even if they aren’t all positive like you’d want to hear. Relax the guidelines, and let us be treated on an individual basis please! We are INDIVIDUALS with varying degrees of pain and don’t fit under a specific guideline created by a non medical pain specialist. Thank you for the respect!<br/><br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Scott	None	None	0900006484f72677	Schulze	None	2022-02-13T23:05:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Schulze, Scott	kzk-kqi3-56li	False	None	False	2022-04-12 01:55:19.733	[]
482	CDC-2022-0024-0488	https://api.regulations.gov/v4/comments/CDC-2022-0024-0488	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wholeheartedly feel that this is a step in the right direction. While the damage done by the prescribing practices of the previous 3 decades is indeed egregious and self-evident, the subsequent overcorrection by the medical community served more to generate fear and mistrust around Opioid medications, and restrict access to this class of medications well beyond what was appropriate for diversion prevention. <br/><br/>In 2017 I was diagnosed with bi-lateral Avascular Necrosis of the Hips, with my left hip having completely collapsed, and the femoral head rotted away to bone-on-bone. <br/><br/>I am a Buprenorphine maintained patient, 12 mg every day. Buprenorphine is an interesting medicine, and it creates a blockade effect, rendering the possibility of obtaining any sensation of 'Opioid' entirely pointless, but this presented an issue when pain-management became an increasingly larger factor. <br/><br/>Surgery was set to December 26th, and it was decided between myself, my surgeon, and my Opioid Assist Therapy (OAT) physician to transition me from Buprenoprhine to a full agonist so that as the Buprenorphine levels in my system went down, there was a greater opportunity for competing Mu-agonists to bind to the receptors and thus theoretically grant some of their analgesic benefits. Again, this was a decision reached and understood by all 3 parties.<br/><br/>What followed that December prior to surgery was one of the most excruciating and unpleasant experiences of my life. It was primarily one week of extreme Opioid withdrawal hell, followed by 3 weeks of better-but-still-insufficient withdrawal. The reason this month prior to surgery was so horrible, even with the ostensible agreement between my two doctors, was due to the abject reluctance and reservations my surgeon had with prescribing me Opioids sufficient to manage a formerly buprenorphine-maintained patient with additional severe acute pain. <br/><br/>The first prescription the surgeon's office handed me to replace Buprenoprhine 12mg/day and offer analgesia was Tramadol 50mg, 1-2 every 6-8 hours. I told the doctor's office immediately that this was unequivocally woefully inadequate to stave off even the most basic Buprenorphine withdrawal symptoms, to which I was told to just take it, and call them after things got uncomfortable. <br/><br/>After I finally got a hold of the surgeon's office that following Monday (started Tramadol Thursday, full blown withdrawal by Friday evening), he prescribed a new medication, Oxycodone thankfully. This medication change was helpful, but the script was for 5mg/8 hours, so while it was markedly better than the Tramadol days, I still spent most of my days in pronounced discomfort, and frequently had a great deal of trouble refilling my prescription on the earlier side of the date-range the refill was assigned. <br/><br/>Throughout the lead up to my surgery, the use of Opioid medications was kept to an extreme minimum at the detriment of my well being throughout the time, despite the explicit action-plan agreed upon previously by all prescribing parties. I ended up ordering and using Kratom and my remaining Tramadol to do my best to manage primarily the withdrawal, I was never able to obtain any appreciable pain-relief prior to the surgery itself. <br/><br/>While in the hospital, my pain levels were handled much more appropriately, and I had my first night of real sleep in a while much to my disbelief. Upon going home, I was sent home with a 10mg/8 hour Oxycodone script which did a much better job of both keeping withdrawal symptoms at rest, and actually managing some of the post-op breakthrough pain. I resumed Buprenorphine a week or so after the surgery, and put the whole saga behind me. <br/><br/>Until that spring. I dislocated my hip replacement twice, first in May and last in July. In both instances, the ER never offered or attempted any kind of pain management once the Buprenorphine-maintenance was established. The first time I dislocated my hip it wasn't as much of an issue as they were able to put me to sleep with Propofol and correct the hip while I was unconscious. The second time was horrendous, however, as all of the doctors on site attempted and failed to re-set my hip, and an orthopedic surgeon from the area had to be called in late that night to perform the join re-set. I spent about 12 hours laid-up in that hospital in excruciating pain. The hospital staff even resorted to putting me completely under with Ketamine rather than use any pain medication.<br/><br/>I like to think an easing of prescribing restrictions and expectations would have had an impact on these experiences, but of course it's impossible to say for sure. I understand that an individual like me is a special liability when talking about these Opioid medications and their responsible use, but I've had some genuinely difficult painful experiences in the last 5 years, and I sincerely believe more access to Opioids (rolling back some restrictions) would have a significant impact for the better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f733fc	Anonymous	None	2022-02-13T23:06:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-fwvq-oetw	False	None	False	2022-04-12 01:55:19.951	[]
483	CDC-2022-0024-0489	https://api.regulations.gov/v4/comments/CDC-2022-0024-0489	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired Fire Captain SFFD who sustained a crushing injury to my spine in 1988 during a building collapse. I had fusions from C-2 to C-7 and six lumbar fractures as well as a broken pelvis. <br/>I tried NSAIDS for 3 years until I developed 4th Stage renal failure. I can never use NSAIDS again.<br/>After losing my pain doctor due to the 2016 “one size fits all regs” I was rapidly detoxed off my methadone pain med which nearly killed me. <br/>I have since found a pain specialist who has increased my methadone to 40 mg per day which is a bit low for the pain I experience.<br/>I weigh 220 lbs and require a higher dose of methadone for my pain level.<br/>I’m pleased that the CDC reevaluated their previous miscalculation. <br/>The modification of ceiling limits is a splendid idea. It’s a step in the return to sanity. <br/>Opioids were a last resort for myself. I am now 70 years old and have been praying for a reevaluation of the former policies.<br/>I am hoping that my doctor will be given a bit more leeway in prescribing methadone from 40 mg/day to possibly 50-60mg (a moderate dose) in the future. I have no other options as I already take Neurontin and prednisone to augment the narcotic.<br/>I am also given 1 mg of Clonazapam for muscle spasm due to truncated Dystonia which I developed. I am forced to see a psychiatrist for this medicine. <br/>Please allow pain doctors to prescribe this med. <br/>thanks for the opportunity to express my opinion.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484f73826	Spanne	None	2022-02-13T23:07:45Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Spanne, Tom	kzl-fglx-bwov	False	None	False	2022-04-12 01:55:20.187	[]
484	CDC-2022-0024-0490	https://api.regulations.gov/v4/comments/CDC-2022-0024-0490	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain from military service injuries and am a 100% disabled veteran. It is my firm belief that the government has made it extremely difficult for people in chronic pain to receive opiods from doctors and pharmacist leading people in real need of help without crucial relief. Often these people then turn to street drugs, seeking relief but leading to death due to the influx of fentanyl and other dangerous drugs like heroin. People, like myself, have suffered greatly while criminals and cartels have thrived. If a patient has a legitimate chronic pain issue, and have tried other medications and procedures that have been unsuccessful, it should not be as hard as it already is to obtain relief. I employee you to consider the scrutiny and difficulties already in place that prevent legitimate attainment of drugs containing opiods and not make it harder on those suffering or cause them to turn to alternative illegal and life threatening means.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kyle	None	None	0900006484f726a4	Kichner	None	2022-02-13T23:12:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Kichner, Kyle	kzk-lcg2-4rs0	False	None	False	2022-04-12 01:55:20.406	[]
485	CDC-2022-0024-0491	https://api.regulations.gov/v4/comments/CDC-2022-0024-0491	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Not everyone deals with pain the same. Some women go through childbirth with no medication while other women need help as soon as the first contraction hits. It doesn't mean one is stronger then the other. It proves that no two people deal with pain the same. Which brings me to these revised guidelines on prescribing. How can you throw all these different people with all these various diagnoses into the same pot and expect the pain medications that are being offered "one size fits all"? Are you really doctors or scientists, because my child could tell you that your data does not correspond to what your guidlines purpose. Some people do not process the same dose of opioid equally. The original 2016 guidelines were pushed into law regardless of what the intention was. Now to fix said guidelines, you need to take out MMEs completely as they only caused harm to patients. Drug Overdoses have not gone down. Suicides due to uncontrolled pain increased. The guidelines did not help at all. They need to be thrown to the ineffective garbage where they belong. Let the doctors treat their patients. Let the patients get the medical care they need and deserve before these barbaric guidelines kill one more innocent victim. Enough is enough!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74188	Anonymous	None	2022-02-13T23:17:28Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-osgn-sgvh	False	None	False	2022-04-12 01:55:20.652	[]
486	CDC-2022-0024-0492	https://api.regulations.gov/v4/comments/CDC-2022-0024-0492	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Blanket limits on dispensing opioids would not work for me and many other times.<br/>I have fibromyalgia and recently had a total knee replacement. Because I am on a blood thinner for atrial fibrillation, I am unable to take over the counter NSAIDS. I am in constant pain, but some says are worse than others. I take Tylenol rapid release on days I am able to move slowly around, but on days that many body parts are painful<br/>I take Norco. My insurance company (Blue Cross of Massachusetts) will not approve Norco, so I have to pay for it myself. I am very careful not to take opioids too frequently and not to take Tylenol too frequently but there is nothing else I can take<br/>because of the blood thinner. Please don’t punish me by only filling a few opioids at a time as it greatly affects my ability to function.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484f7417f	Mantos	None	2022-02-13T23:17:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Mantos, Judith	kzl-oqtm-34zh	False	None	False	2022-04-12 01:55:20.858	[]
487	CDC-2022-0024-0493	https://api.regulations.gov/v4/comments/CDC-2022-0024-0493	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It should be apparent to all oversight committees that obtaining pain medicine through our physicians has become so difficult that desperation has created a much more dangerous market that has seen the importation and adulteration of many substances with fentanyl resulting in unacceptable deaths throughout the entire country. The resulting problems must far exceed the concerns of worrying about misuse of opioids by the general public. Pain is every bit as real a consideration as the potential misuse of those medications by individuals who have a moraless compass. I would prefer that we as individuals take responsibilty for our own wellfare Thank you for considering my comments. As a patient who suffers from advance arthritis I know what it's like to be in misery nearly every day. My prayers go out to anybody who has to suffer due to the outdated and ridiculous belief that we would cause many to suffer for the actions of others.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ray	None	None	0900006484f7413d	Weekley	None	2022-02-13T23:18:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Weekley, Ray	kzl-odi4-0clx	False	None	False	2022-04-12 01:55:21.083	[]
488	CDC-2022-0024-0494	https://api.regulations.gov/v4/comments/CDC-2022-0024-0494	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The MME should exclude chronic pain patients. The use of the milligram morphine equivalence is scientifically flawed because it fails to take into account even the most basic tenets of pharmacology, rendering it scientifically meaningless. These guidelines are rendering disabled people with chronic pain hopeless! Suicides are increasing. People are suffering unspeakable amounts. Lives are being ruined. Please dont tie the hands of doctors and allow them to properly treat their suffering patients. Not doing so is showing complete disregard for human suffering. Please do the right thing!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f73eb3	Phillips	None	2022-02-13T23:18:28Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Phillips, Lisa	kzl-nxzl-tcus	False	None	False	2022-04-12 01:55:21.300	[]
489	CDC-2022-0024-0495	https://api.regulations.gov/v4/comments/CDC-2022-0024-0495	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a step in the right direction to correct an overly restrictive guideline. As an employed physician, rules can be misapplied by non-clinical "supervisors", managers, and administrators who implement protocols based on national guidelines. <br/><br/>I'm a practicing family physician who's responsibly prescribed opioids for ~20 years, I've been surprised to hear colleagues who refuse to prescribe the necessary medications; leaving patients without treatment and in severe pain. More recently, they may be reluctant to prescribe because of increased oversite, worry about the irresponsible patient, the increased work needed to prescribe the med, or others. This perpetuates physician burnout because the provider must cover his/her own prescription refills while on "vacation". Further, if the patient doesn't get the necessary medication, it can worsen the census in immediate care centers because a refill wasn't approved at the primary site and the patient has to go to the urgent care or ED for refills. <br/><br/>Untangling the massive administrative burden on offices, staff, and prescribers is a huge task, but a necessary one. <br/><br/>Patients should not be forced to complete opioid contracts if they've been on the same (low dose) medication for years, especially older patients; it's demeaning.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73e85	Anonymous	None	2022-02-13T23:19:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-nltl-ovs8	False	None	False	2022-04-12 01:55:21.515	[]
490	CDC-2022-0024-0496	https://api.regulations.gov/v4/comments/CDC-2022-0024-0496	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At the very least, this change will hopefully be a minute step in the right direction toward allowing doctors to attend to the individualized pain medication needs of each and every patient. I’ve developed chronic nerve pain from neurological Lyme disease that somehow damaged my central nervous system. Because the pain became so severe over the last decade, and at first no doctor would treat the pain with adequate measures, I went into hospice to die. Once on a small bit of morphine, gabapentin and a tiny Valium dosage per day, I was able to sit up in bed and work on artwork at a side table (I’m an artist). Before getting sick by a spider bite, I was a fully active woman who worked out at the gym, did yoga, did philanthropic ventures along with my husband, traveled, enjoyed being a mother to grown sons, and loved a wonderfully full life. I’ve been reduced to a mostly homebound and bedridden person. Currently, I am trying ketamine infusions and stem cell therapy for pain. The daily morphine allows me to stay alive even in my bedridden state. I believe it should be my choice whether I decide this life isn’t worth living anymore, not up to the government. Hospice helped me find a doctor who does some palliative type care and took me on as a patient. My doctor, who knew me most of my adult life would not treat me. He is a good doctor and yet refused to help other than writing me a letter to be admitted to hospice. He wouldn’t treat my pain due to fear. I have never used street drugs and never abused any medications of any kind. Because of the chronic pain I am in, I have read and researched pain articles online and know that many pain patients are humiliated by doctors, are refused help and often commit suicide. Everyone who has been so fortunate to live a daily pain free life has no right to judge pain patients and write laws that make it so difficult for doctors to help people in need of pain relief. The idea that various modalities such as yoga and massage work for severe chronic pain is laughable. No one wants to be on pain killers for pain. I sure don’t, but the alternative for many chronic pain patients is death. Blood is on the hands of policymakers. Let’s keep moving in the right direction so doctors and hospitals can use opioids again without fear, when people need them to go about living. Help people who are bedridden due to pain. Help hospices treat the dying with dignity. Mostly, listen to pain patients and hear what their needs are and understand how they have been humiliated and tortured by unjust regulations. Listen to the people who have been hurt because you may have it happen to yourself or a beloved one, one day in the future. Life is unpredictable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73e74	Anonymous	None	2022-02-13T23:19:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-nhq6-ydzo	False	None	False	2022-04-12 01:55:21.728	[]
491	CDC-2022-0024-0497	https://api.regulations.gov/v4/comments/CDC-2022-0024-0497	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	MY BIG STORY: Practically speaking, the 2016 CDC opioid guidelines has resulted in my having greater financial and physical burden in getting sufficient pain control. I have chronic and acute daily intractable pain caused by a degenerative genetic connective tissue disorder. Well into my 60’s prior to 2016 I was able to get a 3-month supply of pain medicine (exemption) in a NYS pain management clinic. This allowed me to continue to work at a managerial level. With the imposition of CDC guidelines, coincident with pain programs being hounded by DEA, I was no longer allowed this exemption. I now needed to make monthly appointments (vs. every three months) and I now needed to pay for monthly prescriptions (which tripled my co-payment cost) of pain medicine. <br/><br/> It was a time when the daily media reports of the evils of opioids had the effect of making me feel like an outlaw. As we all now know, the CDC “guidelines” intended for PCPs were instead taken as hard and fast limits of opioids even in pain management programs and by medical insurers alike. No wonder I took it upon myself to start a very slow taper off opioids in the hopes that other medications and non-medication treatments would provide adequate coverage. While I spent years in tapering, nonetheless I nearly died from my several-week period off all pain medicine in 2018. Unwisely, I believed that the opioids might be making me overly sensitive to pain. At least that’s what the “experts” with the megaphones were proclaiming and still do. Maybe I’d be in less pain without opioids? I only found out later from groups of people with firsthand experience that such sensitization is actually rare. <br/><br/>Worst of all, when I was eventually opioid-free I experienced only increased and life-altering pain. By the second month of being opioid-free the pain had reached such wild proportions that my body went into major atrial fibrillation. I was rushed to the NYU Medical Emergency Room (Nov 2018). Noting the degree of pain I was in, the ER docs correctly diagnosed the cardiac dysregulation to the severity of my untreated pain. These competent ER docs were able to think past opioid hysteria and took it upon themselves to try to reverse the cardiac crisis with only an IV morphine drip. And it worked! <br/><br/>How many of you realize that UNMANAGED SEVERE PAIN ITSELF CAN LEAD TO CARDIAC DAMAGE? No matter how many politicians and even doctors might say otherwise, there are some of us pain patients who are unfortunately submitted to MALPRACTICE ON A DAILY BASIS WHEN PAIN MEDICINES ARE WITHHELD.<br/><br/>My suggestions:<br/>1.<span style='padding-left: 30px'></span>Nothing less than a RETRACTION of the 2016 CDC Guidelines is adequate. It must be CLEAR TO THE PUBLIC THAT GREAT HARM WAS DONE TO PAIN PATIENTS in the process of addressing the opioid epidemic among substance-abusers.<br/>2.<span style='padding-left: 30px'></span>Notification should be made how INADEQUATELY TREATED PAIN CAN CAUSE GREAT DAMAGE TO CARDIAC SYSTEMS AND JEOPARDIZE LIFE.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f73e6c	Egelko	None	2022-02-13T23:21:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Egelko, Susan	kzl-nftd-atj4	False	None	False	2022-04-12 01:55:21.946	[]
492	CDC-2022-0024-0498	https://api.regulations.gov/v4/comments/CDC-2022-0024-0498	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This has been nothing short of inhumane. I am 61 years old and I’ve had four spinal surgeries. I am a legacy pain patient. Last year I was forced to taper my breakthrough pain meds due to the guidelines. It was a nightmare to say the least. My blood pressure skyrocketed and my pain increased. I refuse to have anymore surgeries. My meds allowed me to have some quality of life. Due to the decrease I spend most days in bed unable to even preform daily tasks. The CDC should have done more research before putting out the guidelines in 2016. It’s caused many folks a lot of pain and unnecessary misery. I pray the new guidelines delete the 90 MME once and for all. Let Drs make that judgment to each individual. Chronic pain patients have suffered tremendously from these guidelines needlessly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73e50	Anonymous	None	2022-02-13T23:21:41Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-na59-vmcd	False	None	False	2022-04-12 01:55:22.162	[]
493	CDC-2022-0024-0499	https://api.regulations.gov/v4/comments/CDC-2022-0024-0499	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The government is hurting pain patients. Doctors should have the free decision on treating patients. You are making people suffer because of a few bad apples. Please don't shackle physicians. Don't make us suffer. We are treated like criminals at hospitals now because of you all because we have legitimate pain. It should be between the patient and doctor. Do not punish good doctors who truly care about their patients. You are treating them like criminals. It's our right to be free of pain who is the government to punish that right? When I had breast cancer surgery I got one week of pain meds I needed more and it was degrading having to beg for it. I never got it so I suffered for 3 weeks in pain. I am traumatized and don't trust doctors anymore. It's because of your rules. It's unacceptable. Please.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gina	None	None	0900006484f73e34	Stancil	None	2022-02-13T23:22:23Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Stancil, Gina	kzl-n3w3-06jg	False	None	False	2022-04-12 01:55:22.373	[]
494	CDC-2022-0024-0500	https://api.regulations.gov/v4/comments/CDC-2022-0024-0500	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For years i have said i wish i could testIfy before congress about guidelines for prescribing pain management medication. If i had only a few words to describe what the current guidelines are going for me i would say. I FEEL LIKE I AM BEING PUNISHED FOR SURVIVING. I dont know that it matters how i ended up like this but a motorcycle wreck killed me but i was revived and ended up having 25 reconstructive surgeries. I understand i am unique. So i guess i should list my i juries that resulted from the wreck that happened in 1983. I hit the back of a flat bed wrecker at 50 miles a hour. I broke my left leg, i blew out both my knees, i fractured my hip all my ribs on the right side my sternum color bone. I broke my right shoulder blade into 3 pieces and ripped my fight arm off at the shoulder and ejected my deltoid muscle leaving my arm attached omny by a 2 inch wide strip of skin and unbelievable the nerve cord. I also cut all the muscles, tendons and both the bones in my left wrist. I also damaged all the disc in my back and ripped off my scalp and fractured my scul. And Jammed the handle bar threw my lower stomach into my bowels. I DONT KNOW HOW I SURVIVED BEING ROAD KILL. 25 surgeries later including reTtachimg my righ arm st the shoulder i went home. AND NO MATTER WHAT THE DOCTORS SAID I REFUSED TO ACCEPT THAT I WAS DISABLED.<br/>7 months later i went back to work. I was raised in a family off hard working men. Working hard and providing for yourself and your family is what a man does and that us what i was determined to do.<br/>I have done mechanic work 6 days a week fof 40 years WITH THE HELP OF MY PAIM MANAGEMENT DOCTORS. I am 61 and i still get up on my feet everyday and go to work. Up untill 10 years ago doctors wanted to use medication to help me BE A MAN. But over the past 10 years my medication has been cut back 4 times. As mh condition has gotten worse and worse the medication my doctor can perscripe has gotten less and less.<br/>My heart doctor says the racing heart events and chest pains are being caused by my body reacting to my pain level and randomly dumping adrenalin into my system and that if my medication is not increased i will eventually have a heart attach. But my pain management doctor says he is already prescribing me as much as he can under the current guidelines.<br/>And so because people where prescribed medication who had no real need of it and people did things with that medication that they should have never done people like myself who took there medication as directed and followed all the rules including drug screens and medication counts and used the medication so that we could live something close to a normal life are now under the current guidelines ARE BEING PUNISHED FOR SURVIVING.<br/>We did not create the guidelines that caused the opioid crisis to occur but in the end it us who are being punished for the actions of others. The guidelines from 15 years ago where ridiculously loose but we did not create those guidelines. The current guidelines are ridiculously to tight but we the survivers didnt create these guidelines either. If you are like me a extreme trama surviver or you have cancer or a terminal illness under the current guidelines YOU WILL BE PUNISHED FOR SURVIVING. Doctors need to be given the ability to prescribe to there individual patients condition and pain level. How much worse can it get ? There are actually people taking there own life because there doctor can not prescribe enough medication to control there pain.<br/>And here is where i tell a fact that most people dont know about but YOU DO. Hospital associations across america have given billions upon billions of dollars to lobbyist who used the money to try and outlaw pain management inorder to force people onto the operating table. Surgery is BIG BUSINESS. The problem is that they want society to believe they can cure any problem with surgery BUT THEY CANT and those like myself are cast Side and treated as a inconvenience. We cant make any money off of operating on you so you can please leave and go home and suffer untill death. Everyone talks about how the paramedical companies paid billions to lobbyist to make the over prescribing of pain meds a reality but no one talks about the hospital associations paying billions to try to outlaw pain meds completely. ONE IS JUST AS BAD AS THE OTHER. i can only HOPE for a better future. In my life opioid medication is the greatest gift God ever gave me..without it i could have never done all that i have in my life and if you take anymore of it from me and others living with Inoperable chronic pain <br/>I DOMT KNOW HOW WE WILL SURVIVE<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f73e22	Hash	None	2022-02-13T23:23:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hash, Jeff	kzl-n14f-ylin	False	None	False	2022-04-12 01:55:22.583	[]
495	CDC-2022-0024-0501	https://api.regulations.gov/v4/comments/CDC-2022-0024-0501	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 55 year old chronic pain patient. I have been physically disabled for over 10 years but I have been ill and in pain most of my life. I had severe endometriosis early in life. I was born with asthma and contracted tuberculosis at 9 months old. I was severly pidgeon toed and had wandering eyes. I was given tetricycline antibiotic as a baby and have green stained teeth from this. I have had many surgeries including appendectomy, 2 C-sections, hysterectomy, removal of a rare fallopian tumor. I also had poly cystic ovary disease. When I went into labor with my 1st child I had 36 hours of hard labor and my cervix would not open. They called it cranio-pelvic disproportion. My sons head was too big to come through the birth canal and we were both dieing. I started developing back and hip problems after having children. I have serious degenerative disc disease and degenerative joint disease, scoliosis, spondylithesis and I went to physical therapy and a chiropractor for 13 years. I ended up having to have a hysterectomy because of the endometriosis. Then I had a fallopian tumor and was sent to The Siteman Cancer Center in St.Louis. Previous to this I had dealt with cervical cancer twice. The fallopian tumor was benign. About 2 years after the hysterectomy I developed fibromyalgia. I started aching all over like I had the flu. I also started falling asleep while I was driving and talking to people. I was seeing a neurologist and a rheumatologist to try and find out what was wrong with me. I was also going to a multi-disiplinary sleep laboratory at Washington University in St. Louis to find out why I was falling asleep like that. The rheumatologist diagnosed me with fibromyalgia and this is what finally disabled me. I have since found out i have immflamatory arthritis and osteoartritis. I am on many medications, several for pain. I need you to be aware that opiates are just a fraction of what I take daily for pain alone but they do help me so much. I take Ibuprophen 800 2 per day, gabapentin 300 mgs. 1 per evening, lidocaine gel as needed (i use this every day), hydroxychloroquine (this drug has helped me alot too), I have literally taken every NSAID that they have pulled off the market. I was on melloxicam but developed 6 ulcers from this. Before the 2016 Guideline my pain meds were very helpful and I had a way better quality of life. I was prescribed 12.5 mcg fentanyl patch every 3 days and 3 oxycodone 10 mgs per day. The patch was very helpful to me because I was in 24-7 pain, it never ends, ever. I had a very good pain doctor. However now I am only given 4- 5 mg oxycontin per day and this is no where close to what my body needs. I am so undermedicated now that it is very hard to function. I know there are others who are much sicker than I am and I pray for them. I have many other conditions but they aren't pain conditions such as diabetes, high blood pressure, corneal degeneration to name a few. Unfortunately all of us are not born with the best of health and need pain medicine and pain management doctors to survive. Thanks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f726b0	Anonymous	None	2022-02-13T23:24:49Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-lir7-l7vj	False	None	False	2022-04-12 01:55:22.803	[]
496	CDC-2022-0024-0502	https://api.regulations.gov/v4/comments/CDC-2022-0024-0502	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi, I feel like doctors are now afraid to prescribe the lowest dose of opioids even after a procedure or surgery. It’s very scary. I personally was in pain for weeks and got no help. And the doctor always cited that she could only prescribe so many patients opioids because of the new guidelines. And I wanted to kill myself rather than be in that pain. I also personally have had two friends turn to the streets and bought a fake roxicodone 30 and they ended up overdosing and dying. One over tooth pain and one because her doctor cut her off. Please the war on drugs should be for street drugs! Leave our doctors alone!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f726a3	Anonymous	None	2022-02-13T23:25:06Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-lce1-ik0p	False	None	False	2022-04-12 01:55:23.022	[]
497	CDC-2022-0024-0503	https://api.regulations.gov/v4/comments/CDC-2022-0024-0503	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove your heads from where you sit and seriously take a look at the problems you have caused in the chronic pain community please treat us like humans and take care of our pain I am tired of suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72ad4	Anonymous	None	2022-02-13T23:25:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-jqym-oql1	False	None	False	2022-04-12 01:55:23.231	[]
498	CDC-2022-0024-0504	https://api.regulations.gov/v4/comments/CDC-2022-0024-0504	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I took opioid pain medication for 31 years as directed with no addiction issues. After the 2016 guidelines came out and my doctor became afraid of being arrested for prescribing, because it had happened to so many other doctors. He didn’t want to, but started tapering me against my wishes. The he just cut me off completely. I have had scoliosis and have had 10 spinal surgeries. I have degenerative disk disease, arthritis and sciatic nerve pain. I was in agony and became bedridden. Although I was always in pain before, at least the pain medication gave me some quality of life. I was forced to have a pain pump implanted because that was the only way to help me because of even if I could find another doctor, the low mme all the doctors said they were forced to follow was way too low to help me. Please let the physicians decide the appropriate dosage for their patients and don’t include the MME in the revised guidelines. I have through every conservative treatment that was available to me through those 31 years and the opioid pain medication was the only thing that helped me. Not every patient becomes an addict. Some people are actually able to function and be productive members of society because of opioid pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f72d27	Smith	None	2022-02-13T23:26:27Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Mary	kzk-m8ff-8whf	False	None	False	2022-04-12 01:55:23.440	[]
499	CDC-2022-0024-0505	https://api.regulations.gov/v4/comments/CDC-2022-0024-0505	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is just sad: answering to government instead of following your own common sense about tre as thing people in pain. Restrictions will only lead to more deaths. It's like throwing the b as by out with the bath water.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gina	None	None	0900006484f72d39	Sigman	None	2022-02-13T23:26:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Sigman, Gina	kzk-mhm0-6agu	False	None	False	2022-04-12 01:55:23.891	[]
500	CDC-2022-0024-0506	https://api.regulations.gov/v4/comments/CDC-2022-0024-0506	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sadly this a bit too late and very understated. After so much time has passed and so many of us that were effected by the “guidelines “ that gave specifics on how much meds should be given and lengths of times, etc. Doctors will not just open back up the door to properly treating patients without being given specifics and warnings as to the dangers of under treatment of such conditions requiring these types of medications. The CDC had no problems giving dosage numbers and time limits when they decided to rob so many of us from medications that provided us a livable quality of life and in some cases, life itself. They need to step forward with the same urgency, importance and ramifications of not getting patients the help they need. Before the “guidelines” came out, I was able to work on my car, play with my children, go camping and enjoy somewhat of a semi normal life. Now I am lingering on hospice with years of declining health issues, lost weight and muscular development amid other health problems brought on by depriving me of medication at a level of more than the bare minimum which basically allowed me to wither away in my bed and wheel chair.<br/>I beg that you will re-examine what you have written and release it with the same STRONG language in which you attacked it in 2016. Without a more direct and comprehensive set of guidelines we will still be left to live without adequate levels of medications to allow us to return to having whatever level of normalcy our conditions will allow if treated properly. <br/>Thank you for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484f72d4a	P	None	2022-02-13T23:27:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from P, D	kzk-ms79-fqch	False	None	False	2022-04-12 01:55:24.672	[]
501	CDC-2022-0024-0507	https://api.regulations.gov/v4/comments/CDC-2022-0024-0507	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in constant pain due to osteoarthritis. My biggest fear is to be taken off of Gabapentin. I will be bed ridden if this should happen. Another fear is if the Gabapentin stops working. The pain is consistent and bad that I am unable to move my entire body. To have to live in this type of fear all of the time is not fair. I am responsible, I take accountability. I was on pain meds years ago and I detoxed myself due to being on them for so long. I can not function with this type of pain on a regular basis. I’m struggling as it is. This pain destroys a person mentally and physically. It ruins lives. It causes suicides. It causes its victims to turn to the deadly street drugs. I’m scared. I am so afraid of what is to come if I am not able to get pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carmela	None	None	0900006484f72d4f	Evans	None	2022-02-13T23:27:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Evans, Carmela	kzk-mvht-wz88	False	None	False	2022-04-12 01:55:24.878	[]
502	CDC-2022-0024-0508	https://api.regulations.gov/v4/comments/CDC-2022-0024-0508	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No MME should be mentioned in the revised guidelines. Doctors should be able to treat a patient to what THEY feel is best. For almost 5 yrs I’ve not been treated adequately. Doctors are scared to treat pain. So we are made to suffer. If we speak out we are bullied and fired from that doctor. I’ve had an ongoing migraine for 7 days and can’t see GP and won’t go to ER for fear of being treated as pill seeking. No one should live that way. Let doctors do their jobs and focus on the illegal users living on the streets like zombies. THAT is where your problems are. Illegal fentanyl users.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72d52	Anonymous	None	2022-02-13T23:27:29Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-mwlt-s2nu	False	None	False	2022-04-12 01:55:25.097	[]
503	CDC-2022-0024-0509	https://api.regulations.gov/v4/comments/CDC-2022-0024-0509	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am sick and tired of you jerks that don't have the medical problems I have trying to make it harder for me to live. You have the Dr's so damn scared to prescribe anything for pain it's ridiculous. My brother had part of his right leg amputated and our family had t beg the Dr to prescribe him pain pills. What you have done is make it harder for ppl that need these medications to get them and you're now trying to make it even harder. I'm in pain management and have been for years. I've tried physical therapy, steoid injections and nothing worked. If it weren't for the pain pills I'd never get out of bed. Every time I go to pain management they look at me like I'm a criminal or undercover cop trying to catch them screwing up. That goes for the rest of the Dr's I have to see. Stop blaming ppl that need these pills and the Dr's who are trying to make our lives easier. Blame the street drugs that pp are dying from and get your boot off our necks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f72d59	Haddox	None	2022-02-13T23:27:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Haddox , Robert	kzk-n08n-7gff	False	None	False	2022-04-12 01:55:25.366	[]
504	CDC-2022-0024-0510	https://api.regulations.gov/v4/comments/CDC-2022-0024-0510	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an ER doc that trained before the opioid epidemic. I understand may are habituated to opioids. I feel it's imperative that we decrease dependence on narcotic intoxicants for pain amelioration; the European model is instructive.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484f72d5a	Benzoni	None	2022-02-13T23:28:07Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Benzoni, Thomas	kzk-n14o-bygr	False	None	False	2022-04-12 01:55:25.570	[]
505	CDC-2022-0024-0511	https://api.regulations.gov/v4/comments/CDC-2022-0024-0511	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There should be no mention of any limits. You put 50 MME thats what everyone will be tapered to you only have to look at what's happened. Haven't these guidelines done enough damage. Please remove any numbers in limits. You have broken our trust. These new guidelines will make a problem worse if you set any numbers. Stay out of the drs office.Let's start rebuilding trust.Much has been damaged its time to heal. We are chronic pain patients not addicts.We have been treated horribly its taken so long for you to start to fix the damage. Please don't set limits enough people have died.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484f72d62	McCalester	None	2022-02-13T23:28:22Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from McCalester , Cindy	kzk-n58l-iyt7	False	None	False	2022-04-12 01:55:25.782	[]
506	CDC-2022-0024-0512	https://api.regulations.gov/v4/comments/CDC-2022-0024-0512	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines has caused so much harm. Shame on everyone involved with making them. I know people who have committed suicide when their pain medication was taken away. Not because they were addicted but because without the medication the pain won. Doctors are so afraid that they dropped patients cold turkey to fend for themselves. And since they were dropped by one doctor no other doctor wanted to take them on. So, they were left to suffer or end their lives. I know a lot more people that have the same plans. At first, I thought they had just not thought it thru, but since then I have changed my mind. I now feel like this was done on purpose. I hope everyone who had a hand in this mess has to have pain medication very soon and they get treated just like pain patients have been. Only then will they understand what pain patients have been put thru lately. This is not medical care it is torture!! Shame, shame, shame!! These new guidelines do not help pain patients at all and can even do more harm than you have already done with the last guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlotte	None	None	0900006484f72d66	Elmore	None	2022-02-13T23:28:44Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Elmore, Charlotte	kzk-n6xi-oezl	False	None	False	2022-04-12 01:55:25.987	[]
507	CDC-2022-0024-0513	https://api.regulations.gov/v4/comments/CDC-2022-0024-0513	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in so much pain right now and can’t get anything to relieve my pain because my doctor is so scared to write a opiate because the cdc thinks we don’t need them. It is such a shame that this is so cruel and inhuman I shouldn’t have to suffer because of these guidelines but yet millions of pain patients are suffering.. I can’t work because of the pain but yet I don’t qualify for disability so I am left to suffer and trying to take care of my family is hard todo…please please help us pain patients who need the meds and leave it up to me and my doctor on what he thinks is best for me..he went to school to have a judgement on what I need and yet he has to watch his patients suffer because of these guidelines…I think sometimes to end my life because the pain is so bad and I can’t get relief…I have also thought about going to street drugs because the pain is so bad…stop playing doctor and helps up. Please hear our voice	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72d77	Anonymous	None	2022-02-13T23:29:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-ni1l-877v	False	None	False	2022-04-12 01:55:26.198	[]
508	CDC-2022-0024-0514	https://api.regulations.gov/v4/comments/CDC-2022-0024-0514	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No mme for prescribing opioids It's cause too much pain and suffering	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484f72d85	cotrone	None	2022-02-13T23:29:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from cotrone, Teresa	kzk-nmwc-k4tw	False	None	False	2022-04-12 01:55:26.441	[]
509	CDC-2022-0024-0515	https://api.regulations.gov/v4/comments/CDC-2022-0024-0515	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was my grandmother’s caregiver for 5 years. Her doctor dramatically took her from 2 milligrams a day of Xanax to 1/2 a milligram a day. I watched her suffer every day with that. She had Dementia and Psychosis. Taligent care of her was the hardest thing Iv ever done in my life. She was 80 when this started and 85 when she passed away. I had to control her medicine because she wouldn’t remember to take it or that she took it already. I had placebo pills in the drawer she always kept her Xanax in because with her condition and habit of doing that for so many years. If I didn’t it was a fight ever day all day about how she can take her own medicine and yell at me to give them to her. I had to get her dressed every month to take a pee test to get her medicine refilled. She was very frail and hardheaded about doing that every month and it wasn’t fair to her or me. That doctor and her CDC guidelines made a difficult situation even harder. I wished she wouldn’t have lowered her much needed medicine that extreme and I wished she didn’t have to travel to the doctors office ever month. It was cruel and unusual. Looking back I don’t know how we both made it through all that for so long and I hate to say this but I wouldn’t do it again if I had the chance to go back. I loved my grandmother with all my heart and she loved me the same. Not only did I have to watch her fade away before my eyes and change into someone else slowly every day but I had to endure the added pain and struggles of her monthly visit and her over night change of a lower dose of medicine she much needed and had been taking for over 20 years because of these guidelines. I’ll be happy to see them changed, thank you for your consideration and help in this struggle I know so many have faced or are facing. God bless and peace be with you all.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f72869	Knight	None	2022-02-13T23:29:22Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Knight , Robert	kzk-m2wv-whn8	False	None	False	2022-04-12 01:55:26.649	[]
510	CDC-2022-0024-0516	https://api.regulations.gov/v4/comments/CDC-2022-0024-0516	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am presently 69 yrs. old and suffering non-stop severe crippling pain in both feet, both legs, right arm and back from hereditary and peripheral neuropathy. The pain is unbearable and has interfered my ability to walk without excruciating pain. I do have an electric wheelchair but do not use it as often as I should. I refuse to stop using my feet totally because I want to be as normal as possible. I do take Oxycodone 20mgs. 4x daily in order to be able to fight the pain even tho it just takes the horrific pain from a pain level over 10. I am a stubborn woman who does not want to feel weak. If a patient truly has a pain level past a 6, I believe opioids are really called for. We need to be sure we have our patients who are Doctor shoppers from getting multiple scripts from various doctors. It is necessary to have some sort of pain meds after surgery but should not be opioids unless they are really needed. I cannot tolerate people who like the supposed high from the drugs. I have never gotten high from drugs with the exception of an after surgery pain pump. Please keep true severe nerve damaged patients able to get humanitarian relief from this life changing pain. This is a true cause for some of us. I wish I had never gotten into this relationship with pain. My dreams for my life are few but the ability to not cry or scream out in pain as I try to walk to my chair in the yard to hear the singing of myCardinals and other wildlife. Please do not take the one thing I love away by making true pain sufferers some relief from opioids. <br/><br/>Thank you,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484f72da3	Smith	None	2022-02-13T23:30:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Kathy	kzk-o2i5-7yye	False	None	False	2022-04-12 01:55:26.877	[]
511	CDC-2022-0024-0517	https://api.regulations.gov/v4/comments/CDC-2022-0024-0517	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Massage and hot tubs are not covered by insurance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72b00	Anonymous	None	2022-02-13T23:30:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-oc1k-caee	False	None	False	2022-04-12 01:55:27.109	[]
512	CDC-2022-0024-0518	https://api.regulations.gov/v4/comments/CDC-2022-0024-0518	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for over 55 years and had been on opiates for over 40 years of my life. I raised children worked a full time job and hiked all over the world all because with the help of opiods. Since the 2016 guidlines puttinmy doctors in fear and my insurance company both of whom are the same company and have decided they want to bw the first with the gold star for stopping overdosing i have been cut off completely and no longer ha e quality of life. I lost my job, my ability to do regular household chores and spend the majority of time locked away in mynroom in bed. Alone. I no longer contribute to society but am a drag on society. Im so glad to see the rules may be changing, but for those of us whose doctors and hmos are already scared, whose going to concince them to revert? Its a good start so please continue to move forward to help all of us chronic pain patients who have been relocated to the land of the living dead.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Evelyn	None	None	0900006484f72b11	Somers	None	2022-02-13T23:30:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Somers, Evelyn	kzk-okp5-4edj	False	None	False	2022-04-12 01:55:27.312	[]
513	CDC-2022-0024-0519	https://api.regulations.gov/v4/comments/CDC-2022-0024-0519	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not encode MME limits. Pain patients have very different needs. No one but the patient, and their physician, should be able to refuse a legally issued prescription. Stop allowing medical personnel the ability to flag patients and/or refuse medical treatment based on their legal use of pain medicines. Allow millions of pain patients to return to a decent quality of life while some of them still can. And be loud about how wrong the previous guidelines were, and how they were used to harm patients. Please. I have been hanging on for years. Hoping for reason and compassion to return to medicine. Many of my fellow patients didn't make it. I want to make it. I really do. Thank you for this opportunity to be heard.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracey	None	None	0900006484f72d92	Callahan Burnett	None	2022-02-13T23:32:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Callahan Burnett, Tracey	kzk-nsts-nqr6	False	None	False	2022-04-12 01:55:27.519	[]
514	CDC-2022-0024-0520	https://api.regulations.gov/v4/comments/CDC-2022-0024-0520	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read and re- read this guideline and if feels like you are still blaming opiate overdoses on prescription opiate. Clearly as doctors have stopping writing prescriptions overdoses have dramatically increased. I my self have several chronic pain diseases CROS, psoriatic arthritis, osteoarthritis, spondylitis, deteriorating spine and joint disease, MS, gastrointestinal issues and migraine headaches. At one point my pain was at a level that I could have a somewhat normal life. I went to my doctor appointments every month, endured urine testing and pill counts. I even had to show where my pain patch located on my body but I did it all. For 20 years I had the same two pain medications never asking for more but then the big taper. I no longer have a life because I can no longer work. I have tried every alternative therapy out there. Endured trying numerous medications and some had done very bad side affects. But I keep trying but being in constant pain has lead to other health issues. I could no longer take the pain in my right foot and my doctor said we need to amputate so I agreed. BUT WHAT A MISTAKE ITS BEEN! First after my amputation I was given no pain medication did you read that nothing for pain control! That’s barbaric in the United States of America but I have collected hundreds of stories just like mine! It was so traumatic that I know have PTSD from that surgery. To top it off my incision got so infected and I was in so much pain I had to endure a revision surgery again no pain control after my surgery. How can anyone justify letting a fellow human being to lay in their bed crying until they pass out from the pain. I have had nothing but complications since my surgeries and have been in constant pain for 5 months. I do get some pain medication but it’s not nearly a high enough dose to help. I have taken almost 1500 Tylenol and you know this will be a problem very soon. Please stop this insanity you are making this whole situation worse not better! I know what is fueling it right now and that’s the money everyone is getting from the pharmaceutical companies by suing them. All at the expense of human beings. Addiction will always be around look at alcoholics but you can still buy beer, food obsessions but you can still go to McDonalds even though we know how bad it is for people. Shopaholics but we still have stores. Did we not learn anything from prohibition? People are in so much pain they are committing suicide because they have had their pain medication taken away. That’s not okay! Your own data shows thus is an illegal drug problem not a prescription drug problem. Get the DEA and the DOJ out in the streets stopping the illicit drugs and then you will maybe stop the overdose rate! But please stop making us suffer. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484f72b6e	Bratz	None	2022-02-13T23:35:27Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Bratz, Kathy	kzk-py5p-lhv1	False	None	False	2022-04-12 01:55:27.728	[]
515	CDC-2022-0024-0521	https://api.regulations.gov/v4/comments/CDC-2022-0024-0521	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the primary care giver for my wife. She was injured in 2005 and had back surgery and a SCS implanted in he spine. This unit and the pain medication she was given restored her ability to fiction enough to “have a life”. She did fine until 2016 when the CDC issued the guidelines for pain medication. She was cut off more than half of her medication. She no longer was able to go out and enjoy live, play with the grandkids, fish, do laundry and other normal adult activities. She only received enough to survive day to day. Her doctor said he seen no problems but there was nothing he could do because the CDC issued the rules and the DEA was enforcing them. The last 7 years have been pure hell for her. Constant pain. She never abused the meds, passed all the tests. We even bought a safe to keep the meds in. Not to mention the constant worry at the end of each month on getting them refilled. I understand some people abuse the medication and they should be dealt with but it went way to far by devastating the good patients that needed them to function. The medication may be habit forming but so is living without being in pain 24/7. Please for God in heaven adopt the new rules and let the good doctors help the people like my wife. Not only will this help the patients but the people in their life who love them and how it kills them to watch the person they love the most live in pain and depression and can’t do anything about it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R	None	None	0900006484f72b87	Appel	None	2022-02-13T23:35:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Appel, R	kzk-qdni-eify	False	None	False	2022-04-12 01:55:27.931	[]
516	CDC-2022-0024-0522	https://api.regulations.gov/v4/comments/CDC-2022-0024-0522	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We pain patients are trying to lead productive lives. The CDC is making this impossible. These guidelines are supposed to make life more reasonable for us and for the doctors. First you proposed the 90 mme limit in 2016 and now you are suggesting 50. FYI, I don’t exceed 50 but this is no help to do many people. We do not OD. You are barking up the wrong tree. You are sending pain patients to obtain medicine either illegally or legally but without guidance form our doctors. Leave the doctors alone. They know what to do!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Helen	None	None	0900006484f72c02	Smith	None	2022-02-13T23:36:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Helen	kzk-s5bt-1jyz	False	None	False	2022-04-12 01:55:28.136	[]
517	CDC-2022-0024-0523	https://api.regulations.gov/v4/comments/CDC-2022-0024-0523	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm writing on behalf of my severely disabled daughter and myself about the damage the opioid hysteria and CDC guidelines have caused our family. My daughter has severe spastic Cerebral Palsy and Epilepsy and she is a total quadriplegic. She takes a lot of opioid medication for seizure and muscle therapy but she was just fired as an 18 year patient from her primary physician because he is scared of the dea. She's taken this medication since she was put on them at Arkansas Children's hospital at age 8, she's 36 now without a Primary care provider. Finding a new doctor has not been successful because no Doctor wants to deal with her medications. I have MS, Osteoarthritis, stage 4 PAD among multiple other very painful diseases and conditions. I was cut off my 12 hour medication and cut in half on my breakthrough medication, I just had another heart attack and it was preventable. My pain was out of control for over 3 days and my BP was also uncontrollable due to my pain. I have had multiple strokes and I am 100% positive it was untreated pain that caused it. I am now paralyzed from my face to one side of my body on opposite sides. Our quality of life has been destroyed by these guidelines and our government. Please allow our Doctors decide how much and what we need to just live the best lives possible with the painful diseases and conditions we are dealing with. Most of us already suffer enough and now we have to worry about losing our Doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eastridge	None	None	0900006484f72c08	Tami	None	2022-02-13T23:36:52Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Tami, Eastridge	kzk-sb7w-4zbp	False	None	False	2022-04-12 01:55:28.343	[]
518	CDC-2022-0024-0524	https://api.regulations.gov/v4/comments/CDC-2022-0024-0524	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why in the guidelines are you guys still giving 50MME from the 90MME that is ridiculous let the doctors be the doctors and you and help us out the way they are supposed to you guys are making it hard for our pain patients and you guys are not even going through pain I'm sure enough that if you went through pain you'll make sure because you are higher up and get your pain medicine because let you go break a leg and not get anything from surgery I'm going through surgery and only give ibuprofen over the counter And see how you feel we go through pain daily everyday of our life all day 24 7 24 8 at that my back is bruised throbbing I can't move I can even pick up my legs in the morning I can't even play with my grandchildren the way I want to play with them because you guys have taken away our quality of life stop getting in the way <br/>of doctors taking care of us like they used to and stop getting in the middle of It's getting to the point where doctors are scared to even prescribe and drop in our patients and people are dying out here because you guys wrote a 2016 guidelines that you guys didn't even pay attention to what you're writing and it messed everything now we have to fix this imagine your mother and your daughter or your dad dad and they can't get their medicine because they say no it's against the rules and they're in so much pain and they end of killing themselves what would you do oh no you don't think it's gonna happen to you but it can And I hope it doesn't I don't wish this on my worst enemy this is ugly how to live. Stop with the mme we want our quality of life back	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72dc9	Anonymous	None	2022-02-13T23:38:18Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-syho-8kxc	False	None	False	2022-04-12 01:55:28.550	[]
519	CDC-2022-0024-0525	https://api.regulations.gov/v4/comments/CDC-2022-0024-0525	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is ABSOLUTELY UNACCEPTABLE! You made the guidelines EVEN WORSE! The CDC is a PRIVATE entity! What makes you, the CDC, think you can come between a patient and his/her doctor? We all know what the agenda is here! The CDC has LIED about Covid over and over and CONTINUES to LIE to and ABUSE chronic pain patients! If you recommend putting masks on little children, which is literally PHYSICAL/EMOTIONAL/MENTALABUSE, WHY would the CDC NOT abuse adults as well? I suffer from occipital neuralgia and trigeminal neuralgia. They are known as the suicide diseases because of how bad the pain is even WITH medication. Doctors call these 2 afflictions the worst pain known to mankind, and there is no cure. It is acute, intractable pain that the patient feels every second of everyday. How is it that a friend of mine gets FIVE 30MG INSTANT RELEASE oxycodone PER DAY PLUS TWO 80mg MORPHINE ER pills PER DAY, yet I can't get a lousy 4 or 5 10mg oxycodones per day? I've been living with ON since 2005 and have tried EVERYTHING under the sun. Oxycodone, a narcotic, is what helped me do my everyday functions. It DOES help CPP's with LONG TERM treatment/therapy. Opioid therapy is safer than gobbling up ibuprofen, tylenol, Lyrica, Gabapentin, etc. around the clock. As doctors, I'm sure you know how bad those drugs are for your liver and kidneys long term! And the 50mme? WHAT? So this was supposed to be REVISED? You went even LOWER! The CDC knows darn well that doctors AND LAWMAKERS will cling to the 50mme, just like they did the 90mme. This is CRIMES AGAINST HUMANITY! You've not only tortured patients, but doctors as well! The guidelines were written for the sole purpose of opioid LITIGATION so people could line their pockets! We all know about the conflicts of interest these guideline writers have and the "expert" witnesses that testify for the govt against drug companies and COMPASSIONATE DOCTORS. We all know about the real data; that it was less than 8% that were overdosing on legal prescriptions. Judges are noticing this as well, since lawsuits are starting to be thrown out! Give us back our medications, RELEASE THE COMPASSIONATE DOCTORS they locked up, and keep OUT of the doctor's office and ESPECIALLY OUT of the relationship between patients and their doctors. Then give us our medications back so we can go back to work, be good spouses, parents, aunts, uncles, friends and CONTRIBUTING MEMBERS OF SOCIETY. PLEASE, TOSS ALL OF IT OUT. We just want our quality of life back. I'm POSITIVE that when you doctors and experts need pain control, you probably have an unlimited supply of opioids. That, ladies and gentlemen, is what's called hypocrisy. U.S. citizens are used to seeing that disgusting behavior by our government officials these days. TOSS OUT THE 50MME, TOSS OUT THE STIGMA FOR CPP'S; TOSS OUT THE GUIDELINES.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72ded	Anonymous	None	2022-02-13T23:39:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-tqlf-9rxj	False	None	False	2022-04-12 01:55:28.757	[]
520	CDC-2022-0024-0526	https://api.regulations.gov/v4/comments/CDC-2022-0024-0526	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree that federal guidelines need to be set, but I also have to say that those that actually need opioids and take them as needed should not be punished! They should remain being urinalysis testing and monitoring of the medication provided. It’s Impossible for someone to live life in extreme pain, something like that alone can cause someone to do drastic things, just to stop the pain! And those misusing medicines in order to get high, will not stop at a federal withdrawal of opioids, they will just change to harder more dangerous drugs like fetenyal or heroin! In short and to sum up, guidelines and monitoring needs to be the key! Don’t punish those already in pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anthony	None	None	0900006484f72dfc	Marquez	None	2022-02-13T23:40:04Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Marquez, Anthony	kzk-u2rd-5uqc	False	None	False	2022-04-12 01:55:29.000	[]
521	CDC-2022-0024-0527	https://api.regulations.gov/v4/comments/CDC-2022-0024-0527	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain patients have killed themselves under the current CDC guidelines. I need to work and pain medication is the only thing that makes that possible. <br/>Please let doctors prescribe appropriate amounts of medication to chronic pain patients. <br/>Nobody should be made to suffer as we have under these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angelina	None	None	0900006484f72e12	Mancuso	None	2022-02-13T23:40:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Mancuso, Angelina	kzk-uf79-xyrs	False	None	False	2022-04-12 01:55:29.203	[]
522	CDC-2022-0024-0528	https://api.regulations.gov/v4/comments/CDC-2022-0024-0528	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Yes opioids are addictive but since the doctors haven’t been able to prescribe much anymore this why there’s more opioids overdose now people lace there medication with fentanyl because of the lack of being able to get most really have some kind of pain . Not hardly anyone takes opioids starting taking them for fun . It was to stop pain .. I can’t believe the serious of this now we have more heroine and other way more dangerous substances because of this issue . The doctors need to let everyone know so does the CDC AND DEA .. That a everyday of over the counters or gabapentin or all that has is way more dangerous for your body because of the stuff made in them . Your body intestines aren’t good for that at all stomach , kidneys , liver ect. Pain medicine is way more easier on body then all the OTC THIS TRUE.. I know because I suffer from pain and now bad kidney my body can’t handle OTC EVERY DAY FACTS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72e2e	Anonymous	None	2022-02-13T23:40:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-uqr7-9cd4	False	None	False	2022-04-12 01:55:29.415	[]
523	CDC-2022-0024-0529	https://api.regulations.gov/v4/comments/CDC-2022-0024-0529	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a 65 year old man who just lost both of his legs and I have cirrhosis to the liver and I'm dieing I'm on palliative care at my pain clinic but they don't honor that I should be exempt from the guidelines.im begging u to please take off the 50 mme u drop the 90 mme now drs are going to think u drop it to 50 mme and the problem is going to get way worse ...also every pharmacy in Berkeley county are lieing to people and won't take out of state scripts MD is only 13 miles away from here .. there saying the DEA and CDC won't let them fill past Hagerstown MD that's insane ..if there was a Dr here in Berkeley county that could treat me I would have done been there .. this is so unfair to people like my self that are truly sick . please help us sick people ..thank u	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stanley	None	None	0900006484f72e75	Bell	None	2022-02-13T23:41:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Bell, Stanley	kzk-xtua-qtof	False	None	False	2022-04-12 01:55:29.639	[]
524	CDC-2022-0024-0530	https://api.regulations.gov/v4/comments/CDC-2022-0024-0530	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The DEA has, with some regularity, raided the offices of pain mgmt doctors, guns drawn. The DEA has been acting as a rogue agency, terrorizing pain management doctors and their patients. The ignorance among policy makers, the DEA, and DOJ is glaring. The bogus war on drugs has accomplished absolutely nothing to curb illicit drug use. As a matter of fact, illicit drug use has grown and deaths from illicit drug overdoses have increased in direct correlation to the decrease in opioid prescribing. Meanwhile, deaths due to suicide among chronic pain patients has grown exponentially because the guideline has been so vastly misapplied.<br/><br/>After the 2016 CDC opioid guideline was published, my sister's doctors force tapered her off of the small dose of opioid analgesics she'd been stable on for years. She was being treated for multiple sclerosis and suffered with pain and spasticity. After they forced her off of the opioid analgesics, they offered her assisted suicide or nothing. Unfortunately, she opted for assisted suicide because she couldn't handle the pain and spasticity from MS. These ignorant rules that have been so vastly misapplied were responsible for the death of my beloved sister!<br/><br/>Two years later and my uncle was in a house fire. He was burned over 90% of his body. When he was in the hospital they refused to administer opioid analgesics even during debridement! This was a man who didn't even drink, let alone take drugs! That's the ignorance that was created by the initial guideline! Unfortunately, my uncle suffered a massive stroke during one of those debridement sessions and died. <br/><br/>As for myself, I've been a chronic pain patient for over 20 years. I was hit by an 18 wheeler and have multiple problems that resulted from that accident. I also have cancer and refuse to be treated because I know how miserably people with pain are treated. <br/><br/>At any moment this could happen to anyone who currently believes that prescription opioids are the problem, to anyone who's involved with opioid policy. Prescription opioids ARE NOT THE PROBLEM! Chronic pain patients ARE NOT THE PROBLEM! It's abundantly evident that illicit drugs, illicitly obtained drugs, and polypharmacy including alcohol is the problem! <br/><br/>If you actually think about it, you'd realize that no one in their right mind who only wanted to obtain drugs to get high, would ever go to a pain management doctor or play by the rules. Chronic pain patients have to go for a consult and pay, perhaps $500. At that appointment they're drug tested, which costs anywhere from $2,500 to $10,000! Many doctors then require a psych evaluation, which is another $500. Then, if they're prescribed opioid at all, they're required to wait at least 4 weeks and normally they're started off being prescribed 5mg hydrocodone, if anything at all. What addict, dope fiend, or drug seeker would ever go through all of that? If you have half a brain you'd realize that no person who's drug seeking would go through all of that! Only chronic pain patients play by the rules.<br/><br/>I'm furious at the CDC, the DEA, the DOJ, insurance companies, and doctors who buy into this! I'm furious that our policy makers are too stupid to see how incredibly ignorant it is to assume drug seekers would ever play by the rules! I'm angry that chronic pain patients have been forced to go through all of this because a certain group of people has chosen to abuse the only class of medications that help people suffering with severe intractable chronic pain! <br/><br/>If our policy makers actually wanted to help those with opioid addiction, they would legalize the only drug that can CURE opioid and cocaine addiction! Ten days of treatment with ibogaine, has a 91% CURE rate! Those who oppose the legalization of ibogaine might say there's risk. But there's risk with addiction! <br/><br/>If you're paying attention, you know that the DEA ENDORSES self pay for addiction treatment. While chronic pain patients CANNOT SELF PAY AND CANNOT BE SEEN OUT OF NETWORK <br/>because the DEA says it's a red flag for chronic pain patients! <br/><br/>Addicts can use illicit substances and be welcomed back to treatment with open arms. While chronic pain patients are immediately fired from pain management if they have any LEGAL nicotine, alcohol, medical marijuana, or kratom in their system! <br/><br/>So, there's absolutely nothing that's acceptable about the 2016 CDC guideline and there's nothing that's acceptable about these revisions. The CDC has destroyed far too many lives of people suffering with chronic pain. The CDC, the DEA, and the DOJ need to get the... out of pain management and quit interfering in our lives and our medical care. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484f72ead	Spiegel	None	2022-02-13T23:42:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Spiegel, Julie	kzk-zl0v-22im	False	None	False	2022-04-12 01:55:29.844	[]
525	CDC-2022-0024-0531	https://api.regulations.gov/v4/comments/CDC-2022-0024-0531	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm submitting my comment via a screenshot from a known Rx drug dealer's Instagram story. This person makes fake Rx's, calls pharmacies and pretends to be doctors, and fills hundreds if not thousands of illegal prescriptions for Oxy...<br/><br/>This was his response to the news. <br/><br/>This will allow even more Oxy to flow to the street.<br/><br/>You should be tightening NOT loosening!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72ca6	Anonymous	None	2022-02-13T23:44:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-0qjs-57fi	False	None	False	2022-04-12 01:55:30.048	[]
526	CDC-2022-0024-0532	https://api.regulations.gov/v4/comments/CDC-2022-0024-0532	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Changing the mme down to 50. That is all Doctors are going to see. New Doctors have been trained with no opioids. Until there is prof through other Doctors who dare to go against what they believe to be put in stone of 90 mme or that there guideline they will continue to taper people to 50. I was taper off cold turkey in 2016, and told to take 3000-4000 mg of Tylenol or ibuprofen a day. I was 53 and known to have a slow metabolism. So I took as told,after 5 days my sagnificant other and adult son, thought I was acting confused one night. They thought maybe I did buy something or possibly had tried medical mmm. When I didn’t wake in the AM my partner though I didn’t feel good and from night before behavior maybe, I had a fever. After 30 mins and I was not up, I was usually a very early roaster and it was 11. My son called 911, and was later told had he not I’d been dead. I was in a coma from Tylenol of. I only took what I was told. I had gone into multi- organ failure. Had it not been for Hartford Hosp in CT and deticated Dr. Who won’t give up I’d be dead. So after 5 days I then spent 8 days on vent, in ICU, dyalisis for over 3 weeks, before my kidneys came back. All of the pain I endured with liver pain and the vent, I still had the pain from no getting pain meds. Because this Dr. Said” quote it could of been the oxycodones” he cut me back off per I Italy. So I spent 6 hrs a day in a big room on a machine having my blood filtered. It changed my life and not for the better. Please drop the number and let Dr. Treat their patient, as they see fit,,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joannw	None	None	0900006484f72cad	Warren	None	2022-02-13T23:45:43Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Warren, Joannw	kzl-1nx6-pq79	False	None	False	2022-04-12 01:55:30.253	[]
527	CDC-2022-0024-0533	https://api.regulations.gov/v4/comments/CDC-2022-0024-0533	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In the past two months I’ve had two invasive procedures. When I ask what I was going to be getting for pain medication I was told that the doctors were afraid to prescribe anything for pain due to the regulations on them now. This is ridiculous. I was told just to take some Tylenol. I only needed medication for about three or four days just to get me through the basic pain of the procedures. Please let the doctors decide what the patient needs and not be so scared of going to jail or losing their licenses.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484f72caf	Pohlman	None	2022-02-13T23:45:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Pohlman, Richard	kzl-1szs-7s57	False	None	False	2022-04-12 01:55:30.458	[]
528	CDC-2022-0024-0534	https://api.regulations.gov/v4/comments/CDC-2022-0024-0534	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Although I am glad that the CDC is herein supporting a move toward more individualization of care, I express strong dismay that the CDC ever wasn't focused on the individual. Medical care is between doctor and patient. Government bureaucrats have no ethical role and no Constitutional role, whatsoever. The US government and state governments have intruded into the medical system severely and it has created what is truly a fascist/crony medical system. And people have suffered. Doctors indeed have become scared to help their patients feel better. Doctors are now routinely tyrannized by Evidence Based Medicine, forgetting that EBM can never supplant individual outcome information of a specific patient. The people of the CDC, FDA and AMA and other parts of this crony system are responsible for this, and it needs to be reversed, fast. Individuals are (or can be) moral agents. No agency, association or group can make ethical decisions (deciding between right and wrong). Only individuals can do that. The most powerful individuals in the CDC set the "ethics" of the agency, which is really just these powerful peoples' ethics, magnified by the power of the the CDC to force its dictums on others. It is about time that you make a move to get out of the way of individuals living their lives. Your whole agency is illicit, so have some humility please. There's just the beginning of humility here in this document, which I'm glad to see. Meanwhile, real people have suffered from substantial pain that could have been relieved but for the fear your agency has participated in creating among doctors. Exaggerated fear is used aggressively by individuals in government to control people. Fear of COVID, fear of Climate, fear of opioids. And exaggerated fear causes people to support government power, and therefore the individual politicians and bureaucrats who feast on power over others. Although this current document is a slight move in the right direction, the better move is for the CDC to focus their efforts on removing the cancer, or the infection, of the sociopaths who are attracted to positions of power over other people, and therefore enter politics and bureaucracy. We have a severe disease in this country, and it is an infection of collectivist power and a cancer metastasizing sociopaths. . And the CDC is rife with these pathogens. I hope you start treating yourselves, Controlling your own Disease, and stop trying to treat the individuals in the country, because, truly, you have no right or legal authority to do so, and you aren't good at it anyway.. Get out of our way. And by getting out of our way, we can help people live their lives better. Yes there are jerks and lousy doctors, but they don't have the authority or power to compel obedience. Only government does (or, rather, government has taken such power). So the crappy doctors can cause harm to people who choose that path, but not to others. CDC causes harm to people who do not choose it. CDC is far worse than the crappy doctors. Your cure is worse than the disease of crappy doctors. Indeed, CDC seems filled with doctors who are collectivists--and in our society, collectivism is primarily fascism. I reiterate: Get out of our way.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484f72ed4	Hunt, MD	None	2022-02-13T23:47:45Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hunt, MD, John	kzl-4cr7-gk96	False	None	False	2022-04-12 01:55:30.670	[]
529	CDC-2022-0024-0535	https://api.regulations.gov/v4/comments/CDC-2022-0024-0535	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern,<br/>I was one of the people affected by the guidelines you made in 2016. I had been working on getting a diagnosis and doing every treatment under the Sun for the previous 12,years., By that point I had a diagnosis off Fibromyalgia and the pain management I was on under the care of a Rheumotologist was was working wonders for me. I finally felt like I had a resemblance of my old life back, I was a better wife and mother due to not being in pain all the time, and for the first time in a long time I had hope for my future. Also during this time I was diagnosed with severe anxiety and was able to get on medication for that thru my Rheumotologist and seriously life was falling into place. Then the first issue came where it was being suggested that pain management and benzodiazepines not be prescribed together. I could not believe it! People had been on both those medications for as far back as I can remember and there were no issues. However due to addicts on the street who had nothing to do with those of us truly suffering from legitimate diseases decided to start overly mixing these medications together and overdosing. The media was making it out to be that it was ALL people on these medications doing these sorts of things and overdosing and that was the furthest thing from the truth. It was so degrading to be lumped in with people who were buying drugs of the street and overdosing when here I was being so careful and responsible and on top of it seeing my doctor regularly and doing multiple therapies. While others were being foolish and getting high off mixing meds or even just taking an abundance of one, I was finally in a spot where I could breathe and make it thru my day with as minimal pain and anxiety as possible. Then essentially I was in a predicament where I could treat one or the other, the pain or the anxiety both being crippling without medications. Thankfully I was able to see a psychiatrist who determined that I needed the anxiety meds as well as the pain meds to be productive in society. I know this is not the case for millions and it is atrocious that those people have been being forced to choose all because not addicts making foolish choices. The next fight I came up against was the 90 mme guidelines in 2016 which I almost met but was just 2 doses over so there agian I had to suffer and go down on my meds with no taper at all, which is inhumane. For the past 7 years since those guidelines I have been doing the best I can but it had effected my abilities to work at certain jobs I am passionate about because I cannot work full time. On top of all this 2 years ago I was diagnosed with yet another autoimmune disorder psoriatic arthritis and sadly as for the added pain there was nothing that could be done for that except go on immunosuppressants, which I did. Due to this disease and the stress from then pain I lost my hair and suffered immensely in other ways with no way to illuminate the further pain it caused. The amount of medications a doctor feels you need to be on should not be decided by some arbitrary number the CDC comes up with based on the actions of substance abuse users. There is no way for the CDC to know what each patient’s struggling with or what they need to lead a somewhat normal life. They should also NEVER force a patient to choose between treating one disease over another like pain vrs anxiety. That is just cruel. They need to focus on the real substance abuse users and leave those of us who see our doctors regularly and follow all their instructions alone. I respectfully ask you do away with the 2016 guidelines, quit punishing doctors and let them do their jobs, and most of all focus on the real issue at hand which is the substance abuse users making and buying this stuff off the street.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7310b	Anonymous	None	2022-02-13T23:50:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-7tlu-ui25	False	None	False	2022-04-12 01:55:30.899	[]
530	CDC-2022-0024-0536	https://api.regulations.gov/v4/comments/CDC-2022-0024-0536	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When the government publishes "guidelines" they always become de facto mandatory. <br/><br/>Stop publishing guidelines. <br/><br/>This is not a legitimate government purpose, and opioids have nothing to do with disease control. The CDC may as well publish guidelines on accounting practices. Why not? You should be focusing every dollar and man-hour on regulating laboratories that research and possess communicable diseases. We don’t need another virus leaking out of a lab here in America, as happened in Wuhan. Disease control.<br/><br/>Viruses, bacteria, prions, and any other communicable agents that cause disease are the only subjects on which that the CDC should be wasting tax dollars. Hire inspectors to go around making sure facilities that study such diseases are secure. Diseases should not be able to leak out and unauthorized access should not be easily obtained. I have zero confidence that any disease stored in America is safe and secure. This is supposed to be the mission of the CDC. If you must issue guidelines, do so for making all the Wuhan Virology Labs here in America safe and secure. <br/><br/>Does the CDC believe it has authority to address every so-called "epidemic"? Probably. Just because stupid, selfish, self-proclaimed "journalists" metaphorically label things as "epidemics" to scare people and sell more advertisements does not mean it is appropriate for the CDC to regulate these topics. Anything and everything is an "epidemic" these days, from "toxic masculinity" to "cyber-bullying". Every dollar spent addressing these topics is one less dollar to be spent preventing the next Covid-19. Disease control. As in communicable disease. Not metaphorical disease. Will the CDC issue guidelines on bartending next? After all, alcoholism is a "disease." It’s disturbing to see the CDC focused on pain pills in the middle of a global pandemic. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73116	Anonymous	None	2022-02-13T23:51:36Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-7zku-w9bw	False	None	False	2022-04-12 01:55:31.108	[]
531	CDC-2022-0024-0537	https://api.regulations.gov/v4/comments/CDC-2022-0024-0537	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 52 year old female who has been battling chronic pain for over 24years. It has literally taken control of my life. I was on a pain management regime that did keep my pain "manageable" to the point I was able to continue "living" somewhat of a "normal life", But for the last decade, because of the CDC GUIDELINES my regime I was on had been changed and in turn my life has been PAINFUL!!! NO QUALITY OF LIFE!!! No longer able to work! <br/>The guidelines group all pain patients under one "umbrella", As if everyone's pain is the same!!! RIDICULOUS!! I have Crohn's so my body metabolizes any medication different than someone who doesn't have Crohn's. Just an example of how we all are different. EVERYONE HAS THE RIGHT TO LIVE LIFE PAIN FREE!! TO IMPROVE THEIR QUALITY OF LIFE. EVERYONE IS DIFFERENT!!! STOP GROUPING US AS "ONE SIZE FITS ALL"... <br/>Having these guidelines is supposed to "Help" with the opioid overdose epidemic but the ONLY ones who are ACTUALLY going to be affected are the patients! The "addicts" will always find a way to feed their addiction, while the pain patients SUFFER in PAIN !!! Causing DEPRESSION, DESPERATION and sometimes SUICIDE for the can no longer deal with the everyday excruciating PAIN!!! SOMETHING HAS TO CHANGE!!! The BLOOD IS ON THE CDC HANDS!!!! <br/>I'm lucky enough to have a PAIN MANAGEMENT DOCTOR who cares BUT also AGGRAVATED for his hands are tied!! He is too worried of loosing his license. He admits I need a reevaluation of my medication regime BUT he is not able to do so. <br/>Why have Dr spend so many years in school to become a Dr BUT yet the government- CDC, INSURANCE COMPANIES,ETC can make a "medical decision" without the YEARS OF EDUCATION REQUIRED to become a doctor????<br/>We count the "opioid overdoses" on a regular basis, let's "count" the SUICIDES that are happening because people can no longer live with the EVERYDAY EXCRUCIATING PAIN!!<br/>CHANGE NEEDS TO HAPPEN!!!!!!!!! NOW!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484f73146	Johnson	None	2022-02-13T23:56:59Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Christine	kzl-9cp3-dvnn	False	None	False	2022-04-12 01:55:31.315	[]
532	CDC-2022-0024-0538	https://api.regulations.gov/v4/comments/CDC-2022-0024-0538	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is ... I reside in Greenfield MA an area hit hard by the opioid epidemic .<br/>I am a woman in long term recovery from opioids , a recovery coach , and a chronic pain patient having suffered 4 concussions and spinal trauma .<br/>I am extremely grateful that these guidelines are being revised , the misunderstanding of intent and rigid application by Drs , pharmacists etc has caused great harm to the community and perpetuate stigma for my people that can result in deaths . There have been suicides of chronic pain patients and I understand this , I tried to take my life when these guidelines caused my dr to shut off my prescription with no signs of misuse . The need for individualized patient care is supposed to be rule not the exception , yet all patients got pumped into the previous guidance , for me , after 7 years in recovery o know opioids interact with my PTSD and depression giving me the false sense of happiness so much that when they were discontinued I plummeted into a deep dark depression that nobody understood and just labeled a drug seeker for asking to just treat my severe pain . It took me 7 years to understand this and know with wrap around support I can safely take limited opioids ( I choose not to ) but I had to fight for that continuity of care .<br/>The pain amd stigma of the misappropriation of your guidelines I hope will finally end with this revision . I would be more than happy to testify at any subcommittee on my experiences as both a patient and a professional who helps those addicted .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484f7316c	Ahern	None	2022-02-13T23:57:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Ahern, Sarah	kzl-9mwg-73v7	False	None	False	2022-04-12 01:55:31.543	[]
533	CDC-2022-0024-0539	https://api.regulations.gov/v4/comments/CDC-2022-0024-0539	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Unfortunately, the damage is done. Doctors have had their careers destroyed. Pharmacies and manufactures have been sued by states. The government has made the whole system afraid to get pain relieving medication to patients. Some people can’t even get medicine when they are on their death bed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Needing	None	None	0900006484f73239	Change	None	2022-02-13T23:58:09Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Change, Needing	kzl-adyj-kko2	False	None	False	2022-04-12 01:55:31.770	[]
534	CDC-2022-0024-0540	https://api.regulations.gov/v4/comments/CDC-2022-0024-0540	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If the purpose of this document, as described line 26, is to improve communication between clinicians and patients, this document is way to long, 216 pages filled with historic information, and too complicated to expect a patient to read and develop an improved communication tool with respect to to opioid use. Recommend separating and reducing this document into a more readable and understandable form for patients to reasonably quickly read and understand the use of opioids and the possible risks and side effects and the available resources if problems arise from using the medications. In addition this abbreviated document should emphasize as depicted in the table on line 26 what the document/guideline is and is not. It should also emphasize that physicians should use their own professional judgement with respect in prescribing pain medications and stating doing so without fear of overreaching government activities probing into individual physician daily operations. If there is a need for the other historic information and associated references, create a separate document with this information, which would not be a “guideline”. The use of video education using available on line resources could also be developed by the CDC whereby a patient could view a 5-10 video after being prescribed opioids. Referencing the 2016 guidelines, historic race, ethnicity, rural etc information is not required to learn and communicate a patient’s being prescribed a medication. Additionally it seems this document is some sort of medical school book for physicians on how to treat specific diseases. Physicians have had years of training and continued education studies, are the specific treatment suggestions really necessary for each malady? If so, create a physician related document for their use, and keep this document for its intended communication tool between physician and patient.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JOHN	None	None	0900006484f73343	RICHARDSON	None	2022-02-13T23:58:34Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from RICHARDSON, JOHN	kzl-b35m-n71w	False	None	False	2022-04-12 01:55:31.977	[]
535	CDC-2022-0024-0541	https://api.regulations.gov/v4/comments/CDC-2022-0024-0541	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Leave patient care to competent doctors! I am a chronic pain patient who has a long documented relationship with my pain management doctor. I know and trust him and he knows and trusts me because of this well established relationship. He should be the ONLY ONE to determine what I need. I do not have any history with anyone in government or insurance so how would they know what I need? Every single chronic pain person’s needs are different. These needs can only be addressed by their respective doctors, not government or insurance people! Let doctors do what they are educated and trained to do for their own patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72f19	Anonymous	None	2022-02-13T23:59:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-bdzs-q58r	False	None	False	2022-04-12 01:55:32.187	[]
536	CDC-2022-0024-0542	https://api.regulations.gov/v4/comments/CDC-2022-0024-0542	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are miracle medications for people with chronic pain. It allows people to live a normal life and continue doing things that keep the body moving and keep you healthy. I don’t believe that there has been a single person who has overdosed taking a medication as prescribed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Get	None	None	0900006484f72f8b	Real	None	2022-02-14T00:00:29Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Real, Get	kzl-bq6p-6n6l	False	None	False	2022-04-12 01:55:32.404	[]
537	CDC-2022-0024-0543	https://api.regulations.gov/v4/comments/CDC-2022-0024-0543	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We support the elimination of doseage limits which have led to harm for patients and clinicians. Increased rates of pain, disability and suicide have come from forced rapid tapering. Clinicians have been subjected to harm from insurers and regulators who, due the guidelines, have forced clinicians to reduce dosage or, in some cases, force doctors out of practice unfairly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amar	None	None	0900006484f72fd6	Setty	None	2022-02-14T00:02:24Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Setty, Amar	kzl-byp9-r2kq	False	None	False	2022-04-12 01:55:32.623	[]
538	CDC-2022-0024-0544	https://api.regulations.gov/v4/comments/CDC-2022-0024-0544	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to thank you so very much for reviewing this policy that had been posted prior. As a person who is disabled and have some pain medication I always got looked at as seeking more pain meds anytime I had to go to the ER even when I was not asking for pain meds and had my primary doctors has me on palliative care with backing from two of my other doctors. Yet I still get treated as someone who is seeking pain meds if I have to go to the ER. <br/><br/>I have gotten to the place that I will not go to the ER unless I just can't deal with my breathing issues, I currently have chronic lung disease, COPD, sleep apnea to name a few of my medical issues yet I get treated as someone who is looking for pain meds when I don't even speak about wanting anything like that. <br/><br/>I truly hope this new possible review of the new change will make changes in our current ER's around our great country. Thank you so very much for reading my comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cliff	None	None	0900006484f73035	Bailey	None	2022-02-14T00:02:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Bailey , Cliff	kzl-c6wr-p4l8	False	None	False	2022-04-12 01:55:32.856	[]
539	CDC-2022-0024-0545	https://api.regulations.gov/v4/comments/CDC-2022-0024-0545	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read many of the comments. I particularly agree with the comments of ... and ...<br/><br/>I am 80, served in the USMC Force Recon, 89 parachute jumps, collegiate wrestler. I have had chronic back pain for over 30 years. <br/><br/>From my experience with two different pain specialists, it is clear that the rules are based, not on patient needs, rather on the opioid epidemic. This myopic view apparently forces prescribers to protect themselves rather than protect their pain suffering patients.<br/><br/>My prescriber refuses to prescribe more than a 30-day supply. My wife and I took a cross country road trip last year. We live in Tallahassee. When my prescription came due, we were in Los Angeles. The pharmacy verified that I had a new prescription to be filled, but because my prescriber was licensed in Florida, they would not fill the prescription.<br/><br/>I have studied the opioid epidemic in depth. It is clear that the vast majority of overdoses are caused by illegal drugs. The overdose deaths attributed to prescription drugs are 5% of the total overdoses and more than half of those are for methadone. <br/><br/>I have not been able to find a single example of an overdose death caused by the consumption of a prescribed opioid taken 'as prescribed'. <br/><br/>The CDC claims that the rules are 'evidence based'. From my perspective, that is far from the truth<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martin	None	None	0900006484f73043	Adams	None	2022-02-14T00:04:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Martin	kzl-c8sp-fbk3	False	None	False	2022-04-12 01:55:33.061	[]
540	CDC-2022-0024-0546	https://api.regulations.gov/v4/comments/CDC-2022-0024-0546	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have reviewed the CDC Clinical Practice Guideline for Prescribing Opioids–United States, 2022 and came away very positively impressed. For 6 years I led the opioid safety efforts in a large Southeastern academic health system. We were the first in our state and led the way for others.<br/><br/>Here are some of my thoughts.<br/>•<span style='padding-left: 30px'></span>The guideline clearly summarizes what evidence is available across a wide range of important issues. The lack of evidence is pointed out succinctly and clearly.<br/>•<span style='padding-left: 30px'></span>Important domains for clinicians are highlighted and are well organized.<br/>•<span style='padding-left: 30px'></span>The guideline clearly states that it is intended to inform clinical practice but not dictate clinical practice. This distinction is so important.<br/>•<span style='padding-left: 30px'></span>Safety and efficacy are clearly defined and quantitated where possible throughout.<br/>•<span style='padding-left: 30px'></span>Nonopioid pharmacologic and non-pharmacologic therapies are summarized and included. This information will help clinicians to provide evidence-based therapies both instead of and in addition to opioid therapy.<br/>•<span style='padding-left: 30px'></span>Recommended issues to review with patients before and during opioid therapy are clearly defined.<br/>•<span style='padding-left: 30px'></span>Overall, I found the guideline to be an incredibly helpful and carefully written document.<br/><br/>Suggestions<br/>•<span style='padding-left: 30px'></span>Frontline clinicians will not read a document anywhere close to the length of this one. We need an executive summary that is much briefer, easy to use and navigate, and readily found online.<br/>•<span style='padding-left: 30px'></span>Patient information that captures the key findings should be made available for prescribers to share both before and during opioid therapy.<br/>•<span style='padding-left: 30px'></span>Recommendations should be made to systems of care on how to best support clinicians who are providing acute and chronic opioid therapy. We currently have a situation where many clinicians are simply unwilling to prescribe opioids burdening the relative few who will. This massive “dropout” results in undertreatment of pain in individuals who could successfully use opioid therapy.<br/>•<span style='padding-left: 30px'></span>The recommendation to consider buprenorphine for high risk or tolerant individuals as a safer means of managing pain should be given greater prominence. May clinicians don’t know enough about the pharmacology of this medication and believe they must have a waiver to prescribe buprenorphine for pain.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lawrence	None	None	0900006484f73556	Greenblatt	None	2022-02-14T00:13:47Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Greenblatt, Lawrence	kzl-crnq-k3ey	False	None	False	2022-04-12 01:55:33.313	[]
541	CDC-2022-0024-0547	https://api.regulations.gov/v4/comments/CDC-2022-0024-0547	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because of the 2016 guidelines and the “suggested” MME, millions of patients have suffered unbearable pain. The new guidelines MUST be worded strongly to undo the damage that has been caused. Doctors stopped prescribing or greatly reduced pain medication for fear of being arrested, insurance companies made the MME mandatory, pharmacies refused to fill pain medication and the DEA went after innocent doctors and their patients. Only medical doctors should be allowed to decide what the MME should be. They have have been trained to know what limits a patient should have. It is not one size fits all. There is body weight, tolerance, length of time a patient has been taking the medication and other issues that need to be considered. I tried many alternative treatments before taking opioid pain medication including injections, acupuncture, steroids, anti inflammatory meds, many bouts of physical therapy, psychologists, and much much more. Doctors don’t just hand out pain pills to a patient in the beginning. Not everyone is prone to addiction. I took opioid pain medication for over 3 decades, always as the doctor prescribed and never had any problems with addiction. Absolutely help the people who do become addicts, but don’t make patients suffer. There are millions of others just like me. Let doctors decide what is right for their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joan	None	None	0900006484f73615	Paducah	None	2022-02-14T00:14:22Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Paducah, Joan	kzl-drth-xcwk	False	None	False	2022-04-12 01:55:33.531	[]
542	CDC-2022-0024-0548	https://api.regulations.gov/v4/comments/CDC-2022-0024-0548	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is well overdue, being my wife is a chronic pain patient and has suffered enormously by being treated as if she were a junkie. I have watched her go thru 3 artificial joint replacements, nerve ending cauterizations, and other types of procedures that didn’t do anything but put her in more pain. We recently relocated to Texas and the first pain doctor stopped her medications of 6 norco a day and soma for chronic muscle spasms calling soma a dirty drug ( not a medical term) she is now only on 4 norco daily, and no muscle relaxers and suffers in enormous pain all because of these doctors not wanting to do the right thing and face repercussions from the feds. Chronic pain patients have been going without the right help for too long. I hope these changes make a difference for folks like my wife. She and others like her are not the problem, street drugs and illegal drugs coming into our country are the real problem.<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73703	Anonymous	None	2022-02-14T00:15:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-eip5-egi9	False	None	False	2022-04-12 01:55:33.737	[]
543	CDC-2022-0024-0549	https://api.regulations.gov/v4/comments/CDC-2022-0024-0549	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm 62 had 3cervical.7 lumbarwith rods.need thiracis but my physician says I'm not a candidate due to all failed surgeries.. I also have neurostimulator which I'm unable to tolerate At times it gets infected. Point I had a great caring physician for 15 yrs till DEA medical examiner closed hs office.leaving 500pts with no meds.no doctor and no other physicians would accept.My Doctor cared about his pts.even when he was going through cancer tx.and heart surgeries. He was always there for us all. The clinic that did tajecme first visit cut all my meds out immediately.Took my opiates way below 10% decrease. Never examined.or woukd listen to Medical history. All he wanted was our pharmacy records.Mist rude doctor and CRNP ever seen.All he wanted were procedures and drug test with every visit.That drug test were fine. It was state laws allow those kinds of clinics to operate but will close clinics where doctors treat each PT.as individuals.Medical boards in each state are working overtime to close pain management clinics without regards to pts who have followed the rules. Had all drug test.pill counts.Medical and mental test.surgeries.therapies.epidural and trigger points.Opiates was only meds that ease my pain from failed surgeries.fibromyalgia.hip bursitis.knee pain.So I could before care for myself Now my son has to do 99% of it.Opiate laws have destroyed me from being with my family.Off in bedroom crying in severe pain from my complete body. Until you have the pains i do every second of the day you can't imagine how laws you pass or recommend hurts people.Also before when I was prescribed opiates for the pain.Ativan for nerves but also used for spasms.Ambien for sleep.When you live in pain and can't rest your body and mind can't It is wrong to tell pts you can't do opiates and benzo.The doctor and pts shoukd decide that in individual bases.No shoe fits all people just as no dosage or meds fits all pts cases.The opiate laws destroyed my life from being able to care for myself without some pain.all pain is not totally gone just eased enough I could tolerate it. I didn't take opiates for euphoria as majority of chrinic pain pts.We just need some relief. Please take all suggestions guidelines away.Give the medical d's and pts treatment back to doctors and pt.s.They know best cause they see it and live with it everyday.The CDC recommendations gave each state the added opiate laws to close and arrest doctors.take or put fear in one's who did care for CPP.We CPP are ones who are left to suffer.Why? Did not stop illegal drugs from border. Why dont the state's and federal go to border stop drugs. That will save lives. Stop going after innocent doctors Who care for Pts with chronic pain..Stop hospitals from doing surgeries without opiates.Pain is unbearable after surgeries.Why do people have to beg for help and no one cares about chronic pain pts?? Our Gov don't or do care about our pain and how can we stop suffering of chronic pain patients.Put yourself in places of all laws that are decided without asking who will it affect and aftermath. Please don't say don't prescribe opiates and Benzo..Alloq doctors to decide.They know their pts.Not someone who do not see the people who are suffering with pain.or no sleep.Just as the weather causes CPP to have increased pain.God Bless.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73774	Anonymous	None	2022-02-14T00:16:29Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-ex2t-92wo	False	None	False	2022-04-12 01:55:33.957	[]
544	CDC-2022-0024-0550	https://api.regulations.gov/v4/comments/CDC-2022-0024-0550	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s about time the CDC changed the guidelines. We who have been affected by being tapered down and being treated like drug addicts and in pain are tired. Correct use does not equal abuse. My body is tired, in constant pain, and ready to go on to the next level of life. My pain management doctor is one of those who is very strict, I have never failed a drug test in the five years I’ve been going there, nor do I do street drugs, yet I’m treated as though I am a street junkie. And I’m tired of that also. Stop trading as though we are seeking drugs because we aren’t. We don’t want to be on these, but they saved my life, without them, I would not be here. Even though I’m still in a lot of pain because of the CDC guidelines, there’s no reason for anyone to be in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelley	None	None	0900006484f7377f	Eubanks	None	2022-02-14T00:17:10Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Eubanks, Kelley	kzl-exy7-4mko	False	None	False	2022-04-12 01:55:34.167	[]
545	CDC-2022-0024-0551	https://api.regulations.gov/v4/comments/CDC-2022-0024-0551	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient and have been since 2008. I have tried many different non opioid treatments with little or no relief. I was unable to do basic daily tasks. The Doctors have run out of options for me, I just continually get worse. I finally found some relief with opioid treatment. It took a few years to get to the amount to where I was able to have a bit a normal life as long as I didn’t over do things. I have been over the 90MME for about 10 years. Recently my doctor started force tapering me due to fear of the DEA. I’m am still a little over 90MME, but the dr has said I must get below 90MME. I can barely function anymore. I’m in constant pain. I have followed every requirement without any issues since 2008. I would suggest that it be written in your new guidelines that long term chronic pain patients are not required to be at or under the 90MME recommendation. Actually have it in the amended guidelines that through proper Doctors care and overseen with the regulations of urine tests that if the doctor and patient feel that the patient needs to be over 90MME that there shouldn’t be forced tapering of their needed medication. <br/>It really needs to actually written into the new 2022 amendment that there is no limit restrictions or recommendations of under a specific or suggested amount or it will not help long term chronic pain patients. It should be between the Doctor and the patient without the fear of the DEA threaten them with lose of license or jail because their patient needed a different regimen of care. Of course if you need certain documentation in the patients file that would be acceptable too.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlene	None	None	0900006484f73784	Graham	None	2022-02-14T00:17:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Graham, Charlene	kzl-eycn-kjwj	False	None	False	2022-04-12 01:55:34.395	[]
546	CDC-2022-0024-0552	https://api.regulations.gov/v4/comments/CDC-2022-0024-0552	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It seems to me that the cdc intends to lump all prescription opioid users into the same category as heroin addicts and further punish the prescription opioid user’s for having chronic pain that will not improve as time goes on. Not all the people are out to abuse the prescribed medication that they take for the medical conditions that they suffer from and the key word in this sentence is (suffer). Over the counter medications are just about useless in treating the painful conditions that many people suffer from. How can you justify to the people that do not abuse their pain medication and have the nerve to tell them that they are no longer able to receive the medication that they have been prescribed for their chronic pain and never at any time abused. What will end up happening is that in some cases the people that were not abusers will seek pain relief from other sources such as heroin and fentanyl and either end up as addicts themselves or die from abusing illegal drugs, well those that do die will have their chronic pain problems solved and leave behind the family and friends that loved and cared about them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f733bc	Anonymous	None	2022-02-14T00:18:13Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-fozx-1hlk	False	None	False	2022-04-12 01:55:34.599	[]
547	CDC-2022-0024-0553	https://api.regulations.gov/v4/comments/CDC-2022-0024-0553	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Too bad it took SIX YEARS to correct this mistake! How many people suffered or died due to the negligence of the CDC putting out misleading and downright false guidelines? As a long term pain patient suffering from chronic pancreatitis, I was forced to reduce my dosage by 50% after responsibly taking pain meds for nine years. This was due to the CDC knowingly misleading medical professionals. Yes, you knew it was false data when you sent it out in 2016. <br/>I consider myself lucky that I wasn't taken off meds completely or abruptly cut off as were many patients. I work in the addiction field and have seen first-hand how the opiate crisis devastated our communities, but the fact that the CDC knowingly harmed innocent patients is not forgivable. <br/>The stigma of addiction has always been a hurdle for legit pain patients but the false guidelines put an end to hope for tens of thousands and I'm afraid these corrected guidelines are going to prove to be too little too late for meaningful change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484f73912	Patterson	None	2022-02-14T00:18:45Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Patterson, Carol	kzl-gyg5-ocga	False	None	False	2022-04-12 01:55:34.805	[]
548	CDC-2022-0024-0554	https://api.regulations.gov/v4/comments/CDC-2022-0024-0554	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a legacy patient...my Drs from Ohio state university quit in protest of the new regulations..but unfortunately that leaves me trying to find a new Dr....tried 5 so far...tell them what I need..what my issues are ..them call me a seeker..Dr shopping...I'm neither...I broke my spine in 4 places 30 years ago..l1-l4...now 3 spinal operations later..2 failed..I'm constantly in pain..can't sleep.. degenerate disk diease... spinal stenosis..froramanl stenosis nerve damage.. tremors..spasms.. neuropathy pain.. migraine..loss of appetite..neck pain.... sometimes all I can do is sit up...have been on opioids for 10 years.. fentanyl patch.100....norco..tramadol..and I can get around some..once we hit on this combo I got some of my life back...now I sit here starting to go thru withdrawals....no looking forward to tomorrow	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	G	None	None	0900006484f73944	Miller	None	2022-02-14T00:18:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Miller, G	kzl-h4ee-35lc	False	None	False	2022-04-12 01:55:35.065	[]
549	CDC-2022-0024-0555	https://api.regulations.gov/v4/comments/CDC-2022-0024-0555	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is just a start however I think that it needs to stay between doctors and patients not the CDC or the FDA and definitely not pharmacist but I myself in the medical field have seen the damage and what it does to my patients I lost one patient this year just due to these guidelines and due to the Hysteria of pain medicine is absolutely disgusting what they have done to chronic pain patients and even a cute patients and cancer patients GET RID OF THE MME AND STOPPED HOME DOCTORS WHAT TO DO WITH THEIR PATIENTS! THEY ARE KILLING PEOPLE EVERYDAY AND MAKING IT THE QUALITY OF LIFE IS NOTHING.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73969	Anonymous	None	2022-02-14T00:22:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-h9xm-2epe	False	None	False	2022-04-12 01:55:35.308	[]
550	CDC-2022-0024-0556	https://api.regulations.gov/v4/comments/CDC-2022-0024-0556	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a long term chronic pain patient who was force tapered off of my pain meds due to the CDC. Now I am unable to stand or walk for more than 5 minutes due to pain. Even everyday chores are not able to be done without help. My quality of life has become non existent compared to when I had pain meds to manage my pain. I barely can get out of bed most days due to my pain. When my pain hits it is so severe that I have passed out from it. I have become forced to be in my house for fear of passing out somewhere due to my pain. Please take into consideration the chronic pain patients as the CDC and these paid contributors do not care about us at all. Please change the guidelines or take the CDC out of my medical care if they are not familiar with every chronic pain patients medical background. They need to separate overdoses to illegal drugs compared to opioid instead of lumping them all together and hurting me and millions of other pain patients in the process. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f7398f	McDonnell	None	2022-02-14T00:22:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from McDonnell, Mary	kzl-hfsj-6tdg	False	None	False	2022-04-12 01:55:35.534	[]
551	CDC-2022-0024-0557	https://api.regulations.gov/v4/comments/CDC-2022-0024-0557	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain management is one of human society’s ethical obligations, hence we dictate that physicians provide anesthesia prior to surgery. Unfortunately, our Federal Government for reasons not related to medical science, has prohibited the use of analgesics that are used safely in other jurisdictions, including many States in the Union.<br/>Rather than focus on currently sanctioned potentially lethal opioids, I suggest that the Federal Government cast aside decades of political and cultural arrogance and prejudice to allow professional examination of alternate pain management compounds/techniques that have little or no lethal potential and have served humanity for thousands of years.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dr	None	None	0900006484f73a5d	Livingston	None	2022-02-14T00:23:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Livingston, Dr	kzl-i2mb-c7e4	False	None	False	2022-04-12 01:55:35.796	[]
552	CDC-2022-0024-0558	https://api.regulations.gov/v4/comments/CDC-2022-0024-0558	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Pain Management specialist (Fellowship trained and Board Certified) who has been practicing for 27 years in the Pain Management field exclusively. I find that the revision of "Guidelines" issued previously is far overdue. The initial set published by CDC was not worth the paper they were printed on and I do not see any improvement here. They still contain idiotic and medically unjustified restrictions on the use of opioids when necessary due to a particular patient's needs. For example "opioids should not be considered first-line or routine therapy for subacute or chronic pain” makes no sense whatsoever. Opioids like all other treatments should be considered as part of a comprehensive evaluation by the physician treating the patient. No treatment should be "off the table" when dealing with complex and pervasive pain problems. For many patients, routine chronic opioid therapy is the ONLY viable choice for treatment due to the circumstances of their medical status and pain problems. To continue to promote the fraud noted above is a disservice to patients and the medical community alike. The revision most needed in this document is that it only contain the following lines: 1. Opioid use should be comprehensively evaluated as one of the possible modalities for treatment of pain- acute, subacute, or chronic. 2. All other previous Guidelines are hereby withdrawn and all are null and void due to them being medically unsupportable. Those are the accurate statements about opioid use that should be the principles which guide the medical community. I find the CDC totally incompetent in the area to issue any other opinion other than the above. The gross incompetence which was apparent the day the previous material was published is still overwhelming today. There also was no accountability from CDC after those "Guidelines" were published. It was impossible to contact anyone at CDC by phone, e-mail, or Pony Express. Everyone associated with the production of this idiotic paper hid behind a phone system that was impossible to penetrate, no e-mail addresses were made available for comment other than info@CDC.gov,. I sent 15 detailed e-mails outlining the problems that had been created to that address as directed by CDC operators--no response to any of them!!! I did not even get the "Thank you for your comment"--screw you response. I suspect that the same process will continue unabated here. <br/>I find that it makes no sense to issue "Guideline" when the underlying problems of patients are ignored from the start. All good medical care starts with understanding the patient's medical status, problems currently and previously active, and what options for treatment are likely to be effective. This entire premise is ignored and bastardized by the CDC in its attempts to stop opioid use, no matter the suffering it causes patient's, families, and society as a whole. As noted above, I would advocate for my 2 item list as being the only appropriate "Guidelines" that should be published<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484f73a74	Harris	None	2022-02-14T00:24:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Harris, Richard	kzl-i56c-nvcg	False	None	False	2022-04-12 01:55:36.019	[]
553	CDC-2022-0024-0559	https://api.regulations.gov/v4/comments/CDC-2022-0024-0559	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was an athlete, I ate right, worked out, was driven. I built a record label from the ground up alone. I started having severe bone, muscle and nerve pain 20 years ago. It escalated 10 years ago to torture. Pain shooting down my arms, legs, neck. I fought to get into pain management and it gave me my life back some. Then, 2016 happened and drs became scared to treat people's valid pain. Now it's to the point they don't. They are fearful of arrest and give people depression meds when they aren't depressed, dangerous gabapentin, Lyrica. They nearly killed me trying to find alternatives. I've since had to close my business. Gone are the days of hiking, the gym, enjoying life. I sit day in and day out in continuous unstoppable pain begging any dr to listen, but now they just write in notebooks and won't make eye contact. I see the addicts on the streets buying heroin, basement made meds, meth, yet those of us chronic ill sit and lose everything because of them and your guidelines. They need to stop the heroin, neth and now fentenol users. Since 2016 Street drug users, overdoses, suicides, have trippled BECAUSE of the war on the sick.Oddly enough addicts are still addicts and are still dying, but now chronic pain patients like myself are contemplating suicide. I lost my baby sister last year, aged 32. She could no longer take the pain. She cried, like me, asking why no drs would help....could help. Good drs have been made criminals and made to be the police of sick people. Unfairly at that. Enough is enough. I want my life back!!! I hardly get sleep. I'm up all night pacing, the pain not stopping. I have lupus, osteoarthritis, spinal stenosis, scoliosis, degenerative disease, bulging disks, nerve damage, pinched nerves. You're wrong. You're all wrong. Criminals, addicts...they will find a way. You are punishing us, the sick. I pray I don't get cancer. My terminally ill friend is suffering thanks to you. Where's the dignity? I didn't ask to get sick. My late 40s were supposed to be better than this. I pay my insurance, I pay thousands in dr bills.....to not get treated? To suffer????? It's wrong!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f73b02	James	None	2022-02-14T00:25:15Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from James, Kimberly	kzl-itiw-sgto	False	None	False	2022-04-12 01:55:36.241	[]
554	CDC-2022-0024-0560	https://api.regulations.gov/v4/comments/CDC-2022-0024-0560	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A family member has chronic pain. It is not going away ever and will not get better ever. She has three vertebrae that are bone to bone and at least 4 others that have compression fractures. There could be more we don't know for sure because she cannot lay on her back for an xray or mri. It is too painful. Even with medication. She has to have pain relief from medication regularly to get by. The current rules governing prescribing and getting refills are too strict and difficult to abide by. She can only get 30 day's supply and cannot get any medicine before that time. Meaning if the refill falls on a holiday or weekend then it cannot be refilled. Hence she goes without her medicine. The refill time goes by the time it is picked up till the end of the prescription period there is no leeway for errors by the pharmacy the holidays, weekends, and the fact that the doctor that has to sign off on the prescription is only available 4 days a week. The pharmacy four times ran out of medication. I called their corporate office and complained the first time. They only allow certain pharmacist's to order pain medication. If they are not available when it is time for the pharmacy to reorder then it doesn't get ordered. This is more of the CDC's regulations that do not work. For some people pain is not something that goes away. There needs very much so a lessening of the restrictions for filling and getting refills for medication. It is so difficult as it is; it is almost impossible to get what she needs every refill period. It seems that there is a mindset that pain is temporary and that addicts live's are more important than anyone else's.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Clinton	None	None	0900006484f73b77	Bumpurs	None	2022-02-14T00:25:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Bumpurs, Clinton	kzl-jfsl-dtxr	False	None	False	2022-04-12 01:55:36.466	[]
555	CDC-2022-0024-0561	https://api.regulations.gov/v4/comments/CDC-2022-0024-0561	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a great first step. I know I personally have struggled since the 2016 guidelines. We all deserve quality of life. The mme guidelines make every patient the same. Everyone is different and we cannot all be made a number. Please remove the 90mme guidelines and allow doctors to decide what their patients need! Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73b90	Anonymous	None	2022-02-14T00:25:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-jj9q-qf1f	False	None	False	2022-04-12 01:55:36.701	[]
556	CDC-2022-0024-0562	https://api.regulations.gov/v4/comments/CDC-2022-0024-0562	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Punishment for needing stable opioid therapy must END! I was abruptly tapered in 2021 and it nearly killed me. I was injured 10 years ago and went through surgeries, physical therapy, alternative medicine, injections. tens unit therapy and nothing has helped. I can't take NSAIDS anymore because I suffered acute kidney failure due to the doctors insistence that they worked. I had been on a opioid therapy that gave me my life back and then it was abruptly taken for NO REASON. I have never misused my medication, never failed a drug test and followed my pain management contract 100 percent. I'm 64 years old and live alone and have no family to help me with day to day basis needs. I'm now suffering needlessly because I barely get any medication for my deteriorating spine, neuropathy and fibromyalgia. I can't continue to live in this misery. The CDC has ruined my future with the rules and forced reduced medication. <br/>My state of NJ has to be in the loop on giving doctors the ability to prescribe what is BEST FOR THE PATIENTS and stop this problem. People are suffering and it's not fair. <br/>Cut the mme numbers for chronic pain patients!! I can say that I will refuse any surgeries until I know that my post surgery pain will be treated properly. <br/>You must do better than this!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484f73bcc	Gad	None	2022-02-14T00:26:13Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Gad, Kathleen	kzl-jt2f-heyi	False	None	False	2022-04-12 01:55:36.930	[]
557	CDC-2022-0024-0563	https://api.regulations.gov/v4/comments/CDC-2022-0024-0563	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting on behalf of my son, 32. In April 2017 he ruptured his L5-S1 disk lifting a very heavy object, leading to microdiscectomy and laminectomy in December 2017 with good results. He was prescribed opiates between his injury and surgery and was off opiates in a short time post-surgery, returning to work (he is self-employed in a physically demanding area of work) in 9 days. <br/><br/>In 2020 he noticed symptoms we thought related to his previous back injury (left leg weakness and tingling) but in July 2021 were diagnosed as MS. A lumbar MRI was performed in the course of reaching that diagnosis. By Spetember he was experiencing significant pain in his hands and wrists related to MS and possibly to Tourette's tics (he was diagnosed with Tourette's as a child) as well, and was taking Tylenol and ibuprofen to manage that pain with limited efficacy. Gabapentin was added to manage this pain. In late October he suffered spontaneous pneumothorax found to have resulted from a lung bleb rupture, and underwent surgery on his left lung at the time. Because he had more blebs on his right lung, he was scheduled for surgery on that lung in December 2021. Meanwhile he was noticing increasing lower back pain, and beginning to experience GI problems as well, leading to a recommendation he stop using NSAIDs. (Eventually he developed anemia believed to result from GI bleeding). He was also prescribed Tramadol to alleviate back pain. <br/><br/>Two weeks after his second thoracic surgery, he returned to work for a week and experienced extremely severe back pain by the end of the week, while also having gone through his Tramadol prescription. He was usually seen at a resident clinic, and had only once ever seen the resident assigned as his PCP. Refills had been problematic as insurance would only allow one week prescription at a time and did not allow early refills, while the pharmacy (operated by his medical provider) told him he needed to request refills up to 5 days in advance for them to be able to fill the prescription. He was also then required to have face to face visits to get a refill(televisits were not permitted for opiate prescription, I believe this is due to state statute) but could not get an appointment earlier than 2 weeks out. At that point he went to urgent care, where a physician refused to prescribe tramadol, saying he would get a letter from the state within 24 hours and could lose his license (PDMP oversight, when I contacted them, said this is not the case and no physician should have ever made such a claim). He then went to the ER, where he received an MRI showing marked changes from the June MRI with signs indicating possible infection in the L5-S1 area. He was given IV dilaudid and recommended for an overnight stay, which he declined. The next morning he returned to his resident clinic as a walkin. After consulting with the hospital neurosurgeon, admission to a 24 hour CDU unit within the ER was decided. There he received dilaudid while physicians in multiple specialties reviewed his records, concluding he would need a spinal fusion but this would have to be delayed for continued observation of possible infection. <br/><br/>Problems refilling tramadol continued, with little or no evidence of any coordinated or collaborative management of his pain. At times this has resulted in conflict with individual medical staff as well as omments suggesting suicidal thoughts because of his frustration as well as fear of being left with severe pain and no remedy. In the month since his acute pain sent him to the ER, he has worked one day and experienced worse pain in the following days. At the recommendation of a pain management specialist (and after two cortisone injections) he is currently on much higher doses of gabapentin and wearing a medical back brace. Recently he was prescribed oxycontin to manage breakout pain not managed by tramadol--but left without a tramadol prescription and was told to just take the oxycontin until his next appointment. This will be tomorrow with a new physician (he has switched from the resident internal medicine clinic to a non-resident internal medicine clinic in hopes of more consistent care management) but he has no idea what perspective this new doctor will bring to his situation. <br/><br/>I believe the sheer difficulty obtaining a notional collaborative and consistent medical management, as well as emotional trauma due to the onslaught of different serious medical conditions he has experienced in 6 months definitely adds to the challenges of coping with severe pain, while the pain diminishing his capacity to handle the stress. I know Cymbalta has been suggested but has not yet been prescribed. There is never a "plan", he is going from one crisis to another, waiting for appointments hoped to result in a plan which never really do that. <br/><br/>You need to consider the reality in which patients seek and obtain healthcare services (with covid a complicating factor). <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheri	None	None	0900006484f73c7f	McMahon	None	2022-02-14T00:26:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from McMahon, Sheri	kzl-kqvh-e4j5	False	None	False	2022-04-12 01:55:37.181	[]
558	CDC-2022-0024-0564	https://api.regulations.gov/v4/comments/CDC-2022-0024-0564	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a physician who often sees patients who are on opiates/opioids chronically, i am struck by the great variety of individual circumstances that have led to the chronic prescribing of those medications for their pain syndromes. As a gastroenterologist, i see that many of these patients who are struggling not only with their pain but also with the adverse effects that those same medications are causing. Sometimes those adverse effects , constipation or dysphagia are associated with pain as well. Often not recognized by the patient or prescriber that these new painful side effects are themselves become a reason that patients take the same opiates. Conditions such as narcotic bowel syndrome are very challenging to treat.<span style='padding-left: 30px'></span>These side effects often lead to the institution of additional therapies to treat such as the class of drugs PAMORAs.<span style='padding-left: 30px'></span>The new draft guideline goes a long way to address the need for individualization of pain treatment.<span style='padding-left: 30px'></span>I would like to see addressed some specific areas such as: the avoidance of indication or use creep, where a pain drug prescribed for severe musculoskeletal pain does not get used for other pain symptoms like constipation association abdominal pain.<span style='padding-left: 30px'></span>Additionally, there are chronically pain conditions when opiates should likely never be used at all. Functional GI disorders being one such group of disorders. irritable bowel syndrome, non ulcer dyspepsia, functional heartburn, being some of these syndromes.<span style='padding-left: 30px'></span><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73c83	Anonymous	None	2022-02-14T00:27:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-ksuj-3m1k	False	None	False	2022-04-12 01:55:37.410	[]
559	CDC-2022-0024-0565	https://api.regulations.gov/v4/comments/CDC-2022-0024-0565	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ever since the CDC started dictating to my pain mngt MD this 90 m me limit for my pain meds, I have beven limited in my pain relief by the mme's rather than what my pain levels are. I have been told that I would not be getting pain meds that exceed CDC Guidelines. The doctor stated that the would not be losing his license over ANY person. He stated that he was also afraid of jail time if he were to treat me at the level I was being medicated at before the guidelines came into being. When I told my doctor about the work pain advocates were working on and had succeeded in eliminating in RI, I was told by my doctor that I needed to more there, then. This is not good medical practice. This is not even ethical in my mind. No other disease is treated so arbitrarily by government overlookers. Any other disease is treated by the doctor's medical knowledge of his patient and the disease and he then prescribes what he is trained to prescribe for each individual's condition. I have Bern tapered down from an appropriate dosing with narcotics that allowed me to function as a productive petson, capable of fulfilling my obligations to self and family. Now I am a mere show of my former self. I can barely move. I am frustrative because there is no logical nor medical excuse for withholding my meds from me. I hurt every day. I am emotionally super sensitive because I hurt so much. A person can only take so much suffering. And when you know that medications exist that would give you the comfort and productivity you desire...yet the CDC says that the doctor can't prescribe them and I have to needlessly struggle and live in excrutating pain. I am not an addict and never have been. PLEASE let my doctor take over my personal medical care. My doctor IS trained to care for me. He sees me on a regular basis. He evaluated all of my metabolic functions. He knows me and how I react to the meds he prescribes. Give him and me back our ability to be a patient/doctor team. Reinstate HIPPA for the chronic pain patient and take the CDC out of the equation. Help me function and be productive again. Get rid of these guidelines that have become "gospel" and let us get back to OUR normal. Trust the doctor to use his training and brains to treat the chronic pain patient with the meds at the levels necessary to be effective and to be based on the patient's medical history..not the CDC's effort to halt addicts from OD'ing. You cannot legislate sobriety. None of these guidelines will ever sober up an addict or stop their use of means to get high. All the CDC has done is to do GREAT harm to patients like me who have been dealing with their pain issues done 1998 and was doing well with their pain control..until the CDC came along and said that I could not continue with the treatment that was working for me and was keeping me functioning at my best and highest level. Please keep these m me guidelines out of the plan of care between me and my doctor. They do not work and they are harmful to the pain community. People are desperate for pain relief. This is affecting the pain patient both physically AND emotionally. We need these guidelines gone..completely and give doctors back their ability to do what is right by the patient, not by the government. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006484f73c91	Narum	None	2022-02-14T00:28:11Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Narum, Wendy	kzl-kuqt-ue3a	False	None	False	2022-04-12 01:55:37.640	[]
560	CDC-2022-0024-0566	https://api.regulations.gov/v4/comments/CDC-2022-0024-0566	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please get rid of opioid ceiling or MME in the guidelines. There is zero science behind it. Many of The overdoses happened due to mixing drugs or relapses. The attention should be put on not mixing meds. I know many people whose lives were saved because they were on high dose opioids. Also, please make it abundantly clear that these guidelines are only for primary care physicians and pain doctors and specialists must treat every patient in an individualized manner. Above all, I wish you would add something about protection for those on opioids for more than ten years for a legitimate medical purpose to avoid tapering them if they are winning and doing well. If they must be tapered, do so extra carefully and slowly and stop when their pain is unbearable	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73ca2	Anonymous	None	2022-02-14T00:29:16Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-ky38-h4lw	False	None	False	2022-04-12 01:55:37.866	[]
561	CDC-2022-0024-0567	https://api.regulations.gov/v4/comments/CDC-2022-0024-0567	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 73 yo female who takes two Tramadol 50 mg tablets a day. I have been lumped in with the guidelines for hard core users of legal opioids. Here is my story:<br/>Around 2008 I asked my neurologist about what to take before spending hours in my gardens as after a half hour of working my entire body ached and OTC Advil et al were not helping. I have some arthritis. She prescribed Tramadol, taking one tablet about 30 minutes before working. I did not pay attention to what drug was (my bad!) and at that time was not being clearly labeled as an opioid. Sometime in the next 10 years that became 1 tablet everyday regardless of what I was doing. Sometimes would take two. Now I do take two a day. Yes, I am “addicted”. My PCP and I are not concerned about this as by the time I am 83 I may take 3 a day. I have a hard time doing my normal routines without it. That includes yardwork, pickleball, dog walking, etc. I am active and the Tramadol keeps me active. I have issues with corporate pharmacies like CVS and Rite-Aid who are more interested in not violating any federal guidelines than serving their customers. I can only get a 3 month prescription from my PCP, nor can I send away for a 90-day supply. If I travel in the states and need a refill it involves corporate pharmacies getting the prescription transferred to whatever/wherever I am, waiting for that, and then getting it filled. When I return home I have to get a new script as the pharmacy I used when traveling is now with that pharmacy that has that script and can not be transferred back to my home pharmacy. It also seems that corporate pharmacies have even stricter regulations for opioids than federal guidelines as they are so fearful of breaking a rule and being investigated. <br/>When I am traveling overseas, I have asked my PCP to add an extra 10 tablets to my prescription. That then raises a red flag with my insurance company. I pay per pill without insurance for those 10 and I believe I cannot fill a month’s supply at same time as the 10 extra. So that means two trips to the pharmacy. <br/>I would like to suggest that those opioid takers like me when dosage, age, and use are outside the main stream that PCP and pharmacies have more discretion on filling these scripts such as how many days have to be between each refill. Date used for a refill is date of prescription not when script is picked up, number of months extended before new script is needed if patient is taking a low dose and number per day is under 4 (or even more) and discretion for pharmacist to allow patient to add extras to deal with traveling. I had a cousin, a retired nurse, who shopped doctors to get drugs she wanted and the same corporate pharmacy filled multiple scripts for her monthly without looking at her entire patient’s history. So obviously when using a corporate pharmacy and not always same pharmacist the current regulations are useless. Thank you for reading my comment and taking issues like mine and I am sure thousands of others like me into consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	0900006484f73ca6	King	None	2022-02-14T00:30:16Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from King, Catherine	kzl-kygu-glq6	False	None	False	2022-04-12 01:55:38.092	[]
562	CDC-2022-0024-0568	https://api.regulations.gov/v4/comments/CDC-2022-0024-0568	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe that not everyone can be on an NSAID or gabapentin. Opioids are needed. This change from over prescribing to not prescribing at all is detrimental to some patients that have legitimate pain that can not takegabapentin or NSAIDs or that their pain does not fall into this category. My Dr alone says he now has only two people of all his patients on an opioid. To me that shows that he not controlling peoples pain. Not everyone is going to be addicted to opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73ca8	Anonymous	None	2022-02-14T00:30:30Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-kyna-u10v	False	None	False	2022-04-12 01:55:38.323	[]
563	CDC-2022-0024-0569	https://api.regulations.gov/v4/comments/CDC-2022-0024-0569	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired Anesthesiologist who, during decades of practice, never was asked by any person what-so-ever if there are 'dosing regimens' that are safer... NEVER.<br/><br/>After retirement I suffered two accidents (slipping on surfaces) which came to involve several vertebral and rib fractures .. with resulting chronic severe pain. <br/>In fact, after the 1st fall, upon leaving the hospital same day and after a mis-reading of xrays, I was discharged home: a 2nd floor apartment..where I crawled up the stairs on my hands and knees. <br/>Since that tortuous experience, I've endured serious pain that requires me to endure 10-15 minutes each morning just to get out of bed.<br/><br/>Over years, the willingness of attending docs to prescribe opioids quickly lessened. About 9 yrs ago I stopped even asking ... and NO attending who was aware of my disability ever asked me about my pain problem, leaving me with the choice of regular episodes of excruciating pain OR of destroying my liver via Acetaminophen, (the U.S.A's most serious cause for 'liver transplant surgery'.<br/><br/>The above is appalling proof that the medico-political atmosphere has degraded so as to actually torture serious pain patients unnecessarily , and so I hear your news on the matter here today with enthusiastic promise of change.<br/><br/>Is it not ironic that it has come to this, where my professional life dedicated to pain relief, has to endure<br/>such debilitating system abuse !!<br/><br/>Sadly, it will take many years, many decades for a new consciousness of 'caring practice guidelines' to filter down thru not only the Medical Professions but also the public's acceptance of new, humane care standards.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JON	None	None	0900006484f73caf	ANDERSON MD	None	2022-02-14T00:31:28Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from ANDERSON MD, JON	kzl-l05f-mt31	False	None	False	2022-04-12 01:55:38.544	[]
564	CDC-2022-0024-0570	https://api.regulations.gov/v4/comments/CDC-2022-0024-0570	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your initial 2016 report and guidelines has ruined the lives of many pain patient's, mine included. This has to be corrected before more damage is done and more lives are lost. I will be 68 in the next few months and have suffered back and leg pain most of my life. I was hit by a car in my teens direct impact to my lower back with enough force to throw me, this was left go for many until I opted for surgery, with the promise my pain would be gone, instead it was worse and constant. I have tried injections, the spinal stimulator 2 times, I went to John Hopkins in Baltimore MD, and I was told my only option was opioids, and this has been my treatment for the past 18 years, which has afforded some type of normal life. After your 2016 report my pain Dr. started to reduce my meds, I relocated to the west coast hoping the warm dry air would help the pain, it did not, and my pain DR. there cut my meds yet again, so after several years I returned to the east. Prior to the move I contacted my old Dr. from back east and he assured me he would take me back as a patient, since returning I scheduled an appointment 1 day before my appointment, I received a call from his office stating I was "not a good fit." I tried another pain doctor but at this appointment he explained how far above your guidelines my dose was, and he refused treatment, but after telling him I have halved my meds, and was out, he prescribed, 1/4 my dose for 2 weeks to find a new Dr. It will take at least 3 weeks, I have nothing for breakthrough pain, and if this is my life going forward, it is not one worth living. You at the CDC have caused this problem for me and many other pain patients, as well as doctors and pharmacist, and this has to be corrected. Deaths from overdoses are up and it is not from prescribed pain medication, it is what it always was from illegal narcotics. I have and would never share my pain meds, this is my lifeline, but you have taken it away. What do I do now? What do others do? It is not bad enough that we are treated like criminals for suffering from pain, urine test every visit, or refused service both from doctors and drugstores. Your guideline dose is a joke, and it provides little if any relief for my pain. Please fix this terrible mistake that was made. Start by telling pain Doctors not to turn patients away because they are on a high dose and let them know that it is OK to prescribe the patient what is needed to live a normal life, and let the pharmacies also know that you are changing the guidelines for pain patients. We treat dogs better than this in this country.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carroll	None	None	0900006484f73cc5	Crawford	None	2022-02-14T00:32:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Crawford, Carroll	kzl-kqd4-iyig	False	None	False	2022-04-12 01:55:38.796	[]
565	CDC-2022-0024-0571	https://api.regulations.gov/v4/comments/CDC-2022-0024-0571	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing you to address the issues regarding the use of opioids prescribed for chronic pain, with that said, please refrain from including this group of people in the same group that uses heroine, or makes there purchases from the streets, we are not all the same. Most people with chronic pain need there medication just to push a vacuum, going to the store, or just plain existing physically. Since the CDC has made there drastic changes the damage and the shame they have caused to NORMAL people have been extremely damaging to there physical health, basically they have stopped living and moving. I personally was persecuted pain medication years ago after I shared with my Dr I was taking 20 Tylenol a day, unaware that this could damage your liver/kidneys, after having my neck fused, the pain continued down my spine, I am currently waiting for more surgery for my lower back. When my original pain Dr retired, my new Dr, who will not listen insisted I receive injections in my spine, I had shared with him these do not work, and better yet they cause me physical problems, oh but without me allowing him to do this procedure he would not prescribe my medication, so the shot went again into my spine, since then I have had uncontrollable colitis, severe restless leg and are, this is so pathetic that the CDC have caused so much unnecessary pain and stress to millions of GOOD people, they should truly try to have just a little more compassion for the many people that do NOT abuse this medication, do you really think someone likes taking this, NO the stigma and the shame alone is enough, yet the quality of life. Shame on you for the mess you have created! Then you want our name and number so you can trace us, now that’s really crazy!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484f73d3a	Smith	None	2022-02-14T00:32:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, John	kzl-lp7d-ktja	False	None	False	2022-04-12 01:55:39.024	[]
566	CDC-2022-0024-0572	https://api.regulations.gov/v4/comments/CDC-2022-0024-0572	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Revision of the 2016 guidelines to emphasize “clinical judgment and individualized, patient-centered decision-making” in opioid treatment is welcome. However this is the fundamental precept of all patient care and the fact that this requires attestation in the proposed revision is acknowledgment that government “guidelines” carry more weight than simply being advisory.<br/><br/>The multiple, exculpatory caveats that these are voluntary—“does not require mandatory compliance”; “not supplant clinical judgment”; “is not intended to be applied as inflexible standards of care”—underscore the perception that “voluntary” is a relative term here and as such these guidelines will skew patient care to conform with a practitioner’s perception that there are consequences for non-adherence to them.<br/><br/>The 2016 guidelines were also voluntary but drastically affected pain management particularly thru institutional pressure to restrict prescription of narcotics to comply with them. Indoctrination of medical students and residents as to restraint in prescribing virtually all controlled substances has permeated medical education and will affect practice patterns for decades to come as a result of them. <br/><br/>More insidiously between public campaigns and professional admonitions the fear of narcotic effects, addiction or simply the opprobrium attached to opioid use has made patients reluctant to use narcotics affecting their quality of life unnecessarily. I treat lymphoma patients who often develop terribly painful ulcers with advanced stage disease and abjure opioids despite my reassurances. Formally exempting cancer management in these guidelines does nothing to reverse personal or public perception that has created this reluctance by stigmatizing opioid use even when appropriate.<br/><br/>Medical school teaches the pharmacology and appropriate use of opioids and medical societies and professional academies whose members see and treat patients requiring pain management continue to refine treatment with them and promulgate guidelines at the working level. We understand the issues involved with use and overuse of narcotics. We are acutely aware that a risk/benefit calculus attends the prescription of any medication we write for. So precisely why we need CDC guidelines that carry the implicit authority of the government is questionable. And among all the cautions and precautions attendant to these guidelines nowhere do I see it explicitly stated: The first and foremost consideration in pain management is alleviating a patient’s pain. <br/><br/>..., MD, FAAD<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chauncey	None	None	0900006484f73d3b	McHargue M.D.	None	2022-02-14T00:32:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from McHargue M.D., Chauncey	kzl-lpa6-9tou	False	None	False	2022-04-12 01:55:39.257	[]
567	CDC-2022-0024-0573	https://api.regulations.gov/v4/comments/CDC-2022-0024-0573	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please be advised that denying senior citizens and responsible people the pain medicine they need and deserve is terrible. I am 72, had a shouldeer replacement surgery June 2020.. My doctor prescribed 10mg of oxycodone for serious after surgery pain. The nursing staff was great, but when 10mg every 3- 6 hours was entered in the government drug computer, it changed it to one pill every 6 hours. They had to saw off the top of my arm bone for the shoulder replacement, cut muscles, tendons and nerves which were glued onto the new hardware. I was in tears for 12 hours. My husband had to go back home to get some pills prescribed for use at home. I felt so much better in 20 minutes. This was in the hospital! I'm not getting any surgery no matter how urgent knowing I will be denied pain relief. I am suffering from a nerve disease called Complex Regional Pain Syndrome or CRPS, called the suicide disease because people take their own life due to pain which goes way past a ten on the pain scale. I have been a 22. I have it in both feet now instead of one foot and it has spread to my calves and is attacking my knees. The severe pain I have is not being treated. I have seen 29 doctors including 4 nerve specialists who are unable to help me. I was in a wheelchair for 3 years and have been trying to walk. I am not taking any meds and haven't for a year and a half. My feet feel like they are covered in lava. I am going to be forced back into the wheelchair in maybe a month. The doctors want me to take meds for depression for pain. These have no effect on pain for me and only 14% are able to find relief. I am a responsible person and signed a drug contract which I complied with. Please allow surgery patients and others with debilitating pain try to lead some sense of a life without being trapped inside on bed or couch in serious and untreated pain. So many of my friends know elderly people who who can't leave their homes anymore because they can't get the medication they need. I've had 2 C-sections for the births of my children but never suffered such a nightmare after surgery. Please help us get mobile and step back into life as we knew it. This is extremely important and necessary, we are suffering with every breath. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484f73dcc	McDonald	None	2022-02-14T00:34:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from McDonald, Sandra	kzl-mm6x-go5n	False	None	False	2022-04-12 01:55:39.492	[]
568	CDC-2022-0024-0574	https://api.regulations.gov/v4/comments/CDC-2022-0024-0574	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These are a step in the right direction. The thing most used to the detriment of pain patients was the 90MME limit. I myself have been on this same dose for 6 years now. I need to be titrated but my prescriber is hesitant to go above this threshold. I believe the same thing will happen regarding the part saying to use caution above 50MME. Please remove any mention of MME. Also, the part stating there is no research showing opioids are good long term. The research with a control was determined to be too cruel. There is plenty of clinical data to determine it does work to give a better quality of life. It has taken six long years to rectify the horrors that the last “guidelines” created. Please consider taking out these limiting conditions. I would suggest rescinding these guidelines completely but those are my suggestions if it HAS to be done. Thank you for taking the time to read my thoughts. Please think of the lives lost due to suicide directly relating to the last guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amanda	None	None	0900006484f73ddc	Hickman	None	2022-02-14T00:34:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hickman, Amanda	kzl-mp6k-7c3f	False	None	False	2022-04-12 01:55:39.699	[]
569	CDC-2022-0024-0575	https://api.regulations.gov/v4/comments/CDC-2022-0024-0575	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Take away 50mm.we will be right back worse than ever. Leaves <br/><br/> TO much room for misunderstanding or wrong intererputations <br/>CDC and state opiate laws need to stop telling doctors how to 0practice safe medicine.No medical or mental pts have the same level 9f pain or illness. All pts should be treated as ?individuals.<br/>Why don't data show all OD and Deaths from illegal drugs as crack.meth.fentanyl.cocaine herion.Then you can honestly say what is from legal RX in OD and Deaths. You are blaming innicent people and punishing them. Stop.exclude all chronic pain patients from any MM equ.<br/>Allow chronic pain pts to draw up a draft. We can do it without being paid or on Gov.payroll.We endure the pain everyday. Don't judge us by saying MM 50. <br/>Our doctors shoukd decide that according to our medical and mental history.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73dfd	Anonymous	None	2022-02-14T00:35:55Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-mvoo-i4jr	False	None	False	2022-04-12 01:55:39.904	[]
570	CDC-2022-0024-0576	https://api.regulations.gov/v4/comments/CDC-2022-0024-0576	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had severe chronic pain for about 60 years. Over the last number of years, I have watched the public conversation about opioids. It makes me angry that much of the media play up the thousands of deaths from opioids, which is very tragic, but there’s never a word about the tens of thousands of sufferers who absolutely need opioids. This medication is manufactured for these patients, and yet it seems everyone else in the community can get them illegally but the legal patient cannot. Fear of this drug has caused insurance companies to keep this away from me and pharmacists have more than once lied to me about having any to dispense. I’ve read comments from highly trained and educated medical professionals that cause me to shake my head. They seem to tell us that with physical therapy, exercise and the right diet, individuals with severe intractable pain won’t need more than a Tylenol or an Advil. The trend is always to minimize the doctor’s decision to prescribe something stronger. But what is worse, many discount or ignore patient complaints about debilitating pain and imply that the patient needs to “buck up” and live with the pain, and perhaps they even hint that the pain is psychosomatic. <br/>I wish that anyone who can prescribe pain medication could live just one year with the devastating pain that thousands of people in America are dealing with right now. Without strong medication, these people enter a type of ... They can’t escape the incessant torture of every minute. Pain is the monster that is eating them alive. Life loses it’s meaning. The will to live slips away. Their hopes have been dashed into disappointment until all hope is gone. Just talk to some of these people who have tried everything, but there is only partial relief except for opioids! We need to listen to what doctors listen to on a daily basis! <br/>I completely applaud the Center’s willingness to discuss this important topic again. And I am glad that they enter this process with the belief that we need to let doctors treat the sick. After all, who knows the patient and the patient’s needs better than they? <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ron	None	None	0900006484f741a1	Bentz	None	2022-02-14T00:36:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Bentz, Ron	kzl-ozx4-z4a4	False	None	False	2022-04-12 01:55:40.132	[]
571	CDC-2022-0024-0577	https://api.regulations.gov/v4/comments/CDC-2022-0024-0577	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why did you reduce the recommended dosage limit from 90 MME to 50 MME, apparently on the basis of a single study of NSAIDS vs mild opioids for mild back pain? This will become the new limit, further hurting chronic pain patients like me. Also, why not state "intractable" rather than only exclude sickle cell, anemia patients? Why not exclude others with incurable disabling diseases like spondyloarthropathies such as rheumatoid arthritis and ankylosing spondylitis by changing to intractable pain being excluded? Other chronic diseases besides sickle cell anemia cause a lot of severe pain, such as people with spinal cord injury, phantom limb pain, myelopathy, radiculopathy, arachnoiditis, generalized or polyarticular arthritis, etc. Finally, Tai Chi and other recommended treatments have no prove efficacy and delay needed pain relief for millionns of Americans. NSAIDS in particular have been noted by FDA as dangerous. Please see this: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-strengthens-warning-non-aspirin-nonsteroidal-anti-inflammatory#:~:text=The%20risk%20of%20heart%20attack%20or%20stroke%20can%20occur%20as,may%20have%20a%20similar%20risk.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f741cc	Anonymous	None	2022-02-14T00:38:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-p8wp-a9ym	False	None	False	2022-04-12 01:55:40.341	[]
572	CDC-2022-0024-0578	https://api.regulations.gov/v4/comments/CDC-2022-0024-0578	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Let me start off by saying I use to be a firefighter, but unfortunately my career ended in 2015 when I became 100% disabled. I’ve got fibromyalgia, lupus, Sjogrens, raynaulds, CRPS, osteoarthritis, gastroparesis, 3 failed spinal fusions, 1 leaving me with an inoperable spinal fluid leak, birth defect of chronic right hip dysplasia, colitis, tarlov cyst disease, migraines, I had a total hysterectomy because of pre cancer, I’ve had a total colectomy because of chronic inertia and colitis, and my list goes on. I’m a military wife, mother and grandmother. I’m a chronic pain patient and have been since 1999. I am under the care of 5 doctors. My rheumatologist and primary have all confirmed that my illnesses will never go away, but get worse as I get older, I’m now 57. I am on proper pain control for all my disabilities, and hand followed the guidelines since day 1. I have monthly appointments, monthly urine tests, and have not once failed any of them. Correct use does not equal abuse!!! There should not be an MME when each person/patient has different illnesses, we are not all equal, we are different in more ways than one. I just want a quality of life, to be able to do my normal daily task’s without being in pain. Without my pain control, I’m literally bed bound or recliner bound. I have had to hire a cleaning lady to take care of my home, she’s been with me for 7 years. I’m not able to do the things I once loved to do. My passion was serving my community as a firefighter, but when my health declined, I had to medically retire, this is heartbreaking for me!! I miss the person I use to be. I suffer with daily anxiety, depression and anxiety because of my medical disabilities. It’s not fair that we have to suffer, it’s not fair that we should have to choose between pain medication or anxiety medication, it’s not fair that there is even a MME limit/standard/rule/ when the only person who knows what works best for our pain, is the patient themselves!! I will never get better no matter how hard I try, between eating healthy and trying to exercise in my recliner. Please, I sincerely ask you to reconsider the MME limits on chronic pain patients. Please allow our doctors to do their job. Please rethink and understand that all we want is a quality of life we so deserve after all the suffering we have to deal with on a daily basis. Correct use does not equal abuse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484f741ce	Heinbaugh	None	2022-02-14T00:38:49Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Heinbaugh, Cheryl	kzl-p94f-hfxd	False	None	False	2022-04-12 01:55:40.546	[]
573	CDC-2022-0024-0579	https://api.regulations.gov/v4/comments/CDC-2022-0024-0579	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please eliminate the 90MME not everyone is the same people process medicine different they are different weights it’s not an across the board thing. The best people to listen to when speaking of something so individual is the individual and how it is working for them. Putting this restrictive 90MME robs so many people of getting adequate pain treatment. Unless the 90MME is removed the suffering will continue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shannon	None	None	0900006484f741d2	Westovdr	None	2022-02-14T00:38:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Westovdr, Shannon	kzl-paqt-4ypa	False	None	False	2022-04-12 01:55:40.757	[]
574	CDC-2022-0024-0580	https://api.regulations.gov/v4/comments/CDC-2022-0024-0580	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am suffering from chronic pain. For at least 20 years. I think these laws are hurting the patients that really need pain management. The doctors are at the point now they won't give out pain meds for any new patients. The patients they have had for years they have been forced to cut the doses that the patient have been on and that were doing well. Then to add to the problem the pharmacy dont agree with the amount of medication that you are given. I have gone through hoops and with reductions in meds because the pharmacy don't like the amount of meds I receive. So now I have been cut down on my meds without going through <br/>The proper weaning process my Dr was upset and said his hands are tied up in all the new regulations. So I'm suffering because the pharmacy cut my meds down and I'm incurring many more injections rf procedures and my co pay on these are so high I can't afford to get the proper care. These Drs and pharmacy are going against each other and im hurting both in more pain, mental anxiety, and loss of money I can't afford. I read everything that comes out on this matter. The street drug use of fentanal laced pills, herion use is killing people. Something needs to be done to help the long-term suffering of many people. To put it blunt the death rate has increased, turning to alternative need for pain relief is hurting every one. Please help us not kill us. Your laws aren't working needs to be changed today no time to waste we are dying trying to live a pain free life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484f741f2	Sullivan	None	2022-02-14T00:39:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Sullivan, Lori	kzl-pgvh-oifv	False	None	False	2022-04-12 01:55:40.962	[]
575	CDC-2022-0024-0581	https://api.regulations.gov/v4/comments/CDC-2022-0024-0581	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>To whom it may concern,<br/><br/>I've had to take medicine for pain since 1995. Yes I started with non-opiod medicine for a while. Nothing was helping with my pain. To get to the point, I've had 8 back surgeries and a total hip replacement to try to avoid taking medicine for pain. Well it did help with some. But I live with so much pain. I was on fentanyl patches starting in 2005 yes my doses did increase. And I have been taken off those and now put on Xtamza 27 m. and I take Percocet 10 for the break through pain. A couple of months ago the Percocets was deceased from 90 a month to 60 a month. And now it was dropped to 30 a month. Now I'm still taking the Xtamza which it 2 a day. Next month when I go the doctor will be decreasing the Xtamza to 18 milligrams and giving me the increase of Percocets to 60 a month. With all this medicine decreasing it is affecting my life. It's taking away from me being able to do thing with my kids, and just being able to handle doing house work. I know there is a problem with opioids. But when you have someone that keeps medicine like this under lock and key and takes it as prescribed, it really does affect people's lives. I just wanted my voice out there. Thank you for taking the time to read all this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f741f9	Anonymous	None	2022-02-14T00:40:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-pj12-ywnq	False	None	False	2022-04-12 01:55:41.168	[]
576	CDC-2022-0024-0582	https://api.regulations.gov/v4/comments/CDC-2022-0024-0582	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a chronic pain patient due to car accident had two back surgeries and one neck surgery have been on pain meds for 20 yrs and now worried about have sonekind of life with some kind of relief now we have to worry about getting unsafe tapering or cut off ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74219	Anonymous	None	2022-02-14T00:40:19Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-psjh-n71p	False	None	False	2022-04-12 01:55:41.390	[]
577	CDC-2022-0024-0583	https://api.regulations.gov/v4/comments/CDC-2022-0024-0583	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The media are reporting that CDC dropped the "one size fits all" guideline of 90 MME, but in fact you have replaced it with an even lower limit of 50 MME. How is this going to help people with severe pain? From your draft: "Many patients do not experience benefit in pain or function from increasing opioid dosages to 2276 ≥50 MME/day but are exposed to progressive increases in risk as dosage increases. Therefore, 2277 before increasing total opioid dosage to ≥50 MME/day, clinicians should pause and carefully 2278 reassess evidence of individual benefits and risks. If a decision is made to increase dosage, 2279 clinicians should use caution and increase dosage by the smallest practical amount. 2280<br/> Additional dosage increases beyond 50 MME/day are progressively more likely to yield 2281 diminishing returns in benefits relative to risks to patients as dosage increases further. Clinicians 2282 should carefully evaluate a decision to further increase dosage based on individualized 2283 assessment of benefits and risks and weighing factors such as diagnosis, incremental benefits for 2284 pain and function relative to risks with previous dosage increases, other treatments and 2285 effectiveness, and patient values and preferences."	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74232	Anonymous	None	2022-02-14T00:41:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-pz5q-2kq5	False	None	False	2022-04-12 01:55:41.653	[]
578	CDC-2022-0024-0584	https://api.regulations.gov/v4/comments/CDC-2022-0024-0584	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My sister and many friends are unfortunatly chronic pain patients. They are already suffering and it's getting worse every day. Removing Dr's rights to prescribe their patients necessary medication is causing real harm to people, their lives and their ability to function. Stop. Manu of these people have been offered no cures/ real solutions to their pain issues but ripping away the one thing that enables them to go to work, care for their families or simply function in day to day activities is unbelievably cruel and unnecessary.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tana	None	None	0900006484f74249	Carson	None	2022-02-14T00:41:16Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Carson, Tana	kzl-q3t4-x4hg	False	None	False	2022-04-12 01:55:41.896	[]
579	CDC-2022-0024-0585	https://api.regulations.gov/v4/comments/CDC-2022-0024-0585	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to completely remove any mention of MME from the “guidelines”. Licensed, board certified physicians need to be able to treat individual patients with appropriate doses. By putting a MME number in there, this just gives insurance companies a reason not to cover doses higher than your arbitrary number and states start turning that into law. It is damaging to patient care when you don’t allow physicians to do what they are trained to do and treat each patient as an individual. Pain treatment is not a one size fits all, so you need to stop forcing it to be. In addition to removing all numbers related to MME, the DEA needs to be stopped from their relentless harassment of doctors who are just treating patients who have legitimate, documented pain and the pharmacies that are filing the prescriptions. They are making the medical community too afraid to adequately treat their patients. That is outrageous in the USA and needs to stop. Bottom line is the federal government needs to stay out of individual patient care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74253	Anonymous	None	2022-02-14T00:41:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-q4sl-vd0b	False	None	False	2022-04-12 01:55:42.107	[]
580	CDC-2022-0024-0586	https://api.regulations.gov/v4/comments/CDC-2022-0024-0586	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m am an 40 year experienced RN, BSN, CCM. Based on both personal and professional experience, what I see happening is a group of patients who have legitimate pain, and have done all suggested alternatives without relief, who are expected to go on suffering because providers now have it drilled in their head not to prescribe pain medication, end of story. <br/>To withhold available treatment, because some other bad person misused the drug, is unfair to the legitimate, reasonable appropriate need patient. And frankly, inhumane. Please adjust recommendations to clarify that pain medication should not be withheld from the appropriate chronic pain patient..nor should the appropriate patient be made to feel like they are a criminal when needing this medication. They are already suffering. I have seen this happen repeatedly. <br/>And pain clinics have failed this category of patient. Pain clinics historically work to take medication away, treat with a nerve block or a TENS unit, but this fails many legitimate patients. I have seen patients who lives have been shut down due to unmanaged pain. People can only tolerate so much suffering. We need to write recommendations that encourage appropriate pain management for those legitimate need patients. I can site many examples. We need to resolve this now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ann	None	None	0900006484f74279	Probst	None	2022-02-14T00:41:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Probst, Ann	kzl-qegl-vyfx	False	None	False	2022-04-12 01:55:42.313	[]
581	CDC-2022-0024-0587	https://api.regulations.gov/v4/comments/CDC-2022-0024-0587	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a clinical neurologist for 29 years now, but prior to this I was a microbiologist. I don't understand when and why the cdc, which traditionally dealt mainly with infectious diseases the majority of which are unicellular organism, all of a sudden they make a major shift to the treatment of chronic pain, and use of opiates for chronic pain. I really thought that the CDC over stepped its authority despite the fact that they claimed that they're only making suggestions. I don't feel it's appropriate to make suggestions, that will impact literally hundreds of millions unless you are well versed in the subject matter which you are not. I do see that you worked with prop or aside prop in order to draft the hfpp, which was clearly masterminded by the Trump administration. I'm sure you're aware, that the sole purpose behind the hfpp, was to lower the threshold as much as possible on what is considered fraud and abuse, will there be opiate therapy or otherwise, the government's objective at which was to have a stronger vehicle as possible to criminally charge doctors. The government used your so-called "proposals"as a means criminalizing doctors to serve an agenda which is not all appropriate to discuss here. Although I agree, that you never said that these were laws that must be adhered to or otherwise face criminal prosecution, that is what the government did. They do not have to ask your permission. They used your suggestions to throw doctors in prison for a long as 20 years or life. Not only has its impacted physicians, who have a very difficult job, but the impact this had on the general public dwarfed the impact that 1933 to 1945 Nazi Germany had a no so-called undesirables. In this case, sadly the undesirables are your chronic disease patients, the majority of which suffer from chronic pain which falls under the umbrella of chronic disease. Well over 400% rise and suicides, an increase of greater than 1,040% of illegal fentanyl, which has resulted in hundreds of millions of deaths, because legitimate chronic pain patients, have been reaching for some type of relief, and they have no choice but to reach for the streets. The dea, and the doj are very well aware that people are buying drugs from dealers, but they are turning the other cheek to this. Speculation as to why the da is ignoring Street dealers is a whole another subject and not appropriate for the discussion here.<br/><br/>I attended your July 2021 meeting. Nobody at the cdc, is a pain expert, nobody there has ever treated pain patients and nobody there has ever done any extensive research on pain. Except for the entire session, and some of the questions that your experts ask, such as why do we use more opiates in this country than any other country, are evidence of your lack of knowledge on the subject matter.Your only guidance from a medical standpoint is through prop. The leader of prop, ... has a total of four publications that he has led, all relating to physical analysis of opiate use, he has no writings on pain, chronic pain he has no teachings on chronic pain and I see no evidence that he's ever treated a chronic pain patient. He is what I call a King without a kingdom. I<br/>A made up expert, who was used for the government's agenda again which which also is a store within itself.<br/><br/>I would ask if you refrain from writing any guidelines. I can only conclude that you were strong armed by the Trump administration. I beg that you tell the by the Biden administration that you do not wish get involved in guidelines relating to chronic pain management. You need tell them to reach to experts, including certification boards such as the academy of anesthesiology which certifies chronic pain doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Felix	None	None	0900006484f742ac	Brizuela	None	2022-02-14T00:43:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Brizuela, Felix	kzl-qbbu-u4k8	False	None	False	2022-04-12 01:55:42.536	[]
582	CDC-2022-0024-0588	https://api.regulations.gov/v4/comments/CDC-2022-0024-0588	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with chronic pain for over 20 years from a failed laminectomy that caused increased pain. I have tried every injection, stimulator, non-opioid therapy there is, even went into renal failure from one of them before getting placed on a very small dose of real pain relievers. I have since been in so much pain that I had a suicide attempt just to have relief for the first time in 20 years. The pain never goes away, pain meds only help for a small amount of time, given the very small dose I get.These guidelines are KILLING instead of helping people. What else needs to happen for you (the CDC) to admit that these guidelines are a death sentence for some? How many of us need to try to leave this earth and leave our families behind for you to realize the suffering people are going through? Just let us have some relief decided upon through the doctor-patient relationship. I just do not understand how someone outside of the doctor-patient relationship can determine how I am treated for my chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Becky	None	None	0900006484f742b7	Crippen	None	2022-02-14T00:43:36Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Crippen, Becky	kzl-qpwe-zos4	False	None	False	2022-04-12 01:55:42.744	[]
583	CDC-2022-0024-0589	https://api.regulations.gov/v4/comments/CDC-2022-0024-0589	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The MME should exclude chronic pain patients. The use of the milligram morphine equivalence is scientifically flawed because it fails to take into account even the most basic tenets of pharmacology, rendering it scientifically meaningless. These guidelines are rendering disabled people with chronic pain hopeless! Suicides are increasing. People are suffering unspeakable amounts. Lives are being ruined. Please dont tie the hands of doctors and allow them to properly treat their suffering patients. Not doing so is showing complete disregard for human suffering. Please do the right thing!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484f7430d	Farmer	None	2022-02-14T00:43:49Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Farmer, Melissa	kzl-rcf7-n9nm	False	None	False	2022-04-12 01:55:42.962	[]
584	CDC-2022-0024-0590	https://api.regulations.gov/v4/comments/CDC-2022-0024-0590	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi! My name is ... and I am one of the many chronic pain patients that have been hit hard by the government interfering with medical practices and needs. I understand that there is need for some type of control on certain medication and I support that. Saying that, I think that there is a huge lack of regard for how actual chronic pain patients are now being treated by doctors, pharmacies, and insurances. With each state creating their own laws and following CDC guidelines as the line in the sand is hurting many people without due reason.  <br/><br/>I have 12 herniated/bulging spinal discs along with CFS/ME and fibromyalgia… and for the past 10+ years have been following specialists assigned to my care and getting steroid injections, nerve blocks, physical therapy, acupuncture, massage therapy, and soon to be surgery. I always follow strict doctor orders and due exactly as told to help with my pain. This does include medical therapy of higher than 90 MME narcotics which has allowed me to continue working as a professional technology leader with a fortune 500 company for the lasts 25 years. Now that states are forcing pain doctors to taper all patients down to 90 MME or lower, I have been abruptly tapered to a dose that doesn’t allow relief and takes away my capacity for working and taking care of my house.<br/><br/>Opioid medication can be life saving for many and should be left as an alternative for those of us that have tried every possible alternative. The ability to find pain relief with opioids has allowed me to continue to work and put my kids through college. It is one of the many therapies I do to try and lead a somewhat normal life. Please remember that adults need to have personal responsibility and those that abuse should be handled in that respect instead of causing mass suicides due to untreated pain for the many chronic pain patients. Thank you for your continued support in speaking for those of us that can not. <br/><br/>“The use of the milligram morphine equivalence is scientifically flawed because it fails to take into account even the most basic tenets of pharmacology, rendering it scientifically meaningless”<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484f7433a	Quackenbush	None	2022-02-14T00:44:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Quackenbush, Melissa	kzl-rmoz-yca6	False	None	False	2022-04-12 01:55:43.166	[]
585	CDC-2022-0024-0591	https://api.regulations.gov/v4/comments/CDC-2022-0024-0591	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter has several debilitating diagnosis including degenerative spine, which causes her continual pain. She is currently fighting with pain management doctor who wants to get her off all pain meds. <br/><br/>Even with the pain meds, including an opioid, she is in continual pain and is unable to function very well on some days. To live with continual pain makes it difficult not only to function but deprived you of enjoying your life.<br/><br/>Studies have shown that people with legitimate pain don't overuse, they just take what they need to function. Opioid addiction is a result of several things, as are most addictions. Until.we fully address the underlying issues that drive addiction the problem will continue in one form or another. A good start at ending addiction would be free healthcare, including mental health care. So instead if pretending you care, why not do some things to actually address the issue?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f74345	Vronch	None	2022-02-14T00:44:34Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Vronch , Debra	kzl-rolk-1nf0	False	None	False	2022-04-12 01:55:43.376	[]
586	CDC-2022-0024-0592	https://api.regulations.gov/v4/comments/CDC-2022-0024-0592	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a patient. My go to for pain management has been acupuncture for the past 30 years. The other things that work for me are massage and chiropractic. Unfortunately, I have to pay for all of these out-of-pocket. I pay $700 a month for health insurance that I really can’t use because the only thing that’s offered to me are drugs and surgery and invasive tests. I strongly urge you to consider advocating for These other options. None of my practitioners will accept insurance because of the undaunting hurdles they have to leap and the amount of denials. I obviously wouldn’t shell out hundreds of dollars a month for treatment that didn’t work.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicola	None	None	0900006484f74369	Simmersbach	None	2022-02-14T00:49:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Simmersbach, Nicola	kzl-rwy6-bjha	False	None	False	2022-04-12 01:55:43.579	[]
587	CDC-2022-0024-0593	https://api.regulations.gov/v4/comments/CDC-2022-0024-0593	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2008 I fell 30 feet while trimming a large dead limb out of the Evergreen. I broke my back and stretched the brachial plexus from my neck down through my shoulder and into my left arm. I have been on fentanyl patches for the last 13 years. As of this year, my private insurance company has increased my fentanyl medication on a different tier from $25.per month to $75.per month which I feel is targeted, as I was already on a generic form of fentanyl patches to save money. The insurance companies are now making big bucks off of chronic pain peoples needed pain medication. I hope that this can be addressed as well. my cost for my patches went from 25 a month to $75 a month on the generic patches. The insurance companies are now making big bucks are the people who cannot already afford to pay the lower price. It is a 200% increase and $600 a month that I cannot afford.<br/>Since the fentanyl crisis I have been treated like a dope attic, lost friends and family, and the insurance company puts restrictions on me because I suffer from chronic pain. I go to a pain management doctor every month and he knows me best. I have tried every other type of pain control from spinal cord stimulators, tens units, acupuncture, massage therapy, years of physical therapy, and the list goes on and on and on. As a chronic pain suffer I feel that society has thrown me into the ditch and especially in the last six years. My doctor cannot give me adequate pain control because of the scrutiny that he receives from the CDC. My insurance company retaliates against me because of News media that puts fentanyl as a drug users choice of drugs. They do not understand that the fentanyl on the streets is so different from the fentanyl received in a pain patch or at the hospital while going under anesthesia. Please try to educate the insurance companies and stop them from making pain medicine a out-of-control way to get money. I was a taxpayer for over 50 years and now I must settle for my Social Security income. I would invite anyone to walk in my shoes for 24 hours without any medication. I am already on the minimal amount that the CDC allows my pain management doctor to prescribe for me . Thank you for your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl L	None	None	0900006484f743ad	Pearson	None	2022-02-14T00:49:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Pearson, Cheryl L	kzl-sgde-ryq5	False	None	False	2022-04-12 01:55:43.809	[]
588	CDC-2022-0024-0594	https://api.regulations.gov/v4/comments/CDC-2022-0024-0594	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Treat the individual, not a piece of paper!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nickie	None	None	0900006484f73ef4	Harris	None	2022-02-14T00:50:06Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Harris, Nickie	kzl-spll-5122	False	None	False	2022-04-12 01:55:44.017	[]
589	CDC-2022-0024-0595	https://api.regulations.gov/v4/comments/CDC-2022-0024-0595	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel it’s beyond time to get rid of these guidelines. I can’t help but worry the fact that they’re being rewritten is not gonna fix the problems they’ve created. So many intractable pain patients have been medically abandoned, cut off completely or died due to pain cause their hearts gave out or suicide due to pain. Doctors lives have been ruined as well. They’re raided & harrassed, have retired early or just stopped treating pain. These guidelines did nothing but hurt I ruined everyone’s lives since they were created. I have no faith a rewritten version will be much better. If they are to work out and actually care about or protect pain patients the enemy has to go. Unfortunately the enemy has been Weaponized against us. Pain Specialist keep most pain patients under 50mme to avoid DEA- terrorizing them. The DEA has admittedly busted doctors solely off this guideline. It was supposed to just be a guideline why was it allowed to become Weaponized. The best thing you can do for doctors and pain patients is to get rid of them all together. Or at least to get rid of the MME but I don’t even think that’s enough to make doctors feel comfortable treating pain with compassion again. I’m not kidding as well as a pain patient and the horror I’ve seen these guidelines wreak havoc on so many lives it’s disgusting. So many suicides and deaths just in the few years I’ve been doing this. There’s blood on your hands & it’s time to do the right thing..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f73ef9	None	None	2022-02-14T00:50:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Ambassador of Indiana	kzl-stds-wzlz	False	None	False	2022-04-12 01:55:44.233	[]
590	CDC-2022-0024-0596	https://api.regulations.gov/v4/comments/CDC-2022-0024-0596	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with diabetes when I was 34 years old. It caused me to develop painful neuropathy. My doctor prescribed hydrocodone/acetaminophen 10-325, 1 tablet every 8 hours as needed. I needed it! Over the years, I needed small increases in the amount. I had moved across country and sought out a new endocrinologist. He prescribed 6 tablets per day. In a few years, we were talking about my pain and he suggested an increase to TEN tablets a day. I told him that I did not need that much and, in fact, told him that I would stay at 6 tablets daily. Some days I can get by with 5 tablets per day. I switched to the chief of Endocrinology at Stanford and have stayed within 6 tablets per day. I am now 71 years old. <br/><br/>I felt that two endocrinologists I was seeing were forcing the drugs on me. They were very controlling in their actions. I think we must give patients more of a say in what our bodies need and what we can get by on with painkillers. Doctors need to listen to their patients without the worry that they will take the painkillers away from us. There are patients who will take advantage of the prescribing controls, but it is still better to get the prescriptions filled rather than buy them on the streets. <br/><br/>We are looking for pain relief, not getting high from medications. Our physicians need to listen to us.<br/><br/>...<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f73efc	Pereira	None	2022-02-14T00:51:21Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Pereira, Susan	kzl-sv8z-avfg	False	None	False	2022-04-12 01:55:44.466	[]
591	CDC-2022-0024-0597	https://api.regulations.gov/v4/comments/CDC-2022-0024-0597	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient of 11 years, these “guidelines” have destroyed my quality of life. Due to the MME limits my medications were decreased 6 years ago, not changed side, and I live with constant chronic pain daily. Without the medication I would be bed bound, unable to be a mother, grandmother, or functioning member of society. I go through my daily life in pain most people wouldn’t be able to survive. Until you’re afflicted with chronic pain you will never understand how important these medications are to survive. Even with them I can no longer do anything that takes physical exertion without barely being able to move. I can’t even go shopping for a couple of hours or mop my floors without being in extreme pain for the next two days. Having the limitations on my medication for the last six years has made that even worse. I’ve looked at every alternative, they don’t help. People with chronic pain shouldn’t be punished for those who abuse and continue to abuse regardless of these policies. People have taken their lives over all of this, because chronic, severe pain destroys your physical, mental, and emotional health and there is zero reason it needs to be this way. Please, consider what we are going through. Until you’ve walked a mile in our shoes, you’ll never understand and I pray that for you never have to.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73f0c	Anonymous	None	2022-02-14T00:51:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-t04q-84ju	False	None	False	2022-04-12 01:55:44.673	[]
592	CDC-2022-0024-0598	https://api.regulations.gov/v4/comments/CDC-2022-0024-0598	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient of 11 years, these “guidelines” have destroyed my quality of life. Due to the MME limits my medications were decreased 6 years ago, not changed side, and I live with constant chronic pain daily. Without the medication I would be bed bound, unable to be a mother, grandmother, or functioning member of society. I go through my daily life in pain most people wouldn’t be able to survive. Until you’re afflicted with chronic pain you will never understand how important these medications are to survive. Even with them I can no longer do anything that takes physical exertion without barely being able to move. I can’t even go shopping for a couple of hours or mop my floors without being in extreme pain for the next two days. Having the limitations on my medication for the last six years has made that even worse. I’ve looked at every alternative, they don’t help. People with chronic pain shouldn’t be punished for those who abuse and continue to abuse regardless of these policies. People have taken their lives over all of this, because chronic, severe pain destroys your physical, mental, and emotional health and there is zero reason it needs to be this way. Please, consider what we are going through. Until you’ve walked a mile in our shoes, you’ll never understand and I pray that for you never have to.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73f0d	Anonymous	None	2022-02-14T00:52:01Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-t04y-sebj	False	None	False	2022-04-12 01:55:44.881	[]
593	CDC-2022-0024-0599	https://api.regulations.gov/v4/comments/CDC-2022-0024-0599	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been a chronic pain patient for 18 years. I've had eight back surgeries. Fibromyalgia, severe nerve damage, osteoarthritis. I was on the same dose of pain medication for 10 years . Then force tapered to such a low dose I can't do anything at all. Sit in a recliner or bed in tears . Why are we being punished for people who have addiction issues? I'm a wife. A mother a grandmother and can't even shower by myself! Compliant patients should have a card like a license. We need help! I've lost too many friends from untreated pain for almost 6 years. We want our lives back!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484f73f13	Gallup	None	2022-02-14T00:52:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Gallup, Jane	kzl-t31s-payz	False	None	False	2022-04-12 01:55:45.102	[]
594	CDC-2022-0024-0600	https://api.regulations.gov/v4/comments/CDC-2022-0024-0600	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please concentrate on stopping drugs at the border and stay out of my doctor/patient relationship! I like my doctor. He doesn't need your help. The CDC is NOT my advocate nor are you in my appointments. The CDC or any government interface will cause more OD's from illegal substances.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73f2f	Anonymous	None	2022-02-14T00:52:38Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-td81-65rx	False	None	False	2022-04-12 01:55:45.311	[]
595	CDC-2022-0024-0601	https://api.regulations.gov/v4/comments/CDC-2022-0024-0601	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Board Certified Psychiatrist with 36 years experience. Roughly a third of my practice is related to chemical dependence. I am a medical director for a residential alcohol and drug dependence residential program as well as an inpatient psychiatric program focusing on dual diagnosis treatment. I also have a private office and an evening Intense Outpatient Program in my office.<br/><span style='padding-left: 30px'></span>In our chemically dependent patients and the community drug and alcohol population we are seeing an increased incidence of death from overdose. <br/><span style='padding-left: 30px'></span>A portion of our patients were introduced to opioids through treatment of pain. Some of that cohort continued to use street drugs for the euphoria and then for maintenance, others sought out street drugs to relieve the chronic pain then became addicted due to lack of appropriate management.<br/><span style='padding-left: 30px'></span>In our community there are not enough pain management specialists (or psychiatrists knowledgeable about addictions) thus the primary care physicians are very reluctant to address chronic pain using opioid medication and other nonopioid modalities e.g. caudal epidural injections. Consequentl these patients are often depressed, often suicidal, often dependent on the unmanaged street drugs. The longer-term effect on patient's lives can be devastating.<br/><span style='padding-left: 30px'></span>I have thoughts about aspects of the issue, but I do not have overall answers to the conundrum of treating chronic pain while minimizing the risk addiction. Whatever guidelines are promulgated, the guidelines for larger urban areas will not, in their entirety, be applicable to rural areas.<br/><span style='padding-left: 30px'></span>As I am writing this missive, I feel overwhelmed by the entirety of the problem but what we are doing is not helping many of our patients. <br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dr. Bob	None	None	0900006484f73f7d	Winston	None	2022-02-14T00:52:59Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Winston, Dr. Bob	kzl-u02g-q4p3	False	None	False	2022-04-12 01:55:45.522	[]
596	CDC-2022-0024-0602	https://api.regulations.gov/v4/comments/CDC-2022-0024-0602	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The ship has sailed. <br/><br/>I have been practicing pain management since 1997 e. g. The heyday of opioid prescribing. We were taught that under dosing what was the crime. We were forced to review cases where families would sue doctors for under treatment of pain… I was a child of that teaching. One year after the CDC guidelines came out ( I had read them as applying to family Practitioners not pain management doctors) , I started tapering patients down on their meds . I have 95% of my non cancer, non palliative care patients down to 90 mme. I have been yelled at, lost sleep, lost patients, fought with a pharmacist at CVS bc my patient was on 96 mme( down from 200 mme) and had two patient suicides( ? Related to tapering) that I am aware of. Insurance companies ask about the mmes , limit quantities, deny medications and >HALF of the USA has mme limit laws ( Washington state put it at 60). The number of deaths from opioids increased when Texas doctors dramatically decreased opioid prescribing. Me and my patients have found our way… I still have to deal with the poorly insured, onerous and frequent prior auths… just to try and getbuprenorphine for my patients . I am smart and persistent … but good doctors like me are also suicidal frequently… we have enormous pressures on us from our patients, medical boards , government agencies and society as a whole …. And now you want to try and stop a train that already went off the tracks…. Come and talk to me… I am in the trenches with my head on straight.. I maneuvered your mind field and got my troops to the other side and we are mostly ok. You need to guideline yourselves…. You have no idea what you did to people …	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484f73f8c	Jones MD	None	2022-02-14T00:53:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones MD, Stephanie	kzl-u5rp-luvs	False	None	False	2022-04-12 01:55:45.734	[]
597	CDC-2022-0024-0603	https://api.regulations.gov/v4/comments/CDC-2022-0024-0603	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There needs to be no mme limit the exceptions were ignored last time and caused massive damage and they will be ignored this unless removed. Also restrictions on methadone especially as a pain reliever need to be lifted it is exceptionally safe and generally doesn’t cause euphoria or addiction. Every month for years I have been limit at 90mme of methadone for pain with excuse of persecution preventing it from going higher. This has over time drastically reduced my quality of life and ability to physical therapy etc achieving the opposite of what the limits were meant for. Please remove any and all mme limits to prevent patient abuse as is currently rampant	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Emily	None	None	0900006484f73fae	Peters	None	2022-02-14T00:53:29Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Peters, Emily	kzl-ujat-caqu	False	None	False	2022-04-12 01:55:45.943	[]
598	CDC-2022-0024-0604	https://api.regulations.gov/v4/comments/CDC-2022-0024-0604	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>prop/cdc has no authority over pain medications or any medications. That is the FDA. The unscientific 2016 opioid guidelines need to be suspended. As most of us know, they were written in secret by anti opioid zealot addiction psychiatrists who know nothing about pain medications or how to treat intractable or acute pain. They were written with no input from actual doctors that treat patients with intractable and acute pain, and have knowledge of opiate pain medications. Prop/cdc created the worst medical crisis in American history. Millions needlessly suffering and dying from uncontrolled pain, including intractable pain patients, cancer patients, acute pain patients, animals and pets. The worst part is the United States public has been duped. The general public believes legal opiate pain medications are the cause of skyrocketing illicit poly drug abuse deaths, laced with deadly illicit fentanyl. Opiate pain medications have been medically used safely for thousands of years. Only in the United States, beginning over one hundred years ago, hysteria and discrimination against opiate pain medications began.. That is the FDA. The unscientific 2016 opioid guidelines need to be suspended. As most of us know, they were written in secret by anti opioid zealot addiction psychiatrists who know nothing about pain medications or how to treat intractable or acute pain. They were written with no input from actual doctors that treat patients with intractable and acute pain, and have knowledge of opiate pain medications. Prop/cdc created the worst medical crisis in American history. Millions needlessly suffering and dying from uncontrolled pain, including intractable pain patients, cancer patients, acute pain patients, animals and pets. The worst part is the United States public has been duped. The general public believes legal opiate pain medications are the cause of skyrocketing illicit poly drug abuse deaths, laced with deadly illicit fentanyl. Opiate pain medications have been medically used safely for thousands of years. Only in the United States, beginning over one hundred years ago, hysteria and discrimination against opiate pain medications began. Also chronic pain patients should not be forced to choose between their pain medication and a benzodiazepine that they have been prescribed for years under a physicians supervision without any incident except to improve the quality of their life. To be forced to taper off either medication is cruel and dangerous to chronic pain patients	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73fd7	Anonymous	None	2022-02-14T00:53:50Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-uzhg-wqg1	False	None	False	2022-04-12 01:55:46.336	[]
599	CDC-2022-0024-0605	https://api.regulations.gov/v4/comments/CDC-2022-0024-0605	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has lived with excruciating pain for 10+ years related to degenerative scoliosis. If it were not for pain management through opioids, he would have taken his life years ago. I am grateful for the reconsideration by the CDC. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74017	Anonymous	None	2022-02-14T00:53:57Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-vk1n-7ape	False	None	False	2022-04-12 01:55:46.554	[]
600	CDC-2022-0024-0606	https://api.regulations.gov/v4/comments/CDC-2022-0024-0606	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has lived with excruciating pain for 10+ years related to degenerative scoliosis. If it were not for pain management through opioids, he would have taken his life years ago. I am grateful for the reconsideration by the CDC. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74018	Anonymous	None	2022-02-14T00:54:08Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-vk1n-dxye	False	None	False	2022-04-12 01:55:46.762	[]
601	CDC-2022-0024-0607	https://api.regulations.gov/v4/comments/CDC-2022-0024-0607	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient with multiple rare spinal diseases. since the CDC guidelines went into effect, My life and my pain treatment has been reduced in half, but my diseases have progressed. My diseases are debilitating, incurable, painful and there is no surgery to help me. I cannot take NSAID’s due to having one kidney, steroids make my disease worse, and I cannot get anything it into my spinal cord because I have Syringomyelia (cysts in spinal cord), Klippel Feil Syndrome (all the bones in cervical spine are fused except for c4-C5 in which a giant osteophyte has formed and is pressing on my spinal cord, I have Ankylosing Spondylitis (an auto immune disease that is just as painful as Sickle Cell pain that causes inflammation all over my body and effects my organs, spine, spinal cord, skin, nerves) I cannot get palliative care recommendation because none of my doctors feel comfortable due to DEA interference and treating the CDC guidelines as law. My doctors all recommend palliative/integrative care but not one single doctor will treat me. I think you need to get rid of the mme recommendations all together because our doctors and lawmakers have taken the guidelines into law. Also, stop using just the diseases Cancer, Sickle Cell, palliative, and terminal illnesses. There are thousands of pain patients with rare painful diseases and you are restricting their treatment by limiting which treatments you list. This needs to go away and be reworded to include all of us with rare debilitating pain. I am adding this link to an article that goes into detail what other items need to change so that the chronically ill can get their medical treatment, please stop grouping us with addicts. We are just people who want to be able to work, clean our homes and be productive citizens. We are not addicts and should not be treated like one. https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/commentary-how-fill-holes-cdc-opioid-prescribing-guideline-revisi?fbclid=IwAR0Da_gn8kYgMrroA-EvG5MDK2Vdk6AGBXa_0rDWGhtc9TBfLe1C0AE8-UM	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Yvonne	None	None	0900006484f74044	Kass	None	2022-02-14T00:54:25Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Kass, Yvonne	kzl-w2xz-nstq	False	None	False	2022-04-12 01:55:46.970	[]
602	CDC-2022-0024-0608	https://api.regulations.gov/v4/comments/CDC-2022-0024-0608	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 49 year old female with Chiari 1, EDS, RA and multiple comorbidities that have left me in severe chronic pain. I’m a legacy patient who has been on opioid therapy for the last 22 years. I had a good plan that had taken years to fine tune, when I suddenly lost all my meds in 2019. My PMDR of 20 years was shut down by the DEA and the CA medical board for overprescribing. No patient died or was hospitalized for medication interaction, he just refused to stop prescribing for critically ill patients. He had to go to court and can’t Rx controlled meds for 5 years. It doesn’t sound like this revision is going to help him and hundreds of other Dr’s like him get their practices back. It took me 6 months to find a new Dr. who would take me as a patient, but only if I agreed to taper drastically. My new Dr. isn’t aware of any change at the CDC regarding opioid rxing, and when I showed him this he said it didn’t matter unless the hospital group and the CA medical board adopted a more lenient policy. Right now he is under orders to reduce his opioid rxing and the hospital monitor’s his rxing monthly. Somehow this needs to get to the people in charge or it does legacy patients like me no good. I’m also concerned about the addition of a new MME limit of 50. It’s going to make things worse not better. I’m disappointed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484f7405d	Wade	None	2022-02-14T00:54:39Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Wade, Jennifer	kzl-wift-4w9l	False	None	False	2022-04-12 01:55:47.174	[]
603	CDC-2022-0024-0609	https://api.regulations.gov/v4/comments/CDC-2022-0024-0609	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Opioid crisis? What about the Alcohol crisis that kills more INNOCENT people than anything? It kill people that don't even touch it, the car wrecks that kill whole family's, domestic violence, rape, child abuse, etc.etc.etc. that's all because of Alcohol, not opioid's, opioid's help alot of people, who does Alcohol help? Its amazing how much problems Alcohol causes, and its accepted. I'm sure most of the people that make these laws enjoy their drinks, so they'll just keep the Alcohol crisis quiet.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484f7445d	Bellini	None	2022-02-14T00:55:12Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Bellini, Marie	kzl-x283-vzzd	False	None	False	2022-04-12 01:55:47.395	[]
604	CDC-2022-0024-0610	https://api.regulations.gov/v4/comments/CDC-2022-0024-0610	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	End the MME limit!! You cannot paint every patient with the same brush as each patient has individual needs. Physician should feel comfortable treating their patients as they see fit, not pressured by a government angecy/angencies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74479	Anonymous	None	2022-02-14T00:55:23Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-x8dg-jtp4	False	None	False	2022-04-12 01:55:47.602	[]
605	CDC-2022-0024-0611	https://api.regulations.gov/v4/comments/CDC-2022-0024-0611	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Withdraw these guidelines immediately, the CDC is the wholly inappropriate agency to hold authority over any aspect of treating pain, as they’ve proven disastrously. The creep of scope also feels transparent; when you spend your life on the sidelines like we do, you tend to observe a lot-like gaslighting by policy in service to the War on Drugs. The U.S. NIH has known since the 1970s that opiate pain medicines are safe, miraculously helpful for most people in pain, and addiction is rare with use. This self-same society that doesn’t want to be faced by our bodies suffering from painful illness created the conditions of poverty and despair that led people prone to addiction to abuse other people’s medicines, alcohol and illicit substances. CDC’s guideline was a plan to make us both fit into a tidy box together as “malingerers,” that looks just how the morally, physically, financially superior want everything around them to look. Chronically ill, disabled people that require continuous use of medicines for pain…don’t “look hygienic” when you live in a separate, perfect world where everything’s arranged just so. People don’t want to be faced with suffering because it reminds them of their own fragility; it’s instinct to avoid looking at us-healthy bodies are designed to forget what terrible pain feels like once it stops. NIH has now pitched hordes of money on junk, alternatives to science instead of real medicine-people who’s pain requires treatment with opiates have already tried everything on the inefficacious list of non-pharmacological “interventions” being touted without evidence; my god there aren’t even enough hours in the day for us to do all those different interventions, even if they actually did improve pain/function. Did anyone involved even consider how many different specialists, therapists and providers we were already expected to see in one month alone, when we actually had access to care? NIH allowed quack psychiatrist anti-opioid zealots, health economists and eugenicists in to run pain research as though it were a symptom of addiction. The allocated resources were a total waste, as the product is completely useless-the mishandling of data around “overdose” deaths by CDC has created years of research based on the totally false premise that the people in pain and their doctors were the problem. Conflating medical dependence (as with insulin for diabetics, or SSRIs for depression) with addiction (an aberrant behavior disorder characterized by constantly repeating self-harm actions and a perceived inability to stop)…conflating causation with correlation, the research is rife with circular logic constructed to uphold researchers and their funders biased, foregone conclusion-namely that every facet of the symptom “chronic pain” is caused by the opiate pain medications that are required to treat it, and not by the existing underlying disability and disease. The application of epidemiology to “chronic pain,” caused by thousands of different conditions from degenerative disc disorder to sickle cell disease, was one of the most uninspired schemes I’ve ever seen serious scientists effect. Before CDC Guidelines? The U.S. was leading the world to ethical excellence in the treatment of pain. After? The absolute destruction to pain treatment is difficult to quantify, it’s taken so many lives (primarily to suicide), and those of us still hanging on as long as we can…we’re even less pretty than we were before. So much beautiful, carefully crafted science built on the solid foundation of human understanding was completely abandoned and relegated to the trash fire of repeated history. Possibly the worst outcome of this foray into eugenics isn’t the damage done to all the lives of people in pain, but the damage done to medicine for the next and future generations. Not only do they have to inherit this dystopian wreckage, but they will no longer have medicine practiced by compassionate stoics elevating the science of humanity, because most of them will have been exterminated in the War on Drugs. What kind of harms will be inflicted on my daughter’s being by these conditions, and when they are, who will she have left to turn to?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7447c	Anonymous	None	2022-02-14T00:55:58Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-x8lz-wvu9	False	None	False	2022-04-12 01:55:47.809	[]
606	CDC-2022-0024-0612	https://api.regulations.gov/v4/comments/CDC-2022-0024-0612	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We are still in the middle of an opioid epidemic. This is MAN made epidemic that was created by those in official positions who were, and apparently still are, trying to please the Pharma companies, ie Purdue Pharma and others. By giving them free reign and allowing wording that didn’t follow the “do no harm” oath that all in the medical field should espouse, money over the health of humans became the ultimate goal. The fentanyl epidemic is a direct result of the opioid epidemic that began with the FDA’s label of use for moderate pain for Purdue’s OxyContin. What the CDC appears to be doing now is to be caving. For what earthy reason would CDC to this? Do not go backwards. It is a slap on the face to every mother, like myself, who has buried a son as a result of being prescribed a prescription opioid that led to an addiction.<br/><br/>Sincerely,<br/><br/>...: Mother of<br/>...~ ...<br/>Submitted 2/13/2022<br/><br/>...@gmail.com<br/>...<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie Jane	None	None	0900006484f744ae	Herrick-Justus	None	2022-02-14T00:56:47Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Herrick-Justus, Leslie Jane	kzl-xobo-nyns	False	None	False	2022-04-12 01:55:48.018	[]
607	CDC-2022-0024-0613	https://api.regulations.gov/v4/comments/CDC-2022-0024-0613	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been in chronic pain for 35 years, sometimes trying to treat the pain with NSAIDs, sometimes using opioids for more effective care. Most of the reason for the long period of chronic pain is that our broken medical system has done a terrible job of diagnosing the reasons for my pain. Doctors are also now so commonly focused on getting me off pain meds they totally ignore the symptoms right in front of them. I have much training in all the ways of treating pain and still use every one of those crayons in my coloring box. <br/>In 2016 your CDC opioid mandate came to be and created some of the worst trauma of my life. The nightmare began when my doctor talked me into trying to taper off opioids with a promise she would be there if it did not work. When it didn’t work and I needed back on opioids, she refused to return my calls. She abandoned me. I ended up in the e.r. in awful pain. Next was a pain clinic, except the only way he treated pain was with a shot in my back, treating only one part of the pain. He refused to use any other treatment, or prescribe any pain meds, but never told me his limits to treatment. Next was a physician that refused to prescribe any pain meds at all. The next two doctors told me they would taper me off opioids without offering any diagnosis or treatment of the causes of the pain.<br/>Pharmacists refused to fill prescriptions. Pharmacists harassed me for being on opioids. One of the strange things about this was my dose- I was never close to your threshold of 90MME and have never reached 50MME.<br/>All these doctors were afraid of me and my pain, which was a clear change from the way I had been treated as a pain patient for years. They were more afraid of the government coming after them if they prescribed opioids, and I could not provide enough documentation to change their minds, including X-rays and MRI’s. They all admitted to me that they were refusing patient care because they were afraid of federal and state governments, due the changes made due to the 2016 CDC opioid pain regulations.<br/>During all of this I am very ill- like feeling like having the flu every day ill. And my doctors are abusing me based on your recommendations. I already had PTSD and this constant fight for effective pain control added to it. The depression from this treatment was profound. I was totally helpless, and totally unable to advocate for myself as a patient. It required EMDR, a psychological treatment used for PTSD, to bring the medical trauma under control. <br/>Only entering palliative care stopped the medical trauma. I was slowly dying because a long line of doctors were afraid to treat my pain.<br/>Thank you so much for considering changing the regulations of 2016. I did not want to die prematurely because of constant pain. I am not alone.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484f744bf	Eames	None	2022-02-14T00:57:33Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Eames, Diane	kzl-xuhj-yb2k	False	None	False	2022-04-12 01:55:48.224	[]
608	CDC-2022-0024-0614	https://api.regulations.gov/v4/comments/CDC-2022-0024-0614	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After reading the CDC proposed 2022 prescribing guidelines I’m left thinking the chronic pain people are still not being treated fairly. The new guidelines MIGHT work for acute pain but certainly not CRONIC PAIN. I’m a veteran with pain, I’ve had EVERY conservative treat possible Several repeatedly including a pain pump and spinal cord stimulator my doctor has even extended the pain pump refills from every 90 days to every 120 I’ve always been told the meds in my pump lose effectiveness after 90 day so what has changed,? These decisions should be left to the doctor. These guidelines are like saying all diabetics can be controlled with diet and exercise? No pain patient asked to be this way it is the hand we have been dealt shuffling the cards daily between what our body’s will allow today. I pray this will strike a cord with someone and throw us a lifeline.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deanna	None	None	0900006484f744c7	Tonn	None	2022-02-14T00:57:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Tonn, Deanna	kzl-xxyl-v7wv	False	None	False	2022-04-12 01:55:48.431	[]
609	CDC-2022-0024-0615	https://api.regulations.gov/v4/comments/CDC-2022-0024-0615	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter has dealt with chronic lower back pain and pain from complex regional pain syndrome for the last eight years. Throughout those years, she has tried so many alternatives to opioids, such as physical therapy, chiropractic care and nerve blocks. After all other methods failed, her pediatric pain specialist decided to try an opioid. The opioid did not take the pain away totally, but did help her be able to function. She continue to receive numerous nerve blocks, but they never helped. Fortunately, when she aged out of pediatrics, we found a Doctor Who understood CRPS and continued giving her the opioid medication she needed to be able to live a partially functional life. The medication doesn’t take the pain away, but it puts it at a level that is tolerable. As her mother, I have always made certain She was taking her medication correctly. Through the years she has had to go up on her dosage, just as a diabetic might need to increase insulin as they grow and change. My daughter, along with so many others that require opioids to function due to chronic conditions, are doing everything they can to be responsible with the medications they need. This “war on drugs“ is being waged against productive members of society who are not abusing any medication. The true war should be being played out on the streets where these opioid medication are easily found and abused. Because of this “war on drugs“ my daughters doctor has just been forced to lower her dosage of a medication she needs to function. Due to this lowered dose, she has had to quit school and is no longer able to go out and spend time with her friends or volunteer with childcare, which she loved. Because of this war on drugs, my daughterIs no longer a productive member of society. At 24 years old, she is confined to bed most of the time due to intense pain. Most of us will never understand the amount of pain she is in due to complex regional pain syndrome. According to the McGill pain index, The pain she goes through daily is more than cancer patients and natural childbirth. Just as a diabetic needs their insulin to function and survive, a person with chronic intense pain needsThese opioid medication’s to be able to function and survive. Since the decrease in medication for my daughter, she feels like a failure because she can no longer go to school and help me . She has two friends with similar conditions that have recently taken their lives due to not being able to live with the intense pain that could be controlled if the doctors hands weren’t tied due to the new regulations. Please consider that when you are tying the doctors hands to treat their patients as individuals, you are forcing them to go against their oath to “ do no harm”. Each person deserves to be treated as an individual and a “one size fits all” policy just doesn’t work. Stop tying doctors hands to do what they trained to do! Let people like my daughter live their lives with dignity. She wants to work and be a productive member of society, but these regulations have made that impossible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	0900006484f744ca	Saul	None	2022-02-14T00:58:10Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Saul, Tammy	kzl-y0hr-5q63	False	None	False	2022-04-12 01:55:48.634	[]
610	CDC-2022-0024-0616	https://api.regulations.gov/v4/comments/CDC-2022-0024-0616	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is my 2nd comment, because nothing will change if we don't! I live in constant fear now since the guidelines have changed. Fear of my doctor, fear they will take away my medication, fear I might get a false positive on my monthly drug test. I just started advocating for myself and it's been quite difficult, because of these absurd guidelines. The mme of 50 to 90, completely should be eliminated. I feel my doctor and I can figure that out. I have been on these medications for 25 years. Also, I had to choose between my pain meds and anxiety medication, because you cannot be on both! I had no problem with being on pain medicine and anxiety/depression medicine. Unfortunately, depression and anxiety go hand in hand with pain. You have to be more efficient with chronic pain patients. These absurd guidelines are ruining thousands and thousands of lives. You're worried about people "oding", but what about the people who are suffering so bad that they turn to suicide. And can someone please tell me why the "opioid epidemic" deaths have skyrocketed? Because it sure wasn't from opioid prescriptions. Why is it still going up if opioid prescriptions have been cut down about 40%? It's the ILLICIT drugs. I think the CDC knows this and you can do better. Stop harassing chronic pain patients with these insulting guidelines. Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f744e2	Anonymous	None	2022-02-14T00:58:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-y60b-f2bb	False	None	False	2022-04-12 01:55:48.850	[]
611	CDC-2022-0024-0617	https://api.regulations.gov/v4/comments/CDC-2022-0024-0617	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I consider myself very lucky that I have been this stable, sure I have bad days where I have to do a lot to take care of the pain, like hot baths, additional medications like anti-inflammatories and bengay, and my use of heating pads has left marks all over my back like a zebra, but I also worry that if things get worse in the future I will have to fight to get an increase in dose, even though I'm not near the max that the CDC has erroneously set years ago. Drs are just too scared to increases doses, let alone prescribe them to being with. (a friend just had major hip replacement surgery and his dr refused to give him pain killers afterward! Another had a bad tooth extraction (with a large cyst) and wouldn't even give them 1-2 days of pain killers and they almost wound up i the ER due to the pain!) This is doing actual harm to patients! I'm also VERY VERY worried about finding another dr who will take me on as a patient since my current dr is nearing retirement age. Drs all see these medications on your chart and automatically refuse to see you! Have have never taken even 1/2 a pill above my prescribed amount in all these years. Pain patients being forced to find treatment outside of the medical system is a failure of the system. Had I been forced to find pain medication from street providers I would have never known what I was actually getting. Considering many street drugs contain fentanyl I would have been at significantly higher risk from overdose than I ever was taking prescribed opioids. Without any pain management options suicide would have been more strongly considered just to make it stop. While it is impossible to ever know the numbers, the 2016 guidelines killed pain patients across the country and made many more of us criminals.<br/><br/>First, please remove pain exemptions! There are many diseases that cause excruciating pain. No specific disease should be singled out for exemption over others. So unfair and biased. It’s so crucial to clarify the earlier guidelines so that clinicians and HMOs are not afraid to provide pain relief to chronic pain patients.<br/><br/>Secondly, I have debilitating spine degeneration in my lower back. When a doctor sees in your "Checklist" evidence section:<br/><br/>"Insufficient evidence for long-term benefits in low back pain, headache, and fibromyalgia".<br/><br/>What do you think said doctor is likely to do when considering my treatment? These terms are over generalizations and many diseases can result in back pain, headache etc. A person could have muscle tension or a brain tumor. Both cause headache! Remove this bullet point. In fact, remove the entire "Evidence" bullet points section. They are suspiciously shoehorned in, my guess is by psychiatrist recommendation (?) to create an anti opioid bias. So irresponsible!!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Raymond	None	None	0900006484f7450a	Butterfield	None	2022-02-14T00:58:48Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Butterfield, Raymond	kzl-yhc6-zslw	False	None	False	2022-04-12 01:55:49.084	[]
612	CDC-2022-0024-0618	https://api.regulations.gov/v4/comments/CDC-2022-0024-0618	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There are far too many people including myself that get denied proper pain care even when an opioid is a proper treatment plan and I had no prior abuse before this epidemic. Practitioner refuse to treat pain and if you ask you are automatically looked at as a drug seeker. This has forced many to reside to the streets to treat their pain which as we know leads to fentanyl deaths every min around our nation. The healthcare system has hit to change, methadone needs to be more accessible and the stigma around it has got to stop especially from the ones we are suppose to trust the most bring our doctors. I could go on and on. But things have to to change it should be a choice and as an adult we should be able to choose which medicines we want to use and sign a waiver.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kyla	None	None	0900006484f7452e	Macon	None	2022-02-14T00:59:02Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Macon, Kyla	kzl-yr3u-jdfp	False	None	False	2022-04-12 01:55:49.311	[]
613	CDC-2022-0024-0619	https://api.regulations.gov/v4/comments/CDC-2022-0024-0619	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a golden opportunity to address opioids in the context of polypharmacy.<br/><br/>Ther Adv Drug Saf. 2020; 11: 2042098620933741.<br/>Published online 2020 Jun 12. doi: 10.1177/2042098620933741<br/>PMCID: PMC7294476<br/>PMID: 32587680<br/>We still have a culture of polypharmacy that primary care serves as a point of intervention.<br/><br/>Polypharmacy is common in adults using opioids<br/><br/>Opioids, Polypharmacy, and Drug Interactions: A Technological Paradigm Shift Is Needed to Ameliorate the Ongoing Opioid Epidemic<br/>...,1 ...,1 ...,1,2 T...,1 and ...3,*<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7453a	Anonymous	None	2022-02-14T00:59:46Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-yuit-2s50	False	None	False	2022-04-12 01:55:49.523	[]
614	CDC-2022-0024-0620	https://api.regulations.gov/v4/comments/CDC-2022-0024-0620	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe guidelines that restrict doctors’ ability to prescribe opioids results in under-treating people in pain, particularly those with chronic pain. Please update the guidelines so this problem is recognized.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74576	Anonymous	None	2022-02-14T00:59:56Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-z754-4elg	False	None	False	2022-04-12 01:55:49.731	[]
615	CDC-2022-0024-0621	https://api.regulations.gov/v4/comments/CDC-2022-0024-0621	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have just had an experience that indicates something needs to be established, or provided for that allows the issuance of opiate prescription medications by Emergency Rooms and Doctors.<br/><br/>I went to my hospital's Emergency Room facility in my neighborhood on Feb. 8, 2022 suffering from extreme pain on the left side of my lower chest and ribs. I had been laying face down on the carpeted living room looking for what I thought had rolled under the sofa. In trying to get lower down to be able to see more. In doing this I heard a pop and simultaneously had a flash of pain on the left side of my chest that on a 1-10 scale for pain was a 20. I also was having trouble breathing without pain. Right away my wife took me to the E.R. and they took me in right away. Chest x-rays were taken and fortunately for me there were no cracked or broken ribs and there was no damage to my heart and there was no bleeding. I was told that I had a severe contusion but they couldn't do anything to reduce the pain that I was experiencing. I asked if they could get me some kind of pain killer. I was told they they were not allowed to give me any opiate medication. I plead with them and somehow a nurse came in with 2 pills in a cup and some water. I asked if they could write a prescription for pain medication and was told that they could not do that and that I would have to see my primary doctor the next day, to go over the E.R report and get a prescription for pain killer medication. This is where the horror began. When I tried to see my doctor I was told that the first open appointment time that he had was February 17th. But I needed to see him right away because the pain was unbearable. They repeated that his earliest appointment was the 17th. I left messages requesting special consideration under the circumstances. I did this for 2 days and finally got a call back and was told that someone else at the facility could see me the next morning. I went to that appointment and was examined and sympathized with about the pain but was told that there were strict Federal rules addressing opiates and that my pain was not covered by one of the 3 circumstances that were established for the use of opiates. I kept telling them that I was really having difficulty breathing so I was re-examined and then was told that I should wait and that they would be back in a little while. After waiting for some time an assistant came to me to tell me that a 1 week prescription for pain killer was finally sent to my pharmacy and that my visit was now concluded. How this was able to come about I have no idea, but was grateful it was done.<br/><br/>I am a 76 year old man who never expected that I would have to go thru what I did. I'm sure that you may be receiving a deluge of comments but if anyone in your group would like to speak to me about my experience my telephone number is ... <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484f72a46	Landes	None	2022-02-14T01:10:11Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Landes, Peter	kzk-hsrb-fncl	False	None	False	2022-04-12 01:55:50.004	[]
616	CDC-2022-0024-0622	https://api.regulations.gov/v4/comments/CDC-2022-0024-0622	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to the previous law I have been denied pain meds by several drs and after surgeries. I was told to take Tylenol and ibuprofen and those don’t work for me. I’m lucky I get what I get but I fear being weened off the meds or told I can’t have them. Please change the guidelines so I can get the help I need for my excruciating pain I’m in everyday. These opioids give me a quality of life and enable me to participate in society and everyday life	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484f72bbe	Arndt	None	2022-02-14T01:11:54Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Arndt, Nancy	kzk-r6dx-26bo	False	None	False	2022-04-12 01:55:50.210	[]
617	CDC-2022-0024-0623	https://api.regulations.gov/v4/comments/CDC-2022-0024-0623	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s sad shame that because some people misuse opioids or did so in the past, that the people who really need them for chronic pain now have a difficult time getting their doctors to continue to prescribe them. My wife has had severe back pain from an injury years ago, and due to other health issues cannot take OTC pain medication. Nor is her condition repairable (non-operable). Her only option for any relief has been prescription ocycodone for the last few years. HOWEVER, her primary-care doctor does not prescribe pain medicine anymore, due to all the implied legal issues he might have to deal with under the current CDC “guidelines”. Instead, she was referred to a “pain-clinic”, to “manage” her pain. The only “managing” these places seem to do is to administer the smallest dose of medication as possible and dole it out as they see fit. My wife has good days and bad days with her pain. On the good days her “allotted” two pills a day allow her to lead a fairly normal, but limited life. On her BAD days, being able to take an extra pill would make her day at least bearable. But she dare not take another, because the pain clinic will only prescribe one month’s worth at a time. If she has a really bad day her only option is to try and suffer through it because if she takes one extra on that day, she will be short at the end of the month. That is no way to live a happy, fulfilling life. In fact, she has gotten so discouraged lately, that her primary physician has prescribed antidepressants for her. Ironically, he will prescribe something to relieve the depression caused by the pain the current medical establishment is reluctant to address. All because the government has made doctors afraid to do what they think is best for their patients. Please, please leave those type decisions to themselves. The consequences of the current “regulations” have made my wife’s life unbearable for the most part. She doesn’t deserve that just because a few bad actors use opioids to get high. Revise and relax the regulations and let the doctors do their jobs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72dcc	Anonymous	None	2022-02-14T01:12:20Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-t1st-k581	False	None	False	2022-04-12 01:55:50.423	[]
618	CDC-2022-0024-0624	https://api.regulations.gov/v4/comments/CDC-2022-0024-0624	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At the young age of 16, my step daughter was prescribed opioids for a back injury from a car wreck. She quickly became addicted, and life was a downward spiral to all around her. As many of you know, a 30 day script just isn’t enough to an addict… so they turn to other methods to meet their needs from the “pain”. The addiction lead to over 26 rehab centers, 3 years of prison, several felonies, theft, and many close encounters with near death from over-dosing. At the age of 29, she passed away on New Year’s Day, 2022. If you don’t take away anything else from this comment, let this last part sink in… a father lost his only daughter, a brother lost his only sister, a mother lost her only daughter, and daughter lost the only parent present in her 2 years of life… she lost her mother. Had this 16 year old girl not been able to get refill after refill, she might still be here today to see her daughter on the first day of school. To pick out her prom dress, to graduate high school, start college, get married, and one day have a child of her own. All these things have been taken away and it all started with an opioid prescription. Please change the prescribing guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brittney	None	None	0900006484f74596	Anonymous	None	2022-02-14T01:16:51Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous , Brittney	kzl-zenl-j39h	False	None	False	2022-04-12 01:55:50.633	[]
619	CDC-2022-0024-0625	https://api.regulations.gov/v4/comments/CDC-2022-0024-0625	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, to whom this concern, I am a cronic pain patient who has gone through the ringer and now suffers without my opiate medication because of the harm that the CDC guidelines have caused. I was told that I was going to be weened off my medications to be put on a "new great medication" called belbuca. I told them I was on a medication already once with that drug, buprenorphine, already and I had a bad reaction to it. They told me this was different and new. After they took me off my opiate medication that had worked for 4 years, the new belbuca gave me a bad reaction. So they lowered my dose until I was off it. Now in severe pain I said can I have the medication that works. They said I can't prescribe that sorry. Now I am stuck in bed 90% of the day with bed sores because I am in pain an no one will prescribed pain medication because they are being told its to addictive and not to prescribe it any more. I was never addicted. Never have been to anything. Well one day I hurt SOOO BAADD that I took one of the pills from an old prescription of mine and I got kicked out of the practice. My next step will be ordering medication from India that sells it. That's my only option. I can't keep living in this pain bed bound at 40.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doug	None	None	0900006484f745ce	M	None	2022-02-14T01:17:14Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from M, Doug	kzl-zoa3-jx6g	False	None	False	2022-04-12 01:55:50.837	[]
620	CDC-2022-0024-0626	https://api.regulations.gov/v4/comments/CDC-2022-0024-0626	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who has had chronic pain for over 10 years, I can tell you, the studies you are referring to are wrong. I have first hand experience that opioids do work and very well both for acute and chronic pain. Thousands of years of use, also state otherwise. The only caveat is you need them to have an analgesic effect and 50MME is not enough in many cases. It is my great hope that you reconsider the 50MME suggestion and change it to an individualized choice between the doctor and patient. You are also aware that your last guidelines were taken as gospel in most States and Federal agencies. It is fair to assume that they will again and as an agency that is committed to increasing the quality of life for all patients, we CPP hope that you will focus on us and not just the opioid crisis. <br/>While I appreciate what the opioid crisis is doing to the United States, the data is showing that pain patients were better treated by doctors and not left to find relief in other places. At least the medical community can monitor patients and their outcomes. The guidelines are creating an illicit fentanyl problem where people with substance abuse issues are turning to a dangerous substance. The problem is, the guidelines are also pushing a lot of chronic pain patients to take extreme action and turn to the streets as well. This does not mean they have a substance abuse problem; it means their pain isn’t being treated properly. If you can view these problems from the eyes of the patient, you will see we are begging you to support us. <br/>Also, I'm afraid to put my information on this form do to retaliation from doctors, which should tell you just how bad it has become. <br/>Please consider removing the 50MME guideline. Thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74a16	Anonymous	None	2022-02-14T04:08:40Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-63s3-m79r	False	None	False	2022-04-12 01:55:51.043	[]
621	CDC-2022-0024-0627	https://api.regulations.gov/v4/comments/CDC-2022-0024-0627	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have sarcoidosis and chronic pain. I cannot find a doctor to prescribe anything to help. I can’t function when I’m in such pain. In addition, my grandmother went to the hospital several times for severe pain. We found out she had sepsis. Doctors wouldn’t give her anything either and she just cried and cried. This isn’t right. It should be illegal to knowingly cause pain to someone when we have treatment. To see my grandmother scream in pain was horrible. This has got to change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f749c1	Jones	None	2022-02-14T04:09:05Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Amy	kzm-5049-dotq	False	None	False	2022-04-12 01:55:51.251	[]
622	CDC-2022-0024-0628	https://api.regulations.gov/v4/comments/CDC-2022-0024-0628	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started off taking oxycontin for chronic back pain in 2007. I was scared to take but this medication worked better then anything. I tried all the different injections, non-narcotics, PT, I tried light exercise, (I worked out for many years until my 1st back surgery in 2000, 2nd surgery was 2004). Then I hurt my neck in 2006 I have bulging disks, I have moderate to severe spinal stenosis, fibromyalgia, osteoarthritis & bursitis. My Medication was increased through the years & I was taking a high dose of ER oxy & oxycodone for breakthrough pain. Then things got to be very difficult, I had to get prior auth. everytime which caused a delay getting my meds. I was constantly on the phone with Dr, ins company's & the pharmacy which caused my anxiety to go through the roof, going through extreme pain & withdrawal at the same time. Then I weaned myself off half the dose I was taking hoping that would make life easier. My Rheumatologist eventually stopped prescribing narcotics, she was very nice and made a suggestion that I go to an outpatient center to get off opioids & put on subtex . I was willing to do that as long as that medication helped pain. When I started on the medication it seemed to work! I didn't think about taking the oxycontin. But after being on this a month or so my pain came back with a vengeance. I was recommended a Pain Management Dr. and he prescribed 1 hydrocodone a day to start (a nightmare), then gave me dilaudid., (extreme?!) that just made me feel out of it and didn't really control my pain. I changed pmd's to the one I'm seeing now. Dr. C was willing to prescribe oxycontin after I told him it was the only thing that helped my pain but he explained the limitations. He prescribed 2-15mg oxycontin ER a day and up to 4-5mg oxycodone a day for breakthrough pain. Before I weaned myself down halfway I was on 80mg of oxycontin ER 3 times a day. (Too much!) Plus the 5 mg of oxycodone for breakthrough. I don't ever expect to go back to even the 40 mg ER's but my Dr. seems to think I'm on a high dose now and can't go any higher or he will loose his job. I have so much pain daily especially in the winter when I have flare-ups. The first thing I do when I wake up at 5am (can't sleep later because of pain) I take my 15mg, I lay on the couch and have my coffee while I'm waiting for relief. Then I get up and feed my dogs & birds about 7-8am after that I clean and do my regular chores. No matter how much I hurt I make myself get up and do these things every morning. If I didn't have pets I probably wouldn't bother doing as much. I love to bake healthy foods too so if I'm feeling up to it I will bake. Although my meds wear off and I have to wait hours in pain until the next dose. The worse part of my day always seems to be around supper time I'm always in too much pain to make dinner, my husband is nice enough to pitch in and help. He also goes to the store for me. I very rarely go anywhere anymore because I never have a full day being pain free or have less pain. I told my Dr. that the oxy works after I take it but it wears off too soon and I don't feel I have enough to cover my pain through the day. It goes in waves. I wanted him to prescribe another oxy ER for the middle of the day and he said he can only prescribe those every 12 hours. But if he would at least prescribe up to 6 of the 5mg and increase the 15mg ER to 20mg ER. Thats only an extra 20mg dose that I would take. I take 50mg now. That would make a huge difference. I know I would have a much better quality of life. I dont like that I have to take narcotics at all, but I tried other options and going without and I was miserable. How do I approach my Dr. In regards to this new regulation. I hope he is going to be willing to work with me and I also hope that other doctors are going to be more relaxed and open to making a difference to their pain patients. I belong to a support group online for people with chronic pain and its truly sad reading some of their horror stories. It's just not fair! We need to be validated, our doctors need to be better listeners and use better judgment. <br/>Thank you, I hope this helps.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74961	Anonymous	None	2022-02-14T04:10:53Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-3oou-ml9q	False	None	False	2022-04-12 01:55:51.456	[]
623	CDC-2022-0024-0629	https://api.regulations.gov/v4/comments/CDC-2022-0024-0629	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Chronic pain patient that on long term opiod therapy and doing very well fir more than 10 years. Last October 2021 my pain management clinic said I failed a drug screen. They stated they found trace amounts of a metabolite of a street drug I did not use, I even took a DOT drug screen right after that showed no illegal drugs, but they still cut me off medsI was doing good on over 10 years. <br/> Ever since this happened no one will treat my pain with my old medication,. I am being treated like a drug addict .several doctors have told me they will not prescribe to me due to being scared of the government and losing their license. <br/> I am suffering without the medication that allowed me to function for years with no issues. I have had many surgeries for different problems cervical fusion, shoulder and bicep reattached ect, but I am still denied my medication. Where do I have to turn too now? <br/>A lot of us are left too suffer with no choice but to either turn to illegal drugs for pain relief or even worse end things. <br/> This has already happened to a lot of abandoned chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Salmon	None	None	0900006484f74935	Luis	None	2022-02-14T04:11:17Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Luis, Salmon	kzm-34eq-2wh8	False	None	False	2022-04-12 01:55:51.692	[]
624	CDC-2022-0024-0630	https://api.regulations.gov/v4/comments/CDC-2022-0024-0630	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a patient who suffers with the effects of pain for a very long time now. The criminalization of opioids and prosecution of doctors attempting to alleviate pain has affected my quality of life quite severely. I am treated like an addict who has been caught lying. I feel like I’ve been treated rudely & harshly. The intrusion of the CDC & the DEA into my medical treatment means my pain is consistently under treated and my PTSD , anxiety and ADD go untreated. How politicians involved themselves and subsequently pushed “addiction centers” and then profited handsomely is beyond sickening. It should be prosecuted as a crime. Meanwhile because of the 2016 PROP guidelines many patients were left in such severe untreated pain that they committed suicide. Rather than protect or help people, the severe, forced tapers or abandonment of pain patients has resulted in people so desperate for pain relief that they try anything they can find on the black market; substances likely dangerous and contaminated with fentanyl. Medical treatment should be left to the doctors, not the politicians or the government. I find it hard to believe the USA has become such an entity that appears to enjoy inflicting as much pain and suffering to its citizens as possible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74904	Anonymous	None	2022-02-14T04:11:42Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-2dgm-v4tv	False	None	False	2022-04-12 01:55:51.907	[]
625	CDC-2022-0024-0631	https://api.regulations.gov/v4/comments/CDC-2022-0024-0631	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The State boards are pursuing every pain management doctor they can using the CDC Guidelines as LAW. They removed my personal 25 year patient relationship with a PM overnight. They closed his office and all of the patients are struggling. We were told to go to the ER which is not an option as the ER is currently getting federal medics to assist with the pandemic. Additionally the ER put out an advisory telling pain patients to not come to the ER. The primary care doctors in this area will not and did not take over any PM caseloads. I did find a physician and luckily I have two insurance policies. This group requires many levels of testing and epidurals as well as nerve blocks. You cannot continue to be seen if you do not agree to have these things done. They feel the CDC guidelines require this. Another failure of the 2016 release. I have been through all these things. Unfortunately I suffered a horrible nerve block that caused reversible damage. Again permanent damage because of “guidelines” that were determined by zealots. I agree current MRIs are necessary but not all insurance companies will continually update MRIs. Every time I receive an MRI the prognosis is worse. I do very well on opioid management. However the only doctors now handling pain management are rapidly reducing patients overnight. Furthermore they are claiming due to the 2016 CDC guidance, Opioid therapy is only for cancer patients and everyone has to be removed. There was no tapering or any attempt to stay within the CDC reduction of 10% a month. We are in a crisis mode.<br/><br/>Something has to be done to ensure that valid pain patients get the prescriptions needed. Several patients have now died and I feel more or to follow. Many of them suffered high blood pressure due to immediate withdrawal. We keep hearing about these harm policies but yet there are not any clinics opening up to provide help. We need some direction and we need it rapidly. The State Boards have absolutely NO contingency plans in place when they target a physicians office. I do not understand why this is not mandatory before they shutter an office. Why is there not more backlash against these boards and why did the CDC not foresee all of this fallout. The horrible one size fits all was a fail that led to the poisoning of our Country from outside sources because our Goverment told Physicians to stop treating Patients essentially. If the goal is to help the community and provide harm reduction, then why didn’t the CDC work with the AMA and Boards to help taper the patients down to what they “felt” was appropriate. Again, the CDC acted without thought and planning. The currently recommended MME for a patient was calculated without proper investigation or understanding of chronic pain. Personally I do not believe the government needs to interfere with physicians but that is where we are. I do not support the CDC deciding what care somebody should receive. The CDC recommended medication we know does not work for many situations or if someone is on blood thinner. The CDC recommended Tylenol and NSAIDS that we already know can be deadly and at minimum do not address many situations. Is this really about reduction of harm or money? It seems we heard all the “Guidelines” are the reason for lives being lost but yet chronic pain patients are being pushed to a Schedule 1 in most States (medical Cannabis). Is this about a billion dollar industry the Government wants to tap into ? We all know insurance companies would greatly prefer the medical cannabis program instead of PM therapy. As a patient I’m getting very concerned that we have gone the wrong way in attempting to resolve what has been deemed as a crisis. I do not believe we ever had a prescription crisis. The crisis has always been regarding street overdoses and now of course fentanyl has entered the marketplace. The more PM doctors that have to close down the more overdoses we will see from pain patients forced to the street.<br/><br/>I hate to be that blunt but somebody needs to.Many of us trusted the surgeons that helped put us back together when we were broken. We also entrusted that the rest of our lives we would probably be in some sort of pain management therapy. Now that is being stripped away.<br/><br/>What are we supposed to do? I am being told I will have to live with my pain. I am not doing 50% if what I was doing on monitored treatment that was fit for my situation. . My quality of life has plummeted. This is inhumane. This is not the United States of America. Please help us correct the horrible 2016 misinformation that resulted in over a million deaths now. Directly and indirectly related to the CDC Guidelines that became regulation overnight. It is imperative that we (you) step back. Take away the regulations for a minimum of five years to undo the damage that has been done. Study chronic pain and get the physicians involved. Then re-visit. Immediately halt these deadly “guidelines”.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f740aa	Presley	None	2022-02-14T04:13:02Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Presley, Deborah	kzm-1kqz-7yib	False	None	False	2022-04-12 01:55:52.137	[]
626	CDC-2022-0024-0632	https://api.regulations.gov/v4/comments/CDC-2022-0024-0632	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for thr changes you have made to the guidelines so far. PLEASE remove the MME the guidelines as that is the number that states and insurance are using to set up limits. I agree that dosage should start slowly BUT the drs are being told they cannot go over these "suggestions" as this is bring taken and used as a hard limit and hurting pain patients both chronic and acute. Please allow the drs to treat their patients as individuals amd not as one size fits all. There are millions of people suffering and dying due to untreated or under treated pain. The overdose rate is skyrocketing due to ILLEGAL fentanyl from the cartels NOT pain patients amd their medications. And the DEA is using the guidelines as a reason to arrest and terrorize dr offices which then leaves pain patients with NO medical care and then cannot find a physician to treat them. Please correct the 2016 mistakes so that pain patients can be treated again as a human that deserves care and compassion and NOT as drug seeking addicts. We need medication for pain control to have some quality of life not to get high. Thank you for your consideration to this issue	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kris	None	None	0900006484f7463e	Specht	None	2022-02-14T04:13:26Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Specht, Kris	kzm-0s4s-lj24	False	None	False	2022-04-12 01:55:52.346	[]
627	CDC-2022-0024-0633	https://api.regulations.gov/v4/comments/CDC-2022-0024-0633	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the ability to contribute.<br/>I have been dealing with pain for years. It became constant and intractable after I fractured my back in 2016. I’ve had two spine surgeries and will need a third in a year or so. I’ve been stuck bed ridden for four years because nothing I was offered for pain was working. I can’t work, I can’t stand sit or walk for very long. I can no longer cook dinners, take showers when I want or clean my house. I’m to the point where I filed for disability. I was on opioid therapy before until the new guidelines were put into place. I then was cut off and given a medicine that caused headaches and vomiting. I’ve not had any medication for 7 years until last year after spinal fusion surgery. My pain management doctor kept me on the pain medication but will not adjust then because I’m not at the threshold to do so. And I’m on a low dose currently. The dose makes it bearable and that is it. My quality of life is still disputed and I am currently trying to figure out a way to live my life doing the minimum. I should not have to live in agony or figure life out when there are things that can be done to give Me back my life. I have been a single parent for years and I am now a grandma. I’m responsible for taking care of my home and myself and I can’t even do that. I wanted to end it all Two years ago. I didn’t have a plan in place but I was so tired of loving this way. Nobody should have to suffer the way I do. The anxiety and depression that comes along with it can be so debilitating. Combine the pain with the emotional and mental aspect. It can make people like me want to give up and it has. I use to love to cook meals for my family on Sunday. That was a day I looked forward to. I use to love turning music on and cleaning my house or doing yard work. I use to love advocating to stop gun violence. It took me a few years to even love myself again hoping things could change for chronic pain sufferers. I want to be treated like a human being and live my life to the fullest or even close to that. I have myofascial pain syndrome, disc deterioration, a compression fracture deformity where I lost 2% disc height and 3 other issues going on with my spine and I’m offered the lowest dose 3xs a day. I do not like feeling comfortable to stay in bed I want to actually be able to do the things in life that others can. We are not all suffering in the same way. We deserve to have a case by case plan. We did not want to suffer in the ways that we are. I did not ask for these issues nor did I know I wouldn’t be able to tolerate most medication. I’m almost 50 years old I want to live the remaining time I have left how I chose, not living with pain every single second of the day. I want to be able to do other things besides staying in bed.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f74613	Deem	None	2022-02-14T04:14:35Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Deem, Amy	kzm-0bch-mi03	False	None	False	2022-04-12 01:55:52.558	[]
628	CDC-2022-0024-0634	https://api.regulations.gov/v4/comments/CDC-2022-0024-0634	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I guess I can't wrap my head around your insane so called guidelines....you are NOT Doctors nor do you know any if us as patients yet you are making our lives a living hell by making us suffer like you are a Nazi & don't care. .we all know that 98% of overdoses are from illegal drugs mainly Fentanyl (which my Grandson died from in 2020 from taking a xanax cut with Fentanyl, why don't you out that much energy & time to stop that instead of depriving the chronic pain patients who have legitimate & incurable diseases that we suffer with every day. I am 65 and my quality of life has greatly diminished because of what you are doing, I can no longer go on outings with my grandchildren....you are killing our so called golden years. Do your job & stop the deadly illegal drugs, just because you can't control that you are going to do anything you can control at the expense of other people's lives. Because of this I am now suffering from severe depression & anxiety. So thanks for nothing!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fran	None	None	0900006484f743a1	R	None	2022-02-14T04:15:03Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from R, Fran	kzl-sedh-nlne	False	None	False	2022-04-12 01:55:52.774	[]
629	CDC-2022-0024-0635	https://api.regulations.gov/v4/comments/CDC-2022-0024-0635	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern; I am a person suffering with manor disabling pain and have taken all of your prerequisite suggestions with none relieved suffering, only aggravated it and caused more pain and am also allergic to 28 or more medications including gabapentin. I can not take NSAIDS due to life-long Coumadin treatment. Because of your unethical rules it makes it very hard for people like myself to get the ONLY treatment that does seem to ease the pain that is so severe that it breaks you down to your knees and sends electric shock-like sensations through the body that it knocks the wind right out of your chest. I truly believe in screening patients that " use the system " to get medication because of being addicted or don't have ailments that are necessary for this type of medication but my God, there ARE people like myself the don't fit in YOUR OPINIONATED BRACKET that really NEED this medication. I think that you all should let the doctors who know their patients and have more than likely PROOF that their patients NEED this medication be able to prescribe as they are licensed to do so. You do not have the right to pick and choose who needs this medication because you don't work their caseload. Stop trying to play God because one day it could be YOU that may be in such a need and then not fitting into your " chosen bracket " and refused this medication. I feel like I should not have to be damn near dying in order to get this medication. It should be given on a pain scale with documented proof of injury or no other alternatives for us with a multitude of allergies. Im pretty sure that your high-class family can get this medication with no questions asked. While you make the rest of us suffer, just know that the Lord is watching you all and your decision to have others suffer without knowing their case could be a decision that the Lord takes into account on your day of judgment when you are begging Lord, Lord. Im saying this to say BE FAIR to those who really are in dire NEED of this medication and not lean on YOUR OWN guess-work because no way in Gods green earth are you able to individually decide a case by case determination of each individual of need. <br/>Thank you for allowing me to voice my knowledge as I lay in my be in pain at this very moment. Stay safe and stay HEALTHY as your own decisions could come back to bite you or a loved one, God forbid. <br/><br/>Good Day,<br/><br/>02/13/2022 @ 612am Sunday Morning	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fahtima	None	None	0900006484f7311b	Abdul Fattah	None	2022-02-14T04:16:37Z	None	None	1	None	2022-02-13T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Abdul Fattah, Fahtima	kzl-8ay4-hi4k	False	None	False	2022-04-12 01:55:52.980	[]
630	CDC-2022-0024-0636	https://api.regulations.gov/v4/comments/CDC-2022-0024-0636	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from unexplained chronic pain since 2012. What started as a small annoying pain taking up and area of about a quarter in my back ribs, is now constant pain in all of my back ribs, my neck, my shoulder and my hip (on the right side only); as well as occasional headaches that can only be calmed with Sumatriptan and Ibuprofen. Yes, I have had scans and blood tests done to rule out and internal issues.<br/><br/>I wake up with this pain (and the am is the worst) and sometimes sit on the edge of my bed arguing with myself to fight through it and go to work. I tolerate this pain throughout the work day until the end of work where, often times, my ribs are sore, are popping (ribs shouldn't pop) and it feels like they are held together with semi-cured concrete. If I need to work later then I have to tolerate it even longer. <br/><br/>My pain level is low enough to work most days but it is a constant 3-4 level pain (out of 10) that can increase to 5-6 and this pain is exhausting and wears me down. I have missed several days of work since 2012. 24-hrs a day I have this pain and what gives me a break from it? Pain medication, muscle relaxers, ibuprofen and very hot showers/hot tub. My diagnosis? Neuralgia (aka - unexplained nerve pain)<br/><br/>I am seeing a pain management dr and have been since 2017. That's right, for 5 years or so I didn't take anything for pain and managed pain through physical workouts but I couldn't do it, alone, anymore. I have tried: <br/><br/>chiropractic care, acupuncture, massage therapy, physical therapy, and TENS units and they provided some relief, for the day and I was back to the usual the next day.<br/><br/>I have tried: Dry needle trigger point therapy, nerve blocks, RFA in my neck, ketamine/lidocaine infusion (one round) that followed with just lidocaine infusions. In this upcoming week I will be trying cryo-abalation in the intercostal region. Next will be a long term infusion session of ketamine/lidocaine.<br/><br/>Medications I have tried are: Gabapentin, Diclofenac, Desipramine, Buprenorphine - and each of these had side effects ranging from dry mouth to headache to severe drowsiness and incoherence. <br/><br/>I have even approached this form a mental perspective as well and I am actively in therapy for multiple reasons, including this.<br/><br/>What you are missing are the mental effects from daily, annoying, aggravating and exhausting pain. I have a loving and understanding wife and my daughters (now adults) are very understanding also. The fact my family is supportive removes a great deal of stress from the social and family involvement effects the pain causes. <br/><br/>A support system is a crucial life saving aspect - I want you to think carefully about what I just said.<br/><br/>While I agree with the approach to minimize opioids and the doses thereof, there are many patients out there that are trying other things but they are aided with opioids while doing so. I'm asking that everyone involved in these guidelines assure these important pain aides remain available to pain management doctors for patients they have no other answer for, including for long term treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484f74a44	Swasey	None	2022-02-14T13:38:44Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Swasey, David	kzm-6o6y-dcks	False	None	False	2022-04-12 01:55:53.187	[]
631	CDC-2022-0024-0637	https://api.regulations.gov/v4/comments/CDC-2022-0024-0637	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The local medical establishment has taken your published guidelines, made posters out of <br/>them and your “guidelines “ are now the “bible”. The CDC needs to stay out of our business.<br/>We have an opioid crisis because of the lack of due diligence by all government agencies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janlyn	None	None	0900006484f7531a	Moody	None	2022-02-14T13:47:29Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Moody , Janlyn	kzm-qg8p-y7um	False	None	False	2022-04-12 01:55:53.396	[]
632	CDC-2022-0024-0638	https://api.regulations.gov/v4/comments/CDC-2022-0024-0638	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an active duty military veteran who sustained spinal injuries during my contract period with the army. I have severe multi-level degenerative disc disease, moderate/severe spinal stenosis, and multiple bursting and herniated discs throughout my entire spine and neck.<br/><br/>Civilian trained physicians that are employed by the DOD and work at the TMC's (troop medical centers) tried multiple medications and the only one that made ANY type of noticeable difference was the Oxycodone. <br/><br/>Prior to and during the time I was prescribed the medication, I was also scheduled for various types of physical therapy sessions, which had ZERO positive impact, and only exacerbated my injury.<br/><br/>The steroid injections I was receiving (in my spine) from a Tricare (army medical insurance provider) approved sports medicine and pain management doctor, as well as the cortisone shots I was having administered regularly, also had minimal impact.<br/><br/>I am fully aware that these opiates are not a magic cure pill, but the issues I have cannot be resolved through physical therapy, and the army spinal surgeon at William Beaumont refused to do surgery claiming my spinal injuries were to intricate, and attempting any surgery (to include fusing my spine) would likely cause more damage than I already have. As I have stated previously, I am fully aware these narcotics are not a magic cure pill, however, these opiates are the only thing that allows me to be able to physically function semi-normally. Without these medications I have to utilize hand tools, such as a pair of pliers just to pull my shoes on because I cannot bend over far enough, not the case when I can actually take medication that helps me. <br/><br/>To an extent, I can understand the reasoning and motivation behind increasing the difficulty to be prescribed these types of medications. With that being said, let me give you a little insight into what actually happened when these strenuous rules were implemented: <br/><br/>Doctors and physicians were so worried about losing their medical licenses for prescribing opiates, that instead of really evaluating who should or shouldn't be on these medications, they just lumped everyone together into the same category and essentially said nobody is getting opiates. It doesn't matter if you are suffering from severe degenerative spinal issues (that will never get better and will only get worse), or if you are flagged as a "pill shopper" or "doctor shopper" someone who goes from doctor to doctor in an effort to get opiates, even though they have no physical reasoning to be on any opiates to begin with, it doesn't matter, nobody gets anything. <br/><br/>To be honest, it is a pretty terrible design to rule by fear. These doctors and physicians should not feel like they are not allowed to adequately do their jobs without fear of reprisal from the government. Also, not everyone has addictive tendencies and abuse drugs, so it is unfair to punish everyone because some people have no control. These medications will never heal me, but they 150% make doing regular day-to-day things a possibility for me, unlike anything else I have tried, and I have tried everything.<br/><br/> <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f752e3	Anonymous	None	2022-02-14T13:49:32Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-pekt-miu6	False	None	False	2022-04-12 01:55:53.608	[]
633	CDC-2022-0024-0639	https://api.regulations.gov/v4/comments/CDC-2022-0024-0639	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand deeply the need to control and limit the amount of opioids that are accessible for recreational use. However, as a person who suffers from chronic pain and whose partner has endometriosis, the limitations have made it where we have to suffer. I have chronic back and leg pain due to nerve damage from COVID-19. Time and time again I have been told to take OTC pain relievers when I have looked for help - of course I am already doing this I wouldn’t have spent money and time going to the doctor or even the hospital if not. My partner has had multiple surgeries for her endometriosis and when she asks for pain management, just to use 3-4 days out of the month so she can still go to work and live a normal life, she is told instead to have a hysterectomy (at 24 with no children this is not something she wants to do yet), or to have a child and see if that helps. Bringing another person into the world is a far heavier decision that just providing someone medication each month. I really do get it that the risk for abuse is high with these drugs but right now the people in pain are the ones with the most trouble. Overall, addicts are still getting their hands on opioids while people who are in pain and have no desire to abuse drugs suffer. Something needs to change because knowing there is a solution to our pain out there but it is being refused from us is very frustrating and makes it harder to work and live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f74c96	Lippke	None	2022-02-14T13:50:30Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Lippke, Elizabeth	kzm-ozwr-3yyp	False	None	False	2022-04-12 01:55:53.814	[]
634	CDC-2022-0024-0640	https://api.regulations.gov/v4/comments/CDC-2022-0024-0640	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an internal medicine physician and a Suboxone-waivered addiction medicine physician - more than 75% of my patients in the Suboxone clinic are on MAT specifically because they were initiated on incredible levels of high-MME medication regimens, WITHOUT a multi-modal pain approach. No NSAIDs or Tylenol, no GABAnergic medications, no physical therapy, no pain psychology or mindfulness. Usually, these patients also had no verification of doses with UDS or three-month SOAP / ORT scores.<br/><br/>Recently, I've had an influx of patients who were abruptly cut off from their high-dose MME for either having marijuana or cocaine in their system, or for missing one appointment; these patients usually find themselves falling back on illicit substances to mitigate the withdrawal symptoms, and with pressed pills becoming a significant reality, I worry the opiate crisis is only getting worse.<br/><br/>I appreciate the work the CDC has been doing with education, and I would gently and respectfully ask for an increase in awareness regarding tapering regimens, and the danger of abruptly "stopping" these medications - previous suggestions were vague on the amount of time it takes to taper off, and having an established tapering strategy may help some primary care providers feel less like they will be swiftly punished by "the system" based purely on a calculation of MME.<br/><br/>Also, Methadone is listed in MAPS as significantly less MME than is likely true - I've been seeing lots of primary care docs using methadone WILDLY inappropriately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484f74c78	Erck	None	2022-02-14T13:51:24Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Erck, Daniel	kzm-nxak-smb5	False	None	False	2022-04-12 01:55:54.030	[]
635	CDC-2022-0024-0641	https://api.regulations.gov/v4/comments/CDC-2022-0024-0641	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having multi broken bones and surgeries I started of working closely with my doctor with triditional medications , physical therapy, home therapy and even chiropractic and message techniques. It helped to a point . But it never fully helped coping with the chronic pain I was suffering . It got to a point where was unable to perform my jobs effecting my home and family life as well . Then doctor started off with Tramadol which helped so much . It was a turning point for the best , but over time the doseage increased to a point where was taking more than I wanted to control the pain . Switched over to Oxycodone a few years back and kept it below the 90mg morphine guidelines. Also being on a narcotic agreement has never been an issue and seeking out alternatives like Ti Chi ,, Tenns unit my quality of life has improved where I’m able to get back into the work force but not being able to get back into it fully . I’m still limited . I’ve done my home work and research . I didn’t want to make this political but There needs to be something done about the flow of drugs crossing our borders and do away with aquiring needles without an RX and programs the enable injection sites . To me it’s the ppl that use illegal drugs in the first place that has caused this epidemic and not the ones that use their medication as directed and working with your doctor and doctors need to not fear prescribing medication.yes there are ppl out there that make the problem worse for the ppl the benefit from the medication. That’s something that will always be there	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f747dc	Marobella	None	2022-02-14T13:52:25Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Marobella, Michael	kzm-ltro-yn0r	False	None	False	2022-04-12 01:55:54.237	[]
636	CDC-2022-0024-0642	https://api.regulations.gov/v4/comments/CDC-2022-0024-0642	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While it’s a good thing you have rewritten the CDC Guidelines, still so much needs to change. Using ANY kind of specific threshold like “50 MME” is dangerous and can be easily read to be a hardline just like 90MME was. Remember the original supposed guidelines were for primary physicians yet EVERYONE used it as hard fast absolute policy. For me, I went through hell with the previous guidelines. It took 4 new doctors before I was treated like a human being despite not having one blemish on my records as a legacy pain patient. I had threats, forced tapering, emotional abuse and even was threatened with dismissal from pain management if I didn’t agree to at least six unnecessary procedures per year so the doctor could “make his money. Even this week my insurance company, Blue Cross/Blue Sheild citing thee guidelines and a random non applicable Krebs study, has refused to consider anything over 200 MME. Despite numerous health issues, same meds for decades, doctors orders, and allergy to all nerve medication I was DENIED! Frankly I think these new guidelines are too late!! The damage has been done! Therefore why not add that into the guidelines? Talk about revisiting and undoing policies based on erroneous information. Speak up and speak LOUDLY that the misinterpretation and erroneous information proved to be dangerous causing unnecessary pain and suffering to a large group already suffering and too weak to speak for themselves. Also all the people who are now gone because being tapered quickly and no relief in site, suicide was the only answer. These new guidelines need to give the doctors back the ability to make decisions for their patients. Having hard fast MME limits is ridiculous. One size absolutely does NOT fit all. Instead there are a myriad of factors to consider when determining amounts for pain be it short or long. My husband a 250 pound man was denied pain medication for a severe blood infection that went on for months undiagnosed. “Take Tylenol,” they said. “We don’t prescribe pain meds r give them at the hospital.” How absurd is that? Doesn’t that show you how far the pendulum has swing now in the wrong direction???? Time to own ALL THE DAMAGE and really FIX this. Please no more harmful written amounts which will be misconstrued.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lucy	None	None	0900006484f74786	Mills	None	2022-02-14T13:53:41Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Mills, Lucy	kzm-jdor-2nxt	False	None	False	2022-04-12 01:55:54.464	[]
637	CDC-2022-0024-0643	https://api.regulations.gov/v4/comments/CDC-2022-0024-0643	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have volunteered in the pharmacy industry. Opioids are commonly prescribed for pain in our State. I think it is important to add two aspects to the current regimen.<br/><br/>First, all prescribers should add a natural laxative to whatever they are prescribing. Some opioids can directly cause bowel obstructions. On a personal note, I have suffered from two bowel obstructions. Natural products like Senna, prunes, triphala, and some other combinations can be used effectively and should be added to whatever anyone is taking routinely.<br/><br/>Secondly, medical cannabis and cannabis CBD pills do not have this same constipatory effect. They are effective in managing pain equally without the harmful side effects. Perhaps, it is time to have these medicines available by prescriptions to the general public.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lee	None	None	0900006484f74c2d	Henderson	None	2022-02-14T13:54:28Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Henderson, Lee	kzm-iiar-bt11	False	None	False	2022-04-12 01:55:54.676	[]
638	CDC-2022-0024-0644	https://api.regulations.gov/v4/comments/CDC-2022-0024-0644	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regular opioid medicines can cause painful and harmful bowel obstructions in my experience. I recommend regularly prescribing natural laxatives along with any other opioid prescriptions regularly, such as Triphala, prunes, and Senna products to help reduce the possibility of obstructions and increasing patient safety with use of these products.<br/><br/>Medical cannabis pills and medical cannabis CBD pills can also safely and effectively manage pain without bowel obstructions in my experience, while morphine directly caused one. Though I had another with the use of hydrocodone. Perhaps medical cannabis should be further evaluated on a national level and made available to all patients and prescribers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lee	None	None	0900006484f74780	Henderson	None	2022-02-14T13:54:37Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Henderson, Lee	kzm-izsq-n9nv	False	None	False	2022-04-12 01:55:54.894	[]
639	CDC-2022-0024-0645	https://api.regulations.gov/v4/comments/CDC-2022-0024-0645	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove the MME threshold for legitimate chronic pain and no pain exemptions either. Pain is pain and the CDC should not be deciding what type of pain is worthy of treatment. These decisions should be made on a case by case basis by treating physicians. <br/><br/>The MME threshold does nothing but scare doctors away from appropriate dosing resulting in under-treatment of pain. Under-treatment of pain is contributing, in part, to the overdose epidemic by forcing people to the streets for pain relief. Nothing will change for the better until you remove pain thresholds and exemptions. Less than 2% of patients who take RX opioids for pain have issues with abuse. When taken responsibly, opioids are safe and effective for short and long term use. Just ask the multitude of pain patients who have been on long term opioid therapy for decades. There is plenty of evidence to support their long term efficacy if you just look for it.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Madison	None	None	0900006484f74c02	R	None	2022-02-14T13:55:06Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from R, Madison	kzm-g46f-qqlk	False	None	False	2022-04-12 01:55:55.106	[]
640	CDC-2022-0024-0646	https://api.regulations.gov/v4/comments/CDC-2022-0024-0646	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am suffering! Please help! I did nothing wrong and neither did I ask for pain OR Adhesions! My intestines are glued together so what am I supposed to do. A nurse practitioner cut me off cold turkey! I only received my medication 2 yrs out of the 12 yrs I needed it,v I've been living a nightmare of pain 24/7! Whoever over stepped their boundaries and made it impossible for us to receive care have a lot of blood on the hands!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joie	None	None	0900006484f74bed	Canty	None	2022-02-14T13:55:35Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Canty, Joie	kzm-f7gn-yiow	False	None	False	2022-04-12 01:55:55.309	[]
641	CDC-2022-0024-0647	https://api.regulations.gov/v4/comments/CDC-2022-0024-0647	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Does the 50 mmes replace the 90 mmes? This is asking for more and more suicides. Much of the proposed guidelines are the same except you removed 90 mmes and replaced it with 50 mmes. Go back to the beginning and start over. Did you even have any pain patients on the work groups that rewrote the guidelines.these docx need more input from pain patients, their families and their employers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484f74a4e	Hoard	None	2022-02-14T13:56:20Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hoard, Pamela	kzm-6wtw-7wvq	False	None	False	2022-04-12 01:55:55.516	[]
642	CDC-2022-0024-0648	https://api.regulations.gov/v4/comments/CDC-2022-0024-0648	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines have done irrefutable harm to the chronic pain community and those of us who are minorities who are chronic pain patients. As a minority, I already get substandard care. I have to fight to make doctors even believe I have the pain I do have. I've had severe chronic migraines that do not respond to typical triptans or antidepressants. I had them since I was a preschooler and now im in 40s. Plus I have fibromyalgia and myofascial pain syndrome. Neuropathy in my hands and feet from an accident and trigeminal nerve pain. I need opioids to get out of bed and care for my kids. I had them and was functioning until I was cut off cold turkey by Southern CA Kaiser who took the CDC guidelines as law into effect. I fought them for 3 long years to get them back. I couldn't keep fighting after my husband died. I'm tired. I want my life back. I lost my everything to my illnesses and now because of the CDC guidelines that said chronic pain patients wouldn't be affected but we were the first to be hit, my life drastically changed. Then the DeA started jailing good doctors for no reason. The DEA has no business in healthcare. Non what so ever. They should be at the border chasing the cartels who are trafficking fentanyl into the US not worried about a doctor who is prescribing percocet over 90MME. Also MME rules make no sense because every person metabolizes medication differently. That's why they have short acting, long acting Anda time frame for taking meds. Some people like myself who had a gastric bypass need meds more frequently because of malabsorption. Others do not. I'll easily go over the 90MME guidelines. Stop putting restrictions on pain Pain has no restriction, it doesn't care about age, sex, race, ethnicity, status or any of that. It's time to allow doctors and patients to decide what's best from here on out. End prohibition on medication. End MME guidelines and DEA enforcement on doctors and pharmacists.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	NICOLE	None	None	0900006484f74bcf	BRADLEY-BIBBS	None	2022-02-14T13:56:43Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from BRADLEY-BIBBS, NICOLE	kzm-eg0m-x8vp	False	None	False	2022-04-12 01:55:55.723	[]
643	CDC-2022-0024-0649	https://api.regulations.gov/v4/comments/CDC-2022-0024-0649	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am suffering worse than I could ever imagine! There is no quality of life! I never thought I would be treated as if I did something wrong when I only followed Drs orders. I am not the expert my lane is bartending and driving a semi truck not the medical field so when my Dr says I needed a surgery I followed orders. But when the adhesions came no one would help me, left me to a life of chronic pain 24/7 since 2008 and I've been living with my intestines glued together unable to constrict. You can't possibly have a heart if you condemn law abiding citizens to live in pain and give pharmacist and others the authority to say No you must live your life in pain. There is no pain fairy that zaps your pain away or no expiration date on pain. Unfortunately some will suffer pain for life due to a condition. It is what it is. This has been a nightmare and some have opted to take their life and their blood is on numerous hands and they will never come back and all they needed was their medication and compassion!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joie	None	None	0900006484f74bc9	Canty	None	2022-02-14T13:57:13Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Canty, Joie	kzm-e78j-jx46	False	None	False	2022-04-12 01:55:55.936	[]
644	CDC-2022-0024-0650	https://api.regulations.gov/v4/comments/CDC-2022-0024-0650	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s slightly better than the disaster it was. It was designed to harm. Do the right thing, starting with correct overdose numbers as Congress ordered. Daily press briefings telling docs they have to see these folks. Explain palliative care. Set up committees to reach out to each state. Before the disabled are gone. You have tortured a protected class. You have caused their deaths. You have removed their right to privacy. You will be held responsible.<br/><br/>.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74b71	Anonymous	None	2022-02-14T13:57:54Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-be1w-0tzb	False	None	False	2022-04-12 01:55:56.143	[]
645	CDC-2022-0024-0651	https://api.regulations.gov/v4/comments/CDC-2022-0024-0651	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You've messed up by putting parameters in, AGAIN! This is sacred to the patient Doctor team. The patients rights to comfort should not ever be tied to a standard. Everyone is different. Keep government out of the individuals treatment plan.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jess	None	None	0900006484f74b15	Walker	None	2022-02-14T13:58:11Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Walker, Jess	kzm-a2zc-2hh2	False	None	False	2022-04-12 01:55:56.346	[]
646	CDC-2022-0024-0652	https://api.regulations.gov/v4/comments/CDC-2022-0024-0652	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has been in chronic pain for years. All attempts to alleviate his suffering have been a failure. His only option has been opioids as no other treatment or drug has helped and we've tried them all. When the CDC IN 2016 issued its orders for physicians to reduce opioid use we were forced into an untenable position. Even though he followed all medical orders over the years and I controlled his medications, which the physician knows, his dosage was cut in half very quickly. The last few years have been extremely difficult. I have had to commit my husband to the psyc ward for suicide watch several times just in the last year. His quality of life is abysmal! Allowing physicians to treat a patient as an individual rather than "one size fits all" would be a great relief to many chronic pain sufferers. As stated in the release information it is a total change in the culture from the 2016 guidelines which can be characterized as having ordered doctors to “just cut down on opioids — period."<br/><br/>"By contrast, the new proposal has a much more caring voice than a policing one, and it’s left room to preserve the physician-patient relationship" a quote from Dr. Narouze, the chairman of the Center for Pain Medicine at Western Reserve Hospital in Cuyahoga Falls, OH with which I totally agree.<br/><br/>THIS CHANGE IS GREATLY NEEDED TO LET PHYSICIANS HAVE THIS FLEXIBILITY. THEY KNOW THEIR PATIENTS AND ONE SIZE DOES NOT FIT ALL IN THIS SITUATION.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f74aec	Anonymous	None	2022-02-14T13:58:53Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-9ecm-7eny	False	None	False	2022-04-12 01:55:56.581	[]
647	CDC-2022-0024-0653	https://api.regulations.gov/v4/comments/CDC-2022-0024-0653	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain my entire adult life and I'm now 62. There is no single day that I don't have widespread pain. Opioids are just one tool in the toolbox of medications I take daily. I am closely monitored by my physician. I also practice mindfulness, have engaged in massage therapy, acupuncture, had injections, chiropractic care and the list goes on. It is so frustrating and embarrassing for me to admit I take opioids because of the stigma but without the small doses that I am allowed, I am not sure I would not be here today without them. Let the physicians do what they do and don't punish them or their patients for trying to alleviate their pain. If opioids are so bad, then find something that works better. I haven't found anything that really works yet. If the rule makers had to spend their lives the way that I do, I bet they would do better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f75361	Anonymous	None	2022-02-14T13:59:28Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-rgul-wou7	False	None	False	2022-04-12 01:55:56.807	[]
648	CDC-2022-0024-0654	https://api.regulations.gov/v4/comments/CDC-2022-0024-0654	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is no mention of DEA Schedule Numbers in the CDC guidelines. The DEA assigns Schedule Numbers to all prescription drugs such that, the higher the number, the safer the drug. See<br/><br/>https://www.dea.gov/drug-information/drug-scheduling<br/><br/>States use drug Schedule Numbers to determine such things as whether a pharmacy needs a written prescription or whether the prescription can be phoned in. Logically, it would be appropriate to start chronic pain patients on a Schedule IV opioid instead of "lowest dose" of a Schedule II opioid. The CDC is doing serious harm by lumping together all opioids. And I remind you that loperamide is an opioid that is legally sold without a prescription. <br/> <br/>By not explicitly addressing this issue, while verbosely talking around it, the CDC is fostering a lack of public credibility. It's as though the left hand of government (CDC) doesn't know what the right hand of government (DEA) is doing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484f74a9b	Ruzinsky	None	2022-02-14T14:00:02Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Ruzinsky, Steven	kzm-83ak-iwcu	False	None	False	2022-04-12 01:55:57.011	[]
649	CDC-2022-0024-0655	https://api.regulations.gov/v4/comments/CDC-2022-0024-0655	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been had chronic back pain for almost three years. My condition is inoperable and will only worsen. I have tried every treatment option available many more than once. My condition has disabled me causing me to take a leave of absence from my academic pursuit which I have been working towards my whole life. My doctor is unable to adequately manage my pain due to strictly following the CDC guidelines of no more than 90 milliequilivants of morphine per day. Due to this I am in excruciating pain everyday needlessly. My other medical issues limit the types of medications I can take so opioids are my only option. I feel like a criminal every time I go to the doctor due to the stigma placed on chronic pain patients. I just want the pain to stop. I don't want to suffer anymore. I need for the restraints to be lifted so I can get the adequate care needed to have some kind of quality of life. Patients that need opioid medications are not criminals, drug seekers, we are people with legitimate medical conditions that cause use chronic pain. We don't deserve to be victimized. We need compassionate help from doctors that don't fear losing their licenses for doing so. So please consider all that suffer because of the guidelines you impose.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484f74a96	Howell	None	2022-02-14T14:00:30Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Howell, Stephanie	kzm-7yaa-dnls	False	None	False	2022-04-12 01:55:57.254	[]
650	CDC-2022-0024-0657	https://api.regulations.gov/v4/comments/CDC-2022-0024-0657	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain issues from my bone/disk/cartilage/spine degeneration disease for my entire adult life. I’ve also been recently diagnosed by Mayo Clinic with FND a neurological disorder that also causes chronic pain. I now am in a powered wheelchair the past two years from my disabilities and severe chronic pain. I suffer from chronic migraines and have for thirty years. Ever since your recommendations for opioid restrictions in 2016, especially, I have had doctors refuse me any, limit and then reduce it even though I had pain increases, or outright yell at me and accuse me of being addicted even though they were not my PCP who knows what all I suffer from and has been monitoring me, my symptoms, doing tests, trying other meds, etc. They’d see me once and attack me without even knowing my history. Many doctors have signs in their offices saying they refuse to prescribe pain meds to anyone! I have been afraid to leave the area my husband is currently working in and supporting me and being my sole caregiver in a remote area of western Kansas. He has needed to transfer elsewhere for many reasons but we’ve been afraid to leave because my current doctor is the most understanding and supportive I’ve been able to find and we feared my new doctors would refuse any regardless of my obvious needs merely because they’ve been so restricted and legally bound that they feared losing their licenses even though they themselves knew my case was different and I needed help just to be able to not be in tears from pain all day everyday. Doctors in ER would find out I had chronic pain then roll their eyes and claim I was merely a drug seeker even when I hadn’t asked for any! I do understand that there have been many people with problems that could’ve and should’ve been resolved with other meds or therapy who abused pain medications and or sold it on the street. However this has affected me and millions of legitimate, non addicted patients by keeping them from us instead of going after the ones who don’t need them, abuse them, or sell them on the street. I feel that last issue is a police issue where they should find and arrest them and stop punishing the innocent with such strict guidelines and laws. I know many chronic pain sufferers who were denied pain meds due to this and took their lives because they could no longer take the incredible pain and had no quality of life. Who speaks up for THEM??? So I want to thank you for reconsideration of your previous recommendations regarding pain medication prescription especially opioids and urge you to STRONGLY ADVISE states to change the laws they created due to your previous recommendations. I speak for millions but also for myself. T<br/>hank you.<br/>Sincerely,<br/>A 54 year old pain sufferer in a wheelchair mainly confined to bed due to excessive pain and weakened joints, bones, and spine as well as a debilitating neurological disorder there is no cure for.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f749dd	Watson	None	2022-02-14T14:02:31Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Watson, Amy	kzm-5dsy-ggnd	False	None	False	2022-04-12 01:55:57.470	[]
651	CDC-2022-0024-0656	https://api.regulations.gov/v4/comments/CDC-2022-0024-0656	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f74a55	None	None	2022-02-14T14:03:46Z	None	None	0	None	2022-02-14T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from O’brien, Steven	None	True	None	False	2022-04-12 01:55:57.674	[]
652	CDC-2022-0024-0658	https://api.regulations.gov/v4/comments/CDC-2022-0024-0658	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The previous statements that 3 days is usually sufficient and that more than 7 days of opioids for acute pain are rarely needed are both statements that were plucked out of thin air and had no basis. I understand that the writers of the previous guidelines were trying hard to decrease the abuse of opioids, so were also trying to swing the pendulum back. Nevertheless, anyone who has had major surgery such as a lumbar fusion, knows first-hand that those guidelines were bogus, so it is good to hear that physician experience and judgement will prevail over rigid guidelines in the revised recommendations.<br/><br/>Further, although the writers of the current guidelines clearly state that these guidelines should not be interpreted as inflexible, personal experience with my state’s medical board make it extremely clear that in spite of this verbiage, the medical boards of many states WILL interpret ANY guidelines as rigid, inflexible and a justification for punitive, potentially career-destroying actions against any physician who dares to use judgement instead of adhering to rigid guidelines. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Douglas	None	None	0900006484f753d6	Campbell	None	2022-02-14T14:35:12Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Douglas	kzm-sp3w-4u9a	False	None	False	2022-04-12 01:55:57.896	[]
653	CDC-2022-0024-0659	https://api.regulations.gov/v4/comments/CDC-2022-0024-0659	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a cpp myself. Also a rapid metabolizer. I personally see no change from this revision except that you all are going to hurt and kill even more people in pain. That line about 50mme is just death waiting to happen for a lot of u. The mme thing shouldn’t even exist because everyone is so different and responds differently to medications. Why are you all wanting to kill us innocent people in pain. At least offer us assisted suicide so we don’t have to be tortured due to dying painfully and slowly. It’s pretty obvious y’all want us dead and all I ask is that can you at least kill us quickly so we don’t have to suffer so bad.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f753da	Anonymous	None	2022-02-14T14:35:34Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-sro3-md9z	False	None	False	2022-04-12 01:55:58.121	[]
654	CDC-2022-0024-0660	https://api.regulations.gov/v4/comments/CDC-2022-0024-0660	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is ... and I’m a chronic pain sufferer. I take opioids for pain relief but due to current regulations I am unable to get the dosage necessary to help me have any semblance of a normal life. I’ve been on pain meds for several years and will be on them for the rest of my life unless the come up with a spinal replacement surgery in the next decade ( doubtful ). I’m in pain management and can very easily handle double or triple my prescribed dosage ( which when taken at 3x the prescribed dose, actually works helping me to function almost normally. But I can’t do this often because I would run out of my monthly doses to soon. So instead, I take the normal dosage and still have to live with extreme pain. It doesn’t make any sense. The doctors should be able to make that call not some Bureaucratic policy that is a one size fits all plan. What happened to choice? Please put the power of patients and doctors back into our own hands in our own suffering and healing. <br/>Physical pain combines with mental anguish and stress when exposed over long periods of time, making something that should be bearable, unimaginably excruciating. Please stop making polices that are cookie cutter portfolios. Everyone is different and to be able to alleviate pain this day and age is a miracle and should be allowed to let us live our lives pain free without government rules and regulations	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484f6fb90	O’brien	None	2022-02-14T14:50:25Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from O’brien, Steven	84f6fb90	False	None	False	2022-04-12 01:55:58.329	[]
655	CDC-2022-0024-0661	https://api.regulations.gov/v4/comments/CDC-2022-0024-0661	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	According to SAMHSA 41 million are at risk of dying from SUD(substance use disorder) while only 2.4 million are in treatment. While pills & pill mills were responsible for the opioid crisis from 1990 to about 2012, that may no longer be the major cause of this opioid epidemic in the last 5-7 years. 500 new regulations passed to curb the pills & pill mills have restricted access to care, for those who need it the most. Patients have been forced to go to the street to get their fix. Unfortunately, the first 4 drugs in OD deaths found are heroin, Fentanyl, cocaine & methamphetamines. Only 1% of the doctors are actively involved in the patients with SUD/ OUD. Why??<br/>I wrote a book over the past 4 years explaining how we can improve access & reduce overdose deaths in America. Last year 104,000 young Americans died that equals 275/ day. This is a 40% increase from pre covid to last year. 10% of the US population is at risk, with 95% having no access to care.<br/>The title of my book: The Preventable Epidemic: A Frontline Doctor's Experience and Recommendations to Resolve America's Opioid Crisis<br/>is now available on Amazon effective Feb 14th, 2022. Here is the link: https://www.amazon.com/dp/B09PSJLWWB?ref_=pe_3052080_276849420<br/>** *** MD, Author<br/>I will gladly like to discuss my project with anyone, who is interested<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Arun	None	None	0900006484f75412	Gupta	None	2022-02-14T15:13:26Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Gupta, Arun	kzm-tif6-qv09	False	None	False	2022-04-12 01:55:58.533	[]
656	CDC-2022-0024-0662	https://api.regulations.gov/v4/comments/CDC-2022-0024-0662	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The disaster fomented by the release of the idiotic 2016 "Guidelines" still reverberates today. The absolute "maximum dose" fallacy continues to impact patients in a negative way every day. Regulatory agencies, pharmacists, insurance companies, and multitudes of others continue to impose the absolute maximum dose regulations without any validation whatsoever. The CDC had to know that this is exactly what would happen, given the milk toast, weak, and pathetic comment about this not to be used as regulation. I had to fight through this nonsense for many of my patients on multiple fronts, and continue to have to do so. The idiotic and medically unjustifiable "Guidelines" from 2016 have left the agency in the position of being a designated bunch of fools who could not think their way out of a wet paper bag. Given the damage that has been done to the credibility of the agency, and the arrogant way in which they were presented and defended, the "Revisions" being promoted today are an exercise in futility. The only valid response that should be issued is as follows: "Medical practitioners need to comprehensively evaluate patients and their pain problems in order to determine the appropriate treatments needed to address those problems. No arbitrary and capricious restrictions on the use of opioids is to be promoted. The only correct methodology for the use of opioids is to do the proper evaluation of the patient and proceed accordingly. Opioids may be used for acute, subacute, and chronic pain conditions if indicated." This will provide an appropriate and medically justifiable "Guideline" that can be used. Even the current revisions continue to promote arbitrary and medically unjustifiable restrictions on opioid use. It is this continuing failure by CDC to recognize that the way to deal with "Opioid Abuse Disorder" is to do the research necessary to identify those individuals who are at risk for developing this problem, and to make available comprehensive Neuropharmacological methods for treating the disorder. We do not have any good research that allows for consistent and comprehensive treatment of addiction disorders. Failure to address treatment failure and relapse into addictive behaviors is the number one problem that is being ignored by CDC and the research community. Lack of funding and failure to have a sense of urgency to do the genetic and neurophysiologic research into addiction dooms the long term use of any of these products. We must be able to use opioids and then help those who fall into the addictive behavioral pattern. <br/>I am categorically opposed to the 2016 Guidelines and the 2022 Guidelines. I have offered what I believe are the only viable alternatives.<br/><br/>******* * ****** MD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484f7541f	Harris	None	2022-02-14T15:18:27Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Harris, Richard	kzm-tp87-pjp0	False	None	False	2022-04-12 01:55:58.739	[]
657	CDC-2022-0024-0663	https://api.regulations.gov/v4/comments/CDC-2022-0024-0663	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First, I am a MOM to a wonderful 13yo, a wife, child of god...was an O&G ACCT for 20+yrs. I am also a TERMINAL MOM. I have ST4BC. I have cancer floating in my blood. I will die from this disease. Even though I am ST4, my DR's @ MDA took me off medicine (that helped me be a contributing member to my family, my parents well-being etc) to suggest accupuncture. I was taking 90MME and it worked. I could still clean my house, I could take my child to the museum. I could go to family gatherings. I could volunteer. However, due to the guidelines being followed as "LAW", that all changed. You have acknowledged that real world practice treats the guidelines in a way that was not intended. Do you now believe, that stating the guidelines were only a suggestion, that the latest 50MME limit you have put on the guidelines WILL ALSO NOT BE TAKEN AS LAW????? Did you know that people metablolize medicines at different rates?? There is also a mention of "New" patients vs "Old" patients. After the skewed data that was provided to our government officials, that was presented to our Doctors, that we were demonized when it was presented to the Public. The Data was skewed and the CDC made a fool out of our governing body. The data never differentiated between TYPE OF OPIATE that was doing all the killing....Fentynal and Heroine! Maybe if the CDC had provided the correct data in the first place lives could have been saved by focusing funds on the correcty killer, street drugs. WHY are you letting TWO people..Kolodny and Chou, that have a conflict of interest, decide public policy???? This is EXACTLY the same thing Congress did w stock in Pfizer. Can't you see this? Kolodny owns stock in suboxone, which he has pushed our doctors to prescribe. Kolodny also had a child OD from STREET DRUGS. He's a psychiatrist. Why is he being allowed to dictate what our doctors prescribe? Is he even a medical doctor? Don't you think the fact that his child died, may affect his judgement? And WHY are you listening to Chou?? He writes papers, approves them himself, get's paid and does it all over again. Roger Chou, (face behind the current/updated CDC pain guideline) did systematic review of opioid studies. Chou wrote CDC Guideline which used Chou’s systematic review. Chou turned the Guideline into BSC to approve. Chou was on the BSC. Chou gets $ to do another syst. review. Chou writes new GL. Chou turns his own work into BSC, which he’s on”. Everyone in America can see that special interests are at play here. When the only thing needed is to get the CDC OUT of DR's offices. We need to eliminate any mention of MME Thresholds. The doctors and insurance companies will take that as written in stone. We LOVE the fact that the pill mills were shut down. Love it. That needed to happen. We need to correct course on how patients are treated and our doctors are treated. Our doctors are SCARED. The language regarding "new and old", this can be used against almost all patients. Remember, our doctors quit prescribing to us.....so, now, we are all new. All I want is my son to see me being "normal mom" as long as I can put forth that image. I don't want him to keep seeing "sick" mom. I want to be able to take him to the Museum again, do things on the weekend again, be able to clean my house AND cook supper in the same day. When did a S Breast Cancer Mom become the enemy? I believe the CDC has been given a "blank check" on deciding what is best for americans. They are experts on Covid, Opiods, Rent abatement....what a wide range of influence has been given to them. I am terminal. Who CARES, who is it ANYBODYS business, besides me and my DR, if he prescribes something to me that helps me lead a more active, successful, contributing life?? It was never patients. The data shows that. It's the illegal fentynal.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	T.	None	None	0900006484f7545c	Handy	None	2022-02-14T15:29:35Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Handy, T.	kzm-ui8g-e1jl	False	None	False	2022-04-12 01:55:58.956	[]
658	CDC-2022-0024-0664	https://api.regulations.gov/v4/comments/CDC-2022-0024-0664	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Sir,<br/>I applaud this new attitude towards the use of opioid medication. Having had five spinal column surgeries plus open heart surgery, I have had to use these drugs after each surgery. After my last surgery, because I called a day after the one month date of surgery, I was told I had to take Tylenol.<br/>Do you have any idea of the pain I had to deal with? I, like many others, do not abuse opioid drugs, but find them a necessary part of my medical treatment at times. Physicians are highly educated and need much training on use of drugs. Do not punish people who do not abuse drugs to have medical access to them. I use acupuncture monthly and pay out of pocket. Having this covered by insurance and legitimately seen as a medical intervention would be helpful.<br/><br/>***** *	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484f75462	Denys	None	2022-02-14T15:30:23Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Denys, Janet	kzm-um1t-lzux	False	None	False	2022-04-12 01:55:59.168	[]
659	CDC-2022-0024-0665	https://api.regulations.gov/v4/comments/CDC-2022-0024-0665	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thanks in advance for this opportunity.<br/> I suffer from chronic pain. While I have had two procedures to help with my back pain, I still suffer from neuropathy in both legs and in my hands along with being bone on bone in both ankles for almost twenty years. Along with chronic gout and arthritis. I must use a walker or cane to walk and a scooter,for outside mobility. I am prescribed only the amount of hydrocodone that is aloud by my Practitioners guidelines. While I can live with this amount, I am deprived of living a more fulfilling and productive life. I am not concerned, that I will abuse my usage and I am sure my Practiciner would agree.<br/><span style='padding-left: 30px'></span>I have also very fortunate, have being a survivor, of two Heart Transplants. I have only had this latest Heart a few years; However,my wheels are falling off. <br/><span style='padding-left: 30px'></span>I believe I should have an opportunity to improve on my mobility, with a minimal increase of medication.<br/><br/>Thank You and please consider my request!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kenneth	None	None	0900006484f75469	Kerr	None	2022-02-14T15:30:53Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Kerr, Kenneth	kzm-uovv-k41q	False	None	False	2022-04-12 01:55:59.378	[]
660	CDC-2022-0024-0666	https://api.regulations.gov/v4/comments/CDC-2022-0024-0666	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain. I have done so for 5 years. I have always taken the least amount of medication as possible to help ease the pain so I can perform my activities of daily living. I have multiple level disc issues, with approximately a 20 percent success rate with surgery. After surgery my life as I know it today will not exist and this is according to my surgeon. I also suffer from SLE and RA, with good old fashioned OA thrown in for good measure. I can not take NSAIDS because I have renal issues due to my lupus. I do aquatic therapy and try to stay as mobile as possible. I thank God my physician felt fit to start me on pain management. I am able to have a decent quality of life. Without pain management, a simple task like showering became a major ordeal. Please let our doctors treat us appropriately. In 5 years I have never had the dose increased. We work together to develop a strategy that allows me the best quality of life with the least amount of medication. My life would not be what it is today without appropriate pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7546a	Anonymous	None	2022-02-14T15:31:14Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-uq36-c5ga	False	None	False	2022-04-12 01:55:59.591	[]
661	CDC-2022-0024-0667	https://api.regulations.gov/v4/comments/CDC-2022-0024-0667	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm personally having my quality of life put at risk by over zealous actions of the people running the healthcare systems, where the PCP providers are not aware of the exclusions of palliative care from the opioid guidelines. Why is this happening? It is spelled out right there at the start of the guidelines. I'm a patient that has a condition that requires palliative care for my pain, yet can't get anyone to write the new Rx I need filled since no one is willing take over my care, it was due to be refilled last week. The previously PCP before retiring insisted in his micro managing, I move my PCP care since no one would be willing to fill it at that clinic once he left. In changing my address, it moved me across some arbitrary invisible insurance district line, with different insurance providers, Now all my mail order prescriptions were no longer available, plus now requiring a different PCP provider refill them. With my learning disabilities that Dr pretty much destroyed my entire healthcare network. Also the former PCP felt no need of making any real effort to help establish new palliative pain management care with a proper Opioid issuing specialist. My last provider made sure I had my medication until the next doctor took over my care when moving. Now with every contact made, I'm being told the same thing, they will not write opioid pain management patients prescriptions. They will only offer alternative pain management techniques as the only options available. Then I'm told, I'll have to go schedule an appointment requiring starting at ground zero in the process of becoming a pain management patient by seeking a new pain specialists care for evaluate my condition. There is no mechanism for continuity of care, at least in Oregon. <br/><br/>What I have found here is complete lack of following the current CDC guidelines that immediately spell out that they don't require palliative care patients to not be included in the restrictions in the guidelines intended to fight the opioid crisis. I am now in the position when I run out of the reserve doses saved over the last few years to look for alternative sources.For which my only option will be to find alternative illegal sources since it is impossible to complete the process of changing my care in time. The system is so screwed up, the new PCP care provider is sending me back to the clinic my former doctors office sent me to six months ago without looking into finding opioid providers. It took the clinic three months to get the right referral to get an actual appointment, by phone. Only for that clinic to informed me it doesn't do opioid pain management, instead I needed to go to another pain management clinic they recommend. Which also took months to get the proper referral. I finally get a human to call me back after getting my last doctors office to get the paper work done, since no one will directly talk to anyone, other than through poorly understood notes or voice mail. Then I find out the state decided to change my insurance provider. That clinic is not covered by the new insurance. Which they tell me to go to another pain clinic they cover. Now I just got a letter from the new insurances assigned PCP clinic, who won't fill my current meds, that they want me to now go back to the first pain clinic that doesn't do opioid therapy, but if I call all I get is voice mail which no one responds to. If his sounds confusing, your right where I'm at. I have have sleep issues that have me on grave yard making it hard to stay up to communicate, even on my few good days. At this point I have no clue who to talk with in order to fix my issue. It looks more and more like I will be having to seek out alternative sourcing furthering the very problem trying to be solved. In addition on Sunday, I will also be out of Ambein. If I fail to get the Rx for it by Saturday I will also have to quickly seek alternative illegal sourcing for it, as the new PCP won't write a RX for it either, Since my heart is failing from all the years of poor sleep mainly from lack of proper pain management. It just won't tolerate any more going days on end without sleep, My medications after twenty-five years are not optional. I'll have to do whatever it takes to get my medication needs filled. Now all I need is a mild case of covid and I'm the next victim of the opioid crisis for exactly no reason other than no one is making sure doctors along with the healthcare system understand the guidelines don't apply to palliative care.<br/><br/>The CDC needs to take strong action to bring all of the whole entire health care system up to speed on the differences between the types of patients not to be included vs. those individuals that are intended to be included in the guidelines. They're in essence killing palliative patients in order to save an addict from self medicating.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Blake	None	None	0900006484f75475	Duval	None	2022-02-14T15:33:17Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Duval, Blake	kzm-uu45-7rmk	False	None	False	2022-04-12 01:55:59.799	[]
662	CDC-2022-0024-0668	https://api.regulations.gov/v4/comments/CDC-2022-0024-0668	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since 2011, when debilitating spine pain started. I was happy to go to my pcp for medication but due to the new pain management rules I was sent to a doctor who only prescribes my pain medication. A doctor who knows nothing about me really, just needs my MRI's, CT scans, or referrals to justify my meds. <br/><br/>At First I'm subjected to monthly EXPENSIVE urine tests that my insurance won't cover, as if I'm a criminal (now I'm on Medicare so those tests are covered). I'm forced to sign a contract spelling out what will happen if I have to take more than my prescribed dose, like I'm a criminal or parolee. But I'm not, I'm a senior who is in constant pain! My dose was increased to try to control the constant pain, then when the CDC decided it was too much, I was tapered down, with no regard for my individual pain needs. <br/><br/>My doctor decides this is the wrong specialty for him and changes to another specialty. My pharmacy, who is national, gets targeted for filling too many prescriptions (according to the government), so they decide my daily dose Still goes over the recommended amount and discharge me. I went through the agonizing trial of trying to get a prescription filled back when this started (2016?) and the entire state had pain patients going through this nightmare. It was on the local news, this total insanity so that politicians could say the use of opioids was way down, prescriptions were down for opioids, doctors who 'over' prescribed had their licenses revoked or censored. But who could guess, illegal narcotics and deaths spiraled out of control, those poor patients went to find their own relief and often found death from fentanyl-laced fake pills.<br/> <br/>Please, return these decisions back to the doctor and his/her patient. All of these deaths, fentanyl-laced illegal narcotics that became a huge problem because they were not able to be taken care of by their doctors! Drug and alcohol abuse is a world wide problem that can't be fixed this way. You're making chronic pain patients pay the price for the ills of the world. I don't want to spend my life in bed. Please stop, so I can get adequate pain relief and participate in life a little more. Opioids and other pain medications, therapies like PT and chiropractors can help me, they don't end my pain but they make it bearable. It would be so much better if I could be medicated properly. I don't want to end my years in such pain, my 'golden' years. <br/>Thank you for your time and for listening to the experts and the patients! <br/>I will not sign my name, due to the ongoing prejudice against patients in pain<br/>Signed, hopeful pain patient	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7547f	Anonymous	None	2022-02-14T15:47:09Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-uxkp-i3gx	False	None	False	2022-04-12 01:56:00.016	[]
663	CDC-2022-0024-0669	https://api.regulations.gov/v4/comments/CDC-2022-0024-0669	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t understand our government. They give needles to drug addicts, yet a person suffering from chronic pain often can’t get anything to help them control their pain. Our government is always punishing the person who tries to do things the right way. Let doctors decide what is right for their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Time for	None	None	0900006484f75799	Change	None	2022-02-14T15:56:49Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Change, Time for	kzm-vl64-pv6x	False	None	False	2022-04-12 01:56:00.261	[]
664	CDC-2022-0024-0670	https://api.regulations.gov/v4/comments/CDC-2022-0024-0670	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In view of the big picture, I have some general comments. 1) My late mother-in-law had significant back problems for the last few years of her life, she was taking percocet 2x per day as prescribed. Before her afternoon nap and before bedtime. She never abused it and didn't run out before the month was up. However, it became a hassle whenever she needed to refill it. Between her doctor and the pharmacy, the hoops she had to jump through to get her refill because of overly cautious regulations, controls, and provider concerns of lawsuits, she stopped "bothering" to refill it. She spent her last year of life suffering rather than taking the medication. 2) This falls under the notion of unintended consequences and be careful what you wish for: Due to many major lawsuits against the companies that make opioids by states and other parties, there has been a major reversal and strong resistance to prescribing these pain medications. The result? Well, welcome to fentanyl world -- drug overdoses and the dangers a far far far greater than pharmaceutical grade and produced opioids. The old whack a mole problem: you whack one mole down and several other pop-up. But in this case the fentanyl moles are hideous and more dangerous than the original opioid mole everyone has been whacking at. In the end, thanks to lawsuits, hassles, and misguided governmental policies, the wave of deaths and costs that are sweeping over us from fentanyl will make opioids look like a walk in the park. It's all too easy to want to think we are all making a difference by cracking down on providers for prescribing opioids -- and even easier to earn a nice payday be suing the pharmaceutical companies -- but to what real cost?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DJ	None	None	0900006484f7579d	Jong	None	2022-02-14T15:57:33Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Jong, DJ	kzm-vnm0-bsb9	False	None	False	2022-04-12 01:56:00.469	[]
665	CDC-2022-0024-0671	https://api.regulations.gov/v4/comments/CDC-2022-0024-0671	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 5 foot 8 inches 345 pounds 67 years old with constant chronic pain. The only thing keeping me active, giving me the will to live, are my pain medicines. If I ever run out I will be forced go to the street out of necessity. This would put me at risk of non standardized mystery drugs.<br/><br/>I do not appreciate having Medicaid Medicare, and receiving de facto second class heath care. I waited 10 years to get that dental allowance to get implants to fix the root canals Medicaid pulled instead of maintaining. Now finally qualifying for Medicare, i find i do not qualify, because the state pays my part D. If there are Invisalign braces we get horrid metal braces. There are multiple stem cell therapies to fix joints, and the underlying causes of pain. For me; never. I have horribly painful lipedema all through my abdomen. Liposuction or laser therapy would remove that pain. For me, never. Some day you will be judged by God for failing to use the medicine and methods available. That is right; you, who go pushing this phony opiate crisis. The Big Lie needs to stop. You are hurting your citizens. Street drugs should have NEVER been considered when imposing these guidelines, and should not be included to continue the hype. Doctors should be allowed to practice within their scope. And the CDC and DEA should stay in their lanes. They have absolutely hurt more people, caused more fear and death by these guidelines than Covid. The reason Fentanyl and Carafentynl are illegally coming across US border is because of these guidelines, and people desperate to not be in pain. There is a huge difference between addiction and dependence.<br/><br/>Surgeries are no longer gotten due to no pain medication post op. Pain cannot be treated the same for everyone therefore the MME limit is torture for some. I’ve been tapered and due to increased pain, no longer have as an active life as before. Nobody should be allowed to suffer like we are. Please fix this entire problem and let people live a free and fair life. The DEA needs to stay out of healthcare and focus on illegal fentanyl pouring in across our borders. The natural opiates; opium, codeine, morphine, and heroin; are life saving life preserving drugs, whereas drugs like oxycontin, qualude, darvon, fentanyl and all the new chemical replacements tend to be 21st century horrors. Patients should have the option to use traditional purer opiates in pharmacological standardized dosages. <br/><br/>Guidelines are never helpful, especially when they are misinterpreted and taken as a rule of law or used spuriously as a "shield" by states and insurance companies, they can be extremely damaging to patients. Patients that suffer with chronic pain are among the most vulnerable Americans. They should be supported and treated compassionately with due care.<br/><br/>I support the total repeal of the guidelines, remove caps on dosages, and put back control of patient care in the hands individual doctors. Those doctors should not fear losing their medical licenses or being fined, just for prescribing what they believe in their medical opinion is best for their patients. Further, insurance companies should not be erroneously using these guidelines as the basis of denying coverage or increasing the price to patients for doctor prescribed opioids.<br/><br/>The fact that I have chosen to only sign this with initials is out of fear of retribution from employers, insurance companies, or others is an example of the misunderstanding, confusion, and stigma that still exists in 2022 around opioids. Please leave the doctoring to the doctors! We look forward to when these guidelines are finally gone forever and patients and doctors can focus on treatment and healing. I am a responsible member of society now made to urinate in a cup for random drug tests. Why am I treated like a criminal? Why punish the law abiding, tax paying, responsible citizens who truly need medication to endure chronic debilitating disease? Please allow my prescribing doctor to treat my pain and allow me to have to dignity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484f7537e	W	None	2022-02-14T15:58:25Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from W, K	kzm-rsif-zs6v	False	None	False	2022-04-12 01:56:00.681	[]
666	CDC-2022-0024-0672	https://api.regulations.gov/v4/comments/CDC-2022-0024-0672	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had loved ones die due to increased blood pressure because of abrupt tapering by doctors of low-dose opioids. This is happening across the country. People are committing suicide because they cannot access adequate narcotic pain medicine. I myself have had my medicines reduced 70 to 80% and my quality of life including strenuous amounts of exercise and other modalities of pain management impacted. People are dying and the government is lying. Legal prescribed opiates and opioids are helpful, anti-inflammatory her recent research, and do not themselves cause addiction. Addiction rates are actually very low. I hope that the CDC keeps an arbitrary limit out of the guidance, removes harsh language towards pain patients, and genuinely works with the DEA ( who ultimately has the say on How many productions of narcotic pain medication can be allowed or the APQ they determine); <br/><br/>I hate being a chronic pain patient, but opioids are the only thing that have helped me in conjunction with exercise which I have been limited in doing because of the huge reduction in my pain medication.<br/><br/>No Jose limit should be included. Doctors and patients should make these decisions together without a lot of government intervention or oversight. There are already medical boards, and boards of pharmacies, all of these entities control, restrict, and try to exercise ever lasting oversight. <br/><br/>I am able to live a better life. I am able to work better. I am able to make love to my partner better I am able to exercise better and keep my cholesterol lower, keep my blood pressure lower, keep my vitals in better condition, and so many things when I am allowed to take the level of pain medication that I need for my extreme knee pain, back pain, multiple sports injuries, and all of the other pain that I have from fibromyalgia which is extremely painful and addition to multiple sclerosis and Reynards syndrome. Please do not kill people because they need narcotic pain medication. The DEA themselves have published that less than one percent of opioids to get diverted.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f75a16	None	None	2022-02-14T16:26:35Z	DPPR	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from DPPR	kzm-w3py-38dg	False	None	False	2022-04-12 01:56:00.888	[]
667	CDC-2022-0024-0673	https://api.regulations.gov/v4/comments/CDC-2022-0024-0673	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been trying to read the new draft but there is something I don't understand. I read from 90 MME to 50 MME.<br/>I was dropped to 90 MME several years ago after my pain management Dr. retired with only 1 week notice. My Primary care Dr. wrote for me at 90 MME a day. I took Morphine Plus Oxycodone and I had sort of a life. Now with the 90 MME a day I barely am able to get out of bed. I was on a strong pain regime over 20 years and I never one time became high. I used my meds as I was suppose to.<br/>I have Arnold Chiari Malformation type 1 that it took 20 plus years to find and it caused a lot of neurological damage that is irreversible. I had the decompression surgery for this in 2020 and my symptoms are no better today. The only good thing is I can still walk, but most days that is very hard because of the low dose pain medicine.<br/>I am afraid to let the Doctor know how bad things are going for me because I don't want him to think I am just trying to seek more drugs.<br/>I have neuropathy because I had a bone spur in my neck that was sticking in my spinal cord so I lost C-5 vertabrae and part of C-6. I have a harms cage with a plate and screws in their place .I only have 35 percent mobility in my neck due to this. I have multiple arthritis's. Etc, Etc. Since the 2016 CDC guidelines went in to effect I have really lived through something I would like to forget. I have become a recluse. <br/>I rarely ever see my Grandbabies because I can't hold them or play with them.<br/>If CDC leaves this 50 MME in these new guidelines that is what will become law with the Doctors, Insurance, Pharmacies, etc. Please take this 50 MME out.<br/>The CCP patients have been through enough since the 2016 Guidelines, many have committed suicide. This was so unfair.<br/>I so pray you help us, give us Our lives back. Please don't restrict us more.<br/>I can't take anymore.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f75acc	E Eckhoff	None	2022-02-14T16:27:15Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from E Eckhoff, Debra	kzm-wcoj-7wsw	False	None	False	2022-04-12 01:56:01.111	[]
668	CDC-2022-0024-0674	https://api.regulations.gov/v4/comments/CDC-2022-0024-0674	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I must take oxycodone for chronic back pain and scar tissue in my torso due to prior surgery. I do not like taking them, but they give me relief and I am able to function by using them. I have never so much as smoked pot as a girl and woman. I have never done any drugs in my entire life until I had to 8 years ago from surgery from breast cancer rendered me with severe scar tissue in my torso. I understand people abuse these medications, however, I am not one of them. I do not drive after taking my pain medicine due to it may impact my ability in any way. I am tired of all the restrictions because of those that abuse pain medication, but I am on the same dosage for all the 8 years I have had to take them. I do not want a larger dose, they are not good. Some days my allotted dosage is not enough so I suck it up and just lay down and try to get through the pain. I will not ask for more unless necessary. I am a responsible person with unfortunate circumstances. I also now suffer beside the scar tissue from hip pain which will need a hip replacement as well as severe spinal stenosis in my lumbar spine (discs L-2 through s1 are herniated). Scoliosis, 5 of 7 cervical discs are herniated and I could go on. There are people who truly need opioids and I am unfortunately one of them. Vicodin makes me have horrible nightmares, Valium makes me nauseous, there isn’t much else I can do, morphine makes me nauseous too.<br/><br/>Please consider issues such as mine when making decisions that affect quality of life for people like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f75cc3	Ricci	None	2022-02-14T16:27:50Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Ricci, Susan	kzm-wo2y-ysrw	False	None	False	2022-04-12 01:56:01.334	[]
669	CDC-2022-0024-0675	https://api.regulations.gov/v4/comments/CDC-2022-0024-0675	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We have been on a path for some time of treating addictive use of opioids with mitigating efforts such as synthetic agonists, partial agonists and supervised injection sites. We appear to be basing this movement upon reported successes of similar programs in disparate nations with cultures far from that seen in the US. I would urge the CDC to review the efficacy of 'new paradigm' treatment modalities such as those practiced by the Health Professionals Assistance Programs, Sobriety Courts, the FAA Assistance Program and LJAP as guidelines for setting the tone on successful management of opioid addiction and other substance use disorders, rather than anything that pushes us further into the flawed logic of managing addiction with dosage regulations and replacement therapies rather than revolutionizing recovery efforts.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f75cc5	Anonymous	None	2022-02-14T16:28:13Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-wqlq-6rfz	False	None	False	2022-04-12 01:56:01.549	[]
670	CDC-2022-0024-0676	https://api.regulations.gov/v4/comments/CDC-2022-0024-0676	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have sevir pain and have been on hydro condone over 20 years it has been very hard to get my prescription filled due to the regular put on Dr And pharmacy please stop the nonsense	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7609c	Anonymous	None	2022-02-14T17:22:08Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-xhck-v4u4	False	None	False	2022-04-12 01:56:01.760	[]
671	CDC-2022-0024-0677	https://api.regulations.gov/v4/comments/CDC-2022-0024-0677	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors in our area are too afraid to write a prescription for any pain medicine. They have seen other doctors have their careers destroyed. Doctors have their picture on the nightly news accused of writing too much pain medicine. Pain clinics have been shut down for writing too much pain medicine. They have clamped down to the point that people with pain are forced to suffer with nothing more than over the counter medications. I have seen people become suicidal as they see no way to escape and no end to the suffering, others have gone to illegal sources to get relief. It is time to bring back the ability for doctors to prescribe pain medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Public	None	None	0900006484f764bc	Status	None	2022-02-14T17:22:32Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Status, Public	kzm-y44y-uwkj	False	None	False	2022-04-12 01:56:01.972	[]
672	CDC-2022-0024-0678	https://api.regulations.gov/v4/comments/CDC-2022-0024-0678	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 57 year old wife and mother, who also happens to be an RN. I have suffered greatly over the last 25 years with pain due to degenerative diseases and rapid progression arthritis. My medication is the only thing that lets me keep going; it's the only thing that allows me to move; it's the only thing that prevents me from giving up. Nothing takes away my pain, but at least it gives me enough relief that I can function. Relaxing the rules for Chronic Pain is something that should have been included at the start of this Opioid Pandemic. But you want to relax it now, thank you, thank you, thank you. I shouldn't have to beg or plead for medication that is the only thing that keeps me going.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484f76800	Nanney	None	2022-02-14T17:35:13Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Nanney, Michelle	kzm-yuuz-jstn	False	None	False	2022-04-12 01:56:02.181	[]
673	CDC-2022-0024-0679	https://api.regulations.gov/v4/comments/CDC-2022-0024-0679	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No other medical condition is overseen by CDC and DEA as pain management. Yet a person can overdose on insulin, heart medication, anti depressants etc. Why do we as a nation put our physicians through so many years of medical school ,residency and strict license requirements ? After all are they not qualified physicians once that pass their board? Yet you do not allow the sacred physician/patient relationship in one area of Healthcare. CDC needs to remove these guidelines and allow our trained and educated physicians to treat their patients as they see fit. After all they physically see us, examine us, see our MRI and other tests. CDC does not. Yet we are discriminated against because we have chronic 24/7 pain. Please leave our doctors alone. Please stick to the intended purpose of the CDC. Before the guidelines I could work. I could enjoy life with my family because my physician was able to treat me as a individual patient with individual injuries. Now I am stuck in the " one size fits all "scenario the CDC has put me in.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f754c8	Anonymous	None	2022-02-14T17:55:31Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzm-zsrh-cjc4	False	None	False	2022-04-12 01:56:02.436	[]
674	CDC-2022-0024-0680	https://api.regulations.gov/v4/comments/CDC-2022-0024-0680	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering from chronic pain for five years now following a failed back surgery and permanent nerve damage. I am on opioid medication, as there is no other option to treat my pain. There is no surgery or prosecute to reduce or completely relieve my pain. And because of the CDC guidelines, I have to jump through many hoops with a doctor who is following those 2016 recommendations like they are laws. And because medication is the only way to treat my pain, I will have to hope I can find a new doctor in April to take over my care as my current doctor will only prescribe medication management for one year. And if the suggested 50 mme is included in the guideline, I will probably have my medication dose, which is barelu adequate to alleviate my pain, cut nearly in half as my doctor strictly follows the recommended dosage. The CDC is trying to fix a mistake the made years ago that is actively harming chronic pain patients. I implore you to not compound that mistake by including another suggested maximum dosage, nearly half of the previous dosage in 2016’s guidelines that you are trying to correct. Please, I beg you, consider the potential ramifications of this. While the CDC may be against forced reductions of dosages, having this number with cause just that. I can barely function in my everyday life. I struggle to do things as simple as bathing and dressing, cleaning, or even shopping for necessities. If my pain medication dosage is cut in half, I don’t know if I’ll be able to do any of those things. I don’t remember what it’s like to not feel pain anymore, severe pain is my baseline. But I do recall the devastating pain without medication. And the thought of living with that constantly terrifies me. Please consider the individuals who you will make suffer before making this official. Be compassionate and fair. While these may be recommended guidelines, you must know that many clinicians will follow this like strict regulations, without considering the individual patient’s need, for fear of not complying. You know that this will guide state legislatures. Your recommendations will become law, and lawmakers do not consider the individuals.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brittany	None	None	0900006484f754ca	Sherman	None	2022-02-14T17:56:07Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Sherman, Brittany	kzm-ztf2-eo1d	False	None	False	2022-04-12 01:56:02.641	[]
675	CDC-2022-0024-0681	https://api.regulations.gov/v4/comments/CDC-2022-0024-0681	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You MUST allow doctors & patients to confer on an appropriate amount of opioid medication. Pain treatment is NOT a one-size-fits-all approach! It is IMPERATIVE the roadblocks to responsible prescribing be removed!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f754e9	Anonymous	None	2022-02-14T18:00:40Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-02qm-ywbj	False	None	False	2022-04-12 01:56:02.846	[]
676	CDC-2022-0024-0682	https://api.regulations.gov/v4/comments/CDC-2022-0024-0682	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f754f4	None	None	2022-02-14T18:09:24Z	None	None	0	None	2022-02-14T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from White, Sarah	None	True	None	False	2022-04-12 01:56:03.071	[]
677	CDC-2022-0024-0683	https://api.regulations.gov/v4/comments/CDC-2022-0024-0683	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is *** *** and I am a college educated 44 year old living in Arizona. I have arthritis, stage 4 endometriosis, hidradenitis suppurativa and cluster headaches. I have suffered with chronic pain for years. My pain was well controlled for years then in 2016 I was abruptly cut off of my pain medication. I went through horrible withdrawal with no help from doctors and since then I have only had small windows of feeling good enough to work. I work as a nanny for kids with special needs and was full time employed up until 2016. I had been on the same low dose of 2, 5mg hydrocodones for years and never had an issue with taking more than needed or prescribed. I along with millions of legitimate pain patients have had our lives ruined by the guidelines set in place. I am not a drug addict. And I have been treated like one for the last 6 years. Please stop ruining lives. Let doctors actually treat their patients with legitimate pain issues. Stop punishing us because we have legitimate pain issues that are not ever going to go away. I want my life back. I want to be able to contribute to society and work snd pay taxes and do all the things I was able to do before 2016. Please change the laws and stop punishing pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484f6fb91	White	None	2022-02-14T18:12:21Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from White, Sarah	84f6fb91	False	None	False	2022-04-12 01:56:03.274	[]
678	CDC-2022-0024-0684	https://api.regulations.gov/v4/comments/CDC-2022-0024-0684	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC guidelines need to be removed and put in the hall of shame for the pain and suffering and death it has caused to innocent people with chronic pain. It has harmed millions. It has harmed doctors who have done nothing but try to relieve the suffering of their patients. It has made good American citizens with chronic pain out to be criminals. We are tested like criminals through urine screens. We have our pills counted like we are toddlers that have put something in our mouths that needs to be removed. Any other heath condition treated like this? No. Yet ANY medication on the market a person can die from if not taken properly. Has the guidelines reduced overdose deaths? No. They have dramatically increased even though prescription opioids are at a all time low. Seems the guidelines did more harm than good. It did the opposite effect. CDC needs to let our doctors be doctors and if they want to prevent overdose deaths create a department that goes after the illegal drugs. Wait. We have one. It is the DEA. Maybe the DEA needs to go after the illegal drugs and leave our doctors alone? We all want drug overdose deaths to stop. Yet we as chronic pain patients want to be able to live our lives with relief from pain. I do not believe the CDC or the DEA intentionally hurt chronic pain patients. Yet both agencies did. You know this now. You have learned that the overdose deaths were not stemming from prescription opioids. Now please do the right thing and remove the guidelines and go after illegal drugs and let CPP have their Healthcare and their quality of life back. Remove the guidelines. Let our educated licensed doctors treat us with their scrutiny based on their education..Remove the guidelines. It is the right thing to do.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nolan	None	None	0900006484f7711b	Debra	None	2022-02-14T18:13:40Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Debra, Nolan	kzn-0j1i-bctu	False	None	False	2022-04-12 01:56:03.479	[]
679	CDC-2022-0024-0685	https://api.regulations.gov/v4/comments/CDC-2022-0024-0685	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why are you insisting that providers can't prescribe both benztropines and pain medication? I have taken both together for over 25 years without any problems because I have severe anxiety/panic attacks disorder which is well controlled with my benzodiazapine and I also suffer with an extremely painful condition called Trigeminal Neuralgia with is helped greatly by taking Fioracet for horrific pain it causes. As I said I've taken both within 24 hour periods spaced out without any problems whatsoever until now - I have had to decide which condition is more incapacitating and it was extremely difficult to make that decision. Now I cannot leave my home because of being incapacitated with pain! It's ridiculous and totally unnecessary that I have to exist like this instead of having a life like I formerly did. That decision should have stayed between my doctors and I instead of YOU getting involved and running my life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7715f	Anonymous	None	2022-02-14T18:42:18Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-16bp-kbpg	False	None	False	2022-04-12 01:56:03.685	[]
680	CDC-2022-0024-0686	https://api.regulations.gov/v4/comments/CDC-2022-0024-0686	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	They have no business deciding what's best for patients that is up to doctors and their patients. If the CDC has shown us anything in the past 2 years is that they are incompetent and don't follow science unless there is a money trail leading to their pockets. Stop throwing pain patients under the bus! Stop treating pain patients like drug addicts. Pain patients do not go on the streets looking for heroin and fentanyl. Stop treating people that are doing the right thing jumping through the right hoops as though they are drug addicts, pain patients are being treated less than human. I guarantee this is a guideline for all the regular people while all the people with money, people in government and everyone in Hollywood will not have to abide by these rules. The people making these rules obviously have never lived in pain don't know anybody that lives in pain. <br/>The CDC and the US government has shown its time and time again patience that are chronically ill with pain or if no concern to them. They will let people use heroin and drugs on the street and that considered them a problem when using these illegal substances because they are just looking for a high. But when real Pain patients try to do the right thing and see the right doctors they are stonewalled every door is closed to them. But if you are homeless and wanting to live in a tent and to use heroin on the street they will open every door for you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f77173	Anonymous	None	2022-02-14T18:43:12Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-1f1c-53b6	False	None	False	2022-04-12 01:56:03.902	[]
681	CDC-2022-0024-0687	https://api.regulations.gov/v4/comments/CDC-2022-0024-0687	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have PsA, Adrenal Insufficiency, Fibromyalgia, severe IBS-D, etc. While at Kaiser I received Tylenol 4 (2 tabs a day). I recently switched to different medical provider (VA) and was immediately changed to Tylenol 3 and 1 tab a day. My PCP forced me to be part of the chronic pain clinic which has been "doling" out the pain medications 1 prescription at a time to where I run out due to mail issues. I live too far away from the Fresno VA to drive there to pick up a prescription. I have asked repeatedly for them to look at my MARS report to see that in the 5 years at Kaiser I have not escalated or asked for any "extra" refills. When they asked I have told them repeatedly that I took 1/2 to 1 pill during the day and 1 T4 at bedtime. <br/><br/>I now have to choose whether I want to be able to move around during the day or sleep at night. I now know what it feels like to "feel like an addict" as think about running out, when will I get my next prescription, where could I possibly get more, what about on the street, etc, etc. In my opinion I feel like the VA is priming me to have addict thoughts. I am 23 years sober from alcohol, have never had a problem with pain pills and yet the VA treats me like I am an addict and they are the drug dealer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	CAROL	None	None	0900006484f771ba	PETERS	None	2022-02-14T19:09:39Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from PETERS, CAROL	kzn-27gh-gu8k	False	None	False	2022-04-12 01:56:04.115	[]
682	CDC-2022-0024-0688	https://api.regulations.gov/v4/comments/CDC-2022-0024-0688	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I applaud the CDC for considering a revision of the 2016 opioid guidelines. I will try to be brief, but outline concerns about our current situation in treating chronic pain.<br/>1. Pain providers for the most part have learned a considerable amount about opioid prescribing since the 1990's due to several reasons and the outcome is improved understanding of the use of opioids in treating chronic pain. But we are being put in a terrible position trying to manage patient's pain while at the same time doing battle with insurance companies and pharmacies who are using the 2016 guidelines inappropriately. <br/>2. Chronic pain patients are suffering greatly from the misinterpretation (purposeful or not) of the 2016 guidelines and more definition needs to be given to prevent harm to the Chronic pain patient using opioids to function in their daily life.<br/>3. Insurance companies have purposefully taken recommended from the 2016 guidelines to mean mandatory and are now refusing to pay for patients medication if they are over 90 MME.<br/>4. Pharmacies are requiring diagnoses and other personal information regarding patients before allowing patients to fill prescriptions. They are also setting hard limits on MME's such as 90MME's. I am in favor, however, of pharmacies requiring a copy of the patient agreement (contract) with the provider for management of their pain to include the use of opioids.<br/>5. Legacy patients (those who are on higher doses from the 1990's, that have been unable to taper to a more reasonable dose or cannot tolerate further taper need to be excluded from further taper as long as they have proven stable on their dose for at least the last 12 months.<br/>6. All new and current opioid patients need to be on the lowest dose of opioids that will allow for better function on an individual case by case basis.<br/>7. Inclusion of physical therapy, injections, and mental health need to be included<br/>8. The DEA needs to stop limiting production of opioids. It amounts to "prohibition" from the 1920/s. It didn't work in the 20's for alcohol and it is only driving patients to the street for illicit drugs to include carfentanyl and other fentanyl analogues.<br/>9. Please let the Pain Providers who see the patients and evaluate them, make the decisions on care. Those who don't see the patient, but are interested in their bottom line only, should not dictate the treatment plan. I have had many patients who were functional and working jobs only to be put in a position where they can no longer be a contributor to society or fully enjoy their family.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f771ca	None	None	2022-02-14T19:10:44Z	Alpine Pain and Rehabilatation	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Alpine Pain and Rehabilatation	kzn-2hho-tec6	False	None	False	2022-04-12 01:56:04.319	[]
683	CDC-2022-0024-0689	https://api.regulations.gov/v4/comments/CDC-2022-0024-0689	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments cut from Practical Pain Management article. The new 50 MME recommendation will be abused or misinterpreted. I agree with the authors' assessment and further clarification of these new guidelines:<br/><br/>The draft rewrite lacks balance in its treatment of public health concerns versus individual patient quality of life. It fails to adequately address the benefits of prescription opioids in comparison to their perceived risks.<br/>The draft rewrite omits mention of key references while relying on a large number of studies in which a single individual is a principal author.<br/>The draft guideline could be used to force tapers on legacy patients.<br/>A lack of research support for the recommended 50/90 MMED dose thresholds or 3-7 day prescription limitations.<br/>The draft rewrite may facilitate further “misinterpretation” and “misuse” of the original 2016 guideline.<br/><br/>https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/commentary-how-fill-holes-cdc-opioid-prescribing-guideline-revisi	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Davina	None	None	0900006484f771e4	George	None	2022-02-14T19:30:04Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from George, Davina	kzn-2sqf-yda1	False	None	False	2022-04-12 01:56:04.529	[]
684	CDC-2022-0024-0690	https://api.regulations.gov/v4/comments/CDC-2022-0024-0690	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a 32 year old male who has had 3 spine surgeries over the last 3 years. I have done pretty much all forms of conservative approaches to get rid of pain. None have worked, and I will say that I have suffered in pain because of the unwillingness of the majority of doctors to prescribe opiates. It has been a very frustrating and scary time. I am currently working with a pain doctor to wien off, which I think needs to be addressed even more than the actual prescription. I've had doctors and surgeons give me a bunch and expect me to wien off myself. This needs to be actively monitored by a professional, like the doctor I am seeing now. I hope that the cdc can relax a little and give people like me some relief when it is currently extremely hard to get. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keifer	None	None	0900006484f771ed	Olson	None	2022-02-14T19:30:27Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Olson, Keifer	kzn-2xcw-uypq	False	None	False	2022-04-12 01:56:04.742	[]
685	CDC-2022-0024-0691	https://api.regulations.gov/v4/comments/CDC-2022-0024-0691	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. That's right I said patient. I'm not an addict. All decisions regarding health care, including, but not limited to, narcotic/opioid medication prescribing should be made between doctors and their patients. The government should NOT have a say in which medications or which doses will help patients. Without my opioid medication, I would not be able to take care of my cancer patient husband, clean my house, do the grocery shopping or be a Grammy to our 2 grand-blessings. I take as prescribed and follow all rules set forth by my doctor. This being said, I live in fear that at each appointment my doctor will reduce or take away completely my opioid medication because of your so called 'guidelines'. <br/>These guidelines do not impact the addicts. They get the percocet, norco, fentanyl and other drugs off the street so they can get high, not function or ease physical pain. <br/>Again, I am chronic pain PATIENT NOT AN ADDICT. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f7720a	Vorhoff	None	2022-02-14T19:30:57Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Vorhoff, Elizabeth	kzn-38fa-b3e9	False	None	False	2022-04-12 01:56:04.958	[]
686	CDC-2022-0024-0692	https://api.regulations.gov/v4/comments/CDC-2022-0024-0692	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	my name is *** ** .<br/> I have taken Fentanyl patches for about 20 years, i started with dosage of 25mcg/hr, then 50mcg/hr., then 75. was wearing 75mcg/hr(2 every 3 days). Finally iwas wearing 1(75) every day(due to a sweating condition, where the patch would fall off after a day).Soon after the regulations for opioids came out, the insurance company took the patches totally away from me.( we tried to make them understand that i should be weaned down from the dosage i was on. They would not do this, they just stopped paying for them, meaning i could not get them.)Even our pharanist called them & tried to make them understand they were fooling with my life. They didn't care! ( Now with this I was also taking oxycodone-acetaminoph(7.5-325). It was over a year before i got any patches back. I could do nothing during that time except sit on my couch. I was an avid fisherman, also I hunted, could take my dogs for a walk. That all ended.When I finally got some patches back, i got 10 per month, which does nothing for my pain. From being without i got so much pain down my back & down my legs i can't walk any distance without a walker. I no longer can help my wife do anything around the house, i can't go to the store for her. Trying to walk puts me in such pain she won't let me go. Taking away my patches ruined my quality of life! It was not fair , & no one cared!<span style='padding-left: 30px'></span>*** **	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	edwin	None	None	0900006484f7720c	powell jr.	None	2022-02-14T19:32:27Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from powell jr., edwin	kzn-38yu-9akx	False	None	False	2022-04-12 01:56:05.185	[]
687	CDC-2022-0024-0693	https://api.regulations.gov/v4/comments/CDC-2022-0024-0693	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 33-year-old female who has been suffering from genetic degenerative disc disease for seven years. As someone who began experiencing painful symptoms in my late 20s, I hope that I can provide a unique perspective as I am not the typical patient suffering from chronic back pain. I have undergone three invasive surgeries and multiple out-patient procedures and have exhausted and repeated conservative therapies with multiple treatment providers over the last seven years. After the third failed surgery, my third pain management physician suspected I may be concurrently or alternatively suffering from CRPS, though I cannot get an affirmative diagnosis as my symptoms are atypically located.<br/>I suffer from daily, chronic pain ranging from a 4-5 on good days to a 10 on my worst days. The pain is often debilitating and severely limits what I can physically do without taking a break to lie down. I cannot lift anything over ten pounds, sit on a plane for more than three hours, or sit up in a chair for more than five hours without causing a flare up. I am a full-time attorney and have been gainfully employed since my symptoms began. I do not like to talk about my pain with others, particularly since I do not look "sick," and I am constantly terrified that people will think I am exaggerating or faking it and will judge me. I do not want to quit my job and live off of disability. I want to contribute to society and participate in it. And so I hide it from the world as best I can and am often in denial about it even with myself.<br/>I have been prescribed opioids on and off since the symptoms began but began taking them on a daily basis since my third failed surgery, which aggravated my condition. Without them, I could not sleep through the night, or travel, or sit up in a chair to work, or go to the movies or the grocery store. They allow me to sit through dinners out and get through low-impact workouts without agony. In short, they allow me to lead as close to a normal life as possible under the circumstances.<br/>I am fortunate to have been working with a knowledgeable pain management doctor for the last two years who has me on a medicine regimen and works with me and my pain without making me feel like I'm a drug-seeker, as so many physicians have been hard-wired to do due to, I believe, the fallout from the opioid crisis. I have had to change to a smaller pharmacy with limited hours because when I used to fill my prescription every month at CVS, there was so much red tape each time that I could never fill it on time and would end up without medication for multiple days at a time until it was filled. <br/>I acknowledge that the opioid crisis has been devastating and should be addressed. However, putting out one-size-fits-all guidelines that forces physicians and pharmacies to engage in "witch hunts" for patients who are experiencing very real pain actually exacerbates the feelings of shame and anxiety for those patients who are taking their medications responsibly. Last month, I was traveling out of the country for the first time in years and needed to fill my opioid prescription one day early. It took an entire week going back and forth with my insurance carrier, pain management doctor, and the pharmacy, only to be denied the day before my trip and being forced to pay out of pocket for the minimal amount of medication to get me through the trip. I left feeling anxious, sick, and in more pain than I would have had I simply stayed home. <br/>The new guidelines are a step in the right direction. It should be up to qualified physicians to assess each patient individually and determine whether opioids are the right fit for that patient. Pharmacists should not be terrified to fill legitimate prescriptions from legitimate physicians. Patients with real, debilitating, chronic pain with no foreseeable cure are suffering in silence when generalized guidelines directed at opioid-abusers is imposed on us. Please relax or simply better tailor the guidelines and de-stigmatize the use of opioids where medically indicated. Being able to take a medication to quell our pain for a few hours of relief is no different than a diabetes patient needing insulin. Please do not take away any more of our lives than chronic pain already has.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7720f	Anonymous	None	2022-02-14T19:33:12Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-3anr-ai7y	False	None	False	2022-04-12 01:56:05.400	[]
688	CDC-2022-0024-0694	https://api.regulations.gov/v4/comments/CDC-2022-0024-0694	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m in so much pain need my pain medication how can you put a limit on my pain medication, every person different, so please end the Mmes ..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	nina	None	None	0900006484f77210	saffold	None	2022-02-14T19:33:27Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from saffold, nina	kzn-3c40-5r0e	False	None	False	2022-04-12 01:56:05.617	[]
689	CDC-2022-0024-0695	https://api.regulations.gov/v4/comments/CDC-2022-0024-0695	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	...<br/>American Pain and Disability Foundation <br/><br/>Come in guys this is killing people! Your a Disease control center! Stay in your lane. Watching lawsuits all over America that American Pain and Disability Foundation are Initiating.. This seems so counter productive with so many suffering. Your causing implants and injection and so many different harmful issues that will go down in history as a small holocaust. Veteran's and kids dying in misery because doctors are terrified to write legitimate prescriptions in fear of being arrested. Doctors will take your new 50 mme that doesn't even exist as the new threshold. Rewrite the whole thing because this is double talk and your playing with pain patients lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f72052	None	None	2022-02-14T19:36:10Z	AMERICAN PAIN AND DISABILITY FOUNDATION	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from AMERICAN PAIN AND DISABILITY FOUNDATION	kzk-2m69-phxi	False	None	False	2022-04-12 01:56:05.822	[]
690	CDC-2022-0024-0696	https://api.regulations.gov/v4/comments/CDC-2022-0024-0696	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No meme limit should be in new guideline! And hospitals giving iv tylenol post surgery is insane. Sending people home, two here I know personally, with fractures and told to take motrin and call surgeon next week! I'm a retired nurse and just appalled. Also, if one gets hydrocodone now, if you're aged , its placebo. That dear writers needs to be investigated and penalties for fraud, theft given! Sincerely, also speaking on behalf of poor crippled granddaughter, mother of three and wife, she gets nothing for pain for couple years now because her pain doctor arrested for treating patients! Shame. Cpps are not drug addicts and you all know that so why these guidelines to begin with? Who wanted it written? Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f72dd3	Anonymous	None	2022-02-14T19:54:25Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzk-t982-xs25	False	None	False	2022-04-12 01:56:06.032	[]
691	CDC-2022-0024-0697	https://api.regulations.gov/v4/comments/CDC-2022-0024-0697	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi my name is ...,I have been affected by the cdc laws of tapering my meds down were to the point I can not get out of bed . I have been under care since 2014 with a head ache of tailoring the right meds for me and always followed the rules never asked for more medications just what I was told to take and will help to have a normal life to play with my 10 year old son ,plus I also take care of my 80yrld mother which shes in very bad health shape . I have also tried so many other treatments the only thing that works for me is my chiropractor, trigger, shots,medications .I'm asking the cdc we the people should not get discriminated just like the doctor I recently have he keeps messing with my medications which is not right ,I keep asking him to do new x-rays he won't do it . How are we supose to live in this world with 24/7 pain ? When there is legitimate patients being cut off then next you know more deaths because the person is in so much pain that they end up comiting suicide. I just don't get it . I also can't take cannabis or anything else . I just want my life back just like all the people affected by all this cdc laws.... thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f73d9d	Anonymous	None	2022-02-14T20:01:08Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzl-lypf-8lbw	False	None	False	2022-04-12 01:56:06.236	[]
692	CDC-2022-0024-0698	https://api.regulations.gov/v4/comments/CDC-2022-0024-0698	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><span style='padding-left: 30px'></span>Hi, I am a diagnosed Ankylosing Spondylitis patient. I have been living with this autoimmune disease for many years. Although there are bio-medications to slow this disease, there is no known cure. These bio-medications are very expensive with costs up to $40,000 per year without insurance and coverage is very expensive with. Once the disease damage has occurred, there is little to do to correct as it effects the joints of the neck and spine. My joints are calcifying and basically growing together. As this happens, it is like the joints are grinding together until they become totally fused. I become immobile from pain. I have been on Remicade, Humira, Enbrel and Xeljanz to slow the disease. I have been given shots to deaden the nerves in my neck. I have undergone physical therapy. I have had over the counter medication damage my stomach. I have had visits to Rheumatoid, Pain Management, and Neurosurgeon physicians. All with the same conclusion that there is no treatment to help my constant pain. I get out of bed in pain and can make it to my recliner where I wait 30 minutes for my first low dose Hydrocodone pill to take effect. I can then move fairly normally and can finish most tasks. By afternoon, another pill is required to keep me comfortable and mobile. I wake at night in extreme pain and take 1/2 pill to comfort me to a point I am able to sleep. I try to take as few pills as possible for fear my doctor may stop my medication. When I was eligible for Medicare, most doctors would not take me on simply because I used opiates. They didn't even ask why. I am thankful every day for the one doctor that understands but like all doctors, he is under pressure to limit opiates. I have taken low dose hydrocodone for years and have never taken more than prescribed. Anyone that says opiates have little long-term value is simply incorrect. I understand the risks but there are severe risks with many other drugs without the pressure to eliminate them. I would like the ability to manage pain. I hope everyone keeps me in mind when making guidelines concerning pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	robert	None	None	0900006484f781c9	parker	None	2022-02-14T20:18:42Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from parker, robert	kzn-4cf5-9qxg	False	None	False	2022-04-12 01:56:06.447	[]
693	CDC-2022-0024-0699	https://api.regulations.gov/v4/comments/CDC-2022-0024-0699	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with 3 chronic illnesses since the 2016 guidelines were published. All 3 of those illnesses cause pain, but I'm unable to get any meaningful relief from that pain because of the strict rules and red tape that accompany pain treatment. There's no cure for my illnesses - only symptom management. Due to the guidelines, I have to see a pain specialist for chronic pain instead of my primary care or another provider familiar with my disease process and management. The pain clinic has a strict formula for every patient regardless of their medical history or type of pain - physical therapy, cognitive behavioral therapy, and non-opioid or OTC medications. I've had so many joint injections that I've lost count, even though every injection has failed to help. I've been in physical therapy for 3 years, permanently damaging certain joints because imaging wasn't obtained before I was referred to physical therapy. I have Major Depressive Order listed on my conditions in my medical record because I had to see the CBT therapist associated with my pain clinic, even though I've never been diagnosed or treated for depression that isn't associated with my pain. After 2 years of following the clinic plan without any improvement - as well as some worsening - my clinic agreed to prescribe a partial opioid for my chronic pain even though it was only designed for opioid addiction. I can at least leave my bed now, but I've lost every other ability to live my life with any semblance of normalcy. I had to quit school and change careers because my level of pain - a pain level <br/>that has been deemed acceptable by the pain clinic - doesn't allow for movement longer than 30 minutes, bending at the waist at all, and staying in a seated position longer than 60 minutes. I'm now homebound instead of bedbound, and I have to fit my life around appointments, drug screening, and juggling red tape from my insurance, pharmacy rules, and my pain clinic rules. <br/><br/>In addition to my chronic pain, I can't get treatment for acute pain that comes up. Any doctor who sees that I go to a pain clinic refuses to prescribe me pain medication for an acute disease. I had kidney stones twice in the last year and was sent home from the ER with instructions to take my normal medications and dosages. I had orthopedic surgery last year that was treated with morphine in the hospital, but was told to take Tylenol or Advil upon discharge. When I told them I have a GI disorder that doesn't allow Advil, they suggested I just take the maximum daily allowance of Tylenol even though I've had liver complications as well.<br/><br/>The 2016 guidelines have done nothing helpful in my experience, since they resulted in pain patients getting mistreated AND the number of OD deaths has only increased in the last 6 years. When you add the number of patients who chose to commit suicide rather than live in pain, the results have been catastrophic. If pain management doesn't change soon, those numbers are only going to get worse. I still haven't given up hope that my life will get better at some point, but if I have to stay like this for the rest of my life because a government agency said I should, I'm not sure how much longer that hope can survive.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f781ca	Anonymous	None	2022-02-14T20:19:25Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-4d03-a23x	False	None	False	2022-04-12 01:56:06.667	[]
694	CDC-2022-0024-0700	https://api.regulations.gov/v4/comments/CDC-2022-0024-0700	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The term 'chronic pain' is so broad and diverse in its meaning, as a diagnostic entity, as to be almost useless. There is not much commonality between fibromyalgia, lumbar spinal stenosis, painful diabetic neuropathy, migraine and all of the other many somatic and neurological conditions to make generic/general recommendations usefully relevant to all. Non-specialists struggle greatly with the distinction between patients with and without a specific pain generator, and, not understanding how pain can arise without a physical cause, often inappropriately assign one. My suggestion would be to restrict the use of the term 'chronic pain' to those patients WITHOUT a definable physical pain generator. These individuals represent probably half the total 'chronic pain population'. They typically have some degree of physical deconditioning, neurologic 'central sensitization', psychiatric (Axis I) and/or psychological (Axis II) co-morbidity. Of course, individuals with a definable pain generator (i.e. lumbar spinal stenosis) may also have neurologic/psychiatric/psychological co-morbidity, but it is to the former group that the 'biopsychosocial' model and cautions around opioid prescribing best apply.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Adam	None	None	0900006484f78294	Burkey	None	2022-02-14T20:21:36Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Burkey, Adam	kzn-4t5w-ivni	False	None	False	2022-04-12 01:56:06.873	[]
695	CDC-2022-0024-0701	https://api.regulations.gov/v4/comments/CDC-2022-0024-0701	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cancel the mme of pain medications..what works for some does work for all and let my doctors dictate what is best for me and not the cdc…please help us pain patients and don’t put a limit on the amount we get from our doctor…I have to live with the pain for the rest of my life and it’s not fair I can’t control my pain because I can’t get the medication I need to live a full healthy life…please drop the mme and let doctors prescribe when they think the patients need… I am begging you to hear our voice and I have had 30 injections last year that did nothing but cost me and my insurance a lot of money I didn’t have and I still don’t have any relief…please please drop the mme threshold	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f782f1	Anonymous	None	2022-02-14T20:22:27Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-5308-quvy	False	None	False	2022-04-12 01:56:07.084	[]
696	CDC-2022-0024-0702	https://api.regulations.gov/v4/comments/CDC-2022-0024-0702	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a minister that has to deal, at times, with people addicted to different medications. I'm also a person living with two forms of arthritis and chronic pain. I believe fighting this pandemic shouldn't disrupt the patient/doctor relationship with what they need, being a pain medication or otherwise.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f78370	Anonymous	None	2022-02-14T20:32:31Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-5fub-fvkz	False	None	False	2022-04-12 01:56:07.305	[]
697	CDC-2022-0024-0703	https://api.regulations.gov/v4/comments/CDC-2022-0024-0703	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient, I support the proposed revision in guidelines. My suggestion is that doctors be allowed to treat their patients in the way that seems best to them. I support increased education not only for patients but also for physicians, in the belief that "knowledge is power". I think we should form public policies based on facts and clinical experience rather than TV dramas or sensational news reports.<br/><br/>It is undeniable that some people are harmed by opioids (and for that matter, nearly every other drug). Yet the good outcomes, it seems to me, outweigh the bad. I have been a chronic patient since 2010 (12 years) with multiple level lumbar spine and disc problems. I have had three surgeries and months of rehab and am fortunate to still be able to work full-time supporting my family (including a special needs adult child). I now use multiple pain control approaches including oral opioid medications. I do not particularly enjoy taking opioids, but you know, they are effective. I have been extremely responsible with my medications and I believe most other folks in my situation are, as well. It seems wrong to me that our policies are shaped by the behavior of the irresponsible, the unfortunate (or both), to the detriment of the majority of patients. Most of them, like me, are simply trying to get through one day after another against major challenges. We are trying to take care of families and loved ones and to make some kind of positive contribution to the world. In my case, I have not experienced euphoria or the desire to use opioids recreationally (nausea, yes). The meds simply allow me to feel "normal" and, I would say, much more sober than while in the throes of a severe pain attack.<br/>Most of my life I have been disgustingly healthy. Chronic pain has been an experience for me like no other. There is nowhere to run, no escape. One is in a near-constant "fight or flight" state and simply being courteous or reasonable to other people can be quite a struggle. <br/><br/>Unrelated to this specific topic, I would support Federal re-scheduling of cannabis and its derivatives (to Schedule II or Schedule III) mainly to allow broader research to determine if additional, non-opioid pain control alternatives may exist. Personally, I would be delighted not to have to take opioids. But so long as they are the primary effective means, I am stuck with them. I am not a pharmacologist and have no idea whether cannabinoids may offer benefit to chronic pain patients, but the current legal situation makes Federally funded/sponsored research nearly non-existent.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484f7836e	Kurman	None	2022-02-14T20:48:12Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Kurman, Eric	kzn-5f64-cjfh	False	None	False	2022-04-12 01:56:07.516	[]
698	CDC-2022-0024-0704	https://api.regulations.gov/v4/comments/CDC-2022-0024-0704	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a family doctor practicing in rural Western Pennsylvania (2006), I received a Monday morning telephone call from a Rite Aid in Philadelphia. “Did you prescribe Percocet to Mr. XX last Saturday morning by telephone?” asked the pharmacist. I replied, “No.” “Good,” said the pharmacist. “I didn’t think so,” he added. “You know, they sounded just like a doctor’s office. The receptionist asked for the prescription, then put someone on the phone who acted as if they were you.”<br/>…<br/>I asked the pharmacist, “Has my DEA number been used to order Percocet for this patient in the past?” The pharmacist replied, “Yes, 6 other times.” This was not a patient of my practice. <br/>…<br/>I asked the pharmacist, “How many other patients in your pharmacy have received a controlled substance/narcotic/opioid with my DEA number?” The pharmacist said he has no way of knowing. I further asked, “Is there a way corporate Rite Aid could let me know how many controlled prescriptions were used in the Philadelphia area? Or, the entire State?” The pharmacist replied that I would need to know the name of the patient and call each store separately. <br/>…<br/>I called both the Attorney General’s Office of the Commonwealth of Pennsylvania and the DEA. To both agencies, I relayed the story, which meant that a large scale of narcotic drugs were being administered in my name fraudulently. Add all providers in Pennsylvania, then the entire country and a fraudulent epidemic is uncovered. I asked the Attorney General’s Office why a website could not be made available for prescribing providers to track their narcotic prescriptions. Owning our own practice in a town of 3,000, I could easily look at a list and identify names outside of our practice. The representative from the Attorney General’s Office informed me that this information was “none of my concern.”<br/>…<br/>Fast forward to modern times. I know of a patient with cancer pain who has been consistently accosted by one pharmacist. “You don’t look like you are in pain,” the pharmacist declares while deciding whether the prescription should be given to the patient. <br/>…<br/>My son, after released from tonsillectomy-adenoidectomy in Tampa, stayed at our Poinciana, FL home. We were not able to fill a prescription for narcotic pain pills at CVS because of the “opioid crisis.” The pharmacist recommended a non-steroidal anti-inflammatory drug, like ibuprofen despite my son being s/p kidney transplantation and forbidden from using high dose NSAID. To obtain the prescription, we went to the local emergency room and had the Rx filled at a different pharmacy. The original Rx from the surgeon was missing the pill count and the pharmacists would not accept telephone or fax verification from the surgeon. <br/>…<br/>Not long ago, “pain” was considered an additional vital sign. When discharged from a hospital, patients were asked to rate their pain. A high level of pain reflected poorly on the provider and the institution. Today, we ignore pain. We try to convince ourselves that severe pain can be controlled with acetaminophen or ibuprofen. Individuals with chronic severe pain know opiates are better able to reduce pain and allow for some activities of daily living. <br/>…<br/>Opioid abuse is a problem. When removing fentanyl overdoses and focusing solely on patients who faithfully see their providers on a monthly basis, opioid abuse is very rare. <br/>…<br/>Opioid treatment, per existing policies, is very lucrative for providers/institutions and costly for patients. I’ve seen monthly urine tests at a charge of $1,500. The CDC recommended not testing for marihuana for long term opiate patients, yet centers continue to charge for the extended urinalysis and a sense of control. Patients with Diabetes mellitus may see a provider once every 4-6 months. Yet, a patient with chronic pain, say from an inoperable spinal cord tumor, must travel monthly to a facility and check-in like a convicted felon out of prison on parole. <br/>…<br/>I applaud new guidelines recognizing less draconian practices when caring for people with chronic pain. Allowing for 90-day prescriptions gives patients the ability to travel and visit family/friends without the anxiety of the next 30-day Rx. <br/>…<br/>Thank you for giving me the opportunity to comment,<br/>***** ****, DO, CPC, CPCO, CPMA, AAPC Fellow<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f783bb	Warner	None	2022-02-14T20:50:44Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Warner, Michael	kzn-584m-x9ys	False	None	False	2022-04-12 01:56:07.941	[]
699	CDC-2022-0024-0705	https://api.regulations.gov/v4/comments/CDC-2022-0024-0705	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a indvidual who suffers from chronic pain for over 15 years and having exhausted all other measurws and being allergic to injections . If i didnt have my pain meds i woould not be able to function daily . Its unfortunate that i am made to feel as though i am drug seekinh or a addict because of my pain meds that are a lifesaver.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484f78562	Denzer	None	2022-02-14T20:59:41Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Denzer, Pamela	kzn-69az-g8sm	False	None	False	2022-04-12 01:56:08.154	[]
700	CDC-2022-0024-0706	https://api.regulations.gov/v4/comments/CDC-2022-0024-0706	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are an effective treatment for valid medical concerns, however, prior to prescribing them patients should be screened thoroughly for an alcohol and drug assessment, submit to random weekly urine drug screens and should be negative for ALL substances (including alcohol and marijuana), and medical providers should be completing not only education for opioids but current treatment trends that correspond with addiction and recovery. This should also be done during ANY medical evaluation by ALL medical providers, not only pain management, but general practitioners and OB/GYNS as well. Women and pregnant women that are active in addiction are increasing in numbers and are surpassing men in addiction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christy	None	None	0900006484f78581	Gillespie	None	2022-02-14T20:59:58Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Gillespie, Christy	kzn-6d0m-xlqg	False	None	False	2022-04-12 01:56:08.373	[]
701	CDC-2022-0024-0707	https://api.regulations.gov/v4/comments/CDC-2022-0024-0707	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started having surgery when I was 19 years old. I am currently 58. I have had 23 surgeries and have been on and off opioids most of my life. I live in severe chronic pain and was on Norco when the opioid epidemic started. I was taken off my medication and have not had any quality of life since. I had a heart attack when I was 53 and was told I had 5 years left to live. Most of those five years have been spent in bed due to my pain (yes, I made it past 5 years, going on year 6). I have pain taking a shower, walking just to my mailbox. I can't do housework and am basically giving up. I can't spend time with my Grandchildren, visit friends, go shopping, etc. I have never overdosed and have been on some pretty strong painkillers throughout all my surgeries and in between for the chronic pain I am in now and have been in for at least 10 years now. <br/>I would think being at an "end of life stage" I should be allowed to enjoy what time I have left. My last cardiologist appointment I was told I could "drop dead" (his exact words) at anytime. I am still currently spending all my time in bed due to the pain and depressed. When I was on Norco for chronic pain I was able to due house work, go to the beach, visit my Grandson ( I have two Granddaughters also now) mow the lawn and had a life. I would like to have some kind of life before I die. I have tried physical therapy and NSAIDS, but can't take NSAIDS anymore due to my heart. They were also taken away. I always followed instructions on how to take my medication, had monthly urine tests to make sure and never had a problem. Please give those of us suffering our pain meds back. Living in chronic severe pain is a miserable existence.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484f78683	Harwood	None	2022-02-14T21:23:19Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Harwood, Barbara	kzn-76ui-h425	False	None	False	2022-04-12 01:56:08.641	[]
702	CDC-2022-0024-0708	https://api.regulations.gov/v4/comments/CDC-2022-0024-0708	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient after a severe car accident. I needed my opioids at one point in my life. My pain was so intense I would’ve committed suicide without them. Life would’ve been unbearable. I am now off opioids and do meditation daily and swim to help my pain. But if the restrictions that you guys have now were around then I wouldn’t have made it. Chronic pain patients need help. Living daily in severe pain is not a way to live. If your taking prescribed amount it should be ok.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f78694	Anonymous	None	2022-02-14T21:23:32Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-7adg-4795	False	None	False	2022-04-12 01:56:08.873	[]
703	CDC-2022-0024-0709	https://api.regulations.gov/v4/comments/CDC-2022-0024-0709	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I work in a pain center in my community. We have VERY stringent standards and weed out those who are trying to abuse the system. We treat those who have been dealt a rough hand in life, whether they were born with painful conditions, acquired them through work or accidents. We have some strong, truly wonderful folks. The limitations on prescribing narcotics have impacted their lives immensely. People in chronic pain do not have the choice to be pain free, they have to choose what tasks they can try to accomplish on a given day. That means they may have to choose between going to run an errand over quality time with friends or family. They may be able to make it through a work day but are in too much pain to do anything else after work. Chronic pain makes it hard to focus on things, makes it hard to enjoy life. It's not something you can choose to ignore, chronic pain stops you dead in your tracks and demands you give your body the rest, help it needs. Chronic pain will not always go away if you lose weight, exercise, do yoga or try acupuncture...and it is not all in your head or from anxiety. Our medical system, our doctors, are getting burnt out by watching patients in pain and having their hands tied by not being able to help them as they need to.<br/>My own health issues have given me more compassion and understanding to those who suffer with chronic pain.... I know first hand what they are dealing with daily. I have a genetic connective tissue disease called hypermobile Ehlers-danlos. My muscles fight 24/7 to hold my bones, joint, organs in place due to having faulty collagen. On any normal day I dislocate 20-30 joints a day, on a bad day it is much worse. I wear many kinds of braces to try to prevent dislocations, but I cannot brace each joint in my body. Some days I cannot use my hands as my fingers lock up and/or dislocate. Some days reaching for a cup will dislocate my elbow. I fall often as my hip/knees/ankles dislocate often. Because I am a healthy looking 47 yr old woman with an invisible disease, most doctors do not see a need for pain medicine and suggest alternative therapies. After having tried all alternative therapies, they then tell me I am too young to need pain management. I live in chronic pain, most days bad enough that I am brought to tears multiple times. I don't have the option of living a life with less pain,there is no cure for hypermobile Ehlers-danlos. Having a doctor who feels comfortable enough to prescribe opioids for the bad days would be wonderful, but doctors feel as though their hands are tied. I beg you to please give doctors back the ability to help those of us in need, to not worry about losing their license for honoring the oath they took to treat their patients to the best of their ability. <br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f786b4	Anonymous	None	2022-02-14T21:33:05Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-7jkz-pthy	False	None	False	2022-04-12 01:56:09.123	[]
704	CDC-2022-0024-0710	https://api.regulations.gov/v4/comments/CDC-2022-0024-0710	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	IT IS ABOUT TIME THAT SOMETHING IS DONE TOHELP PEOPLE IN pain. I have had 11 back surgeriesand have hardware in the neck,tye thorsic and lumbar spine and also have a spinal cord stimulator. I know that taking the medicine I am on is not good for my overall heath but it is the only thing that gives me any relief from my severe pain. Since the CDC put in the guidelines my meds have been greatly reduced and I now have no quality to my life. People like me are not the ones who are abusing these opiods and we should not be penalized because of people who do abuse them. You also should stop harrasing doctots who are willing to help people who are in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Frederick	None	None	0900006484f78703	Thompson	None	2022-02-14T21:44:16Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Thompson, Frederick	kzn-7tu6-zsj8	False	None	False	2022-04-12 01:56:09.342	[]
705	CDC-2022-0024-0711	https://api.regulations.gov/v4/comments/CDC-2022-0024-0711	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For some years I worked at M.D. Anderson Cancer Center. Experience and involvement with some of those who suffer teaches me the guidelines for prescribing pain meds over the last few years have had severe negative effects of those who need regular pain treatment to help them return to something approaching normal lives. Please do all you can do to put decisions about pain treatments back into the hands of physicians. Ideally, pharmacists should have no reason to refuse to fill prescribed meds, patients should not suffer needlessly due to extreme reductions in doses that have worked for them, and laws should allow pain med dosages to be tailored to individual patients to allow them lives as pain-free as safely possible. Thank you for doing all you can to correct a situation that has taken a terrible toll on some of our most vulnerable. Hoping for some good news for our wonderful physicians who know medical needs and for the many patients who have suffered under the current rules! Hopefully changes to the current rules will also reduce the number of desperate patients who turn to dangerous illegal pain meds because they are left suffering beyond their abilities to endure. Thank you again for working to improve lives!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f772ba	Simon	None	2022-02-15T00:37:05Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Simon, Patricia	kzn-dd9u-tfno	False	None	False	2022-04-12 01:56:09.552	[]
706	CDC-2022-0024-0712	https://api.regulations.gov/v4/comments/CDC-2022-0024-0712	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a chronic pain sufferer due to a fractured back and severe nerve damage. I depend on opioids to be able to take care of my family and pets. They allow me to function and live as close to a normal a life as possible. I tried other medications, PT, meditating and various natural remedies. They helped to a limited degree but nothing was able to restore my function like opioids. Opioids also have less side effects than other medications I tried. For me they give much more pain relief. I have been on a stable dose for 5 years without any need to increase. I understand there are some who develop addiction issues and serious consideration needs to be given to prescribing but things have went so far to the extreme that I live in fear of losing my medication for an arbitrary political reason. Pain patients are strictly monitored and tested beyond any reasonable amount but many still lose access to Doctors and suffer tremendously due to the fear the CDC guidelines instilled in practicing Doctors. We also deal with shortages of medication throughout the year due to DEA demanded production quotas. This is insane. Please use balance and reason. You are hurting so many people who are already in pain. People are being prescribed ibuprofen after major surgeries. My daughters friend recently had a car accident that resulted in a ruptured spleen and broken ankle and was refused pain medication IN the hospital. It's nightmarish. Everything went from one extreme to the other. I never thought I'd see the day when even hospitals are limiting pain relief. It's shocking and agonizing to see this happen in the U.S. Your guidelines have a ripple effect that is massive. Please stop this. Please be balanced and nuanced in your approach.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shannah	None	None	0900006484f772a2	Jones	None	2022-02-15T00:40:47Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Shannah	kzn-d6q9-zntm	False	None	False	2022-04-12 01:56:09.773	[]
707	CDC-2022-0024-0713	https://api.regulations.gov/v4/comments/CDC-2022-0024-0713	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have service connected disabilities after serving 22 years in the military. I was prescribed pain medication which greatly relieved my pain and allowed me to work after retirement. I was on them for approximately 5 years and doing well. The VA and my pain management physician stopped prescribing my medication due to the backlash the doctors received for helping me and others. It should be at the physician's discretion and NOT THE CDC! I WENT THROUGH YEARS OF HELL AND ATTEMPTED SUICIDE TWICE DUE TO THE PAIN!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f77289	Anonymous	None	2022-02-15T00:41:28Z	None	None	1	None	2022-02-14T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-d20j-1hoo	False	None	False	2022-04-12 01:56:09.990	[]
708	CDC-2022-0024-0714	https://api.regulations.gov/v4/comments/CDC-2022-0024-0714	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like you to know that I, like I am sure the majority of people, would have a heavy handed approach to pain and drug addiction had I not had a sudden onset of GBS Jan. 2018 resulting in unimaginable pan, hospitalizations for 5 mts.... I am a 69 yr. old woman who hesitated to take even OTCs (before they had a bad wrap). I had my first born after 24 hrs. of labor, with no meds, ate organic and did yoga when I was a freak for doing so. OK, you get it. My pain was so severe I begged my beloved husband to help me die. When I finally yelled at the staff that they were heartless, they tied me down. Yep, acted like I was "crazy." I will get to the point. YOU, and no one who has not experienced it, have NO IDEA how horrible pain can be unless you experienced it.<br/><br/>It is not only HEARTLESS, you medical professionals are not doing their job. Yes, I have tried ALL alternatives (and by the way ONLY because I could afford it-as you know another very weak in the lack of help for the ill in the US).<br/><br/>I now take Gabapentin, and I am down to 10 MCG pain patch (for which I am treated like I am an addict when approaching any dr. or hospital situation). Sometimes the pain sickness are manageable now. I am telling you all this to inform you that you have it all wrong and ARE NOT DOING YOUR JOB. You are supposed HELP those who suffer.<br/><br/>Is it the US government (FDA, DEA, etc.) as well as the MDs. Do no harm, and help. What I usually get is condescending physicians who have to be concerned the the federal agencies. I must go to a pain dr. because, yes, my two physicians CANNOT dispense pain meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f7901b	Carter	None	2022-02-15T12:49:57Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Carter, Patricia	kzo-2uj8-kthk	False	None	False	2022-04-12 01:56:10.267	[]
709	CDC-2022-0024-0715	https://api.regulations.gov/v4/comments/CDC-2022-0024-0715	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because of what the 2016 CDC Guideline recommended, I was cut off from my monthly prescription of 225 MG of ER Morphine, abandoned by my Navy doctor, and forced into opioid withdrawals with no help or treatment. As a Christian, it is my duty to forgive the authors of the Guideline, but I will never forget what they did. I am a retired US Marine who gave 23 years of my life to support and defend the United States and its people. Because of my service, I am now 100% disabled by the VA and SSA. I have multiple service connected disabilities and injuries and because of them, also have high impact chronic pain. I have been on high doses of pain medication now for almost 35 years. That all came to a halt after my Navy doctor misread and then misapplied the 2016 Guideline. My doctor’s exact words were “it is my job to clean up the mess that your former doctors created”. The CDC knew that its Guideline would negatively impact chronic pain patients, but nonetheless; it still published the 2016 Guideline. In my opinion, the CDC was wrong to get involved in the first place! If any government agency should have gotten involved, it should have been the FDA or HHS, not an agency responsible for disease control. The CDC has done absolutely nothing to rectify the harms that it created, until now - six years too late! I don’t care what healthcare clinicians say, there is no difference between cancer pain and non cancer pain. Our bodies and receptors don’t know the difference! I pray and hope that the CDC does the right thing this time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484f79016	Collins	None	2022-02-15T12:51:17Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Larry	kzo-28jk-96mp	False	None	False	2022-04-12 01:56:10.529	[]
710	CDC-2022-0024-0716	https://api.regulations.gov/v4/comments/CDC-2022-0024-0716	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Under prescription of acute pain relief medication and delaying diagnostic testing is creating harder to treat subacute nearing chronic pain. Opioid-fear for practitioners has negated the goal of health and rehabilitation. I am at week four of a back/hip injury that occurred while shoveling snow. Day 1 began with “you should not hurt, you cannot have” healthcare providers panic. Instead of diagnosing my injury and resolving symptoms, my medical interactions have focused on managing regulations not healing me. In 1 month I have had urgent care, emergency care, primary care and have gone from active to near bed bound with pain, without diagnostic imaging studies while waiting for Physical Therapy availability. These care priorities are backward and not suited to returning me to functional health. Layers of legal “no” only adds to pain being moved to back street providers. I am a senior and suffering, legally.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Effie	None	None	0900006484f791c4	Atkinson	None	2022-02-15T12:52:07Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Atkinson, Effie	kzn-ygce-2hsi	False	None	False	2022-04-12 01:56:10.755	[]
711	CDC-2022-0024-0717	https://api.regulations.gov/v4/comments/CDC-2022-0024-0717	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is my 2nd comment. I have gone through the new draft a bit closer and have a few concerns. Seeing the recommendation of 50mme listed in the new guidelines scares me that this will be taken out of context just like the 2016 recommendation of 90MME. I have the fear that this will be made the new norm and more long term opioid patients will be forced tapered to 50mme. <br/>My next concern is how the section about patients already on long term opioid therapy that are over the current 90MME. It does say to outweigh the risks, but then continues on about tapering and discontinued use of opioids. I had to read it several times (I am not in the medical field) and it can be taken as these patients must be tapered until they are eventually off of opioids. <br/>The wording used needs to be reconsidered on both the above areas. <br/>#1 by listing the 50mme this will cause unneeded force tapering to long term opioid therapy patients. In my opinion I feel that there should not be a maximum amount of medication listed in this manner. In 2016 the recommendation of 90MME was taken out of context and made into laws and doctors were threatened by the DEA and State to lower all patients no matter the circumstances or lose their license and possible jail time. With this in your new guidelines I can see it happening all over again. <br/>#2 patients already on long term opioid therapy. There needs to be something in this section about each patient being different and it is up to the doctor and the patient whether or not the benefits outweigh the risk to continue at their current dosage. The way it is written on this draft makes it sound as though all patients must be tapered until they no longer take opioids. <br/>My final suggestion is to remove the DEA from the Doctor/Patient relationship. It is next to impossible to get the care that we the patients need while the DEA is breathing down the Doctors neck, threatening them actions if they do not lower all patients to below the CDC guidelines (which now looks like 50mme). <br/>I am currently a long term opioid therapy patient over 90MME and I am being force tapered. I was at a dosage where I was able to have minimal issues with daily functions, now (slightly over 90MME) I am having difficulties with basic daily functions. I have followed every recommendation from my Dr, such as monthly urine and pill counts, non-opioid therapy and any testing they need without any issues. I follow my prescribed dosage exactly as it is written. I do not seek extra medication, drink or take any illicit drugs. I would love it if I didn’t need to be on opioids at all, but that isn’t the reality of my situation. I have no relief or improvement in my condition in my future. I have been on opioid therapy since 2008 and my medication has not increased in over 6 years. I finally found the proper dosage that I need to be an active member of society and it is being ripped out from under me. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlene	None	None	0900006484f78fe1	Graham	None	2022-02-15T12:54:20Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Graham , Charlene	kzn-wb5r-e7vn	False	None	False	2022-04-12 01:56:10.980	[]
712	CDC-2022-0024-0718	https://api.regulations.gov/v4/comments/CDC-2022-0024-0718	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lung cancer. My pain is reduced to a 5/10 pain level with 30mg Oxycodone IR every 4 hrs AND 60mg OxyContin every 8 hrs. This pain level allows me to get out of bed and function, almost like a regular adult. If I'm not mistaken, that's 270 MME for my IR and 270 MME for my ER, so 540 MME/day? That regimen barely gets me to a 5/10!!! I understand the need for starting new patients on the lowest possible dose that provides therapeutic relief, but even suggesting that 50 MME limit or guideline is ludacris without providing a recognized, respected source for your claims that 50 MME is somehow the "magic number" that clinicians should use to target their dispensing practices. I suffered for almost a year because my doctors were afraid to prescribe me a dose of opioids that adequately relieved my pain. Now that I have a regimen that works, it has remained unadjusted for almost six months and it is still working. It does not leave me walking around like a zombie, and I am not "high" on my pills. Please don't further restrict these important medications to people who need them. Do whatever you want with regards to guidelines for starting opioid naive patients on opioid therapy but please don't further harm those of us with chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Josh	None	None	0900006484f78faf	Lenz	None	2022-02-15T12:55:09Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Lenz, Josh	kzn-ther-mlnk	False	None	False	2022-04-12 01:56:11.192	[]
713	CDC-2022-0024-0719	https://api.regulations.gov/v4/comments/CDC-2022-0024-0719	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	DOCKET NO: CDC 2022-0024 <br/>I WAS A HARD WORKER BROUGHT UP TO BE GET UP IN THE MORNING AND GO TO WORK TO SUPPORT YOURSELF UNTIL IN OCTOBER 2005, I WAS A MEAT CUTTER AND I HAD SEVERE PAIN RUNNING DOWN MY LEG,I WAS ATHLETIC WORKED OUT ALL MY LIFE, AND OVERALL BEEN HEALTHY I STARTED CHIROPRACTIC CARE. THE PAIN WAS SO BAD I COULD NOT SLEEP, LAY, WALK, SIT IN ANY POSITION TO BE COMFORTABLE AT ALL.WELL, TWO MONTHS OF VISITS AND ADJUSTMENTS NO RELIEF AT ALL. IT WAS LIKE I WANTED MY LEG AMPUTATED.SO I WAS REFERRED TO ORTHOPEDIC SURGEON,NOW THIS WAS 2005 DOCTOR PUT ME ON LORCET PLUS AND CYLCOPHENIZIPHERENE .DID MRI RIGHT OFF,CALLED ME SAID WE NEED YOU TO COME IN YOUR MRI IS BACK AND ITS VERY LONG JUST DID MY LUMBAR SECTION OF MRI .I HAVE CONGENITAL SPINAL STENOSIS ,BIRTH DEFECT IN WHICH ITS NARROWING OF MY SPINAL COLUMN ,WITH 2 BULGING DISCS BONE SPURS ,THE PAIN WAS ALL THE WAY DOWN MY LEG INTO MY FOOT ,WELL IT STILL IS NUMB AND VERY PAINFUL ,I AM VERY ACTIVE AND I DO PHYSICAL THERAPY ,APPLY HEAT PAD ,LIDOCAINE PATCHES ,PAIN CREAM ,AND OPIOID THERAPY .THE OLD GUIDELINES HAS DONE ALOT OF DAMAGE TO ME .IN 2012 I WAS ON 80 MG OF OXYCODONE A DAY ,20 MG OXYCODONE 4 TIMES A DAY ,WITH A SOMA AT NIGHT ,BED TIME BECAUSE OF MY SEVERE CRAMPS AT NIGHT .LORD BEHOLD IN 2016 I WAS TOLD BY DOCTOR I CAN NOT WRITE YOU SOMA AND I WILL HAVE TO CUT YOUR PAIN MEDICATIONS BECAUSE DOCTOR DID NOT WANT THE DEA COMING IN HIS OFFICE AND PULLING HIS MEDICAL DEGREE .WELL LATER IN 2018 I HAD BACK SURGERY BECAUSE I WAS TIRED OF THE PAIN AND SLEEPLESS NIGHTS ,WELL THAT WAS A MISTAKE ,MY RIGHT LEG GOT BETTER BUT MY LEFT LEG STILL TO THIS DAY IS VERY PAINFUL AND NUMB LIKE TINGGLING FEELING .I DONT WHAT ELSE TO DO BUT TRY TO GET BETTER BUT I HAVE CAME TO CONCLUSION I WANT GET BETTER CAUSE THE NERVES ARE DAMAGED AND THEY DONT HEAL.WHAT DID I DO TO DESERVE THIS ,THIS IS NOT ALL NOW MY WHOLE BACK IS HURTING SHOULDERS AND ARMS .I BEEN CUT TO 10 MG OXYCODONE AND 10 MG FLEXERIL ,100 MG PREGABLIN WITH TO ALTERNATE 800 MG GABOPENITIN ,I HAD SMOKED WEED TO HELP ME SLEEP INSTEAD OF ALL THESE GABOS ,PREGABLIN ,MIXTURE WHICH WILL KNOCK ME OUT AT TIMES ,MY GOSH I NEED TO FUNCTION ,I CAN FUNCTION IF I DID NOT TAKE BOTH SO I CHOOSE TO DROP THE LYRICA MY SELF ,NOW I HAVE STAGE 3B CHRONIC KIDNEY DISEASE ,THEN 4 MONTHS AGO I HAD TO HAVE A HEART CATH DONE CAUSE OF CHEST PAINS I CANT COUNT THE NEEDLES THATS BEEN IN MY BACK ,ITS BEEN GOING ON FOR 17 YEARS OF MY LIFE ,I JUST WANT MY QUALITY OF LIFE BACK AND NOT SUFFER WITHDRAWLS BECAUSE OF THE HARM OF THE 2016 GUIDELINES AND DEA INVOLVEMENT .SO THE NEW DRAFT GUIDELINES TO ME IS BETTER BUT NOT QUITE WHERE I FEEL IS GOOD ENOUGH TO HAVE THE CORRECT HUMAN KIND CARING COMMPASION OVERALL CARE ,IT STATES OTHER THINGS TO BE TRIED ALONG WITH OPIOID THERAPY ,WELL I DO ,I HAVE A EPIDURUAL SHOT FEBUARARY 24 ,I JUST DONE 6 WEEKS OF PHYSICAL THERAPY AND DRY NEEDLING TO LOOSEN MUSCLES AND SCAR TISSUE ,I STILL AM ACTIVE WHEN I HAVE MY PAIN MEDICATION ,CAUSE IT DOES NOT LAST .NOW I BEEN ON TWICE THE AMOUNT IN 2012 ,JUST TEN YEARS AGO BOY HOW LIFE WAS THEN ,I COULD STAY ACTIVE GO TO PHYSICAL THERAPY DO HOME THERAPY TOO IF I COULD NOT GET TO THE THERAPY OFFICE ,SO YALL ARE CLOSE TO IT BUT YOU ARE NOT THERE TO WHERE THE ONES WHOM ARE IN NEED OF THE ADEQUATE AMOUT DUE TO THERE CONDITION AND YEARS ON THE MEDICATIONS AND THEY WAY THE BODY IS DIFFERNT FROM OTHERS .SO LETS DO AWAY WITH THE MME ,ORDER LOCK BOX DISPENSIERARIES FOR AT HOME FOR PATIENTS ,THAT WAY YOU KNOW ITS TAKEN PROPERLY AND NOT GET INTO THE WRONG HANS AND THEY WILL NOT BE A OPIOID EPIDEMIC ,NOW IM JUST A COUNTRY BOY ,BUT I ASSURE ANYONE IM TIRED OF PAIN IM TIRED OF THE HATE BECAUSE I HAVE TO TAKE PAIN MEDICATION TO HAVE A QUALITY OF LIFE TO DO THE BASICS AT HOME AND ABROAD .LETS BE A TEAM AND ACHIVE PERSONAL QUALITY GOOD OLD FASHIONED CHRONIC PAIN CARE IN THE UNITED STATES AND DO BETTER .ALL OF US	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	BRANDON	None	None	0900006484f78f95	POLLARD	None	2022-02-15T12:58:34Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from POLLARD, BRANDON	kzn-q0y8-8tks	False	None	False	2022-04-12 01:56:11.486	[]
714	CDC-2022-0024-0720	https://api.regulations.gov/v4/comments/CDC-2022-0024-0720	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Blanket CDC guidelines and solutions denying physicians the capability to adequately reduce or relieve any given patient’s unique pain via the use of opioid prescriptions, should simply not exist. The CDC guidelines should specifically include a message to all state governments and insurance entities to repeal or modify laws and industry policies enacted due to the CDC’s 2016 guidelines. Simply releasing new guidelines without addressing state legislatures and insurance entities will essentially be useless, as prior guidance resulted in action in order to prevent nonconformity with these guidelines, but when fixing these flawed guidelines resulting in a more liberal stance, state legislatures and insurance entities will have no incentive to spend time and money in order to reform and subsequently make their own adjustments to become more liberal in line with the new guidance. In fact, if there is any method to enforce the national healthcare industry to perform a mandatory review of opioid prescription policies to conform to the latest CDC guidelines, in addition to a federal mandate for state legislatures to form special committees with the encouragement to adjust state laws to the new guidelines. If all applicable efforts are not made for the updated CDC guidelines to be implemented, they simply won’t be implemented or even considered by those authorities and entities in power to set their respective opioid policies.<br/><br/>Each patient has both a unique severity of pain and length of time experiencing this pain. Issuing any guidance which prevents honest ethical doctors from assisting honest suffering patients by providing adequate relief, is not an acceptable solution to any opioid or overdose epidemic currently being experienced throughout the country. Part of the opioid epidemic is in fact caused by the CDC’s 2016 guidelines, as extremely desperate patients can no longer rely on their physicians, hospitals, and insurance companies to provide them with the pain relief they require. Such desperation often leads to street drugs, which then leads to breaking the law and incurring penalties and a permanent felony record, or even worse, using street drugs which have been mixed with toxic substances or stronger deadly opioids such as fentanyl and subsequently causing permanent mental impairment or death. Focus should be transitioned to monitoring the specific prescription habits of doctors and the level of documentation and diagnostic testing required to prescribe opioid medications based on strength and quantity prescribed. The more prescriptions written and the higher the dosage of each prescription on average, should subsequently result in a requirement for more detailed formal standardized documentation to warrant those prescriptions of opioids and ideally a review board should be established to monitor the prescription databases available to flag specific doctors at the top end of the bell curve. Patients are simply experiencing pain and should not be held accountable or penalized if their pain levels exceed the extremely harmful and arbitrary limits in place in many states and by many insurance entities.<br/><br/>A focus of future guidelines on documentation as previously mentioned should look to discover the specific type of pain sensation and the source of pain being experienced by each individual patient, such as the physical damage location and severity, any patterns experienced by the patient such as certain activities which aggravate the level of pain, or the underlying disease which is the source of the acute or chronic pain. Once all documentation is gathered, it should be compared to all known medical literature to determine the most effective treatments per the doctors’ specific experience and medical literature. In addition, all other types of treatment applicable to the patient’s specific type and severity of pain should be documented and discussed with the patient to potentially implement additional treatments alongside prescribed opioid medications. As an example, if the patient is physically unable to be treated via physical therapy, that should require a mandatory discussion with the patient and adding documentation to the patient’s file noting the results of the discussion. Subsequent potential treatment options should follow until all alternative options are exhausted. Guidelines should recognize that some chronic pain will persist if certain prior treatments have failed, such as physical nerve pain derived from damage during a prior surgery, or specific radiology scans which are determined to show physical damage to any area of the body. In many cases, nerve pain debilitates a patient and disrupts daily life, with the only relief coming from opioids due to the physical inability to enter physical therapy as one example. All efforts should be made to verify the legitimate source of pain and offer alternative treatments to eliminate the need for opioid medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f79141	Noonan	None	2022-02-15T13:00:57Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Noonan, James	kzn-p2fn-5l05	False	None	False	2022-04-12 01:56:11.716	[]
715	CDC-2022-0024-0721	https://api.regulations.gov/v4/comments/CDC-2022-0024-0721	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In the CDC guidelines I read things like this:<br/><br/>“In the United States, opioid prescribing increased four-fold between 1999 and 2010, and this increase was paralleled by a nearly four-fold increase in overdose deaths involving prescription opioids during the same time period as well as increases in prescription opioid use disorder. In addition to the overall volume of opioid prescriptions increasing during this period, how opioids were prescribed also changed, with opioids increasingly prescribed at higher dosages and for longer durations…”<br/><br/>Without ever reading any asking or answering of a seemingly obvious question: WHY?<br/><br/>No one asks why greater amounts of opioid pain medicine were being prescribed. It seems to be an assumption that the drugs were made more available by drug companies and doctors were suddenly treating pain more aggressively. Never is it asked whether there was now MORE PAIN overall.<br/><br/>It would be like being in a war and noticing that suddenly the soldiers were using so much more ammunition, and more ammunition was being handed out and fired, but not asking WHAT the soldiers were firing AT. Some might think the answer was there was just more prolific firing at the same few targets, and not that there were more targets to fire at.<br/><br/>This is a problem in the writing about opioid prescribing. No one has asked “is there MORE pain?” The answer to that is YES. Why? Because modern anesthesia and antibiotics have allowed medical practitioners to do more: More advanced surgeries, joint replacements, cosmetic surgery, dental surgery (root canals) have become much more prevalent during this time period. Advances in cancer care give many people longer lives, but many have more painful lives. The ability to save people from horrible injury has become better, only for those saved to be able to experience more and greater levels of pain. Illnesses that were previously deadly now have become chronic because of new treatments but the pain of those illnesses is prolonged and made chronic too. And the more usual ways for people to die have changed. Lingering past a prior natural death because modern emergency medicine can stave off the moment of death has lead many into more painful daily lives before the inevitable end. The ability to give antibiotics and do more surgeries, including more “same day surgery” has led many doctors to turn to surgical options much more readily than ever before in history. More exotic testing procedures like endoscopies that require anesthesia and, realistically, pain management, have become commonplace. And dentists have been able to do more procedures to save teeth instead of pulling them - root canals and other dental surgeries are done in greater and greater numbers and so dentists have been prescribing more opioid pain medicine.<br/><br/>None of this information was added to the calculation about changing opioid pain medicine requirements.<br/><br/>Great advancements have been made. Medical treatments have changed. Lives have been prolonged. But the outcome of this has been more pain experienced by more people for longer periods of time than in any point in human history. The dead do not require opioid pain medicine, and so run no risk of becoming addicted to opioid pain medicine or overdosing.<br/><br/>This information about how we now practice medicine is the missing piece that makes the increased use of pain medicine make sense, and it is the piece that no one wants to think about. Because the amount of money made in the American medical system is vast and overwhelming. And to stop and think, “is this painful procedure necessary” or “is a longer life worth living if it is a life spent in horrible chronic pain” are not questions that anyone in the business of medicine wants asked or answered. But they need to be asked and answered before anyone makes any recommendations on how to treat pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f774bb	Anonymous	None	2022-02-15T13:05:14Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-lc4d-dw04	False	None	False	2022-04-12 01:56:11.929	[]
716	CDC-2022-0024-0722	https://api.regulations.gov/v4/comments/CDC-2022-0024-0722	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/>I felt an overwhelming need to voice that I believe there needs to be a representative from the perspective of a Certified Peer Recovery Support Specialist regarding all aspects of Centers for Disease Control and Prevention, especially Substance Use and the CDC Guidelines being set-forth during and in response to the Opioid epidemic.<br/> I am a PRSS in long-term recovery from Opioid Addiction, using my experience to help further research on substance use and addiction treatment so others can achieve their goals of sobriety. <br/>I personally have 2 perspectives on this matter. Mine, being the misuse of prescription opioids, giving me a unique perspective into how to prevent misuse of medications without causing more deaths from synthetic opioids. The attempt of previous guidelines and the effects that have taken place since the "response to the opioid epidemic" and "War on Drugs" speak for themselves in every area of public health and the judicial system. I also have the perspective of watching my mother, who does not have the disease of addiction and has never nor will ever abuse or take any excess of her prescription medications, however does suffer from post-polio, is made of half metal, and has suffered greatly physically, emotionally, mentally, financially and has been stigmatized so much so that it nearly put her over the edge.<br/>I do not claim to have all the answers, but as we aim to take a more person-centered approach, who better to help then someone with experience who can tell you "If you would require, or at least strongly suggest that physicians writing chronic pain management medications request an unexpected pill count and drug screen 3-5 day after their appointment and refill, it would wean out at least half of patients misusing or dispensing their medications while allowing those using them correctly to maintain what works for them"?<br/>Thank you for allowing my input.<br/>[NAME and LOCATION redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f7749d	Childress	None	2022-02-15T13:11:58Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Childress, Elizabeth	kzn-ktci-wwp9	False	None	False	2022-04-12 01:56:12.151	[]
717	CDC-2022-0024-0723	https://api.regulations.gov/v4/comments/CDC-2022-0024-0723	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. These proposed guidelines still lump both illicit and prescribed opiates together. Before my life-altering injury, I was an active community member who volunteered with Scouts, church, and community groups. Then, I fell off a roof. I now live a life filled with pain. The PA at my pain management office told me he was "risking his license" by writing my prescription. How are doctors supposed to properly care for patients when they feel like this? My quality of life is driven by the fear that the government will interfere and possibly cost the doctor his license. I have tried multiple treatments before opiates, but nothing else worked. Due to failing kidneys and liver, I can't "just take a Tylenol." These guidelines will become the "law of the land" and I will have nowhere to turn.<br/><br/>Yes, it is upsetting that we have opioid deaths. But, how many deaths have occurred because people lost access to the very medications that gave them a quality of life? Fewer people have died from overdoses in the last 15 years than have died in the COVID pandemic's 2-year span. The focus of these guidelines is wrong. There is no war on drugs except the one where politicians argue over whose pockets should be lined the most.<br/><br/>Stop interfering in the doctor-patient relationship. The government doesn't know me, but my doctors do. They were schooled to help people. Government interference only causes harm.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Audra	None	None	0900006484f77451	Parker	None	2022-02-15T13:12:51Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Parker, Audra	kzn-jogw-t9x2	False	None	False	2022-04-12 01:56:12.377	[]
718	CDC-2022-0024-0724	https://api.regulations.gov/v4/comments/CDC-2022-0024-0724	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please have mercy on those of us suffering in chronic pain of many forms. We need opioid medication to function and live somewhat of a normal life. Leave it up to our doctors to help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7743e	Anonymous	None	2022-02-15T13:13:06Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-jfdr-ftah	False	None	False	2022-04-12 01:56:12.636	[]
719	CDC-2022-0024-0725	https://api.regulations.gov/v4/comments/CDC-2022-0024-0725	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It has been so difficult for me to get the amount of medication I used to take for pain. I have chronic pain due to many different illnesses. I have a deteriorating spine along with degenerative disc disease, crohn's disease, sjogren's, and fibromyalgia to name a few. I also deal with anxiety and can no longer take my Ativan since I take my pain meds, even though I took them together for years without any problems. I am not an addict and have never abused my meds. I can't take ibuprofen or other NSAIDs due to my illnesses. I can't even have another fusion in my neck because I can't be guaranteed pain control. My pain management doctor has always been respectful and thorough and has records of all my illnesses, medications and when they're filled, and test results. I also get drug tested often. Please help chronic pain patients and the doctors that help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f77406	Woods	None	2022-02-15T13:13:40Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Woods, Debra	kzn-iblr-rcs4	False	None	False	2022-04-12 01:56:12.843	[]
720	CDC-2022-0024-0726	https://api.regulations.gov/v4/comments/CDC-2022-0024-0726	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think the ' one size fits all' approah to Pain is a very harmful and scary decision for those of us struggling with chronic on going pain that varies daily. There are so many people in pain that affects there daily loves and any type of 'restrictions ' like that make life a little less liveable and for some not liveable at all and it is sad. I do hope the CDC does change the guidelines so that doctors have the means to help patients again and the patients not worrying themselves to death if they can make it without there pain medication and what happens if they can't. I am very thankful it is coming to light how much this has hinder all patients through out the Under States and beyond. I pray there is more good to come.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ruth	None	None	0900006484f773ee	Jennings	None	2022-02-15T13:14:32Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Jennings, Ruth	kzn-i49z-epyo	False	None	False	2022-04-12 01:56:13.059	[]
721	CDC-2022-0024-0727	https://api.regulations.gov/v4/comments/CDC-2022-0024-0727	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient and human being, the proposed changes open up a world of possibilities for managing my CRPS. The dosage I'm currently on doesn't even meet current guidelines. I'm truly hoping that this change allows a more open communication with Pain management and they won't be afraid to step in and truly help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484f7739a	Crites	None	2022-02-15T13:17:01Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Crites, Jennifer	kzn-h073-51y3	False	None	False	2022-04-12 01:56:13.294	[]
722	CDC-2022-0024-0728	https://api.regulations.gov/v4/comments/CDC-2022-0024-0728	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I find it very disturbing that the people like myself who are in legitimate pain have no where to turn because of the select few who take advantage. It is extremely unfair that we have to suffer everydau in such pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f77329	Sellas	None	2022-02-15T13:18:02Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Sellas, Debbie	kzn-f4kh-ts6v	False	None	False	2022-04-12 01:56:13.543	[]
723	CDC-2022-0024-0729	https://api.regulations.gov/v4/comments/CDC-2022-0024-0729	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please have mercy on us chronic pain patients. None of us are looking to get highbut we are treated that way by medical "professionals".I have had to wean myself off of Norco so my pain isnt being managed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484f77312	Johnson	None	2022-02-15T13:18:20Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Pam	kzn-eufg-xkzp	False	None	False	2022-04-12 01:56:13.750	[]
724	CDC-2022-0024-0730	https://api.regulations.gov/v4/comments/CDC-2022-0024-0730	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The regulations that are currently in place are ridiculous. It's not the pain patients that are causing the "opioid crisis." We are just normal people wanting to live a semi-normal life. I pray that the CDC will realize that it's the fentanyl coming from Mexico causing the problem and not the chronic pain patients. We are all suffering thanks to the 2016 guidelines. Our doctors and our pharmacies are frightened because the DEA has too much power. Please help us! We can't even get help after surgery.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f772ed	Anonymous	None	2022-02-15T13:20:10Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-eeqg-0sks	False	None	False	2022-04-12 01:56:13.962	[]
725	CDC-2022-0024-0731	https://api.regulations.gov/v4/comments/CDC-2022-0024-0731	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Re: Opioids guideline Update. I am a responsible R.A. patient who applauds the guideline update review. My medication that allows me to sleep at night is Triazolam 0.25mg. Notice... Mine is a low dose item. But, without it I am awake all night long. And believe me the nights can be very long. I get annual exams and blood work every 3 months like clockwork. I am 70 years old. The guidelines for pharmacy's who will not or can not fill this prescription until the last date on the bottle are a pain in the butt and cause my life to be interrupted for many days. Not every month has the same amount of days and sometimes I am short a pill or 2, but since the guidelines are so stringent my pharmacy will not fill it any earlier. This month I am 2 days short, so I will not be sleeping for the next 2 nights, and it will take me 3 days to catch up on my sleep. This is not good for my routine. Please,This is extremely important to me and others like me. A 3-5 day leeway is needed to help those of us who do not abuse our Medications. Many of us take care of ourselves and don't abuse drugs. It is not my job nor yours to save the addicted, we just want to live normal lives. I am asking you to adjust the guidelines to allow flexibility in the refill guidelines. Thank you for allowing my input.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Valerie	None	None	0900006484f772e0	Koker	None	2022-02-15T13:20:56Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Koker, Valerie	kzn-e7vt-ygpx	False	None	False	2022-04-12 01:56:14.172	[]
726	CDC-2022-0024-0732	https://api.regulations.gov/v4/comments/CDC-2022-0024-0732	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started having severe back pain 7 years ago. It was eventually determined that I had a large deformity in the L3-L5 region of my back and needed fusion surgery. I had a second opinion and was told the same thing. However, I still had to work full time and take care of my children as I was a single mother. I was prescribed an opioid as a way to deal with the pain so I could sleep.<br/>I have since had the surgery but now have ankylosing spondylitis. It's a degenerative arthritis mostly affecting my hips and back. I still work full time and have since remarried so I cook and clean just like anyone else. But unlike others, I do these things with a considerable amount of pain. I cannot walk very far without pain, cleaning one room in my house will leave me in pain for at least 2 days, standing at the stove to cook my family a meal can bring me to tears.<br/>I understand that there is a crisis in this country. Sadly bad actors used a system that has resulted in many deaths. And I understand the need to respond swiftly, but unfortunately that action had other unintended consequences.<br/>I take my medication as prescribed, I go to physical therapy, I make my appointments and yet getting the medicine I need to help me becomes increasingly difficult. My physicians are afraid to prescribe me medication for fear of losing their licenses. Imagine not being able to treat your patient because you could lose your livelihood.<br/>I am subjected to drug tests to ensure I am following rules despite never having a record of not following the rules. I am guilty until presumed innocent. I have had to sign documents saying that I will not call the doctors office and "bother" them about refilling my prescription. Imagine asking someone with diabetes or cardiac issues to do the same.<br/>I have chronic pain that requires me to take 1 opioid every day. That's it. Just 1 at the end of my day so I can sleep. And yet the rules are set to treat me as a potential drug abuser. <br/>I just want to be able to treat my condition with dignity and without fear.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tina	None	None	0900006484f7994e	Younger	None	2022-02-15T13:22:46Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Younger, Tina	kzo-5fvb-g7pe	False	None	False	2022-04-12 01:56:14.462	[]
727	CDC-2022-0024-0733	https://api.regulations.gov/v4/comments/CDC-2022-0024-0733	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a step n in the right direction, but a baby step. Doctors have been scared out of prescribing, so even if the guidelines are updated, will it do us any good? I guess we will find out.<br/><br/>Now if only the DEA would back off of the medical practioners and go after the illicit drugs, the entire nation would be better off.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f791fe	Anonymous	None	2022-02-15T13:23:15Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-4z8c-on2d	False	None	False	2022-04-12 01:56:14.691	[]
728	CDC-2022-0024-0734	https://api.regulations.gov/v4/comments/CDC-2022-0024-0734	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Navy veteran on pain meds as the only way to work and be a functional member of society or have any quality of life. I am labeled now due to this "war on opioids" which is really a war on Americans with pain. This has caused a huge upset in my medical care and life. We can't go about this is the typical American way, going from one extreme (too many opioids) to the other (almost none at all)! The numbers of overdose and addiction are UP since all this began! This is because we've made prescribers terrified to prescribe causing people who have NEVER been criminals to engage in what is criminal behavior in order to seek any relief they can find to survive. We've also now created a huge black market for things like heroine and "dirty 30s" which kill in droves. Patients under doctor observed care have a statistically low rate of these issues. We have got to do better! You are never going to be able to weed out every person that will abuse the system but with the current horrible restrictions on opioids we are destroying far more people. The numbers don't lie. Please put an end to this madness where opioids are the devil and prescribers are punished for prescribing them! Annual or more drug panels and provider oversight will reduce the "problem children". Funds for treatment for those with addiction issues is still needed. Especially now that these recent guidelines since 2016 by the DEA and CDC have caused so many to have to turn to street drugs because their provider cut them off. Case in point- the VA cut off every veteran on chronic pain medication in 2017 because of this "war". Though I had never had a bad urinalysis or problems with my prescriptions, I and millions of vets were hung out to dry. I was given 6 weeks to get off all my pain meds and it took 6 months to get back into a community provider. I almost lost my job, my house, and my life in that 6 months because I could not work or function due to uncontrolled pain. Now, my community provider has been put under investigation for prescribing opioids and so hundreds of patients (myself included) have been thrown out of that clinic (which is no longer willing to do pain management) and sent to other clinics who are equally terrified and so they are cutting people off too. If the current policy continues I will be forced to apply for disability before she 45! I work full time and run a dog rescue. I am highly functional, but will not be functional at all of this continues. Look at Portugal and their stance. Their addiction rates are down 50%! The "wars" on drugs have never been anything other than a war on Americans. It's easy to say we need to do better for our veterans, which are the largest population being destroyed by the opioid war, but really we need to do better period! Please end the insanity and these restrictions on opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Justice	None	None	0900006484f791fc	Isaacson	None	2022-02-15T13:24:37Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Isaacson, Justice	kzo-4yg6-q79h	False	None	False	2022-04-12 01:56:14.910	[]
729	CDC-2022-0024-0735	https://api.regulations.gov/v4/comments/CDC-2022-0024-0735	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I and many Americans no longer have confidence in anything the CDC is involved in. This is especially true when it comes to PCP's prescribing opiate pain relief medication for patients with bonafide acute or chronic pain. How does any bureaucrat have a clue as to what my chronic back, hip, and joint pain is to live with every day I wake up and face the day. You, CDC, stay out of my Doctor's practice with your "recommendations." They are worthless. I've given my all to this great country, and at 67 years old, I'm still working because I can. I'm a professional nurse, and RN, and I'm cursed with lumbar disc pathology with severe chronic pain. I have relief with 5mg hydrocodone/325 acetaminophen qid. Yet, you continue to strike fear into all prescribers who are tasked with treating their patients chronic or acute pain. I'll say again, stay out of my Doctor's practice with your inept "recommendations." You need to concentrate your efforts on the southern border where the synthetic fentanyl is flowing unabated across the border every day along with "unvaccinated migrants" by the hundreds. I'll attach what the synthetic fentanyl looks like since you seem to not be aware of the real threat. I truly hope you have the ability to "awaken" to this issue and stop interfering with medical practice.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f774de	Anonymous	None	2022-02-15T14:03:16Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-lzop-rg64	False	None	False	2022-04-12 01:56:15.139	[]
730	CDC-2022-0024-0736	https://api.regulations.gov/v4/comments/CDC-2022-0024-0736	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At first the new draft Guidelines looked like some thought and compassion may have went into these guidelines. As I continued to read, I discovered that this is actually worse in some ways than the 2016 guidelines. By repeatedly encouraging 50 MME, doctors, pharmacist and insurance will latch on to this as hard limits and refuse anything above ( down from 90) . There is zero scientific basis for MME and it does not take into account individual metabolism, patient response etc. I have been a victim of 50MME limits (Ohio- bottom tier) for the past year. I went from working a full time job to fighting hard to be able to continue a PT work from home job due to undertreated pain. Much of my time is spent in bed as standing and sitting are super painful. Try having referred pain that refers to almost all areas covered by shorts. I have tried all conservative treatments and non-opioid medication with no success ) There should be no reference to any limits in these guidelines! Doctors know how to treat their patients without these guidelines! Doctors need to be able to treat their patients without government involvement and pressure from the DEA. All this draft will do is continue human suffering and driving chronic pain patients to the streets or suicide. Many chronic pain patients are holding on to the hope that these 2022 guidelines will restore humane medical treatment and end the suffering. Please make the right decision and don't make Grandma ( or and other chronic pain patient) have to make the decision to suffer, go to the streets or end it all. Pain relief is a basic human right! Let doctors be doctors!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tami	None	None	0900006484f774d6	Caldwell	None	2022-02-15T14:04:44Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Caldwell, Tami	kzn-m1y0-rtn5	False	None	False	2022-04-12 01:56:15.377	[]
731	CDC-2022-0024-0737	https://api.regulations.gov/v4/comments/CDC-2022-0024-0737	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Registered Nurse in California, I hope that these patient comments are taken seriously because many people suffered needlessly since the 2016 guidelines were put in place. In my career, we've gone from pain being the 5th vital sign to not treating pain at all. There has to be a middle ground for chronic pain suffers. Just because people use opioids for pain control doesn't make them drug addicts, but they're forced to drug test in order to get their prescription like criminals. What was done to millions of patients in 2016 was criminal! Patients who were previously stable on opioids legally prescribed to them were just cut off. It forced patients to go to the streets to get relief and many patients died because of those 2016 guidelines. As far as I'm concerned, the government agencies that put those guidelines in place are liable for those deaths. I've taken care of hospice patients whose pharmacy wouldn't dispense their opioid medications because of the high dosages ordered. These poor people suffered needlessly their last days on earth in pain and withdrawal. I hope this is a serious, evidenced based change in these guidelines so people with chronic pain can get the help and medication they so desperately need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Devon	None	None	0900006484f774ae	Williams	None	2022-02-15T14:05:12Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Devon	kzn-l3f1-fv50	False	None	False	2022-04-12 01:56:15.597	[]
732	CDC-2022-0024-0738	https://api.regulations.gov/v4/comments/CDC-2022-0024-0738	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Like many other who have commented, I live with daily chronic pain due to fibromyalgia. Tramadol works for me, but yet for the last several years, I have watched my primary care continue to cut back on the number of tablets I may receive per month. Every 3 months, I am urine tested for opioids, and sign a pain contract every year. It is suggested every 3 month visit that I try other complementary methodologies to manage my pain, or that perhaps the pain meds themselves are causing my pain, or that I need to see a counselor. Fibromyalgia is a pain disorder, individuals who live with it are in constant pain. I have and do implement multiple strategies and practices to manage pain from distraction, mindfulness, meditation, massage (when I can afford it), aroma therapy, weighted blankets, topical treatments such as icy hot and voltaren gel. I eat a gluten free diet, avoid "white foods", including sugar, alcohol, no artificial sweeteners of any kind. I've done the counseling route. Agreed to using antidepressants, nerve blocking meds that only cause weight gain and little relief. Currently, I am in the pain clinic merry go round of trying various injections to manage pain: trigger point, optic nerve blocks to cervical facet joint injections (no numbing provided prior to treatment-left me bruised and in tears with no relief). My pain interferes with my ability to do my job well, and affects my overall quality of life. I can't do a quarter of the things I used to enjoy. All of these things, I am willing to deal with. But what I just can't abide by anymore is being made to feel like I am crazy, I am drug seeking, being marginalized, discredited and not believed. We have a pain epidemic in this country. There is NO compassion from physicians, no solutions. There are studies and screening tools that can be utilized to determine if a person using pain meds is in danger of becoming dependent. Why don't we use them? There is also a wide misconception that all people will become addicted to pain meds, when the vast majority of people who live with chronic daily pain manage their meds well. As a country, we created a war on opioids in response to Purdue pushing oxycontin to prescribers with disastrous effects when it become a street drug. I live in an area that was hard hit and have seen far too many young people die as a result and support any and all efforts to rectify and prevent this from happening again. In the meantime however, we have ignored the needs of those who live in daily pain, allowing them to live a sometimes torturous existence with no hope of relief. How many of us have committed suicide? Are depressed and no longer able to contribute to society? Put the control of medicine back in the hands of physicians who KNOW their patients! Let my doctor makes decisions about what I use to treat my pain and stop shackling her hands.. And please, let's invest resources in studying pain, developing medications to manage it. I thank you for your consideration. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484f77306	Brewer	None	2022-02-15T14:10:11Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Brewer, Janet	kzn-en2f-3lv3	False	None	False	2022-04-12 01:56:15.812	[]
733	CDC-2022-0024-0739	https://api.regulations.gov/v4/comments/CDC-2022-0024-0739	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient with a chronic pain disease nicknamed the "suicide disease," I find it exceedingly difficult to manage my pain and lead a normal life with the American regulations on pain medication . I'm currently in Costa Rica and I'm considering moving here permanently because they don't treat pain patients like criminals. The war on pain patients is inhumane, and has only resulted in more overdoses. Desperate people seeking medication online and often dying because one pill is laced with fentanyl. This law has hurt more people than it has helped.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ChristinaChristina	None	None	0900006484f79c03	Bellrose	None	2022-02-15T14:18:08Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Bellrose, ChristinaChristina	kzo-5kt5-eafv	False	None	False	2022-04-12 01:56:16.046	[]
734	CDC-2022-0024-0740	https://api.regulations.gov/v4/comments/CDC-2022-0024-0740	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since 2016 I and other CPP's have been treated like addicts, called names, placed into dangerous withdrawals and left in pain in order to the save lives of the addicted. Let's check your "success" numbers shall we? 2016 63,000+ Deaths, 2017 76,000+ Deaths, 2018 68,000+ Deaths, 2019 80,000+ Deaths<br/>2020 90,000+ Deaths, 2021 100,000+ Deaths GOOD JOB GANG! <br/><br/>Doctors, CDC, and State Reps told us to "suck it up" or "take a tylenol" or my favorite, "You are an addict, you need to learn to deal with your chronic pain without any opioid relief. It is not our job to help you as an addict."<br/><br/>I have since stopped all care for my chronic health condition no more remicade infusions, no more surgeries instead I have a DNR! Where I once had hope, I now have hate! Now, after 6 years of calling us all addicts you are now saying the opposite, "you can take pain meds again". Until when? Who is going to remove all of the red flags on our medical files to now receive proper care? How do we know a doctor or government won't yank them again sending us spiraling into hell? No thanks. Common reply from doctors, "I need you to trust me." My response, "Doc, don't use big words you obviously do not understand or are capable of exacting in your practice with ethics or humanity. I would rather crawl across an ocean of broken glass than to let you near me again."<br/><br/>WE DON"T TRUST YOU ANYMORE! YOU ABANDONED US FOR 6 YEARS, CALLED US NAMES AND LIED ABOUT US ON OUR MEDICAL RECORDS! How do we change that? I can't even get out of my bed on most days! I am 44 years old and exist in the cell of my bedroom with yarn, burns on my belly from a heating pad being overused, and at 5 ft 2 inches I weigh 88 lbs starving because eating = PAIN! See before and after pictures of your fine work below! <br/><br/>I never missed/failed a drug screen, never misused/sold my medication. In 2016 the doctors informed me they would no longer accept me as a chronic pain patient (due to the new guidelines you placed) with palliative care (whom I had been with since 2012) and told me to seek out marijuana illegally on the streets until it was made legal in our state of Ohio in 2017!!! Insurance doesn't cover marijuana so all of that is now supposed to be out of pocket on a social security check! Plus the state wants 200.00 for a card! GFY I don't have the money!<br/><br/>They left me to go through withdrawals with NO proper titration during the weekend of cmas 2016 holidays. I sent my husband to his parents for the holiday and stayed home by myself to go through withdrawals ALONE because I did not want him to see me go through that. I was sick for 3 weeks which caused my crohns to flare sending me into gastric pain and nausea for the next 11 months. I went from a healthy 138 lbs that Dec to 79 lbs in July of 2017. I am still fighting to keep anything down and current weight is 88 at 5 ft 2. That is a 16.1 BMI (underweight) malnutri<br/><br/>I stopped all care for my crohns because I was tired of the medical abuse of not receiving proper relief during multiple surgeries. They sent me to a pain doctor who wanted to dig into my spine to place a DRG stim implant. When I asked for the MAUDE studies on how well this treated crohns pain, risks of lead migration/fracture into the spinal column specifically for women they promised me information... only to never send it. After 4 requests by mail they finally sent me an advertisement phamplet for the device but NOT the MAUDE risk information I requested. When I finally got the doctor on the phone he could not answer my questions nor could the specialist whom he called from the Abbott manufacturing company. After requesting the information 1 final time I instead was sent a refund for the doctor visit to his office! I never did receive the information. NONE of these products have been studied for long term treatment in patients and once again I was going to be used as a guinea pig for their monetary gain! I will never trust another doctor. I hate them, with a passion just as much as I detest you at the CDC. If I went to the ER, I was automatically treated like a Drug Seeker and ignored. I had one doctor tell me, "Stop complaining, you aren't getting anything for pain because of the notes on your chart." They wanted to do surgery but provide no pain relief afterwards! I told them, "No thanks and checked out AMA. I have not returned."<br/><br/>My hair (down to the middle of my back) is my permanent record of having no opioid drugs in my system. My husband and lawyers have been instructed to do a drug test on my long locks and then sue my doctors for wrongful death and medical torture of their patient. If they want to run tests, they can do so when I can no longer feel it!<br/><br/>As for your regulations... it does not mention any changes for DEA when it comes to hounding doctors out of practice/business. It does not change their willingness to actually prescribe meds to us CPP's. Nothing but window dressing! Go smell a scratch-n-sniff at the bottom of a bird bath!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006484f6bc17	Swaneck	None	2022-02-15T14:28:25Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Swaneck, Robin	kzh-paxa-47jz	False	None	False	2022-04-12 01:56:16.257	[]
735	CDC-2022-0024-0741	https://api.regulations.gov/v4/comments/CDC-2022-0024-0741	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First, thank you for allowing people like me to comment on the opioid prescribing situation.<br/><br/>I am 60 year old female. I have had 2 back surgeries, 3 foot and 1 knee surgery. I have worked physically hard all my adult life. My last MRI showed herniated and/or degenerated discs above my fusion, and 4 bulged discs in thoracic spine. I still continue to work full time, took care of my parents until their passing, and live alone and do all chores and remodeling.<br/><br/>I had been in pain mgmt for 9 years after my failed fusion. I voluntarily found a way to quit Percocet (Butrans patch), and jumped through every hoop my Dr recommended, even going as far as getting a spinal cord stimulator, which never helped. <br/><br/>For the past 2 years, as my pain had increased, my provider refused to prescribe anything stronger than Tylenol 3. I kept telling him my pain was debilitating but no go. So eventually, one month I took 8 more pills in a month (out of 60/month prescribed) and got dropped in seconds.<br/>Now I am on my own, taking as much Otc Tylenol, ibuprofen, and kratom to get me through the day.<br/>It is not right for legitimate pain patients to have to suffer because Drs are afraid to prescribe what we need to live a somewhat quality life.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DEBRA	None	None	0900006484f79485	GRIFFITH	None	2022-02-15T14:30:41Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from GRIFFITH, DEBRA	kzo-7vy9-czoe	False	None	False	2022-04-12 01:56:16.478	[]
736	CDC-2022-0024-0742	https://api.regulations.gov/v4/comments/CDC-2022-0024-0742	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Well, it’s about time. I had surgery to remove a massive, cancerous tumor in my cheek in February of 2021. I was prescribed opiods for pain afterward. I spent a week in ICU, then a week after coming home, I had to wrestle with the doctor about getting more opiods for my pain. I was in terrible pain. The last thing I needed, while recovering from a surgery that left me with half a face and an inability to eat solid foods and pain such as I hope you never have to experience, was to have to spend time on the phone arguing with nurses about whether I was still in actual pain. <br/><br/>It’s not like we haven’t been down this road 2 or 300 times before. I would hope that government entities would have a better memory for our country’s seesawing policies regarding opiods since the 19th century. Nothing has changed. We freak out because people get addicted to opioids then crack down on opioids then realize that we are causing unnecessary suffering to people with real needs for opioids so we loosen the rules again. Lather, rinse, repeat.<br/><br/>Would it be possible to create policies that allow opioids to be prescribed for people with obvious need for them, while maintaining stricter standards for less clear issues? People recovering from surgery and dealing with cancer need opioids. People dealing with achy muscles don’t. <br/><br/>It’s really not that difficult, although we like to make it so.<br/><br/>It’s too late for me: I’ve already suffered the hell of dealing with judgmental and withholding treatment for my pain. But perhaps some future pain can be spared for future patients with legitimate needs.<br/><br/>I’m attaching a picture of my face, so you can see what a drug-seeking cancer patient looks like.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Xandra	None	None	0900006484f6c81b	Coe	None	2022-02-15T14:34:58Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Coe, Xandra	kzi-als8-c4wd	False	None	False	2022-04-12 01:56:16.691	[]
737	CDC-2022-0024-0743	https://api.regulations.gov/v4/comments/CDC-2022-0024-0743	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was denied pain med for abscessed tooth last fall. I have Ehler Danlos Syndrome and do not go numb with Lidocaine or most anesthesia. There was no other Medicaid dental appt for months!The dentist refused to pull the tooth. I was denied any pain medication. I hurt to the point I pulled my own tooth (back molar) at home with a pair of pliers. I pass my kidney stones at home, all the doctor at the ER can do is give Toradol and Motrin, which I can't take because of my bleeding ulcers I take meds for. This shouldn't happen in a modern country, or with insured patients. Doctors should be able to look on DEA WEBSITE & see if you're "Dr Shopping" for drugs, or legitimately need pain meds for a legitimate medical reason (CT Scan shows kidney stone moving!). The Federal Government does not belong in day to day decisions micromanaging our doctors and dentists, threatening them with losing their prescribing license if they fail to follow a set protocol for everyone. Everyone is different, and should be treated differently. People are allergic to different things, react to meds differently. I'm not saying that ANY physician should write a prescription for 240 tabs of any opioid pain medication. But, discipline those physicians that do, and leave the rest alone to practice medicine, not follow a blanket law dictated by FDA that obviously didn't work to prevent overdoses as the death rates have proven. <br/><br/>Thank you,<br/>A Concerned Citizen.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484f714dd	Jurgens	None	2022-02-15T14:40:14Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Jurgens, Teresa	kzj-ac4v-ijdn	False	None	False	2022-04-12 01:56:16.904	[]
738	CDC-2022-0024-0745	https://api.regulations.gov/v4/comments/CDC-2022-0024-0745	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 40 have been on opioids throughout my life for reasons of debilitating back pain and most recently. Serious 3rd degree burns on 40 percent of my body. I have never had a problem stopping the pain pills when the pain is has subsided. They are the only thing that helps when you get injured. But most recently when o got burned i spent a month in the hospital. The dr and nurses were giving large amounts of ibuprofen and Tylenol. So much so that it tore a hole in my stomach and made ulcers. Those pills did more damage than anything i have ever taken. Once released from the hospital every time I picked up any prescription from the pharmacy. I always was hassled. Had to have my dr resubmit paper work for prior authorizations that left me waiting a week or more without anything to help with the pain. Because of the restrictions and paperwork. I think you have gone way too far with all of this. We already take urine tests and psychology exams when prescribed opioids. Most people are not abusing them. And the ones that are arent getting them from doctors. They are getting fentanyl and using the dark web. I plead with you to make the Right decisions and stop the nonsense. Of your ever in pain you will see that the opioids are what works and the only thing that works. Nobody should be able to treat us all like we are drug addicts because of pain. Its a human experience and it will hit your doorstep if it hasn't already. Its inhumane the way we are treated and it needs to stop now. My mother passed away in December. She would write you but cannot she had diabetes and gout. Her last days she would cry herself to sleep at night because of pain and it was terrible the way she was treated in her last days. I could go on but it needs to stop. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronald	None	None	0900006484f72cda	White	None	2022-02-15T14:52:17Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from White, Ronald	kzl-4ngv-ctjp	False	None	False	2022-04-12 01:56:17.198	[]
739	CDC-2022-0024-0746	https://api.regulations.gov/v4/comments/CDC-2022-0024-0746	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Was a shame the way patients where treated.Got ship to a pain 70 miles away because I had to much hardware in back <br/>Was forced into a pain pump and Tense unit so am tied down to the clinic have to make drive there once a month because they will not even E file my break through pain meds just to pick up a piece of Paper every 3 months to service the pump on a fixed income with the price of fuel is ridiculous!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tony	None	None	0900006484f73543	Youmans	None	2022-02-15T14:57:42Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Youmans, Tony	kzl-cog1-evgd	False	None	False	2022-04-12 01:56:17.411	[]
740	CDC-2022-0024-0747	https://api.regulations.gov/v4/comments/CDC-2022-0024-0747	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please don’t set maximum dosages. People tolerate pain kills differently. A high dose for me might be low for someone else	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	NEIL	None	None	0900006484f7948e	YASHINSKY	None	2022-02-15T15:05:43Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from YASHINSKY, NEIL	kzo-8ejf-6sv7	False	None	False	2022-04-12 01:56:17.651	[]
741	CDC-2022-0024-0748	https://api.regulations.gov/v4/comments/CDC-2022-0024-0748	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please revisit your mmm guidelines. These are guidelines or law? How long are you going to punish people for diagnosis they/we have no control over. How did the FDA ever get involved in this nightmare? <br/>Why has the HIPPA agreement between patient and doctor open for review?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deb	None	None	0900006484f794a8	Good	None	2022-02-15T15:06:32Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Good, Deb	kzo-9alw-iamt	False	None	False	2022-04-12 01:56:17.858	[]
742	CDC-2022-0024-0749	https://api.regulations.gov/v4/comments/CDC-2022-0024-0749	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My Mother in Law which lives with us is 79 years old, has Scoliosis and chronic back pain. She has been treated and perceived as someone who is a drug addict or drug dealer. She has followed the law and went to a pain clinic to obtain her medicine which she has to do urine testing at a great cost to Medicare. Everything has been documented for years and still she is perceived as a drug addict. We need to give the Doctors the right to prescribe the medicine needed with no fear of doing so.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f794a9	O'Brien	None	2022-02-15T15:07:39Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from O'Brien, James	kzo-9bap-0wbg	False	None	False	2022-04-12 01:56:18.090	[]
743	CDC-2022-0024-0744	https://api.regulations.gov/v4/comments/CDC-2022-0024-0744	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f72b2d	None	None	2022-02-15T15:29:29Z	None	None	0	None	2022-02-15T00:00:00Z	None	Withdrawing comment to redact for language.	None	None	None	None	None	None	None	None	Comment from Bradway, Mildred	None	True	None	False	2022-04-12 01:56:18.311	[]
744	CDC-2022-0024-0750	https://api.regulations.gov/v4/comments/CDC-2022-0024-0750	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's okay that a manufacturer can lie to the FDA when it comes down to total joint replacements ( Aescukap b braun Columbia Vega implant). Doctors lie about your surgery. You get a child doseage of 5 ml. 3X a day for 2 weeks. They send you home with bandages bloody . It gets infected you have to go back into surgery. The outcome is a failed total knee revision costing $135,000.00. Why do I have to suffer at the expense or a manufacture & a doctor who [redacted] up my knee. Because of the Class action law suit I can't get both my knees fixed so I can go back to work. This is discrimination. Doctors should be able to prescribe Pain medication to a patient like me. I did not ask for 2 failed total knee implants. Stryker Trailrhlin with cones. Maybe is the doctor was better trained & longer training both total knee replacement might have turn out successful instead of failures. If it was not for pain medication I would not be here today. Maybe if the doctor used staples my knee might not have gotten infected along with a adult doseage then a child. This is outrageous. If I get the chance to SUE YOU BET I WILL. NO ONE SHOULD HAVE TO SUFFER 8 YEARS FOR THE 1ST ONE & AS OF 2/12/22 ITS BEEN 2 YEARS & 6 MONTH. WHY do I have to suffer when it's not my fault.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mildred	None	None	0900006484f6fb93	Bradway	None	2022-02-15T15:42:10Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Bradway, Mildred	84f6fb93	False	None	False	2022-04-12 01:56:18.524	[]
745	CDC-2022-0024-0751	https://api.regulations.gov/v4/comments/CDC-2022-0024-0751	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the restrictions were put in place, trying to combat the opioid crisis, it has hurt patients like me, who have chronic health issues and pain. As time passed, I was made to choose between my alprazalome or pain medicine. At one point I had gotten my AR [redacted] card and thought I would be able to deal with the pain.But Arkansas prices are so high that on disability I was unable to use it. I had the Dr add gabapentin which has helped but has not relieved my issues. I never took pain pills every day, I have always taken them as I needed them. But now getting them, is like pulling hens teeth. I have never abused my medications. And I don't take risks with mixing medications. <br/><br/>The people that abuse medications are the ones that tend to buy them off the street. And they are the ones that will figure out a way to get them. <br/><br/>Darvocet was the only pain medication I have ever taken that did not make me sick. But when people od'd on it, it was pulled from the market. <br/><br/>Please ease the restrictions. Dr's are scare to perscribe it, period. <br/><br/>I dislocated my right elbow, in motor vehicle accident and the hospital gave me 8 pain pills. A week and a half later when i saw the surgeon, he said it wasn't an injury that was painful. I would like him to have that injury and then tell me it doesn't hurt. It hurt and still hurts some times, but it hurt like child birth!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484f77356	Duncan	None	2022-02-15T15:45:47Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Duncan, Donna	kzn-fr96-zn78	False	None	False	2022-04-12 01:56:18.759	[]
746	CDC-2022-0024-0752	https://api.regulations.gov/v4/comments/CDC-2022-0024-0752	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 49 year old wife to my best friend of 32 years and mother of 2 amazing boys. In 2003 when I was pregnant with my second child I was involved in a hit and run. I was hit from behind and dragged almost a mile close to going over the embankment on the beltway by a guy who had stolen a car when I was 3 months pregnant. The pain was so severe. Nothing could really be done while I was pregnant. My son was born a month earlier than his original due date (thank God healthy) and I had congestive heart failure during my c section. We still don’t know if it was the stress and pain while pregnant. In 2004 I started seeing a pain specialist. Hundreds of procedures and medications were tried. After 4 years we found what worked to get my pain from a 10 down to a 6. For 15 years I was maintaining my pain. The medications that we finally got to work allowed me to remain employed at a job that I love (28 years and still going strong) and live a semi normal life raising my children. Then the government came in and blamed doctors for over prescribing opioids causing the “opioid Pandemic”". In 2016 CDC said they were updating their guidelines to a “one size fits all”. Chronic pain patients had to ALL be taken down to 90mme a day. This was ridiculous as some patients were forced tapered to a bare minimum, some were stopped all together. Being a chronic pain patient we became criminals. No person suffering any kind of health issue should have to sign a “contract” to receive treatment. It’s unheard of. . I mean our rules are worse then someone on parole who has just being let out of prison. So now suicide in the pain community is at an all time high as well as people suffering excruciating pain that have no place to get relief so now they go to the streets looking for relief not knowing what is actually being sold to them. So now fear of overdosing is a reality for people who just want their life back. We pay for healthcare and see a different tie yet some have to actually buy medications from a “dealer”. Can you imagine the outrage of this happened to people who needed heart medications or other non pain medical issues. The CDC has destroyed so many lives. They lied in 2016 regarding the overdose numbers and when they were caught they basically said “oops, sorry”. They didn’t change anything or come out and say we need to help these patients. Nope, they quietly swept it under the rug that they had lumped heroin and illicit Fentynal together with prescription medications. However they never retracted the 90mme daily limits. Our lives have been destroyed. There was a time when our pain was being controlled and our lives were almost back to normal. We could work, play, go on vacations and attend family events but that was taken away from us with a snap of a pen. Addicts get more relief then chronic pain sufferers. An addict can get out on 180mg of methadone to treat their addiction and they taper down when the patient says it’s time. However a chronic pain patient taking methadone to help their pain is given 20mg a day and told they will reduce it per the guidelines to risk addiction. Are you kidding me? We are begging you to rescind the 2016 Guidelines and let doctors prescribe the best treatment to fit each patient not what a piece of paper being looked at by a person who has never talked to you or seen your records or you in person. <br/>tells you There is no “limits” in any other area of healthcare.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Holly	None	None	0900006484f772ac	Agouridis	None	2022-02-15T15:49:34Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Agouridis , Holly	kzn-darv-eeom	False	None	False	2022-04-12 01:56:18.970	[]
747	CDC-2022-0024-0753	https://api.regulations.gov/v4/comments/CDC-2022-0024-0753	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support the proposed changes to the guidelines for prescribing opioids. I have a chronic medical condition which exacerbates pain from any injury/surgery. Due to current guidelines my doctors have limited my access to opioid medications for a longer and/or a sufficient amount of time based on my pain. This has resulted in insufficient sleep, exercise, etc. over many years. Pain medications should be prescribed carefully, yet provided to patients based on their specific medical condition/needs. It is understood that it is important not to over prescribe opioids, so careful monitoring of patients who need prolonged use is essential. Documentation of rationale for extended use would be beneficial to limit abuse. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484f7727a	Carranza	None	2022-02-15T15:50:25Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Carranza, Teresa	kzn-cs6p-t2ge	False	None	False	2022-04-12 01:56:19.184	[]
748	CDC-2022-0024-0754	https://api.regulations.gov/v4/comments/CDC-2022-0024-0754	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 69 years old been in chronic pain 24 hours a day I used to be able to take six oxycodone per day which manage my pain beautifully but then I was cut down to for a day it was very hard to get used to it and the pain never leaves but if I didn't have the Oxycodone to take every 6 hours I don't think I would want to live the pain is relentless I never thought I would get used to being in a wheelchair but I did and I beg the government please do not take away my pain medication at least being able to control my pain gives me a reason for living if I had to live in pain life would not be worth living 2 hours 4th and Sue and thank you for letting me write this to you I appreciate it [redacted Name/PII]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f77276	Mulhall	None	2022-02-15T15:52:05Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Mulhall , Mary	kzn-cn2h-5ghu	False	None	False	2022-04-12 01:56:19.391	[]
749	CDC-2022-0024-0755	https://api.regulations.gov/v4/comments/CDC-2022-0024-0755	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Looks a little better other than you need to remove the 50MEQ number totally. It will result in more pain patients being cut back to the point they are in agony and increase the suicide rate of pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dennis	None	None	0900006484f78a53	Ewing	None	2022-02-15T15:52:26Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Ewing, Dennis	kzn-cjej-7u0k	False	None	False	2022-04-12 01:56:19.603	[]
750	CDC-2022-0024-0756	https://api.regulations.gov/v4/comments/CDC-2022-0024-0756	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain management is an important part of quality of life. Hence, managing patient’s pain is important. However, an opioid prescribing guideline should be more of a pain management guideline. I’m in healthcare for almost 15yrs and worked in a pain clinic for about 10yrs and based on my observation long-term opioid therapy creates more damage than good. I see patients lost their families from this on multiple occasions, children went to foster homes, homelessness, etc.<br/><br/>Evidence-based research shows that long term opioid increases risk for addiction and does not relieve the pain eventually. A multimodal approach is necessary for effective chronic pain management. Many may argue that the CDC & DEA should not get involved with pain management. I totally disagree, providers need some form of monitoring as it relates to prescribing narcotics because it’s human nature, “if no one watching, I’ll do what I want”. Once there’s some form of guidelines, it’s likely patients will receive effective pain management and better quality of life. I think patients that requires narcotics should be referred to pain specialist and managed by pain specialist, not a primary care provider because that’s their expertise.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f78a45	Anonymous	None	2022-02-15T15:53:12Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-cdlr-4zkv	False	None	False	2022-04-12 01:56:20.311	[]
751	CDC-2022-0024-0757	https://api.regulations.gov/v4/comments/CDC-2022-0024-0757	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 66 year old retired caregiver who suffers from arthritis in several areas of my body and has had many surgeries. I have do use Advil but I try to only as needed as it effects organs in the body and blood vessels. When I wake up in the morning I am very stiff and painful and the advil alone does not ease it unless I take my one Norco 7.5/325. My Dr has prescribed this for my arthritis , injuries in my neck from car accidents and a neck injury from a surgery that I also augmented with dry needling which lessened the pain. I also have a bad bunion foot with the bone jutting out that has a good deal of pain when walking or standing . I did have surgery for the right foot many years ago but it really made my foot and ankle worse. I will not have surgery on the other foot due to this. I also suffer from severe muscle spasms due to chronic fear and anxiety of which I have made improvements in due the therapy and psychiatric medication but the spasms do linger. I do exercise to help with the anxiety and for the pain most days of the week. My father and grandparents had terrible arthritis and I saw them suffer terribly so I am so grateful that I do get some relief with the norco along with 2 Advil's that they didn’t have the advantage of. When I ride in cars it aggravates my neck terribly so I try to limit that but when I travel to my daughters and grandchildren out of town my arthritis gets aggravated and I may need an extra one a day for that pain. I have never needed extra norcos to help the pain, only the prescribed amount every month that I have taken them for several years now. I do not have any addiction issues nor do I need an increased dose to cover the level of pain. Consequently I do not abuse this opioid and I would hate to think that I would have to pay and suffer because other people do abuse them. While I feel for their situations I also feel for the many , many patients that suffer with debilitating pain and cannot get the treatment they need. Thank you for considering my situation and information. Please take all these comments into consideration when you make your decisions. I do agree that the decision should be made by the individual physicians as they are the only ones who know the patient’s condition and health all around. If they are Board Certified physicians in good standing in their community I feel safe with their highly educated decisions. My pain management Dr is very honest Dr and has tried many other treatments which are only temporary and I cannot tolerate steroids. I also have done much physical therapy when needed but pain still exist. Thank you for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amelia	None	None	0900006484f78a34	Stewart	None	2022-02-15T15:54:40Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Stewart, Amelia	kzn-c9un-ue71	False	None	False	2022-04-12 01:56:20.522	[]
752	CDC-2022-0024-0758	https://api.regulations.gov/v4/comments/CDC-2022-0024-0758	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Even with these changes, the damage that's been caused cannot be undone. There is SO much more work CDC must do to attempt to right some of the wrongs caused it is very difficult for someone like me who's life has been taken away-and has seen HER DOCTOR'S LIFE destroyed-not to get emotional here. The PR campaigns CDC has run, the horrible mishandling of "overdose" death data, the laws that have passed and the innocent doctors being persecuted and imprisoned DIRECTLY based on metrics CDC laid out....you MUST use even more momentum to undo these atrocities than you used to create them. For years I watched as my fellow disabled/elderly/veteran painfully disabled patients deteriorated and more often than not had to take their own lives to mitigate their suffering, and for these same years I watched as CDC was made VERY clearly aware of exactly what was happening and treated us as though we were never here. CDC repeatedly declined to track ANY basic outcomes, even suicides, and continued to pathologize any use of these essential medicines required to maintain even basic human rights. CDC chose "policy-based evidence" lacking any basic scientific integrity and chose to ignore slightly older, established rigorous science because it did not support the policy CDC desired to promote. NONE, none, NONE of the authors of either guideline iteration has had any business being involved in crafting clinical practice guidelines for treating pain-most are not PHYSICIANS, let alone experts in pain or even pharmacology! These are zealot addiction psychiatrists, and I would argue, eugenicists. In a just world, CDC would simply withdraw these guidelines immediately and gracefully hand the issue over to the APPROPRIATE agency that should have been designated the responsibility in the first place. Sadly this is not a world with disability justice, so I'm sure this will not happen, but at the very least there 1 more adjustment to this guideline that you failed to address and CDC absolutely cannot justify the negligence that you would be committing if you release these without correcting this abberation:<br/><br/>"Many patients do not experience benefit in pain or function from increasing opioid dosages to ≥50 MME/day but are exposed to progressive increases in risk as dosage increases. Therefore, before increasing total opioid dosage to ≥50 MME/day, clinicians should pause and carefully reassess evidence of individual benefits and risks."<br/><br/>Strike this. Strike it immediately, unless the lessons of "unintended consequences" truly have been lost on this agency. Not only is MME arbitray, unscientific and harmful but the 50mme threshold WILL ONLY serve to make all the harms CDC has caused so, so much worse. CDC was amply warned what would happen, warned as it happened & worsened and has publicly stated that these harms were unintended. If CDCs word is to be trusted at all, it absolutely must prove worthy and REMOVE THIS THRESHOLD-not to be replaced. ANY number you give will be codified into law, used to justify torture and set the bar for the blunt instrument law enforcement will use to complete it's extermination of physicians. Is CDC aware that almost 50% of primary care physicians now REFUSE to accept any patients with chronic pain, a direct result of harms you caused? We are talking about US, the remaining elderly/disabled/veterans in pain, CDC has locked out of any healthcare access entirely!<br/><br/>You must swiftly remove any and all mme dosing thresholds (50mme) from the guidelines, without doing so you are GAURANTEED the same outcome over again. <br/><br/>Here's an anecdotal example for you from the current epidemic and what happens when CDC makes this type of guidance:<br/><br/>Recently CDC dropped the isolation time required for a person testing positive for Omicron from 10 days to 5. Do you know what happened? Corporate America IMMEDIATELY changed the allowed paid sick leave for a positive tested employee...from 10 days to 5. HARD LIMIT BASED ON CDC SUGGESTION.<br/><br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachael	None	None	0900006484f789f9	Horning	None	2022-02-15T15:57:46Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Horning, Rachael	kzn-bk5k-qbh5	False	None	False	2022-04-12 01:56:20.765	[]
753	CDC-2022-0024-0759	https://api.regulations.gov/v4/comments/CDC-2022-0024-0759	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What the CDC is doing is negligence. Providers should be sued for NOT treating their patients and not abiding by the oath they took to “do no harm”. People are dying because they cannot live with the pain. Post op patients are taking months to heal and suffering infections increasing hospital stays. <br/><br/>CDC must remove any mention of MME from the guideline and it must be removed from the EHR. <br/><br/>The 2016 CDC pain guideline was embedded into the EHR with clinical decision support tools. Providers looked to this EHR as a mandatory requirement.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacquelyn	None	None	0900006484f789ac	Hansford	None	2022-02-15T15:58:10Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Hansford, Jacquelyn	kzn-bivr-rukz	False	None	False	2022-04-12 01:56:20.984	[]
754	CDC-2022-0024-0760	https://api.regulations.gov/v4/comments/CDC-2022-0024-0760	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern,<br/>I have been a Chronic Pain patient for more than 35 years and have taken my opioids responsibly and exactly how they were prescribed. That's until 2016. My NP informed me she wasn't prescribing anymore because she was scared to death of loosing her license because of the new guidelines set in place. I was then sent to a "pain management" Dr. that completely cut me off, even with all the documents that I clearly had multiple pain related illnesses. It was the worse year of my life! I finally found a clinic to take over my care but it was still the bare minimum of what I was successfully on for over 30 years.<br/>Since then I've been barely living my life. I can't shop, I can't clean, I can do my own laundry ect.. my life has changed drastically. At one point I didn't know if it was worth living in bed....but Thank God I couldn't do that to my kids and husband.<br/>Please, please consider changing these guidelines so the people that really need long term Chronic Pain care can get the help we need. Thank you in advance for letting us be heard. I pray everyday that something will change for the better for us suffering every single day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f78953	Anonymous	None	2022-02-15T15:58:48Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzn-ax5i-wqlr	False	None	False	2022-04-12 01:56:21.227	[]
755	CDC-2022-0024-0761	https://api.regulations.gov/v4/comments/CDC-2022-0024-0761	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Believe the CDC guidelines were well intended but maybe the execution was not clear. If these guidelines were presented a best practices, hopefully the recommendations would not have taken as fact. As a practicing pain physicians it became very apparent the guidelines were misinterpreted by must clinicians so re-educating prescribers has been critical. Having educational module for prescribers with clear expectations and descriptions would be very helpful.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484f7ab58	Walker	None	2022-02-15T15:59:01Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Walker, Kevin	kzo-aqqm-z1pw	False	None	False	2022-04-12 01:56:21.456	[]
756	CDC-2022-0024-0762	https://api.regulations.gov/v4/comments/CDC-2022-0024-0762	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why is the government trying to punish pain patients more??? The OD rate from Fentanyl off the streets should be an awakening! STOP PUNISHING PAIN PATIENTS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kassidi	None	None	0900006484f7ab5c	WalraveN	None	2022-02-15T15:59:32Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from WalraveN, Kassidi	kzo-ay4h-uj27	False	None	False	2022-04-12 01:56:21.691	[]
757	CDC-2022-0024-0763	https://api.regulations.gov/v4/comments/CDC-2022-0024-0763	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC is touting this as a revision when in all honesty it’s just a rejumble of the original 2016 Guideline which has caused unimaginable harm to those suffering in pain.<br/><br/>All that needs to be said is that:<br/><br/>Opioids are a safe, effective treatment for pain but patients should be informed of the dangers of addiction <br/><br/>Pain patients rarely become addicted to illicit drugs <br/><br/>Doctors, should be valued for their insight, their education. They should be allowed to prescribe opioids without limitations, based on the patients condition.<br/><br/>Every body is different, some metabolize medications differently<br/><br/>IINTRACTABLE PAIN should be included as an EXCLUSION<br/><br/>RARE DISEASES should be included as an EXCLUSION<br/><br/>There should be no MME limitations AT ALL-MME is an unscientific calculation <br/><br/>The CDC has done nothing but create an atmosphere of fear and death. It should NOT be involved in the prescribing of pain medication to those who need them<br/><br/>STOP with the references to prescription opioids being responsible for the opioid crisis. Look at the true issue, illicit drugs <br/><br/>Your taking away a viable option for pain sufferers and forcing them to choose suicide or street drugs when they could live a life with their pain managed<br/><br/>Those involved in the Guidelines are intentionally pushing an anti opioid narrative to make themselves a profit in litigation. Follow the money <br/><br/>CHOU should have NO INVOLVEMENT in any Opioid Prescribing Guideline due to conflict of interest <br/><br/>Reflexive and one-size-fits-all approaches to tapering or discontinuing opioids prescribed for chronic pain should be avoided<br/><br/>legacy patients,” require individualized care. Tapering and discontinuing opioid therapy for chronic pain have been associated with multiple negative outcomes in both publicly and commercially insured populations (see figure). Outcomes include increased illicit opioid use, increased use of emergency medical services and opioid-related hospitalizations, increased rates of mental health crises and overdose events, and increased mortality from overdose and suicide. Outcomes tend to be worse the longer patients have been receiving opioids before tapering and the more abrupt the taper. Even more troubling, outcomes are worse among patients who are the most likely to have their doses tapered: those with mental health or substance use disorders<br/><br/>A personalized, patient-centered approach to opioid management can prevent iatrogenic harm and death — but it will take time and require the perseverance to develop trusting relationships between patients and clinicians (see box). We believe the medical establishment must step forward to resist applying a one-size-fits-all approach to inherited patients, fight back against overzealous regulators, and stop abandoning patients. Patients who have received long-term opioid therapy cannot be treated the same as those who have not.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484f7893c	Helmick	None	2022-02-15T16:00:19Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Helmick, Marie	kzn-arkr-rewx	False	None	False	2022-04-12 01:56:21.906	[]
758	CDC-2022-0024-0764	https://api.regulations.gov/v4/comments/CDC-2022-0024-0764	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ever since the implementation of these “guidelines” the overdoses have gone up, not down. Basically, pain patients are being punished as, and being treated as, addicts. That is not the case. We want our lives back. As a chronic pain patient, I went from a productive, happy person to someone who basically has no life because of my pain level with no treatment. I was told by a pain center that because the shots and ablations didn’t work that “they couldn’t help me”. The overdoses are on heroin and fentanyl and YOU KNOW IT! YOU’VE ALWAYS KNOWN IT! Stop politicizing pain. Stop terrorizing doctors. Let them treat their patients as doctors without the fear of losing their licenses. One day you may be in our shoes. Then you will see what it’s like to have major surgery and given TYLENOL post op. It doesn’t work.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	carol	None	None	0900006484f78926	Okoniewski	None	2022-02-15T16:01:16Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Okoniewski, carol	kzn-an4h-kghe	False	None	False	2022-04-12 01:56:22.144	[]
759	CDC-2022-0024-0765	https://api.regulations.gov/v4/comments/CDC-2022-0024-0765	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who has chronic non cancer pain (CNCP) as well as opiate addiction (both in recovery - 30 years with CNCP and 22 years with addiction) I am both concerned and cautiously optimistic seeing this. The problem with treating CNCP or addiction with long term opioids is that in the long run opioids CAUSE pain, and most people who get addicted when treating pain have such strong denial that they cannot differentiate the true from the false. I was one of them. Angered when someone mentioned addiction and of course used my experience with pain as a weapon to threaten and coerce prescribers into prescribing for me. I was on opioids for 18 years, and addicted as well for at least 15. This insight occurred after many years of recovery. The problem with using opioids for pain without any form of mental and physical therapy creates all sorts of problems. Exercise is the most important part of my own CNCP treatment. <br/><br/>Accountability along with excellent communication and preemptive approaches to new pain (such as surgical), avoidance of a drug of choice, and absolute family accountability have maintained pain MANAGEMENT (not “perfect relief”) for acute on chronic pain. <br/><br/>The worst problem we have is systemic in that prescribers are not taught well on CNCP or addiction; patient satisfaction has compromised best care work (because some pain is normal), and the coddling approach to most care now in addiction has created intolerance for any discomfort at all. <br/><br/>What I AM cautiously optimistic about is that dialog will be opened to discuss this very tough subject. I myself have left the work of both CNCP and addictions treatment bc of the basic harm reduction pharmaceutical approach being embraced today. This current harm reduction will create large amounts of money for drug companies and yes, reduce public harm to an extent, but individuals will be denied many solid chances to become holistically better if the only focus id to provide more opioids. <br/><br/>Unless a holistic approach is taken, this will be another swing of the pendulum and the only winners will be the companies providing the product. <br/><br/>Here is an article I wrote years ago, more important now than ever. <br/><br/>https://amp.indystar.com/amp/5709569	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jim	None	None	0900006484f788e1	Ryser	None	2022-02-15T16:02:32Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Ryser , Jim	kzn-a6hq-2wmb	False	None	False	2022-04-12 01:56:22.353	[]
760	CDC-2022-0024-0766	https://api.regulations.gov/v4/comments/CDC-2022-0024-0766	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel that rules have gone too far the wrong way by putting all these restrictions on meds. Let the Dr's that have a relationship with the patient make the orders as every patient has a different pain threshold. The idea of only 3 days' worth of opioids after surgery makes me decide to NOT have surgeries that I need.<br/><br/>We need to help our patients not let them lay in bed and suffer or turn to street drugs to be able to function.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	0900006484f788a4	Drury	None	2022-02-15T16:02:52Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Drury, Leslie	kzn-9xzi-tei5	False	None	False	2022-04-12 01:56:22.568	[]
761	CDC-2022-0024-0767	https://api.regulations.gov/v4/comments/CDC-2022-0024-0767	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 69, had to retire early because of a car accident. I was a active in shape senior before the accident that worked a very physical job (vet tech).<br/>I have a pain managment Dr. I have had epidurals, an ablation all with varying results. I pass all my urine and drug counts. Have done everything asked. But my pain is worse I sit home and cry many days. I have thought of ending the pain, but at this point have my dogs to consider.<br/>Please don't blame us for the opioid problem. We are legitimately hurting and need help.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484f7ab72	DeVoto	None	2022-02-15T16:35:13Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from DeVoto, Diane	kzo-bhxp-opcn	False	None	False	2022-04-12 01:56:22.781	[]
762	CDC-2022-0024-0768	https://api.regulations.gov/v4/comments/CDC-2022-0024-0768	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Safe opiate prescribing is practiced by the vast majority of licensed providers.<br/>Onerous regulations do not help the ability to provide care for patients in pain.<br/>For older complex pain patients the safe prescribing of opiates is for pain relief and comfort and should be at the discresion of licenced providers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ab7a	Anonymous	None	2022-02-15T16:40:24Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-bxio-rp7h	False	None	False	2022-04-12 01:56:23.009	[]
763	CDC-2022-0024-0769	https://api.regulations.gov/v4/comments/CDC-2022-0024-0769	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Bravo for listening to pain patients, however I fear there is much still to be done since now insurance companies and doctors offices have the prior guidelines as laws of their offices and companies. This will need to be widely publicized and education and outreach given to patients, insurance companies and doctors offices. I am one of many affected by the limits imposed by the old guidelines which resulted in me having to go part time and leave my full time job as well as missing important family milestones because I was unable to get adequate relief to function.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachael	None	None	0900006484f7ab7e	Bowman	None	2022-02-15T16:41:01Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Bowman, Rachael	kzo-c0wm-p58m	False	None	False	2022-04-12 01:56:23.217	[]
764	CDC-2022-0024-0770	https://api.regulations.gov/v4/comments/CDC-2022-0024-0770	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please update the rules for prescription for pain. I’ve lost 3 doctors because they didn’t want to deal with me as a chronic pain patient. I’m having to suffer daily because they believe they will go to jail. One told me to blame my government. They other sent me a certified letter saying she can’t see me anymore. The third said I’m sorry but I’m getting in trouble helping your pain management. I’ve never had any stiles against me and suffer now for six years and don’t know how much longer I can take the pain. Please hurry and let doctors do there jobs in East Tennessee. I’m scared now every day to just try to do stuff around the house and can’t walk back in alone. Thanks for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484f7ab81	McCarty	None	2022-02-15T16:44:04Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from McCarty, Daniel	kzo-c71n-hpzj	False	None	False	2022-04-12 01:56:23.431	[]
765	CDC-2022-0024-0771	https://api.regulations.gov/v4/comments/CDC-2022-0024-0771	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Our family Dr. should manage our pain.. They know us...... YOU have destroyed my marriage my life... MY husband changed states lost his pain meds and now not even enough for him to walk.. We had a life .. We had the ability to move...We could play with our grandchildren. We had a garden, You have stolen that from us.. Dr. are scared.. How dare you!!!!!! Never have I wished anything on anyone but I hope you have pain, But then you dont do manual labor do you??? old folks that have built America and you deny them meds??? You YOU are FORCING Americans to street drugs...Why is the goverment in our meds? You have drugs coming in open border like water..DRUGS COMING IN AT BRODER YET YOU PUT AMOUNTS ON OUR MEDS?. Yet you deny us American Citizens from getting help from our Dr.??? You are forcing pain patients to purchase Street Drugs to walk...DOnt you feel something is wrong with that?????? Give us our meds to be productive humans....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	donna	None	None	0900006484f7ab82	LOWDER	None	2022-02-15T16:45:30Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from LOWDER, donna	kzo-c8qp-krwu	False	None	False	2022-04-12 01:56:23.642	[]
766	CDC-2022-0024-0772	https://api.regulations.gov/v4/comments/CDC-2022-0024-0772	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines need to be destroyed. What has gone on for the last 6 years is a crime. Compassionate doctors jailed & disabled punished. The 50mme is actually you tightening the noose. You know it’s will scare more doctors to stop prescribing. You have sidelined me & others from our lives. Destroy all guidelines & have a press conference immediately saying doctors need to treat pain. Then apologize to all our injured Veterans you forced to serve their country again, as a Guinea pig. Likely why so many took their lives right at VA hospitals. Anything less is you continuing an inhumane torture experiment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ab9e	Anonymous	None	2022-02-15T17:05:47Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-d8m2-94nc	False	None	False	2022-04-12 01:56:23.853	[]
767	CDC-2022-0024-0773	https://api.regulations.gov/v4/comments/CDC-2022-0024-0773	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been one of the lucky ones who's pain medicine went unchanged. Most likely because I was only at 80mme. I was however lectured many times about the mme threshold and how regardless of my deteriorating condition that line can't be crossed due to fear of persecution and prosecution. I am now a senior and my condition is constantly deteriorating and pain medicine is the only thing that helps me come close to leading a semi normal life. This did not come easy as I have had failed back surgery, therapy and many other unsuccessful techniques. I was also in a motorcycle crash and broke 24 bones and now also have post traumatic arthritis in several joints. I would hope as I age and my pain increases my doctor on a joint decision will at least be able to consider raising my dose at some time in the future without the fear that has limited doctors all over the country. I want to deeply thank you for listening and taking steps to improve the level of care that has handcuffed doctors, pharmacies and insurers for thr last 6 six years. I appreciate your caring.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ab9f	Anonymous	None	2022-02-15T17:07:05Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-dd4h-6wtt	False	None	False	2022-04-12 01:56:24.078	[]
768	CDC-2022-0024-0774	https://api.regulations.gov/v4/comments/CDC-2022-0024-0774	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to ask how this will affect me as a chronic pain patient since 2004, my pain doctor forced me to taper from 86.5 mg to now at 38mg a day, I was on the same dose for 15 years without an increase, and I was doing well at that dose? Now I can't do the things I used to do, and I am afraid it will affect my long term health. I have done steriod shots, PT, & spinal chord stimulator, I have tried most everything, and opioids are the only thing that gives me Quality of Life. Also my concern is are the doctor's, pharmacy, hospitals going to misinterpert your guidelines once again, and also is the DEA going to arrest doctor's for prescribing the higher does? So will the doctors still be afraid to help the chronic pain patients? What can you do to stop them attacking good doctors from being arrested and jailed for only helping people in pain? At this point in my life, my pain care facility is forcing me to have procedures which do not work, and they know this, and I even had one NP tell me if I wasn't at such a low dose they would have to force me to have a Pain Pump. Every month I fight the Pain Care Facility I go to, then I have to fight the pharmacy for they treat me like a drug addict, not wanting to fill my medication, pretending they don't have it, making me wait days so I am without medication, it is a nightmare. In America people with Chronic Pain, Surgeries and people with cancer should have access to opioids if they need them. I am all for trying everything first before taking opioids, but when all else has failed, I should be able to get relief from opioids if I need them. I appreciate that you revised the guidelines, but once again will this help me and other chronic pain patients?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jean	None	None	0900006484f7aba0	McGrath	None	2022-02-15T17:48:41Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from McGrath, Jean	kzo-dh69-xgi3	False	None	False	2022-04-12 01:56:24.294	[]
769	CDC-2022-0024-0775	https://api.regulations.gov/v4/comments/CDC-2022-0024-0775	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have with pain from my back for the last 8 years my Dr saw that Turin was not working so she put me on morfine 30 A day when that did do the job she would have up it but she new how I felt about med so she gave me Osborn I move away I saw a pain management Dr stay on same I was the one asked to be taken of the ocxcont so we changed it to morfine 45 mg a day when I moved back I have been with it for 5 years I am never pain free but I quit it no problems but now I can hardly walk. S<br/>Wish I could have my morphine back I never abuse items	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7aba2	Anonymous	None	2022-02-15T17:49:37Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-diyr-8pv1	False	None	False	2022-04-12 01:56:24.517	[]
770	CDC-2022-0024-0776	https://api.regulations.gov/v4/comments/CDC-2022-0024-0776	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 Guidelines provided restrictions to medical doctors. MD’s were terrified to prescribe a greater daily dose even when necessary for fear of being punished. Chronic pain patients “wound up” because of this under treatment of sever pain and now they suffer with even great pain the rest of their lives. Where are the civil rights for pain patients to be treated with dignity and respect? These patients are NOT drug addicts and drug abusers! Thank goodness for the new policy but please keep encouraging doctors to treat patients effectively and improve the quality of life for these unfortunate people who were sometimes actually struck down in auto accidents where a drug addict or alcoholic injured them terribly! Remember to have compassion for the people who suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484f7abb0	Stickley	None	2022-02-15T17:50:34Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Stickley, David	kzo-duux-kpmh	False	None	False	2022-04-12 01:56:24.751	[]
771	CDC-2022-0024-0777	https://api.regulations.gov/v4/comments/CDC-2022-0024-0777	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sadly the damage has been done an I don’t see physicians going back to quality of life dosing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484f7abb4	Peterson	None	2022-02-15T17:50:53Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Jeanne	kzo-dzrv-x3zq	False	None	False	2022-04-12 01:56:24.970	[]
772	CDC-2022-0024-0778	https://api.regulations.gov/v4/comments/CDC-2022-0024-0778	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a patient on pain management for two years. I was cut off cold turkey by my doctor. This is very wrong. I need my medications to function due to back pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Letha	None	None	0900006484f7abce	Luckerson	None	2022-02-15T17:51:21Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Luckerson , Letha	kzo-eocz-hbyi	False	None	False	2022-04-12 01:56:25.222	[]
773	CDC-2022-0024-0779	https://api.regulations.gov/v4/comments/CDC-2022-0024-0779	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for this important revision. As a pain patient, I have been harmed by the 2016 guidelines. Not only has my pain not been adequately treated, but it created distrust between me and my doctors. I know longer believe they have my best interests in mind. It also resulted in ridiculous demands for "monitoring" that are insulting and demeaning.<br/><br/>I hope the CDC will take an active role in dismantling all the state laws and insurance demands that resulted from the original guidelines.<br/><br/>Thank you,<br/>[Name Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joanne	None	None	0900006484f7addb	Muldoon	None	2022-02-15T18:27:33Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Muldoon, Joanne	kzo-firn-7va9	False	None	False	2022-04-12 01:56:25.437	[]
774	CDC-2022-0024-0780	https://api.regulations.gov/v4/comments/CDC-2022-0024-0780	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The opioid epidemic is already a huge problem in our country. The last thing we need is more people with chronic pain getting addicted to these deadly substances. <br/><br/>The long covid crisis will probably soon turn into the long covid opioid crisis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7addc	Anonymous	None	2022-02-15T18:28:14Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-fnu7-mcrv	False	None	False	2022-04-12 01:56:25.648	[]
775	CDC-2022-0024-0781	https://api.regulations.gov/v4/comments/CDC-2022-0024-0781	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for re-evaluating these guidelines. The current 'guidelines' are being used by insurers as absolute limits, and this heavily impacts patient care and their quality of life. It also heavily impacts providers as we are audited with respect to prescribing habits by insurers as well as state pharmacy and other government bodies. I practice pain management for those individuals for whom no other modalities are available--those who have had everything else possible or who are not candidates for those modalities, and those who have conditions for which nothing else is available. yes, we write a lot of narcotics. Yes, we closely monitor all patients, pull BOP reports for every visit, utilize non-narcotic therapies, run frequent assessments of functionality, overdose/diversion risk, mental health impact, titrate to lowest effective doses, etc. We strive to avoid the 'pill mill' label and receive referrals from all over the state which are thoroughly vetted before offered appointments. Our patients often feel as if they are 'guilty-before-proven-innocent' due to the restrictions placed on access to pain management. We have excellent rapport with specialists and PCPs, law enforcement, EMS, and pharmacies. In our region, various services are extremely limited or simply not available. It is senseless to ask a 78-year-old coal miner with severe spinal stenosis to attend an assessment for addiction 2 hours from his home when he his pill counts and UDS have been appropriate and his dose stable for over a year, yet this is the type of situation we regularly encounter from insurers who fall back on the 'CDC guidelines' and use them as absolutes. We are wasting patient and provider time and the cost is ridiculous. The regulations associated with the opiod epidemic have failed in their intended effect and simply fueled the heroin crisis. Patients with chronic pain are suffering the failed war on drugs, while illegal drug use is skyrocketing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanette	None	None	0900006484f7adde	Jackson, D.O.	None	2022-02-15T18:30:28Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Jackson, D.O., Jeanette	kzo-fsgq-47nh	False	None	False	2022-04-12 01:56:25.861	[]
776	CDC-2022-0024-0782	https://api.regulations.gov/v4/comments/CDC-2022-0024-0782	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/>I am so very thankful to hear that some progress has been made in the war on pain. I am a 63 year old female who worked in acute rehabilitation in the hospital back in 1996. At 33 years old an uninsured driver hit me from behind as I sat at a light which was red at 9:00am in the morning. The result would be 12 years in bed, 6 major back surgeries, and 4 vascular surgeries at UCLA. I had right drop foot for 7 years, the loss of muscles in both arms, and reflex sympathetic dystrophy. I had never heard of the diagnosis I had been given. Chronic regional pain syndrome and I have lupus as well.<br/><br/>My attitude was good the entire journey, but the pain was so severe I wanted to die. The only thing that helped me to fight was some measure of pain relief. As amazing as this is I have been able to live on 30mg of methadone a day since that date. I was able to start working 2 hours a day starting in 2004 and and 3 hours every other day 2014. I am in so much pain now I will need to retire at 64 because I am really, really struggling. But if I had no medication I would not be here. Unless you have suffered mind altering pain, you cannot understand. It will rip you to shreds.<br/><br/>I had what was called an internal disc rupture. The covering on my sciatic nerve ripped open. When the doctor sewed it back on he crushed the nerve. With 3 months of time between surgeries the nerve went from a 10 to a 2 on the nerve conduction test. I had 6 back surgeries and one was 9 hours long. I also had to have two ribs removed in my chest, bilateral sympathectomies, and numerous other procedures. I have had over 30 epidurals for pain.<br/><br/>Please help us. I know we may seem a burden. I feel like one. I do not seek drugs, do not drink, and long to make it to retirement one more year. Since I went back to work I go in two hours, come home and lay down 2-3 hours, and go back for one hour more. I cannot sit so stand for work and it is 3 miles from the house. In 20 years I have been on 3 vacations. All three were for my parents anniversary at 50 years, 60 years, and 70 years. They are both alive at 93. So my life is lived right close to where I live for obvious reasons.<br/><br/>Finally, because I was 33 at the time, my Social Security Disability check was $495 a month to live on. After 12 years I was up to $560. That is criminal. The police think the man was illegal and that is why he took off. I was sitting at a red light heading to Bible Study when it happened. I never again was able to work in my profession. I became a swim coach so I could stand to work. Please, please hear my story. I want my life to count. I want to be a blessing to my community. And if I cannot go up in my pain medicine, I will be done working in May due to my pain. I do not think my pain management doctor will object since I have been with him 27 years and never asked for more medication. What would I have done without him? And can you relax the laws that require us to go every month and pay $35 a visit. You can see the expense for someone with my income. How I thank God I was able to go to work 3 hours a day and have medication so I could walk. Thank you for reading this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judi	None	None	0900006484f7ade4	Terhar	None	2022-02-15T18:34:27Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Terhar, Judi	kzo-g36d-67bw	False	None	False	2022-04-12 01:56:26.103	[]
777	CDC-2022-0024-0783	https://api.regulations.gov/v4/comments/CDC-2022-0024-0783	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want the mme removed. There should be no limit put on drs who have been treating us. Especially when we have been tampered off!! <br/>Do you understand that people are killing them selves with untreated pain. Please REMOVE the mme it also has no scientific proof other than suggestions from people who will financially benefit from the change!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joelle	None	None	0900006484f7ae88	Maloney	None	2022-02-15T18:35:05Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Maloney, Joelle	kzo-g421-e3v5	False	None	False	2022-04-12 01:56:26.320	[]
778	CDC-2022-0024-0784	https://api.regulations.gov/v4/comments/CDC-2022-0024-0784	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's great to see this new and updated draft of the 2016 clinical practice guideline....... When my chronic pain started interfering with my life, I tried to find a CURE, verses management. But there are no cures for the diseases from which I suffer. Further, every complaint from the pain could be and was seen on xray or scan! Pain, not aches, has stolen my quality of life. Instead of vacations and travel, I have weekly doctors' appointments. Cardio workouts at our local gym helped the pain quite a bit! Now COVID 19 has stolen that relief from me. Being on auto immune suppression therapy, I HAVE to remove all possible risks of infection.<br/>What concerns me is that the doctors will not abide by the revisions. So many good doctors were made examples of, initially, that most doctors are too scared to prescribe now! For those of us suffering from excruciating pain from autoimmune diseases, cancers, etc, when may we expect changes, and what about state laws and limits?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lucy	None	None	0900006484f7ae8b	Burkett	None	2022-02-15T18:36:15Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Burkett, Lucy	kzo-g6y7-j9c3	False	None	False	2022-04-12 01:56:26.559	[]
779	CDC-2022-0024-0785	https://api.regulations.gov/v4/comments/CDC-2022-0024-0785	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Reputable physicians, especially pain care specialists, should be able to use their good judgment to treat their patients as appropriate for that patient. Each patient is an individual with different reasons for pain control, especially for those patients who have permanent injuries/conditions and will need pain management long-term. This also applies to horrific pain caused by cancer, sickle cell disease, rhematoid arthritis, etc.<br/><br/>Since most people who overdose and die from pain medication, 96%, are taking illegal, contaminated drugs they have purchased off the street and not from a pharmacy, why don't you attempt to stop the illegal drug crisis? Illegal drug users do not see pain care specialists to have their pain medications monitored. Why do people who have legitimate pain and not drug additions have to live life in misery because of the people who are not law abiding citizens?<br/><br/>Additionally, why are Medical Malpractice Insurance groups allowed to bully physicians into providing health care to patients "according to their ideas" rather than the physician's personal knowledge of the patient and the patient's needs? Please investigate!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Evelyn	None	None	0900006484f7ae8d	Beebe	None	2022-02-15T18:37:13Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Beebe, Evelyn	kzo-g9nk-nd78	False	None	False	2022-04-12 01:56:26.769	[]
780	CDC-2022-0024-0786	https://api.regulations.gov/v4/comments/CDC-2022-0024-0786	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People in pain should NEVER be denied pain medicine. I have many relatives and friends who are suffering as I write this. To be of help, The CDC NEEDS to assure Doctors that its Okay to treat their pain patients. Doctors need assurance that they WILL NOT GO TO JAIL for prescribing these thousands of year old, life saving opioids. I hear about desperate people with untreated and ignored pain who died trying to quell their pain with bad street drugs. The CDC has the power to change these horrible tragic stories. Please help our doctors treat patients without fear. UNTREATED/UNDERTREATED PAIN IS INHUMANE. When nothing else works, there should be no problem with using the opioids that have been used to help humanity for 5000 years. Thank you for listening to a fortunate pain patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006484f7b19f	Goering	None	2022-02-15T18:48:30Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Goering, Margaret	kzo-gsja-ktip	False	None	False	2022-04-12 01:56:27.027	[]
781	CDC-2022-0024-0787	https://api.regulations.gov/v4/comments/CDC-2022-0024-0787	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While opioid addiction is certainly a scourge, the current prescribing guidelines interfere with a doctor's ability to treat each individual patient accoding to their needs. <br/><br/>I survived a horrendous rollover car crash 3 1/2 years ago and received only Tylenol 3 upon discharge, which was insufficient to curb my pain. I did, however, get an 8-page document from the hospital informing me how terrible opioids are. Sure would have been nice if they had treated my actual problem -- because that pain loop wasn't treated and broken adequately from the start, I now suffer chronic neck and shoulder pain.<br/><br/>In short, it's time to give doctors (and pharmacists) a little more flexibility to help their patients. Vigilance is important, but not at the cost of timely and appropriate patient care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachel	None	None	0900006484f7b448	Zoch	None	2022-02-15T18:50:04Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Zoch, Rachel	kzo-h7ap-4eog	False	None	False	2022-04-12 01:56:27.239	[]
782	CDC-2022-0024-0788	https://api.regulations.gov/v4/comments/CDC-2022-0024-0788	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s unethical and goes against our rights as Americans to involve the government in our healthcare. The government is not doctors. People who actually need pain relief and can’t take NSAIDS are being denied pain medication because the doctors are too scared to write anything. Healthcare has gone down the drain. The government has to live with how many lives are being lost due to the lack of care in healthcare. Let the doctors do their jobs in peace.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484f7bdfa	Bachmann	None	2022-02-15T19:19:09Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Bachmann, Kathleen	kzo-huyk-c35p	False	None	False	2022-04-12 01:56:27.455	[]
783	CDC-2022-0024-0789	https://api.regulations.gov/v4/comments/CDC-2022-0024-0789	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I would like you to know that I, like I am sure the majority of people, would have a heavy handed approach to pain and drug addiction had I not had a sudden onset of GBS Jan. 2018 resulting in unimaginable pain for a *** of about 6 weeks while hospitalized several months and paralyzed for 8 mths . I am a 69 yr. old woman who hesitated to take even OTCs (before they had a bad wrap). I had my first born after 24 hrs. of labor, with no meds, ate organic and did yoga when I was a freak for doing so. OK, you get it. My pain was so severe I begged my beloved husband to help me die. When I finally yelled at the staff that they were heartless, they tied me down, with no sympathy for the level of my pain. I was "crazy." I will get to the point. No one has any IDEA how horrible pain can be unless you experienced it. It is not only HEARTLESS, medical professionals are not doing their job. Yes, I have tried ALL alternatives (and by the way ONLY because I could afford it-as you know another very weak in the lack of help for the ill in the US). I now take Gabapentin, and I am down to 10 MCG pain patch (for which I am treated like I am an addict when approaching any dr. or hospital situation). Sometimes the pain and sickness are manageable now. I am telling you all this to inform you that you have it all wrong and ARE NOT DOING YOUR JOB. You are supposed to HELP those who suffer. The US government (FDA, DEA, etc.) as well as the MDs are contributing to the problem. Do no harm, and help! What I usually get is condescending physicians who have to be concerned the the federal agencies. I must go to a pain dr. because, my two physicians CANNOT dispense pain meds. I hear many hit the street because heroin is cheaper and more convenient. Please, please help those in pain by giving power to the patient and their doctor. Wouldn’t hurt to have government sponsored aide to those addicted.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f7bdde	Carter	None	2022-02-15T20:32:29Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Carter, Patricia	kzo-huqk-6stp	False	None	False	2022-04-12 01:56:27.694	[]
784	CDC-2022-0024-0790	https://api.regulations.gov/v4/comments/CDC-2022-0024-0790	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you from all of us living with constant pain. Our physicians should have the final work on which medications and how much medication is needed on a patient by patient basis. This may actually help prevent patients from turning to other, illegal sources. I personally have never done that, but the thought has certainly crossed my mind many times.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wanda	None	None	0900006484f7c3c4	Goleman	None	2022-02-15T20:33:03Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Goleman, Wanda	kzo-ipxt-efv7	False	None	False	2022-04-12 01:56:27.906	[]
785	CDC-2022-0024-0791	https://api.regulations.gov/v4/comments/CDC-2022-0024-0791	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm in my late 40s with chronic back pain that shoots down one leg from an assortment of nerve issues including spondylolysis, pinched nerves, bulging disks and so forth. It can't be fixed with surgery and I've tried everything from massage and chiropractors to physical therapy and non-opioid medications. The only thing that allows me to go about my day is opioid pain medicine. Otherwise, I probably could not even manage my work-from-home job. About five or six years ago, before the crackdown on prescribing opioids, my pain was managed exceptionally well with a long-acting Fentanyl patch as well as short-acting opioids. The long-acting was taken away, then the short-acting was cut in half. My pain is pretty out of control most of the time. Now I feel like I'm just waiting for doses to again be decreased or taken away altogether. It frustrates me to no end that people who use opioids responsibly for chronic pain are punished for the mistakes of drug abusers. Please give doctors the authority to decide what and how much pain medicine is appropriate for those of us in chronic pain. The pendulum has swung too far and people who need pain medicine to function are living in constant pain because the federal government has decided how much pain medicine we should get, not the doctors treating us. I fear the CDC has already caused problems that cannot easily be undone. Even if these suggested caps are lifted tomorrow, most doctors will be too worried about legal exposure to increase our pain medicine. Please stay out of the business of deciding how we should be treated and stop punishing us for that small percentage who abuse opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deanna	None	None	0900006484f7c454	Morey	None	2022-02-15T20:34:07Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Morey, Deanna	kzo-isr8-jnly	False	None	False	2022-04-12 01:56:28.124	[]
786	CDC-2022-0024-0792	https://api.regulations.gov/v4/comments/CDC-2022-0024-0792	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a CPP for 18 years, I have been discriminated against, laughed at, mocked & humiliated by the US Healthcare system. I have zero criminal record & zero history of addiction or substance abuse. That is somehow overlooked when seeking critical medication to carry out daily life. I believe these cases should be case by case & not government controlled. The anxiety alone each month when having to re prove myself every 30 days is enough to have a significant negative impact on my mental health. Please listen to these people, we are hurting. Period.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7c497	Anonymous	None	2022-02-15T20:34:47Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-iuas-fp74	False	None	False	2022-04-12 01:56:28.359	[]
787	CDC-2022-0024-0793	https://api.regulations.gov/v4/comments/CDC-2022-0024-0793	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm writing in regards to the 2016 CDC prescription opioid guideline & it's revision. In 2008 I discovered I had bulging disks, stenosis, scoliosis & osteopenia. In 2018 I was told I also have arthritis in my spine. Before the 2016 Guidelines my pain was treated & I was able to continue working & raising my son. My pain was never treated to the point of being gone but it was managed enough that I could do most of what I needed to do daily. I did everything that was asked of me by my doctor in the hope that I could improve my spine problems as well as not make it worse. I seeked out all the alternative treatments I could afford such as acupuncture. In 2016 I was forcibly tapered to half in 30 days. My pain flared up & it didn't help that I suffered from withdrawals as well. I became unable to work & my quality of life was greatly reduced. I am either bed bound or in my recliner & I have to choose daily between a shower , cooking, or cleaning any part of my home. I go nowhere unless I have to. I use a tens unit daily & utilize every natural alternative I can afford now which isn't much. My income has dropped to ss only now which is below federal poverty level. <br/><br/>Treatment for my pain should be between myself & my doctor who has known me for over 25 years & long before my spinal issues. It was almost 4 years before my pain meds had to be adjusted & it was for a small increase once. I have tried everything alternative, I've been compliant, I've done the steroid injections, physical therapy & even searched out other drs that I thought might be able to help me but they all told me that they could only keep me comfortable with pain meds. <br/><br/>Since I was forced tapered my life has been at a standstill & my pain is a 6- 7 on a good day. My health has suffered because I'm not able to be active enough. I just want pain relief back. Every day pain is always at the forefront of my thoughts because I can't get away from the high pain level. One size does not fit all & because of the 2016 Guidelines I'm just living a slow painful death. Please, please let our doctors treat us for pain again without having to worry about going to prison, being targeted by DEA & losing the right to prescribe & for patients to not experience the trauma of the DEA raiding their doctors office while there's a full waiting room. There's never a need for this kind of trauma on the sick, disabled & elderly. Please give us our pain meds back & stop the unnecessary suffering forced on millions of legitimate pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484f7c50c	Messinger	None	2022-02-15T20:40:02Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Messinger, Karen	kzo-ixnl-gbti	False	None	False	2022-04-12 01:56:28.577	[]
788	CDC-2022-0024-0795	https://api.regulations.gov/v4/comments/CDC-2022-0024-0795	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 80 year old female. I’ve had surgery on my left ankle for a multiple break requiring the insertion of screws, plates and assorted other pieces of metal. I’ve had my right hip and knee replaced probably the result of being a nurse and on my feet for long shifts. None of this surgery alleviated pain and as I grow older I find daily chores are more and more painful . I now live in a retirement home and my major joy is my little dog. I use a waker and as I grow more and more immobile I fear I will not be able to walk my much loved dog as well as get to the pharmacy and bring groceries up to my room from a somewhat distant parking lot. The “pain specialist” only allows 4 Hydrocodone and 4 amytriptaline a day. In short, life is an endless round of increasing pain not mitigated by the amount of Hydrocodone available with todays government rules . I’ve asked my doctor why there isn’t a role for palliative use of Hydrocodone in a treatment plan for someone who is never going to “get better” and indeed their pain will probably increase with age. The current government rules prohibit consideration of a humane and individual treatment plan for pain.<br/><br/>Please consider the millions of patients like me. I want to continue walking my dog!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joyce	None	None	0900006484f7c631	May	None	2022-02-15T20:42:34Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from May, Joyce	kzo-jc74-wa0g	False	None	False	2022-04-12 01:56:28.800	[]
789	CDC-2022-0024-0796	https://api.regulations.gov/v4/comments/CDC-2022-0024-0796	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient and your morphine equivalent needs to go. You have put my life straight into hell. I lost have of my medications because of stupid guidelines. I can no longer do anything. I can walk can’t help around house. I miss my kids events. I’m amputee that got shot with assault right blew my left leg from knee off. I have severe pain. Your mme messed my life up. People are all different and respond differently to each medication. What helps one person doesn’t another. Or what one is prescribed the dosage doesn’t work for another. These nonsense needs to stop. Let the doctors be doctors that help there patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484f7ac08	Whitlock	None	2022-02-15T20:44:43Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Whitlock , Brian	kzo-jq0v-vgsi	False	None	False	2022-04-12 01:56:29.304	[]
790	CDC-2022-0024-0797	https://api.regulations.gov/v4/comments/CDC-2022-0024-0797	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The progress with the new outline is GREAT! However, the standard MME should be dropped, because everyone is different & everyone’s body is different! There is no “standard” on pain. Everybody’s body metabolizes medication differently and, just like any other medication, different situations calls for different medications & doses!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachel	None	None	0900006484f7cd27	Pender	None	2022-02-15T20:47:25Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Pender, Rachel	kzo-labd-21te	False	None	False	2022-04-12 01:56:29.540	[]
791	CDC-2022-0024-0798	https://api.regulations.gov/v4/comments/CDC-2022-0024-0798	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines will be useful when they are separate for acute vs chronic pain and separate for new starts vs long term prescription opioid recipients. The confusion exists when recommendations for the treatment of chronic pain are applied to management of acute pain. Long term prescription opioid recipients cannot be managed in the same way that new starts would be managed because of opioid induced tolerance and dependence.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A. Kenison	None	None	0900006484f7cb9c	Roy, III, MD	None	2022-02-15T20:48:01Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Roy, III, MD, A. Kenison	kzo-ktkk-ub8t	False	None	False	2022-04-12 01:56:29.770	[]
792	CDC-2022-0024-0799	https://api.regulations.gov/v4/comments/CDC-2022-0024-0799	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My adult son is a T5 paraplegic and has been in this condition for 18 years now at the age of 32. His pain has gotten worse over time and currently it is devastating his life as he spends each day trying to deal with his pain...as he says he feels like he is being tortured every day. We live in Virginia.<br/><br/>He just lost his previous pain doctor as he closed his doors. My son was on extended releases at 36 mg twice a day and had 6 10mg immediate releases per day and his pain was still not being managed or barely managed and he currently has no quality of life each day is minute by minute.<br/><br/>We had to find a new pain doctor; we went to several where they refused to see him because he was on to high of a dose, and we found one that would. This new Doctor which was the only one we found immediately said your doses are too high and i am reducing you and we need to get off of the Extended Releases. The Doctor cut his extended releases in half and left the immediate releases which was a 30% reduction in medication...I told him that was ridicules that he is being reduced because his pain relief is barely effective, and any reduction was not good and 30% is ridicules based on recommendations. He said that is what he will do and that's it.<br/><br/>So my son is now not only not getting the minimal relief he was getting but now has to suffer more and today, the time of this writing, my son kept taking his meds at the previous rate for relief and is now out of his extended releases and were going for a painful week and a half before his next appointment with this Dr who did this to him<br/><br/>My son has said that the only way he gets a few hours of sleep is by using the extended releases at the dosages he was at and were in for a very difficult 1 1/2 weeks. He has stated that he was going to ask friends if they could find anything on the street to help, i suggested that was a bad idea, but what the heck is he supposed to do when you're in such pain.<br/><br/>In trying to find pain doctors and based on the interaction with the recent one we have it seems like they dont want to get on the flag list for DEA and other monitoring when high levels are prescribed...this current doctor even stated that his goal was to get my son off of extended releases and only immediate releases and keep him at 80 MME and possibly up to 120 MME...this does not sound like managing my sons pain it sounds like managing prescriptions to a predetermined safe level that does not get the scrutiny or oversite based on some arbitrary number somebody said was good for everybody...<br/><br/>I want to thank everybody involved in this mess for making my sons life in agony and my life in agony to watch my son cry in pain, scream in anger from his pain, and he even held a bible to his chest and asked god to take him and relief him from the torture...I hope it makes you cry as it does me every day as I interact with my son and see the misery he is in <br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484f7cb80	Lourenzo	None	2022-02-15T20:49:58Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Lourenzo, David	kzo-ksb0-a75a	False	None	False	2022-04-12 01:56:29.996	[]
793	CDC-2022-0024-0800	https://api.regulations.gov/v4/comments/CDC-2022-0024-0800	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Better late then never is what I thought when I read about revising the 2016 CDC guidelines. After being on a stable dose of Hydrocodone (10mg q.i.d) for 18 years due to Complex Regional Pain Syndrome, the NP cold turkey me off my pain medication and anti anxiety medication. She stated she wasn't go to lose her license for anyone even though there are no state laws prohibiting her from prescribing the medication I needed to have some quality of life. I went through extreme withdrawal symptoms about 36 hours later and ended up in the ER. They offered no help there either. After advocating for myself, I was started back on the pain medication at half the dose and no anxiety medication. I had to make a choice which one I suffered from the must. Pain or anxiety? This is no way a human should have e to live their lives. I was stable and had a decent quality of life. In the meantime the CRPS has spread (which it has since the beginning) and I have to live in pain. Why? I can see why some chronic pain sufferers have taken their own lives. It's a shame that people have that kind of power over an individual.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronda	None	None	0900006484f7cb5b	Arroyo	None	2022-02-15T20:51:53Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Arroyo, Ronda	kzo-kqtx-ttlm	False	None	False	2022-04-12 01:56:30.274	[]
794	CDC-2022-0024-0801	https://api.regulations.gov/v4/comments/CDC-2022-0024-0801	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s about time that the people with chronic pain will be getting help instead of being told it’s all in my head!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484f7cea3	Knox	None	2022-02-15T20:54:06Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Knox, Stephanie	kzo-lqb8-km5a	False	None	False	2022-04-12 01:56:30.516	[]
795	CDC-2022-0024-0802	https://api.regulations.gov/v4/comments/CDC-2022-0024-0802	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Family Medicine physician, I believe these new guidelines will cause a new explosion of addiction in American. Current guidelines are just that- guidelines. Not rules. I believe lifting the 90 mmq ceiling will result in patients requesting ever higher doses and physicians having no "back up" to say no. With any medication, a physician can write a higher than usual dose. Anything above an accepted norm always makes us stop and think seriously about it. Please- do not change the accepted norm.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f7cf6c	Rountree, MD	None	2022-02-15T21:16:59Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Rountree, MD, Michael	kzo-lyos-1e8c	False	None	False	2022-04-12 01:56:30.742	[]
796	CDC-2022-0024-0794	https://api.regulations.gov/v4/comments/CDC-2022-0024-0794	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f7c58b	None	None	2022-02-15T21:28:09Z	None	None	0	None	2022-02-15T00:00:00Z	None	CDC is withdrawing this comment to redact the commenter's name and/or location that were included in the comment and will repost shortly.	None	None	None	None	None	None	None	None	Comment from Cast, Judith " Bram"	None	True	None	False	2022-04-12 01:56:30.967	[]
797	CDC-2022-0024-0803	https://api.regulations.gov/v4/comments/CDC-2022-0024-0803	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a pain patient. I have chronic issues including fibromyalgia & chronic migraines. I tried many different therapies, surgeries & medicines other than opioids to control my pain. Many made me nauseous and caused vomiting. Others caused me to faint. The only medicine that truly controlled my pain were opioids. For 15 years, I saw a pain specialist every other month and was prescribed 90 mg of time released morphine. This continued until last year when the supervising doctor told me that I no longer qualified for pain treatment. This happened at the same time that a new PA began practicing in the office. My morphine was cut from 90 mg daily to zero in 21 days. No additional support of any kind was offered to assist in weaning off the medication. The pain specialist refused to fully explain why I no longer qualified to be a patient. The closest I could get to an answer was that my pain was not due to a spinal injury. I was treated by the same MD & PA for the entire 15 years. I took my medication as prescribed, I do not use illegal drugs, never had an overdose issue. I was able to work, be a mom, take care of my aging parents, volunteer in dog rescue. My life was very full. <br/><br/>So now, my GP has agreed to prescribe three 5 mg Vicodin per day. This does little to control my pain, especially in my joints, but it’s better than nothing. I am afraid to consider going back on morphine for several reasons. First, there is so much stigma attached to the use of opiates for pain. With the constant drug testing & pill counting, the implication is that all pain patients are drug addicts and/or drug pushers. Also, a 15 year long doctor/patient relationship can be terminated on a whim. Pain treatment has become so controversial that it’s viewed as borderline illegal. I do not want to enter treatment only to have to stop again because a pain specialist is fearful that they may lose their license or be charged with a crime for continuing to treat me. Finally, the 21 day withdrawal from 90 mg to nothing was extremely unpleasant. I still do not feel back to normal. I have a lot of pain. I’m much more tired than I was when my pain was being adequately treated. I cannot sleep through the night. My life was significantly better when my pain was being addressed. <br/><br/>Changes need to be made to the current pain management standards and how they are applied. Neither pain patients nor pain management specialists should be demonized or blamed for the current illegal fentanyl overdoses. There are millions of people just like me who have been abandoned by their doctors out of fear and misinformation. We are not all running out to find street drugs to replace our discontinued prescriptions. We are just being forced by these circumstances beyond our control to get by as best we can. Our lives are diminished & smaller than before. If this was the desired outcome of these guidelines, then mission accomplished. I would ask you to take a more measured & compassionate approach & trust the doctor/patient relationship to determine the best avenue of care for pain patients. <br/><br/>Thank you for the opportunity to comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7d8d6	Anonymous	None	2022-02-15T21:36:01Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-n5tp-ycv2	False	None	False	2022-04-12 01:56:31.444	[]
798	CDC-2022-0024-0804	https://api.regulations.gov/v4/comments/CDC-2022-0024-0804	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Bravo! Severe pain patients won't have to suffer endlessly anymore!<br/>Thank you!<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith " Bram"	None	None	0900006484f7d216	Cast	None	2022-02-15T21:38:57Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Cast, Judith " Bram"	84f7d216	False	None	False	2022-04-12 01:56:31.696	[]
799	CDC-2022-0024-0805	https://api.regulations.gov/v4/comments/CDC-2022-0024-0805	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	1. Too many nursing directors at nursing homes take the patient's opioids. 2. Patients abusing alcohol a lot of time are so because of underlying chronic pain. No one screens for that. 3. Suboxone works for fibromyalgia, a subset of women who were just given opioids for long periods. The group of women who could be on Norco their entire pregnancy and no one cared. 4. The leading cause of death is opioids purchased on the street, not from a provider 5. No doctor has a screening tool to see when patients have been exposed to opioids- like a smoking history- most of the time, patients are chronically depressed because someone took their opioids away. 6. Why are we still focusing on opioids when stimulant deaths are soaring. Stimulant deaths laced with Fentanyl. 7. Fentanyl urine checks should be available at a pharmacy for harm reduction. 8. Funding for opioid care goes to the county level and never reaches the patients. Small programs are not getting the money. 9. Addiction treatment needs to be revamped. It's old and outdated. 10. How is it ok to take someone's opioids away and put them on high doses of antipsychotics and gabapentin and Seroquel? 11. Why can't patients on state insurance get their medication covered by ANY prescribing provider? A patient saves enough money to see an addiction provider and then gets to the pharmacy, and it's $300. There are so many cracks in the system. So much money is being lost. I mean, if we give patients needles and crack pipes as harm reduction, you would think we would give them their medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ce9d	Anonymous	None	2022-02-15T21:42:03Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-lq0t-r48n	False	None	False	2022-04-12 01:56:31.928	[]
800	CDC-2022-0024-0806	https://api.regulations.gov/v4/comments/CDC-2022-0024-0806	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Saying a Chronic Pain Patient has Opioid Use Disorder is the same as saying a Diabetic Patient has Insulin Use Disorder.<br/>Opioid Use Disorder is a made-up term to label anyone and everyone who has ever taken a pain pill for any medical reason an addict. That way #Eugenics based Hate Groups like PROP/Remmler/ASAM/Shatterproof can make profit off the patients suffering. <br/>Long Term Opioid Therapy gives Quality of Life to patients with incurable painful diseases. There is Data to prove my statement. Without Long Term Opioid Therapy most if not ALL chronic pain sufferers will lose all quality of life and have 3 choices; Turn to street drugs, Live in unrelenting Agony, or Suicide. <br/>After surgery a patient should receive treatment with opioids to ease the pain in order for the body to focus on healing. Without it patients can develop permanent chronic pain because the body is not focused on healing. After surgery if the pain is not treated then the patient can or will die from preventable complications. <br/>Most if not ALL Acute and Chronic Pain Sufferers Have and Will Benefit Greatly from Opioid treatment. <br/>Myself as an example: Physical Therapy, Acupuncture, Meditation and Holistic Remedy cannot treat incurable diseases like Ethers Danlo Syndrome, Degenerative Disc Disease, Lupus, Fibromyalgia, etc. There is No Exercise, Holistic Gimmick, Deep Breathing, Positive Thinking or Prayer that can "Cure" crumbling vertebrae nor can it "Cure" Arthritis.<br/>Please for the sake on 40+ million Americans suffering from acute or chronic pain take to heart the Un-Biased Data that proves opioid therapy gives Quality OF Life to patients to mind. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484f6a0f4	Sisk	None	2022-02-15T21:44:57Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Sisk, Melinda	kzh-9o16-lp3x	False	None	False	2022-04-12 01:56:32.157	[]
801	CDC-2022-0024-0807	https://api.regulations.gov/v4/comments/CDC-2022-0024-0807	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a myriad of diseases starting with breast cancer, liver & kidney dis, autoimmune dis, post shingles neuralgia, CRPS neuropathy from a re-injury sustained in 2017. I had(and have) been blessed with 2 very concerned & caring rheumatologist, past & present from 2012 until today, who do rx opiate pain meds for me. I have been on the same dose for 7 of the 10 yrs. Every pill I take around the clock (I get 5 a day) helps take the scream out of this horrific pain I would not wish on you, the reader or my enemies. I suffer GERD for which I am on PPIs @80mgs daily, therefore I TRY never to take ibuprofen. I can only have 2Grams Tylenol but as with a compromised liver, I choose not too. My mother died of metastatic ca. She also had ens stage RA but never took more than Tylenol arthritis bcux her VERY CONSERVATIVE rheumatologist said that's all she needed. Being from the old school, she trusted her drs. So much so that when they blew off her cough for 3 yrs as "post nasal drip" & gave her Zyrtec, she abided by her Drs orders & never questioned him. It wasn't until she was in rehab for stroke that i demanded a CT of her chest which the hospitalist called & stated "your mom has mets cancer encroaching into her stomach which is probably why she hasn't been able to eat for months" she died 3 days later. Did I sue her Dr? No. Would it bring my beloved mother back? No. My point? Drs, & "well meaning so called "Pain Specialists" working on the revised 2022 opioid gdlns, should never have been allowed to write the 1st draft much less be allowed to sit again at the same table & cause more harm to the already suffering thousands of pain pts that the 1st 2016 gdlns destroyed, & killed by way of force tapers, cut offs, low mme thresholds, specifically specialists taking the CDC recommendations totally out of context of the well thought out well informed scientific backed studies (none,0 done of which included chronic pain pts) as LAW & caused the ruination of the ppl in this country whose daily lives have 0 QOL, left flailing around like half dead fish on a dock waiting to die. This is how I feel every day being that I'm under treated due to same. My Dr feels at this point I'd be better served if he increased my dose or added a pill but states he can't, his hands r tied due to the govt interference in his practice of medicine. He's more than qualified to make a judgment yet he isn't allowed bcuz the DEA threatens Drs who rx pain meds with loss of license & income & scares them half to death w/threats of jail. In Portugal & other countries where decriminalization exists, there is no higher drug use amongst teens or others with the exception of ADDICTS. Pain pts r not addicts. Let me say that AGAIN. WE R NOT ADDICTED TO OUR MEDICATION. We may DEPEND on our meds & our bodies do build a tolerance BUT, we work thru that with other means of coping. IF we can't get a correct dose & MOST OF US DON'T, we make do with what we DO have, but we don't seek to get high, we don't go on corners to buy drugs, inject drugs, transmit blood borne diseases, steal, lie, destroy our families. That's what the small % that started with pain meds (they didn't, they just LIED & say they did) want ppl like [NAME redacted] & [NAME redacted], others who've lost children sadly to illicit street drugs & those with vested interest in drugs (Suboxone etc)for adxn & rehab centers want everyone to believe. Well, we don't. I know of ppl in my age group 60+ who have been put on Suboxone post knee surgery only to find out later they've been flagged (they r really sweet elder ppl that have no earthly idea what's going on) or put on drugs like gabapentin (one that nearly killed me & doesn't work) their lives now ruined & have to either take the Suboxone or go home & suffer in silence. <br/>We want the MME THRESHOLD TO BE REMOVED, every BODY is different & tolerates & metabolizes medication differently. It is not necessary to have a PDMP OR URINE DRUG SCREENS FOR THOSE OF US THAT TAKE OUR MEDS FOR YEARS w/o incident, w/o diversion, w/o calling in for refills early, going to multiple pharmacies etc. We don't need any of those & we don't need PAIN CLINICS. Those drs r only interested in giving DANGEROUS INJECTIONS of steroids into our spines (one Dr punctured my dural space causing post headache requiring ER VISIT & BLOOD PATCH. They cause arachnoiditis as well as introduce bacteria, cause infection etc & make the drs VERY rich. Let's be frank. It's time for the federal government to get out of our doctors offices let our Doctor's practice medicine ethical doctors I should say, and to abide by all laws and regulations that they are sworn to by hippocratic oath, not forced on by the government. The CDC has no business mandating what doctors do with our care neither do the insurance companies nor the pharmacies. The mme threshold is a terrible marker for one-size-fits-all. Please take my thoughts into consideration when finalizing these guidelines thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7c4c7	Anonymous	None	2022-02-15T21:47:58Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-ivhe-f3mb	False	None	False	2022-04-12 01:56:32.388	[]
802	CDC-2022-0024-0808	https://api.regulations.gov/v4/comments/CDC-2022-0024-0808	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sucks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresz	None	None	0900006484f7b5e2	Morgan	None	2022-02-15T21:48:42Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Morgan , Teresz	kzo-h9rs-jqk0	False	None	False	2022-04-12 01:56:32.662	[]
803	CDC-2022-0024-0809	https://api.regulations.gov/v4/comments/CDC-2022-0024-0809	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an acupuncturist practicing in Colorado, and have seen over my 10 years of experience, that acupuncture is a low risk, cost effective and fabulous modality used to treat acute and chronic pain. There are Chinese herbal formulas that help the healing, and the actual act of needling help give clients relief. Acupuncture has been able to last for a few centuries. This fact alone shows its efficacy. If it didn't work, it would not have survived. In the modern era, research has been able to show the mechanism of action when one receives acupuncture and demonstrates the scientific efficacy. Acute pain is really easy to treat with acupuncture and most clients see dramatic results when they get acupuncture close to the date of injury. Chronic pain has more dynamics involved within it, and each client has three areas to treat to relieve pain. We as acupuncturists treat the whole person, and those three layers I argue we treat to help clients in chronic pain is to treat the spiritual/emotional, internal medicine/inflammation, and the physical layers. As we address all of these layers in a client, they gain relief. To what degree of relief is always dependent on the case. I strongly advise the CDC to incorporate acupuncture into these new guidelines. I see it every day, and see how this modality can help clients. Its not the end all be all fix but it does plug in really well in a well balanced treatment protocol. Any questions can be asked through Healing Path Acupuncture in Colorado. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f7c55c	None	None	2022-02-15T21:50:32Z	Healing Path Acupuncture	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Healing Path Acupuncture	kzo-j23s-lmhk	False	None	False	2022-04-12 01:56:32.894	[]
804	CDC-2022-0024-0810	https://api.regulations.gov/v4/comments/CDC-2022-0024-0810	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Right before Christmas of 2020 I started experiencing severe pain in my neck. I had already had two previous neck surgeries so I knew this wasn’t the normal chronic pain which is bad enough but pain that got worse and worse and ended up being intractable. My neurosurgeon who I had seen prior to this refused to prescribe any pain medication. I also went to see my primary care doctor who also refused to prescribe any pain medication. I was referred to a Pain Management Clinic but was not able to get an appointment until three weeks later. So for three weeks I was in intractable pain with no relief. I obviously lived through it but that experience alone left me with Medical PTSD. I did need surgery because I had a Ruptured Disc, Pinched Nerve that was being compressed by bone and severe narrowing of the spine. Did I mention Degenerative Disc Disease (this was my third neck surgery). I had my third neck surgery on 2/10/21. I assumed that after surgery my pain would be controlled. I was so wrong! I woke up in the hospital after surgery in so much pain. It was more pain than I had ever experienced after surgery! Besides the three neck surgeries I’ve also had several other surgeries for other health conditions. When I told tfw nurse how much pain I was in she told me they had me on a Tylenol Drip! I demanded to speak with either my surgeon or the charge nurse. Someone from the hospital pharmacy came and talked with me and I was able to finally get some pain relief but even then it was no where near controlled. It was a constant fight to get the hospital to give me pain medication when it was due. I basically had to either threaten to speak to someone in charge every time. It was an awful experience and one I wouldn’t wish on my worst enemy. After I was sent home from the hospital (2 days later) again I assumed I would have adequate pain medication to control the postop pain. I was prescribed about 3-4 days worth from my surgeon which 3-4 days after a Posterior Neck Surgery like I had was not nearly enough. Then I was required to go back to the Pain Clinic for further help with the postop pain where again my pain was not controlled! I am so thankful that I have not needed opiate pain control since then but I constantly have anxiety over the next time I might! I mean what’s going to happen? Will I not be treated at all?! I can’t go without telling you that I also have struggled with addiction at times in my life. Also in that time before I had this neck surgery and the three weeks that I had suffer before I could get into the Pain Clinic I got desperate! I hadn’t wanted to look for pain pills on the street in 20 years but my pain was so intense I felt like I had no other choice. At this time I had not heard of the Illicit Fentanyl being put in pills sold on the street (probably because prior to this I had no idea I would be resorting to this) and I feel extremely lucky and blessed that fentanyl wasn’t in the five pills that I was able to purchase. The more important point here is that as someone who has struggled with addiction in the past the last thing I wanted to do was to to search for and by illegal pills off the street! In conclusion I not only went through severe intractable pain with improper treatment which was nothing short of torture but was forced to go against what I believe in as a recovering addict.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f7c715	Duncan	None	2022-02-15T21:54:12Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Duncan, Susan	kzo-jl16-92b6	False	None	False	2022-04-12 01:56:33.128	[]
805	CDC-2022-0024-0811	https://api.regulations.gov/v4/comments/CDC-2022-0024-0811	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to include language in the updated guidelines acknowledging the numerous harms done to healthcare professionals, specifically Pain Specialists, secondary to the egregious 2016 CDC Opioid Guidelines. These flawed 2016 guidelines precipitated a witch-hunt perpetrated by The Department of Justice and The DEA against well intentioned physicians practicing their trade leading to irreparable harm to the chronic pain community. Forced tapering, patient abandonment and suicides are 100% the responsibility of the CDC. Shame on you and on the dilettante PROP members for these weaponized bogus 2016 guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christopher	None	None	0900006484f7ab76	Russo	None	2022-02-15T22:01:29Z	None	None	1	None	2022-02-15T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Russo, Christopher	kzo-bh7a-fikd	False	None	False	2022-04-12 01:56:33.386	[]
806	CDC-2022-0024-0812	https://api.regulations.gov/v4/comments/CDC-2022-0024-0812	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is [redacted]. I would like to comment on Docket No. CDC-2022-0024. As a Patient with Chronic Pain, living in [redacted]. Back in 2018 my Primary Care Physician was Forced by Medicaid and the Exiting Governor Eric Greitens to STOP Prescribing me Opioids or Risk losing his License to Practice Medicine in MO. I was sent to a Pain Management Doctor who knew that I had been taking these Medications since the 1990's for an Injury to my Back and Knees. I have Levoscholeosis, Sciatica, Schmorl's Nodes, Degeneration of lumbar or lumbosacral intervertebral disc, bulge of lumbar disc without myelopathy, narrowing of spinal canal, narrowing of lumbar spine, joint disorder, lumbar root disorder, no disc between L-3 & L-4, L-4 & L-5, rounding or balling of L-2 to L-3. Similar issues with the Thoracic and Cervical Spine regions. The Pain Management Doctor that I was sent to Automatically cut my Dosage in Half, and I was right at the 90 MME per Day limit. Which caused my Quality of Life to begin to Diminish. I was in too much Pain to even be able to do Half of the Household Chores, let alone want to go out to a Dinner or anything else. He continued to Cut my medication Dosage until I'm living with a constant Runny Nose, Nausea, Diarrhea, Very Irritable, Fever that comes and goes. Blood Pressure raising and lowering, Dizzy Spells and Fainting with elevated Vital Signs. In my opinion and the opinion of several Physicians that I've spoken with, " Patients like myself that have been taking these Medications for Decades, and Don't Abuse Them, but Take Them Exactly As Prescribed, Don't Go Out Searching for More Than Prescribed, it's more Detrimental to Our Health to Remove the Medication or Lower the Dosage than to leave it as is." I'm having to drive 2 hours away from home to a Pain Management Doctor now, to be able to get my Medication adjusted to a strength that works for both, Pain Management, and To Keep Withdrawals and Adverse Reactions from not having the Medication. I Definitely Got Rid Of The Other Pain Management Doctor that kept cutting back my Medications. Not to mention, not only was he cutting back my Medications, " There Wasn't Any Titration, it was just quietly taken away from me and I wouldn't know until I looked at the Prescription after I left the Office." No, discussion with me about lowering my Dosage or anything.<br/> I was to the point of going to the black market to get the medication that I needed. When a person can't stand up without being in pain, can't walk without dragging a leg, and only gets 2 hours of sleep per day, I think Someone has Overreached on their Authority to Regulate the Healthcare of Another Human Being.<br/> The CDC, Board of Medicine, even a person's Physician Don't Have To Live In The Body Of That Patient And Feel What They Are Feeling !!! Please, show some Compassion and allow the Primary Care Physician, or Pain Management Doctor to Prescribe the Medication the Patient Needs.<br/> Have the Patient to Sign an Affidavit releasing the Physician from ANY and ALL Responsibility's of Addiction or Other Potential Harmful Side Effects from the Opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f7eabd	Keller	None	2022-02-16T13:04:16Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Keller, Michael	kzp-jdtn-bg24	False	None	False	2022-04-12 01:56:33.617	[]
807	CDC-2022-0024-0813	https://api.regulations.gov/v4/comments/CDC-2022-0024-0813	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Each person is an individual & experiences pain at different levels. An arbitrary limit of pain medication is preposterous. No one can experience another's suffering and none of us are exempt from the possibility of unrelenting chronic pain. I myself exercise, use heat and ice, have nerves burned and major surgery to ease pain but still have to resort to an opioid to be able to function. With restrictions to the treatment (mme) I am at a loss as that's my only option fir relief of severe pain as is for many other Americans. It's inhumane to cause human suffering when there is relief available.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ea7c	Anonymous	None	2022-02-16T13:04:40Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-j0ga-7aeb	False	None	False	2022-04-12 01:56:33.856	[]
808	CDC-2022-0024-0814	https://api.regulations.gov/v4/comments/CDC-2022-0024-0814	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ever since I was abandoned by a Navy doctor, whose specialty is OB/GYN, my quality of life and high impact chronic pain has suffered. Because of the CDC 2016 Guideline, my Navy doctor cut me off from receiving any further prescriptions of 225 MG ER Morphine for my chronic pain. In addition, she abandoned me and forced me into opioid withdrawals without any support or treatment. For over 23 years, I served my country as a US Marine, defending our country from all enemies foreign and domestic. All of my chronic pain is due to several service connected injuries and disabilities. Now that I am medically retired and receive 100 % disability from the VA and SSA, the same government that I swore to defend, has decided to abandon me as well. The CDC has placed chronic pain patients into two groups! One group is those patients who suffer from cancer or end of life issues, the other group are patients like me who suffer from high impact chronic pain from disabilities or injuries. The human body does not distinguish between the two, chronic pain is chronic pain! I guess, what the CDC Guideline did to millions of chronic pain patients, like me, is considered collateral damage. The CDC didn’t use science or long term studies to warrant a 90 MME threshold for all chronic pain patients. The CDC simply, grabbed a threshold or number out of nowhere - a number that was and still is questionable. Because of the unethical way that the CDC pushed an unscientific guideline down the throats of millions of chronic pain patients and hundreds of doctors, patients that deserve to be treated fairly and ethically have been abandoned, forced tapered, and some have even committed suicide. I did everything by the book! I followed all of my previous doctors orders, never doctor shopped, never failed a random drug test, never diverted my pain medication, and never came close to an overdose. But, because a government agency, that had no business of getting involved with a doctor patient relationship and the prescribing of opioids for chronic pain, responsible chronic pain patients are now suffering. This kind of treatment towards chronic pain patients is not only a travesty, but is unethical and inhuman. The FDA is supposed to be the government agency in the US that makes the decision as to whether a particular drug is beneficial or not - do the benefits outweigh the risks? The CDC has not only harmed millions of chronic pain patients who depend on opioid pain medication to help manage and control their pain, the CDC is also solely responsible for the unnecessary deaths, by suicide, of military veterans who suffered from service connected disabilities or injuries. Why has it taken the CDC over six years to correct a wrong that it created? I honestly hope and pray that this new update will allow chronic pain patients to receive the pain medication that they deserve and need and that the prescribing of opioids gets put back into the hands of doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484f7ea36	Collins	None	2022-02-16T13:06:23Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Larry	kzp-i36j-54x6	False	None	False	2022-04-12 01:56:34.083	[]
809	CDC-2022-0024-0815	https://api.regulations.gov/v4/comments/CDC-2022-0024-0815	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There should not be a MME limit. You all are killing prople. Get out of the doctor's exam room. Chronic pain patients deserve the relief opioids provide. The limits force people to the black market, which if filled with deadly synthetic opioids. Opioid prescribing has dropped precipitously but overdoses have skyrocketed. Your approach isn't working. It's killing people. No MME limits. Let doctors treat their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e9d4	Anonymous	None	2022-02-16T13:07:09Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-h1qp-uc1q	False	None	False	2022-04-12 01:56:34.342	[]
810	CDC-2022-0024-0816	https://api.regulations.gov/v4/comments/CDC-2022-0024-0816	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think the guidelines do need review, but The prescribers need reviewed also. Working in pharmacy, I have seen too many unqualified health professionals prescribing massive opioids all under the supposed watch of one MD. How can one MD supervise 10 or so NPs, PAs etc to accurately assess a patient’s pain without the NPs and PAs having formal training. When all the rxs from one group are all alike for all their patients- one suspects these MDs of not adequately evaluating the patient individually, but more feeding a habit. The pharmacist is getting attacked by DEA and lawsuits- but no one blames the prescriber.<br/>We need to weed out the bad MDs that give everyone a bad name, and require other presribers to have more training on opioids. Our country uses more narcotics than the rest of the world- isn’t that a red flag itself? Perhaps these guidelines will help those in pain without enabling those that are drug seeking.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484f7e9c5	Lipasek	None	2022-02-16T13:07:44Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Lipasek, Pam	kzp-ggcp-4n1p	False	None	False	2022-04-12 01:56:34.626	[]
811	CDC-2022-0024-0817	https://api.regulations.gov/v4/comments/CDC-2022-0024-0817	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines are responsible for countless deaths of patients in pain, addiction for pushing some patients to the streets, dishonesty of medical personnel who keep writing "drug seeker" codes in our records and enriching those who profit from these lies. Please get rid of these guidelines and STOP tormenting legitimate patients in pain for profit.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paulette	None	None	0900006484f7ee78	Barton	None	2022-02-16T13:08:00Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Barton, Paulette	kzp-dsmt-rjmj	False	None	False	2022-04-12 01:56:34.865	[]
812	CDC-2022-0024-0818	https://api.regulations.gov/v4/comments/CDC-2022-0024-0818	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m tired of feeling like I’m not doing the right thing when all I’m trying to do is recover from my addictions! I am on siboxone have been for 6 years and the entire time i was deceived and become addicted! My clinic has repeatedly made me feel like a failure bc they think they know everything there is to know about the medication i have been taking for many years! I don’t feel i can trust a single doctor out here to the point i have neglected my own health! I’ve watched cancer patients suffer and die from a disease that takes in millions every year! I’m pissed bc i didn’t ask to become addicted to suboxone! I though I’d be on and off it in two years bc this is what i was led to believe! My teeth have completely rotted into my gums and I’m so afraid to even get them done bc i can’t trust doctors ! And the CDC guidelines makes everything harder for the doctor and patient both! Start caring or stop profiting ! Period<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashley	None	None	0900006484f7ee76	Ross	None	2022-02-16T13:08:39Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Ross , Ashley	kzp-diw1-eyti	False	None	False	2022-04-12 01:56:35.091	[]
813	CDC-2022-0024-0819	https://api.regulations.gov/v4/comments/CDC-2022-0024-0819	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a pharmacist, and a chronic pain patient for 8 years, I believe the pain level experienced by the patient has to be the first consideration looked at. I have tried multiple NSAIDS, anti-convulsants, anti depressants (ssri snri tca muscle relaxants physical therapy acupuncture exercise TENS AND OTHER MODALITIES. The opioid pain relievers do a much better job of relieving the nerve pain I have than any aforementioned modalities. Restricting their use with appropriate counseling and avoiding poly pharmacy is essential , but when I’m told by my pain Doc that the push is to reduce dosages, without reason of concern if overdosage, is not realistic. Is the CDC or practicioner going to lessen my burden at work or home while decreasing med dosages. The idea of cutting doses to fall in line with some arbitrary guidelines, when the dosages used have never reached to 50% reduction in pain as a goal since inception is short sided and detrimental. How many of the authorities dispensing guidelines would like to trade 1 week, née 1 day with me and see if they feel the same way. When a dosage increase is even brought up to a pain physician, it is not even listened to for fear of “violating “ guidelines. Listen to the patients , especially the informed ones, and let the doctor decide on therapy without fear of Big Brother looking over their shoulder.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronald	None	None	0900006484f7e967	Buckley	None	2022-02-16T13:09:21Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Buckley, Ronald	kzp-8k2l-0ara	False	None	False	2022-04-12 01:56:35.319	[]
814	CDC-2022-0024-0820	https://api.regulations.gov/v4/comments/CDC-2022-0024-0820	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, to whom it may concern,<br/>I am a chronic pain patient. I was diagnosed with juvenile arthritis and Ehlers Danlos syndrome when I was 13yrs old. I tried the gamet of medications such as but not limited to: Mobic, meloxicam, celebrex, diclofenac, relafen, gabapentin, enbrel, humira, cymzia. I also have pseudo porphyria related to NSAIDs so I can no longer take any form of NSAID and that includes simple ibuprofen. I started physical therapy when I was 11 for my joint and pain while I was in between diagnosis’. I continued physical therapy all the way until I was aged 23. It did not work, it did nothing for me, only made my pain WORSE. But I was following my drs orders. Around age 15yrs old I was started on remicade infusions I get those still to this day through a port in my chest every 4wks. I also was started on methotrexate that makes me extremely sick. I throw up for days. But I am still taking it to try and treat my pain as proscribed by my dr. So fast forward to now. I am age 29yrs old. I have bi-lateral pars defects in my hips, degenerative disks in my back, osteoporosis (I’m only 29), I still have STILLS disease which is juvenile arthritis which I did not grow out of. I have kyphosis, lordosis, Chiari malformation. And cervical spine instability. I was also just recently diagnosed with Fabry disease and I found out I have a rather large bone tumor in my pelvis they are testing it to find out if it is cancerous or not. So given all of this. I was proscribed opioids. I take my medicine 2x a day as needed. I have NEVER abused it. I don’t even take it every day. I take it when I have unbearable pain days. When the CDC changed their laws. My dr then said oh let’s go back through all of the other first hand treatments again because “maybe your body changed with age and you haven’t done those treatments in a long time.” So AGAIN I was thrown into physical therapy, oral steroids (I have steroid induced diabetes so when I have my steroids I need insulin as well), and gabapentin. Well let me tell you guess what. It does not work. It only makes my pain 10x worse when I come home from PT I can barley move. The pain is so severe I have to take my pain medication. But before the CDC changed the laws. I didn’t and don’t need it that often only when my pain is extremely severe. By throwing me into PT again I needed it more. So my dr and I agreed that pt was doing more harm than good and I have stopped. So, in some cases in people like me, though I may be young I have tried everything and I am responsible, I do not and will not ever abuse my medication. In people like me, opioid medication is needed. By the way. I take a low dose. I am on 5mg of oxycodone 2x a day as needed. And well I don’t take it everyday as I said I only take it when I am in extreme pain. I would say to make the laws up to the Drs choice and given the Patience to dr relationship. Let them make the decision and use their discretion. And allow what needs to be proscribed to be proscribed. <br/>Thank You <br/>Sincerely, A Young complex chronic pain patient	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ee41	Anonymous	None	2022-02-16T13:11:03Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-7oay-ospn	False	None	False	2022-04-12 01:56:35.587	[]
815	CDC-2022-0024-0821	https://api.regulations.gov/v4/comments/CDC-2022-0024-0821	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in health care for many years, and I remember when the guidelines were changed and those who had chronic pain were having a hard time getting their medications. It was sad to see the stories of some of my patients. Based on the comments I heard it should be obvious that for those with severe pain, those harsh rules actually pushed people to do something to relieve their pain they normally would not have done, such as buying those drugs they could no longer get, on the street. Pain management patients have had so many hurdles to deal with from the stigma attached to being in pain management, to healthcare providers treating them like "drug addicts" to having their meds constantly switched around or jerked out from under them, and more. I understand there are concerns with narcotics such as misuse, overdose and such, but the thing that has been lacking in pain management is a great deal of education. A 1 page hand out at your first visit is not sufficient. Most all people who do overdose on narcotics, do not want to die, nor are trying to commit suicide, they just do not know that if you mix this medication with this for example, this will slow respirations and you could die. When patients start pain management, no one really tells you anything (other than a pain contract is signed). I have seen some horror stories from these pain mgmt. offices such as a 78 yr old woman was called in for a pill count and given 2 hrs. to get there. She no longer drove a car, and had to find a ride, but could not find one within 2 hours and was kicked out and left to suffer. Another went to stay with her mother in the hospital and left 1 of her pain meds at home and forgot to take it during the stress with her mother, and took a urine test the next day, and was kicked out over not having the short acting one in her system, even though she explained her situation. Stuff happens, emergencies happen, yet they are given no consideration. The current scale should be changed, its out dated and we now have medicinal marijuana dispensaries popping up everywhere and yet archaic pain management rules. Patients and providers should have a video, power points and take home journals, with Q&A or something like that. There is not enough education amongst providers (regarding proper and kind, understanding treatment of these patients) nor patients. Most patient want to be compliant but there are no contingencies for everyday life situations and just when people get to doing good on a med regimen, it seems NP's and MD's at PM get scared and want to start cutting down patient meds, then the patient has setbacks and quality of life goes down, pain goes up and it is a setback for the patient. MD's need to have more leeway and decide each case individually, not a cookie cutter approach to pain medicine. Cookie cutters belong in the kitchen, not the health care providers office.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ann	None	None	0900006484f7ee2f	Voss	None	2022-02-16T13:12:28Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Voss, Ann	kzp-6jih-17be	False	None	False	2022-04-12 01:56:35.844	[]
816	CDC-2022-0024-0822	https://api.regulations.gov/v4/comments/CDC-2022-0024-0822	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines have been treated as laws by many physicians. This has injured and killed many chronic pain patients via suicide and escalation of illness due to the stress of 24/7 uncontrolled pain. Its the pain of an initial injury, a heart attack, a broken arm, having the flu, a migraine, the worst pain you can imagine all day every day for years and looking fone on the outside. Its being told you must accept that life is pain and just deal with it that makes living with illness or injury even harder. No one is asking to be pain free, just to have a quality of life. The MME guideline isnt backed by any study, it is an arbitrary number that appears to be plucked out of thin air. Physicians have been force tapering patients as much as 100mgs at one time forcing them into withdrawal and serious illness because they are afraid of what will happen to them as opposed to the damage it will do to patients. There is no patient centered language nor care anywhere in these guidelines. Please go nack to the drawing board and allow physicians to make the decision as to what suits each individual patient for medicine. Please stop punishing chronic pain patients for the opioid crisis that is really an illegal drug crisis. There are huge differences between being addicted and living to take a drug verses being dependant and taking a medication to live so you have a quality of life. Dropping Chronic Pain Patients lower when they are already suffering is asking for more suicides and a direct impact on our workforce. We dont expect to be pain free, we just want to function at a level that is bearable. That decision needs to lie with us and our doctors not with an arbitrary number. <br/><br/>The so called experts arent experts until they have walked in our pain filled shoes. Chronic Pain Patients are the experts on pain. We are who you should be listening to.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shylo	None	None	0900006484f7ed26	Ferguson	None	2022-02-16T13:13:33Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Ferguson, Shylo	kzp-5clk-3812	False	None	False	2022-04-12 01:56:36.121	[]
817	CDC-2022-0024-0823	https://api.regulations.gov/v4/comments/CDC-2022-0024-0823	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe that one of the biggest changes that will help is the tailored dosing. When I was prescribed opiates in the past I was lucky to have the benefit of knowing how addictive it is to not feel pain and that there is not one dose that works for everyone. This is something that plagues the entirety of our healthcare system. For example, if I go into the hospital with nausea I am given a 25 mg tablet of promethazine yet, I only generally take half of a tablet . I have taken them before and a whole tablet was not needed and just adds to the side effects, the same is true with opiates, even the Dr looks at you funny if you crack apart a pill in the Emergency Room. <br/><br/> People often take their medicines as prescribed by the Doctor, because they trust them to be correct. If they are told they need 5 mg of hydrocodone they take 5 mg, instead of tapering up from 1/2 a tablet or 1/4 of a tablet at a time until the pain is manageable. Also, one of the other issues I have seen is that alot of people have no idea what PRN means. When a person sees that they should take a one Vicoden every X amount of hours PRN they believe it is the same as being told to take Amoxicillin 500 mg every 8 hrs. Sure, in the office the Doctor may tell them as needed but when they read the bottle to them it says something different because of the way it is worded. I have seen alot of elderly patients get confused by this especially when taken multiple medicines.<br/><br/> I believe that instead of turning opiates into this evil thing if we can just tailor doses and still prescribe them frequently in small amounts at small dosages we would do a world of good in helping to treat pain while still trying to control the potential for addiction as opposed to looking at them as if they are evil or even a last resort in most cases. <br/><br/> My biggest problem with the last resort method is it puts a stigma on something that truly can help and sometime forces people to have to take pain relievers that do more harm than good like prescription NSAIDS for those with stomach issues or steroids for people who are diabetic. We have reduced our arsenal of helpful drugs and are now prescribing things that may be more dangerous. Also, when we remove those two there are very few medications left to actually treat pain. <br/><br/> In conclusion, I believe we should keep opiates fairly accessible but in small doses, with alot of information on what is "As needed", change the labeling, and use them for as short a time as we possibly can and make sure that people are doing therapies while on these medications. Opiates are not the problem our inability to properly administer the medication and monitor the patient is. We hand them the medication and throw them out the door, when they come back as an addict we then wondered how this happened and then point the finger at a medicine. <br/><br/> With smaller doses and fewer pills and proper patient monitoring and repeat visits for pain management instead of assembly line doctoring we could prescribe opiates quite often and still see a major reduction in addiction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Clay	None	None	0900006484f7ed19	Richardson	None	2022-02-16T13:14:43Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Richardson, Clay	kzp-4xww-wf9j	False	None	False	2022-04-12 01:56:36.360	[]
818	CDC-2022-0024-0824	https://api.regulations.gov/v4/comments/CDC-2022-0024-0824	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Public Participation Comments - https://www.regulations.gov <br/>Federal eRulemaking Portal: http://www.regulations.gov. Follow the instructions for submitting comments. <br/><br/>RE: [FR Doc. 2022-02802 Filed 2-9-22; 8:45 am] <br/>Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). Agency/Docket Number: <br/>Docket No. CDC-2022-0024 <br/>Document Number: 2022-02802<br/>Document Citation: 87 FR 7838 <br/><br/>Public Comment submitted by:<span style='padding-left: 30px'></span>..., Woodstock, GA	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484f74359	Hamilton	None	2022-02-16T14:52:59Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hamilton, Judy	kzl-rhda-fb5i	False	None	False	2022-04-12 01:56:36.622	[]
819	CDC-2022-0024-0825	https://api.regulations.gov/v4/comments/CDC-2022-0024-0825	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom this may concern,<br/>I am an American citizen who is concerned about how my country is going to be fighting the Opioid Crisis. In 2016, while volunteering at a drug and alcohol detox unit, I witnessed the opioid epidemic and decided right then to do something about helping people with pain. My research of scientific articles led me to pursue the study of Chiropractic, which I believe, and evidence shows is one of the answers to the fight against opioids.<br/>The CDC’s guidelines for chronic pain include treatment options such as physical therapy, exercise, nonopioid medications, and CBT. The research coming out the Veterans Affairs Hospitals is showing that patients who received chiropractic care had a lower frequency of opioid use (1). The VA utilizes an integrated approach to deal with pain (2). This approach includes chiropractic treatment. Research indicated that patients with spinal pain who saw a chiropractor had half the risk of filling an opioid prescription. Among those who saw a chiropractor within 30 days of diagnosis, the reduction in risk was greater as compared with those with their first visit after the acute phase (4). The CDC guidelines unfortunately do not mention chiropractic at all. This is going to have a huge impact on whether patients use Chiropractic care for pain. <br/>I have volunteered at detox centers since 2015, and what I have noticed is that especially when it comes to opioid addiction, patients are not given ways to treat existing pain. Most patients are treated like they are liars and don’t experience pain at all. Although the CDC’s 2016 guidelines were meant to help ad heal, the previous guidelines have not worked, as these patients have been denied access to opioids all at once and this has forced a good percentage of them to find their own way to get opioids. There are many detox centers across the country and many of them advertise having chiropractors on their staff to deal with pain. I have called almost all of them to see if I could talk to the chiropractor on staff. I always end up learning that they either falsely advertised, or that they offer massage therapy or that they have a chiropractor who shows up only very rarely. With this reality in mind, I have had to start a non-profit of my own. With limited resources, two of my friends and I are starting a non-profit to combat the opioid epidemic in the Chicagoland area. Here we will be using chiropractic, cognitive behavioral therapy, teaching patients technical skills to get jobs (if needed) and recommending 12 step programs if necessary. As the model to treat opioid addiction is failing, citizens like us are having to do what the government and organizations such as the CDC should be doing already. We don’t know if our non-profit is going to work or not, but we had to do something because we can’t sit on the sidelines and watch the opioid epidemic destroy countless lives. I apologize for sounding frustrated or angry. I am neither. I am just trying to do what I believe and what research shows, is the way to go about this crisis.<br/>Please take the time to review the research that states that Chiropractic care can reduce opioid usage and please add Chiropractic care to your guidelines for alternative treatment for pain.<br/>Sincerely,<br/>[name redacted] D.C.<br/>Bibliography. <br/>1.<span style='padding-left: 30px'></span>https://pubmed.ncbi.nlm.nih.gov/30203014/<br/>2.<span style='padding-left: 30px'></span>https://www.va.gov/painmanagement/docs/vha09paindirective.pdf<br/>3.<span style='padding-left: 30px'></span>https://www.va.gov/painmanagement/docs/vha09paindirective.pdf<br/>4.<span style='padding-left: 30px'></span>https://pubmed.ncbi.nlm.nih.gov/32142140/<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	O	None	None	0900006484f78260	Siddique	None	2022-02-16T14:58:50Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Siddique, O	kzn-4bbt-fv0a	False	None	False	2022-04-12 01:56:36.864	[]
820	CDC-2022-0024-0826	https://api.regulations.gov/v4/comments/CDC-2022-0024-0826	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [REDACTED], I am 56 years old and have obtained CRPS in February of 2018 after a nurse slammed IV phenergan into my R hand IV line which then blew and the medicine burned everything in it’s path. I then required 6 surgeries after that to fix everything. From there I developed CRPS in both feet due to IV sticks and also my ribs on the left side due to a fall. I also have it in my back but it’s not confirmed yet. I am allergic to all NSAIDS which limits what I can take. I beg of you to please don’t make this change as I am only able to take opioids and muscle relaxers. I can be reached at [REDACTED] if you have any questions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sue	None	None	0900006484f740c5	Russell	None	2022-02-16T15:00:28Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Russell, Sue	kzm-1j66-htjt	False	None	False	2022-04-12 01:56:37.104	[]
821	CDC-2022-0024-0827	https://api.regulations.gov/v4/comments/CDC-2022-0024-0827	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Torture: any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions.<br/>As a responsible 61 year old adult woman and retired RN and mother of 2 children and CHRONIC PAIN SUFFERER, I include the definition of torture here for a purpose. <br/>The original CDC guidelines and even any further "guidelines" has caused torture to so many people who have chronic pain. The government overreach, laws enacted, and the irresponsible actions by the DEA has caused more torture for people with incurable diseases which cause them chronic pain that the word torture is entirely appropriate. <br/>The CDC has been irresponsible because they have blamed opioid deaths on the legitimate prescribed and regulated Opioids and not on the real culprit, which is the most deadly ILLEGAL Chinese FENTANYL which pours into this country. The fact that the CDC has not put out a Public Service Announcement warning the general public about the real cause of most deaths which is the ILLEGAL FENTANYL is unconcionable!<br/>The CDC blamed deaths on MDs who help treat pain, blamed the Sackler family, blamed the patients who suffer pain, when the blame must go directly to the ILLEGAL Chinese FENTANYL and the inaction of any federal agency of not warning the general public!!! <br/>The CDC must NOT continue to "guide" physicians in any amount of opioids which an MD feels is proper to prescribe to help a chronic pain patient lead a quality life. <br/>NO MME must be discussed nor "guided" because every person is different. Every body weight and reaction to an opioid is different! <br/>I have had 3 surgeries in my lifetime due to chronic diseases and when I have had proper pain management I've recovered quicker and my physical therapy has gone smoother and I have been able to improve my ADLs and activity much faster when properly treated with proper pain management through my sacrosanct MD/patient relationship with my MDs and my surgeons. <br/>The CDC must stop advising MDs on any amounts of opioids! The CDC must acknowledge that the deaths that have occurred are mostly from the ILLEGAL Chinese Fentanyl and NOT legally prescribed and properly prescribed medication from our MDs. <br/>Not only have chronic pain patients suffered unnecessarily due to the "guidelines" but acute and surgical pain patients have also suffered "torture" at the direct hands of the CDC, the government overreach and the DEA!!!! <br/>That a surgeon is afraid to provide proper pain management (often Opioids) post operatively is unconcionable!!! <br/>That a dentist is afraid to prescribe an opioid for a major tooth extraction is unconcionable!!!! <br/>That our physicians are afraid to lose their licenses because they fear the loss of their licenses due to the DEA (who has no oversight) threats and attacks and imprisonment is unconcionable!!!!<br/>The CDC must allow the MDs who go through years and years of medical training to practice how they see fit. Opioids are just a tool, which if used appropriately can improve a patient's quality of life, improve a patient's ability to perform ADLs, and improve a patient's ability to often return to work. <br/>The CDC must stop PROP as they have taken advantage of this situation, and many PROP physicians benefit financially through the prescribing of suboxone and through "treatment clinics". This behavior by PROP is unconcionable!!!<br/>As a chronic pain sufferer, I have never once abused any medication, I have endured random drug screening, endured NarxRxcare program, endured forced tapering, endured a total hip replacement without proper pain management! I have endured torture! <br/>The CDC must stop! <br/>[name and telephone number redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f7f527	Aellig	None	2022-02-16T15:01:52Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Aellig, Debra	kzp-nhek-wu86	False	None	False	2022-04-12 01:56:37.356	[]
822	CDC-2022-0024-0828	https://api.regulations.gov/v4/comments/CDC-2022-0024-0828	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The regulation of opioid needs to be at the discretion of the physician. I have seen my wife who has multiple spinal afflictions suffer because she has used up her allotted monthly supply. The physician on the other hand is overly cautious in the said prescription so as not to fall under government scrutiny. I think there should be a viable answer in treating chronic pain with opioids and the government should respond to physician's input.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Greg	None	None	0900006484f7f525	LaFrance	None	2022-02-16T15:02:07Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from LaFrance, Greg	kzp-nh07-olx4	False	None	False	2022-04-12 01:56:37.589	[]
823	CDC-2022-0024-0829	https://api.regulations.gov/v4/comments/CDC-2022-0024-0829	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient with chronic nerve pain, the 2016 guidelines have derailed my life. It's so unfortunate that lives have been lost due to the underprescribing of the only medications that have worked for millions of people. I hope it doesn't take another 6 years to turn things around.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alta	None	None	0900006484f7f518	Hanlon	None	2022-02-16T15:02:16Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Hanlon, Alta	kzp-nbid-q94y	False	None	False	2022-04-12 01:56:37.847	[]
824	CDC-2022-0024-0830	https://api.regulations.gov/v4/comments/CDC-2022-0024-0830	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think it's a great idea to ease prescribing for opiod. Fentanyl and herion used have killed many people who really needed opiod for their health situation. There are many opportunities to treat opiod addiction today then there was 10 years ago. If it's needed recommend patients to that. Being strict with this medicine is not the way. Fentanyl is becoming the norm and more death will be expected because the cartels will fill the role of prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Demarcus	None	None	0900006484f7f516	Griffin	None	2022-02-16T15:02:29Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Griffin , Demarcus	kzp-n9j9-e32m	False	None	False	2022-04-12 01:56:38.087	[]
825	CDC-2022-0024-0831	https://api.regulations.gov/v4/comments/CDC-2022-0024-0831	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In my opinion, the CDC Guidelines NEED to be REDRAWN completely. Especially since the CDC has NO RX authority whatsoever! Only the FDA and the FDA alone has this authority!<br/><br/>They have only caused me harm both directly and indirectly through my terrified-of-the-DEA physician when he felt he was was forced to taper my higher-dose opioids, which had been working for many years with NO trouble. 4 days after I was abruptly withdrew, I had a stroke in my early 30s. I still have some residual effects from that stroke a few years later. My pain is still undermanaged a bit with a Medtronic pump, but I've been told by several pain clinics that it's either that or very ultra-low dose opioids with never-ending steroid injections in my spine and in certain joints. I have developed Cushing Disease as a result of countless steroid injections over several years since these harmful guidelines were used by DEA to go after and arrest our pain physicians for just doing their jobs!<br/>I want and NEED to have my old life back with my old meds back which I know worked for many years. Even my current pain physician acknowledges I'm right but he/she is too terrified of the DEA because they get threatening letters from the DEA and they're quoting these guidelines as if they're an actual law, even when it isn't!<br/>Please just retract the guidelines, and/or help us hold the rogue DEA accountable for terrorizing our trained physicians! All of this is the direct cause of hundreds of suicides due to uncontrolled and unbearable pain which has been left under/un-treated. Thousands more have died from pain related complications such as heart attacks, strokes, etc caused either directly or indirectly from under/un-treated severe chronic intractable pain.<br/>Please allow the FDA to take over these very harmful "Opioid Guidelines" and help us to put a stop to the rogue-DEA, who have been threatening physicians for simply relieving untold amounts of pain. Please work with us and help put a stop to this harmful madness to American's health, just because they live a life in severe chronic/intractable pain and NEED daily opioids in order to be functional with a decent Quality Of Life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484f7ece2	Nunn	None	2022-02-16T15:03:11Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Nunn, Christina	kzp-l61c-eyij	False	None	False	2022-04-12 01:56:38.357	[]
826	CDC-2022-0024-0832	https://api.regulations.gov/v4/comments/CDC-2022-0024-0832	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	hair transplant clinics are responsible for this?<br/><br/>https://hairtransplant-turkey.net	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7eaf2	Anonymous	None	2022-02-16T15:03:23Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-jry8-wl08	False	None	False	2022-04-12 01:56:38.589	[]
827	CDC-2022-0024-0833	https://api.regulations.gov/v4/comments/CDC-2022-0024-0833	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	hair transplant clinics are responsible for this?<br/><br/>https://hairtransplant-turkey.net	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7eaf1	Anonymous	None	2022-02-16T15:03:41Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-jry5-5m2t	False	None	False	2022-04-12 01:56:38.836	[]
828	CDC-2022-0024-0834	https://api.regulations.gov/v4/comments/CDC-2022-0024-0834	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronically ill person/patient. I have several diagnosed conditions that have no cure and have completely taken over my life. I have had 9 surgeries, and more are possible in my future. I have a rare spinal injury now that will never go away; it can only get worse and can eventually leave me paralyzed. Since 2016, trying to find a doctor to properly treat my pain has been [word redacted]. We are looked at as statistics. A drug seeker. Offices, nurses, and doctors judge you before words even come out of your mouth. PEOPLE LIKE ME, CHRONICALLY ILL with debilitating dx, and symptoms are in [word redacted]. There IS a DIFFERENCE between an addict and a chronic pain patient. One doc asked if I had a super power. What would it be? I replied that I wish I could touch people and let them feel the pain that I feel every day. Most people wouldn't be able to handle it. I've had people say to me how, "How do you do it?" My answer. Because I have too, I don't have a choice. This is my life. Doctors and medications are also a big part of my life. Taking away and limiting the one thing that makes us feel human is cruel. Not allowing doctors to prescribe for after surgerical pain should be in jail. I have had 5 brain surgeries and 4 spinal surgeries. Not by choice, but to have some quality of life, these were beyond necessary. If I were told that I was being sent home with Tylenol and Ibuprofen, I would have an advocate and a lawyer in that hospital so fast. I think that many of you have this twisted idea of opiates and chronic pain patients/people. Yes, we are people. We are NOT addicts. We want to live. We want some resemblance of a normal life, as normal as it will ever get for us. And then it's taken away snaps fingers just like that. Who DOES that? I'll tell you. Someone who has NO IDEA WHAT WE GO THROUGH minute to minute. Hour to hour. YOU HAVE NO IDEA WHAT OUR LIFE IS LIKE. BECAUSE YOU NEVER HAD TO LIVE OUR LIFE. I honestly wonder how you sleep? What HAPPENED to you when you went into politics? Did you lose your humanity? What if this was you? Or your mother? Your wife? Your child? Would you then see from our point of view? And have to go through the lengths and hoops we have to go to? Just to survive and have one day just live with a moderate amount of pain instead of bedridden pain? Because of these horrid laws doctors have become more for their bottom line and keeping themselves out of jail or being prosecuted for prescribing proper pain management that they now have a disconnect with their patients. Because of these laws I went from being on 2 or 3 medications. To being on 30. Most of them were anti depressants. That don't treat pain!!!! I am now in the process of getting that number down and trying to heal my mind after all unnecessary medications that I was put on, because I didn't have access to the ones that I actually needed. We are human beings; we deserve proper pain control. We deserve to have a life. A voice. To those who have been that voice for us, thank you will never be enough. But taking the time to write a comment about my experience and others and say the MME guideline is absolutely ridiculous (along with most of this original proposal that hindered my life and so many others) that I can do. And will cont. To do. I hope you all find your humanity and start listening to the people who are struggling. You made a mess. You thought you were helping and made one [word redacted] of a mess. More people have died under your 2016 guidelines than before they were written. Now, it's your turn to listen and do what is right.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7f558	Anonymous	None	2022-02-16T15:07:19Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-o2op-huus	False	None	False	2022-04-12 01:56:39.076	[]
829	CDC-2022-0024-0835	https://api.regulations.gov/v4/comments/CDC-2022-0024-0835	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived for over 30 years with severe head pain due to a TBI suffered when I was electrocuted. Contrary to what "experts" say, it took a decade before I found a pain mgt doctor willing to prescribe long-term opioid therapy. I was with that doctor for over 16 years, and that period of time was the best I felt. For 16 years, I was prescribed the same exact dose/strength of pain medication without any issues related to addiction. However, due to the 2016 CDC Guidelines and the fact that the DEA used them to persecute doctors, that doctor was arrested in 2018 and is still imprisoned. The 4 years since that happened have been extremely detrimental to my life. I've had to travel across the USA (on Social Security LTD income) to find doctors willing to prescribe the same dise/strength of pain medicine. I'm now on my 3rd doctor in 3.5 years. However, in September of '22, a DEA agent told my current doctor that one of my meds "is only intended for cancer pain". Because of that specific intimidation, my doctor immediately stopped prescribing those meds. I have now been cutoff from 80% of the same meds I'd been prescribed since 2002. I am now barely living, praying daily for God to bring me home.<br/><br/>My last "comment" regards the use of MME in determining "safe dosages". My condition requires high dose/high strength medication. If the CDC had always insisted on using MME for prescribing pain meds, I would have given up 20 years ago. The use of MME is a ruse. It is NOT based on legitimate science. Each individual should have access to whatever medication helps them. What the CDC is doing by using MME in ALL of its "Guidelines" should be criminal. MME is meaningless. But what the CDC is actually saying is that people like me, who suffer from great pain, are the ones who are actually meaningless. It's sad to say, but my own government could not care less about my suffering. My own government is KILLING ME.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Danny	None	None	0900006484f7f556	Elliott	None	2022-02-16T15:07:59Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Elliott, Danny	kzp-o27z-jhpt	False	None	False	2022-04-12 01:56:39.318	[]
830	CDC-2022-0024-0836	https://api.regulations.gov/v4/comments/CDC-2022-0024-0836	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First I will start off by saying look at the suicide rate since the Crack down of all this! I have heard my mother who can barely walk due to chronic back/leg pain if she loses her meds she will end it all! As a suffering person myself I as well rely heavily on my meds to do daily chores even to just walk I rely on them! So I can honestly say I understand we're my mother is coming from as bad as it hurts to hear her say it! People do not stop to think how much people like us truly need these medications to do our day to day living. All they look at is these people with their addiction and oh we need to Crack down when WE HAVE TO SUFFER FOR THEIR HABITS!!! Ask yourself how fair is that? I have been under a pain docs care since 1998 and my illness just keep getting worse no matter what surgery I have had, no matter what therapy I have tried I have even paid out of pocket for stretching of my spine for the insurance didn't cover it so don't think for a second people who are on these medications for REAL PAIN do not need them and haven't tried options! However do not punish us all either because I'm telling you now the suicide rate is going to surpass numbers unlike ever seen before!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484f7e9dd	Lyons	None	2022-02-16T15:08:30Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Lyons , Donna	kzp-hebt-8wg3	False	None	False	2022-04-12 01:56:39.559	[]
831	CDC-2022-0024-0837	https://api.regulations.gov/v4/comments/CDC-2022-0024-0837	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 65 year old female Chronic Pain Patient. I was seriously injured in a pedestrian accident 02/06/2005. A vehicle hit me as I was walking out of Lowes in the crosswalk by a SUV backing up in which it slammed me down underneath the buggy I was pushing. I received a closed head injury where I lost my speech and cognitive, I had a herniated disc in my neck at C 5-6, ruptured 3 discs in my back L3-4, L4-5 and L5-S1 and a sprained right wrist. I had neck surgery in June 2005 in [city redacted] AL by Neuro-surgeon [name redacted] due to being misdiagnosed by a board certified Emergency Physician in [city redacted] AL. I went to speech and cognitive therapy for 9 months to retrain my brain, I could add, subtract, spell, speak, I didn’t know a key on the piano in which prior I taught piano lessons, I could not clap to a beat, nor could I type on my computer; I lost everything cognitive and speech. I was misdiagnosed in [city redacted] again and flew to [city redacted] TX to Texas Back to get a correct diagnosis. 7 days later I had 3 level back surgery where I was opened internally by a vascular surgeon and an orthopedic surgeon. I had to get injections in the side of my head up to the crown of my head in [city redacted[to be able to have the swelling go down every two weeks. I was 48 at the time and my life was turned upside down. I had major depression, saw a local psychiatrist where she placed me on Paxil and Wellbutrin. I was also place on Brand Name Klonopin to assist with my head pain. My psychiatrist explained Klonopin was being prescribed for my head pain, it originally came out to treat seizures. I was referred to Pain Management in [health facility name redacted], I was evaluated by [name redacted]. I was prescribed (2)two opioids a day of Endocet 5/325mg. Given a muscle relaxer Zanaflex 4mg 2 tablets a day And was given multiple lumbar and cervical epidurals, SI joint injections during the years of being a patient. I was a compliant patient, brought my medications to every visit although my medications were never reviewed by a nurse or medical assistant nor were they ever counted. I was never weighed nor did I have my blood pressure taken to get a BMI. I can remember at one visit, after. A procedure, my Blood Pressure was over 200/100 + . No one called 911 to have EMS assist me. I was told to go to the ER in [city] in which no one came immediately to assist me, after waiting over 2 hours, I took a Klonopin and decided to ride home with my driver. I have passed every Urine Drug Screen and never called in between appointments. One winter, I requested [name redacted] could he prescribe me one more pill during the winter months. He immediately shouted at me “No Ma’am” and I promised myself I would never ask for any increase of my Endocet 5/325mg. I went every year for my appointments until 2019, I was asked to pick between My Klonopin or my Endocet, that I could not take both. I told my physician he knew why I was being prescribed Klonopin for my head pain and swelling and this was not an option for me. He said I could not take an opioid with a benzodiazepine. Again I reminded my physician I was not being prescribed Klonopin for anxiety, it was for pain on the right side of my brain for head pain and swelling. Let me back up [name] found large lipomas resting on my hardware. I had to see a general surgeon to have the lipomas surgically removed. I had three putting pressure on my lumbar hardware, one the size of a softball, the other two the size of boiled eggs, I had one laying on a nerve the size of an egg at the inside bend of my left arm. After having these four lipomas removed, my surgeon told me I could not have any more procedures in my neck or back, that the steroids were creating these lipomas. This was a horrible surgery to get over. I asked if my physician wanted me sign a release for my medical records and he stated he didn’t need my medical records. My physician never requested a copy of my labs, surgical reports from my neck and back surgery. In 2016, I saw my cardiologist due to chest pain and acute pain in my left side of my neck going up by head, I had a heart cath and ended up with 3 stents in my LAD, the widow maker. I was very fortunate to have lived through 90+ % of blockage. I asked at my next visit if my doctor wanted me to sign a release of my surgical heart medical records and he stated he didn’t need them. BUT all of a sudden at that exam he wanted to increase my mg of pain medication. I stated why would you want to offer me an increase now but you wouldn’t when I was suffering. There’s was no explanation except you just have heart surgery and I need to increase your pain medications. He tried me on OxyContin 10mg and it was like taking a placedo, it did absolutely nothing for me. I want you as the CDC to know that your changes in 2016 just about killed me. I have extremely suffered in pain and with increased depression. I have no life, I cannot function like I use to be very active. Shame on you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f7ee09	Shedden	None	2022-02-16T15:12:41Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Shedden, Patricia	kzp-5n3x-8poj	False	None	False	2022-04-12 01:56:39.871	[]
832	CDC-2022-0024-0838	https://api.regulations.gov/v4/comments/CDC-2022-0024-0838	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Mental health is a problem for those In Need of depresion and anxiety medications such as zanax or lorazepam. I was able to balance my life with pain and help me with my mental issues. How can people just say okay you have to give up one or the other. There is nothing there to help people in that situation like myself. I was only taking 2 mg a day and I had to give it up. No one really thought about the patients they just thought about the junkies that they want to try to save and I have compassion for people but regardless of where they get it a junkies going to get it up I	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ed13	Anonymous	None	2022-02-16T15:12:54Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-4t0h-adn8	False	None	False	2022-04-12 01:56:40.104	[]
833	CDC-2022-0024-0839	https://api.regulations.gov/v4/comments/CDC-2022-0024-0839	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The last guidelines caused a lot of harm to chronic pain patients such as myself with a rare spinal deformity that will continue to get worse as I age the only way I can function on a daily basis and have any quality of life is with opioid medication which I will periodically need increases in for the rest of my life. You state that you realize the harm your previous guidelines caused with dosage limits but at the same time you have reduced it from 90mme to 50 mme this makes sense to you???? You have doctors cutting people's pain meds operating on patients and not giving out any pain medication afterwards cancer patients who have been cut off from their pain meds etc from the last guidelines all while the number of overdose deaths have continued to rise (obviously not from pain patients prescriptions) and you think stricter guidelines are the answer? How is anyone supposed to seriously comment on that except to say that you obviously don't care about how much suffering you are causing I have never taken my medication except as prescribed and do not deserve to have it restricted because someone else has	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lysia	None	None	0900006484f7ed0a	Gilmore	None	2022-02-16T15:13:17Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Gilmore, Lysia	kzp-4hkk-4ctm	False	None	False	2022-04-12 01:56:40.337	[]
834	CDC-2022-0024-0840	https://api.regulations.gov/v4/comments/CDC-2022-0024-0840	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since 2002. I have had every medical intervention more times than I can count, including two back fusions, injections of many kinds, nerve burning, facet and epidural, a procedure to help remove scar tissue caused by the many injections, and many diagnostic procedures. Nothing has ever given me any relief except opioid pain medication. I have been a model patient. Never refusing appointments, pill counts, or urine screens. I have never failed one test. But, like thousands of chronic pain patients I have been force tapered to a very minimal amount of daily opioids. My quality of life has been stolen from me. I rarely get out of bed. I go to my once monthly pain management appointment to again be reduced time and time again. However, you can say I am one of the lucky ones as I was not forcibly removed all at once. There are so many of us that are living this reality. I am being denied basic rights to quality healthcare and freedom to live a good quality of life. So many of us suffer daily in horrendous amount of pain. I mean the kind of pain that never stops, never lets up, never has any mercy. I sometimes wonder if I should continue on this path of overwhelming suffering. I have however, have some hope that this time the CDC will stop with the lies, with the junk science and every wrong statistic or wording that has been used in the past that will prevent this suffering. I have hope that someone will allow doctors to treat chronic pain patients without threat of losing their livelihood and the hope that one day I will be allowed to have a quality of life again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484f7e8fd	Bradley74	None	2022-02-16T15:13:45Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Bradley74, S	kzp-49qy-51xj	False	None	False	2022-04-12 01:56:40.605	[]
835	CDC-2022-0024-0841	https://api.regulations.gov/v4/comments/CDC-2022-0024-0841	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new guidelines have been sorely needed for six years. I commend the CDC for hearing the voices of those most negatively impacted by the 2016 guidelines, chronic and acute pain patients (and to a lesser but still significant extent, their friends and families). The "dangers" of opioid medications prescribed and taken as needed pale in comparison to living with debilitating pain, as seen by the escalation in suicide rates in chronic pain patients and the increase in overdoses caused by tortured patients turning to dangerous street drugs instead. Moreover, these "dangers" are based on unsubstantiated junk science studies that detractors have spread in order to advance their various agendas. <br/>Stay the course. Please continue this positive, evidence-based, humane line of work and address the similar crisis occurring among anxiety patients with the similarly draconian actions that have arisen around benzodiazepines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e8f6	Anonymous	None	2022-02-16T15:14:01Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-405x-diey	False	None	False	2022-04-12 01:56:40.868	[]
836	CDC-2022-0024-0842	https://api.regulations.gov/v4/comments/CDC-2022-0024-0842	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescription opioids have been extremely beneficial to me as a disabled patient with a painful genetic disorder. Prior to treatment under careful supervision of a pain management team, I was unable to work or function with more conservative treatments. I had tried an extensive variety of OTC and prescription medications, as well as other therapies and treatments. Due to the nature of my disorder, I experience dislocations, sprains, cartilage tearing and other injuries very easily. Along with this, there are a handful of comorbidities common to the disorder that are also painful and debilitating. While counseling, compression, heat, ice, mindfulness, and other tools are always valuable, they are only part of the approach to treat the symptoms. The pain is real, and unique to each person. Pain should be treated individually.<br/><br/>Opioids are a valuable tool along with all of these other methods to treat patients. Because patients have individual, specific needs, providers should be able to address their patients' needs appropriately. The MME limits should be regarded on an individual basis, instead of having a low limit that will harm countless patients. Removing these restrictions allows providers to provide individuals with individualized, patient-centered care. <br/><br/>For me, long-term prescription opioid therapy has given me independence, improved function, the ability to work and contribute to my family and society. The pros greatly outweigh the cons and when I look at the bigger picture as a disabled person trying to navigate life, work, and family, opioids have been one tool, a necessary tool, that have made a difference in my ability to move through the world.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e8f2	Anonymous	None	2022-02-16T15:14:22Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-3x3r-l87g	False	None	False	2022-04-12 01:56:41.101	[]
837	CDC-2022-0024-0843	https://api.regulations.gov/v4/comments/CDC-2022-0024-0843	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Comments are in context on the document but summarized here:<br/><br/>1.<span style='padding-left: 30px'></span>In key areas seem to be missing goal directed care and instead favors functional outcomes. Patient goals are mentioned at times, but lacking at other times. Being sure that the measured functional goals or QoL metrics are individualized to a patient’s perception of their care needs is crucial.<br/>2.<span style='padding-left: 30px'></span>Lack of discussion/mention of step-wise approach to pain care. This is mentioned in post-cesarean section pain management but not in other areas. The shot-gun approach when using CIH is frequently noted in practice and can be a waste of resources, impose time and cost burdens to patients. <br/>3.<span style='padding-left: 30px'></span>Acupuncture is included in non-invasive, non-pharm. Acupuncture is invasive. So maybe at some point mention that acupuncture was put it into this category because of the low risk nature of the procedure that would help identify that the understanding it is invasive. <br/>4.<span style='padding-left: 30px'></span>Suggest alpha ordering approaches throughout the document when they are listed unless they are trying to rank them in a way that indicates some are favored over others (?). Sometimes massage is first, sometimes another approach is first, does that mean there is better evidence for massage?<br/>5.<span style='padding-left: 30px'></span>Finally, made a comment about imprecise description of sham acupuncture definition (mimics acupuncture but should have not benefit) the non-specific benefit of a penetrating needling away from acupuncture points can obscure the meaningful differences between sham and verum acupuncture.<br/> <br/>It is a great document that is quite valuable and good for CIH use!<br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Juli	None	None	0900006484f753d0	Olson	None	2022-02-16T15:15:57Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Olson, Juli	kzm-s9ua-1b5o	False	None	False	2022-04-12 01:56:41.388	[]
838	CDC-2022-0024-0844	https://api.regulations.gov/v4/comments/CDC-2022-0024-0844	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The government needs to stay out of our doctors offices. [name redacted] has conflicts of interest and should not be involved in this at all. People involved in the rewrite of the 2016 CDC guidelines should not be addiction doctors, they need to be pain management dr's. Biggest concern for me is even bringing up a maximum MME. You are stating 50 MME. History should tell you that this will be used as a hard limit. You should remove any mention of limits ANYWHERE.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f7894e	Giles	None	2022-02-16T15:17:01Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Giles, Linda	kzn-av7b-2z12	False	None	False	2022-04-12 01:56:41.626	[]
839	CDC-2022-0024-0845	https://api.regulations.gov/v4/comments/CDC-2022-0024-0845	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern. I’m writing in response to the 2022 CDC opioid guidelines. While I see some improvement in wording I’m not sure I see much in change. The mention of 50MME must be eliminated. First any MME isn’t based on any science. From what I can find is 120MME was mentioned in a meeting and 90MME was settled on. Where is the science on MME? Everyone reacts differently to medication so individual care is needed not 50MME. What will happen just like your 90MME it will be used as a set in stone policy. I live in WI who went even farther when it was 90MME WI went to 50MME. What will happen here is WI will go down even farther. You have seen the damages done by saying voluntary 90MME so why even mention 50MME? It must be removed!<br/>Then as I read I see your still conflating OD deaths with illegal drugs and polysubstance OD’s. People like me who are 56 and in need of pain control were never the ones overdosing but your recommendations have had drastic effects on my life. I have personally had my pain management clinic shut down because of the DEA taking your recommendations as a iron law. Many physicians have been harmed and sent to prison because they want to treat their patients. Is this what you intended to happen? It sure looks that way when you mentioned 50MME. Please stop the madness. Another point I would like to make is why is [name redacted] in any form having anything to do with these guidelines a second time? First he is an anti opioid zealot. Second he has conflict of interest that needs to be addressed. Third since when can someone write something like the guidelines and use mostly his work to justify his actions? This is simply wrong. If you are to have any credibility with the CPP community he must not be anywhere near the new guidelines. He did enough damage his first time with the 2016 guidelines. <br/>I do think your strong wording saying these are not laws or hard limits is great. Thank you. My recommendation are as follows. 1. Remove any mention of a MME. 2. Refine your data to show prescriptions OD’s who had a active prescription, no polysubstance OD’s because we all know it doesn’t say take with alcohol, cocaine or other drugs. Opioids have helped hundreds of millions worldwide safely and effective. <br/>3. Keep [name redacted] away from the updated guidelines he has done enough damage. Your credibility is on the line along with my life.<br/>I thank you for trying to address the 2016 guideline damages. But you need to do better. <br/>Sincerely, <br/>[Name redacted] <br/>About me. I am a 56 year old male. I have had 7 spine surgeries and 14 fusions. When my spine started to fail I was 27 I didn’t require around the clock pain medication for 20 years. As my disease progressed at the age 47 it became impossible to work. I was on a stable dose of pain medication but, with the 2016 guidelines that all changed. After my pain clinic was shut down by the DEA it took me years to find a physician who didn’t say I understand why your in pain but I can’t help you. Now I found a physician who is willing to help with a very small dose of daily pain medication. Like I stated earlier I live in WI who took your 2016 guidelines as iron law and went even farther with a 50 MME limit. I now receive 5mg oxycodone 3x a day. It’s not enough to give me any resemblance of a life but it is enough from keeping me from stopping the pain permanently. No I don’t have suicide ideation. One it’s against my religion and two I don’t want to leave my family with that destruction. However without the small dose of pain medication the pain would kill me one way or another. My new physician will only prescribe that dose because of the WI state guidelines. <br/>It’s time to stop this madness. As my disease is progressing I will need better pain care. <br/>If you only consider one of my suggestions please the 50MME needs to be removed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f772ca	Curtis	None	2022-02-16T15:19:16Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-14T05:00:00Z	None	None	None	None	None	None	None	Comment from Curtis, Robert	kzn-dqmr-xgda	False	None	False	2022-04-12 01:56:41.854	[]
840	CDC-2022-0024-0846	https://api.regulations.gov/v4/comments/CDC-2022-0024-0846	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m currently 67, wife of a veteran, and have been in chronic pain since 1991. It took several doctors years to finally diagnose my degenerative disc disease. It took even longer to find a drug that actually helped, one I believe the Sacklers are in trouble for. I lived in California then but the direction my home state was going (and the after effects of 9/11) caused our family to flee to Louisiana. My California doctor (a primary care physician) warned I’d have trouble finding a doctor to help with my kind of pain. He was right. I found just one an hour from our home but there were dozens of patients waiting hours each visit and he had partners in fields like psychiatry we had to see before he would dispense prescriptions. I felt he was padding services to bill my insurances. I and other patients discussed our displeasures with how we were being treated. The doctor didn’t like it and I soon received a letter from him saying I had 30 days to find another doctor, so I looked for another pain management specialist. I found just one who was in [city redacted], 3 1/2 hours drive one way. He’d previously been an anesthesiologist so I felt secure. The patient load was just as bad, if not worse, and the wait time was between 4 and 6 1/2 hours. This made those trips between 11 and 13 1/2 hours long every 30 days! It ended for all of us without notice the day we arrived for our appointments, doors closed, no one inside and no sign on the door. We all stood around waiting for awhile, exchanging phone numbers in case we found another specialist to share. I found out in 2021, while googling his name, that he’d killed one of the patients through neglectful practices during one of my visits with patients like me in his waiting rooms. It took a few months for me to find my current specialist, months of torture. My current drive is 2 hours one way to [city redacted]. Fortunately, she writes 2 scripts at 30 days each so we only have to make the trip every 2 months, plus we usually get out in about an hour. I undergo nerve ablation every 12 to 18 months for additional help that lasts about 6 months, but it’s not enough to completely take away the pain. With medications my pain level is usually between a 4 and can go as high as 8-9 before ablation. As we get older it’s harder and more exhausting on us to make these 5 hour days. It takes a day or 2 to recuperate. THERE HAS TO BE A BETTER WAY. I’ve always had a high pain threshold, thank God, because I might have joined him without the minimal access I’ve had here. Thirty-one years of constant pain in varying degrees is more than most can tolerate, and that doesn’t count the pain from 2 bad knees plus a herniated disc trying to flatten my spinal cord in my neck. NSAIDs can’t be used for anything due to Stage 3 kidney disease. I may not be a typical chronic pain patient but I’m caught up in the nonsense of CDC dictates which are so rigid people like me have turned to street drugs for relief - no doctors to keep us from overdosing, exposed to unregulated drugs. Of course, most of us are just peons, barely able to afford meds even with insurance (as many of my neighbors don’t have). Government elites forget us, ignore us, don’t care we exist until election days, then step on us after. If any of you reading this are one of us, you understand. The others never will.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Theresa	None	None	0900006484f7e8d1	Warden	None	2022-02-16T15:21:19Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Warden, Theresa	kzp-32yv-ksrg	False	None	False	2022-04-12 01:56:42.083	[]
841	CDC-2022-0024-0847	https://api.regulations.gov/v4/comments/CDC-2022-0024-0847	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Lowering from 90 to 50 is catastrophic. So many people have committed suicide due to your negligence. Please allow chronic pain patients to receive the medication that provided them a better quality of life. Quit making doctors scared to treat their patients. My dog had better pain control for an acl tear than I did for my hysterectomy. They sent me hone with naproxen and Tylenol and I thought I was going to die. What you have done to the chronic pain population is absolutely disgusting. We get treated like criminals for asking for relief. I have cluster headaches, arthritis, hidradenitis suppurativa and invasive endometriosis stage 4. I have been unable to work since getting my endometriosis diagnosis and denied disability. My pain was very well controlled and I worked full time up until 2016 when I was abruptly cut off my meds and suffered horrendous withdrawal and almost died. This needs to be fixed. It’s absolutely appalling how you have destroyed so many lives. And most of these lives are people who truly need these medications snd do not abuse them. My dosage had been the same for 10 years. Stop punishing legitimate pain patients and stop scaring doctors to the point where they literally just let you suffer now. Fix this!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484f7acbb	White	None	2022-02-16T16:07:04Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from White, Sarah	kzo-jwcc-twfu	False	None	False	2022-04-12 01:56:42.314	[]
842	CDC-2022-0024-0848	https://api.regulations.gov/v4/comments/CDC-2022-0024-0848	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75 year old female with significant arthritic deterioration of my right shoulder, a condition that suggests a shoulder replacement as the first choice of remedy by orthopedic surgeons. During a previous surgery, I suffered a pulmonary embolism resulting in a week-long hospital stay followed by six months of strict monitoring of my circulatory system for potential clotting. I do not want to risk another surgery given the complications of my last surgery.<br/><br/>My orthopedic surgeon informed me that his practice follows the national associations guidelines regarding pain medication: they do not ever prescribe medication for pain relief. Given, these are surgeons who make their living through surgery; however, he also recognized that the 33 million patients of orthopedic surgeons all face the refusal of monitored pain relief medication.<br/><br/>I have never taken oxycontin yet am as much a victim of that drug as those who became addicted to it. I have been denied responsible pain medication because of Purdue's actions. I urge you to provide relief for those of us with few other legal options.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachel	None	None	0900006484f7d832	Vance	None	2022-02-16T16:10:49Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Vance, Rachel	kzo-mxts-uqlv	False	None	False	2022-04-12 01:56:42.570	[]
843	CDC-2022-0024-0849	https://api.regulations.gov/v4/comments/CDC-2022-0024-0849	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Bravo! Severe pain patients won't have to suffer endlessly anymore!<br/>Thank you!<br/>[NAME redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith " Bram"	None	None	0900006484f7d215	Cast	None	2022-02-16T16:12:02Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Cast, Judith " Bram"	84f7d215	False	None	False	2022-04-12 01:56:42.815	[]
844	CDC-2022-0024-0850	https://api.regulations.gov/v4/comments/CDC-2022-0024-0850	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You cannot fathom what life is like in chronic pain. Actually it is no life at all! The agony itself is impossible! The simplest task is impossible, like showering, cooking, etc. it is inhumane to allow people to live like this! The only thing that helps is meds. They aren’t evil. They are a life saver! We should not be blamed or punished because drug addicts We are not them! Please have some compassion. Leave doctors alone to treat their patients! Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7dd6b	Anonymous	None	2022-02-16T16:16:43Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-oyq8-urc0	False	None	False	2022-04-12 01:56:43.042	[]
845	CDC-2022-0024-0851	https://api.regulations.gov/v4/comments/CDC-2022-0024-0851	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We need change in the mme so chronic pain patients like myself can be a productive member of society and not live on disability so young… and if the cdc don’t change to eleminate the mme I have thought about ending my suffering…I shouldn’t have to live this way… I shouldn’t have to suffer when I can’t help it…no one should have to suffer and we need the mme to be gone..I shouldn’t have to end my life or go to the streets to get herion to relieve my pain… so please help the pain community and end the mme…I am begging you to end the suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e041	Anonymous	None	2022-02-16T16:16:55Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-q702-9j2p	False	None	False	2022-04-12 01:56:43.365	[]
846	CDC-2022-0024-0852	https://api.regulations.gov/v4/comments/CDC-2022-0024-0852	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's a nice start but the CDC needs to be involved in making sure providers and insurance companies let go of punishing people with chronic pain and get with the new program of doctors prescribing what the patients actually need. And teach pharmacy workers at all levels not to be judgmental reactionaries. Thank you for beginning change. Now follow through.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amie	None	None	0900006484f7e0e7	Harrison	None	2022-02-16T16:17:06Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Harrison, Amie	kzo-qgny-82r2	False	None	False	2022-04-12 01:56:43.588	[]
847	CDC-2022-0024-0853	https://api.regulations.gov/v4/comments/CDC-2022-0024-0853	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic Pain management has become very hard for an individual to receive pain medication. An individual that has been taking pain medication for years that has Chronic Pain is not wanting to get high their wanting relief from the pain. The ones that want to get high go to the streets to get fentanyl or heroin. The Doctor’s have a computer system that red flags a patient if the patient goes to more than one Doctor or Pharmacy and this has been in place since 2012. The opioid addiction is not from Doctor’s Patients. Please reconsider the guidelines for pain medication management as too many people are suffering. Too many people are committing suicide due to pain. Many people are not able to leave their house from being in pain. Many people have went to the street looking for illegal pain medication. It’s inhumane for people to live in pain! Thank you sincerely for this open issue regarding pain management! Doctor’s can and will monitor their patients that are on pain medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e177	Anonymous	None	2022-02-16T16:17:26Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-qpp3-xgyp	False	None	False	2022-04-12 01:56:43.837	[]
848	CDC-2022-0024-0854	https://api.regulations.gov/v4/comments/CDC-2022-0024-0854	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	you asinine idiots obviously have never had to contend with real pain, why don't you just overtake your Tylenol like you all do, destroy your liver/kidneys, and then if you survive come to talk to me, so I can enlighten you, and hopefully {but probably no chance} of telling you real pain is a real problem, we don't want to resort to going to drug dealers and take chances with fentanyl but you're driving people like me who have legitimate pain to do just that I know you will throw my comment away because it's what you constipative {constipative meaning youre full of [word redacted] minded individuals seem to do best, just not notice a person's true pain, so in closing let me say I guess I will start looking for a dope dealer because its what you nincompoops are making good ordinary citizens with true medical problems do, because it's easier for you to just pretend we don't exist and let us suffer in true agony because our pain is so real, as [name redacted] infectious disease dr. told me a normal person given my pain would drop into unconciousness instantly! kindly go to [word redacted], and leave my medications alone, you're a bunch of no achieving boobs impersonating medical scholars, and you don't deserve to be paid for what you're trying to duplicate the job of a true professional. which you will never achieve no matter how long you study or say you have because it takes skill working with patients like me from begining to now	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	roman	None	None	0900006484f7e7fc	smetak	None	2022-02-16T16:20:19Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from smetak, roman	kzo-zvvv-i5j8	False	None	False	2022-04-12 01:56:44.068	[]
849	CDC-2022-0024-0855	https://api.regulations.gov/v4/comments/CDC-2022-0024-0855	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There are definite errors in the section discussing Buprenorphine/Naloxone. Specifically<br/> "Naloxone is not 3866 absorbed orally". This is patently false with published data documenting Naloxone's systemic absorption when given in sublingual Buprenorphine combination products. See attached files. IN addition the statement that follows is not well established and there is certainly data that conflicts with this. "but if buprenorphine/naloxone is manipulated and injected, naloxone can trigger opioid 3867 withdrawal (Indivior, 2017)" This is not well established as a true deterrent to injection of Buprenorphine/Naloxone combination products <br/>.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484f7ac20	Sorboro	None	2022-02-16T16:24:03Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Sorboro, John	kzo-je61-wf38	False	None	False	2022-04-12 01:56:44.319	[]
850	CDC-2022-0024-0856	https://api.regulations.gov/v4/comments/CDC-2022-0024-0856	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My spinal tumors keep me from sleeping, to restrict my doctors to the recommended MME is damaging to my ability to function. When it comes to chronic pain, one size DOESNT fit all. PLEASE exclude CHRONIC PAIN patients, CANCER patients, POST OP patients from your harmful guidelines. I talk to suicidal pain pts on a daily basis. YOU ARE CREATING TERRIBLE SUFFERING and damaging lives. The rate of overdoses are still climbing even tho there has been a dramatic cut in prescription drugs. This is because the over doses are happening from illicit fentanyl that people are buying off the street, NOT from legitimate prescribed medications. Chronic pain patients deserve proper medications the same as diabetics do. We should not be punished for the actions of others. We are law abiding people that do not deserve to suffer for the crime of being in pain. PLEASE do the right thing and exclude us from your harmful guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f7e1b0	Phillips	None	2022-02-16T17:04:02Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Phillips, Lisa	kzo-qtxk-fv84	False	None	False	2022-04-12 01:56:44.547	[]
851	CDC-2022-0024-0857	https://api.regulations.gov/v4/comments/CDC-2022-0024-0857	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a healthcare provider, I have been very compliant in decreasing my opioid prescriptions. I have substituted Tylenol and ibuprofen in high doses for pain control. For much dental surgery, it is sufficient. For much dental surgery I have found over these last 4 years, a much higher level of return appointments by patients for pain control. I am now changing my opinion that Dentistry may not have been responsible for significant opioid addiction. I do not believe patients become addicted with 2 to 4-day use of opioids at a minimal level for dental pain control. I now also believe that as long as the borders are open for free fentanyl flow and other stronger illicit drugs, there is truly very little need for so much emphasis on opioid control in dental pain control. The CDC needs to recognize the amount of illicit drugs coming over the open borders. I believe pain control after surgery is not the best place to crack down on controlled opioid prescriptions. DEA knows every RX via practitioners and tracks it accordingly. DEA does not know all the illegal drugs coming into the US every day. The emphasis may be miss placed. Maybe CDC needs to become concerned about open borders and thousands of pounds of illicit drugs coming into the US every day and less about practitioners trying to manage post-operative pain.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L.	None	None	0900006484f7e274	Scott	None	2022-02-16T17:05:10Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Scott, L.	kzo-r677-cpwq	False	None	False	2022-04-12 01:56:44.798	[]
852	CDC-2022-0024-0858	https://api.regulations.gov/v4/comments/CDC-2022-0024-0858	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 64 year old woman who is also a 19 year survivor of breast cancer and a person who has had arthritis for my entire adult life. The treatment that I received to save my life left me with even worse arthritis and tendon problems that continue to this day. Due to the strict recommendations, I am now under the care of a pain clinic in order to get the medicines that I need for relief. In the past few years, I found it a struggle to get adequate relief with the meds that my family doctor was allowed to prescribe. I don't want the medicine to get high, I just want to live a life that is as normal as possible with pain that is reduced to the point where I can live an active life. I know that there are many people with addiction problems, but I honestly feel that the tight restrictions that have been imposed hurt more people like me. I just made my monthly trip to another town, which is 30 miles away, to go to my pain clinic. I had to not take Percocet as I had to drive myself and I am very careful not to drive when I take it. Because of that I will be in severe pain for at least a day while I recover. If my family doctor was allowed to prescribe this for me I would only have about an hour off of my medicine. There has to be a better way to help people like me who honestly suffer from chronic pain. Please don't make it any harder to obtain the medicine that I need to stay active and keep my arthritis from getting even worse. Thank you for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sally	None	None	0900006484f7e356	Back	None	2022-02-16T17:05:34Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Back, Sally	kzo-rlq6-3l9r	False	None	False	2022-04-12 01:56:45.030	[]
853	CDC-2022-0024-0859	https://api.regulations.gov/v4/comments/CDC-2022-0024-0859	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe Degenerative Disc Disease with Osteomalacia and have several disc bulges that have caused severe pain since 2000 (and later). The 2016 CDC guideline has caused me unimaginable suffering that I am experiencing today because of the tapering down of my medications - all due to the CDC recommended daily dosage was taken as the law. Before the guidelines I was taking roughly 120 MME daily and it WAS working. The guideline came out and my pain management clinic started tapering me - they started with Methadone and cut my Daily MME . Today I am taking 45MME and I am in severe pain. I am scheduling a surgery for my neck which I KNOW will trigger a SEVERE PTSD episode, but IM feeling forced to get this because I know I won't receive enough opioid medication to relieve my pain. - Side Note: I told by the pain management provider who was cutting his patients back from opioids, to go see my insurance and get fixed. His practice recommended a hospital / doctor and I followed through with a surgery because the pain management provider stated that all opioid prescriptions would be cut by their clinic. At the hospital they installed a CoFlex in my Lumbar that NOW causes me severe pain at times. It prevents me from sleep as I cannot sleep in my normal positions before the surgery. <br/><br/>I feel all my suffering is from the past CDCs guidelines that were too ridged and even calls out - by example - patients suffering with degenerative disc disease and Spinal Stenosis (Back Pain) as "Drug Seeking" addicts who plague our Emergency Rooms (Paraphrasing, but the damage listing an example of Drug Seeking Behavior as a patient with back pain seeking pain medication in Emergency Room is unacceptable).<br/><br/>One of the biggest problems of all the is in the CDC's relations with members of "Physicians for Responsible Opioid Prescribing" - PROP members - and their ideology that addiction is worse than "Life Long Pain". PROP doctors will NOT prescribe opioids even under situations that strongly warrant opioid prescribing. To this organization opioid prescribing should be outlawed. Because of this groups meddling with the CDC guidelines, our country is in the worse illegal Fentanyl epidemic in history.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484f7e432	Parsons	None	2022-02-16T17:06:18Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Parsons, Joseph	kzo-s130-bmzq	False	None	False	2022-04-12 01:56:45.268	[]
854	CDC-2022-0024-0860	https://api.regulations.gov/v4/comments/CDC-2022-0024-0860	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been denied pain medication for a serious hip injury. I am not an addict, dealer, or any of the things my hospital emergency room tried to call me. I am disgusted and disappointed by the current guidelines for opiods. People that are addicts are now overdosing on heroin and fentanyl. What good is a policy that denies pain relief for the general public.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jenifer	None	None	0900006484f7e443	DePaolo	None	2022-02-16T17:06:30Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from DePaolo , Jenifer	kzo-s2dp-poxc	False	None	False	2022-04-12 01:56:45.495	[]
855	CDC-2022-0024-0861	https://api.regulations.gov/v4/comments/CDC-2022-0024-0861	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for many years….MANY years I have lived with never ending pain. I’m in pain in my dreams. It never goes away. It’s very difficult, if not impossible to explain to someone who has never experienced it. I was being treated by a very compassionate, caring doctor who understood. He treated my pain appropriately. Then he was gone. I was sent to a new doctor. This doctor didn’t understand; he was probably afraid to treat my pain appropriately for fear of being “in trouble”. I was taken off of the large majority of my pain meds. Since that time I have been forced to stop working. I spend at least 12 hours a day in bed. I absolutely dread getting up because I know my day will be filled with, basically nothing. I can no longer cook, which I love to do because I can’t stand up for more that 5-10 minutes without being in excruciating pain. I have a great deal of difficulty even cleaning my house, again I cannot stand for long. I used to exercise regularly. I walked my dogs daily, lifted weights. I cannot do that anymore. This is more than an inconvenience. I am a heart patient and exercise is vital for me to continue with a healthy heart. I have been given dangerous medication to try to deal with my pain without opiates. They are not only ineffective; they are dangerous and much more addictive than the opiates I know work. Gabapentin was just one. I have been given anti depressants even though I’m not depressed. They do nothing for my pain. <br/>To sum it up, my life has ended at age 60. I am too young to be this old! My husband and I dreamed of traveling. Again can’t happen because of my chronic pain. Please allow doctors and patients to determine what works best for each patient. The government has no place in pain management. The only people dying from drug overdose are people buying drugs on the streets. Many chronic pain patients have resorted to this and have paid the ultimate price. Too many of us give up and end their lives. This is completely unacceptable. <br/>Thank you for your time and hopefully your attention,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e44f	Anonymous	None	2022-02-16T17:07:20Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-s2te-42jv	False	None	False	2022-04-12 01:56:45.721	[]
856	CDC-2022-0024-0862	https://api.regulations.gov/v4/comments/CDC-2022-0024-0862	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am again shocked and dismayed by the blanket statement you dish out on the premise that your organization and members "know everything". <br/><br/>My issue is the callous disregard for the welfare or interests of me, the patient. I am a 72 year old, Veteran who has led a productive and very active lifestyle. And to this day I continue to do so. I currently have am employed as a salesman that is not too physical and well within my abilities. This lets my wife and I live well, and not have to worry to much. We have a small nest egg for when I either can't or choose not to work.<br/><br/>However, due to a degenerative disk disorder, I have bee under a physicians care for this ailment for over 10 years, while taking Hydrocodone Acetaminophen 750/325, 3 times daily. I have no side effects, no drug or alcohol issues, nor other difficulties. Except that we tried every therapy, to the point where we tried the opioid. Which, in accordance with the goals of it's creators, it eliminates the severe referred pain to my hip, due to the disk issue.<br/><br/>I have seen a doctor every 6 months since, never had any complication nor problems until I do not take the medication. Then I am virtually crippled. Unable to walk more than 25 feet at a time due to the severe pain. The VA and most other entities, insurance companies, clinics employers, drug screeners and YOU - all think of me as nothing more than a drug addicted useless parasite.<br/><br/>Your arrogant, unfounded "report" I found (because I want to know about every aspect of this treatment) led me to this page. <br/><br/>Please consider me. I have paid many thousands of dollars for MRI, x-ray, laser therapy, creams washes and other cure, yet the best solution your profession has been condemned because of the irresponsible actions of a very few people. <br/><br/>You lump fentanyl, heroin and other illicit and stolen drug users into the same status and viewpoint as me.<br/><br/>It's not fair. Don't ruin the short time my wife of 40+ years and I have left to relax and enjoy ourselves, I love to work as a salesman, What give you the privileges of ruining my life in the name of whatever hand wringing campaign your on. You don't care, so let me live, or develop something else.<br/><br/>I am going to continue this crusade through whatever means I can muster.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Francis	None	None	0900006484f7e46b	Weiser	None	2022-02-16T17:07:58Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Weiser, Francis	kzo-s4ob-k7lp	False	None	False	2022-04-12 01:56:45.963	[]
857	CDC-2022-0024-0863	https://api.regulations.gov/v4/comments/CDC-2022-0024-0863	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would appreciate the CDC and especially the DEA to get completely out of my doctor’s right to treat as his education has prepared him to do. The DEA, an arm of the Justice System, should not have the authority to dictate pharmaceutical production levels, nor dictate how physicians treat patients. Physicians should not fear criminal prosecution for treating pain patients. This needs to change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e483	Anonymous	None	2022-02-16T17:08:06Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-s5yk-rbv4	False	None	False	2022-04-12 01:56:46.209	[]
858	CDC-2022-0024-0864	https://api.regulations.gov/v4/comments/CDC-2022-0024-0864	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer and I'm so tired of doctors not taking my pain seriously. It's led me to severe depression and suicidal ideation. I know it's not the doctors fault as they are subject to severe scrutiny, however that does little to change the fact that my almost constant pain continues to go untreated due to the over regulation of opioid pain relief. In the course of opioid therapy I reached a certain level of tolerance. I was informed that this is a natural thing for the body to do when in long term treatment. Unfortunately, due to the 2016 CDC guidelines my primary healthcare doctor was unable to prescribe a higher dose of opioids. Then, because I was opioid dependant, she completely stopped treating my pain. It is for this reason I believe there should be no cap on the therapeutic dose of opioids as this changes wildly from one patient to the next. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ryan	None	None	0900006484f7e4c3	Mullaney	None	2022-02-16T17:08:40Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Mullaney, Ryan	kzo-sb07-fesn	False	None	False	2022-04-12 01:56:46.440	[]
859	CDC-2022-0024-0865	https://api.regulations.gov/v4/comments/CDC-2022-0024-0865	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m in awful pain , bone Spurs in my hips , & blood polling in leg vein , the pain is awful , I cry every night. I been on the same dose of oxy for 7 years , I asked my Pain management if he could give me break though , i Take Motrin too but I have high blood pressure ,so I ask for low dose break through , my doctor told me he can’t go over 90 mme that I’m in the highest allowed by CDC , that’s so mean. Leaving me in pain , been on the same dose for a Long time. It’s not working , and I’m suffering, this needs to stop , please drop the Mmes , no one size fits all in pain world	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nina	None	None	0900006484f7e5b2	Saffold	None	2022-02-16T17:08:56Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Saffold , Nina	kzo-tc7j-aiff	False	None	False	2022-04-12 01:56:46.870	[]
860	CDC-2022-0024-0866	https://api.regulations.gov/v4/comments/CDC-2022-0024-0866	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC, <br/><br/>As a practitioner of Hospice & Palliative Medicine, I would like to recommend the following with regard to the 2022 Clinical Guidelines for Prescribing Opioids:<br/><br/>1. Renounce arbitrary, hard dosing thresholds and their misuse by health insurers, state and federal governments, pharmacies, and call for a ban on involuntary opioid tapers. These are the most harmful and misapplied portions of the 2016 guidelines.<br/><br/>2. Publicly affirm a renewed commitment to a balanced opioid policy which emphasize the need for an individual approach to care of patients with chronic pain and explicitly acknowledge that some patients with chronic pain may benefit from treatment with an opioid for greater than 90 days when medically appropriate. This would include patients with serious illness.<br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f7e653	Iocca	None	2022-02-16T17:09:32Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Iocca, Michael	kzo-unkh-t63w	False	None	False	2022-04-12 01:56:47.107	[]
861	CDC-2022-0024-0867	https://api.regulations.gov/v4/comments/CDC-2022-0024-0867	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To correct a previously sent comment. <br/>I had surgery for my Chiari in December 2000 not 2020. I had my corpectomy with placement of harms cage with plate and screws in April 2000. That was a very bad year.<br/>My pain began in my early 20s but instead of the Doctors I went to trying to find out what was going on with me. They would just say take Tylenol you are too young for pain medicine. So finally in my 40s I found a Doctor who sent me for test and MRI etc and the Chiari Malformation type 1 was found, but the neurological damage had been done and it couldn't be fixed. This was very discouraging. I have been to many Specialists. Recieved many diagnosis. My only solution is to live the rest of my life on pain medication. When my Pain management Dr retired and I went to my primary care doctor and he would only give me 90 mme of one of my medications. I had to cold turkey the morphine. <br/>I get 2 pain pills a day now and believe me that is not any good. <br/>Please remove the MME protocol from this.<br/>No 2 people are alike. <br/>I have been reading some of the comments on here from some of the doctors that I will say are against pain medicine and I am sorry but just because they are educated they do not know what they are talking about. <br/>Through the years I have done everything you can imagine to try to help with the pain. Nothing has helped. I was always a go-getter. I worked 10 to 12 hours a day then came home and took care of my house and family. The hardest thing I ever did was surrender and let someone help me.<br/>It is not fun when you have to have help getting out of bed. Help getting in the tub. On the toliet. Getting you a cup of coffee. <br/>Then I read these hypocrite doctors say we don't need strong pain medication. I hope they never need it.<br/>If you all leave the 50 mme in this the Doctors will adhere to that along with everyone else and us the Ccp patients will die.<br/>The Doctors also need to know that it will be alright to give our medicine back. I think they will be scared still and won't want to. The Dea needs to keep out of our business and our Doctor office. <br/>I am sorry this is so long. I have just been frustrated for so long. I have been praying for these 2016 guidelines to change for years and then it looks worse when it starts to happen. We need help. We have been through so much. So many of us have already committed suicide or had heart attacks and died.<br/>I have had palpitations ever since I was cut.<br/>Take the 50 mme out.<br/><br/>Thanks for letting us comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f7e65a	Eckhoff	None	2022-02-16T17:09:59Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Eckhoff , Debra	kzo-upvk-saw0	False	None	False	2022-04-12 01:56:47.324	[]
862	CDC-2022-0024-0868	https://api.regulations.gov/v4/comments/CDC-2022-0024-0868	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am disabled because of strokes. I also have chronic pain for years. I’ve been on the same medication for several years. I recently had to switch insurance, what a nightmare. Why is it so hard to get my medicine that I have always been on. Beyond ridiculous. I’m also at the point where I feel I may need an increase in dosage, but am terrified to ask for it because of the stigma etc	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e6bb	Anonymous	None	2022-02-16T17:10:15Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzo-vrih-fi1c	False	None	False	2022-04-12 01:56:47.551	[]
863	CDC-2022-0024-0869	https://api.regulations.gov/v4/comments/CDC-2022-0024-0869	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings all , let me begin 1989 [Location Redacted] 11:27 AM I’m at work when a drunk driver TBoned my vehicle at 58MPH 2 blocks from [Location Redacted] . Multiple witnesses including a ambulance crew watched this take place . 2.3 hours later they got me cut out of what was left of my vehicle . The seatbelt buckle broke from impact throwing me into several objects before I was pinned to the steering wheel . Separated ribs , partly cut spinal cord , brain damage , twisted both ankles backwards , whiplash , ruptured bladder I was one mess . Much later on the wealthy driver was found in gross neglect …. 2.3 years in and out of [Location Redacted] TX I finally could talk and stand up with leg braces but the nerve damage in my spine is done for life . I’m in adult diapers every since . As a very young man in a snap my life forever changed . Forward to today I’m being treated currently at [Location Redacted] AR . All these years I’ve gone from morphine pumps to my spinal cord area to just hydrocodone tabs . Suddenly out of nowhere in the last 4 years I’m being attacked by doctors over my prescription . Most agree I have terrible nerve damage not just a back pain problem . One wicked doctor two years ago went off on me over my prescription I ended up at [Location Redacted] l for stroke treatment over this attack . The doctor says theCDC is responsible not him . BS ! He took this farrrrr to far . This man posted on my chart DRUG ADDICT because I threatened to sue him over this attack . UAMS freaked out removed his terrible comments and apologized profusely over this insanity . UAMS as a whole is a great center that trained new doctors that’s a fact I have no Ill will to them just that one wildcat doctor I’ve never ever been attacked by a doctor in 30+ years dealing with my disabilities . I know of two friends both took their own lives I kept the proof one I witnessed him shoot himself in the mouth over pain medication removal . Both were terribly in pain with legitimate conditions . Both refused to try and find illegal drugs to deal with this mess so they instead took their own lives . They reduced my prescription as our state prosecuting attorney is hell bent on attacking pain management patents she has constant TV adds screaming how they are after allll of us here in Arkansas . Why? I’ve filed a complaint with civil rights action federal laws . I’m told the CDC , DOJ , DEA are responsible plus a tad of religious BS in our state . For 30+ years I’ve managed quite well with what was considered low dosages up until the CDC went off the rails . Now I can not do simple home care things such as mow my property it causes such pain I’m flat for days . All the while swimming in my head is it time to check out as my two friends did . I’ve considered it seriously I’m tired ,old hurting all the time . Can’t sleep , do much activity although I still try . OPIODS do their job after being on these for years low dosage they’re is nothing that gets you HIGH as they say it just keeps me going another day . I’ve met others that take farrrrr more than myself they have far greater damaged body’s or severe diseases . They gave me a pot medical card I’ll say this I tried pot it does 0 for nerve damage 0! It does relax muscles so my spasms are not as bad and I only use a THC oil I can’t stand smoking that stuff . Be dam sure the state pushes it hard because they are getting million in taxes . The CDC went wayyyy to far attempting to stop illegal drugs by attacking the truly physically disabled . Please stop ! I’m getting tired people if not for my loving wife I promise you I would have already chewed on a pistol . Photos added are the eye rupture caused by the doctor mentioned and why he attacked me in the report . I have compiled a paper file full of the hospital stroke testing done over this ridiculous attack on myself . <br/>[Name Redacted] , [Location Redacted] Arkansas	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenten	None	None	0900006484f7abb6	Stevens	None	2022-02-16T17:12:41Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Stevens, Brenten	kzo-dp00-k3mj	False	None	False	2022-04-12 01:56:47.760	[]
864	CDC-2022-0024-0870	https://api.regulations.gov/v4/comments/CDC-2022-0024-0870	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 79 year old female. Previously a lifelong resident, first of Washington State, more recently of Oregon, we moved to [city] Maine in September, 2020. For several years, I had a prescription for a low dose of hydrocodone/acetaminaphen which allowed me to remain a productive human being able to walk adequately, keep my home orderly, and care for my cognitively disabled husband. I was never dependent or addicted to the hydrocodone. I had a "contract" with my provider and was regularly tested. Over many years I tried many pain relievers, none of which were effective for my extensive chronic pain problems, but the hydrocodone was a miracle for me with minimal side effects. Upon arriving in Maine, I was shocked that no doctors would renew my prescription. I have been without effective assistance for controlling my pain for a year and a half, in spite of requesting, many times, a new prescription for hydrocodone. I am overwhelmed constantly by pain. My physical ability has been severely impacted and my heath has deteriorated dramatically. I can no longer care adequately for my husband or myself. Please give elders like myself the gift of an enlightened attitude and finalize the proposed CDC guidelines for opioid prescribing, making the cruel and cowardly behavior of the medical community a thing of the past.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Helen L	None	None	0900006484f7daba	Zuelow	None	2022-02-16T17:13:25Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Zuelow, Helen L	kzo-nwzj-pwc0	False	None	False	2022-04-12 01:56:48.001	[]
865	CDC-2022-0024-0871	https://api.regulations.gov/v4/comments/CDC-2022-0024-0871	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am trying this again. My original comment was over your allowed limits. To make this short and to the point, I am writing regarding my brother who has been diagnosed with neuro-sarcoidosis, seizure disorder, and avascular necrosis. He is a disabled veteran, and he was told that the VA would not provide him with pain medication. He was diagnosed approximately 15 years ago. He has not had much luck with doctors because they up and left the practices after prescribing him oxycontin for his severe pain. He was put on so much medication before the guidelines came out that he took himself off the Fentanyl patches and just took the oxycontin 30mg tablets three times a day with one for break-through pain should he need it. When the guidelines came out, the physicians got scared. They kept telling my brother they couldn't prescribe the medication for him because they would lose their licenses. One pain doctor that treated him and got him out of a bedridden state, left the practice and moved four hours away. My brother called him, and he said he doesn't practice pain management any longer because he was not able to take care of his patients according to their needs. My brother was left high and dry not knowing if he was going to get any medication or not. He went to another clinic an hour away. They cut his medication dosage in half and my brother ended up bedridden yet again. His seizures have also started back again because his pain is so bad all over his body. This new pain doctor in our town will not prescribe the dose we know works for my brother. He uses the morphine scale and says he can't prescribe more than the 15mg tablets he is on now. My brother is suffering. There is no cure for what he has. Thank God he doesn't have cancer, as this doctor says that would be the only way he could provide my brother with a higher dose. However, there is no cure for what he has, so why not provide him with what we all know works for him and leave him alone. Count his pills every month. He never took more than was prescribed. He was out of bed, playing with his grandchildren and had a much better quality of life. I am asking that you make it clear in your new guidelines that the physicians should not be running scared of losing their license, to use their best judgement and provide the patient with what they know works for them. Acute pain patients, sure, cut the dosage. Their pain will be gone shortly. Chronic pain patients, live with it every day. Give them back their quality of life. Many are talking about having to take illegal drugs to get the relief they need and apparently some are. It's backfiring. <br/><br/>I appreciate your time and consideration of my request. My brother is only 58 and should not be spending his time bedridden. Please give him back his life. If there is no cure for their disease, what does it matter? At least let them have some semblance of a normal life.<br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rose	None	None	0900006484f7dc1c	Branson	None	2022-02-16T17:14:23Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Branson, Rose	kzo-oh1r-mjj0	False	None	False	2022-04-12 01:56:48.212	[]
866	CDC-2022-0024-0872	https://api.regulations.gov/v4/comments/CDC-2022-0024-0872	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have sciatic nerve pain & have had 3 nerve blocks so far! Have documents from Dr saying I have bad arthritis in same area plus knees, shoulders, wrists! When there is proof you have pain that can't be eliminated it makes no sense not to be given pain meds! I totally agree with NO over prescribing but quality of life is poor living in constant pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7f70a	Anonymous	None	2022-02-16T18:43:14Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-sagi-gmc5	False	None	False	2022-04-12 01:56:48.429	[]
867	CDC-2022-0024-0873	https://api.regulations.gov/v4/comments/CDC-2022-0024-0873	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My comment is attached as a MS WORD docx file named CDC-Guideline-Response-[Name Redacted] -22-2-15.docx (27.87KB)<br/>Thank you for your time and attention.<br/>[Name Redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484f7ab98	Commons	None	2022-02-16T18:44:44Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Commons, Tom	kzo-cp4n-acdt	False	None	False	2022-04-12 01:56:48.658	[]
868	CDC-2022-0024-0874	https://api.regulations.gov/v4/comments/CDC-2022-0024-0874	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please reconsider the guidelines. It does no good for CPP to decrease the daily MME from 90MME to 50MME. MME should not even be discussed in these guidelines. Prescription application should be based upon the individual diagnosis and the provider. Each instance should be decided on a case by case basis. There should not be one generic “rule” just blanketed across. <br/><br/>Furthermore, the CDC should not even be involved in “guidelines.” As the CDC is not well versed in such information. Any concerning guidelines should be completed by pain management specialists. These providers specialize in pain. They know how to adequately treat CPP. <br/><br/>As a CPP, who lived a normal life until one day I experienced a seizure at the top of the stairs. I fell face first down 16 stairs unconscious. I broke my face in 8 places (I detached my face from my skull) and my back in 2 places. I was told I was lucky to be alive and lucky that I was not a quadriplegic. One day I was loving a normal life and the next I was being rushed to a trauma 1 center. There I was admitted and received emergency surgery. On the second day of recovery, my pain was not controlled. I kept telling the nurse about my pain. She kept going back to the doctor. A pain specialist finally came in and recommended a morphine drip. He said it was his professional opinion that it would benefit me in my situation. Two hours later he return and apologized to me. He said unfortunately the attending doctor cited the 2016 CDC guidelines and said that morphine was not appropriate for my situation and the attending doctor overrode the recommendation by the pain specialist. Even 2 years after this tragic accident I remember this conversation. Much of those following months were a haze. But I will never forget this. If morphine was not appropriate for 10 broken bones and a completely distorted face, then under what circumstances would it be appropriate?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484f80184	Ilarazza	None	2022-02-16T19:25:06Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Ilarazza , Christine	kzp-x9cy-bd52	False	None	False	2022-04-12 01:56:48.865	[]
869	CDC-2022-0024-0875	https://api.regulations.gov/v4/comments/CDC-2022-0024-0875	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’am a 59 I have trigemenal neuralgia that means I have two nerves that are compressed on the right side of my brain which that also equates to facial pain,pain in my eyes cheeks gums bridge of nose well this encompasses the whole head The doctor see it Neurologists sees it,neurosurgeons see it they both sent me to Pain Management and Pain Management does not want to help manage my pain A certain doctor says that I am not complying and not taking the proper dosage of medication that is a lie I’ve been with this for eight years I’ve had every pill possible out in the market they want me on such a high dosages that my body will not tolerate when all it takes is one pill to manage the pain on a low-dose and I would feel a lot better . I’ve been with this now for eight years and it’s tiring my body. I NEED HELP This is killing me from the inside very slowly I want to get back to work I want to be part of society I don’t want my family to suffer anymore. Please I NEED HELP	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Migdalia	None	None	0900006484f7f725	Reyes	None	2022-02-16T19:25:54Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Reyes, Migdalia	kzp-sk9b-sc4k	False	None	False	2022-04-12 01:56:49.096	[]
870	CDC-2022-0024-0876	https://api.regulations.gov/v4/comments/CDC-2022-0024-0876	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i am submitting this in support of all the people with chronic pain who need an alternative to over-the-counter medications to control their pain for a halfway normal life. i am a 78-year-old male who has had 2 lumbar operations, shoulder operations, hip replacement and a year of pain management care for chronic neck pain, including multiple injections in the neck vertebrae with no relief. In short, i have chronic pain in the neck, hips, shoulders, back, legs, hips, hands etc. Currently i take no medications other than pain relievers and anti-inflammation meds to lessen the pain mostly so i can sleep or take part in activities such as golf and dancing. Since i have trouble getting prescription meds such as Norco, I worry about taking so many Nsaids. Having been subscribed Norco many times over the years for post operative and pain management, i know how to control its use and withdrawal. My preference would be to have Norco available for periodic use (2-3 times a week to get a good sleep when pain is bad) rather than so much use of Ibuprofen. From CDC's own stats, you say most deaths are from illegal use such as fentanyl and i am tired of all the '30-year-olds' deciding that people with pain don't need opioids.....they have no idea what's in store for their later years. Thanks for letting me put in my 2-cents.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Edward	None	None	0900006484f7f73d	Sharar	None	2022-02-16T19:26:28Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Sharar, Edward	kzp-sqvt-ekm2	False	None	False	2022-04-12 01:56:49.402	[]
871	CDC-2022-0024-0877	https://api.regulations.gov/v4/comments/CDC-2022-0024-0877	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 70 years old. I have 6 back surgeries, two shoulder, two ulnar nerve, one neck and I shot my leg off 5 years ago. I suffer with pain that keeps me up for two or three days.<br/><br/>Christmas eve this year my pain was so bad that I passed out and had to go to the hospital. After three days there I was told that I had fluid in my lungs and heart problems because of my pain!!!!!<br/><br/>I ask what I should do to get a pain prescription and they could offer no help! <br/><br/>Your rules are causing me a horrible slow death.<br/><br/>Please help me. Back off you pain med rules so I can live without tears and fainting.<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ALVIN	None	None	0900006484f7f74b	GOLDEN	None	2022-02-16T19:44:01Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from GOLDEN, ALVIN	kzp-sjz3-ir9s	False	None	False	2022-04-12 01:56:49.616	[]
872	CDC-2022-0024-0878	https://api.regulations.gov/v4/comments/CDC-2022-0024-0878	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you so much for this major update! As a chronic pain patient, I am glad to see that we have been heard.<br/><br/>My only concern is this statement:<br/><br/>Providers are urged to be careful about increasing doses above 50 MME and to weigh the individual needs of each patient.<br/><br/>Regardless of your intent, 50 MME will be written as the new standard by overzealous states and insurance companies - just as the 90 MME was. I would like to believe that any doctor prescribing opioids knows the parameters for dosing, please consider removing this statement.<br/><br/>Thank you,<br/>[name redacted]<br/>[city redacted] FL	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	0900006484f7f778	Terrell	None	2022-02-16T19:47:51Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Terrell, Rebecca	kzp-tfzx-xydx	False	None	False	2022-04-12 01:56:49.831	[]
873	CDC-2022-0024-0879	https://api.regulations.gov/v4/comments/CDC-2022-0024-0879	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a veteran who survived multiply combat related injuries I have been and continue to be in pain. I still work full time in a office and without the opioid pain medication I simply could not work. Over the the past few years the VA hospital system has become VERY AGGRESSIVE on cutting out all opioids regardless if the are medically necessary. Even after NEVER failing a drug test and the the VA hospital own pain management specialist who agreed that my treatment plan was medically necessary & appropriate the VA have made multiply attempts to stop it as they state that's the "national guidelines".<br/>I continue to be regarded as veteran with a problem despite being cleared by the VA own specialists that I do not drug problem and I am not drug seeking. The stigma created by using an opioid that has been deemed medical necessary and appropriate is unacceptable and should not be tolerated. Many veteran's are suffering in pain because they simply gave up trying to get relief or have serious side effects of the huge amounts of non-narcotic medications they are using to try and treat chronic pain. <br/>Clear and concise guidelines need to be revised/established so that MD's that are prescribing can do so without the fear of reprisal for doing what they deem medically necessary.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7f77a	Anonymous	None	2022-02-16T19:48:52Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-thdu-6hu9	False	None	False	2022-04-12 01:56:50.037	[]
874	CDC-2022-0024-0880	https://api.regulations.gov/v4/comments/CDC-2022-0024-0880	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First off, I applaud this. HOWEVER:<br/><br/>1) Government bureaucracies never reverse their positions unless there's a reason. Obviously, you've discovered that you exposed yourselves to high levels of liability for the deaths of thousands of legitimate chronic pain sufferers that lost access to their prescriptions and died of street drug overdose, or suicide.<br/><br/>2) [name redacted] statement about the ineffectiveness of long-term opioid use is "Bull". I was prescribed opioids on a fairly regular basis 20 years for chronic gout, then 10 years, daily, for degrading spinal problems, and they were the ONLY source of relief until you "folks" intervened and put an end to it "Cold Turkey".<br/><br/>3) I happen to be an honest and law abiding 70 year old and have lived in AGONY the last 4 years because of my refusal to go the "street" for relief. (But that may yet change. Desperation calls for Desperate Measures!) Believe me, I've tried every possible solution offered by the medical profession, up to and including surgery and the [health facility name redacted] . I drew the line at spinal stimulating devices because the flaws are becoming apparent and starting to smell of Medicare fraud. I mean, $30,000 procedure versus $10 worth of the cheapest and most effective pain reliever for centuries?<br/><br/>4) You've "killed off" an an entire profession of Pain Management Specialists, that became the only source of opioids, with ever increasing restrictions. By the time I was finally "booted", I felt humiliated like a "criminal parolee" that had to report to the "parole officer" on a regular basis to prove my "worthiness".<br/><br/>5) I'm skeptical that even if you completely abolished opioid restrictions that medical professionals will ever start to prescribe them again. You've "Brow-Beaten" doctors into submission so badly that they're scared to death to change! Remember Obama telling us that the government would never come between the doctor and the patient? Another "crock".<br/><br/>6) The only thing that the DEA and CDC managed to accomplish with the "war" on the "prescription opioid epidemic" was to create an infinitely worse "fentanyl opioid epidemic". It should be obvious by now that the DEA has not, and never will be able to control elicit drug use. There's just too much demand from the illegitimate users. You cracked down on the easy target, the captive legitimate chronic pain sufferers. I'm sure it looked great on the statistic sheet.<br/><br/>7) Then there's the "CURSE". At a time in the middle of a typical sleepless, agonizing night, I placed a curse on folks responsible for this insanity that they would experience my same level of agony and lack of relief. Then, from wherever I end up, whether it be Heaven or Hell, I'll be looking, up or down, laughing my [word redacted] off at you jerks!<br/><br/>8) The covid epidemic had brought to light the danger of having unelected, incompetent, power wielding bureaucracies making incredible irresponsibly mandated decisions forced upon the entire population.<br/><br/>9) I participated in another bureaucracy's 60 day open comment period. The FAA summarily rejected 55,000 objections to their proposals on overbearing model airplane and drone restrictions. It'll be interesting to see what happens with yours, but I'm not holding my breath!<br/><br/>In Summary:<br/><br/>Please, God, do something right. But if you don't, or can't, remember the "CURSE"!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keith	None	None	0900006484f7e672	Brown	None	2022-02-16T19:49:41Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Keith	kzo-uwu9-69ki	False	None	False	2022-04-12 01:56:50.277	[]
875	CDC-2022-0024-0881	https://api.regulations.gov/v4/comments/CDC-2022-0024-0881	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient, I was forced tapered of one of my medications in 2019 by the dr who took over the clinic. My NP noted I have increased pain, and depression from being undertreated but my dr refused in December to give the medication back. I was only on 93mme of morphine a day total now I’m below 60mme. The cdc needs to get out of my drs decision making, what is the purpose of medical school if government guidelines are going to prevent my dr from doing what is best my situation. You stuck us all in a small box together, one size fits all is not how our medical community is supposed to work, a 100lb person doesn’t have the same medical needs as the man in the next room. <br/>I was diagnosed in October with progressive idiopathic peripheral neuropathy in my feet & legs and a fractured heel, plantar fasciitis fibromatosis in my left foot. I suffered a month through that because of your guidelines. <br/>The CDC DEA nor anyone else has a right to interfere in my doctors & my decisions about my healthcare. I pay my premiums & I pay my copays yet you took my rights as American citizen away from me when you decided to over rule my doctors medical decisions about my health and my pain care. <br/>Please get out of my drs decision making about my healthcare decisions. The irreparable harm you have done to the pain patients of this country can never be undone. The families who lost love ones to suicide can never be undone. Our veterans who lost limbs and other body parts that you hurt by taking away their opioid pain medications can never be undone. <br/>Maybe you can salvage your reputation, but I doubt that. 50+ million pain patients in this country will never trust the CDC or DEA ever again.<br/>I can be counted among those that won’t ever trust your guidance again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathileen	None	None	0900006484f7e724	Woods	None	2022-02-16T19:50:21Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Woods, Kathileen	kzo-x2r3-h44r	False	None	False	2022-04-12 01:56:50.494	[]
876	CDC-2022-0024-0882	https://api.regulations.gov/v4/comments/CDC-2022-0024-0882	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was 11yrs. old when I hurt my back for the first time. Then after entering the work force. I've had several more injuries and a back disease passed down from my father. I have tried everything to help with the pain. With these series of injuries. I can no longer work. I started at mild pain killers. For the last 9 plus years I have had different kinds of pain meds. The one that makes life bearable is optics. And for the last 9yrs. I have never ask for more, never begged. I have done exactly what my Doctor has ask me to do. From trying other meds, to losing weight, to P.T. I have given up all my pain meds, except the opiods. It's only 4hrs long. I get more relief from it. So I willingly gave up some of the rest to keep this one. What are patients that on pain meds to do about there meds. I feel like we stand on our heads just to keep the ones that really work. I have never been addicted to them. What are we to do about our life? You need to get the ones who are addicted to pills not the ones that have never done anything wrong. We're not the ones that go buy drugs from the drug sellers. Protect our rights and life to lead. We need something that gives us some type of relief. If we showed signs that we're hooked slowly take us off. Don't pull the rug from under us. Sincerely [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f7e757	McCauley	None	2022-02-16T19:51:06Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from McCauley, Lisa	kzo-xxuj-m7mn	False	None	False	2022-04-12 01:56:50.711	[]
877	CDC-2022-0024-0883	https://api.regulations.gov/v4/comments/CDC-2022-0024-0883	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help us with chronic pain get relief. The current guidelines makes that nearly impossible. Acetaminophen & ibuprofen can only do so much. I do everything that I can to not take pain meds but, when you cannot move due to the pain you need something more. 3-7 days of pain meds doesn't always do it. Can you imagine having to see your doctor every week when you're in so much pain that getting out of bed is a struggle? Please, help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484f7e7bb	Allen	None	2022-02-16T19:51:18Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Jennifer	kzo-z1dj-uyo2	False	None	False	2022-04-12 01:56:51.016	[]
878	CDC-2022-0024-0884	https://api.regulations.gov/v4/comments/CDC-2022-0024-0884	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Myself as well as so many others have been effected by opiod restrictions and cut offs. I have scoliosis and chronic pain. I was prescribed percoset back in 2013. Once I got cut off I had no tapering down from my medication it was just taken and all the doctors I tried seeing all thought I was doctor shopping g a d all I wanted was my meds back to be able to do the same everyday tasks without being in constant pain. When I couldn't get the help I needed I went to using other methods like buying off the street or heroin. It COMPLETELY RUINED MY LIFE! I'm truly hoping one day the people like me that have pain like me can use meds like opiods to manage their pain and not be treated or pushed into addicion and lives being ruined all over someone just trying not to live with every day horrible pain! I'm not saying all people should be giving options because their are some people only out to get high off them but not everyone and it's those people looking g a high that ruins it for everyone that actually needs them!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacquilyn	None	None	0900006484f7e7d2	Murdock	None	2022-02-16T19:51:47Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Murdock, Jacquilyn	kzo-zbfx-5k3u	False	None	False	2022-04-12 01:56:51.223	[]
879	CDC-2022-0024-0886	https://api.regulations.gov/v4/comments/CDC-2022-0024-0886	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a woman in my 60s suffering with complex regional pain syndrome after several difficult shoulder surgeries. A pain pump became my only option, but due to the placement of the catheter in my cervical spine, the dosage is so low that relief is minimal. However, I also have severe arthritis that causes immense pain in knees, feet, and hands that remains untreated. I am also a fiber artist trying to teach and encourage others to be the best they can even though my pain is unbearable at times. I fear my health is being ruined by use of OTC, but legal meds such as tylenol, alleve and advil that I must use at the upper limits with little if any effect. My passion is weaving, and that requires mental and physical concentration- a medication that could relieve my 24/7 excruciating pain at minimal dosage would absolutely increase my quality of life and contribution to society. But that is impossible to get in this age of draconian rules. Meanwhile I do the best I can, in tears every day and night with unrelieved pain in most of my body except for the shoulder. I do not understand why persons such as myself, after decades of being a good citizen, must suffer in severe pain every waking hour of every day	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484f7e80e	Kobyljanec	None	2022-02-16T19:53:13Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Kobyljanec , Kathleen	kzp-058w-u7mp	False	None	False	2022-04-12 01:56:51.428	[]
880	CDC-2022-0024-0887	https://api.regulations.gov/v4/comments/CDC-2022-0024-0887	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines that have been in place since 2016 have served as an excellent tool for helping we pharmacists in community practice, help curtail opioid abuse. Without these guidelines we are back to the Wild West, where anything goes and there are no tools to dispute unsafe and inappropriate prescribing. We won’t have a leg to stand on when it comes to refusing excessive opioid prescriptions, inappropriate combination therapy, etc. It seems bizarre that you would make it easier to obtain opioids in a nation that has the highest number or overdose deaths and an increasing number of these deaths. This is the worst professional news I’ve heard in a long time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e842	Anonymous	None	2022-02-16T19:53:30Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-0xsi-n4zq	False	None	False	2022-04-12 01:56:51.692	[]
881	CDC-2022-0024-0888	https://api.regulations.gov/v4/comments/CDC-2022-0024-0888	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been a chronic pain patient since 2006. I turn 57 tomorrow & have been in horrible pain starting in 2017 when I was forced off the medications I once was on that controlled my pain. I’ve been with the same pain management physician since 2006. I worked as a R.N. in the operating room & also served my community as a Reserve Police Officer for 18 years. I always took my medications as they were prescribed & other than OTC meds I never took anything that wasn’t prescribed to me. I’ve never failed the random drug screens taken by my physician. The medications I was on, before the CDC guidelines came out, allowed me to function & perform my daily activities with minimal break through pain. When the 2016 CDC guidelines were instituted and states started cracking down on opioids, it caused a mass hysteria in the medical community. I was personally told by my pain management physician that he HAD to cut me off my medications because he was fearful of the DEA, States Attorney General, or local law enforcement coming after him because he wasn’t in compliance with these Guidelines. When I explained that those were instituted for primary care physicians that didn’t normally prescribe for chronic pain patients and he snapped back “I can’t jeopardize my way of making a living they’ll take my license.” He said “our states attorney general has already charged a physician, someone I knew was a reputable physician.” So out of this hysteria arose fear of loss of license or prosecution. My physician even told me at another one of my visits that “if you have a wreck & someone dies in that wreck & they test your blood & find opioids in your system they can come after me & either take my license or sue me.” Another scenario he gave me was “if you die of a heart attack & they find opioids in your system they can say the opioids was the cause of your death & then they come after me.” These we’re reasons he gave as to why he had to adhere to the 2016 CDC Guidelines. When I asked if he thought this would change as this can’t be a one system fits all he said “I don’t see things changing for 5-10 years if at all.” This is how crazy this opioid crisis has driven honest hard working physicians into no long treating chronic pain patients with medications that worked. They now have switched to Buprenorphine. This Buprenorphine does not cover my pain like my past medications did. It doesn’t allow me to work or do things I could’ve done in the past. Pre CDC guidelines I had a Methadone for my pain & had a hydrocodone for break through pain. My physician switched me from Fentanyl patches when I lost my job because of the restrictions I had from injuries to my back from a car wreck & had no insurance. Now I only have Buprenorphine only & it DOES NOT cover my pain. I’ve been on Gabapentin for years along with Tizanidine. Physicians need to be able to go back to treating patients without fear or prosecution or being held liable. Reversing the 2016 CDC Guidelines would be a start but there needs to be more. The CDC Guidelines were an over step as it’s the FDA that should be the guiding force since medications fall under the FDA umbrella. The CDC has caused undue harm to millions of chronic pain patients causing undue suffering & pain for the last 6 years. I’ve lost out on time spent with family because I was in to much pain to attend outings. Day’s I couldn’t sit in a chair because of pain to visit with family & had to go lay in my bed. I’ve spent more time in my bed in the last 5 years than I did in the 10 years before being taken off medications that I was on before the CDC guidelines. Many people worry about the comfort & being able to interact with their loved one and not worry about their level of pain. Pain management is a key part of managing this & they need to be able to do their job without fear. If pain is well managed, quality of life will be better. The person is likely to sleep better and have more energy during the day. If they feel less pain, they can be more active, which also reduces the risk of complications. It’s well documented that people in chronic pain if left untreated are more likely to suffer decreased mobility, impaired immunity, sleep disturbances, migraines, depression, as well as shorter life span. With the recent Covid outbreak this can only increase the risk factors for those suffering from lack of adequate pain control of their chronic pain. Then there’s those chronic pain patients that have died because they couldn’t handle living in pain anymore. [name redacted] has been a voice for those as well as an outspoken advocate for chronic pain patients & their constant struggle.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7e86d	Anonymous	None	2022-02-16T19:55:25Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-1ji7-z596	False	None	False	2022-04-12 01:56:51.931	[]
882	CDC-2022-0024-0885	https://api.regulations.gov/v4/comments/CDC-2022-0024-0885	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f7e7fa	None	None	2022-02-16T20:01:03Z	None	None	0	None	2022-02-16T00:00:00Z	None	improper redaction--reposting full comment.	None	None	None	None	None	None	None	None	Comment from Engel, Winslow	None	True	None	False	2022-04-12 01:56:52.149	[]
883	CDC-2022-0024-0889	https://api.regulations.gov/v4/comments/CDC-2022-0024-0889	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC is providing helpful leadership in the contentious issues related to opioid prescribing. The Pain Management program at [name of health facility redacted] applauds the previous and current efforts to underscore the complexity of opioid therapy in the 2020's. Specifically, we endorse efforts to support practitioners working in this challenging area of medical care. We would like to see:<br/><br/>1. More grants to support use of "hands-on" therapies in chronic pain management including PT, osteopathic manipulation, acupuncture, therapeutic massage and chiropractic care<br/>2. More grant support for incorporating cultural practitioners into multi-disciplinary teams working in pain management - we have been successful in adding Hawaiian cultural practices, herbs, Lomi-lomi massage to our team's approach. We would like to build on this success.<br/>3. Shifting the DEA and state narcotics boards emphasis towards a more useful role in sharing information about best practices and away from engendering fear among practitioners. <br/>4. Helping insurers to recognize that the risk of black market opioids (often laced with Fentanyl) currently has eclipsed the risk from prescribed pain medication. Placing administrative obstacles in the way of legitimate treatment of pain disorders drives patients towards black market products with their attendant risks.<br/>5. Encouraging pharmacists to be a part of the prescribing team with easier communication and a recognition of mutual goals for safe, prudent prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Winslow	None	None	0900006484f7f291	Engel	None	2022-02-16T20:04:35Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Engel, Winslow	84f7f291	False	None	False	2022-04-12 01:56:52.410	[]
884	CDC-2022-0024-0890	https://api.regulations.gov/v4/comments/CDC-2022-0024-0890	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you to the committee for a detailed and thoughtful review of opioid prescribing and recommendations. The work on this project sets an important national gold standard. <br/><br/>Here are a few comments to consider:<br/><br/>Recommendation #10.<br/>OWB observations<br/>First bullet. Third sentence. “Perhaps cannabis should be approached similar to alcohol, which is not routinely tested among individuals taking opioids.”<br/><br/>This is a problematic statement and should be removed. The SAMHSA testing guidelines include THC in drug testing. Is the CDC disputing recommendations from SAMHSA?<br/>Furthermore, cannabis (THC) interacts with over 300 medications and cannabidiol (CBD) interacts with over 500 drug interactions. With the growing commercialization of cannabis more adverse drug interaction occur. Some drug interaction, such as ones with blood thinners can be life threatening.<br/><br/>Recommendation #11.<br/>Recommend adding a bullet that cannabis is not recommended for patients with an opioid use disorder. (ASAM)<br/><br/>Please don’t wait six more years to address the the growing number of cannabis related medical complications that exist today, many stemming from people who use cannabis for pain. (IASIC1.org)<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roneet	None	None	0900006484f7e8a5	Lev	None	2022-02-16T20:05:14Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-15T05:00:00Z	None	None	None	None	None	None	None	Comment from Lev, Roneet	kzp-2hrh-wj2l	False	None	False	2022-04-12 01:56:52.646	[]
885	CDC-2022-0024-0891	https://api.regulations.gov/v4/comments/CDC-2022-0024-0891	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regarding Doc.Nr. CDC-2022-0024, I believe any new regulations on prescribed opiates must strongly consider Dr./patient pain management relationship. When the pain issue is expected to require a short term solution, surgeons and primary doctors should have the latitude to prescribe opiates when necessary. Long term requirements should be decided by both the patient and Pain Management Specialists (PMS), with the patient being fully briefed on the perils of opiates. PMS are best suited to provide such remedies and most able to recognize signs of misuse. A one rule fits all approach cannot be expected to be useful.<br/><br/>Pharmacists can also be trained to both recognize over-use by a patient, as well as be aware of doctors who over-prescribe and fraudulent use of a doctors prescription pad. I've witnessed my Pharmacist refusing to fill any scripts by a certain doctor as I waited in line for my script to be filled.<br/><br/>So there are built-in safeguards we can rely on, by simply requiring doctors and Pharmacists observe and report suspected fraud.<br/><br/>In summary, we should provide pain relief where needed and step up observation and enforcement.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484f7f796	House	None	2022-02-16T20:50:18Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from House, William	kzp-tvml-qah2	False	None	False	2022-04-12 01:56:52.981	[]
886	CDC-2022-0024-0892	https://api.regulations.gov/v4/comments/CDC-2022-0024-0892	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Senior Citizen with chronic pain from a back injury when I was 14 years old that has left me with a pretzel shaped spinal cord in my lower back. I have been examined by spinal experts in the medical field. My last visit with the Cleveland Clinic confirms that a surgical option is not reasonable. I do live my life with some physical restrictions which interferes with my daily activities, exasperated due to recent opioids fears for the general public. It has left me with chronic misery due to cookie cutter opioids prescribing restrictions my Doctors are forced to follow. I accept that I can no longer do certain physical activities but I should not have to live my life with such pain that I now live with. In the past, even a marginally smaller increase in the amount of opioid pain medication improves the quality of life I have. I now have to plan my life around the limited medication I can receive from my pain doctors. I am not seeking narcotics because I want to get high, I have a condition that warrants some individualized care management. I once had this with my doctor but now they are afraid to be singled out from the Board of Pharmacy and the regulators that they are "pill doctors." I agree that we do not need "pill doctors" just feeding pills to individuals that do not have legitimate needs. I support allowing my pain doctors the freedom to treat my condition without fear of regulatory cookie cutter oversight. I also in the last few years have been forced to be treated like a drug addicted criminal to obtain the limited medication. Please consider and allow my doctors to be able to provide and prescribe medications to improved my quality of life without being treated as a criminal. I need your help and please allow doctors to develop my care plan in an individualized care management way. Please help correct what has developed the last few years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	0900006484f7f7b6	Obojski	None	2022-02-16T20:51:33Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Obojski, Catherine	kzp-u97k-0s8i	False	None	False	2022-04-12 01:56:53.190	[]
887	CDC-2022-0024-0893	https://api.regulations.gov/v4/comments/CDC-2022-0024-0893	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Apparently the CDC has never had the pain that comes with are illnesses or situations.,I have a spinal cord injury my pain is intense I use opiats so I can function somewhat during g the day I find people that abuse opioids are the people that are not prescribed them so they can get high. Let's wake up u dint get high when I take mine they allow me to function somewhat normally. Let's stop this nonsense. Stop allowing non prescribed people from getting them. And allow those who are to live are life's somewhat normal with dignity!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marshall	None	None	0900006484f7f7d5	Buersken	None	2022-02-16T20:55:04Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Buersken, Marshall	kzp-ud2o-kglq	False	None	False	2022-04-12 01:56:53.465	[]
888	CDC-2022-0024-0894	https://api.regulations.gov/v4/comments/CDC-2022-0024-0894	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered greatly from the CDC guidelines on prescribing opioids, and the policing from the DEA. I’ve been in chronic pain since 2015. Two failed lumbar surgeries made the pain worse. I went through physical therapy and multiple steroid injections with no relief. In 2019, I had a spinal cord stimulator implant. I suffered greatly for two weeks with horrible surgical pain and because of the restrictions of prescribing opioids, I was only allowed pain medication for three days! It was NOT enough and I cried constantly because the pain was unrelenting! I continued to suffer after the surgery and had to seek a pain management physician. I, again, went through physical therapy which made my pain worse and all the injections that pain doctors want their patients to have instead of pain medication. Each time I had a steroid injection into the spine, I had to pay a co-pay for the ambulatory surgical center in the amount of $250. After none of the injections helped, my doctor FINALLY prescribed Hydrocodone 5/Acetaminophen 325 and ONLY 1 A DAY! It only took the edge off my pain…again, I suffer! After a year, the doctor upped the dose to Hydrocodone 7.5/Acet325…AGAIN, only 1 a day! I have Degenerative Disc Disease throughout my entire spine, Scoliosis, Osteoarthritis, Facet arthritis, Stenosis, Foraminal narrowing, bulging discs, peripheral neuropathy, Fibromyalgia, Spinocerebellar Ataxia, etc. At 68 years of age, I will get progressively worse! In addition to suffering with pain, the pharmacists but in and will reduce the amount of medication the doctor prescribes, and will ask you why you need pain medication, etc. WHY is there no patient-doctor relationship anymore??? Why are the good doctors being made to pay for the unethical scruples of the doctors who started all of this??? My life suffers from being in pain ALL the time! Why can’t I have the medications my doctors and I decide upon??? The legislation of the states and insurance companies have gone along with the CDC and make it even harder to get the relief needed by pain patients! PLEASE, PLEASE, PLEASE help me!!! What keeps happening to chronic pain patients is a denial of their rights to be treated with lawful prescriptions that are proven to work! OH, and now I have NASH…so taking NSAIDs are damaging to me, but I’m forced to take a lot of them trying to get pain relief. I wish the good-hearted people with morals and good ethics will become courageous and fight for those of us who need help! I’m afraid these new guidelines will not help…lowering the “less than 90 MME daily to 50 MME” will hurt not help!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dianne	None	None	0900006484f7ffc4	Pitts	None	2022-02-16T21:24:38Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Pitts, Dianne	kzp-vkvd-y708	False	None	False	2022-04-12 01:56:53.709	[]
889	CDC-2022-0024-0895	https://api.regulations.gov/v4/comments/CDC-2022-0024-0895	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a disabled veteran. 100% permanent disability rating. I have always used my opioids as responsibility as possible. Pain is not something that can be predicted. If I am active, I hurt more. If I worry, I hurt more. Any regulations that may restrict patient care are only going to cause more problems. I hurt to the point of exhaustion. I need more help than I'm allowed. You have supplanted my life with debilitating pain. Let doctors do their job without fear. I have been driven to self-harm and mostly bedbound for years; all due to forced taper. Doctors are afraid to prescribe. I wish I was dead. I'd gladly take my own life, but my family would lose my paycheck. I'm suffering with undertreated pain and unable to even end my own life. <br/><br/>Please remove these barriers. Monitoring is all that is required. <br/><br/>Let individual responsibility prevail. Government entities should not be involved in individualized health care. You claim to allow it, yet your guidelines are a direct contradiction for individuals getting personalized care. <br/><br/>Opioids work, and have worked for centuries. I've had almost every possible treatment for my pain. Opioids are one of the best options that I have. Please help me have a little bit of relief. <br/><br/>Remove recommended maximums. Let doctors evaluate their patients. Or many will continue to suffer. Doctors and patients alike.<br/><br/>Thank you for your time.<br/><br/>Very Respectfully,<br/><br/>EM(N)1 SS USN retired	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7ff1f	Anonymous	None	2022-02-16T21:30:09Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-uy5t-hqbr	False	None	False	2022-04-12 01:56:53.939	[]
890	CDC-2022-0024-0896	https://api.regulations.gov/v4/comments/CDC-2022-0024-0896	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting as a daughter of a 74 year old Mother who is fighting cancer. Your agency has indeed limited her doctor and pharmacy to fill medications that would limit her pain caused by the HOLES in her BONES from this cancer. Now, I am going to comment on the behalf of my 84 year old Father who retired after 27 years from active Duty from the Army as a Ranger of 82 AB. With this he became NATIONAL Guard. This man is a combat Vet and cancer survivor. His biggest battlefield has been with this agency because the bulk of his impressive military service left injuries that he should have some pain relief from. BOTH my elderly parents deserve some sort of quality of life and I do not think 5 mg of Norco is hardly going to have my 74 year old cancer ridden Mother dealing drugs or my 84 year old Green Beret wearing Daddy addicted out on a corner. But, this is how they have been treated by you policies. It's insulting and humiliating to see how these policies have treated them. It is demeaning, discriminatory and violates their Constitutional Rights. I am furious that these policies have impacted my parents who are suffering beyond measure. I feel certain that whomever decided these never have endured severe pain. Pain so bad they hyperventilate...or fully understands that pain is actually a stimulant and there is a low incidence of those who are in real pain abusing their legally prescribed medications. Or that pain can somehow rewire neuro-transmitters so that pain medications do not always react the same way as they would if rx'd on the non-pain mgmt pt...so if this dimwit is worried about the getting a high...they might need to review some more research and talk to more front line pain mgmt doctors???? I wonder if they had a cognizant moment to understand that pain is used as a form of torture and a Human Rights violation and whomever has come up with this should be reported and brought upon Human Rights Violation Charges. My parents deserve so much more than this. Any living being that has a medically documented rational to have some sort of quality of life that a brings down pain deserves such. THERE IS A DIFFERENCE BETWEEN TRYING TO GET SOME RELIEF FROM PAIN AND/OR TRYING TO GET HIGH. Let the Doctors, Counselors, Pharmacists do their jobs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484f80060	Carbrey	None	2022-02-16T21:33:08Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Carbrey, Stephanie	kzp-w6vd-mhl8	False	None	False	2022-04-12 01:56:54.196	[]
891	CDC-2022-0024-0897	https://api.regulations.gov/v4/comments/CDC-2022-0024-0897	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove any reference to MME (morphine milligram equivalent) from these new updates. I truly feel that everyone is so different that MME makes no sense to add. Not only that, just the idea of a potential limit scares doctors into prescribing below that number, discriminating against patients who legitimately need more medication than that, further widening the gap between the doctors patient relationship & actively encouraging doctors to ignore the needs of their patients. The entire chronic pain community, myself included, have requested this specific change for a long time now. It’s long past time to abolish the Opioid Prescribing Guidelines in general, they do no good. But if we can’t do that, we could at least remove the hard limits - the biggest problem I’d say we ALL have in receiving life-saving medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebekkah	None	None	0900006484f80064	Morris	None	2022-02-16T21:33:52Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Morris, Rebekkah	kzp-w9k4-bsdr	False	None	False	2022-04-12 01:56:54.408	[]
892	CDC-2022-0024-0898	https://api.regulations.gov/v4/comments/CDC-2022-0024-0898	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow Doctors to determine that their patient is in need of opioid medication. There are people with chronic conditions that are rendered immobile due to pain and needless suffering due to current legislation. My heart truly goes out to family's that have lost loved ones due to negligence, and addiction. But this is not the case of those with inoperable health and physical conditions who only have medicine and minimal to zero options to reduce pain. There are people who literally can not contribute to society as they would love to due to pain and Needing a high dose of their only relief. Everyone does not abuse opioids and is there only recourse. Please allow Dr. to administer pain medication to chronic sufferers that have no other option for their pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8010d	Anonymous	None	2022-02-16T21:34:17Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-wnj7-p8jd	False	None	False	2022-04-12 01:56:54.643	[]
893	CDC-2022-0024-0899	https://api.regulations.gov/v4/comments/CDC-2022-0024-0899	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer who has had no relief since the strict guidelines were imposed. I did all the alternative treatments to no avail. Some of the time I can relieve the pain with mega doses of ibuprofen, but that’s not good for my kidneys. I fully support the easing of restrictions because chronic sufferers like me have been disregarded for years now. One prescription for 30 five mg tables of hydrocodone can last me between two and four months but I can’t even get that under the present guidelines. Please pass the new ones.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f80663	Heiser	None	2022-02-16T21:38:33Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Heiser, Susan	kzq-1vdw-mu5n	False	None	False	2022-04-12 01:56:54.855	[]
894	CDC-2022-0024-0900	https://api.regulations.gov/v4/comments/CDC-2022-0024-0900	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Rhuemitoid arthritis is 2012. I was referred to pain management after my feet, elbow, lower back and hands couldn't take the pain any longer just taking over the counter meds. I actually developed an ulcer from taking so much Tylenol and alieve. I started on a very low dosage of pain medication in the beginning. They made my life, MY life again. My drs were able to give injections and maintain my pain level all that time, to where I could at least function enough to care for myself and my home again. With no warning at all, I was forced to go from that functioning level, down to a level where I am barely able to do personal tasks.And someone other than my Dr set this level for me. A level that my Dr agrees does NOT control my pain. I am now on the 90mme set out by YOUR guidelines. I now can no longer function in every day life. I am now made to live in constant PAIN. A decision NOT made by my Dr. But, by YOU. You have taken away my access, to my own life! And now you threaten to suggest even lower. You are killing people. Literally. I personally know 3 lives that were taken by there own hand.. Because they could no longer live in that constant pain, that I suffer now. I have x rays. I have medical records. I have blood test. I have monthly urine test like a criminal. I have MRI's. Everything my Dr needs to see to know I'M IN PAIN. REAL PAIN. I'm suffering because of these "guidlines" you put on my Drs. You have made it law to them. They fear you, more than they care for me. So , as long as you continue to threaten them... They Will continue to let us suffer.. NEEDLESSLY. The medication is in existence to help me, and MANY like me. We can't go make big protest and walk the capital to make our voices heard. We are disabled and in PAIN. It is all I can do to make it to my every single month Drs appts. You should feel ashamed for what you are putting us thru. Not to mention all the older people I see in the office that they are making jump thru the same hoops. You are drug testing grandma's and grandpa's! I can't even imagine how humiliating that must be to them. Because I know how humiliating it is to me! I am very responsible with my medication and keep them under lock and key. I take my medications as proscribed to me by my Dr. My Dr is very capable of caring for me without you making his decisions, for him. Please reverse the course you have taken. Unless your intent is to eliminate large numbers of us who are suffering daily. And for no reason. The blood of those who have already taken their lives, is on your hands! God forbid you or someone you love have to live and suffer from an injury or disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kris	None	None	0900006484f8012a	Dilbeck	None	2022-02-16T21:39:07Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Dilbeck, Kris	kzp-wyk3-94h0	False	None	False	2022-04-12 01:56:55.119	[]
895	CDC-2022-0024-0901	https://api.regulations.gov/v4/comments/CDC-2022-0024-0901	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I heartily urge all to watch in its entirety Amazon Prime’s GOLIATH Season 4 with Billy Bob Thornton to understand what is going on with respect to opioids and the pharmaceutical manufacturers regarding marketing practices and their overriding motive of profit-maximization. The pharmaceutical companies, their top management, and owners should have NO SAY WHATSOEVER over if, when, how, where and to whom opioids are prescribed, which should be restricted exclusively to qualified medical doctors in consultation with their patients.<br/><span style='padding-left: 30px'></span>Opioids should only be prescribed to those suffering objectively measured chronic pain accompanying terminal illnesses such as cancer. Rigorous testing of all opioids to determine reasonable and safe levels of dosage/exposure published in a legitimate peer-reviewed medical journal must precede any individual prescriptions.<br/><span style='padding-left: 30px'></span>Congress must take steps ASAP passing legislation to end the capture of all relevant regulatory agencies of the federal government, which has turned the FDA, CDC, and NIAID (among others) into virtual subsidiaries and profit-centers of these corrupt and insatiable industries.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f80636	None	None	2022-02-16T21:39:10Z	The Edwards Trust	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from The Edwards Trust	kzq-1fpr-eiit	False	None	False	2022-04-12 01:56:55.338	[]
896	CDC-2022-0024-0902	https://api.regulations.gov/v4/comments/CDC-2022-0024-0902	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is best to start out saying: " UNLESS you ARE or HAVE experienced CHRONIC pain, you have NO idea WHAT we experience OR HOW we feel. THUS they are NOT qualified to rule, comment, judge or have a opinion. I HAVE been in CHRONIC pain since 2001 as a result of hard, repetitive manual labor and several injuries. Some injuries were addressed by surgery. Some injuries went without surgery. AFTER being told by a Renown Orthopedic Surgeon that I needed to change careers due to the damage to my body, I enrolled in Medical school Graduating with honors 6yrs later as a Nuclear medicine/ MRI Technologist. While in school, I developed CHRONIC pain Which SLOWLY but deliberately got worst. I would reluctantly take OTC ibuprofen or acetaminophen to help the pain. By 2010, the CHRONIC pain was SO bad I resorted to seeing a Rheumatologist who prescribed Meloxicam. INITIALLY, it worked well. But after a year it was not sufficient to reduce my pain level substantially. LET me interject here to simply say my injuries and pain was from my back ( cervical thru the lumbar region )and right knee. IN 2011, I began going to pain mgmt. It was only then I began taking OPIATES. I was prescribed low dose ( 5mg ) tablets and took them AS PRESCRIBED. SINCE the doctor understood and documented my past medical history, he prescribed four ( 4 ) tablets a day. SURGERY NEVER WAS a option for me BECAUSE performing the THOUSANDS of imaging exams I did over the years, I SAW 1st hand the POOR ratio of SUCCESSFUL surgeries for back problems. I DID have NUMEROUS knee surgeries; but NONE being able to permanently fix the problem. In the mid-90's, Pain Mgmt Clinics BACKED by pharmaceutical companies were prescribing OPIOIDS to those ( indicating need ). Unfortunately, drug addicts were ALSO devising and developing WAYS to get prescribed opioids. CAUGHT in the middle WAS the physician. Being urged by his EMPLOYER; given INCENTIVES by the pharmaceutical reps And DECEIVED by the MAJORITY of his patients. SO WHEN the CDC came out with their 60 page " guideline " in 2016, THIS was ALSO a LIFELINE for the DEA. Their funding HAD been drying up. In some parts of the US, they were begging for funding from County & City governments to keep their local office open. SO they AGGRESSIVELY ENFORCED measures SUGGESTED by STATE HEALTH AGENCIES. * The states MANDATED the clinics follow the " guidelines " from the CDC. EVEN THOUGH in reading the " guidelines ", it closes by stating the PHYSICIAN SHOULD HAVE the FINAL say in treatment of his patients. BUT DUE to pressure and intimidation from the DEA, physicians started cutting prescribed dosages IN HALF. * DOSAGES which WERE given BASED on DOCUMENTED imaging, lab and medical history. FOR people LIKE ME, it WAS a terrifying ordeal. CHRONIC PAIN IS 24/7. IT IS also Moderate to Severe. I feel like I was a lucky one. ONLY through research did I find a option that worked for me. MOST opioids have a 4 to 6hr half-life. I found buphenorphine, usually NOT given for " pain mgmt " had a 12hr half-life. SO I approached my doctor & asked for: #2 - 2mg tablets a day INSTEAD of the #2 - 10mg percocets I was taking. He delightfully agreed. SO for the last 10yrs, I HAVE been on this regiment. IN THE MEANTIME, the Drug Addicts HAVE turned to ANY OTHER medication they can find that WHEN ABUSED can give them the high they seek. ie, Gabapentin.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f80160	Hodges	None	2022-02-16T21:54:05Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Hodges, James	kzp-x2rs-8510	False	None	False	2022-04-12 01:56:55.583	[]
897	CDC-2022-0024-0903	https://api.regulations.gov/v4/comments/CDC-2022-0024-0903	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Do I have a life? I live alone and have a chronic pain condition, psoriatic arthritis and fibromyalgia. I’ve been fighting these conditions for over a decade. Finally two years ago, after a working as a hospital pharmacist for 27 years, I had to stop working and go on disability. I was in too much pain to keep up with the demands of my disease. Each year my condition worsens. My function decreases and my pain increases. But my physician is afraid to prescribe effective and adequate pain control. They fear that they’ll get in trouble with the DEA. So, I am basically housebound. I have great difficulty taking care of myself and my house. It’s very stressful to see everything around you falling behind. And the isolation is even worse. I’m alone. I’m in so much pain. And I was a pharmacist so I know that treatment exists that could change my life. <br/>I shouldn’t be required to live like this because there are some people who abuse opioids. My condition will never go away. Damage has been permanently affected the joints in my body. Why is the government interfering in the practice of medicine? Why am I forced to live in pain, with no quality of life? There have been many times when I’ve considered ending my life. Times when I just couldn’t bear the pain and isolation. What kept me here? Firstly, my pets. I can’t bear to leave them without knowing they’re cared for. Secondly, I can’t bear the idea of causing my parents the pain that ending my life would cause them. And lastly, I don’t want to die. I want to live. I just want to have some relief. I want to be able to stand for more than 2 minutes. I want to do my laundry and my dishes. I want to be able to stand up and fry an egg on my stove for breakfast. I don’t want to resort to ordering out fast food delivery for every meal because I’m in too much pain to cook. I’m asking for things that most people take for granted. Things that I once took for granted. My husband left me and ended it marriage because he wanted someone who was more functional. He was tired of my depression related to my condition. So, I was thrown away. But first, I was thrown away by the medical community, who had the answer to my pain, but withheld treatment. My physician withheld treatment because they were afraid based on the CDC 2016 guidelines. There should be no MME for pain. Pain is progressive at times. There isn’t a “one size fits all” dose regarding pain management. And length of pain is also individual. Different surgical procedures result in varying intensity and length of pain. Chronic pain patients have a tolerance to pain meds. So, when undergoing surgical procedures, their pain management requirements may significantly differ from an opioid naive patient. This is basic pharmacology. There are many patients avoiding life altering and life saving surgical procedures because they’re fearful of inadequate pain control following surgery. How is this possible? Also, many pharmacies abd practitioners are forcing patients to choose between treatment fir their pain or their anxiety. Chronic pain patients are especially susceptible to depression and anxiety. It makes sense. Imagine living 24/7 in uncontrolled pain. It’s a natural progression to develop anxiety and depression. Why is a chronic pain patient forced to choose which condition to treat? It’s barbaric. We don’t ask a diabetic either hypertension to choose their insulin or their blood pressure medication. Both pain and anxiety can be successfully treated with proper medical supervision. It’s very easy to monitor patient prescription requests and refills. If your patient requests their prescription too early, a red flag is easy to catch. There is no need to punish all patients from receiving medical treatment. Problematic patients are easily identified. And limiting treatment will only lead to potentially dangerous outcomes. There are an increasing number of pain and anxiety patients resorting to the illicit practice of seeking relief on the street. This last resort is an extremely dangerous choice. We’re all now aware that the deadly drug fentanyl is now tainting more and more street drugs. A mother in chronic pain just wants to take care of her children. She feels guilty that she can’t be the wife and mother that they need. She’s been denied pain control by her physician. She ends up on the street searching for an answer. But she ends up overdosing on what she thought was a Vicodin tab, but it was a fatal dose of fentanyl. This is wrong. And it’s cruel. Pain can be treated responsibly and adequately. The CDC should allow individual physicians the ability to care for their individual patients. We just want to function and lead a positive life. Please allow us that option. Please give us hope again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	KarenKaren	None	None	0900006484f802e0	Davidson	None	2022-02-16T21:56:43Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Davidson, KarenKaren	kzp-y54d-94lk	False	None	False	2022-04-12 01:56:56.034	[]
898	CDC-2022-0024-0904	https://api.regulations.gov/v4/comments/CDC-2022-0024-0904	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I welcome the revised guidelines. However, I feel we must remove the mention of MME from the guidelines. Dosing should be left to be determined in the good faith of doctors. I also feel that reinstating the 90 day refill would greatly improve the lives of many chronic pain patients by eliminating the fear of potentially not being able to get their meds due to mobility restrictions from disabling conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484f80354	Christianson	None	2022-02-16T21:56:59Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Christianson, Nicole	kzp-yd79-rhxl	False	None	False	2022-04-12 01:56:56.253	[]
899	CDC-2022-0024-0905	https://api.regulations.gov/v4/comments/CDC-2022-0024-0905	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from Chrones disease, I have tried many many different medications, nothing but high levels of steroids worked, with bad side effects. Biologics made me sicker. One Percocet a day stops my cramps and slows my bowel movements. Gives me quality of life. Also because of my autoimmune disease I have frequent joint pain, because of Chrones I can't take most over the counter pain meds, Percocet is the only relief I get, it doesn't upset my stomach and bowels, and works<br/>wonders on my Chrones <br/>I dont doctor shop and I follow the rules, please don't make doctors afraid to prescribe these meds long term for legitimate patients	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484f803be	Weckman	None	2022-02-16T21:57:25Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Weckman, Thomas	kzp-yp4j-pkf3	False	None	False	2022-04-12 01:56:56.461	[]
900	CDC-2022-0024-0906	https://api.regulations.gov/v4/comments/CDC-2022-0024-0906	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[Name redacted]. I have several painful conditions. Osteoarthritis in both hands,wrists my right knee ad hip. Full thickness tear in left shoulder right elbow bone chip,bunion on left toe ,and degenerative disc disease along with disc herniations throughout spine. Had adequate pain control from 2006 to 2016. Then the government decided to stop prescribing opiates for chronic pain. So back in2016 the Fountain pain clinic claimed my urine was dirty with methadone a drug I never used in my ilife. I was a married 61 year old man with a son and a home. I wasn’t some street thug using illegal drugs. Anyway from 2007 to 2016 my pain was under control. But when I was dismissed from clinic it was impossible to get any pain relief cause I was looked at someone seeking drugs for fun. A local doctor in Staten Island said the best he could give me for pain was Buprenorhine. I now live in constant pain cause the buprenorphine helps very little. I tried PT alll over the counter drugs and nothing worked. It’s a shame that in America today you don’t even have the option for pain control cause doctors are fearful of prescribing this medicine. So now I’m no longer living just waiting for my life to end. All because the government thought that by preventing pain patients from getting medicine that would really help overdose deaths Instead they have increased. This ridiculous plan of not letting doctors prescribe pain medicine when needed turned into amajor mistake. More overdoses than ever along with people who suffer needlessly It’s as if the government won’t admit the plan didn’t work. Hopefully they will reconsider their stance on not allowing patients to be helped. This is for docket no. CDC 2022-0024	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f80482	Steele	None	2022-02-16T21:59:38Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Steele, James	kzp-zmdj-hcfr	False	None	False	2022-04-12 01:56:56.673	[]
901	CDC-2022-0024-0907	https://api.regulations.gov/v4/comments/CDC-2022-0024-0907	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Limbic Encephalitis, Ankylosing Spondylitis, Psoriatic Arthritis, Mixed Connective Tissue Disease, Adrenal Failure, have had 2 strokes with stroke pain and this is no longer America as I am being denied my pain medications by pharmacy’s all over, suffering in extreme pain and overwhelming fear of how I will get my next month’s medication. I have no rights. My doctors cannot even save me ( they are frustrated and can do nothing) due to the power of the government and the pharmacist’s fear of them! It’s absolutely gone insane. My doctors try and help get me help and they cannot even do it! Then some pharmacy’s treat me like a drug abuser ( very rudely) or make me bring ALL my medications to their pharmacy (if they even WILL fill my pain meds) but then refuse goodrx or any competitive pricing. They will price gauge me as they know I’m trapped. I can hardly afford my medication as it is! I have to take steroids to live and function and the stress of this government control is absolutely aging and killing me beyond my own disease. Why is the government telling me what pain medication I need?? Leave it to my doctors! And why are the pharmacy’s so powerful? Fear of the stupid laws! Meanwhile I am quivering in pain and fillled with fear for tomorrow. Just fighting to stay out of pain with the stress of the laws controlling me is making me much more unwell! I have no guarantees that my pharmacy will get my pain medication to me on time. I take it 6 times a day for years as the nerves around my sacriollititic joints and hips are inflamed and I have deep, horrendous, resistant pain all the way down my hips, buttocks, legs and upward into my back so much that I feel like I’m in labor. And I would go into withdrawel and be in terrible pain, even be hospitalized, if they can’t just order it to have for me regularly, but they say the government has rules that they have to build up their quantities slowly. But they can’t do a partial fill. So I may have to wait between orders. But I can’t! And meanwhile I would have transferred all my medications there. There is no way to save the meds up as the rules are too stringent and I need to take all my medication. I am so sick and I have so many problems. I cannot cope with people who make these crazy rules meant to stop kids and people who have addiction problems but they are getting it not from the pharmacy anyway! You are making ME suffer when I go to the doctor and follow the rules. I have brain swelling and seizures and nerve pain and strokes and joint pain and unbelievable suffering and WHY not just allow me to get the pain relief I need? Would you want your mother to suffer this way? I literally shake when I call the pharmacist. I have fear of them now. I am so afraid I won’t get my medication or go broke trying. But mainly I can’t even get the medication so often just because of the fact that they are afraid. And it’s making me suffer so, so much. PLEASE stop this madness and give our freedom back! I didn’t use to be be for legalizing drugs but if marajuana and cigarettes and frankly junk food are legal then just give me my prescribed pain medication without all the rules! And let me transfer it to another state so I can go see my kids! I need to have the freedom to travel if I even ever CAN due to my health but I’m trapped due to the fact that it can’t be filled in another state and I’ll run out. People are suffering and this is not supposed to be happening in America! And pharmacy’s shouldn’t overpower the doctor either. Please give us our freedom to get medical care and pain management. Stop making it impossible for me to find a willing pharmacy in South Florida! Help!! I will die soon from this if it’s not stopped. I shouldn’t have to be this afraid of suffering just because of the governments overbearing rules. The rheumatologists won’t even prescribe pain medication anymore for arthritis! I mean this is crazy. I have to go out again to the pain doctor and I have seizures and I have to go monthly because that is the rules and get my same medication again for $150 an appointment every time. Then the face of the hassle with the pharmacy’s again and hope it comes on time. I can only hope someone is listening. I pray that you will have empathy in your heart for something you can only imagine and pray that you never have to go through. But please allow me atleast the relief of the relaxation of the rules so this stops. I just don’t want to be in fear of pain anymore. Please vote to relax the laws on opioids and controlled medications. You are not solving the problem by keeping these laws but you are sure creating a terrible one if you don’t. The drug abusers will get something else. Don’t make me suffer due to them. If YOU had what I have I promise you would change it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather	None	None	0900006484f804b3	McCready	None	2022-02-16T22:02:28Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from McCready, Heather	kzp-zuyn-caqk	False	None	False	2022-04-12 01:56:56.911	[]
902	CDC-2022-0024-0908	https://api.regulations.gov/v4/comments/CDC-2022-0024-0908	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Opioid Guidelines must be changed for Chronic Pain sufferers. Fifteen years now I’ve been suffering with chronic pain and other symptoms in my feet and hands due to an idiopathic, incurable neuropathic disease that has gotten progressively worse.<br/><br/>I’ve endured numerous EMGs, foot and spinal surgeries, nerve blocks, spinal stimulators, homeopathic remedies etc., all without relief or cure.<br/> <br/>This pain is constant, debilitating, life-altering, and spirit-crushing. <br/><br/>My only relief has been the PRESCRIBED opioid pain medications I take that don’t render me pain-free, but give me some relief and allow me some level of normalcy in my daily life.<br/> <br/>Due to the CDC Guidelines, my insurance company abruptly stopped approving one of my medications. This means more pain, disability and suffering. Read the effects of chronic pain on the human body, they're real.<br/><br/>This blanket ruling on prescribing opioids without consideration of chronic-pain sufferers is not the answer to the opioid crisis, it's inhumane - lacks any compassion for the misery of others. Surely, there's a better way.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f804b5	Anonymous	None	2022-02-16T22:03:27Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-zvb3-rxta	False	None	False	2022-04-12 01:56:57.128	[]
903	CDC-2022-0024-0909	https://api.regulations.gov/v4/comments/CDC-2022-0024-0909	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi, thank you for opening your eyes and hearts to the realistic suffering of so many people. Thank you for admitting you made a mistake and are trying now to correct it. We all appreciate this. <br/>I'm a social psychologist, at [School Name Redacted] School, and would love to help you structure this policy if you are looking for anyone. For free. <br/>I've had lower back pain since 2006. I just started looking for meds in the past year as I realized how much they actually help. I got my life back. I can cook a full meal for my daughter, clean the house, garden, focus on my lectures, get out of bed without being in moderate to severe pain. Im not irritable, suicidal, dispondent from a life lived horozontally from the couch. I take my medication conservatively, as a Dr would prescribe them. They are left over from a surgery. When they ran out, I couldn't function anymore. I was back to the darkness of life lived on a couch. My house got dirty. I didn't make good tasty meals for my daughter, I couldn't sit upright to teach her. It was hard to maintain focus in classes. <br/>I can't get a prescription from any doctor. It is ruining more than one life. And because of the work I'm doing, it will effect thousands more. People like me need help and medication. <br/>And yes, I do PT, yoga, eat healthy, exercise, get sleep, take anti depressants, and have seen chiropractors on and off since 2006. I don't even drink. I want my life back. I feel strongly that forcing us to choose between suicide, a terrible life in pain and half engagement, and obtaining medication in a way that could compromise our freedom, is incredibly cruel and oppressive. <br/>Please, please, PLEASE, realize the full effect of this. And as a patient, I should have the choice regarding my body, if I want to take my chances with the side effects. The cost benefit analysis is mine. It's my life. Please, let us live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f804d3	Anonymous	None	2022-02-16T22:06:43Z	None	None	1	None	2022-02-16T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-03gl-vgly	False	None	False	2022-04-12 01:56:57.348	[]
904	CDC-2022-0024-0910	https://api.regulations.gov/v4/comments/CDC-2022-0024-0910	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My use of opioid medications have been rather long term, off and on since 2005. Following a bunionectomy I was prescribed Vicodin. The surgery was a failure and I soon thereafter developed "hammertoes" and a new Podiatrist claimed the Bunion came back. After a second surgery I was given Vicodin again, and it was for over a several month period. That surgery failed. The reason for the prolonged time of taking Vicodin was the pain associated with bad surgeries, but also the fact that I suffer severe, chronic GERD. At one point without taking Opioids I was taking almost 4 grams of Tylenol a day to soften the pain to where I could live free of pain. The other factor that was consider for prescribing opioid medication was considering my clinically diagnosed state of "Major Depression, in partial remission". When suffering pain it triggers depression.<br/><br/>I received a third surgery and again was placed on opioid medication, "Norco." <br/>That surgery only corrected the problem of my tendons growing into the skin. I continue to suffer severe chronic pain in my right foot, despite all of the failed surgeries and Physical Therapy intervention.<br/><br/>Recently I underwent a medical procedure, Radio Frequency Ablation. This is due to osteoarthritis/osteoporosis of the spine. For about 5 years during 2011-2016 I was prescribed Oxycodone. That treatment helped me sustain a fair quality of life and allowed me to continue working. At that time there was no other treatment available to me. One day the doctor said he could no longer prescribed the medication and wanted to ween me off. I said, "No, just stop it." He did and I have no withdrawals or cravings.<br/><br/>My back developed severe chronic pain again and I was placed on Tramadol. I only take it as needed, do not work or drive while taking it.<br/><br/>Thank God for opioid intervention.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f7f662	Riffey	None	2022-02-17T13:08:40Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Riffey, Robert	kzp-qmkq-x8fc	False	None	False	2022-04-12 01:56:57.557	[]
905	CDC-2022-0024-0911	https://api.regulations.gov/v4/comments/CDC-2022-0024-0911	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I read this with great appreciation. More than two years ago, I sustained a severe comminuted, displaced and intraarticular fracture of my right ankle/lower leg. I was in an exterior fixation device before having it repaired by internal fixation. Initially, my trauma surgeon did prescribe opioids for the pain, but became hesitant long before the pain abated significantly. The pain I complained of was brushed off. For months after starting to walk, i complained repeatedly of right malleolar pain which was not even addressed. After around the fifth time of being brushed off, I refused to leave the surgeon's office without a diagnosis. The surgeon (irate, of course) left to reexamine the CT scan of my fracture and returned, chagrinned, and told me I had also broken the os peroneum, something which had been missed before. When I asked, again, for oxycodone, she very reluctantly gave me a prescription with the admonishment, "This is the last one. I'm not your oxy doc!" This, despite the fact that os peroneal syndrome is extremely painful. Although I continued having a lot of pain (as well as injections and physical therapy), I never received another prescription for opioids when they were clearly indicated. Even the pain management clinic did nothing but giving me a referral to PT. I later discovered that the reluctance to prescribe opioids was because of Federal guidelines. For shame! People in severe pain should be able to get the needed medication without their doctor being afraid of censure by the government. Because of my over-reliance on ibuprofen, I developed an ulcer, which further delayed my recovery. On top of this, I am a retired physician. Treating pain is one of our responsibilities to our patients. It has been a prolonged and extremely frustrating recovery period.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f7f670	LeClerc	None	2022-02-17T13:13:09Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from LeClerc, Susan	kzp-qr9e-ql4j	False	None	False	2022-04-12 01:56:57.767	[]
906	CDC-2022-0024-0912	https://api.regulations.gov/v4/comments/CDC-2022-0024-0912	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a suffer of chronic pain severe severe degenerative bone and disposes in my back who has suffered at the hands of physicians in northern Florida who cut me off complete Pain Medication and and would not prescribe any other pain medication so that I could have a quality of life. Being 59 With a two-year-old child I am basically Riding in pain 24 hours A-day trying to care for care for her. This has to stop there are people that do not get addicted to these pain medications who need them to to survive and have any kind of quality of life. Please change these guidelines so these doctors will stop being afraid of their own shadow. Help those of us that need it that have chronic pain that is not going to get any better We do not deserve to ride in pain because of the CDC's recommendations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynette	None	None	0900006484f7f69b	Preston	None	2022-02-17T13:14:23Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Preston, Lynette	kzp-r5xh-yh6y	False	None	False	2022-04-12 01:56:57.994	[]
907	CDC-2022-0024-0913	https://api.regulations.gov/v4/comments/CDC-2022-0024-0913	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After review, I support the 3 themes and the CDC's responses. As CMIO, I have been deeply engaged in the local Opioid Crisis and supported providers thru many difficult situations. The recommended suggestions from CDC encourage provider/patient discussions and leaves autonomy with the prescriber and not with payers. I totally support the changes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484f7f6d2	Danhauer	None	2022-02-17T14:02:48Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Danhauer, David	kzp-rox6-z7sp	False	None	False	2022-04-12 01:56:58.229	[]
908	CDC-2022-0024-0914	https://api.regulations.gov/v4/comments/CDC-2022-0024-0914	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing first as a caregiver a spouse to a patient that lives with chronic pain since 2007, in 2016 when the new " guidelines" came down from the CDC our lives were turned upside down. My husband's PCP of 25 years decided the 180 mg of morphine he was taking was too much and it should be cut back, this was directly related to the new guidelines. He could not come up with a safe tapering schedule , he just wanted to get him below the recommended 90 mg MDD, for him that was a 50 % reduction. There was no alternative interventions suggested, but every time he went to see the MD he was badgered and treated as if he was a drug addict. I am a nurse and did push back with the doctors but it was not enough my husband stopped taking on of the 60 mg doses without telling anyone and suffered in silence until he told the doctor who was very happy , not the reaction I expected because the action of stopping pain medication without letting anyone know is STUPID and I feel the doctor should explained that to him not congratulate him. It was at this point I explained to his PCP there would be no additional reduction. Prior to this happening my husband was able to get out of bed , he is disabled due to injuries but he was at least not spending 16-18 hours a day in bed, as he did after this reduction in meds. In addition to his pain increasing, the decrease in the ability to preform his daily living skills, my health insurance for 1 year refused to pay for his medication because it was over the CDC recommended limit. I can tell you in 2016 his medication cost me $200.00 monthly eventually they started paying for it with an authorization. but I never got reimbursed for the year I paid fully. <br/>As I stated I am a nurse, I am a hospice nurse , I have seen many cancer patients , and end of life patients during this time that suffered due to the MD and insurance companies misinterpreting the CDC recommendations as law and not taking each patient situation into considerations. I know my husbands story did not end in tragedy as I know some did. I hate to think what would of happen if he didn't have me to push back and refuse to allow the MD to do what he actually wanted to do. <br/>In my opinion the recommendations that came down in 2016, ruined lives, caused many patients to go to street drugs because of either being cut off from the MD or not being able to afford the medications when the insurance companies stopped paying.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f7f6fa	Anonymous	None	2022-02-17T15:22:15Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzp-s22m-ekh2	False	None	False	2022-04-12 01:56:58.442	[]
909	CDC-2022-0024-0915	https://api.regulations.gov/v4/comments/CDC-2022-0024-0915	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patients are still not being heard!! We need a more defined guideline to pain doctors to prescribe to their patients. A chronic pain patient is still not being heard. Pain patients need to be protected and have a clear and defined way to help them. Pain Dr's are still being targeted and not protected!! Chronic pain patients are not being helped.. Put yourself in our shoes. If your mom or sister had brain surgery, would you want them to suffer EVETY during day wreaked in pain? They would never be able to enjoy grandparenting, or hold a job. They are being punished for having a brain tumor!! Not ok! When will a brain tumor patient be heard?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	KJ	None	None	0900006484f805d0	Ross	None	2022-02-17T16:05:16Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Ross, KJ	kzq-1erj-aa3d	False	None	False	2022-04-12 01:56:58.654	[]
910	CDC-2022-0024-0916	https://api.regulations.gov/v4/comments/CDC-2022-0024-0916	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer who has had no relief since the strict guidelines were imposed. I did all the alternative treatments to no avail. Some of the time I can relieve the pain with mega doses of ibuprofen, but that’s not good for my kidneys. I fully support the easing of restrictions because chronic sufferers like me have been disregarded for years now. One prescription for 30 five mg tables of hydrocodone can last me between two and four months but I can’t even get that under the present guidelines. Please pass the new ones.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f80664	Heiser	None	2022-02-17T16:06:39Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Heiser, Susan	kzq-1ve8-zw6q	False	None	False	2022-04-12 01:56:58.869	[]
911	CDC-2022-0024-0917	https://api.regulations.gov/v4/comments/CDC-2022-0024-0917	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	TELL THE DEA TO LOOSEN CONTROL OF SUBOXONE:<br/>As a former heavy opiate user and addict for several years, having used both Rx pills, street heroin/fentanyl and other opiate research chemicals (RCs), I can attest that they are all more or less identical in their effects. Suffering from multiple daily use (~7-10 bumps/day) for years, and with multiple relapses on my record as I tried to get clean, I am still in early recovery, with just over 6-months of clean time.<br/><br/>The one thing I've found is that Suboxone is effectively used as a "detox" medicine to transition to from full u-opioid agonists. It is virtually impossible for a true opiate addict to get "high" from Suboxone, and is much easier to taper off than full u-agonists, which are nearly impossible to taper down without experiencing terrible withdrawal symptoms (trust me, I've tried. Like a million times.). The Buprenorphine in Suboxone is only a partial u-agonist (technically a mixed agonist/antagonist), so it is much safer to use, as it is much more difficult to overdose from. It is also very effective at keeping away the worst of the withdrawal symptoms. But tapering must happen very slowly, so the packaging warning against cutting the strips has to be ignored. In fact, I don't know of any doctor with Suboxone prescribing privileges who doesn't ignore this statement. I have found that tapering off over the course of several months, or up to a year or more, depending on length of time in active addiction, is best. The first doctor I saw made me taper off in just one month, which was much too short a time. It just prolonged my withdrawal symptoms and I felt like I was detoxing the entire time, and then I detoxed all over again after stopping the Suboxone strips. It HAS TO BE DONE SLOWLY!<br/><br/>The biggest problem I have had with Suboxone is that it was controlled so tightly, which often made it VERY DIFFICULT to obtain. It's insane! This drug literally won't make you "high", and while I agree that it shouldn't be sold at the street level, the fact that it's even a controlled substance seems ridiculous to me. And that, coupled with the fact that doctors need a special license to even prescribe it (which also prevents them from prescribing other controlled substances), makes the laws surrounding Suboxone ludicrous! The DEA needs to loosen control of this human suffering-preventing, LIFE-saving medication, and should allow anyone with a "MD" after their name to prescribe it. A quick, continuing-education course should cover how to prescribe it, and would allow doctors who know the most about their patients (i.e., primary care physicians, family practice doctors, etc.) to write scripts for Suboxone, resulting in much greater access, and giving addicts a much more probable chance of successfully recovering from their opiate addictions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80684	Anonymous	None	2022-02-17T16:09:37Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-23p6-ee4q	False	None	False	2022-04-12 01:56:59.085	[]
912	CDC-2022-0024-0918	https://api.regulations.gov/v4/comments/CDC-2022-0024-0918	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a previous firefighter who had to unfortunately medically retire in 2015 because I was no longer able to perform my job, I feel that the MME threshold should be lifted for those patients who are chronically ill, suffer with debilitating illnesses, failed spinal fusions, an inoperable spinal fluid leak, fibromyalgia, Sjogrens, lupus, raynaulds, CRPS, osteoarthritis, birth defects, etc. I’m talking about myself….I am this person. <br/><br/>I have been under the care of 5 different doctors, and one of them oversees my pain management part. I have never had a problem in the last 9 years while taking my medication. The only person who knows what works and what doesn’t, is the patient themselves. <br/><br/>I feel it’s unfair to reduce the MME from 90mme to 50mme, if the patient shows improvement with their quality of life. Without my medication I’m literally bed bound. I am a military wife, mother and grandmother. I am 58 years old, and all I want is to live a normal life with limited to no pain. If the MME is reduced or taken away from me, my life might as well be done and over with. I have much respect for everyone’s decision, but please think of the millions of patients that just want the same, a quality of life. <br/><br/>I’d give anything to be a firefighter again, but unfortunately my health will not allow me to return. All my doctors advise me that they can only treat my illnesses and to monitor me, because there are no cures to my illnesses. The main symptom is chronic Intractable pain, and it’s all day. With my pain control, I’m able to function as a human being. Please reconsider the 2016 CDC guidelines by not placing a limit on the MME. Or at least re-evaluate each patient, and if the current MME they are on is not working, than adjust accordingly. <br/><br/>Thank you for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484f806bd	Heinbaugh	None	2022-02-17T16:11:07Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Heinbaugh , Cheryl	kzq-2b7m-0y7s	False	None	False	2022-04-12 01:56:59.300	[]
913	CDC-2022-0024-0919	https://api.regulations.gov/v4/comments/CDC-2022-0024-0919	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When I broke my ribs several years ago, I was in excruciating pain for 3 months and the only thing that made life bearable and allowed me to continue my regular work and activities was the fact that my doctor provided me with an opioid for the duration of my healing. Doctors should be allowed to use their professional judgment to determine what is best for the patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jamie	None	None	0900006484f80730	Schulinn	None	2022-02-17T16:14:15Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Schulinn, Jamie	kzq-2y2f-i1ac	False	None	False	2022-04-12 01:56:59.532	[]
914	CDC-2022-0024-0920	https://api.regulations.gov/v4/comments/CDC-2022-0024-0920	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	TELL THE DEA TO DECRIMINALIZE ADDICTION AND DRUG USE:<br/>Drug addiction has been a recognized medical condition and mental illness (and physical illness with opiates) since the 1950s. It is not a "criminal activity", a "moral failing" (although the choice to start using may arguably be). So why is this particular medically-diagnosed illness used to discriminate against - and incarcerate - our fellow human beings? Would you berate a diabetic for having diabetes? Arrest a schizophrenic for being schizophrenic? Why don't we lock up cancer patients and cut off their chemotherapy "cold turkey" for having cancer?<br/><br/>The time is long overdue for both the CDC, and especially the DEA, to get behind the medical research, and decriminalize addiction. The Criminal Justice System (including State and Local law enforcement and court systems) should be completely separate from - and have absolutely nothing to do with - my personal medical history and mental health. Sure, go after the dealers and traffickers who are keeping people enslaved in their addictions and even killing them with fentanyl, fentanyl analogues, and untested research chems; and stop being afraid of the cartels and international criminal organizations and actually go SHUT THEM DOWN. They're the real problems, yet the police routinely go after the "low-hanging fruit" of the down-and-out addicts or small-time dealers who are just selling to fund their addictions. That's no way to win the futile "War on Drugs". How did the "War on Alcohol" (Prohibition) turn out? Decriminalization and is the only rational answer to this problem, and would allow people to finally have hope of life after addiction, and restoration of families ripped apart by both this terrible illness and lengthy prison sentences.<br/><br/>Both physicians and their patients should not fear criminal prosecution for treating patients who use pain medications, and ALL physicians should be able to prescribe Suboxone. The CDC and DEA should have no say over my personal doctor’s right to treat and prescribe medications and treatments to help me overcome my personal illness. Suboxone has been a literal life-saver for me. Our society has come pretty far on the issue of drugs, but the criminal justice system still has a long, long way to go in accepting the medical evidence and genuinely helping addicts recover from this life-threatening illness.<br/><br/>I'm not saying we should go back to the free-wheeling, mass-overprescribing of opioids like we had in the '90s, and selling opioids at the street level should still be a (minor) crime/infraction, but we now have mountains of evidence about when prescribing opioids is appropriate, how absolutely addictive all of the full u-opioid receptor agonists are, and how to successfully treat people who have become addicted. Doctors should be able to help people who truly want help living in recovery by prescribing ANY APPROPRIATE MEDICATION; Suboxone should not just be limited to treatment clinics or those with insurance. Control of this medication needs to be loosened, and all controlled substances need to be decriminalized (for personal use).	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f807ad	Anonymous	None	2022-02-17T16:16:24Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-3is2-1tux	False	None	False	2022-04-12 01:56:59.741	[]
915	CDC-2022-0024-0921	https://api.regulations.gov/v4/comments/CDC-2022-0024-0921	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The difficulty obtains a prescription, having it filled by the pharmacy AND the insurance company “agreeing with the doctor is ridiculous! My own orthopedic surgeon who performed my knee surgery was FORCED to send me to a “pain clinic”. He did not want to do this but was forced. Attending a pain clinic was humiliating. This can not be the standard of care in this country no matter how bad the opiate problem is in America. I am 48 years old and the only time I really need a doctor is sever every pain. Broken toe, damaged knee etc. I don’t go to the doctor with a cold or the flu. I barely go for annual physicals. The only time I truly NEED a doctor is severe pain/ injury. I am lucky that I am healthy. I get that not all can say that but what is the point of going to doctor if everyone is treated like a drug addict? Let’s get rid of vehicles since some people speed, have car accidents and kill people. Stupid!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Blair	None	None	0900006484f806d8	Cook	None	2022-02-17T16:46:03Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Blair	kzq-2ga8-lgqo	False	None	False	2022-04-12 01:56:59.952	[]
916	CDC-2022-0024-0922	https://api.regulations.gov/v4/comments/CDC-2022-0024-0922	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since the 90s and was horribly affected by the 90 MME in the CDC guidelines. I could have been on the dose I was on the rest of my life but was tapered Down to under 90MME a day. Please eliminate this guideline for persons who are chronic pain that have been on documented high doses of opioids and are stable and not experiencing problems. My life has been affecting in a major way by this. Before I was tapered down I had controlled pain but ever since I have struggled to even go to work. It has been extremely hard on me and my family. Please eliminate the 90MME a day for documented chronic pain patients. Please. God Bless you all <><	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	0900006484f80856	Thompson	None	2022-02-17T16:50:15Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Thompson, Mike	kzq-4dpi-ahio	False	None	False	2022-04-12 01:57:00.203	[]
917	CDC-2022-0024-0923	https://api.regulations.gov/v4/comments/CDC-2022-0024-0923	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi I have been a chronic pain patient for 31 years I have had 17 back surgeries from a accident and and I am in pain 24/7 without the help from my medication I’m not a contributing member of society I have been working closely with my doctors to help me my doctor is a pain specialist and I think that the government shouldn’t be the ones deciding what is the treatment that should be between the doctors and the patient. <br/>The guidelines from 2016 hurt the people that really are the patients. The people that really need the help shouldn’t be the ones that suffer from unreasonable people! Please think of the patients <br/>The government needs to let the health care <br/>should be up to the doctors and patients <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R	None	None	0900006484f80883	Healey	None	2022-02-17T16:55:03Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Healey , R	kzq-4vzq-ck99	False	None	False	2022-04-12 01:57:00.440	[]
918	CDC-2022-0024-0924	https://api.regulations.gov/v4/comments/CDC-2022-0024-0924	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 72 year old female with severe chronic pain due to small fiber neuropathy and spinal stenosis. My PC has prescribed Tramadol for daily use and I experience relief sufficient to have a reasonable QOL. I am grateful that the Tramadol works so well; I have maintained the same dosage for over a year with no side effects. I don't know how I would function without the Tramadol relief and strongly encourage new guidelines to refrain from discouraging use or creating barriers to use of Tramadol by PCs or pain doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8088e	Anonymous	None	2022-02-17T16:55:51Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-54e2-6181	False	None	False	2022-04-12 01:57:00.657	[]
919	CDC-2022-0024-0925	https://api.regulations.gov/v4/comments/CDC-2022-0024-0925	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regarding the recommendation to clinicians, “Before increasing total opioid dosage to ≥50 MME/day, clinicians should pause and carefully reassess evidence of individual benefits and risks. If a decision is made to increase dosage, clinicians should use caution and increase dosage by the smallest practical amount." - What study is used to determine dosage at 50MME per day recommendation? Patients will undoubtedly suffer from unrelieved pain while jumping through unnecessary hoops that are suggested in this document. I know, as I’ve been there on many occasions! I had necrotizing fasciitis of the abdominal wall and because of the damage, I suffer from debilitating chronic pain which will continue for the rest of my life. Over the last four years, I’ve had to jump through hoops many times, whether it be with pain management or the pharmacy causing added stress and unnecessary suffering. In addition, I’ve spent an enormous amount of money out of pocket because I’m required to see a pain doctor every month because of the CDC’s 2016 recommendations. Doesn’t appear much is going to change. Seems the war on drugs takes precedence over patient welfare.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80897	Anonymous	None	2022-02-17T16:58:03Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-589k-xk9d	False	None	False	2022-04-12 01:57:00.869	[]
920	CDC-2022-0024-0926	https://api.regulations.gov/v4/comments/CDC-2022-0024-0926	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting as a person forced to live in unrelenting and horrendous chronic pain by 2016 CDC Guidelines that make it impossible for doctors to adequately treat my pain. Please remove restrictions so that responsible citizens can find some relief from the inhumane torture that is poorly and/or untreated chronic pain. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484f808ae	Nelson	None	2022-02-17T16:59:06Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Nelson, Karen	kzq-5bs4-weud	False	None	False	2022-04-12 01:57:01.083	[]
921	CDC-2022-0024-0927	https://api.regulations.gov/v4/comments/CDC-2022-0024-0927	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had fibromyalgia since I was in my 40's. It began after I had two surgeries. I was doing great until I was referred to a Pain Management Clinic where they changed my medication. I am now 75 years old and they always say it is due to my age that they will not give me certain medications. I cannot get anything for my anxiety or my pain. I could understand if I were a pill-seeking patient, but I am not. I just want to be able to function in my home and in public. Everything is due to the CDC guidelines or so I am always told. Opioids are a danger to the patients that abuse them, but the statistics make it bad for the patients that really do the right thing. It is not fair for the CDC to make a judgment or a guideline for patients when they have no idea what a patient goes through with chronic pain. Having pain every day of your life is very debilitating and frustrating. The guidelines have doctors afraid to prescribe the necessary medication that a patient needs to function in society. I wonder what persons making the decisions would do if they had to go through pain every day. Fibromyalgia is not something that is in my head or no one else's head. Pain is something I live with every day, and when there is a good day, it is a joy. God put doctors on earth to help patients with whatever illness they have, so why do doctors feel they can decide whether a patient is in pain or not. Sure, there are patients who do abuse medications such as opioids, but why do the patients who do not abuse opioids have to suffer for someone else's ignorance. Oh! I almost forgot to say that along with fibromyalgia, I have osteoarthritis, spinal stenosis, and neuropathy. I pray that the decision be made to allow doctors to prescribe opioids to patients who really need them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gail	None	None	0900006484f808ce	Bullard	None	2022-02-17T17:01:29Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Bullard, Gail	kzq-5n1d-b1zn	False	None	False	2022-04-12 01:57:01.321	[]
922	CDC-2022-0024-0928	https://api.regulations.gov/v4/comments/CDC-2022-0024-0928	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No mmes please , we are all suffering in pain because of your new guidelines no more mmes , please , this is insane , we are american people , land of the free , how can you dictate my pain medication.. let the doctors do their jobs , CDC , should of only had the job to shut down the pill mills , once all the pill mills were closed , then just educate the doctors not to over prescribed make sure their patients has all their medical records.. no reason for Mmes now that all the pill mills are shut down , No Mmes !!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nina	None	None	0900006484f8099c	Saffold	None	2022-02-17T17:12:25Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Saffold , Nina	kzq-94wb-d3rc	False	None	False	2022-04-12 01:57:01.534	[]
923	CDC-2022-0024-0929	https://api.regulations.gov/v4/comments/CDC-2022-0024-0929	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. I find it highly insulting that I am made to feel that my quality of life is meaningless. Each day we all have to choose to be positive, or just get through the day as best as we can. This is 2022. I am an elderly adult. I should have the right to choose how I live my life. I follow direction well and never use a pain killer for a 'high'.. I live in Colorado and could just go down to a dispensary for that. I believe that it is cruel to withhold comfort of people that these opioids work for. It's a matter of addiction, not what one is addicted to. Some people eat too much. Please stop treating like a drug addicted child. Let me choose.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484f809c3	Bernia	None	2022-02-17T17:13:39Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Bernia , Barbara	kzq-9nmz-08qv	False	None	False	2022-04-12 01:57:01.743	[]
924	CDC-2022-0024-0930	https://api.regulations.gov/v4/comments/CDC-2022-0024-0930	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>I am commenting as both the spouse/caregiver to a chronic pain patient as well as a scientist with a Ph.D. in psychology who has published research in the area of pain (though frankly, not my main research focus). The recent article by [redacted title] does a great job of stating point by point the problems with the new guidelines, so I won’t rehash that article, but I do hope you will strongly consider the authors’ recommendations. Instead, please allow me to share my personal experience with the issue. After many years of living with undiagnosed pain, at the age of 50 my wife was finally diagnosed with the autoimmune disease, Ankylosing Spondylitis. I’ve watched her suffer as she’s been to too many doctors to count and numerous ER visits just to find little to no relief. The fused vertebrae, cysts in her spinal canal (syringomyelia), the musculoskeletal pain from scoliosis, pinched nerves, herniated disks, and other pains from her disease are unbearable. We hope that the biologic prescribed by her rheumatologist may help prevent further deterioration, but it certainly will not reverse the problem and her pain will persist. <br/><span style='padding-left: 30px'></span>Given my profession, I am well aware of the problem of opioid addiction, so I appreciate what the CDC is trying to do to curtail it. However, I think many of the guidelines are perhaps misguided given that the primary cause of overdose has been, and continues to be, the use of street drugs and that opioids/opiates are safe when used as prescribed. The research shows that for patients prescribed 100 MME or more, there is a mere .25% chance of becoming addicted, and the chances only increase to about .5% when the dose is over 400 MME. Moreover, operationally, using MME as your standard unit makes very little practical sense. The various forms of opiates are absorbed at different rates leading to different amounts of bioavailability that are not considered in the MME conversions. The MME standard also does not consider individual body mass or metabolism rates by patients (see [redacted title ] for a good explanation). One size does not fit all. Regardless, patients such as my wife, who follow their prescriptions and are at an extremely low risk of addiction, must fight just prevent their dosage from being reduced to an MME level that provides inadequate pain control. My wife’s 40 MMED dose of Oxycodone provides minimal relief and does nothing for her pain flair ups (breakthrough pain), but doctors will not increase her dosage, not for fear of her becoming addictive, but out of fear of being investigated. <br/><span style='padding-left: 30px'></span>The CDC guidelines also do very little in considering individual differences in terms of pain tolerance and disease type or progression. My wife’s Ankylosing Spondylitis is not on the list of chronic pain conditions (such as cancer, sickle cell) that are exempted from the guidelines, but is nonetheless extremely painful and incurable. The state we live in does not consider her eligible for palliative care, as the state reserves that care for terminal patients only. Though the dose she is prescribed should not raise any red flags being well below the guidelines, the pain doctors are afraid to increase the dose for fear of losing their license, despite the very low risk for addiction. Though the guidelines clearly state that they are providing recommendations that should not outweigh the judgment of the clinician, this does not seem to alleviate doctors’ concerns. My wife has already lost at least 5 highly qualified pain doctors and nurse practitioners who have left their practice due to fear of losing their licenses or out of frustration that they could not adequately treat their patients. Most available pain doctors work for for-profit organizations that do not seem to understand, or just choose to ignore, the difference between guidelines and laws and therefore instruct their doctors not to exceed doses that do not even rise to the upper limits of the guidelines. Instead, they have the doctors push either unproven alternatives such as stimulators, nerve ablations, or other drugs that are not only less effective than opiate treatment plans, but may also carry greater risks and side effects for patients like my wife (who by the way, was born with just one kidney). So, while I agree that addiction is a problem in our country worthy of tackling, policies and guidelines aimed at preventing overdose deaths should not come at the expense of those suffering from chronic pain. The recommendations of [redacted title] spell out very sound advice to amend the guidelines that I hope you will strongly consider.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484f80826	Kass	None	2022-02-17T19:25:16Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Kass, Steven	kzq-40qz-ktxy	False	None	False	2022-04-12 01:57:01.955	[]
925	CDC-2022-0024-0931	https://api.regulations.gov/v4/comments/CDC-2022-0024-0931	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regimented Confirmatory urine drug testing must be judiciously and prudently utilized to ensure appropriate identification, surveillance and monitoring of patients being prescribed medications with known addictive properties and chance for misuse. Appropriate prescriber documentation will support patient safety and protection of prescribers and institutions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f80927	None	None	2022-02-17T19:27:12Z	Meridian Emergency Consulting	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Meridian Emergency Consulting	kzq-77o8-457z	False	None	False	2022-04-12 01:57:02.175	[]
926	CDC-2022-0024-0932	https://api.regulations.gov/v4/comments/CDC-2022-0024-0932	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a veteran chronic pain patient that has been advised there is nothing to do to fix the problem, life has turned into hell with the old cdc guidelines. It looks like the new wording may help. But I am not really sure because the way the system works now. No primary care doctors are dealing with long term pain patients. All are being shipped off the pain clinics. And when you live rural that adds at least an hour driving plus, insurance, plus and plus. There are those out there that are real patients and not drug or future drug addicts. All the past recommends have done is open and expanded the illegal drug business. And the current numbers reflect that. And speaking of numbers, one should post how many people have died from suicide because of the way cdc guidelines since this has been implemented. I am glad that the cdc is starting to change this. But, it will be a wait and see if it will help it improve the lives of chronic pain patients. The way the old guidelines exist, there has been a break down in patient/doctor confidence, break down in patient honesty to their doctors, and fear of seeking mental help for fear of what will used against them later on the most trusted chronic patients. Hopefully this change goes through and relationships can again be formed. As a veteran, I am really upset that the cdc and other government agencies have used us for a control group for new pain mangement without our consent or knowledge. <br/>I know I am only one person not a doctor, business or agency. However, like the vote, my one voice should be heard and acknowledged. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f8093b	Muir	None	2022-02-17T19:32:08Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Muir, Debbie	kzq-7kzd-iszn	False	None	False	2022-04-12 01:57:02.387	[]
927	CDC-2022-0024-0933	https://api.regulations.gov/v4/comments/CDC-2022-0024-0933	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a veteran chronic pain patient that has been advised there is nothing to do to fix the problem, life has turned into hell with the old cdc guidelines. It looks like the new wording may help. But I am not really sure because the way the system works now. No primary care doctors are dealing with long term pain patients. All are being shipped off the pain clinics. And when you live rural that adds at least an hour driving plus, insurance, plus and plus. There are those out there that are real patients and not drug or future drug addicts. All the past recommends have done is open and expanded the illegal drug business. And the current numbers reflect that. And speaking of numbers, one should post how many people have died from suicide because of the way cdc guidelines since this has been implemented. I am glad that the cdc is starting to change this. But, it will be a wait and see if it will help it improve the lives of chronic pain patients. The way the old guidelines exist, there has been a break down in patient/doctor confidence, break down in patient honesty to their doctors, and fear of seeking mental help for fear of what will used against them later on the most trusted chronic patients. Hopefully this change goes through and relationships can again be formed. As a veteran, I am really upset that the cdc and other government agencies have used us for a control group for new pain mangement without our consent or knowledge. <br/>I know I am only one person not a doctor, business or agency. However, like the vote, my one voice should be heard and acknowledged. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f8093c	Muir	None	2022-02-17T19:32:44Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Muir, Debbie	kzq-7kzf-7932	False	None	False	2022-04-12 01:57:02.618	[]
928	CDC-2022-0024-0934	https://api.regulations.gov/v4/comments/CDC-2022-0024-0934	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a veteran chronic pain patient that has been advised there is nothing to do to fix the problem, life has turned into hell with the old cdc guidelines. It looks like the new wording may help. But I am not really sure because the way the system works now. No primary care doctors are dealing with long term pain patients. All are being shipped off the pain clinics. And when you live rural that adds at least an hour driving plus, insurance, plus and plus. There are those out there that are real patients and not drug or future drug addicts. All the past recommends have done is open and expanded the illegal drug business. And the current numbers reflect that. And speaking of numbers, one should post how many people have died from suicide because of the way cdc guidelines since this has been implemented. I am glad that the cdc is starting to change this. But, it will be a wait and see if it will help it improve the lives of chronic pain patients. The way the old guidelines exist, there has been a break down in patient/doctor confidence, break down in patient honesty to their doctors, and fear of seeking mental help for fear of what will used against them later on the most trusted chronic patients. Hopefully this change goes through and relationships can again be formed. As a veteran, I am really upset that the cdc and other government agencies have used us for a control group for new pain mangement without our consent or knowledge. <br/>I know I am only one person not a doctor, business or agency. However, like the vote, my one voice should be heard and acknowledged. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f8093d	Muir	None	2022-02-17T19:33:50Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Muir, Debbie	kzq-7kzm-et91	False	None	False	2022-04-12 01:57:02.831	[]
929	CDC-2022-0024-0935	https://api.regulations.gov/v4/comments/CDC-2022-0024-0935	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 64yrs old I have disc disease but the spine pain isn't the only pain I have , the leg pain that goes wit it , is at time almost unbearable. It's like standing on a electrical outlet that's plugged into 220 volts and it travels from your toes to your [redacted language] cheek if you try to put your foot on the floor. This pain can last four months some times. Mornings it takes me 3hrs to get moving after I take my meds. I can not longer cook or clean, life sucks, without meds I would not have a life, I couldn't do anything the pain who out weigh the worth. I don't abuse my meds, I've never asked for extra meds, I take them as I'm suppose to. You take away people's meds they will commit suicide, they will turn to herion , it will not be good. It's not an addiction when it's used for pain , I'm a retired nurse, I am not addicted to pain meds , I am in chronic pain , I do not sleep well , I do not eat well, I am in pain, I have tried other meds, I have tried acupuncture, I have spent thousands of dollars on decompression which helped with the lighting but not the pain, I have tried all kinds of so called remedies and wasted money. So please don't tell me to try something else.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Justine	None	None	0900006484f80945	Miner	None	2022-02-17T19:36:06Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Miner, Justine	kzq-7pwc-o84s	False	None	False	2022-04-12 01:57:03.060	[]
930	CDC-2022-0024-0936	https://api.regulations.gov/v4/comments/CDC-2022-0024-0936	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new guidelines should include statements that MME restrictions should not be in place for those with clearly documented chronic pain conditions where all other treatments have been exhausted. This is especially true for those patients who cannot have an interventional procedure to fix their pain. There should also be a statement that any licensed provider who specializes in pain should not have restrictions in the MME amount. Many pain practices have an pain specialist MD who only wants to do procedures and the NPs or PAs will see patients for their chronic pain. In Arizona, APPEs cannot prescribe more than 90 MME unless okayed by a pain physician and those pain physicians won't take on the patients that get referred to them. It is honestly a mess for those with chronic pain and I am sure the number of patients who have had to resort to meds from the street or unfortunately suicide have increased. Providers are also now afraid of prescribing any opioid for fear of unnecessary repercussions from people who know nothing about the patient and who may not even be medical professionals.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laurem	None	None	0900006484f80990	Cherrier	None	2022-02-17T19:37:40Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Cherrier, Laurem	kzq-91z6-9sbt	False	None	False	2022-04-12 01:57:03.270	[]
931	CDC-2022-0024-0937	https://api.regulations.gov/v4/comments/CDC-2022-0024-0937	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a good start, however, am really concerned regarding the MME limit (50MME sprinkled throughout the document). I do not know where you are getting this number from and last time an MME limit was mentioned (90MME, 2016 guidelines) that was used to force taper patients, cut them off entirely, and was the goal post used by medical boards, the DEA, insurance companies, etc., without any consideration to the patient's weight, or how they metabolize these medications. Please remove it as it is not grounded in science.<br/><br/>Also, why is cancer pain and sickle cell pain, to name a couple, considered more worthy of treatment, than other chronic, painful conditions? I understand the politics behind wanting to ensure these patient sets receive medication, government doesn’t want to look too much like the monster it has become, however, there are several well documented reports that those patients have been made to suffer alongside the rest. You should be ashamed!<br/><br/>Since your 2016 guidelines I have seen cancer patients treated like pill seekers, traveling from pharmacy to pharmacy trying to get their prescriptions filled. I have read reports of hospice patients in the last instances of life left the writhe in unbearable pain because they cannot get mediation. There was even a gentleman who had a fresh amputation that was infected begging on Twitter for pain relief. It took his plea going viral before he received anything.<br/><br/>What has been done is disgusting! Vile! And wholly unethical and while these new guidelines look to be stepping in the right direction, troubling items from the first set still remain. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f807b1	Anonymous	None	2022-02-17T19:54:46Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-3p5b-bphd	False	None	False	2022-04-12 01:57:03.481	[]
932	CDC-2022-0024-0938	https://api.regulations.gov/v4/comments/CDC-2022-0024-0938	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am glad the CDC finally found out what is really going on with the abuse doctors created and misused on the 2016 guidelines. Oregon is the worst State, I am Happy I no longer live there, I had a painful injury and was told I’d be in pain for over a month in Linn County, Oregon at an urgent care they gave me 8 pain pills and not even my primary care would refill them and I suffered for a while. Not only that in 2019 I ended getting bronchitis at 10 days into being sick went to my primary care and asked for a antibiotic guess what I was told? My doctor said I didn’t need one because its viral? Really? No testing and they know what it is? I ran up $5,000 in doctor bills two months of being sick a few visits to Urgent care/doctor and two ER visits with an elevated white count before I was given antibiotics, something needs to be done about the way they treat people in Oregon. They are Disgusting!! Also a family member who has compression fractures in his back and herniated disks injured his already bad back and was in severe pain, he went to the ER visit, he was told by the attending doctor there that he could not give any pain medication unless he broke his back, do you think he was given any pain med? No and his back is fractured. This is pure Abuse of authority plain and simple, The Oregon HMO Health system needs a complete overall for how they are Practicing medicine. Hopefully something will get done there.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sherry	None	None	0900006484f809f4	Reo	None	2022-02-17T20:20:23Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Reo, Sherry	kzq-akul-wx7m	False	None	False	2022-04-12 01:57:03.703	[]
933	CDC-2022-0024-0939	https://api.regulations.gov/v4/comments/CDC-2022-0024-0939	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Though the updated recommendation very clearly specifies that this update is merely a guidance and is specifically NOT to interfere with the doctor/patient relationship or the judgements that come out of that relationship. Historically it always does.<br/>Two examples clearly demonstrate this propensity. <br/><br/>At one point the DEA, in defense of the schedule list, testified before congress AND the senate that the intent and efforts of the schedule list are not and never will be construed as an interference of the afore mentioned relationship.<br/>Yet look at the DEAs involment with treatment choices. If an MD and patient opt to use one of those items on the schedule list it is under severe penalties. Millions of people have been arrested and imprisoned merely for wanting to try different treatment options other than the cookie cut , one size fits all regulations.<br/>When the 'opioid epidemic' was coined, once again doctors were given 'guidelines' that were to be followed as rigidly as laws.<br/>Accepting that there is a severe problem with substance abuse in this country and elsewhere it is never acceptable for government to dictate what constitutes acceptable treatment options.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484f80a0c	Steele	None	2022-02-17T20:21:54Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Steele , Kevin	kzq-av8f-m5z5	False	None	False	2022-04-12 01:57:03.917	[]
934	CDC-2022-0024-0940	https://api.regulations.gov/v4/comments/CDC-2022-0024-0940	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I completely agree that there needs to be some sort of updated guidelines to the treatment of pain management. The opioid crisis has affected every American in some way shape or form. Whether you were prescribed opioids or you know someone who is addicted to them, everyone has some sort of acquaintance with the opioid epidemic. The CDC needs a reassessment of how they determine which patients are prescribed opioids and which are not. In many of the cases that I have gone through involving pain and an urgent care/emergency room almost always I am prescribed some sort of opioid painkiller. Without trying alternatives first the Opioids are almost always the first choice. Many people who became addicted to opiates didn’t intend to become dependent on a pill but because of a prescription given to them by their doctor they are exposed to the extremely powerful narcotic. These new guidelines can tremendously help communities all over America dealing with this crisis. Although this may not be a perfect fix for the problem it is a step in the right direction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Trevonte	None	None	0900006484f80a77	Brooks	None	2022-02-17T20:22:56Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Brooks, Trevonte	kzq-ba17-vw3j	False	None	False	2022-04-12 01:57:04.129	[]
935	CDC-2022-0024-0941	https://api.regulations.gov/v4/comments/CDC-2022-0024-0941	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have seen first hand what my husband goes through daily with pain all over his body. He has had two back surgery, two knee replacement on the same knee because a doctor screwed up the first replacement, two neck surgeries, both hips replaced and his Achilles replaced. My husband goes from chair to couch when he does not have his pain meds can barely walk without his meds. Due to this 2016 law he has been humiliated by doctors saying they can not help him. They have stopped his meds cold turkey and this was terrible for him. I cried watching him in all this pain. Animals get treated better than my husband had been treated. All my husband want is to have some relief from this constant pain each day. It is a battle to control the pain when the laws do not let the doctors do their job for their patients. I wish one day the people making these law could walk in a patient with chronic pain shoes. I could go on and on but just want to say doctors should be the ones how taking care of their patients. They are the professionals and you need to give the doctors leeway without them worrying the will lose their license. Please Please consider changing these laws so all these people with chronic pain have some help with the pain Thank you for letting me have a say	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f80a7f	Marasco	None	2022-02-17T20:24:11Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Marasco, Debbie	kzq-bhgb-g228	False	None	False	2022-04-12 01:57:04.370	[]
936	CDC-2022-0024-0942	https://api.regulations.gov/v4/comments/CDC-2022-0024-0942	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow us chronic pain patients to continue. I as well<br/>As many others DO NOT abuse the meds. I have never ever once gone over my script, I always follow up with the doctor. A lot more doctors are scared of prescribing and that should never be the case especially when the doctor knows their patient well.<br/><br/>Please please allow doctors to be able to help chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	christine	None	None	0900006484f80a80	wynn	None	2022-02-17T20:25:14Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from wynn, christine	kzq-bhti-8asd	False	None	False	2022-04-12 01:57:04.586	[]
937	CDC-2022-0024-0943	https://api.regulations.gov/v4/comments/CDC-2022-0024-0943	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines for prescribing opiates is very much needed, the previous guidelines have failed an caused an opioid crisis. The opioid problem touches every corner of America and affects millions of families every day. The requirements for an opioid prescription are simply pain, when I injured my back in the Marine Corps I was prescribed opioid after opioid but none truly solved the problem. The painkillers were just used to sweep the actual issue under the rug. After taking one prescription I realized I was becoming dependent on the opioids but my original problem was never resolved which left me with two problems now. The CDC doesn’t have to get rid of the use of opioids completely, but there should definitely be stricter guidance on who should be prescribed and who shouldn’t. If there was a more clear protocol to follow in regards to pain pills, the country wouldn’t be suffering from so many Americans being addicted to painkillers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80c80	Anonymous	None	2022-02-17T20:26:06Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-c6sf-1z3m	False	None	False	2022-04-12 01:57:04.797	[]
938	CDC-2022-0024-0944	https://api.regulations.gov/v4/comments/CDC-2022-0024-0944	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer every single day from a accident that happened 2002 I was getting the help I needed until I relocated then I was giving nothing, was referred to pain management, these places are Drill Mills, none of these places are taking new patients nor my insurance, the clinic I go to now completely refuses any type of pain medicine, because they are led to believe there is an opiate crisis, we have ILLICIT FENTANYL AND HERION problem. All clinics should be help their patients not sent to pain management to be forced into painful injections that don’t work. My own Doctor nor NP will even discuss the issues I am having , I can give you statements from family members who know what I go through. Correct use doesn’t equal abuse, remove the MME , all chronic pain patients need to be treated and not treated as drug seekers , we medicate to have equality of life not to abuse them. Please remove the MME , all clinics should treat chronic pain patients in office not to be sent away. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80e8e	Anonymous	None	2022-02-17T20:27:27Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-dj1l-paez	False	None	False	2022-04-12 01:57:05.021	[]
939	CDC-2022-0024-0945	https://api.regulations.gov/v4/comments/CDC-2022-0024-0945	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer every single day from a accident that happened 2002 I was getting the help I needed until I relocated then I was giving nothing, was referred to pain management, these places are Drill Mills, none of these places are taking new patients nor my insurance, the clinic I go to now completely refuses any type of pain medicine, because they are led to believe there is an opiate crisis, we have ILLICIT FENTANYL AND HERION problem. All clinics should be help their patients not sent to pain management to be forced into painful injections that don’t work. My own Doctor nor NP will even discuss the issues I am having , I can give you statements from family members who know what I go through. Correct use doesn’t equal abuse, remove the MME , all chronic pain patients need to be treated and not treated as drug seekers , we medicate to have equality of life not to abuse them. Please remove the MME , all clinics should treat chronic pain patients in office not to be sent away. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80e8f	Anonymous	None	2022-02-17T20:27:52Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-dj1n-wj3d	False	None	False	2022-04-12 01:57:05.231	[]
940	CDC-2022-0024-0946	https://api.regulations.gov/v4/comments/CDC-2022-0024-0946	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer every single day from a accident that happened 2002 I was getting the help I needed until I relocated then I was giving nothing, was referred to pain management, these places are Drill Mills, none of these places are taking new patients nor my insurance, the clinic I go to now completely refuses any type of pain medicine, because they are led to believe there is an opiate crisis, we have ILLICIT FENTANYL AND HERION problem. All clinics should be help their patients not sent to pain management to be forced into painful injections that don’t work. My own Doctor nor NP will even discuss the issues I am having , I can give you statements from family members who know what I go through. Correct use doesn’t equal abuse, remove the MME , all chronic pain patients need to be treated and not treated as drug seekers , we medicate to have equality of life not to abuse them. Please remove the MME , all clinics should treat chronic pain patients in office not to be sent away. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80e90	Anonymous	None	2022-02-17T20:28:25Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-dj1s-5ajc	False	None	False	2022-04-12 01:57:05.460	[]
941	CDC-2022-0024-0947	https://api.regulations.gov/v4/comments/CDC-2022-0024-0947	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I believe this is a great start in changing the Center for Disease Control and Prevention guidelines for treatment for chronic pain patients. There are many individuals who have no quality of life and are suffering from constant pain or are even bedridden. Considering they are not provided with medication from their doctor. The guidelines have made things challenging for individuals who rely on pain medication to function normally from day to day. Individuals shouldn't have to be punished for these types of actions. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80eff	Anonymous	None	2022-02-17T20:29:01Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-f0c1-040e	False	None	False	2022-04-12 01:57:05.676	[]
942	CDC-2022-0024-0948	https://api.regulations.gov/v4/comments/CDC-2022-0024-0948	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe this guideline should be in place because opioids could have various negative side effects for many people. There are numerous cases where patients may deal with their pain without the opioids prescribed to them. The clinical practice guidelines should be more lenient and allow for the patients to make their own decisions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80f14	Anonymous	None	2022-02-17T20:29:34Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-f9hy-mth7	False	None	False	2022-04-12 01:57:05.904	[]
943	CDC-2022-0024-0949	https://api.regulations.gov/v4/comments/CDC-2022-0024-0949	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I have been dealing with chronic back and leg pain for years. My usage of opioids has always been a controlled dosage and amount. I don’t abuse my dosage, but I need this to help me with my ability to function on a daily basis or I will be bed ridden. My pain in my back can become unbearable and life restricting. It seems to me there are a lot of people like me who need this to live somewhat of an active life. Has anyone thought that the opioid abuse and deaths is due to the street drugs and the lacing of fetynol and pesticides is the cause and not what is controlled by our physicians. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f80f43	Mularie	None	2022-02-17T20:30:37Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Mularie , Linda	kzq-gfxm-252n	False	None	False	2022-04-12 01:57:06.284	[]
944	CDC-2022-0024-0950	https://api.regulations.gov/v4/comments/CDC-2022-0024-0950	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a National Board Certified teacher and was injured on the job in September. I was subsequently diagnosed with Complex Regional Pain Disease, given a future of burning pain that I cannot ease. My physiologist is unable to give me the amount of medication I need to fully get relief. The guidelines keep responsible individuals from being able to get the relief they need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Priscilla	None	None	0900006484f80f45	Dunn, NBCT	None	2022-02-17T20:33:38Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Dunn, NBCT, Priscilla	kzq-gj0f-7a6y	False	None	False	2022-04-12 01:57:06.497	[]
945	CDC-2022-0024-0951	https://api.regulations.gov/v4/comments/CDC-2022-0024-0951	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree with this guideline. There are several different drugs that could be used instead of opioids. Opioids are harmful and can cause various negative side effects. Putting these guidelines in place would stop opioids from harming people negatively.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80f82	Anonymous	None	2022-02-17T20:34:04Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-idmm-qnlo	False	None	False	2022-04-12 01:57:06.707	[]
946	CDC-2022-0024-0952	https://api.regulations.gov/v4/comments/CDC-2022-0024-0952	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Submitted 2/16/2022<br/>Regarding the document “CDC Clinical Practice Guideline for Prescribing Opioids–United States, 2022,” which was published for comment in the Federal Register on February 10, 2022.<br/><br/>References: <br/>Publication Date: 02/10/2022<br/>Agency: Centers for Disease Control and Prevention<br/>Date: Written comments must be received on or before April 11, 2022. <br/>Comments Close: 04/11/2022 <br/>Document Type: Notice <br/>Document Citation: 87 FR 7838 <br/>Page: 7838-7840 (3 pages) <br/>Agency/Docket Number: Docket No. CDC-2022-0024 <br/>Document Number: 2022-02802 <br/><br/>The goal of this comment is for the revised Guideline,“CDC Clinical Practice Guideline for Prescribing Opioids–United States, 2022,” to allow for long-term prescription of opioids for patients with high-impact chronic pain with no treatment available for the underlying cause.<br/><br/>The implementation of the 2016 Guideline has limited accessibility of opioid pain relief to only those patients suffering acute pain, or meeting the eligibility criteria for the four exception categories: sickle cell disease, cancer, palliative care and hospice care.<br/><br/>I suggest that the revised Guideline make a clear, highly visible statement that responsible, conscientious medical practitioners may prescribe opioids to alleviate severe chronic pain in patients with other underlying intractable conditions.<br/><br/>This comment is based on experience of severe chronic pain by a person within my extended family. Based on the current Guideline, this over-65 family member has been denied further access to oxycontin unless hospitalized. They do not fall under the category of exceptions because they do not have sickle cell disease or cancer, and are not under palliative or hospice care.<br/><br/>They have been suffering for several years from increasingly debilitating, constant pain due to spinal stenosis, which in their case is not treatable by surgery. The non-pharmaceutical treatments, which they have been using, are no longer adequate to alleviate their pain. Other medications are either ineffective or not tolerated. Medication suitability is very difficult due to organ transplant drugs and diabetes. The pain has become so great that it totally dominates this person's life and has led them to question their will to live. Of several medications that their doctors have tried, oxycontin is the only one that is both effective and tolerated. However, it was withdrawn from them due to the medical establishment's implementation of the 2016 Guideline that was intended to limit over-use of opioids and risk of over-dose.<br/><br/>I suggest below an editorial change to achieve the goal of this comment. This suggestion should be reviewed by legal counsel to either assure that it achieves the intent, or find a better way to say it.<br/><br/>The following statement, which appears on both pages 76 and 85 of the draft, should be brought to a higher level of attention. A more succinct version of this statement should be added to the recommendations, or to the guiding principles:<br/>“Opioids should not be considered first-line or routine therapy for subacute or chronic pain. This does not mean that patients should be required to sequentially “fail” nonpharmacologic and nonopioid pharmacologic therapy or be required to use any specific therapy before proceeding to opioid therapy. Rather, expected benefits specific to the clinical context should be weighed against risks before initiating therapy. In some clinical contexts (e.g., serious illness in a patient with poor prognosis for return to previous level of function, contraindications to other therapies, and clinician and patient agreement that the overriding goal is patient comfort), opioids might be appropriate regardless of previous therapies used.”<br/><br/>Thank you for the opportunity to comment.<br/><br/>Submitted 2/16/2022	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joan	None	None	0900006484f80f8c	Etzweiler	None	2022-02-17T20:40:17Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Etzweiler, Joan	kzq-ip1q-1ezr	False	None	False	2022-04-12 01:57:06.917	[]
947	CDC-2022-0024-0953	https://api.regulations.gov/v4/comments/CDC-2022-0024-0953	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Day, Since 2015 my life is as I'm living in the twilight zone. I lost 80% of my pain medication, my quality of life went from having a life to wanting to end my life. Pain has a way of wrecking your entire life, your family, your friends , everything you had goes down the toilet fast. Please let the doctors find the right MME, get rid of the 50mme or any amount mme you want listed. I've been with my doctor for over 17years, he should be the person telling the amounts of pain medication I need. Please think hard and deep for what your about to change. PLEASE let doctors that work with their patients do their job. Thank you for time and hopefully giving me my life back. THANKS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484f80f90	Tank	None	2022-02-17T20:41:51Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Tank, Kevin	kzq-ity5-xzc9	False	None	False	2022-04-12 01:57:07.133	[]
948	CDC-2022-0024-0954	https://api.regulations.gov/v4/comments/CDC-2022-0024-0954	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In my 26 yr old cousin's memory, I'm writing to request 2 recommendations in the proposed 2022 CDC guidelines be removed. My 26 yr old cousin suddenly died in March 2021, likely as a result of these guidelines. He was in a car accident that left him with debilitating, burning nerve pain in his back. He had costly injections, radiofrequency ablations, and underwent surgery for an SCS implant- it did little to alleviate his pain. Additionally, after COVID-19, he was diagnosed with Trigeminal Neuralgia, a shooting nerve pain in his face. His doctor prescribed him Gabapentin and Tramadol, yet, I witnessed pain in his face despite these medical interventions & medications. His pain was greatly undertreated. Our family's lives were forever changed in March 2021 when we received the call that he unexpectedly died. The autopsy confirmed: Accidental Synthetic Fentanyl Overdose. If it were not for the 2016 CDC guidelines, I believe my cousin would be alive today, as his pain would not have been undertreated. <br/><br/>Please consider omitting the following from the proposed guidelines: <br/><br/>1) Remove the 2016 CDC recommendation that patients should stop taking a benzodiazepine in order to have their pain treated with an opioid. <br/>--Allow the prescribing physician the authority to decide whether or not it is in the patient's best interest to continue/discontinue a benzodiazepine without the CDC's recommendations interfering in care, as the physician tailors a specific, individualized treatment to the patient that is not a "one size fits all". Many patients take benzodiazepines responsibly while being prescribed an opioid. <br/><br/>2) Remove the 50 and 90 MME limits. <br/>---Allow physicians the full authority to decide whether or not to prescribe them a medication and if so, the amount.<br/><br/>Please consider my 26 yr old cousin's untimely death in your consideration of omitting the two from the 2022 guidelines. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80fa8	Anonymous	None	2022-02-17T20:47:22Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-jzgg-g1vl	False	None	False	2022-04-12 01:57:07.345	[]
949	CDC-2022-0024-0955	https://api.regulations.gov/v4/comments/CDC-2022-0024-0955	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been living with back pain and nerve pain for many years, and to get help with the pain has been a total nightmare!! Any doctor can run blood tests to see if a patient is abusing other drugs. When my nerve pain goes off, I have to spend thousands of dollars in emergency room bills, so that I can get something to work to stop the pain. I don't understand why I can't have some kind of a back up pain medication for when this happens. Very frustrating. <br/>I really hope that you can make some changes to help the people who have chronic pain because many of them are turning to the streets to find some relief when a doctor could have helped them with a safe controlled pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80fb2	Anonymous	None	2022-02-17T20:48:16Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-k92x-9bpf	False	None	False	2022-04-12 01:57:07.577	[]
950	CDC-2022-0024-0956	https://api.regulations.gov/v4/comments/CDC-2022-0024-0956	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This needs fixed, I went from getting my prescription from my doctor and getting it filled costing me around $10 to $15 every month. To taking a day off from work, to drive an hour away, to a pain management doctor that cost $120 to get in the door. Only to be processed like a criminal and treated as a junky. Once inside pills counted to many left over is bad having to little is worse. Urine tested every 3 months which cost even more money, not to mention the reminder of being kicked out of their pain management clinic at any time for almost anything knowing it’s almost impossible to get your medication anywhere else. Also hoping that the doctor likes your religion and politics, which of course has nothing to do with the pain you are in. But a way to profile and be used against you if you need an increase or change. You are like inmates or cattle to them, squeezing any money they can out of you. Or fix the problem to where my family doctor can give me my prescription, and be treated as a human being that has bulging and degenerating disc causing nerve pain that makes my feet feel like they are in ice water. We all know that anything can be abused and that the bigger issues are fake drugs that look like pharmaceutical with fentanyl in them flooding the streets. Stop abusing chronic pain patients would be a place to start.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80fb5	Anonymous	None	2022-02-17T20:50:04Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-ki93-2xhh	False	None	False	2022-04-12 01:57:07.791	[]
951	CDC-2022-0024-0957	https://api.regulations.gov/v4/comments/CDC-2022-0024-0957	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Now watch the overdose numbers dramatically fall! If there is no one that would touch fentynal then it will slowly disappear. Smart move trusting physicians and I'm being honest on that. There are bad apples in every group of people but I'd like to believe the majority are good.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f80fbf	Anonymous	None	2022-02-17T20:50:41Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-lanc-qhh3	False	None	False	2022-04-12 01:57:08.011	[]
952	CDC-2022-0024-0958	https://api.regulations.gov/v4/comments/CDC-2022-0024-0958	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Problem: Opioid Crisis<br/>Solution: Find every patient experiencing intense nonstop pain and prohibit patient from receiving the only medication known to relieve pain, or at least reduce it to an amount not known to help.<br/>Here's a better solution. Go after the illegal Fentanyl production and import. You might also check on people selling their Opioid meds instead of using them to relieve pain.<br/> I have taken Oxycontin for 20 years for major spine problems. It is the only thing that makes me want to keep active and lead a somewhat normal life. I haven't slept in a bed in 20 years. I have to pile up pillows to create a shape that conforms to my body in a sitting position. But I'm happy.<br/> At least I was. Before these ridicules new prescribing rules came about. I can't even move around the house like I used to. I know people who have died because they thought life wasn't worth it anymore. Fortunately, I like living. But it's getting to the point where it's hard to decide what to do anymore.<br/> When this country finds something to complain about, they find goofy solutions. Unfortunately, there are real people hurting ... literally. I used to say nothing can take pain away. Well, I was wrong. Opioid medications work. Now, if we can just get the government out of the way and get the doctors unafraid to prescribe again, we'll stop the pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Clifford	None	None	0900006484f80fc4	Marohl	None	2022-02-17T20:52:08Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Marohl, Clifford	kzq-lzqq-w260	False	None	False	2022-04-12 01:57:08.259	[]
953	CDC-2022-0024-0959	https://api.regulations.gov/v4/comments/CDC-2022-0024-0959	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For far too long in this country the doctor patient relationship has been systematically eroded by the greed of the insurance companies and an over reaching federal government. When considering the appropriate response to this epidemic we must consider many aspects of it. For instance, much of the statistical data regarding opioid overdose comes from Veteran Affairs institutions and doctors. Using this data to determine whether or not doctors should have full authority to decided, with their patients, what treatments and dosages are appropriate is very misguided. Injured soldiers treated with opiates for both acute and chronic pain are not the same as the average citizens receiving the same treatments. Soldiers often find themselves battling many forms of depression prior to any opioid pain management treatment. The fact is that these men and women, through their training processes, are made to believe that they are essentially indestructible. That their minds can force their bodies to overcome any physical obstacles. However, when faced with a painful, debilitating, and life changing injury, often accompanied by PTSD along with other issues, these patients fall into depression due to a feeling of being a hindrance to their family units. Consequently many of these patients turn to suicide, not accidental overdose. This has nothing to do with the opioids being prescribed or their dosages, rather underlying mental health issues. Often due to their military training, instead of seeking help for these mental health issues, these patients will suffer in silence or "suck it up", so not to be a hindrance or liability to their military and or family units. In the majority of the data from VA institutions the prescribing of opioids and the dosages at which they are prescribed are not the instigating problem. <br/>Also, when considering the opioid epidemic you must consider the great impact that illicit opioid drugs and their abuse have on the statistics. Overdose from abuse of heroin and illegally manufactured fentanyl are surging the numbers. The fact that these instances of overdoses are being lumped into the numbers without context is also very misleading. I believe in most of these instances these numbers can be attributed to poor work on the part of the DEA. The US is not a poppy growing country. The fact that heroin and worst of all, In my belief, fentanyl laced heroin is so prevalent in this country is a gross failure of the policies of the war on drugs. <br/> The main problem with the opioid epidemic is not doctors having the final say in the treatment of their patients, what to prescribe,or what dosage. I'm sure I can say with great certainly, that after the past decade of prosecution of physicians for prescribing opioid treatments, all physicians in this country are well aware of the possible consequences for prescribing opioid treatments. Yet they continue to do so because of its great benefit to many patients. The choice to prescribe, oversee, and alter an opioid treatment protocol should not be a decision for an insurance companie to make and it should not be a decision for the government to make. It should always be a decision made by a competent doctor and an informed patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8120b	Anonymous	None	2022-02-17T20:55:28Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-o27v-398x	False	None	False	2022-04-12 01:57:08.471	[]
954	CDC-2022-0024-0960	https://api.regulations.gov/v4/comments/CDC-2022-0024-0960	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Those that have been grandfathered in should be able to get a reasonable upped dose every 5-10yrs to help when they or work on breakthrough pain meds that help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8122e	Anonymous	None	2022-02-17T20:59:34Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-re4r-9iid	False	None	False	2022-04-12 01:57:08.714	[]
955	CDC-2022-0024-0961	https://api.regulations.gov/v4/comments/CDC-2022-0024-0961	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an Hiv+ chronic pain patient. I currently take 120mg of oxycodone a day. That is 4 -30mg oxycodone fast acting tablets a day. I have no history of abuse or diversion. This medication works well and allows me to live my life to a much higher degree than without. I tolerate this medication well. Others give me major side effects. I ask that the rules be rolled back. The constant back and forth has taken a toll on my mental and physical being. Lets be honest.....non-political. Overdoses are mostly from Fentanyl. Off the street. Please stop punishing legitimate chronic pain patients for poor decisions from improper usage of medication and street drugs. How about stopping the real problem? Fentanyl- which is found in majority of all street drugs. Thanks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484f8125b	Campanaro	None	2022-02-17T21:09:57Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Campanaro , Paul	kzq-x89e-7p6m	False	None	False	2022-04-12 01:57:08.924	[]
956	CDC-2022-0024-0962	https://api.regulations.gov/v4/comments/CDC-2022-0024-0962	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescribers should discuss risks of relapse to their patients who are in recovery and discuss their strength of connections to their recovery support systems, as well as plans to mitigate cravings and relapse risk even for some who take as prescribed. I had cravings after my knee replacement even after taking exactly as prescribed, and in 22 years in active recovery.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	lori	None	None	0900006484f8125e	dorsey	None	2022-02-17T21:10:32Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from dorsey, lori	kzq-xfdm-2qvj	False	None	False	2022-04-12 01:57:09.166	[]
957	CDC-2022-0024-0963	https://api.regulations.gov/v4/comments/CDC-2022-0024-0963	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a 58 yr old woman with Osteogenesis Imperfecta Type 1, also called "Brittle Bone Disease". I've had 50+ fractures lifetime, not counting fingers and toes. I cracked my R femur neck on 12/2. X-ray inconclusive, MRI ordered. Insurance company DENIED the MRI, my OOP for an MRI is $2300.I can't afford that. No MRI, no pain meds. Dr suggested Advil.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f8147b	Cochrane	None	2022-02-17T21:11:06Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Cochrane, Elizabeth	kzq-zpnh-1crk	False	None	False	2022-04-12 01:57:09.382	[]
958	CDC-2022-0024-0964	https://api.regulations.gov/v4/comments/CDC-2022-0024-0964	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a doctor in Michigan who has lost his license because of the 90 MME requirement. It doesn't matter if you add caveats, prosecutors see a limit and it becomes the law. The 50 MME "suggestion" is even worse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jonathan	None	None	0900006484f8147f	Robertson	None	2022-02-17T21:11:46Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Robertson, Jonathan	kzq-zxkz-dhd3	False	None	False	2022-04-12 01:57:09.592	[]
959	CDC-2022-0024-0965	https://api.regulations.gov/v4/comments/CDC-2022-0024-0965	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are beneficial long term in very select medical circumstances and short term only as last resort and if absolutely medically necessary for acute settings. <br/>It really should not be use first line for management of chronic pain unrelated to sickle cell disease, cancer related disorder or terminal illness requiring pain control. <br/>Decades of literally liberal use of opioids took a lot of toll to a lot of communities in every possible way. <br/>It is very important we all remain cautious not to be sway both ways. Not to go too far in restricting use but also Never ever go back to the old ways of using opioid for every complain of chronic pain without emphasizing opioids are not cure for chronic pain. <br/>Chronic pain as a medical condition per se and as a symptom literally is multifaceted and multi-factorial. <br/>Opioids will not cure chronic pain which unfortunately a lot and some maybe surprise but a lot of patients will say this…. I was never told my chronic pain can get worse with opioid use long term, that it is habit forming…. No one is immune to opioid dependency. <br/>Cure for chronic pain is not yet available. There are treatments for chronic pain and opioids are just one of them but it should be use as a last resort unless absolutely medically necessary.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8148a	Anonymous	None	2022-02-17T21:13:24Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-0eqz-e9za	False	None	False	2022-04-12 01:57:09.806	[]
960	CDC-2022-0024-0966	https://api.regulations.gov/v4/comments/CDC-2022-0024-0966	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had a few instances where opioids were denied to me. First, I had a uterine ablation. This was very painful procedure. After discharge from<br/>the hospital, the only pharmacy that was open at the time didn’t have any of the opioid medication I was prescribed. I had to go home in pain. The next procedure I had, was a partial hysterectomy. I was told to take 1200 mg of Tylenol. I was give. 3 Percocet to get me through this procedure. I was unable to move for about a week. The guidelines are too strict and doctors are withholding them when they are necessary. Changes should be made.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484f81499	Santo	None	2022-02-17T21:14:12Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Santo, Tracy	kzr-0yg0-d5bj	False	None	False	2022-04-12 01:57:10.015	[]
961	CDC-2022-0024-0967	https://api.regulations.gov/v4/comments/CDC-2022-0024-0967	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I managed my pain for over 30 years without meds until a failed surgery made that impossible to function without them. For the last 7 years I was given methadone in a low MME (40mg) dose that didn't quite do it. In early Dec 2021 I was terminated from my pain clinic because because I didn't do well with their further tapering to end the only med that releived my pain. I've NEVER abused my prescriptions! My very new case manager decided I was too old to take methadone at all--no one over 60 should take it according to her.How is it that an addict at a clinic can get 350mg/day, but a chronic pain patient can't get any? I know people with active cancers being refused meds. Is that really your intent?<br/> If all you people setting the laws felt this chronic pain, would it be a case of laws for thee and not for me? Why don't you watch "The Fix" documentary and see what the real drug problem is. Please. But of course that wouldn't change anything in this government, would it?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather	None	None	0900006484f814ae	Angers	None	2022-02-17T21:15:48Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Angers, Heather	kzr-1v77-yrli	False	None	False	2022-04-12 01:57:10.225	[]
962	CDC-2022-0024-0968	https://api.regulations.gov/v4/comments/CDC-2022-0024-0968	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband had spinal stenosis that lead to surgery (2008) fusing several vertebrea in his neck. 18 months after the surgery the chronic pain returned 2 fold. He underwent a couple of years of neck injections which offered some relief. Unfortunatly it was a 4 month roller coaster of pain-injection-relief-pain-injection.<br/>After doing some research, I discovered Belbuca, an opioid film he would disolve in his cheek. He was started on 75 mcg twice a day and with careful monitoring by his pain management Dr. the difference was phenominal. His dosage was never increased because we were able to control break through pain with OTC pain relief.<br/>What they did right: only gave him one month prescription at a time, required a visit every three months with frequent urine drug tests.<br/>He passed away (2021) from an unrelated condition and I was so grateful for the pain free years he had.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484f814c4	Andersen	None	2022-02-17T21:16:56Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Andersen, Barbara	kzr-2e14-5ugn	False	None	False	2022-04-12 01:57:10.434	[]
963	CDC-2022-0024-0969	https://api.regulations.gov/v4/comments/CDC-2022-0024-0969	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There needs to be a change. I'm 62yr old male with disabilities and I am on disability. I'm type 2 diabetic I also have locked shoulder syndrome in both of my shoulders I have lost 85% of movements in my arms. I also have peripheral neuropathy, as well as some back pain and extreme arthritis. There should be leeway in prescribing opiates more than 90 mg rule.<br/><br/>Most deaths from opiates are probably in the younger generation that use these drugs partying tools. People like myself and others really need them I don't call it addiction call more dependent on them for the relief and restore some good quality of life. Other big issue is Pharmacy's playing like God syndrome. If they don't like the way you look,talk, walk etc...<br/><br/>I don't believe that a pharmacist should have the right to override the doctor's recommendation on opiate use. So many people are having issues with this. They really need to do away with that rights. Pharmacist who deny you write to doctor's prescription for pain medication needs to be eliminated, as this also can cause unfortunate overdoses of illegal street drugs. I know patients that are paying the Pharmacy quadruple the price of the pills based on the amount and call potency. In upwards of $350 on top of regular prices.<br/><br/>Also I'm on Medicaid and there is not a pain management doctor or clinic within 70 miles of where I live. These doctors do not want to change the reduce rates for their services. I have to drive 130 miles one-way to see doctor that only takes cash! It's killing me financially. It's costing me $450 a month for services. New laws or a revised of 2016 provision I believe being a good thing! (Facts and opinions)<br/>Thank You...All stay well!<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	VINCENT	None	None	0900006484f814c8	DELLA TORRE	None	2022-02-17T21:19:07Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from DELLA TORRE, VINCENT	kzr-2gv1-d8y1	False	None	False	2022-04-12 01:57:10.645	[]
964	CDC-2022-0024-0970	https://api.regulations.gov/v4/comments/CDC-2022-0024-0970	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My father 30+ years ago was in an accident and had many invasive surgeries, till they were unable to operate on him anymore. I witnessed my father living life in pain and maintained a functional life for many years. What I did not know was the amount of pain he was enduring while maintaining a lifestyle including his role in our family unit. He tried working different types of jobs to still contribute but eventually had to retire very early on disability. He did orchestrated different doctors giving him opioids in the beginning to function but eventually for him to “numb out”. He was no longer the man I knew and looked up to. It was not until I at a young adult did I realize what he was enduring until I became in chronic pain with my diseases. I have tried many different avenues for pain control because I wasn’t going to go down the path of my father. My illnesses have progressed and to other illnesses that are extremely painful, one nicknamed the suicide disease. I have a new illness that resembles rheumatoid arthritis throughout my body leading to pain levels past 10 and crying for mercy. I had a PCP prescribed me different meds to help my complex conditions but had rare dystonic reactions. I ended up to be able to handle morphine extended release. I also have a condition that requires me to take a benzo as well. As stated I have complex conditions that require such medications. These conditions disabled me to the point I had to retire with disability and took away the majority of quality of life I once had. I’m pretty much bed bound and have to still live many years to come since my illnesses are not life threatening. This is what my father had to do. My dose of opioid is at maximum due to regulations, but even my doctor knew since the length of time on this med, the progression of my illnesses, my size and plain body temperament, the amount being given was equivalent to an aspirin. I don’t want to have to be on such medications but to function in what quality of life I have I need these meds. I am never high, doped or abusing these meds as my father did. But I understand why he did from firsthand experience. The pain fought for decades and he was tired. Anyone that knew him knew he was about life as do I. Each case is different than the next. Each condition requires different treatment. Each person’s body is different. Our doctors are aware of such situations. Yes I believe there should be some regulations to monitor these opioids abuses but not one case fits all. You are making life more unbearable than our illnesses trying to get Adequate help. Most chronic pain patients aren’t seeking drug addiction but quality of life. They aren’t in it to get high but to function in life. There would be less street drugs sought out and more control over what is being taken by the patient if you allow these doctors to help us adequately per patient, per circumstances. These doctors know that, except you make them in fear of their license and of their patients. These types of regulations are leading to overdoses because of patients self medicating instead of under a doctor review. I’ve lived in chronic pain for over 11 years now and all I want is quality of life not to be high. I want to live! You can’t put me under the same umbrella as those who want to forget their pain and tired of it. So yes some regulatory measures need to be in place so that those of us required to take opioids to have quality of life can and not have it ruined by those others. Again this should be done in a different way than these regulations that you are putting upon us. Those doctors that are trying to give us the help we need know us, our conditions and current quality of life shouldn’t be held responsible for those that abuse the trust given. The ultimate abuse is allowing these requirements to abandon those who can be trusted with the responsibility of their quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f81d0f	Anonymous	None	2022-02-17T21:26:15Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-494c-ehg5	False	None	False	2022-04-12 01:57:10.885	[]
965	CDC-2022-0024-0971	https://api.regulations.gov/v4/comments/CDC-2022-0024-0971	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>I ASK THAT THE CDC CONSIDER THOSE VETERANS IN CONSTANT PAIN AS A RESULT OF THEIR SERVICE. MANY VETERANS LIVE WITH CONSTANT PAIN WHICH LIMITS THEIR ABILITIES FROM THE MOMENT THEY WAKE UP TO GOING TO BED. THERE ARE MANY WHO CANNOT FIND PEACE FROM PAIN DURING THEIR SLEEP HOURS. THEY EXPERIENCE A RESTLESS SLEEP WAKING UP MANY TIMES AND SOME TAKING HOT SHOWERS IN THE MIDDLE OF THE NIGHT IN ORDER TO LESSEN THE PAIN.<br/><span style='padding-left: 30px'></span>THE MEDICAL PROFESSION IS MORE CONCERNED WITH LIMITING PRESCRIPTIONS AS OPPOSED TO<br/>HELPING THE PATIENT'S PAIN. FOR MANY, STRESS REDUCTION PROGRAMS AND LIMITING THE PRESCRIPTIONS DO NOT EVEN TOUCH THEIR ABILITY TO DEAL WITH PAIN. PAIN IS REAL. PAIN IS LIMITING. PAIN IS NEVER ENDING.<br/><span style='padding-left: 30px'></span>PLEASE CONSIDER RULES WHICH DO NOT LIMIT OR PUT A BULLS EYE ON DOCTORS WHO PRESCRIBE PAIN MEDICATION.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	THOMAS	None	None	0900006484f81d8a	James	None	2022-02-17T21:30:48Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from James, THOMAS	kzr-6o80-1tw7	False	None	False	2022-04-12 01:57:11.113	[]
966	CDC-2022-0024-0972	https://api.regulations.gov/v4/comments/CDC-2022-0024-0972	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The FDC proposed a new regulation about prescribing opioids hoping to reduce the misuse of drugs , by applying that the pills will simply manage pain . The thing is this regulations sparks a debate and the opposing sides are kind of reluctant because prescribing drugs seems unethical . Let's not ignore the elephant in the room many people misuse drugs . The gateway statement always starts with "I need these pills for pain relief" but what started off so innocent can end with an addiction. Although medical professionals are aware of the risk , they still continue to enable this behavior because drugs is a lucrative business . The goal is to promote wellness , but that's far from the case , yes some people are capable of not going down this rode but is it a risk worth taking .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kendall	None	None	0900006484f81db4	D	None	2022-02-17T21:33:08Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from D, Kendall	kzr-7l5t-l3hm	False	None	False	2022-04-12 01:57:11.325	[]
967	CDC-2022-0024-0973	https://api.regulations.gov/v4/comments/CDC-2022-0024-0973	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Given that there is a research and clinical consensus that chronic pain is a multidimensional construct and experience that is influenced by a range of contextual factors (personality, family or origin and current family, prior psychological adjustment and history, economics, social supports), opioids should be considered as a means of facilitating re-engagement with family, social, and ideally work, contexts and not be focused solely on reduction of pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484f81dc1	Kvaal	None	2022-02-17T21:33:47Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Kvaal, Steven	kzr-7ze7-mvko	False	None	False	2022-04-12 01:57:11.577	[]
968	CDC-2022-0024-0974	https://api.regulations.gov/v4/comments/CDC-2022-0024-0974	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe the 2016 and the 2022 opioid guidelines should be thrown out.Although there was some little bit of change between the guidelines it's not enough.You caused great harms and deaths to many which is why opioid deaths and suicides went up instead of down.The guidelines didn't help or protect anyone.millions of pain patients have been suffering greatly because of these guidelines.The FDA should be writing these guidelines,not people who are not qualified.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484f81de9	Vennell	None	2022-02-17T21:34:59Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Vennell, Lori	kzr-8jwp-6n2j	False	None	False	2022-04-12 01:57:11.822	[]
969	CDC-2022-0024-0975	https://api.regulations.gov/v4/comments/CDC-2022-0024-0975	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a disease called Schwannomatosis, with dozens of tumors on the nerve roots, nerve sheathes, and peripheral nerve bundles of my spinal cord from C1 through the sacrum bilaterally. The pain it is intense and virtually crippling. In the past, my pain was well controlled. I became open water SCUBA certified. I hiked, led classes, took care of my dying husband, took classes. Now, because of the CDC guidelines I am only allowed 3 10MG Oxycodone per day. I am virtually housebound. Pain is my constant companion. Not small, annoying pain. Huge, overwhelming pain. <br/><br/>Doctors must have autonomy to prescribe as they see fit to patients who have diseases, injuries, and/or surgeries which require pain relief. Surely you must see the disaster that has occurred to the patients in the wake of the 2016 GLs. Please, please undo that disaster. Please allow pain to be addressed adequately again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484f81e05	Roberts-Anderson	None	2022-02-17T21:38:22Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Roberts-Anderson, Sandra	kzr-94ot-p8oh	False	None	False	2022-04-12 01:57:12.035	[]
970	CDC-2022-0024-0976	https://api.regulations.gov/v4/comments/CDC-2022-0024-0976	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	THE PLANNED GUIDELINE SOUNDS LIKE A RELAXATION OF THE EARLIER GUIDELINES. HAS NOT ENOUGH PEOPLE DIED RELATED TO OUD? I WAS HOPING FOR CONTINUED RESTRICTIONS WITH PERHAPS MORE OVERSIGHT. WHAT A SHAME.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	AMY	None	None	0900006484f8225e	MIZELL	None	2022-02-17T21:39:12Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from MIZELL, AMY	kzr-cetl-m5eh	False	None	False	2022-04-12 01:57:12.250	[]
971	CDC-2022-0024-0977	https://api.regulations.gov/v4/comments/CDC-2022-0024-0977	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	people need to be able to function , pain is awful take away opioids and deadly drugs will consume many good people the need pain relief.that is why the death rate has gone up.also money good doctors lives have been destroyed because they have sympathy for their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	dan	None	None	0900006484f82271	sciarra	None	2022-02-17T21:39:40Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from sciarra, dan	kzr-cjvt-sr73	False	None	False	2022-04-12 01:57:12.477	[]
972	CDC-2022-0024-0978	https://api.regulations.gov/v4/comments/CDC-2022-0024-0978	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The revised guidelines are well over due! Happy to hear about this, finally. However, putting in limits of “50mme” is only going to make Drs , pharmacist s, DEA, insurance companies, etc hold this over our heards, just like the “90mme” limit was made “law” in so many states. <br/>Medical boards are using this as “law” and not allowing Drs to prescribe what is needed. <br/>Most CPPs have all done step therapies - more than once! Every time a physician retires or quits and we spend months looking for a new one who will continue our pain care, we end up starting over with all the non opioid medications, physical therapy, etc etc etc <br/><br/>Please reconsider the wording of this “50mme” it only ends up costing patients more $$$. Drs making patients come in every month, drug test every month, smaller scripts, all adds up. It now cost pain patients up to 10 x what it used to cost. <br/><br/>Individualized care is of utmost importance- every dr, every patient, type of pain, cause of pain, metabolizing, etc is so different from case to case. <br/><br/>Medication- what works for one, doesn’t work for all. Dose, type, immediate or extended , all plays a big part of individualized care. <br/><br/>Thank you!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tami	None	None	0900006484f822a5	Mckee	None	2022-02-17T21:45:41Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Mckee, Tami	kzr-cugk-fqjx	False	None	False	2022-04-12 01:57:12.688	[]
973	CDC-2022-0024-0979	https://api.regulations.gov/v4/comments/CDC-2022-0024-0979	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Physicians need to ensure that their patient's pain is properly managed and assessed. Having optimal pain, may be a legitimate way to prescribe opioids, but the obligation to provide pain relief needs to have a severe balance with an equal responsibility of not exposing patients to the risk of addiction and diversion. Basic ethical principles can provide a framework to help physicians make ethically appropriate decisions about opioid prescriptions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kay	None	None	0900006484f82566	Maggette	None	2022-02-17T21:46:55Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Maggette, Kay	kzr-dxsw-xcqj	False	None	False	2022-04-12 01:57:12.903	[]
974	CDC-2022-0024-0980	https://api.regulations.gov/v4/comments/CDC-2022-0024-0980	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This isn’t going to work the docs are still going to be scared get rid of the mme. I am suffering so bad I haven’t walked my dog in a year. I can barely have pain coverage. My break through pain makes it impossible for me to do anything. I can’t clean or do my hair nothing. If this is going to get better let the doctors who went to school all that time be the doctors. Please I’m begging you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sammie	None	None	0900006484f82e02	Winslett	None	2022-02-17T21:47:33Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Winslett, Sammie	kzr-fhua-5t3a	False	None	False	2022-04-12 01:57:13.120	[]
975	CDC-2022-0024-0981	https://api.regulations.gov/v4/comments/CDC-2022-0024-0981	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I remember when my first pain doctor introduced me to OxyContin when it first came out. He was telling me how safe it was and suppose to be the best medicine out their for patient with chronic pain. I was just happy to have pain medication that could hopefully help me have a normal day where I could function doing daily activities. Nearly 20 years later My amount had increased to a very high amount of OxyContin a day with also break through pain medications. I was afraid that I was on such high amounts what’s for me down the road so I decided to worked with a new pain doctor to slowly get off OxyContin and lower the strength of the new pain medication. I was doing okay until the government decided that doctors needed to cut pain patients way down. I was already at a level that just wasn’t helping me function through the day. My doctor also changed. He was so concerned of the new regulations he lost his ability to help me. He kept cutting me down when I asked him not to. He didn't care about my pain anymore he just kept throwing this new guideline at me. It didn’t matter that I was telling him that taking away my meds wasn’t helping me get my quality of life back. I struggle everyday and I hate going to see my so called pain management doctor on a monthly visit, I feel I’m going to see my probation officer who always looking for a way to take more Medicine away or treat me like I have a drug problem. I don’t have the same pain everyday and in the same place. Some days are worse than others. I fell 20 feet when I was eighteen and landed straight down on my right ankle. Crushing my foot and ankle, broke my back, broke my tailbone, and other injuries. Around 1990 My pain and issues started and seemed to never end. I have had back surgery, neck surgery x2, neck fusion, right ankle surgery and then total fusion of my right ankle. I do have pain everyday and I’m only looking for a way to function everyday. I want to take care of my family and home like everyone else. I shouldn’t feel guilty asking for pain relief which I do. The problem with pain medicine is not the chronicpain patient it is with the doctors sending patients home on strong opioids for to long of time when they should be slowly taken down. I have never had one day without pain and I know that day will never come. I just want to live the best I can.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suzanne	None	None	0900006484f82f05	Shedenhelm	None	2022-02-17T21:50:06Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Shedenhelm, Suzanne	kzr-fpw3-x45w	False	None	False	2022-04-12 01:57:13.330	[]
976	CDC-2022-0024-0982	https://api.regulations.gov/v4/comments/CDC-2022-0024-0982	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First and foremost, treatment should be between the patient and the doctor! If the CDC cannot get and use neutral writers with clinical pain management experience, the CDC needs to abolish the opioid guidelines!!! It is an absolute atrocity that writers of the original and the revised guidelines have serious conflicts of interest. Furthermore, they must think that chronic pain patients and the American public are illiterate and flat out stupid. They continue to use the same twenty-one studies that have been proven by the medical community to be invalid, hand-picked data, to meet their needs of invalidating the use of opioids. Then they think that by making the draft almost three hundred pages, we won't notice that they are trying to lower the MME to 50. Another completed useless arbitrary number! The only significant change that they are proposing is that doctors should not force taper. NEWS FLASH, this is too late! The CDC needs to either abolish the guidelines are go back to the drawing board and get doctors without conflicts of interest that know what they are doing. The oversight should be left to the FDA not the CDC, the CDC does NOT have the authority.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f82f0c	Anonymous	None	2022-02-17T21:51:38Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-fwqb-mhcj	False	None	False	2022-04-12 01:57:13.554	[]
977	CDC-2022-0024-0983	https://api.regulations.gov/v4/comments/CDC-2022-0024-0983	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think you need leave it how it is now. A Dr who has since committed sucided in 2016 ruined my husband life with these pills he was talking enough kill an elephant. But once the system currently in place was in acted all the over prescribing stopped. And I got my husband back. Your not doing anyone a service here leave it be as it is. The system works just fine. Those pills don't help anyone they just ruined peoples live and they loose everything as a result. There are 15 kids my youngest child's classes and 11 of those kids live with there grandparents or are in the system because opioids ruined there lives and these kids parents where longer able to function and properly care for the kids. There so many people from generation who died as result of these pills.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8341f	Anonymous	None	2022-02-17T21:54:46Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-gvke-1zys	False	None	False	2022-04-12 01:57:13.764	[]
978	CDC-2022-0024-0984	https://api.regulations.gov/v4/comments/CDC-2022-0024-0984	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Drugs aren't killing people. People are killing people. I love with chronic pain and take my meds exactly as prescribed but I'm not prescribed what I need bc I'm being punished for those that abuse their meds. When a Dr cuts a pain patients meds off they head straight to the street to buy illegal drugs. I have a perfect history of passing urine test and pill counts. Why should I be punished. Drs should be allowed to give chronic pain meds to a patient according to their past history with meds. People are in such bad pain, some are just commiting suicide. This is wrong and Drs keep cutting us chronic pain patients back so we just suffer. Leave us out of it if we follow the rules. Apparently whoever wrote this article can stand more than 2 minutes without having excruciating back pain. I, myself am at wits end with all the different types of pain I have, with no teleif. Pain meds helped me to function and have some quality of life. Now, I just lie in bed 7 days a week!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484f834a3	Davenport	None	2022-02-17T21:55:59Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Davenport, Judy	kzr-gyfm-gf2v	False	None	False	2022-04-12 01:57:13.989	[]
979	CDC-2022-0024-0985	https://api.regulations.gov/v4/comments/CDC-2022-0024-0985	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a pain pain for couple of years. Been diagnosed with chronic pain. In the past my previous doctor and I have tried numerous medications for my chronic pain for months. Lastly we have tried opioids Hydrocodone and the medication finally helped me with my daily chronic pain I deal with. <br/><br/>I was told by my local provider here in Alaska that CDC is taking the opioids away from all patients and only using them for procedures and dental work. <br/><br/>This isn’t fair for patients who have been diagnosed with Chronic Pain. This means I will be having Chronic Pain for the rest of my life and I am only 40 years old. I am devastated and scared with all the information that my doctor is bringing up plans on changes for pain medication. <br/><br/>I do not think it is fair for patients who have been diagnosed with Chronic pain showing the patient is suffering and needs help to deal and lower pain levels. <br/><br/>The local clinic has all my paperwork and proof that I was diagnosed with Chronic Pain and to be taking my pain medication away that helps me is not fair at all. I basically will be suffering the rest of my life because Tylenol and/or ibuprofen does not help with my chronic pain. <br/><br/>I am hoping my comment makes sense and makes a different in choices.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Juliet	None	None	0900006484f83683	Stonecipher	None	2022-02-17T21:57:26Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Stonecipher , Juliet	kzr-hcvn-j7dq	False	None	False	2022-04-12 01:57:14.199	[]
980	CDC-2022-0024-0986	https://api.regulations.gov/v4/comments/CDC-2022-0024-0986	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Being a sufferer of chronic pain for over two decades you're still not doing enough. The difficulty even getting a physician to consider using opiates is practically insurmountable. I understand they're addicting, dangerous and difficult to justify these adverse indications and prescribe them in spite of these things. But because the crackdown was so harsh and so absolute, the consideration of opiate therapy has been buried under miles of painful physical therapies, snake oil treatments, outright disbelief and bullying mockery from doctors as opposed to trusting your patients even a little bit and bringing relief from their suffering and a quality of life that while not the same as before a quality none the less. While we chronic pain patients wake up every single day of our lives suffering such myriad difficulties that many of us consider suicide or getting drugs from the streets which is tantamount to suicide these days with the fentanyl issue. Pain is not our only hurdle, when chronic issues arise or flare up the sufferers need to find different ways to circumvent those issues and different ways to be able to live our lives and take care of the things we need to each and every day. Just because my back may ache so bad it causes me to clench my teeth to the point of breakage, doesn't mean I get the day off of caring for my 7 year old, taking her to and fro, cleaning my house and doing the dishes that I've already put off for days or making a meal so that my family doesn't go hungry because I'm having another bad day this week, or perhaps having a bad week altogether. I speak from lots of experience, I'm fully disabled for the rest of my life and on the fixed income that accompanies lifetime disability so thank heaven I have insurance but there are loads who do not and that have to pay cash for all these services and going from doctor to doctor because this one is scared to prescribe because of the draconian limits strict rules and threats of DEA intervention, this one has quit prescribing altogether because of the hassle, this one wants to use traction injections spinal fusion and anything and everything else, and this one just doesn't believe in opiates/ opioid therapy and then maybe just maybe you'll find a doctor who will give you far less than you need in milligrams and quantity of pills so that you've got to try to play around with taking less when you need it and more when you really really need it, which brings the hellish nightmare that is withdrawl into your life. Opiates aren't for every ache and pain, they're not for anxiety depression or mania, and they aren't for everybody. For some they're a lifesaver, for others they are more trouble then they are worth but let the people who are dealing with the pain daily decide because you have no right to arbitrarily and without a second thought decide that they won't help. Stop fooling with people's lives, stop being controlled by fear of the DEA and finally stop forgoing one of the best weapons against agony that the lord provided on this earth. There is a reason opiates have been used since the beginning of time, who are you to say they don't work anymore?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Aaron	None	None	0900006484f83a0c	Lukitsh	None	2022-02-17T22:00:49Z	None	None	1	None	2022-02-17T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Lukitsh, Aaron	kzr-i5o6-2xyj	False	None	False	2022-04-12 01:57:14.418	[]
981	CDC-2022-0024-0987	https://api.regulations.gov/v4/comments/CDC-2022-0024-0987	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Registered Nurse I do see a lot of opioid abuse, however I see it in heroin addicts and fentanyl addicts. In my years of practice I have only come across one who was misusing a prescription. It turns out she had a much more serious condition than her doctor realized and it was not being treated. Her comment was “it’s either find relief or commit suicide”. What a terrifying thing to hear from a patient! <br/>I am having my own major surgery next week and I’m honestly terrified of the lack of pain control I may end up with due to the fact the CDC has counted street drug overdoses as if they’re prescription drug overdoses which are very different. <br/>Also the government making MD’s afraid of treating their patients appropriately is horrible. These doctors know what their patients needs are but fear losing their license if they treat their patient’s pain appropriately. Remove the caps and excessive regulations on medications that help chronic pain and post op patients recover their lives.<br/>(For example my grandmother was up and active until her MD removed her pain meds & started suboxone which she is allergic to (he told her an allergy was impossible)! Without that medication she lost mobility. She had to start home oxygen. She now has blood clots in her legs. And the only reason she was ever on them is because she’s in her 80’s with a back condition that needs surgery but her heart has leaking valves and damage from a MRSA infection she got in her blood many years ago from a staph infection in her arm that spread. She’s not a surgical candidate. But taking her opiate prescription has worsened her mobility and overall health and she is so depressed she has no quality of life anymore). Her doctor treating her pain with an appropriate opiate kept her up and moving, without blood clots or oxygen. These rules are highly dangerous to those who have chronic conditions & pain. It’s also scary for those who are surgical patients. I’ve put off a surgery that is required to save my life for years because I’m afraid of how unbearable the pain will be, but now the pain is unbearable regardless. When I told my doctor how it had progressed and the pain I was in he said “that’s not my problem.”<br/>Thankfully I was immediately given a new surgeon and my pre-op appointment is on Wednesday. I’m still scared but I’m in horrific pain no matter what so I may as well, right? Please, people are suffering needlessly. Stop this madness. <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lauren	None	None	0900006484f8562b	BSN-RN	None	2022-02-18T10:40:39Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from BSN-RN, Lauren	kzs-2dnh-1z8l	False	None	False	2022-04-12 01:57:14.630	[]
982	CDC-2022-0024-0988	https://api.regulations.gov/v4/comments/CDC-2022-0024-0988	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, <br/><br/>I am writing, because I have been a chronic pain patient for 11 years. It’s been 11 years since I’ve been able to do anything “physical” without being in excruciating pain for two days after. That includes long walks, roller skating, mopping my floors, shopping for more than an hour, and many other things I used to love and enjoy doing. I can’t remember when I had a full night of sleep without waking up in pain from my pressure points. Even without doing anything physical, it takes medication and time to get out of bed, due to all over body pain, stiff joints, and for the last 6 years in major pain. Due to the MME limits my medication was reduced and hasn’t changed in 6 years. While it is still the only thing that allows me to get out of bed in the morning and be a somewhat functioning adult for work and to be present at best for my kids and grandkids, I am in constant daily pain. Pain that most people would stay in the fetal position in their bed. These guidelines are not justified or fair for those of us who live in daily chronic pain, with illnesses or conditions that aren’t going to go away. We deserve to have a better quality of life. We deserve proper help from our providers who specialize and were trained to do provide us that care. Our quality of life should not be dependent on the rules made by our health insurance providers or the pharmacist who believes they are trained better than your pain management physician. I just want to be able to get up in the morning and not dread getting out of bed, because lawmakers have decided how to treat my chronic pain, instead they of my doctor and myself. Please, remove the MME guidelines and let the trained pain management physicians and the chronic pain patients decide what is needed for our quality or life. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f86d56	Anonymous	None	2022-02-18T10:41:27Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-u58b-ozf5	False	None	False	2022-04-12 01:57:14.886	[]
983	CDC-2022-0024-0989	https://api.regulations.gov/v4/comments/CDC-2022-0024-0989	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, <br/><br/>I am writing, because I have been a chronic pain patient for 11 years. It’s been 11 years since I’ve been able to do anything “physical” without being in excruciating pain for two days after. That includes long walks, roller skating, mopping my floors, shopping for more than an hour, and many other things I used to love and enjoy doing. I can’t remember when I had a full night of sleep without waking up in pain from my pressure points. Even without doing anything physical, it takes medication and time to get out of bed, due to all over body pain, stiff joints, and for the last 6 years in major pain. Due to the MME limits my medication was reduced and hasn’t changed in 6 years. While it is still the only thing that allows me to get out of bed in the morning and be a somewhat functioning adult for work and to be present at best for my kids and grandkids, I am in constant daily pain. Pain that most people would stay in the fetal position in their bed. These guidelines are not justified or fair for those of us who live in daily chronic pain, with illnesses or conditions that aren’t going to go away. We deserve to have a better quality of life. We deserve proper help from our providers who specialize and were trained to do provide us that care. Our quality of life should not be dependent on the rules made by our health insurance providers or the pharmacist who believes they are trained better than your pain management physician. I just want to be able to get up in the morning and not dread getting out of bed, because lawmakers have decided how to treat my chronic pain, instead they of my doctor and myself. Please, remove the MME guidelines and let the trained pain management physicians and the chronic pain patients decide what is needed for our quality or life. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f86d55	Anonymous	None	2022-02-18T10:42:02Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-u585-9eud	False	None	False	2022-04-12 01:57:15.096	[]
984	CDC-2022-0024-0990	https://api.regulations.gov/v4/comments/CDC-2022-0024-0990	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was getting 3 pain pills a day which I had to save them for night so I could actually sleep.. I was struggling with a job, personal hygiene, shopping and cleaning my home.. <br/>My body and mind was exhausted from physical pain and I was mentally exhausted.. <br/>I tried taking my pain meds through out the day but it left me without anything at night and I suffered all night awake and struggled to do my job and suffered with my memory problems from a lack of sleep and pain which I still have memory problems today..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f86b6e	Anonymous	None	2022-02-18T10:43:24Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-tki4-r1xs	False	None	False	2022-04-12 01:57:15.305	[]
985	CDC-2022-0024-0991	https://api.regulations.gov/v4/comments/CDC-2022-0024-0991	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m just one more voice pleading for a return to more availability. The damage done to those who legitimately use is obvious. Having quantity limits, strength restrictions, and needing to physically see one’s prescriber every 20-30 days is unnecessary. Yes, we understand both sides of the argument. But hindsight has shown more freedom should be the way. Opiates should and do help, and make life better. But the restrictions make acquiring meds life consuming. The decision becomes “be consumed by pain” or “be consumed with getting meds”. <br/>I moved to Florida in 2006 for access to oxycodone. I had a great few years. Some of the best in my life. Then that was all taken away.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f86b6c	Anonymous	None	2022-02-18T10:44:21Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-tiiq-dajt	False	None	False	2022-04-12 01:57:15.516	[]
986	CDC-2022-0024-0992	https://api.regulations.gov/v4/comments/CDC-2022-0024-0992	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please, I am BEGGING YOU to please give me my life back. My doctors can see my pain through scopes & catheters & I have no semblance of life, due to the fact that I am so under medicated & I have to shake & cry monthly scared my doctor will not fill my script, though I have never abused, never failed a urine screen or asked for an early fill.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria D	None	None	0900006484f85667	D Dicino	None	2022-02-18T10:47:48Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from D Dicino, Maria D	kzs-a9a8-bwc1	False	None	False	2022-04-12 01:57:15.738	[]
987	CDC-2022-0024-0993	https://api.regulations.gov/v4/comments/CDC-2022-0024-0993	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a woman in my mid 50’s & have suffered with chronic pain for 15yrs now Worked in healthcare until I couldn’t physically do my job anymore Am now on disability I am a pt in pain management Many changes have occurred over the yrs such as urine tests, contracts, monthly dr appts & forced tapering of pain medication due to the MME recommendations Every person is an individual Medication dosing is not one size fits all What is sufficient to manage pain well for one person may not be enough for someone else Because of the 90 MME 2016 decision many CPP have been forcibly lowered or tapered, to a dosage that no longer manages their pain I fear this new 50 MME will cause further mandatory tapering With that said let me tell you about living with chronic pain You not only suffer physically but mentally as well Pain robs you of sleep, of peace of mind, of happiness & joy It destroys relationships Family and friends can only handle so much If I complain too much about my pain they avoid me causing isolation & depression If I don’t complain enough they don’t understand why I decline to go to a movie, eat at restaurants or just visit them at their house I can’t sit for more than 15 mins at a time, need to lay down and change positions often Pain makes your world very small It’s just dr appts, trips to the pharmacy & grocery store But when pain is managed with the correct dosage my quality of life increases My relationships are better the world isn’t so small I can face another day and even look forward to the future I understand some have abused their medication or take it not for pain but for a “ high” & have become addicted & worse case have died But you can’t punish the many for the actions of a few Illicit fentanyl is much more of a problem than legal, safe when taken as prescribed, pain medication In closing drs need to not fear losing their license or fear prosecution by prescribing pain medication to patients who need it People are suffering needlessly Please don’t punish pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dee	None	None	0900006484f84c87	Jones	None	2022-02-18T11:01:38Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Dee	kzr-n78n-3b2x	False	None	False	2022-04-12 01:57:15.948	[]
988	CDC-2022-0024-0994	https://api.regulations.gov/v4/comments/CDC-2022-0024-0994	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my name is [name redacted] I’m writing to tell u about what’s going on with chronic pain patients and their meds. First I have been dropped to 1/4 of what I got by on for 25 years and it’s not working out well Suicide is a daily thought even tho I don’t want that cuz I have kids and Gkids that I want to see grow. I can’t play with them like I used to because of my pain now I’m just a lump in the bed all day. Surely u guys can’t think that (a one size fits all) program can help people. It can’t. doctoring has always been an individual assessment because we are all individuals with different issues. This new guideline has ruined my life and 100s of thousand other folks as well. Everyone’s pain is different and needs to be treated that way. You guys probably think I’m crazy but what if something happened and you needed pain medication?? Please consider this and all the other patients stories. This is our lives depending on this. You guys need to talk to patients and listen to them. We all want to live at close as possible to normal but now we can’t and that just brings us more pain. You must wake up and listen <br/>Thank u	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484f83ffc	Brawley	None	2022-02-18T12:02:59Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Brawley, Kevin	kzr-jl70-ct2m	False	None	False	2022-04-12 01:57:16.157	[]
989	CDC-2022-0024-0995	https://api.regulations.gov/v4/comments/CDC-2022-0024-0995	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm an 80% rated disabled veteran who has lived with chronic back and neck pain for 25 years now. I have taken Vicodin for over 20 years. I have gone through every alternative treatment from acupuncture, chiropractor, biofeedback, TENS, ect. Those help but are no replacement for pain meds. Tylenol or Ibuprofen are not effective substitutes. I do nerve ablations on 8 nerves twice a year. I do as much as financially possible to treat my pain. Doctors need to monitor and get to know their patients. That will prevent most problems. I was always aware of the potential of becoming reliant on pain meds but my VA doc years ago said as long as I only took them for real pain it would not be a problem and he was right. I've been offered stronger meds at times for acute problems and I always refuse them. I have actually reduced what I take and am splitting them in half. Because of the relationship I have with my VA doctors we have honest conversations and I am not just a prescription recipient. On a normal day I am down to at most one Vicodin but there was a point before I started regular nerve ablations that I took 4 a day. You can't just stop prescribing them without giving patients an effective, affordable substitute and not expect them to seek another way to ease their pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006484f84561	Raschke	None	2022-02-18T12:04:57Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Raschke , Cynthia	kzr-l068-emw8	False	None	False	2022-04-12 01:57:16.378	[]
990	CDC-2022-0024-0996	https://api.regulations.gov/v4/comments/CDC-2022-0024-0996	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If the purpose of this document, as described line 26, is to improve communication between clinicians and patients, this document is way to long, 216 pages filled with historic information, and too complicated to expect a patient to read and develop an improved communication tool with respect to to opioid use. Recommend separating and reducing this document into a more readable and understandable form for patients to reasonably quickly read and understand the use of opioids and the possible risks and side effects and the available resources if problems arise from using the medications. In addition this abbreviated document should emphasize as depicted in the table on line 26 what the document/guideline is and is not. It should also emphasize that physicians should use their own professional judgement with respect in prescribing pain medications and stating doing so without fear of overreaching government activities probing into individual physician daily operations. If there is a need for the other historic information and associated references, create a separate document with this information, which would not be a “guideline”. The use of video education using available on line resources could also be developed by the CDC whereby a patient could view a 5-10 minuet video after being prescribed opioids. Referencing the 2016 guidelines, historic race, ethnicity, rural etc information it not required to learn and communicate a patient’s being prescribed a medication. Additionally is seems this document is some sort of medical school book for physicians on how to treat specific diseases. Physicians have had years of training and continued education studies, are the specific treatment suggestions really necessary for each malady? If so, create a physician related document for their use, and keep this document for its intended communication tool between physician and patient.<span style='padding-left: 30px'></span><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JOHN	None	None	0900006484f856b6	RICHARDSON	None	2022-02-18T12:57:19Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from RICHARDSON, JOHN	kzs-ea2l-mx3j	False	None	False	2022-04-12 01:57:16.587	[]
991	CDC-2022-0024-0997	https://api.regulations.gov/v4/comments/CDC-2022-0024-0997	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Four years ago I herniated all the discs in my neck on the left side which resulted in some rather horrific pain that traveled down my arm. I did all the steps that were asked of me. Physical therapy, steroids, injections, chiropractic care, and drowned in a bucket of NSAIDs. My insurance company refused to approve prior authorization for imaging so all the work that was done on my neck was done flying blind and all the aforementioned therapies didn’t even come close to touching the pain. <br/><br/>It was after a visit with the chiropractor that things really hit the fan. He was a devotee of the TENs wand, even though I told him it felt like it made things worse, not better. In my last session with him, he went to town on my neck and shoulder with that vile device and the pain I had been dealing with for almost 3 months went from a 7 to a 10 and I ended up in the ER.<br/><br/>I was able to finally get imaging done while there which showed what was going on but despite my blood pressure soaring 148/100 (my blood pressure usually hovers 90s/60s), a raising heart, and bloody pictures showing the herniated disc, I was treated like a junky looking for a fix.<br/><br/>I left with Tylenol 4 and another packet of steroids and the recommendation to see a surgeon. The Tylenol 4 was the most helpful item out of all I tried hands down, but the hoops I had to jump through to get it was asinine and unfair. Physical therapy is a joke, they literally slapped a heating pad on me, gave me a printout of some stretches, and walked away. I was charged $450 for that visit. The chiropractor was mildly helpful while actively being worked on but the pain never subsided below a 5 and as soon as I left the office it bumped back up to a 7 or 8 and finally a 10 from that last visit. The injections did absolutely nothing and the NSAIDs… it was like taking sugar pills. I have never found Ibuprofen or Aleve to be particularly helpful for anything I have taken them for, minor or major, and they carry their own risks.<br/><br/>My neck issues subsided, though not 100%, it’s like I have ghosts of the pain still haunting my shoulder and arm and I wonder at times if I had been treated in earnest with proper medication if I would be in better shape than I am now.<br/><br/>I get there is a risk of addiction. However, that is for a small subset of the population that is exposed to opioids and not the majority. I have used that medication after surgeries and injury and never felt the need to hunt it down for nefarious use once I have completed a course. <br/><br/>This ongoing hysteria is misplaced and causing massive harm to a huge swath of the population that had nothing to do with it. I mean for crying out loud! The Human Rights Watch has flagged our country for the barbaric manner in which we treat our most vulnerable citizens! <br/><br/>Lastly, get rid of the 50 MME you have sprinkled throughout the document. That will absolutely be used by the DEA, insurance companies, ill-informed doctors, etc., as a hard limit and will cause graver harm. It is based on junk studies and junk science and has no business in this document. Unless your goal is to let this madness continue? <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f85685	Anonymous	None	2022-02-18T12:57:44Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-bkmm-bvy2	False	None	False	2022-04-12 01:57:16.800	[]
992	CDC-2022-0024-0998	https://api.regulations.gov/v4/comments/CDC-2022-0024-0998	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 64 yr old male. I was in an auto accident 21 hrs ago which resulted in fracturing my left hip in 32 places and tore my PCL ligament in my left knee. I also had an accident at work a few years later that broke my tibial plateau also left knee. I have had 14 surgeries on my left hip which included two full blown sepsis infections and severe osteomyelitis ( bone infection ). Which means they had to take out all the hardware, many courses of IV antibiotics, revision surgeries, debridements all in the last 20 years. 21 years ago after the first couple of surgeries I was prescribed Vioxx for surgical pain as well on being a morphine drip. I was also given two 20mg OxyContin per day. One in the morning and one at night. After leaving the hospital I was prescribed Vicodin 750ES every 4 to six hrs as needed. I took the Vicodin as prescribed when needed. Which was most of the time. I was in tremendous pain as you can imagine. I saw my surgeon every few weeks, then every few months for two years.the first year I was taking the Vicodin. I visited my doctor after the first year he asked if I needed a refill on my Vicodin prescription, I told him no that I still had most of my last prescription left and don’t need them anymore. He was surprised and commented that most people that were in Vicodin for that long were addicted or at least dependent. I used as prescribed and it was a great addition to my pain management regimen which included, moderate exercise, good diet, supplements, modalities, etc. <br/>present day, I had to have another revision 2 years ago due to infections after an attempt to only fix the broken trochanter which holds the bottom of the prosthesis in place. After that surgery I developed another sepsis infection. More IV antibiotics, surgery to remove the complete prosthesis once again and installed an antibiotic infused spacer. A few months later the spacer was taken out and a new prosthesis was installed. I was out 20 weeks from surgery when I had to have another surgery on my left hip to remove a blood clot. I am now about 35 weeks out from my last surgery. <br/>And the prosthesis is in place and anchored well. <br/>During this last infection I had an abscess on my spine from the sepsis. They had to operate on my spine immediately to remove the dangerous abscess from my spine. It also caused osteomyelitis of some of the vertebrae and they had to do a thoracic laminectomy T-5 thru T-10 lamina we’re removed. That was two yrs ago and the back pain never stopped. Now it travels up and down my spine. I am in constant chronic and sometimes severe pain. From my cervical spine down to my tailbone. My Dr is afraid to prescribe opiates or opioids. He prescribes tramadol. He may as well prescribe tic tacs. They do not have any perceptible affect on my pain. So this overreaction to the opiate pandemic has put me in a position to have to beg my Dr. for pain medication that works for me. I feel like a drug addict asking for a fix. I have been caught in the middle and it’s not fair to me. <br/>While I understand the position that this places the Doctor in, no one seems to care what position this is places me in. I am suffering and they have forced me to SELF MEDICATE. I know I am not alone and I know that the CDC is investigating this. Since 2016 when the new protocols for prescribing opiates became crazily strict, deaths from opiate overdoses has actually gone up. The overreaction has actually caused more deaths. Because people with chronic pain will find other means of anesthesia and pain relief. Fentanyl comes to mind. People are dying in droves because they are now in a situation where they have no choice but to SELF MEDICATE. Whether it’s alcohol, fentanyl or other unregulated uncontrolled substances that kill them. There is a vacuum created by the medical community for pain relief that is being filled by illegal drugs. This is all factual. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f848ac	Anonymous	None	2022-02-18T13:00:00Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-m7jv-kiux	False	None	False	2022-04-12 01:57:17.076	[]
993	CDC-2022-0024-0999	https://api.regulations.gov/v4/comments/CDC-2022-0024-0999	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient with over a dozen major surgeries as many years. I was determined by social security to be totally disabled in 2012. Before that, I enjoyed 40 years as a high level health care professional including university, hospital, CDC positions in 15 states and 3 continents. I am commenting based on my personal experiences as a patient and from my years of professional experience and observations. When recommendations for opioids were first issued, no primary care provider in Anchorage would prescribe any schedule drug for any indication. No zolpidem, no clonazepam, no oxycodone, nothing. Ultram/tramadol went from being available on the Walmart $4 formulary to being prescribed by restrictive pain specialists. Pain management clinics revised their written procedures and "contracts" to restrict patients from leaving the state, require UA monthly irrespective of patient Hx or situation, etc. ER physicians were not allowed to prescribe opioids without authorization or anesthesia oversight. Your new guidelines do nothing to prevent this. Physicians, whether PCPs or pain specialists will adopt the same response- "I don't want any problems so let's just impose the most restrictive on everyone. There will be no difference. Patients will be denied, and worse, they will be treated as identical machines, assembly-line care designed to avoid the prescriber's standing out from national or state averages, attracting any attention. You should have written the recommendations to state unequivocally and as the first stand-alone recommendation that nothing in these guidelines should be interpreted as recommending or requiring any particular course of tx for any particular patient. The recommendations should then have reinforced that patient pain should be treated with primary concern for patient history, situation, co-morbidities, payor source, transportation, etc. Only then should you recommend that physicians remain knowledgeable about the dangers of opioid misuse, at-risk populations, etc., and that all treatment plans for pain, whether acute or chronic, should document consideration of risks and benefits just like the requirements for ALL treatment plans for ALL conditions require. I also have hypertension requiring both an ARB and a calcium-channel blocker PRN a beta-blocker. I am not required to seek out a hypertension clinic or specialist, nor am I required to sign a "hypertension contract" or mandatory UAs to determine my compliance even though I am "addicted" to these medications - I cannot discontinue them without serious and life-threatening consequences. Diabetics are not - though insulin overdose is as dangerous as opioid overdose. But law enforcement and homeless services had no way to control or even adapt to the addiction problem and no one wanted to address the socio-economic reasons why addiction could be attractive and so you created a guideline that put the entire onus on the pain patient You and I all know that physicians earn a living by maximizing the number of 11-minute visits, of RVUs. It is completely improbable to assume that physicians will choose the route of spending extra time to document individual patients in a manner that will avoid DEA and other government trouble for "exceeding the guidelines " when they can simply implement the easier and more time-friendly method of treating all patients by the most restrictive portion of the guidelines and blaming it on "the guidelines," as testimony already proved to you that they now do! So you added a little comment to the guidelines and you think you can then respond,"But we didn't require that...." My goodness, you are supposed to be the best in the field. Shame on you for not doing a good job, for taking the easy way out. Shame. You could have written an excellent, useful, instructive guideline. Instead, you just changed the date.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Reva	None	None	0900006484f84c89	Katz	None	2022-02-18T13:01:28Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Katz, Reva	kzr-nb9u-3d9s	False	None	False	2022-04-12 01:57:17.360	[]
994	CDC-2022-0024-1000	https://api.regulations.gov/v4/comments/CDC-2022-0024-1000	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had Trigeminal Neuralgia (TN)—which has been nicknamed “the suicide disease” because of the excruciating nature of the pain and disability it causes—for at least two decades, and am only in my late forties. There is no known cure for this rare, progressive disease, so research is very scarce.<br/><br/>What is known is that TN is among the most painful, debilitating diseases known to humankind, and I am therefore using one of the five mild opioids I am allotted per month just to write this comment, because I would otherwise be unable to comment at all.<br/><br/>In summary, the outrageous restriction of opioids—by the government, doctors who are afraid for their licenses, pharmacies, insurance companies, and so on—has cost me and countless other US citizens everything.<br/><br/>And with TN in particular, I’m not just talking about the inability to have a career and contribute to our household and retirement (not to mention taxes). I’m talking about relationships with friends, family, and doctors. The ability to read and write. The ability to speak and chew food. The ability to listen to music, dance with my spouse, or even wear my glasses.<br/><br/>Prior to my TN going into “full bloom” (as one of my doctors once remarked), I was a highly successful, fully participating, and generally happy member of society, both as a professional and as a member of my various personal communities. But after the TN reached that level, I had to quit my career, lost touch with too many people dear to me to count, and eventually ended up spending most of my days in bed totally incapacitated, a state from which I have not only never fully recovered, but haven’t even recovered to a degree where I can count on being able to, say, brush my teeth every day, because it is just too painful.<br/><br/>I have been on a number of antiepileptic drugs (old and new) to try and treat this disease, and I have not been able to “tolerate” a single one of them. In addition, for people like me who do not have a genetic or personal history of addiction, every single one of them is more dangerous than opioids, both in the short and the long term. Carbamazepine, for example, the so-called “gold standard” of treatment for TN, very nearly gave me a fatal blood disease after a single month of use. Gabapentin, the second most-recommended pharmaceutical for TN, gained me thirty pounds in thirty days in a period during which I could not even chew food. A simple review of the side effects of these extremely dangerous drugs vs the side effects of opioids will illuminate this point to anyone who has any kind of reading comprehension.<br/><br/>It also bears mentioning that people like me who had TN for a long period of time before it was diagnosed (which is most people with TN) are not good candidates for any of the surgical options for this disease, and neither are people with both types of TN. In addition, the surgical options for this disease basically amount to brain surgery, do not cure it, and are therefore (you guessed it) also more dangerous than opioids. Especially because—even if a patient beats the abysmal success rates—the surgeries often must be performed over and over again when the pain almost invariably returns.<br/><br/>Therefore, I fully and unrestrictedly support the use of opioids as an adjunct treatment for the 24/7 torment of TN2, and also as either a primary or adjunct treatment for anyone embattled by chronic pain whose “quality of life” may be restored through their use.<br/><br/>Trigeminal Neuralgia may be rare, but there plenty of other, more “mainstream” diseases that cause deep, daily, unrelenting pain to their victims, and simply being alive does not mean that you are living.<br/><br/>I support the CDC in this step forward and encourage them to go the full distance, as the government, frightened and/or illogical/uninformed medical staff, and everyone else on the planet needs to stop demonizing people who are in chronic pain, coming between them and their trained medical professionals, and contributing to the alarming rise in suicides that have resulted from the misapplication of the former version of this policy, FULL STOP.<br/><br/>Important note: people should be able to just “like” these comments, because a lot of us out here are in too much pain to comment, let alone at any length.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f863b0	Anonymous	None	2022-02-18T13:02:44Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-rx2a-852u	False	None	False	2022-04-12 01:57:17.579	[]
995	CDC-2022-0024-1001	https://api.regulations.gov/v4/comments/CDC-2022-0024-1001	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and have been subject to the cruelty of the system. The MME guidelines MUST be removed. Each person is different and to have these statements about the MME hurts the patient and their relationship with their doctor. Chronic pain patients are not criminal and not abusers. We are humans with intractable pain. These medications when prescribed correctly for each patient are lifelines. We have been made to feel like drug seeking addict criminals when all we want is relief from the never ending physical pain. #wedontgetbetter	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shara	None	None	0900006484f84c8a	Danziger	None	2022-02-18T13:16:59Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Danziger, Shara	kzr-nc79-buyo	False	None	False	2022-04-12 01:57:17.791	[]
996	CDC-2022-0024-1002	https://api.regulations.gov/v4/comments/CDC-2022-0024-1002	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Day<br/>I am an ANESTHESIOLOGIST, Addiction DR, PAIN specialist, and EMERGENCY MEDICIE DR. The pendulum has swung too far, in the minimize pain direction. Healthcare providers now rationalize poor or nontreatment of pain, even in patients with Cancer. There are a number of creative approaches to deal with pain and to eliminate or minimize Narcotics in non cancer patients. A thorough understanding of non Narcotic pain pathways is necessary.<br/>The other problem, is the proliforation of large pharmacy chains, the patient/phycisian dialoging pharmacist is RARE. Some of these Pharmacists feel empowered to comment, to the patient regarding the Pharmacist's OPINION of Pain Management.<br/>This has been a life long problem, the balance between Dr's who think that Chronic Narcotics are the solution for Chronic Pain and those Dr. who feel that pain is no longer a symptom that needs to be addressed<br/><br/>GOOD LUCK<br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	geoffrey	None	None	0900006484f87e0a	hart	None	2022-02-18T13:25:27Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from hart, geoffrey	kzs-fykl-g4ea	False	None	False	2022-04-12 01:57:18.034	[]
997	CDC-2022-0024-1003	https://api.regulations.gov/v4/comments/CDC-2022-0024-1003	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started experiencing excruciating pain in my forearms, shoulders and quads back in 2003. It was so bad that I would sit in my office and just cry because nothing would help it. I went to my doctor and we started down the road of trying MANY different medications. You name it, I’ve probably tried it. I was on Cymbalta at one point and after months and months of use, we decided it wasn’t working and I started weaning off of it. After a few days I started experiencing psychosis while at work and was to the point I was ready to walk in front of a bus. Between the pain I was in and the effects of the medication it left me in a whirlwind of emotions as well as mentally and psychically drained. I immediately called my doctor and she had me come into her office for emergency medication. Which helped. For the next 10+yrs it would be a plethora of doctors and tests trying to figure out what was wrong with me and what was causing this excruciating pain I was trying to live with. Eventually, I ended up in surgery for my shoulder and was prescribed a few Lortab for the first 3 days after surgery. It was then that I realized that I finally found something that helped ease the pain enough to allow me to sleep more than 2-3hrs a night. I was a single mom with 4 kids and my youngest being disabled. I couldn’t allow pain to run my life but no matter what I did, it wouldn’t go away. Used to work out 2hrs a day, 6 days a week and ate only healthy, non processed foods, didn’t help. In fact, it made my pain so much worse. Year and years of tests and procedures and I was finally able to procure a diagnosis from a doctor who just wouldn’t give up, like 99% of the others had. I’m so thankful for her. But what I was diagnosed with is something that will NEVER go away and one that I’ll need pain meds for for the rest of my life if I want any sort of life at all. My meds need to be increased but I cannot risk being flagged for being on high doses of opiates. I still have a disabled child at home who needs me. He needs me to be able to get up and help him when he needs me to. To be able to cook for him and clean for him. But right now there are days I can barely make it out of bed, more so when I’m in a flare. But if there comes a time that you make my doctor take my meds away, I won’t be able to have ANY kind of life and myself, as well as many others I know who suffer, will either end up taking our lives or looking else where for help controlling our pain. WE SHOULD NOT BE FORCED TO RESORT TO STREET DRUGS JUST TO BE ABLE TO LIVE A LIFE THAT IS SOMEWHAT PAIN FREE! Am I addicted to these meds? NO! I could come off them if I was forced to but I would not have any sort of life and would be bed ridden. Is this fair? We did not ask for these illnesses nor do we want them! We shouldn’t be punished for what we are going through any more than we already are by our own bodies!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f860d2	Anonymous	None	2022-02-18T13:26:20Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-rvj2-r225	False	None	False	2022-04-12 03:13:19.875	[]
998	CDC-2022-0024-1004	https://api.regulations.gov/v4/comments/CDC-2022-0024-1004	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These new guidelines are a disgrace. I wouldn't be able to function without my opoid prescription. Been in Chronic Pain for over 2 years while I await surgery on a plexiform neurofibroma (tumour) in my calf. There's no guarantee that this operation will lessen my pain and could actually make it worse meaning I would need even stronger pain relief. These politicians that make these rules have no idea what it's like to live like this 24/7 day in day out for weeks, months or even years. We don't abuse these drugs and the majority (which is what you need in any voting) of us are not daft, we manage our medication and pain relief. Endless Sleepless Nights because of pain. I've lost my career as a chef after 37 years of being a chef because I'll be unable to do the hours even if they fix my leg. Amputation has been discussed so what am I supposed to do then without access to good pain meds. Distinct possibilities of being in pain for years to come and we the people have to make a stand against these ignorant policies made by politicians that say they've got out best interests, well you clearly don't. The system just need to be tightened so it's not open to abuse by drug users and abusers. I can't stand up for more than 10 minutes, been housebound for nearly a year. The only time I go out is to a hospital appointment and that's in the back of an ambulance because I'm high dependency because I'm on high amounts of oxygen because of multiple lung diseases. I already take antidepressants and therapy and bit having the pain relief would knock me for 6 again. These new regulations are likely to increase suicide rates because they won't be able to cope.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484f85684	Harper	None	2022-02-18T15:47:34Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Harper, Peter	kzs-b36l-pryq	False	None	False	2022-04-12 03:13:20.093	[]
999	CDC-2022-0024-1005	https://api.regulations.gov/v4/comments/CDC-2022-0024-1005	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment. I am an RN and have witnessed the elderly not having adequate pain control. Everybody ages and having the ability to move comfortably is so vital to their remaining years. Prescribing opioid medications has been reduced so many times, even Tramadol. What is left? Tylenol? Alternative measures like music and visualization are not adequate. <br/><br/>In addition to opioids for pain, they are also used for restless leg syndrome. I take two non opioid medications for this already and Tramadol is used prn for breakthrough. I do not abuse this medication and have never had an increase in the 12 years. You can research where this group of people do not require increases and does not lead to abuse.<br/><br/>As far as the abuses of opioids, something needs to be done about the illegal drugs pouring in from the border and China. People abusing the meds need to take responsibility. It’s heartbreaking to see parents of children who died from overdoses, but putting more restrictions to help only this population without broadening the scope is wrong. <br/><br/>Please don’t take away the medications for post surgical pain, accident victims and the elderly. Compression fractures in the elderly are some of the saddest you can see. Nursing Home MDs are so reluctant to prescribe anything for pain and residents are suffering. These are the people you don’t see on the news. <br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8951a	Anonymous	None	2022-02-18T16:26:23Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-llnj-tyml	False	None	False	2022-04-12 03:13:20.298	[]
1000	CDC-2022-0024-1006	https://api.regulations.gov/v4/comments/CDC-2022-0024-1006	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering from chronic pain for the last 10 years. I have followed my doctors guidance to the letter. I had 10 spine surgeries, 2 neuro stimulators , nerve animations and steroid injections. There is nothing that I have been asked to do that I have refused. Since the changing of the laws in 2016 I have been treated with disrespect by pharmacies, nurses, hospitals and doctors. Recently I moved to Florida after retirement because I felt better in warmer weather. For 6 months I flew back and forth monthly to get my medication. I tried to find doctors in Florida but found it very difficult.<br/>This month I finally found a kind hearted doctor who reviewed my records and realized I had tried everything possible and he agreed to write my prescriptions for now and possibly look into a pain pump another surgery. With little options I agreed. He gave me the prescriptions on paper because he was concerned that local pharmacies may not fill them. <br/>After trying a few I decided to work with Express Scripts and have them sent to me. After all they we’re paying for the for the past 10 years. Express scripts s agreed and I thought my nightmare was over. To my surprise it had just begun.The pharmacy refused to fill until speaking with the doctor ignoring my history that the had. I contacted them no less than 10 times to try and understand the issue and explain I would run out of medication. I finally spoke to a pharmacist who talked to me as I was a drug addict and berated me for 20 minutes with no reason to back it up. She literally told me if she was the pharmacist on my account she would not give me my medication. I explained the surgeries, the problem with other meds and the recent hospitalization she could care less. I finally gave up on her and waked for my doctor to call her. That Sunday I was called by a PA from my doctor who I never met and also did not know me. She was also condescending, cruel and generally uncaring. She said she approved for this month but going forward they would not prescribe the medication that helped me. By the time I got off the call I was in tears and suicidal for no reason other than not being able to get the medication that helped me for the past 10 years and I had reduced as requested without issue except being in additional pain. The new rules are in most cases only hurting good patients like me . Drug addicts still get there drugs. Something needs to change when pharmacists are able to make decisions for doctors not knowing a patient’s history nor caring . I understand the issues but chronic pain patients are the ones suffering. Please change situation living with pain is hard enough without being berated monthly and treated like a drug addict.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f89907	Lukowicz	None	2022-02-18T16:26:48Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Lukowicz, Susan	kzs-lnqh-vhhs	False	None	False	2022-04-12 03:13:21.063	[]
1001	CDC-2022-0024-1007	https://api.regulations.gov/v4/comments/CDC-2022-0024-1007	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a adult male who sustained an on the job injury in 1996 and was expected to be on disability the remainder of my life. With the help of very compassionate Dr's over the past 20 plus years I have excelled in my job and in my career. Of course I participated in 2 years of rehabilitation education to find a new career, but have ultimately went on to work and pay taxes and become a productive citizen. All due to Dr's who have chosen to treat my chronic pain with opioids. Over the past 20+ years I have been on different levels of opioids. Some higher doses and some lower doses. If not for the on going treatment with opioids I would have surely been relegated to a sedentary life on my couch or in bed. I am currently employed by a State University where even without a college degree I hold a position as an Assistant Director which in most cases requires a degree. With the correct dosage and close monitoring by my Dr. we have developed the right combination of opioids to relieve most of my pain and still allow me to excel in my life and career. Thank You for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f8994f	Adamson	None	2022-02-18T16:27:04Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Adamson, Robert	kzs-lpbp-9c3k	False	None	False	2022-04-12 03:13:21.310	[]
1002	CDC-2022-0024-1008	https://api.regulations.gov/v4/comments/CDC-2022-0024-1008	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired nurse who’s husband has had 2 surgeries for a ruptured disc and has been disabled for 35 years. I have witnessed his suffering throughout the years. Treatment has changed significantly. He is limited to 1 50mg tramadol a day and has to take 3 drug screens a year for this treatment that gives minimal relief at best. Why do we treat good people like drug addicts taking away their dignity? Why do we let them suffer when we have good medications for pain control? I believe if there is a problem with pain treatment it lies in patient education. Patients should be told and understand that if your prescription states you can take it every 4-6 hours, you should wait until your pain is severe enough . The medicine won’t work if you take it too often. These people just need a break from pain for a few hours once in awhile. They need to enjoy a family gathering or a small vacation. We can and should do better. I believe that a lot of addiction is actually caused by the Lack of treatment for pain. Some people turn to the streets where they quickly become addicted to heroin and fentanyl. I have seen this in our small town. We have a lot of blue collar workers here. Doctors feel threatened. They are so afraid to prescribe even a small amount of pain medication. It’s very sad . The government has done more harm than good. Reconsider your interference in a Doctor/ patient relationship. You are ruining lives. Thank you for your interest.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Evelyn	None	None	0900006484f8997b	Hall	None	2022-02-18T16:27:26Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Hall, Evelyn	kzs-lqbb-hsbw	False	None	False	2022-04-12 03:13:21.517	[]
1003	CDC-2022-0024-1009	https://api.regulations.gov/v4/comments/CDC-2022-0024-1009	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The pain doctors need to be left alone to treat their patients!!! Living in chronic pain is horrific! We needed meds to even function…….take a shower, cook a meal, do some laundry. When left with no help, our lives are in agony. Chronic pain is a monster!! Never giving us a minute of relief. Our lives are useless, meaningless, etc. we are not the problem. Drug addicts are the problem. These addicts have probably used everything from marijuana to cocaine to meth. Chronic pain patients are NOT these people! Leave us and our doctors alone!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashby	None	None	0900006484f89aeb	Walton	None	2022-02-18T16:27:39Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Walton, Ashby	kzs-lv2y-2z5j	False	None	False	2022-04-12 03:13:21.761	[]
1004	CDC-2022-0024-1010	https://api.regulations.gov/v4/comments/CDC-2022-0024-1010	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 5-0 yr old female with degenerative disk disease, Rheumatoid Arthritis, and spinal stenosis. I also suffer from a heart issue (both Afib and Aflutter). These diseases affect my quality of life drastically. I’ve always been a very active woman who absolutely loves her family and around 15 years ago everything changed. I started having issues walking very far, my back hurt which in turn dictated all of my daily activities. I was put on many RA drugs which came with many side effects. Then I had a surgery. Post surgery during recovery, I felt so good. The pain meds they had me on literally made me feel like I had my life back. I was able to sit in the floor and play again, or walk to the park or shopping mall. I was also able to regain my intimate life with my husband. You see, while I was hurting so much (especially my back and joints) I quit every thing I enjoyed. Even the intimate part of my marriage. After talking with my doctor and a very long meeting of him educating me on all of the possible issues that could come along with opioid pain treatment, I was ready to start my life again. So I was put on a regimen of pain meds with anti inflammatory meds combined with regular visits to his office. Now..over the years, I did have other health issues follow and I hurt my back blowing my L4,L5, L6 and C4 disks. It was a game changer. In 2016 I had been on OxyContin 30mg twice daily and 10mg oxycodone 4 time daily for breakthrough pain. I had a otherwise normal life at least for me. I was still able to function at most levels. In 2016, the CDC RUINED my life. I went from the aforementioned dosage of my medication down to 45mg daily. I suffered natural withdrawals, intense pain and depression. In September of 2018 I seriously considered ending my life. The pain, depression and lack of any quality of life (after having such a good quality) was simply not worth it. I prayed for relief and understanding but the CDC had my doctors hands tied. They claim they are guidelines but as we all know, when not followed, the doctors would get written up or threatened. My doctor is amazing and absolutely followed all rules but even he felt helpless and himself considered retiring Bc he no longer had the ability to do his God given gift of helping people who suffered pain daily. My heart was broken and my body hurt. I am still in pain above a 6-7 each and every day. I can only pray that the CDC gives the power back to the doctors who’ve been trained in the prescribing of medications to their patients whom they’ve built relationships with instead of creating a broad brush in which to paint every patient with by imposing unreasonable guidelines for the trained doctors to have to abide by. Yes, there are addicts. But the majority of them aren’t getting the drugs from the doctor but on the streets which is why they die. They are accepting any drug they can get from whomever they find it. It wouldn’t matter if it was pain meds or heroin, the addict will always get what they want while the Honest patient suffers the consequences. Please allow the doctors to have full control and if a specific doctor gets out of line, bring the wrath of God down on them!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angel	None	None	0900006484f89c20	Bond	None	2022-02-18T16:28:46Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Bond, Angel	kzs-m1p0-jk7q	False	None	False	2022-04-12 03:13:21.982	[]
1005	CDC-2022-0024-1011	https://api.regulations.gov/v4/comments/CDC-2022-0024-1011	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been a chronic pain patient since 2002, I have conditions that will not improve but worsen...I went from 180 Norco an 60 morphine to 90 Norco a month. No my pain is not controlled or managed but there nothing my doctor can do since cdc/dea have his handstide....hand-tied.... have tide steroid injection wich in long term will cause serious problems not only because of my diabetes, but I have to do something even though they don't last long treatment wise. Being pain patient your treated differently example was in hospital because migraine and bells passed I rang buzzer but nursing staff kept shutting it off finally when a nurse came in I was screamed at and she stomp her foot that she doesn't have time for my drug seeking ways, what I need Is pads for my period I walked across hall to nurse manager asked her to step in my room and had my roommate at the time tell her what nurse did....that is only one of many encounter I received by medical staff because I am a chronic pain condition....after I had hysterectomy that went wrong badly and I had spent 3 weeks in hospital to return week later to be cut open hip to hip left open I went to pain management morning after they drug tested as usual and physicians assistant starts screaming at me for having fentanyl in my system I told hold up, I asked medical assistant to get my caregiver and to get head physicians assistant once everyone was gathered I spoke to the one who screamed at me, I said before you scream at me first you need to read discharge notes from hospital, I said nurse at hospital gave me a shot before I went home because and I lifted shirt and pulled my sweats down which exposed gaping open wound from hip to hip....I told that person before you assume and make an ass of me and you . .you read paper work on me from the hospital don't accuse before you know thefacts , I told her you are fired from my care get out she left crying and head physicians assistant had to hold laughter in because he new me he prescribed me meds and apologized for his associate...I have had many encounter because I chronic patient with not just pain issues...I have clotting disorder that has caused 8 strokes, and heart attack.....I have broken my ankle 3x and torn my Achilles Tendon 3x to only reduce my pain meds...I have never had drug test I failed but am treated worse then those on probation....I am human with genetic conditions I have little control of but I deserve to be treated with dignity and with meds that will aid me..iknow thereare those abuse street drugs but I am not one of them I just want a pain controlled existence if possible ty....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f89d13	LaRowe	None	2022-02-18T16:30:59Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from LaRowe, Deborah	kzs-m7tg-tt6v	False	None	False	2022-04-12 03:13:22.190	[]
1006	CDC-2022-0024-1012	https://api.regulations.gov/v4/comments/CDC-2022-0024-1012	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please! We all know you made a terrible mistake now it’s time to fix it! First of all you need to disregard THE MME’s …. all bodies are different and all Pains are different. The only way you can make an impact is if you leave the doctors to do their jobs! There is a reason they went to school for 8 years and interned for four….. have some sympathy for people who need pain management to live a normal LIFE!! Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484f89d99	Galvin	None	2022-02-18T16:31:11Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Galvin, Janet	kzs-ma3u-acsx	False	None	False	2022-04-12 03:13:22.405	[]
1007	CDC-2022-0024-1013	https://api.regulations.gov/v4/comments/CDC-2022-0024-1013	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a very painful nerve condition called pudendal nerve entrapment developed during my time as a cyclist. After 2 years of just trying to live with the pain, I elected to have surgery about 8 years ago in an attempt to "release" the nerve. The pain never went away so after 8 years from surgery number one I elected to re-do the surgery. This second surgery confirmed the suspicion that scar tissue from the first surgery was entrapping the nerve. After this second surgery wherein scar tissue was removed, I again suspect scar tissue has re-formed and I am worse now than ever before. I have lost the ability to sit, bend over or lay on my left side and to lay flat on my back. I work full time in a very professional occupation. I am 53 years old and I am 18 months from retiring, but sadly I am uncertain I can make it the 18 months as the nerve pain is excruciating and my joints have taken so much abuse from standing literally 16 hours a day. I self medicate at night with an unhealthy amount of alcohol because tylenol, ibuprofen, and similar medications do not begin to help. I don't know if opioids will help, but I would sure like a treatment option involving something other than drinking enormous amounts of alcohol at night so that I can at least lay in bed and fall asleep.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f89f8a	Anonymous	None	2022-02-18T16:31:27Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-ml3c-bgzr	False	None	False	2022-04-12 03:13:22.613	[]
1008	CDC-2022-0024-1014	https://api.regulations.gov/v4/comments/CDC-2022-0024-1014	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in chronic pain for over 25 years due to several different debilitating diseases that are not curable. I have had multiple surgeries and continual procedures performed by my pain management doctor and neurosurgeons that help to replace parts of my body that are too damaged which gives me some relief from 10+ pain and keeps me mobile. Along with the surgeries and procedures I've obviously been prescribed opioid medications. Without these medications I truly wouldn't be able to function. My daughter also now has this disease and is t seeing a pain management doctor. Since the change in policy it has been difficult in many ways. First and foremost it has made it so that doctors are scared to prescribe opioids to their patients regardless of their medical need. My daughter's pain management facility (the only one she could see under her insurance) told her they could no longer prescribe her the opioid medication they had been giving her for years but could only give her something less and procedures. She now sees another pain management doctor who gives her the medicine because he sees her medical need for it. She has to pay cash for this doctor. Secondly, we as patients are made to feel like we are drug addicts. This is so far from the truth. As I stated before, I couldn't function without this medicine. Lastly, doctors are the only ones who should be in charge of what they prescribe to their patients. Insurance companies and government shouldn't have any say in how a doctor treats his/her patient for any reason wether it be for procedures or medications. Please change the opioid guidelines back giving the doctors power to treat their patients as they seem fit.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8a02e	Anonymous	None	2022-02-18T16:31:51Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-mors-zz9v	False	None	False	2022-04-12 03:13:22.817	[]
1009	CDC-2022-0024-1015	https://api.regulations.gov/v4/comments/CDC-2022-0024-1015	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Fibromyalgia in 1985, occipital neuralgia in 2014, and have worsening lower back pain due to an injury in 1979. I qualified for SSDI in 2003. Until 2017, I was able to get either hydrocodone or oxycodone as a supplement to my regular daily dose of tramadol to use only for severe flareups. With this combination, I was able to do most daily basic living tasks. Now with tramadol alone, I have become less functional; can’t stand to fold clothes or wait in line for more than 5 min. I’ve used ibuprofen but due to my IBS, it inevitably causes me intestinal cramps and more pain. My doctor would agree that I’ve always used my medications as prescribed. Of course my first request would be to restore my previous medication regime that truly improved my productivity and QOL.<br/>In case you’re wondering, I have tried all of the antidepressants, lyrica, gabapentin & muscle relaxers. Each of these had side effects that were greater than any benefit they might have had. <br/>My doctor has been told not to prescribe opiates & is afraid of getting in trouble. I want that to change.<br/>I am so very relieved that the guidelines are being addressed and corrected.<br/>Thank you.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f8a2ff	W	None	2022-02-18T16:50:12Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from W, Patricia	kzs-n752-tc27	False	None	False	2022-04-12 03:13:23.033	[]
1010	CDC-2022-0024-1016	https://api.regulations.gov/v4/comments/CDC-2022-0024-1016	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been on a 5mg or less daily dose of oxycodone, following an in incomplete cervical spinal cord injury in 2014. My prescriber has been able to monitor my benefit, usage and support from my partner for this many years. It was extremely critical when I graduated off very high dosage fentanyl patches during year one. It supplements the lyrica I take for acute nerve pain. It helps ease my chronic pain enough to complete and benefit from my physical therapies and home exercises. I’ve been told it’s long term use is less damaging to my liver than the same use of NSAIDs. At the dosage I’m on, my brain is active and not addled or drowsy. It absolutely supports me regaining much of previous lifestyle and productivity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynde	None	None	0900006484f8a519	Collins	None	2022-02-18T16:55:35Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Cynde	kzs-nkbh-qjzm	False	None	False	2022-04-12 03:13:23.237	[]
1011	CDC-2022-0024-1017	https://api.regulations.gov/v4/comments/CDC-2022-0024-1017	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 1997, I was dragged 25 feet by a car, and my doctor prescribed Vicodin for the pain. I took one pill and immediately flushed the bottle of pills because it made me so sick. Then I developed chronic pain so severe that working became impossible. I developed chronic migraines that left me in a dark room for 10 days out of every month. I tried all of the various migraine medications that were offered and found I had heart related side effects from every one of them. I could not find relief. I was also diagnosed with Systemic Scleraderma, CFS, I.C, fibromyalgia, and developed debilitating insomnia due to the pain. Not only did I lose my ability to work, I lost any semblance of quality of life. My doctor put me in a pain management group. I had therapy, bio-feedback, acupuncture, hypnosis and injections. But the pain continued and my Pain Specialist suggested Vicodin -- and this time I took it. I had to. <br/><br/>I applied for disability In 2007, and in 2009, I was determined to be permanently disabled by Social Security.<br/><br/>Vicodin improved my life: I could sleep and go for short walks. I could contribute and participate in family events again. I could sleep. I began to have hope that I could make a life worth living. I focused on what I could do for my family, within my limitations, and I stopped being so self loathing.<br/><br/>But when the opiod crisis hit, the CDC left me out of the equation, and suddenly, I felt like a criminal. <br/><br/>My brother, who has served his country in the Marines at the end of the Viet Nam war, is a patient of the VA. He has multiple pain issues included two rotator cuff injuries. The VA immediately stopped treating pain for all veterans because of the CDC's findings. In my opinion, you do not take into consideration your power to affect the lives of people like myself and my brother, when you make a ruling. I hope that changes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006484f8a6c1	Burton	None	2022-02-18T17:12:58Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Burton, Robin	kzs-nvd9-3159	False	None	False	2022-04-12 03:13:23.465	[]
1012	CDC-2022-0024-1018	https://api.regulations.gov/v4/comments/CDC-2022-0024-1018	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment.<br/><br/>I am a 71 year old man, who suffers from gout, and degenerative arthritis where the cartilage wears away and spurs form in the neck and spine. Very painful. I had a script for Vicodin, 3 a day that worked very well. About five years ago my Doctor cancelled the script and gave me Motrin instead. Motrin doesn't touch the pain. When I swing a golf club it feels like an ice pick in my neck. Needless to say I would much rather have the Vicodin.<br/><br/>Here is a short story on how the present day " Opiod crises" began: A bunch of guys on a three day golfing trip in Maine. While waiting our turn to tee off a friend comes to my partner and I and offers us a new pill called oxycontin. he says it's just like a Vicodin except it last's all day. We decided to break it in half and share it. - - - <br/>Long story short: By the ninth hole we couldn't even swing the club, went back to the condo and slept through Dinner, and even missed breakfast. My partner and I agreed that we would never take that sh-- again. MOST IMPORTANT POINT IS:WE BOTH DISCUSSED AND AGREED THAT THIS CRAP WAS BAD NEWS AND WAS GOING TO CAUSE SERIUOS PROBLEMS.THUS THE BEGINNING OF THE OPIOD CRISES. Consequently, our friend who gave us the pill ended up dying a few years later a victim of opiod abuse, that began with prescribed Oxycontin. Moving a few years ahead we end up with Fentanyl and now they are stamping out counterfeit pills and killing people everywhere.<br/><br/>A SOLUTION<br/><br/>Ease restrictions on Vicodin and Percocet. no more than 10 milligrams, no more than 90 per month.<br/><br/>Reserve oxycontin for people with real serious problems, and educate them on the danger of getting addicted to it.<br/><br/>Charge people who sell Fentanyl with murder.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	stephen	None	None	0900006484f8a7de	Pike	None	2022-02-18T17:13:56Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Pike, stephen	kzs-o3ad-ddvs	False	None	False	2022-04-12 03:13:23.670	[]
1013	CDC-2022-0024-1019	https://api.regulations.gov/v4/comments/CDC-2022-0024-1019	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree 100% with Dr. ...!!<br/>As a person on opiods since 2001 safely to keep my alive and functional as best as possible due to severe autoimmune diseases, psoriatic arthritis and back/neck severe spinal problems, I am suffering!! I am forced to pay over $500/month to have someone drive me 4+ hours every month just for prescriptions!! My former family doctor managed me from August 2003 until August 2021 and did prescriptions and osteopathic neuromuscular manipulation medice treats every month!! CDC is further disabling me!! It is inhumane and torture!!<br/><br/>“ the 2022 draft revisions continue to misapply weak medical evidence and to systematically over-emphasize “risks” in a nuanced but still obvious and deliberate attempt to suppress patient access to opioid therapy. The revision attempts to encourage replacement of therapies long known to be safe and effective for many patients, with experimental non-pharmacological methods that lack trials support. If these systematic errors are not corrected before final publication, then the document must be publicly repudiated in total and withdrawn. <br/><br/>The proposed guidelines are deeply influenced by and organized around the concept of “Morphine Milligram Equivalent Daily Dose” (MMEDD). However, this concept is grounded upon sixty year old speculations unsupported by rigorously validated data, concerning the relative strengths of various types of opioids. Careful reading of papers referenced in the proposed revisions reveals them to be junk science. All mentions of MMEDD in this document need to be removed.<br/><br/>The CDC writers cannot "have their cake and eat it too" by acknowledging only some of their many errors and widespread misdirection while continuing to systematically overstate risks and undervalue benefits of opioid prescribing. CDC cannot direct clinicians to perform risk-versus-benefit assessments, but fail to offer any quantitative framework within which to accomplish such assessments. CDC cannot mention “taper” at least 21 times without appearing to be advocating for precisely the measure that they say should not be done carelessly. - Dr. ...!”	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	E	None	None	0900006484f8ab17	Hinkle	None	2022-02-18T17:48:36Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Hinkle, E	kzs-p4yd-ym6c	False	None	False	2022-04-12 03:13:23.875	[]
1014	CDC-2022-0024-1020	https://api.regulations.gov/v4/comments/CDC-2022-0024-1020	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree that misuse of opioids should be addressed. However, those of us who take them occasionally and responsibly for severe pain, should not be punished. A bottle of 30 last for a few months. When you take that away, it leaves us in pain and with a desire to get and take whatever may help. That is extremely dangerous. Pain clinics handing out opioids started this mess. Why didn't they get shut down instead? Very disappointed in the choices made to combat this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8acd6	Anonymous	None	2022-02-18T18:09:34Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-q1m9-irso	False	None	False	2022-04-12 03:13:24.080	[]
1015	CDC-2022-0024-1021	https://api.regulations.gov/v4/comments/CDC-2022-0024-1021	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm an NP in Texas. Daily Tramadol has given several of my chronic pain patients a significantly better quality of life. There is no evidence that Tramadol has attributed to any overdose as stated in the CDC's updated recomendations. It is crazy that I see providers hesitate to prescribe this medication. Read some of the comments from patients on this topic.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f8ad55	Ryan	None	2022-02-18T18:25:09Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Ryan, Michael	kzs-qavh-5hxc	False	None	False	2022-04-12 03:13:24.287	[]
1016	CDC-2022-0024-1022	https://api.regulations.gov/v4/comments/CDC-2022-0024-1022	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This change is just a start in healing this area of medicine and those affected. <br/><br/>We need efforts to reverse the damage already done. This starts by removing any MME or MEDD recommendations. People seem to be unable to understand that they are completely arbitrary and dangerous. <br/><br/>Patients should be able to navigate the healthcare system without prejudice and be treated as patients with human rights. That’s not what’s been happening since your “guideline” was used as a weapon by the government against doctors and patients. <br/><br/>Legitimate patients NEVER WERE THE PROBLEM. It should be obvious now that this policy motivated a massive increase in illicit fentanyl. The numbers are clear and visible. Rx’s are historically low for every year after the guideline, contrasted by the overwhelming spike in OD deaths. So many deaths that there’s not enough prescription medication available to effect those numbers due to other misguided efforts to limit supply, manufacture and distribution. <br/><br/>Where’s it coming from? Simply turn on the news to see an open southern border with record fentanyl traffic. <br/><br/>Concerted efforts are needed to reverse the false narratives that mistook patients for addicts. Pain care needs to exist without interference or over-protective policies “for our safety.” <br/>The fact that someone receiving a mild opiate analgesic is required to have Narcan is ridiculous and telling.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8ad99	Anonymous	None	2022-02-18T18:25:31Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-qisx-ex74	False	None	False	2022-04-12 03:13:24.498	[]
1017	CDC-2022-0024-1023	https://api.regulations.gov/v4/comments/CDC-2022-0024-1023	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for letting me comment. My husband lives with chronic pain. He was involved in a logging accident 15 years before I married him. A tree fell on him, crushing his back and legs. At the time of our marriage, 2010, he was doing really well. He had a caring doctor that listened to his needs and tried every conceivable thing to give him the best life possible.<br/><br/>Then 2016 hit. His doctor retired, but we felt like it had more to do with fighting with Workers comp and others over prescribing pain meds. At the same time, a doctor in the nearest city was convicted of giving out too many drugs. So in this area, it is hard just to find a doctor who will prescribe pain medication. Supposedly, the CDC just suggests guidelines/recommendations. The doctors, and workers comp. act as if this is written in stone. My husband spent 20 years taking 110 mme and when he finally found a new doctor it immediately went to 60mme. Urine test every month. It was either take the 60mme or have none.<br/><br/>So, how is my husbands life now? He is getting older and all that entails, but no chance that they increase his pain meds. Every moment is spent trying to regulate the pain. And yes, he has tried everything. He even had another back surgery which has not helped. He wishes he didn't have to take the opioids. He tries not to do too much so that his pain level doesn't go to high. But then he feels so unproductive and gets depressed. Depression is such a hard thing. It is not a good life for him now.<br/><br/>It just feels like every one is laying the problem at the feet of the people with chronic pain. My husband jumps through hoops to get his pain meds. He has to go to the doctor each month to get a prescription even though the refill is always the same. The doctor is an hour away. He gets drug tested each time. Then Workers comp has to OK it so we have to hope they don't think about it for too long. (Our workers comp in NY does not even have opioids on their formulary list. I thought they were in the business of helping people who are hurt on the job?) He can't pick up his meds from the pharmacy until 30 days from the last refill whether it is convenient or not. <br/><br/>Does the US have a drug problem? Do people abuse drugs? Of course! But there is not one doctor who has seen my husband who thinks he is abusing his pain meds. Anyone who hears my husbands story would know that pain is part of his life. In our area, it seems like heroin and phentenyl are bigger problems. He has come to terms with his accident/disability but the chronic pain that is not relieved is what weighs on him the most now. <br/><br/>In this country, we do a good job of training our doctors. They know who needs the pain meds and who might be abusing them. Please give the doctors more lee way to make decisions concerning these people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paula	None	None	0900006484f8afd8	Kilbourn	None	2022-02-18T18:46:17Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Kilbourn, Paula	kzs-rfuu-qtzl	False	None	False	2022-04-12 03:13:24.715	[]
1018	CDC-2022-0024-1024	https://api.regulations.gov/v4/comments/CDC-2022-0024-1024	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please, I suffer 24 hours a day over the last 15 years and more due to injuries in my service to the country in the US Army for 21 years and as a law enforcement officer of 30 years. You are just like the lying democrats. You have punished all our society for your misguided uneducated, common sense handling of chronic suffering paitients instead of arresting the criminals including pill mill Doctors who where doing wrong. The Veterans Administration went from allowing doctors to treating suffering patients properly to totally refusing any doctor now from prescribing any pain medication or long standing anxiety medication for those verified as desperately needing the treatment. All Doctors including specialists are forbidden from prescribing any of these medication. All patients must be sent to the pain clinic where they apply the same idiomatic rules you imposed. I was forced and told go to private doctors outside of the VA for treatment. Then, these doctors were threatened by DEA etc., to stop prescribing pain medication or their license would be taken in writing. Numerous doctors who refused to comply with your dictates license were taken. Pharmacies were raided by the DEA and forbidden from prescribing pain medication. Your dictate in 2016 has caused the increase in suicides and hugh increase in overdose deaths and illegal drug tade killing off our suffering citizens. Call me and I will testify to your inhuman treatment. Pharmacies won't fill doctors prescription now because of this. Unbelievable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f87a73	Blades	None	2022-02-18T19:27:39Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Blades, Michael	kzs-gjsb-auua	False	None	False	2022-04-12 03:13:24.934	[]
1019	CDC-2022-0024-1025	https://api.regulations.gov/v4/comments/CDC-2022-0024-1025	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While your guidelines state that they “provide recommendations and do not require mandatory compliance” many states have codified them, creating situations where chronic pain sufferers were victimized, including individuals who were supposed to be excluded from the recommendations i.e. cancer patients. Please move us beyond this hysterical overreaction to the behavior of feckless recreational drug users and allow doctors more lattitude to treat their patients appropriately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484f87cb3	McGhee	None	2022-02-18T19:40:09Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from McGhee, Paul	kzs-kwca-2dqi	False	None	False	2022-04-12 03:13:25.160	[]
1020	CDC-2022-0024-1026	https://api.regulations.gov/v4/comments/CDC-2022-0024-1026	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is no disputing the tragedy surrounding the manufacturing, distributing, prescribing and drug seeking impact opioid analgesics have had on the countless lives lost to and impacted by this epidemic. There is also no disputing the literature that opioid analgesics are effective at treating pain and are addictive when prescribed without careful consideration for the patient as well as monitoring and follow-up. What has been lost in the endeavor to curtail overt opioid analgesic prescribing are patients who would benefit from their use in a comprehensive pain management program. The policies, regulations, monitoring, reporting, and programs focused on mitigating the risks associated with opioid analgesic prescribing have ushered in what is perceived as the vilification of clinicians who prescribe these agents and their patients who receive them. The massive efforts to combat the opioid epidemic has created a whole new cohort of patients who suffer from uncontrolled pain and endure patient care delays due to hesitancy in addressing patient’s pain. Along with updating these guidelines to grant clinicians more professional autonomy in treating pain, I would like to see the CDC conduct research and the impact the last 10 years have had on untreated pain and negative impacts this overcorrection has caused. Namely, what have patients done in the face of uncontrolled pain? What exposure risk have patients endured by being prescribed countless other pharmaceutical agents? What unsafe and unfounded self-medication strategies did patient’s employ given barriers to medically supervised pain management? What psychological, social-economic, emotional, financial, and other quality of life indicators on patients and their families were negatively impacted by these initiatives?<br/><br/>Again, I concur some change was needed to address bad actors in preserving life and correcting gaps in all things opioid analgesics but the time has come to re-address and come back to the center in maintaining systems and processes to prevent gross errors in how patients are managed but to also restore clinician and patient faith in how pain can be managed by a very effective drug class.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terry	None	None	0900006484f87c74	Hoffmann	None	2022-02-18T19:42:21Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Hoffmann, Terry	kzs-khpo-xv4g	False	None	False	2022-04-12 03:13:25.367	[]
1021	CDC-2022-0024-1027	https://api.regulations.gov/v4/comments/CDC-2022-0024-1027	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If you are a law abiding patient in pain, your doctor should be able to prescribe any medication that works for you, including opioids. The law abiding public should not have to be in pain because of the relatively few people who abuse drugs. These prescriptions should be 100% up to and between the doctor and the patient only.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484f87c73	Finch	None	2022-02-18T19:42:56Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Finch, Thomas	kzs-khkv-th0r	False	None	False	2022-04-12 03:13:25.583	[]
1022	CDC-2022-0024-1028	https://api.regulations.gov/v4/comments/CDC-2022-0024-1028	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. <br/><br/>I am highly in favor of changes being made. As a chronic pain sufferer, it is almost impossible to get the proper opioid medication. I have been diagnosed with chronic pain by multiple doctors. I visited over 10 chronic pain doctors that all diagnosed me with chronic pain and not one of them doubted my claim or had concerns my pain was acute. Even with these diagnoses, every doctor said I needed to be treated with long term opioid medication but none of them would prescribe as they all said they were not allowed due to government intervention or they would say they just can’t prescribe it even though they would acknowledge I need it. I had another approximately 8 to 10 clinics not even give me an appointment at all when I advised them what I was trying to see the pain doctor for. This was terrifying and distressing. I know 2 people that had the same situation and were so discouraged they moved to illegal substances and that is more scary. <br/><br/>After all of this back and forth and distress, two years into my search I finally was in a pain doctors office and when they said I need medication but they can’t prescribe it I broke down crying uncontrollably. This doctor finally prescribed me opioids and I have now been on them 4 years with monthly drug test. I have passed every one of them. <br/><br/>The biggest concern I have now is that I have worked my way up to 30 mg of oxycodon a day, I need to go up but they say the government restrictions won’t allow a higher dose without them getting in trouble. This is now discouraging. <br/><br/>So please make changes, there are too many people suffering with real pain that need medication. <br/><br/>My father has cancer and chronic pain, his cancer doctor says he needs opioid medication sent him to a pain doctor and they said no due to government restrictions, this is insane and cruel. <br/><br/>Also and very important. Even though the government recommends the pain doctors to not test for marijuana, EVERY SINGLE ONE of them test for it. Using marijuana is proven to lower opioid use and could really help people lucky enough to get medication after jumping through hoops to take less. People could use marijuana and opioids together and would lower the amounts needed to be taken. <br/><br/>PLEASE make it mandatory pain doctors remove marijuana from the monthly testing. <br/><br/>Sincerely <br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jason	None	None	0900006484f87cb5	Taylor	None	2022-02-18T19:50:19Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Jason	kzs-ky0l-8r0f	False	None	False	2022-04-12 03:13:25.801	[]
1023	CDC-2022-0024-1029	https://api.regulations.gov/v4/comments/CDC-2022-0024-1029	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My comment?<br/><br/>You have no intention of ending this atrocity. You have had people in the pain community chasing their tails for years while asking for our input and our 'comments'. We've explained over and over that we are suffering and dying out here in the real world. That MDs tell us to our faces that they are AFRAID of the DEA, and that we are not worth risking their licenses over. This is not an unfounded fear, as your arbitrary and medically baseless MME 'speed limit' gives LE a made up metric by which doctors are now flagged and targeted as 'over prescribers'.<br/><br/>Those in the CDC and HHS seem divorced from reality. Our legislators and government agencies are either willfully ignorant or knowingly complicit in the ongoing torture and deaths of some of the most vulnerable among us. When the governments own data shows that overdoses are still skyrocketing despite ongoing, draconian, prescription opioid policies and practices, one can only come to the conclusion that it is the latter.<br/><br/>Nothing short of a public declaration that our leaders got this 'opioid crisis' response ALL WRONG, and that PROPs opioid guidelines and the weaponized PDMP will be rescinded immediately, will be acceptable. It is the only way to effect meaningful changes for the tens of millions of sick and injured people for whom opiate class prescription medicines mean LIFE.<br/><br/>We have been given platitudes and promises that things would change for far too long, and the 'science' shows that the current 'opioid' response is doing ONLY HARM to both the pain community and to people with addiction issues.<br/><br/>It is long past time for this insanity to end.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Arianne	None	None	0900006484f81d0a	Grand	None	2022-02-18T19:51:37Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Grand, Arianne	kzr-45x4-3ye5	False	None	False	2022-04-12 03:13:26.008	[]
1024	CDC-2022-0024-1030	https://api.regulations.gov/v4/comments/CDC-2022-0024-1030	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please don't make chronic pain patients lives any more intolerable by stripping much needed medications from them. We understand there are OD's happening, but it's not the fault of ours. It's from illegal drugs coming across the border. Go after them, not us. There have been suicides happening because the person couldn't live with their physical pain any longer. Pain medications allow us to return to life. An illegal drug user uses it to escape life. Huge difference. Don't punish us for wanting to live. Please.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484f8b77a	M	None	2022-02-18T20:05:31Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from M, K	kzs-talc-1yh8	False	None	False	2022-04-12 03:13:26.228	[]
1025	CDC-2022-0024-1031	https://api.regulations.gov/v4/comments/CDC-2022-0024-1031	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Resubmission of comment to adjust CDC redactments [brackets] of the original, and add an amendment.<br/><br/> First off, I applaud this. HOWEVER:<br/><br/>1) Government bureaucracies never reverse their positions unless there's a reason. Obviously, you've discovered that you exposed yourselves to high levels of liability for the deaths of thousands of legitimate chronic pain sufferers that lost access to their prescriptions and died of street drug overdose, or suicide.<br/><br/>2) [A CDC's guideline planner's] statement about the ineffectiveness of long-term opioid use is "Bull". I was prescribed opioids on a fairly regular basis 20 years for chronic gout, then 10 years, daily, for degrading spinal problems, and they were the ONLY source of relief until you "folks" intervened and put an end to it "Cold Turkey".<br/><br/>3) I happen to be an honest and law abiding 70 year old and have lived in AGONY the last 4 years because of my refusal to go the "street" for relief. (But that may yet change. Desperation calls for Desperate Measures!) Believe me, I've tried every possible solution offered by the medical profession, up to and including surgery and the [prominent Minnesota clinic]. I drew the line at spinal stimulating devices because the flaws are becoming apparent and starting to smell of Medicare fraud. I mean, $30,000 procedure versus $10 worth of the cheapest and most effective pain reliever for centuries?<br/><br/>4) You've "killed off" an an entire profession of Pain Management Specialists, that became the only source of opioids, with ever increasing restrictions. By the time I was finally "booted", I felt humiliated like a "criminal parolee" that had to report to the "parole officer" on a regular basis to prove my "worthiness".<br/><br/>5) I'm skeptical that even if you completely abolished opioid restrictions that medical professionals will ever start to prescribe them again. You've "Brow-Beaten" doctors into submission so badly that they're scared to death to change! Remember Obama telling us that the government would never come between the doctor and the patient? Another "crock".<br/><br/>6) The only thing that the DEA and CDC managed to accomplish with the "war" on the "prescription opioid epidemic" was to create an infinitely worse "fentanyl opioid epidemic". It should be obvious by now that the DEA has not, and never will be able to control elicit drug use. There's just too much demand from the illegitimate users. You cracked down on the easy target, the captive legitimate chronic pain sufferers. I'm sure it looked great on the statistic sheet.<br/><br/>7) Then there's the "CURSE". At a time in the middle of a typical sleepless, agonizing night, I placed a curse on "folks" responsible for this insanity, that they would experience my same level of agony and lack of relief. Then, from wherever I end up, whether it be Heaven or Hell, I'll be looking, up or down, laughing my [anatomical part] off at you jerks!<br/><br/>8) The covid epidemic had brought to light the danger of having unelected, incompetent, power wielding bureaucracies making incredible irresponsibly mandated decisions forced upon the entire population.<br/><br/>9) I participated in another bureaucracy's 60 day open comment period. The FAA summarily rejected 55,000 objections to their proposals on overbearing model airplane and drone restrictions. It'll be interesting to see what happens with yours, but I'm not holding my breath!<br/><br/>10) Narcan (or Naxalone), an overdose mitigating drug, is available without prescription at most pharmacies, usually covered by insurance. It's alarming that pharmacies in my area are putting up notices they will no longer carry opioids, complicating any possible rollback of the restrictions.<br/><br/>In Summary:<br/><br/>Please, God, do something right. But if you don't, or can't, remember the "CURSE"!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keith	None	None	0900006484f8070b	Brown	None	2022-02-18T20:06:14Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Keith	kzq-2n3w-atz8	False	None	False	2022-04-12 03:13:26.432	[]
1026	CDC-2022-0024-1032	https://api.regulations.gov/v4/comments/CDC-2022-0024-1032	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Get rid of all the ridiculous guidelines and let educated physicians care for their patients! It is absolutely useless for the public to comment. CDC has already made up its mind to further destroy peoples lives that are afflicted with chronic pain. My Dr quit treating pain patients in January 2019 thanks to you. My life has never been the same. I can no longer cook, clean , sew, nor enjoy visiting with my children and grandchildren. I pray almost daily for God to take me off this earth. No Dr will prescribe more than 45 of your so called “MM’s.” I became disabled working as an RN pushing patients in ICU beds downstairs to CT, and lifting and turning them. I never in my wildest dreams imagined the United States government would treat those with painful age related diseases, our own veterans, and victims of accidents in such a cruel and inhumane way. Chronic pain 24/7 is not like a toothache or a broken bone that can be fixed. But y’all know this. Each and every one of you that participated in this mass torture will face our creator one day. You will also age and be in our shoes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Opal	None	None	0900006484f81d9d	Richard	None	2022-02-18T20:06:21Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Richard , Opal	kzr-771o-x9k1	False	None	False	2022-04-12 03:13:26.645	[]
1027	CDC-2022-0024-1033	https://api.regulations.gov/v4/comments/CDC-2022-0024-1033	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is unfair to limit chronic pain patients on medications that actually help them. A large percentage of people who overdose on opioids didn't have a prescription for them and therefore got them illegally. Most legal users of opioids do not abuse their medication. <br/>My issues started back in 2011 when I was only 20 years old. I started having numbness in my right pinky toe. It progressively spread to my whole right foot and I also began to experience intense nerve pain. I was referred by my PCP to a neurologist who tested me for neuropathy. That came back negative. He did nerve conduction studies and blood work. Eventually he decided that my issue was possibly low b12 so he told me to take supplements and come back in a month. Every month I would go back and be told it was low b12 and to come back in another month for more blood work. Frustrated at the lack of answers I gave up on going to the neurologist. In 2015 a lump began to protrude from the inside of my right foot, so I went back to my PCP. He referred me to a podiatrist who did an xray and ordered an MRI. He suspected I had tarsal tunnel syndrome. Which is where your nerves in your foot are compressed and it causes pain. On the MRI the lump looked benign and resembled a lipoma. I was referred to pain management to try to get my pain under control before resorting to surgical intervention. I did pain management for months to no avail. We tried countless medications and even steroid injections into my foot, which actually just made the pain unbearable. I went to see an orthopedic surgeon. He did the tarsal tunnel release surgery to free up the nerves and also removed the lump and sent it to pathology. That first surgery was 4/11/16. That Friday (4/15) I got the call that the lump was cancer. It was epithelioid sarcoma which is a rare form of soft tissue sarcoma. It is resistant to chemotherapy and radiation typically. I had an MRI to see if the cancer had spread. It was all throughout my foot but nowhere else in my body. My oncologist told me that my best chance at survival from this cancer was to have my right leg amputated below the knee.I am in pain every minute of every day. I have chronic nerve pain from my nerves all being cut. I have phantom limb pain which is where your brain still thinks you have the limb and it thinks it hurts. So I have pain in a foot that I no longer even have. I also have various other forms of pain resulting from my amputation and use of my prosthesis. I have severe lower back pain from my gait being irregular. I have pain in my leg from wearing my prosthesis. I get sores on my leg at times which make it hard to wear my prosthesis. But I have to wear it to survive. I have to work. I am only able to handle working part time. Work is very difficult for me due to the pain. I have trouble concentrating and i have trouble with physical activity. However I also have pain when sitting, from having my knee bent. No matter what I do now, I have pain. I'm almost six years out from my amputation and there has been little to no improvement. Some types of pain have even gotten worse, such as the lower back pain. Due to overusing my left leg. I am starting to get arthritis in my left knee. I have plantar fasciitis in my left foot as well. All these types of pain that I deal with on a day to day basis make me wish I hadn't amputated my leg and that I had just let the cancer kill me. This amount of suffering is nearly unbearable. The one thing I have found that helps out of the many different medications I have tried is percocet. Due to the "war on opioids" and me being 31 years old (relatively young), doctors are afraid to prescribe me the dosage that would actually control my level of pain. It's so unfair that due to other people abusing narcotics, people who actually need them don't have access to them. Doctors in oklahoma have been cutting their patients doses left and right. A lot of time with no warning. When the pain becomes so unbearable that you can't get out of bed, people get depressed. The more opioids are limited in this state, the more we will see chronic pain patients commiting suicide. The more we will see people overdosing from fake pressed pills that contain fentanyl because there are fewer and fewer doctors willing to write scripts. Doctors are terrified legal action will be taken against them. So they end up not even being able to help a percentage of their patients at all. There are a lot of people who can use other types of medication and that's great for them. People shouldn't take opioids unless they are actually needed. But to limit people who really do need them is just wrong. There are ways to be sure that the doctor isn't liable if a patient overdoses. It should be up to the patient what they do with their body so long as they understand the risks and think that the benefits outweigh the risks. It's not fair for the government to try to make that decision for everyone as a whole.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f809d5	Anonymous	None	2022-02-18T20:08:09Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzq-a040-w86o	False	None	False	2022-04-12 03:13:26.855	[]
1028	CDC-2022-0024-1034	https://api.regulations.gov/v4/comments/CDC-2022-0024-1034	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In my opinion what is going on within the medical field and the "pain management" committee is wrong and unethical. It is clear they are trying to take away "pain medicine" from all patients no matter what they have been diagnosed with, with the exception of people that are terminal. I have first hand knowledge of this through my own experience and others. Patients that have been diagnosed with "Chronic pain" are now being taken completely off their narcotics and in turn being introduced to other medicines that the "pain management" says will help them. <br/><br/>When the doctor tells his new patient "Let me assure you I am not here to try or to take away the pain medicines you are on". A short time later the patient is now meeting with the "pain management" and is being told they are going to be tapered off their narcotics and to try experimenting on the patient with other "non narcotic" medicine. <br/><br/>I have never been diagnosed with what my pain is. The medical field cannot explain or figure it out. I have gone bankrupt in the past due to Doctors referring me to Ketchikan, Anchorage and Seattle to E.N.T. specialists to try and determine what I have. I was put on pain medicine for a time but since they are not able to diagnose me then my pain really does not exist. To live with chronic pain every day 24 hours a day 7 days a week is unethical and in my opinion violates all that doctors and the medical field SHOULD stand for. <br/><br/>I feel this is just so the medical field can submit documents showing how many people they are taking off narcotics for whoever they have to answer to. Showing they are doing such a good job. We are not just some statistics. We are people that live in constant pain and need help from the only professionals that are supposed to help. The people that are supposed to provide help go home every day feeling comfort and satisfied they helped. They don't live with the pain their patients are going through but its okay they successfully took narcotics away from someone that day. <br/><br/>I wanted a doctor to understand and to help. Now what I have is a doctor who says his hands are tied and is unable and unwilling to stand up and fight for me. For 15 years I have struggled with my pain and the only relief "thank god" was when I was on my pain meds "narcotics". Now it has been taken away. Narcotics is not a nasty word or a word that needs to be associated with addiction. It is a medicine that helps people, me, deal with pain. <br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terry	None	None	0900006484f84472	Stonecipher	None	2022-02-18T20:10:50Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Stonecipher, Terry	kzr-kvj7-g9dw	False	None	False	2022-04-12 03:13:27.063	[]
1029	CDC-2022-0024-1035	https://api.regulations.gov/v4/comments/CDC-2022-0024-1035	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	New Proposed CDC Guidelines <br/><br/>Twenty two years ago, I simply stood up and ruptured several vertebral discs in my lower back. For two years I saw a top rated orthopedic surgeon who gave me Tylenol prescription strength and some xerox copies of some exercises. I was bed-bound and in severe pain. All I did was cry and try to sleep when I could. I lost my friends, my job and the toll on my husband was enormous. I took up to twelve high dose Tylenol a day, giving myself gastric and kidney problems in my attempts to ease the pain. When I asked for an MRI, the surgeon in exasperation, said, “If I were a betting man, I'd lay odds your spine is fine”.<br/><br/>It wasn't fine, I had two ruptured discs. I found another doctor and I was finally offered surgery to fuse the discs. Being desperate, I took up the offer. Initially much better, the fusions failed. At this point I saw no future or hope in my life. I no longer wanted to live in this much pain. I'd heard about pain doctors and asked my primary care Dr. about them. His answer was immediate and he said, “Oh no, you want to stay away from them.” However, he offered me no alternatives.<br/><br/>Shortly after that, is when I entered Pain Management. I used all manner of non-drug therapies (PT, Chiropractic, Acupuncture, Exercise, Spinal injections, etc., etc., for little to no improvements in pain reduction. My pain doctor took a chance on me and I believe he saved my life. Today I am what's now called a "Legacy" Chronic Pain Patient now in my 20th year of Transdermal Pain Patch usage. I have been on the same dosage all this time. I also receive short-acting pain pills for breakthrough pain which doesn't happen very often, but if I've overdone it during the day and need quick relief, it's there. While nothing takes all the pain away, it's mostly tolerable now, and I've had much improved functionality. There is still much that I cannot do, but at least I can have a life.<br/><br/>My diagnoses include: Failed Back Surgery, Sciatica, Two lumbar fusions and two cervical fusions, complete shoulder replacement, non-alcoholic autoimmune cirrhosis, and Primary Biliary Cholangitis, and Medical PTSD, plus Anxiety. <br/><br/>The 2016 CDC Guidelines proved to give me severe anxiety and just several months ago my Dr's new NP attempted to force taper my meds never having met me before, know my history, studied my X-rays or MRI's, etc. So fortunate for me, my Dr. finds my risk ratio to harm as very low and continued my regular dosages. However, he did mention that in the future, things could change due to legal and or Federal and State laws, guidelines and so forth.<br/><br/> I am nearing my 80th year and have now many more health issues that cause pain. Every time I have a Doctor's appointment, I suffer severe anxiety wondering if this time I'll be denied pain meds. I have had sleepless nights fearing the fate that some of the people like me have endured.<br/><br/>How does the CDC come up with the MME dosages? It was 90mme and now CDC wants it lowered to 50? There are no ways a one-size fits all pain medication will work. We each metabilize differently. What happened to the patient-centered approach. At best the small studies (some of them 60 yrs. Old) can be labled “junk science”. The MME requirement should be removed entirely.<br/><br/>38 states now have harmful laws or regulations on pain medications because of CDC's 2016 “recommendations”. What on earth will they do with 229 pages of them? The damage has been done. Even as CDC's new proposed guidelines might be somewhat better, what of all the damage already done to CPP's, Veterans, Children, Animals and Doctors already. How can these unintended consequences be rectified? Left on the books, thousands of human beings are and will continue to suffer. In this day and age, is that not unacceptable?<br/><br/>Please let CDC get out of the practice of medicine and interferring with the doctor-patient relationship. Please abolish the CDC’s guidelines once and for all. Thank you for taking the time to read this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f8bd2c	McCarty	None	2022-02-18T20:11:23Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from McCarty, Linda	kzs-u42a-jc0b	False	None	False	2022-04-12 03:13:27.276	[]
1030	CDC-2022-0024-1036	https://api.regulations.gov/v4/comments/CDC-2022-0024-1036	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 68 year old woman with severe scoliosis and a host of other spinal problems. There is no cure, only treatment. <br/>Opioid pain meds are the best treatment there is. I know. I’ve been dealing with these problems for almost 40 years.<br/>Before the last “guideline” update, i was getting adequate pain management. Never totally pain-free, but I was able to have a pretty good life.<br/>Now, i spend most of my time sitting or lying down and in severe pain. No quality of life.<br/>I don’t want opioids. I need opioids. I’ve tried every other treatment there is and the medicine is, unfortunately, the only thing that works. I’m suffering without adequate medicine.<br/>Drug addicts will get and abuse whatever drug they want from the street. And many will die. And that’s heartbreaking. But please stop punishing those of us with legitimate, unrelenting sever pain by forcing doctors to treat patients with a “one size fits all” protocol. One size does NOT fit all.<br/>Please, please reconsider your guidelines for those of us who are forced to live with pain.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484f8be5d	Lochamy	None	2022-02-18T20:11:44Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Lochamy , Melissa	kzs-ubl5-u5m4	False	None	False	2022-04-12 03:13:27.485	[]
1031	CDC-2022-0024-1037	https://api.regulations.gov/v4/comments/CDC-2022-0024-1037	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to the numerous previously identified and inarguable conflicts of interest, via the numerous specific references attributed to Dr. [name redacted] throughout these draft recommendations - (https://www.pallimed.org/2021/09/[name redacted]-undisclosed-conflicts-of.html), this document must be publicly repudiated (in total) and withdrawn from any future consideration.<br/><br/>While prescription medication guidelines generally fall under the legal purview of the FDA, (not the CDC). The FDA needs to take the lead with the creation of any subsequent opioid prescription guidelines. The FDA also needs to exclusively allow participation/interjection from practicing pain physicians, advocates for effective pain care, and actual patients experiencing or having experienced some degree of chronic and/or intractable pain.<br/><br/>Additionally, due to no generally accepted method of determination, any/all reference to morp[hine milligram equivalents (MME's) needs to be stricken from the document. Opioid medications generally DO NOT SPECIFY, NOR IDENTIFY any maximum dosage. Therefore, pain patients need to receive individualized care and be carefully titrated, e.g., the medication is started at a low dose. Every couple of weeks, the dose is raised (“up-titrated”) until the maximum effective dose (“target dose”) has been achieved or side effects occur. <br/><br/>There is not now, nor has there ever been a "one-size-fits-all" dosage of medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bradley	None	None	0900006484f8be7b	Percell	None	2022-02-18T20:13:18Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Percell, Bradley	kzs-uc9z-v2pf	False	None	False	2022-04-12 03:13:27.690	[]
1032	CDC-2022-0024-1038	https://api.regulations.gov/v4/comments/CDC-2022-0024-1038	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guidelines were damaging to many legitimate chronic pain patients. First, the opioid epidemic is being driven by Mexican heroin and Chinese fentanyl, not doctors ordering appropriate and legitimate prescriptions. Beating up on the doctors will NOT help this problem. The Eighteenth Amendment to the Constitution with the sole cause of the rise of Organized Crime in the united States, and it did little to curtail the use of alcoholic beverages. In addition, the whole concept of Milligrams Equivalent to Morphine (MME) is a scientifically bankrupt concept. Every individual has his or her own absorption capacity, pharmacokinetics, pharmacodynamics and tolerance mediated through the NMDA and other receptors. But still the Legislators and Regulators want to put more Draconian rules on the doctors just to "prove" that they are making a difference to the illicit opioid problem. Portugal is doing fine with "decriminalizing" drugs. But the United States regulators and legislators continue to talk about ACUTE pain and illicit opioid trafficking in an attempt to divert the conversation from their having to face all of the legitimate chronic non-cancer pain patients that they have injured, forced to the street for pills, or forced into suicide by their harsh and ill-conceived "guidelines". They have made the problem WORSE. - [initials redacted], MD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8b81e	Anonymous	None	2022-02-18T20:13:48Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	kzs-toa0-qwa9	False	None	False	2022-04-12 03:13:27.893	[]
1033	CDC-2022-0024-1039	https://api.regulations.gov/v4/comments/CDC-2022-0024-1039	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My life was turned upside down by your 2016 guidelines and I was forced to retire early on ssdi due to a 50% forced taper that caused high blood pressure and various health issues. I’ve battled for almost five years to get to a point where I can live my best life despite being in bed most of the day. The damage is done and my life almost over which I suspect is your true agenda after reading your 2022 updated guidelines. <br/><br/>—The cdc has no business dictating what happens in my doctors office.<br/>—The fact that Dr. [name redacted], a rabid anti opioid crusader, and self proclaimed conflict of interest author, wrote these guidelines and referenced himself about a hundred times tells the world all they need to know about how biased the guidelines are. <br/>—The beginning of the draft claims to want to use quality evidence yet it doesn’t. It referenced more than once, the now discredited Krebs study and that tells anyone with a brain that the authors of the draft have no interest in trying to help anyone but themselves. <br/>—You claim to have gotten rid of the mme limits, then mention any dose greater than 50 mme is considered a high risk dose and that there is little chance of a patient being helped by greater than 50 mme. This is just plain false. There is no scientific consensus as to mme, patients differ in their ability to metabolize opioids and, the FDA has no max dose for a very good reason. Each patient is different. <br/>—a document that purports to want to help people in pain, mentions addiction and overdose too much. Studies show addiction is incredibly low for prescription opioid users and if you had real scientists authoring the document, you would know that. <br/><br/>This draft is quite frankly an embarrassment to the entire CDC, especially the director, for allowing such poor quality evidence and allowing authors with an agenda that is not in the American people’s best interest. People are suffering and dying in pain everyday. Pain that can be relieved with opioids that have been safe, effective and cheap for thousands of years. Anything short of a complete removal of the 2016 guidelines and no updated guidelines will continue to hurt Americans.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f866e6	Anonymous	None	2022-02-18T20:18:28Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-shrz-kfee	False	None	False	2022-04-12 03:13:28.097	[]
1034	CDC-2022-0024-1040	https://api.regulations.gov/v4/comments/CDC-2022-0024-1040	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I have been suffering with a injury to my lower back since 1994. I have a blood clotting disorder ,I've had blood clots in my lungs as a result of it. The Drs all the Drs have told me I'm not a candidate for any injections, accupunture, anything , I tried PT several times but it was so painful I couldn't walk for days. My only alternative was pain medication,. I see a pain management Dr the same Dr for years now. When I first saw him he took his tests and saw that I had been in this position for years now and was not having any quality of life because of constant brutalizing pain. He slowly increased my pain meds until I was able to move without the sharp pains in my back,(several herniated discs and sciatica in one leg. Finally I was able to participate in my family and enjoy life. Then my Dr said the laws have changed and I have to slowly cut your medication to the law. Well I'm on the bare minimum allowed by law and I'm in a worse position than ever. The pain is unbearable and now I have sciatica in both legs now and I can hardly walk without terrible pain. I don't deserve to have to live like this. I'm 65 and I feel like my lifes over.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Theresa	None	None	0900006484f84b19	Morrone	None	2022-02-18T20:22:38Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Morrone, Theresa	kzr-mmyy-u5iw	False	None	False	2022-04-12 03:13:28.302	[]
1035	CDC-2022-0024-1041	https://api.regulations.gov/v4/comments/CDC-2022-0024-1041	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have worked in law enforcement for both federal and state. I watch many family members suffer through diseases and death in unbelievable pain. I am not a chronic pain sufferer for many years from injuries receive on 21 years active duty Army. I was on strong pain medication prior to 2016. I was cut off due to your over reach and punishment. I have since suffered 24 hours everyday. This was inhuman and stupid to say the least. I foresaw all the horr that you policy inflicted. It is time again to let Doctors treat their patients as human and prescribe medication to those that suffer. They were trained for this. Just like the punishment of police, go after the criminals not the innocent. Horrible policy. Stop punishing all society because of a few bad apples. You cannot put the blame on doctors for this when the DEA closed down pharmacies and threatened doctors with taking their license and actually taking their licence. Call me please!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f866e9	Blades	None	2022-02-18T20:27:37Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Blades, Michael	kzr-sley-33cc	False	None	False	2022-04-12 03:13:28.505	[]
1036	CDC-2022-0024-1042	https://api.regulations.gov/v4/comments/CDC-2022-0024-1042	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The statements from line 1632 through line 1636, line 1787 through 1789, line 1965 through 1971, line 1984 through 1990, line 2049 through 2053, line 2159 through 2163, line 2276 through 2277, line 2281 through 2282, line 2294 through 2297, line 2375 through 2380, line 2466 through 2467, and line 3108 through 3110 are inaccurate and should be removed. I am 69 years old, have severe sleep apnea, use a bipap machine, have been on high-dose opioids since 2007, and have not experienced a single risk from long-term high-dose opioid use. I continue to remain on a stable high-dose opioid treatment plan, and my doctor has no intention of reducing or discontinuing my dose, because he knows how effective the treatment plan is in controlling and managing my severe status migrainosus intractable pain without aura. My pain has been completely eliminated most days out of the month, if not all days out of the month, thanks to the stable and highly effective dose I'm on. Line 4101 should be amended to say, "...consequences of prescription opioid misuse and overdose for those patients at risk." [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	0900006484f87afc	Bythewood	None	2022-02-18T20:29:16Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Bythewood, Leslie	kzs-ilg9-zh2r	False	None	False	2022-04-12 03:13:28.713	[]
1037	CDC-2022-0024-1043	https://api.regulations.gov/v4/comments/CDC-2022-0024-1043	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve had spine complications ever since I was a teenager and enumerable issues because of it. My problem developed to a chronic pain level and I’ve been on prescription opiates going on 22 years now. I also have a medical background and direct experience with treating chronic pain patients for about 5-6 years of my career. I’ve also been a 15-year, outspoken advocate for those that suffer with chronic pain issues. All of my experiences’ have given me a unique look at the opiate problem that most will never see or understand. <br/>I plan to submit several comments for the next couple of weeks and I hope you will all follow my narrative. I’m not attempting to grab any spotlight here. My true intent is diagramming the problem that I have found with this “War on Opiates” and the problems it has caused and not solved. <br/>I urge everyone to carefully scrutinize the CDC’s opiate guideline revisions. On face value, the proposed revisions to the 2016 opiate guidelines seem to be a conciliatory outreach towards the pain patient community. Yes, it’s wording gives doctors more flexibility, which may make a patient’s life a little easier, but it does nothing to fix a glaring problem for someone suffering from a chronic pain issue, including all current patients and especially, those new to pain or those yet to be in the future.<br/>The opiate guidelines introduced in 2016 (The Cures Act) created an absolute mess in my opinion. It pressured doctors to change their prescribing habits. Most, drastically reduced patient’s MME level or simply chose to drop a patient’s drug regiment all together. No proper titration downward, just a cold heartless cutoff. This is wrong, cold, and inhumane. <br/>“The Cures Act” of 2016 was directed at combating the opioid problem with billions of dollars going here and there. Fast forward and look at the CDC data on opiates, the use and consequent deaths has risen steadily. While deaths from prescription opiates fell and continue to trend downwards, illicit use deaths have risen dramatically, very dramatically. It’s almost as if 2016 Act fueled America’s issue with opiates. I encourage everyone to review the CDC graphs. The CDC data hints at something I think is a contributing problem and It’s frightening in its reality. <br/>I say “contributing” because the opiate problem has many facets and there are lots of ways you can look at the problem. My hypothesis contends that part of it has to do with legitimate pain patients being denied prescription medicines and thus are turning to illicit drugs. I think this is further fueling the opiate crisis in an unexpected way. A void is being created and a vacuum being filled. It’s also creating a goldmine for the unscrupulous. <br/>In my course of trying to shed light of this un-spoken problem, I will submit various letters that I have written throughout the years. Almost as if I was a visionary, I could see the mess coming that we are now seeing today. You will see my frustration growing to a crescendo throughout my journey of pain. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f87bea	Cook	None	2022-02-18T20:34:38Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	kzs-jrd1-6h8f	False	None	False	2022-04-12 03:13:28.918	[]
1038	CDC-2022-0024-1044	https://api.regulations.gov/v4/comments/CDC-2022-0024-1044	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is no scientific basis for MME. Each individual patient metabolizes medication differently. Using the blanketed 50 to 90MME is Junk Science just like the ideology of Eugenics.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f83a8d	Anonymous	None	2022-02-18T20:35:50Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-i9lc-r4ez	False	None	False	2022-04-12 03:13:29.127	[]
1039	CDC-2022-0024-1045	https://api.regulations.gov/v4/comments/CDC-2022-0024-1045	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and was diagnosed with ankylosing spondylitis and rheumatoid arthritis at 18 years of age. I am now 45 years old. My quality of life has diminished significantly over the years and I am now in permanent disability meaning my condition and my pain has worsened since my diagnosis yet my pain medication has been lowered to a quarter of what I was bring prescribed by the same pain clinic who started me on the higher dose to begin with. I have also been prescribed my previous drs since being diagnosed and also at a much higher dose than I am now. My quality of life has diminished with the lowering of these medications. I find it extremely difficult to do simple daily tasks and cannot make it through the night without waking up in severe pain. I have spinal stenosis, bulging and fused vertebrae , bursitis is both hips , shoulders and knees. I have torn meniscus in both knees and both knees are riddled with cysts and are constantly filled with fluid to the point that I cannot walk. I cannot do simple things like showering without help. The duration at which I’ve been on pain medication should’ve been considered before lowering my dosage and the lose of quality of life should’ve been considered as well. As my disease progresses which it most definitely will and has my pain will only get worse and I feel it is extra unfair to ignore these factors when lowering my medications. I’m highly allergic to NSAIDS so that is not an option for me. They cause anaphylaxis. I’ve had hundreds of injections with no relief or very little and/or for a very short time if any. I ask that you please consider us long term chronic pain patients be treated fairly and out quality of life be considered when having our pain meds taken away. It is unfair and devastating. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R Michelle	None	None	0900006484f87bd2	Witek	None	2022-02-18T20:37:51Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Witek, R Michelle	kzs-jfsw-0d2i	False	None	False	2022-04-12 03:13:29.364	[]
1040	CDC-2022-0024-1046	https://api.regulations.gov/v4/comments/CDC-2022-0024-1046	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2000 I shattered a heel bone and was on lortab 10mg. by 2006, I was on 60 mg oxycontin twice daily as I had developed a limp causing back pain. by 2016 I had dropped down to 4 10 mg. oxycodones a day and three Ativan a day was weaned off ativan and was switched back to 3 10mg. lortab daily. My Dr. died from throat cancer in 2017. Today I buy from known and fortunate people who are prescribed and pay sometime up to $25/ $30 for an oxycodone 20 mg. I sometome get them off the street with mexican logo. fears of fentanyl I break off small pieces until I know it's not tainted. lumbar has self fused during the absents of daily dose of opiates. I need at least three 7.5 either oxycodone or lortab but Drs fear losing their jobs and won't prescribe. I am 68 yrs old, live alone and doing my own cooking, cleaning and everyday chores spend most all my ssa check for pain meds. what is the point of a young man wanting to beome a dr these days?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tony	None	None	0900006484f87bef	Ausbon	None	2022-02-18T20:38:49Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Ausbon, Tony	kzs-jzvb-b6eu	False	None	False	2022-04-12 03:13:29.567	[]
1041	CDC-2022-0024-1047	https://api.regulations.gov/v4/comments/CDC-2022-0024-1047	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and was diagnosed with ankylosing spondylitis and rheumatoid arthritis at 18 years of age. I am now 45 years old. My quality of life has diminished significantly over the years and I am now in permanent disability meaning my condition and my pain has worsened since my diagnosis yet my pain medication has been lowered to a quarter of what I was bring prescribed by the same pain clinic who started me on the higher dose to begin with. I have also been prescribed my previous drs since being diagnosed and also at a much higher dose than I am now. My quality of life has diminished with the lowering of these medications. I find it extremely difficult to do simple daily tasks and cannot make it through the night without waking up in severe pain. I have spinal stenosis, bulging and fused vertebrae , bursitis is both hips , shoulders and knees. I have torn meniscus in both knees and both knees are riddled with cysts and are constantly filled with fluid to the point that I cannot walk. I cannot do simple things like showering without help. The duration at which I’ve been on pain medication should’ve been considered before lowering my dosage and the lose of quality of life should’ve been considered as well. As my disease progresses which it most definitely will and has my pain will only get worse and I feel it is extra unfair to ignore these factors when lowering my medications. I’m highly allergic to NSAIDS so that is not an option for me. They cause anaphylaxis. I’ve had hundreds of injections with no relief or very little and/or for a very short time if any. I ask that you please consider us long term chronic pain patients be treated fairly and out quality of life be considered when having our pain meds taken away. It is unfair and devastating. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R Michelle	None	None	0900006484f87bd3	Witek	None	2022-02-18T20:39:45Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Witek, R Michelle	kzs-jft4-4srb	False	None	False	2022-04-12 03:13:29.774	[]
1042	CDC-2022-0024-1048	https://api.regulations.gov/v4/comments/CDC-2022-0024-1048	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain for over 20 years. It began with a diagnosed of degenerative disc disease. I have six bulging disc's. Three in the neck, two in the mid back and the lower disc, L5 S1. After all these years I still only take 2 Tramadol a day. Mostly at night before going to bed. Truth us, even If I was having a particularly bad day, of which there are many, I simply have to suffer. I am limited to 60 per month or 40 in a 20 day period. I am frequently humiliated at the pharmacy because even although my doctor has prescribed 2 per day, the latest assistant at the pharmacy does not understand the rules. It is further complicated by the insurance provider. The solution for them is to charge me almost $30 for the "extra" 20 pills. I understand the damage overprescribing caused. I understand how opioids were pushed by big pharma. Yet, in the end, the ones who truly suffer are the ones who were already suffering from legitimate chronic pain. My case is not subjective. I have my MRIs to show my condition. And yet, Dr's were running scared from having overprescribed that they went the other way. Balance is required by intelligent thoughtful people.... [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Frank	None	None	0900006484f87c7a	McEleny	None	2022-02-18T20:40:08Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from McEleny, Frank	kzs-kndw-3x8n	False	None	False	2022-04-12 03:13:29.980	[]
1043	CDC-2022-0024-1049	https://api.regulations.gov/v4/comments/CDC-2022-0024-1049	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A comprehensive review of the "new Guidelines" yields the same result as the original ones--this is idiocy beyond belief. There is no medical justification for this publication of unfounded and useless inputs as to how to manage chronic pain patients with opioid medications. We should not be subjected to once again having to fight our way through pathetic and medically idiotic "Guidelines". There is no usefulness to be found here, and chronic pain patients are once again flushed down the toilet with no consideration for their complex and difficult to treat problems. It is the comprehensive evaluation of chronic pain patients that yields the appropriate manner in which they are to be treated. These "Guidelies" are of no use whatsoever. It is difficult to deal with an agency which hides behind non-communicative procedures when they publish these kinds of poorly created work products. I doubt that much work went into this conglomeration of useless and damaging ideas. It is not time to double down on what was a completely wrong headed and medically unjustified publication in 2016. Chronic pain patients were irreparably harmed by the 2016 publication when unsupported maximum doses were created out of thin air. We continue to fight insurance companies, pharmacists, and regulatory agencies about those absolute maximum dose requirements. Again, in the 2022 publication we see the same underlying premise that there is some maximum dose limit for all patients. It is the individual patient and their problems that define the use of opioid medications. I think that the only guideline that should be published is one that says " Opioids may be used for acute, subacute and chronic pain without limitation given appropriate evaluation and monitoring." Otherwise shut up CDC and the gutless authors who refused to communicate with anyone after publishing the 2016 paper. No one would make themselves available to communicate with physicians or others who objected to their ideas. We were told we could only send e-mails to info@cdc.gov and someone would read our input and respond. I sent in more than 10 e-mails with comprehensive inputs as to why the 2016 Guidelines should be withdrawn immediately. NO RESPONSE FROM ANYONE TO ANY OF THE E-MAILS SUBMITTED!!! All attempts to reach the authors by phone were foiled by not having accurate numbers for the authors--those numbers that you could find inevitably were "not in use at this time". Are we going to face the same BS this time??? I suspect so given that what is being proposed in not worth the paper it is written on. As a Pain Management Specialist (Fellowship Trained, Board Certified by Board of Anesthesiology) and 27 years of experience I resent being treated like a nobody who cannot understand the issues. I would suggest that the authors are the ones who do not understand the issues and have no basis for publishing this garbage in the first place<br/><br/>[Name redacted] MD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RICHARD	None	None	0900006484f8120d	HARRIS	None	2022-02-18T20:55:08Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from HARRIS, RICHARD	kzq-o3np-uvgb	False	None	False	2022-04-12 03:13:30.186	[]
1044	CDC-2022-0024-1050	https://api.regulations.gov/v4/comments/CDC-2022-0024-1050	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 57-year-old female with a doctorate in nursing and a nurse practitioner. I have premature osteoarthritis, and inherited clotting disorder, and subsequent diagnosis with fibromyalgia. I refused to be diagnosed with fibromyalgia for 20 years because of the stigma around it. I have had multiple surgeries due to degenerative joint and disc disease which is hereditary. For an early 20 years I was able to keep mobile, lean and strong, as well as work two full-time jobs in part because I was able to take the prescription medication I needed. My dose changed only once during that time. When the dosing guidelines changed, I felt like a criminal when I went into see my physician. I refuse to go to pain management because I did not want to be treated this way and I have been in healthcare long enough to know what the stigma is like. Since stopping opioids have gained 60 pounds and have become periodically depressed. Exercise is extremely difficult and painful. I am not somebody sitting in a bed. I am a state legislator, I have my own business and every day is a struggle. Recently I was diagnosed with needing a full knee replacement. When I asked for pain medication I felt so disrespected and like a drug addict. I was so upset that this young physician would treat me this way, I told the him this is what is wrong with medicine today. Though I was given a seven day prescription I was told I would have to go to pain management for any refills. I was also told I could not have surgery for a minimum of three months because they had just injected steroids one week prior. I have never had a problem with addiction. When I quit opioids a few years ago I did have several days where I did not feel good but that is a physical dependence that anybody without an addiction issue can ride that out. Not everybody gets addicted but what these guidelines have done is not allowed providers to have that unique relationship with their patients. I have been fighting almost singularly to stop adding barriers to patient care in the legislature. We need federal support at the state level. We need to let prescribers have relationships with her physicians. The education is now there. Let prescribers be responsible professionals but they were trying to be . Do I have to describe my personal situation, allowing people to be in pain without health is cruel but it has larger societal implications. When people can’t exercise appropriately they have one less tool for pain management and one less tool for mood management. Weight gain and immobility increase chronic disease comorbidities. This will ultimately increase the cost of healthcare. It is just so important that we let people who are educated in medicine, who have now been educated about opioids, utilize them for their patients in their patients best interest, at the doses patients need, for the duration they need them. Thank you for allowing me to provide public comment . [Initials redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn M	None	None	0900006484f81081	Adams	None	2022-02-18T20:55:44Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Dawn M	kzq-uxqg-mx5p	False	None	False	2022-04-12 03:13:30.418	[]
1045	CDC-2022-0024-1051	https://api.regulations.gov/v4/comments/CDC-2022-0024-1051	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who life has been destroyed by the CDC and their guidelines. My pain meds were the only thing that helped me love my life and do my daily chores. Now I have no quality of life and can barely stand more than 10 minutes. I am unable to do the simplest household chores or even shower without help. I took my meds as I should to maintain some sort of daily life and the the CDC took them away without even allowing my Doctor to treat me. Why don't they classify all these overdoses as truthful a category for illegal fentanyl one for opiods one for heroin and so on. We pain patients have been forced to taper from something that was the only thing to make our lives bearable. The CDC needs to be removed from the judging they do about people they do not know. All their paid "doctors" who hold no medical license are only in it for the money. How about letting our doctors treat us as they were so that I for one can get my quality of life back. Have any of the CDC passed out from being in so much pain? Well I have and it's scary. This has made me literally a prisoner in my home as I'm afraid to go to a store and not being able to walk around. I can't do many things I used to do like working or going out with my family. Please reach out to the Don't Punish the Pain group before letting the CFC make any stipulations on our doctors or on us as some of the stories they've heard are truly horrible. People have died due to not being able to have their pain made tolerable. I hope you take this seriously as a lot of people are suffering. Thank you for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f81df6	McDonnell	None	2022-02-18T21:00:35Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from McDonnell, Mary	kzr-8w82-7t82	False	None	False	2022-04-12 03:13:30.717	[]
1046	CDC-2022-0024-1052	https://api.regulations.gov/v4/comments/CDC-2022-0024-1052	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Either make pain medications and treatments more accessible, or else legalize assisted suicide for pain conditions. Without either, you're subjecting patients to torture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f81e6d	Anonymous	None	2022-02-18T21:01:53Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-c3xj-w6bz	False	None	False	2022-04-12 03:13:30.931	[]
1047	CDC-2022-0024-1053	https://api.regulations.gov/v4/comments/CDC-2022-0024-1053	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016* CDC Guidelines Are Fraudulent and Based On counting PolySubstance, Heroin and StreetFentanil Death as being Caused by Prescribed PainMedications.<br/>THIS IS A NATIONAL FRAUD AND ITS KILLING PATIENTS.<br/>The 2022* “Revised* Verbiage are NOT BASED ON ANY MEDICAL SCIENTIFIC FACT.<br/>CDC has NO BUSINESS ISSUING ANY GUIDANCE, LIMITS OR SUGGESTIONS for PainMedication.<br/>This is clearly ABUSE OF CDC Mandate.<br/>CDC Guidelines MUST BE RESCINDED IN THEIR ENTIRETY.<br/><br/>As a patient of more than 20 years, I cannot let these CDC Guidelines stand as they are contributing to my Physical demise and mental deterioration. Because of them, I am nearly immobile.<br/>The 2016* CDC Guidelines and Dose Limits are realistically akin to the “Sword of Damocles” hanging over my life as I never know when I will have ALL Meds Removed. At which point I will become a burden.<br/>Although my Dr is Double Board certified in Anesthesiology and PainManagement, I have been FORCIBLY REDUCED from a safe effective dose of LEGAL medicine I’ve been taking for TWO Decades, as he cited DEA INTIMIDATION AS THE REASON. “I’m not ALLOWED to Prescribe that much” (Verbatim)<br/><br/>The 2016* CDC Guidelines Violate the ADA (Americans With Disabilities Act) of 1990 and have far reaching and Fatal consequences for more than 20 Million Americans who used to be known as the Protected Class described by the ADA.<br/>Additionally, these 2016* Guidelines prompted the DEA to Declare an, even more Fatal WarOnDrugs In 2016 by promoting a DEA Mandate to CUT Manufacturing quotas on CII-PainMedication.<br/>Between 2016 and 2020, DEA REDUCTIONS REACHED 70%~(53% IN 2016+18% thereafter)<br/>The Original 1973 DEA Mandate was “Enforcement of Controlled Substances Act of 1970<br/>The Current DEA ACTIONS WEAPONIZE THE CONTROLLED SUBSTANCES ACT BY MANDATING REDUCTIONS IN THE SUPPLY OF LEGAL PainMedication Available to suffering patients and PROSECUTING Drs BASED ON FRAUDULENT CDC DATA.<br/>DEA RAIDS ON PRESCRIBERS ARE SO COMMON, Drs STOPPED PRESCRIBING PainMedications.<br/><br/>In short, CDC Guidelines and rampant DEA Overreach and ABUSE HAVE CAUSED TWO OpioidCrisis:<br/>DEA BAN ON MFG-REMOVED NEARLY 3/4ths SUPPLY OF LEGAL PainMedication.<br/>The Proliferation of StreetFentanil poisoning users and Eradication of a more Safe supply of Heroin.<br/>DEA HAVE RUN AMOK AND ILLEGALLY WEAPONIZED THE CONTROLLED SUBSTANCES ACT<br/><br/>America’s “National Pain Strategy is “ForcedTapering and Patient Abandonment”<br/>Another way to view this is National Malpractice.<br/><br/>CDC Abuse and DEA Overreach CAUSED 100,000 StreetFentanil deaths LAST YEAR.<br/>CDC Guidelines & DEA ABUSE CAUSED the “OpioidCrisis”<br/><br/>RESCIND ILLEGAL CDC Guidelines completely.<br/>RESTORE CONTROL OF CONTROLLED SUBSTANCES ACT and Practice of Medicine To Drs.<br/><br/>Get CDC OUT OF MY DRS OFFICE.<br/>GET DEA OUT OF MY DRS OFFICE.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484f8229f	Tammaro	None	2022-02-18T21:03:54Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Tammaro, Paul	kzr-cr0g-h9zl	False	None	False	2022-04-12 03:13:31.135	[]
1048	CDC-2022-0024-1054	https://api.regulations.gov/v4/comments/CDC-2022-0024-1054	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a pharmacist in the field of pharmacogenomics (PGx), I understand the importance of PGx testing in the area of pain management (including opioids and non-opioids). The inclusion of PGx testing can help aid providers in finding the most optimal therapy for their patients. PGx testing can also help prevent potentially life-threatening adverse effects. This is evident given the black box warnings included in the FDA labels for both codeine and tramadol for patients that are ultra-rapid metabolizers due to the risk of life-threatening respiratory suppression. There are several organizations that do extensive literature research and publish recommendations for medications that have an evident gene-drug relationship. Two of these organizations are the Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Dutch Pharmacogenetics Working Group (DPWG). CPIC provides recommendations for both opioids and NSAIDs, and DPWG provides recommendations for several opioids. PLEASE consider adding PGx testing as a recommendation in the clinical practice guideline given the evidence that adverse drug reactions and inefficacy can be a result of genetic variations. Here are some links to publications that support my comments: https://www.nature.com/articles/s41431-021-00969-9 <br/>https://pubmed.ncbi.nlm.nih.gov/33387367/ <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cathryn	None	None	0900006484f8341b	Jennissen	None	2022-02-18T21:04:16Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Jennissen, Cathryn	kzr-gtan-eyeb	False	None	False	2022-04-12 03:13:31.339	[]
1049	CDC-2022-0024-1055	https://api.regulations.gov/v4/comments/CDC-2022-0024-1055	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want the CDC to drop the MME guidlines totally because they are being used to judge patients, doctors, pharmacists and pain clinics. It’s wrong what the CDC has done to people who are already suffering, and keeping any mention of the MME will continue to cause problems.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8cee9	Anonymous	None	2022-02-18T21:07:48Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-waot-6mdz	False	None	False	2022-04-12 03:13:31.546	[]
1050	CDC-2022-0024-1056	https://api.regulations.gov/v4/comments/CDC-2022-0024-1056	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f81dd0	Cook	None	2022-02-18T21:13:34Z	None	None	1	None	2022-02-18T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	kzr-7uli-bts3	False	None	False	2022-04-12 03:13:31.753	[]
1051	CDC-2022-0024-1057	https://api.regulations.gov/v4/comments/CDC-2022-0024-1057	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Hello, my wife of 49 years who is presently 73 years old has had chronic pain for the last 15 years. She has been under the care of the same board certified rheumatoid physician that entire time. She was managing well until these 2016 CDC guidelines came out. Her physician was reluctant to continue with the well working regimen and decreased her medication. This move by him, although understandable in light of CDC, has made her life unbearable. She is home bound now and there is no other option for her like surgery etc. We haven't been able to go out to eat or visit our grandchildren. It is so sad for me to watch her gradually decline. <br/><br/><span style='padding-left: 30px'></span>Our prayer is that the CDC will made right the disasterous 2016 Guidelines. Please consider our sincere request and accomplish this as fast as possible. <br/><br/>Sincerely........long time residents in [location redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ted	None	None	0900006484f8d1b0	kwarchak	None	2022-02-20T14:20:28Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from kwarchak, ted	kzs-wr22-tl0k	False	None	False	2022-04-12 03:13:31.972	[]
1052	CDC-2022-0024-1058	https://api.regulations.gov/v4/comments/CDC-2022-0024-1058	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Although I am not a chronic pain sufferer, my wife is. She is only 33 years old and already has had multiple cervical spine surgeries, all to no avail. She has attempted therapy (holistic or otherwise), OTC pain killers, changing her diet, and the list goes on and on. Unfortunately, nothing seems to help. As a last ditch effort, her doctors placed her on a regiment of prescription pain killers. While she is not a fan of the medication, she has no choice but to take said medication. It is the only thing that gives her a semblance of a normal life. I have watched her over the years go through an excruciating process of obtaining said medication. I have also watched her go through countless hurdles just to obtain her monthly prescription. She is extremely mindful of her dosage and ensures that the medication is not administered until absolutely necessary. It is a daily struggle that has adversely impacted her/our lives. Unfortunately, individuals like my wife have been wholly ignored in the face the government seeking to enforce tougher regulations to overcome this "opioid crisis." I hope more attention is given to individuals who suffer from chronic pain on a daily basis, rather than wholly ignoring their pleas for help. Clearly, based on the comments, this is an issue that has sadly impacted thousands of folks. It is the government's duty to ensure that individuals like my wife are also taken care of and not ignored. It pains me on a daily basis to see her struggle with her chronic pain. Something needs to be done and done soon.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8d661	Anonymous	None	2022-02-20T14:21:54Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-xjnp-xdeg	False	None	False	2022-04-12 03:13:32.191	[]
1053	CDC-2022-0024-1059	https://api.regulations.gov/v4/comments/CDC-2022-0024-1059	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for listening to a wide representation of patients and physicians. <br/><br/>My only request is that you remove any MME limitations or requirements from your amended guidelines. I don’t believe that an anonymous body like the CDC should be able to tell my doctor and myself what is best for me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jay	None	None	0900006484f8d675	Schankman	None	2022-02-20T14:22:10Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Schankman, Jay	kzs-xk2f-28lh	False	None	False	2022-04-12 03:13:32.445	[]
1054	CDC-2022-0024-1060	https://api.regulations.gov/v4/comments/CDC-2022-0024-1060	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good afternoon, <br/>I have commented earlier but forgot some really important facts. I think the cdc doesn't belong in making decisions in the regulations that affect me personally. My quality of life has been severely compromised because of the mme chart. That should not be part of the new regulations because all medications effect people differently, some medications have a half life, and some metabolize medication differently so I strongly recommend that be removed completely from the new guidelines. There shouldn't be any threshold on pain patients especially chronic pain patients that have been on opiods long term. The doctors are the ones that are educated in the field of pain medication and they should determine what medication and how much and for how long a patient needs this medication. I for example will need my pain medication for the rest of my life. Because of the mme chart and thresholds I like many others, suffer being under treated, our quality of life is poor because of the mme and thresholds, we could do much better if we were able to be treated properly by our pain management doctor. Please remove the mme chart and all thresholds so people like me don't have to suffer anymore. Thank you for taking the time to read this and have a great day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484f8c215	Piselli	None	2022-02-20T14:23:33Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Piselli , Denise	kzs-yc0j-892f	False	None	False	2022-04-12 03:13:32.658	[]
1055	CDC-2022-0024-1061	https://api.regulations.gov/v4/comments/CDC-2022-0024-1061	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been chronic pain patient since 1995. I have been a patient in a pain management clinic since then. I was being treated for intractable migraine and neck pain at that time. Through those years we tried several seizure and anxiety medications, spinal cord nerve stimulators, Imitrex and other then new migraine meds, and low grade opioids, all with dismal success. In fact, during most full blown migraines, only an emergency room visit from a powerful opioid injection (Demerol) could stop the pain. That is until my pain doctor suggested Methdone as a maintenance med, with Percocet for breakthrough pain. Once we established a good base line dosage, IMMEDIATELY, there were no more visits to ER! And this wonderful, beautiful, pain controlled and well tolerated regimen, with one stable dosage, lasted until about 2016. That is when the CDC began releasing their “guidance” to pharmacies and medical professions, to help combat the great opioid crisis. <br/> The government (CDC) is surely it naive enough to think these guidance releases did not have a major impact on prescribing practices! I can WITNESS about how bad it got. Overnight, my doctors were considering tapering regimens. Luckily, mine was fairly gradual. But still, even my WalMart pharmacy demanded my doctor accelerate my taper… even goin so far as to tell me they could no longer fill my prescriptions!! A loyal customer for almost 2 decades, kicked to the side for attempting to fill a legal prescription. Thanks, CDC! <br/> So, now I am in worse pain than ever. Migraines, back pain, knee pain, neck pain,etc. I get regular injections and treatments, including ablations, at my current pain management clinic. And the Dr is only willing to prescribe Belbuca max strength, so my pain level is consistently 8 or better. Of course he will gladly try more surgeries, with no guarantee of success, even though I have a history of well tolerated opioid tolerance and pain control! I never needed my med strengths raised for almost 20 years. I was a poster child for successful opioid pain management! But CDC ruined all that.<br/> So now I am marginally encouraged that you CDC folks have perhaps released you overshot your mark, and mandate! The opioid crisis was never caused by pain patients, yet we have suffered the brunt of it. All the party kids still get whatever they want, only now it’s basically Fentanyl straight through our southern border. Why don’t you guys go after those guys and leave us pain patients alone? <br/> Please know this is an extremely condensed version of my life as a chronic pain patient. I have spent a small fortune on pain relief, yet nothing has worked as well as cheap, effective and safe prescription opioids. Please fix your massive mistake!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f8c244	Looney	None	2022-02-20T14:24:44Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Looney, Robert	kzs-yfh5-wj35	False	None	False	2022-04-12 03:13:32.875	[]
1056	CDC-2022-0024-1062	https://api.regulations.gov/v4/comments/CDC-2022-0024-1062	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a retired pharmacist and a dentist I think there are several things that will help prevent abuse of controlled substances and yet allow patients in pain to be able to receive the benefits of opioid pain relief. <br/>1. All prescriptions for controlled substances should have a place for the prescriber to sign that they have logged into and reviewed data from the CSRS. The pharmacy should also enter this review in the patient's record.<br/>2. All patients receiving controlled substances are REQUIRED to have counseling about their prescription. They can not decline counseling for any reason. This pharmacist counseling should include the following and be entered in the patient's computer record. <br/> a. How well are the patient's symptoms being controlled.<br/> b. What is the patient's pain score today.<br/> c. How is the patient taking the medication now?<br/> d. Are all controlled substance prescriptions in a secure location where an unauthorized person would<span style='padding-left: 30px'></span>be prevented access?<br/> e. The pharmacist will provide education about physical and psychological addiction.<br/> f. The pharmacist will educate the patient about drug abuse and how everyone can help prevent drug diversion.<br/> <br/>Pain management is important but referring to a "specialist" as such should not prevent a patient from receiving adequate pain relief. In rural areas there might not be a pain management specialist. The PCP then must take on the responsibility and treat the patient appropriately.<br/><br/>All clinicians must consider the patient's current pain and address it. When it is not possible for the patient to take NSAID's clinicians must prescribe some medication to obtain adequate relief.<br/><br/>Alternative therapy for pain relief like acupuncture, physical therapy etc. should be utilized but pain relief should not be delayed. The PCP needs to continually address the patient's pain situation and determine how relief can be obtained. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Claire	None	None	0900006484f8c2b4	Gill	None	2022-02-20T14:25:33Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Gill, Claire	kzs-ymhk-wm5r	False	None	False	2022-04-12 03:13:33.083	[]
1057	CDC-2022-0024-1063	https://api.regulations.gov/v4/comments/CDC-2022-0024-1063	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am one of the Severe chronic pain patients who has been writing. <br/>I have not read the complete 200 pages ,but I must say that this is improvement. <br/>I'll comment more after I read everything. <br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith "Bram"	None	None	0900006484f8e179	Cast	None	2022-02-20T14:26:54Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Cast, Judith "Bram"	kzs-zuhc-gcpu	False	None	False	2022-04-12 03:13:33.287	[]
1058	CDC-2022-0024-1064	https://api.regulations.gov/v4/comments/CDC-2022-0024-1064	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good day,<br/>My wife's pain medication was reduced because of the 2016 CDC guidelines. Her mme is 90, a drop of 45 mgs, her life is confined to the bed and recliner since her meds were forced reduced. She has not been able to so many things she use to do,like stand longer than 15 minutes, she can only shower once a week, with a chair, then is exhausted from pain and must rest for at least a hour. We can't travel because of her uncontrolled pain. We're retired and had looked foward to traveling in our senior years. There are to many to mention.. The past 6 years she has undergone over 15 spinal epidural and many other invasive procedures with zero relief. I have with a broken heart watched my wife go from a cheerful, greatful, moderately active women to a shell of herself. I asked her "What do you think would help you get half of your life back?" Her answer was to be put back on her old mg dosage of her pain medication. Please eliminate the mme from the new guidline. I'm sure I'm not the only one who is watching a loved one suffer because they are under medicated. My wife has been on opioid therapy for 16 years she has severe degenerative dics disease, Osteoarthritis, Rheumatoid disease and migraines, 17 surgeries. Her Doctors are in fear of losing their licenses if they prescribe more medication. This is so inhumane when at the right mg dosage for her could make her quality of life so much better. The pain and sadness, feeling hopless in her eyes is heart breaking. <br/>Sincerely, <br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lee	None	None	0900006484f8e249	Dorsey	None	2022-02-20T14:29:05Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Dorsey , Lee	kzt-0jyx-3leu	False	None	False	2022-04-12 03:13:33.491	[]
1059	CDC-2022-0024-1065	https://api.regulations.gov/v4/comments/CDC-2022-0024-1065	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 61 yr old, college educated female. I worked in the medical field for over 25 years, until I became disabled with a progressive/painful autoimmune disease. My symptoms were very well controlled, with opiod medication (massage, yoga etc) until 2018. <br/>I required a neck surgery & was told, due to new CDC regulations, I could only receive a "child's dose" of IV pain control. The evening of my surgery, I had my 1st heart attack. My life spiraled downhill since June 5th, 2018.<br/>Although I was disabled, I was able to work part time & put my 2 kids through college. I could drive, attend church & volunteer as a "court appointed guardian" for children. <br/>Then, my pain medication was lowered, to half the dose, then lowered again to 1/4 the dose. NO ONE would listen to me, NO ONE cared about my pain. My Doctor's were too "afraid " to prescribe what I needed to get my quality of life back. <br/>In 2021, I had my 2nd heart attack, due to very high blood pressure from UNMANAGED pain. I am now "almost" bedridden. My life is not worth living, but, Thank God I still have my faith...<br/>I've prayed every day, for SOMEONE/ANYONE to hear me, & the thousands of others suffering needlessly, due to being denied pain medication. I pray these updated regulations REALLY take effect, & our Doctor's are no longer afraid to precribe the "appropriate " medication, without losing their license? I do NOT want to die from a 3rd heart attack or a stroke. <br/>I'm not asking for much, just to visit my kids & hug my granddaughter. As of this writing, I am unable to do either.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maura	None	None	0900006484f8e44c	Thompson	None	2022-02-20T14:30:25Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Thompson , Maura	kzt-2gih-q8sx	False	None	False	2022-04-12 03:13:33.699	[]
1060	CDC-2022-0024-1066	https://api.regulations.gov/v4/comments/CDC-2022-0024-1066	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>For 5 years I have watched my best friend (41 years old) become the shell of the man he was due to chronic excruciating daily pain from multiple auto accidents and construction jobs. I have been with him on appointment after appointment with orthopedic surgeons, neurologists, thoracic specialists and pain management physicians . They all passed him around like a hot potato for someone else to fix. Nerve ablations, injections, thoracic outlet surgery, acupuncture, gabapentine and Tylenol and PT. All of those solutions did was attack his organs and increase his anxiety and bipolar disorder, and make his joints and nerves worse. <br/><br/>All refused to prescribe anything beyond a lidocaine patch and never listened to his complaints, even while holding medical reports in their hands. The 2016 CDC guidelines have tied Drs hands and have forced people like my friend to head to street drugs for relief, increasing overdoses and suicides. Many times I’ve talked my buddy down off the ledge because he gets no relief. While he is under the care now of a compassionate, smart PCP we have had to fight for months, just to get him to the ‘acceptable’ 90 mme level. Every month we are chasing meds: pharmacies are out of stock or it’s a manufacturer that he cannot tolerate, or the DEA number won’t work and now the practice is going to transfer his care elsewhere. What kind of quality of life is this for him , or the millions of others that are caught in this death hole? It’s cruel and in humane and rules and guidelines must be changed NOW. Do the right thing. Change the rules and make the guidelines clearer. Let the Drs do their job without fear because I can’t lose my friend.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f8f11d	Massey	None	2022-02-20T14:31:07Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Massey, Michael	kzt-3f73-uv0z	False	None	False	2022-04-12 03:13:33.911	[]
1061	CDC-2022-0024-1067	https://api.regulations.gov/v4/comments/CDC-2022-0024-1067	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to stay out of the doctor-patient relationship. Chronic pain patients never recover. We must live every day in agony to accommodate for addicts. Stop punishing chronic pain! I want my quality of life back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8f19e	Anonymous	None	2022-02-20T14:37:51Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzt-3yvf-n30t	False	None	False	2022-04-12 03:13:34.137	[]
1062	CDC-2022-0024-1068	https://api.regulations.gov/v4/comments/CDC-2022-0024-1068	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a stage 4 cancer patient. I have had numerous surgeries. A lung resection perforated my diaphragm in 2015, after surgery to do extensive repairs I was sent home with only extra strength Tylenol for pain. I was ambulanced back to the cancer center 5 days later for out of control pain. I have been left with constant/chronic pain. NOBODY is willing to give those of us with chronic pain anything more than over the counter pain remedies, driving many to go to Mexico or the street for pain relief. I know people in the cancer aftercare process who are in the same position. I have also seen people with active end stage cancer denied pain medication . They are already dying, and the doctors fear the repercussion of an overdose so much that they won't prescribe an opioid. Show some mercy to the terminally ill who are paying, literally with their lives, because no life is better than constant pain. I have been on that edge and I will never let that happen to myself or a family member again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paula	None	None	0900006484f8f1c6	Murray	None	2022-02-20T14:38:46Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Murray, Paula	kzt-45au-rfrp	False	None	False	2022-04-12 03:13:34.339	[]
1063	CDC-2022-0024-1069	https://api.regulations.gov/v4/comments/CDC-2022-0024-1069	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Guillain Barre (GBS) since 2015 and I would be in constant, debilitating leg pain and probably in a wheel chair without low dose Oxycodone. We have not increased the dosage for 7 years. I am so grateful that the new recommendations are more personalized. The last guidelines were "cruel" for many patients.<br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484f8f28f	Huber	None	2022-02-20T14:39:55Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Huber, Jeanne	kzt-4yjc-t4aw	False	None	False	2022-04-12 03:13:34.576	[]
1064	CDC-2022-0024-1070	https://api.regulations.gov/v4/comments/CDC-2022-0024-1070	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 51 & a 15yr CRPS chronic pain sufferer. my CRPS effects my left hip/leg. date of injury May 27 2007. in the early stages due to trouble regulating my pain I had a cytochrome test done only to discover i am CYP2D defective. therefore I do not fully metabolize many opioids. when the doctor who cared for me from the date of injury passed away in 2019, I was sent to a reputable Pain management clinic where it quickly became evident the effects of your 2016 iron fist opioid obliteration guidelines. <br/>I was rapidly titrated from 90MME a day(20mg oxycodone 3x day) to 30MME (10mg oxycodone 2x day), because opioids are bad according to the doctor. Then I was given a consult with a addiction pain management specialist, who evaluated me to see is I was an addict which they concluded i am NOT addicted to my pain meds nor an addict despite the amount or time on them; and to assist my new dr in my quick titration from oxycodone to Belbuca, only to discover I'm allergic to buprenorphine. so I was switch back to low dose oxycodone. a total of 3 weeks of HELL because of your 2016 opioid rules. it felt and still feels like the doctors are scared to treat people who live with pain conditions.<br/><br/>I went from a somewhat tolerated life where I maintained some functioning to pure suffering barley functioning. everyday I am in increased pain due to being POORLY treated is no life. half the time I cant function enough to get out of my chair. I use mobility assistance aids more often now. my daily CRPS pain level went from 4 to 7 (I have an extremely high pain tolerance), and have lived with this elevated daily pain levels for 2 years now. I have done everything my doctor asks. I pee in a cup, have my pills counted every visit. I see a therapist because my doctor wants alternative ways to manage my pain (doesn't work). physical therapy to help with the muscle wasting and neuropathy exacerbated the situation, was stopped by the Dr. yet i am still denied adequate care or pain control. my pain mgmt. Dr. has a hard line on opioids because of the 2016 guidelines, the federal war on opioid addiction and the negativity towards opioids. current guidelines do not help at all. I have talked to my doctor many times to no avail. all I want is relief. I myself have contemplated suicide because of the amount of pain i live in.<br/><br/>I have felt first hand the effects of the CDC and federal govts effects of the 2016 opioid regulations on the patient doctor relationship. we are made to feel like we are addicts, pain does not exist or the stigma of being on opioids. I am not alone in my experience or suffering in this. there are 50 million who sufferer from pain in our country. our doctors have lost their compassion to treat us due to fear of DEA retribution, lack of ability to render aid because of the 2016 over-regulation, even skepticism to treat due to the opioid negativity campaign.<br/><br/>the 2016 rule needs a serious overhaul for people who suffer from pain conditions. really what is the point of being a human guinea pig from extensive testing to have documented medical records and tests which verify conditions that will not be treated? your regulations and the feds involvement has caused damage that is already done. despite this the drug overdose rate is still skyrocketing, and its NOT from prescriptions, pain patients dont get, its from illegal fentanyl that floods into this country. last year alone your own data shows an increase of overdose deaths by 28.7%. year before that it was up 67%. In fact all the 2016 CDC opioid regulation, and the DEA and federal govt involvement in pain medications did was destroy the doctor/patient relationship and hurt the 20.4% of adults with chronic pain and the 7.4% suffers whos pain interferes with their daily lives. what have we been left with from the 2016 fiasco? degradation of the doctor patient relationship, faltering faith in our health care providers, doctors in fear to treat, non medical persons, i.e. insurance companies, pharmacy CEO's(CVS Caremark) and politicians making our(the pain patients) care decisions overriding our trained /educated doctors; and most importantly increased pain and increased suicide rates of pain patients. <br/><br/>when redoing our pain management guidelines please listen to ALL the pain sufferers. bring in compassion and flexibility. pain is not a one size fit all. please consider those like myself who are CYP defective and do not metabolize pain meds and need 30mg to get 15mg. also realize alternative medicine does not work on everyone. every person, their needs and requirements are different. just because we were unfortunate enough to end up with a condition, disorder or disease that cause us pain doesn't mean we should be made to suffer to the point death becomes welcomed. most importantly try to figure out how you are going to repair the damage that has already been done and make doctors feel compassion again and that they are safe to actually treat their patients. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carolyn	None	None	0900006484f8f2f8	Lagle	None	2022-02-20T18:25:11Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Lagle, Carolyn	kzt-5nn5-4tzh	False	None	False	2022-04-12 03:13:34.782	[]
1065	CDC-2022-0024-1071	https://api.regulations.gov/v4/comments/CDC-2022-0024-1071	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Centers for Disease Control and Prevention<br/><span style='padding-left: 30px'></span>I Myself Personally agree with your Decision to move forward with the CDC change pertaining the prescribing of Opioids.<br/><br/> I Myself has experienced the Whole situation being Subscribed Opioids and Takin Down Unsafely with my Dosage. I had pain due to an Car Accident on the highway as an passenger,I had received medical care and also an Settlement.after being in the accident I thought I was well enough to not seek future Treatment,But I say a week or Soo I started to have ALOT of leg Pain, so I started going to the doctor complaining about my legs all the time,Soo she said well before I give u anymore pain medication u will have to get a MRI,Soo we made the appointment I go and then the following Month I go back to the doctor,She tells me she has an explanation of why I'm having pain in my legs,she advised me that I had Chronic back problems and damaged nerves and Disc issues and Soo on, Now at that point,she subscribes me an Opioid called Vicoprophen, And that's when it All Started.<br/><br/> Moving Forward,12yrs,I was on 20mgs Roxicodone 10mg of Methadone,I at this point was with a new doctor and clinic for 7yrs and in 2020 my doctor had up and left and none of her patients knew until she was Gone so after that I had decided to stay at the same clinic and see another doctor there because I was use to and comfortable there. The Very First visit with the New Doctor,she took my Medication down from 20mg Oxicodone to 7.5 Percocets and 30 of my Methadone and DiD Not titrate me Down Slowly or Safely! So after that I was having withdrawals and alot of Pain,I told her how I was feeling and she said that my pain is coming from the medication said that it can cause me to have pain and she wasn't looking at the fact of how she took my medication down from the Milligrams to the quantity. I was Soo Sick and she said that the CDC Only wanted the patient's to be subscribed opioids having a equivalent of 90mg of Morphine and I was wondering What about my PAIN What about the fact that I have been on this Medicine for 12yrs Straight!? Soo instead of me wanting to go out there and find Street Drugs,I Chose and Didn't have any other Choice but to admit myself into a Methadone Clinic and all I hear is I just moved from One Drug to another and it will be HARD To get Off!<br/><br/> Being at the Methadone Clinic I done heard and seen horror Stories and ALOT of them started because their Doctor put them on Opioids and got them Hooked just to snatch their medicine away from them because they either look at us as addicts that they MADE or the Doctor is Scared of the DEA and Don't want their license TOOKING.I realize that it is Not the Opioids that is causing the Overdose it's because the people that are Sick and having Withdrawals get out in the streets trying to find opioids to get better and or is Getting Bad pills or bad heroin and THAT'S WHAT IS KILLING THEM!! U Can go to 10 different States and find a 100 people from each State that Is orHas been on Opioid Pain Medicine and Every ONE of them will have the Same Back drop!<br/><br/> Soo what I am Saying is PLEASE Make that Change if it's not already and EMPHASIZE To these DOCTORS Practitioners ect.What thee CDC ORDER MEANS!<br/><br/><span style='padding-left: 30px'></span>THANKS,<br/><span style='padding-left: 30px'></span>A VICTIM	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Minyon	None	None	0900006484f8f2fc	Blount -Mincey	None	2022-02-20T18:27:43Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Blount -Mincey, Minyon	kzt-5ohs-u5ck	False	None	False	2022-04-12 03:13:34.996	[]
1066	CDC-2022-0024-1072	https://api.regulations.gov/v4/comments/CDC-2022-0024-1072	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/> Hi, my name is [redacted] and I have also been under prescribed for surgeries and from having pinched nerve pain daily. And I think people that are in pain should have never got let off of having pain medication so they can get to do their daily task without having so much pain to get through the day. When I had surgery the dr refused to give me any more pain medicine than 3 days. And I had to go to the emergency room to get relief. So it’s been extremely difficult to get any pain medication because the dr misused the guild lines and as you know it only made the situation worse where more people have died from buying street drugs And drs have also been sued for leaving people in pain and dismissing any help to those like me with nerve pain serviré migraines and shoulder atrophy from having a disk bulge and spondylitis is not easy to get any help no matter how bad the pain is they misused the guideline so I feel the new guidelines that say to try ibuprofen or Accupuncture they will only go by that as before and leave people in pain once again the people that have major surgery or severe pain needs more pain relief so I believe the guidelines should not say ibuprofen should be given to the people in more serious cases because they will go by that and misuse the guidelines and the dr made me explain myself so many times and denied giving anything only muscle relaxers and I had to go in circles for years so I don’t want the dr doing the same because once again the guidelines are not clear and they will continue to refuse pain medication to those that need it the most. It would help if the cdc gives proper guideline in pain medication so drs won’t go by ibuprofen and Accupuncture as they did with the last guidelines because they will use that again to yet give us no help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julia	None	None	0900006484f8f4b4	Florez	None	2022-02-20T18:29:36Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Florez, Julia	kzt-8lzv-6y0i	False	None	False	2022-04-12 03:13:35.203	[]
1067	CDC-2022-0024-1073	https://api.regulations.gov/v4/comments/CDC-2022-0024-1073	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have several very painful diseases, a deteriorating spine and neck, psoriatic arthritis, osteoarthritis, joint disease, MS, CRPS, Amputation of a leg, and migraines almost daily. For many years I took the same opiate dosage for 20 years and never needed more, I was not totally pain free but, I was functional and I worked and raised my children. Then this whole blame the doctors and take opiates away from everyone. I followed the rules, I passed the urine test and monthly pill counts to now have my medication lowered by 75%. I can no longer work. A good day for me is I made it to the living room. I have had 44 surgeries and my last two I was given no pain medication after a leg amputation! You can only imagine what went through only to have gotten a staph infection and need another surgery 14 days later. Again no pain control. Do you realise how barbaric that is. I am guessing most of you put in the same situation because of your position or because you have money would get treated properly. And don’t even try To tell me none of you have had a surgery with no pain control. And then to put 50MME limits on opiates if your lucky enough to find a doctor to prescribe them. We are not all the same size or have the save metabolism so I am not sure why a doctor could not decide what we should get and again don’t insult me because you know the DEA is threatening doctors! I CC wish they went after illegal drugs like they do doctors. I am a human being I followed the rules but I am left to suffer everyday. Why is that okay? <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8f4c7	Anonymous	None	2022-02-20T18:30:25Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzt-8rpo-ol1e	False	None	False	2022-04-12 03:13:35.411	[]
1068	CDC-2022-0024-1074	https://api.regulations.gov/v4/comments/CDC-2022-0024-1074	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern, <br/>I am employed as a full-time Nurse Practitioner in a pain clinic in the US. I am concerned about several issues that affect patients who receive opioids. <br/>1) The government and media seem to have inadvertently encouraged prejudice<br/>against patients receiving opioids. My patients have been subjected to rude comments from pharmacy and hospital staff and from the public.<br/>2) There is pressure in my county to limit dosing to 3-4 Norco per day. This is inadequate dosing for many of my patients. I do limit dosing to 5 tab per day per preference of the local DEA.<br/>3) Medicaide declines Belbuca and Oxycontin but offers formulary drugs of Fentanyl, methadone and Hysingla. Fentanyl is high risk for overdose and methadone and Hysingla are high risk for slowed breathing. And the VA won't pay for Qulipta. Nurtec,Ubrely,Emgality, Ajovy, Aimovig for migraine H/As.<br/>3) There are times when MMEs of > 90 and occasionally, MMEs up to 180 are needed to control an individual patient's pain. Pharmacists tell me they're afraid they'll lose their job when they fill narcotics and they have to fill out questionnaires as to why the patient needs narcotics and they ask when I will taper patients off of opioids they need for quality of life. There is pressure to keep patients undermedicated. I always submit ICD 10 codes.<br/>4) Now multiple CVSs in IN. Il. Wisconsin and other states are out of Norco 10/325mg. Patients have to switch pharmacies or have to switch opioids doses or medications. How much worse will this get?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484f8f4e4	Cox	None	2022-02-20T18:31:33Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Cox, Nancy	kzt-9099-23m9	False	None	False	2022-04-12 03:13:35.620	[]
1069	CDC-2022-0024-1075	https://api.regulations.gov/v4/comments/CDC-2022-0024-1075	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. Female, 51 yo. Pain patient for 7 years. Spinal and joint pain, hasimotos hypothyroidism, migraines.<br/><br/>With my opioid pain management I am able to work 32 to 40 hours a week, paint, garden, play piano, take care of my husband, children and pets. It has been wonderful being able to maintain a mostly normal life with the aid of hydrocodone and other treatments (physical therapy, cortisone etc)<br/><br/>But every month I worry that I'll be denied my pain medication which helps make my life almost normal. <br/><br/>I am not a surgical candidate per my spinal doctor so unfortunately I have to wait until technology catches up. In the mean time I still have a life to live and my pain medication makes it possible.<br/><br/>Please continue to revise the guidelines to help people who just want to be a functioning human being.<br/><br/>Thanks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484f9119d	Diaz	None	2022-02-20T18:32:07Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Diaz , D	kzt-agz5-3uu8	False	None	False	2022-04-12 03:13:35.823	[]
1070	CDC-2022-0024-1076	https://api.regulations.gov/v4/comments/CDC-2022-0024-1076	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since 2010, I have been dealing with a condition that causes chronic pain. I have had multiple surgeries for this condition and nothing has fixed me so far. I was in pain management for this condition. After 2016, my pain management doctor took me off of the medication that was helping me and letting me have a better quality of life to take care of my kids and do the things I need to do in my daily life. I have become depressed and have gained an unhealthy amount of weight due to that. Taking away medications that help people with chronic pain like myself, is taking their quality of life away. I am in multiple Facebook groups where chronic pain sufferers have been cut off of their meds and they are on the verge of committing suicide. If a patient has a known disease or condition that is known to cause pain, prescribing them pain medication should not be an issue! We need that medication to function! Please reconsider the 2016 guidelines so that people like me don't have to suffer in silence.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f928b9	Anonymous	None	2022-02-20T18:32:39Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzt-ds9n-36co	False	None	False	2022-04-12 03:13:36.028	[]
1071	CDC-2022-0024-1077	https://api.regulations.gov/v4/comments/CDC-2022-0024-1077	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revisiting the regulations and protocol for prescribing opioid medications. I understand the drug abuse is way out of control in the US espcially and even doctors and pharmacies have been in trouble for being part of this problem. But I hope you understand that many of us live in daily or periodic horrific pain and there is a place for properly dispensed opioids for chronic pain and for surgical pain. I have had major back surgery, knee replacement, 6 other knee surgeries, 3 foot surgeries, 2 hand surgeries, but none of them are as bad as rheumatoid arthritis when it rears it's ugly head with throbbing, burning, stabbing neuropathic pain. Except for my last foot surgery to fuse 3 hammertoes on my left foot where I developed nerve pain related to complex regional pain syndrome, but at least Gabapentin was able to take the edge off of it enough to sleep. But for the RA tenosynovitis pain I can get that looks like a rattlesnake bit my wrist and back of hand, the only medication I have found to work is a very high strength prednisone taper which my Rheumatologist will not give me as she is worried some day I might get diabetes or heart disease, or opioids. And again even the opioids do not remove the pain, just dull it enough to allow me to breath and sleep till the flare subsides for a while. I never feel "high" from the opioids, not sure why everyone else is wanting them to get "high", they just allow me a tad bit of pain relief. I have never wanted to use them on a daily basis or have ever had to go through any kind of a program to<span style='padding-left: 30px'></span>to be able to stop the opioids. I think the solution will be to regulate very heavily who these drugs are scribed to and why and make the pharmacies have better accounting and security to insure they are not being stolen or improperly dispensed with very harsh penalties for offenders. And remove doctors that are caught improperly distributing these drugs. The drug is not the problem, it is the people who choose to abuse it. I was a Law Enforcement Officer before I knew I had RA and before it exploded and altered my life so I was not able to work as a LEO any longer. Please help us in need as chronic pain is the worst and it is totally different then the pain most people experience in life, broken bone, burnt hand, smashed finger, ripped off toenail, blunt trauma, car wrecks. I have experienced all of that and way more and nothing is like RA pain or this CRPS neuro pain, they need the big guns to dampen the pain. Please think of me when you make your decision on what you will do about allowing certain usage for opioid medications!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marcia	None	None	0900006484f91256	Ewell	None	2022-02-20T18:36:14Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Ewell, Marcia	kzt-gtyc-61tf	False	None	False	2022-04-12 03:13:36.261	[]
1072	CDC-2022-0024-1078	https://api.regulations.gov/v4/comments/CDC-2022-0024-1078	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These CDC guidelines have ruined my life. I was on a stable dose of 40mgs of Percocet a day for severe chronic pain in both my knees and back. My doctor left and the new doctor refused to prescribe me anything saying that 40mgs of Percocet a day is cancer level pain meds then proceeded to ask me if I have Narcan. I was on this dosage for 3 years no issues then my doctor leaves and Iam left with nothing. I have been to multiple specialists. I've had 4 failed knee surgeries, multiple injections, tons of physical therapy. I've ran the gambit fo non opioid options first none of which helped and many I had bad side effects too. Now doctors are usings medications off label to try and treat pain. If I have a cold Iam gonna take something that was made to treat a cold. Iam not gonna take an antacid just because it may have helped a few people with cold symptoms. Most of these off label meds don't work and carry serious side effects. Iam too young for knee replacements and they want me to lose weight before I can have another surgery but if I can barely walk how can I lose weight. The amount of medicine I was on allowed me to go grocery shopping, cook dinner, do fun things with my daughter, take care of my cats, do dishes, take a shower, do laundry etc etc. I was on a dose that was under the 90mme limit for patients with chronic pain but it didn't matter my new doctor took it all away. I now risk losing my housing because I can't clean my house for inspections, I can't take a proper shower because I can't get up my stairs to the bathroom with the shower, I can't sleep in my own bed because it's upstairs, I can't do my laundry because my washer and dryer are in the basement. Iam running out of food in my house because I can't go grocery shopping and even if I had the food I can't stand long enough to cook or do the dishes. I had to rehome my animals because I could no longer care for them because I can't even make it to the store to buy them food. Iam going to have to send my daughter to live with my mother because I can't do anything for or with her anymore. Iam lucky that I can make it to my one bathroom on the main floor then it's right back to the couch because the pain is so bad. My knees chronically dislocate and the pain is so excruciating that it cause me to throw up and then Iam basically immobile for days. At least when I had the pain medications I could manage to at least hobble around after a dislocation. My doctor didn't offer any other substitutions except ibuprofen ( which I have to take 800mgs ever 3 hours just to put a dent in the pain and gives me bleeding ulcers) or Tylenol which does absolutely nothing and the amount I would have to take would literally kill my liver. I live in rural area in the Upper Peninsula of [redacted] and doctors are too scared to prescribe anything even in an emergency setting for fear of DEA repercussions or people getting addicted or they believe the hype that pain meds don't work well for chronic pain yet there have been no long term trials to prove this. My medicine gave me 70% reduced pain. I never abused it. I never failed drug tests or doctor shopped or used multiple pharmacies. There are no pain clinics left in the Upper Peninsula and none downstate will take me because I live to far away and that raises red flags with the DEA. These guidelines have taken away my life and Iam only 38. I shouldn't have to live like this, bedridden and useless to myself, my family, and society. The pendulum has swung too far the other way and it's going to take a lot of work to put it back into the middle and that work starts with your office. You need to get rid of MME statutes. Everybody's bodies work and metabolize meds differently so what dosage works for one person may not work for another. Also the false narratives that opioids don't work well for long term pain needs to be changed. I was on them for 4 years and they worked just fine. No quantity increases or dosage increases. We go to doctors offices and we are treated like drug seeking addicts just because we need pain relief to have some form of quality of life and the emergency rooms are even worse when it comes to labeling patients. I have tons of X-rays and MRIs backing my diagnosis and that my pain is real but doctors are being told not to care for fear of losing their license. This can't continue to happen. People are commiting suicide because of their untreated pain. Who wants to live life bedridden? Others in search of pain relief go to the streets and are buying meds that are laced with Fentanyl and these people are dying. They are not drug addicts they are people in so much pain that they are literally forced to go to the streets. How is this better then legally prescribed meds that are safe and effective when taken appropriately? How much longer should we have to suffer in needless pain when there are medications that were specifically made for pain and work and are safe under a doctor's supervision? Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janell	None	None	0900006484f912ab	Ansell	None	2022-02-20T18:40:26Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Ansell, Janell	kzt-jddv-r9f3	False	None	False	2022-04-12 03:13:36.497	[]
1073	CDC-2022-0024-1079	https://api.regulations.gov/v4/comments/CDC-2022-0024-1079	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have spinal stenosis, psoriasis, psoriatic arthritis and diverticular disease. I can no longer get the pain medicine I need to be able to hold a job because the government has taken the ability of the doctors to use their judgement to treat each patient as they see fit. So now I'm on medicaid,food stamps and are applying for disability. I also had my pain medicine stopped suddenly because of the new government guidelines for prescribing opioids so I am now going to a methadone clinic. I am only 42 years old. If it weren't for methadone clinics I probably would have contiplated suicide because I'm in so much pain without pain medicine. I have taken pain medicine for years so I no longer get any euphoria from it,it simply helps manage my pain so I can work and have some kind of quality of life. Please keep the government out of the dr office and allow the dr to treat each patient according to their needs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f93f67	Anonymous	None	2022-02-20T18:40:53Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzt-k4q5-1pe3	False	None	False	2022-04-12 03:13:36.711	[]
1074	CDC-2022-0024-1080	https://api.regulations.gov/v4/comments/CDC-2022-0024-1080	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As published today in The Hill, the guidelines need to be rescinded and not updated, due to the extensive adverse effects they have generated and lack of impact on overdose fatalities as well.<br/><br/>Like prohibition on alcohol, the approach to regulate our outlaw a substance only increases the desire to obtain that substance, thus worsening the problem, which we can see with the continued rise in overdose deaths despite the 70% reduction in prescribing. It is basic human psychology which is why your guidelines will never be beneficial to anyone. Working on the supply side of the market is inevitably doomed to fail.<br/><br/>The only feasible approach to take can be seen with the government's approach to tobacco. Through a long term investment in education of the harms of tobacco, the demand dropped, and so smoking is down from 60% to less than 20%. Again, basic human psychology.<br/><br/>For law enforcement, for those taking illicit street drugs, consider mandatory military service for repeat offenders.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f94471	Anonymous	None	2022-02-20T18:41:27Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzt-ltn6-9om2	False	None	False	2022-04-12 03:13:36.916	[]
1075	CDC-2022-0024-1081	https://api.regulations.gov/v4/comments/CDC-2022-0024-1081	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am currently taking Ms continue and roxicodone for severe back and leg pain. Before the gov. Regulation of lowering the amount of opioids that I can take I was on and amount of pain medication that was working very well. Now I am in severe pain again because of the lowered amount of opioids that my pain clinic can administrator to me. I mean severe pain to where I am in bed 23 hours a day. Before the reduction of pain meds I could at least have a somewhat of a normal life,but now Im back in bed. Please let my pain clinic have control of how much pain. Medication can be given so I.can get back part of my life that the Government took away from me with the 2016 mandate. I'm so tired of being bed ridden. No more cortical steroids. 44 injections was enough. No relief. I need my pain meds. To be increased back to before the mandate.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	roy	None	None	0900006484f912e7	bartlett	None	2022-02-20T18:43:34Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from bartlett, roy	kzt-o2qw-jxnd	False	None	False	2022-04-12 03:13:37.202	[]
1076	CDC-2022-0024-1082	https://api.regulations.gov/v4/comments/CDC-2022-0024-1082	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer with osteoarthritis in my hands, elbows, hips ankles and feet. I have been to my rheumatologist several times with no help. After contracting Covid the pain intensified. I struggle daily with the chronic pain. <br/>I had both knees replaced to help with that pain. Why do we have to suffer when there is help out there? Why does the big pharma get to dictate how we're receive treatment? There has to be a better way to help many people like me with chronic pain that doesn't involve the Insurance company or CDC telling us what is best for us. Not only does the CDC need revised but the way we treat people thru insurance needs to be reformed. I am tired of the CDC and the insurance companies getting more respect than the people that have half their paycheck go to something that we're not getting proper care in return.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shannon	None	None	0900006484f95f3b	Roberts	None	2022-02-20T18:57:22Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Roberts, Shannon	kzt-uoig-aj7h	False	None	False	2022-04-12 03:13:37.419	[]
1077	CDC-2022-0024-1083	https://api.regulations.gov/v4/comments/CDC-2022-0024-1083	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to reiterate that these "Guidelines" are absolutely useless and will continue the unsupported position of CDC to attempt to control medical practice without a license. We see that none of the critical elements in Pain Management are emphasized as being the basis of how to treat patients, instead we have the arbitrary and capricious pronunciations of the CDC authors who are responsible to absolutely nobody. Chronic pain patients cared for by qualified pain specialists are not removed from the idiotic pronunciations of the CDC. We use chronic opioid therapy when it is necessary to treat patients for whom treatment options are extremely limited. WE DO NOT HAVE ANY OTHER OPTIONS FOR THESE PATIENTS!!!. I find that the ongoing threat to chronic pain patients being cut off of their medications or arbitrarily radically reduced in the doses of medications that they are on, inflicts permanent damage to these patients. I do not see any methodology being advocated by CDC to address the real critical issue at hand, which is addiction treatment. We need neurophysiologic and pharmacologic methods to treat these individuals. Addiction relapses are pervasive because our current treatment methods are ineffective, half hearted, and without solid scientific evidence to make them effective. Do we see the CDC advocating for the kind of research that is necessary to really assist patients with addictive disorders? NOT ONE WORD FROM CDC TO HELP THOSE AFFLICTED WITH ADDICTIVE BEHAVIORS!!. Yet we see physicians burned at the stake for trying to help those who have significant pain problems. I find that to be unjustifiable and without scientific merit. The authors also hide behind a wall of being unresponsive on any level to those who wish to engage them about their faulty "Guidelines". No author would ever respond to e-mails, phone calls and letters sent to them to request that they engage professional pain specialists in a review of their pronouncements from on high. These new "Guidelines" are of no benefit to anyone and should be scraped. The only "Guideline" needed is one that says the following: "Chronic opioid therapy may be used for acute, subacute, and chronic pain after a comprehensive evaluation of the patient and their medical problems". Nothing else is needed.<br/>[Name redacted] MD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RICHARD	None	None	0900006484f96388	HARRIS	None	2022-02-20T18:59:23Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from HARRIS, RICHARD	kzt-w5g3-rs3c	False	None	False	2022-04-12 03:13:37.634	[]
1078	CDC-2022-0024-1084	https://api.regulations.gov/v4/comments/CDC-2022-0024-1084	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My father went through bone cancer and his kidneys failed after that. Colostomy and all. He was denied pain meds before and on his death bed because doctors were so scared to treat pain. I hope no one’s loved one ever goes through something like that. I had severe gallstones and sludge had surgery they were scared to treat my pain. Inhumane. You’ll learn when it happens to your or a loved one.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484f9140b	Clar	None	2022-02-20T19:08:19Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Clar , A	kzt-x1q5-2sq1	False	None	False	2022-04-12 03:13:37.874	[]
1079	CDC-2022-0024-1085	https://api.regulations.gov/v4/comments/CDC-2022-0024-1085	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dealing with chronic pain is something you will hopefully never deal with. Unfortunately, l do daily. I have a rare connective tissue disease that causes my joints to dislocate randomly. My only relief is narcotics. I have tried everything else and continue to explore more. To be told that has been taken away, makes life unbearable. That medication is for people like me! I have no side effects. If l don't set a timer for the next dose, l can't chase the pain.<br/><span style='padding-left: 30px'></span>Everyone is different and deserves access to life changing relief. Please allow that to happen. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97164	Anonymous	None	2022-02-20T19:21:45Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzu-2f5m-9y70	False	None	False	2022-04-12 03:13:38.076	[]
1080	CDC-2022-0024-1086	https://api.regulations.gov/v4/comments/CDC-2022-0024-1086	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an individual that has been in pain for over 10 years, it's fair to say, I'm an expert in chronic pain. I don't understand why the board insists on quoting studies that have been proven false or inaccurate time and time again. It's junk science and what is concerning is, it seems to be taken as fact. I know we are smarter than this as a nation. The MME philosophy needs to be thrown out all together and instead focus on a patient-based angelic effect. Also, the whole philosophy that prescription drugs are the cause of the opioid problem needs to be reviewed.<br/><br/>You are effectively removing the strongest thing we have to fight against chronic pain and it's not right. We don't ask diabetics to stop taking their insulin because it can cause problems in the future, so why do we have such a problem with prescription pain medicine? The analogy is fitting because you are destroying chronic pain patients' lives by not allowing prescription pain meds. The only thing the guidelines are doing, is forcing pain patients to take matters into their own hands and that is far more dangerous. <br/><br/>It is my belief that a pain patient is better off in the care of a doctor than they ever are on their own. While there are always going to be problems with any medication, if a doctor is doing their job and reviewing a patient's case every few months, it's highly unlikely that we are going to have massive overdoses. I propose that we try and go back to allowing doctors to make this medical decision. I also believe by doing so, you will see a dramatic drop in overdose fatalities. <br/><br/>Rescind the 2016 guidelines and admit they were a mistake. Let's get back to treating patients with pain.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97168	Anonymous	None	2022-02-20T19:22:30Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzu-2j37-5apn	False	None	False	2022-04-12 03:13:38.277	[]
1081	CDC-2022-0024-1087	https://api.regulations.gov/v4/comments/CDC-2022-0024-1087	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	HELLO, I am a 90 yr. Old female who has had the need for opioids in my past and presently for 2 broken pelvis bones and dislocated hip replacement. However I have learned through past experiences that opioids constipate me terribly and have led to bowel blockages. <br/><br/>Therefore I avoid opioids at all costs. I use gabapendren and Tylenol as much as possible. I have it put in my records that I avoid opioids at all costs.<br/><br/>While it may not be as effective in controlling the pain, it's worth my discomfort to try other avenues of pain control.<br/>Thank you for changing these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	0900006484f971b2	Cupp Doe	None	2022-02-20T19:31:44Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Cupp Doe, Shirley	kzu-3m2m-3sgd	False	None	False	2022-04-12 03:13:38.493	[]
1082	CDC-2022-0024-1088	https://api.regulations.gov/v4/comments/CDC-2022-0024-1088	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chiari malformation, syringomyelia and have had three surgeries and still suffer with an extreme level of pain, especially in my neck, which is debilitating. I utilize physical therapy and massage (out of pocket) to try to manage my pain. I still require a low dose of an opioid, which I have maintained on the same dosage for years (without any side effects) to help manage my pain and try to function and help me to continue to work part time and have relief and help me in my daily life. Please take into consideration that non-opioid therapy (and in my case, spinal injections are not an option due to extensive scar tissue and other anatomy issues. Do not leave chronic patient patients in a more dire situation, which will most definitely have a severe impact on l their life/livelihood.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f972d1	Anonymous	None	2022-02-20T19:44:00Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzu-86rc-hu2t	False	None	False	2022-04-12 03:13:38.707	[]
1083	CDC-2022-0024-1089	https://api.regulations.gov/v4/comments/CDC-2022-0024-1089	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have commented before but I neglected to mention that keeping in morphine equivalent amounts like 90mme is not useful as individuals are different and what’s good for one may not be good for another. Writing in specific amounts is going into the doctor’s office and determining what’s appropriate for all, male or female, different weights and different genetic responses to different medicines. I was once prescribed a medicine that put me in intensive care for a week but it works well for others. So to decide that that medicine has no value because of the reaction that I had is nonsensical. So why do that with opioids? And face it, legal opioids did not start the overdose problem, yet people who have been on them responsibly are the ones who paid. Please consider this when writing these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	I	None	None	0900006484f972f3	Mitchell	None	2022-02-20T19:51:41Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell , I	kzu-8wx5-lncr	False	None	False	2022-04-12 03:13:38.916	[]
1084	CDC-2022-0024-1090	https://api.regulations.gov/v4/comments/CDC-2022-0024-1090	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This must end today! Enough already. So many patients have been abandoned or tapered so aggressively they have lost jobs, are homebound & some now bedridden, that once led productive lives with their medication.<br/><br/> I have been here as well.ivd had to find a new dr to treat my pain 5 times since 2016. <br/>I started pain management because I was no longer able to hold a steady job. Due to pain, flare ups, attendance. Once a dr treated me regularly, I managed to stay employed, managerial position, for 14 yrs!! Since 2016, I've been afraid of losing my job several times. <br/><br/>Some Dr's since 2016, have made us come in every month, count our medications, pee in a cup which is humiliating!! We are patients not parolees. But we do it! Because we have too. Some get a dirty UA result when Dr's want to get rid of you! You can't trust anyone in Healthcare anymore. Some expect yiu to leave your sample in a unattended they have been known to be tampered with.Some drug screens are costing us or insurance over $1500 per month!Some co-pays or charges are over $500 per month.All these guidelines have done is made criminals out of Healthcare!! <br/>How many Dr's have been charged w unnecessary drug testing charges to Medicare?it's in news all the time. Pain patients don't over use medication as they don't want to run out before 30 days. It's hard enough to get a script. Street drugs are so easy to get, if everyone could afford them, I don't thjnk people would bother going to a dr anymore fentanyl warnings or not. <br/><br/>People dieing from so called "OVERDOSES" are really being POISONED BY FENTANYL. "ILLICITLY MADE FENTANYL"AND "ADULTERATED DRUGS BY FENTANYL" People dieing are Opiate Naive or mixing with other drugs & alcohol. <br/><br/>This is not going to end anytime soon. Too many people have lost access to pain meds & pain care. <br/>There will always be pain patients, & there will always be drug addicts. But let's not make a mistake of lumping them all into one group! They are not the same!<br/><br/>MME is Junk Science. There are multiple different mme calculators on the web. Who is correct? Why? They all give different results. Especially for Methadone.which is a great pain med, however, it doesn't work for everyone. No one med will work for everyone just like no same MME will work for all! Everyone's pain is different, cause of pain is different, pain relief is different. You can't treat all cpps the same! <br/><br/>Why cap mme at 90 or now 50? Why are revised GL down to 50 now? This is not going to work and only drive more people to illicit drugs & suicides! <br/><br/>Why keep making CPPs pay for addiction issues? Overdose & poisoning issues? For Purdues issues? Most pain patients had nothing to do with any of these things! Pill mills ended years ago! Oxycontin ended years ago!! <br/><br/>Many many overdoses are from illicit drugs. Naive patients. And people, not patients, using someone else's pills or street drugs. They may have had 1 script. Then bought street drugs. That doesn't make it a RX overdose! People w opioids in system at time of death, doesn't make for RX death. <br/><br/>Alcohol related deaths with opioid in system doesn't make for RX death. It's an alcohol death. Alcohol affects mind, thinking, judgement, motor skills, etc etc. OPIOIDS do not. <br/><br/>93,000 ALCOHOL RELATED DEATHS IN 2019! Where is the outrage?? Alcohol is sold on every corner, gas station, grocery , drug store, etc One can purchase as much as they want, as often as they want, etc. Alcohol causes more domestic violence issues, health issues, driving issues, etc it has absolutely no medicinal purpose what so ever! Yet it's available all the time to anyone. But! It's socially accepted! <br/><br/>Drugs have a dirty stigma to them. It's pathetic. Every single person is just 1 vehicle accident, work related injury or horrible diagnosis away from a lifetime of pain! You, your loved ones, your neighbor your coworker, everyone!! May you pray its not you!! <br/>We are fortunate to have pain relief. We have natural opioid receptors in our brains. Poppy plants were put on this Earth. Coincidence?? I think not. <br/><br/>Patients need to be accountable and responsible for their meds, actions, treatment, life, etc. We need to be able to work w our Dr's. <br/> <br/><br/>No one asked for a LIFE OF PAIN! That doesn't mean you can't help give back some of that relief w the correct individualized care that each & every patient deserves to experience!! <br/><br/>Please reconsider revising these rules that have been torture to so many. RX is at a 20 yr low yet overdoses/ deaths are at a alltime high. This in itself says, it's not RX, it never was. Give physicians the power to diagnose and treat as they are trained for. Hundreds of thousands of Dr's can't be wrong. <br/><br/> <br/><br/>Now we have long term pain from Covid to add to the millions & millions of pain patients. This is only going to get worse. <br/><br/> Many CPPs could be back in workforce, which is suffering, if only they had some pain relief. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kellie	None	None	0900006484f96ca0	Gasser	None	2022-02-20T21:41:23Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Gasser, Kellie	kzu-p8ip-cwu9	False	None	False	2022-04-12 03:13:39.142	[]
1085	CDC-2022-0024-1091	https://api.regulations.gov/v4/comments/CDC-2022-0024-1091	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted], I was injured at work back in 2003. I was a milkman and drug 200 lbs constantly. One day I hurt my back real bad. I ended up getting 2 surgeries. Neither of them helped now I have neuropathy in both legs and feet. Alway in pain. Had a pain doctor in [redacted]. The government stept on his feet , and now he will no longer take workers comp. Now I go to a doctor in [redacted] the prescribed me extampza which is a joke. Just enough to stop me from withdraws. I need help I can't find a doctor. This is killing me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484f96ccb	Lotz	None	2022-02-20T21:42:47Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Lotz, Mark	kzu-re2v-726i	False	None	False	2022-04-12 03:13:39.352	[]
1086	CDC-2022-0024-1092	https://api.regulations.gov/v4/comments/CDC-2022-0024-1092	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have to add to my previous comments the outrage that I still have over the "hard limits of 90MME...etc". There needs to be an absolute repudiation of these types of recommendations and that does not exist in the new "Guidelines". I believe that there is also a requirement that the authors specifically direct that all governmental regulations and laws that were passed using the 2016 publication be rescinded immediately!! There needs to be a clear and unchallenged statement that the previous "Guidelines" were medically and scientifically wrong and that the hard limits have no basis in medical fact. There needs to be an overt recognition that the laws that have been passed using the 2016 publication are harmful to patients, cannot be justified in any manner, shape, or form, and that it is critical that these laws be removed from the books immediately to reverse this gross miscarriage of justice. There needs to be a statement of medical fact that specifically creates the ability for practitioners to use the new publication as a defense against the laws promoted by 2016 errors. There needs to be an unassailable pathway for practitioners to be shielded from the errors that have caused this issue in the first place. It is unconscionable that a number of "Pain Specialist Advocates" have endorsed this latest bunch of garbage without demanding the corrections needed to reverse the damage done by the "hard limits" issue. There needs to be public statements and extensive education of legislators, regulatory agency employees, and the judges in the judicial system that there can be no valid law or regulation that relies on the 2016 publication for the underlying premise validating such laws and regulations. It is time for the authors to get their collective heads out of the sand and stand up for what is right and just. One cannot practice medicine without taking in and being responsive to all of the components that make up such a practice. To be painted into a legal corner by outright fraudulent publication of "hard limits on opioid prescriptions" is outrageous at best and deliberately dishonest at its worst. The authors have only "The Emperors New Clothes" defense to offer in regards to the hard limits issues. It is time that the authors take full responsibility for their failures and work to right the wrongs that they have promulgated from the 2016 fiasco. Anything less than this is to be deliberately dishonest and to totally fail in ones professional responsibility to fix the mistakes that they have made. [name redacted] MD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RICHARD	None	None	0900006484f97544	HARRIS	None	2022-02-20T21:44:44Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from HARRIS, RICHARD	kzv-1owe-9gxc	False	None	False	2022-04-12 03:13:39.556	[]
1087	CDC-2022-0024-1093	https://api.regulations.gov/v4/comments/CDC-2022-0024-1093	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	THIS IS A TEST - regulations.gov appears to be down multiple days. <br/>Even if this form on the Federal Register domain accepts comments, parties trying to comment on regulations.gov are being thwarted by the failure of the page to load.<br/><br/>PLEASE EXTEND COMMENT PERIOD.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97563	Anonymous	None	2022-02-20T21:44:59Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-5lvp-6cwg	False	None	False	2022-04-12 03:13:39.770	[]
1088	CDC-2022-0024-1094	https://api.regulations.gov/v4/comments/CDC-2022-0024-1094	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After a radical prostatectomy, my husband was given Ultram which didn't work for his pain so we were told to alternate Tylenol & Motrin. I was having to lift him out of the bed. You are punishing the wrong people by scaring physicians so they won't prescribe opioids after surgery.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ginget	None	None	0900006484f97588	LaChapelle	None	2022-02-20T21:45:25Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from LaChapelle, Ginget	kzv-7v2v-e4sm	False	None	False	2022-04-12 03:13:39.974	[]
1089	CDC-2022-0024-1095	https://api.regulations.gov/v4/comments/CDC-2022-0024-1095	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	this link does not work:<br/><br/>The docket can be found at https://www.regulations.gov/.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f979b1	Anonymous	None	2022-02-20T21:46:07Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-en3y-0eiz	False	None	False	2022-04-12 03:13:40.186	[]
1090	CDC-2022-0024-1096	https://api.regulations.gov/v4/comments/CDC-2022-0024-1096	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer with chronic pain, 23 hours a day, 7 days a week, 52 weeks a year. I NEVER want to take opioids. I will do anything and everything possible to avoid these medications. You tell us not to use them and to use alternate therapies such as PT, Massage, acupuncture, etc. WHAT A GREAT IDEA, BUT HOW WOULD YOU LIKE ME TO PAY FOR IT. THESE THERAPIES ARE NOT COVERED OR BARELY COVERED ON INSURANCE POLICIES. YOU CARE MORE ABOUT INSURANCE EXECUTIVES MAKING MONEY. YOU ARE LYING AND DUPLICITOUS BY EVEN SUGGESTING THERAPIES THAT PEOPLE CAN NOT PAY FOR UNLESS THEY ARE RICH. MAYBE YOUR ARE RICH, MAYBE YOU JUST DON'T CARE ABOUT ANYONE OTHER THAN YOURSELF. YOU SHOULD BE ASHAMED OR AT LEAST IN CONSTANT PAIN AND POOR LIKE THE REST OF US.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lesley	None	None	0900006484f979b8	Price	None	2022-02-20T21:46:32Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Price, Lesley	kzv-ey4o-71s9	False	None	False	2022-04-12 03:13:40.392	[]
1091	CDC-2022-0024-1097	https://api.regulations.gov/v4/comments/CDC-2022-0024-1097	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This control of opioid prescribing is despicable! The CDC decision to manage medical providers in managing their patients pain is ridiculous! The people making these decisions at the CDC have not ever had orthopedic surgery, needs more than 3 days to 1 week of opioids for pain and the painful rehab needed, especially knee and shoulder surgery! How about we go back to having the doctor manage his patients care! <br/><br/>[name redacted], Retired RN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f976ea	Anonymous	None	2022-02-20T21:47:18Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-hyk7-anzt	False	None	False	2022-04-12 03:13:40.601	[]
1092	CDC-2022-0024-1098	https://api.regulations.gov/v4/comments/CDC-2022-0024-1098	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This control of opioid prescribing is despicable! The CDC decision to manage medical providers in managing their patients pain is ridiculous! The people making these decisions at the CDC have not ever had orthopedic surgery, needs more than 3 days to 1 week of opioids for pain and the painful rehab needed, especially knee and shoulder surgery! How about we go back to having the doctor manage his patients care! <br/><br/>[name redacted], Retired RN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f976eb	Anonymous	None	2022-02-20T21:48:00Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-hysc-fxx0	False	None	False	2022-04-12 03:13:40.849	[]
1093	CDC-2022-0024-1099	https://api.regulations.gov/v4/comments/CDC-2022-0024-1099	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support having prescriptions of pain medication left up to clinical judgment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97706	Anonymous	None	2022-02-20T21:48:28Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-iemq-ah5a	False	None	False	2022-04-12 03:13:41.053	[]
1094	CDC-2022-0024-1100	https://api.regulations.gov/v4/comments/CDC-2022-0024-1100	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC should rescind opioid prescription guidelines which result in refusal of beneficial medicine being prescribed to citizens without due process. Seeing that States have sued pharmaceutical companies and won can citizens who have been harmed by the new guidelines sue the CDC? Three mentors of mine who wouldn’t have ever assumed were prescribed medicine have been harmed two of them are no longer alive. Our company, their family’s are forever harmed by the CDC.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97b63	Anonymous	None	2022-02-20T21:48:44Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-ogzh-ycpw	False	None	False	2022-04-12 03:13:41.280	[]
1095	CDC-2022-0024-1101	https://api.regulations.gov/v4/comments/CDC-2022-0024-1101	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for 16 years. I have tried every therapy under the sun and the only thing that gives me quality of life and allows me to function are opioids. My usage has not escalated during this time and I understand the risks and benefits. Denying us pain relief is absolutely sadistic and cruel.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97bc1	Anonymous	None	2022-02-20T21:49:02Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-pji8-verk	False	None	False	2022-04-12 03:13:41.489	[]
1096	CDC-2022-0024-1102	https://api.regulations.gov/v4/comments/CDC-2022-0024-1102	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for 16 years. I have tried every therapy under the sun and the only thing that gives me quality of life and allows me to function are opioids. My usage has not escalated during this time and I understand the risks and benefits. Denying us pain relief is absolutely sadistic and cruel.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97bc2	Anonymous	None	2022-02-20T21:49:12Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-pjid-24ho	False	None	False	2022-04-12 03:13:41.931	[]
1097	CDC-2022-0024-1103	https://api.regulations.gov/v4/comments/CDC-2022-0024-1103	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe people with have chronic pain should have access to the appropiate opioid medications needed for long-term care! Please look into the facts and see that this benefits a massive amount of chronic pain patients rather than making them suffer.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jordan	None	None	0900006484f96b23	Martelle	None	2022-02-20T21:50:08Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Martelle, Jordan	kzu-dh05-jp5v	False	None	False	2022-04-12 03:13:42.157	[]
1098	CDC-2022-0024-1104	https://api.regulations.gov/v4/comments/CDC-2022-0024-1104	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with chronic pain for more than 20 years. It all started when I had cancer and I wasn't supposed to live but I did. Between the cancer and the steroids my body is failing. I have Avascular necrosis now and have had a hip replacement in my 30's and now in my mid 40's getting ready for the other hip replacement. I have a Nero stimulator implanted in me. There are times when I just want to give up because my pain is so bad. I'm currently taking the maximum dose according to my doctors and they can't increase my meds. I go through random drug tests to make sure that I am taking my medicine as well as to see if I am doing illegal drugs. I can't work because of my disability and pain. There are days that I stay in bed for 2 or 3 days because of the pain. I can't get a higher dose and I don't abuse my meds, but if the pain gets any worse I'm going to have to do something to end it.It's really sad that when it gets so bad and can't get any relief because of a pencil pusher says that I can't get a higher dose that I have thought about ending it all.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f7f785	Taylor	None	2022-02-20T21:52:34Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-16T05:00:00Z	None	None	None	None	None	None	None	Comment from Taylor , Robert	kzp-tkhc-l2uw	False	None	False	2022-04-12 03:13:42.463	[]
1099	CDC-2022-0024-1105	https://api.regulations.gov/v4/comments/CDC-2022-0024-1105	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why so cruel?? You need to bring trust back to our relationships with our.Dr's.. I've been a severe pain sufferer for 25 years. I need my pain meds to even move. The fight has been long and hard. Trying everything to.be normal. To like life again. To leave my bed and home. Just to have a real smile on my face.. tried suicide and thank God I lived. For my grandbabies need pa pa batman.. I've tried to leave my pain meds behind .the result almost killed me.. please don't put the mme guilines in . My doctor and I have this.. he is the must caring man I've ever known. And he is not stupid! We have had many talks and many changes to my treatment. I am on less meds now because though hard work we have found what works.. I have been with him 15 years.. mme is wrong on so many levels. I'm 58. to old to suffer anymore.. I'm good but I am rare because of compassion. I am at 120 mme and you say I don't deserve that?? Please let me and my dr. do this please..... God bless.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8d24a	Anonymous	None	2022-02-20T22:05:12Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-wukh-sv9f	False	None	False	2022-04-12 03:13:42.845	[]
1100	CDC-2022-0024-1106	https://api.regulations.gov/v4/comments/CDC-2022-0024-1106	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><br/><span style='padding-left: 30px'></span>I find it curious why the CDC has proposed both in the publish 2016 Opiate dosing guidelines and the 2022 proposed opiate dosing guidelines, that they are stating that chronic pain should be treated in an entirely different manner than what medical science does in treating just about any other chronic disease state.<br/><br/><span style='padding-left: 30px'></span>It doesn’t make any difference if the pt has been diagnosed with high blood pressure, diabetes, COPD, high lipid/cholesterol and on and on...<br/><br/><span style='padding-left: 30px'></span>Typically the diagnosis is done from some urine/blood lab test value that is outside of what has been a predetermined range that is safe.<br/><br/><span style='padding-left: 30px'></span>A good example is a pt being diagnosed with having diabetes, a type II diabetic will typically be initially prescribed Metformin with a starting dose of 500 mg BID. If the pt’s blood sugar does not come down to “normal range” the dose can be increased up to 2550mg/day in divided doses. If the pts blood sugar still does not reach “normal range” the practitioner could add a few other meds in combination up to three different meds. If the pt’s blood level doesn’t reach “normal level” the practitioner can add insulin. For decades the standard of care with insulin, insulin potency was standardized at 100 units/ml, but now there are also now 200 units/ml and 500 units/ml. There appears to be NO UPPER LIMITS OF UNITS/DAY for individual pts - dose is determined by their blood glucose or A1C readings returning to what is considered a “normal range”<br/><br/><span style='padding-left: 30px'></span>Same thing applies to pts diagnosed with hypertension, the final goal is to get the pt’s BP into normal range no matter the dose or the number of different meds are needed.<br/><br/><span style='padding-left: 30px'></span>The CDC previous opiate and proposed opiate dosing guidelines has turned what has been the traditional chronic disease treatment process ON ITS HEAD. First the MME equivalence process has ABSOLUTELY NO BASIS IN SCIENCE. It has been reported that these ratios were developed with opiate naive people with mechanically induced pain (Heat or Cold) and using a SINGLE DOSE. At a time when medical science had no knowledge of CYP-450 opiate metabolism rates and/or PGx opiate metabolism rate. As well as the ratio were determined on the “subjective opinion” of the people involved in this study and the results have no application to the use in treating chronic pain issues.<br/><br/><span style='padding-left: 30px'></span>Since studies have demonstrated that treating chronic pain pts with opiates will result in a 0.6% to 2.0% becoming addicted. So this proposed guidelines is prohibiting >98% of chronic pain pts getting treatment with opiates that will optimize their QOL, while there is no proof that those up to 2% will not be abusing some other substance(s).<br/><br/><span style='padding-left: 30px'></span>The LD50 of opiates is highly variable and will decrease on those pts who have taken opiates long term. I have had first hand experience with end stage CA pts being given 20mg to 30 mg/hr Morphine via IV without fatal respiratory suppression. In theory, that would be equivalent of 200mg to 300mg of Morphine PER HOUR.<br/><br/><span style='padding-left: 30px'></span>Every other chronic disease is treated to get the pt’s vitals into what is considered an acceptable range, The 2016 and 2022 proposed opiate dosing guidelines does not address getting the pt’s vitals to a acceptable range, only limits - in theory - a particular MME max dose and the pt is expected to live/exist in a intensity of pain that many could consider a torturous level of pain, and many other biological/physiological functions are outside of acceptable ranges because of under/untreated pain. <br/><br/><span style='padding-left: 30px'></span>The attached chart will demonstrate the possible complication of a pt’s comorbidity issues and/or cause the pt to develop additional comorbidity issues.<br/><br/><span style='padding-left: 30px'></span>Practitioners are suppose to be “healers”, but creating opiate dosing guidelines that does just the opposite is basically inhumane.<br/><br/><span style='padding-left: 30px'></span>I communicate regularly with pts whose practitioners have taken their pt’s opiate doses down to meet the arbitrary MME limits. Their blood pressure is in “stroke range” , typically north of 200/100 - even when taking four or more blood pressure meds, under/untreated pain has caused their adrenals to fail, in trying to compensate for the stress on their system, and the pt now is diagnosed with Addison’s disease.<br/><br/><span style='padding-left: 30px'></span>Pts are dying from premature deaths from all of these unnecessary biological stressors or and many more are committing suicide because they can no long tolerate the intensity of pain that they are being forced to live/exist in.<br/><br/><span style='padding-left: 30px'></span>The CDC, needs to rescind/revoke the 2016 guidelines and pull the proposed 2022 guidelines and turn the practice of medicine back to the FDA and the various state medical licensing boards.<br/><br/><span style='padding-left: 30px'></span>To do otherwise and proceed with these inappropriate opiate dosing guidelines, would strong suggest that the CDC is confirming that the CDC’s position that putting/leaving chronic pain pts in a torturous level of pain is acceptable and what should be considered “ a normal/acceptable range” for pt dealing with chronic pain.<br/><br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484f8d96d	Ariens	None	2022-02-20T22:09:16Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Ariens, Steve	kzs-xpkt-cqps	False	None	False	2022-04-12 03:13:43.306	[]
1101	CDC-2022-0024-1107	https://api.regulations.gov/v4/comments/CDC-2022-0024-1107	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	State of Illinois fatal opioid overdoses:<br/>2013: 1,072 (583 of which are heroin others synthetic) no cdc guidelines <br/>2020: 2,944 6 years after cdc guidelines <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97e1f	Anonymous	None	2022-02-20T22:13:10Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-tf4z-o3ej	False	None	False	2022-04-12 03:13:43.562	[]
1102	CDC-2022-0024-1108	https://api.regulations.gov/v4/comments/CDC-2022-0024-1108	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I still have more to say. Besides laying in my bed most of the time with no quality of life anymore do to chronic pain, I cry because when my pain was controlled I had a life worth living. Now I cannot even clean my own house. The only option I am given in [location redacted] is more shots in my back at the drill mill. I've already went through that for 2 years and refuse to go through it again. It did not help me and I feel it made things worse. These shots are nothing more than a money maker for these places, and most of the time cause more problems for the patients. At 67 years old, I would love to have quality of life in whatever years I have left. I can see now,why some people choose to go to the streets for illegal substances just to gain some relief from a life of torture. My mother at 91 years old was taken off her medication. Her last 6 months of life was miserable suffering. Because of the illegal substances flowing through our country, we as chronic pain patients should not have to live out our time in extreme pain. Go after the them and give us our lives back. Let our doctors be doctors again. I want to say, I sure hope whoever did this to us, goes through the pain and misery that we go through but actually I couldn't wish this on anyone else. Maybe our government agency should think about the fact that this could happen to them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484f97e15	McMahon	None	2022-02-20T22:14:26Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from McMahon, Sandra	kzv-taa7-ptot	False	None	False	2022-04-12 03:13:43.842	[]
1103	CDC-2022-0024-1109	https://api.regulations.gov/v4/comments/CDC-2022-0024-1109	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Certainly this update is long overdue. I have 2 friends with chronic acute pain: one from injury, she has an electric implant which still leaves her in great pain; one from a back operation which left a large portion of her spine enclosed in a metal cage. <br/><br/>The latter is 78 years old and her doctor cut back her medication, not by much but significantly affecting her quality of life. She has been on the same amount of medication for over 10 years and has learned to live and enjoy life on the original amount.<br/><br/>The former is only 60 but is so frightened of being accused of addiction she is afraid to go to a new doctor for relief. Her life is severely impaired by chronic acute pain. When she last had her battery replaced the hospital staff told her she should be on much higher levels of opioids, and since she cannot work or be on her feet for long anyway, why worry about addiction in her case. Her pain doctor subsequently refused to help her.<br/><br/>I would never have recovered from knee replacement had I not had Vicodin for 18 mo. After 1 year I voluntarily cut the medication in half because the pain level dropped. After discussing my situation with a psychiatric addiction expert, I was assured I was not addicted, after another 8 months I no longer needed the a acute pain treatment and switched to an NSAID. <br/><br/>Among anyone caught in a pain nightmare should be able to have some quality in their life, regardless of the possibility of addiction. For some the addiction may be preferable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diana	None	None	0900006484f97e0c	Runde	None	2022-02-20T22:15:08Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Runde, Diana	kzv-t869-1dyg	False	None	False	2022-04-12 03:13:44.112	[]
1104	CDC-2022-0024-1110	https://api.regulations.gov/v4/comments/CDC-2022-0024-1110	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDCs 2022 proposed GLs are worse than the 2016 GLs. You saw the results of the original GLs! 100,000 ODs! There are no Dr's now willing to prescribe opiates because the DEA rushes in & grabs their license. I can tell you MY experiences are they couldn't taper my opiates fast enough back in 2017. My health is now badly damaged due to the original GLs.I have heart damage due to the taper. I have liver damage from too much Tylenol! The 90 mme limit was what every PCP tapered to. NOW you say don't taper. But then you also put in a new limit of 50mme. It sounded good until I read the new mme limit. Which isn't something you are supposed to be dictating! I had a life after 23 years on MS Contin. Now-I can't even get out of bed. My house is a mess. My life is a mess & my property is a wreck. I live alone. I have no caregiver. I needed those meds to even move! I called a dozen different Dr's in 2021 & not one would even see me as a patient. I've been called a drug addict. I've been winked at by people thinking I'm a drug addict. I am almost 70 years old. IF I was doing illicit drugs I would be dead.This new GL is going to confuse PCP even worse than the first one & I can tell you right now that every pain patient still getting any opiates will be cut down to 50mme. Do NOT make this GL public! I'm begging you for every single person who suffers from pain be it temporary or long term. People that are disabled die to pain are losing all hope of ever getting out of pain. I spent 24 years on opiates & am NOT a drug addict. I am in pain all the time! Please don't pass these GLs w/ that 50 mme limit attached. It will kill people!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suzanne	None	None	0900006484f97cae	Weinstein	None	2022-02-20T22:15:59Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Weinstein, Suzanne	kzv-rbg1-n5w4	False	None	False	2022-04-12 03:13:44.326	[]
1105	CDC-2022-0024-1111	https://api.regulations.gov/v4/comments/CDC-2022-0024-1111	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi. I have been a chronic pain patient since 2008 and I'm currently still a chronic pain patient in 2022. I suffer tremendously from a long list of medical conditions. In the past 14 years, I have been taking oxycodone. I have been capped off at 10 mg 6 times a day. I was advised that I cannot be put on any more than 10 mg at a time, 6 times a day, according to rules because of the morphine equivalent cap. I suffer all day every day, and the 10 mg is not working on my pain other than helping me not get sick from not taking it, however if I do not take it then obviously I'm worse off than before. My doctor agrees that after 14 years of taking 10 mg oxycodone, that I should be able to up the milligrams that I am given at a time however he cannot do so due to legal reasons. I go see him every single month, I am required to take a drug test every single month ( which I have never failed). I do not even have insurance so these monthly visits and monthly drug tests are paid out of pocket. I am on approximately eight other medications as well, a lot of them being for pain ( non-opioids). I do not believe it is fair that my pain is capped off and being compared to others pain. I also do not believe that it is fair that because people are overdosing on heroin and fentanyl, that I have to suffer for it. 14 years is a very long time to be on the same milligram of oxycodone, after a while it doesn't work on your pain anymore at that same dosage, all it does is keep you from getting sick and going through withdrawals. I have been suffering long enough. I would really appreciate this morphine equivalent being dropped. Yes I have been on morphine before, the morphine didn't even help me at all, which some doctors say is weird, but I think the weird part is that the oxycodone helps better than the morphine so to me there isn't an equivalent. To people like me who are taking their medication as prescribed, see their doctor every month, take a drug test every month, abide by all rules, and are just trying to get help but can't because of the strict rules that even the doctors think are ridiculous, it is not fair to us because after a certain time frame your dosage has to be increased for it to continue working, after 14 years my dosage needs to be increased but I can't get it increased because my doctor isn't allowed. It seems like a big circle of non-ending pain, unfair rules, and it leads to even more depression and anxiety that I already have. I really hope someone reads this and understands. Not everyone is the same, not everyone breaks rules, not everyone overdoses, not everyone fails drug tests, people who have been on long-term pain management need help to be able to get their milligrams up in order to get the continued Care they need and deserve. Thank you so much for reading this and I really hope with all my heart that things change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97b87	Anonymous	None	2022-02-20T22:17:10Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-p6xd-zax7	False	None	False	2022-04-12 03:13:44.598	[]
1106	CDC-2022-0024-1112	https://api.regulations.gov/v4/comments/CDC-2022-0024-1112	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The following is a letter I wrote back in 2015, even before the CDC's 2016 Opiate guidelines. I think I wrote this to my insurance company at the time. As you can see, the problems for the legitimate chronic pain patient have been going on for a long time. We need to fix this problem.<br/><br/>Written 08/13/2015<br/>To whom this may concern:<br/>I feel that this survey needed a little more input than just the survey. <br/>I’ve been having a real problem with this provider for a very long time. I’m a chronic pain patient and have been for many years, starting at about age 19. I’ve been with this provider since about 1998. I’ve always presented with chronic spine issues and this is the biggest health issue I have. Otherwise, I’m a fairly healthy individual. The problem is that I started on a low dose pain killer treatment in 2001 as ordered by this Doctor. I’ve been on the same regiment with slight increases and decreases in my prescription depending on how I feel that day or any related injuries I may have incurred. So, for nearly 14 years this has been my life…pain of some form on a daily basis. <br/> However, as of the last 3-4 years I feel that I’m nearly harassed about my use of prescription painkillers. By most standards, mine is considered low dose and I take them less than how it’s prescribed ( 3-4/day but I’m typically less than 2/day. I feel that I’m good at self regulating the use and my deterrent from taking more is I feel almost toxic with too many in a day’s time. Over the years I’ve run the gamut of alternative treatments, OTC medicines, etc. While some have helped and others caused additional problems, nothing has compared to the relief I get from opiates. So, I choose as a patient to continue this routine along with other holistic approaches. The fact that I haven’t increased my use is due to my involvement in activities and other treatments that I include in my daily routine. I don’t feel it has ever interfered with my life to a point of necessitating a discontinuance or intervention. <br/>The problem is that this Doctor now has such a mind set to get me off of this regiment that I don’t feel that I’m even listened to and consequently ignored about any other health issues I have. On many occasion I’ve talked about other issues only to find it never mentioned on my medical history. It seems to me that he can only focus on trying to discourage me about my use and blocks his mind of anything I have to say. His demeanor is often passive\aggressive towards me and is very uncomfortable. I sometimes come home to my wife, depressed due to my meeting with my doctor. In fact, he’s urging me towards treatments that indicate this is a psychosomatic dysfunction and not really a physical issue. This (redacted) as he refuses to understand what I’m really going through.<br/>I fully understand the campaign to reduce opiate use in our society as I’ve directly seen the problems that narcotics cause for some. However, why should I be penalized? <br/>Unfortunately, I’ve tried to find another doctor here, (redacted), but we have a critical physician shortage and finding another doctor is impossible. I’ve called and all have closed even their waiting lists. It’s very frustrating. <br/>So, I only hope that this strikes a chord with someone and maybe changes can come about that make me feel like I’m truly cared for by the medical community. Otherwise, I may have to turn to illicit sources such as heroin and what have we really gained at that point?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f976e7	Cook	None	2022-02-20T22:18:50Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	kzv-hupe-8mym	False	None	False	2022-04-12 03:13:44.956	[]
1107	CDC-2022-0024-1113	https://api.regulations.gov/v4/comments/CDC-2022-0024-1113	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe we went way too far in the opposite direction and had a knee jerk reaction. As a result, people with a real need for this medication can no longer get it, or were forced to go to pain management, or even worse, the streets, to get it. My own mother, who had scoliosis, and a few other painful conditions, was on them for 25 years. For years before the rules changed she got a 3 months supply mailed to her house! Not once did she run out, need to order early, or have any problems with them whatsoever. She could barely walk, and was required to go to pain management in person every month, pee in a cup, get grilled on what she was doing, and the doctor would try to wean her. The next month she would be back letting him know that she needed to go back to her dose that she had been on for 25 years and they reduced her instead! Finally, after some months of being in terrible pain, they started increasing her again, but it was a fight at 84 years old. Eventually she was bedridden, and then the only way to get them was for her to go on hospice since she could no longer go to the doctor's office herself! DISGUSTING!<br/><br/>And my best friend whom I loved dearly who passed away from breast cancer. She would call me while driving around all day after chemo to try and find a pharmacy that would give her what she was prescribed. She was DYING, and the pharmacist at Walgreens yelled at her in front of other customers that her doctor should be weaning her instead of increasing her dose until she started crying and told him "I am not going to be weaned, I am dying"! And then he refused to fill it because it wouldn't leave him enough in the pharmacy to give to other customers as they were being rationed to each store. She finally went on hospice and it was the first relief from the pain in months.<br/><br/>I myself have CRPS. I have had a spinal cord stimulator implanted in my back but still get major flare ups where my ankle swells up like a balloon at night. Even going to the emergency room they will not prescribe for me. Mostly because most of them don't know what CRPS is or that it's rated number 1 on the McGill index of pain, surpassing cancer pain! And I do not want to go to pain management as I don't need to take then every day, but if I don't take them and they test me I will get thrown out of the clinic. DOES THIS MAKE ANY SENSE TO YOU??? I am trying not to take too many so I don't get addicted and they won't prescribe them to me unless I take them every day. I only need them a couple of times a week so now I just take tons of Tylenol and Aleve and am ruining my liver and kidneys. See anything wrong with this picture?<br/><br/>You HAVE to change this. People are commiting suicide and have no quality of life. I have honestly thought about it myself. Please, make this a case by case basis. I am a substance abuse counselor as well as a person in pain so I am not advocating that we throw all the restrictions out the window. What I am saying is that it is pretty easy to tell if someone is abusing their medication as they run out early, and have all kinds of withdrawal symptoms going on that can be spotted fairly early in the process. If that happens, send them back to pain management. Pain management places should be the last resort as for the most part they feel shady, and you feel like everyone is suspicious of you. And you're fearful that they will cut you off if you do something wrong. It's uncomfortable, and humiliating to have to pee in a cup to get medicine you really need. PLEASE!! We have to do something different.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97a0a	Anonymous	None	2022-02-20T22:20:04Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-hftm-7bb6	False	None	False	2022-04-12 03:13:45.236	[]
1108	CDC-2022-0024-1114	https://api.regulations.gov/v4/comments/CDC-2022-0024-1114	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I fractured my humerus and had reverse shoulder replacement. I was in the trauma center for 8 days and under treated for pain because of "new rules" and an anti narcotic mindset with younger doctors and nurses who are unaware of the previous hundred years of pain management.<br/><br/>It wasn't just me. Every night there was horrific screaming, crying, and moaning from nearly every room. This was met with screams back Give them some [redacted] pain meds"<br/><br/>The first doctor in the ER, who was about 60, told me he could have made me comfortable if it happened before 2014. I had to wait even though the first dose had no effect and my BP kept rising. <br/><br/>Most of the younger doctors and nurses were anti opiate zealots. I was given BP medication rather than pain meds to deal with high BP from pain. I have never had high BP in 62 years.<br/><br/>I cannot take NSAID because I take Eliquis. So I only have useless Tylenol. The last prescription I got from the surgeon was for 12 Tramadols (the same amount our 15 lb dog got from the vet). I have the $240K hospital bill that list every med given to me including the $14 Tylenols. I was given the lowest or second lowest dose of each medication (morphine equivalent). The same as 2 Percoset. The same as you woukd get from the dentist 10 years ago. That is ridiculous for a trauma patient with a broken humerus hanging off his body. Every slight movement was excruciating. The risk of dependence would be the least of my problems.<br/><br/>This anti opiate hysteria is dangerous. I am traumatized and will never subject myself to another painful procedure or treatment again even if my life depends on it. I am in another FB group about pain, chronic pain patients are taking their lives at such an alarming rate. You are contributing to the opiate problem by forcing pain patients to use dangerous street drugs. Causing survivors of torture to never seek treatment again. People like me that cannot take NSAIDs have no options now. My hematologist said someone with my other condition (Post Thrombotic Syndrome / Chronic DVT) would have life long opiates but he said that he is having trouble helping his terminal patients. There is no other option for me other than Tylenol.<br/><br/>This thinking is dangerous and has real implications. You people are cruel to create this new mindset.You are fueling the opiate OD problem by forcing people to use street drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f974ea	McLean	None	2022-02-20T22:25:09Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from McLean, Michael	kzu-vuq1-7iw8	False	None	False	2022-04-12 03:13:45.468	[]
1109	CDC-2022-0024-1115	https://api.regulations.gov/v4/comments/CDC-2022-0024-1115	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should rescind the opioid prescribing guidelines altogether and stop trying to practice medicine. The 2016 guidelines led to unprecedented patient abandonment and suffering by physicians. And even though the guidelines were intended for general practitioners, nearly EVERY physician took them as gospel such that surgeons are denying post-op pain medication, and even pain management specialist who regularly prescribe opioid pain medication are denying patient regardless of their conditions. My own wife who suffers from EDS has been denied treatment by many doctors. She used to function fairly well with some mobility and quality of life while on opioids for chronic joint pain and benzodiazapines for autonomic dysfunction. But the hysteria created by the guidelines caused one doctor after another to deny her treatment saying it was unsafe to not only co-prescribe those medications, but to prescribe her opioids at all. She became bedridden and has zero quality of life anymore. All because of the hysteria created by the CDC guidelines. They have ruined my wife's life. I have also read countless accounts in chronic illness groups online about the exact same scenario my wife went through. It truly is a horrific catastrophe that has unfolded over the last several years, where millions of people with chronic illness are treated like addicts, and people with injuries and acute pain issues are given no effective pain medication in hospitals (Tylenol doesn't count since the dosages required to actually control serious pain are highly toxic). Rescind the guidelines altogether. Stop the abuse of people in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anders	None	None	0900006484f96c99	Angstrom	None	2022-02-20T22:25:47Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Angstrom, Anders	kzu-ov4w-2wrk	False	None	False	2022-04-12 03:13:45.690	[]
1110	CDC-2022-0024-1116	https://api.regulations.gov/v4/comments/CDC-2022-0024-1116	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted]. I want to tell you why I should be able to receive a prescription for opiate pain relievers. I’m 66 year old man from time to time maybe once a month or or every other month I start feeling a debilitating pain. It’s on the left side of my body. Doctors can’t seem to find out what causes the pain. When I have this pain. I can’t do anything I have to rest till the pain goes away. This is been happening for years. The pain may last a week or so. When I take a Percocet or a OxyContin the pain goes away, and I’m able to function such as working around the house, and able to run my errands. To me it’s almost as if my body does a 180 the opiate pain reliever is like a miracle pill for me. I only use them as needed until I feel normal. So I may take them for a week or a couple days. I don’t know how much time I have to live maybe if I’m lucky 10 to 15 years, but I shouldn’t have to live in pain the rest of my life. If there’s a pill to make me feel better during these bouts of pain. I thought doctors were suppose to help people feel better when their in pain. So if there. ’s a pill available to help function through the pain. I don’t see why doctors can’t prescribe it for people.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484f97408	Anderson	None	2022-02-20T22:26:33Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anderson , Joseph	kzu-ocr1-u6vn	False	None	False	2022-04-12 03:13:45.933	[]
1111	CDC-2022-0024-1117	https://api.regulations.gov/v4/comments/CDC-2022-0024-1117	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a pain patient for 20 years. My doctor retired and I had to get a new doctor, I was on 500mg a day morphine and was able to work and function. I did not get on that amount overnight it was over years. The new doctor said because of CDC guidelines she could only do 90 mme a day dosage it was not based on my pain but she was worried about her license. I had no other choices because all the doctors were afraid of government over reach in their practice. So after several bad months of with draw they got me to 90 mme. This has affected my life dramatically. I can no longer do the things I could with the right amount of pain relief, I am now facing early retirement which will put my wife and I in a tight spot. Without my job I will not have insurance without paying very high rates I am 64 and my wife is 63 so we do not yet qualify for Medicare. I have worked and been productive my entire life and because of a hap hazard guideline being released that was getting in the way of doctors patient decisions and looked at as gospel. I am glad to see this is being looked into again because each individual patient is different and it should be the doctors decision based on examining the patient what works for them.<br/>Not all pain patients are junkie drug seekers,yet we are treated that way. It’s ashamed that blanket statements by the CDC are thrown out as if they are law, and scaring doctors into making decisions not based on their patients well being but what they interrupt as all they can or will do. Being in pain is a terrible thing but when managed properly it can be lived with allow people to lead normal lives.<br/>I would like to see doctor patient decisions be made by doctor and patients not a group of people completely removed from the situation making guidelines , and judging by the doctors reactions I would say that there is also a threat on them rather real or perceived that affect their decisions. The opioid crisis is not from pain patients and these doctors. I believe open borders and the influx of illegal drugs coming in have a lot more to do with it. I do wonder at times how many people In pain could not bare the restriction on their pain medication the last few years and may have made bad decisions and going to other sources for pain relief and ended up dead. This would ultimately have been their choice but they may have felt abandoned by the system that at one time was trying to help them.<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M	None	None	0900006484f973d6	L	None	2022-02-20T22:27:26Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from L, M	kzu-mg3b-zmbp	False	None	False	2022-04-12 03:13:46.162	[]
1112	CDC-2022-0024-1118	https://api.regulations.gov/v4/comments/CDC-2022-0024-1118	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/> I've had four major back surgeries. Three of those were by a doctor who caused more damage and pain. Since then I've tried epidural injections, physical therapy, an implanted Spinal Cord Stimulator (another surgery), TENS unit, acupuncture, the Quell device, supplements and many combinations of medications. For over seventeen years I've had two medical conditions: LUMBAR ADHESIVE ARACHNOIDITIS and a SYRNX in my spine. Both are lifetime conditions with no cure at this time and the pain is constant. Opioids are the only medication that lower my pain intensity and make life more bearable. An addict uses drugs to escape life. A pain patient receiving legal pain medications use them to rejoin in life. <br/>Some patients have been on opioids for decades. After that amount of time some patients have needed to increase (with their doctors approval) the daily MME. To say what works for one person should work for another, is incorrect. Most doctors could tell you this is fact. Please don't tie doctors hands when it comes to knowing what works for their patients pain. Placing a daily MME limit will cause more problems than it will help. I am not an addict. I depend on my pain medications to do my daily living chores and hygiene. Without them I'd be bed bound, needing others to care for me. I cherish my independence. Don't take it away from me. Please.<br/><br/>Thank you for reading my comment. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f981a0	Anonymous	None	2022-02-21T00:53:56Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-ysqj-zscu	False	None	False	2022-04-12 03:13:46.454	[]
1113	CDC-2022-0024-1119	https://api.regulations.gov/v4/comments/CDC-2022-0024-1119	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from debilitating chronic pain for 4+ years. There is a PAIN CRISIS in this country and I feel as though I am being left behind. I have tried just about everything under the sun, and it’s maddening that there are so many hurdles just to even have a conversation with providers about opioids, let alone to possibly get it prescribed in a manner that would be individualized to my case. People like me are not “drug seekers.” We just don’t want to live in pain. This shouldn’t be a radical position or ask.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484f97e9d	Lerner	None	2022-02-21T01:02:39Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Lerner, Sarah	kzv-vc80-6inp	False	None	False	2022-04-12 03:13:46.667	[]
1114	CDC-2022-0024-1120	https://api.regulations.gov/v4/comments/CDC-2022-0024-1120	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an emergency medicine clinician that prescribes opiates and a chronic pain sufferer, I feel it is important to maintain a balanced approach to prescribing opioids. All medications have risks and those risks must be weighed for each individual patient. Many people cannot take NSAIDs and find acetaminophen ineffective. When such a person breaks a hip, it's hard to tell them to meditate or "take a walk." <br/><br/>If it weren't for advanced spine surgery and long acting opiates, I would have had to quit emergency medicine 20 years ago. I know that my patients and coworkers are glad that I was able to continue my practice, especially since the pandemic began.<br/><br/>When I assess whether an opiate medication is appropriate for a patient, I ask myself, "would I want this for my mother?" When you publish your guidelines, perhaps you should ask yourself the same question.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Craig	None	None	0900006484f97e8f	Sheerin	None	2022-02-21T01:03:04Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Sheerin, Craig	kzv-v152-g11x	False	None	False	2022-04-12 03:13:46.918	[]
1115	CDC-2022-0024-1121	https://api.regulations.gov/v4/comments/CDC-2022-0024-1121	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an RN, or was rather, til my body fell apart in 2004. I was dx with fibro and ic at that time. I was seeing doctors who called me a hypochondriac and said that as a woman we don’t understand our pain. That was the beginning of my journey. I found a caring pain mgmt doctor who believed me and helped me get my life back by taking OxyContin 10mg BID and 40 mg oxycodone per day. I never failed a urine test, I never tan out early. I knew the consequences of abusing my meds and never had the urge or need to do so. Come 2017 my life was ripped out from under me. My long acting meds were taken away and I have been on 90mme of oxycodone since then. I’ve been dx with Sjogren’s, SEVERE DDD, early onset OA, gout thanks to heredity and probable lupus. It didn’t matter what new painful condition I was dx with. I was on 90mme no matter what. I had 3 surgeries through this nightmare. A lumbar fusion and two knee replacements. I got very little pain meds for these. The knees weren’t so bad but my fusion was so painful!! Trying to do PT and move, walk, turn so that I can heal was hell on earth. I personally know several people with IC who have committed suicide due to unending pain. We are HUMAN BEINGS!!! This is the United States and I saw people who would rather die than live in that pain. We no longer had a doctor patient t relationship!!! You get what you get for fear of the doctor losing his practice!! I also know people who have turned to street drugs. People who would never think of physically seeking any drug to help their pain. These are some of the statistics of the 2016 restrictions!! Pain patients rarely abuse our meds. We don’t want a high. We want to do our laundry. We want to clean our homes! We want to buy groceries and gain some independence back. Please, give my doctor the ability to prescribe what HE thinks is best for us. Please get rid of the crazy loops we have to go through to even get our meds from the pharmacies!!! We’re SICK. We shouldn’t have to call pharmacies to find our meds only to have to get the doctor to send in a new RX to that pharmacy. Treat us as humans. Have faith in our doctor and in US!! We want to live our lives again. Not spend most days in bed!! Thank you. Oh, and remember most if all that we are human beings and we have real, intractable pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97e4f	Anonymous	None	2022-02-21T01:04:07Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-tzxf-1q8e	False	None	False	2022-04-12 03:13:47.151	[]
1116	CDC-2022-0024-1122	https://api.regulations.gov/v4/comments/CDC-2022-0024-1122	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Health Services. <br/>Please rescind the 2016 guidelines for pain medicine or please allow the Doctors to choose if they wish to prescribe pain medicine or not. I am a 47 year old female with fibromyalgia. I suffer daily with pain. I can’t even tell my Doctor because I know she won’t prescribe me any pain medicine because of the law. I live with pain daily. Sometimes I’m in bed rolling around in pain. Please. Please change the law. <br/>One day the laws you are making will affect someone you love too or maybe even you. I pray not though, no body should live in pain every day, every second. <br/>Thank you. <br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Courtney	None	None	0900006484f981c1	Waricher	None	2022-02-21T01:05:08Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Waricher, Courtney	kzv-zu8m-1rd5	False	None	False	2022-04-12 03:13:47.386	[]
1117	CDC-2022-0024-1123	https://api.regulations.gov/v4/comments/CDC-2022-0024-1123	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife shattered T12 vertibre in 2006, which left her in severe pain but thankfully no paralysis. Since that date she has had multiple procedures to help with her pain. She has hat multiple vertibro-plasties, spinal cord stimulator, nerve blockers, physical therapy and mental therapy. The only thing that allowed her to have any kind of a productive life is her pain medicine. Working with her doctors she was on a high dose of opioid medicine. She discussed the risks with her doctors and the benefits outweigh the long term effects. Since 2016 she has not had her pain managed very well. The risk of not having her pain under control are very bad. She can not attend our son's athletic events or school functions, she can not keep up with her household chores or barely go out to dinner. This has not only taken a large toll on her physically, but her mental state also. I know she has contemplated ending her pain permanently. My wife's doctor's agree that in her situation she would benefit from over the 90MME amount, but are afraid to prescribe it to her. Please give the doctors back the ability to help their patients that really need the help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dave	None	None	0900006484f81d33	Hoffman	None	2022-02-21T01:15:11Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Hoffman , Dave	kzr-5hwc-s97q	False	None	False	2022-04-12 03:13:47.616	[]
1118	CDC-2022-0024-1124	https://api.regulations.gov/v4/comments/CDC-2022-0024-1124	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I will make this short since doctors are short with us of chronic pain patients. For me personally that have been on meds for a diskectomy and fusion and now something new. I moved to [redacted] for a better life and have done nothing but think of was to take myself out because NO doctor would give me my meds that I have been on for years and never ever failed a test. I was dismissed from my primary Dr because he helped me for two months with one med till I was able to get into a pain management clinic. Now I have no primary Dr . Now I’m being put on Subox for pain??? This is my mri I just got last week. People should NOT have to suffer like this , if we are playing by the rules , Not putting everyone in the same boat and judged as an addict.These new rules are killing people!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484f822a2	S	None	2022-02-21T01:18:07Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from S, Tracy	kzr-cftk-rq1p	False	None	False	2022-04-12 03:13:47.931	[]
1119	CDC-2022-0024-1125	https://api.regulations.gov/v4/comments/CDC-2022-0024-1125	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who has suffered from chronic pain for over 22 of my 40 years, the current guidelines have compounded and even harmed my situation to the point of contemplating suicide. I have had multiple back surgeries as the result of a vehicular accident and endured multiple complications including CSF leaks and bacterial meningitis. I have been diagnosed with failed back surgery syndrome, arthritis throughout my spine, stenosis, and most recently, severely collapsed discs from L3-S1. In January of 2021, I could not walk and had to be transported via ambulance to the ER where I was given a shot of morphine but was sent home empty handed and told to call a spinal surgeon. I then had to wait over a month to get into the surgeon and was never prescribed medication to help me through a time where it took all the energy I had just to bathe myself. I have habitually been treated as a drug seeker by my doctors when I complain of pain, and as such, I have stopped mentioning my pain. This has increased my depression, enhanced my feeling of isolation, and as aforementioned, led me to the brink of suicide. Imagine a life of severe physical pain where no one with the ability to help will, and moreover, treats you as if you are a drug addict rather than a victim of circumstance. It's appalling to say the least, and I have told my family that if I ever give in to suicide, they should go after my doctors and law makers to the fullest of their abilities to help others in my situation who no longer have hope of just FUNCTIONING. Many chronic pain sufferers are only wishing to medicate to FUNCTION; we have given up all hope of the idea of 'no pain', yet those without chronic pain do not understand this and are the ones calling all of the shots. I have been to pain clinics and have had over half a dozen epidurals, all costing at least two grand a pop, with no relief. I have passed my pain doctors' drug tests, attended physical therapy (which is not cheap), and have jumped through all of their hoops only to be told there's nothing more they can do for me. Heaven forbid they write a script to help get me through when the pain is unbearable. Shame on the lawmakers, doctors, and CDC for victimizing those who ACTUALLY need opioids rather than dealing with the real problem, which is the drugs on the streets and open immigration leading to more Fentanyl and drug overdoses than ever before. This needs to STOP. STOP penalizing the law abiding citizens of this country who have already suffered enough.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8d6ee	Anonymous	None	2022-02-21T01:19:55Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-xmx5-2g8b	False	None	False	2022-04-12 03:13:48.244	[]
1120	CDC-2022-0024-1126	https://api.regulations.gov/v4/comments/CDC-2022-0024-1126	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Reporting about a close friend.<br/>He is 84 this year. History of back surgery and both knee replacements. Has been using antidepressants plus opiates for 25 years. In 2015, was prescribed 60 mg/day oxycodone by pain doctor. In 2019, same pain doctor cut him off cold because his regular MD prescribed a small dose of alprazolam to help him sleep. My friend says he told both doctors what he was taking and suggested they talk to each other. I guess doctors don’t do that anymore. He goes back to regular MD for help, gets tapered to 40mg for one month. Went into shock and to ER visit, still no help. Went to Rheumatologist he had seen yrs ago, and after two hour long visits, he was prescribed 60mg oxycodone/day. Only inconvenience now is the monthly UA. He still feels victimized by the pain management doctor and he worries constantly that there will be no help if his elderly Rheumatologist retires. <br/>I have been friends with this man for 30 years. These last 3 years have been extremely disruptive and traumatizing for him. He is a veteran and has contributed by working and supporting his family for as long as he was able. What these CDC guidelines of 2016 resulted in for him was extremely traumatic and life threatening. No one deserves to be treated like this. <br/>Problem remaining is that doctors fear the DEA!! This must be changed so that the doctor/patient relationship can be restored for all patients who need treatments for pain.<br/>Thank you for considering our comments.<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97182	Anonymous	None	2022-02-21T01:22:52Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzu-2tdu-g4lr	False	None	False	2022-04-12 03:13:48.567	[]
1121	CDC-2022-0024-1127	https://api.regulations.gov/v4/comments/CDC-2022-0024-1127	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Iam a 50 year old woman who suffers from liver cancer, cirrhosis, upper and lower scoliosis, spinal stenosis and spondylosis, epilepsy etc. I have been on pain management with the same drs. receiving 100mg of medication, and to taper me down to 20mg is pure torture. I have went from working for taxes and payroll as a data entry clerk to a person who can barely make it out of bed, take a shower etc. My life has become unbearable and I am on palliative care. I hope that you take the people with true illnesses and pain issues seriously. Please remove the mme guidelines. I would do anything to be able to enjoy my life, go back to work and most importantly have my children and grandchildren in my life again. They are in my life, but I don't like them seeing me like this, it is pure torture. Iam dying at a young age and I'm spending these last days in severe pain unable to do the things I love best, or just plain be human without screaming in agony. Please remove the guidelines and allow our doctors to continue our care. No more suicides. Thank you from [redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angelita	None	None	0900006484f972a3	Torres	None	2022-02-21T01:24:11Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Torres, Angelita	kzu-7fse-0izz	False	None	False	2022-04-12 03:13:48.850	[]
1122	CDC-2022-0024-1128	https://api.regulations.gov/v4/comments/CDC-2022-0024-1128	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in chronic pain. I hurt SO MUCH I've gone through a divorce and lost custody of my son because my ex husband is TIRED OF HEARING ME COMPLAIN!! IT IS NOT FAIR THAT I SHOULD SUFFER IN PAIN BECAUSE SUPPOSEDLY others are getting high	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484f96a93	Winkelman	None	2022-02-21T01:24:57Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Winkelman, Stephanie	kzu-aghc-qu91	False	None	False	2022-04-12 03:13:49.095	[]
1123	CDC-2022-0024-1129	https://api.regulations.gov/v4/comments/CDC-2022-0024-1129	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel that people who have temporary or chronic pain have to be penalized because of the abusers who use opioids for recreational use. If someone has medical need they should not have to rationed. I have in the past had surgeries and needed strong pain relief and just got a small amount of meds.this is wrong.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484f96aac	Laruccia	None	2022-02-21T01:25:17Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Laruccia, John	kzu-b053-o3z6	False	None	False	2022-04-12 03:13:49.382	[]
1124	CDC-2022-0024-1130	https://api.regulations.gov/v4/comments/CDC-2022-0024-1130	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Remove all mention of morphine milligram equivalent from the updated CDC guideline.<br/><br/>-Best<br/> [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rick	None	None	0900006484f96abb	Schiel	None	2022-02-21T01:25:44Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Schiel, Rick	kzu-b6es-cdcn	False	None	False	2022-04-12 03:13:49.644	[]
1125	CDC-2022-0024-1131	https://api.regulations.gov/v4/comments/CDC-2022-0024-1131	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve worked in the pain-management industry and I’ve been a long-term pain patient myself. After all these years, I’ve come to the conclusion that America’s efforts to cure itself of the “opiate scourge” has only backfired. The CDC’s own data spells this out very well. <br/>As a medical professional, I’ve been witness to things I would best describe as atrocious. The Cures Act of 2016 gave carte blanche to the medical industry without any real meaningful oversight and without any policing. Add greed and a lack of ethics and you have a recipe for abuse. I have innumerable anecdotes to back up my assertion. <br/>I’ve also been an advocate for the chronic pain community for about 15 years. One question I would always ask a patient is if they felt there was a greedy side to their doctor experience and the answer was always yes. I would ask this question because it was common theme with most of my experiences as well.<br/>The Cures Act, with its opiate guidelines, created a massive industry dedicated to pain treatment. It also created a breeding ground for a myriad of abuses. In the midst of all this, I saw how horribly a patient could be treated and how insurance fraud could be allowed to exist. As I read the comments from others, I stand even more convinced of the industries greedy foreshadowing of the opiate mess we now see.<br/>I knew and I predicted this problem long ago. I knew that this “new approach” to opiates as outlined in the first opiate guidelines would cause a mess but I didn’t expect it to be this fentanyl mess. I truly believe that the guidelines of 2016 are attributable to our illicit opiate scourge, just look at the data. <br/>After reading the new revisions, I don’t see the pain patient’s problem getting better. In fact, I predict that this will further fuel the demand for illicit drugs as the prescribing of opiates is further curtailed. This revision looks like an attrition type of approach to slowly ring-out opiates of our society. It looks good for the doctors but frightening for pain sufferers when you look at it further.<br/>I think the authors of the original opiate guidelines and the authors of the new revisions don’t understand the problem I’m speaking about. They obviously don’t understand pain but they do understand their assignment. The assignment to curtail prescribed opiate use\abuse will be achieved but the cry of a patients will once again be ignored. <br/>The pain patient community is obviously unique in the terms of medicine and politics. Because of this, we must have laws protecting us or we will always be at the mercy of this Triad of Powers called, Doctors, Insurance Companies, and Legislators. <br/>I beg the decision makers to read each and everyone of these comments. It is here you where you may begin to understand the collateral damage caused by this “opiate war.” There are some incredibly impactful comments here and very heart-breaking some of them. Separate the notion of addiction and try to understand the true need of a pain sufferer. Addiction is one affliction and pain is a recognizable other. Stop punishing pain and start understanding the real problem, please!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f96ae5	Cook	None	2022-02-21T01:27:04Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	kzu-c3t6-k5w1	False	None	False	2022-04-12 03:13:49.888	[]
1126	CDC-2022-0024-1132	https://api.regulations.gov/v4/comments/CDC-2022-0024-1132	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This update doesn’t help the pendulum that has swung so far the other direction. Everyone is different and pain medication metabolism is different and some meds don’t work but putting limits on someone is insane. I live in chronic pain daily and have a plethora of conditions that require pain management. I use a variety of tools to help the pain but not everyone can afford to pay cash for treatments not covered by insurance. One of my conditions is progressive and I’m already almost maxed out according to the dosing guidelines which scares the [redacted] out of me because I’m only going to get worse but yet there is no additional pain control to come. How can you do this to people??? No wonder people are taking their pain control into their own hands. It’s not human to let someone suffer. The street drugs are the problem and not taking meds as prescribed!!!! When you take opioids correctly there is only pain relief. I have a support group and have heard horror stories of people having knee surgeries and getting NO OPIOID PAIN CONTROL I want each of you to imagine having the same care the people does. You live in a different world and I’m so sick and tired of the government controlling how chronic pain patients get treatment. I had to choose between my REM Disorder to treat or my pain because the cdc guidelines say I can’t have the meds that treat both. The guidelines were written by people who benefited from them. They need to be written by pain doctors that treat pain. These guidelines become law and hurt chronic pain patients!!! Where is the pain strategy document?? That should have been done first. We treat animals better than we do humans. It’s extremely sad! Remember your suffering grandparents, parents, siblings and friends when writing this. I just want to live a reduced pain life!!! Let my doctors treat me as they see fit!! Stop this madness	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f96afc	Vallejo	None	2022-02-21T01:28:18Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Vallejo, Amy	kzu-cjt9-xxgm	False	None	False	2022-04-12 03:13:50.192	[]
1127	CDC-2022-0024-1133	https://api.regulations.gov/v4/comments/CDC-2022-0024-1133	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support these updated opioid guidelines, that the easing of restrictions will save lives and save quality of life for those in acute and chronic pain. Opioids are a medical treatment that help so many in pain to suffer less. I have an inoperable syrinx in my thoracic spinal cord and I would not be here without opioids carefully measured safely for me by my pain management team at a pain research center in [redacted]. <br/>Thank you for acknowledging errors in an effort to stop abuse and criminal sales of medications. Thank you for realizing opioids are a necessary medical treatment of many conditions including mine. Patients seeking pain relief are using opioids for physical pain only. Street drug use of any drug is a separate issue. Please let doctors prescribe opioids to people in acute and chronic pain. Thank you. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marjorie	None	None	0900006484f96b11	OConnor	None	2022-02-21T01:29:08Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from OConnor, Marjorie	kzu-d65s-4xyd	False	None	False	2022-04-12 03:13:50.410	[]
1128	CDC-2022-0024-1134	https://api.regulations.gov/v4/comments/CDC-2022-0024-1134	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>CDC Docket 2022-0024<br/><br/>The CDC 2016 guidelines and the new CDC guidelines for prescribing opioids needs to be abolished, not updated. The CDC needs to get out of drug regulation. That's the FDA'S job! The 2016 CDC guidelines were a total disaster and these new guidelines will be another disaster. The CDC needs to worry about illegal illicit fentanyl poisoning period. Nothing else. Let doctors practice medicine without government interference. The 2016 CDC guidelines only hurt doctors and legitimate pain patients. Abolish, rescind the guidelines. Is IDEOLOGY, junk science. The very fact that the authors had CONFLICTS of interest, should have made the CDC abolish the guidelines. The guidelines have been weaponized against doctors. The guidelines have harmed chronic pain patients tremendously. How many turned to the streets looking for pain relief? How many hundreds have taken their own lives? What will it take for the CDC to admit their wrongs? ABOLISH ALL OPIOID PRESCRIPTION GUIDELINES!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f96b1a	Smith	None	2022-02-21T01:29:37Z	None	None	1	None	2022-02-20T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Kimberly	kzu-dc0t-f13u	False	None	False	2022-04-12 03:13:50.636	[]
1129	CDC-2022-0024-1135	https://api.regulations.gov/v4/comments/CDC-2022-0024-1135	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please, please listen to chronic pain suffer's we are not street drug addicts, but are treated worse than one when we go to drug store or doctor. Iam a senior 69 yrs. Old been on pain meds since teen. Appt. Every month,pee tested, pill count, denied at drug stores. I was a guinea pig for [redacted] for scoliosis in early 1960 taught a classroom of doctors at [redacted] AFB hospital. It was a very radical surgery at that time total spine fusion, bone grafted from hip, casted in bed for 1 yr. No therapy, then rod came loose and back in to chip rod off and remove from spine. I was 15 yrs old. Had to learn walk again very very traumatic time. I have lived with pain my whole life, but worked my entire life and still want to except they won't allow you to be pain free. After surgery they said we have no idea what life will be for you as you will be the oldest ones to have this done. I carried 2 children no pain meds for delivery as spine fuse. So I know pain. But today I have lost all, of what is left of my life due to cdc lack of empathy for real pain people.I am left in pain 85% of day, no holiday plans, no social life, no way to make income. Due to doctors who don't want to give pain med. Afraid of cdc and have had horrible pain management doctors who treat you terrible and scream at you, demean you as they know they can because they have the power to leave you in pain. And it happen to me. It's disgraceful out there. Iam up all night screaming pain,crying, dreaming legs won't move, Dr. At univ. Of [redacted]. Won't touch my spine, [redacted] Dr. Won't do knees to many red flags, can't get into spine for pain med. No one what's to be around someone crying in pain all the time, and I don't want to subject them to my pain.<br/>You wouldn't leave a dog in this pain. I have terrible leg pain and fibermyalaga, deteriorating spine. Please Please stop the pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pat	None	None	0900006484f98072	Gray	None	2022-02-21T15:14:06Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Gray, Pat	kzw-tvgv-pzkv	False	None	False	2022-04-12 03:13:50.870	[]
1130	CDC-2022-0024-1136	https://api.regulations.gov/v4/comments/CDC-2022-0024-1136	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Govt should not regulate medication without a license. Since the guidelines were implemented in 2016, I've had two friends who were intractable pain and subsequently committed suicide. If guidelines are driving people to suicide the guidelines are wrong, they are "doing harm"	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9806a	Anonymous	None	2022-02-21T15:14:22Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-tq6c-j45o	False	None	False	2022-04-12 03:13:51.089	[]
1131	CDC-2022-0024-1137	https://api.regulations.gov/v4/comments/CDC-2022-0024-1137	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These useless guidelines for opioid prescriptions have ruined my life. I took Vicodin for 7 years and I was able to exercise for 2 hours daily, work, drive, and clean my house; go shopping, to the beach, to the mountains. Then the new guidelines: just suffer. It took me 6 years of my life, while my spine was deteriorating, to find a doctor who is willing to treat me with the medication that is verifiably and falsifiably effective. The “guidelines” are ruining lives. Can you please give me 6 years worth of time back? No you can’t. TENS machines are quackery. Lidocaine cream does not relieve bone pain and you know it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shawna	None	None	0900006484f98962	Martin	None	2022-02-21T15:15:01Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Shawna	kzw-t3pl-1c7g	False	None	False	2022-04-12 03:13:51.304	[]
1132	CDC-2022-0024-1138	https://api.regulations.gov/v4/comments/CDC-2022-0024-1138	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient who has jumped through all the hoops required. Why do I have to see a doctor every time I need a refill? Noting has changed and I am also made to feel like a drug addict peeing in a cup. Please resend the requirements that make me feel less of a person. I under Ninety days but not every month.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484f98952	Brokaw	None	2022-02-21T15:15:17Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Brokaw, Melissa	kzw-sr58-txyi	False	None	False	2022-04-12 03:13:51.544	[]
1133	CDC-2022-0024-1139	https://api.regulations.gov/v4/comments/CDC-2022-0024-1139	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a RN for 52 years. I have worked 40 of those years in an adult hospital. During that time I have had 2 major back surgeries, Ray cages at L4-5 and screws & plates at L3-4; both of my shoulders are totally titanium. I currently have been told that I need a total knee surgery on my left knee, which I have rejected. As you can see I have paid the price for being an "Angel of Mercy". <br/>Up until 6 months ago, I took one Skelaxin, one Neurontin and one Tramidol, each night to settle the pain of the day. On occasion, not frequently, I had to take an extra Tramidol for a BAD pain day; but, I used extra strength Tylenol if needed.<br/>I am not now, nor have I ever been adicted to any pain medication. Every so often the doctor would have me stop the Tramidol.....no withdrawal, only more severe pain....so she would restart the medication. I am 73 years old and since 6months ago when my doc stopped the Tramidol and told me it was Tylenol or nothing, my QUALITY of life had certainly gone downhill. I am unable to use ibuprofen or aspirin, at my cardiologist's order, due to the 2 stents in my right coronary artery.<br/>I am not alone in this situation. Many other patients are suffering due to the inappropriate use of opiods by those who just want to "get high". I hope the CDC will realize their mistake with the previous edicts and let the doctors be doctors and care for their patients appropriately. The md oath says, "Do No Harm". I say to you that it is the CDC rules doing the harm and doctors having to be complicit in their inability to take care of their patients in need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f98920	Maphet	None	2022-02-21T15:16:19Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Maphet, Mary	kzw-rjsk-3coi	False	None	False	2022-04-12 03:13:51.759	[]
1134	CDC-2022-0024-1140	https://api.regulations.gov/v4/comments/CDC-2022-0024-1140	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For goodness sake, please give the people in chronic pain the medication they require. I'm beyond stressed with mine and if I could, I'd be on the street trying to buy anything to help. I don't even care if it's laced with something that could kill me - cause then I'd be out of pain. They have gone to far with telling us to take friggin Tylenol!!!!! What the hell good does that do???? I swear, I'm 68 and in so much pain I can't bend down to get anything out of the crisper in my fridge. I'm so damn angry, yes people have abused it in the past, I understand that, but I've been dealing with chronic pain since 2010 and due to bad doctors and worse surgeons who have dropped me off the operating table, burned me with lasers, screwed in a hip into soft tissue instead of bone, and that's just for starters. I also have fibromyalgia so my entire body feels like its on fire. This is just beyond ridiculous, I'm considering seeing a [redacted] vet and pretending to be a [redacted] dog!!!!!11	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98906	Anonymous	None	2022-02-21T15:18:56Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-qrn1-srvm	False	None	False	2022-04-12 03:13:51.976	[]
1135	CDC-2022-0024-1141	https://api.regulations.gov/v4/comments/CDC-2022-0024-1141	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People on pain meds. should have a legitimate reason for needing pain meds. Things that can be proven such as X-Rays or MRI's showing the reason pain meds. are needed. You can't prescribe pain meds. just because someone ask for them !! The fakers are making it harder for the real patients to get the pain meds. they need !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484f988f4	Bush	None	2022-02-21T15:19:18Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Bush, Robert	kzw-qarv-dqen	False	None	False	2022-04-12 03:13:52.196	[]
1136	CDC-2022-0024-1142	https://api.regulations.gov/v4/comments/CDC-2022-0024-1142	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2016 I became DIsabled by EXXcessive pain ,I have Polyneuropathy,Bilateral Occipitical Nueralgia Nueropathy in all extremities Cervicalgia,Radiculopathy of CERvical and lumbar region VERtigo Bi lateral carpal tunnel Bi lateral tennis Elbow Right rotator cuff pain .I had A cervical Fusion in Oct of 2018.AFter my fusion I Recieved 2 weeks of %mg pain pills I was told too take on every 6 bto 8 hoiurs .I was Torchured by the Dr the Emergancy roon I then got a FRozen shoulder after my surgery ,I wwent to see my Dr,He Called me a faker so I would leave his practice and he wouldnt have to deal with a pain patient like me .I wewnt to a pain Clinic and THey wanted My primary care to Up my Methadone dose from !5 mg to 20 ,thats when he called me a faker .He wanted me gone ,I wewnt through hell .And I am alive .I am so happy to hear this wonderful news .Maybe i can have a life again soon .Thank you CDC for being honest and please Know more suffering this have beern torture .I want to be at my Daughter wedding .I go to bed at 5pm as the pain is too much.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f988f1	Anonymous	None	2022-02-21T15:20:02Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-q64t-gcl6	False	None	False	2022-04-12 03:13:52.408	[]
1137	CDC-2022-0024-1143	https://api.regulations.gov/v4/comments/CDC-2022-0024-1143	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the revision of this guideline. As a palliative medicine advanced practice nurse, I have seen the negative consequences of this guideline with payors denying medication coverage and physicians fearful of prescribing evidence based opioid therapy for dying patients. I agree with the proposed changes to the 12 recommendations.<br/><br/>I urge you to modify nurse practitioner to include other "advanced practice registered nurses" as all APRNs prescribe opioids such as clinical nurse specialists, nurse anesthetists, and nurse midwives.<br/><br/>Thank you for your work and consideration.<br/><br/>[redacted], PhD, APRN/CNS, ACHPN, PMGT-BC, FNAP, FAAN<br/>Palliative Medicine Clinical Nurse Specialist	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Phyllis	None	None	0900006484f988e3	Whitehead	None	2022-02-21T15:21:02Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Whitehead, Phyllis	kzw-pppp-7ob3	False	None	False	2022-04-12 03:13:52.626	[]
1138	CDC-2022-0024-1144	https://api.regulations.gov/v4/comments/CDC-2022-0024-1144	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understood the need to stop the over prescribing opioids for minor conditions. I recently was sent to pain management for my spinal stenosis, the first thing I got was a lecture that they wouldn’t give me pain meds. I didn’t ask for any. But was made to feel like that’s what I came for, that was such a bad attitude from the doctor. As I said, I believe in guidelines, but people should not have to live in chronic pain if it can be helped. The human body can only take so much! I know people who have turned to alternatives like alcohol, marijuana or elicit drugs. Human compassion must be part of these guidelines. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97fee	Anonymous	None	2022-02-21T15:22:22Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-k98b-gqp9	False	None	False	2022-04-12 03:13:52.857	[]
1139	CDC-2022-0024-1145	https://api.regulations.gov/v4/comments/CDC-2022-0024-1145	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern:<br/> Hello My name is [redacted] I am a 40 year old woman, wife and mother. I’m writing in regards to the cdc opioid prescribing guidelines. I personally feel like the government or any agency should have a say when it comes to doctors treating their patients. I live with chronic severe pain. In 2016 when doctors could no longer adequately treat my pain due to the regulations placed on them, I have suffered in ways many people could never understand. I’ve been on oxycodone since 2011 in 2016 my dose was dropped to the 90mg limit which is just not enough to control my pain. I’ve tried so many other things and medications to try to control my pain such as physical therapy, message, acupuncture, cupping, cortisone injections, chiropractors.etc… All of these things do help if you keep doing them, but it’s impossible, it would cost me $400-$500 a week and that’s no exaggeration. I’ve tried many medications tramadol, gabapentin, lyrica, every muscle spasm medication you can think of. All these medications help a little but cause horrible side affects. I get headaches, dizzy, spinning head, high feeling.etc…<br/>I know opioid medicine has a reputation for getting people “high” and yes when you first start taking it it can, but when someone has been on it for years it does not give you the high feeling, it causes absolutely no side effects at all and it really does temporarily help the pain, so I can live a somewhat ok life. It would be much better if my doctor could prescribe a dose more suitable for me personally instead of a one size fits all approach. I honestly am one of the lucky ones, because I have always taken my medications correctly in 11 years I have not asked for a early refill or lost my medication. My doctor trusts me. I know people who have not been so lucky, they too took their medications correctly but one person I knew was going to a pain clinic that shut their door and he was unable to find a doctor to prescribe to him. They all told him he should be on the medication but their hands were tied and they were scared to help him. He could not live with the excruciating pain and killed himself. My brother had 3 knee surgeries and was in a huge car accident where the car flipped it was a miracle he lived. He too was on pain medications and was cut down to the 90 mg. It didn’t touch his pain and he turned to the streets and is now a heroine junky who is in and out of jail and homeless. That’s just 2 of my personal stories. I’ve read thousands of peoples stories who have similar experiences and it breaks my heart. People who rely on this medication are treated like drug addicts <br/>I know their are people who abuse the medication or don’t need it at all, but it should be up to the doctors to make sure everything is ok. There’s ways to be sure things are being done right, like random drug tests, pill counts, being prescribed narcan as a requirement etc… please don’t punish the people who truly need the medication because of the few bad apples anymore. I’m sure most people think 90mg is plenty, but when you have been on it for years it doesn’t work as well, we should at least be given a long acting form for the break through pain. Please don’t get me wrong these medications don’t completely take away the pain they make it manageable so you don’t end your life. <br/>I was a mail carrier for Usps for 15 years when I had my accident. I was denied initially for workmen comp. I had no choice but to continue working, because of that I did so much more damage. It took the post office over a year to approve my workmens comp and put me on a limited duty, but it was to late. I ended up being forcing to retire with disability from the Usps. Because the pain was unbearable.<br/> At this time I’m not a candidate for surgery, I have hope technics will advance to where I can get surgery to relieve my pain, until then I have to have opioid medication at a dose that works for ME. Thank you for your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shandra	None	None	0900006484f97fdc	Gutierrez	None	2022-02-21T15:24:33Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Gutierrez, Shandra	kzw-j1j1-nrfo	False	None	False	2022-04-12 03:13:53.072	[]
1140	CDC-2022-0024-1146	https://api.regulations.gov/v4/comments/CDC-2022-0024-1146	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am begging u to take all mme out of the guidelines ..u say that it's between patients and Dr .but that's not true cause if it was u would not have no guide lines on the CDC ..u guys are hurting sick dieing people like myself ..I can't even get a pharmacy here in the state of [redacted] to fill my pain script s they all say them can't fill over 40 miles from here so my Dr is in [redacted] .there is no pain Dr here in [redacted] to help with serious pain .I'm on palliative care and still being treated bad ..please changed this ..and do away with all mme mention in the guidelines or do away with it all that would be the right thing to do ...thank u	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brandon	None	None	0900006484f98825	Wright	None	2022-02-21T15:25:58Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Wright, Brandon	kzw-iwld-6d5b	False	None	False	2022-04-12 03:13:53.305	[]
1141	CDC-2022-0024-1147	https://api.regulations.gov/v4/comments/CDC-2022-0024-1147	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Finally this is better than the previous nightmare, but not good yet. Doctors should be able ( and feel free) to prescribe what the patient needs. Under treatment of pain is a significant cause of suicide and and even bigger cause of suicidal thoughts. “ one size does NOT fit all and there have been chronic pain suicides directly as a result of scared rabbit doctors who call patients addicts at the very mention of pain. Doctors feel they can refuse to treat pain, and would rather someone due in agony …..than be accused of “overprescribing “. The patient can go to [[redacted]. This is why we dont trust doctors and we dont trust the CDC. It is policies like the 2016 one that show us we dont matter. Doctors put themselves first and their fears of opioids have turned them into monsters. This policy is better but needs to go further to reduce selfish doctor phobia of medication. And btw: personally? My experience being denied needed post op pain meds changed my perspective on healthcare forever. I don’t trust the cdc or any doctor…. And shocker: wont be getting a covid shot because all my trust in “ the medical community” has bern erased by that single post op experience of being denied painkillers and sobbing in pain that could have easily been controlled but wasnt because i could “ get addicted!” ( four days after major surgery , with no history of addiction. Yea right. Sure. It was empowered cruelty. Done with the medical community after that . You guys have a LOT of work to do and this barely scratches the surface. Your 2016 plan was stupid, evil and deadly and cost lives and trust. You’ll never get my trust back and i am not alone. Then when you want people to trust you, and we dont, look in the mirror. I wonder how many vaccine refuser s have bern betrayed by medical cruelty snd thus do no trust you or the white coat minions of agony for “ thee, but not me!” This one for sure.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97fba	Anonymous	None	2022-02-21T15:27:47Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-d7si-99so	False	None	False	2022-04-12 03:13:53.524	[]
1142	CDC-2022-0024-1148	https://api.regulations.gov/v4/comments/CDC-2022-0024-1148	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have degenerative disc disease. When I fully pinched a nerve and lost function of my arm, the ER would not prescribe any pain medicine. I was in agony. I have since had 2 surgeries on my neck and I am still in pain due to nerve damage. After each surgery I was taken off pain medicine when I felt like I still needed it. I am living with the pain drug free now. Some days it's pretty bad. I recently had a wisdom tooth and molar removed and I had to beg for pain medicine. My mother insisted (I am 47 years old) until they prescribed me 10 Tylenol 3's. For a few days my neck and arm didn't bother me nearly as much and it was wonderful. There has got to be a way to balance prescribing medicines safely to those that truly need it. I know I will have future surgeries and hopefully I can recover comfortably with doctors allowed to prescribe necessary medication. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ALEXIS	None	None	0900006484f97f3d	KEELY	None	2022-02-21T15:28:26Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from KEELY, ALEXIS	kzw-7ja2-7o9c	False	None	False	2022-04-12 03:13:53.739	[]
1143	CDC-2022-0024-1149	https://api.regulations.gov/v4/comments/CDC-2022-0024-1149	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. I’m a 66year old woman. I’ve been active most of my life. Retired from 25 years puplic educator. Most of my career in Special Ed ., mostly 6-8 grade students. Love my job. Between activities in my life, I now have PTSD, depression, anxiety, but more troublesome is degenerative bone disease in spine, C2-4 and L2-6 I have taken a lot of OTC pain killers.Twenty years ago my doctor I can’t take OTC pain pills because they have caused problems in my digestive tract. (Barrett’s disease, gallbladder removal, and many other things). Hence my doctor prescribed Vicodin. I would take when I couldn’t do the things I had to do. It helped me through many days and expectations required for maintaining a job, caring for 3 bedridden family members. Sometimes I didn’t know how I could keep going with back pain. <br/><br/>Time goes by and I moved changed doctors. I am ready to give up. My new doctor said it was the same as using heroin and no longer would prescribe Norco. Just like that , thrown out to dealing with extreme pain with any activity, such as daily home and self care. <br/>I have thought about not living anymore but I know that is not how to live an eternal life with God in it. So I sit all day, struggle to get to sleep, and wake up to the same <br/><br/>In my mind I have a lot of things to do. I want to enjoy my grandkids, and the freedom of time to do all those things I looked forward to doing. <br/>It’s ready hard to understand how a doctor can cut your life off by not prescribing a pill that helps make your life doable. <br/>I’m not an abuser or anything of that kind. <br/>Just want my life better and enjoy the life I have worked so hard for. <br/>Need help!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary Kaye	None	None	0900006484f989d2	House	None	2022-02-21T20:15:47Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from House, Mary Kaye	kzx-4yr0-yf38	False	None	False	2022-04-12 03:13:53.951	[]
1144	CDC-2022-0024-1150	https://api.regulations.gov/v4/comments/CDC-2022-0024-1150	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC has contributed to opioid addiction and death. I have suffered from chronic pain for 47 years and have tried every modality possible including 7 years at a pain clinic. Pain clinics need to be outlawed. I imagine no one in the CDC knows about the Spinal Cord Stimulator which I have. It not only intercepts my pain, I now can sleep all night!! When we stand before God's judgment, they Will know who they have killed with the opiates at the pain clinic as opposed to the family physician who used to prescribe them in moderation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f989cb	Martinelli	None	2022-02-21T20:16:10Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Martinelli, Mary	kzx-4tru-v8yw	False	None	False	2022-04-12 03:13:54.199	[]
1145	CDC-2022-0024-1151	https://api.regulations.gov/v4/comments/CDC-2022-0024-1151	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Being a chronic pain patient for approximately 10 years now the 2016 CDC Guidelines made my life miserable. I’ve never taken a controlled release medication nor have I drifted from taking exactly what was prescribed to me and nothing more. I don’t drink alcohol or smoke cigarettes and have led an active lifestyle which included being an equestrian my entire adult life. I’m now 62 years old and until my medication was cut to a fraction of where I was comfortable I was happy and active. Rode my horses at least 5 times a week and cared for my 3 Golden Retrievers daily. Walks, hikes, playing ball etc. I’ve been cut down to a dosage of meds that barely sustains me. Im not sleeping and I can’t preform as I used to before the CDC over stepped their realm of being helpful and turned us into helpless individuals. How is it that my doctors don’t know me better? After 10 years of total compliance I was punished. This is no joke. My life is not a joke nor should it be micromanaged by bureaucrats who never examined me. Im not an abuser. I was a success story. Highly functioning on my medication. Now I have to take more muscle relaxers which make me grumpy and tired all the time. So you took away a drug which helped me function and put me on another drug that makes me feel badly. How does that help? I am not the person who’s contributing to an opioid crisis. Im the opposite. The crisis comes from those breaking the law and careless people who leave medication where children can take them. Why punish legitimate pain patients and their doctors? Because we were the easiest targets. The DEA swooped into my doctors office and slapped down rules which harmed their patients. These restrictions were beyond harsh. They were callous and mean. Not taking into consideration how much harm they caused chronic pain patients was irresponsible. The cap needs to be lifted so we can once again function comfortably. I’d like to live my life and travel without being miserable every day. Hopefully someone who cares and has a shred of decency will read these comments and help those who need help. Thank you for the consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Loretta	None	None	0900006484f989c9	Ambrosio	None	2022-02-21T20:17:50Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Ambrosio, Loretta	kzx-4sxp-764u	False	None	False	2022-04-12 03:13:54.441	[]
1146	CDC-2022-0024-1152	https://api.regulations.gov/v4/comments/CDC-2022-0024-1152	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 73 year old male, diabetic type 2 for 67 years suffering severe spinal stenosis for more than 50 years, I strongly urge additional research before making changes to regulations that adversely impact the truly suffering patients. Severe depression and thoughts or suicide are daily battles I face; similarly experienced by many chronic pain sufferers. Due to numerous other health issues 'we' typically are not candidates for surgical procedures which MAY alleviate some of this ugly, ongoing horrible pain experience.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	jeffrey	None	None	0900006484f989c2	wohlfeld	None	2022-02-21T20:18:25Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from wohlfeld, jeffrey	kzx-4gx6-cvj1	False	None	False	2022-04-12 03:13:54.655	[]
1147	CDC-2022-0024-1153	https://api.regulations.gov/v4/comments/CDC-2022-0024-1153	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While your clinical practice guideline is stated to be voluntary to provides recommendations and not require mandatory compliance, the damage has already been done and physicians who are quite capable of managing the needs of legitimate chronic pain patients no longer do so because previous guidelines were handed down to them as punitive laws by their perspective medical boards. If one with chronic debilitating pain does seek prescription relief (that most likely had in the past before guidelines), they are turned away from doctors offices, hospitals, etc., and told to see a pain management clinic. This is not easy or affordable for most patients so they go without or succumb to other avenues including suicide to escape their daily relentless pain. Do you truly see what has happened here with the interference of these guidelines and how they are not seen as such by most physicians? They'd rather turn people away than risk having their medical board come at them! If people are lucky enough/wealthy enough to travel to a pain clinic, the fees are astronomical for most of us and there are very few clinics who offer actual medication vs. pain injections by anesthesiologists. In my state, there is one clinic that is quite a distance away. And their contracts with people to obtain life saving medications is just incredible. I see people crawling into this clinic in wheelchairs. walkers and if very bad shape that should NOT be asked to make these monthly trips nevermind try to pee in a cup every month ($500 profit) when they can barely walk or toilet themselves alone. It's just beyond cruel and doctors need to be allowed (no matter what it takes to alleviate their fears) to serve their chronic pain patients once again with medications that were known to work well and were NOT being abused by the people who really needed them. People in chronic pain who used their once legal prescription medications safely and appropriately need to STOP being punished by the unsaid rules of the guidelines which somehow magically appear to be LAWS to a physician's eyes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98e86	Anonymous	None	2022-02-21T20:19:19Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-3urw-u28k	False	None	False	2022-04-12 03:13:54.875	[]
1148	CDC-2022-0024-1154	https://api.regulations.gov/v4/comments/CDC-2022-0024-1154	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's sad and ridiculous. Physician's know their patients ,not government agencies. I don't like taking pills to start with, but have digestive issues since I've gotten older. There are medications out there we were given by old school doctors, ours a family friend as both my parents were in the medical field, that doctors today won't prescribe because of fear of getting in trouble. One being Lomotil.<br/>These are condition controlling medications, but doctors now seem to live in fear at the patient's expense. Even old fashioned Kaopectate worked until somebody decided after years it wasn't "proven" and they changed the ingredients to nothing more than Pepto Bismol which does absolutely nothing. If it's physicians making decisions on these things they need to go back to med school and talk to some old school doctors. My former gastrointestinal doctor took me off Lomotil and said angrily he'd prescribe it one more time, but would have to write a letter to the DEA explaining why. That had to be a lie. My internist refused to and told me to take OTC meds which are like putting out a house fire with a water gun. I had to retire early due to a disability because doctors were so afraid to prescribe meds that worked. I know there are some pain meds that are abused,and control is needed, but when doctors are scared to write prescriptions for other meds to control severe IBS or Colitis it's hurting the patient, not helping. My dad practiced for 67 years and never had a problem, but was careful with what he prescribed patient's. He had more pharmaceutical knowledge though, looked at the patient's situation and applied as needed. No more. Never a problem.Today it's absurd though. It's like doctors live in fear of getting in trouble.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98e79	Anonymous	None	2022-02-21T20:20:05Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-3jf7-o4xj	False	None	False	2022-04-12 03:13:55.105	[]
1149	CDC-2022-0024-1155	https://api.regulations.gov/v4/comments/CDC-2022-0024-1155	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Degenerative disc disease sufferer.Chronic pain patient for 15 years. Worked for 30 years before waking up one morning to numbness on the right side of my neck,shoulder,& arm. Left with nerve damage due to amount of time waited for surgery by insurance co. Treated like criminal by doctors and medical staff for needing opioids. Anyone who wants to abuse opioids will get them. People like me who go to doctors and abide by rules take the hit! It's tiresome! The fact I live in a rural town and have to drive 2 hours into another state or 3 hours in state because a regular doctor doesn't want to prescribe opioids is disgusting! I'm 62 years old and fed up!I limped along the end of last year to be with my sister and her husband who was terminally ill. I was at least able to be with him when he died. I was still unable to get my pain meds locally and had to do without! The last Dr. Wanted so much imagining the insurance co. HUMANA turned them down! I am searching for another! If you need pain meds a doctor any board certified Dr. should be able to fill it period!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rosemary	None	None	0900006484f98e60	Edwards	None	2022-02-21T20:23:23Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Edwards, Rosemary	kzx-31cm-a714	False	None	False	2022-04-12 03:13:55.338	[]
1150	CDC-2022-0024-1156	https://api.regulations.gov/v4/comments/CDC-2022-0024-1156	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors are NOT following the GUIDELINES. They are trying to FORCE me and other people to have RISKY EPIDURAL shots even though I had a STROKE with my last epidural. CDC guidelines state NONINVASIVE ways to control the pain. I am a retired RN and I can only get tramadol that only recently was added as a control substance. <br/><br/>With the world Population being almost 8 BILLION people, why can't we take the RISKS to take the pain meds and make BIG PHARMA IMMUNE from PROSECUTION for opioid deaths. I would rather die a year or so sooner than live with the pain.<br/><br/>Everyone should be able to get 2 Vicodins, or 2 Percocet, etc PER DAY for ACTIVITIES of DAILY Living, with it increasing to a Maximum of 4 pills per day at say age 55. But increasing earlier if you have MRI evidence of Arthritis, cancer, terminal illnesses, or definite proof that the person is suffering more pain and they can get 6-8 pills per day.<br/><br/>Please help give BIG PHARMA IMMUNITY from PROSECUTION for opioid deaths, and make doctors prescribe the pain medication OF the PATIENTS CHOICE, following the Number per day guidelines. <br/><br/>Patients just need to know that if the pain meds stop working, they just need to go on a medication HOLIDAY for several weeks and start back at a lower dose and they may have to skip a day or two between doses to get the pain meds to work again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484f98e55	O'Kelley	None	2022-02-21T20:24:06Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from O'Kelley, Patricia	kzx-2sn1-py62	False	None	False	2022-04-12 03:13:55.558	[]
1151	CDC-2022-0024-1157	https://api.regulations.gov/v4/comments/CDC-2022-0024-1157	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi my name is [redacted] I'm 49yrs old. I have had chronic pain for years which was managed by gabapentin until I had a procedure 2018 almost died spent 2 mths in hospital. Gabapentin no longer worked I came home on hydrocodone was sent to pain Dr the Dr took me off hydrocodone and put me on belbuca spelling might be off a film goes inside my cheek to help with pain. 1st night taking it I had hallucinations called my Dr they lowered the does come find out I was allergic to it. Other meds they wanted to try could not because all my meds has to be crushed or chewed. Well after trial of other meds they put me back on hydrocodone along with injections in back and knees. I have seen a surgeon for both back and knees and I am not a candidate at this time for knee replacement and nothing can be done for my back. Since all changes y'all decide to make based on a few bad apples it has hurt people like me. I have been compliant with all my Dr treatments and testing. I went from an income of $45,000 a year to less then $15,000 I do not get Medicaid due to income I do have Medicare advantage but with that comes a $45 co pay Everytime I visit my Dr 1-2 times a month I have passed all my drug test which I never know when until I walk in and they hand me a cup to pee in. All these rules y'all want to put in place is understandable but they need to be able to be adjusted based on each person. Why should I have to suffer because of others the thought of trying a new drug scares me because if it doesn't work or like before an allergic reaction then I have to suffer rest of the month because according to Dr office they can only see me every 30days according to the law they said. Also making it where I have to be seen every 30days hurts someone on disability like I am $45 is a lot of money. Never in my dreams did I ever think I would be in this shape. I worked 30yrs in a nursing home looking after people now I need help and with new guidelines y'all coming up with making it had for me to get that help. I would love one time for government put themselves in other people shoes. This could be u this could be your mama. Sorry so long but I have always been an advocate for my patients now I'm having to learn to be an advocate for me. I can't do it my mama was my advocate I lost her 2019 6mths after almost dieing she looked after me like a baby until I was able to look after myself now I'm asking u to be an advocate and do what is right for people like me yes I know some people are abusing the system but Dr can tell who is and who ain't. I just ask don't make it a one shoe fits all because it doesn't. And people who really need it help them cut back on Dr visits to every 60-90days at the Dr regression. Dr knows who really needs help and who don't. Thanks for listening to me	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f98e51	Hall	None	2022-02-21T20:25:42Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Hall, Elizabeth	kzx-2pn4-z9y2	False	None	False	2022-04-12 03:13:55.792	[]
1152	CDC-2022-0024-1158	https://api.regulations.gov/v4/comments/CDC-2022-0024-1158	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my husband suffers from CPPD and 5 herniated disc. His PCP has prescribed percocet for 18 months, along with agreement by his out of state rheumatologist. His PCP retired and now he has to work with a pain management clinic. He has never abused his medicine, he's actually taken it exactly as prescribed. And it's worked. He can move and lead a normal life. Without them, he would not be able to walk or have his garden, his heart and soul. I am praying the pain Mgt clinic works with him. I don't want to lose my husband to sitting in a chair all day and not being able to function. He doesn't drink alcohol and I've heard from other patients that they drink now on a regular basis and some buy drugs on the street. That scares the [redacted] out if me. I understand if doctors over prescribe and not monitor patients, then there could be trouble for the patients. My husband had quarterly blood work and twice a year in person visits. Suffering is not what the AMA or CDC should ever represent. But I'm afraid the drug cartels are laughing in our faces because they now have the upper hand. Please give the doctors their rights back. They worked so hard in school to care for others. And medicine is what they use to help people. The lumber injections are not FDA approved and only last about 3 months. They can be very dangerous & no one should have to undergo that kind of trauma so often just because a doctor doesn't want to manage a chronic patient on a regular basis. Please...help the millions of Americans not become victims of fentanyl. Thank you, [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jean Ann	None	None	0900006484f98e50	Lopezzi	None	2022-02-21T20:27:25Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Lopezzi, Jean Ann	kzx-2kgc-5f2x	False	None	False	2022-04-12 03:13:56.013	[]
1153	CDC-2022-0024-1159	https://api.regulations.gov/v4/comments/CDC-2022-0024-1159	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mom is 86 In chronic pain seen multiple doctors cannot get any pain medication bad everything no help from anybody no one will give her any pain medication.Wake up the system is broken NO HELP EVEN FOR THE ONE'S THAT NEED HELP.DO THE DOCTORS REALLY THINK THAT MY MOM IS GOING TO O.D SHE JUST NEED'S HELP BUT NO HELP FOR HER IN [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dan	None	None	0900006484f98e49	Adams	None	2022-02-21T20:28:02Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Dan	kzx-2j6q-hk97	False	None	False	2022-04-12 03:13:56.243	[]
1154	CDC-2022-0024-1160	https://api.regulations.gov/v4/comments/CDC-2022-0024-1160	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain due to multiple neck, ankle and shoulder surgeries for the last 20 years. I am an RN with 42 years experience and at times have not been able to work if I am on opioids. I am now retiring and will continue to have a need for opiates. I will be moving from [redacted] to [redacted] and changing health insurance plans I have so much anxiety that my new doctor will not prescribe the medication’s that keep me able to keep moving and have my best life. I’m 64 years old and I can only pray that this doesn’t further close the door to those who need pain medication for chronic conditions.<br/><br/>Respectfully,<br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacqueleen	None	None	0900006484f98e44	Williams	None	2022-02-21T20:29:17Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Jacqueleen	kzx-2bh7-q7sp	False	None	False	2022-04-12 03:13:56.471	[]
1155	CDC-2022-0024-1161	https://api.regulations.gov/v4/comments/CDC-2022-0024-1161	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain will make you insane, chronic pain is never ending torture. Some days you want to run down the street screaming, but you can't because you hurt too much. You cannot ignore so many people in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484f98e41	Ryder	None	2022-02-21T20:29:31Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Ryder, Diane	kzx-28la-ebbl	False	None	False	2022-04-12 03:13:56.687	[]
1156	CDC-2022-0024-1162	https://api.regulations.gov/v4/comments/CDC-2022-0024-1162	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient for 20 years or so,the 2016 guidance was harsh punishment for myself, my family and has scared my Doctor so much that I'm not sure he would consider upping my now meager pain regimen.I suffer daily now,can't sleep past 1:00am because of severe pain,but am stuck in limbo with just trying to hang onto what few pain meds I am prescribed. I am angry at the CDC. My dosage today is about one quarter of what it used to be.Instead of relief most of the day prior to 2016,now maybe I get relief once a day for about three hours.I used to travel to other Countries, not anymore. I used to be able to do some yardwork, not anymore. Now my Doctor won't prescribe above 50 milligrams morphine equivalent. This has been the hardest 6 years,the always tapering,more tapering etc. I used to have a somewhat "normal " life,not so,anymore. You (CDC) may have meant well,but you really screwed over me and many thousands of chronic pain sufferers, and I don't think the pendulum can ever swing far enough to make up for the pain that YOU have caused. What a tragic mistake, what a letdown. Hope you can do better next time,but I'm sure it won't help me. Yeah,what a major letdown, sincerely someone who has lost faith in you. Have a nice day !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98e3a	Anonymous	None	2022-02-21T20:30:10Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-23vh-dzce	False	None	False	2022-04-12 03:13:56.907	[]
1157	CDC-2022-0024-1163	https://api.regulations.gov/v4/comments/CDC-2022-0024-1163	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern,<br/><br/>The concept of MMEs (milligram morphine equivalents) is totally flawed as a therapeutic tool. Thus these guidelines must remove it, if they are to add any value to the treatment of patients who are receiving these drugs for pain relief.<br/>As I'm sure you are aware, the various drugs in this class are absorbed and metabolized differently by different individuals, so titration of each patient on a specific drug is the only sensible way to approach the problem, and this should be left to the physician.<br/><br/>It is clear that the enthusiasm engendered by the previous set of guidelines has done nothing to solve the problem. More people than ever seek illicit drugs when they are unable to get prescriptions to alleviate their pain, and more than ever (>100k annually) are dying from these (mostly fentanyl-laced) illegal pills. <br/><br/>Put prescription practices back in the hands of doctors and pharmacists. Big government oversight is not helping to solve the problem, and is hurting the patients suffering in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MICK	None	None	0900006484f98e0c	HITCHCOCK	None	2022-02-21T20:32:04Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from HITCHCOCK, MICK	kzx-0vt4-nn75	False	None	False	2022-04-12 03:13:57.123	[]
1158	CDC-2022-0024-1164	https://api.regulations.gov/v4/comments/CDC-2022-0024-1164	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After 20 years with the same Dr on the same medications, because of the CDC guidelines, my Dr informed me they would no longer be able to manage my pain medications. I was referred to a Pain Management Dr who did not know of my history nor was a specialist on the Dx's that I have. They were only interested in any pain that was spine-related or back pain. They pushed for painful procedures and injections that are not approved by the FDA like epidural injections. <br/>I had spent almost 5 years getting alternative and non-opioid therapies before ever starting any type of opioid treatment options from acupuncture, massage, chiropractic care, physical therapy, etc. None of which were covered by my private health insurance and added up quickly. <br/>Opioid therapy allowed me to function, continue working, raise my children, care for my aging parents and in-laws, do charitable work in our community, and stay as physically active and healthy as possible. <br/>The changes in my treatment of pain had left me without pain medications for over 3 years, trying everything my Dr's suggested. One of the medications even caused such a horrible reaction that I was hospitalized for 5 days.<br/>My health has deteriorated to the extent that my body has undergone muscle wasting, increased blood pressure, etc. I am at a higher risk of stroke, cardiac events, blood clots, and many others associated with poor physical health.<br/>The risk/benefit factors of use of opioids long term have proven that it is more beneficial for people like me to have the option to continue an active healthy life over becoming a burden to the system from becoming disabled long before I would be if I had access to my previous regimen. I have worked since I was 14 years old and would like to continue to do so. <br/>Please see that just because a person abuses medication, does not mean that everyone will and I should not be treated as though I will, especially when I have proven to be a compliant patient and I have never had any issues in my past regarding the safety of my medications, their use or my intentions for nothing other than having the best quality of life that medical science can provide for someone with my Diagnosis's.<br/><br/>With that, I can only follow up with the suggestion of allowing my Dr's to be the ones who are in charge of my care and not the policies written about things that I have nothing to do with. Overseen and regulated by my doctors based on my diagnosis. My actions, responsibilities, and compliance should be the only reason any medications that worked so well should be discontinued without obvious medical reasons like side effects or blood tests that may result in a need to discontinue. <br/><br/>Stop the continued mistreatment of patients who through No fault of their or their doctors being affected by the misinterpreted Guidelines now turned LAW. It is ridiculous that in 2022 people are suffering link it is medieval days.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f98e07	Emmel	None	2022-02-21T20:33:14Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Emmel, Debbie	kzx-0qeo-zpys	False	None	False	2022-04-12 03:13:57.410	[]
1159	CDC-2022-0024-1165	https://api.regulations.gov/v4/comments/CDC-2022-0024-1165	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I deal with chronic pain every day from fibromyaliga and a brocken that healed right and had to have shoulder replacement which continues to give pain. i cannot get pain pill. It gets very tiring to deal with every day not to mention depressing	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006484f98dfc	Clevenger	None	2022-02-21T20:33:52Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Clevenger, Margaret	kzx-0iew-w1nq	False	None	False	2022-04-12 03:13:57.687	[]
1160	CDC-2022-0024-1166	https://api.regulations.gov/v4/comments/CDC-2022-0024-1166	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The Pharmacist, Of the Netflix Docuseries shone to over 100 million viewer supports a few of the CDC Opioid Rx guideline changes proposed, but disagrees with much. Agree with the change that for patients on high doses of Opioids, urge Doctors to not abruptly halt treatment unless there are indications of Life-threatening danger, also suggestions on how to taper off. As to the other proposed changes I am against. It takes only 3+ days for some patients to become addicted. exceptions for acute pain should be rare so keep this guideline in place. Then agency should make sure that Doctors are aware that in severe pain and in terminal cases , there is no problem and should be no FEAR of Prudent, legitimate Doctors prescribing. Limits on extreme doses can prevent fatal overdoses. High dose opioids form extended periods should also require Narcan or Naloxone also. Restriction on days supply( large quantities) must be must be kept, because patients must be closely monitored and to prevent possible diversion. (pills on the street.) Sadly this can cause some inconvenience but is necessary. Otherwise, Free Flowing Rx Opioids that has led to the huge addiction issues by millions and now much of the reason for over 100,000 deaths a year will continue. We do need more efforts on awareness, education, harm reduction, treatment, and recovery. Prayer, "The Pharmacist" [redacted] RPh.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f98df3	None	None	2022-02-21T20:34:57Z	Tunnel of Hope	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Tunnel of Hope	kzx-07dt-3prz	False	None	False	2022-04-12 03:13:57.956	[]
1161	CDC-2022-0024-1167	https://api.regulations.gov/v4/comments/CDC-2022-0024-1167	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My pain prescriptions were lowered to address a one size fits all dosage that is totally unfair. My dosage was cut by more than half. I have lost quality of life and can no longer care for my home or live my life adequately. I have been told that I have to try to adapt to life without pain meds after being a chronic pain patient for 23 years. I have been prescribed 600 mg ibuprofen, gabapentin, muscle relaxers, Analgesic strips etc. My stomach doesn't tolerate ibuprofen in high doses so I now have to add an acid reducer daily. Every patient is unique and can not all be treated the same just because drug cartels have freely crossed the border...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484f98df1	Peterson	None	2022-02-21T20:35:20Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Denise	kzx-042c-pk0g	False	None	False	2022-04-12 03:13:58.210	[]
1162	CDC-2022-0024-1168	https://api.regulations.gov/v4/comments/CDC-2022-0024-1168	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket cdc-2022-0024-0001 I have been forced to suffer excruciating pain from torn rotator ruptured tendon and have impingement of spinal cord in cervical neck and believe bulging and severe pain of right lumbar.SI. I detoxed under medical supervision from legally persccribed methadone.i done great with soboxine program for years. No failed screens.i go to sleep and wake up with feeling of being torn to shreds.left shoulder arm blade and spine to left side. Medical ER drs,pcp, specialists even used my past( over 8 years ago nearly) and the soboxine then methadone as a reason that I couldn't get actual opioid medicine.im suffering, agony and can't even due physical therapy without intensifying the already extreme pain and discomfort.i am needing help.this condition has/is stealing ability to drive, cook, bath shower stairs. Vehicle riding especially long ways. 1-2 hours 1 way from home to drs office visits.perscribing & telehealth needs permitted by any MD a patient see and definitely positive changes to benefit suffering patients, by the Cdc.gassaway [redacted] resident, in need of pain control to be home or & long term nursing home/ physical rehabilitation. I feel ignored and need prompt attention given to my chronic pain level and for my current [redacted] medical staff various teams TO care more. Respond to calls and make it easier for me/patients to be closer to care, telehealth,or inpatient nursing rehabilitation center near the main specialists needed. [redacted] Neurosurgery.ive asked for admittance to hospital care. Short term facility for my physical problems near the specialists. My requests are put off.because it's complicated for someone in medical team to do the work. Sad!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484f98df0	Drennen	None	2022-02-21T20:37:19Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Drennen , Christina	kzx-01yk-53bv	False	None	False	2022-04-12 03:13:58.473	[]
1163	CDC-2022-0024-1169	https://api.regulations.gov/v4/comments/CDC-2022-0024-1169	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have sever to moderate Rheumatoid Arthritis. I am in pain daily. Because of government interference my doctor has changed his policies for dispensing pain pills. Every time a patient needs a refill we are made to pee into a bottle to prove that we are not druggies. I’m a 72 year old great grandmother who until I was diagnosed with RA I rarely took Tylenol. For ten years I was prescribed Hydrocodone/APAP. Then the government got involved. I went from taking 4 pain pills most days, 8 on bad days to 0 pain pills. I have a problem I can’t pee in a cup at the Dr.office. Never have been able to. No peeing in cup in dr. Office no pain pills. For the past four years I’ve had a very limited life. Some days I don’t even want to get out of bed, I do because I have a life to try to live. My poor husband has had to take over several of my chores because I just can’t do them any more . I feel like I’m becoming a burden to my family because I can’t do the things I want to. I have sever pain in my hands and feet so playing with my great grandchildren is almost impossible to do. I couldn’t even carry my youngest great granddaughter when she was born because my hands hurt and I was afraid that I could drop her. Being a grandparent is one of my greatest joys but without pain meds I’m not safe to take care of them. Tell the government to limit drug companies but not doctors who want to help their patients. I’m not a chronic drug user but I can’t live my best life without pain meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eleanor	None	None	0900006484f98ded	Hansen	None	2022-02-21T20:38:00Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Hansen, Eleanor	kzx-01h3-6zlx	False	None	False	2022-04-12 03:13:58.697	[]
1164	CDC-2022-0024-1170	https://api.regulations.gov/v4/comments/CDC-2022-0024-1170	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The negative impacts these guidelines had on my husband was horrific. His providers began attempting to take his medication away. Instilling fear that he could die. Made attempts to substitute medications that were clearly dangerous given his other medical issues. He was subjected to numerous random urine drug screens used in a punitive fashion. Eventhough my husband NEVER requested increase in his medications, early renewals or ever failed a drug screen in 15 yrs. He was labeled by the stigma around these policies as and abuser, even accused of diversion and was repeatedly challenged about his pain level.<br/>My husband served this country in WAR was injured. His primary care and mental health providers designed a regime that relieved his pain and in turn improved his anxiety and PTSD .. AND ALONG came this guidance that physicians took as threat to their licences as a directive - policy and they overturned years of work. It was irresponsible and poor standard or care and has resulted in un necessary harm. <br/>The CDC failed these people and did unknown harm. What the physicians engaged in was nothing short of negligence - malpractice and dumping of these patients. <br/>Persons closely managed who require relief from their pain should not be labeled with a moral failure stigma, character attacks and questioning of their integrity. Patients should not have to defend their needs and rights to compassionate care..But all who engaged in this panic driven policy should have to now justify conduct that clearly was unethical, uniformed and unnecessary and violated patients rights.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98deb	Anonymous	None	2022-02-21T20:38:39Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-01di-g9ka	False	None	False	2022-04-12 03:13:58.914	[]
1165	CDC-2022-0024-1171	https://api.regulations.gov/v4/comments/CDC-2022-0024-1171	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had 5 kids in the last 7yrs. And meningitis a few years ago. The combination has caused sever back and hand pain. It has triggered an autoimmune disorder that we are trying to figure out exactly what it is. I have been to the rheumatologist. Had imaging done. Been in PT. Nothing is working. I also have pain in my right shoulder that has worsened over the last 15 years from a car accident as a teen which has caused severe shoulder pain. I can't play hop scotch with my kids or throw a ball due to the pain. When I went to the doctor i was almost scared to tell them due to not wanting to look like a seeker. I was a nurse in a pain clinic for a few years and have been in health care for 22. The pain is debilitating. Almost on a daily basis my kids say,"Oh mom can you not do this with us because of your pain?" Even with the medication I am on, it sometimes still isn't enough. I am 36yrs old and do not want to be in pain meds, however I have young kids and can barely get out of bed without them. I can't play and have fun with them like I want to. My insurance only covers medication every 30 days however the doctor's office can only give 28 days worth, so I am having to pay out of pocket every other month. Some people can't afford to do that. My mom has Multiple sclerosis. She has a baclofen pump. She is on pain meds daily. Every once in a great while her pain increases. I have watched her cringe in tears from it. The few times I have talked her into going into the ER, she was treated like a drug seeker. This woman who has never had an addiction in her life. Has no use of her legs. Hates to take medication. And in so much pain that her legs that she can not otherwise move, spasming from the pain, gets treated like a drug seeker. It is heartbreaking to watch as a nurse and as a daughter.<br/><br/>I do agree that there are some people who are opioid abusers, however it isn't a one size fits all deal. There are also some physicians that have over prescribed which leads to addictions for some. We saw that in the clinic. Someone would be prescribed something like Dilaudid and then soon they were on a whole bunch of meds and we would be able to cut them back to get them to a functionable level. Due to the extreme regulations, some physicians are scared to prescribe medications that can be life changing in a good way. There are a lot more people in pain then there are doctors to help them as doctors are scared to get reprimanded for prescribing pain medications so we don't have enough doctors specialized in pain management. Maybe having a more drawn out plan would be beneficial. For example for x pain start with this medication. For y pain start with this. If x doesn't work then try z medication. <br/><br/>I think some of the biggest problem is there are people in pain. They get prescribed medication but it sometimes isn't enough. So then they turn to the black market to buy them. People get them from Mexico which doesn't have drug standards like the US does. The things like Norco coming from over there are laced with fentanyl. People then take the same dose that they would from US Norco and problems happen. I am curious how many people that have died from overdose have taken not regulated Norco.is this the real issue at hand? They can't get enough here to help them so they get desperate. We do need to have regulations, but the stigma makes it hard for many people. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98dd6	Anonymous	None	2022-02-21T20:40:40Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-zgey-vugr	False	None	False	2022-04-12 03:13:59.143	[]
1166	CDC-2022-0024-1172	https://api.regulations.gov/v4/comments/CDC-2022-0024-1172	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a physician board certified in both pain and addiction I have been deeply disappointed in regards to the ignoring of addiction(opioid use disorder) as an unintended consequence of the opioid epidemic. Here are some recommendations that I hope will help address both chronic pain and addiction in patients.<br/>1. Recognize the existence and prevalence of addiction(opioid use disorder) in patients with chronic pain and to treat it as the national emergency that it is. This should include free treatment for patients with opioid use disorder. The majority of persons buying illegal opioids on the street are doing so to prevent withdrawal more than to get high or treat only pain. <br/>2. CDC should recommend that non-pharmacological therapies including mental health treatment should be required to be funded by Medicare, Medicaid and private-insurance to treat pain and underlying issues. <br/>3. Require all providers treating pain to triage patients for opioid use disorder and to either provide addiction treatment themselves or make an appropriate referral for treatment for medication assisted therapy(MAT). <br/>4. Modify the CDC guidelines to recommend if not require all providers prescribing opioids over 90 MEDD(Morphine equivalent daily dose) to have the SAMSHA waiver to prescribe suboxone and buprenorphine for opioid use disorder. These medications are opioids and also treat pain. Currently only registration is required to treat 30 patients but I would recommend the 8 hours of training be required for MD/DO and 24 hours for PA/NP providers for providers wishing to prescribe over 90 MEDD. If a provider does not recognize a condition and know how to treat it, the condition may go untreated and worsen. The United States uses about 80% of the world's opioids in a population making up about 5% of the world's population. We do not have an opioid shortage problem as much as we have an opioid dependence problem that is undiagnosed and untreated. The response is to acknowledge this and provide free medication assisted therapy(MAT) and mental health support for patients with chronic pain who have developed dependence by trained competent providers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RANDALL	None	None	0900006484f98dc5	JAMES	None	2022-02-21T20:41:51Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from JAMES, RANDALL	kzw-z22l-b2ko	False	None	False	2022-04-12 03:13:59.366	[]
1167	CDC-2022-0024-1173	https://api.regulations.gov/v4/comments/CDC-2022-0024-1173	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I do support the proposed rule because it is suggesting a healthy relationship with patients and pain medications.  It is a known that some people's addictions start from a medication that was prescribed for pain.  They are constantly searching for something stronger to give them the same feeling that the opioids did.  One of the great things about this rule is that it is not mandatory, just encouraged heavily.  This will give the clinicians a chance to create a healthy communication when it comes to giving opioids to their patients.  Explaining the side effects and risks that come with using the opioids, offering opioid therapy and suggesting other techniques that manages pain is what is important.  It will provide the patients with higher quality of life and knowledge of opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mya	None	None	0900006484f98da2	T	None	2022-02-21T20:42:11Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from T, Mya	kzw-ylg4-6pac	False	None	False	2022-04-12 03:13:59.590	[]
1168	CDC-2022-0024-1174	https://api.regulations.gov/v4/comments/CDC-2022-0024-1174	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with Klippel-fell Syndrome,a very rare congenital disease.Ive had to deal with pain all my life,much much worse now that I'm 62 yrs old.No one can imagine the pain from day to day.<br/>I should be being treated with pain meds the same as a cancer patient but I struggle every day with hellish pain because of the CDC guidelines on opoids.Doctors don't want to prescribe the necessary medication for me and millions like me who suffer from chronic pain.<br/>You are partly responsible for the increase in overdoses,the cartels are making and selling"killer" pills to people because they can't get pills from their doctors!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f98d96	Peterson	None	2022-02-21T20:42:33Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Kimberly	kzw-ygxe-wrq6	False	None	False	2022-04-12 03:13:59.806	[]
1169	CDC-2022-0024-1175	https://api.regulations.gov/v4/comments/CDC-2022-0024-1175	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have crps. The highest pain on the McGill pain index. People who do not live with constant severe pain can not imagine what this life is like. When you smack your thumb with a hammer you bite your lip. Why to avert that pain to somehow make it less painful. Your body is programmed to fight pain with pain. Dentist is drilling in your mouth you push your feet against each other. Getting stitches you pinch your thigh and bite your lip. Now imagine pain 10 times this. Imagine this pain 24 hours a day. Imagine this pain every single day you open your eyes (that is if you were exhausted enough that you finally went to sleep). You soon see why people without proper pain control can cause harm to themselves. I was in that place in my life before fentanyl patches to ease my pain. I seriously did not know how I was going to get through the next 5 minutes let alone the next 24 hours. You stressed every pain sufferer with all the laws you put into place. I thank God my doctor did not change my pain meds through all of this. I worried every visit that it may happen. I worried endlessly what I would do if she did. My heart breaks for those that did have their meds cut back and even taken away completely. Before the patches I cried all day everyday. Imagine how my husband felt. He was exhausted. My son would stop by to check on me but you could tell he was uncomfortable the entire time he was here. Now I can fix meals. Set at the table and carry on a conversation with my family. Sit on the porch and talk about their day. My life is still miserable but I am able to get through my day with a few tears in my bathroom or in the shower instead of tears all day that tare down those around me. I look forward to visitors instead of avoiding people because I felt my tears made everyone else uncomfortable. My crps was caused by a botched surgery. They damaged my sympathetic nervous system. There is no way to repair this. I always felt your body gets use to pain along the way and you just learn to deal with it. Not so with crps. Everyday is like groundhog day. We are going to start everyday with agonizing pain and going to end the day with the same pain. Thank god I have a wonderful pain management doctor and she has worked with me through all of your craziness. My heart is broken for those who have taken their life because their doctors buckled under your pressure. I am here for my family because mine did not. You seem to think just because you take drugs you are a druggie. WRONG. You see the meds never take away all of the pain. There is no euI do not seek out more meds. In fact my hubby needs to remind me it is time to take my breakthrough meds because he can tell when I am really uncomfortable. He helps me remember when to change my patch. I never ask if I can get more pain meds. I am thankful for the relief I do get from what I get. I remember what life was like before the meds. I have been on the fentanyl and oxycodone for break through pain for 6 years now. I still have respect for the drugs. I would never take anything my doctor does not prescribe. I am not a druggie just because I have to take the drugs. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f98d80	Summers	None	2022-02-21T20:43:50Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Summers, Debbie	kzw-y7tp-pt5c	False	None	False	2022-04-12 03:14:00.023	[]
1170	CDC-2022-0024-1176	https://api.regulations.gov/v4/comments/CDC-2022-0024-1176	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Those who are truly in chronic pain do not need another government agency interfering in their medical needs. <br/><br/>There should be guidelines that doctors should not give opioids to patients who do not have the medical diagnosis necessary for opioid medication. <br/><br/>If a patient does not have an MRI, CT Scan, or some other medical diagnostic showing that a patient has damage to their body which justifies the use and need for opioid medications, then no doctor should be writing a prescription for pain medication to a person who does not have a legitimate reason for it.<br/><br/>Having been suffering from long term issues with my spine, numerous surgeries and decades of doctors, I have seen people who are truly in pain and I have seen scammers who just want the drugs to use or sell. Some may be addicted to the drugs and it started out for a legitimate reason. Now they are just addicted and want the drugs instead of getting treatment and getting off the drugs. <br/><br/>Any good doctor should be able to tell the difference, but it should come from a doctor that knows the patient and their medical history, and not from a government agency that has no idea of the patient's medical history.<br/><br/>In some states like New York, New Jersey, Pennsylvania, and California, they have instituted restrictions on doctors and pharmacies. If you live in those states, you can not find a pharmacy that will fill your legitimate prescription for opioid medication. The states have made laws that make so much red tape, it becomes impossible for pharmacies like Walmart, CVS, Walgreens, Rite-Aid, etc., to carry and dispense those medications. This makes a hardship for patients with legitimate medical issues to find the medication they need to keep their chronic pain in check. I do not need this to happen in my state. I went through it for the 18 months I lived in [redacted] undergoing treatments for my spinal condition (which only partially helped me).<br/><br/>My own doctor (back in my home state) has been given reports from the CDC and FDA that he has too many patients that are in chronic pain and should refer them to pain management facilities. This is in a fairly rural area, and it requires patients to drive 30 - 60 minutes one-way, every month, to see a doctor and get a written prescription for the pain medication the patient needs just to live a somewhat normal life. The patient has to pay a monthly copay for the doctor, as well as have to drive out of the area for this appointment and prescription (during Covid, some RXs can be faxed in), but the doctor still bills Medicare or the insurance company for each monthly phone call for a prescription. <br/><br/>This has created an insurance mill for the pain mgmt doctors to make more money and a financial challenge for people on disability or fixed income. I'm sure that is not what the government had intended, but they rarely know what is going to happen when they institute a new policy.<br/><br/>Our government should get out of the doctors way and let them practice medicine. Prescriptions should be monitored so that doctors who that do overprescribe can be stopped. People who are addicted and do not have a legitimate reason for using opioids should be sent to treatment. <br/><br/>This would be the best way for the government to be looking out for the people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lily	None	None	0900006484f98d2e	Barnes	None	2022-02-21T20:45:59Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Barnes, Lily	kzw-wwr4-3c38	False	None	False	2022-04-12 03:14:00.281	[]
1171	CDC-2022-0024-1177	https://api.regulations.gov/v4/comments/CDC-2022-0024-1177	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help us with chronic pain especially the baby boomers are older now. I personally was locked up in a mental institute for complaining to my personal physician about pain. This did not help I ended up in emergency surgery and still not enough pain medication. I am not a drug seeker but in severe chronic pain for 20 years with crippling arthritis. I have changed my physician and now see a pain management specialist but I am terrified to make any complaints or not accept any recommendations for alternate treatment for fear of them cutting off my meds. I have been taking since they invented them and other drugs before that. Pain physically has been with me for 30 years now and I truly fear the future trying not to be an addict to something like fentanyle because I can't trust the system won't leave me without meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484f98d0e	sharp	None	2022-02-21T20:46:27Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from sharp, Janet	kzw-wcx2-hnl8	False	None	False	2022-04-12 03:14:00.609	[]
1172	CDC-2022-0024-1178	https://api.regulations.gov/v4/comments/CDC-2022-0024-1178	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Personally as a nurse this new mandate makes people turn to unregulated pain relief. I have seen 10x more gastric bleeds as people ingest large amounts of ibuprofen to get rid of their pain. And alcohol abuse and even heroin abuse in the older and elderly population. This mandate has made the patients look for other means of help. Why not arrest the doctors and and now the drug dealers making illegal opioids. Because when patients are in severe pain it is easy to walk to the corner and get something. How can you say you are fixing a problem when actually you are creating a market like never before for illegal medication that isn't monitored by a health care professional. This has been just what I have been seeing: a drastic increase in the last 4 or so years working in this profession.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484f98d35	Runningbied	None	2022-02-21T20:46:52Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Runningbied, A	kzw-x0ge-rb0d	False	None	False	2022-04-12 03:14:00.827	[]
1173	CDC-2022-0024-1179	https://api.regulations.gov/v4/comments/CDC-2022-0024-1179	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Although,i understand why,guidelines were changed 5-7 years ago,unfortunately, it has harmed so many people,that genuinely suffer from chronic pain-folks who have sought out street drugs,because the CDC guidelines prevented their physicians from helping them. That is dangerous &deadly. I feel the guidelines must be amended, as soon as possible. If guidelines could be amended to help,chronic pain sufferers, as well,as identify addicts,and guide them to treatment,that would be better than the way things are now. Thank you for the opportunity to comment,and your time,reviewing the comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fondale	None	None	0900006484f98d4b	Smoot	None	2022-02-21T20:47:11Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Smoot , Fondale	kzw-xa0b-k47f	False	None	False	2022-04-12 03:14:01.065	[]
1174	CDC-2022-0024-1180	https://api.regulations.gov/v4/comments/CDC-2022-0024-1180	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First of all, thank you for attempting to revise the guidelines. At this time I feel irreparable harm has occurred to patients and doctors by the swift and constrictive changes to state laws based on the last CDC recommendation based on erroneous data (by clumping prescription opioid deaths in with street opioid/illegal fentanyl deaths and generalizing terms - scaring the public and turning prescription opioids into something evil.) I hesitate to tell people that I am in pain management because of the new opioid stigma. <br/><br/>The DEA and Attorney Generals have threatened our doctors so that the majority of doctors will not prescribe opiates any more causing unimaginable pain and suicide. Doctors have lost their licenses or been thrown in jail for helping people cope. Patients who have chronic and painful conditions have had to spend much more money and time, jump through all kinds of hoops to get their pain management medications and in many cases drive farther to find a doctor who is willing to treat pain. Insurance companies (I can speak to BCBS in particular) have dropped pain management doctors and discontinued coverage for pain medications. At this time in [redacted], it is almost impossible to find a pain management doctor. The pain management doctors who do exist have tapered or cancelled patients and their licenses are in jeopardy if they feel the need to prescribe more MMI than the CDC's guidelines - so they won't do it out of fear, regardless of patient's needs. Instead, patient must take more medications of different types to try to cope and this can lead to liver and stomach problems where there were none before. For chronic pain patients, acute pain patients, all pain patients, this has been devastating. I know people who have gone through major surgery with very little medication - people whose personalities have been so altered by pain that they can't cope with life let alone their way to make a living. This is all due to the CDC overstepping the doctor - patient decision to manage patient pain. <br/><br/>While I appreciate that ILLEGAL STREET OPIATES cause death and that a small percentage of people may become addicted to medication, in my opinion, treating a person's pain with safe, FDC approved medications is so much more preferable than forcing people in pain to get relief on the street or by committing suicide. People who take prescription pain medications for chronic pain do not become street drug addicts and are unlikely to overdose on their pain medicine. I personally have a pain agreement with my doctor and I have regular urinalysis. I would be scared to try to use drugs obtained on the street but if I were not able to get my prescription pain medications, I can imagine I might try or just give up hope and commit suicide. Pain is a terrible thing. A daily, hourly, minute by minute thing that radically alters and destroys lives. <br/><br/>I can only hope that the CDC will more strongly word their update so that LAWS might be changed in response, and doctors will again feel free to treat their patient's pain with medications that work. I can't believe that in America we have worse pain care than in other countries. It is NOT RIGHT. <br/><br/>As a past data analyst, I know it is important to collect data properly and to publish it correctly so that it portrays the right image to the recipient. The "opiate crisis" has been mislabeled, mismanaged and just plain erroneous causing people to be fearful of medication that saves lives and allows people in pain to have a quality of life. Please listen to the experts, the real doctors who have been in pain management for years, helping people have a quality of life that they would not otherwise have without the god-send of prescription opiates, not the so-called "experts" who are basically fear-mongers and fanatics spreading misinformation and lies...paid people seemingly out on a witch hunt to line their pockets while others suffer unthinkable pain. <br/><br/>Thank you for your time and attention. Thank you for recognizing that the past guidelines have done unintended harm. <br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484f98d6a	D	None	2022-02-21T20:49:06Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from D, Melissa	kzw-xr8a-lxa6	False	None	False	2022-04-12 03:14:01.339	[]
1175	CDC-2022-0024-1181	https://api.regulations.gov/v4/comments/CDC-2022-0024-1181	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It seems the CDC is trying to correct the errors they have bestowed on 1 in 5 Americans and to stop making your good Dr's feel like criminals. The decisions they made created suicides, overdosing due to seeking drugs from the streets be it the likes of heroin or getting fake pills. Who knows how many lives could have been saved if they would have just gone after the Dr's that were overprescribing, instead of making a one blanket bill. So as not to incriminate anyone I'll say I'm writing this for a friend. That friend is over 60, he had a very active life in sports, started his own business at a young age and became successful. About 10 yrs after starting his business he was having chronic neck and back pain for over a year. He tried physical therapy, otc meds, chiropractors and finally pain injections all to no avail. Surgery was eventually performed, well there was a problem with the positioning of the hardware and they had to go back in for a 2nd surgery. This left him in so much pain he needed a w/chair to get around. They then wanted to do surgery on his neck. I think you can figure out what he said about that. He ended up losing his business his wife and his dog. 2 years later he was prescribed oxycodone and a couple of other meds. After doing his own therapy for a year, he went from a w/chair to a walker to a cane to walking and jogging on bike paths, and soon after asked to be weened off his meds. He soon started his business again which ended up doing well for a number of years. Until he could not handle the neck pain. Finally has neck surgery scheduled but for the last year he has been relegated to his bed for the most part, and couldn't work. His Dr knew of his history and sent him to a neuro clinic and after all imaging was done was sent to a pain clinic. They said Gabapentin and pain injections which failed yrs ago when the pain wasn't so severe. This after neuro did x-rays then MRIs and ct scans. Those showed more lumbar problems the guy was in constant pain but drove through it for years. The neck now needed ACDF surgery on multiple levels, 3 bulging discs, bone spurs, spinal stenosis and an unnatural curve in the spine etc. Due to covid all "elective" surgeries were suspended. This guy contemplated suicide yrs ago when he was in a w/chair in awful pain until he reached out and got help. Forward to today literally today, he has been fighting Dr's, insurance companies and the system for a year now and finally is scheduled for surgery in 3 days. He has been depressed, lost a vacation spot on a lake but thankfully has his dog. He said he has gone through some dark, dark days and nights for the last year. He now fears neck surgery failure much like his back yrs ago, and fears of continued pain from his neck with no help much like no help for his back that he has been trying to receive. So to the CDC, these drugs to me enabled him to live his life many years after failed back surgery and did not take these drugs for years after getting out of the w/chair. Rumor has it he has resorted to the streets seeking relief after all the Dr's said there hands were tied. Thank God he didn't find any fentanyl laced pills that have fueled the opioid deaths. Every time I hear the news mislead the general public about the opioid crisis, not mentioning the majority of these deaths being caused by these fake meds it makes my blood curdle. We know there's a difference between a 25 yr old with a twisted ankle, and someone elderly or not with documented proof of why these meds would be beneficial. So please let our Dr's help the chronic pain sufferers when needed. No off label prescribing of an anticonvulsant (Gabapentin) for one size fits all, not a low dose of these meds to everyone, you know everybody is different. Let our Healthcare professionals be Healthcare providers once again.<br/> Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Concerned	None	None	0900006484f98d7b	Citizen	None	2022-02-21T20:50:35Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Citizen, Concerned	kzw-y40n-z7fv	False	None	False	2022-04-12 03:14:01.566	[]
1176	CDC-2022-0024-1182	https://api.regulations.gov/v4/comments/CDC-2022-0024-1182	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired coal miner and suffering with cornice pain I take a middle type of pain medication called Ultram and natural one called Kartom this helps some but still suffer a lot Doctor are not offering to write pain medication because of the trouble they have to go through this is a shame for people who suffer with pain for real.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Henry	None	None	0900006484f98d0b	Lawson	None	2022-02-21T20:51:08Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Lawson, Henry	kzw-wc0h-ggf0	False	None	False	2022-04-12 03:14:01.811	[]
1177	CDC-2022-0024-1183	https://api.regulations.gov/v4/comments/CDC-2022-0024-1183	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After injuring my back in the late 1970’s I have suffered from chronic lower back pain. Treatment began conservatively with chiropractic treatments that produced no results. Over the decades of seeking relief treatment’s kept escalating from conservative to more aggressive treatments. I was treated by physical therapists, given series of shots, acupressure, and acupressure to name a few. An orthopedist sent me for CAT scans and MRIs. I was diagnosed with ‘degenerative nerve and disk disease’ and had two herniated disks at L5-S1 and L4, with severe sciatica.<br/> I tried all medical treatments suggested to find a permanent solution to alleviate this debilitating pain. I endured six surgeries to find relief but none worked. The last procedure was the permanent implantation of a spinal cord stimulator which also failed to resolve my pain problem.<br/> The last thing I wanted was to remain on pain medications indefinitely. Yet here I am.<br/> After the new updated ‘guidelines’ from the CDC in 2016, my doctors became reluctant in prescribing my narcotic medications. I had never abused the privilege of being pain free by overmedicating myself so I was confused by this change in attitude until I learned of the new ‘guidelines’. <br/> For years my daughter encouraged me to move to near her in [redacted]. I was reluctant because my established relationships with my physicians. <br/> Unfortunately I was proven correct in my fear. <br/> Since the move two years ago I have been treated as though I am a drug seeking criminal by both my physicians and pharmacists. All my other prescription medications are reliably available except for my morphine prescription. There were even two occasions where my pharmacy deleted the active prescription from my account! I suffered through two days of debilitating pain. My doctor’s office rectified the problem, but I should not have to endure the pain and stress created by these kinds of situations. <br/> Please rectify this problem. Senior citizens (78) should be treated with more dignity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f980f8	Anonymous	None	2022-02-21T20:52:34Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-vxq0-jc7k	False	None	False	2022-04-12 03:14:02.138	[]
1178	CDC-2022-0024-1184	https://api.regulations.gov/v4/comments/CDC-2022-0024-1184	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC has NO business putting guidelines on something that they know nothing about!<br/>My Husband [redacted] had his Spine "severed" in a work related Accident in 1999,now 23 years later he suffers from Peripheral Neuropathy in his feet and hands and he is not Diabetic. He was also on Life Support 2 times in one year in Respiratory failure. He suffers just to get out of Bed.<br/>And now, due to cutbacks from the FDA, they have now cut his meds in half, and he doesn't even have enough to take as prescribed every 4 hours. His Blood pressure has now gone to Heart attack levels due to pain.<br/>He see Pain Management every month for 8 years, and they just don't care, because they say "the new Laws" prevent them from giving him what he was taking. <br/>I think it is awful that the CDC is now going to make it worse!<br/>What about him? He will Die from his heart exploding due to Pain. Why is there no exceptions?<br/>Sad time for America, and the people who suffer from them changing the Laws without knowing the damage it has caused.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa Ann	None	None	0900006484f980e7	Mastrarrigo	None	2022-02-21T20:53:27Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Mastrarrigo, Lisa Ann	kzw-vq7n-jomk	False	None	False	2022-04-12 03:14:02.414	[]
1179	CDC-2022-0024-1185	https://api.regulations.gov/v4/comments/CDC-2022-0024-1185	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would hope that the current regulations would change in regards to Opioid prescriptions. I have watched my husband suffer for two years. His pain management doctor changed his prescription. since then he is in terrible pain or sleep most of the day. He is a brilliant man who has neuropathy but desires to work. We understand there is an opioid epidemic, as a part of the changes it seems people who really need their meds have been red-flagged, punished, and unable to live. Please put the power of prescribing back into the hands of the doctors. The doctors know their patients and have the best knowledge of who has done well with their prescriptions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98a3d	Anonymous	None	2022-02-21T21:07:04Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-605x-m714	False	None	False	2022-04-12 03:14:02.627	[]
1180	CDC-2022-0024-1186	https://api.regulations.gov/v4/comments/CDC-2022-0024-1186	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The other comment portals are showing an error message <br/><br/>Could you fix it please	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f989f1	Anonymous	None	2022-02-21T21:07:17Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-5oj1-khtx	False	None	False	2022-04-12 03:14:02.952	[]
1181	CDC-2022-0024-1187	https://api.regulations.gov/v4/comments/CDC-2022-0024-1187	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I fractured my spine L2-5 and my sacrum I have degenerative disc disease and spinal stenosis. Since 2012 I have been taking the same dose. I’m urine tested every two months Treated like I’m looking for drugs. I also am in need of total knee replacement on both and I dread it. Imagine being afraid of having necessary surgery to improve my quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diana	None	None	0900006484f98128	Desantis	None	2022-02-21T21:08:13Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Desantis, Diana	kzv-wmj6-sk3m	False	None	False	2022-04-12 03:14:03.184	[]
1182	CDC-2022-0024-1188	https://api.regulations.gov/v4/comments/CDC-2022-0024-1188	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's difficult to say how bad a revision is needed, it's beyond words. The amount of damage these government regulations have done is unfathomable. I can guarantee people have lost their jobs, marriages, homes and others have paid the ultimate price by taking their lives. Not only have pain suffers paid the consequences for bad inflexible regulations but so have doctors and businesses. Are you going to pardon prosecuted doctors and give them their lively hoods back? How about the drug companies that shut down because of malicious guidelines? What about the patients having unnecessary injections, trashing their bodies taking mass amounts of over the counter drugs, or resorting to illegal drugs for relief? People caught using illegal are now stigmatized for life because the government screwed them over, once legal abiding people forced from medical care now have their lives ruined in a different manner. Once productive people before the guidelines are now unemployed drug seekers because of the guidelines. So after years of damage, wrongful prosecution and ruining people's lives we're grateful for change and it can't come fast enough. <br/><br/>Going forward we can no longer have "That was not or intention" as a response for people's suffering. It needs to be a clear message to the doctors you will not be investigated for treating pain. I repeat if a doctor is performing medically necessary care they need to know that the CDC or DEA won't ruin them. There should be no wording involving tapering unless requested by the patient and doctor. There should be NO mention of a max MME. The previous 90 MME is a ridiculously low amount for people who actually suffer. Everyone who actually pays attention realizes that a majority of overdoses come from illegal drugs from other countries and aren't prescription, not saying there's none but all these changes in the effort for fewer overdoses has been effort in the wrong place. Go after the criminals not doctors and patients. <br/><br/>All that said I've been better off than most people, still can't work but haven't lost everything like some because of short sided guidelines. I'm hoping that changes come fast and with razor sharp clarity for the doctors and pain suffers. If I had anything else to add is Marijuana should be legalized for medical use federally. I don't know if it would help me or not but I'm not willing to try and risk giving up my rights. It should also be an option for people supervised by doctors. Again it needs to be Clearly stated doctors are free to treat, it needs to be done fast because we're way past due and honestly there needs to be an investigation on how/why the DEA was given enough power to ruin people. Something is very wrong with the current system. Thank you for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484f97ed8	Munkres	None	2022-02-21T21:09:34Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Munkres, Brian	kzv-wh4b-ul4j	False	None	False	2022-04-12 03:14:03.446	[]
1183	CDC-2022-0024-1189	https://api.regulations.gov/v4/comments/CDC-2022-0024-1189	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for at least 14 years now. When I first started with the chronic pain ( Caused by industrial injury and Rheumatoid Arthritis) that has been much like unrelenting pain except in the early stages. In the early stages the allowable pain killers I was on included Morphine and Oxycodone HCL together, my pain was somewhat controllable. It still hurt but not enough that I could not enjoy a somewhat normal life. But as my pain has gotten less controllable these days, due to the reduction of allowed pain killers I am no longer on Morphine and only on Oxycodone with limitations of how much of that I can take, my life is now no longer easy. The pain is so severe that I have a very hard time sleeping and living a normal life. I am now retired and was deemed 100% disable about 13 years ago. I have had 9 Heart attacks with 12 stents in my heart. So much ability to do surgery is no longer available to me. I am on Blood Modifiers, Plavix and can not be without it. Last time they tried surgery I was off of the Plavix and had a major heart attack that almost killed me. My Cardiologist told me no more surgery unless it was my life in the balance. So all I can rely on is pain killers but with the reductions in allowable Opioids I am in severe pain all the time now. I awake every day with the thought if the pain will allow me to not have my blood pressure rise too severely and kill me. I am left with no choices anymore. Severe Pain or die from highly elevated Blood pressure. The choices are very limited and in my retirement years I am left with an all consuming level of pain. Not a way to live well anymore. You may loose more people to suicide these days as the pain grows worse and worse.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f98143	Brigham	None	2022-02-21T21:11:27Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Brigham, Michael	kzv-wy8o-erhx	False	None	False	2022-04-12 03:14:03.673	[]
1184	CDC-2022-0024-1191	https://api.regulations.gov/v4/comments/CDC-2022-0024-1191	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a long time pain patient who has been denied over and over, shamed and basically made to look like an addict I have an appointment March 7th and I am going to ask again if I could have my own pain pills … I think you have more work to do but this is a start	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f986f7	None	None	2022-02-21T21:12:44Z	Don’t Punish Pain!!	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Don’t Punish Pain!!	kzw-4jq2-w6so	False	None	False	2022-04-12 03:14:03.888	[]
1185	CDC-2022-0024-1192	https://api.regulations.gov/v4/comments/CDC-2022-0024-1192	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/><span style='padding-left: 30px'></span>I am a chronic pain patient who has lived in [redacted] since 1996. Although my B.A. is in English and my A.A.S. is in E.E.T., I completed two Persian Gulf tours in the USN and rose to the rank of E-5. I suffered from Tarsul Tunnel Syndrome at 12 and had the release surgery done at 15. My feet were extremely flat by then , although I suffered no chronic pain until I was 42. I was then prescribed orthotics and was able to work pain free until I was 46. At 46, the cartilage in both big toes crumbled due to Hallux Rigidus and my Podiatrist began prescribing Norco. The toe pain finally became so bad that the same Podiatrist performed toe fusion on both feet. I was SO active after the first toe fusion surgery that the toes did not properly fuse and the same Podiatrist repeated the 6 hour surgery. By this time, my employer of 11 years laid me off and I was put on short term and then long term disability. I then needed Carpul Tunnel surgery of the right hand due to being in a wheelchair for too long and had to have Carpul Tunnel release surgery done on the right hand. I then suffered stress fractures on the tops of both feet and pinched seural nerves of both feet due to my ankles being so pronated. I consulted another Podiatrist who operated and confirmed that my seural nerves were pinched but that he could do nothing for them. I was fortunate to become re-employed performing arduous skilled labor as a Maintenance Mechanic , but my regular Podiatrist referred me to a Pain clinic around 2008, after prescribing various Opioid pain pills for post operative pain and chronic pain. I went to one pain clinic for about 6 years and saw either the same doctor or nurse practioner. I went from just low doses of Norco to low doses of MS-Contin and Norco until I was finally at 3-60 mgs of MS-Contin and 6 10/325 mg's of Norco.Due to the effect of MS-contin on the Endocrine system, my PCP diagnosed low Testosterone and I began self injection of prescribed Testosterone every 2 weeks, which I still do. I then had to change pain clinics due to the owner retiring. My last employer let me go in April of 2021 and I have been looking for work since then. Thankfully, I have savings to get by, but living in [redacted] with the current for profit health insurance is very expensive. About 4 years ago, my pain doctor gradually reduced my MS-Contin to 3-30 mgs/day and gradually phased out my Norco, due to the CDC "guidelines". Because of Federal and State law, I get drug tested at least 4 times/year, which costs me, out of pocket , about $180.00 each time. I pay $300.00/month for insurance, since I am still unemployed, but the current amount of MS-Contin just doesn't last all day , especially when I am working. I am also prescribed Duloxetine by my PCP to assist with the pain. However, the burning pain in both soles of my feet due to neuropathy, the stabbing pain in both ankles and stress fractures and the throbbing pain of both fused large toes make walking, much less working, a painful task. I discovered and use carbon fiber antiflex insoles, coupled with military lace up boots, compression stockings and custom orthotics. Again, the 3-30mg of MS Contin just does not suffice over a 12 hour day. I am 5'11", weigh 195 pounds and am in very good shape for 61. The CDC guidelines need to be modified or dropped completely, because the DEA, coupled with [redacted] DPS, are using them to justify their losing battle with illegal drugs, especially Fentanyl. Chronic pain patients are the innocent victims in the war on illegal drugs. Statistically, chronic pain patients do not abuse their prescriptions, as they have very little control over their chronic pain levels.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484f98723	Waldron	None	2022-02-21T21:15:19Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Waldron, John	kzw-6m5g-d9fh	False	None	False	2022-04-12 03:14:04.107	[]
1186	CDC-2022-0024-1193	https://api.regulations.gov/v4/comments/CDC-2022-0024-1193	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a lifelong sufferer of back pain, which has been increasing over the years. I now have degenerative arthritis of the spine, an some other back issues. I have chronic headaches and migraines. I wake up in pain, I fall asleep in pain. I had to stop working in my early 50s because of inability to stand for any length of time. I have been on disability since then. I have had radiologic studies verifying my reasons for pain. I have been on every non narcotic pain medication available. I have sought chiropractic care and it did not help. I have gone to 2 pain clinics who can or won't due anything for me. The last pain Dr. I saw recommended Tai chi. My life is miserable because of the pain. It wakes me up and/or keeps me awake. I sleep 30 min to up to 5 hrs a night. Sometimes I don't sleep at all. Animals are not allowed to suffer with pain, but humans are expected to. <br/>Not all of us are drug addicts. Some are seeking drugs off the street because they can't find pain relief from a Dr. Maybe the drug crisis wouldn't be so bad if true pain and misery was treated properly. I can't enjoy life in this much pain. My pain has been verified but I am told I have to live with it. What kind of quality of life is that? Dr's take an oath to do no harm, but when they don't treat pain appropriately, it is harm. <br/>WAKE UP PEOPLE!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484f980be	Sonnenburg	None	2022-02-21T21:16:30Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Sonnenburg, Stephanie	kzw-uq9y-df1k	False	None	False	2022-04-12 03:14:04.340	[]
1187	CDC-2022-0024-1194	https://api.regulations.gov/v4/comments/CDC-2022-0024-1194	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been under the care of a registered pain management specialist for sixteen years. I also am under the care of a neurologist and a rheumatologist chronic conditions. I am opioid dependent but not addicted. I receive nerve blocks when pain exceeds my tolerance and cannot be managed by nerve medications, opioids, and OTCs as prescribed by my pain management specialist <br/><br/>Pain management specialists must have the latitude to prescribe medications to the level to control their patients pain. If one has not experienced chronic pain and the agony of extreme pain for hours on end, they cannot understand what legislating away legal relief for millions of sufferers will do to society. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484f980cd	Huber	None	2022-02-21T21:16:50Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Huber , Gary	kzw-v43r-pamr	False	None	False	2022-04-12 03:14:04.585	[]
1188	CDC-2022-0024-1195	https://api.regulations.gov/v4/comments/CDC-2022-0024-1195	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In both America and other countries there has been a number of studies of Medical marijuana use for chronic pain ... and there have been many sucess stories. <br/> Additionally, we personally know people in the nearby area who have been successfully helping people control pain, diminish opiate use alog with seizure control with controlled marijuana use. This is mostly accomplished with non-smoking methods... along with the use of CBD Oil and gummy forms.<br/> The artificial chemical versions of marijuana have many more side effects than natural;source controlled marijuana. <br/> The people I refer to have worked with Doctors, plus educating people on how to achieve correct dosage for best patient results. <br/> Also need to point out that they live in a state where marijuana use has been legalized. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ellen	None	None	0900006484f980ce	Straw	None	2022-02-21T21:17:41Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Straw , Ellen	kzw-v4na-lb2w	False	None	False	2022-04-12 03:14:04.829	[]
1189	CDC-2022-0024-1196	https://api.regulations.gov/v4/comments/CDC-2022-0024-1196	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since 2015. I have been on the same low dose of percocet since. I hate the way the medication makes me feel. If I don't take the medication I can't work. I can't get out of bed. I have never abused my medication. I've had multiple spine surgeries. The last multi level ACDF surgery I was refused pain medication and had to sign myself out of the hospital a week early just to get relief from my pain. There was a doctor (not mine) that override my surgeon and said that I would become a drug seeker if they gave me pain meds. I was in agony and hysterical from the pain. It was outright torture. I am treated like a criminal when I have done nothing wrong. I drive an hour to submit to monthly drug tests. I am submitted to psych evals and invasive questioning about whether I was molested as a child. I was, 50 years ago, so that makes me a higher risk of becoming a drug seeker and puts a flag on my records even though I have done nothing but follow the rules and have never abused drugs in my life.<br/><br/>I’ve watched my best friend die from cancer. She was given the tiniest bit of liquid morphine. She yelled, cried and moaned from the pain until she finally passed. I watched my brother in law suffer after a stroke. He screamed for 3 days because he was denied pain medication until he finally passed away. I met a woman that had a double mastectomy who was given only Tylenol to help with the agonizing pain of losing her breasts to cancer.<br/><br/>We as pain patients are doing everything we can to alleviate our pain before we turn to opioids as a last resort. I’ve had so many invasive and painful treatments to help and none of it has worked. I’ve done every type of physical therapy. I just finished 2 months of PT and it did nothing for the nerve pain that I suffer from. I jump through every hoop the doctor says to jump through. I try every painful procedure they request just so I don’t lose my prescription. It is a [redact] of a way to live.<br/><br/>Stop the suffering. We are not drug addicts or criminals. We are trying to get help so we can live our lives. What you are doing to people is torture.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f81d32	Anonymous	None	2022-02-21T21:29:15Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzr-5hr9-pg3w	False	None	False	2022-04-12 03:14:05.044	[]
1190	CDC-2022-0024-1197	https://api.regulations.gov/v4/comments/CDC-2022-0024-1197	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a chronic, dehabilitating condition that's called Ehlers-Danlos syndrome - it is an inherited disease that causes suicidal inducing severe pain - I am close to my life expectancy at 50 but with the limited amount of opioid pain medicine the previous guidelines and resultant laws I have zero quality of life - I am homebound, I can't clean my house or enjoy the extensive things that I used to - working, volunteering, art, travel, cooking, etc - I have children and grandchildren I can't even see because I can't travel nor interact with them when they visit. I have worked with my doctors for years trying different treatments that have failed and some almost killed me - a recent severe reaction to a different medication caused severe liver inflammation that caused me to collapse suddenly - striking my head so hard I couldn't see, move or talk - just hear and feel and my family called 911 - as soon as the paramedic saw I was on a low dose opioid he assaulted me screaming I was a drug addict and dragged me slamming me into things yelling at me to stop the bullshit and even though my family told him I have ehlers danlos with a brain aneurysm he dismissed it and took me over an hour away to the main addiction hospital in the state insisting I was a drug addict on meth and the drugs he treated me with were wrong and I almost died. I have NEVER done any illicit drugs nor ever wanted to. I want and have a human right to live a good life - I was a veterinarian tech for many years and enjoyed my work - I literally enjoy nothing now - I haven't been even able to eat more than 5 bites of healthy food a day for years now and am almost anorexic due to the inability. The leading research insists that EDs requires high dose opioids - largely due to associated malabsorption issues - I am in palliative care but because of the new laws I can't even be treated properly. Due to the pain and constant stigma I am losing my will to live - if this doesn't change very soon I will be dead and my family destroyed - and it will be the fault of the government. There's been much research showing the basis behind the the guidelines were false - obviously and transparently false - and used by PROP to fuel their addiction centers. I have never gotten "high" off of my pain medicine - and my doctors have reached the point that there's nothing else we can try. All of this goes against my constitutional rights to life liberty and happiness - right promised by you - the government. With the proper amount of opioid medicine I can become a productive member of society again instead of a burden to all. Return pain treatment decisions to the doctors trained in pain management - force the laws on limits to be recinded and call the DEA off of attacking the prescribing of legal medication to chronic pain patients and go after the illegal drugs that are fueling the overdose crisis. Without these changes the genocide of thousands of not millions of Americans will continue and their - and my blood - will be on your hands.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8e14e	Anonymous	None	2022-02-21T22:11:32Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-zrhi-23a6	False	None	False	2022-04-12 03:14:05.293	[]
1191	CDC-2022-0024-1198	https://api.regulations.gov/v4/comments/CDC-2022-0024-1198	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For starters I don't understand why the regulations are so strict. Pain patience go through so much scutiny to get there RX that helps them live a somewhat normal life day to day. We already go through 1. Drug testing 2. Pill counts 3. Scheduled doctor appointments, which cost many of us alot of money monthly. 4. Have to make our meds last till next refill so the majority are not going to over take their meds. Many of us are to ill to even make it out of bed in the morning or in to much pain. I have been with the same doctor for many years and as of Monday 2.14.2022, I got the word from my doctor that I have to be tapered down on my meds and use Suboxone, I don't know if that a good fit for me. I am not a drug addicted which I feel that will label me as one. As of right now I'm not going to go that route but will proably end up taking more tylenol then is good for my body, now I won't be monitored on how much meds I can take and will be seeking releif. My pain hasn't stopped so why are we being forced to switch meds that I have been on for 30 years, safely. The change in pain managment makes absolutely no sense. But here in my neck of the woods, if your a druggie, you can get free needles I hear they are making safe injections sites for druggies, is taking away pain meds really the answer when we are under a doctors care and monitored. Who ever makes these rules I hope one day you have pain so bad and you cannot get relief, problem is you'll be to sick and in pain to fight for your rights. Also since when does my doctor get to decide that I no longer have pain, it didn't just stop one day, not my chronic pain. I wouldn't go to my appointments, get scans, mri's, etc if I wasn't having this pain. Now I guess I will have to sit back and suffer and no point in seeing my a doctor if she/he can't help. Someone I know was forced to go through a surgery or she would and probably still will be cut off her pain meds, she is worse then prior to the surgery and now is disabled for life due to a surgery that at the time wasn't needed. She was learning to live with chronic pain and manager her pain with her meds, now it's 1000 times worse and has had to go back to the ER for pain relief and they refuse to help her.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8e1c7	Anonymous	None	2022-02-21T22:12:03Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzt-03gk-660f	False	None	False	2022-04-12 03:14:05.508	[]
1192	CDC-2022-0024-1199	https://api.regulations.gov/v4/comments/CDC-2022-0024-1199	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I lost my job and had to go on Medicaid until I found a new job. My pain management [name redacted] of [health facility name redacted] in [city redacted] CA dropped me cold. They don't take Medicaid insurance and refused to let me cash pay due to "contractual agreements", without further explanation. They refused to refill my prescriptions unless I was seen, but refused to see me. I had been on Percocet and methadone for chronic and severe back and leg pain. My primary care physician, [name redacted] of [health facility name redacted] in [city redacted] CA refused to write for my pain medication for only one month in order to help me until I could square away my insurance problems. I plead with the patient liaison and even though it was taken to administration, she refused to refill my regular prescriptions. I was left abandoned, alone, terrified and without information on how to deal with withdrawals. I had been on opioid pain medications for more than 15 years. I am still suffering and found road blocks everywhere I turned. The stance the CDC has taken on opioid use, especially the standards released in 2016 have been so difficult and painful for me. I am a healthcare provider, a mother, a sister, a genuine and honest person who has chronic pain. I've never abused opioids, only taken as indicated by my Drs. I cannot express firmly enough how I've been hurt and abandoned. This is not the first time medical practitioners have left me cut off of opioid medications coldy and without compassion. How is this "first doing no harm"? People in my shoes buy black market drugs, they commit suicide. This is a serious problem that needs to be addressed with compassion and understanding.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nickie	None	None	0900006484f8e1cc	Harris	None	2022-02-21T22:14:42Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Harris, Nickie	kzt-040k-go75	False	None	False	2022-04-12 03:14:05.728	[]
1193	CDC-2022-0024-1200	https://api.regulations.gov/v4/comments/CDC-2022-0024-1200	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My Dr refused me medication for my severe Stenosis of the cervical disks. C4-T1. I had to go to pain management.. that whet the dr told. [health facility name redacted] [city redacted] NY.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484f8f2df	Arcara	None	2022-02-21T22:15:51Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Arcara , Mary	kzt-5grt-a55c	False	None	False	2022-04-12 03:14:05.941	[]
1194	CDC-2022-0024-1201	https://api.regulations.gov/v4/comments/CDC-2022-0024-1201	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How many of us have to die before you listen. I have been responsible my whole life to be careful of my meds. I don't Dr shop, er hop ect. Yet I'm treated as an addict because I have to go to the er for break thru pain because my primary can't prescribe without issues. I am delaying treatment as I type because my primary wants me in the er. I cannot, not without pain meds because I'm hyperacusive with 24/7 migraines. That mean noise sensitive. An er is loud. It is torture. So I get to puke up blood because of you. We are not addicts. We are in pain. Pain that would break you. It's breaking us and y'all are just waiting for us to die because it's cheaper and easier. Shame on you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tishia	None	None	0900006484f92944	Partchey	None	2022-02-21T22:16:29Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Partchey, Tishia	kzt-dwyh-zimk	False	None	False	2022-04-12 03:14:06.258	[]
1195	CDC-2022-0024-1202	https://api.regulations.gov/v4/comments/CDC-2022-0024-1202	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just wanted to add my two cents in as a chronic pain patient of 10+ years. I was opioid naive when I was first introduced to pain meds in my 20s for Degenerative Disc Disease. For the first few years, they had me on 60mg Morphine time release twice a day and six immediate release Norco a day for breakthrough pain. Looking back, that was entirely too much medication for a young woman but I digress. For the first few years, that treatment went fine up until they stopped the opioids cold turkey cause my primary was no longer prescribing pain medications. I ended up in the ER and psych ward after two weeks because I hadn't slept and had no idea what was happening but now know that it was withdrawls I was experiencing. The next day, I saw a pain doctor at the pain clinic that notified me that it was indeed withdrawls and that I was not crazy and who agreed that I was on too much medication and decided instead to put me on 8mg Dilaudid 5 times a day! Yes, you read that correctly. Well, of course, that fixed my problems. I was no longer sleep deprived or crazy. However, within 60 days, I was a full blown drug addict with worse pain than I started out with in my twenties. After a steady downward spiral for a few years and I had lost my will to live and everything else I loved, I decided that I had had enough and wanted off this sick cycle. I checked myself into a detox center and got off all the drugs and entered a life of sobriety. So now I am out of detox and living in sober housing but I still have a problem, I am a person living with chronic pain. Now what do I do? I white knuckled it for a year an a half, then I tried marijuana maintenance but eventually I was walking back into a pain clinic. Scared to death and in pain, I ended back on the hamster wheel of opioids, Norcos three times a day. Until one morning, I woke up and couldn't physically move without screaming like a banshee. The ER wouldn't treat me so, the pain clinic got me in for a same day appointment. They put me on a week's worth of Dilaudid and what do you know, it helped within an hour and I could move without screaming. But, the downfall was sure to come and within two weeks I had a gun in my mouth. I had been here before and never wanted to go down that road again. So, I made the decision to find an addiction specialist that also treated chronic pain. The reason I am able to even share this story is because he saved my life. He prescribed me Buprenorphine and since that day, I have been able to bathe myself regularly, take care of myself, hold a job, have relationships with my loved ones and even take a vacation planned months ahead of time. He gave me the closest thing to a normal life that a person with chronic pain and arthritis in the spine and hips can have. Why was this not the FIRST option 10 years ago for me? Why did my life have to become completely destroyed and on the brink of suicide? I don't know why I am a sharing this story with whoever may be reading it. What is my point? Maybe by sharing it someone will recommend Buprenorphine as a better treatment plan for chronic pain patients than full opioids or at least consider it at the beginning of treatment and not after lives and families are destroyed or when it's too late to be an option anymore. I am an addict (in recovery) and a chronic pain patient and no one is talking about us. Is all of this irrelevant? Maybe, maybe not but I hope that my voice will be heard cause there are a lot of people out there just like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	WENDY	None	None	0900006484f912a6	C	None	2022-02-21T22:18:37Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from C, WENDY	kzt-it2z-mwg3	False	None	False	2022-04-12 03:14:06.503	[]
1196	CDC-2022-0024-1203	https://api.regulations.gov/v4/comments/CDC-2022-0024-1203	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Have been on pain medications since 2004. My meds have been cut so drastically I no longer have quality of life. I spend most of my time in bed actually thinking of death. Looking forward to it. Before I had a life at times I could enjoy. No longer. I cannot imagine more years of this. OTC medications do nothing, except harm my other organs. I think often that is the goal of CDC, to rid the earth of CPP by suicide, liver failure, heart attacks etc. <br/><br/>When did you ever take into consideration our pain? Seriously. Most deaths are from illegal drug use. The people on the board should be ashamed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joni	None	None	0900006484f94618	Cloud	None	2022-02-21T22:18:54Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Cloud, Joni	kzt-mdpy-1c0l	False	None	False	2022-04-12 03:14:06.895	[]
1197	CDC-2022-0024-1204	https://api.regulations.gov/v4/comments/CDC-2022-0024-1204	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The war on illegal drugs is now being used against the medical establishment to solve a problem that does not exist. People are dying because of illegal fentynal. Not legally prescribed medication for the treatment of pain. Doctors are afraid to prescribe because of the dea. The dea cannot stop drugs so now they attack doctors. Now doctors won’t prescribe proven and safe pain medication. So now millions of people are suffering needlessly. We are “Lucky” I’d a doctor prescribes a small amount of opioid medication. Now it’s monthly visits with a doctor . Tests and other hoops to jump through. When government gets involved in the doctor patient relationship nothing good comes from it. I’m just trying to get through life now. I don’t need the cdc dea and anyone else being involved in my healthcare. I’m thinking maybe all this stuff about limiting medication from patients is just a way to get rid of hurting people. People who are apparently a drain on the system. I along with millions of other people with painful conditions won’t just sit on our hands. People matter. All people. Rip up these “suggestions “ from the cdc. There are millions of people going through this craziness. Do the right thing government. Help us. Let the practice of medicine be between a doctor and a patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bruce	None	None	0900006484f949be	Digre	None	2022-02-21T22:19:19Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Digre, Bruce	kzt-np7h-sxft	False	None	False	2022-04-12 03:14:07.109	[]
1198	CDC-2022-0024-1205	https://api.regulations.gov/v4/comments/CDC-2022-0024-1205	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	my name is [name redacted] and i've been treated worse than a piece of garbage , i'm still a person even tho i have pain , i'm not a criminal or addict ... the nurse at [health facility name redacted] in [city name redacted] n.d actually laughed at me when i said i'm dying from pain , SHE LAUGHED then the doctor told me i would have to see three more doctors and maybe after that they might refer me to a pain management doctor ... just a long story i don't know how to explain my situation but the world is over for me i think about suicide every single day which wouldn't bother me but i have 2 children , you see nothing matters at all to doctors they just want money a person's life means nothing now ... i have titanium in my neck with nerves entangled in it , acdf fusion surgery went bad and the doctor lied on my medical records ever since i've been cut off cold turkey and denied all medications with no taper or weening me off , also cut off anti depressants which is horrible to do to a person will attach a picture of my surgery ... this is KILLING ME AND NOONE CARES ITS HORRIBLE , u see i know compassion and empathy , my mother was a nurse my entire life and she actually cared about people	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erik	None	None	0900006484f912f1	bjornson	None	2022-02-21T22:22:03Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from bjornson, Erik	kzt-o8i8-pajw	False	None	False	2022-04-12 03:14:07.313	[]
1199	CDC-2022-0024-1206	https://api.regulations.gov/v4/comments/CDC-2022-0024-1206	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After the guidelines caused the pendulum to swing so far it broke the need for clarification is very late and has had devastating results!<br/>Primary care doctors will no longer treat their patients pain out of fear. <br/>Specialist for painful diseases such as rheumatologists, the doctors who know the most about the disease and how to treat it will not treat their patients for pain out of fear. <br/>Pain management doctors are bullying patients into unnecessary and NON FDA approved spinal cervical and other joint injections. They use tactics such as signing a pain contract stating the patient agrees to ANY treatment or procedure recommended or risk having their pain medication stopped or even being dropped as a patient. These doctors and centers are now making HUGE profits as the patients are not able to advocate for themselves again out of FEAR!<br/>The MME equivalent guideline needs to be erased completely! It should be the doctors decision ALONE how to treat each INDIVIDUAL patient. Stop lumping all patients together. We all have very different and personal disorders and diseases. We have the right to be treated according to our doctors expertise and awareness of our medical history and very individualized pain levels. <br/>We have seen a significant increase in suicide in many pain communities such as support groups for Lupus, Rheumatoid, Scleroderma and other painful autoimmune diseases. The increase in suicides of our Vererans is just shameful as even the Veteran Affairs doctors are abandoning and neglecting their veteran patients due to your guidelines. You need to fix this problem before you have more blood on your hands!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484f959dd	Armstrong	None	2022-02-21T22:27:17Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Armstrong , Christina	kzt-sxh6-evzv	False	None	False	2022-04-12 03:14:07.520	[]
1200	CDC-2022-0024-1207	https://api.regulations.gov/v4/comments/CDC-2022-0024-1207	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In addition to doctors under prescribing, pharmacies are also to blame. I take my medication as prescribed even when it’s not nearly enough, and every time I go to fill my prescription I have to go in-person to sometimes literally 30 pharmacies. They won’t let me use the same pharmacy, like you are supposed to and have done in the past with no problems, and won’t even order the pills they claim are “out of stock” EVERY time I go and no matter where I go. I have scripts that I was simply unable to fill at all. I’m In so much pain that sometimes I think death is the only thing I can actually look forward to now. I used to get proper treatment in my home town, because the doctor refused to let blanket guidelines dictate how he treats patients. Here in Georgia, it’s [vulgar language redacted]. I’ve done everything possible for my neck. I have no choice but take opioids, get surgery I can’t afford and won’t be covered by insurance, or die. I think they want me to die, because no solutions have been even attempted. I’m currently prescribed 2 15mg morphine ER pills a day. It took over a year just to get this, between the Dr neglecting me and the pharmacy refusing to fill without speaking to a Dr who won’t speak to the pharmacy. The situation is going to kill me, and has already ruined me. For 2 whole years trying simply to get a pain dr, while my other dr was still prescribing out of sheer moral obligation, I eventually got stuck with no help. I was forced to go to some drug clinic every day for about 6-weeks. The methadone was so strong yet worked so poorly in terms of side effects, i got fat and developed other health problems before I finally found a dr and I came off the methadone. That was the worst thing I’ve ever felt in my life. The state will get me hooked on liquid heroin, but won’t pay for my little amount of pills. I payed $85 to fill my last rx of 2 15mg pills. For a 4-week supply. The state will pay to hook a legitimate pain patient on methadone during a pandemic where I had to go around a bunch of drug addicts in a tiny room every day though. I have health issues now from sheer neglect. I’ve stopped caring whether I live or die, because this is not living. Im suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gavin	None	None	0900006484f972b9	Munoff	None	2022-02-21T22:43:58Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Munoff, Gavin	kzu-7wq4-wj5s	False	None	False	2022-04-12 03:14:07.772	[]
1201	CDC-2022-0024-1208	https://api.regulations.gov/v4/comments/CDC-2022-0024-1208	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello everyone I'm a 60 year old man born with Spina Bifida the bad kind had a repair at 6 months old and was OK till I was 13 and developed a drop foot on my left side they did all the tests and found out I had grown a tumor on my spine where the Defect was it had totally enveloped the spinal column wrapped itself around and through my father made sure I had the best surgeon in Los Angeles his name was [name redacted] anyway he operated and I came out OK still had a drop foot but being a California kid I bounced back my brother in law [name redacted] got me in great shape a few years past I moved to [city name redacted] Texas and finished my education got a good job at [company name redacted] and met my wife and was married had a son one morning I got to work and was walking in and my lower back went totally out I had never felt pain like this before again they did the tests and once again the Tumor had returned trying to do what my father had done I found the best surgeon I could at [facility name redacted] hospital [name redacted] he did the surgery but this time the tumor had wrapped itself in my spinal cord and it took them 17 Hours to remove 90% in post op I was begging for something to help with the pain and the nurse said they had to xray my lungs to see if any anything had pooled in there during the 17 hours so a little lady radiologist about 4 ft tall came in tried to place the xray board under my back and realize I'm about 175 lbs so she couldn't move me so she called an orderly to help and even with him they couldn't roll me so they set me up splitting my stitches and realize this incision is about 15 inches up my lower spine so they had to take me back into surgery for I think it was 5 hours to repair what they had done I nearly died I leaked spinal fluid for 7 weeks then they finally let me go I have lived in agony every since that surgery I wear braces on both my legs and walk with crutches back in early 2000s my Dr and I finally found a combination of opiods that killed my pain and allowed me to return to work and lead a comparatively normal life and I was fine for 15 years working doing my thing and here comes the CDC including me with the people that are abusing these drugs that let me live my life ITS NOT FAIR what they did now I can't work and I have no life all I know is pain my lower back all down through my hips hurt like crazy and I have torn rotator cuffs in both my shoulders from falling so many times I do see a pain management Dr he prescribed 15 MG of morphine 3× per day but like I've been telling him morphine has never worked for me ever it keeps me from going into withdrawals but that's it I take a great deal of ibuprofen to keep the swelling down but I live now dayto day sometime just waiting to die and that's not a joke I'm trapped in this body full of pain and my Government doesn't give a crap they put me in a category and say we'll shame on you I WAS BORN THIS WAY I have gone to other pain management Dr's before but all they want to do is more surgery or implants that I don't want it's just not fair I want to go back to work I want to live again please.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484f973c7	Miller	None	2022-02-21T22:54:33Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Miller, Richard	kzu-m1az-ifzs	False	None	False	2022-04-12 03:14:07.976	[]
1202	CDC-2022-0024-1209	https://api.regulations.gov/v4/comments/CDC-2022-0024-1209	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was 25 years old when I was diagnosed with complex regional pain syndrome (CRPS) on my right upper extremity after an injury and was seen by 4 doctors before being diagnosed. CRPS is a rare neurological disorder that causes an nervous system dysfunction which causes ongoing severe burning pain, swelling of a limb, muscle atrophy, allodynia, weakness, and many more system wide complications. It is listed as the highest pain condition someone could have on the McGill Pain scale, so why is that for the last 3 years of having CRPS from 2018 until now doctors are resistant to prescribe opioids long-term to treat my condition? In the beginning I was given a small supply of opioids and also when I sprained my knee and ankle, but this was only after 2 emergency room visits and being in tears at the doctors office because of how much pain I was in. I've had to treat my CRPS with stellate ganglion nerve blocks which are highly expensive and not easy physically, emotionally, or mentally. I was placed under anesthesia for these injections that I spent 3 weeks recovering from because of the side effects of the steroids and mix of medications they injected. I had an adverse reaction undergoing one injection where I was unresponsive for what seemed like 20 minutes and it terrified me. Not to mention dealing with the extra pain from being injected from a needle that is about 2 inches long multiple times in my neck which to me is way more risky than if I were to just be given opioids to treat my pain. I haven't been able to work since being injured. I have undergone about 10 stellate ganglion blocks. The second worst part is that I suffered an ankle sprain and knee sprain which caused me to develop CRPS in those areas also. I then underwent 6 lumbar nerve block injections which were also painful and would only provide about a week of temporary relief. The injections provided temporary relief and I would have done anything just to have adequate pain relief, but because they only lasted a limited amount of time I had to continuously get them. I definitely experienced providers not wanting to prescribe opioids because of the guidelines that were set and deterred providers from prescribing opioids to chronic pain patients, so instead my doctors prescribed muscle relaxants (zanaflex, cyclobenzaprine), beta blockers (clonidine), lidocaine topical numbing cream, celebrex and Ketorolac (antiinflammatories), gabapentin, lyrica, antidepressants and all of these medications had their own side effects that made it intolerable to continue on for long. Imagine holding a job when you are on muscle relaxers that are sedating and still expected to function, drive, & work? Its been hard to be prescribed opioids when my pain flares up and instead im directed to get another injection or steroids when instead I know a simple opioid script is more affordable and can be effective without all of the sedating side effects, nausea, injection site pain, IV phlebitis, steroid side effects, upset stomach, and adverse reactions. Ive come to the point where celebrex is my daily vitamin and I have to take more than the recommended dose because the standard dose is ineffective but at least it doesn't sedate me like muscle relaxers because I need to function- I have to take care of my children and start working again to support myself . I currently have restrictions that dont allow me to lift more than 3 pounds and no repetitive motion. Everything that I used to do I can no longer do everyday is a struggle even for simple household chores like mopping, washing dishes, unloading the dishwasher, doing laundry, and it would be easier if I had adequate pain relief. Pushing gabapentin and muscle relaxers to treat one of the most painful conditions known is truly cruel when its ineffective. Also the opioid guidelines that passed in 2016 increased STIGMA for chronic pain patients and encouraged providers and medical professionals to label them as drug seekers when all we want is a chance at pain relief. The guidelines of 2016 did more harm than good for chronic pain patients and this must be changed. There is so much stigma that I shut down talking about my pain even with my doctors it feels uncomfortable even with my family because of the stigma which was all perpetuated by the 2016 guidelines. There is a major difference between chronic pain patients needs for opioids because these medications work yet are so restricted. CRPS is also known as the suicide disease because there is a high rate of CRPS patients taking their own lives because the pain is unbearable. Treatments for CRPS also include burning the nerve, amputation, spinal cord stimulator, and of course alternative therapies. However, think about it you would rather restrict opioids and practically force someone to consider these other extreme options which aren't very effective than to just write a prescription for opioids with ongoing monitoring and screening which can be safe and effective.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Aria	None	None	0900006484f9751d	Kent	None	2022-02-21T23:01:25Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Kent, Aria	kzu-z48r-siee	False	None	False	2022-04-12 03:14:08.182	[]
1203	CDC-2022-0024-1210	https://api.regulations.gov/v4/comments/CDC-2022-0024-1210	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support Red Lawhern's comments about the CDC's new guidelines. Lowering MMEs and basically worse than 2015 and will make pain meds obsolete which they almost are.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peggy	None	None	0900006484f97575	Oconnor	None	2022-02-21T23:01:47Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Oconnor, Peggy	kzv-6frn-rv5m	False	None	False	2022-04-12 03:14:08.458	[]
1204	CDC-2022-0024-1211	https://api.regulations.gov/v4/comments/CDC-2022-0024-1211	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC guidelines have severally ruined my quality of life due to a severe accident which left me in chronic pain!Please drop any MME’s and stop pinpointing certain diseases or injuries. if a doctor believes his/her patients needs these life saving pain medication that should be between the doctor and patient not the insurance companies, pharmacist,d.e.a or anyone else.I have 1 life due to false narrative i cannot live it!I cannot help what happened to me!Please this is not a pain medication problem look at the real issue here….patients in pain! We are dying due to suicide,heart attacks, strokes etc.You have the power to stop this!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Char	None	None	0900006484f97966	Revelo	None	2022-02-21T23:01:56Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Revelo, Char	kzv-cgke-rbnp	False	None	False	2022-04-12 03:14:08.662	[]
1205	CDC-2022-0024-1212	https://api.regulations.gov/v4/comments/CDC-2022-0024-1212	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This control of opioid prescribing is despicable! The CDC decision to manage medical providers in managing their patients pain is ridiculous! The people making these decisions at the CDC have not ever had orthopedic surgery, needs more than 3 days to 1 week of opioids for pain and the painful rehab needed, especially knee and shoulder surgery! How about we go back to having the doctor manage his patients care! <br/><br/>[name redacted], Retired RN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f976ec	Anonymous	None	2022-02-21T23:02:24Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzv-hz72-93a8	False	None	False	2022-04-12 03:14:08.867	[]
1206	CDC-2022-0024-1213	https://api.regulations.gov/v4/comments/CDC-2022-0024-1213	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in serious pain that can only be abated by opioids. This creates suicide ideation feelings in me. Please rescind the guidelines totally.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f97f38	Anonymous	None	2022-02-21T23:04:27Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzw-7ecs-blz0	False	None	False	2022-04-12 03:14:09.084	[]
1207	CDC-2022-0024-1214	https://api.regulations.gov/v4/comments/CDC-2022-0024-1214	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in chronic pain every day all day. I have break through pain that can force me to bed mid day, usually for a number of hours. While I understand the situation regarding opioids and the loss of life that has resulted I cant help but feel abandoned and left to suffer until I can hold on no longer and take my own life. I already think about that solution on occasion, and it terrifies me. I want to live, I love my family and want to hold my grand kids a while longer. But it is becoming harder every day as I see no solution to my pain and nothing to ease my pain when it flares, allowing me to have some quality of life. At what point do people who take their lives become counted as part of the opioid death toll? I do not wish to be an opioid collateral damage victim.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484f988df	Calkins	None	2022-02-21T23:07:06Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Calkins, Thomas	kzw-pn4k-q4us	False	None	False	2022-04-12 03:14:09.297	[]
1208	CDC-2022-0024-1215	https://api.regulations.gov/v4/comments/CDC-2022-0024-1215	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f98dcb	None	None	2022-02-21T23:09:38Z	Countrywide	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Countrywide	kzw-yzgs-7c89	False	None	False	2022-04-12 03:14:09.502	[]
1209	CDC-2022-0024-1216	https://api.regulations.gov/v4/comments/CDC-2022-0024-1216	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m sitting here right now in agonizing pain due to severe osteoarthritis and sever cervical and spinal stenosis and a tendonitis exacerbation. When I call my PCP, all I get is the lecture and how I am on the opioid team at [facility name redacted]. He does not listen and always talks about how HE can get in trouble. I have been on the same dose for almost 2 years and yet my arthritis is progressing and I frequently get tendonitis flare ups which are agonizing. Tolerance is real yet the only issues my [facility name redacted] physician is concerned with is his career. I have suffered needlessly for years and if you have been taking opioids long term, you do not get “high”. An addict will use and abuse anything and anyone using an opioid is treated as if they are a junkie. I have been treated horribly by pharmacy staff and emergency room physicians. I have suffered for days because my Doctor was unavailable and no one else could prescribe after I suffered a bad fall and literally tore the muscle of my forearm off the radius bone. I also participated in the MUSE study. Medicine is not black or white! As a RN and case manager I know first hand there is a sea of grey. I willing explored the grey for my patients. You also can not fit a square peg into a round hole and there are many shapes of pegs that our current healthcare industry demands fit in round holes. For those of us in real excruciating pain, these laws and the stigma is wrong and unfair. It is sad when you think suicide is your only option when you are in severe pain from a fall or storm. Please change the laws and allow the suffering of real people in real pain to cease. <br/>And worker compensation companies such as [company name redacted] have a widely known practice of delaying authorization of pain meds to save money, thus purposely sending people into withdrawals when the only treatment they will authorize is only pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jen	None	None	0900006484f98dea	Anonymous	None	2022-02-21T23:11:36Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous , Jen	kzx-00wj-nx3b	False	None	False	2022-04-12 03:14:09.705	[]
1210	CDC-2022-0024-1217	https://api.regulations.gov/v4/comments/CDC-2022-0024-1217	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter died of a drug overdose January 2nd 2018 because of your 2016 “rules” for doctors prescribing pain medications. She suffered from chronic pain as a result of a severe auto accident in 2006. She had pain management doctors all those years and she did ok for 11 years until her pain management doctor cut her pain medication 75% in 6 months, which drove her to the street for heroin to relieve her pain. For the first time in 11 years she failed a drug test at which point her pain doctor cut off her medications completely! She was dead a week later from a heroin/ fentanyl overdose. Your rules resulted in a doctor denying pain medication to a person who had broken 2vertabrae in her spine, her pelvis on both sides, her femur was snapped, her left knee had screws and pins holding it together, her left foot was crushed and also had pins and screws in it, she had a crushed disc in her back and her left arm was disabled with nerve damage. Thank you CDC for killing my daughter! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ric	None	None	0900006484f98916	Hopkins	None	2022-02-21T23:12:59Z	None	None	1	None	2022-02-21T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Hopkins, Ric	kzw-rc4k-fq3k	False	None	False	2022-04-12 03:14:09.928	[]
1211	CDC-2022-0024-1218	https://api.regulations.gov/v4/comments/CDC-2022-0024-1218	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After 20 years with the same Dr on the same medications, because of the CDC guidelines, my Dr informed me they would no longer be able to manage my pain medications. I was referred to a Pain Management Dr who did not know of my history nor was a specialist on the Dx's that I have. They were only interested in any pain that was spine-related or back pain. They pushed for painful procedures and injections that are not approved by the FDA like epidural injections. <br/>I had spent almost 5 years getting alternative and non-opioid therapies before ever starting any type of opioid treatment options from acupuncture, massage, chiropractic care, physical therapy, etc. None of which were covered by my private health insurance and added up quickly. <br/>Opioid therapy allowed me to function, continue working, raise my children, care for my aging parents and in-laws, do charitable work in our community, and stay as physically active and healthy as possible. <br/>The changes in my treatment of pain had left me without pain medications for over 3 years, trying everything my Dr's suggested. One of the medications even caused such a horrible reaction that I was hospitalized for 5 days.<br/>My health has deteriorated to the extent that my body has undergone muscle wasting, increased blood pressure, etc. I am at a higher risk of stroke, cardiac events, blood clots, and many others associated with poor physical health.<br/>The risk/benefit factors of use of opioids long term have proven that it is more beneficial for people like me to have the option to continue an active healthy life over becoming a burden to the system from becoming disabled long before I would be if I had access to my previous regimen. I have worked since I was 14 years old and would like to continue to do so. <br/>Please see that just because a person abuses medication, does not mean that everyone will and I should not be treated as though I will, especially when I have proven to be a compliant patient and I have never had any issues in my past regarding the safety of my medications, their use or my intentions for nothing other than having the best quality of life that medical science can provide for someone with my Diagnosis's.<br/><br/>With that, I can only follow up with the suggestion of allowing my Dr's to be the ones who are in charge of my care and not the policies written about things that I have nothing to do with. Overseen and regulated by my doctors based on my diagnosis. My actions, responsibilities, and compliance should be the only reason any medications that worked so well should be discontinued without obvious medical reasons like side effects or blood tests that may result in a need to discontinue. <br/><br/>Stop the continued mistreatment of patients who through No fault of their or their doctors being affected by the misinterpreted Guidelines now turned LAW. It is ridiculous that in 2022 people are suffering link it is medieval days.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f98e06	Emmel	None	2022-02-22T15:22:34Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Emmel, Debbie	kzx-0qeo-hg29	False	None	False	2022-04-12 03:14:10.130	[]
1212	CDC-2022-0024-1219	https://api.regulations.gov/v4/comments/CDC-2022-0024-1219	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The following is a document I sent to my Representative back in 2017. I saw the problems then and I see even bigger problems with SB2235 and the CDC's opiate guideline revisions. Much of the original letter-Professional Studies on the subject- has been removed to fit the word restraints on this commentary. <br/><br/>January 10, 2017<br/><br/>To the Honorable (REDACTED)<br/><br/>The war on opioids has translated to the war on pain. And those that are losing the battle are legitimate chronic pain patients. They have no voice nor recognition.<br/>While the CDC issued “voluntary” recommendations for non-cancer chronic pain patients aimed at curbing epidemic misuse, abuse and overdose – it is in no way voluntary. Physicians across the country systematically have not just reduced prescribing opioids but have denied medications or worse, totally dropped/eliminated treating pain patients.<br/>Pain patients have been ostracized, labeled addicts, hypochondriacs, liars, dopers and on. Their integrity is always in question and they are now being treated as second class citizens. Legitimate pain patients gladly try alternate therapies (yoga, exercise, physical therapy, psychotherapy, etc.) but relief is fleeting at best and cost prohibitive at worst.<br/>Chronic pain patients already have compromised quality of life, often the inability to carry on daily activities of life let alone recreational activities. Now they are in jeopardy of having no life. With no/inadequate treatment, sound evidence shows an escalation into depression, solicitation of illicit drugs (especially heroin) and/or suicide.<br/>The latest data shows:<br/>•<span style='padding-left: 30px'></span>Chronic pain is an epidemic leading to vocational, social, and familial malfunctioning of the individual<br/>•<span style='padding-left: 30px'></span>116 million Americans have serious, chronic pain, many are inadequately treated (Institute of Medicine)<br/>•<span style='padding-left: 30px'></span>Rate of chronic pain is increasing due to baby boomers age<br/>•<span style='padding-left: 30px'></span>Chronic pain suffering cost the country $560 - $635 billion annually in medical bills, lost productivity and missed work<br/>•<span style='padding-left: 30px'></span>Opioid addiction usually begins in the same place that all other addictions stare – in the childhoods, traumas, mental illnesses, and genes of those affected<br/>•<span style='padding-left: 30px'></span>Data on people who start pain treatment yields the same conclusion: the vast majority don’t misuse their drugs<br/>•<span style='padding-left: 30px'></span>Less than 1/3 of opioid users get them from their doctors<br/>•<span style='padding-left: 30px'></span>NIH spends little on pain research<br/>•<span style='padding-left: 30px'></span>Physicians have little pain management training; nor is training on opioids training on pain management<br/>•<span style='padding-left: 30px'></span>Solicitation of illegal drugs and suicide rates will increase with denial of legitimate opioid prescriptions<br/>•<span style='padding-left: 30px'></span>Opioid deaths are not predictive of chronic pain opioid use but rather massive opioid use as an illicit drug<br/>•<span style='padding-left: 30px'></span>The American Academy of Pain Management states there are serious issues with the CDC guidelines that need to be addressed. They contend CDC’s current guidelines actually may be misleading practitioners, giving recommendations based on a flawed evidence review process that excludes a wide breadth of relevant studies. The recommendations seem to be more focused on “mitigation of societal risk in response to an epidemic of opioid misuse and abuse, as opposed to quality evidence-based clinical management of pain”.<br/>In summary, the huge majority of legitimate chronic pain patients with properly prescribed opioid medication are not abusers nor recreational high seekers. They are simply trying to achieve some level of life quality and pain reduction. They want to be productive, useful, and valued.<br/>Dramatically reducing opioid therapies will cause irreparable harm for these patients in agony AND will not prevent opioid deaths. Worse yet is the substantiated fear of the inability to have access to appropriately prescribed opioids will truly turn these unfortunate Americans into criminals as they have no choice but to revert to illicit drugs. Or, worse yet, choose suicide.<br/>The question--who is being protected or served -- must be asked. Is medicine about the health of an individual or about something else such as the interests of capital venture? This spear-headed effort to get rid of opiate use in America will only produce unwelcome consequence subverting the original intent.<br/>Throwing away legitimate, law abiding chronic pain patients would be a disgrace to humanity, medicine and technology. It is these types of acts that alienate and disenfranchise people promoting an unsteady population that may act out in ways that are opposite of a truly civilized society. The condition of chronic pain can happen to any one of us at any moment, including you and your loved ones.<br/>Please, hear me and many others, in not only our grievances but in our plea for justice and equality in medical treatment. Opioid deaths are a symptom, not the root cause. Controlling the real problem, illicit opioid access/distribution/abuse is the solution but not at the expense of chronic pain patients.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f98e23	Cook	None	2022-02-22T15:47:57Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	kzx-1f07-azds	False	None	False	2022-04-12 03:14:10.348	[]
1213	CDC-2022-0024-1220	https://api.regulations.gov/v4/comments/CDC-2022-0024-1220	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It all started when i had surgery around 2004. Doctor went threw the front of my neck. to do my dic/s c/5 6 7. when he was cutting me he cut a hole in my neck and after a couple of weeks i was one sick person. my white count went up to 28.000. so this went on for a month or two.the cut just close on its on. doc put a plate in my back but the mri shows two scerws backing out. the had surgery on my knee. it went wrong so another doc had to go in and fix my knee. then surgery on my shoulder.doc scrape the inside of my shoulder.7 hole he made. it started hurting and has not stop. one doc told me i have RA.THE HAD A MRI ON MY NECK. DOC TOLD ME I HAVE SOME REAL PROBLEMS.HOPE YOU CAN READ THIS.NOT A DAY GOES BY THAT I DON/T HURT.GOD TRUTH.2016 EVERTHING WENT WRONG. THEY TOOK THE MED THAT WORK AND GAVE ME ONE THAT OUR NOT WORKING. MY DOC KNOWS WHAT WILL WORK BUT AFRAID HE WILL GO TO JAIL.IM 66 10101955.PS MY RIGHT HAND JUST DROPS. WHEN IM HOLDING SOMETHING.PLEASE HELP THE ONE/S WHO REALLY NEED IT. I KNOW MY SPELLING IS BAD. GOD BLESS THE USA. [redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronnie	None	None	0900006484f98e64	Horne	None	2022-02-22T15:51:03Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Horne, Ronnie	kzx-34u4-pdab	False	None	False	2022-04-12 03:14:10.562	[]
1214	CDC-2022-0024-1221	https://api.regulations.gov/v4/comments/CDC-2022-0024-1221	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have fibromyalgia and other pain related health issues. I live with pain every minute of every day. I think the prescriptions should be the discretion of the doctors. They KNOW their patients and they know the difference between those of us who truly suffer and those who are drug seeking. How is it possible for ANY government body to step in and dictate how a patient who they DO NOT EVEN KNOW should be treated? It is ridiculous.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98ca5	Anonymous	None	2022-02-22T15:52:00Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-7erk-rs12	False	None	False	2022-04-12 03:14:10.766	[]
1215	CDC-2022-0024-1222	https://api.regulations.gov/v4/comments/CDC-2022-0024-1222	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in pain management for 20 or so years. My Dr. Has been cutting my pain medication since the cdc guidelines told him to. I now get less than half of what I did before that . Even though I have had 2 neck surgeri3s , 2 back surgeries, one elbow surgery. On shoulder surgery. At this moment I have pinched nerves , In my neck, back, and elbow. With new MRI. New nerve conductive studies. I have and suffered a lot. I am disabled from this pain and have collected a social security check for these issues as well as depression and anxiety, due to pain and lack of a social life. These opioid guidelines have really taken a tole on my quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484f9914f	Ortego	None	2022-02-22T15:52:54Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Ortego, Elizabeth	kzx-7sxo-xkd2	False	None	False	2022-04-12 03:14:10.982	[]
1216	CDC-2022-0024-1223	https://api.regulations.gov/v4/comments/CDC-2022-0024-1223	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[Name Redacted] - Pharmacist<br/>February 111 at h9t17:0a4 AnMs9o2ed · <br/>Shared with Public<br/>The Pharmacist supports a few of the CDC Opioid Rx guideline changes proposed, but disagrees with much. Agree with the change that for patients on high doses of Opioids, urge Doctors to not abruptly halt treatment unless there are indications of Life-threatening danger, also suggestions on how to taper off. As to the other proposed changes I am against. It takes only 3+ days for some patients to become addicted. exceptions for acute pain should be rare so keep this guideline in place. Then agency should make sure that Doctors are aware that in severe pain and in terminal cases , there is no problem and should be no FEAR of Prudent, legitimate Doctors prescribing. Limits on extreme doses can prevent fatal overdoses. High dose opioids form extended periods should also require Narcan or Naloxone also. Restriction on days supply( large quantities) must be must be kept, because patients must be closely monitored and to prevent possible diversion. (pills on the street.) Sadly this can cause some inconvenience but is necessary. Otherwise, Free Flowing Rx Opioids that has led to the huge addiction issues by millions and now much of the reason for over 100,000 deaths a year will continue. Many stopped worked on overcoming their addictions because of the tightening. We have less addicts today, but sadly more deaths More addicts however will mean more addictions and ultimately death. I have seen generational deaths. Let's not go back to what started this Epidemic. We do need more efforts on awareness, education, harm reduction, treatment, and recovery. Prayer, "The Pharmacist" [Name Redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dan The Pharmacist	None	None	0900006484f991c1	Schneider	None	2022-02-22T15:56:33Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Schneider, Dan The Pharmacist	kzx-827e-vnqy	False	None	False	2022-04-12 03:14:11.190	[]
1217	CDC-2022-0024-1224	https://api.regulations.gov/v4/comments/CDC-2022-0024-1224	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[Name Redacted] - Pharmacist<br/>February 21 <br/>The Pharmacist supports a few of the CDC Opioid Rx guideline changes proposed, but disagrees with much. Agree with the change that for patients on high doses of Opioids, urge Doctors to not abruptly halt treatment unless there are indications of Life-threatening danger, also suggestions on how to taper off. As to the other proposed changes I am against. It takes only 3+ days for some patients to become addicted. exceptions for acute pain should be rare so keep this guideline in place. Then agency should make sure that Doctors are aware that in severe pain and in terminal cases , there is no problem and should be no FEAR of Prudent, legitimate Doctors prescribing. Limits on extreme doses can prevent fatal overdoses. High dose opioids form extended periods should also require Narcan or Naloxone also. Restriction on days supply( large quantities) must be must be kept, because patients must be closely monitored and to prevent possible diversion. (pills on the street.) Sadly this can cause some inconvenience but is necessary. Otherwise, Free Flowing Rx Opioids that has led to the huge addiction issues by millions and now much of the reason for over 100,000 deaths a year. Keep in mind some, many weaned themselves off of Opioids because of theses guidelines. Some went to MAT, other abstinence. We now have less addicts, but more Overdoses. Opening the Faucet is not the solution. Let's not have history repeating ITSELF. We do need more efforts on awareness, education, harm reduction, treatment, and recovery. Prayer, "The Pharmacist" [Name Redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f99245	None	None	2022-02-22T15:57:45Z	Tunnel of Hope	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Tunnel of Hope	kzx-8cxy-nao6	False	None	False	2022-04-12 03:14:11.402	[]
1218	CDC-2022-0024-1225	https://api.regulations.gov/v4/comments/CDC-2022-0024-1225	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Those who are in chronic pain require their doctor to be freed from the restrictive rules currently in place for opiate prescription. Please allow the sacrosanct doctor/patient relationship to determine the best form of pain relief, as has been the traditional tried and true prescription care plan. <br/> Do not penalize Drs for taking good care of their patients. <br/> Do not force suffering patients to make the heartbreaking choice of either going outside of the law for pain relief from dangerous, likely adulterated substances, or else suffering in agony. <br/><br/> The relatively few physicians who take advantage of their prescription writing privilege can easily be spotted and stopped, without jeopardizing the lives and livelihoods of physicians who are doing the noble work of properly caring for their patients. <br/><br/> Thank you, <br/> [Name Redacted] <br/> Retired ICU RN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vivianna	None	None	0900006484f9932b	McCoy	None	2022-02-22T16:00:24Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from McCoy, Vivianna	kzx-8vka-f7m2	False	None	False	2022-04-12 03:14:11.660	[]
1219	CDC-2022-0024-1226	https://api.regulations.gov/v4/comments/CDC-2022-0024-1226	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had my first back surgery in 2016 - a fusion at L4 / L5 at 35 years old. Three years later at 38, due to osteonecrosis in both hips, I had two full hip replacements. Then, in November of 2021, my L2 / L3 disc herniated and I had to have a microdiscectomy. Now, one month from my 41st birthday, my L5 / S1 disc is in failure and I found out today that I have to have an L5 / S1 fusion which will require a revision at L4 / L5 as well. I have been in chronic pain every day for six years. This whole time I have been taking opioids. Not once have I failed a urine analysis. I am at the current maximum dosage that the 2016 guidance allows and this dosage is becoming ineffective. I have been to three different pain management specialists and even with all these documented medical issues, the response is always the same - you are a perfect candidate for a higher dosage, but the current CDC guidelines do not allow a higher dosage. These guidelines may make sense for someone who is new to opioid pain management. However, for the millions of chronic pain sufferers out here with documented ongoing pain management issues - this is torture. We are being punished for those that cannot responsibly manage their medication intake and the guidance needs to be revised to take us into account.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Isaac	None	None	0900006484f993de	Mims	None	2022-02-22T16:02:04Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Mims, Isaac	kzx-9ana-kupd	False	None	False	2022-04-12 03:14:11.877	[]
1220	CDC-2022-0024-1227	https://api.regulations.gov/v4/comments/CDC-2022-0024-1227	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer and have been prescribed Vicodin (nothing stronger than that) since an auto accident in 1999. I had two total hip replacements in 2015 but continued to suffer pain in my neck and lower back. I’ve been getting epidurals in both areas for many years. I have never had any type of drug problems over the years, no rehab or anything like that. The Vicodin has made it possible for me to have some quality of life. A few months ago my pain management doctor began tapering me off of the Vicodin despite me having pain that affects my daily life. The last medication he prescribed me was Tramadol which gave me no relief. Since I must travel 6 hours each way monthly to get medication I stopped going. I have now been without any pain medication for about six months, and suffer every day. My hope is that with the adjustments the CDC is making people like myself that just want some quality of life can get some help that makes sense. Since I haven’t been receiving any pain medication I have spent a fortune on acupuncture and CBD ointment with the very relief. My pain management doctor is [Name Redacted] in [City Redacted] California, and I have always felt that he has taken my pain seriously. I hope doctors like him will have their hands untied so they can go back to treating their patients on an individual basis. Pain management is not a “one size fits all” situation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Minta	None	None	0900006484f9958f	Bacher	None	2022-02-22T16:37:37Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Bacher , Minta	kzx-a8nr-ac18	False	None	False	2022-04-12 03:14:12.081	[]
1221	CDC-2022-0024-1228	https://api.regulations.gov/v4/comments/CDC-2022-0024-1228	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for considering this new change. I suffer daily. And can tell you that it’s taken 5 years to finally be diagnosed and helped after going from Doctor to Doctor to ask for help. No one believed me. Until one Doctor said I’ll order MRI. MRI showed severe Spinal disfunction and more, lots more. <br/>Now I’m living with chronic pain after working for 40 years 80 hours a week. I am basically bed bound. But have to go to Pain Dr. Every month for urine test. I asked why I can’t just go to my reg. Dr. For prescription? I have to travel over 1/1/2 hours just for monthly ursine test. That travel wipes me out for three days. It would be easer if I could just go to my Doctor. Also, I never failed a urine test. And have been on same medication for years now. I’m getting worse but can’t get more relief as they can’t give me more. Or help me. So I manage the best I can. And fight daily with depression because I feel so alienated and am in so much pain. Pain is real. It’s hard to breath when your in pain. Now I have hypertension. Please help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f996cb	Anonymous	None	2022-02-22T16:42:58Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-ayk6-ilcr	False	None	False	2022-04-12 03:14:12.294	[]
1222	CDC-2022-0024-1229	https://api.regulations.gov/v4/comments/CDC-2022-0024-1229	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an RN who worked in the Mental Health and Addiction Treatment field for many years I know that persons with pain levels that compromise their quality of life on a consistent basis can function effectively on controlled Opioids.<br/>Many of the Professional Team I worked with did not truly have an understanding of ‘Chronic Pain’ that leads to Major Depression and inability to function at normal levels. It was only when they experienced a major event personally, that led to Chronic Pain compromising their ability to enjoy and perform routine activities, that they questioned why opioid levels of pain medication was so difficult to acquire.<br/>Opioids should be available to persons who do not have a drug-seeking nor Addictive type personality on a short or long term basis.<br/>Physicians must NOT be intimidated or controlled by the Government, allowing them to prescribe Opioid medications, facilitating patients to reclaim their life with controlled, tolerable pain levels.<br/>I witnessed many human beings, gradually return to a high level of functioning, while on Opioid medications, with little to no evidence of drug dependence.<br/>Please know that Opioids play a major role in the treatment of Chronic Pain if we are to allow appropriate patients to continue to contribute to society in a constructive, quality of life way. <br/>Many Thanks for the opportunity to contribute my Professional and personal experience to this forum.<br/>[Name Redacted], RN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484f997b9	Clark, RN	None	2022-02-22T16:45:20Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Clark, RN, Judith	kzx-bysq-b7qs	False	None	False	2022-04-12 03:14:12.498	[]
1223	CDC-2022-0024-1230	https://api.regulations.gov/v4/comments/CDC-2022-0024-1230	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am pleased to see that you have been developing a conscientious approach to pain management. Your organization has offered more pain than it has relieved since 2016.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donnie	None	None	0900006484f99831	Jones	None	2022-02-22T16:46:19Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Donnie	kzx-civ6-3jro	False	None	False	2022-04-12 03:14:12.736	[]
1224	CDC-2022-0024-1231	https://api.regulations.gov/v4/comments/CDC-2022-0024-1231	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The clinical practice guidelines have heretofore been based, not on the number of deaths due to prescribed opioids (about 8,000 per year), but on the overwhelming number of illicit opioid deaths (about ten times as many). <br/><br/>The guidelines have not reduced the number of these deaths. But they have contributed to the number of suicides in the chronic patient community, as those whose pain is severe have found they cannot live with inadequate treatment.<br/><br/>They have forced other pain patients into withdrawal, as no doctor wants to face the consequences of prescribing to more than a few patients. I am one of them.<br/><br/>When my PM doctor relocated out of state and I went to a new pain management clinic, I was told they could give me nothing because of the "new patient" guidelines. This was after the superceding letter from HHS explaining that the guidelines should not apply to long-term patients. <br/><br/>I told him I had taken the same dosages of the same medications for the previous 18 years. I offered to give him copies of my prescription records to verify. He said it didn't matter what I'd had in the past, I was a "new patient" to his practice. He couldn't make an exception or he would be subject to "harassment" by the state.<br/><br/>The fact that they have been brutally misapplied by law enforcement agencies should be reason enough to RESCIND rather than adjust the guidelines. LEAs have consistently used their funds not for prosecuting importers of illicit drugs, but for the easier task of punishing doctors and chronic pain patients. <br/><br/>I have no faith whatsoever that the "adjustments" to the original guidelines will make any difference to law enforcement. They've found an easy target and will be reluctant to let it go.<br/><br/>There is no need for "adjusted guidelines" in the patient/prescriber relationship. There is no need for any guideline at all.<br/><br/>The government should stay out of doctors' offices and pain patients' lives. All we ask is the chance to live our lives as best we can, enduring our pain while being treated for the worst of it.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teri	None	None	0900006484f9983e	Vanore	None	2022-02-22T16:48:29Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Vanore, Teri	kzx-ck4z-h24d	False	None	False	2022-04-12 03:14:12.964	[]
1225	CDC-2022-0024-1232	https://api.regulations.gov/v4/comments/CDC-2022-0024-1232	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer taking opioid pain relievers for nearly 12 years, I can see a lot of patients like me feeling the overwhelming negative affects of the "war on opioids". They were not the first line of treatment,but a last resort. Many other treatments were tried first but nothing really worked on the headaches and body pain. When the uproar started, I was called a junkie by several pharmacists and humiliated in front of more than a few other patients. It seemed no one cared about the chronic pain sufferer and a lot still don't. I feel the whole situation was grossly mishandled and focused on the wrong people. Sure,there were pill mills but they are all shut down,at least in our area.other issues have arisen from this war that are needlessly cruel. For instance: my doctor office visits are every 30 days at $180 pervisit and have to have a SEVERAL HUNDRED DOLLAR drug test at least 8-10 times a year even though I've NEVER failed one and never will because I follow rules. Fill dates are totally inflexible so I've missed out on more than a few family trips because no pharmacies will account for the doubling of our population for 6 months every year so are often running out of my medication. So I get to go through withdrawals and untreated pain from time to time. This medication does NOT get rid of pain. It only allows for enough relief so that I can hold a part time job and interact with my family most of the time.It is obvious to me and a lot of other patients that we are just expendable and forgotten because the world views us as addicts first and if you raise your voice, you could be cut off. We all live with the fear that we are going to go back to little or no pain relief because of the EXPERTS saying that whatever opioid you are taking is too much and DOCTORS saying they are in constant fear of the DEA. We are human beings but are being treated like street level junkies and drug dealers. Dogs and cats are shown more sympathy. This needs to stop. There is NO trust left. Even though the article says that these guidelines are just that,Suggestions. Doctors and many phar macists treat them as law in concrete. I have been lied to by both doctors and pharmacists about these guidelines and been told that the DEA tells them what they can prescribe. I wish I could be normal again. I wish I didn't have to take this garbageand go through the humiliation but I don't get to choose because at this point, it's all I have. Sorry for being in pain and inconveniencing everyone. I must remain anonymous for fear of retaliation.<br/><br/>C- A Sufferer and an individual <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f98fbd	Anonymous	None	2022-02-22T16:50:18Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-dy8m-98sx	False	None	False	2022-04-12 03:14:13.168	[]
1226	CDC-2022-0024-1233	https://api.regulations.gov/v4/comments/CDC-2022-0024-1233	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain from fibromyalgia, which got worse after radiation, and chemotherapy in 2004. I also have sciatica ,osteoarthritis, scoliosis, and degenerative disc disease, . I was on hydrocodone for 4 years , and had one bad drug test which involved valium. A one time use. I was immediately taken off of hydrocodone, and had to do detox my myself. I wanted to die. The pain was unbearable. I was given no choice in the matter. Never a problem before. My doctor just decided that was it, and dismissed me like that. It had been a few years that I went without help. One day I told my doctor (the same doctor) that I could not take the pain anymore. That I happen to be one of those people that truly have pain, and that the CDC has over stepped themselves. That People are going to see more suicides from not having the help they need. Then by getting the help they need. My doctor listen to me and put me on gabapentin, and tramadol. I figure it's better then nothing. Plus I'm afraid to go back on anything stronger. I never want to go through that again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484f9904c	HOOSE	None	2022-02-22T16:51:07Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from HOOSE, Debbie	kzx-f3lp-h3xq	False	None	False	2022-04-12 03:14:13.374	[]
1227	CDC-2022-0024-1234	https://api.regulations.gov/v4/comments/CDC-2022-0024-1234	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I sure hope this change will help those with chronic pain. The current guidelines just make it very difficult to get the proper medication to those that truly new it. My husband was in a severe auto accident in 2004. His medicines are what enable him to be a functioning member of society. Doesn't any one realize that if you can't get the needed meds to function that forces you to file for disability?? We have also fought with a few insurance companies who are leaving the insurer the impossible burden of paying out of pocket for expensive meds that they won't cover while the insured is paying for said insurance coverage? It's infuriating!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patti	None	None	0900006484f99a84	Duffy	None	2022-02-22T16:54:02Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Duffy, Patti	kzx-hs8m-pv24	False	None	False	2022-04-12 03:14:13.583	[]
1228	CDC-2022-0024-1235	https://api.regulations.gov/v4/comments/CDC-2022-0024-1235	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Shame on you for turning us chronic pain patients i to enemy #1 for the past six years! May you have as many sleepless nights as I had trying to deal with pain and being terrified of being cut off!<br/>This was irresponsible on your part!<br/>Doctors didn’t want to treat us anymore and dumped their frustration on us. I went through surgeries without proper pain meds and crying in pain.<br/>This is why I don’t trust the CDC for anything!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerdy	None	None	0900006484f9989f	Proffitt	None	2022-02-22T16:54:52Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Proffitt , Gerdy	kzx-llea-8qj9	False	None	False	2022-04-12 03:14:13.795	[]
1229	CDC-2022-0024-1236	https://api.regulations.gov/v4/comments/CDC-2022-0024-1236	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is time to provide pain patients opioid medications again. Attempts to reduce overdose deaths since 2016 have FAILED. Maintenance drugs and even medical grade heroin are the only way to reduce death now that black market Fentanyl has taken over. <br/><br/>Chronic pain patients have experienced severe withdrawal symptoms, turning to street opioids to find relief, then dying from overdoses. Getting tough on addicts and chronic pain patients does only one thing really well. Getting tough, kills. Dependence on opioids is NOT something to be ashamed of. The dismally failed Drug Wars, is. <br/><br/>If the DEA is allowed to continue it's attacks on opioid dependent people, overdose deaths will continue unabated for people with chronic pain. Doctors will abandon their pain patients to protect themselves. Just like they responded to Trump unleashing his DEA agents to look tough on crime. This hasn't worked.<br/><br/>Fentanyl and it's analogs are never going away. Chronic pain will never go away. If laws and drug policies aren't changed, the death rate will continue to grow and grow. Drug experts are well aware of this. It is about time to end the failed War on Drugs. Because we the people are losing. Drugs? Oh, they have won. Law enforcement, politicians, Treatment Industries, live on our death. Shame on them. Shame on US. <br/><br/>The United States voracious drug consumption will disable our country. If we don't approach this in brand new ways, our country may actually collapse. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484f998e2	Cornwell	None	2022-02-22T16:56:26Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Cornwell, Laura	kzx-mfhn-h862	False	None	False	2022-04-12 03:14:13.997	[]
1230	CDC-2022-0024-1237	https://api.regulations.gov/v4/comments/CDC-2022-0024-1237	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guidelines, were the worst written bunch of misinformation and affected more people than just about anything ever written. The CDC took advice from PROP and other paid for Hacks about things it should never have. Hiw can you say these guidelines were in the best interest for ALL patients? Kolodny had ulterior motives as he is in addiction industry. Meaning he gets money!! By labeling everyone a drug seeker!!<br/>Why ,in a world where communities are giving syringes injection sites aka shooting galleries, free kits to insert illegal drugs up their rectoms, can't I, a legitimate pain patient, with no problems with my meds for 15 years, not be able to receive my.meducations?<br/>Why am I subjected to random pill counts monthly and urine tests, at my own expense? Why am I the criminal? The CDC needs to reverse these so called Guidelines and get out of my Dr appointments!!<br/>And truly if they were just guidelines did they have Dea arresting dr.s? Why didn't they halt this mass hysteria after the 1st year of the " misapplication " of the guidelines? All a bunch of horse pucky!!!<br/>Hope the jerks who put these out and let PROP influence their behaviors are brought up on charges for crimes against humanity!! Murderes!!!<br/>KC	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	KC	None	None	0900006484f998e5	Emery	None	2022-02-22T16:57:48Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Emery , KC	kzx-mh3e-y7qq	False	None	False	2022-04-12 03:14:14.241	[]
1231	CDC-2022-0024-1238	https://api.regulations.gov/v4/comments/CDC-2022-0024-1238	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is regarding the new CDC guidelines per Notice # 2022-7839. Due to CDC guidelines and the atmosphere of fear and paranoia on the part of physicians, I have suffered at least as much from federal guidelines around prescribing opioids as I have the pain itself. Point of fact: I moved from OK to CA to take on a new position. But the local pain physician abruptly cut back on my prescription, even though I repeatedly told him that the treatment regiman I was receiving in Oklahoma was exactly what I needed. He ignored the completely, and arbitrarily cut back on the medication. The result was the I lost my job. This has thrown our family into a financial crisis, at a time when we least needed it. <br/>AT the behest of several physicians in [city name redacted] CO I wrote a book on my history of chronic pain, because they couldn't believe that I had actually reversed the ossification process from Ankylosing Spondilitis. The book is available on Amazon, in both Kindle and paperback format. But I am willing to bet money that none of the local physicians have bothered to read it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484f80f97	Mercer	None	2022-02-22T18:31:34Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Mercer, Stephen	kzq-is7q-drg3	False	None	False	2022-04-12 03:14:14.483	[]
1232	CDC-2022-0024-1239	https://api.regulations.gov/v4/comments/CDC-2022-0024-1239	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello those @ CDC, Just like most things in life, it's hard to put yourself in another's position. I completely understand the "need" for guidelines. Please take heavy consideration that every injury, person, & thier circumstances are very different.<br/>See a strong need for astute doctorse that have a healthy doctor/ patient relationship of high regard that take take thier job of utmost importance. They are there to help people, difficult or impossible to if they are under strict scrutiny or fear of facing charges for trying to care for folks that are in dire need of help. Incredibly difficult to get help &/or treatment because of strictness of regulations. <br/> If folks can NOT turn to doctors for help with out being labeled as "drug seeking" & "red flagged" at hospitals because guide lines that are overly strict. I can only see much more negative impact on society to keep people healthy, happy, & a positive contribution to our great nation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f9b27c	Binder	None	2022-02-22T18:33:07Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Binder, Jeff	kzy-d5ss-8wvg	False	None	False	2022-04-12 03:14:14.697	[]
1233	CDC-2022-0024-1240	https://api.regulations.gov/v4/comments/CDC-2022-0024-1240	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am opposed to softening prescribing guidelines for opioids per Docket No. CDC-2022-0024. I have seen nothing but harm come from prescribing opioids/narcotics for subjective pain control. I have never seen the pain complaints decrease. The prescribing only increased dosage. It led to endless family and friend suffering and death.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annmignon	None	None	0900006484f9b412	Terranova	None	2022-02-22T18:33:49Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Terranova, Annmignon	kzy-e1tn-r85p	False	None	False	2022-04-12 03:14:14.900	[]
1234	CDC-2022-0024-1241	https://api.regulations.gov/v4/comments/CDC-2022-0024-1241	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Oh Goody! The CDC - the most incompetent agency ever decided to change up their low quality or very low quality guidelines that should’ve never been written in the first place. The same incompetent agency that doesn’t even acknowledge my complex incurable disease of Sarcoidosis even exists and refuses to list it in their Diseases and Conditions Index after I’ve repeatedly requested. The American Lung Association did respond to me and called the omission “glaring”. These new “guidelines” written by same bunch of PhD’s quacks like [name redacted] and one star review so called M.D. like [name redacted] - none smart enough to understand complex disease will be useless since first ones are so permeated throughout our medical system there is no hope of any survival of the systematic bigoted fascists targeting of innocent people born with bad genes or had bad luck. I don’t give a damn what new ones the same group of bigoted fascists nobodies wrote. The CDC will still promote the mythical OUD with fervor pushing Suboxone since we all know the guardians of SmallPoxs sold themselves out to [name redacted]. These new guidelines are not going to stop the gestapo DEA from terrorizing are doctors like [name redacted] is hiding in the exam rooms. This CDC [name redacted], [name redacted] ,PROP, Michigan Open, Washington State University Stanford created humanitarian disaster that is now ultimately worse than the Tuskegee experiment. The horror created by the CDC will never end in any of our lifetimes. My advice is that every policy from the CDC be destroyed in a giant shredder on the Capital floor with an open apology begging forgiveness. [name redacted] be putting a federal prison for the rest of his life and The National Guard come in and empty the building of all of the liars and crook currently occupying the building to guard the SmallPoxs and the other biological weaponry that The CDC holds over our nation as hold as emotional ransom to do whatever the [vulgar word redacted] they want. The CDC needs to be dismantled! The CDC is a civil rights violating hateful agency utilizing thugs at the DEA to do their dirty work. Any guidelines from you before or now is Pharma Shill garbage. You’re also a bunch of racists since you can’t acknowledge incurable agonizing disease that predominantly affects 70% African-American people. I have to literally beg CDC to just list my disease Sarcoidosis which you adamantly and arrogantly refuse because they’re bunch of racists who want African American people to be tortured to death like [name redacted] and [name redacted]. Any guidance from you is worthless to all those afflicted with the agonizing incurable and untreatable by any non-narcotic method disease of Sarcoidosis. The CDC literally willfully and gleefully killing people with Sarcoidosis. The CDC is so moronic that it doesn’t even understand that our bizarre hyperactive immunity that’s is literally devouring our healthy tissue could also be the cure for something worse than COVID but you’d rather kill us to safe space your precious drug addicts. Your pre-decisional low or ver low guidelines have permanently destroyed our medical system with malice and cruelty and it is now behind fixing. Reasoning with the CDC is like discussing and reasoning with terrorists. You all should be sent to the Hague for crimes against humanity. Seriously, what kind of monsters make it national policy to deliberately target incurable disabled people to be tortured to death by denial of pain and suffering relief? The CDC Soft Genocide will not unnoticed in history. Human rights watch has already notified the world the CDC does indeed targets incurable disabled to be tortured. I’m still glad I live in a country room able to express how I feel (for now). Along with Sarcoidosis the CDC does not acknowledge Democracy. We all know these dockets will be thrown in the trash and the CDC will do whatever you like because you have SmallPoxs and we don’t!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484f8b035	Killingworth	None	2022-02-22T18:42:38Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Killingworth , Julie	kzs-rem2-82hk	False	None	False	2022-04-12 03:14:15.108	[]
1235	CDC-2022-0024-1242	https://api.regulations.gov/v4/comments/CDC-2022-0024-1242	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While it is great you all see perhaps the rush to the last guideline was rash an ill-advised, there are a few areas that still need revision. <br/>I oppose any and all reference to MME numbers for for starting or maintaining a patient on prescription opioids or for a restriction on how much to titrate individual patients because MME is scientifically flawed and ignores the variances in individual metabolism, genetic factors, tolerance, and basic pharmacology associated with each specific medication. <br/> I oppose expanding the guidelines to include other providers outside of primary care providers. Medical professionals who have received additional education, training, and certifications in various Specialties such as Pain Management physicians, Oncologists, Palliative Care Specialists,ect are experts in their field and have much more knowledge and experience with specific diseases should never be included with guidelines or suggestions that they had no chance to be involved with. <br/>*I strongly oppose [name redacted]'s being involved with the writing or decision making process for the CDC Guidelines based on his obvious conflicts of interest.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f8c2e6	Anonymous	None	2022-02-22T18:43:14Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzs-yp8i-wdo3	False	None	False	2022-04-12 03:14:15.327	[]
1236	CDC-2022-0024-1243	https://api.regulations.gov/v4/comments/CDC-2022-0024-1243	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was reading some of the previous comments as well as the latest document. We have a huge problem when we are attempting to acknowledge that non opioid therapies should be preferred but are only suggesting insurance carriers make it more accessible. As a chiropractor who works with the public daily, high copayments, large deductibles and tiered networks clearly reduce access to both our profession, physical therapy and other drug free professions. While it is understood medical providers are most likely to offer drug alternatives, these alternative drugs merely deal with the symptom of pain, while making many problems more chronic . Medication is not a treatment, but merely a bridge that is used post surgically. Many back surgery cases that were worsened by procedures they had out of desperation found themselves depending on opioids as we see by the many comments placed in this section. <br/><br/>We foolishly encouraged these procedures when there was growing evidence that back surgeries often did great harm, while at the same time, we allowed insurance companies to underpay more effective lower level providers of drug free care. The incentives have to change and the recommendations must more forcefully handle insurance company abuses of high per visit costs for patients which simply discourage drug free care. Medical providers must also understand that chiropractors and therapists have better tools for the care of the musculoskeletal system and they must refer them instead of using medication to treat them. They must also get continuing education in the area of musculoskeletal care. There would be no opioid crisis without physicians prescribing them. There would be better access if insurers made it easier but their financial incentives are to make our costs higher, not lower. This needs to change either with a public option or some other method that truly forces them to compete.<br/><br/>One more thing. Insurers have been using precert programs for chiropractors to reduce their costs while not increasing their reimbursements despite years of increasing costs. These precert programs merely add costs, result in frustration of the patient and the provider and add nothing to the value as provider can give. There is also no financial incentive for providers to solve problems other than trying to help a patient improve faster avoiding future precerts. There has got to be a better way to make non drug care a win for patients and those who try to help them and a disincentive to use medications period. That is how we got into this opioid mess in the first place. Those who are addicted are people I feel for. It is hard and costly to get them to get off opioids as we all know. The best way is going forward, we make bold moves and incentivize these patients to go to those who are best equipped to help them, pay them appropriately and make the cost reasonable so its compatible with rehab. Getting insurers out of the way can reduce costs long term by help people see those who have the best tools to help them naturally, which can likely avoid joint damage later on which simply fuels the cost of drugs as these people age.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	william	None	None	0900006484f9b489	c	None	2022-02-22T18:44:48Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from c , william	kzy-efjb-0976	False	None	False	2022-04-12 03:14:15.545	[]
1237	CDC-2022-0024-1244	https://api.regulations.gov/v4/comments/CDC-2022-0024-1244	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am opposed to this rule change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Scott	None	None	0900006484f9b4b0	McKennon	None	2022-02-22T18:45:19Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from McKennon , Scott	kzy-eip6-061f	False	None	False	2022-04-12 03:14:15.757	[]
1238	CDC-2022-0024-1245	https://api.regulations.gov/v4/comments/CDC-2022-0024-1245	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>DOCKET# CDC-2022-0024<br/><br/>Thank you for allowing me to comment on the proposed 20222 CDC guidelines. <br/><br/>First of all I don't think the CDC should have the right to regulate pharmacutical drugs. That's the FDA'S job! The CDC has harmed all pain patients for the past 6 years. Opioids have been around for centuries for the treatment of pain. All the authors of the 2016 CDC guidelines have/ ,had conflicts of interest. [name redacted] just admitted that he CONFLICTS of interest, which in itself should have made the CDC guidelines abolished, but the CDC turned a blind ear,and has allowed anti-opioid psychiatrists to be opioid experts, not pain specialists or the people who actually live chronic pain. <br/><br/>Secondly, I believe that primary care physicians should be able to prescribe opioid pain medication. Primary care physicians are medically licensed and attended medical school. People who live in rural areas may have to travel far for a pain management doctor. Primary care physicians know more about their patients. And pain doctors have retired or refused to use opioids for pain. <br/><br/>Thirdly, there should be NO MME DOSE THRESHOLDS! MME is junk science. It doesn't allow doctors to treat their patients with appropriate pain relief. We're all different, we metabolize medications differently. It takes individualized care away. It causes misinterpretation. And turns into law. There should be NO MME dose of 50 MME for chronic pain. Doses above 50 MME can be beneficial for pain relief and a better quality of life. Absolutely no mention of any MME. Let doctors practice medicine. If the CDC uses any MME thresholds the CDC once again will weaponize the guidelines for the DEA, and the DOJ to terrorize, target and prosecute doctors. We have doctors in prison for 20-40 year sentences. Yet the CDC doesn't care. Chronic pain patients have turned to the streets looking for pain relief and many have committed suicide. More will turn to the streets and/or commit suicide because of unrelenting, undertreated or non treated pain. The 2016 CDC has blamed the pharmacutical companies and doctors for the illicit fentanyl poisoning epidemic. I never hear the cartels mentioned, yet is because of the cartels that hundreds of thousands of people have overdosed or died. All for litigation purposes? Chronic pain patients have been thrown under the bus because of parents losing their own child to illegal drugs laced with illicit fentanyl. The parents need to blame someone. And because of the CDC, the damage is done against the doctor patient relationship. Doctors are living in fear not taking chronic pain patients and putting themselves first before the needs of a pain patient. Pain is no longer subjective!pain is even more undertreated then ever before. Chronic pain patients can't receive or access the care they need because of stigma and the CDC guidelines. Chronic pain patients have been left to fend for themselves because of doctors fears of the DEA and prosecution. <br/><br/>Forth, I also believe that with appropriate education that benzodiazepines can be safely given to chronic pain patients, weather it's for anxiety or for insomnia. The key is not to take a benzodiazepine with your prescribed opioids. Space the two medications apart, don't drink alcohol with either medication. Is education and knowledge that is needed. And patients needing both medications shouldn't be labeled high risk. Manu pain patients have safety taken benzodiazepines and opioids for years without any issues of overdose. Stop making pain patients having to choose between their mental health and their painful conditions. <br/><br/>Fifty, There's not much mention about the benefits of opioids. Adequately, individualized care can give pain patients function. Can keep people from being housebound, or bedridden, it can allow participation in more activities. It can allow chronic pain patients to work, be hands on parents, it can allow people in pain to visit with their friends and family. All pain patients are suffering inhumanely and cruelly. Opioids make healing faster. Tylenol is the #1 poison for poison control. Both tylenol and NSAIDS are more dangerous to your liver and kidneys. These drugs can cause bleeds, heart attacks and more. Chronic pain patients are now refusing elective surgeries, the risk of addiction when used to treat medical painful conditions is low ,like 0.3% and one has to have the gene. Because of the false narrative/propaganda about prescription opioids for treatment of acute pain, people are now afraid of becoming addicted by receiving post operative pain relieving medicines. <br/><br/>If the CDC did the right thing, they would abolish the guidelines and go to work on the illicit fentanyl poisoning. Get out of the prescribing opioid medication business. the CDC'S job is infectious diseases. You want to reduce harms, abolished the CDC guidelines and work on the illicit fentanyl poisoning epidemic. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f8f44b	Smith, RN	None	2022-02-22T18:45:49Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-18T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, RN, Kimberly	kzt-7vh0-1l3h	False	None	False	2022-04-12 03:14:15.995	[]
1239	CDC-2022-0024-1246	https://api.regulations.gov/v4/comments/CDC-2022-0024-1246	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Docket # CCD-2022-0024<br/><br/><span style='padding-left: 30px'></span>Thank you for allowing me to comment. I'm an RN and chronic pain patient.<br/><br/>The treatment of pain, All pain from cancer, hospice, end of life, chronic pain, intractable pain, pain from sickle cell disease, autoimmune diseases shouldn't have any mention of a MMR in the CDC guidelines. Unfortunately, pain isn't subjective because of junk SCIENCE MME thresholds. There's no talk about the benefits of opioids. Just anti-opioid ideology that is unscientific. There can't be a one size fits all dose. That's like telling everyone to wear a size 5 shoe. It doesn't work. All MME dose thresholds and any mention of MME should be removed from the CDC guidelines. The CDC guidelines should have been abolished as soon as the CDC was made aware of the conflicts of interest by the authors of the guidelines. The CDC didn't care if they were harming chronic pain patients. The CDC and it's authors throw chronic pain patients under the bus. The CDC let its guidelines to be written into state laws, be misinterpreted and allowed for its guidelines to be weaponized by the DEA, the DoJ. Terrorizing, targeting and prosecution of doctors for 20-40 years sentences. <br/><br/>All MME dose thresholds needs to be taken off the updated guidelines. Is IDEOLOGY, JUNK SCIENCE . The authors of the CDC guidelines aren't pain specialists or pain patients. How can a physiatrist think that they are a medical expert in the care of painful conditions? Are these physatrist experts in surgery too? I'm sure that they believe that they are!<br/><br/>I can't go back to trusting the CDC because the CDC had no business in prescription drugs and their regulations. That would fall on the FDA. The CDC has caused tremendous pain and suffering that's been inhumane and cruel. So inhumane and cruel that pain patients have had to turn to the streets looking for pain relief or take their own lives. The CDC has taken away pain patients quality of life, causing pain patients to be homebound, or bedridden. Years of chronic pain patients lives, and the damage is done. Pain is so much futher undertreated and not treated. One can never imagine what it's like to live with pain 24/7, unless it happens to you. <br/><br/>I fully endorse the comments of [name redacted] who has filed his comments separately with the Federal Register. <br/><br/>All pain patients want is pain relief and quality of life that opioid medication gives at the individualized adequate dose. I'm not saying all pain will go away, but enough to provide adequate pain relief and a better quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f92b15	Smith	None	2022-02-22T18:47:43Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Kimberly	kzt-ei2r-ja6l	False	None	False	2022-04-12 03:14:16.207	[]
1240	CDC-2022-0024-1247	https://api.regulations.gov/v4/comments/CDC-2022-0024-1247	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop killing us. Thanks to y'all, I haven't had proper pain management in over 3 yrs. I'm disabled and poor; therefore, I'm on Medicaid in my state. Do you know how many pain management clinics take my insurance in my area? ZERO!! Nobody will treat patients like me because your bogus, made up (not backed by data or research) GUIDELINES have been weaponized against them. Just admit you messed up. Admit that chronic pain patients aren't addicts. Stop trying to fix it when you know it's being used to kill us. PLEASE, STOP KILLING US! I may be disabled with pain treatment, but I can bathe daily, sleep most nights, exercise, shop, garden, clean my home, and more when my pain level is a 3 or 4 instead of the 8, 9, & 10 that I have to suffer daily. The very least y'all could've done was include experts on pain like [name redacted] , but you went with addiction docs instead. We're not addicts. Every pain mgmt doc runs their practice in such a way that addicts are quickly identified & referred to treatment for addiction. Even addicts know this. Pill mills haven't existed in many years. Again, please, stop killing us. <br/><br/>https://www.practicalpainmanagement.com/sudden-unexpected-death-chronic-pain-patients	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9121c	Anonymous	None	2022-02-22T18:49:27Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzt-fpzf-co7u	False	None	False	2022-04-12 03:14:16.418	[]
1241	CDC-2022-0024-1248	https://api.regulations.gov/v4/comments/CDC-2022-0024-1248	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 72 years old and on 1/14/1970 when I was 20 I was struck by a car and pronounce dead at the scene. A rescue squad man saved my life and for the past 52 years I have had to undergo many, many surgeries. I have undergone a lot of therapy and pain meds. It took me a year to learn how to walk again. I went back to work for as long as I could but at age 50 found I needed to file for disability. 8/1/2003 I began SSI and Medicare. In the past several years I have found that it is nearly impossible for me to function without oxy or a pain med. Because of the crack down on these drugs I have found it impossible to get any pain meds and therefore my life is declining due to the fact I have nothing to help me get up and get moving. At age 72 the likely hood of me becoming addicted is next to none. I need the meds to function due to chronic pain. I have and still am having surgeries. My last one was 6/9/2022 because one of my knee replacements collapsed and needed to be replaced with a longer one that now because of its length cause pain every time I walk. Like I said before my life is going downhill because I can't find a Dr. that will give me the pain meds I need because of the laws. I was a very active person until my pain meds were stopped. If there is anyway at all you can help me get my life back, I will be forever grateful. Thank you!! [NAME redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484f9b519	Davis	None	2022-02-22T18:57:54Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Davis, Pamela	kzy-euer-8xdr	False	None	False	2022-04-12 03:14:16.622	[]
1242	CDC-2022-0024-1249	https://api.regulations.gov/v4/comments/CDC-2022-0024-1249	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>I am a licensed healthcare provider. I am also currently a pain patient and have been since 1986. The etiology of my pain is well documented. While under-going treatment for stage IV, non-Hodgkins lymphoma at the National Institutes of Health/National Cancer Institute (NIH/NCI) acute pain developed in my neck, radiating through my left shoulder down my arm through the ulnar region and into the ring finger and little finger of my left hand. My initial complaints of pain were dismissed or ignored by the oncology doctors. I was labelled "narcotic dependent" and regarded as a seeker of pain medications...this, on top of dealing with the administration of a dual protocol (MOPP and PROMACE) chemotherapy regimen in a clinical trial for last hope patients. At the urging of the Director of Lymphoma Studies I was referred to [name redacted] Medical Director of Pain Research at the NIH. [name redacted] did a full scale investigation into the cause of my pain and determined thru imaging and neuro-testing that a cyst or tumor was situ-ated intraspinally in the C5-7 region of my neck. Due to location, biopsy determination was not possible. Under the direction of [name redacted] I was given various pain medications. He referred me to psychiatry for counseling and trials with various antidepressants. Opioids seemed to be the best analgesic for my pain. I was given a trial run of oxycontin in increasing dosages but it was discontinued after I decided that the instant release oxycodone enabled me to manage my pain, which was moderate to severe, better. The use of oxycodone to manage pain enabled me to deal with the many heavy side effects of the chemotherapy. It was a godsend. I was presented as a opioid test subject to pain specialists at the NIH and later to the [facility name redacted] . Chemotherapy ended and I continued pain management under [name redacted]for several years after. For over a year I was treated by [name redacted] , an acupuncturist from China, brought over to be the cornerstone of the new Alternative Medicine Branch of the NIH. Three times a week I saw [name redacted] and at some point was able to discontinue all meds, including oxycodone. It was great, am a firm believer in the benefits of acupuncture, which I continue with today at [facility name redacted] in [city name], Virginia. After discharge from the NIH in 1996 my oxycodone was prescribed by my personal care physician..until the opioid epidemic and resulting guidance and directives from the CDC and Virginia Department of Health made prescribing narcotics so onerous and burdensome that my doctor was forced to refer me to a pain clinic where I have to go today to get my monthly prescription for Percocet (oxycodone prescriptions are not given). I get acupuncture there for peripheral neuropathies (chemo related) and see a nurse practitioner for pain meds. I'm subject to random drug testing, treated somewhat condescendingly, subjected to threats of changing my medicine or reducing the amount of pills...it's not a comfortable relationship. It's more pill management than pain management. It's time consuming, it's, quite honestly, a drag. In all the years I've never failed a drug test, never diverted medicine. I've raised my son mostly as a single parent since my days at the NIH (he's now a college educated careerist in law enforcement. I went back to college and got my degree in nursing and worked several years as a hospital RN and nursing supervisor in long term care and skilled nursing facilities.I have led an active and productive life despite my continuing cervical radiculopathy. Oxycodone has enabled me to live with my pain.I sincerely hope that the federal guidelines in prescribing will be relaxed and that the Virginia Department of Health will likewise ease prescribing opioids to people who benefit from them. It's very unsettling to have a prescriber repeatedly threaten to change the regimen that allows me to live my life, to "fix" what works, what isn't broken. It was the CDC guidelines that suddenly changed prescribing practices in Virginia, hopefully Virginia will follow new CDC guidelines and allow my prescriber to finally adjust my monthly dose (ie, number of pills) and treat me as an individual pain patient rather than a pill consumer with strict, unchangeable parameters on my treatment. Rigid limitations on the strength and/or number of pills is not proper pain management. One size fits all is not proper pain management. Individualized treatment is essential in proper pain management. My current prescriber at the pain clinic and others before them are not aware nor interested in the etiology of my pain, nor of my history living in pain. Their focus is on the pills, not the pain. They have no idea what living in pain is like and they don't care. Hopefully there will be a change if the CDC loosens its guidelines for opioids. I pray it does.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484f971fc	McConnaughey	None	2022-02-22T18:58:17Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from McConnaughey, Tom	kzu-4m32-c40e	False	None	False	2022-04-12 03:14:16.826	[]
1243	CDC-2022-0024-1250	https://api.regulations.gov/v4/comments/CDC-2022-0024-1250	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a narrowing of discs in my spine and a bone spur in my neck. I have taken a generic Percocet for pain for a few years. I do not have an addictive personality and only take as needed. In fact, I only take it during the day as I have trouble sleeping if I take one after 5 pm. Surgery for my spine is an option I would prefer to avoid. The surgical options for my neck offer a 50% chance of doing away with the pain.<br/><br/>There are times when I suffer from pain, and I have to evaluate whether I want to use a pill or suffer through a bad day because of the limited availability. My usage is about one per week on average. I miss things in life, and I'm sure it affects my family as well. <br/><br/>Pain limits my exercise. When I take the medication, I try to exercise during that window. However, there are periods when my back acts up, and I may take more. <br/><br/>Male age is 70. I have hyperparathyroidism, which takes calcium from my bones, and I have some osteoporosis because of this. I have had two injuries that may or may not have had an effect on my back. I was rear-ended in a car accident in the mid-1990s, fell out of a bathtub in 2020, and landed on my lower back. I would be happy to add anything further.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f9b53b	Allen	None	2022-02-22T18:59:24Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Allen, James	kzy-ey44-9coc	False	None	False	2022-04-12 03:14:17.073	[]
1244	CDC-2022-0024-1251	https://api.regulations.gov/v4/comments/CDC-2022-0024-1251	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a PTK laser eye surgery on January 10, 2021 on my right eye. I had what I thought was a very good surgeon. I had this surgery on my left eye aprox. 10 years earlier. When I had the first surgery the surgeon told me the surgery was going to hurt like hell and prescribed me 30 percocets for my recovery period even though I was currently taking pain medicine. He knew I would be in extra extreme pain. In recovery from this I was still in pain but very thankful for what he had given to help me because fast forward 10 years to the new surgery and the surgeon lied to me and said there was no pain involved due to a bandage contact lens. I didnt think a Dr. would lie to me but after surgery I was sent home numb and when that wore off I was in extreme pain. They did give me a numbing drop called tetracaine but I could only use this 3 drops a day. I had to go for a follow up the next day in extreme pain. The Dr. who saw me said Yea you have a 4 mm hole in your eye of course it going to hurt. I made it through that and I posted on a pain site about my troubles. A woman posted back that she had her leg amputated and was only given tylenol in the hospital. She developed sepsis and had to go back in for a revision to cut out the infection and again no pain medicine. My 86 year old Mother had a quadruple bypass in 2018 and they did use fentanyl during surgery but afterwards only lidocaine patches and get this Tylenol. My Mother was on massive amounts of blood thinners and 86 years old. She made it through that quadruple bypass but was in so much pain and so were all of the elderly people on that floor of one of what was one of the best hospitals in [city redacted]. Now please tell me, any of you who are in the workgroup for this new guideline or any of you with the CDC or any other government agency involved in this fiasco of making people suffer needlessly, what exactly is going to happen if its you, your Mother, Father, Siblings or how about your children who have to have surgery or get into a terrible car accident and need those pain medications. What if they are disabled for life as many of us are and need pain meds just to be able to have a few hours in a day to be able to function as a semi normal person. What then.....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f9b53f	Donaldson	None	2022-02-22T19:06:02Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Donaldson, Linda	kzy-eyl9-6kmu	False	None	False	2022-04-12 03:14:17.277	[]
1245	CDC-2022-0024-1252	https://api.regulations.gov/v4/comments/CDC-2022-0024-1252	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Lawmakers:<br/>I am a chronic pain patient with spinal stenosis(lumbar and cervical), ddd, global osteoarthritis, osteopenia, scoliosis, chronic migraines, anxiety, major depression and cptsd (PTSD).<br/>Your revision of the opioid prescribing laws have pretty much ruined my life.<br/>I am bed ridden now.<br/>My pain has been severely uncontrolled for years now, and on top of that, I have been made to feel like some kind of junkie for even asking almost ANY DR OR ER for help. I ALWAYS get the "look" like I'm a drug seeker, thanks to these laws. Every visit to the er (one of my most recent) I was made to feel like I was wasting everyones time even though 2 hrs prior I had a seizure and lost conciousness and was incontinent during a panic attack((PTSD) which I had because I was forced off my BENZODIAZEPINES. <br/>I spent my Christmas and Christmas Eve on the suicide help lines, due to my PTSD.<br/>I have pain and PTSD. I'm sorry but I need both opioids and benzodiazepines to function and live a productive and happy life. <br/>Not everyone out there that takes these meds misuses them. Some of us actually NEED them.<br/>I don't want to die. But if I have to chose, idk if I am strong enough to survive this.<br/>My cPTSD was just dxd. I'm 59 and it started (the flashbacks I remember, anyway)at age 6. That's 53 yrs of pain. I'm finally getting help and that is bc of benzodiazepines. That's a lot of emotional pain.<br/>There's also a lot of physical pain. As a former gymnast, my spine got messed up as gymnastics is as hard on the body as football is. So, Idt I need to explain how wear and tear has affected my bones.<br/>Please listen when I ask to remove any and all mention of mme limitations from ALL 229 pages from the document you propose and supporting text. And also, As when the opioid slashing began, reverse that damage, by retraining all interested agencies and parties of these changes to policy, so I don't have to live my life in shame moreso than I already do.[side effect of PTSD].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f9b569	Berthiaume	None	2022-02-22T19:07:24Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Berthiaume, Deborah	kzy-f9kx-6ifa	False	None	False	2022-04-12 03:14:17.481	[]
1246	CDC-2022-0024-1253	https://api.regulations.gov/v4/comments/CDC-2022-0024-1253	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There should be a separate contract for IP- Chronic Intractable Pain Patients. My Doctors Primary and Neurologist are both agreed that I needed the MMJ card, both same Insurance company and same facilities. I immediately told both doctors both agreed to monitor me. Six months later one nurse decided to ignore the note listed by my Drug test done each month that said- Cannabis - this is expected MMJ Medical Marijuana and the patient is being Monitored. The same as it says about my Oxycodone and Morphine on each drug test. The nurse told my Primary, I violated the Pain Management Contract despite my Doctor Monitoring me the pass 6mos.. The contract is with both doctors are all qualified to treat me under my Insurance. My Doctor called and said I can no longer treat you. I am a Cancer survivor, Bulging Disc, Spinal Bifida different kinds of arthritis and some other issues. Today 2/22/2022 is the first day without my prescriptions of Pain Medication so far I have not been offered any assistance. The Medical Marijuana has no effect on my pains. It has great affects on my Nerves, it allows me to have better control of my legs when walking. It's a fear that comes with pain, it hurts to think or talk about my pains. The turn Chronic Intractable Pain IP fits for Crimping Pains that will not be cured or go away. IP - Patients are being told to go home and suffer in privacy. IP patient have had our pain medications reduce as if we have Mild to severe pain, IP patient need a separate contract. Our Doctors treat us as if we are Criminals. To walk in Doctors office with the staff pointing and looking as if they betting on if you're going to cry or Curse. That is humiliation alone to have to endure. I went back to the Neurologist to ask his opinion on the MMJ card he thought he had offered to me before because I cannot take any of the other nerve medications. To have to acknowledge the pains hurts so bad to have to explain because you have to peel away your defence that you have in dealing with your pains. IP patients cry in Doctors office 8 out of 10 times because we have to explain our pains meaning we have to think about our pains. One Medical Facility put at the end of there contract- Don't Cry, Yell or Curse because we are discontinuing your Pain Meds. I search my Insurance company website for IP Patients management, Chronic Intractable Pain and Intractable Pain management it only showed Doctors treating mild to severe Chronic pain. That term suggests it's a possibility of this patient condition can are will get bettter. IP Patients aren't getting better are going to heal. My Doctor stated you should be happy you got you got your MMJ Card. now I feel as if I have been tricked into some type of clinical study, that didn't initially agree to and would not have been part of. There should be a Chronic Intractable Pain Patients data area for the Patients and Doctors showing every Law related to IP Patients Management. IP patients should be able to go and seek care in the same facilities without being told they are Doctor shopping just because they may not want to be humiliated by there prior Doctor and staff since they are under the same contract. The things my Doctor has said to cover himself makes me look as if I am a Drug addict. Not fair at all to me. Now his on vacation and no one at his facilities will offer me help. Regardless of how this come out it won't change the humiliation and all that has been placed in my file. Thanks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9b586	Anonymous	None	2022-02-22T19:12:42Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-fj94-p6gv	False	None	False	2022-04-12 03:14:17.696	[]
1247	CDC-2022-0024-1254	https://api.regulations.gov/v4/comments/CDC-2022-0024-1254	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The extreme response from doctors now refusing to prescribe opioids under almost all situations is absurd. Millions of citizens are responsible with their medication and absolutely do not want to become addicts. I'm 57 and have sometimes used opioids, exactly as prescribed. I've never abused them or become addicted. I don't desire to continue taking them after my pain has resolved. I've been living with chronic back pain for over a decade and I have never asked for opioids to treat my pain. However, I am considering spinal fusion and honestly what's holding me back from getting the surgery is that I am anxious my doctors will not prescribe me adequate pain medication to get me through the recovery period. I already feel as if it's wrong for me to ask in advance if I will receive opioids post surgery. There's now a stigma placed on every responsible patient for inquiring about opioids, when the situation is perfectly acceptable. Doctors need to be given the responsibility to help their patients without all this nightmare scenario and fear of lawsuits. Stop punishing and shaming the millions of responsible patients who deserve to receive opioids when needed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shane	None	None	0900006484f9b5cb	VanOosterhout	None	2022-02-22T19:13:46Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from VanOosterhout, Shane	kzy-fy89-msyv	False	None	False	2022-04-12 03:14:17.908	[]
1248	CDC-2022-0024-1255	https://api.regulations.gov/v4/comments/CDC-2022-0024-1255	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] from [city redacted], Idaho. I had a 4 disk blowout when I was 24, with 4 more discectomies. Original surgery 1980, 2nd 1984, 3rd 1989, 4th 1995, 5th 1999. My vertebrae are virtually sitting on top of each other. I have Al so had 9 Abdominal surgeries with 3 of them being bowel obstruction a from adhesions. I have also had both knees replaced with a revision once on left. <br/><br/>I did not start taking hydrocodone or anything for chronic pain until 2010. They help keep me active for my daily activities. I stay busy because I have enough common sense to know that is the best thing I can do. My pain level is about a 9 by the end of my day. I take 4-325mg hydrocodone acetaminophen a day every 5-6 hrs. It is my job to protect myself from addiction, and I do. My concern is this, I have asked multiple times what kind of damage may happen to internal organs with prolonged use of opioids, but no one seems to have the answer. Why not help those of us who are responsible answer our questions. Addiction is a horrible problem but it is not the only problem. <br/><br/>The CDC blew it in 2016 with such a blanket policy and I can see why suicides spiked with chronic pain suffers. This policy needs revamped drastically for people with chronic pain. I am as strong and tough as any person out there, but at 65 my pain increases exponentially every year and if I have no expectation of help from pain meds then what's my option. Further surgeries will cause more complications. Stop treating all patients as if they are addicts. That should be for our Doctors and ourselves to deal with.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharron	None	None	0900006484f9b72a	Davis	None	2022-02-22T19:20:02Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Davis, Sharron	kzy-gp93-onmb	False	None	False	2022-04-12 03:14:18.124	[]
1249	CDC-2022-0024-1256	https://api.regulations.gov/v4/comments/CDC-2022-0024-1256	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a concerned citizen who is in pain. Please help all of us .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9bab9	Anonymous	None	2022-02-22T19:20:14Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-gup4-jqy6	False	None	False	2022-04-12 03:14:18.341	[]
1250	CDC-2022-0024-1257	https://api.regulations.gov/v4/comments/CDC-2022-0024-1257	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have serious concerns about the conflicts of those whose input was used in the prior and draft update the guidelines.<br/><br/>The guidelines grossly underestimate how PCPs interpret the guidelines as firm rules.<br/><br/>The inclusion of MMEs should not included at all since the dosage btw patients varies so greatly. As well, my PCP, ER DR & specialists all seem to use different methods of calculating these 'caps'resulting in a variety of dosages & some apply them as a rule.<br/><br/>I have concerns over the data being used in justifications such as the claim regarding the efficacy Tylenol over opioids for Kidney Stones. This will certainly be misused against anyone with the condition, not just patients with chronic pain.<br/><br/>Lastly, the draft guidelines fail to adequately acknowledge, stop & correct the on going harms of previous & on going forced tapers.<br/><br/>Please consider an unbiased, equally represented guideline, completely separate from the origins & originators not qualified to advise rather than carrying over the injustice, malpractice & misapplication of the current & draft guidelines.<br/><br/>Sincerely, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	F	None	None	0900006484f9bb25	Gagnon	None	2022-02-22T19:21:34Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Gagnon, F	kzy-hl13-y34g	False	None	False	2022-04-12 03:14:19.053	[]
1251	CDC-2022-0024-1258	https://api.regulations.gov/v4/comments/CDC-2022-0024-1258	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good afternoon.<br/>I have been suffering from increasing debilitation, degeneration, arthritis, stenosis, sciatica, and generalized pain from chronic lumbar spine issues, fibromyalgia, and foot deformities for over 20 years, taking opioids on and off successfully over that period of time. In 2016 my medications were drastically reduced and then cut off completely, with no input from me or my pain management doctor, by my general practioner, without even seeing me in her office. Since then my pain management doctor and general practitioner left their specialties for other areas of medicine not dealing with pain. I have had to start over with new doctors since then, trying every treatment module imaginable all over again. After 5 years my PM doctor finally agreed to add opioids back to my treatment plan, in very small doses. My quality of life has tanked since your 2016 guidelines. Even on a small dosage of opioids I am still in severe pain, am barely able to function, and certainly not at the level of what I was able to do before the 2016 guidelines were enacted. At my very first appointment with my new PM doctor in 2016, after I told him what treatment had been working for me, he said "I will not lose my license" (by prescribing opioids). I am due for a spinal fusion soon, I am still working for a living, and it is very probable that I will need pain management for the rest of my life. It's my opinion that even if these new guidelines are enacted, prescribers will still be in fear of losing their license, so emphasis must be placed on keeping the DEA out of our doctor's offices so they can effectively do their job, without fear of reprisals. There are millions of people like me in this country, and I ask you to give us back some semblance of a life, by severely curtailing the war on opioids for the treatment of chronic pain.<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9bb65	Anonymous	None	2022-02-22T19:22:41Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-i2ee-9n4g	False	None	False	2022-04-12 03:14:19.258	[]
1252	CDC-2022-0024-1259	https://api.regulations.gov/v4/comments/CDC-2022-0024-1259	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s).<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheryl	None	None	0900006484f98184	Donnell	None	2022-02-22T19:24:35Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-20T05:00:00Z	None	None	None	None	None	None	None	Comment from Donnell, Sheryl	kzv-xskk-e1q0	False	None	False	2022-04-12 03:14:19.477	[]
1253	CDC-2022-0024-1260	https://api.regulations.gov/v4/comments/CDC-2022-0024-1260	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To: CDC authors of the guidelines:<br/><br/>I am one of millions Americans that are suffering from horrible pain. Mine is due to a genetic condition and pain medication is the only thing (AFTER failing multiple therapies) that works. I have been on the same dosage/strength for nearly a decade, without any issues. I cannot take NSAIDs, or Tylenol, and have failed invasive and non-invasive treatments. Nobody wants to be subjected to pain for the rest of their lives, but the reality is that we exist and deal with pain every single moment of every single day. Your new MME guidelines would cut my medicine in half, and there is no way that I could have any semblance of quality of life. Please, let doctors do their jobs, please stop punishing legitimate patients and torturing them with these guidelines. Please, stop DEA scaring doctors into not practicing their profession and treating their patients based on individual needs, because one size (dosage/treatment) does NOT fit all. While there are people that do abuse opioids, majority of them are NOT pain patients. Please do NOT politicize this issue. Please ask yourselves would you treat any other illness the way you're ostracizing and penalizing pain patients. People are dying in response to their medication being either reduced or stopped completely. These medications have been around for quite some time and are effective and less harmful than OTC options. Please, I am begging you to remove any and all restrictions as to MMEs in your revised guidelines, and please recognize that being in pain is not a crime, and treat us with respect and compassion. The alternative is suffering, torture, and agony. Disability should not be punished, and your guidelines are doing just that.<br/>Thank you for your time.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9bbbd	Anonymous	None	2022-02-22T19:25:26Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-if38-3sqw	False	None	False	2022-04-12 03:14:19.692	[]
1254	CDC-2022-0024-1261	https://api.regulations.gov/v4/comments/CDC-2022-0024-1261	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer, I would welcome any way to help me alleviate that pain. When doctors are constrained by restrictive laws preventing them from helping their desperately hurting patients, those patients WILL seek out alternatives themselves, ones that are not legal, nor safe.<br/><br/>I have neck damage, that impacts the spinal cord. This causes overall body pain, which no other palliative helps with as well. As it is the nerves directly that are impacted (literally), only remedies that also impact nerves directly can help. But as it disables me, I am unable to work. My pitiful state's medicaid only allows 14 doctor visits a year...and pain management guidelines force most pain management clinics and doctors to require a monthly visit. Twelve out of the fourteen...but I have many other physicians, including two cardiologists as I am also afflicted with heart failure. The stress from pain has impacted me negatively in every facet of my life, including I'm sure, my heart conditions. <br/><br/>The plain truth is, if someone wants to abuse anything...medications, alcohol, illicit drugs...they will do so, no matter what lawmakers desire. The point is not to harm those who definitively REQUIRE opiod pain management, by hog-tying the hands of medical professionals with unnecessary restrictions. The 'opiod epidemic' has not been halted, nor even SLOWED by these ridiculous restraints; in fact, they have made it WORSE, by forcing those of us who need help to seek it elsewhere.<br/><br/>I implore you to use compassion in your guidelines.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MICHAEL	None	None	0900006484f99d74	BARRETT	None	2022-02-22T19:33:13Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from BARRETT, MICHAEL	kzx-owkj-hk1t	False	None	False	2022-04-12 03:14:19.902	[]
1255	CDC-2022-0024-1262	https://api.regulations.gov/v4/comments/CDC-2022-0024-1262	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered severely due to the misinterpretation by physicians who were suppose to be helping patients cope who have chronic pain I have to break my 5mg oxycodone in half to stretch it because I am only allowed 30 per month I don't quite understand the MRI'S speak for themselves I just under went having a spinal cord stimulator implanted to try an help with all the back, neck and sciatic pain I can barely walk at times yet I am only allowed 1 pill per day what a slap in the face and when I lie down I want to cry from the pain. I am a nurse and have given over 40 years of my life to service even through this pandemic yet I have to suffer I could NEVER have imagined I would have to live like this. Please revise your 2016 guidelines so that people will stop dying due to street drugs out of desperation and I will stop suffering!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	La Faye	None	None	0900006484f99d85	Gordon	None	2022-02-22T19:33:58Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Gordon, La Faye	kzx-peet-ap7y	False	None	False	2022-04-12 03:14:20.112	[]
1256	CDC-2022-0024-1263	https://api.regulations.gov/v4/comments/CDC-2022-0024-1263	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain sufferer. X-ray and MRI show a bulging disc and major spinal curve. The only thing that I have used that actually relieves my pain is codeine. Hydrocodone doesn’t help and I’ve never asked for or used other, stronger medications. My old prescription were 30/300 codeine/acetaminophen. One pill would take approximately an hour to take affect and the minimal relief would last for one to one and a half hours. On average I took one pill two or three times a month. I took them only when my pain was so bad even using my crutches didn’t help. <br/>I’m a 75 year old female and have never abused any medication. I do not want to become addicted. My mother was alcoholic and drug addicted, my father was a mean alcoholic, and my sister was not only addicted but a drug dealer. The dealing part got her shot in the head. She did survive but was never the same. That history makes me respect medication and safe use of medications. <br/>I CANNOT get any pain relief medication here in Oklahoma. My doctor is afraid of losing his license. I’ve printed out the CDC guidelines but he tells me it makes no difference in this state. <br/>What am I supposed to do?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484f99e11	Blake	None	2022-02-22T19:35:04Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Blake , Sharon	kzx-q8y6-kjlf	False	None	False	2022-04-12 03:14:20.318	[]
1257	CDC-2022-0024-1264	https://api.regulations.gov/v4/comments/CDC-2022-0024-1264	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This dumb law you have about opioid is really ridiculous!! You are forcing so many people to live in pain!! Day after Day!! What gives you the right to impose so much pain!!??? <br/><span style='padding-left: 30px'></span>I understand that you believe stopping the scripts, making it difficult for us to attain what we rightfully! You think you're doing the right thing because of all the OD'S ,, But you're not!!! You need to give the people what they need, I'm speaking mostly of geriatrics, Enough suffering because a few kids want to be idiots!!! We enders did not do it. <br/><span style='padding-left: 30px'></span>I sincerely hope you think hard on this matter. Thank you for your time in Reading!!! This and everyone's letters..<br/><br/><span style='padding-left: 30px'></span>Sincerely [Name Redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f99e1e	Anonymous	None	2022-02-22T19:36:01Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-qjbd-uk34	False	None	False	2022-04-12 03:14:20.529	[]
1258	CDC-2022-0024-1265	https://api.regulations.gov/v4/comments/CDC-2022-0024-1265	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who suffers daily from chronic pain from a back injury and several genetic disorders I definitely agree something must change!!! I have been dismissed by many many doctors who do not know the severity of my pain or familiar with my disorders. I’m automatically deemed a “drug addict” and brushed off prescribing me ibuprofen or nothing along with obvious irritation. When Iam finally settled in with a doctor I’m finally prescribed opioids but the minimum because as they always say “ my hands are tied” as a result Iam in daily pain sometimes so bad Iam unable to leave the bed. Most days my medication just takes the edge off and it’s very difficult to manage doing anything even showering is a daily battle. I can only hope something will change so me and others like me can actually be able to have the medication we so desperately need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynette	None	None	0900006484f99e42	Rieder	None	2022-02-22T19:38:30Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Rieder, Lynette	kzx-r0mu-ww2i	False	None	False	2022-04-12 03:14:20.760	[]
1259	CDC-2022-0024-1266	https://api.regulations.gov/v4/comments/CDC-2022-0024-1266	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If we all write the CDC site in this article... maybe they will get the difference between a chronic pain patient differs from a drug addict. If you or a loved one has been negatively impacted from the change in prescribing practices in their pain meds.. the very ones that enable them to have some decent quality of life. It will never fix our problems nor will the other, often toxic, medications we take for our life long afflictions. If a med works and I can get out of bed and do a little house work or take a shower or best yet... play with my grandchildren. Its just cruel to take it away. I'm currently working on changing my medical treatment to palliative, so I don't have to deal with this extra misery and stressor month after month. I hear that Washington state is decriminalising drug use but, we patients are treated like criminals every time we ask for help or have to do a med review including UA just to get our meds we've taken as needed for years. I'm in shock. So we decide it would be less painful to just let go. This is so wrong and the complete opposite of what they claim to be preventing... death. What happened to do no harm?! Medicine has become just another business... heck, it's on the stock market. People make money off everyone paying in but they don't want to pay back so the money goes into pockets of the investors... not the people doing the work. Doctors don't even make great money anymore. They are cranking out "pain clinics" and treatment centers like crazy. Most big chains. They just want to do expensive procedures or give other drugs that can drive a person to suicide.... it a cruel time in America. We can fix this. But it will take the voice of the people not those telling US what we need... it's what they want so they keep their pockets lined.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484f99e64	Butler	None	2022-02-22T19:40:59Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Butler, Pamela	kzx-rloj-bekn	False	None	False	2022-04-12 03:14:20.982	[]
1260	CDC-2022-0024-1267	https://api.regulations.gov/v4/comments/CDC-2022-0024-1267	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient who was personally driven to almost committing suicide because my doctor feared the DEA due to CDC "Guidelines" I demand that you totally rescind and do not provide any replacement.<br/><br/>I further demand a US Congressional hearing on how the 2016 guidelines were written given the harm they caused to thousand of people who committed suicide due to the excruciating pain inflicted as a direct result of these guidelines, and the authors charged with murder along with everyone who contributed to this guideilne. You have not only killed thousands, you have caused the torture of millions of pain patients and driven doctors to abandon patients, to be arrested merely for prescribing more than 90 MME, and many quit or retired thanks to the CDC's brutal stupidity.<br/><br/>Not a single one of the authors have any training in pain management. An MD degree and a bureacratic or professor role does not make you God to decide who gets pain relief and who does not. You should all face criminal charges for the harm you caused to the US public.<br/><br/>I demand you revoke these evil guidelines and allow doctors to do what they were trained to do. FDA not CDC has authority over drugs. Your actions are illegal and I do not think any MD or state or federal agency should recognize your CDC precribing guidelines for any purpose whatsoever.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f99e72	Anonymous	None	2022-02-22T19:42:21Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-rqnu-yjy8	False	None	False	2022-04-12 03:14:21.193	[]
1261	CDC-2022-0024-1268	https://api.regulations.gov/v4/comments/CDC-2022-0024-1268	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Let me first say I know a crack down is needed to prevent addiction and deaths. As a person who suffers from chronic pain I would like to give you my input. I have ankylosis spondylitis which has caused my entire thoracic to be fused. Furthermore I have two herniated disc in my neck, two herniated disc in my lower back, radicular pain and stenosis just to name a few. I had a laminectomy 6 years ago that has now failed. I suffer everyday and am constantly reminded of my failing condition at the age of 56. I am not on any opioids currently but have had them in the past after my surgery. I refuse to take them because I know the risk. BUT there may come a day when I might need them (hopefully never) and I would hope I could have them. I see people being taken off their medication that is providing them at least some quality of life, that is inhumane. I don't think people have any idea unless you have their shoes. I could go on and on how it has affected my life, and my families life. <br/>Finally, for me personally I am afraid of taking opioids, but am more afraid of needing them as a last resort and not being able to have them prescribed because of regulations set by people who are blessed not to have live in the pain.<br/>Thank you for taking the time to read this<br/><br/>[Name Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484f99beb	Thomas	None	2022-02-22T19:45:36Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Cheryl	kzx-v9jo-4183	False	None	False	2022-04-12 03:14:21.450	[]
1262	CDC-2022-0024-1269	https://api.regulations.gov/v4/comments/CDC-2022-0024-1269	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for over 30 years, I stayed active and employed with pain medicines.<br/>I’m 63. Educated. Know the risks and benefits of narcotics. Let the patient have a say in what their needs are and what works best to keep them active. It’s our choice and right to pick quality of life .<br/>Thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f99f6f	Anonymous	None	2022-02-22T19:46:03Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-0nxk-gwe5	False	None	False	2022-04-12 03:14:21.655	[]
1263	CDC-2022-0024-1270	https://api.regulations.gov/v4/comments/CDC-2022-0024-1270	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After reading this article, I thought to myself, WOW THERE'S SOME ONE LIKE ME!!! Since 1998, after being diagnosed with multiple CHRONIC CONDITOINS, I've been in & out of physical therapy, injections, epidurals, traction, nerve blocks, tens machines, AND YES OPIODS. I am full of titanium parts; replacement surgeries & reconstruction of spine. I've too many conditions, diseases & disorders to list for this comment. Two years ago I moved from New Hampshire to Florida, BIGGEST MISTAKES OF MY LIFE!! In New Hampshire, I saw specialist's, & also went to a pain management for treatment, where I was compliant & respected. I was tested (urine), periodically for un-prescribed street drugs.Now you need to know that I saw my PCP, ORTHOPEDIC SURGEON, NEUROLOGIST,PAIN CARE DOCTOR,even my GASTROENTEROLOGIST & GYN DOCTOR. They ALL worked as a team to better treat my disabilities & conditions, ALL found me compliant. Now, The state of Florida denounces my pain & refuses to treat me. I've been pushed to the curb while people how don't need opoids sell them at your local 7-11'S, DOLLAR GENERAL, WALGREENS,,PARKING LOTS!!! There's ways to treat your patient's without the stigma. I NEED my pain Meds & I can't get them..Soo sad. I have NO QUALITY OF LIFE, I'm in chronic, debilitating pain everyday, self medicating with marajuana & vodka. CDC??? WAKE UP!!! YOU'RE KILLING PEOPLE!! PLEASE HELP US INSTEAD OF HURTING US!! I'd like to THANK MY MEDICAL TEAM IN NEW HAMPSHIRE FOR THIER LARGER THAN LIFE, STELLAR, A1 CARE THEY GAVE ME!! THEY ARE THE BEST IN THEIR FIELD & IM SORRY I LEFT THEM FOR THIS STATE OF FLORIDA'S ABUSE & NEGLECT OF A PATIENT'S RIGHTS & CARE (LACK OF COMPASSION) WHAT A DISGRACE! Thank you for letting me voice my opinion & if anyone reading this can help me,,PLEASE CONTACT ME.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mia	None	None	0900006484f9a408	Gemmiti	None	2022-02-22T19:48:31Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Gemmiti, Mia	kzy-6u6y-foj7	False	None	False	2022-04-12 03:14:21.867	[]
1264	CDC-2022-0024-1271	https://api.regulations.gov/v4/comments/CDC-2022-0024-1271	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer with chronic pain due to several car accidents (spine and neck injuries), fibromyalgia and costocondritis and have for many years. Due to not being able to get pain medication to control the pain somewhat and to get good quality sleep, I have developed other health issues and just recently breast cancer. I truly believe I developed cancer because I cannot sleep due to excessive pain at times. My body cannot renew and heal because I cannot get quality rest. I have had to use other types of medical treatments that do not work. I used hydrocodone for over 20 years, carefully monitored by my PCP and had no addiction. I worked and was productive. I was able to eat, exercise and take good care of myself, but since I cannot treat my pain issues effectively, I have developed so many other health issues and I can no longer hold down a job. The pendulum has swung too far the other way. Those people who really need the medications can not get help. I have been referred to many other doctors for treatment and "pain management" doctors. Drugs are prescribed that do not work. It has cost me a lot of out of pocket money and stress. Stress is not good for my disorder. Please give doctors the ability to use their judgement on a case by case order. There will always be abuse, but those of us who really need pain medications are paying the price. One size does not fit all. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f9ab32	Brown	None	2022-02-22T19:50:02Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Debra	kzy-99fy-ehy7	False	None	False	2022-04-12 03:14:22.092	[]
1265	CDC-2022-0024-1272	https://api.regulations.gov/v4/comments/CDC-2022-0024-1272	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	With this change millions of people who have been punished by our government,CDC and DEA since these draconian dictates where wrongly imposed on the chronically ill and suffers of chronic or periodic medically documented pain it's about time that commin sense be applied to this overreach by our government. I am a 100% disabled 21 year retired Army senior enlisted and Officer who was treated with appropriate pain medication for years since I went to the Veterans Administration (VA) starting in 1994 due to my injuries from service to my country. Then when your ban on proper use of pain by the same doctors and even specialist to myself and thousands of other suffering veterans were kicked off of their pain medication without any tapering off of these medication without any warnings and told by the same doctors that they where told they could no longer prescribe any pain medication for any conditions or suffering by the VA Administration both verbally and in writing from the top of the Administration "cold turkey" and when asked what these patients where going to due to treat their verified suffering, my doctors told me I would have to seek any further treatment by doctors outside of the VA. They said they were ordered to prescribe antidepressants for pain knowing this treatment was totally insufficent for human treatment but had no choice. After finding outside proper treatment by human doctors. I was put back on the same pain medication until the government and DEA informed these doctors that if they did not stop issuing narcotics, they would take their license and charge them. These doctors told me this to my face and said they were sorry but had to think of their future and supporting their families. This was a constantly recurring fact with all doctors. I finally found only one doctor in my whole extended geographical area to again treat me for my severe chronic pain with a similar pain medication until they took this pain specialist license. I was a federal and state law enforcement agent for 30 years working and supervising under cover drugs operations throughout thr United States and Europe. Therefore I know what I am taking about. When you say and our government says they cannot understand why suicides and Overdoses have increased drastically, it is because of their open border policy and forcing those patients suffering from having no choice but to buy the poison off of the street not knowing it may possibly kill them. I hate to say that use of common since has been abandoned by imposing these dictates on the American people. At least under doctors care, these patients use of pain medication was controlled and humanely controlled unlike this policy destroyed. In all criminal justice it is irrational to punish all of society for the crimes of a few like pill mills. Just like punishing a police officers for the misdeeds of a very, very few to meet a political agenda. All doctors and psychiatrist have all, throughout our country have been forced, intimidatedand threatened to punish any doctor or pharmacist who do not comply with the government dictates. This is Communism/Socialism. Pharmacist even refused to prescribe medication that doctors wrote legally. I can't believe two things: one is that the CDC recommended proper changes which blames doctors for misuse of these dictates which the CDC says were misused and over restrictive or misunderstood by all Doctors and physicists throughout America for the last seven years which was allegedly a misinterpretation by all except the CDC WHICH is unbelievable; second is the fact that these recommended changes have not been sent to any doctors or pharmacist for their input on these proposed changes for their input. Why is this the case? None of my doctors, hospitals or pharmacist I know are aware of these recommended changes for their input. Totally disgusting when thousands of Americans have been put through this unbelievable suffering for the last seven years unless they are dying or had cancer being actively treated. Even then, these patients were under treated through their suffering until their death which studies have shown. Statistics lie and liars use Statistics. Call me and I will explain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f9ab59	Blades	None	2022-02-22T19:53:28Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Blades, Michael	kzy-9kic-d4zm	False	None	False	2022-04-12 03:14:22.312	[]
1266	CDC-2022-0024-1273	https://api.regulations.gov/v4/comments/CDC-2022-0024-1273	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What pain med is NOT addictive?? <br/>As a long term chronic pain patient on Oxycontin for years..Oxy did not create a "high" and in all the years prescribed I never abused the drug. Does the CDC realize OXY abusers crush the pill into powder and sniff? This changes the molecular structure and produces a euphoria high which is highly addictive. <br/>In pill form the opioid is highly effective for pain. Note, effective NOT addictive!! <br/>The CDC rules for Oxy are not addressing <br/>the pain with disease. The victims are the patients who NEED it! The hoops through insurance, 30 day supply only requiring a new rx monthly AND the rx cost has created abuse as the drug is sought on the street<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristi	None	None	0900006484f9abdd	Reeves	None	2022-02-22T19:54:15Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Reeves, Kristi	kzy-aad2-khaz	False	None	False	2022-04-12 03:14:22.517	[]
1267	CDC-2022-0024-1274	https://api.regulations.gov/v4/comments/CDC-2022-0024-1274	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We must do away with the MME altogether due to the fact they are 4 ways in calculating ,there is no way you can use morphine as a threshold its mainly codine that treats pain ,we are not in a end of life care living in pain .when i have my medication my home is in good shape dishes washed food cooked ,but when i dont have my pain medication my home is a disaster its no way for anyone to live.the guidelines have created more harm than good ,before the 2016 guidelines there where no guidelines .we need our medication like we need water .its been used for hundred of years .please do away of the mme for it can not be at number on pain level we are not all the same.it aint a working !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9abf5	Anonymous	None	2022-02-22T19:55:06Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-ah3l-mthj	False	None	False	2022-04-12 03:14:22.719	[]
1268	CDC-2022-0024-1275	https://api.regulations.gov/v4/comments/CDC-2022-0024-1275	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The action(s) of the CDC guide to opioid prescriptions have caused immeasurable harm. Thousands have committed suicide due to these, allegedly, science based guidelines. Science, not fallacy, have proven diversion did not cause the so-called opioid crisis. In fact, your actions exacerbated the ‘crisis’. Millions have had access to safe and effective opioids tapered and discontinued. Harm reduction? Safe prescribing? Your guides, old and proposed, will continue to harm people. The lack of actual, fact based, guidelines further harm initiated in 2016. Lack of transparency continues to dispel any real pursuit of ‘harm reduction’. When will the madness stop? Only when these ‘guidelines’ are scrapped and the Doctor/patient relationship is fully restored. Nothing proposed will stop your harm!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jack	None	None	0900006484f9bcf2	Althen	None	2022-02-22T20:15:11Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Althen, Jack	kzy-ka5d-26mt	False	None	False	2022-04-12 03:14:22.925	[]
1269	CDC-2022-0024-1276	https://api.regulations.gov/v4/comments/CDC-2022-0024-1276	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I’m a patient on pain management for many years, going on my 6 th joint replacement. All the changes in laws restricting access have made it very hard to get my needs met. <br/><br/>Making pills tamper proof is a good start to keep people from abusing the medication in other forms. For those of us who are long term patients who have never abused our meds we should be granted an every other month protocol like it used to be years ago, as long as my medication doesn’t change and we tested negative for any drug abuse.<br/><br/>Please consider marijuana for its pain/brain association in pain management did it relaxes the body and allows the brain a distraction to the pain.<br/><br/>Thank you very much for asking and looking at making this better for patients who really need this service.<br/><br/>[name redacted]<br/>[email redacted]<br/>[city redacted] Tn	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lorraine	None	None	0900006484f9bca7	Hough	None	2022-02-22T20:15:49Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Hough, Lorraine	kzy-jxhj-rau8	False	None	False	2022-04-12 03:14:23.128	[]
1270	CDC-2022-0024-1277	https://api.regulations.gov/v4/comments/CDC-2022-0024-1277	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wrote .a comment recently about the CDC guidelines and tapering, and the 50-00 mme limit. Personally i'm suffering from liver cancer, cirrhosis, upper and lower scoliosis, spinal stenosis and spondylosis, epilepsy etc. I've been on methadone for my pain management I started out at 40mg for the scoliosis treatment and went up when I started chemotherapy. Iam on palliative care and don't understand why my doctor is tapering down to 20 mg .currently I am on 50 a day and every 2 months I go down another 10 mg I am a 50 year old widow who has to take care of myself, bills,etc. I am continually having nightmares, insomnia because I am going to have to retire from my employment working as a data entry clerk for the IRS, child support, etc. basically paperwork for all of the clients we have which is about 100 plus buisnesses and people in the community and all ocer Alaska. Iam on the road to being a cancer patient living in my car in the winter in Alaska because of these guidelines. My life is horrible and I dread waking up. Somedays when the pain is too much I get angry that I didn't pass away. I never used to feel that way. I want to be the mother and grandmother I used to be, my family knows that I'm hurting and they are all writing to you also, that I have no quality of life anymore. I'm not that happy, smiling grandmother anymore, I'm always crying from the agony of the chemotherapy pain. You give methadone to addicts, no problem, but us with chronic pain and conditions no way .Please think about the regular working people and cancer patients, chronic pain patients with severe pain daily. Let us get our medication back so qe don't have to depend on SSI or ssdi to live, you help addiction with methadone and suboxone clinics now its time to remove the mme limits from the guidelines please. Thank you so much, [name redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angelina	None	None	0900006484f9b45f	Torres	None	2022-02-22T20:32:06Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Torres , Angelina	kzy-ec3g-nqyx	False	None	False	2022-04-12 03:14:23.336	[]
1271	CDC-2022-0024-1278	https://api.regulations.gov/v4/comments/CDC-2022-0024-1278	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a disabled veteran who has lived with chronic pain for years. I use multiple alternative therapies but sometimes it isn't enough, so I have a very low dose, low quantity prescription of Norco that I have used for 15 years. In 2016, the rules changed and my private practice doctor told me that I would now be required to come in every 90 days to have a urine test and fill out a four-page form stating I wasn’t misusing my Norco by selling it or using it with street drugs or a dozen other humiliating suggestions.<br/><br/>She was also very honest with me that from this point forward I would be looked at as an addict for asking for refills and that she would be extensively questioned about why she was prescribing it each time I came in. <br/><br/>Basically, this change made us both feel like criminals for treating my condition with a medication that I had been using without issue for over a decade. It's hard enough to live with chronic pain, but being treated like a criminal or an addict on top of that is somehow even worse.<br/><br/>Sadly, I am one of the lucky ones. Many of my fellow veterans didn’t have the option of care outside the VA and they were just suddenly cut off from their medications without any help to deal with withdrawal or pain. There is already a suicide crisis with 22 veterans killing themselves very day in this county. How many of those could have been prevented by something as simple as pain relief? <br/><br/>I understand the issue of addiction and that there need to be safeguards in the way opioids are handled. But punishing everyone who takes a particular medication was never the right choice. Hopefully this review period will allow those of us who are responsible with our medications to stop being treated like criminals and start being treated as people in pain.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelly	None	None	0900006484f9bdce	Sharp	None	2022-02-22T20:33:31Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Sharp, Kelly	kzy-kznj-crg1	False	None	False	2022-04-12 03:14:23.560	[]
1272	CDC-2022-0024-1279	https://api.regulations.gov/v4/comments/CDC-2022-0024-1279	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've suffered chronic pain for years, and now, as I am on blood thinners for life, my choices are limited to opioids for the most part. I am under treating my pain because I fear being pulled off them at any time because of some arbitrary thing. As well, my doctor's are all terrified of the DEA. I know my pain is not well treated, but I am terrified to ask for even a minimal amount more because of the stigma, doctor fear of the government, and the assumptions that many people make about opioids even when the patient is extremely compliant and will undergo all the unnecessary drug testing. I understand diversion control, but as someone who takes these medications as needed and not every day so I can have the amount I need when the pain gets much worse, I have to make sure I take a pill a day or two before going to the doctor simply so it will show up on the drug test as not to be accused of diverting them. We patients live in fear over things like this including rapid tapers (and often no taper at all and being thrown out of a practice or being blacklisted by an entire hospital system and having to turn to the black market - still thriving from what I understand). None of this is safe for patients, and part of your guidelines should be mandatory as well as getting the DEA to lay off the medical professionals. I know there were pill mills and all that, but when a doc cannot treat a legitimate problem with a controlled substance without fear of reprisals from Big Brother, that is a giant issue that doesn't seem to be addressed in these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484f9bdb8	Griffith	None	2022-02-22T20:36:02Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Griffith, Melissa	kzy-kw3y-4219	False	None	False	2022-04-12 03:14:23.767	[]
1273	CDC-2022-0024-1280	https://api.regulations.gov/v4/comments/CDC-2022-0024-1280	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 32 yr. old paraplegic since I was 4. EVERY month I have to contact my MD to reorder my medication. Obviously my condition is not going to improve. I also do not drive.My mother is 61 yrs old with severe arthritis since she was 47 yrs old. My mother does drive and takes me and herself to and from the doctor every 3 months. Basically what I have seen is doctors to scared to do their job. We are long time patients who are treated like first time patients. The OD problem seems to be meth, fentanyl and heroin in our area.I know pill mills exist,that is where the focus needs to be instead of a blanket policy. What happens when my mother cannot make the trip every 3 months? Our state even has a database where a doctor or pharmacist can look up our history, it's like they don't check. They are scared to do their jobs and SHAME on you for taking away their power, yet allow pill mills and dealers to dictate OUR medical care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	justin	None	None	0900006484f9be0d	kelly	None	2022-02-22T20:53:29Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from kelly, justin	kzy-lege-mb6j	False	None	False	2022-04-12 03:14:23.977	[]
1274	CDC-2022-0024-1281	https://api.regulations.gov/v4/comments/CDC-2022-0024-1281	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from stenosis in my lower back for a number of years and have had a laminectomy on L-3 and L-4. I continue to have chronic pain in lower back that often affects one or both hips or one of my knees to the point that walking is very difficult. I have been on Oxycodone for several years. To complicate matters, my wife and I are full time RVers and being tethered to one location every two months for doctor appointments and to a pharmacy every month really inhibits this lifestyle. Any travelling at all means working around the doctor appointments when scheduling. The purpose of being a full time RVer is to be on the road and not in one location or returning to a specific location every 30 days or so. The need for a urine test at uncertain intervals adds to the difficulty in travelling, even with the use of telemed appointments for the past couple of years. It would seem that some of the requirements could be relaxed after a couple of years in which one has demonstrated that they are not abusing the process. Changing this so that a prescription could be transferred to another pharmacy in another state would be a significant step in the right direction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484f9be15	Goode	None	2022-02-22T20:54:32Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Goode, Thomas	kzy-lhgg-l5cr	False	None	False	2022-04-12 03:14:24.193	[]
1275	CDC-2022-0024-1282	https://api.regulations.gov/v4/comments/CDC-2022-0024-1282	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For seven years (easily) I've been in chronic pain so bad that without pain management intervention I'm completely nonfunctional. I have neuropathy in all limbs, Migraines, legion on my brain, arthritis, difficultly breathing, GI issues accompanied with complete loss of appetite (for days on end), sciatica, and more with a diagnosis of fibromyalsia.<br/><br/>We have tried ALL types of antidepressants (which had extremely aggressive side effects with no pain relief) nerve blockers (which did nothing to help and actually made the neuropathy worse while still creating a dependency). So, in hopes of maybe tackling this on my own -since I have received no help from numerous specialist and primary care physicians, due to fear of prescribing- that I would make life changes ie diet, yoga, removal of chemicals in our home, reducing stress, counseling, acupuncture, and more, to no avail. Even with all the work I've put in on my end I get NO MEANINGFUL RELIEF! Stuck in bed sobbing, unable to care for my family or myself.<br/><br/>And so, I'm left between two bad options:<br/><br/>Live everyday in crippling pain that makes it impossible to care for myself or my family, this includes menial tasks such showering, cooking & cleaning as well as major contributing factors like being able to work to pay our bills)<br/><br/>OR, to outsource a regiment outside medical practice and without medical supervision. <br/><br/>Neither option is ideal, or even good, but when faced with the inability to breathe, move, shower, or care for yourself or your family, what choice is left?!<br/><br/>And why should I HAVE to make it?! When the poppy has been in use for MILLENIAS! It was only after ultrarefining and the mentality that dependency isn't possible that we ended up here. We know better now, so we should act like it.<br/><br/>If my options are being a slave to frail body that rejects me daily, or dependency on a medication that actually helps, guess which 1 I pick?<br/><br/>But alas, I have no say in my medical care except to say I can reject the non-working medications, but cannot legally and with medical supervision aquire the medications which have helped in the past and still work now. It's unjust. It's unreasonable. And frankly, it's unkind to refuse viable options that keep me working, maintaining bills, a home & a family.<br/><br/>One of the most surprising parts of all this, is that I know several other first hand accounts of people going through the same exact thing. Unable to aquire or maintain the medications that actually work. This is unacceptable and unjust, in a world where resources are plentiful but distribution from a reasonable source is made impossible. Help us help ourselves, as right now, I'm the voice of the many in pain, not the few. And no society should withhold viable, effective & necessary pain medications that are life changing and many cases life saving.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alex	None	None	0900006484f9be36	England	None	2022-02-22T20:57:32Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from England, Alex	kzy-lp7v-29fe	False	None	False	2022-04-12 03:14:24.446	[]
1276	CDC-2022-0024-1283	https://api.regulations.gov/v4/comments/CDC-2022-0024-1283	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My only concern is all the people you have done harm to with your damn witch-hunt for opioids . I am also one of your victims from it. I can't believe the amount of pain I have suffered in the last two years. I had a normal life and did things around the house with no trouble. Now I can't. <br/>I even found my friend dead because of it. When you cut his meds he shot himself two times to die. He had broken his back working in the mines years ago. I myself have had a herniated disk in my neck that badly it wrapped itself around the spinal cord.<br/>I know it was a very big coincidence that right after your witch-hunt for the opoids your big money maker POT was made available to the heads and to greedy people who are making a lousy buck on it! That's what is wrong with this country,GREED!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ted	None	None	0900006484f9ac87	Curnow	None	2022-02-22T21:18:58Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Curnow, Ted	kzy-batl-ps2u	False	None	False	2022-04-12 03:14:24.669	[]
1277	CDC-2022-0024-1284	https://api.regulations.gov/v4/comments/CDC-2022-0024-1284	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	0900006484f9ac9b	Singer	None	2022-02-22T21:19:32Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Singer, Jeffrey	kzy-b2k4-t3ya	False	None	False	2022-04-12 03:14:24.883	[]
1278	CDC-2022-0024-1285	https://api.regulations.gov/v4/comments/CDC-2022-0024-1285	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	2/22/22 unable to view documents or comments, not sure why this has happened over the last three days however how can i comment on a guideline i am unable to view? please fix this server connection.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9acf1	Anonymous	None	2022-02-22T21:19:42Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-bnyj-itkd	False	None	False	2022-04-12 03:14:25.104	[]
1279	CDC-2022-0024-1286	https://api.regulations.gov/v4/comments/CDC-2022-0024-1286	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The implementation of restricting opioids for chronic pain was a complete failure. The stress, injustices and stereotypes are rooted in fear & ignorance. As a chronic pain sufferer, I have NEVER been so belittled, labeled or discriminated against more than having to take prescribed medication to limit my day to day pain & allow for a somewhat decent quality of life. As a professional nurse, I have never been so disgusted & frustrated with my own colleagues when it comes to their judgmental attitudes regarding pain management, this is supported by research (See articles attached). The American Nurses Association warns about the ethical implications of patients who suffer and are undertreated for their pain. As nurses, "we have an have an ethical responsibility to relieve pain and the suffering" (ANA 2018). Many nurses, including state nursing boards stereotype pain patients as drug addicts, dangerous & suffering from (pseudo) substance use disorder. We must allow for responsible practitioners to have the autonomy to treat and manage chronic pain without some governmental entities breathing down the patient or the specialists neck. I pray you never have to deal with chronic pain, it is time for responsible, reasonable legislation that does not punish those individuals who take their medication properly & responsibly. It is also important for legislatures to understand that tolerance is a phenomenon of chronic pain management. Because a patient takes a dose you don't approve of DOES NOT mean it is recklessly prescribed. The discrimination by chronic pain patients is systemic & awful, it should be actively protected under the Americans with Disabilities Act 1973 provisions, it is however ignored & not enforced. Thank you for reading my comments, I DO hope they resonate and we evolve in our understanding of chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f9b4e2	Wohead MSN, RN	None	2022-02-22T21:21:57Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Wohead MSN, RN , Kimberly	kzy-ec9u-cjcx	False	None	False	2022-04-12 03:14:25.316	[]
1280	CDC-2022-0024-1287	https://api.regulations.gov/v4/comments/CDC-2022-0024-1287	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband died of stomach cancer. No one knew util after he died that the divide between the esophagus and chest had been attached by the cancer and was in provable excruciating pain. During the last year of his life he used the pain medication he was given, went to pain clinics, tried hypnosis, so many things. Finally in desperation he sent me to his doctor to beg for medication. I went because I knew he was not pretending nor was he one to take the easy way out. Much of the time, this brave man just put up with the suffering. It even caused him to think I must be poisoning his food because the doctor said he couldn't find a reason for the pain. My husband shot himself on the front porch. No hospice care, no palliative treatment, only pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006484f9b5dc	Sather	None	2022-02-22T21:22:08Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Sather, Margaret	kzy-g4oe-8rhj	False	None	False	2022-04-12 03:14:25.522	[]
1281	CDC-2022-0024-1288	https://api.regulations.gov/v4/comments/CDC-2022-0024-1288	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read through the comments from the Workgroup and noticed the CDC still does not do what these people advised. It seems they did not agree with putting a limit on pain medicine because the MME is not good scientifically. So why did the CDC drop from 90MME to 50MME and then tell providers anyone over 90 MME needs to be discontinued off opiates. They are the sickest individuals and the Drs. on the Workgroup know this. These people are sick and dying. This is barbaric to say the least and how in the world do you think this looks to other countries. I have read the letters from the AMA and the Anethesiologists that were sent to the Workgroup and the CDC. Quit allowing these cops to rule our most valued professionals. What is wrong with you people. We have also noticed the authors of the guidelines having conflicts of interest that the workgroup was well aware of. Do you think the American public is stupid Come on CDC All Lives Matter especially the sick the dying our medical professionals our pharmacists. You and your guidelines have turned this into a giant witch hunt. The DEA is terrorizing cancer DRs.and taking their liscenses and still you pretend to care about the patients. They have already made your draft into law. Drop the MMEs<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	anon	None	None	0900006484f9bdcd	anon	None	2022-02-22T21:22:30Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from anon, anon	kzy-kzlc-8krw	False	None	False	2022-04-12 03:14:25.731	[]
1282	CDC-2022-0024-1289	https://api.regulations.gov/v4/comments/CDC-2022-0024-1289	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In Tennessee it has become impossible in rural areas to get pain medication when it is desperately needed. If I hear one more time, "take Tylenol for your pain" I'm going to scream. Tylenol does nothing for my arthritis pain which I have in my neck and hips. I have resorted to expensive surgeries (nerve blocks and ablations and steroid shots using floroscope) and they have helped. When I am in pain I should not be required to wait for months to get the appropriate procedure done and remain in pain during that time. Chronic pain causes depression and does cause illicit drug seeking. Trust me I have thought of it!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	susan	None	None	0900006484f9c501	wright	None	2022-02-22T21:29:11Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from wright, susan	kzy-mz09-l7wv	False	None	False	2022-04-12 03:14:25.943	[]
1283	CDC-2022-0024-1290	https://api.regulations.gov/v4/comments/CDC-2022-0024-1290	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines need more flexibility.<br/>I have chronic back pain and recently had wrist surgery. Due to being stuck at the maximum cdc guidelines since 2016 my medication has been less effective from my tolerance and I’m $16,000 in debt due to trying the alternative methods that have not helped. I have lost two friends who went to getting drugs off the street because there doctors couldn’t prescribe them any more. Had they kept seeing there Doctors and they were adjusted due to there tolerance. I wouldn’t of lost two friends. I fell and broke my arm and wrist back in December. Had surgery. The pain was unbearable. I told my pain doctor I was in tears over the new pain and he said there wasn’t anything he could do because I was at CDCs maximum dosage.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9c0b8	Anonymous	None	2022-02-22T21:29:58Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-mtj4-wenp	False	None	False	2022-04-12 03:14:26.154	[]
1284	CDC-2022-0024-1291	https://api.regulations.gov/v4/comments/CDC-2022-0024-1291	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, (redacted) and I’m a long-term chronic pain sufferer, former chronic pain employee, and 20-year prescription opiate user. <br/>I’m writing you today because in the midst of this national opiate crisis there is another crisis happening. This crisis involves chronic pain sufferers who are being discriminated against and left to fend for themselves. This fervor to rid our society of this apparent evil is leaving many pain suffers with few if any alternatives to their plight. As a pain patient and former pain clinic worker (radiology tech), I’ve seen this problem from the inside out and I believe I have a unique view of the problem from both sides. <br/>Throughout my life I’ve seen or experienced myself a multitude of examples that I hope will illustrate my point or points that I’m about to make. I hope you will indulge me as I detail my points, of which there are many. <br/>I want to say one thing first. Where is the outcry for the alcohol or tobacco crisis? Many, if not more are dying from these but where is the national outcry for these problematic substances? My father was a full-blown alcoholic and cigarette smoker and he died because of it. Alcohol has a ripple effect where anyone associated with an alcoholic usually suffers right along with that individual. They may not die but they do suffer. Tobacco is known to give nearby non-smokers cancer also.<br/>First, I would like everyone to pause for a moment and rethink this. Are we really looking at a full-blown opiate crisis or are we looking at a widespread suicide crisis where opiates are being used to end one’s life? Think about it, what better way to leave this world. It’s not messy, it’s not painful, and it can be an easy way out. Sure, there are many who don’t intend to die but take just one pill too many and mistakenly do perish. I can’t help but to think we are looking at a suicide crisis instead. I use my own experiences to support this.<br/>Somehow the “narrative” or “National dialog” of the opiate crisis has been commandeered by those who wish, apparently, to see the end of opiate use on all levels. Sure, they may be okay with a short-term medical application or in an extreme cancer case, or end of life situations but anything else is inappropriate and not necessary according to them. Remember, I’m a 20-year user and I will argue the contrary and use my self as an example of that argument. I’m still alive and doing well, in spite of my “Tango” with this insidious and dangerous scourge called opiates. I think the fervor and outcry is truly misguided and misinformed because I’ve obtained a college degree, worked in a very technical and challenging occupation and have never had opiates interfere with any of it or any other part of my life. I’m sitting here scratching my head why this has become such a problem in our Nation?<br/>I’ve attended 2 of the “Opiate Crisis” roundtables here in (redacted)and I was given a turn at both to argue my points. I was supposed to be a member and to be notified of any future events but mysteriously was dropped from the list as I never heard from this group again…Curious? Consequently, I produced a rather lengthy packet of supporting evidence and testimonials and gave to (redacted) local office and never heard anything back, nor did I see any legislation proposed to protect chronic pain patients. No surprise really as our Nation has taken a turn towards an uncaring and cruel approach to just about anything concerning the unfortunate. (redacted) is lock step with the current Administration so I’m not shocked but I am disgusted. <br/>Speaking of uncaring and cruelty, again speaking as a patient and former pain clinic employee, I have a multitude of examples of why I say this. I have far too many examples and can’t possible address them all in this letter so I will give you the more pointed occurrences. Honestly, I’ve been witness to things where I had to question myself and wonder if I was just a part big scam and walked away feeling almost like a criminal accomplice. I’m not joking or embellishing this statement. <br/>My last job in the radiology\imaging field was with a local pain clinic. This job prompted me to make the decision to walk away from the medical field entirely as I began to view all of medical as a money hungry rip off. My cynicism has grown and continues to grow towards this industry.<br/><br/>(paragraph redacted to fit comment) <br/><br/>I used to get so disgusted with that office because while they would occasionally grant the patient the ability to receive pain mediation, they would also insist first that the patient jump through all these other money-making hoops before they could get their prescription. They would be subject to a seeing the in-house psychologist, ordered to PT, monthly drug testing, etc. before they would get a prescription. I viewed the prescription as a bag of Halloween candy but you had to do a trick first. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f9be1c	Cook	None	2022-02-22T21:32:21Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	kzy-ljno-wucx	False	None	False	2022-04-12 03:14:26.366	[]
1285	CDC-2022-0024-1292	https://api.regulations.gov/v4/comments/CDC-2022-0024-1292	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My Dr. Has dropped me as a patient due to failed drug screen. Due to THC showing up on the test. I tried Tch in cookis due to my pain management dr. Cutting my pain medication down to half of what I was getting. Before the cdc told him he had to. Now im with no pain medication.I have been in chronic pain due to neck , back shoulder surgeries, and I have very large and dense breasts. That add to chronic pain. I'm a 60 year old woman. I would never even dream of buying medication from a person. Mainly because it may have fentanyl in it . It could kill me. That is why so many people are dying.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9c530	Anonymous	None	2022-02-22T21:33:41Z	None	None	1	None	2022-02-22T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-n8mq-au9z	False	None	False	2022-04-12 03:14:26.584	[]
1286	CDC-2022-0024-1293	https://api.regulations.gov/v4/comments/CDC-2022-0024-1293	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This seems like a common sense change that will allow physicians to determine if an opioid prescription is a reasonable option for certain patients suffering from acute pain episodes.<br/>A concerned older citizen<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rae	None	None	0900006484f9c5b4	Woods	None	2022-02-23T13:29:10Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Woods, Rae	kzy-o4qy-8hcv	False	None	False	2022-04-12 03:14:26.826	[]
1287	CDC-2022-0024-1294	https://api.regulations.gov/v4/comments/CDC-2022-0024-1294	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The demonization of patients that take opioid pain medications is so notable in the [city redacted] VA Healthcare System. It has enacted a no tolerance policy for long term opioid therapy with the exception of cancer patients and multiple sclerosis. Doctors have been threatened with loss of thier DEA registration and jobs if they don't toe the line. There is an emphasis on alternative methods that could help (e.g., physical therapy, acupuncture, aquatic therapy and psychiatric drugs). If these alternative methods aren't effective then a patient is told to just deal with it. Anyone that has ever been on long term opioid pain treatment is classified as being opioid dependent, a status that can never be removed from the patient's charts.<br/><br/>My pain clinic doctor emphasized in my records that opioid therapy is not to be used for my "non terminal" pain and that I should instead focus on coping with it in my everyday life. If alternatives aren't effective and a patient isn't terminal then he is expected to just deal with it. I was cut off an opioid therapy cold turkey due to this no tolerance policy and it forced me to endure a week worth of painful withdrawals. I wasn't provided a taper medication until a week later and it was too late to be effective. Forcing a patient off an opioid without a taper is considered wrong by the CDC however it still happens within this system. <br/><br/>Today I'm forced to just deal with my chronic pain and it effects my ability to contribute to society. I've experienced weight gain from decreased activities. I have to call in sick more frequently. I'm unable to have meaningful friendships because my chronic pain distracts me from engaging.<br/><br/>I know a fellow veteran that turned to acquiring opiates illegally because the pain doctor cut him off and he was told to just deal with. His treatment was no longer under the caring supervision and expertise of a doctor and he died from overdose.<br/><br/>Overdose is a very significant danger when patients turn to acquiring opiates illegally out of desperation. I must emphasize that most people take opiates as prescribed and under the care and observation of their physician. The select few patients that do acquire opiates illegally are no longer under the care and observation of their physician and it puts them at greater risk of overdose and death.<br/><br/>I'm not sure if opiates are right for me but my clinic has eliminated alternative treatments and placed me on the "just deal with it" category. I'm fortunate to have an employer that is willing to accommodate me while I continue to explore different treatments from a different doctor. Few patients have an employer that is so understanding and many fall into depression because they feel helpless. A patient's quality of life should matter to a doctor just as much as risks.<br/><br/>No doctor should fear losing his/her job for prescribing opiates responsibly. No patient should be demoralized because they're in pain. No patient should be treated as if pain is all in their heads and told they just need to cope. All doctors should take their patients pain seriously. The current system has betrayed that philosophy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484f9c5df	Burmood	None	2022-02-23T13:30:56Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Burmood, James	kzy-ohjs-zvsx	False	None	False	2022-04-12 03:14:27.034	[]
1288	CDC-2022-0024-1295	https://api.regulations.gov/v4/comments/CDC-2022-0024-1295	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A clinical practice guideline would be a step in the right direction to the problem of overprescribing medication if it is commonly used. It would also be taking a step in the right direction to minimizing overdose cases per year. Since it is a recommended guideline we of course should be aware that this will not be a miracle cure to these issues but it is however a first step! Ergo, the guideline does not hurt and only really has the capacity to help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Arianna	None	None	0900006484f9c617	St. Peter	None	2022-02-23T13:31:30Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from St. Peter, Arianna	kzy-otkn-ichj	False	None	False	2022-04-12 03:14:27.265	[]
1289	CDC-2022-0024-1296	https://api.regulations.gov/v4/comments/CDC-2022-0024-1296	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines have been and will continue to be misused by state and federal government agencies, pharmacists, law enforcement, hospitals, the media, legislators, and insurance companies. This misuse has lead to persecution of physicians and discrimination against chronic pain patients (in particular against seniors/elderly). Misinformation published by the CDC and associated organizations regarding prescription opioid impact on addiction, overdose, and death has fueled this persecution and discrimination. <br/><br/>"From data published by CDC, we know that opioids are prescribed three to six times more often among seniors over age 62 than they are to youth under age 19. But overdose-related mortality in youth is three to six times higher than in seniors. Mortality has been stable for the past 17 years in seniors while it has skyrocketed in youth. More basically, there is simply no cause-and-effect relationship between State-by-State prescribing rates versus overdose mortality. Although mortality overall has risen sharply since 2010, it remains below national average in States with the highest medical prescribing rates." http://face-facts.org/.../the-opioid-crisis-in-three-charts/ Legally prescribed opioids are not responsible for the addiction and overdose issues we currently experience.<br/><br/>The 2016 CDC Guideline for Prescribing Opioids for Chronic Pain and the 2022 update should be withdrawn. The FDA should form a task force composed of FDA and non-FDA pharmacologists, chemists, pain management physicians, neurologists, primary care physicians, surgeons, and pain patients. The task force should formulate an unbiased medically scientific based set of recommendations that are focused on treating and preventing pain, not simply stopping addiction.<br/><br/>The use of morphine milligram equivalent daily dose (MMEDD) is unreliable. This can cause more harm than help due to the differences in the absorption rate of different drugs into the bloodstream, half-life of different drugs, the impact of one or more other drugs on opioid levels, and large differences of the rate of metabolism caused by genetic factors. It is now possible to identify the genes that affect how opioids are metabolized. Use a genetic profile to identify a safe and effective dose for individuals who are at risk of an overdose and those who need higher doses due to their personal metabolic makeup. Do away with MMEDD limits.<br/><br/>Patient tapering and discontinuation of opioid medication should not be dictated or directed by the Guidelines. Leave this to medical professionals who actually treat patients in pain. These physicians are not idiots. Unfortunately, out of fear of a visit from the DEA, many physicians have followed these Guidelines and discontinued or tapered their patients. As a result, their patients have resorted to acquiring illicit drugs or suicide. Those who do not go this route have found their lives disrupted to the point where they are unable to function.<br/><br/>There are issues of bias and conflict of interest among writers of the CDC Guidelines. Input from addiction specialists is important, however, it is very apparent that anti-opioid proponents wrote the Guidelines. The majority of writers should be pain management practitioners and researchers, not addiction specialist and psychologist. I find it very disturbing that research used in the Guidelines has been carefully selected to support anti-opioid opinions. There is equally viable evidence that demonstrates the benefits of long-term prescription opioid treatment for chronic pain. Despite cardio and strength building exercises, yoga, meditation, epidural injections, muscle relaxers, and anti-inflammatory drugs, I would be unable to move without severe pain if not for my opioid medication. <br/><br/>Sincerely,<br/>[name redacted]<br/>[email redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dana	None	None	0900006484f9c61c	Miller	None	2022-02-23T13:34:30Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Miller, Dana	kzy-ovxa-svnh	False	None	False	2022-04-12 03:14:27.469	[]
1290	CDC-2022-0024-1297	https://api.regulations.gov/v4/comments/CDC-2022-0024-1297	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a 100% Disabled Veteran. I have Degenerate Rheumatoid Arthritis in my entire Lower Back. I deal with constant pain every single day. My new PCP has me on a Prescription that does nothing for my pain. This should be a case by case basis	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f9c61d	Hale	None	2022-02-23T13:34:51Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Hale, Michael	kzy-oxwr-8yk5	False	None	False	2022-04-12 03:14:27.689	[]
1291	CDC-2022-0024-1298	https://api.regulations.gov/v4/comments/CDC-2022-0024-1298	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 45 year old female with an undiagnosed autoimmune disorder. I am in chronic pain, and can barely walk 5 ft. I stay swollen all the time with bad Adema. I have never had a opioid problem, any kind of drug problem, and I can't get on pain management whatsoever. Every time I speak yo my doctor about it, he is always wanting to give me something for depression, and/or for anxiety. I have been like this for 3 1/2 years, and steady getting worse, and my doctor is afraid to give me anything because he is afraid of losing his lisence. I'm tired of living in pain, and want pain management., and can't get it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484f9c648	Hall	None	2022-02-23T13:35:29Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Hall, Michelle	kzy-p8gq-uskt	False	None	False	2022-04-12 03:14:27.922	[]
1292	CDC-2022-0024-1299	https://api.regulations.gov/v4/comments/CDC-2022-0024-1299	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please that are in pain should be able to get pain meds. I have been seeing a pain management doctor in Georgia since 2013<br/>Moved to TN in 2021 and found a pain management doctor.<br/>They got all my medical records and would not give me the medication I was taking, so the medication does not touch my pain.<br/>That’s why so many people are buying on the streets.<br/>That’s why you have so many people die of drug overdose.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f9c654	McCormick	None	2022-02-23T13:35:55Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from McCormick, Lisa	kzy-pbk5-lpj1	False	None	False	2022-04-12 03:14:28.128	[]
1293	CDC-2022-0024-1300	https://api.regulations.gov/v4/comments/CDC-2022-0024-1300	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The MME equivalent makes no sense at all. This needs to be left out entirely! Also, patients need some patient rights. If our doctor retires or if we move, the new doctor must keep us on the same meds we’ve been receiving. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sara	None	None	0900006484f9c2b3	Walton	None	2022-02-23T13:36:13Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Walton, Sara	kzy-pu6b-iaob	False	None	False	2022-04-12 03:14:28.400	[]
1294	CDC-2022-0024-1301	https://api.regulations.gov/v4/comments/CDC-2022-0024-1301	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed after 8 years of Lyme disease in 2015. Chronic kidney infections and kidney stones requiring surgery along with broken tailbone 4 times. This is when I was given the stigma of drug seeker. I never thought I would be treated like a criminal for having chronic pain. Or a bad person for seeking medical doctors for intolerable pain. In 2016 with the cdc opiod guidelines escalated that for everyone suffering. For which I cannot understand how a government organization for infectious diseases could define and have authority over people suffering. My life has fallen into a black hole since March 2021 I broke my left foot in 3 places and got Complex Regional Pain Syndrome. The highest amount of pain a human can endure. Broken bones and pain so bad I screamed, say and night I wanted to die. I was denied opiod pain medication. I didn’t sleep for weeks, thought of suicide just to stop the physical torment. I trusted doctors because they took an oath to do no harm. Instead I was discarded like trash. They put me on Gabapentin instead. It made me tired, permanently ruined my eyesight, insomnia, memory and cognitive issues and weight gain. It did nothing for pain. So I tried a nerve block. It worked for a week, back to square one. I’m now off Gabapentin. Then they wanted me to try Cymbalta. Even worse after 2 doses. Then fed the absolute lie that combining Tylenol and ibuprofen would act like morphine. Told by three different doctors. Blatant lie. I’ve taken so much ibuprofen my stomach has become so damaged, I cannot take anymore. And the media saying there’s people dying of opiod overdoses. Not explaining that it’s illicit street fentanyl and it’s not overdose but poison. My mom has rare type of breast cancer and she herself has been denied opiod pain relief. This has been deceit, over reaching and inhumane. My disease is also known as the suicide disease, now I know why. The experts on chronic pain isn’t the cdc, lawmakers, politicians or doctors. It’s chronic pain patients who are the experts. And we’ve been shunned, labeled and discarded. The doctors that actually have compassion and good intentions are being put in prison for abiding by the oath to do no harm. To help, care and give hope they are punished. This has to stop. It’s murder to keep people in pain to where they die from poison or suicide. I pray this sticks to the minds of the ones in power who have all the control while we don’t. We don’t have the right for pain management anymore.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mandy	None	None	0900006484f9c2fa	Wright	None	2022-02-23T13:37:11Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Wright, Mandy	kzy-qjp6-8a06	False	None	False	2022-04-12 03:14:28.670	[]
1295	CDC-2022-0024-1302	https://api.regulations.gov/v4/comments/CDC-2022-0024-1302	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who was denied any stronger medication than acetaminophen because of agonizing pre-surgery knee pain; and post surgery knee pain, I sincerely hope you make amendment to your no opioid for any reason policy. I had agonizing pain, especially after the complete knee replacement surgery. My ortho prescribed three days of Tramadol! That was it! I am 75 years old, I shouldn’t deal with such pain, especially since I have had two major surgeries and was given hydrocodone, and fared well. It should be case by case not a blanket prohibition. I have heard of people committing suicide because they were taken off their usual pain relievers and given something milder. I can understand why. I am in excellent health. Regardless of age, my ortho would not prescribe more days for pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carolyn	None	None	0900006484f9c305	Nelson	None	2022-02-23T13:37:37Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Nelson, Carolyn	kzy-qnjz-pfhg	False	None	False	2022-04-12 03:14:29.224	[]
1296	CDC-2022-0024-1303	https://api.regulations.gov/v4/comments/CDC-2022-0024-1303	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for this thorough updated evidence review and update:<br/><br/>Please stop using the term “immediate-release” throughout the document. It is confusing term because the only true immediate release opioids are the “rapid-onset” transmucosal and buccal fentanyl products. You use the more accurate term of “short-acting” opioids I think only once on page 4, line 63 but after that in many places (e.g. page 64, line 1473; page 71, line 1642; page 91 line 1642, page 92, line 2159-62, 2184 and so on) use immediate release. Please replace “immediate-release” throughout with “short-acting” or parallel construction or IR/SA. Note also some opioids are long-acting (i.e. methadone, buprenorphine, levorphanol) without being “extended-release”.<br/><br/>Page 95 what about transdermal buprenorphine (Butrans patch)?<br/><br/>Pg 96 (lines 2269-71) & 99 line 239 states “The lowest starting dosage for opioid-naïve patients is often equivalent to a single dose of approximately 5 to 10 MME or a daily dosage of 20-30 MME/day.” A listing of common opioid medications and their dosage in MME equivalents is provided (Table). Yet oral morphine tablets comes only in higher dose strengths (15mg, 30mg) and the package insert for Morphine Sulfate Oral Solution (2mg/mL or 4mg/mL) lists dosing as 10 to 20 mg every 4 hours as needed. Do you mean to refer to equivalent of 5-10mg of oral oxycodone which would be even a lower oral morphine equivalent dose? This needs careful wording and clarification<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f9c327	Gordon	None	2022-02-23T13:38:48Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Gordon, Debra	kzy-r7d8-7dsi	False	None	False	2022-04-12 03:14:29.444	[]
1297	CDC-2022-0024-1304	https://api.regulations.gov/v4/comments/CDC-2022-0024-1304	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. <br/>I have had 9 back fusions, 2 pain pumps and 2 back stimulators. In 2010 I had a doctor mess me up and now I have never damage. I had to quit work, stop working on my own vehicles, hunting, fishing, working out, yard work, house work. And ever since you change the guide line for pain management all I do is lay in my 0 gravity bed and walk around the house because I'm in such pain. When you told the doctors to lower everyone's meds you did not take under consideration people like me with Cronkite pain. At least when my pain pump meds and oral meds were higher I could walk more than a half block before my low back and hips were killing me. Please change the guidelines for people like myself. <br/>And people are overdosing on Herron and Fentanyl not pain meds. In my history I have never abused my pain medication. I do not get a high off them. It just makes my life much easier. <br/>Thank you. <br/>[name redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monte	None	None	0900006484f9c338	Edgar	None	2022-02-23T13:40:01Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Edgar , Monte	kzy-rhx3-l6t1	False	None	False	2022-04-12 03:14:29.664	[]
1298	CDC-2022-0024-1305	https://api.regulations.gov/v4/comments/CDC-2022-0024-1305	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a long-term chronic pain patient. I have multiple degenerative diagnoses, with my chronic disease state, being degenerative and incurable, I have still been able to work, I enjoy work, I enjoy boosting the economy by spending my money in this economy. If I am unable to work, I will be unable to spend money in this economy. If my medication cannot be titrated to help me obtain optimal performance, because of your MME MANDATES, I am at a detriment. I do not need anti-depressants because what is degenerative is not in my brain, it is in my body. Utilizing medications that affect my mood MAKES ME UNSTABLE, which causes a detriment to society because of MENTAL INSTABILITY. I have been given medications that have made me feel homicidal/suicidal instead of titrating my opioid medications to help me physically work, this is what you are doing to people. This is what you are actually doing to me, I do not wish to be "high" for if I did, I would consider illicit drugs, I do not wish to be "out of my mind" for if I did, I again would do illicit drugs. It seems those type of substances is easy to find and psychotropics be prescribed, but to go to a doctor for a legitimate physical deteriorating problem which affects your daily life and functionality so as to function better, clear minded, with control over your body and mind, not cured but still able to function and progress with life to a somewhat normal standard is not encouraged now. My family have watched as this war on chronic pain has affected my functionality. They have seen firsthand my doctor state that the CDC and DOJ have tied his hands in helping me titrate my medications to a therapeutic level again. And then give me a substance that affects my mental state to a point that I lose my car leaving work, heaven only knows what I did at work that day,or discuss harming someone or myself as if that were normal. Using psychotropic drugs "off label" is basically the same as me going to the street and finding some substance to make me not think of the pain which is still very much there, but now I have the added ideology of not afraid to act in ways I normally would not even dream of acting. I have a chronic illness, but I do not let this control my life, nor do i let medication control my life, I use this medication to ease the pain of a degenerative, debilitating condition that will not "get better". We "chronic pain community" see what is happening. those of us that take the medication just as people take high blood pressure meds or insulin, and theirs is titrated to the level that they need for therapeutic benefit, we see that ours is not. Lumping an entire group of people together as if all people are the same is catastrophic. Just as there are therapeutic benefits to the insulin and the blood pressure meds, and all other medications that have been created for the "greater good". My family have now wondered, if everything that has been done through the years is for profit alone. Seeing as now how ketamine "cat tranquilizer" haladol "psychoactive trip drug" paxil "murder pill" has been created and pushed to the public and the results were horrific. They wonder if the standard of care for people is a joke, if ALL medications, or professionals and even the research that is done is for the greater good to anyone but stakeholders. or is it a way to destroy people's lives instead of helping them live better ones for society, upstanding law-abiding order, if governmental agencies are trying to create distrust, then they have done so admirably. Once a very large group of people have been made to suffer kind of like this chronic pain holocaust, the younger generations will not trust government at all. They see it as: "you made way for grandma, grandpa and mother to suffer, you are to blame for parents, grandparents committing suicide." when there could have been relief provided, relief that has been around and studied for AT LEAST 100 Years. Our youth are watching, as you've tried to put all people in the same category as addiction. It is a separate animal, addiction is. Government knows it, and people know it as well. For the people that have addiction issue, may they get the help they need and deserve, but so shall the chronic pain people, all of us that have been placed in the same group that have been tortured to get our medications, being drug tested like we are on parole, like we are addicts being in treatment for addiction and have done wrong to ourselves or society. Your war on drugs is moot, but the way that you've portrayed our trusted physicians, as if they are drug dealers, and we are the addicts, the way you've created such distrust in healthcare and community. Do not think this issue is not spread far and wide, now that chronic pain patients know your intent, our families and communities want to fight in this world of suffering, they ARE finding alternatives, just not from the trusted doctors, or governments. You'll be worthless	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	d	None	None	0900006484f9c35c	l	None	2022-02-23T13:43:52Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from l, d	kzy-rz4z-shjr	False	None	False	2022-04-12 03:14:29.890	[]
1299	CDC-2022-0024-1306	https://api.regulations.gov/v4/comments/CDC-2022-0024-1306	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024 <br/><br/>AGENCY:<br/>Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS).<br/><br/>I iwrite to request that you open an investigation into the process by which writers were selected for the recently released draft revised and expanded practice guidelines for prescription of opioids in acute and chronic pain. I believe it is apparent that CDC violated its own internal procedures for ensuring that consultants hired by the Agency have no personal, professional, or financial conflicts of interest and that their work reflects a balanced understanding of subjects on which they consult.<br/>I offer as evidence for this concern, the published work of [names redacted] in "[name redacted] Undisclosed Conflicts of Interest; How the CDC's 2016 Guidelines for Prescribing Opioids for Chronic Pain Lost its Clinical and Professional Integrity", Palimed - A Hospice and Palliative Medicine Blog, September 21, 2021.<br/>[name redacted] was selected for the CDC writers' group in both the original publication and its 2022 revision, despite having an established publication profile that includes co-authoring several anti-opioid papers, with members of "Physicians for Responsible Opioid Prescribing" - PROP. This group has been prominent in efforts to deny patient access to prescription opioid analgesics. Moreover, [name redacted] has been placed in positions that enable his advocacy for his own research as US National policy for regulation of opioid pain relievers and of physicians who employ them.<br/>[name redacted] was paid under contract as a principal or contributing author of several published studies of the Agency for Healthcare Research and Quality that are centrally referenced in the CDC Guidelines<br/>-- Several of these studies contain scientifically weak or outright erroneous assertions about the state of research in Acute and Chronic Pain, treatment with opioids, and alternative non-opioid therapies.<br/>[name redacted] has also served on the Board of Scientific Counselors of the National Center for Injury Control and Prevention, which oversees development of the CDC opioid guidelines.<br/>[name redacted] also served on the appointed Opioid Workgroup of the NCIPC BSC, which reported its concerns and findings on the revised CDC guidelines in June 2021.<br/>I believe this combination of positions, combined with [name redacted]'s other publications, constitute a profound and disabling professional conflict of interest. Thus, your office should immediately convene a Board of Review for all reports in which [name redacted] has contributed, that have been influential in drafting the 2022 revised guidelines for prescription of opioids. Ideally, this Board -- unlike the guideline writers group itself -- should include clinicians experienced in the community practice of pain medicine as well as technically trained patient advocates who understand research protocols and data analysis	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f996ac	Anonymous	None	2022-02-23T15:40:09Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-aw6k-iewk	False	None	False	2022-04-12 03:14:30.127	[]
1300	CDC-2022-0024-1307	https://api.regulations.gov/v4/comments/CDC-2022-0024-1307	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 71 years of age and have several different issues that cause pain in my body. I Was a Dental Hygienist for 40 years and have chronic neck and back problems that developed over a period of those years of leaning over patients. Also I developed arthritis in my shoulders,hands,neck and knees. I had rotator cuff surgery and was sent home with Tylenol. I ended back at the hospital in significant pain. My surgeon clearly wasn't interested in my pain because he had already received the payments for the surgery. Growing up I had migraine headaches that usually came with my menstrual cycles. If I couldn't get relief with my own treatment at home my mother would take me to the ER. I learned I was immediately labeled a drug seeker. This is no longer my country. Where you had compassion and concern from my doctors. They are scared of the DEA AND CDC. I NOW LIVE IN A 3RD WORLD COUNTRY. They even limit pain treatment in hospice....how ridiculous is that. The person is dying and [name redacted] decided it was not living up to his team's idea of no more pain meds. You have no idea how many people you have killed via suicide or forcing them to seek relief elsewhere. This isn't my country anymore. There will be a day of reckoning. There will be hard questions you must answer. Mostly about following the money. We are uniting. We deserve to have happy productive lives.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jan	None	None	0900006484f9be2a	Fulton	None	2022-02-23T15:42:22Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Fulton , Jan	kzy-llrz-s83t	False	None	False	2022-04-12 03:14:30.339	[]
1301	CDC-2022-0024-1308	https://api.regulations.gov/v4/comments/CDC-2022-0024-1308	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 46 and have had a kidney transplant for over 20 years which means I am not able to take nsaids, like Advil or Motrin. The only OTC pain medication I can take is Tylenol, but that doesn't always work. <br/><br/>Back in 2015 my doctor gave me a 20 dose prescription of Dilaudid because I would find myself in the ER with severe, debilitating abdominal pain almost once a month. Instead of paying for an expensive visit to the er, she gave me the prescription for the dilaudid. This not only allowed me to treat my pain immediately at home, but it freed up a space at the emergency room for someone who needs it.<br/><br/>Then in 2018 when I asked for a refill, I was told I could not get one. Not only could I not get dilaudid, I couldn't get anything. It didn't matter what doctor I saw, my PCP, my nephrologist, the doctors at the pain clinic, whenever i complained that i was having pain i was told to take Tylenol. Well i wouldn't be at the doctor office complaining about being in pain if Tylenol worked. I couldn't get anything not even Tylenol with codine. I just had to suffer till it passed. <br/><br/>20 pills lasted me 3 years so clearly I'm not an addict, but that didn't prevent my doctors from treating me like one. The doctors are so afraid to prescribe opiods that they just don't period. Then the patients suffer because no one will help them. <br/><br/>This guideline hurt more than it helped, especially here in Michigan where it became a law. I haven't been able to get a prescription for pain medication for years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9c369	Anonymous	None	2022-02-23T15:44:28Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-s318-mo59	False	None	False	2022-04-12 03:14:30.566	[]
1302	CDC-2022-0024-1309	https://api.regulations.gov/v4/comments/CDC-2022-0024-1309	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because of current rules people with documented chronic pain are treated as second class citizens. We are denied care and looked at with suspicion at every turn. Emergency room visits are the worst. I have been treated like absolute scum and had to prove I wasn’t seeking meds before being taken seriously/treated (for what turned out to be a ruptured ovarian cyst). I literally brought out my meds and counted them in front of the nurse while doubled over in pain, scared to death that something was seriously wrong inside me while she looked at me with scorn. I’ve had a judgmental pharmacist question why I needed my medication (she was actually reprimanded by her supervisor and my doctor). <br/>I have to pay an extra copay every month to a for profit pain clinic for a nurse practitioner who barely knows me to count my medication and drug test me before deciding whether I get the medication I need to function that month. It’s absolutely absurd that my doctors who have treated me for 13 years aren’t allowed to decide what medication and treatments I need. Instead I got to a clinic which is constantly pushing expensive injections I’ve tried in the past that have actually made my pain worse. If I decline too many of these injections I risk being kicked out of pain management. I have never been missing medication or failed a drug test, I never even ask to raise my dosage and yet that all means nothing. I’m still treated like a criminal and made to jump through more and more hoops to get the care I need while drug addicts are still dying at ever increasing rates. If these hoops actually helped save people I would gladly jump through them but all that is accomplished is punishing people who are suffering from chronic illness. Please stop this! We have suffered ENOUGH!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melanie	None	None	0900006484f9c37e	Tranka	None	2022-02-23T15:46:21Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Tranka, Melanie	kzy-sf14-68rr	False	None	False	2022-04-12 03:14:30.785	[]
1303	CDC-2022-0024-1310	https://api.regulations.gov/v4/comments/CDC-2022-0024-1310	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Here is my feedback: often people in pain are forced to return to work after being out in disability only temporarily; <br/>however if a person has enough credits on disability from putting in enough years of work service, then Disability should allow them to stay home on disability with the 2K per month. This would avoid people having to take more pain killers than needed if they had a choice to stay home. Also taking pain killers makes people drowsy and they shouldn’t be driving to and from work as it’s unsafe and often the doctors say not to drive yet disability is telling people that they are able to work. By approving this it would help so many citizens suffering daily.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rosaleen	None	None	0900006484f999f3	Clarke	None	2022-02-23T16:01:55Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Clarke , Rosaleen	kzx-gamp-jmnp	False	None	False	2022-04-12 03:14:30.997	[]
1304	CDC-2022-0024-1311	https://api.regulations.gov/v4/comments/CDC-2022-0024-1311	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How can people without any training or experience in treating chronic pain patients with training in anesthesiology and pain management be qualified to tell those with training how to treat their patients? Every single member who contributed to this update has a biased background in addiction, and no one has training in anesthesiology or pain management and clinical experience applying that training.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f99a5c	Anonymous	None	2022-02-23T16:03:28Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzx-h2lx-7nov	False	None	False	2022-04-12 03:14:31.223	[]
1305	CDC-2022-0024-1312	https://api.regulations.gov/v4/comments/CDC-2022-0024-1312	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i am sorry if i don't comment properly about this. my doctors seem more afrade of loosing their jobs due to government intervision that on actually taking care of the paitent. i have long term pain. going on for 15 years. i found fentynal takes care of most if not all of my pain issues much better than any and all opioids that i was on before. i was on oxi80s three a day plus three somas a day. i believe 350s. i was changed to doses of fentynal 50mcg every two days going up to 150mcg every two days. i moved to new york and was taken down to 25mcg every two days. i have been on the 25 dose for seven years. the 150 dose was for three years. 100 does for two years. 50mcg does for two years. for a total of about 17 plus years. although my present dose of 25mcgs is helpful. after seven years i find that an increase of any small amount would increase my pain relief greatly. the improvement of my quality of life because of this medication is to me profound, my last three doctore have said that they will never increase my dose. with my history as an example. i would think that any doctor would consider a small increase as medically helpful.no doctor should have to be afraide of loosing their jobs for putting the care of their paitent first. plus our state and local governments should not be in control of our doctors but the CDC- doctors. should be in control of doctors. and that way doctors are in control and in care of their paitents. i personally do not think that i should need to hAVE THE LARGE DOSES THAT I ONCE HAD. STILL IN THE BEGENNING THEY WERE SO IMPORTENT TO MY HEALTH AND CARE. very sorry for spelling and caps, i am recovering from eye sugury. please consider those of us who need long term care. thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	patrick	None	None	0900006484f9d4dd	hudson	None	2022-02-23T17:12:27Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from hudson, patrick	kzz-b4hy-5nrl	False	None	False	2022-04-12 03:14:31.463	[]
1306	CDC-2022-0024-1313	https://api.regulations.gov/v4/comments/CDC-2022-0024-1313	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a chronic pain patient with several conditions that need pain relief with morphine. I take morphine as prescribed by my doctor after saying no to this medication for several years. I had no life, in constant horrible pain. Without morphine prescribed by my doctor I would be completely bed bound. With this opioid I can at least get out of bed. At no time have I ever misused or abused morphine. There are many, many people just like me who can at least have some sort of life with their families because we are using opioids. <br/>In 2016 the government, decided to step in and regulate opioids because there were many deaths from street drugs containing opioids. Everyone panicked and withdrew patients pain medications so they would not be in trouble with the government. This was a disaster for those who depend on opioids for pain relief. <br/>I am very lucky that I have a sensible doctor who understands the need for pain relief in my conditions. We had a conversation about my care and decided that as a team we are doing the best we can for my health. I see my doctor every month and there are times he changes things or orders other therapy to help lesson my pain. Communication is vital and should be between the doctor and patient. The government does not need to be involved! <br/>I'm sorry for those who turn to illegal drugs for pain relief because they cannot receive that type of help with their health provider. Illegal drugs laced with high doses of fentanyl that kill so many people. <br/>This is where the government needs to be looking at. Look at those who from 2016 that no longer were able to get the legal prescriptions for opioids and then turned to illegal drugs for pain relief! That is what the government did to these people! So now seven years later, the government says oops sorry, we didn't mean for it to turn out like this. Too late for so many. I hope that these updated guidelines will have a positive effect for the future of chronic pain patients who have been turned away by their health providers because they were afraid of what the government would do.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484f9d4e1	Smith	None	2022-02-23T17:14:28Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Brenda	kzz-bgij-2p89	False	None	False	2022-04-12 03:14:31.678	[]
1307	CDC-2022-0024-1314	https://api.regulations.gov/v4/comments/CDC-2022-0024-1314	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for recognizing that there is a necessity for change.I pray that Doctors & Hospitals don't misconstrue your words. Doctors are afraid of losing their jobs,inspite of doing the right thing. The patients are the ones who are suffering.<br/><br/>I was in a motorcycle accident many years ago. I broke L5 & had multiple surgeries on both my back & for internal injuries. I was given an 85% chance to walk again. I beat the odds after 3mos and 3 different hospitals.<br/><br/>PROBLEM #1:<br/>After 10yrs of tolerable pain, I started seeing a Chiropractor every 2wks eventhough he advised 3x/wk til improvement. I could NOT AFFORD the co-pays. Paying up front for massage & accupuncture, even with insurance partial reimbursement wasn't affordable. Who can?? There are services that athletes have everyday availability to help them recover quicker. These are not affordable to the average person nor does insurance cover it. Insurance needs to be required to treat those necessary services as part of a multifaceted pain management approach with $0 or affordable co-pays for pain management patients. <br/><br/>PROBLEM #2<br/>Because my insurance didn't cover any or all of the above services UPFRONT, I was sent to a Back Doctor whom they did cover. He gave me what ended up being false hope. 10 more surgeries later & I am in worse pain then before surgery. I have severe nerve, bone, & muscle damage. The Back Doctor wanted to operate AGAIN! When I said "NO", he dropped me. Over operating & operating as the 1st option is not always beneficial.<br/><br/>PROBLEM #3<br/>Per my insurance, I went to P/T but again, could NOT afford the $35 co-pays 2x/wk on a SSD income nor did I qualify for help because I was $6000/yr above the threshold.<br/>Many have the same circumstances. I have a Medicare advantage plan with a monthly premium & absorbent co-pays collectively. <br/><br/>PROBLEM #4<br/>I fell into a depression while struggling to deal with a 9-10 level pain daily. I started to see a Psychiatrist who OVER rx'd making me a "liability" in the eyes of other Doctors.<br/><br/>HOPE:<br/>At last, I found a Pain Management Doctor who was compassionate yet firm. I followed the guidelines & we found the right combination of rx & rest,ice/heat & reasonably limiting my activities that increased my pain. I was able to see my friends & family on a limited basis but still reasonable & go to Church with my Mom again. Things were looking up.<br/><br/>PROBLEM #5<br/>Then, the CDC changed the rules. Once again, I was struggling with a 9/10 level pain & fell into a depression again...which was held against me<br/>When finding another Pain Doctor to treat me. <br/>Finding one who would treat me without demanding more "Surgery" was a battle. After I said no "5x", suddenly they couldn't fit me in for 8wks yet only wrote a 4wk rx. Refused to fill the rx after 4wks until my next appt another 4wks away.. forcing me to suddenly be without rx.This occurred repeatedly. <br/>These pain mngment Doctors should be required to.get patients scheduled in a timely manner. Forcing complying patients to go through this is unethical...yet it happens. If they can't,they should be required to give us fair warning in written form & continue to rx for an addt'l 8wk, which is the average time to get in to see another Doctor.<br/><br/>PROBLEM #6<br/>I was diagnosed with Leukemia & told that I've had it for 6yrs. The new Pain Management Doctor feared for his job & only rx Tylenol with codeine for a 9/10 level pain. <br/><br/>PROBLEM #7<br/>I went to the ER & needed surgery asap to remove an infected Gallbladder full of stones. This delayed the start of Chemotherapy. My pain was NOT managed after surgery in & out of the hospital. I only had the Tylenol with Codeine for post-surgery pain.<br/>The 1st 4days & nights were the worst. I didn't sleep,eat,drink or get out of bed. Depression set in. They Failed to manage pain following surgery.<br/><br/>PROBLEM #8<br/>My pain Doctor will treat back pain but not the addt'l pain from the Cancer & the Chemo. The Oncologist left it up to my pain doctor. Fighting for my life is hard enough. I shouldn't have to Fight for my pain to be managed.<br/>It's not a one fits all solution. It's a multifaceted approach & insurances need to pay for alternative methods up front.<br/>P.S. Yes, there are patients ALLERGIC to CBD. I am one of them.<br/><br/>Chronic pain patients are DYING from meds bought on-line because they are tainted. This is NOT an addict. This is a person with a family who is in despair from unbearable pain & Doctors failed them. Have you ever been in this much pain? Then you wouldn't understand. Don't judge!<br/><br/>**I don't take anything that isn't rx'd by the doctor.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anita	None	None	0900006484f9cf4c	Fuchs	None	2022-02-23T17:15:40Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Fuchs, Anita	kzz-cuwj-ehm1	False	None	False	2022-04-12 03:14:31.892	[]
1308	CDC-2022-0024-1315	https://api.regulations.gov/v4/comments/CDC-2022-0024-1315	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain treatment in this country has turned into an assembly line of dangerous and often useless procedures, such as epidural steroid injections, which the drug companies themselves tried to have outlawed through the FDA. Think about that for a minute... Pain clinics are awful places where patients are treated like drug seekers no matter their condition or what medications they are taking. Most of the alternative medications replacing opioids are useless and have their own extensive list of side effects. NSAIDs do not work on nerve injuries and they are dangerous taken at high doses. <br/><br/>These updated procedures focus a great deal on the risks of opioid medication but do not discuss the benefits of them which give the whole document a biased slant. The studies cited within the document are of low quality and a few items cited such as the MME limits are based on junk science. Christ! Do better CDC, if you’re going to stick your nose in it at least try and be balanced and truthful! What you have presented here is a prime example of slapping lipstick on a pig.<br/><br/>I am not a chronic pain patient, thank the gods, but I am someone who had to watch her own mother go through the medical meat grinder. I myself was stigmatized a few years back when I presented to the ER with an acute injury and needed pain relief alongside treatment for the injury. As if I was faking the injury in order to score drugs… what a joke considering the ease I can imagine in scoring drugs on the streets. I like the vast majority of people have been exposed to opioids at several points in my life and after I finished my course of treatment did not feel the urge to hunt down more.<br/><br/>What has been done in the decade leading up to this moment is wretched. You have had your hand in punishing a large swath of innocent people (cancer patients, the elderly, sickle cell patients, people with chronic incurable conditions, etc.) because of the actions of a few. And these updated guidelines, do not go nearly far enough. We are back in the age of undertreating pain in this country and all your efforts did nothing to stem the tide of overdoses. Why? Because it was never a prescription issue, it was an illicit drug issue! <br/><br/>I know for myself and several others that I will decline any elective surgeries that may come up in my future. When you have hospitals bragging that they are giving post-op patients Tylenol and sending them home with Ibuprofen there’s an issue. Maybe if enough of us decline the big-ticket items from you, i.e. surgeries, you’ll come to your senses and stop this insanity. And stop listening to the “opioid experts” they are biased twits pushing an agenda in the hunt for the All-Might Dollar, nothing more. And they have blood on their hands. So do you. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cf59	Anonymous	None	2022-02-23T17:21:25Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-dp0w-z7tu	False	None	False	2022-04-12 03:14:32.122	[]
1309	CDC-2022-0024-1316	https://api.regulations.gov/v4/comments/CDC-2022-0024-1316	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient of over 25 years, I have been stable and successful on the same 200 MME dose of medicine for years for multiple severe health conditions, but my life has been a struggle due to CDC guidelines causing doctors to deny surgery to correct orthopedic problems that might allow a reduction in pain and thus opioid use, and I've been on the verge of suicide due to threats to cut my pain medicines or other medications that I've also been stable on for 25 years.<br/><br/>WHy does a federal government agency believe they have the authority to dictate dose limits, medication choices such as buprenorphine over fentanyl patches, or attempt to interfere with the patient-physician relationship?<br/><br/>Your 2016 guidelines have caused so much suffering and torture of US citizens and the data on overdoses proves that all the suffering and deaths you have caused have not had any significant impact on the nation's overdose problems. Prescriptions were falling well before the 2016 guideline, and are down 70% since the peak around 2010, yet overdoses are higher with every report or update we receive.<br/><br/>Instead of being under the safe supervision of an expert in pain management, now general practitioners and other non-specialists have had to assume this role, arguably reducing patient safety by driving patients to non-specialists.<br/><br/>Also, your own data suggests that most people now report misusing analgesics for pain, not recreation. Isn't that proof that you have driven people to use of street drugs such as carfentanyl or heroin, when they were stable on safer medications such as the long venerated oxycontin or the now under attack fentanyl patches?<br/><br/>The federal government has no right to dictate decisions for adults. IF it did, why has that same government allowed tobacco to continue to be sold, which kill many times more US citizens a year than every other drug combined? Why can I get cigarettes at the local convenience store, yet I must go through incredibly difficult trials and difficulties and ridiculous expense, have my privacy invaded, and be subjected to ineffective and expensive procedures like epidural steroid injections, radiofrequency ablations, and other unproven and inffective interventions.<br/><br/>Adults should have the freedom to choice whatever pain relief they desire without government regulations and control, the same as they can choose tobacco and alcohol use.<br/><br/>Did our government not learn anything from prohibition of alcohol in the 1930s, such that you cannot control the supply of a substance, and to attempt to do so runs contrary to basic human psychology, and consistent results in an increase in use despite more and more government attempts to curtail and limit the supply?<br/><br/>Instead of killing and torturing US citizens, end this senseless and harmful regulation and restriction of analgesics so that people are not needlessly tortured and driven to suicide.<br/><br/>I call for a complete revocation of all CDC precribing guidelines. We do not need an update, we need these limits gone permentantly. Doctors and adults should along determine what is in the best interest of each individual. If I want to risk my life to have my pain treated, that is my decision, not some bureaucrat's right.<br/><br/>CDC needs to delete all prescribing guidelines and stop interfering in patient care. You've done quite enough damage, and people have sufferred. And we have more overdoses now than ever. <br/><br/>I'm sure the Mexican drug cartels would thank you for all the customers and business you have created. Now our children are flooded with street drugs that did not exist prior to these stupid guidelines and it may take decades to undo the damage CDC has caused.<br/><br/>The DEA needs to stop persecuting doctors and patients as well, and instead do their actual jobs and stop illegal drugs that have worsened every month and year for at least 10 years, much thanks to the CDC.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cf6a	Anonymous	None	2022-02-23T17:32:30Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-ecc4-0pk1	False	None	False	2022-04-12 03:14:32.344	[]
1310	CDC-2022-0024-1317	https://api.regulations.gov/v4/comments/CDC-2022-0024-1317	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why did the CDC spill millions of dollars wasting the public's tax money when guidelines such as the attached already existed?<br/><br/>And why did it not get rescinded on April 10, 2019 when multiple problems were admitted by CDC's Alford letter that has been posted on Chronic Pain Facebook groups?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cf7f	Anonymous	None	2022-02-23T17:34:22Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-fk13-irb0	False	None	False	2022-04-12 03:14:32.559	[]
1311	CDC-2022-0024-1318	https://api.regulations.gov/v4/comments/CDC-2022-0024-1318	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because of herniated lumbar disks & cervical disks, as well as fibromyalgia & migraines w/aura, I have been prescribed opioids since 2000. Originally working, I began with the weakest dose. After several years, I began taking the next higher strength for another several years. Approximately since the last ten(10) years, I am now taking the strongest dose to help manage never-ending pain that I live with. <br/>I have never been arrested, have had only two(2) traffic violations, and have never broken my pain management contract with my caregivers. I respect my doctors and honor the trust they give me with every prescription. <br/>I believe that each & every pain patient should be treated exclusively, not grouped into a class with others whose pain situation is as different as each person’s particular life is. I only want to be judged & accountable for myself, not a group, or a class of patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484f9cf82	Medley	None	2022-02-23T17:34:41Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Medley, Sharon	kzz-g2ze-vn30	False	None	False	2022-04-12 03:14:32.776	[]
1312	CDC-2022-0024-1319	https://api.regulations.gov/v4/comments/CDC-2022-0024-1319	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How will the new guidelines answer all of the problems the CDC identified in April 2019, as cited below?<br/><br/>"CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain<br/><br/>Some policies, practices attributed to the Guideline are inconsistent with its recommendations.<br/><br/>In a new commentary external icon in the New England Journal of Medicine (NEJM), authors of the 2016 CDC Guideline for Prescribing Opioids for Chronic Pain (Guideline) advise against misapplication of the Guideline that can risk patient health and safety. <br/><br/>CDC commends efforts by healthcare providers and systems, quality improvement organizations, payers, and states to improve opioid prescribing and reduce opioid misuse and overdose. However, some policies and practices that cite the Guideline are inconsistent with, and go beyond, its recommendations. In the NEJM commentary, the authors outline examples of misapplication of the Guideline, and highlight advice from the Guideline that is sometimes overlooked but is critical for safe and effective implementation of the recommendations.<br/><br/>CDC is raising awareness about the following issues that could put patients at risk:<br/><br/>Misapplication of recommendations to populations outside of the Guideline’s scope. The Guideline is intended for primary care clinicians treating chronic pain for patients 18 and older. Examples of misapplication include applying the Guideline to patients in active cancer treatment, patients experiencing acute sickle cell crises, or patients experiencing post-surgical pain.<br/><br/>Misapplication of the Guideline’s dosage recommendation that results in hard limits or “cutting off” opioids. The Guideline states, “When opioids are started, clinicians should prescribe the lowest effective dosage. Clinicians should… avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to ≥90 MME/day.” The recommendation statement does not suggest discontinuation of opioids already prescribed at higher dosages.<br/><br/>The Guideline does not support abrupt tapering or sudden discontinuation of opioids. These practices can result in severe opioid withdrawal symptoms including pain and psychological distress, and some patients might seek other sources of opioids. In addition, policies that mandate hard limits conflict with the Guideline’s emphasis on individualized assessment of the benefits and risks of opioids given the specific circumstances and unique needs of each patient.<br/><br/>Misapplication of the Guideline’s dosage recommendation to patients receiving or starting medication-assisted treatment for opioid use disorder. The Guideline’s recommendation about dosage applies to use of opioids in the management of chronic pain, not to the use of medication-assisted treatment for opioid use disorder. The Guideline strongly recommends offering medication-assisted treatment for patients with opioid use disorder.<br/><br/>The Guideline was developed to ensure that primary care clinicians work with their patients to consider all safe and effective treatment options for pain management. CDC encourages clinicians to continue to use their clinical judgment, base treatment on what they know about their patients, maximize use of safe and effective non-opioid treatments, and consider the use of opioids only if their benefits are likely to outweigh their risks.<br/><br/>The Guideline includes guidance on management of opioids in patients already receiving them long-term at high dosages, including advice to providers to:<br/><br/>maximize non-opioid treatment<br/>empathetically review risks associated with continuing high-dose opioids<br/>collaborate with patients who agree to taper their dose<br/>if tapering, taper slowly enough to minimize withdrawal symptoms<br/>individualize the pace of tapering<br/>closely monitor and mitigate overdose risk for patients who continue to take high-dose opioids<br/>Patients may encounter challenges with availability and reimbursement for non-opioid treatments, including nonpharmacologic therapies (e.g., physical therapy). Efforts to improve use of opioids will be more effective and successful over time as effective non-opioid treatments are more widely used and supported by payers.<br/><br/>CDC developed the Guideline to be practical and created clinical tools to help primary care providers help patients manage pain more effectively and safely, while mitigating the potential risks of prescription opioids when needed. CDC has also created specific resources on tapering, dosage, and appropriate application of the Guideline such as:<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d4fb	Anonymous	None	2022-02-23T17:41:53Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-gaxn-2yxp	False	None	False	2022-04-12 03:14:32.990	[]
1313	CDC-2022-0024-1320	https://api.regulations.gov/v4/comments/CDC-2022-0024-1320	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband is 63 years old. His Doctor Passed away. His new Doctor said he could not write him pain Medication and he Couldn't find one because of the cdc. He has 99 percent Blockage in one leg and 98 percent in the other. He had 4 neck Surgeries and then throat cancer his back is so bad Nothing Can be done to fix it. His neck again needs Surgery but Doctors say it just can't be done. They also said you do need Pain medication but the law has Changed. He needs surgery On Both legs without it he will die. Because of the law by the cdc he turned to Hospice knowing the pain will kill him he has Been on pain medication for 30 Years Then cut off His Blood Pressure went to 190 over 110. He has Had multiple Strokes. The elderly with this many Health problems please help them Live in peace not die in pain. They don't have a long road a Head of them as it is.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484f9d4fc	Worley	None	2022-02-23T17:42:16Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Worley, Pamela	kzz-ggda-khjd	False	None	False	2022-04-12 03:14:33.203	[]
1314	CDC-2022-0024-1321	https://api.regulations.gov/v4/comments/CDC-2022-0024-1321	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Close the border and the uncontrolled supply will be significantly reduced. CDC has idiots if they don't take the obvious steps.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484f9cfc2	MacKay	None	2022-02-23T17:45:09Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from MacKay, John	kzz-j6fe-2b9c	False	None	False	2022-04-12 03:14:33.425	[]
1315	CDC-2022-0024-1322	https://api.regulations.gov/v4/comments/CDC-2022-0024-1322	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why did it take 3 years for CDC to address this dire warning of suicides that you created at CDC with your poorly written 2016 guidelines?<br/><br/>" The U.S. Food and Drug Administration (FDA) has received reports of serious harm in patients who are physically dependent on opioid pain medicines suddenly having these medicines discontinued or the dose rapidly decreased. These include serious withdrawal symptoms, uncontrolled pain, psychological distress, and suicide.<br/><br/>While we continue to track this safety concern as part of our ongoing monitoring of risks associated with opioid pain medicines, we are requiring changes to the prescribing information for these medicines that are intended for use in the outpatient setting. These changes will provide expanded guidance to health care professionals on how to safely decrease the dose in patients who are physically dependent on opioid pain medicines when the dose is to be decreased or the medicine is to be discontinued.<br/><br/>Rapid discontinuation can result in uncontrolled pain or withdrawal symptoms. In turn, these symptoms can lead patients to seek other sources of opioid pain medicines, which may be confused with drug-seeking for abuse. Patients may attempt to treat their pain or withdrawal symptoms with illicit opioids, such as heroin, and other substances.<br/><br/>Opioids are a class of powerful prescription medicines that are used to manage pain when other treatments and medicines cannot be taken or are not able to provide enough pain relief. They have serious risks, including abuse, addiction, overdose, and death. Examples of common opioids include codeine, fentanyl, hydrocodone, hydromorphone, morphine, oxycodone, and oxymorphone.<br/><br/>Health care professionals should not abruptly discontinue opioids in a patient who is physically dependent. When you and your patient have agreed to taper the dose of opioid analgesic, consider a variety of factors, including the dose of the drug, the duration of treatment, the type of pain being treated, and the physical and psychological attributes of the patient. No standard opioid tapering schedule exists that is suitable for all patients. Create a patient-specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support, as needed, to avoid serious withdrawal symptoms, worsening of the patient’s pain, or psychological distress (For tapering and additional recommendations, see Additional Information for Health Care Professionals).<br/><br/>Patients taking opioid pain medicines long-term should not suddenly stop taking your medicine without first discussing with your health care professional a plan for how to slowly decrease the dose of the opioid and continue to manage your pain. Even when the opioid dose is decreased gradually, you may experience symptoms of withdrawal (See Additional Information for Patients). Contact your health care professional if you experience increased pain, withdrawal symptoms, changes in your mood, or thoughts of suicide.<br/><br/>We are continuing to monitor this safety concern and will update the public if we have new information. Because we are constantly monitoring the safety of opioid pain medicines, we are also including new prescribing information on other side effects including central sleep apnea and drug interactions. We are also updating information on proper storage and disposal of these medicines that is currently available on our<br/>Disposal of Unused Medicines webpage."	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d4fd	Anonymous	None	2022-02-23T17:51:15Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-gh6v-e24x	False	None	False	2022-04-12 03:14:33.696	[]
1316	CDC-2022-0024-1323	https://api.regulations.gov/v4/comments/CDC-2022-0024-1323	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When will the CDC fully answer this letter and incorporate the input into the 2022 update?<br/><br/>"Professionals Call on the CDC to Address Misapplication of its Guideline on Opioids for Chronic Pain through Public Clarification and Impact Evaluation<br/><br/>I. In 2016, the Centers for Disease Control and Prevention, CDC, issued a Guideline for Prescribing Opioids for Chronic Pain for primary care physicians. Its laudable goals were to improve communication between clinicians and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy. The Guideline reflected the work of appointed experts who achieved consensus on the matter of opioid use in chronic pain.<br/><br/>Among its recommendations are that opioids should rarely be a first option for chronic pain, that clinicians must carefully weigh the risks and benefits of maintaining opioids in patients already on them, and that established or transferring patients should be offered the opportunity to re-evaluate their continued use at high dosages (i.e., > 90 MME, morphine milligram equivalents).<br/><br/>In light of evidence that prescribed dose may pose risks for adverse patient events, clinicians and patients may choose to consider dose reductions, when they can be accomplished without adverse effect, and with possible benefit, according to some trial data. <br/><br/>Nonetheless, it is imperative that healthcare professionals and administrators realize that the Guideline does not endorse mandated involuntary dose reduction or discontinuation, as data to support the efficacy and safety of this practice are lacking. <br/><br/>II. Within a year of Guideline publication, there was evidence of widespread misapplication of some of the Guideline recommendations. Notably, many doctors and regulators incorrectly believed that the CDC established a threshold of 90 MME as a de facto daily dose limit. Soon, clinicians prescribing higher doses, pharmacists dispensing them, and patients taking them came under suspicion.<br/><br/>Actions that followed included payer-imposed payment barriers, pharmacy chain demands for the medical chart, or explicit taper plans as a precondition for filling prescriptions, high-stakes metrics imposed by quality agencies, and legal or professional risks for physicians, often based on invocation of the CDC’s authority. Taken in combination, these actions have led many health care providers to perceive a significant category of vulnerable patients as institutional and professional liabilities to be contained or eliminated, rather than as people needing care.<span style='padding-left: 30px'></span><br/><br/>III. Adverse experiences for these patients are documented predominantly in anecdotal form, but they are concerning. Patients with chronic pain, who are stable and, arguably, benefiting from long-term opioids, face draconian and often rapid involuntary dose reductions. Often, alternative pain care options are not offered, not covered by insurers, or not accessible. Others are pushed to undergo addiction treatment or invasive procedures (such as spinal injections), regardless of whether clinically appropriate. <br/><br/>Consequently, patients have endured not only unnecessary suffering, but some have turned to suicide or illicit substance use. Others have experienced preventable hospitalizations or medical deterioration in part because insurers, regulators and other parties have deployed the 90 MME threshold as a both a professional standard and a threshold for professional suspicion. Under such pressure, care decisions are not always based on the best interests of the patient.<br/><br/>lV. Action is Required: The 2016 Guideline specifically states, “the CDC is committed to evaluating the guideline to identify the impact of the recommendations on clinician and patient outcomes, both intended and unintended, and revising the recommendations in future updates when warranted”. The CDC has a moral imperative to uphold its avowed goals and to protect patients. <br/><br/>Therefore, we call upon the CDC to take action:<br/><br/>●<span style='padding-left: 30px'></span>We urge the CDC to follow through with its commitment to evaluate the impact by consulting directly with a wide range of patients and caregivers, and by engaging epidemiologic experts to investigate reported suicides, increases in illicit opioid use and, to the extent possible, expressions of suicidal ideation following involuntary opioid taper or discontinuation. <br/><br/>●<span style='padding-left: 30px'></span>We urge the CDC to issue a bold clarification about the 2016 Guideline – what it says and what it does not say, particularly on the matters of opioid taper and discontinuation. "<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d4fe	Anonymous	None	2022-02-23T17:52:00Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-gmz7-wvve	False	None	False	2022-04-12 03:14:33.943	[]
1317	CDC-2022-0024-1324	https://api.regulations.gov/v4/comments/CDC-2022-0024-1324	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why hasn’t the CDC’s Guideline addressed anything about DNA testing (enzymes) for chronic pain patients who have problems with enzymes and drugs that could inhibit opioid drugs. There are certain people in our society who process opioid drugs differently. Additionally, some of those same people, because of genetics, can’t get the full impact from opioids. Some people because of certain enzymes in their bodies need to be on higher doses of pain medication to obtain relief. When is the CDC and its Guideline authors going to get it right and start using the science that is available and listen to medical/healthcare professionals who have more experience and training? The CDC Guideline information so far, has been biased, distorted, and full of incorrect data and statistics. The 2016 Guideline has become law and has negatively impacted thousands of chronic pain patients who use to depend on pain medication to help manage and control their chronic pain. The only sure thing that the CDC has done with its unethical Guideline, is increase overdose deaths and suicides, has created unnecessary pain and suffering for responsible chronic pain patients, and has caused most chronic pain patients to lose faith in the so called “doctor patient relationship”. There is no longer any transparency between the two. How can the greatest nation on earth, mistreat and withhold an FDA approved drug, from people who need it to survive and have a somewhat quality of life?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484f9d512	Collins	None	2022-02-23T17:52:22Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Larry	kzz-hdgz-5rz5	False	None	False	2022-04-12 03:14:34.173	[]
1318	CDC-2022-0024-1325	https://api.regulations.gov/v4/comments/CDC-2022-0024-1325	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from lower back pain due to scoliosis. I have had it since a child and with gravity it will only get worse as I age. I have been in physical therapy and have been seen by neurologists and scoliosis specialist that tell me there’s not much they can do for me. The neurologist says if they go in and clean out some of the bulging discs etc it could make my back curve worse! The scoliosis doctor says if he goes in and puts metal pins to straighten the curve it will severely reduce my ability to move. So I suffer pain every day. It’s inhibiting my ability to walk and live my life. I am afraid to use steroids or pain blocking techniques because I want to feel where my back is and not cause more damage. In addition treatments like that require sedation in some cases are expensive and only temporary. Hydrocodone works for me because it takes the edge off my pain as needed. Some days are worse than others. The days it’s bad I can’t even get out of bed and even while in bed can’t get comfortable unless I a just wriggle in<br/>pain and contort myself into strange positions that twist my spine to release pressure. It’s Excruciating. I am 60 years old I know at some point I will need assistance to walk with a scooter. I want to be able to enjoy my life as much as possible before that time comes. I feel it’s torture for people like me to be deprived of this amazing drug that allows us to live a life without torture. There’s is no other drug that can be substituted. They are not as effective. After saying all that it’s an awful feeling to ask for relief only to be told by your doctor that their hands are tied. It’s a shame some people have died of overdose. But life has risks. We should not deny everyone because of mistakes of some. I also do not think fentanyl and heroine should be categorized together with prescription opioids for people who have chronic pain. Many people out there take it as prescribed and it offers them relief so they can live without daily Torturous pain. I previously submitted a comment and it left out the word “not” where I said “ people with chronic pain are not all drug addicts” I want to correct that. It’s terrible to be made to feel as though you are one by just asking for relief. Please allow people this drug again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelley	None	None	0900006484f9cfd8	Brescia	None	2022-02-23T17:52:58Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Brescia , Kelley	kzz-j3v5-em4j	False	None	False	2022-04-12 03:14:34.393	[]
1319	CDC-2022-0024-1326	https://api.regulations.gov/v4/comments/CDC-2022-0024-1326	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic Pelvic pain - Pudendal Neuralgia - its a daily pain level of 5-9 / I try so hard not to use Hydrocodone, 5-325 which doesnt even help my pain / Its the worse pain I have ever experienced in my life - I have not tried other pain relievers but Gabapentin and amitriptyline has not helped and makes me dopy, I no longer take this medicine - There are not a lot of local doctors who are familiar with PN and it causes severe Abdominal Pain / and pain in other private areas / its also causes Central sensitization and anxiety / depression / people live with this pain for years before getting a true diagnosis and it debilitating - CDC has to take certain nerve pains and prescribe what is needed for Nerve pain, its horrible to live with and its considered a disability in most cases / please dont hurt the people who truly have nerve pain. Maybe have guide lines for certain meds to treat Nerve pain as a class - I tried herbals / I have a nevro unit / I have tried blocks to no avail as of todays date / I have been suffering since 2018 / been to many specialist / many imaging's / My body is stressed out from pain and I have no good quality of life only because I am unable to sit or stand for hours at a time due to the pain. Until one lives with debilitating pain one can never understand / I	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9da18	Anonymous	None	2022-02-23T17:53:52Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-kf8l-au2x	False	None	False	2022-04-12 03:14:34.605	[]
1320	CDC-2022-0024-1327	https://api.regulations.gov/v4/comments/CDC-2022-0024-1327	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CLOSE THE SOUTHERN BORDER AND MOST OF THE FENTANYL OVER DOSE'S WILL STOP!!!!! IT DOESN'T TAKE A ROCKET SCIENTIST TO UNDERSTAND THAT SIMPLE SOLUTION!!!!! BUT IF THE BORDER IS CLOSED THEN THE LIBERALS WON'T HAVE THE ILLEGAL VOTES THEY NEED TO WIN ELECTIONS WILL THEY!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9da2f	Anonymous	None	2022-02-23T17:54:13Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-kvr4-385e	False	None	False	2022-04-12 03:14:34.816	[]
1321	CDC-2022-0024-1328	https://api.regulations.gov/v4/comments/CDC-2022-0024-1328	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in chronic pain for many years. My PCP prescribes me hydrocodone. I have osteoporosis, rumatoid arthritis, failed back surgery. I can stay on my feet no more than 15-20 minutes at a time. I take no more than needed to control my pain and I still have pain. I went to the pain clinic which did not help at all. Maybe none of you making these decisions have ever been in such sever pain that you could not function. Well trust me it is not fun! Maybe you should look at street drugs and let our PCP decide what we need not the government who wants to control our lives. What about all the illegal immigrants who are bringing drugs over our borders. It's evident that you are not concerned about those. Leave the current guidelines alone. Let our doctors treat us!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9da5a	Anonymous	None	2022-02-23T17:54:29Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-kxvn-qipc	False	None	False	2022-04-12 03:14:35.063	[]
1322	CDC-2022-0024-1329	https://api.regulations.gov/v4/comments/CDC-2022-0024-1329	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 40 years old I suffer from chronic migraine back pain and neuropathy one of these by them selves is horrible but grouped altogether its excruciating pain and if you have to go to the er for any of them your treated like garbage to the point you just want to stay in bed.so help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9de38	Anonymous	None	2022-02-23T18:22:24Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-vk53-zd56	False	None	False	2022-04-12 03:14:35.279	[]
1323	CDC-2022-0024-1330	https://api.regulations.gov/v4/comments/CDC-2022-0024-1330	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a nurse of 35 yrs, also a patient. I have a rare genetic disorder Ehlers Danlos. I have had 7 different surgeries trying to stabilize different joints. I work in a level 1 trauma center. I am appalled to see patients with multiple injuries from falls, MVC, MCC, being given woefully inadequate pain management in the hospital and discharged without any pain medication all in the name of following the CDC guidelines. One patient with a C 2 Cervical fracture, Tibia Fibula fracture, humerus fracture, and abdominal surgery. I myself have had large abdominal surgeries and 2 & 3 level fusions of the spine and foot long incisions and have been told not to take Ultram (milder pain Med) at discharge. Discharged being told to take Tylenol 4 times a day, my poor liver! This is a Fentanyl crisis not an Opoid crisis most overdoses I have seen were due to Fentanyl. Doctors treating patients in acute pain situations should not be afraid to properly treat their patients due to prescription police. Oath to first to do no harm is broken. I see many distraught patients that are overwhelmed with chronic pain, which effects their ability to function, causing depression, and suicide. Doctors taking chronic pain patients off their long standing pain management plans often not weaning, just making them go cold Turkey they often come to the emergency room looking for relief. A sad situation to watch patients beg for care and relief unnecessary suffering. The fifth vital sign pain, asking patients to rate their pain from 1 to 10 is a farce because you can’t adequately treat that pain any more.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anita	None	None	0900006484f9da97	McCabe	None	2022-02-23T18:23:00Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from McCabe, Anita	kzz-lx6b-l1ps	False	None	False	2022-04-12 03:14:35.492	[]
1324	CDC-2022-0024-1331	https://api.regulations.gov/v4/comments/CDC-2022-0024-1331	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please, p,ease, please let doctors treat,their patients. Millions of people are suffering needlessly! They didn’t ask to have chronic pain. It’s not their fault that medication helps them. It’s inhumane! Pain patients have zero to do with drug addicts. Living with pain is horrendous!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sara	None	None	0900006484f9c3a2	Walton	None	2022-02-23T18:25:27Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Walton, Sara	kzy-smm0-1yuy	False	None	False	2022-04-12 03:14:35.720	[]
1325	CDC-2022-0024-1332	https://api.regulations.gov/v4/comments/CDC-2022-0024-1332	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Responsible opioid users are made to feel like pariahs, criminals and addicts. It is insane to think you can spend years with a pain management doctor, with ZERO change in diagnosis, only to find out our pain management treatment has been arbitrarily changed because of "guidelines".<br/><br/>Even WORSE is the prescription does not get filled by a pharmacist with ZERO knowledge of your medical history other than the scripts they have filled. To top it off, these "guidelines" assume the person is average in size, weight and metabolic rate, never mind nobody is ever tested for polymorphism to determine if they break down drugs faster.<br/><br/>Now let's talk about the supposed Opioid Epidemic. NOBODY talks about the fact that nearly 75% of these deaths are due to illegal opioid (fentanyl), much of which comes across our open southern border. OR talk about the sudden rise in suicides since 2016 due to arbitrary medication reductions by physicians and pharmacists, giving patients the feeling there is no other way to cope. If you really boil it all down, there is likely only a few thousand deaths due to abuse of PRESCRIBED opioids...prove me wrong with peer reviewed studies...but, even if it is higher it is STILL a very small minority. Heck, if we wanted to treat all deaths this way, NOBODY would be allowed to smoke or drive a car. This politically charged "crisis" is just a way to create the pariah feeling in MILLIONS of responsible opioid users to RESPONSIBLY treat their pain. It is unfathomable to think that such a small minority of users could adversely affect a LARGE majority of people.<br/><br/>Now let's talk about the mental health of pain medicine users since 2016. I would argue that there has been a SERIOUS decline in mental health of these good people since they started feeling the pressure of government crackdown, some comments I have heard:<br/>1. Look and act great, feel like [explicative redacted] and just want to die…looking at me, you are likely not going to see how much pain I am in…I've learned to hide it well.<br/>2. Made to feel like drug addicts and criminals<br/>3. Appear lazy, but I am really exhausted and depressed from the pain<br/>4. I am getting fat, not because I am lazy, but the pain does not allow me to be active<br/>5. YES, I have tried almost everything to reduce my pain, stop asking<br/>6. ALWAYS feeling guilty because I cannot participate in family matters, I nap too much, I eat too much, I take drugs and feel guilty about wondering if it is all worth it<br/>7. I am TIRED of apologizing for my pain<br/>8. Scared of my doctors and the bull___t opioid "epidemic". Taking pain meds DOES NOT MAKE ME A F__KING ADDICT!!!! Wanting something to eliminate the pain DOES NOT MAKE ME WEAK!!! F__K ALL YOU THAT SAY SO!<br/>9. Fully depressed knowing I will have chronic pain for the rest of my life…and still not sure how to deal with it.<br/>10. I live in fear that the next minute, hour or day will bring on ANOTHER severe flare up<br/>11. Frustrated that I cannot do the little things I normally could do<br/>12. I AM NOT FAKING IT!<br/>13. Often get the feeling that people think I am faking it and don't want to get better…[explicative redacted]???<br/>14. I'll take anything, including experimental drugs, if there is a chance it will make me feel better…DON'T CARE about side effects, it is not likely they can make me feel worse<br/>15. Don't ask when I expect to get better, it is likely not going to happen.<br/>16. CONVINCED doctors REALLY do not understand what it is like to live in pain and wish I could find someone that does…until you lived it, others will always down play it<br/>17. People are IGNORANT to the term Chronic Pain…CHRONIC MEANS ALWAYS! Put a clamp on your arm until the bones hurt, then try living with it 365/24/7!<br/>18. Pain medications WORK and help me feel normal at least for a small part of the day.<br/>19. Yes! Severe chronic pain folks DO have passive thoughts about taking their life to take care of their pain…it is VERY common, more common than folks think…that does NOT mean it translates into and ACTIVE plan…it is a CRY for help that nobody seems to hear and respond too.<br/>20. Medical professionals say they are watching out for our liver health by limiting pain medication, yet when suicide becomes a thought process…HOW is that helping my health?<br/>21. Doctors change medications levels WITHOUT talking/advising their patients…WHY!!!!!<br/><br/>I hope this gives some insight as to what RESPONSIBLE people think that use opioids for pain relief.<br/><br/>Take care, Be well.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f9d630	Stelmat	None	2022-02-23T18:27:09Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Stelmat, Michael	kzz-muqx-fw5s	False	None	False	2022-04-12 03:14:35.944	[]
1326	CDC-2022-0024-1333	https://api.regulations.gov/v4/comments/CDC-2022-0024-1333	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 1995, while 7 mos pregnant, I was hit by a drunk driver and fractured my neck in 3 places, causing me to wear a halo for 3 mos. Over the years, I have now been in over 25 car accidents, none my fault. In 2010 and 2012, I had 2 double fusions, cervical and lumbar. I was prescribed pain medication during my surgeries and didn’t need any after. I was doing well until another car accident in 2018. Now with the changes with medication, neither my surgeon nor the pain specialist I was referred to can help with my pain which is chronic. I have had numerous cortisone injections, ryzotimies (sp?), given different medication, physical therapy, and finally set up for medical marijuana. I don’t like marijuana, and was not educated properly on how to use the different forms, so now am scared to use it. I shouldn’t feel forced to take a substance I don’t want to. Most days I can live with my pain as I am used to it, but on others I need some help just to be able to sleep. I have asked for 5 pills a month just to use as needed, when my pain reaches a 9/10 and been denied. I have passed all drug tests given me to show I am not an abuser. I have never had a problem with addiction or abuse since my original accident in 1995. Guidelines need to be changed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d693	Anonymous	None	2022-02-23T18:27:26Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-nl9n-e3qf	False	None	False	2022-04-12 03:14:36.163	[]
1327	CDC-2022-0024-1334	https://api.regulations.gov/v4/comments/CDC-2022-0024-1334	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The draft gives a thoughtful and needed guideline for managing patients on opioids. Concerns for stopping opioids and dangers to consider when tapering opioids were discussed. How to handle non-compliant PDMP checks and Urine Toxicology was discussed. <br/><br/>I do feel that how a patient on opioids responds to pain varies from a patient that is not on opioids. Also patients on opioids respond differently to other therapies that may work well in the patient that never took opioids. <br/><br/>Even though we have too many patient on opioids for specialists to treat, pain management has become very complicated for primary care. I am seeing many primary care providers just saying that they won't prescribe opioids and patients are forced to quit cold turkey which puts them at higher risk. I am not sure how we can get these providers to use these recommendations.<br/><br/>I feel that many providers are suspicious of Buprenorphine due to all the requirements to prescribing it for OUD. Many providers are underdosing it in their patients which I feel leads to increased risk by putting patients in a Prolonged Withdrawal situation. <br/><br/>The barriers to treating these vulnerable patients are considerable. Thankyou for putting together this thoughtful document.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484f998ac	Farrell	None	2022-02-23T18:27:28Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Farrell, Kathleen	kzx-lqup-drjd	False	None	False	2022-04-12 03:14:36.375	[]
1328	CDC-2022-0024-1335	https://api.regulations.gov/v4/comments/CDC-2022-0024-1335	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Very simply. Pain management should be determined by doctor and patient. CDC and government should not be involved.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9c3aa	Anonymous	None	2022-02-23T18:29:52Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-ssxw-ya8q	False	None	False	2022-04-12 03:14:36.587	[]
1329	CDC-2022-0024-1336	https://api.regulations.gov/v4/comments/CDC-2022-0024-1336	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m am encouraging this proposal to move forward to serve those who have severe chronic pain. This allows doctors to help manage the individual pain plans for patients they know health history so well. My friend who has suffered with chronic pain for years just wants her doctor to prescribe the kind of medicine she needs for extreme pain on a limited basis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lucy	None	None	0900006484f9c3b9	Hewitt	None	2022-02-23T18:30:01Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Hewitt, Lucy	kzy-t2aj-yuhg	False	None	False	2022-04-12 03:14:36.799	[]
1330	CDC-2022-0024-1337	https://api.regulations.gov/v4/comments/CDC-2022-0024-1337	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Suicide because a future with unending pain that leaves you confined to a sofa and still doesn't go away becomes unbearable can be prevented with this action. I had a friend who was on public assistance and couldn't convince people that she wasn't a junkie looking to get high but was really in unendurable pain. She finally convinced them. She put a bullet through her head. In her note she said they'll do it for horses so I guess this is the only solution for me.<br/><br/>I've been on hydrocodone for 30 years due to multiple disc problems and the result of failed foot surgery. This only came about after I had tried to deal with my pain using Nsaids prescribed by my doctor but found I was taking them like jujubes, 5 at a time 4 and 5 times a day to be able to walk. I was still in pain, suffered a mental breakdown where I was in tears for hours each day and lost my job and nearly lost my home. I did this even knowing I was killing my liver and possibly my blood marrow because I was in so much pain, I was unable to function.<br/><br/>I eventually found a doctor who recognized how hard I was trying to be functional and prescribed oxycodone. But first he saw to it that I was educated about it, we established that this was not going to be a pill a day type thing. This was for pain management and included a whole lot of behavioral modifications (frequent rest breaks, daily Physical therapy exercises, etc. and firm guideline as to when I would take it. And it has worked. I was able to build the homme I live in myself; true it took 2 years but following the guideline it only took an annual prescription of 100 5 mg tablets a year. and during that time, I still had the mental reserves to deal with the pain when it was impossible for me to take the drug, like to drive to grocery shop (yes, we even had a plan for those times and that promised relief makes the pain bearable).<br/><br/>So please make some changes in the current rules that make it easier for others to accesss it. I was lucky that my doctor believes in me and with reduced activity he was able to precribe a course of higher dose pills that met the current guidelines and trusted me to cut them in half to keep our successful program working. <br/><br/> I would like to see wording that suggests educational support for chronic pain users that will increase the effectiveness of the medication as well as reduce the chance of <br/>addiction. Mine even includes propholactic use to stop pain before it gets out of control by using it just prior to an activity that will result in creating the pain levels that lead to the mental breakdown. [health facility name] had a pain behavior modification program in the 1990's that worked wonders.<br/><br/>thank you for helping those with chronic pain get some relief. I admit the pain doesn't go away but it at least it is something I can live with and see a future. I am fortunate that, unlike a friend of mine, I never reached the point where it was so unbearable, and the possibility seemed so hopeless, that she killed herself.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	jan	None	None	0900006484f9c3e1	de	None	2022-02-23T18:32:21Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from de, jan	kzy-tukc-024e	False	None	False	2022-04-12 03:14:37.008	[]
1331	CDC-2022-0024-1338	https://api.regulations.gov/v4/comments/CDC-2022-0024-1338	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	2003 turned out to be a very bad year for me. I am a health care professional, therapist. I had never used controlled drugs prior to 2003. That early summer I started to experience a GI bleed, loss of appetite and weakness. My initial examination turned up nothing. Within a few weeks, I was extremely ill, lost 20% of my body mass, in extreme pain and unable to eat without bloody diarrhea. I was hospitalized for over a month in three different hospitals. The last one was a major university in NYC. I was quickly diagnosed with severe inflammatory bowel disease. I was put on high dose Steroids and IV medications. It took several months to see any improvement. By late fall, I returned to work; but, the exhaustion hadn't dissipated and I was now very short of breath and in pain. I took myself to a cardiologist and by December of the same year found myself an emergent triple bypass patient. One theory was that the extreme inflammation I had recently experienced may have contributed to the cardiac disease. Once again, unfortunately, the surgery did not go well as the steroids had taken a toll on my vessels resulting in over a dozen cuts to find a vessel that would work. I was cut in several directions from my left malleolus all the way up through the groin area and the chest. I will cut to the chase. This was an emergency and I did not get to pick my surgeon. I had only one followup with him before he left that hospital. My pain was intense. I healed very poorly and had several complications requiring blood transfusions and hospitalizations. Even after discharge, my chest and leg pains continued. The leg pains were burning-like "I felt as if they were forever on fire". The chest pain was truly unbearable--felt like the two sides of my sternum were jagged and always bumping up against one another. Eventually, another cardiac surgeon ordered a CAT scan and it was found that I had non-union of the sternum. It is almost twenty years and my sternum has never fully healed--it forms a band and then breaks--my sternum is in two pieces and rides over one another constantly. The paresthesias have only grown worse--now walking on broken glass and on fire. My ulcerative colitis has never gone into remission. Much of the complications are due to the chemo agents needed to keep me from getting worse. My sternum is too risky to operate as surgeons are afraid of damaging my mammary artery under sternum. I have gone into this very lengthy detail because I am not seeing a very fair representation of people like me--those suffering with CHRONIC pain. I have seen a pain physician ever since the CAT scan. He tried all the non narcotic agents with little to no avail. My lifestyle only became functional once the pain physician started me on opioids. I have been on the same amount of narcotics for nearly 17 years without increasing. They don't relieve all the pain by any means. But, I can function. I no longer consider suicide as my only option. Please keep in mind that there are patients like me who are only functional when they can live on their pain medication under the control of a doctor who is not afraid for his/her career to prescribe. Without it, I do know I would not be here. I have tried to change meds, take med free vacations--both narcotics and the immunosuppressant meds--to no avail. Sometimes, you really MUST leave pain control up to the doctors. If doctors are allowed to prescribe necessary pain meds for those of us with chronic conditions, you might find that we are very productive members of society. We are not people who would need to go through back doors to procure drugs that are not safe nor have to resort to other means to lessen our pain. I might add that even though I am lucky enough to have a physician work with me, pharmacists have been another story. Beyond all the nasty looks and advice, quite often meds can't be filled at all pharmacies and there are backorders. I have been witness on several occasions older people crying in pharmacy because they are begging for pharmacist to fill pain prescription only to be told I can only give you a generic and it may take a week or two for your wife (who was suffering with metastatic cancer). I will not give you my real name because I don't entirely trust this site.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484f9c6d3	Doe	None	2022-02-23T18:33:41Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Doe, Jane	kzy-uil0-7unh	False	None	False	2022-04-12 03:14:37.221	[]
1332	CDC-2022-0024-1339	https://api.regulations.gov/v4/comments/CDC-2022-0024-1339	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in chronic pain since August 2006 when I had a herniated disk. After many treatments including opioids, I had a Spinal Cord Stimulator placed 5 years later. I dropped my need for opioids over 80%. However, without opioids, I could not have continued working for this past 15.5 years. I am told my spinal cord is scarred and not repairable. My pain at times is at 10 for hours even after taking Xtampza ER as directed. If I could not continue on the opioids, I do not know how I would function or even exist. I have been on the same dosage for over 5 years and never take more than directed daily. If you would like more information or for me to testify, I am happy to do whatever so I can continue to exist.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dean	None	None	0900006484f9c6fc	Harner	None	2022-02-23T18:33:59Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Harner, Dean	kzy-v8vh-jeip	False	None	False	2022-04-12 03:14:37.437	[]
1333	CDC-2022-0024-1340	https://api.regulations.gov/v4/comments/CDC-2022-0024-1340	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been living with chronic pain for several years. After back surgery I had cancer that complicated matters. I'm in remission but the toll it took on my body is too great to cope without using pain medication. I've been taking the lowest effective dose of options for swveral years and it does help me have somewhat of a life. It seems that everything that's done to control the abuse of these medications fails miserably to make it so that people with legitimate need can obtain them. Never have I taken more than prescribed or used any other types of legal or illegal drugs. While it is a problem, it must be balanced so that those who are compliant with their regimens and not abusing them should be able to receive care while preventing abuse. Our legal system is based in the "innocent until proven guilty" premise but the current means of being treated for chronic pain are not. I'm tired of feeling like a criminal without giving any reason to be. If the new regulations relax the requirements, I'm all for it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9c91e	Anonymous	None	2022-02-23T18:34:21Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-vn74-tjtu	False	None	False	2022-04-12 03:14:37.650	[]
1334	CDC-2022-0024-1341	https://api.regulations.gov/v4/comments/CDC-2022-0024-1341	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescribing Physicians should take into account the patient's medical and mental health history as well as any substance abuse and related addictions such as alcoholism, etc when prescribing.<br/><br/>What should also be carefully scrutinized is the patient's living situation and risk for drug dependence and abuse. Patient's should have a safe and secure residence when being prescribed opioids or any kind of mind altering drug. Transient living IS NOT an ideal environment for opioid treatment. The risk of addiction and illegal activities resulting from careless prescribing practices are astronomical and too often result in patient deaths and long term disability.<br/><br/>Please take these matters into consideration. Thank You.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Naomi	None	None	0900006484f9c98d	Hopkins	None	2022-02-23T18:34:37Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Hopkins, Naomi	kzy-vyuk-qi31	False	None	False	2022-04-12 03:14:37.865	[]
1335	CDC-2022-0024-1342	https://api.regulations.gov/v4/comments/CDC-2022-0024-1342	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I realize that we are in an opioid crisis. I realize that there are people who are addicted or will become addicted to those painkillers. However, there are people, like myself, that have chronic pain. There is only one medication that has ever helped take the edge off the pain and unfortunately, that is a painkiller that docs are afraid to prescribe. I always followed the rules when I was on it for recuperating from a surgery. I would only get it legally, which means providing a license and getting a prescription. There is a STATEWIDE SYSTEM that tracks who is filling pills. Are there a way around it? Yes, I'm sure people figure it out. Are there also people that will get it off the street just to get high? YES. I don't want it to get high. I just want to life a life with less pain. Please keep this in mind for us who suffer every single moment of our lives. Thanks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484f9ca77	McCarthy	None	2022-02-23T18:34:52Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from McCarthy, Michelle	kzy-w6vy-cowq	False	None	False	2022-04-12 03:14:38.098	[]
1336	CDC-2022-0024-1343	https://api.regulations.gov/v4/comments/CDC-2022-0024-1343	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I for one have to take opioids as needed for chronic and acute pain due to severe arthritis. It is time for physicians to be allowed to treat their patients who have been coming to them for more than 6 months, with the pain relief they need. I understand the frequent flyers who are looking for a doctor to just prescribe them opioids to get high or sell, but the physicians can usually tell those patients from the ones who truly need help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9ca79	Anonymous	None	2022-02-23T18:35:03Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-wcce-le7v	False	None	False	2022-04-12 03:14:38.334	[]
1337	CDC-2022-0024-1344	https://api.regulations.gov/v4/comments/CDC-2022-0024-1344	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a pain patient (2005 dx with Fibromyalgia, DDD, Osteoarthritis both knees), I’ve been vilified time and again. I take Norco 10-325, up to 5 times a day. There have been pharmacists that wouldn’t fill my script, there have been doctors that didn’t acknowledge my pain from other conditions because I take Norco. It is problematic being a chronic pain patient. The last thing I need is to be sanctioned by cdc, advising that my doctor should cut my amount in half, or completely cut it off. I experienced a pharmacist telling me he would fill my script if I decided to only get half of what the script allowed. It angers me that no one thinks about those of us in legitimate pain. I personally know the far outreaching of opioid addiction and death. If a patient is being treated by one doctor and the one doctor is prescribing the medication, there shouldn’t be any problem with the patient getting their medication. The doctor is playing god, the pharmacist is playing god, and the cdc is playing god. There are those of us real people who have real pain that need pain medication. I read that the persons receiving high doses of opioids are persons who work factory jobs….I don’t know how true it is. I did lots of walking as a licensed MA and my knees are bone on bone. No one is treating that. And no one is treating the arthritis in my back. All of this pain I’m in and now, yet again, there’s another suggestion for cutting my dose in half or discontinuing my medicine. Please keep in mind, those of us, who have severe pain and have been model patients for years. We need our meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marium	None	None	0900006484f9ca7f	D	None	2022-02-23T18:36:34Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from D, Marium	kzy-wft3-a91k	False	None	False	2022-04-12 03:14:38.559	[]
1338	CDC-2022-0024-1345	https://api.regulations.gov/v4/comments/CDC-2022-0024-1345	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I believe the 2016 Guidelines for prescribing opioids should be completely rescinded due to the facts of great pain and suffering placed on chronically I'll patients & the fear it placed on doctors to properly treat pain. As we all now are aware, the 2016 only created more overdoses and jail time for patients & doctors. Start over! Get new leadership to manage this crisis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jean Ann	None	None	0900006484f9d6b7	Lopezzi	None	2022-02-23T18:41:58Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Lopezzi, Jean Ann	kzz-nvkm-j2zd	False	None	False	2022-04-12 03:14:38.774	[]
1339	CDC-2022-0024-1346	https://api.regulations.gov/v4/comments/CDC-2022-0024-1346	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stay out of doctor patient relations. My doctor prescribed what he thought was the necessary amount of medication for my condition. I followed his advice and was doing well, with no shortages or overdoses, for many years. Since your ill advised document recommending MME limits, my doctor has reduced my medication to the point that it no longer does what it is intended to do. I live in constant excruciating pain.I have tried alternatives to pain meds with little success. I have little hope that I will ever be able to live a normal life with the amount of meds I am provided.Once again, PLEASE revise your guidelines to allow doctors to do what they know is right for their patients. My life, and many others, depend on it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484f9d6ba	Rifkin	None	2022-02-23T18:42:10Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Rifkin, Kimberly	kzz-nzm6-doob	False	None	False	2022-04-12 03:14:38.986	[]
1340	CDC-2022-0024-1347	https://api.regulations.gov/v4/comments/CDC-2022-0024-1347	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC and the government should not be between a relationship between a legitimate chronic pain patient and they’re highly trained pain management physician. As the overdose death rate continues to rise, clearly not as a result of opioid medication, he would think that you would’ve seen the harmed that you’ve caused so many!!! Suicide rates are going up A monks legitimate pain patients, including our veterans! We don’t even allow our canines to suffer inhumanely this way! A one size fits all approach to pain management is not the way to go. Your apology came too late, and clearly it sincerity was limited at best after reading the proposed changes. Pain management physicians have forced tapered and in many cases completely stopped and abandoned legitimate chronic pain patient across the country within the last few years. Please stop this madness	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d70b	Anonymous	None	2022-02-23T18:42:23Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-oajf-4c5n	False	None	False	2022-04-12 03:14:39.197	[]
1341	CDC-2022-0024-1348	https://api.regulations.gov/v4/comments/CDC-2022-0024-1348	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Patients with chronic pain who have no known substance issues should be able to get pain meds with a lot less red tape. Why do we have to suffer? I have chronic pain from past cancer treatments, toe amputation, and wound debridement. A week is not enough for pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d729	Anonymous	None	2022-02-23T18:42:34Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-onf0-h509	False	None	False	2022-04-12 03:14:39.407	[]
1342	CDC-2022-0024-1349	https://api.regulations.gov/v4/comments/CDC-2022-0024-1349	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand that opioids are dangerous with people misusing them but where does that leave people who actually need them?<br/>I have a friend who described her pain as “a voice in her head that never went away” and her Dr thought she just wanted drugs so she never got the pain meds she needed until she tried to kill herself and ended up in a psych ward and got proper care<br/>I have a friend right now with constant pain and she can’t get the pain meds she needs and I’d hate to see that happen again<br/>There has to be a middle of the road where these medications can be prescribed and monitored. <br/>I happen to have cancer and I know I can get them but don’t…..<br/>Maybe it was a Dr problem and not a patient problem<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484f9d73a	Elliott	None	2022-02-23T18:43:04Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Elliott, Barbara	kzz-owy7-er4h	False	None	False	2022-04-12 03:14:39.624	[]
1343	CDC-2022-0024-1350	https://api.regulations.gov/v4/comments/CDC-2022-0024-1350	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with chronic pain since 2005. I have several different problems that contribute to my pain. I have Rheumatoid Arthritis, osteoarthritis, CPPD (pseudo gout), numerous spine issues to include a 25 degree scoliosis in my lumbar spine. I have arthritis in my spine, I no longer have viable discs I could go on and on. Last year I hat to have a surgery on my C-spine to stop from being paralyzed, I now have platinum plates, screws,and cages from C3 to T1 to stablelize my neck. 2 days after I returned home from the surgery my pain Dr wanted to decrease my pain meds. I wasn't ready for that but the following moth I agreed to try the decrease with the understanding if it didn't work, I'd be able to resume my meds. When I told my pain med Dr it wasn't working for me, she told me she wasn't comfortable putting me back on the regime I was on. I've asked several times as my quality of life has diminished to a point all I can do is sit in a recliner, 15 minutes of standing, I have to choose whether to cook, clean, laundry, brush my hair or suffer the consequences of increased pain. This is a pain management Dr. She decreased my muscle relaxers, when I told her my pain and decreased mobility again she said she wasn't comfortable resuming dosage. I asked, if not you, then who? She said any other Dr. If a pain management Dr is treating patients this way, I can't imagine how others are treated. I'm being treated without compassion and no regard to my physical problems. There are times suicide seems like the best option to relieve the pain that I must endure.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karin	None	None	0900006484f9d740	Hockett	None	2022-02-23T18:43:22Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Hockett, Karin	kzz-oyfg-t435	False	None	False	2022-04-12 03:14:39.872	[]
1344	CDC-2022-0024-1351	https://api.regulations.gov/v4/comments/CDC-2022-0024-1351	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 55 years old, I live in New Mexico, our governor has gone beyond opioids and pain medications and included many others. I have found it almost impossible to get one of my seizure medications, clonazepam, to get refilled and I have experienced many seizures since then. I do not understand this way of thinking? All of a sudden I am lumped into the groups of people that abused medications? I have been taking my seizure medications since 1981, when I was diagnosed. They have kept my epilepsy in check... Until last month. The relapse I suffered has been very taxing on my one relative and I am afraid I will lose my home. Something has to be done.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484f9d77b	Smith	None	2022-02-23T18:43:41Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Steven	kzz-pltc-kl1a	False	None	False	2022-04-12 03:14:40.092	[]
1345	CDC-2022-0024-1352	https://api.regulations.gov/v4/comments/CDC-2022-0024-1352	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a US veteran currently being treated at a veteran hospital. Over the years I have had four lumbar back surgeries, I have been repeatedly diagnosed with MRI scans at the VA hospital with adhesive arachnoiditis, two bulging disc, and Degenerative disc disease, as result of irreparable crippling pain from those conditions my VA providers decided, and I agreed with them, rather than attempt a fifth back surgery pain medication would be a better treatment option for me, so they prescribed 60mg of morphine plus 15mg of morphine for breakthrough pain three times a day. <br/><br/>Needless to say, in terms of pain control and functionality for over 15 years I did exceptionally well on the medications . I was a model patient, I never experienced any negative complications or dangerous side effects like addiction or overdose from the medications . <br/><br/>However, after the CDC issued its 2016 tapering guidelines, and Veterans Affairs decided to adopt and implement the tapering guidelines, VA hospitals started arbitrarily tapering patients including me off our pain medications, it didn’t matter to them whether you had been a model patient or if you needed the pain medication or not. <br/><br/>In my particular case, even though I hadn’t been seen or examined by a spine specialist in over a decade, the VA hospital started tapering my pain medications at the beginning of the Covid-19 pandemic. <br/><br/>As a result, today, all of my pain medications have been terminated and no access of being prescribed any by the VA hospital or from clinicians in my community. <br/><br/>Obviously, my life is in shambles, because of excruciate untreated pain, I am basically isolated and homebound unable to participate in activities with my family members or in my community. <br/><br/>In my view, the CDC tapering guidelines and Veteran Affairs are responsible for turning me into a Cripple, for example, when I’m forced to leave my home for medical appointments or for other functions , I have to rely on family members to push me around in a wheelchair . <br/><br/>In conclusion, what’s happened to me and to other veterans as a result of the CDC’s 2016 tapering guidelines is unconscionable , we bravely fought for our country and now when it comes to untreated or under treated pain or access to adequate pain medications, today we’re being treated like lowlife criminals allowed to suffer and no one Gives A [explicative redacted]!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Howard	None	None	0900006484f9d77c	Roberts	None	2022-02-23T18:44:40Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Roberts, Howard	kzz-pnml-fidy	False	None	False	2022-04-12 03:14:40.305	[]
1346	CDC-2022-0024-1353	https://api.regulations.gov/v4/comments/CDC-2022-0024-1353	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	More deaths are caused by alcohol than any other drug. Yet you can get it on any street or at most any store. Yet chronic pain patients have to be treated like criminals, do pill counts and pee tests. Why? Because they have injuries or diseases that cause 24/7 unrelenting pain. Yet the drug overdose deaths have skyrocketed while prescription drug being filled are at a all time low. So prescription drugs were not nor are the reason for overdose deaths.<br/>Addicts will find drugs. They do not have to go to a physician. Yet people in chronic pain go to the doctor because it is a health condition and want relief from pain. Yet the CDC has interfered in CPP health care and overdose deaths have increased. CDC need to do away with the guidelines and let the doctor patient relationship be as it is for any other health problem. Or if the CDC must put out guidelines such as dosage etc then do not discriminate against CPP and make the guidelines for every medication there is.<br/>Every human being is entitled to Healthcare based on their individual conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f9d7bb	None	None	2022-02-23T18:45:00Z	Media For Now	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Media For Now	kzz-q9u9-sh0p	False	None	False	2022-04-12 03:14:40.517	[]
1347	CDC-2022-0024-1354	https://api.regulations.gov/v4/comments/CDC-2022-0024-1354	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	With Fibromyalgia, I take Ultracet (Tramadol/Tylenol Combo). I've never had an issue with getting my meds via mail order until last year. By reducing renewal to only 3 days, there's no way a mail-order pharmacy can process and mail then receive within 3 days. I have had to change to local pharmacy. They monitor refill guidelines very closely so I could be on my last day of pills by the time I can pick it up.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	vicki	None	None	0900006484f9d7c1	gasorski	None	2022-02-23T18:45:12Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from gasorski, vicki	kzz-qcyg-654p	False	None	False	2022-04-12 03:14:40.728	[]
1348	CDC-2022-0024-1355	https://api.regulations.gov/v4/comments/CDC-2022-0024-1355	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These are nice guidelines. I might suggest to highlight pain specialists earlier - in recommendation 1 - as many physicians may not, given the reasonable burden of competing scope of knowledge demands, be able to learn all methods. <br/><br/>Ketamine etc in acute setting may be worth mentioning. <br/><br/>In addition, one can mention scheduling meds as part of optimisation prior to escalation/adding agents. <br/><br/>I contribute these comments as a physician trained in addiction medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484f9d81f	A	None	2022-02-23T18:45:38Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from A, Michael	kzz-qxat-2212	False	None	False	2022-04-12 03:14:40.981	[]
1349	CDC-2022-0024-1356	https://api.regulations.gov/v4/comments/CDC-2022-0024-1356	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The more comments I read, the more incensed I become over the damage done by the Cures Act of 2016. <br/>As a long-term chronic patient, I’ve often wondered who these people are that have such control over my life. I’d like to meet them someday but they seem so elusive. Who are these people that apparently lose sleep over my being on opiates? Do they toss and turn worrying about someone they don’t know who’s causing them no harm? Do they drink snifters of hard liquor to help them sleep as they anguish over someone they don’t know, who’s condition or story they don’t understand? Do they even care to know?<br/>To meet me, one would be hard pressed to know that I use opiates for my pain. I’ve never crashed my car, I’ve never overdosed, I have 2 college degrees and a respectable GPA, I’m not chronically depressed, I’m active, or any other number of social ills the other side claims about us. To talk to these armies for the Anti-Opiate War, you would think I was a wrinkled, miserable hulk that looks like Gollum and hides in the darkness. Nope, I look and act just like anyone else. Sorry to dash anyone’s contrived notion of me. Maybe that’s the problem here?<br/>The narrative in America right now is anything opiates is bad. Has anyone read any article about these stories that we are reading here? All we hear is from the anti-opiate side and maybe it’s time to start publicly hearing the horror stories we see here. We need to get these stories out because I think in large part the original opiate guidelines caused most of these heart-wrenching stories. I think the CDC, or someone, has some splainin’ to do to the American society.<br/>I’ve been outspoken about this problem well before 2016. Having worked directly in the pain management industry and a patient myself, I began to notice this doctor trend starting about 2010. Before this time, opiates didn’t seem to be a problem to anyone. But as the years rolled on, I saw more and more terrible treatment of chronic pain patients and of myself. My stories are too numerous to even begin. Someday, I’d love to stand in front of all of America’s legislators and tell them the madness I have seen and its consequent damage from the enactment of the original guidelines of 2016. I bet they will hide from me as I’ve already witnessed with my own Senator and another former House member have already done so. They have all refused to engage this subject after several letters written over the years. Maybe that’s the problem, our representatives just simply don’t listen or even care to listen.<br/>Has anyone has noticed the battle cries? “Prescription pills are the new gateway drug to the harder stuff.” “Opiates are guaranteed to ruin your life.” “You’ll become addicted!” The list goes on and on because that’s the narrative right now. It’s funny how so many people can get sucked in by the rhetoric. If you’re told something enough times you begin to believe it as fact. Maybe that’s part of the problem?<br/>We should bring forward all of the facts before another guideline is set in stone. Let’s get it right this time and avoid the damage we’ve already witnessed. The chronic pain patient must be represented and should not be ignored and be an absolute part of the decision-making process. Every round-table I’ve attended never included a patient representative and this is where it all went wrong in the first place. I showed up and stated my case but my words were never headed. Maybe this time we can get it right?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484f9d824	Cook	None	2022-02-23T18:46:53Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	kzz-qzvs-qc9y	False	None	False	2022-04-12 03:14:41.211	[]
1350	CDC-2022-0024-1357	https://api.regulations.gov/v4/comments/CDC-2022-0024-1357	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and have used opiates and other non-surgical methods for controlling my pain. I have been on opiates for 14 years and during this time I have gone from being a trusted patient to a criminal based upon my chronic pain issues. Currently, I'm only allowed a thirty day supply of my medication. Plus, I have to meet with my doctor every 3 months and every 6 months supply a urine sample to make sure I'm taking my medicine correctly. I also have to sign a contract to abide by a long series of things, some of which could include a police investigation, if I do not take my medication correctly. I forgot, I also have to show my ID to put my prescription in at the pharmacy and to pick it up. The current practice clearly does not reflect what may have been in your original intent and for patients makes our lives difficult. When I was first prescribed my medication, I still had to see my doctor every three month (their decision), but could receive a 90 day supply of my medication. Now that so many other rules have been added I live in fear of not being able to get my medication in a timely manner, which would cause me to go into a forced detox, which not only creates the issues of detox, but includes spiraling, out of control pain. It then takes at least a week to get myself back to a tolerable level of pain control again. I have not, nor do I ever, take the idea of my pain medication lightly. The decision to start taking an opiate was made after much trial and error through several non-opiate medications, surgeries, pain relief techniques (i.e. epidural steriods, nerve ablations, etc.), acupuncture, physical therapy, and anything else that the doctors and I thought was worth trying. I have always been open to try things as I believed we would find the combination that worked best...a process that occurred between my doctors and myself, not from a government regulatory agency. In fact many studies I have read (ones my doctor suggested I read before making the decision to begin opiates) strongly suggest the proper use of this medication can be used safely long term and with a doctor's guidance (not a regulatory agency's guidance) I could live a life of better quality with manageable pain levels. I have not and do not expect these medications would ever completely make me pain free, but as such they are treated as another weapon I have to enhance my quality of life. I would like to see my doctors again be able to give me a 90 day supply of medication or at the very least a 60 day supply. It is quite difficult to make plans to visit family or have a quick vacation as I always have to be conscious of when do I need to get my prescription filled. The last three times I filled my prescription (for example) I have had difficulty getting the prescription filled in a timely manner due to the new rules and have been quite concerned about what would happen if any delay occurred. The types of things that have happened are: the system for delivery of prescriptions to the pharmacy changes my prescription because it thinks my doctor has made a mistake in prescribing it, my insurance company now wants to give their approval before I get it filled, and supply issues. It is as if my doctor is unable to make decisions about my care and I as the patient am left in the dark, because it is up to someone other than my doctor and myself to make these decisions. CHANGES NEED TO BE MADE!!! The hoops I jump through are ridiculous and frankly do not deter the use of opiates by people determined to destroy their own lives through misuse of opiates. I have to show more proof of who I am to pick up my medication than I do to vote, which seems quite wrong to me in this day and age. I hope the new recommendations made will allow my doctor the freedom to prescribe my medication for a longer period of time than 30 days (i.e. a 60 or 90 day supply), not so many drug tests (unless there is a reason to suspect I'm misusing my medication), and to fully allow me and my doctor the ability to be the ones that ultimately decide what is best for me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Victoria	None	None	0900006484f9d83d	Dehlbom	None	2022-02-23T18:47:22Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Dehlbom, Victoria	kzz-r49c-nvul	False	None	False	2022-04-12 03:14:41.522	[]
1351	CDC-2022-0024-1358	https://api.regulations.gov/v4/comments/CDC-2022-0024-1358	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom it may Concern…..probably not anyone reading this. I say this not to be rude but to emphasize the struggle only people who live with chronic pain can understand. I have had severe back pain for decades. It was controlled, as much as it could be through doctor prescribed opioid medication. But since the new guidelines were put in place I have suffered immensely. I have had to stop working because my pain is unbearable. I can no longer exercise, which is vital since I am also a heart patient. My life has basically come to an abrupt halt. I was taken off all but a small amount of my pain medicine. I have nothing time released so I very small amounts of relief, perhaps a couple of hours a day. Mind you these are not pain free hours; they are small amounts of time that I can use to clean my house, do some laundry. My husband and I had planned to travel some but that, too is no longer an option. Sitting in the car for even an hour is pure agony for me. So, not only has MY life come to a screeching halt but so has my husband’s. I spend a minimum of 12 hours a day in bed. I dread getting up because I know what my day will consist of: sitting in my chair, crying because I hurt so much, attempting to complete mundane tasks then crying some more. <br/>My current pain management doctor has given me “alternatives” to opiates. These include Gabapentin, a HIGHLY dangerous and addictive drug, antidepressants which have the RARE side effect of reducing nerve pain. I have tried everything they have offered with ZERO relief. It is not chronic pain patients who are overdosing. It’s the people buying drugs on the streets. Of course some of these overdose deaths are a direct result of patients being taken off of the medication that gave them some relief and being so desperate they feel they have no choice but to buy unregulated, illegal drugs on the streets. I can promise you this; if you or someone you love suffered like we do, none of this would be happening!<br/>Please allow doctors to decide what medication their patients receive, not some nameless, faceless agency that knows nothing about the devastating effects on chronic, never ending pain. <br/>I thank you for your time,<br/>...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484f9d852	Thomley	None	2022-02-23T18:48:57Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Thomley , Lisa	kzz-raz5-lh0q	False	None	False	2022-04-12 03:14:41.739	[]
1352	CDC-2022-0024-1359	https://api.regulations.gov/v4/comments/CDC-2022-0024-1359	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC's current opiod guidelines have affected many, leaving them devoid of adequate pain relief for both chronic and acute situations, adults and children alike. My sister, with degenerative and inoperable spinal issues has been affected so drastically, she is unable to function normally and enjoy any time free from pain. We have seen children and adults with dental procedures, knee and carpal tunnel surgery, appendix, kidney and gallbladder removals, sent home with little to no pain medication only to end up back in the doctor office or emergency room due to pain. This is not only cruel but unnecessary. Doctors blatantly say that they are legally unable to prescribe or that they are fearful of doing so. This is unfathomable. Are there bad doctors? Yes. Deal with them. Are there addicts? Yes, and you, the CDC, are responsible for many of them. Deal with them instead of coddling, aiding and absolving them of any personal responsibility as they are deemed 'powerless' over their addictions. Punishing all in an attempt to 'save them from themselves' is futile on their behalf and cruel to the rest. If you truly want to affect change, hold bad and negligent doctors accountable. Hold negligent parents who expose their children to drugs accountable instead of returning them to their care as quickly as possible. Hold big pharma accountable for knowingly manufacturing, distributing and incentivizing highly addictive and faulty medications. Hold the FDA accountable for giving their stamp of approval to those highly addictive and faulty medications. And, in the case of the FDA, as yourselves, CDC....this should include any/all medications, food additives, pesticides, herbicides, etc.. Stay out of the direct doctor/patient relationship. Hold the criminal and negligent responsible for their actions instead of punishing all as your prophylaxis. It has been cruel, destructive and likely contributory to fentanyl deaths as those normally law and prescription abiding chronic pain patients have found it necessary to supplement their medications elsewhere in order to maintain a sustainable existence. This is ludicrous and inhumane and the FDA and CDC bare responsibility for the opiod crisis and the horrible handling of trying to clean up your own messes. At this point, if both organizations were dissolved and entirely new ones were developed...it would probably be in the best interest of America's citizens, patients, parents and children alike.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anita	None	None	0900006484f9d896	Kahrs	None	2022-02-23T18:49:31Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Kahrs, Anita	kzz-rtef-6ub5	False	None	False	2022-04-12 03:14:41.952	[]
1353	CDC-2022-0024-1360	https://api.regulations.gov/v4/comments/CDC-2022-0024-1360	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient in Oregon. I am concerned that the prescribing guidelines will go down as far as the equivalent to the mme. I was on methadone and was asked to switch to Buprenorphine. It took a while to find a dose that works for my chronic pain due to Lupus and 6 knee surgeries and osteoarthritis issues. I also have severe anxiety and depression. Most of my anxiety comes from the daily pain I live with and the quality of life the combination of meds I am on gives me as there is no cure for Lupus or my other chronic pain causes. If the mme number goes down again I will be forced to go down on the dosage that my doctor and I have worked hard on finding that simply allows me to sleep at night. Get out of bed in the morning and enjoy the days with my two children and husband. I am actually able to work with a Personal Trainer twice a week with the dose of medication I’m on and not be in agony. I stay far away from ER’s because they immediately look at you like you’re a drug seeker if you go in because of pain control needs. Most don’t even prescribe anything but otc meds because of the prior guidelines. Aren’t hospitals and doctors supposed to treat the individual patient to the best of their ability? The current guidelines do not allow for that as most doctors have become afraid to prescribe because of the current cdc guidelines and consequences. I have a primary care physician who sees me as an individual and cares about my quality of life. I would not just be upset if that were to change but I would experience even more anxiety and depression and pain leading to a life with little times of peace. People who use and abuse pain pills and turn to street drugs are always going to find a way to do so whether or not doctors prescribe to chronic pain patients and I feel this is a missed observation of reality. I don’t want to be punished for others bad choices when I didn’t ask for these chronic diseases and follow all the rules. Please take this in to account as their are so many like me who suffer and whose doctors are so afraid to prescribe that they are cutting them off cold turkey with no warning or prescribing a fifth of what would improve their patients quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kalee	None	None	0900006484f9d8a7	Gilbertson	None	2022-02-23T18:50:04Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Gilbertson, Kalee	kzz-s1q2-paf2	False	None	False	2022-04-12 03:14:42.186	[]
1354	CDC-2022-0024-1361	https://api.regulations.gov/v4/comments/CDC-2022-0024-1361	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why is there mention of 50 mme in the purposed<br/>new guidelines? Your actions are causing suicide & medical collapse from the stress and inhumanity of untreated pain. Most people do not realize there are limited amount of prescription/otc medications that treat chronic pain. Many only work for a small percentage of people. And when you have chronic pain lasting years/decades you cannot take Tylenol and/or NSAIDS every day for years. It only took me about 6 months of being on antiinflammatories to put me on life support for two weeks bc I was slowly bleeding to death. I barely survived.I was so weak I couldn't even feed myself. I spent two more weeks in a nursing home. Over the counter pain relievers cause more deaths every year than opioids! So I obviously can't take those ever again. For many their other alternatives to opioids don't work & have loads of nasty side effects. Opioids are the last line of treatment (usually) but a very important one.Often That is the only thing giving many chronic pain patients quality of life. We don't abuse our med. Drs are afraid to do their jobs & are letting people suffer horrific post surgical or even cancer pain. And what's this new 50 mme limit sneaked in to the proposed new guidelinesHow do you suppose a 120lb. woman and a 220lb man should receive the same dose? Besides people metabolize it differently. You're causing so much fear,pain, suffering, & death. Children, parents and other families members grieve the senseless loss of their loved ones bc of govt bureaucracy Please stop listening to the likes of ... and others that have a vested interest in keeping things the way they are. These drs that drafted the original cdc guidelines in 2016 did so in secret without any opportunity for stakeholders to weigh in. And you need more than one pain dr involved. PROP needs to be investigated,now.Sadly cdc you have lost your credibility you "mistakenly" included deaths from illicit drugs or using opioids as a cause of death when it really wasn't. You claimed thousands & thousands of death were from rx opiates..turns out (at least half) of those ppl had died from illicit drugs or polydrug abuse.Please consider how you would feel if this was you or your loved one and show some compassion. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d8c6	Anonymous	None	2022-02-23T18:51:06Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-shtu-mb07	False	None	False	2022-04-12 03:14:42.409	[]
1355	CDC-2022-0024-1362	https://api.regulations.gov/v4/comments/CDC-2022-0024-1362	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When faced with chronic pain, patients must have the choice to work with their doctors free from restrictive rules currently in policy and practice regulating opiate prescription, interfering with the doctor patient relationship for dealing with chronic pain. Please support CDC changes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484f9d8ed	Casteel	None	2022-02-23T18:51:32Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Casteel, Marilyn	kzz-syom-1u4p	False	None	False	2022-04-12 03:14:42.632	[]
1356	CDC-2022-0024-1363	https://api.regulations.gov/v4/comments/CDC-2022-0024-1363	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic opioid users, who have likely developed tolerance over the years, likely have different characteristics in terms of opioid use patterns and needs, as opposed to those who are suffering from pain conditions but not yet exposed to, or dependent on, opioids. Limiting prescriptions and suggesting alternative options for the former can result in inadequate control, while these suggestions may be more helpful in preventing pain patients from developing new dependence or tolerance. I will suggest stating more explicitly in the recommendations whether a different approach is needed for the 2 groups of patients, as well as how to approach patients with tolerance to gradually shift towards alternative options before imposing restrictions on them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484f9d8f2	Lai	None	2022-02-23T18:52:11Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Lai, Teresa	kzz-t04m-agtm	False	None	False	2022-04-12 03:14:42.851	[]
1357	CDC-2022-0024-1364	https://api.regulations.gov/v4/comments/CDC-2022-0024-1364	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I am a young up & coming doctor. I will be finishing medical school & my residency in 4 years. I am adding my comments to this in regard to the CDC’s change in prescription practices regarding opioids. Since the later 2010‘s, people who are in serious pain have had their lives seriously impacted from your horrible extreme prescription regulations. I understand there must be strict guidelines in place, however what you are doing is punishing the people who have serious pain. For years my mother would complain of serious back pain. Back pain that my father had diagnosed as a herniated disc 20 years ago. After the opioid epidemic cracked down, she lost access to her prescriptions. The doctor cut her off just like that. So, in other words, the people who were abusing their drugs can continue to do it, even going to the streets, but someone like my mother who has serious legitimate pain can’t get more than a Tylenol 800 mg prescription? <br/>Please reconsider your CDC guidelines in regard to prescribing opioids to people with chronic pain. I would love to go into neurology, just like my father, however I fear legal repercussions if I do so. Doctors, in today’s day and age, are too afraid to prescribe opiates to their patients because the government will then go after them. If you want real change go after the major drug companies, not the little doctor trying to help his beloved patients. I know far too many doctors who have suffered legal and civil repercussions because of these new guidelines you put in place. Are you too afraid of big Pharma? Why haven’t they received years behind jail but brilliant doctors I know have payed their due ? Fix these guidelines at once to help those suffering from real pain. Total disaster you created, people with legitimate pain must suffer b/c addicts ruined it and you choose the extreme option as a way to fix this problem but it did the total opposite.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rico	None	None	0900006484f9c3bf	Pelicci	None	2022-02-23T18:53:13Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Pelicci, Rico	kzy-t4xu-y2tf	False	None	False	2022-04-12 03:14:43.069	[]
1358	CDC-2022-0024-1365	https://api.regulations.gov/v4/comments/CDC-2022-0024-1365	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear sirs and madams,<br/>I was physically emotionally and functionally damaged severely by the 2016 CDC 2016 opioid prescription guidelines. I was cut off my medicine and forced into withdrawal which made my blood pressure soar and did damage, permanent damage, to my heart. I was then forced to resume medication at a fraction of what I was comfortable on. Prior to these guidelines I was on four 60 mg morphine tablets a day and eight methadone capsules. I was able to function quite comfortably without any side effects or impairment to my body. Before this I had been through years, actually decades, of over the counter drugs, which left me with both liver and kidney damage, as well as numerous mechanical interventions. I have had so many steroid injections into my back and joints that I have developed Addison's disease.I am basically bedridden on the 90 mme I cannot do much without my blood pressure soaring due to uncontrolled pain.<br/>In my opinion my pain management doctors have the education and experience to treat me safely and adequately. I see no need for the CDC to be intervening in prescribed opioid treatment for chronic pain patients. Before 2016 my pain management doctor had me on an ironclad contract which very carefully held me accountable to any abuse or misuse with my opioid drugs. It also explained clearly the possible side effects or issues opioid can present. I had no side effects and no damage to my body from opioid. They are the only thing that gives me any quality of life.<br/>I request that the CDC considering recalling their 2016 guidelines and putting this treatment back in the hands of the doctors that are qualified to provide it. I agree with general practitioners or surgeons not providing opioid treatment long term. Options you force which I will NOT do is Black market or alcohol. Speaking of alcohol it creates much more damage and turmoil to individuals as well as innocent bystanders, much more than opioid ever has or ever will.<br/>Many of us perceive this withholding of opioids as prejudicial, intentionally damaging actions towards elders, disabled and Ill patients. It's a shame that so many have died from related causes or have committed suicide due to uncontrolled pain. Uncontrolled pain ruins your life.<br/> The CDC is the centers for disease control, treating pain with opioid is not a disease. Addiction is a disease but then why aren't you treating all of the addicts instead of singling out opioid patients who are not atticts? In fact looking at statistics, accurate statistics, you would find that chronic pain patients taking opioids have a much lower rate of addiction or overdose then the general population. So why are you punishing them when they are the responsible ones, following their doctors instructions and acting properly? We are trying so hard to abide by your rules but it's killing us. Our doctors will not go over the 90 mme unless it's temporary for surgery or an emergency injury or other physical ailment. And then that's only temporary. They are intimidated by the DEA who should never have been involved in this. I agree there were some doctors who had set up pill Mills but you are always going to have bad actors in any place or anything. Now we have fake prescription drugs on the black market made with fentanyl that are killing people. Why is it so much better than just letting chronic patients have their medicine so we can survive and have a better quality of what's left of our lives? You are depriving us of one of the basic functions of our constitution which is the right to pursue freedom and happiness. You have totally denied those from us. <br/>What the DEA has done to some doctors is criminal in itself essentially bankrupting their practices and putting many doctors in jail for murder when their patients died by abusing and misusing their prescribed opioids. Most of the deaths you will find had poly drug use within their bodies. Even if it's just alcohol,l that's one of the main things that can cause a reaction with opioid and any opioid patient who cares about themselves knows that and does not drink with their opioids. Thank you for giving us this opportunity to speak and I hope you listen to us and please reverse this drastic decision that is hurting millions of Americans all over our country. Please trust our pain management doctors, they do know what they're doing and they are very much accountable and holding us chronic pain patients accountable. I understand some pill Mills were closed which I applaud, however this could have been done by other means rather then damaging millions of chronic pain patients. Again thank you for giving us this forum to voice our opinions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f9d8fc	Kirkwood	None	2022-02-23T18:53:14Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Kirkwood, Amy	kzz-t5tb-adpy	False	None	False	2022-04-12 03:14:43.308	[]
1359	CDC-2022-0024-1366	https://api.regulations.gov/v4/comments/CDC-2022-0024-1366	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear sirs and madams,<br/>I was physically emotionally and functionally damaged severely by the 2016 CDC 2016 opioid prescription guidelines. I was cut off my medicine and forced into withdrawal which made my blood pressure soar and did damage, permanent damage, to my heart. I was then forced to resume medication at a fraction of what I was comfortable on. Prior to these guidelines I was on four 60 mg morphine tablets a day and eight methadone capsules. I was able to function quite comfortably without any side effects or impairment to my body. Before this I had been through years, actually decades, of over the counter drugs, which left me with both liver and kidney damage, as well as numerous mechanical interventions. I have had so many steroid injections into my back and joints that I have developed Addison's disease.I am basically bedridden on the 90 mme I cannot do much without my blood pressure soaring due to uncontrolled pain.<br/>In my opinion my pain management doctors have the education and experience to treat me safely and adequately. I see no need for the CDC to be intervening in prescribed opioid treatment for chronic pain patients. Before 2016 my pain management doctor had me on an ironclad contract which very carefully held me accountable to any abuse or misuse with my opioid drugs. It also explained clearly the possible side effects or issues opioid can present. I had no side effects and no damage to my body from opioid. They are the only thing that gives me any quality of life.<br/>I request that the CDC considering recalling their 2016 guidelines and putting this treatment back in the hands of the doctors that are qualified to provide it. I agree with general practitioners or surgeons not providing opioid treatment long term. Options you force which I will NOT do is Black market or alcohol. Speaking of alcohol it creates much more damage and turmoil to individuals as well as innocent bystanders, much more than opioid ever has or ever will.<br/>Many of us perceive this withholding of opioids as prejudicial, intentionally damaging actions towards elders, disabled and Ill patients. It's a shame that so many have died from related causes or have committed suicide due to uncontrolled pain. Uncontrolled pain ruins your life.<br/> The CDC is the centers for disease control, treating pain with opioid is not a disease. Addiction is a disease but then why aren't you treating all of the addicts instead of singling out opioid patients who are not atticts? In fact looking at statistics, accurate statistics, you would find that chronic pain patients taking opioids have a much lower rate of addiction or overdose then the general population. So why are you punishing them when they are the responsible ones, following their doctors instructions and acting properly? We are trying so hard to abide by your rules but it's killing us. Our doctors will not go over the 90 mme unless it's temporary for surgery or an emergency injury or other physical ailment. And then that's only temporary. They are intimidated by the DEA who should never have been involved in this. I agree there were some doctors who had set up pill Mills but you are always going to have bad actors in any place or anything. Now we have fake prescription drugs on the black market made with fentanyl that are killing people. Why is it so much better than just letting chronic patients have their medicine so we can survive and have a better quality of what's left of our lives? You are depriving us of one of the basic functions of our constitution which is the right to pursue freedom and happiness. You have totally denied those from us. <br/>What the DEA has done to some doctors is criminal in itself essentially bankrupting their practices and putting many doctors in jail for murder when their patients died by abusing and misusing their prescribed opioids. Most of the deaths you will find had poly drug use within their bodies. Even if it's just alcohol,l that's one of the main things that can cause a reaction with opioid and any opioid patient who cares about themselves knows that and does not drink with their opioids. Thank you for giving us this opportunity to speak and I hope you listen to us and please reverse this drastic decision that is hurting millions of Americans all over our country. Please trust our pain management doctors, they do know what they're doing and they are very much accountable and holding us chronic pain patients accountable. I understand some pill Mills were closed which I applaud, however this could have been done by other means rather then damaging millions of chronic pain patients. Again thank you for giving us this forum to voice our opinions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484f9dd00	Kirkwood	None	2022-02-23T18:53:21Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Kirkwood, Amy	kzz-t622-cye2	False	None	False	2022-04-12 03:14:43.546	[]
1360	CDC-2022-0024-1367	https://api.regulations.gov/v4/comments/CDC-2022-0024-1367	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 62 year old female...chronic pain sufferer since age 20...I personally have not tried opioids for pain management...but that is not why I am reaching out. I implore you to please please add RLS : Restless Leg Syndrome to your guidelines and acknowledge the long term suffering once and for all...I personally have suffered from this since I was a child and ...well there are just no words to describe the agony ...opioids have been found to relieve some peoples' suffering.... again I have not tried this...but found a great deal of relief was noticed when prescribed opiates for post op pain....<br/>That's all I wanted to say...please please please listen to us....<br/>Even though chronic pain has disabled me...RLS is my most formidable foe.<br/>Thank you for this opportunity to maybe give voice to this devastating condition.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484f9dd10	Clark	None	2022-02-23T18:53:35Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Clark, Susan	kzz-tgw6-7sdv	False	None	False	2022-04-12 03:14:43.773	[]
1361	CDC-2022-0024-1368	https://api.regulations.gov/v4/comments/CDC-2022-0024-1368	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a rare spinal cord disease, adhesive arachnoiditis. This is EXTREMELY painful, and there is no cure or treatment currently available aside from the occasional causal nerve block. I currently take oxycodone-acetaminophen 5/325 MG. Because of the opioid "crisis," I am only allotted four tablets a day, which is ridiculous. I have been taking these for over two years and am not addicted to them. There are many days when I need more than my allotment and certainly would benefit from a stronger dose. I am denied this due to the guidelines and political agendas. I am 69 years and dread my future because of the agonizing pain and disability. While I certainly do not want to become addicted, you need to make some allowances for people who are in situations similar to mine. With the FBI breathing fire and brimstone, doctors are afraid to provide patients with enough pain medication so that our lives are not miserable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f9d159	Karlen	None	2022-02-23T18:53:57Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Karlen, Linda	kzy-xckd-cxso	False	None	False	2022-04-12 03:14:44.000	[]
1362	CDC-2022-0024-1369	https://api.regulations.gov/v4/comments/CDC-2022-0024-1369	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a rare spinal cord disease, adhesive arachnoiditis. This is EXTREMELY painful, and there is no cure or treatment currently available aside from the occasional causal nerve block. I currently take oxycodone-acetaminophen 5/325 MG. Because of the opioid "crisis," I am only allotted four tablets a day, which is ridiculous. I have been taking these for over two years and am not addicted to them. There are many days when I need more than my allotment and certainly would benefit from a stronger dose. I am denied this due to the guidelines and political agendas. I am 69 years and dread my future because of the agonizing pain and disability. While I certainly do not want to become addicted, you need to make some allowances for people who are in situations similar to mine. With the FBI breathing fire and brimstone, doctors are afraid to provide patients with enough pain medication so that our lives are not miserable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f9d15a	Karlen	None	2022-02-23T18:54:16Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Karlen, Linda	kzy-xckk-bqak	False	None	False	2022-04-12 03:14:44.214	[]
1363	CDC-2022-0024-1370	https://api.regulations.gov/v4/comments/CDC-2022-0024-1370	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Knowing what and how to prescribe any drug to a patient especially a strong and lethal one is very important to know symptoms and pains of the patient in order to properly medicate them. Opioids is properly and legally used to reduce or sever chronic pain but opioids are being utilized non medically and shortly become addicted and causes high overdosage rates. Allowing practically guidelines for medical experts can reduce the high rates because the should be able to calculate how much to give the patient and not have the ending result in addiction. It's unethical and irresponsible, prescribing opioids to an individual is a serious matter that should be looked over to have principles and duties to the patients that the pain will be taken care of and nothing more.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d38c	Anonymous	None	2022-02-23T18:54:36Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-y1bn-al7w	False	None	False	2022-04-12 03:14:44.427	[]
1364	CDC-2022-0024-1371	https://api.regulations.gov/v4/comments/CDC-2022-0024-1371	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You are once again failing the American people. I do not understand why it is so difficult for you to see the errors you are making, errors that do a great disservice to those like me who suffer chronic pain, and irreparable harm to many in the form of resultant street drug addiction and/or suicide. <br/><br/>It is known that people who cannot get the relief they need from their providers will turn to illegal substances, and that increases the problems with street drugs in this country, NOT those who use narcotics safely under the direction of a physician. Yet you continue to force people into that situation with your ridiculous guidelines, under the guise of doing good. You are not doing good, and you know this. <br/><br/>I have chronic pain from a serious neck surgery and fibromyalgia. My life is utter misery without Tramadol. I am stable, never ask for more, and just get by with mostly good days now. Yet you make it ridiculously difficult for me, and risky for my pain doctor. Why? Who benefits from this? <br/><br/>My daughter is 36 years old and has rheumatoid arthritis as well as serious back/spine issues due to a poorly placed epidural needle during childbirth. She gets zero in the way of real relief, and works on her feet at least 40 hours a week. She cannot get anything stronger than the NSAIDS that barely touch her pain and neurolytics that help about as much as massage, which is nil. So you know what she does? Smokes pot so that at least she can care less about the pain. <br/><br/>Quite honestly, I generally support you all and appreciate the work you do, especially in these times. But this is your failure. You fail every single American who suffers from excruciating daily pain because you make it too risky for doctors to do what they are specifically trained to do: take care of their patients. <br/><br/>Please please please reconsider your position on this, and take a closer look at the real information out there that you seem to be ignoring at this point. <br/><br/>I would also like to endorse comments submitted separately to the Federal Register and published on social media by [name redacted], PhD.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Theresa M	None	None	0900006484f9dd23	Cogdill	None	2022-02-23T18:54:57Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Cogdill, Theresa M	kzz-tu32-1y9e	False	None	False	2022-04-12 03:14:44.639	[]
1365	CDC-2022-0024-1372	https://api.regulations.gov/v4/comments/CDC-2022-0024-1372	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello<br/>I am a 58 year old man that has had 31 surgeries since the age of 15, I have 2 bone diseases called degenerative joint and disc disease as well as Ankylosing spondylitis I remember crippling pain from the age of 6. I wore special shoes and leg braces. I will spare you a description of all of my surgeries, i have taken a washer machine to the and and then I knocked me down the stairs and landed on me. I also fell off the stairs and ruins a hip replacement that was in for a month, that went through my femur and shattered it all the way through. I have been on oxycodone for 20 years, always have taken it as prescribed never have I drank or smoked cigarettes, or done any drugs. This medication keeps me functioning, I am feeling almost human when I take, I’m able to get out of bed and walk around and function normally. When the new 2016 CDC guidelines and force tapering came about, I am bed and recliner bound I can’t hardly move around, I’m sad at how all CPP are treated it’s not far the way the whole situation has occurred. Please put the power back in the right hands The doctors hands and maybe the government ,and the DEA,CDC, should be busy on national security and Pandemics. <br/><br/>[name redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9d38f	Anonymous	None	2022-02-23T18:55:29Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-y27k-1bdb	False	None	False	2022-04-12 03:14:44.854	[]
1366	CDC-2022-0024-1373	https://api.regulations.gov/v4/comments/CDC-2022-0024-1373	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am a Family Physician by training but also practice Addiction Medicine with plans to join a full time practice in Addiction Medicine in the near future. As both a Family and Addiction provider, I feel that I have a unique perspective of opioid prescribing, including the harms and potential problems that come from opioids. I do feel that in some cases of chronic pain, opioids can be a benefit to a select group of patients. I have myself seen patients that have been on the verge of suicide due to severe pain. However, on the Addiction Medicine side, I have also seen the harms that can come from prescribing opioids to patients for chronic pain problems (development of tolerance the the push to continuously increase doses). I do in general agree with a revision to the guidelines. I believe that the current 2016 guidelines do push some providers to discontinue opioids rapidly in patients sometimes causing them to turn to street drugs or nonprescribed medication, which would not be in line with the principle of harm reduction. I feel that some patients do require opioids to treat chronic intractable pain but I also feel that some physicians have overprescribed or incorrectly prescribed opioids in the past due to the lack of guidance. The 2016 guidelines were a good starting point in helping prescribers identify the correct patients for management with opioids but as stated above, led to some very strict prescribing by some providers and have at times contributed to some of the problems that we are currently seeing in the Addiction Medicine world. I think that some guidelines for prescribing are necessary. In review of literature on the subject, most family physicians/primary care physicians are not well equipped to manage chronic pain. Patients in chronic pain require more time (more thorough history, physical exam, discussion of other options for pain management, and evaluation for signs of past problems with substance use or other “red flags” for opioid prescribing), and time is unfortunately something that primary care physicians do not have. I do feel for these reasons that guidelines for prescribing are very necessary to help guide physicians with minimal experience in management of chronic pain in managing this difficult patient population. I also feel that very stringent guidelines can contribute to the problem by limiting access to opioids in patients that really need them or those in risk of turning to street drugs or nonprescribed medications due to prescribers being unwilling to prescribe. The most important aspect of the new guidelines in my opinion is a piece that the guidelines cannot correct. The limited insurance coverage for true “multidisciplinary” pain management. This would include counseling, case management services, physical therapy, interventional services, and other nonmedication pain management modalities under one roof. Until policy changes allow for better coverage and reimbursement for nonmedication pain relief modalities, our patients in chronic pain will continue to require medications, whether opioid or nonopioid, to control pain. As we know from experience, medication is not the cure for everything. I believe that the updated guidelines will hopefully be a benefit, allowing more flexibility in prescribing without being too stringent, which can contribute to problems. I do not think that the CDC or any insurance company or agency should be dictating prescribing by medical providers because that can cause issues with limiting access to care. However, as stated previously, guidelines are important as a “guide” in how to prescribe safely so that physicians that are in a crunch for time and have limited experience in pain management have guidance on how to appropriately manage chronic pain patients. I also strongly believe that the pharmaceutical industry or insurance industry should have no role in development of guidelines or input into the development of guidelines. I think that the most important things that we can do for our chronic pain patients would be policy changes to allow better coverage for nonmedication modalities of pain management. I also think that state medical boards should play a role in mandating training in appropriate prescribing of opioids for physicians that are not specifically trained in pain management. Again, I believe that the revision of the guidelines will hopefully be a good thing for people in chronic pain but at the same time would argue that a lot more needs to be done on the policy front to allow better comprehensive pain management services for people who need them. Thank you for your time and consideration.<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Oliver	None	None	0900006484f9dd3f	Benes	None	2022-02-23T18:55:43Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Benes, Oliver	kzz-txak-elcl	False	None	False	2022-04-12 03:14:45.074	[]
1367	CDC-2022-0024-1374	https://api.regulations.gov/v4/comments/CDC-2022-0024-1374	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone living with constant chronic pain from psoriatic arthritis, I am living with far more pain than I feel I should be due to limits placed on my rheumatologist. Due to opioid prescribing restrictions, I am limited to 3 5 mg Oxycodone a day. And that is only because I am exempt from the state's unreasonable restrictions. I am not at a point I need to take the maximum amount I am prescribed daily, but I have flare-ups that cause me to be in bad pain for a week or more at a time.<br/><br/>I am 6'5" and weigh 330 pounds. This limited amount of oxycodone does little for me during a bad flare-up. I have been advised that the time-released version would make things a little easier for me, but my doctor is not allowed to prescribe it. And for me to receive it, I would have to enter pain management.<br/><br/>I have no desire to be in a pain management program because I know others that are. If I were in such a program, I would be required to take all of the daily amounts prescribed whether I needed it or not. I have no wish to do that.<br/><br/>I would just like to be able to live and work with less pain during periods that the arthritis is acting up.<br/><br/>I would like common sense judgment to be returned to doctors so that I can try and live more comfortably. Please allow doctors to use the training they have to determine what is best for me and not some politician's judgment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrew	None	None	0900006484f9dd76	McCluskey	None	2022-02-23T18:55:59Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from McCluskey, Andrew	kzz-u9i5-z7l3	False	None	False	2022-04-12 03:14:45.312	[]
1368	CDC-2022-0024-1375	https://api.regulations.gov/v4/comments/CDC-2022-0024-1375	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 68 year old woman. I had 2 surgeries within 2 years and was NOT given proper pain management medications. To this day I am suffering severe pain and anxiety and using excedrin for pain. Help the seniors live better lives with better pain care, some of us need additional medication even after operations. I have become very depressed with the pain I live with, my quality of life is worse, not better after surgeries.<br/>Don't punish us help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484f9dd8b	Williams	None	2022-02-23T18:56:10Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Linda	kzz-ugtq-5xfn	False	None	False	2022-04-12 03:14:45.528	[]
1369	CDC-2022-0024-1376	https://api.regulations.gov/v4/comments/CDC-2022-0024-1376	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s time the government stayed out of the patient-physician relationship and let doctors do what they trained for. It’s been an absolute travesty that millions of people with legitimate pain have suffered needlessly due to some academics who never had a pain in their lives sticking their noses into such a personal and subjective experience as pain. And have the so-called guidelines stopped the drug addicts from getting their illegal drugs? Absolutely not. Life goes on for them, and they manage to get their next fix while the true pain sufferers are denied the only relief they can get and try to overcome something that is impossible while at the time being treated with shame and scorn because they may need a narcotic to control their pain and help them live as best of a life as they can. The talking heads go on about “quality of life” but in no means do they try to improve it for the ones suffering from chronic or intractable pain. Even the pharmacists get in on the act and seem to enjoy withholding a dose or two of meds if they can find some loophole to deny filling the Rx. “Sorry. Nothing I can do,” chirps the 28 year old PharmD while the sad old arthritic who has dragged themselves through the pharmacy in hopes of getting the only relief they will see for the day turns away with tears in their eyes, desperate because they know they are in for a horrendous time because they are at the mercy of the government and insurance red tape. Never mind that the weekend is coming up and the pain sufferer is only trying to get their meds a day or so a head so as not to suffer needlessly with no access to the prescriber should they run out. It’s pathetic when a country has the resources to assist people and keep them comfortable yet treats them like addicts because they happen to require pain medication. Seems like it’s ok to be “dependent” upon blood pressure medication as hypertension appears to be on the “acceptable” list of diagnoses; pain isn’t. We treat our animals better!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cd30	Anonymous	None	2022-02-23T18:56:21Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-y816-95vv	False	None	False	2022-04-12 03:14:45.740	[]
1370	CDC-2022-0024-1377	https://api.regulations.gov/v4/comments/CDC-2022-0024-1377	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who suffers chronic, unrelenting pain, I really wish the doctors would be allowed to decide what and how much pain medication i can be prescribed. Right now, I am rationing the pain pills as I know I can't get more or stronger. so, here I sit, reading a book as that involves no movement. Please allow the doctors to make the decisions, not government as it is here in Florida. I have never taken illegal drugs, although I sure have been tempted. If I thought any would work on this constant pain, I might consider it, but no, I just do my best to get through each lousy day and pray for it to end. I have been to 2 pain clinics both of which were jokes, so I am not doing that again!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9dd8f	Anonymous	None	2022-02-23T18:56:33Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-uhgd-skof	False	None	False	2022-04-12 03:14:45.956	[]
1371	CDC-2022-0024-1378	https://api.regulations.gov/v4/comments/CDC-2022-0024-1378	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The main reason there are overdoses is because people cannot get prescribed pain medicine and they go out and buy on the street and end up overdosing on fentynal that comes from Mexico. Most doctors are intelligent enough to know what his or her patient needs to help with pain relief. When you take that choice away and scare doctors from prescribing then people go to buying on the street. Most people do not abuse their pain medicine. I know that patients who are in a pain management clinic use their pain medicine as prescribed. The other problem is when you are on pain management over a long period of time then you will eventually need some type of increase because your body gets used to most pain meds. Limiting patients to 90mg a day can leave a patient still in a lot of pain and makes their life unmanageable. Please leave this decision to the doctor and patient and not to a government agency. When you are in pain everyday your life can become very depressed and living can very scary. Again, the government should not be involved in pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joe	None	None	0900006484f9dd91	Public	None	2022-02-23T18:56:56Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Public, Joe	kzz-uhp4-d305	False	None	False	2022-04-12 03:14:46.171	[]
1372	CDC-2022-0024-1379	https://api.regulations.gov/v4/comments/CDC-2022-0024-1379	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who had my opiods abruptly start. It changes ur whole life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f9de19	Bertolino	None	2022-02-23T18:57:12Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Bertolino, Deborah	kzz-v89u-xn0h	False	None	False	2022-04-12 03:14:46.385	[]
1373	CDC-2022-0024-1380	https://api.regulations.gov/v4/comments/CDC-2022-0024-1380	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am just going to say this, 15 years of pain management and I never over dosed and my pill count was always correct. Most chronic pain patients are not addicted, nor are we criminals or lying to be productive citizens. This is how I was treated by Doctors, was on oxcodone and fentanyl for years, and told when you made these recommendations years ago that they was going to have to cut my medications and take more useless injections in neck,back,shoulder and knees because now opoids are bad. I was left without ANYTHING, cold turkey! Treated like my life didn't matter. But if I was addicted, like you wanted everyone to believe, how come I was OK ? No withdraws, just terrible pain I have had to deal with since. I practically crawled into the doctors and few months ago with severe pain in lower back, pissing on myself and unable to move, guess what I got for pain? A steroid shot and ibuprofen!. If this is the best FDA,DEA and Doctors can do, then I hope you all suffer the pain I deal with EVERYDAY. Bet you will getting more than ibuprofen. Now I take 8 or more ibuprofen and tynleol everyday, guess what I am told now, I am damaging my liver and kidneys. I now refuse to give my hard earned money to a Doctor, that took an oath to do no harm. Well they are harming me, by denying me the medication that helped me want to live and work and provide for my daughter, ya I am a single parent, that she has only me to support her. Now think about this for a second, look at all the fentanyl overdoses and opoid overdoses that are happening, all from illegal drug use. Why you think that is? I have your answer, chronic pain patients are not going to suffer and shouldn't have to because of Regulations that missed the mark. I just ask that you easy up and let people like me that always did what was expected and never abused the medication that helped me want to get up and go everyday. Stop judging us chronic pain patients and help us. Not that it's going to do any good now, since doctors are afraid to treat their patients without ending their career. Between the insurance companies and who ever came up with these current regulations, pain management is a none existence career. It's sad when the new drug of choice to treat pain is ibuprofen. If this is the best we can do, then we all are in trouble. What's next, surgery without anesthesia? Ya it coming.....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cliff	None	None	0900006484f9cd31	Rogers	None	2022-02-23T18:57:21Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Rogers, Cliff	kzy-y8d2-3g8x	False	None	False	2022-04-12 03:14:46.603	[]
1374	CDC-2022-0024-1381	https://api.regulations.gov/v4/comments/CDC-2022-0024-1381	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to you about the situation we patients are suffering with. I am a 43 year old father, family man and a hard worker. I have been on opioid medication for many years. I have never abused, misused, or sold my medication in my life. When the laws changed and politicians decided to be medical doctors, everything turned for the worst. I can no longer receive the proper meds and dosage necessary to treat my pain. It’s very unfortunate, that in one instant my meds had to be cut down. I and millions of Americans can not be treated properly now! The rate of overdose deaths are higher than ever! Changes need to be done now and go back to doctors prescribing how they need to.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kalil	None	None	0900006484f9de1d	Haj	None	2022-02-23T18:57:31Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Haj, Kalil	kzz-va3q-293r	False	None	False	2022-04-12 03:14:46.820	[]
1375	CDC-2022-0024-1382	https://api.regulations.gov/v4/comments/CDC-2022-0024-1382	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I AM A CHRONIC PAIN PATIENT, AND I PERSONALLY FEEL THAT THE DOCTOR'S WHO ARE REAL DOCTOR'S WITH THE TRUE CONCERN OF THEIR LONG TERM PAITENTS SHOUL BE ABLE TO PRESCRIBE ACCORDING TO THE PATIENT'S NEED AND THE DOCTOR'S RESPONSIBLE DOSAGE. SINCE 2016, PAITENTS OF CHRONIC PAIN HAVE SUFFERED GREATLY YET THE OPIOID EPIDEMIC CONTINUES PROBLEM NOT SOLVED, THERE WILL ALWAYS BE BLACK MARKETS WHERE PEOPLE WHO ARE ABUSING THE MEDICATION CAN GET THEM, WHILE THE INNOCENT AND IN PAIN PATIENTS ARE RESTRICTED. I PERSONALLY FIND IT UNFAIR AND DISGRACEFUL THAT PAIIENTS EVER HAD TO SUFFER BECAUSE OF THIS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanetta	None	None	0900006484f9de34	Miller	None	2022-02-23T18:57:49Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Miller, Jeanetta	kzz-vjsl-8oyr	False	None	False	2022-04-12 03:14:47.033	[]
1376	CDC-2022-0024-1383	https://api.regulations.gov/v4/comments/CDC-2022-0024-1383	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am [name redacted] retired, and will be 81 years old in a couple of days. I have taken Morphine pain pills for 4-5 years now, prescribed by licensed Doctors! I have for at least 3 years have taken (4) 30mg's each per day, for severe back pain, which worsened after major back surgery at a Philadelphia hospital, [health facility name redacted], who is now bankrupt! Surgeons here in [city name redacted] now tell me after this surgery, nothing can be done surgically to repair the damage done by the above hospital!<br/>I have had a serious back problem for over 20 years now, and I must live with the pain!<br/><br/>As to taking Morphine, I have never gotten a high from taking it, anytime, and do get a little relief! One thing I found out is taking morphine rases hell with the stomach. I have cut back on morphine on my own, and now take it 2-3 times per day along with over-the-counter pain relief pills.<br/><br/>One other thing I did was, signed up for Medical Marijuana, about a year ago, and tried it 2- 3 times in a year, and was not satisfied, with the foggy feeling I got, and cannot say I got any relief from it. Further, using it would ruin your lungs, and its worse than smoking! <br/><br/>Finally, if it is the intent of Human Services to take the one drug, I get relief from, I am opposed to your efforts, leave me alone, and other sensible people who might be in the same category, I am! Good luck and God Bless! [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ray	None	None	0900006484f9cd33	Smith	None	2022-02-23T18:59:07Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Ray	kzy-y9dr-04u6	False	None	False	2022-04-12 03:14:47.246	[]
1377	CDC-2022-0024-1384	https://api.regulations.gov/v4/comments/CDC-2022-0024-1384	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patients desperately need to have adequate pain control to be able to live their lives. I have nearly lost my job due to the fact my pain could not be controlled, but that was because I was so limited in what the doctor would prescribe. I have many health issues, including CRPS, which is an extremely painful disease causing massive amounts of pain and nerve pain. At 37 years old I also have extremely bad arthritis in my hips. So, there are multiple very painful diseases/syndromes and the pain control give was literally one pill a day, and then it was stopped out of nowhere. I could barely care for myself, and it shouldn’t get to this point at my age. Please help chronic pain patients! I would type more, but even this is exhausting. Please, on behalf of chronic pain patient everywhere please help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erica	None	None	0900006484f9cd38	Engel	None	2022-02-23T18:59:31Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Engel, Erica	kzy-yhr4-he1u	False	None	False	2022-04-12 03:14:47.460	[]
1378	CDC-2022-0024-1385	https://api.regulations.gov/v4/comments/CDC-2022-0024-1385	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/><br/>I was in an auto. accident while working in 2001 & had neck & back injuries that ended up going thru MD Workers Compensation (WC) After numerous Theraphies on my neck I had an injection which did away w/headaches that I had. I had numerous Theraphies, Facet injections,etc. & was prescribed Celebrex, Gabapentin, Duloxitin, Trazadone & Oxycodone in approx. 2004. In 2006 I had a 3 level spinal fusion from L-3 to S-1. Over the yrs. my pain level has typically been 6 @ a min. up to approx. 9 for a high. I have CHRONIC LOWER BACK PAIN !<br/><br/>I've been in Pain Management (PM) since 2009 & over a couple of yrs. I settled out @ 4 10/325 mg./daily Oxycodone (= to 60 mg. Morphine) & was able to do some things around the hse. @ a pain level of 5 @ a min. up to 8 for a high in order to have some Quality of Life (QOL). I understood that there was an Opioid Epidemic, that people can get addicted & IF the are, go out & purchase Street Drugs that @ times are laced w/Fentanyl. I saw that each yr. 10's of thousands of people were overdosing from Opioid use.<br/><br/>In June 2018 I moved to SC for a warmer wintertime climate & the WC Ins. Co. wanted me to wean down on my Opioid use. While in PM we (I) tried to wean down but my pain level went up to 6.5 after reducing down to 3 10/325 mg./daily Oxycodone & my QOL was reduced. My PM Dr. told me to return to taking 4 10/325 mg./daily Oxycodone & documented this. Later that yr. the WC Ins. Co. refused to pay for more than a Rx of 2 10/325 mg./daily Oxycodone. My Lawyer got the WC Ins. Co. to pay for 4 10/325 mg./daily until they end of 2018 & we agreed to wean down thru PM @ the beginning of 2019 even though my PM Dr. said that I'd lose my QO w/CHRONIC LOWER BACK PAIN. I was also looking for a New PM Dr. on SC that would take MD WC.<br/><br/>In Jan. 2019 I began weaning down 1/2 pill every 2 wks. When I was @ 3 10/325 mg./daily Oxycodone my pain level required me to take 3 650 mg./extra daily Tylenol. Once I weaned down to 2 10/325 mg./daily Oxycodone I was taking 5 650 mg./extra daily Tylenol to be @ a pain level of 6.5 @ a min. & my QOL was greatly reduced. The MAIN PROBLEM was that I was taking a TOTAL of 3,900 mg./daily Tylenol & my PM Dr. documented this along w/recommending that I return to 4 10/325 mg./daily for QOL & because of the Tylenol use which could cause Liver Damage in the future.<br/><br/>Finally after looking for 17 mo.'s I found a PM Dr. in SC & had my 1st visit in Feb. 2020 & @ that time I was taking 3,900 mg./daily Tylenol for a TOTAL of 11 mo.'s. After reviewing my PM Dr.'s notes he decided to prescribe me 4 10/325 md./daily Oxycodone in order to increase my QOL, & to reduce my Tylenol intake which would eventually kill my Liver in the future. The WC Ins. Co. paid for my Rx of 4 10/325 mg./daily in Feb. 2020 but when I went back to the PM Dr. in Mar. 2020 the WC Ins. Co. would NOT pay for the Rx, so I started paying for my Oxycodone Rx.<br/><br/>The WC Ins. Co. then said that they would find me a New PM Dr. but after a couple mo.'s they could NOT find 1 that took MD WC. Then the WC Ins. Co. said they'd give me 3 mo.'s to find a New PM Dr. & I said, "It took me 17 mo.'s to find this 1 & I'm keeping him". The WC Ins. Co. then went to the WC Commission & LOST. Then in Jan. 2021 the WC Ins. Co. went back to the WC Commission & got a different Commissioner to wean me back down AGAIN. The WC Commissioner wanted to "SAVE ME FROM OVERDOSING" (?? per her Dr. degree ??), even though I was in PM for approx. 12 yrs., NEVER MISSED AN APPT., NEVER FAILED A PISS TEST & have ALWAYS HAD MY PILLS RIGHT. The WC Commissioner did NOT LOOK @ ME AS AN INDIVIDUAL but as a OPIOID USER. I felt like I was on a 3 lane hwy. w/a speed limit of 90 MPH; I'm in the middle lane doing 60 MPH & they went me in the right lane doing 30 MPH.<br/><br/>In Feb. 2021 I started weaning down 1/2 pill every 2 wks. AGAIN w/ CHRONIC LOWER BACK PAIN. In mid Mar. 2021 I was down to taking 3 10/325 mg./daily Oxycodone along w3 650 mg./extra daily Tylenol. I had been seeing a product called Relief Factor on TV about 4 Anti-inflammatory ingredients (Curcumin, Icariin, Omega-3, Resveratrol) that help w/pain, so I ordered it because I knew that taking all of the Tylenol was probably going to kill me in the end. I started taking the Relief Factor @ 4 packets/daily, per their recommendations, for 2 mo.'s because of CHRONIC PAIN then cut back 1 packet/daily every 2 mo.'s & take 2 packets/daily thereafter.<br/><br/>Bottom Line is that I actually felt better taking 4 10/325 mg./daily Oxycodone alone. I've spent a lot of $$$ paying for my Oxycodone Rx for 20 mom's & paying for Reliek Factor for 11 mo.'s to keep the Tylenol from killing my Liver in the future. From what I've read I REALLY HOPE that the New CDC guidelines for Opioids looks @ the Individual & the relationship w/the PM Dr. in order to CARE for the INDIVIDUAL w/CHRONIC LOWER BACK PAIN over the past 20+ yrs.<br/><br/>THANKS for the venue to vent!<br/>[name redacted] in SC	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cd66	Anonymous	None	2022-02-23T19:03:26Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-zmx4-m65s	False	None	False	2022-04-12 03:14:47.677	[]
1379	CDC-2022-0024-1386	https://api.regulations.gov/v4/comments/CDC-2022-0024-1386	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in chronic pain for years I've been to emergency rooms where the doctors tell you you're faking I've been there when the nurses will tell you you're wasting their time and the only thing that truly will make your life better is some sort of pain relief. have you ever experienced severe pain for an extended period of time? It gets to be unbearable at times. When you have severe pain you go to your physician for help and all you get is a lecture about how pain pills are bad for you and I just take some Tylenol and you'll be fine....Dr's are so afraid of having their license revoked, thanks to all the threats from the Government, that they feel that they can't treat a patient with the compassion, and care they deserve! So, the patient starts to feel like I f their zDoctor feels they don't need pain medication, then they begin to feel like they must be unable to cope, so it's their faul in some way.So we silently withdraw into our constant pain, until the day we can't. It's a miserable existence. In a country like the U. S., this is ridiculous. It's not some sort of high we are looking for, it's just some relief so that we can TRY to live out our lives doing something other than lying in pain all day as night. Thank you for the opportunity to express my feelings.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doreen	None	None	0900006484f9cd76	Peschilli	None	2022-02-23T19:04:18Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Peschilli, Doreen	kzz-005d-uzhw	False	None	False	2022-04-12 03:14:47.895	[]
1380	CDC-2022-0024-1387	https://api.regulations.gov/v4/comments/CDC-2022-0024-1387	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have close family members who have very painful chronic conditions that requires them to see a Pain Management doctor and be prescribed opioids. If it weren’t for these medications they wouldn’t be able to function in society. If they were forced to be taken off these types of medications their lives would not be the same and they would lose all ability to be able to function. They didn’t choose to have chronic pain and they certainly do not wish to have to take daily medication just to be able to function in life. They have a very good relationship with their doctors and are monitored closely. I think these decisions should be between doctor/patient not the government/DEA. And doctors shouldn’t have to be afraid of losing their medical license for wanting to help their patients to live productive lives. I realize that there are those that are abusing and misusing these drugs but the ones that truly need these medications shouldn’t be punished for those that are abusing them. Not ALL people are drug addicts searching to get high. For chronic pain patients these medications are literally a lifesaver and I feel without them a lot of these patients will lose their will to live. Stricter regulations are not the solution.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cd81	Anonymous	None	2022-02-23T19:04:54Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-0bp2-svg4	False	None	False	2022-04-12 03:14:48.122	[]
1381	CDC-2022-0024-1388	https://api.regulations.gov/v4/comments/CDC-2022-0024-1388	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/> I sustained a piland fracture in 2009. My fracture is similar to [name redacted] . It is rare and happens 1-9% of lower leg fractures. I have undergone seven surgeries [including ankle replacement] and am facing two more eventually as have traumatic arthritis resulting in bone spurs.<br/><br/> My new primary care physician barely gives me two Tramadol per day and thinks Norco is same as oxycontin. He thinks I should just have another surgery to fuse my subtalor joint as I'll probably feel better!! Having that surgery would keep me non-weightbearing for three-four months.<br/><br/> I have been able to have a quality of life by using CBD pain balm and Tramadol and occasionally a few Norco.<br/>How does a decent Dr. tell a person to just have the surgery! Also he agrees that its terrible that people in chronic pain have to suffer because they can't get the drugs that would help them have some quality of life!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	karen	None	None	0900006484f9cd92	balbier	None	2022-02-23T19:15:26Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from balbier, karen	kzz-0ykb-m4if	False	None	False	2022-04-12 03:14:48.347	[]
1382	CDC-2022-0024-1389	https://api.regulations.gov/v4/comments/CDC-2022-0024-1389	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 73 years old and have suffered with chronic pain from osteoarthritis for over 40 years. I have managed back pain with acute episodes since I was 30. My Pain Dr. and GP are both sympathetic. I parse out micro doses of Tramadol, which has become a Class 3 or 4 something or Other Controlled Substance since it started giving me relief 15 years ago when I herniated my L4 and L5 discs. I had numerous surgeries including total ankle replacements for both feet. I still play tennis actively. I do everything I can to manage my pain. I keep a pain journal. I average less than 2 full 50 mg Tramadol per week, halving the pills and fortifying them with 500 mg Tylenol, which greatly enhances their effectiveness for me. I realize some people get in trouble with Tramadol. And that the more I use the less well it will work. So I work at it, using as little as possible when most needed. I mix and match physical therapy, yoga, daily stretching routine, varied exercise, Celebrex an RX NSAID, Kratom a whole other story where the DEA, which should be abolished wants to limit my options), Green tea. You name it. If it help with my pain, I'll incorporate the substance or practice into my life. I stopped drinking alcohol over the past few years because it doesn't help with my pain. Similarly medical marijuana, tho I use some of the topicals. I have some leftover real narcotics from my most went surgeries which I hoard take slivers of when my back gives me acute pain to exacerbate my daily challenges. I know my Docs don't want to give me anything stronger than Tramadol. They've become gun shy given the Opioid crisis, which I know is real. I talk to a lot of other old people with chronic pain in my life. And we all notice the change over the past few years in Doc's willingness to prescribe. I've even run into Nurses and Nurse Practitioners who were clearly trying to screen me as a drug-seeker from their Docs and didn't give a shit about me or my pain. They're part of a larger totally dysfunctional entity: the so-called American Health Care System. <br/><br/>God Help Us. We all are.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484f9cdac	Holcombe	None	2022-02-23T19:16:28Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Holcombe, William	kzz-1pfy-l6et	False	None	False	2022-04-12 03:14:48.597	[]
1383	CDC-2022-0024-1390	https://api.regulations.gov/v4/comments/CDC-2022-0024-1390	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment on this important topic, Prescribing Opioids.<br/>I had a life altering accident in 1995. I have taken some kind of opioid since 1996. I have also had many surgeries, physical therapy, alternative treatment, other medications and seen many doctors. I have survived. Please do not take opioids away. It is a life saving treatment for me. I have never abused these, nor have I tried to get more than I need. At one time I was taking 120 mg of Oxycontin daily; I am now only taking two (2) 10/325 mg Oxycodone/Acetaminophen daily. I did this myself, without the help of another person or professional. At the time I did it was when I learned of the misinformation from Purdue, that really upset me. Again, please do not take this life saving treatment from me. According to your own statements "excessive drinking was responsible for 1 in 10 deaths among working-age adults aged 20-64 years" or "approximately 95,000 deaths and 2.8 million years of potential life lost (YPLL) each year in the United States from 2011 – 2015". (See https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm#:~:text=Excessive%20alcohol%20use%20led%20to%20approximately%2088%2C000%20deaths,10%20deaths%20among%20working-age%20adults%20aged%2020-64%20years.)<br/>Once more, let me thank you for this opportunity. If anything further is needed from me I have provided my contact information hereinbelow.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484f9d6aa	Barkley	None	2022-02-23T19:16:43Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Barkley, Deborah	kzz-nqdy-rd5x	False	None	False	2022-04-12 03:14:48.820	[]
1384	CDC-2022-0024-1391	https://api.regulations.gov/v4/comments/CDC-2022-0024-1391	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have viewed several of the comments listed here and there is so many that I have empathy for and can understand their need for opioid pain medication. However I cannot ignore how misinformed some folks are in regards to opiates. I am a person in recovery for almost 5 years now and I have been working in the field of substance use for three of them. What I have observed is that there was an extreme problem with over prescribing opiate medication in this country, in fact a lot of people that I serve were victims of the deadly effects of Oxycontin. I have seen those same people struggle with illicit drugs like heroin that nowadays is often laced with Fentanyl. From my own personal experience, my own addiction had started with a prescription of opiates and it kick started a 7 year battle with heroin addiction. I am grateful to have made it out when I did because it is a whole different animal out there. I say all of this to get to this point, do I believe that the guidelines for prescribing opioids for true chronic pain sufferers yes and they need to be adjusted, I am only fearful of how delicate of a balance it will be so these medications are given to the people who really need it. I only can ask that others be mindful of yes, fentanyl is a big problem in the US right now, in fact, the number one killer in this country. But those people who may be using those illicit substances may have started using them as a result of a prescription opiate which I believe the whole reason these strict and difficult to navigate around guidelines were put in place. We need to do better with evaluating patients so they can get the proper care they need. Make no mistake the opiate crisis is alive and well, I see it every day. So hopefully these changes can make a difference for the better.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9df7e	Anonymous	None	2022-02-23T19:17:08Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-xacn-17xl	False	None	False	2022-04-12 03:14:49.042	[]
1385	CDC-2022-0024-1392	https://api.regulations.gov/v4/comments/CDC-2022-0024-1392	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was so happy to find this site. I am a chronic pain patient , I was diagnosed with fibromyalgia 7 years ago after ruling out other conditions. I have suffered with all over pain for several years before being diagnosed and finally it was affecting my work ( hair stylist for 44 years) and living my daily life. <br/>The last 7 years with medication (hydrocodone 5 mg.-325 mg.of acetaminophen)have allowed me to actually function in my life.<br/>I love gardening , refinishing furniture, camping etc.I can again do these things.<br/><br/>My husband and I have retired and have been blessed to spend the last 3 winters camping in sunny Arizona ( we live in Wash. state ). However every year here has been harder and harder to get my medication. I changed my health insurance so I could get a DR. here in Arizona , which I did. She did prescribe me a total of 5 weeks medication, but when I asked for a refill she refused ( I believe she was concerned about getting into trouble.) So she sent me to Pima Pain Clinic here in Tucson. <br/><br/>I was actually looking forward to going to a pain clinic as I have not been to a pain clinic before. <br/>My experience at the pain clinic has been so extremely frustrating. So far they have done x-rays on my hip and shoulder and wanted to do x-rays on my knees. They also wanted to do one of several options they offer, however I've already done physical therapy,acupuncture, massage , all very temporary I guess what is the most frustrating to me is I am being treated at home in Wash. state and monitored every 90 days, so I don't understand why the just won't talk to my Doctor ???<br/>I finally said enough. 'I'm not sure what these x-rays are supposed to show <br/>with fibromyalgia , but at this point of no pain meds. for 4 weeks I have resorted taking 3000 mg.s a day acetaminophen and for the first time in my life trying CBD with THC. Most of the time it helps ,but it is an awful feeling in my head, like I am high, which I hate. <br/>last week ( which will be my last appt.) I finally was prescribed Tramadol , which I've never had. I took one and first it did nothing for the pain and it made my chest feel really heavy and my heart was racing. I tried to take another one the other day with the same result. I called the pain clinic to tell them what my reaction was and they said they would get back to me. Chelsea at the pain clinic said they don't want to prescribe hydrocodone because they would have to keep increasing my dosage, which is NOT true as I have been on 5 mg. hydrocodone with 325 mg . for over 7 years with NO increase in dosage. <br/><br/>The thing that is so frustrating is I have been being treated successfully for a long time and I come down to Arizona to enjoy this time with my husband and friends, but spend more than 50% of my time dealing with pain and staying inside on my heating pad.<br/><br/>i understand why there is a crackdown on prescribing opioids. I get that people are dying from overdoses. But not all people are abusing these medicines, some of us are using them to make it possible to live our lives, but we are all being treated as drug abusers. The frustrating thing is you can look at my medical records and see my stable record. <br/><br/>What scares me is these laws to protect people from themselves are causing people like me to seek help from a pot shop.....if anybody had told me this I would have laughed at them. I'm not laughing now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	0900006484f9e066	Thayer	None	2022-02-23T19:29:16Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Thayer, Shirley	kzz-y59q-u3os	False	None	False	2022-04-12 03:14:49.289	[]
1386	CDC-2022-0024-1393	https://api.regulations.gov/v4/comments/CDC-2022-0024-1393	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Address how this draft corrects every one of the errors CDC and FDA and others have pointed out:<br/><br/>https://docs.google.com/document/d/1RzQDSppUKhjiAsEmhW2WbTXlP5V8vJ4M_vBPQLKhK_8/edit?fbclid=IwAR0tlDlD2It4KJzxxr9cSqAA_JARaa1GgAJN2tgiKFNMSQGEzSjTGPCDK_U<br/><br/>https://www.cdc.gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html<br/><br/>https://static1.squarespace.com/static/54d50ceee4b05797b34869cf/t/5caf661d7f312b0001bac1b8/1554998814907/Alford+Final+.pdf<br/><br/>http://freepdfhosting.com/0dc0977cdd.pdf<br/><br/>https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes<br/><br/>https://reason.com/2018/05/14/opioid-death-rates-are-not-correlated-wi/<br/><br/>https://heatherzamm.medium.com/the-secret-government-study-that-leveraged-the-opioid-crisis-the-truth-part-ii-124ea4dfec91<br/><br/>https://www.usatoday.com/story/news/health/2019/04/24/opioid-pain-pills-crackdown-doctors-prescriptions-cdc-fda/3562373002/?fbclid=IwAR1ZRyedTjKJUUW1csNE5ismHoksduErdAobpu7IO8JwwXMwz-0xU8cdj6k<br/><br/>https://www.painnewsnetwork.org/stories/2019/4/24/cdc-opioid-guideline-should-not-be-used-to-taper-patients?fbclid=IwAR03IESMuvkmdI2qJoXFIjq8XqvUMZYak7b5Myv4IhCo0QgFEwpiAdwl31M<br/><br/>https://www.cato.org/blog/cdc-researchers-state-overdose-death-rates-prescription-opioids-are-inaccurately-high<br/><br/>https://www.fda.gov/drugs/drug-safety-and-availability/fda-reports-quality-problems-data-provided-firm-iqvia-were-used-inform-estimates-some-controlled<br/><br/>https://www.practicalpainmanagement.com/resources/news-and-research/cdc-opioid-overdose-death-rates-over-reported-half<br/><br/>https://www.acsh.org/news/2017/03/25/cdc-opioid-guidelines-violate-standards-science-research-11050<br/><br/>https://edsinfo.wordpress.com/2016/09/08/cdc-guidelines-refuted-with-scientific-evidence/amp/?__twitter_impression=true	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9a16e	Anonymous	None	2022-02-23T19:52:34Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzy-3zi1-ekjo	False	None	False	2022-04-12 03:14:49.508	[]
1387	CDC-2022-0024-1394	https://api.regulations.gov/v4/comments/CDC-2022-0024-1394	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Update will cause more harm and add to the current Suicide Crisis. The previous 2016 Guidelines were based on inflated numbers and flawed data. There is data proving after the Fake Opioid Crisis, the real cause of overdoses is Illegal Street Drugs! The number increases dramatically on a daily bases and the CDC does nothing to address the real Crisis of Illegal Street Drugs flooding the border! These Illegal Street Drugs flooding the border remains the number one cause of Overdose in the US. <br/>Yet, the CDC with the help of certain Prop Members that helped co-write the previous 2016 Guidelines continue to leave people in pain in unbearable, nonstop pain and financial hardship? Why? Who is profiting? While Millions suffer to the point of suicide certain members of Prop associated with Rehab Centers at the time the 2016 Guidelines were written is still investing in Addiction Drugs and is a Paid Court Consultant using the very 2016 Guidelines they co-wrote with the CDC. The Guidelines based on inflated numbers and flawed data are used in Billion Dollar Lawsuits and to have Insurance Companies cover more and more cost of Rehab Centers and the cost of Expensive Addiction Drugs! Prop Members associated with these Rehab Centers do all they can to promote pain as addiction! The problem is Pain is not Addiction and this is not only a major Conflict of Interest, people that do not want to use Street Drugs and cannot take the pain anymore are taking their own lives! We now have a Suicide Crisis of epic proportions due to 2016 Guidelines and set MME based on inflated numbers and flawed data. The continued statements made by those that have never treated pain and are not Medically Trained and Licensed to treat pain and especially Chronic Pain should never have played such a major and important role in the writing of the previous Guidelines and certainly not the Update! Judges are also realizing these Billion Dollar Lawsuits are frivolous! It’s time to end this Pain for Profit and completely Remove the 2016 Guidelines and the current draft. Stop the Suicide Crisis and allow people in pain to function and have some quality of life. How inhumane does one have to be to deny Surgery Patients, chronic Pain Patients, patients in accidents, end of life patients the proper pain control. Stop putting people in pain thru unbearable suffering! Stop this Pain for Profit that has resulted in the largest Suicide Crisis of our time! Pain is not addiction! It is unbearable, nonstop 24/7 agony! Please help those suffering!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9e0ce	Anonymous	None	2022-02-23T19:53:44Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-ywsg-gruk	False	None	False	2022-04-12 03:14:49.726	[]
1388	CDC-2022-0024-1395	https://api.regulations.gov/v4/comments/CDC-2022-0024-1395	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE PULL THESE GUIDELINES: The overdose rate has nothing to do with legal prescription drugs taken as prescribed by those in need for pain relief, be it from surgery, Chronic pain, cancer, auto accidents etc. look at the illegal drugs coming into our borders instead and focus there. Doctors are smart enough to be able to tell when someone is misusing or doctor shopping, but instead you feel the need to tell them what to prescribe. As a 22 year chronic pain patient, I will say I was functioning much better prior to 2016 when I was properly treated with opioids and treated as a human being. I ran my own small business accounting services for local Non Profits, raising 3 kids, volunteering, doing my civic duties in my community. That is not the case now, I never know if I will feel good enough to function each day and if it is a good day for how long it will last and if I do try to be a normal part of society how many days after that will I pay for it and be in bed in unresolvable pain. It is inhumane to allow someone to needlessly suffer. Put this back into the hands of doctors and patients to decide what is best for each patient. These decisions should not be made by someone sitting behind a desk with no contact to patient care. There is no one size fits all when it comes to patient care. LEAVE THE DOCTORS ALONE, QUIT MAKING THEM AFRAID TO TREAT THEIR PATIENTS !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9e0f4	Anonymous	None	2022-02-23T19:54:06Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-z178-ed44	False	None	False	2022-04-12 03:14:49.937	[]
1389	CDC-2022-0024-1396	https://api.regulations.gov/v4/comments/CDC-2022-0024-1396	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gregg	None	None	0900006484f98e18	Kervill	None	2022-02-23T19:56:40Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-21T05:00:00Z	None	None	None	None	None	None	None	Comment from Kervill, Gregg	kzx-0wfm-x1ng	False	None	False	2022-04-12 03:14:50.156	[]
1390	CDC-2022-0024-1397	https://api.regulations.gov/v4/comments/CDC-2022-0024-1397	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you CDC for continuing to address our nations opioid epidemic. It is critical, however, that CDC address our worsening opioid epidemic in the face of more states legalizing cannabis for both medical and recreational purposes. There is a pervasive, false narrative that the use of cannabis for pain will improve drug overdoses, but there is a strong correlation between expanded cannabis legalization and the worsening drug crisis	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kenneth	None	None	0900006484f81d04	Finn MD	None	2022-02-23T20:43:09Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-17T05:00:00Z	None	None	None	None	None	None	None	Comment from Finn MD, Kenneth	kzr-3t16-rnrv	False	None	False	2022-04-12 03:14:50.373	[]
1391	CDC-2022-0024-1398	https://api.regulations.gov/v4/comments/CDC-2022-0024-1398	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While the guidelines have been largely focused on the abuse and overdose of opiates, it is critical not to lose site of the fact that marijuana use frequently, if not always, precedes the abuse of opiates. <br/><br/>To this point at a minimum, a urine drug screen should be carried out upon consideration of the use of opiates, and this screen MUST include cannabis. <br/><br/>Furthermore, the coexistent use of marijuana (cannabis) for pain is a sham, and should not take place. The risk of opiate overdose and death clearly is associated with marijuana. Legalizing states such as Colorado as an example have seen staggering increases in opiate overdose deaths associated with marijuana legalization. <br/><br/>Eric A. Voth, M.D., FACP<br/>Internal Medicine, Pain, and Addiction medicine<br/>President- The International Academy on the Science and Impact of Cannabis<br/>https://iasic1.org	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f96380	None	None	2022-02-23T20:45:06Z	The International Academy on the Science and Impact of Cannabis	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from The International Academy on the Science and Impact of Cannabis	kzt-vpqw-kh73	False	None	False	2022-04-12 03:14:50.591	[]
1392	CDC-2022-0024-1399	https://api.regulations.gov/v4/comments/CDC-2022-0024-1399	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been lucky to never have needed pain meds until recently. I’ll be 70 years old in November and am just now having knee problems. I’ll be using a cane till early summer at least ( already got appointments for mri and x-rays). My only option for the pain is otc medication which really don’t help much. My primary physician doesn’t prescribe anything for pain because he doesn’t want to deal with the legal and regulatory loopholes. I understand that there has to be some guidelines but they seem to have gotten to a point where some people are suffering needlessly. We should trust our physicians knowledge and experience, that they will treat their patients as is best for quality of life. I’m thankful my inconvenience is only for a few months but I’m very concerned about patients who have long-term pain issues. Let’s keep regulations to a minimum so that our physicians can help us as efficiently as possible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fred	None	None	0900006484f9e531	Guzman	None	2022-02-23T20:46:11Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Guzman, Fred	kzz-zie0-h1aq	False	None	False	2022-04-12 03:14:50.808	[]
1393	CDC-2022-0024-1400	https://api.regulations.gov/v4/comments/CDC-2022-0024-1400	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think it is important for doctors to watch closely who they give Opiates to but not refuse to give a patient these drugs when nothing else has worked for them.I am such a case.In my mid 20s I moved into a rental house that was severly infested with fleas,I was bitten hundreds of times by them,I then became ill with something that gave me a fever of 103,headache,a rash all over my body & total from head to toe body pain in my muscles.I went to my doctor & since it was Febuary he just assumed I contracted the flu inspite of not having a sore throat or vomiting.Months down the road I never got over the low grade fever of 100 to 101,never got over the total body pain.The pain worsened so the doctor started giving me different arthritic drugs & NSAID drugs that did nothing to help but did make my life even more misurable because of drug side effects,I would go back to the doctor again & again just to have him switch my meds to another drugs that did nothing to stop my full body pain,this same doctor assumed I had adult rheumatic fever after my mother had talked with him because she was upset I was not getting better.He started giving me PenVK injections every 3 weeks.I endured these injections for 6 months until I could not,I went to another doctor.This doctor did tests on me for everything he could think of plus did a test on me for this rheumatic fever stuff even after I had told him hours prior to my visit with him the doctor that I have been going to just did that test.Well the results of the 2 tests,the original doctor was positive but the new doctors was negative & that doctor advised me to stop getting the PenVK injections because if a person don't need a heavy duty antibiotic the antibiotic will harm other organs in that person's body.He then sent me to a rheumatologist that did hios tests & said he felt I had fibrosis.But here I was doing the same thing with the NSAIDS that did nothing to relieve my full body muscle pain that got worse & worse to the point it made me become disabled & unable to work,me a single mother of 3 small children that received no child support from the father of the children.To make a much longer story shorter,I finally made my way to Kansas where I live now.I went to my new doctor & explained what I have been going through for over 20 years with all the prior doctors I seen about this same full body pain.I told him that my pain started a few days after I got hundreds of bites by fleas & that the pain was in all my muscles not in my joints.well he did an arthritic blood test that showed if their was any inflamation in my joints which needless to say no <br/> joint inflamation was found,he told me I had Fibromyalgia & because I had tried every NSAID on the market along with muscle relaxers & even drugs like Elvil & some others that didn't help just gave me horrible side effects,he broke down & gave me that oxycontin drug.I was amazed my pain I suffered with for over 20 years was not completely relieved but so much of it was gone I felt like a new person,then after a few weeks the drug started giving me a bad headache I reported it to the new doctor so he sent me to a pain clinic.that doctor changed my meds to Morphine(MSCONTIN ER)30mg 3 times a day.well that worked & worked well,but I started suffering from bad constipation.Talking with my doctor I ask him to take 3 of the 30 mg morphines away & just give me the 1-30 mg for in the porning & a 15mg at night while I sleep since I am not trying to do house work & the like while I am asleep.That has proven to be the best meds for my Ills for now nearly 29 years.If the doctor would have never given me this drug I would still be in so much pain I wouldn't be able to type this.This drug & others like it are a huge benefit to people like me.I think doctors should be open to give these drugs to people that truly need it,that they need to take the time to tell people that they are giving the drug to that it is addictive,and most IMPORTANT,THAT THESE DRUG DO NOT TAKE AWAY ALL THE PAIN SO DON'T EXPECT THAT.this at least will give the person the knowledge to not expect total pain relief so they don't decide to start taking more of the drug to get rid of the rest of their pain.which in turn causes the addiction & abuse of these types of drugs.EDUCATION that these drugs will not 100% take all the persons pain away is a MUST because some injury's & or sicknesses like I have 3 to 7 days only of the drug may not be enough time to heal & the person might need a few days more or as in my case YEARS of this drug so I can have some sort of a life.you will never get rid of the drug abusers that just want to get high off drugs,Doctors need to be very educated on them types & refuse to give them the drugs.But for those of us that truly need it & do not abuse it,the medical people need to also be EDUCATED in NOT assuming a person is a drug abuser after they get told the person takes morphine drugs prescribed to them & start looking for injection marks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484f9e5a7	Helm	None	2022-02-23T20:49:51Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Helm, Janet	l00-0yb3-vd6p	False	None	False	2022-04-12 03:14:51.031	[]
1394	CDC-2022-0024-1401	https://api.regulations.gov/v4/comments/CDC-2022-0024-1401	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is very important to revise your recommendations so that patients with chronic pain are able to receive their medications and are not limited by 7 day rules made for acute pain patients. Actually these patients should not be confined to 7 days either. Imagine having a leg fracture and having to go to the pharmacy every 7 days. Likewise, many chronic pain patients have difficulty getting to the pharmacy even every 30 days because of disability caused by chronic pain. They also experience difficulty getting refills of their prescriptions if they change insurance companies or doctors. Because of the threats states have made to doctor’s licenses, many are fearful of writing these prescriptions at all, and patients are made to suffer. They fear changing pharmacies, drug plans or physicians— they are essentially locked into one provider, one pharmacy and one drug plan. Doctors have to jump through hoops like checking the automated pharmacy system with every prescription. The pendulum has swung so far toward forbidding these opioids that many patients suffer unimaginable and unmanageable lives of pain which could be treated with medication we already have. You should take away the arbitrary limits from your previous recommendations and show some compassion.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484f9e5bc	Brinker	None	2022-02-23T20:50:16Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Brinker, Debra	l00-1229-yna1	False	None	False	2022-04-12 03:14:51.284	[]
1395	CDC-2022-0024-1402	https://api.regulations.gov/v4/comments/CDC-2022-0024-1402	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cdc-22<br/><br/>My name is [name redacted] , my medical history is nuanced and complex. I was sent away to “wilderness therapy'' at age 13. I know how the addiction industry feeds vulnerable people into the various prison pipelines. I had brain surgery at the age of 14. About a year earlier I had started having headaches frequently. The MRI showed a cyst in the midbrain region and it was called a pineal cyst-nonsymptomatic. I eventually felt the headaches evolve from daily headaches into something else, I began passing out, vomiting, having heat flashes, out of options I elected to have the cyst removed. after harsh recovery and continuing dysautonomia pathology.<br/>The thing about brain recovery is that it is strenuously painful. you are sleeping 12 hrs a day, you have to stay away from electronics and blue light, and walk2 hrs . After the acute phase, I went to Michigan to visit a chiropractor. I spent a week going to multiple daily appointments that involved many nonpharmacologic treatments, but my pain is still daily. I likely will live with pain my entire life, I can accept that and plan accordingly<br/>. I feel that I have been through enough pain and medical gaslighting to decide whether or not I am in a sufficient amount of pain; especially from academic psychiatrists who rarely deal with actual patients on a clinical level.<br/> looking into the citations it seems as if a group of doctors has been blowing their studies out of proportion to retain grant money that funds more studies that they cherry-picked. When brought to their attention they responded in ad hominin and accusations of taking money from pharma companies. during which they are taking funding from shatterproof pacira pharmaceuticals, Rummler hope network,indivior,pain script algorithms, and expert witness in opioid lawsuits where they exaggerate statistics. The barrier to healthcare cannot be understated and the widespread multi-intersectional consequences profound<br/>How are multiple board members of PROP simultaneously the board of scientific counselors? Why is the CDC endorsing fringe science and going against their weaning guidance? why is the CDC lying about the reliability of the mme metric? Why did Bluecross Blueshield and the DEA send in fake patients with fake imaging? Why does [name redacted] believe every opinion in support of any opioid is funded by the pharma industry; when he has taken money from pacira pharmaceuticals, alkermes, adapt, CVS, Suboxone. Why did he try to lobby for every physician to be held to the guidelines dosing and duration based on studies contingent on measurements that have four different equations? Both the CEO and the VP of shatterproof believe that ALL opioids should be taken off the market.<br/>[name redacted] is an expert witness for opioid class actions across the nation receiving hundreds of thousands each time simultaneously, he was going around new york financially incentivizing suboxone [name redacted] is also the co-founder and executive director for PROP.he was also involved in the FDA failed to petition the original guidelines while codirecting<br/>Brandis universities funded over 8 million federally. he was also chair of psychiatry at phoenix house funded over 8 million federally. he was also chair of psychiatry at phoenix house who was reported by Reuters to have persistent regulatory violations and resident patient concerns dating back several years<br/><br/>[name redacted] is on the [facility name redacted] and conducts research for [facility name redacted] while consulting with PROP. why do you repeatedly find the same people on different boards and organizations at high-level positions; sometimes sitting at the board that oversees the same studies. these same doctors, whenever confronted about the facts of current prescribing-throw a thermonuclear piss fit whenever confronted by the fact that very vulnerable disabled populations including veterans cancer patients, and surgical patients. They feel the need to prop up hysterical and racial stereotypes. They feel the need to universally label all people with chronic pain taking a drug they see as immoral.<br/><br/>Many of the following logical fallacies<br/>Absence of evidence is equivalent to evidence of absence<br/>You can reliably equivalent opioid analgesics<br/>The conflation of dependence and addiction <br/>The conflation of illicit and licit opioids.<br/>Misconstruing terminology lies dependence withdrawal persistent use misuse abuse<br/>You can equivalent oral ingested extended-release and intravenous heroin<br/>And many more <br/><br/>It is evident to me that this quack science and its immoral disingenuous doctors are going to force the CDC to do what the FDA said they couldn't. They will enforce the 50 mme as a universal ceiling which it is not. They know this will send more people to the streets; they couldn't care less. In Fact, they are only doing these comments from the public is that the whole guideline is so secretive it would have violated the first amendment. I don't need a single [vulgar word redacted] person questioning my lack of willpower or the viability of my suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	shannon	None	None	0900006484f97377	Broughton	None	2022-02-23T20:54:29Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-19T05:00:00Z	None	None	None	None	None	None	None	Comment from Broughton, shannon	kzu-fodt-3g9p	False	None	False	2022-04-12 03:14:51.701	[]
1396	CDC-2022-0024-1403	https://api.regulations.gov/v4/comments/CDC-2022-0024-1403	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC panel in charge of opioid dosing:<br/>Folks: <br/>I am a long term opioid patient and the previous rulings on opioids affected me quite adversely. <br/>I have multiple health issues that cause me great pain and discomfort. <br/>I do not have nor ever had a problem with overdosing but the current rules caused me not only increased physical pain but costs which I cannot afford if I were to be on my old formulary. <br/>My insurance company told me very clearly that because of the rules in effect that they would no longer cover my prescriptions, but I was welcome to pay for them out of pocket ( ~$5000/month) - for OxyContin ( which is ridiculously expensive even for the generic) . My doctor ( who is a pain management specialist ) had to juggle my medications to try and keep me reasonably comfortable and still avoid a menu of hot dogs and beans while paying for my medications. <br/>My old doctor stopped doing pain management because of the new mandates as did many other doctors, I was VERY fortunate to get accepted by a new doctor in my area. <br/>The current rules in effect are HURTING people like me and have done little to solve the real problems. <br/>I ask two things: <br/>Please rewrite your guidelines to allow realistic dosing of legitimate patients and allow their doctors to do so without fear of recrimination, and:<br/>Make it a requirement of your staff who are responsible for the opioid issue to watch the HULU series DOPESICK. This is a very well researched and accurate depiction of WHY we have an opioid problem and why Purdue made millions off of people dying from legal drug dealing. <br/>Thank you for your attention to my comments.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	robert	None	None	0900006484f9cb4f	applegate	None	2022-02-23T20:55:23Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from applegate, robert	kzy-wnas-t4id	False	None	False	2022-04-12 03:14:51.913	[]
1397	CDC-2022-0024-1404	https://api.regulations.gov/v4/comments/CDC-2022-0024-1404	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>I am a chronic pain sufferer who is struggling to get help. I use physical therapy, non-opioid treatments like plasma rich protein and cortisone injections, I even do cognitive behavioral therapy at Cleveland Clinic for chronic pain.<br/><br/>While I agree those modes should be added in CONJUNCTION with opioid use, it should not be used instead of!<br/><br/>That is all the physicians will provide me with, alternative therapies, and my life quality is so low. I can’t play with my 6 year old. I can’t even walk a quarter of a mile. And I’m only 35 years old.<br/><br/>Doctors are too afraid of government crackdowns to use their own common sense. I agree that not everyone should be on opioids and they should be used sparingly. But guildelines like this that only BRIEFLY mention for doctors to use their best judgment, isn’t advocating at all for the chronic pain patient who can’t get care because all of their doctors are afraid to prescribe.<br/><br/>I think we’ve come a long way with urine tests, pull counting, contracts, etc that should deter illegal activity. But just flat out suggesting to doctors not to prescribe it is wrong. <br/><br/>It’s a sad sad world right now for people with chronic pain. I’m sure there are so many suicides from people who can’t live in pain anymore and can’t find a doctor to help. I know I’ve considered it before but could never leave my son. <br/><br/>But I do fear my future. I’m only 35 and my pain is so bad and uncontrolled and doctors hands are tied. I can’t imagine living like this for the rest of my life.<br/><br/>Consider LIFTING some of the restrictions on prescribing, while ENCOURAGING doctors to use the measures mentioned above to prevent misuse, like opioid contracts, pill counts, drug tests, etc.<br/><br/>That way we can minimize abuse while maximizing care for chronic pain patients.<br/><br/>Thank you for listening. I beg of you. I’m literally on my knees begging. Help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484f9cd83	Kippelen	None	2022-02-23T20:56:08Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Kippelen, Michelle	kzz-0fvt-djox	False	None	False	2022-04-12 03:14:52.142	[]
1398	CDC-2022-0024-1405	https://api.regulations.gov/v4/comments/CDC-2022-0024-1405	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My doctor made my dose from 7.25 to 5.00 of Norco. I am disabled 63 year old and they really help. When I need them	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lenora	None	None	0900006484f9cd8b	Sexton	None	2022-02-23T20:56:36Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Sexton, Lenora	kzz-0n5j-6i75	False	None	False	2022-04-12 03:14:52.354	[]
1399	CDC-2022-0024-1406	https://api.regulations.gov/v4/comments/CDC-2022-0024-1406	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What does it say about society when the elderly are denied legal and safe pain relief in order to have a good quality of life but the supply of morphine is endless when Grandma is in hospice?<br/>I'd say not much. <br/><br/>Relax with the paranoia of addiction in old <br/>People.<br/><br/>Quality of life is all we are asking for.<br/>Not to be accused of being drug seeking junkies<br/>When we want medicine to have on hand<br/>For when the pain is unbearable. <br/><br/>Rarely these days do you hear about prescription <br/>Pain medication overdoses. <br/>Instead you hear a lot about Dr's <br/>Getting arrested for medicaid fraud.<br/>I guess this is the newest thing.<br/><br/>Give drs back the ability to prescribe<br/>Using their good judgment. Just because <br/>You have pain you shouldn't be afraid <br/>To ask for relief and doctors shouldn't <br/>Be afraid to say yes to patients..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tonesha	None	None	0900006484f9cd8c	White	None	2022-02-23T20:56:55Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from White, Tonesha	kzz-0p7z-9vmz	False	None	False	2022-04-12 03:14:52.562	[]
1400	CDC-2022-0024-1407	https://api.regulations.gov/v4/comments/CDC-2022-0024-1407	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC claims they could only find one study about long term efficacy, yet this study is cited in the bibliography of the one cohort [name redacted] study you did include. Why, because it did not fit your anti-addiction bias and supported long term use? How many other studies exist that you excluded because it did not yield the answer you wanted?<br/><br/>Eleven studies (1025 patients) compared oral opioids with placebo for four days to eight weeks. Six of the 15 included trials had an open label follow-up of 6–24 months. The mean decrease in pain intensity in most studies was at least 30% with<br/>opioids and was comparable in neuropathic and musculoskeletal pain. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cf12	Anonymous	None	2022-02-23T21:03:06Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-6s6t-toam	False	None	False	2022-04-12 03:14:52.780	[]
1401	CDC-2022-0024-1408	https://api.regulations.gov/v4/comments/CDC-2022-0024-1408	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 73 years old and have suffered with chronic pain from osteoarthritis and assorted sports related injuries for over 40 years. I have managed back pain with acute episodes since I was 30. My Pain Dr. and GP are both sympathetic. I parse out micro doses of Tramadol, which has been “upgraded” to a Class Something or Other Controlled Substance since it started giving me relief 15 years ago when I herniated my L4 and L5 discs. I’ve had numerous surgeries including total ankle replacements for both feet. I still play tennis as actively as my beat up body allows. I do everything I can to manage my pain. I keep a pain journal. I average less than 2 full 50 mg Tramadol per week, halving the pills and fortifying them with 500 mg Tylenols, which greatly enhances the Tramadol’s effectiveness for me. I realize some people get in trouble with Tramadol. I tolerate it really well and find it does not slow me down and constipate me the way traditional narcotics do. I fully realize that the more I use it the less well it will work. So I work at using as little as possible. I mix and match physical therapy, yoga, a daily nd now sometimes multi-daily stretching routine, varied exercise, Celebrex (an RX NSAID), Kratom—another story altogether (which the DEA, which should be abolished, wants to limit my options), Green tea. You name it. If it helps with my pain, I'll incorporate the substance or practice into my life. I stopped drinking alcohol over the past few years because it doesn't help with my pain. Similarly medical marijuana, tho I use some of the topicals. I have some leftover real narcotics from my most recent surgeries which I hoard—taking slivers of with 500 mg Tylenol when my back acts out with acute pain adding in to my daily challenges. I know my Docs don't want to give me anything stronger than Tramadol. They've become gun shy given the Opiod crisis, which I know is real. Seems to me the pendulum has swung far enough toward repression in prescribing narcotics. Would that the CDC and others could recognize nuance and that while risky and life-threatening for many, narcotics can and should be used judiciously for others and that each person should be treated an individual case of one. unfortunately my Docs, very good people, work with increasing documentation requirements from the Feds, insurance companies, etc. etc. and spend most of their time with eyes on the screen rather than me and their other patients. I talk to a lot of other old people with chronic pain in their lives. Old folks trading post op stories, back pain stories, chronic pain from other sources, etc. etc. And we all notice the change over the past few years in our Doc's willingness to prescribe. I've run into Nurses and Nurse Practitioners who were clearly trying to screen me as a drug-seeker from their Docs and didn't give a shit about me or my pain. And I hear the similar stories from others. These nurses and others are part of a larger totally dysfunctional entity: the so-called American Health Care System. <br/><br/>God Help Us. We all are. See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	0900006484f9e627	Holcombe	None	2022-02-23T21:15:16Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Holcombe, Bill	l00-1lj4-jarm	False	None	False	2022-04-12 03:14:52.990	[]
1402	CDC-2022-0024-1409	https://api.regulations.gov/v4/comments/CDC-2022-0024-1409	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Five years after the Centers for Disease Control and Prevention initiated a crackdown on opioid pain medications, experts have concluded the policy has been a miserable failure. Overdose deaths have gone up, not down, and now, courts are starting to recognize the arguments used to justify the crackdown are largely bogus.<br/>“So these numbers, they just push these false numbers and now you have courts of law calling them out,” said [name redacted] <br/><br/>As a Las Vegas physician, [name redacted] has a unique vantage point from which to evaluate the great opioid crackdown. {name redacted] is a pain management doctor and an attorney who represented patients who suffered pain after being denied legal medications. <br/>Of the 50 million Americans plagued by chronic pain, about 20 million depend on prescription opioids to try and lead somewhat normal lives. Since 2016, those millions have suffered immensely because of a war on legal pain meds. <br/>“Chronic pain patients are basically in a fight for their lives,” [name redacted] said. “They’ve been under attack for several years now with this. Antiopioid sentiment and sort of the overreaction to the opioid crisis.”<br/>{name redacted] says the campaign against opioids is largely about money. More than 1,500 civil lawsuits have been filed against drug companies by state and local governments, including in Nevada, as officials and trial lawyers eye multibillion dollar settlements. But the lawsuits, most of which accuse big pharma of being a public nuisance for causing the opioid epidemic are starting to fall apart.<br/>In California this month, a lower court tossed out a huge lawsuit with a scathing opinion that found the underlying facts don’t support the allegation that 25% of opioid patients get addicted. And in Oklahoma, the state’s supreme court reached a similar conclusion and held that the benefits of opioid meds far outweigh the risks. <br/><br/>“But the litigation narrative, the narrative that the trial lawyers want to push is that it’s prescribed opioids that are causing all of these deaths. This huge upswing in opioid deaths has occurred because of fentanyl, yet they continue to pound this drum that it’s prescription opioids, causing the deaths and the reason they are is because this is being driven by litigation by the people involved in this. Aren’t talking about millions of dollars, they’re talking about billions and billions of dollars. So if it hurts a few chronic pain patients, and if they’re collateral damage, you know, I guess they look at it as you’ve got to break a few eggs to make an omelet,” [name redacted] said. <br/><br/>But prescription drugs are not the cause of a spike in overdose deaths. Ninety thousand overdoses were recorded in 2020, a huge increase, but 87% of those were caused by illegal street drugs, notably fentanyl and heroin, not a prescription medication. Cutting down on prescriptions hasn’t worked because legal pain patients are not the ones overdosing. <br/><br/>One outspoken advocate for chronic pain patients, [name redacted], says the CC’s own statistics prove the crackdown on prescription opioids is unwarranted.<br/><br/>“So seniors, who get the most opioid prescribing have the lowest rates of opioid overdose related deaths by a factor of three to one,” [name redacted] told Mystery Wire. “Kids under the age of 19 have the lowest prescription rates for opioids. And they have a rate of opioid related overdose death, that is three times that of seniors.<br/>So what I’ve been telling people for the last roughly four years is that you can’t explain this inversion of demographics, by any model that proposes that prescribing is the problem or the cause of addiction. It’s not there, it has never been there. So what we are seeing is, statistics of the CDC itself demonstrate that the logic behind the 2016 guidelines is bogus. It’s flat not supported by the data that CDC itself has reported. But CDC has chosen to ignore the data, and instead to enlist the opinions of people who were hand-picked as anti opioid advocates, who may even believe the nonsense that they talk. But they’re lying through their teeth.” <br/><br/>Studies show less than 1% of them become addicted, not 25% as alleged in the lawsuits. Millions of patients who followed the rules and their doctors have been cut off altogether or had their dosages slashed. Suicides among those patients jumped 470%, many of them veterans in pain who were cut off by the Veterans Administration. Patients are starting to fight back by suing doctors and hospitals who deny legitimate medications. <br/><br/>Also coming under scrutiny are the very same anti opioid crusaders who crafted the CDC’s opioid crackdown in 2016. Several are now working as expert witnesses in lawsuits against big pharma. <br/><br/>“One person, [name redacted] who is a psychiatrist with no formal postgraduate training and pain management is an expert witness for again, Oklahoma case against Johnson and Johnson Pharmaceuticals. His expert witness fee for that case reportedly is $500,000.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9ce2d	Anonymous	None	2022-02-23T21:33:59Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-5sp0-i8tk	False	None	False	2022-04-12 03:14:53.218	[]
1403	CDC-2022-0024-1410	https://api.regulations.gov/v4/comments/CDC-2022-0024-1410	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For those of us that suffer severe chronic pain, we are not able to have a life. The pain becomes our life. Some of us have gone through steroid injections only for them to stop working and now am dealing with pre-diabetes or diabetes as a result. There has to be a way to address this situation do that people that really need the help can get it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9cdef	Anonymous	None	2022-02-23T21:34:09Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	kzz-3776-v5ww	False	None	False	2022-04-12 03:14:53.432	[]
1404	CDC-2022-0024-1411	https://api.regulations.gov/v4/comments/CDC-2022-0024-1411	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am now 2 years plus with no tx for my pain 24/7 I yet again tried anything that was recommended to me and nothing worked. I even paid out of pocket for a medication for a year and that did not work. I had to cut my food bill and go with out some things to just afford it. I am on ssdi and its hard. I used to be able to function but now with out my script I can not. my elderly parents are watching me deteriorate and get worse. I am having issues just doing things I need to do on a daily basis such as eating, cleaning that up, showering. I dont shower daily. maybe once a week. Mentally the effects have been overwhelming and I had depression and ptsd dx prior. When I first had pain I was told it wa sin my head. Then doctors treated me and I refused opiates at first. Then after trying things a doctor just said to try opiates. They informed me I could be addicted and would be on them for the rest of my life. I accepted those terms at that time because I wanted quality of life. Guess "you will be on them forever" was a lie. No doctor will prescribe to me. Before I lost my script I was trying a patch which didnt stick to me. The CDC guidelines created a hostile environment and constant fear of loosing them because everyone around me was. I told my dr it was not working and she upped the patch. I kept telling her and she was not listening. It was xmas and she snapped at me in email. I figured I would wait till after the holidays and go back to my pills. I stupidly put on a used 2patch. I ended up having an overdose. Sitting in fromt of the heater made the patches release more I was told. They should not have "revived" me if this was my fate. I never really ever thought about suicide and ending my life until now. I have no plans to do it but if this is all I have and wont ever get them back I dont stand much of a chance of a life. I am falling apart and this is too hard. I never abused any drugs growing up. I dont even drink, never have. Then they were pushing me into addiction med. The things put in my file are obscene and straight out lies. The doctors who saw that just cut and paste the bad info again and again. No one really just writes what was talked about. They put their own angle on it. Its not what I report. I am told they cant change whats in my file. Am told no doctor really believes whats in therebut the other time speaking to him he got mad the file was not accurate. I told him member when you said... he got mad. Told me to go to addiction med cuz they are specialists in opiates. I keep asking for them cuz they worked. I tried everything and had landed in the ER due to the side effects. I finished a pain management program and they will not script opiates they say its too dangerous ... so not being able to take the pain and killing myself is better? Why would you deny a patient this care esp with the deadly fent on the street? So many are going to the street. I refuse to. Never have and never will. My doc told me I belong in Pain management and this doctor wont treat me. SO my pup is telling me to get a second opinion. I asked another program and they told me I would have to do their program then. When I went long distance to do the one I completed I asked if I had to do the program again. I was told no. But here I am. No doctor wants to write for me... No dr wants to help me. I asked if it was cuz of the cdc and the DEA being out of control and the doc silently nodded. They are scared and as a result doctors have lost their oaths... Do no harm has become do lots of harm. I dont trust my doctors. They recommend things to try that are not in my best interest. Never did they suggest this before when I was open and willing to try anything to avoid opiates. I cant do infusions they are hard on your heart and I cant have another seizure or I loose my driving ability. I dont want to trip while getting ketamine either. Suboxone pushed on me hard and 2 yrs ago I told them no cuz I need my teeth cuz I am poor ... super poverty and cant replace them. Dr said no but FDA just said YES! I need them since I am hypoglycemic from another condition. I drop fast and unexpectedly reacting to foods and sometimes just because. I am so tired. I dont like not being able to trust my dr. I want the doc pt relationship back. As things are there is no trust.. not sure if it will ever come back really. The cdc have done this damage. I was told by many nurses that this happens sadly and if it was not hte opiate epidemic I would have been put on a strict probation and given a script again. this is not compassion. they dont listen, no one is. Yes I did make an error but does that warrant a second chance? I was not abusing it. I since found out others who the patch didnt work for and they said they dont react to it well. The patch would not stick to me .. which is why I had more pain cutting my pils. If the goal is to kill people off then just say so. make it humane. why? it was not scripts on the street the problem help! too short	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484f9cdec	Jane	None	2022-02-23T21:36:21Z	None	None	1	None	2022-02-23T05:00:00Z	None	None	2022-02-22T05:00:00Z	None	None	None	None	None	None	None	Comment from Jane, Jane	kzz-33lg-s5qx	False	None	False	2022-04-12 03:14:53.675	[]
1405	CDC-2022-0024-1412	https://api.regulations.gov/v4/comments/CDC-2022-0024-1412	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's nice for the federal government to admit it's mistake after years of suffering and death . Do we really have another 3 to 6 months or a year for revised guidelines. We need the federal government to step aside and let the physician and the patient come to the correct treatment. Also I would hope the federal government has better things to do than monitor patients and doctors and keep a narcotics report card. Lastly it's ok to take prescribed pain meds that are a combination of morphine and suboxone costing 20 times the cost of inexpensive morphine sulfate to regulate pain so once again it's all about the money. Please get rid of these restrictions immeadiately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hugh	None	None	0900006484f9e6a0	Patterson	None	2022-02-24T14:31:49Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Patterson, Hugh	l00-3u0d-sf7w	False	None	False	2022-04-12 03:14:53.885	[]
1406	CDC-2022-0024-1413	https://api.regulations.gov/v4/comments/CDC-2022-0024-1413	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient who has been on 5-325 mg of hydrocodone for over 6 years with no issues regarding overdosing, because I am a responsible patient. How much, how often I take this medication it makes life manageable, not pain free. And a physician and patient should be allowed to manage pain without worry of repercussions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484f9e6f1	Gallagher	None	2022-02-24T14:32:08Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Gallagher, Kathleen	l00-51b6-zf0s	False	None	False	2022-04-12 03:14:54.111	[]
1407	CDC-2022-0024-1414	https://api.regulations.gov/v4/comments/CDC-2022-0024-1414	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe that not all individuals are addicts to opioids and some really are chronic pain patients and need the medication to function on the daily. Most take it at the exact dosage given and need to work to support themselves and their family. Doctors should be able to give their opinion and make the calls on what a patient needs, no one knows each other's medical history other than them or what they've gone through. As there is a lot of scarcity around opioids in today's society, it doesn't mean that patients should be treated differently if needing opioids or doctors being scared to lose their license on their recommendation or insurance companies taking advantage and upping the prices of medications. I do believe a small set of guidelines are needed/helpful; however, I support the uplift on the restrictions that have come with them so that patients can feel better, and their caregivers can treat them right.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	T	None	None	0900006484f9e77b	L	None	2022-02-24T14:32:35Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from L, T	l00-74wf-k2a4	False	None	False	2022-04-12 03:14:54.343	[]
1408	CDC-2022-0024-1415	https://api.regulations.gov/v4/comments/CDC-2022-0024-1415	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been personally affected by the 2016 decision of the CDC to alter the guidelines regarding prescribing opioid medications to those who are in chronic pain for more than 3 months. My husband has had two back surgeries that have adversely affected his quality of life. Before 2016, my husband was being prescribed Hydrocodone at 30 mg per day (three 10 mg hydrocodone tablets per day). This medication allowed him to be able to function and perform basic chores in our home such as cleaning house, taking out the trash, washing clothes and mowing the yard (on a riding mower). When the guidelines changed in 2016 his family doctor would no longer prescribe Hydrocodone for my husband. I have seen him slowly deteriorate before my eyes because he is in constant pain. We have tried everything under the sun to try to get him some type of relief from constant pain and nothing works.<br/><br/>Our efforts at pain management can be compared to putting a band-aid on an amputated limb. We have tried physical therapy, over the counter medications, topical creams, tens units, ice packs, heating pads, massage and anything anyone suggests that will work for chronic back pain, but nothing has worked. I've been forced to become the breadwinner because he is unable to keep a job due to the constant pain he is in everyday. Some days when I come home from work, I worry that he may have resorted to suicide because he can no longer live with the pain he is in. He has promised me that he would NEVER do anything like this and I believe him but I wonder how much one man can suffer through without giving up. I do not say these words easily and tears are flowing as I compose this message. I pray to God that someone will hear my plea. I want you to understand that there are situations where individuals need relief and that relief comes in the form of medications. <br/><br/>Believe me, I understand opioid addiction and the consequences suffered as a result. My brother passed away in 2009 from an opioid overdose and his body was left on a graveyard by his "friends" because they were afraid to take him to a hospital. So I TRULY understand the pain caused by opioids and opioid addiction. BUT opioids can help those people that NEED relief from debilitating conditions. My husband is 61 years old and I am 56. I'm hoping that we will be able to enjoy the few years we may have left, if I get to retire someday. At the moment it doesn't look like we are going to be able to enjoy much of anything because we are busy struggling to make it through another day. I just want to live like "normal" people do. I want to come home from work without a constant fear of finding my husband has ended his days of suffering himself because his doctor won't/can't prescribe him medication that allows him to function without suffering. <br/>Should he have another back surgery and another back surgery and another back surgery? There's no guarantee that is going to work since he as osteoarthritis and once you repair one section of the spine another gives out and you are back to square one. For God's sake, hear my plea. Help those people who don't deserve to suffer through each day. I'm praying that someone at the CDC understands. <br/>I feel that one of the main reasons that so many overdoses began to occur when the CDC changed the opioid regulations in 2016 was because doctors stopped giving their patients the lifesaving drugs they needed to live. In our experience, my husband went to his primary care physician and he was told by his doctor that he would immediately stop prescribing the pain medication he so desperately needed because the regulations had changed and he couldn't prescribe pain medications any longer. So, my husband did not taper off of the medicine but this did not matter because it was the mandated guidelines, we were told. <br/><br/>It is my opinion, in 2016, people who were in constant pain and were no longer prescribed opioids by their doctors sought medications from sources that were unreliable. I'm assuming the medications they consumed were from unregulated suppliers and laced with ingredients that caused their deaths. My husband and I would never resort to anything like this or break the law. But others have and it cost them their lives. I suppose the people that resorted to buying drugs from the streets and other unreliable sources were willing to risk their lives to get relief from debilitating pain they suffered, no matter if it cost them their lives. <br/><br/>I don't really think my words will make a difference or even be read, but they are all I have to contribute. Opioid regulations probably won't change and my husband will probably suffer the rest of his days. But, he won't be the only one that suffers. I suffer each day as well. I suffer when I see him struggle to move, to walk, to sit, to rise, and to live a somewhat normal life. I’m begging you ~ please help us. Thank you.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9ee5e	Anonymous	None	2022-02-24T14:36:10Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l00-dah9-h7yb	False	None	False	2022-04-12 03:14:54.598	[]
1409	CDC-2022-0024-1416	https://api.regulations.gov/v4/comments/CDC-2022-0024-1416	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Before the Guidelines were introduced, I was on a stable dose of opioid medication and was able to function as long as I paced myself.<br/><br/>Now, I have been force tapered to half the dosage that enabled me to have a normal life and I am BEDRIDDEN and HOMEBOUND. <br/><br/>You need to stop persecuting and demonizing pain management physicians and chronic pain sufferers with, "Guidelines" and implementing the DEA to support your misguided policies. <br/><br/>The government should focus on preventing illicit recreational drugs being imported through our southern border and from China and get out of our doctors' offices.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maureen	None	None	0900006484f9ee8e	Roland	None	2022-02-24T14:37:50Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Roland, Maureen	l00-hati-r1au	False	None	False	2022-04-12 03:14:54.846	[]
1410	CDC-2022-0024-1417	https://api.regulations.gov/v4/comments/CDC-2022-0024-1417	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel compelled to write this letter so that hopefully someone will actually read it. <br/><br/>I have been prescribed opioid pain relievers for over 30 years. In the early days, no one knew why I had such horrible pain. Since 2008, I have had the diagnosis of psoriatic arthritis. My joints are slowly crumbling away while the tendons remain swollen and painful with small tears. There is no cure. I also have Emory-Dreyfus Muscular Dystrophy and cardiomyopathy due to a genetic defect. Again, there is no cure. My core and large muscles slowly turned to a fatty fibrous tissue over the years. Even sitting up now is difficult and painful. <br/><br/>I am a Registered Nurse. I worked in the ED, pediatrics and at the VA Hospital caring for our Nation’s heroes. I was stabilized on a daily dose of Oxycontin 120mg per day. I had been on that dose successfully for over 10 years. I never made any errors or caused any patient harm. I never ran out early or had any issues needing refills before they were due. But I worked long hard hours on my feet in the career I loved; caring for people who needed my help. I kept a huge garden by hand in my off time and fed my elderly neighbors for free with the excess produce. When the 2016 guidelines came out and my happy life as I knew it ended. <br/><br/>My provider said she was being pressured by the medical group and threatened that she had to move all of her pain patients to under 90MMEs per day. That meant I went overnight from 120mg daily to 60mg daily. There was no taper, no discussion, nothing to help with the withdrawal. I tried, I kept trying to live my life, work my job at the level my employer had come to expect and be the wife and mother my family deserved. It was a failure in the making. I lost functioning quickly. I got up from a long night without much sleep and cried for the fear of the long day I was about to endure. The pain made it difficult to even get dressed. Once I drove the hour to my job, I could barely get out of my car. The new lower dose barely kept the worst of the agony at bay. I cried more than I spoke. I called off my job until I was out of PTO and then I tried going on FMLA so I could attempt to recover between my shifts. I bounced from job to job for over 2 years. Then the reality hit, I was going to have to stop working. It was no longer safe for me or my patients. December 2018, I filed for disability. What a horrible, disheartening thing to have to do at the age of 46. Even more disheartening, SSI agreed that I was totally and permanently disabled, I didn’t need to appeal or get a lawyer or even go to their doctors. They read my medical records and saw what a nightmare I live. <br/><br/>Now I stay home all day every day. I don’t bother getting dressed or much of anything else. I get up from my bed in pain around 3am and move to the recliner in the living room where I might get another hour or two of sleep before my household wakes up. My husband does everything in the house. Takes care of our daughter and me. <br/>I stay in the recliner or laying flat on the sofa until evening when I sit in the shower and cry some more. Then I crawl into bed where I can’t even enjoy being intimate with my husband. I pray for sleep until the pain wakes me again. <br/><br/>Now the newest guidelines are set to come out and you say that 50MME is the new max dose a provider should “carefully think over” before prescribing above. Please explain why you would put in any MME level when you admit that it was an error to list the 90MME limit in the 2016 paper. What authority do you have to decide what is better for me than my Doctor of 20 years? You have never seen my medical record nor examined my tortured body. Quite simply, you have no idea what medications I should be taking nor how much. My provider actually warned me in October 2021 that this second round of reductions was coming and wanted me to try marijuana because she knows how bad my pain is. I can’t stand the smell or taste of marijuana and it is not even legal in my state of Wisconsin. <br/><br/>It is proven that despite the low level of prescription opiates being prescribed, the rate of overdoses has continued to rise sharply. You claim to be highly educated doctors and scientists. Common sense is all that is needed to see that prescription opiates are not the problem. Illicit fentanyl and internet pill mills are the real problem. If you continue to put the 50MME limit in the revised guidelines, you will see that same outcome, less opiates being prescribed and more overdoses occurring at an exponential rate. I can promise you that some of those who will die of overdose will be under treated chronic pain patients doing whatever they can to help ease some of the constant suffering. <br/><br/>These guidelines should have never been written in the first place. Medication choice and amount needs to be a conversation between the patient and their provider.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484f9e8c9	Woodberry	None	2022-02-24T14:42:52Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Woodberry, Laura	l00-ohmh-outg	False	None	False	2022-04-12 03:14:55.074	[]
1411	CDC-2022-0024-1418	https://api.regulations.gov/v4/comments/CDC-2022-0024-1418	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer and have been since a severe injury in an auto accident where I was told by the operating surgeon that I was lucky to not have lost a limb that was affected and is the main cause of my chronic pain. <br/><br/>I have been on many medications over the years to manage my chronic pain. I PREVIOUSLY had been on an amount that managed my pain and function ability well enough. I am NOT on that amount presently. I am on less. It is NOT managing my pain/function as well. I have been told by my pain management provider that the CDC says they have to reduce the amount of ALL medications to a total of 90mg or below, and that rather than be right at 90mg, BELOW 90mg was the preferred amount.<br/><br/>I was told by a pain provider that that CDC guideline was just that, a GUIDELINE, for Primary Care physicians in particular, and not a MANDATE for ALL providers. That Pain Management providers, different from Primary Care physicians, have the ability to evaluate every patient's pain and prescribe medications accordingly, but that THEY ARE AFRAID that if they go above those recommended 90mg guidelines, the CDC and any other regulatory body will look at them with a critical eye and reprimand them somehow. When told that to one of my providers she said ** "We go by the CDC guidelines. If you don't like it go somewhere else." That pain providers have no care of their patients' well-being BECAUSE THEY FEAR THE CDC or don't ask the CDC for clarification, causes providers to think this way and causes unnecessary anguish for patients with chronic pain.<br/><br/>The medication amount where my pain is manageable does NOT take all the pain away. It's the LEAST amount that I can tolerate pain that's still there and function somewhat normally, but due to my provider's fear of the CDC I'm forced to suffer more pain that the reduction causes. Even a small reduction means I sleep more to get away from the additional pain. I do less of any activity due to the extra pain. I live with a certain amount of pain in order to not take a higher dosage or stronger medication. However, if I'm told I have to live with more pain than I feel is tolerable, you are pushing me to get relief elsewhere. TOLERABLE does NOT mean NO PAIN!<br/><br/>I was told that at my next appointment I will now be reduced further. <br/><br/>I was also told by my provider that I could not call to have the reduction returned to the previous amount, even when they know it causes me more pain. That I would have to suffer the additional pain until my next visit in 2 months. My normal visits are every 2 months, but they have now instituted a "well check" visit in between those 2 months where I'm asked questions about my health and pain, but can't talk about my medications until my regular 2 month visit. Personally I feel it's a money grab, another visit that is billed for nothing more than questions that can be asked at the regularly-scheduled visit.<br/><br/>I feel that the CDC and other regulatory bodies don't have any people that have actual experience with chronic pain and they just make arbitrary pronouncements about what they believe will alleviate someone's chronic pain. There are all kinds of pain that respond to different medications and amounts. A pain management provider said they can certainly tell if someone is abusing their medications and treat them accordingly without affecting other patients. I'm seen every 2 months (with the exception of that "well check" visit) because they have treated me for years and can see I don't abuse my medications. Yet they don't take that into consideration for fear of the CDC, et al.<br/><br/>I am not taking my medications to get high. I am not selling my medications for money. I am trying to use the least amount that will alleviate my pain so that I can function somewhat normally. That doesn't mean I have no pain at all. However, when I keep getting my medications reduced because someone arbitrarily decides a certain amount will manage my pain, it just means I have to deal with more pain for a longer period of time. THAT arbitrary decision would make me want to supplement my medications by going to street-level drugs in order to not suffer more pain longer. I can certainly see how people can go that route. I'm not that type of person so I suffer the PRESCRIBED additional pain.<br/><br/>PEASE be more empathetic to chronic pain sufferers. Let providers distinguish between abusers of their medications and those that aren't, and medicate accordingly. Don't lump all pain sufferers into one category which only penalize the many against the few. EMPHASIZE TO ALL PROVIDERS THAT GUIDELINES ARE NOT MANDATES AND THEY WILL NOT BE PENALIZED FOR USING THEIR JUDGEMENT WHEN PRESCRIBING!!!!<br/><br/>** Your initial dictate was EXTREMELY punitive to ALL chronic pain sufferers who couldn't go anywhere else as no provider would touch them due to fear. That is still the case today. We are at their mercy. And yours.<br/><br/>We need pain relief and nothing else.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9e8de	Anonymous	None	2022-02-24T14:44:27Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l00-qsuz-mexy	False	None	False	2022-04-12 03:14:55.307	[]
1412	CDC-2022-0024-1419	https://api.regulations.gov/v4/comments/CDC-2022-0024-1419	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with chronic back pain for 20 years, two years ago ago prior to the pandemic I moved to another area and have yet to find a physician who will refill my prescription for my medication. They treat me like I am so sort of drug addict. My options are to drive four hours to see my doctor who has taken care of me for 20 years or give up. At 68 years old this medication allows me to live independently with quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f11b	Submission	None	2022-02-24T14:45:28Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Submission, Anonymous	l00-ymks-x89u	False	None	False	2022-04-12 03:14:55.550	[]
1413	CDC-2022-0024-1420	https://api.regulations.gov/v4/comments/CDC-2022-0024-1420	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make provisions for legacy patients. Compliant chronic pain patients, like myself and my husband, who’ve demonstrated over many years that they follow all the rules and do not abuse their meds should not be treated like addicts or abruptly force tapered or dropped. Physical dependence is NOT the same as addiction. By constantly throwing up roadblocks up for stable compliant patients or subjecting good doctors to fears of losing their license you are sending patients to the streets and we all know that doesn’t end well. If a patient and doctor can document that there has been years compliance with no problems, LEAVE THEM ALONE!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484f9f1db	Carneal	None	2022-02-24T14:46:20Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Carneal, Pamela	l01-20a2-wqpr	False	None	False	2022-04-12 03:14:55.781	[]
1414	CDC-2022-0024-1421	https://api.regulations.gov/v4/comments/CDC-2022-0024-1421	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic Pain Patients are not seeking to be gymnasts. We are not wanting to go skiing. We only want to be able to shower, cook a meal, go to a family dinner. Please let our doctors treat our pain. Pain meds are not evil! They can be a blessing! We need to have some quality of life!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484f9f22e	W	None	2022-02-24T14:50:57Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from W, S	l01-32wd-26x2	False	None	False	2022-04-12 03:14:56.012	[]
1415	CDC-2022-0024-1422	https://api.regulations.gov/v4/comments/CDC-2022-0024-1422	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 72 year old Clinical Psychologist who has been in practice 40 years. I have dealt with many who have chronic pain. Due to the restrictions of the recent past, an increasing number of patients are experiencing uncontrolled pain. When patients are talking to their doctors, there is a third presence in the room (at least one), the FDA. Doctors reign in their prescriptions to avoid losing their licenses or having problems with the government. Despite this opioid belt-tightening, the deaths from opioid abuse increase.<br/><br/>AS A RESULT, MANY PATIENTS HAVE NOW TURNED TO MEDICAL MARIJHUANA OR THE BLACK MARKET for general pain control. I know people my age who have a marijuana card and MANY OTHERS who have a dealer for marihuana (in states where it is not legal or in situations where <br/>it is too expensive in the dispensaries). Does this make sense? I am not saying that I have an answer, just that we should look at the whole picture here. Many patients are humiliated to ask for more help with pain control and be turned down with no explanation. One person not typically on opioids but with increasing spinal pain asked for medication to keep on hand in case of a pain flare-up and was told, "That's not happening." Is that a medical opinion or fear? <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	PRISCILLA	None	None	0900006484f9f236	BRIGHT	None	2022-02-24T16:14:44Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from BRIGHT, PRISCILLA	l01-3bbe-k5mx	False	None	False	2022-04-12 03:14:56.243	[]
1416	CDC-2022-0024-1423	https://api.regulations.gov/v4/comments/CDC-2022-0024-1423	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 82 year old man suffering from osteoarthritis. My doctor prescribed 90 5 mg oxycodone tablets per month to control my pain. The cost of this med is covered by Medicare at a very low cost. I also have VA insurance but the VA will not prescribe this med for me.<br/><br/>The VA has prescribed many different meds for me to control the pain but none of them worked. These meds included morphine, tramadol, codeine and many different antidepressants.<br/><br/>The only side effect I receive from oxycodone is pain relief. I don't get high and I don't get dizzy. Just pain relief.<br/><br/>I moved to Arizona from California and bought a house 100 yards from a golf course. I was hoping to play golf three of four times a week but I cannot do that because of the pain in my hips. By the time It takes 5 to 6 of the oxy pills to get me through a round of golf. I would like by dosage to be increased to 7.5 mg but my doctor will not do it and I know he is concerned about my well being due to my advanced age.<br/><br/>I am one of the people this drug was designed for and it angers me that the street addicts out there have made if very difficult for people like me to get the drug to ease the pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JOSEPH	None	None	0900006484f9f72b	SOPRANO	None	2022-02-24T16:16:50Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from SOPRANO, JOSEPH	l01-4hvf-bwd4	False	None	False	2022-04-12 03:14:56.475	[]
1417	CDC-2022-0024-1424	https://api.regulations.gov/v4/comments/CDC-2022-0024-1424	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 61 year old female. I’m on disability due to four failed spinal surgeries. I also have RA and fibromyalgia. I stay in constant pain. I was put on opioids 20 years ago. Due to the MME limit I was forced to taper my meds six months ago. I never thought I’d see the day that I was denied adequate pain relief due to the CDC. If you issue new guidelines and put a MME limit on meds it’s going to hurt many more chronic pain patients. So much damage has been done to innocent patients who take their medication Responsibly. I’m praying the new guidelines have no mention of a MME limit. Enough is enough.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f741	Anonymous	None	2022-02-24T16:17:53Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-4jx7-b73n	False	None	False	2022-04-12 03:14:56.769	[]
1418	CDC-2022-0024-1425	https://api.regulations.gov/v4/comments/CDC-2022-0024-1425	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove Any and All mention of MME from all 229 pages of the report.<br/>MME is irrelevant in terms of pain patient needs and dependence. Age and length of treatment mean more than that. <br/>Do not teach incoming medical professionals the wrong way to treat patients!!!!<br/>This will have DISASTROUS results.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f747	Anonymous	None	2022-02-24T16:18:25Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-4spv-u685	False	None	False	2022-04-12 03:14:56.997	[]
1419	CDC-2022-0024-1426	https://api.regulations.gov/v4/comments/CDC-2022-0024-1426	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove Any and All mention of MME from all 229 pages of the report.<br/>MME is irrelevant in terms of pain patient needs and dependence. Age and length of treatment mean more than that. <br/>Do not teach incoming medical professionals the wrong way to treat patients!!!!<br/>This will have DISASTROUS results.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f758	Anonymous	None	2022-02-24T16:20:17Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-4sqc-myng	False	None	False	2022-04-12 03:14:57.270	[]
1420	CDC-2022-0024-1427	https://api.regulations.gov/v4/comments/CDC-2022-0024-1427	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient since 2006,I have tried many therapy options. PT,accupuncture,injections,muscle relaxers, cymbalta, Lyrica, antidepressants,x-ray guided SI joint injections,nerve blocks,celebrex, and OTC medications,ALL have failed. The only thing that has worked for me is combination opioid medication. With the current guidelines in place, it's harder every month to obtain these medications.I endure random urine screens, pill counts,bloodwork and doctors visits. The whole MME system needs to be eliminated all together due to varying factors in how opioid medication is metabolized in the body.No two people are alike and absorption rates are as unique as each one of us are individuals. It's unethical to put restrictions on an individual's pain and quality of life due to a MME formulation that isn't accurate. I work in healthcare, and without my current regimen of medication,I would be completely bed bound. My quality of life has dramatically increased due to the use of opioid therapy.I am fully aware of the risks and side effects,as with any medication.My point is, please let doctors be doctors and treat pain. It's barbaric the direction we are into right now. Nobody should be having surgery and denied pain medication.I have conditions that will never get any better,but opioids keep them manageable.The real issue is heroin and illicit street drugs.Too many people have lost their lives due to restrictions put on doctors about prescribing. Why are we in the pain community being singled out? Diabetics aren't denied insulin, cancer patients aren't denied chemotherapy so why should chronic pain patients have to suffer? Remove the DEA from the doctors offices and drop the MME formulation altogether, and let people live,and have quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jovita	None	None	0900006484f9f759	Anderson	None	2022-02-24T16:23:27Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anderson, Jovita	l01-4sx2-iuxr	False	None	False	2022-04-12 03:14:57.518	[]
1421	CDC-2022-0024-1428	https://api.regulations.gov/v4/comments/CDC-2022-0024-1428	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 62 ye. Old man living in Florida where l intended. To retire and lie out the rest of my life with my wife. We are financially stable and we're looking forward to our retirement. My wife is a chronic pain patient and l have watched this amazing spirited woman become a shell of what she once was due to the 2016 CDC GUIDELINES drafted by a select group of individuals who have conflicts of interest and are obviously anti opioid zealots! Now after review of the proposed new Guidelines l know that the harm done to her will continue be austere changes are not going to help physicians who treat her pain nor her, nor the millions of others who remain in pain. First, let me start by saying the MME is not based in any scientific evidence that makes the standards required. Second it should be completely removed due to the fact that it is not a one size fits all situation and my wife is a "fast metabolizer" then what? <br/>The Guidelines should be rescinded as pain is not a contagious disease and the CDC has done nothing but harmed patients and my wife further. Monthly, l watch my wife suffer with PTSD due to her Dr. being concerned about continuing to treat patients because the rogue DEA has not been told to stand down, so that she fears each month that the following month he may have quit or the DEA went after him for treating pain something his is trained to do? It is beyond me why our government has chosen to punish the aging community with such rigid and ridiculous suggestions that states turned into law. We have been forced to move due to a lack of Healthcare in certain areas in FL. In addition there have been Dr's who insist upon invasive non FDA injections or no pain medication? I have watched my wife suffer in additional pain for that ploy as well. In my opinion, the FDAs refusal was accurate and you should not attempt to rewrite any Guidines!! Rescind in thier totality! The rewrite cannot be done by non-treating psychiatrists, individuals with conflicts of interest, et. Al. Please stop all the harm you are doing and let the physicians do thier job and treat patients. By the CDC own admission, overdoses in our age bracket have remained stable and extremely low under the care of a physician who is able to diagnosis! Further please stop allowing pharmacists to shame or further delay the process as all my wife wants is a quality of life in her retirement! Enough is enough!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Henry	None	None	0900006484f9f75b	Gross	None	2022-02-24T16:27:25Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Gross, Henry	l01-4txc-0n90	False	None	False	2022-04-12 03:14:57.780	[]
1422	CDC-2022-0024-1429	https://api.regulations.gov/v4/comments/CDC-2022-0024-1429	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I found the revised guidelines for opioid prescribing encouraging. However, these changes need to be further expanded to permit primary care physicians to manage chronic pain issues. Pain management has become a steroid pushing business in which patients are refused care if they don't qualify for injections. Patients who need narcotic meds to function are forced to sign unreasonable agreements but are never warned of the dangerous side effects of long term steroid use.<br/>As a retired R.N., l've witnessed this sad trend in my career and personal life.Specifically, regarding the current edict of not prescribing benzodiazepines and narcotics concurrently. I've safely administered these medications together for years without incident.<br/>Primary care doctors are focusing on loss of licenses and reprimands and totally neglecting patient pain needs. l've researched the current addiction rate of prescription drugs and statements in the media regarding this situation are exaggerated and false.Patients deserve to be treated humanely and not as drug seekers. The misguided and weak-willed behavior of addicts has ruined what is a basic human right to a decent quality of life.<br/>In summary, what is needed are rational prescribing guidelines instead of a "no prescribing" edict which leads to patient suicide, depression. Immobility, loss of function, isolation and extended recovery times.<br/>Thank you for your consideration.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f7c0	Anonymous	None	2022-02-24T16:39:01Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-5z9w-2lck	False	None	False	2022-04-12 03:14:58.010	[]
1423	CDC-2022-0024-1430	https://api.regulations.gov/v4/comments/CDC-2022-0024-1430	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 26-year-old daughter, [name redacted], is an extremely intelligent, articulate, creative and beautiful young woman. Anyone blessed with these attributes should be well on their way to a wonderful and fulfilling life. But [name redacted] is suffering in ways that most people could never imagine. Diagnosed at 13 years old with Complex Regional Pain Syndrome, formerly known as Reflex Sympathetic Dystrophy (CRPS/RSD), an incurable and progressive chronic pain disease of the sympathetic nervous system, she lives every day in severe pain.<br/><br/>Report ad<br/>CRPS/RSD is ranked as the most painful form of chronic pain that exists today by the McGill Pain Index. With the advice of numerous physicians over the last 13 years, we have tried every possible remedy and every possible treatment. None of them worked. So many days, I can only hold her in my arms as she cries in agony. The only thing that eases her suffering slightly is her prescription of opioid medication. Yet the government, in a short-sighted effort to combat widespread opioid abuse, wants to take [name redacted] lifeline away. She, along with many others in her situation, are apparently considered collateral damage.<br/><br/>Collateral damage is not acceptable. Our military does the best it can to minimize collateral damage on the innocent and unintended targets even if it means sparing the intended targets. This is supported by not only by our government, but by the international community as well. And it should be that way. It’s compassionate.<br/><br/>Report ad<br/>Why, then, is our government inflicting cruel and unusual punishment for innocent victims here at home? They are putting extreme pressure upon physicians, under the threat of being removed from their practice, to reduce and/or eliminate the levels of prescribed opioids to all patients. But there will be collateral damage to this. Tens of thousands of people who have chronic pain will suffer. For them, there is no relief without opioid medication, and for whom the reduction or the elimination of their medication will cause unspeakable pain and even death.<br/><br/>The United Nations Universal Declaration of Human Rights states in Article 5, “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.” Medical doctors in the United States take the Hippocratic Oath that states, “I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous.”<br/><br/>Report ad<br/>How can we be in direct conflict to both the Declaration of Human Rights and the Hippocratic Oath, and cause immense suffering to those of us who are in chronic, incurable pain? How can we reconcile the fact that, as a country, we can show compassion and lend assistance to refugees, and send food and medical aid to Third World countries, yet allow our family and friends to be denied the medication they need to survive?<br/><br/>It is because we are only being shown one side of this story. What we are not shown are the millions of patients in the USA alone who, but for their opioid medication, would be left in constant and excruciating pain. Taking away their right to be treated for their pain is the real opioid crisis.<br/><br/>Sadly, there are thousands of people who die from the over-the-counter drug ibuprofen every year. There are tens of thousands of people dying from their antidepressants and benzodiazepines. There are hundreds of thousands of people who die from complications associated with anticoagulants. Although these numbers are tragic, we would not want to see the physicians associated with these prescriptions threatened. This, however, is exactly what is happening in the case of the opioid crisis.<br/><br/>This is Unacceptable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kindy	None	None	0900006484f9f204	Lemmon	None	2022-02-24T17:00:35Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Lemmon, Kindy	l01-2loa-phwr	False	None	False	2022-04-12 03:14:58.245	[]
1424	CDC-2022-0024-1431	https://api.regulations.gov/v4/comments/CDC-2022-0024-1431	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescribing guidelines should be individual patient-based not a group base because each individual patient reacts to the medication’s in their own way and has pain in their own way being a chronic pain patient I get Inferential injections about every six weeks the opioid medication that I am prescribed is to help me with breakthrough pain in between these times.<br/>My activity level and what I’m doing dictates the amount of pain medication I may need with these group guidelines that have been set forth by the committee it does not take individual pain into account.<br/>Every month when I go to the pain clinic to get my medication refilled I am made to feel like a drug seeking second class or lower class citizen just because I need these pain medication‘s for my daily life I do not like feeling like you’re being treated like a drug seeker due to chronic pain that I use these medication properly to combat. Again I feel prescription guidelines should be patient-based not group-based. Also tracking to fight patient abuse should be a tool used to whether a patient is using the drugs properly or not and not affect a large group of people that use them properly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karrie	None	None	0900006484f9f862	Kirkham	None	2022-02-24T18:44:04Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Kirkham , Karrie	l01-7iee-7eau	False	None	False	2022-04-12 03:14:58.485	[]
1425	CDC-2022-0024-1432	https://api.regulations.gov/v4/comments/CDC-2022-0024-1432	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to simply state what I see going on with the so called Opiod problem. What I see to be the problem is the fact that Drs and other professionals, decide a patient needs these medications, and then they get in trouble for prescribing such medications. I am certain, that as soon as that pt. gets cut off from pain medication he/she needs to function in life, is causing them to go to the streets looking for relief. Therefore making the situation even worse with illegal medications. There is a distinct line in needing, and abusing . The MME guidelines now, are too strict, and making physicians afraid to fix the pain WHY Should a person suffer in pain, when there is no reason for the suffering? Please let drs do the job they were trained for, and you will see a decrease on opiod deaths on the street. I feel that desperation, makes many of these overdose deaths, preventable. when you are abrubtly taken off your medication, it causes panic, and panic causes decisions, that should not have to be made.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kari	None	None	0900006484f9f867	sledge	None	2022-02-24T18:45:30Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from sledge, Kari	l01-7nq0-6unn	False	None	False	2022-04-12 03:14:58.727	[]
1426	CDC-2022-0024-1433	https://api.regulations.gov/v4/comments/CDC-2022-0024-1433	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Concerned citizen... Why would you suggest to punish all Drs & all people who have legimate pain by the actions of a handful. When you experience poor quality of life bc of pain you will fully understand! It's like removing all guns & ammo bc of the bad ones who carry them! Bc of wrecks, why not ban all autos?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f86b	Anonymous	None	2022-02-24T18:46:10Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-7vus-5u99	False	None	False	2022-04-12 03:14:58.962	[]
1427	CDC-2022-0024-1434	https://api.regulations.gov/v4/comments/CDC-2022-0024-1434	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Although I can appreciate the time invested by all involved in the re-draft of the 2016 CDC guidance on prescribing for pain, the damage is done. This effort may be met with well intentioned contributors, but it will be a monumental task to undo the damage on the state level involving many states if not nearly all. <br/><br/>When the US declared an “opioid crisis” there were federal funds offered to the states to adopt the guidance or some form of policy & many states passed legislation which weaponized the guidelines & caused a chilling affect to many practitioners which resulted in the under treatment of cancer related pain & long term chronic pain which I can attest to in both aspects. My state was one of the many states that accepted federal funds and passed legislation which tied many physician’s hands. <br/><br/>There are a few advocates who worked with legislators in their states to try and rectify these guidelines/laws & minimize the damage done for the past several years, but it took MANY long years to succeed. If you are fortunate enough to live in one of these states, you may see some positive change. The rest of the pain community will just continue to languish in a broken system. There was a Senator from my state (around 2017) who was instrumental in an attempt to right this wrong by assembling a steering committee but did nothing on the legislative level in my state to do away with said legislation or at the very least modify the law which affects patients both with cancer & long term chronic pain. <br/><br/>Unless the CDC & it’s revisionist attempt to work with legislators to undo the damage on the state level, I don’t see how this will help those of us who through no fault of our own, were dealt a band hand in life. As I’ve heard so many times… no one is immune to the same fate that has been the injured veteran, cancer, & pain patient’s reality. This is everyone’s cause! The really sad part of all that has transpired— we all know now, these chain of events did NOTHING to curb the illicit Fentanyl OD crisis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f895	Anonymous	None	2022-02-24T18:52:51Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-88h8-i9jw	False	None	False	2022-04-12 03:14:59.218	[]
1428	CDC-2022-0024-1435	https://api.regulations.gov/v4/comments/CDC-2022-0024-1435	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has been a chronic pain patient since [month and year redacted] 2003 due to being electrocuted with 480volts and 1 1/2 amps. While we’re glad that he’s alive it’s been a long road of surgeries and therapies and while they helped what they were meant to, nothing fixes nerve damage in his neck. He has tried every injection, procedure, therapy & medication to help him manage his pain, be it anti depressant, anti convulsive, opioid, and we found his medication & mg that allowed him some relief. Unfort it was 180mg of oxycodone a day. Needless to say, when the CDC come out with their “guidelines” he was cut back to 60mg a day and gets by hour by hour for over 4 yrs…his pain clinic allowed him to stay at 180mg as long as they could but then tapered him very quickly and because his pain was so high, it threw his heart in to very erratic a fib…178bpm with only 25% of his blood making it through his heart. Luckily we found a cardiologist that did a cardiac oblation to keep him from dying (Note not the Oxy he’s been on for years. that the CDC is trying to save him from) He is still on 60mg of Oxy & now 450mcg of Belbuca which does nothing so he’s going to get out of it. Also.. his Oxy is $5 and this Belbuca is $100 for the current dosage. He does use non THC CDB, (cuz his pain clinic would kick him out of it had THC in it which gets him a little relief but comes with a high price tag because of the high strength.<br/><br/>New CDC guidelines need to remove ALL mention of any MME. Leave prescribing medication & amount to the dr’s and require all states to remove their mandates to remove DEA & pharmacy involvement and pass legislation that protects dr’s. There needs to be a separation of rules for true pain patient & the addicts. <br/><br/>At this moment, my husband is 59yrs old and is in such pain he has tears running down his face, because any relief he can get is still 50 minutes away. Please think of these people when you rewrite these “guidelines”	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484f9fcda	Brutlag	None	2022-02-24T18:57:29Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Brutlag , Lori	l01-8sl6-ipx3	False	None	False	2022-04-12 03:14:59.453	[]
1429	CDC-2022-0024-1436	https://api.regulations.gov/v4/comments/CDC-2022-0024-1436	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is Barbaric!! The Pain Community is SUFFERING! Get rid of the 50 mme	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa0ac3	Anonymous	None	2022-02-24T19:21:40Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-bgnf-f9pw	False	None	False	2022-04-12 03:14:59.686	[]
1430	CDC-2022-0024-1437	https://api.regulations.gov/v4/comments/CDC-2022-0024-1437	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 67 years old and have several diseases. I am in severe pain most of the time. I have MS, RA, Thyroid, heart, Fibromyalgia, Spinal Stenosis, several degenerating disk in lower back.<br/><br/>I have tried OTC pain relief and Massage Therapy. They don't work. My pain keeps me from sleeping so I never feel well.<br/><br/>I don't think it's fair to keep certain medications from people like me that has chronic pain. I need some relief and I only take them when I need them. I have had opioids in the past, as a matter of fact I still have some from 2016.<br/><br/>Please hear us that have all the proof of having all these Diseases to get some relief. It interferes so much in my life.<br/><br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carla	None	None	0900006484fa0c98	Lussier	None	2022-02-24T19:22:28Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Lussier, Carla	l01-bvoz-l382	False	None	False	2022-04-12 03:14:59.960	[]
1431	CDC-2022-0024-1438	https://api.regulations.gov/v4/comments/CDC-2022-0024-1438	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 72 years old. At 63 I broke my back. I had complications and was hospitalized for 7 months in excruciating pain. I was stabilized on a fentanyl patch and 5 mg of oxycodone for break thru pain. I returned to life it was a miracle. I had been a long distance runner who had to learn to walk again. I had 3 weeks in patient rehab and walked out. Work and determination along with pain meds that allowed me to function. That was 2012. In 2016 at the CDC urging, I was taken off fentanyl cold turkey and given 3 pain pills a day. I almost died detoxing. I never came close to overdose or abuse. I was so grateful to be walking. I was up to 7 miles a day. In 2016, I was treated like a drug addict my fentanyl patch was torn off cold turkey and I have been barely surviving these last years of my life on oxycodone 10 mg 4 x a day. There are no more 7 mile walks as I can barely get out of bed to the bathroom. This is no improvement for a senior citizen. I was active and had a social life and never the sinful “high” that you all are so worried about. Thanks for taking the last years of my life and reducing it too bed ridden days. 40 pounds weight gain, swollen and painful feet and legs. Everyday pain that is unspeakable, no running or walking with friends. This is what the 90 MME limitation has done for me. I’ve never bought an illegal drug or even smoked mariajana in my life. I don’t drink, I don’t smoke. I am a bona fide miracle in 2012 only to be thrown back to suffering in 2016. My doctors who saved my life knew what pain meds I would need to live again. The CDC doesn’t know me personally with their high handed judge mental manor. The doctor’s were forced and intimidated into conforming. They were scared to lose their licensing.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484fa130c	Bodell	None	2022-02-24T19:24:28Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Bodell, Marie	l01-cetz-xbhv	False	None	False	2022-04-12 03:15:00.212	[]
1432	CDC-2022-0024-1439	https://api.regulations.gov/v4/comments/CDC-2022-0024-1439	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After my Multiple Sclerosis diagnosis, I learnt about Herbal Garden [email address redacted] and their effective MS Formula treatment through an MS support group on google, I quickly started on the treatment. Few months on the treatment, my tremors mysterious stopped, had improvement with balance and walking. When I completed the treatment, symptoms were gone, this MS Herbal treatment relieved my symptoms significantly. Thank you for giving those of us with Multiple sclerosis a new hope.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9fcd6	Anonymous	None	2022-02-24T20:05:40Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-8khq-v94f	False	None	False	2022-04-12 03:15:00.464	[]
1433	CDC-2022-0024-1440	https://api.regulations.gov/v4/comments/CDC-2022-0024-1440	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>On behalf of The ILC Charitable Foundation (TheILC) (https://theILCFoundation.org), we are providing our response to the call for public feedback on the draft CDC Opiate Guidelines.<br/> <br/>We are deeply concerned that these draft guidelines will further marginalize our heritable connective tissue disorder and pain communities, resulting in discharge from multi-team pain care, loss of primary care support for our pain, and the loss of opiate pain control pharmaceuticals that many heritable connective tissue patients depend upon to participate in society.<br/> <br/>Connective tissue is responsible for holding our bodies together. Muscles pull on bones through connective tissue; mesentery suspending internal organs is connective tissue, skin (and scar) integrity depends on connective tissue, the central nervous system is suspended within fluid filled connective tissue membranes, gastrointestinal tract motility depends on connective tissue, and joint stability requires intact connective tissue. Patients with heritable connective tissue disorders are often undiagnosed when they present at chronic pain clinics. Patient lives are profoundly impacted by pain, but that pain does not meet the definition of primary chronic pain. Instead, connective tissue vulnerability persists for more than three months (a lifetime), but healing is ongoing and never complete because of the genetic vulnerability/ imperfect healing. This subset of chronic pain sufferers needs to be represented in these guidelines with sensitivity to the known biological basis for their pain.<br/> <br/>Since connective tissue disorders are typically inherited in an autosomal dominant manner, half of the children of an affected parent are expected to be affected. Physicians managing patient chronic pain must recognize heritability as an alternate explanation and consider heritability as an explanation even in the absence of a known heritable connective tissue disorder diagnosis..<br/> <br/>Thus, heritable connective tissue disorder patients will receive poorer care than ever under these revised guidelines. Our community will be hurt in several ways:<br/> <br/>1.<span style='padding-left: 30px'></span>Heritable connective tissue disorders are under-diagnosed and under-studied. <br/>Patients are frequently excluded from clinical trials because of their complex pain and comorbidities. <br/>2.<span style='padding-left: 30px'></span>These opiate guidelines must acknowledge that our chronic pattern of acute and recurrent pain is valid, and cannot be expected to reach a state of ‘cure’ any more than inflammatory arthritis will.<br/>3.<span style='padding-left: 30px'></span>The very clear statement about outpatients with pain outside of sickle cell disease-related pain management, cancer pain treatment, palliative care, and end-of-life care explicitly excludes any diagnosis not mentioned. In so doing, these draft guidelines will explicitly deny ongoing opioid pain management to our community in spite of the obvious biological basis for our pain Our community needs, at a minimum, lifetime multi-disciplinary care and treatment equivalent to rheumatoid arthritis.<br/>4.<span style='padding-left: 30px'></span>The GRADE table for migraines demonstrates mixed findings. If heritable connective tissue disorders are not considered in every case, craniocervical instability, undiagnosed Chiari, etc will remain hidden in the clinical trial populations – and contribute to the cases that fail to discharge as cured.<br/><br/>5.<span style='padding-left: 30px'></span>The CDC’s guidelines do not take into sufficient account the effects those guidelines have on chronic pain patients. Regulators have created a climate of intolerance. Physicians stopped prescribing opioids. The negative climate has discouraged medical students from practising in pain management. Pain patients have been abandoned, and left without effective pain management. These new guidelines come closer to a solution, but they do not come close enough.<br/><br/> <br/>6.<span style='padding-left: 30px'></span>We are a collaborative non-profit and would welcome your questions. It is essential that these guidelines do not make the assumption that all pain that persists for more than three months has no underlying biological basis unless it is sickle cell, or cancer, or palliation. As currently written, our community will be denied access to appropriate pain management.<br/> <br/><br/>7.<span style='padding-left: 30px'></span>We thank you for having this open comment interval so that we can alert you to this unintended consequence lurking in these guidelines.<br/> <br/><br/>Dr. Katherine E. Wynne-Edwards, PhD<br/>Research Development<br/><br/>[email address redacted]<br/><br/>Sandy Smeenck<br/>CEO<br/><br/>[email address redacted]<br/><br/>Martie Whitaker<br/>Wellness Leader<br/><br/>[email address redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fa0064	None	None	2022-02-24T20:07:03Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from The ILC Foundation	l01-9fan-137f	False	None	False	2022-04-12 03:15:00.728	[]
1434	CDC-2022-0024-1441	https://api.regulations.gov/v4/comments/CDC-2022-0024-1441	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think that doctors especially pain management doctors have the knowledge to know what they should or should not be prescribing for their patients. I think they know more than the CDC about the care of their patients. To limit doctors from prescribing enough pain medicine to adequately keep their patients out of pain is not in the best interest of doctors and patients. This practice leads to cruel and inhumane treatment of those patients. When a person cannot control the severe pain they are in they become depressed,inactive and sometimes suicidal.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	envolved	None	None	0900006484fa16f8	citizen	None	2022-02-24T20:08:43Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from citizen, envolved	l01-d10y-h70w	False	None	False	2022-04-12 03:15:00.973	[]
1435	CDC-2022-0024-1442	https://api.regulations.gov/v4/comments/CDC-2022-0024-1442	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For me it’s like Groundhogs day. Each day I’m in pain before I open my eyes in the morning. First thing I must do is take the minimal dosage of pain medication, prescribed to me by pain management. I also take 4 Tylenol and 4 ibuprofen. The human body is not designed to take that much Tylenol in a day, doctors tell me I am harming my liver. Without it I would be right back in bed. I am so tired. I have no fight left. I have been swimming upstream all my life and it has gotten me nowhere. Tomorrow will be as long and painful as yesterday, I have no changes to expect. It is not going to change. I pay to go to pain management each month, take a drug test, tell them my pain is 7 or 8 on a scale of 1 to 10. Leave with my paper script for thirty days. For the doctor my pain is gone until my next appointment, for me it is right here holding me down. Smothering me but letting me breathe just enough that I don’t die. I am so tired. And no one cares. No one wants to step up and help an old woman with a genetic disease that will cause pain every day for the rest of my life. I have no hope of help, no hope someone will choose to care. No hope anyone will believe my pain causes suffering no human should have to endure.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawne	None	None	0900006484f9e784	Hodder	None	2022-02-24T20:10:39Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Hodder , Dawne	l00-7ey9-v5ij	False	None	False	2022-04-12 03:15:01.216	[]
1436	CDC-2022-0024-1443	https://api.regulations.gov/v4/comments/CDC-2022-0024-1443	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We need the 2016 guidelines rescinded . Having a doctor not be able to prescribe what works because of the government, we may as well live in Another country. The people that abused drugs then, are still doing it. The boarders are flooded with it and people die from illegal drugs. Meanwhile chronicle I’ll are dying in pain and this is inhuman. <br/>Let me add that Federal workers , regular workers, anyone on federal type insurance are not paying for opiods, not even tramodol, you got to many non medical people deciding what only a Dr should be free to do. Get out of our Drs office.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484fa18a1	Averett	None	2022-02-24T20:11:08Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Averett, S	l01-dckn-dwf2	False	None	False	2022-04-12 03:15:01.450	[]
1437	CDC-2022-0024-1444	https://api.regulations.gov/v4/comments/CDC-2022-0024-1444	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please fix how you treat us Chronic Pain Patients. Many of us can no longer function because of the forced limitations you've placed on our opioid medications. We are not ADDICTS we are people who have had our lives turned upside down because our bodies have betrayed us. We didn't ask for this pain and it destroys us everyday when we can't move or simply get out of bed because we are in some much pain. Many have given up because our government gave up on us and labeled us as addicts and decided that because we need pain medication to function that were obviously abusing our opioid. No chronic pain patients pain is the same, you can't fit us into a neat little box. Stop interfering in our very lively hoods, you think we want to waste away in bed because of our pain? We want to move and function just like everyone else. You've ostracized us with you actions and it needs to be fixed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicky	None	None	0900006484fa1d9c	Wagner	None	2022-02-24T20:14:34Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Wagner, Nicky	l01-ed2s-g97e	False	None	False	2022-04-12 03:15:01.692	[]
1438	CDC-2022-0024-1445	https://api.regulations.gov/v4/comments/CDC-2022-0024-1445	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If those thoughtless, soulless psychos have pain, they probably snort the highest dose of Oxycodone dipped in gold sprinkles	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9e82b	Anonymous	None	2022-02-24T20:17:16Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l00-c3zj-zcbd	False	None	False	2022-04-12 03:15:01.942	[]
1439	CDC-2022-0024-1446	https://api.regulations.gov/v4/comments/CDC-2022-0024-1446	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a pain patient who suffers from Spinal Stenosis, Osteoarthritis and hip issues and as you may well surmise my days are very uncomfortable! I have had 4 surgeries one on the right hip and three<br/>on my lower (lumbar) spine. In the early 2000 when the Stenosis condition was first uncovered I was already unable to function normally, however after my Orthopedic Md place me on a moderate dose of pain medication I began to function much better and could care for myself, work and maintain a home.<br/>Around 2017 prior to my first spine surgery my pain had increase so much my Dr placed me on 10mg<br/>Hydrocodone every 4 hours and initiated a exercise plan, after approximately 6 months he realized I needed surgery, laminectomy. It seemed to work great until one morning I woke up paralyzed from the waist down. Again surgery and again I was walking though in pain, he tried exercise and injections but with minimal results. So again my medications had to be reinstated and increased. <br/>6 month after we moved to Az, I found a Dr who refused to help my pain actually two Drs. One Dr who became my Family Doc referred me to a pain clinic. I gave the clinic the information from NC and they continued my medication. After I was in the clinic about 2 months they cut my dosage back and gave no explanation, OK I went on but functioned less.<br/>This last year as my condition progressed I literally begged for a return of my original dose as I was barely able to move without crying. They told me that because I was about to have another (3) surgery they would return the additional meds till the surgery. At present my spine is holding its own and I am waiting for an appointment (in April) for my hip. I have suffered all these years because of Federal Agencies CDC, DEA and FDA have listened to lies, misrepresentation, and manipulation of facts from people so called experts. These agencies obviously have done little research of presented information letting most so called experts make money off pain patients suffering by misrepresenting the true needs and conditions of people in unmanageable moderate to severe pain. I am begging you to stop listening to anti opioid people with their misrepresentations and find true balanced educated experts in the medical field who will best know how to share information that allows Drs to honestly care humanely and with integrity care for their patients.<br/><br/>I wish to indorse comments separately submitted to the Federal Register and widely published on social media by [name redacted].<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janine	None	None	0900006484f9ee93	Murphy	None	2022-02-24T20:23:14Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Murphy , Janine	l00-hm48-xy70	False	None	False	2022-04-12 03:15:02.252	[]
1440	CDC-2022-0024-1447	https://api.regulations.gov/v4/comments/CDC-2022-0024-1447	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If the CDC moves forward with these changes, then the pain patient should demand performance guarantees. We, as patients should fully expect a 100% result if we are directed towards these alternative treatments to opiates. If a steroid injection is recommended, then fine, but it should come with a guarantee. If a long, drawn-out physical therapy is recommended, then great, but at the end of it we should expect to pain free because that’s what we are seeking. If this can’t be guaranteed then we should be able to get our money back, including payments for the pain and suffering we endure while we wait for the miracle of pain free living to happen.<br/>Yes, I’m being a bit sarcastic here but I think it illustrates a point. If I’m a new pain patient and I’m being asked to go through treatments without any opiates introduced, then I think the pain and suffering a patient endures during this time should be compensated somehow. Doctor appointments can be several days to several weeks away in scheduling so what is the patient supposed to do during this wait? Suffer? Please, whomever will be making these decisions, answer that question! What is a person in pain supposed to do during the duration of their treatment? Do you get my point here? It’s a big ask of someone in pain to just go along with the journey that could be stretched out for weeks or months, often without any guarantee the treatment is going to work. Do I have to explain that any further?<br/>I’ve gone through every alternative treatment imaginable and with very few, if any, results. I’ve had around 9 steroid injections (Epi, facet, SI) and only one did much of a trick. Also, the effect wore off about a half year later. I’ve had dry needle with stim and Acupuncture at various times, which did absolutely nothing for me and I have had many of these treatments. I’ve gone through physical therapy (PT) during moments of extreme pain, pain that can almost make you pass out. I agree that PT is beneficial but it does nothing for immediate relief. So, what’s a patient to do, suffer? <br/>Now, imagine what the insurance companies doled out along with my co-pays. Many of these treatments were 100% out-of-pocket, my pocket. I would hate to know what I’ve spent over the years looking for answers. I know I’ve spent a lot! But, have I received a benefit, equal to my financial outlays? How about an emphatic, NO, to that? Frankly, I’m so turned off by my experiences and wasted money that I have a hard time considering any further treatments of any kind. If these treatments are doing nothing for me then why in the world should I keep doing down that road. It’s like beating ones’ head against a wall. I’ve grown tired of being nothing more than an experiment.<br/>So, if the CDC can’t fix the problems I’ve mentioned, then I think we need to take a much different stance on opiate prescribing. I see this proposal seeking to avoid using opiates as a first line treatment, causing unexpected consequence. We’ve already observed what the Cures Act of 2016 has done to pain management and I don’t see the new proposals addressing this problem on the alternative treatments. They don’t often work, they’re expensive and it just promotes undue suffering. These highly touted alternative treatments definitely need more scrutiny because, from my lengthy experiences, they seem like an expensive farce.<br/>Keep opiates as a choice in all pain cases and stop promoting something that is questionable in its efficacy. If we don’t do this, we’ll continue to see patients seeking their cure for pain in the illicit streets. It’s time to take the blinders off and see this problem in its entirety.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fa2212	Cook	None	2022-02-24T20:25:15Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l01-f1ad-5pp9	False	None	False	2022-04-12 03:15:02.485	[]
1441	CDC-2022-0024-1448	https://api.regulations.gov/v4/comments/CDC-2022-0024-1448	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Rescind the 2016 CDC Pain Guidelines. Totally rescind and withdraw the 2016 CDC Pain Management Guidelines, which have been employed to the detriment of pain patients. Let physicians and surgeons use their education and experience to help their patients. Punish lawbreakers, yes, but don’t punish pain patients. <br/><br/>You say not to enter PII, but you require it: name, address, phone number. <br/><br/>“ Do not submit personally identifiable information through this form. Any personally identifiable information (e.g., name, address, phone number) included in the comment form or in an attachment may be publicly disclosed in a docket or on the Internet (via Regulations.gov, a federal agency website, or a third-party, non-government website with access to publicly-disclosed data on Regulations.gov). By submitting a comment, you agree to the terms of participation and privacy notice.”	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fa2584	Andrews	None	2022-02-24T20:26:26Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Andrews, Michael	l01-fjoc-n35r	False	None	False	2022-04-12 03:15:02.758	[]
1442	CDC-2022-0024-1449	https://api.regulations.gov/v4/comments/CDC-2022-0024-1449	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 60 years old and a retired RN. I have worked with many patients with pain disorders due to debilitating illness, cared for my husband (deceased) who suffered from RSD due to a partial spinal cord injury along with chronic degenerative arthritis and also I currently suffer from debilitating chronic pain. My pain started with fibromyalgia, acute back injury related to lifting patients and neuropathy from IDDM. Currently I suffer from severe peripheral neuropathy, chronic lower back pain from degenerative arthritis and chronic pain in my right foot from surgery to repair torn Achilles Tendon and heel (bone) surgery. I also have a torn rotator cuff in my right shoulder, peripheral neuropathy in my hands and intermittent migraine headaches. With the assistance of compassionate and thorough physicians I am able to function daily, caring for my home/yard and performing ADL'S on my own. I currently am enrolled in a pain-management clinic where I am seen by my physician monthly for a status review, medication review and CDC guideline drug testing. I also take anti-inflammatory medications along with Neurontin and Lyrica for pain control along with a narcotic (opiod) for pain relief. I truly understand the ramifications of the opiod guidelines. Without the medication I currently take I would not be able to be independent in caring for myself or my home. I would ( and have been) home bound and at times bedbound. I would not be able to take a walk or ride my bicycle without debilitating pain that would dictate my daily activities. <br/>I follow ALL of the guidelines as directed by my physician. I only take my medication as prescribed and do not over-indulge in it. I do not drink alcohol or partake in any illegal drugs ( eg. Marijuana, cocaine, etc). I do not miss my physician appointments or the drug tests as ordered. My pain is MY PAIN. It is subjective and a government agency should not dictate how I live my life, or do not live my life. Pain is subjective and the decision to take medication to control/lessen/alleviate pain is between my physicians and me. To only allow opiods to be given to those with terminal illness is dictating living versus not living for me and so many more suffering from chronic pain.<br/>To end, no one...NO ONE chooses to be in pain. I choose to live and am able to actually not just live but to survive every day without overdose from opiods but better, without the pain which previously made me near bedbound. Please consider those of us trying to LIVE with pain when deciding on this subject. <br/><br/>,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Radine	None	None	0900006484f9ee9e	Green	None	2022-02-24T20:30:20Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Green, Radine	l00-hjip-l460	False	None	False	2022-04-12 03:15:03.000	[]
1443	CDC-2022-0024-1450	https://api.regulations.gov/v4/comments/CDC-2022-0024-1450	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC's 2022 revisions of the deeply flawed 2016 Prescribing Advice contains some welcome changes that should reduce the needless suffering of pain patients. Unfortunately, the new document does not go far enough.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Josh	None	None	0900006484fa1d95	Bloom	None	2022-02-24T20:35:35Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Bloom, Josh	l01-dvej-9l85	False	None	False	2022-04-12 03:15:03.245	[]
1444	CDC-2022-0024-1451	https://api.regulations.gov/v4/comments/CDC-2022-0024-1451	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because some people abused opioids is not a reason to restrict them for actual patients who need them. Some people will abuse anything. Afflicted with an excruciating blistering disease, I was denied pain-relief by 6 MDs because of the “opioid epidemic”. I informed each one that I was drinking a half-bottle of vodka every day for the pain. This was more acceptable to them than prescribing pain medication!<br/><br/>My PCP understands my medical needs so will prescribe hydrocodone, but since CVS is too scared to fill the RX, I’m forced to ration out tiny pieces of my pills like a crazy hoarder, enduring daily pain in the fear that I’ll run out of medication and suffer all the more. Not a healthy way to get through life.<br/><br/>A blanket approach to a specific problem is NO way to decide on medical care. Let MDs and their patients (and Pharmacies!) all cooperate in what is best for their patient. <br/><br/>Thank you for considering this issue and patients needs.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9fcdb	Anonymous	None	2022-02-24T20:47:30Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-8vqo-majr	False	None	False	2022-04-12 03:15:03.469	[]
1445	CDC-2022-0024-1452	https://api.regulations.gov/v4/comments/CDC-2022-0024-1452	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope they do change these guidelines, ever since these ObummerCare regulations incorporating the 30 day prescription limit and other mandates it's increased the cost substantially for long term care. Where I used to have a one year prescription and got it refilled when needed for about $8, usually 2-3 times a year. Then I had a new mandate to have an in office appt with a $100 co-pay, for a 30 day $12 supply.<br/> I've had to use painkillers since my early 20's for a bad back I got from working. Never been addicted, have had plenty of times when I've gone weeks or months without needing the pills, and other times when I couldn't get out of bed and work without them. I've had the same doctor for about 30 years, so I'm not doctor shopping for scrips, I just want to stop all of the BS with the mandates for all of restrictive policies that the 2016 regs have forced those of us on long term care have had to deal with for the past several years. We can do better and still take care of those of us who have had to deal with long term debilitating pain. Please change these policies that allow doctors who have patients like myself to care for them with the presciptions which they need without the restrictive regulations we now have. What used to cost me $24-40 a year now costs me $100 per visit for the co-pay and $12 for the prescription, which as I get older I need more than I did when I was younger, so the cost could be as high as $1,300 a year if I need a prescription every month. That's too much for something like this, especially for those on fixed or low income.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484f9e8a9	Magee	None	2022-02-24T21:49:23Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Magee, Gary	l00-l9hm-qfvq	False	None	False	2022-04-12 03:15:03.686	[]
1446	CDC-2022-0024-1453	https://api.regulations.gov/v4/comments/CDC-2022-0024-1453	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I submitted a comment but made it anonymous because when I chose "Individual" where it said "tell us about yourself! I am...", it was mandatory to include your first and last name. <br/><br/>And although the statement is made that - "You are filing a document into an official docket. Any personal information included in your comment text and/or uploaded attachment(s) may be publicly viewable on the web." - it included my first and last name in the text, even thought I DID NOT write them in the text or upload any document that had them.<br/><br/>So they were included at the end of my comment, even though I didn't add them to the text. If my names were not included in the comments I would have posted as an individual, giving both names. Since it looks like they would be published along with the comment text, I chose to go with Anonymous. Doing the same here.<br/><br/>You might want to fix that.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9e8e1	Anonymous	None	2022-02-24T21:50:04Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l00-rbdz-nh6s	False	None	False	2022-04-12 03:15:03.912	[]
1447	CDC-2022-0024-1454	https://api.regulations.gov/v4/comments/CDC-2022-0024-1454	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer and have been since a severe injury in an auto accident where I was told by the operating surgeon that I was lucky to not have lost a limb that was affected and is the main cause of my chronic pain.<br/><br/>I have been on many medications over the years to manage my chronic pain. I PREVIOUSLY had been on an amount that managed my pain and function ability well enough. I am NOT on that amount presently. I am on less. It is NOT managing my pain/function as well. I have been told by my pain management provider that the CDC says they have to reduce the amount of ALL medications to a total of 90mg or below, and that rather than be right at 90mg, BELOW 90mg was the preferred amount.<br/><br/>I was told by a pain provider that that CDC guideline was just that, a GUIDELINE, for Primary Care physicians in particular, and not a MANDATE for ALL providers. That Pain Management providers, different from Primary Care physicians, have the ability to evaluate every patient's pain and prescribe medications accordingly, but that THEY ARE AFRAID that if they go above those recommended 90mg guidelines, the CDC and any other regulatory body will look at them with a critical eye and reprimand them somehow. When told that to one of my providers she said ** "We go by the CDC guidelines. If you don't like it go somewhere else." That pain providers have no care of their patients' well-being BECAUSE THEY FEAR THE CDC or don't ask the CDC for clarification, causes providers to think this way and causes unnecessary anguish for patients with chronic pain.<br/><br/>The medication amount where my pain is manageable does NOT take all the pain away. It's the LEAST amount that I can tolerate pain that's still there and function somewhat normally, but due to my provider's fear of the CDC I'm forced to suffer more pain that the reduction causes. Even a small reduction means I sleep more to get away from the additional pain. I do less of any activity due to the extra pain. I live with a certain amount of pain in order to not take a higher dosage or stronger medication. However, if I'm told I have to live with more pain than I feel is tolerable, you are pushing me to get relief elsewhere. TOLERABLE does NOT mean NO PAIN!<br/><br/>I was told that at my next appointment I will now be reduced further. <br/><br/>I was also told by my provider that I could not call to have the reduction returned to the previous amount, even when they know it causes me more pain. That I would have to suffer the additional pain until my next visit in 2 months. My normal visits are every 2 months, but they have now instituted a "well check" visit in between those 2 months where I'm asked questions about my health and pain, but can't talk about my medications until my regular 2 month visit. Personally I feel it's a money grab, another visit that is billed for nothing more than questions that can be asked at the regularly-scheduled visit.<br/><br/>I feel that the CDC and other regulatory bodies don't have any people that have actual experience with chronic pain and they just make arbitrary pronouncements about what they believe will alleviate someone's chronic pain. There are all kinds of pain that respond to different medications and amounts. A pain management provider said they can certainly tell if someone is abusing their medications and treat them accordingly without affecting other patients. I'm seen every 2 months (with the exception of that "well check" visit) because they have treated me for years and can see I don't abuse my medications. Yet they don't take that into consideration for fear of the CDC, et al.<br/><br/>I am not taking my medications to get high. I am not selling my medications for money. I am trying to use the least amount that will alleviate my pain so that I can function somewhat normally. That doesn't mean I have no pain at all. However, when I keep getting my medications reduced because someone arbitrarily decides a certain amount will manage my pain, it just means I have to deal with more pain for a longer period of time. THAT arbitrary decision would make me want to supplement my medications by going to street-level drugs in order to not suffer more pain longer. I can certainly see how people can go that route. I'm not that type of person so I suffer the PRESCRIBED additional pain.<br/><br/>PLEASE be more empathetic to chronic pain sufferers. Let providers distinguish between abusers of their medications and those that aren't, and medicate accordingly. Don't lump all pain sufferers into one category which only penalize the many against the few. EMPHASIZE TO ALL PROVIDERS THAT GUIDELINES ARE NOT MANDATES AND THEY WILL NOT BE PENALIZED FOR USING THEIR JUDGEMENT WHEN PRESCRIBING!!!!<br/><br/>** Your initial dictate was EXTREMELY punitive to ALL chronic pain sufferers who couldn't go anywhere else as no provider would touch them due to fear. That is still the case today. We are at their mercy. And yours.<br/><br/>99% of us are looking for pain relief and nothing else. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9e8e4	Anonymous	None	2022-02-24T21:51:35Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l00-s1n2-fo4a	False	None	False	2022-04-12 03:15:04.122	[]
1448	CDC-2022-0024-1455	https://api.regulations.gov/v4/comments/CDC-2022-0024-1455	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My chronic pain journey began around 2012, after many X-rays, MRI’s I was told massive arthritis and disc degeneration I was put on several medications but none helped. My doctor put me on Percocet 10/325 every 4 hours. Absolutely no pain! I was able to keep working, cleaning house, doing laundry as well as grocery shopping and working in my vegetable garden. When the rules changed I was dropped to 1 Percocet every 8 hours. I couldn’t work due to the pain in my lower back and eventually hips and legs. <br/>I filed for disability and received it in 5 months. Since then I’ve gone through 6 or 7 spinal injections which did nothing for my pain. Then I elected for a pain pump to be implanted in my abdomen. Over several months I was having worse pain. At this time I was not on oral medications. Plus I had been changed to morphine and dilaudid. It made me sick to my stomach. Back to morphine. Then the pump wasn’t working properly. The pump was turned down to the lowest dosage once daily and I was put back on my oral medication. I still have intense pain in my left hip and knee, but they say they can’t do anything else for me. I’m using a walker now because the pain never stops and I can barely walk with the walker. I had been on opioids for 7 years when the CDC and DEA got involved. I’ve lost everything, my job (it’s better income than disability), lost my company paid for health insurance, lost the ability to keep my garden, I try at least once or twice to clean house and do laundry but I hardly ever get everything done. Plus the expenses have been unbelievable. I have to keep my Primary care doctor due to blood pressure and cholesterol,etc. But pain management is very expensive. Not only the appointments but the experimental choices and just the gas expense, having my husband take off work and drive me.<br/>What I’m giving you in this letter is not the pain level I’ve dealt with for the last 3 years. But I can tell you that when a person really has intense pain the last thing they’ll be thinking about is selling their medications. I’ve gone hungry because I haven’t had the money to buy food but I’m not selling the only thing that helps me get up everyday. I had always said I would work until I was 72; unfortunately taking my medication from me had me disabled at 58 years old. I’m so angry with the CDC and the DEA for involving themselves in my personal health decisions. I had already been diagnosed with chronic pain for over 12 years	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa2aa4	Anonymous	None	2022-02-24T21:51:37Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-gcvu-h8je	False	None	False	2022-04-12 03:15:04.370	[]
1449	CDC-2022-0024-1456	https://api.regulations.gov/v4/comments/CDC-2022-0024-1456	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC needs to remove the unsubstantiated MME guidance that was part of 2016 guidelines and 2022 guidelines. Every patient needs to be allowed individualized care and there are no large studies that determine that a specific MME results in better outcomes. I'm a disabled veteran that was force tapered, not because my pain levels improved, but because my Dr feared for his license if he continued to prescribe at the current level. Never mind that I had been stable for years and enjoyed a great QoL. The 2016 guidelines have destroyed the bond of trust between pain patients and doctors. Patients are treated like criminals and doctors are refusing to prescribe opioids which has left many patients little choice but to seek out relief from street drugs. This war on pain patients is misguided, cruel, and is not based on science. Why am I treated like a criminal for needing a prescription medication to have QoL but another chronic condition doesn't have to worry about having a pharmacist or DEA agent either refuse to dispense or raid my doctor? The CDC needs to remove itself from the doctor/patient relationship and quit trying to play god.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa2aee	Anonymous	None	2022-02-24T21:52:47Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-geiw-dqs3	False	None	False	2022-04-12 03:15:04.607	[]
1450	CDC-2022-0024-1457	https://api.regulations.gov/v4/comments/CDC-2022-0024-1457	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient with a long list of painful diseases/conditions. I’m begging you to remove the 50MME limit from the guidelines. My pain meds were cut in half when the 90MME limit was put in place. What that did to me, was take away my life. I went from having my pain under control, to living in excruciating pain. I used to grocery shop, visit with friends, do all the things average humans do, until you placed the 90 MME limit in your last guideline. What that cutback did to me was awful. I can’t go grocery shopping. Can’t clean house. I only leave my house to go to doctor appointments. <br/>I have 20 different diseases/conditions now and most are autoimmune related and they trigger each other. I’ve come close to taking my own life many times from your last cutback. I will not survive on a morphine equivalent of 50. What you send out as a guideline is quickly changed to a rule in many states and you’re killing patients like me who live with chronic, excruciating pain. I’ve lost so many friends in the IC (Interstitial Cystitis) community because of the 90 MME limit. To you it may just be a guideline or recommendation, but pain management doctors view it as a rule they have to follow in order to keep their practices open. Forcing chronic pain patients to reduce their pain meds again is only going to (once again) increase the suicides among those of us who can’t tolerate the pain they’re in. You are signing our death certificates by doing this. Please, I beg of you, for the sake of Chronic Pain Patients, remove the 50MME limit from your guidelines. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janelle	None	None	0900006484f9efee	Krafthefer	None	2022-02-24T21:53:44Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Krafthefer, Janelle	l00-xy25-zltn	False	None	False	2022-04-12 03:15:04.819	[]
1451	CDC-2022-0024-1458	https://api.regulations.gov/v4/comments/CDC-2022-0024-1458	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with a congenital orthopedic medical condition, leaving me with disabling arthritis and osteoporosis as a child. 50 years of joint degeneration, spinal stenosis, ruptured discs, calcium deposits by the 100's is damn painful. Per surgeons for hip, back, and neck consider any surgery to be risky ..for them. <br/><br/>Thank you for stealing the only occasional relief left for me while I'm old and disabled. This isn't the first time you've backstabbed the elderly and disabled and it won't be the last. You do this every 15 years or so until the chronic pain suicides start to go public. This time, you all have the stench of an Aktion T4 program. Your hatred of us has even slipped into current Covid policy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roberta	None	None	0900006484f9f1b8	Critchett	None	2022-02-24T21:55:55Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Critchett, Roberta	l01-1agc-44pu	False	None	False	2022-04-12 03:15:05.083	[]
1452	CDC-2022-0024-1459	https://api.regulations.gov/v4/comments/CDC-2022-0024-1459	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m writing about the guide lines I have no doubt that these guidelines will bring greater suffering torture and genocide because this is what it is now patient’s pain and diseases are being ignored to the extent that they’re dying n been ding n cdc does not care ! the 90 MME brought torture and suicide rates we have never seen while the overdose deaths from Illicit carfentanyl continue to skyrocket because it was never prescription drugs causing addiction or the epidemic fact, but with a 90 mme causing so much damage why would the CDC even recommend a 50 MME this has to stop this is not scientific nor statistical! It’s working here it’s nothing but mere opioid opinions anti-opioid that is ! opinions from people that are not specialized in pain diseases or pain control and this is fraudulent at best !And instead of overdose deaths going down it actually skyrocketed to numbers that’s never been seen in history so it did the opposite ! It did nothing to slowdown or lower od deaths, call Dr. [name redacted] who is on the HHTASK force n CDC admitted that only 1.2% have a prescription drug in thier system at the time of overdose death!!! with multiple other modalities so it’s not prescription drugs and a fax stars show it <br/>it’s a complete failure and yet you keep doing the same thing as if you want to see more deaths and bought more in both groups we have to be honest here they have to trash the guidelines completely they have to drop it there should be no thresholds no cautions no opinions about anything that a doctor should give their patient or be advising drs to not treat new patients to opiode treatment when they been suffering <br/>Or suggest how much and it shows that the CDC does not care that people are dying in both separate distinct groups !! N didn’t listen to one complaint or concern of patients n real specialists addicts and chronic pain patients will continue to die at record numbers due to cdc!!! seven years they’ve been dying and why is it taking so long to redo another deadly dismissive reckless irresponsible guidelines stop the torture n Genocide now	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ree	None	None	0900006484fa3215	Luc	None	2022-02-24T21:57:08Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Luc, ree	l01-gvev-svif	False	None	False	2022-04-12 03:15:05.327	[]
1453	CDC-2022-0024-1460	https://api.regulations.gov/v4/comments/CDC-2022-0024-1460	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm legally disabled with a progressively degenerative genetic disease cluster. My pain management started in the mid 90s. It was successful in managing my pain until 2016 when my pain clinic closed. I couldn't find any pain doctors who dealt with opiates, only injections that did me no good. Im now in palliative care and my pcp is forced to deal with my meds. Because of this I've had no medication adjustments in 6 YEARS even though all my doctors know my pain is extremely worse. My pcp is so scared of my meds I can't get anything for anxiety or muscle relaxers. I'm stuck now with no pain doctor, no medication adjustments and in so much pain I've been suicidal more than a few times. I've been FAR closer to committing suicide due to my insane pain levels where I've not only passed out but went into seizures. This is NO way to help people already suffering to be somewhat more comfortable and functional. Its too bad people who have actual chronic illnesses aren't helping make these decisions for us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Isa	None	None	0900006484f9f75c	Shisha	None	2022-02-24T21:57:45Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Shisha, Isa	l01-4va9-fymb	False	None	False	2022-04-12 03:15:05.558	[]
1454	CDC-2022-0024-1461	https://api.regulations.gov/v4/comments/CDC-2022-0024-1461	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Trash the deadly torturous guide lines n listen to the realmexperts the patients n Drs n fda <br/>Your are enabling the deaths of two separate groups ! It’s killing patients n addicts you have no rights to add mme thresholds n lowered it after the deadly impacts of 90 mme ??? <br/>It’s evil n can’t be trusted to care for lives <br/>U have no right tell or advice drs what to treat suffering patients with n how much<br/>You see the deadly failure and literal negative impact your guidelines have had it did nothing to stop the opioid epidemic od deaths at all infact increased it by millions -millions 4075% up ! prescriptions are not the cause of the opioid epidemic it never was nor is it the cause of addiction and the stats prove it stop ignoring the stats and stop listening to anti-opioid corrupt fraudulent people have no expertise in this field who are fattening their pockets and profiting off the suffering and it will catch up with them in court I’m positive	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3533	Anonymous	None	2022-02-24T21:58:29Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-hbn5-lxwy	False	None	False	2022-04-12 03:15:05.788	[]
1455	CDC-2022-0024-1462	https://api.regulations.gov/v4/comments/CDC-2022-0024-1462	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please reconsider your planned regulations. I suffer from spinal stenosis and without the pain relief from my doctor I probably would be bedridden.<br/>I implore you to NOT prevent my doctor from helping me by provided relief	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa374b	Anonymous	None	2022-02-24T21:58:50Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-hqle-y84x	False	None	False	2022-04-12 03:15:06.000	[]
1456	CDC-2022-0024-1463	https://api.regulations.gov/v4/comments/CDC-2022-0024-1463	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm legally disabled with a progressively degenerative genetic disease cluster. My pain management started in the mid 90s. It was successful in managing my pain until 2016 when my pain clinic closed. I couldn't find any pain doctors who dealt with opiates, only injections that did me no good. Im now in palliative care and my pcp is forced to deal with my meds. Because of this I've had no medication adjustments in 6 YEARS even though all my doctors know my pain is extremely worse. My pcp is so scared of my meds I can't get anything for anxiety or muscle relaxers. I'm stuck now with no pain doctor, no medication adjustments and in so much pain I've been suicidal more than a few times. I've been FAR closer to committing suicide due to my insane pain levels where I've not only passed out but went into seizures. This is NO way to help people already suffering to be somewhat more comfortable and functional. Its too bad people who have actual chronic illnesses aren't helping make these decisions for us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Isa	None	None	0900006484f9f75d	Shisha	None	2022-02-24T21:58:57Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Shisha, Isa	l01-4vcq-o3f0	False	None	False	2022-04-12 03:15:06.264	[]
1457	CDC-2022-0024-1464	https://api.regulations.gov/v4/comments/CDC-2022-0024-1464	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I found the revised guidelines for opioid prescribing encouraging. However, these changes need to be further expanded to permit primary care physicians to manage chronic pain issues. Pain management has become a steroid pushing business in which patients are refused care if they don't qualify for injections. Patients who need narcotic meds to function are forced to sign unreasonable agreements but are never warned of the dangerous side effects of long term steroid use.<br/>As a retired R.N., l've witnessed this sad trend in my career and personal life.Specifically, regarding the current edict of not prescribing benzodiazepines and narcotics concurrently. I've safely administered these medications together for years without incident.<br/>Primary care doctors are focusing on loss of licenses and reprimands and totally neglecting patient pain needs. l've researched the current addiction rate of prescription drugs and statements in the media regarding this situation are exaggerated and false.Patients deserve to be treated humanely and not as drug seekers. The misguided and weak-willed behavior of addicts has ruined what is a basic human right to a decent quality of life.<br/>In summary, what is needed are rational prescribing guidelines instead of a "no prescribing" edict which leads to patient suicide, depression. Immobility, loss of function, isolation and extended recovery times.<br/>Thank you for your consideration.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484f9f7c1	Anonymous	None	2022-02-24T21:59:30Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-5zas-swvh	False	None	False	2022-04-12 03:15:06.555	[]
1458	CDC-2022-0024-1465	https://api.regulations.gov/v4/comments/CDC-2022-0024-1465	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove all<br/>Mention of MME. The MME does not serve the chronic patient who’s surgical options have already been tried. So many patients have killed themselves, legitimate patients with severely painful conditions that most people would not survive. Please end this war on legitimate patients. We are suffering, and the proposed alternatives have all played themselves out. Going without medication for my painful spine resulted in unhealthy weight loss, no appetite. When I am able to medicate my pain, I have better quality of life. I am able to participate in family visiting more frequently, sometimes help prepare a meal for my family. This is not about recreational habits, but quality of life. Without adequate pain medication, I cannot sit up right, or barely move from bed. I have cauda equina incomplete, which means partial paralysis on one side of my lower extremities. The painful shooting radiculapathy and spams caused by the scarring of my nerve root are unbearable, taking anti spasmodic neuro medication has all but stolen any semblance of life I held onto. Having tried all forms of alternatives, natural and homeopathic formulas, this mandate against pain medication, and patients must end now. Return to compassionate care. <br/> End all mention of MME and allow physicians to care for Legitimate patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484fa3769	Sanders	None	2022-02-24T22:00:46Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Sanders , Sarah	l01-hsu0-y4m3	False	None	False	2022-04-12 03:15:06.788	[]
1459	CDC-2022-0024-1466	https://api.regulations.gov/v4/comments/CDC-2022-0024-1466	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have neuropathy and muscles spasms I need my trigger shots and pain medication because I don’t want to have spinal surgery. Pain management helps my body to function. <br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484fa389c	SuttonWarren	None	2022-02-24T22:01:43Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from SuttonWarren, Barbara	l01-ig83-9ple	False	None	False	2022-04-12 03:15:07.007	[]
1460	CDC-2022-0024-1467	https://api.regulations.gov/v4/comments/CDC-2022-0024-1467	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I fell down a flight of stairs on [month and day redacted] 1999 while at work, this caused me to not be able to work for about 3 to 6 months, after recovering I returned to work, I was mostly okay and pain free, unfortunately the pain returned about ten years later and has steadily been getting worse, as of [month and day redacted] 2019 I was no longer able to work due to the constant chronic pain. From the time the pain came back till today, my doctors have been prescribing pain medications, over time the medications became stronger and stronger. These pain medications are the only reason that I am able to function in the limited capacity that I am able to, also I was involved in a car accident on [month and day redacted] 2021, where the car I was in was rear ended, almost immediately after the accident I has new pain from my head down to my lower spine. The previous pain was made worse by this accident. After a couple of weeks after the accident, my doctors sent me to get MRI’s on my head, neck and entire back, the MRI’s showed that I had a neck injury that never caused me pain until this accident. The multiple MRI’s also showed that the injury to my lower back had gotten worse. I also had a concussion and also a new issue if I touched the left side of my scalp it was really painful, I was told that there was something wrong with my occipital nerve, my doctor gave me a couple of injections in my neck that helped with this but the pain would always return, finally he suggested a radio frequency ablation which basically deadens the nerve for whatever period of time it woks for, since the RF Ablation, that pain has not returned. In regard to my back, I have to get epidural’s to my neck and lumbar spine every 4 months or so. The injections help but they ultimately wear off over time. This whole time I continue to take the pain relievers as prescribed, I heard that politicians are trying to take these medications away from us, if this was to happen, I honestly do not know what I would do, I am not sure I would be able to function at all without them! I understand that there are people who have died and or became addicted to them. I make sure that I only take any of my medications per the prescription recommendations, I don’t want to become addicted nor do I want to die! Unfortunately taking these medications away might leave me in a fate worse than death!!! Being in constant pain with no way to lessen said pain! This is not only unfair but it is cruel to do this to anybody!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Billy	None	None	0900006484fa399a	Silverglad	None	2022-02-24T22:09:16Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Silverglad, Billy	l01-j78g-1gqf	False	None	False	2022-04-12 03:15:07.234	[]
1461	CDC-2022-0024-1468	https://api.regulations.gov/v4/comments/CDC-2022-0024-1468	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I receive pain medication because I was hurt on the job 2x. I also have bone cancer. I I just had my second stem cell transplant. I have a tumor on my left ankle which is very painful. It’s difficult to put on a shoe or to stand for any length of time. I also have severe lower back pain and get spasms in my upper back while I’m walking. I’m not understanding why you can’t get medication under a physicians care but our border is wide open with illegal drugs flowing freely into the country. People of all ages are dying due to the recklessness of the lunatics running the country. I should not have to suffer in pain like this. My doctor doesn’t over prescribe my medication. Who’s regulating all the drugs coming in at the southern border? Why are needles given out freely to addicts snd now can openly shoot up in public places with no on monitoring them. That’s fine with you but having an office visit one one with a physician who monitors you, that’s where you feel the problem is. I feel you should rethink your position on this but iI doubt that will happen. Thank you for listening	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484fa39a1	Calvacca	None	2022-02-25T02:21:50Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Calvacca, Katherine	l01-jj58-6jq5	False	None	False	2022-04-12 03:15:07.448	[]
1462	CDC-2022-0024-1469	https://api.regulations.gov/v4/comments/CDC-2022-0024-1469	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prehaps the CDCshould leave Chronic Pain Patients and Pain Management Doctor alone before we find an attorney to sue them for torture and denying us our civil rights	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa39a7	Anonymous	None	2022-02-25T02:22:15Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-jrsk-wfmj	False	None	False	2022-04-12 03:15:07.671	[]
1463	CDC-2022-0024-1470	https://api.regulations.gov/v4/comments/CDC-2022-0024-1470	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish to share with you my morning regiment. I suffer from stenosis, arthritis in my spine and discs that have moved. I have scoliosis, but not just a simple case. My spine is not only curved, but it has rotated to the point that NO surgery can be performed because the vertebrae will fall on itself. Naproxen everyday, and topical volteren is a must, if I want to go to school in a semi upright position. The ride to school is about 45 min.- 1 hr. on a heated seat ( thank god for that invention). By mid day I am hunched over and can't wait for the ride home-again on heated seats. There must be some other alternative painkiller that my Dr.s can prescribe for me without having their hands tied by you, the Federal Government. Please end the 2016 ruling against opiods. This is a necessity for others like me. The answer is NOT just stop teaching.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	SUSAN	None	None	0900006484fa39a9	DOWLING	None	2022-02-25T02:23:56Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from DOWLING, SUSAN	l01-ju6i-25pf	False	None	False	2022-04-12 03:15:07.886	[]
1464	CDC-2022-0024-1471	https://api.regulations.gov/v4/comments/CDC-2022-0024-1471	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a mother of two with chronic pain that will literally never be fixed, I agree with the idea of trying other non opioid options first. It wasn't hard for my Dr to come to the conclusion that stronger meds would be better. We did the cat scans and everything first. It did take a few months but honestly it was fine.<br/>The new guidelines also make me feel safer about talking to my Dr when my meds aren't working as well as they should be. Previous to this I have been hesitant to say anything. But honestly I think so many doctors are hesitant to prescribe more because of the lack of judgment allowed per previous cdc rules. I think the change will welcome more positive results as far as patients feeling heard and doctors being able to prescribe as they see fit.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Corinna	None	None	0900006484fa39d1	Lawrence	None	2022-02-25T02:32:51Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Lawrence , Corinna	l01-kbem-jmop	False	None	False	2022-04-12 03:15:08.097	[]
1465	CDC-2022-0024-1472	https://api.regulations.gov/v4/comments/CDC-2022-0024-1472	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I oppose any regulations that limit my physician's ability to provide me with the care I need. I have a number of health conditions that keep me in constant pain. I have tried all alternative treatments without success. Being able to have opioids prescribed to me gave me back my life. I can function, go to work, do my job and support myself. I understand that it is not ideal, but unless and until a better treatment comes along I depend on these medications to have a life. Please understand that we are not all junkies looking for our next fix. I record every pill I take every day, keeping myself to a strict schedule between pills. I don't abuse my medication I use it to give me some quality of life. I am a professional and would not be able to function if I am forced to live by someone else's idea of how my medical conditions should be treated. I have a great doctor who I see monthly and I am not in any danger except for the danger of people wanting to interfere in my medical treatment. Leave it to my doctor and myself.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marjorie	None	None	0900006484fa39f5	Annonynous	None	2022-02-25T02:33:59Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Annonynous, Marjorie	l01-kjs0-zpv9	False	None	False	2022-04-12 03:15:08.309	[]
1466	CDC-2022-0024-1473	https://api.regulations.gov/v4/comments/CDC-2022-0024-1473	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Psoriatic Arthritis and several joints with osteoarthritis. I have successfully managed my chronic pain with Norco without having become addicted. I generally take one pill per day if needed. I cannot tolerate stronger pain meds, nor would I want to have anything stronger than hydrocodone. These guidelines need to take into account that every patient is unique. We are not all subject to addiction and shouldn't have to suffer for those who have abused these meds. My medication helps me to endure what is sometimes a physically demanding job and also to have a better quality of life by being able to exercise harder and do my physically demanding household chores. It shouldn't be this hard for a patient with no history of addiction to get medication that improves quality of life. I don't care what the "studies" have shown; chronic pain IS helped with the proper use of opioids. People are always going to find ways to abuse drugs if that is what they want to do. The ones who are addicted are going to get them somehow. Putting all these rules and regulations in place so that doctors are afraid to prescribe opioids is not going to stop the addicts. It just punishes the legitimate patients who are responsible with how they take these drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa39f9	Anonymous	None	2022-02-25T02:35:13Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-kqp1-csq0	False	None	False	2022-04-12 03:15:08.554	[]
1467	CDC-2022-0024-1474	https://api.regulations.gov/v4/comments/CDC-2022-0024-1474	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Speaking from the perspective of living with RSD 25 years. I would like to know why RSD was not included with cancer, sickle cell or end of life as a Chronic Pain Condition that should be treated with a Physician’s best medical judgment without restrictions? When your life changes so dramatically due to Rotator Cuff Repair Surgery resulting in Reflex Symphatic Dystrophy it is so traumatic physiologically but the pain is is nonstop agony without proper pain management. When the pain is not controlled you cannot use the arm in my case. I can function to a point when the pain is controlled if not, aching pain radiates from the shoulder into the arm with throbbing pain that continues to the hand and fingers feeling like needles are sticking them constant non stop 24/7 pain. The arm and hand swell, turns purple and sweats. All this pain at once! Then there are the muscle spasms that radiates down both legs into the feet leaving your legs aching from the severe spasms! To add to the pain anxiety sets in because of the constant nonstop pain and wanting to have the proper pain control because you just want to function and have some quality of life! Rsd has three stages, can spread to the entire body and result from the trauma of surgery or a little broken finger! When my hand swelled the size of a cantaloupe and turned purple for three months after a RotaCuff Repair Surgery! I ask what was wrong until I was told I could have a Claw Hand if not treated! I had 12 Nerve Blocks and when my insurance only covered 12 blocks. I was left in unspeakable pain! Gapbepein, forgive the spelling is a medication suggested in your update, the side effects are constant sleep, weight gain and thoughts of suicide! I had to stop taking it because it did nothing to control pain but had serious side effects! I was tested and diagnosed with RSD and told with the spondylitis in my back and shoulders, I would end up in a wheelchair! I was prescribed low dose pain medication and as the condition progressed was given long acting and short acting medication for break thru pain. Physical and occupational therapy did not help. For years I was treated with a 5mg anxiety medication that helped with muscle spasms and anxiety. One medication treated two conditions saved on prescription cost. For 15 years I was treated by my Primary Care Physician and seen every two months with drug test at his digression periodically. I never knew when I would be tested but never failed a test. In 2016 my Doctor stopped treating. I had one month to find care! My medication was reduced to a one size fits all mg and does not control the pain as my previous treatment plan did for 15 years. The removable of a 5mg anxiety medication resulted in more pain and anxiety. Less pain control and higher prescriptions cost. I now pay for two medications that do not work as well at higher cost. The set mme of many of these so called dangerous medications neither control the pain or the anxiety as before the Witch Hunt on Proper Pain Management. I suffer daily! Today the spasms were so bad I had to lay in bed until the medication took effect. Anyone with real pain knows triggers like cold weather can increase your pain levels. In my case a breeze can trigger unbearable pain. Knowing the pain I go thru. I question why certain members of Prop were allowed to co-write the 2016 Guidelines using inflated numbers and flawed data and use the same Guidelines in testimony in Courts as a Paid Consultant. While Profiting as a Paid Consultant the Suicide Crisis continues a direct result of their actions! The real numbers are available and it has been proven daily that Prescribing has decreased while Overdose from Crisis is Illegal Street Drugs and Suicide due to denied proper pain control increases! Pain patients in the Millions suffer unspeakable pain while Expensive Addiction Drugs and Rehab Centers are promoted by some Prop members. Pain is not addiction and thousands of chronic Pain Patients have committed Suicide as a result if guidelines and recommendations for profit! This business of denying Surgery Patients, Dental Patients, Patients with broken bones, end of life patients because they might get addicted is a unsafe medical practice. The list goes on with Cancer Patients and RSD patients that has No cure! Why are you not funding cures for these Pain conditions rather than causing pain patients to suffer to the point of suicide? It is obvious when you write 2016 guidelines with members of Prop, Behind closed doors with no public input what is really taking place. When those same Prop Members use the same guidelines to testify in Billion Dollar Lawsuits while they promote Rehab Centers and invest in Expensive Addiction Drugs with copays as high as $2000. The CDC can stop this Suicide Crisis. Please remove the 2016 Guidelines and set mme daily limit. Chronic Pain is not a one size fits all condition. Thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3a24	Anonymous	None	2022-02-25T02:41:38Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-l9ve-rzdw	False	None	False	2022-04-12 03:15:08.771	[]
1468	CDC-2022-0024-1475	https://api.regulations.gov/v4/comments/CDC-2022-0024-1475	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I recommend authorizing and funding acupuncture treatments. As the medical community tries to reduce the use of narcotics, providers need to be able to offer patients alternative treatments to manage their pain. Many patients have had success managing chronic and acute pain with the use of acupuncture but are not able to pay for this treatment since most insurance does not cover it. I highly recommend that acupuncture be provided by Veterans Affairs Medical Centers as these facilities attempt to reduce the use of narcotics.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrea	None	None	0900006484fa2e29	Millman	None	2022-02-25T02:49:14Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Millman, Andrea	l01-ld5q-egdc	False	None	False	2022-04-12 03:15:08.992	[]
1469	CDC-2022-0024-1476	https://api.regulations.gov/v4/comments/CDC-2022-0024-1476	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient, being denied pain management beyond NSAID's for chronic pain is barbaric. Doctors notes and documentation should show that the patient doesn't request constant refills. Same with the pharmacy. <br/>Low back pain caused by degenerative disc disease, arthritis and the like is extremely painful. <br/>Migraine headaches -- not all are preventable or stopped with vasodialators etc. Some drugs increase blood pressure too high. <br/>Neuropathy is another case to be acknowledged with pain management beyond NSAID's.<br/>A lot of these new drugs cause more problems with overall health. Been there done that. <br/>Please allow physicians and NP's to actually provide comfort and care to their patients. They took an oath. Let them care for their patients again. <br/>Heroin is what you should be going after. And cocaine.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M	None	None	0900006484fa2e3b	B	None	2022-02-25T02:50:07Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from B, M	l01-lmnj-yj2e	False	None	False	2022-04-12 03:15:09.220	[]
1470	CDC-2022-0024-1477	https://api.regulations.gov/v4/comments/CDC-2022-0024-1477	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People in pain are being mistreated. I have chronic digestive issues and will have them for the rest of my life. I have been told that I will have pain and it will be severe at times, but no one will give me any pain medication. You have made it nearly impossible for people in pain to get any pain medication. You need to change this. You are the reason people are turning to illegal substances and overdosing. There needs to be a change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa2e59	Anonymous	None	2022-02-25T02:50:46Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-mbsl-rawl	False	None	False	2022-04-12 03:15:09.445	[]
1471	CDC-2022-0024-1478	https://api.regulations.gov/v4/comments/CDC-2022-0024-1478	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 did alot od damage to Chronic pain patients, cancer patients and Post operative patients. They are now giving patients Ketamine, a horse tranqulizer, to patients instead of pain medicine, which is created for pain. The CDC then puts out thses new regs, promising to fix the damage but them hidden in the new regs, they are teyong to lower the MME. The CDC has no right to what happens between a Dr and his patient. I unfortuanly believe yhe damage has been done, bit I hope that the CDC shows that it actually cared about true patients instead of false statistics. The Opiate Crisis is from what's on the streets not the Drs. Office. Stop punishing innocent patients!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa2e5a	Anonymous	None	2022-02-25T02:51:45Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-md9d-57o5	False	None	False	2022-04-12 03:15:09.674	[]
1472	CDC-2022-0024-1479	https://api.regulations.gov/v4/comments/CDC-2022-0024-1479	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The impact of the 2016 CDC guidelines on people with chronic pain created a swath of collateral damage. People with controlled chronic pain functioning well with opioid pain control therapy, were literally cut off by physicians, and many committed suicide. I believe the CDC has blood on their hands for publishing guidelines that were adopted as law in many states. I have had 6 back surgeries due to disease and would not have a greatly needed surgery fearing that my surgeon could not manage the duration of my pain. I actually left the state of Tennessee to have surgery in another state that did not adopt the 2016 CDC opioid guidelines. Most opioid overdose is from illegal fentanyl, the idea of treating legitimately ill patients like drug addicts is the result of the 2016 CDC guidelines, which have also invaded the physician-patient relationship. If pain was a one size fits all, as the 2016 CDC guidelines are, we would not need physician judgement. I think CDC has much blood of chronic pain patients on their hands. Perhaps leaving opioid decisions to the physician's judgement is better than a one size fits. Less is more with CDC intervention between physician judgement.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	April	None	None	0900006484fa3a48	Eidson	None	2022-02-25T02:53:32Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Eidson, April	l01-mxk3-9r3w	False	None	False	2022-04-12 03:15:09.894	[]
1473	CDC-2022-0024-1480	https://api.regulations.gov/v4/comments/CDC-2022-0024-1480	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Guillain Barre Syndrome, neuropathy in arms/hands and feet, and drop foot. Non diabetic peripheral neuropathy is extremely painful. A 24 hour flare incapacitates me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fa3a7e	Grimes	None	2022-02-25T02:53:54Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Grimes , Kevin	l01-o76e-v627	False	None	False	2022-04-12 03:15:10.105	[]
1474	CDC-2022-0024-1481	https://api.regulations.gov/v4/comments/CDC-2022-0024-1481	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who has been restricted from using opiates due to a new severity rating score for the state I live in. I followed all rules of the pain clinic, passed all drug tests, counting of pills and I was living a relatively normal life able to do a lot more than I can do now. I was on a very low dose of 5mg 2x a day of OxyContin. This was tapered down from 3 months of 10mg 2x a day. I was referred to pain management in a very prestigious university from my endocrinologist after I developed a rare condition while pregnant known as PLO or "pregnancy lactation induced osteoporosis" I suffered 8 compression fractures to my thoracic and lumbar spine, insufficiency fractures of pelvis and sacrum. My back popped one day lifting my not even 10 pound baby out of the crib. That moment changed my life forever. With a collapsed spine I sought medical help but ignored. It took months before I could get an MRI and an actual diagnosis. During that time I was referred to PT and more damage was done when I heard that pop again unable to get off table. With the stress on my body caused by opiate withdrawal with no taper I developed an autoimmune disorder, Graves’ disease further complicating my physical and emotional recovery. No one believed my pain then and not now. 4 years later no doctor will prescribe me opiates bc of some obscure rating aka bias of my mental health history. Who hasn't experimented with drugs in college?! I am a licensed clinical professional well versed in patterns of addiction and what is truly risky opiate prescription users. These guidelines ruined many lives including mine. I know what works I am responsible with my use of them. Following all the rules but yet there are millions like me who needlessly suffer. There has to be a better way to help us. I have considered finding street heroine and or ending my life. It truly breaks my heart for the ones who suffer even more than me. Please help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3aa1	Anonymous	None	2022-02-25T02:58:52Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-q1no-fsqf	False	None	False	2022-04-12 03:15:10.322	[]
1475	CDC-2022-0024-1482	https://api.regulations.gov/v4/comments/CDC-2022-0024-1482	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been treated for chronic pain since 2014. The initial treatment was due to a car accident, but at the time I was also in a very, very abusive marriage. My pain management regimen has decreased by 3/4, my quality of life the same. I have recently been experiencing the most severe pain that I have ever felt in my life. The decrease in medication has made a drastic impact on both my mental health and finances. I cannot work like I used to, even trying different jobs. Lifting, sitting too long, standing too long, turning a particular way, even shifting unknowingly in my sleep, I SUFFER. Although I have medical conditions, each and every time that I have an episode I can't help but contribute some of the pain to the abuse that I had endured. It is a constant reminder. I am frustrated, hurt, and I honestly feel hopeless/helpless. I used to have a great relationship with my doctor, but things have changed. I get it, it's their career, their means of income, but the same goes for us. I have never struggled financially the way that I have since I have not been able to work like I used to. I am 34 years old, I shouldn't feel this way. I was going to the ER 4-5 times per month, but now I try my best to stick it out because of how they treat patients prescribed medication for pain. Imagine risking being exposed to COVID because of your pain. It gets that bad, and nobody will listen.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3ac2	Anonymous	None	2022-02-25T03:00:15Z	None	None	1	None	2022-02-24T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-qjjd-xrqk	False	None	False	2022-04-12 03:15:10.540	[]
1476	CDC-2022-0024-1483	https://api.regulations.gov/v4/comments/CDC-2022-0024-1483	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	25 years ago I fell down a story and half at a fire station, and immediately destroyed my right ankle joint. I was diagnosed with avascular necrosis a month after surgery and my ankle collapsed shortly after that. Fusions surgery failed, no one would touch me with an ankle joint replacement. The bone on bone pain was unbearable. My doctors put me into a pain management program and their recommendation was for me to use the fentanyl patches. My grandma had died using those so I told them I would not use those. They then came up with a combination of time release morphine sulfate and dilaudid. I was very responsible with my medication. Instead of increasing dosage amounts, I changed my activities when I felt I needed "more help." I was on these medications without issue for 20 years. Then my doctor retired. During the middle of covid I was called in by my new doctor, who then told me that I was going to be forced to taper. She didn't tell me down to what as I would "freak out." I asked her how I was going to hold a job, walk take care of my special needs child? I was already told it was a miracle I could walk.. and she said I could have a wheel chair and motrin. Now they have given me a high dosage of motrin and I am in so much pain I can barely function. I lost my job and I am having to try and live of social security. I can no longer exercise, so I have gained a lot of weight, which has led to other health issues. Running errands is no longer something I can do on my own. I can't stand long enough to cook, or clean. I am depressed and miserable, and the scary part is I am still not done tapering! I don't know how I am going to survive if they take away more. I really hope you make changes because even if the long term effects of the pain meds end up being a negative thing, at least I can live now. This is not living. I feel like I am being punished for people who were being irresponsible. I was not one of those people. I depended on these medications so I could function. Thank you for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deena	None	None	0900006484fa3b60	Foley	None	2022-02-25T10:48:29Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Foley, Deena	l02-237i-paol	False	None	False	2022-04-12 03:15:10.747	[]
1477	CDC-2022-0024-1484	https://api.regulations.gov/v4/comments/CDC-2022-0024-1484	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please, please, PLEASE remove any and all references to MMEs. Noone beyond the patient AND DOCTOR should be setting these limits. You have already seen, and admitted, that citing an arbitrary number of MMEs was DISASTROUS for pain patients. States erroneously legislated these numbers and destroyed the doctor/patient relationship. . So PLEASE don't tell my doctor how to treat ME. Citing numbers will only continue to erode ANY sense of comfort, confidence and freedom in being honest with my doctor. No government entity should be telling my doctor how to do his job... not importantly it shouldn't be telling ME that MY PAIN doesn't matter.... and that's EXACTLY the message you're sending with these ridiculous MME limits. Learn from the past and REMOVE the MMEs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lin	None	None	0900006484fa30c4	Anderson	None	2022-02-25T10:50:52Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anderson, Lin	l01-yez7-gbgm	False	None	False	2022-04-12 03:15:10.963	[]
1478	CDC-2022-0024-1485	https://api.regulations.gov/v4/comments/CDC-2022-0024-1485	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	With the 2016 CDC Guidelines it has ruined my quality of life like many others out there. Because of the MME’s you have created putting limits on meds makes them barely work for me and others like me with intractable pain. It’s a known fact that these guidelines are killing people either by getting meds off the streets in desperation or by suicide itself. Please leave the doctors and patients alone and let them continue to do their jobs being doctors and tell the DEA to go after the real problem with the illegal fentanyl that’s coming across our borders.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3b71	Anonymous	None	2022-02-25T10:51:27Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-4jm1-n5c4	False	None	False	2022-04-12 03:15:11.197	[]
1479	CDC-2022-0024-1486	https://api.regulations.gov/v4/comments/CDC-2022-0024-1486	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	With the 2016 CDC Guidelines it has ruined my quality of life like many others out there. Because of the MME’s you have created putting limits on meds makes them barely work for me and others like me with intractable pain. It’s a known fact that these guidelines are killing people either by getting meds off the streets in desperation or by suicide itself. Please leave the doctors and patients alone and let them continue to do their jobs being doctors and tell the DEA to go after the real problem with the illegal fentanyl that’s coming across our borders.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3b70	Anonymous	None	2022-02-25T10:51:51Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-4jlr-hv8p	False	None	False	2022-04-12 03:15:11.407	[]
1480	CDC-2022-0024-1487	https://api.regulations.gov/v4/comments/CDC-2022-0024-1487	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You need to remove the morphine milligram equivalent. It is not helpful. It needs to be gone altogether. Pain is not objective. Everyone is different. Therefore medications can’t be dispensed as a one size fits all because it doesn’t work. Plan B us a great example of how one size fits all doesn’t work because it stops being effective once you’re over 150 lbs. Tolerances work the same way and you are still punishing pain patients. We need our meds to survive. Please stop punishing us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alissa	None	None	0900006484fa3b42	Belyeu-Ayers	None	2022-02-25T11:25:49Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Belyeu-Ayers, Alissa	l01-xtc9-73q2	False	None	False	2022-04-12 03:15:11.622	[]
1481	CDC-2022-0024-1488	https://api.regulations.gov/v4/comments/CDC-2022-0024-1488	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. For the last 12 years I was on a dose of 10mg of oxycodone four times a day. The entire past 12 years! Not a bad urine test, not a bad pill count. In the last two months my Pain Management Doctor has cut my dose by 2/3rd. I can no longer read, cook, participate in normal day to day life due to the pain.<br/><br/>Make it legal for doctors to treat patients fairly! <br/><br/>I feel like I'm being treated like an addict.<br/><br/>I've watched people I loved writhe in pain due to your interference with the medical profession.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tess	None	None	0900006484fa3b53	Rowan	None	2022-02-25T11:30:24Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Rowan, Tess	l02-0rpw-xisj	False	None	False	2022-04-12 03:15:11.848	[]
1482	CDC-2022-0024-1489	https://api.regulations.gov/v4/comments/CDC-2022-0024-1489	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I’m a CRPS patient who has lived with the horrible debilitating disease for over 24 years. It has continued to get worse over time and now consumes 100% of my body,,including my internal organs. CRPS, Complex Regional Pain Syndrome is a wicked pain disease that can attack any part of you body. It is a pain worse that cancer or child birth. I live with that pain at a level of 9 out 10 on the pain scale. Before 2016 my pain was being managed very well by using opiods and benzodiazepines. I could function and contribute to my family and community. Then the CDC decided to get involved in my medical care by authoring new guidelines that reduced the medication I could receive. They targeted all pain management doctors for prescribing opiods. My doctors immediately forced tapered my meds to a level so low they were totally ineffective. My quality of life went to hell. My pain and CRPS began attacking my body rendering me bedridden and requiring a motorized wheelchair in order to get around. Now both legs and feet along with my right arm are in so much pain they can not be touched. Even my bedsheets hurt. The CRPS is an auto immune disease attacking my sympathetic nervous system. It affect my blood flow as well as making my skin hypersensitive. I lose my body hair in the areas affectied and I get skin lesions that are very painful and take months to heal. My wife has had to take time off work to care for me. The new CDC guidelines still include mme recommendations for chronic pain patients and they must be removed. They jeopardize our health and well-being. They are also used as a tool to target good doctors who are trying to help pain patients. If you want to go after the real problem, seek out the illegal fentanyl and heroine users. If you continue to go after chronic pain patients and their doctors, you are only forcing us to seek out illegal street drugs. This will result in thousands of death by overdose or suicide. Please help us and do the right thing. Respectfully submitted, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fa3b65	Gallagher	None	2022-02-25T11:34:48Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Gallagher, Michael	l02-2srb-k7iu	False	None	False	2022-04-12 03:15:12.109	[]
1483	CDC-2022-0024-1490	https://api.regulations.gov/v4/comments/CDC-2022-0024-1490	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for 27 years; I have had 5 back surgeries & 15 broken bones in just the last 5 years; I am 56 years old but my bones are like a person in their 90's I have a disease called brittle bone syndrome; I have had arthritis since I was 13; I have had cervical cancer; thyroid cancer; & I am now on Palitive care for the last 3 years; but for the last year I have had to worry every month about my pain meds; I have never took more than amount my Dr prescribes; I have never mis-used my pain meds; I worry every day what will I do if the government makes it where I can't take the pain meds I am on now; which still is just enough to keep me from being in severe pain; the amount I am on now is not even what controls my pain but it absolutely keeps me from living in my bed 24/7; it keeps me from being in a wheelchair anytime I get out of bed; I am paralyzed in my right leg but I fight daily to walk with a walker; I hurt so bad that at 4am every morning I am crying when I first wake up cause the pain is so bad! My Dr is absolutely amazing he has me on the most he can have me on right now; & he knows it's not the amount I truly need but I still can't imagine my life if I had to be reduced any lower; so I know you don't know me; & I know there is hundreds of thousands pain patients begging to not have their pain meds reduced of taking away completely so I am just another pain patient to y'all; but I pray that those making these rules & changes in pain meds never have to feel the pain I go through even 1 day; I don't wish my pain on anyone! I can't have anymore back surgeries cause my bones are to brittle for the surgeries; so my only way to have a little relief is my pain meds; & those are being threatened to be taken away from me! & I just don't know what I will do if this happens so I truly can only pray that y'all will think of all the people like me that will truly be miserable & it's not just me that would be miserable if I didn't have pain meds but my grandchildren; my mom who is 86 & I love with her; she is in better health than I am; so I live in fear lately that one day I will be told I can no longer take pain meds that can truly give me some relief so I can actually live! Please know I am not good with my words but I am coming to you as they say "on bended knee begging y'all to really think what you will be doing if you take chronic pain patients pain meds away or reducing them to very little? <br/>I hope my letters is read & I pray that if you do read this you can feel the pain I am feeling & know even me typing this hurts my fingers; & sitting up in a chair longer than 30 mins hurts me so bad; but right now I have something I can take that will allow me to do this; but if you were to take my meds or reduce them super low; I would be laying in my bed again crying in pain & begging for some relief; we don't let animals suffer please don't let us suffer	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bridgette	None	None	0900006484fa3ae1	Byrd	None	2022-02-25T16:27:20Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Byrd, Bridgette	l01-s3he-ey8n	False	None	False	2022-04-12 03:15:12.346	[]
1484	CDC-2022-0024-1491	https://api.regulations.gov/v4/comments/CDC-2022-0024-1491	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines have been misused horribly by pain mgmt drs to the detriment of pain patients everywhere! I have been disabled from surgeries meant to help a back injury for 20 years. I had a Clydesdale horse fall on me and have herniated discs, compression fractures from severe muscle spasms, bulging discs, ruptured discs, fibromyalgia, rheumatoid arthritis, regular arthritis, and severe post laminectomy pain amongst other things. Before the 2016 guidelines I was stable on a higher dose of opioids for years with no problem from the medications whatsoever. I never abused my medications, I never failed a drug test, I have no history of addiction, and I had some semblance of a normal life. In 2016 due to the CDC guidelines, my meds were cut drastically and so was my quality of life. 2 years ago my meds were cut by another 75% with no tapering by a pain Dr citing the 90mme limit from the CDC guidelines (despite those guidelines not being meant for pain mgmt situations most pain drs use them now anyway). In the past 2 years, I have been unable to sleep for more than 2 hrs at a time, I'm stuck in bed 24/7, I've had to start blood pressure medicine, hormones, cholesterol medicine, I no longer have any independence or mobility, I've been diagnosed with 2 new autoimmune diseases, I can no longer exercise or do physical therapy and my depression and anxiety have skyrocketed. I can barely get myself in the shower, much less do basic household chores. I can no longer handle going grocery shopping and have no chance at all of doing anything recreational anymore. My quality of life is so small now due to untreated pain that I often consider suicide. Something needs to change, pain management should be a human right. The mme scale has been proven to not be accurate since every patient has different genetics, biology, metabolism etc. Pain mgmt is not a one size fits all thing, like every other branch of medicine. I agree 100% that the pill mill situations needed to be shut down, but the patients who have a long term history of needing opioids to treat severe pain shouldn't be punished because of a handful of doctors doing something they shouldn't have! Those of us who have been forced off our medication, usually with no tapering, for no reason other than these CDC guidelines have been left with 3 choices: live a life of no quality in excruciating pain, seek illegal dangerous street drugs, or commit suicide (which a horrible number of pain patients have done since 2016). I know for a fact there are many people far worse off than I am and I can't imagine how they are still alive. Please, I beg you, ammend these guidelines and let the drs treat their patients as they see fit without fear of repercussions from the government! Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3084	Anonymous	None	2022-02-25T16:59:12Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-vezv-tuqf	False	None	False	2022-04-12 03:15:12.561	[]
1485	CDC-2022-0024-1492	https://api.regulations.gov/v4/comments/CDC-2022-0024-1492	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been living in Chronic pain for the last 20 years with multiple diagnosis. After 20 years on opioid medication because my spine is beyond fixing. I follow all the rules with my medication. My pain medication has been cut to one third as of last month. The doctor says is because of the new CDC guidelines for prescribing opioid. I am in absolute agony now on a daily basis. What is the sense of living with having to lay in bed every day. I've had to give up all my passions in life due to pain. Why are you punishing good people that suffer every day? Because of bad decisions made by some. I'm at my wits end.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn M	None	None	0900006484fa30a3	Skinner	None	2022-02-25T19:28:14Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Skinner, Dawn M	l01-xb37-ok5h	False	None	False	2022-04-12 03:15:12.773	[]
1486	CDC-2022-0024-1493	https://api.regulations.gov/v4/comments/CDC-2022-0024-1493	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been living in Chronic pain for the last 20 years with multiple diagnosis. After 20 years on opioid medication because my spine is beyond fixing. I follow all the rules with my medication. My pain medication has been cut to one third as of last month. The doctor says is because of the new CDC guidelines for prescribing opioid. I am in absolute agony now on a daily basis. What is the sense of living with having to lay in bed every day. I've had to give up all my passions in life due to pain. Why are you punishing good people that suffer every day? Because of bad decisions made by some. I'm at my wits end.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn M	None	None	0900006484fa3b3e	Skinner	None	2022-02-25T19:28:32Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Skinner, Dawn M	l01-xb3n-y7j4	False	None	False	2022-04-12 03:15:12.983	[]
1487	CDC-2022-0024-1494	https://api.regulations.gov/v4/comments/CDC-2022-0024-1494	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You need to remove the morphine milligram equivalent. It is not helpful. It needs to be gone altogether. Pain is not objective. Everyone is different. Therefore medications can’t be dispensed as a one size fits all because it doesn’t work. Plan B us a great example of how one size fits all doesn’t work because it stops being effective once you’re over 150 lbs. Tolerances work the same way and you are still punishing pain patients. We need our meds to survive. Please stop punishing us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alissa	None	None	0900006484fa3b43	Belyeu-Ayers	None	2022-02-25T19:36:21Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Belyeu-Ayers, Alissa	l01-xtdd-0h5r	False	None	False	2022-04-12 03:15:13.191	[]
1488	CDC-2022-0024-1495	https://api.regulations.gov/v4/comments/CDC-2022-0024-1495	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe that the only reasonable guideline should be that the only person who can decide how an individual patient should be treated when it comes to any medications, surgeries, therapies, or any other medically related decision should be left alone to the people who possess the necessary education required and have earned a Doctorate degree in medicine or the equivalent required for the license to practice medicine however is required by the state in their respective districts. Anyone who does not possess the necessary education as well the proof by which they earned the official documentation provided by nationally recognized medical education programs etc. should not have a say in any decisions or course of action or methods of treatment any respectable Licensed Doctor makes regarding his individual patients except in special circumstances <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3ff6	Anonymous	None	2022-02-25T19:42:58Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous , Anonymous	l02-g3ts-mp83	False	None	False	2022-04-12 03:15:13.402	[]
1489	CDC-2022-0024-1496	https://api.regulations.gov/v4/comments/CDC-2022-0024-1496	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. My name is [name redacted]. I have been in long term pain management for several years as a result of having 4 spine surgeries. These surgeries caused severe nerve damage. My life today has no resemblance to my life before these surgeries. My husband and I used to participate in competition ballroom dancing. Today, I can’t even go food shopping.<br/>I completely appreciate the governments issues in dealing with the Opioid epidemic in our country today. For someone like me, a middle aged taxpayer who worked at the same job for 38 years, and now I am on social security disability. The regulations already in place make my life a living hell at times. If I have pain and take 1 extra pill, I must go without pain medication for a day at the end of the month. Up until a year ago, we lived in a county where I needed to travel an hour just to find a pharmacy that carried the drugs prescribed for me.<br/>I am unable to function without the drugs prescribed for me. I am carefully monitored by my pain management physician with monthly visits that include urine testing as well as blood pressure monitoring. <br/>Please do not pass any law that would change my life for the worse. Thank you .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fa3ff7	Johns	None	2022-02-25T19:44:35Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Johns, Deborah	l02-g5fv-kcd2	False	None	False	2022-04-12 03:15:13.610	[]
1490	CDC-2022-0024-1497	https://api.regulations.gov/v4/comments/CDC-2022-0024-1497	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is a real concern about the abuse of opioids and the simple profit motive we know that the pharmaceutical companies have put above the well being of ourselves and our families. This does not disregard the needs of some people that are suffering. Of course there should be a pathway to providing needed medications but too often, as history tells us, the prescribing of opioid pain medications helped create a crisis that started with a lie that OxyContin was not addictive. It went even further to rate the certification of hospitals based on pain as a fifth vital sign and the wheels fell off.<br/><br/>Over time we have found that in any cases opioids are not necessary to manage pain. The ease at which they have been prescribed is dangerous and does not increase quality of life but rather harms individuals and families.<br/><br/>Somehow we need to provide bumper guards and practical regulations that will guard against misuse and over prescribing, not forgetting pathways to help those that have conditions that only respond to the opioid medication.<br/><br/>Remember, the entire lie that was told about opioids started with a study on patients who had terminal cancer and from that the pharmaceutical companies spread the lie that OxyContin was not addictive. We must be vigilant against the marketing campaigns that existed throughout history, starting with Morphine, through heroin, and on-and-on.<br/><br/>To summarize, the use of opioids should not be withheld from truly appropriate patients, while at the same time keeping in mind the potential (proven by history) of the dangerous and devastating effects of over prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fa4031	Gonnella	None	2022-02-25T20:09:37Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Gonnella, James	l02-h1pl-t4l6	False	None	False	2022-04-12 03:15:13.819	[]
1491	CDC-2022-0024-1498	https://api.regulations.gov/v4/comments/CDC-2022-0024-1498	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Primary Progressive Muscular Dystrophy There is no treatment for me or any kind of medication to help make this better. The only thing for me are opioids. I'M IN PAIN 24/7 WITH NO RELIEVE EVER!! What your doing is a crime your robbing me of any kind of a life. I wish you would reconsider your guidelines as I'm sure there are more people out there like me. Please	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484fa419f	Roth	None	2022-02-25T20:10:21Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Roth, Cindy	l02-i59a-mexk	False	None	False	2022-04-12 03:15:14.040	[]
1492	CDC-2022-0024-1499	https://api.regulations.gov/v4/comments/CDC-2022-0024-1499	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been living? With pain from an auto accident hit from rear. [Name redacted] on his phone didn't use breaks at all. I had been a firefighter for 26 years ,captain . I was taking scba cylinders to have hydro. Tested part of my captain duties. I didn't claim worker's comp. My friend Fire chief was doing much work I didn't want to put more on him.I have had many injections 3 made it worse never again! The opioid medication helps but the reduction has made it worse!! It is wrong to make people suffer because others abuse these. My name is [redacted] you can reach me at I hope something positive comes from this!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484fa4447	Brockman	None	2022-02-25T20:27:52Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Brockman, William	l02-o8ey-o371	False	None	False	2022-04-12 03:15:14.302	[]
1493	CDC-2022-0024-1500	https://api.regulations.gov/v4/comments/CDC-2022-0024-1500	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted]. I have spinal stenosis and have had this for well over 30 years. The condition has worsened over the years and the only relief I get is with opioid medication and physical therapy. They go hand in hand.If I didn’t have the medication, I wouldn’t be able to get out of bed on many days. I am not overdosed. I function perfectly. I am able to do routine activities including shopping, long walks, playing with my grandchild.By restricting my allocation of opioid medication, has restricted my day to day living. Drs are worried about prescribing that they will be tormented by the DEA or DOJ. This is my life. Please seriously consider withdrawal of 2016 guidelines that are flawed and weakened by lack of medical evidence and anti opioid bias.and gross exaggeration of opioid misuse by qualified drs.<br/>Standards for treatment should be set by professional medical associations and those who treat patients. Please, this is my life you are playing with.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ellen	None	None	0900006484fa444b	Forti	None	2022-02-25T20:30:21Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Forti, Ellen	l02-occr-novh	False	None	False	2022-04-12 03:15:14.521	[]
1494	CDC-2022-0024-1501	https://api.regulations.gov/v4/comments/CDC-2022-0024-1501	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I HAVE BEEN A PATIENT AT [location redacted] IN ALASKA. MY DR. ,DR.[name redacted] JUST WANTS TO GIVE NINE THOUSAND DOLLAR INJECTIONS OR HE DOESN'T WANT TO SEE YOU. MY PRIMARY CARE PHYSICIAN ACTUALLY SITS AND LISTENS TO ME AND DOES A CHECKUP ON ME ,REFERS ME TO SURGEONS FOR OPERATIONS THAT I DESPERATELY NEED DONE AND HIS SAME INJECTIONS THAT HE DOES ARE THREE HUNDRED DOLLARS. WHAT A DIFFERENCE. AND HIS ACTUALLY HELP MY SCOLIOSIS, UPPER AND LOWER, MY SCIATICA PAIN, SPINAL STENOSIS AND SPONDYLOSIS. HOWEVER HE CANNOT PRESCRIBE ME MY PAIN MEDICATION THAT I HAVE BEEN ON FOR 13 YEARS. IM TAPERED DOWN TO LESS THAN HALF OF WHAT I AM USED TO AND I'M IN AGONY. I WORKED FOR THE IRS AND BOROUGH AND SEVERAL BUISNESSES IN MY TOWN DOING THEIR DATA ENTRY WORK. I DEALT WITH THEIR BANK ACCOUNTS, MAKING SURE THAT EVERY PURCHASE WAS ELIGIBLE FOR A TAX WRITE OFF. NOW IT TAKES MY EVERY BEING TO GET OUT OF BED AND GET ON WITH MY DAY. I FEEL LIKE A WORTHLESS PILE OF FLESH. <br/>MY DR TELLS ME THAT I AM ON PALLIATIVE CARE WHICH I BELIEVE IS A LIE BECAUSE I HAVE NOT RECEIVED A PHONE CALL FROM THEM. I'VE LOST MY OLDEST SON, MY MOTHER, MY STEPFATHER, MY GRANDFATHER, MY ONLY SISTER AND MANY FRIENDS WHO HAD DEBILITATING DISABILITIES AND WERE BEING TAPERED AND IN A TEN YEAR PERIOD THEY HAVE COMMITTED SUICIDE STARTING WITH MY HUSBAND OF 18 YEARS. PEOPLE WONDER HOW I'M STILL ALIVE. I BELIEVE THAT I CAN KEEP GOING AND HAVE FAITH THAT YOU WILL DO AWAY WITH THE90MME THRESHOLD. I CAN'T GET SSI OR SSDI BECAUSE I HAVE NO ONE TO HELP ME. I'M ABOUT 2 WEEKS FROM BEING HOMELESS AFTER LIVING IN MY APARTMENT FOR 5 YEARS. WE HAVE OVER 20 INCHES OF SNOW IN ALASKA. PLEASE I'M BEGGING THE CDC TO REMOVE THE MME GUIDELINES AND LET ME AND PEOPLE LIKE ME TO HAVE THEIR QUALITY OF LIFE BACK. THANK YOU SO VERY MUCH. SINCERELY, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angel	None	None	0900006484fa3b61	Torres	None	2022-02-25T20:34:11Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Torres , Angel	l02-2ay5-ugng	False	None	False	2022-04-12 03:15:14.777	[]
1495	CDC-2022-0024-1502	https://api.regulations.gov/v4/comments/CDC-2022-0024-1502	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am 66 years old, I have suffered from arthritis in both knees ankles back and shoulder. While on the appropriate amount of opiate medications described by my Pain Management physician I was able to get my Master’s degree and was able to work for many years a a ny state licensed, creative art therapist Ever since my medications have had to be resurrected because of arbitrary CDC regulations. I believe these refs were based on fear of the many overdosages of opiates - many of which from powerful o Fukui of Fentanyl type street drugs. I have suffered in recent sun despite trying many alternative methods of pain relief including years of physical therapy, chiropractic care, acupuncture to varying degrees of success. The medications I have tried in addition to opiates have left me drowsy forgetful. They do much more harm to my liver than the proper amounts of opiates. I am lucky that I can afford medical marijuana but the pain relieving effects are still a strain on my budget and not as effective in relieving my suffering. Sometimes when I can’t sleep because of pain it makes me feel suicidal. I want my medical issues not decided by 2016 CDC guidelines but by Pain management, specialist doctors without fear of persecution by the DEA. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fa3ac8	McCarthy	None	2022-02-25T20:47:40Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from McCarthy , Mary	l01-r2yq-p8uw	False	None	False	2022-04-12 03:15:15.179	[]
1496	CDC-2022-0024-1503	https://api.regulations.gov/v4/comments/CDC-2022-0024-1503	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who lives with chronic pain I have a lot of experience and knowledge with opioid use. I am considering moving to a warmer climate. Then I stop myself because I’m concerned I won’t get a doctor to prescribe the opioids for pain I’m on. <br/><br/> I have heard of doctors telling people they can’t be on pain meds and Xanax. Everyone who has chronic pain has anxiety. People should not have to chose. It’s inhumane.<br/><br/>The other thing I run into is my specialists want to know who is prescribing the opioids. I will be specific here. The pain management doctors do not prescribe opioids now. There answer is steroid shots and medical marijuana. I went that route. It helps manage the pain, not take it away. It will never replace opioids. If I had to chose it would be my pain meds. <br/><br/>When people are in chronic pain they will do anything to take it away. That’s where street drugs come in. If you can’t get your doctor to help you, it is an avenue or so they think to take away the pain. Then you add the problem of cutting drugs with who knows what and it’s not regulated. <br/> <br/>I am educated. As a matter of fact I worked on the h1n1 grant for pa. <br/><br/> We need to as a society come to middle ground here. Some people NEED pain medication that regulations are controlling not the doctor. <br/><br/>Thank you. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	0900006484fa3d9b	Meyer	None	2022-02-25T20:54:00Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Meyer, Tammy	l02-a4ce-hkn8	False	None	False	2022-04-12 03:15:15.409	[]
1497	CDC-2022-0024-1504	https://api.regulations.gov/v4/comments/CDC-2022-0024-1504	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Sworn Testimony by both sides in the May-July, 2021, WV Opioid Distributor’s Trial and all other such trials in other states against other opioid supply chain entities, including the Nation’s new Drug Tsar, Dr. [name redacted], agreed, “The people receiving Prescription Opioids are not the ones dying from them (their own prescription opioids) later!” This dispels the predicate for the existence of the Guidelines altogether! I can provide proof of this testimony!<br/><span style='padding-left: 30px'></span>Also in agreement of both sides in these trials, is that “most overdose deaths are occurring to people in their mid-twenties,” when most receiving prescription opioids long-term are fifty and older! There is also sworn testament to this I can provide! <br/><span style='padding-left: 30px'></span>These facts under oath call into question every paragraph of and the ultimate existence of the CDC’s 2016 and 2022 draft Opioid Prescribing Guidelines which cite “the major harm to patients receiving Opioid Prescriptions is their own overdose”, when the actual harm is caused by the CDC telling physicians what they see is not happening, and to restrict or suspend opioid therapy because of the potential harm of their own overdose. The factual harm is dictating clinical determinations contrary to a clinician’s knowledge and experience! Not to mention withholding pain treatment is a violation of International Law. That from testimony as well! <br/><span style='padding-left: 30px'></span>This all begs the question of WHY? HINT: $$$$$$$$$$$$$$$$$$$$ !!! <br/>~~~~~ END ~~~~~<br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fa3047	hughes	None	2022-02-25T20:55:20Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from hughes, Karen	l01-rh1z-y39v	False	None	False	2022-04-12 03:15:15.618	[]
1498	CDC-2022-0024-1505	https://api.regulations.gov/v4/comments/CDC-2022-0024-1505	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don't agree with this. I'm a pharmacy tech and work in an orthopedics office. I see primary care physicians acting as pain management specialists, over prescribing oxycontin om numerous occasions. I see orthopedics trying to limit the opioids after surgical procedures and people constantly asking for more, way after the surgery. Narcotics are an easy go to. There are other options that are not addictive. I understand for some, there is so much damage in their body, there's no other choice. But narcotics should not be that easy to obtain. It should be harder. The doctors prescribing them need to be select few, meaning no primary cares and other specialists for post surgical only. If any of them are prescribing still a prior auth would need to be obtained, and the insurance company needs to be keeping track of those continuously over prescribing and bring it to the DEA. The DEA needs to be watching this more closely and taking away some doctor's rights to prescribe narcotics. Making it easier to obtain for pain management does not help curb the opioid crisis, it helps feed it. I have seen oxycontin 60mg ER prescribed to someone for over 10 years. The diagnosis, headache. Seriously? Pharmacists need to step up more. Doctors who are not opioid happy need to step up. Pharmacy Technicians need to step up if pharmacists don't step up. Too many are dying. Too many are addicted. Be a part of the solution, not be a part of the problem.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa44f4	Anonymous	None	2022-02-25T21:00:20Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-pi2x-536c	False	None	False	2022-04-12 03:15:15.857	[]
1499	CDC-2022-0024-1506	https://api.regulations.gov/v4/comments/CDC-2022-0024-1506	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I highly recommend adding risk factor assessment BEFORE starting therapy not just when to to taper, but if opioids are being considered, a concomitant risk factor assessment for oversedation need to be taken into consideration: age, naive, post op, bzd use, obesity, smoker, OSA, pulmonary disease, renal/hepatic dysfunction, and if risk is high by having multiple risk factors opioid therapy, is not appropriate d/t risk >benefit. In addition when patients are on chronic opioids, especially with with risk factors above, and they become acutely ill, i.e sepsis, pna, etc. These opioids have a narrow therapeutic window and toxicity can occur even at chronically prescribed doses, its important to note that doses may need to be held or lowered based on symptoms and affected systems. These two points need to be emphasized for providers prior to management and during acute illnesses.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Yleana	None	None	0900006484fa4d09	Baggenstos	None	2022-02-25T21:01:30Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Baggenstos, Yleana	l02-pmf9-jyh4	False	None	False	2022-04-12 03:15:16.087	[]
1500	CDC-2022-0024-1507	https://api.regulations.gov/v4/comments/CDC-2022-0024-1507	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support the alternative treatment, like acupuncture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484fa4d27	Lee	None	2022-02-25T21:01:47Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Lee, Charles	l02-ptzh-69qi	False	None	False	2022-04-12 03:15:16.912	[]
1501	CDC-2022-0024-1508	https://api.regulations.gov/v4/comments/CDC-2022-0024-1508	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Support alternative treatment, acupuncture treatment	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jenna	None	None	0900006484fa4d28	Zhang	None	2022-02-25T21:01:56Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Zhang, Jenna	l02-pu7t-gk44	False	None	False	2022-04-12 03:15:17.116	[]
1502	CDC-2022-0024-1509	https://api.regulations.gov/v4/comments/CDC-2022-0024-1509	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support alternative treatment, like acupuncture.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leiqi	None	None	0900006484fa4d33	Chen	None	2022-02-25T21:02:26Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Chen, Leiqi	l02-q1f4-j9b0	False	None	False	2022-04-12 03:15:17.331	[]
1503	CDC-2022-0024-1510	https://api.regulations.gov/v4/comments/CDC-2022-0024-1510	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a severe chronic pain patient. I survived 5 cancers and a motor vehicle wreck that crushed 14 vertebrae from my neck down and permanently injured my right hip. I currently am suffering from a 6th cancer. There is no cure. Every month I have to be treated and go through the same process a felon on parole has to do just to be treated at a pain clinic. It feels like im being punished and forced to be in torturous pain because the guidlines mafe are hurting patients like me. I have two surgeries i can not have now because drs dont want to treat surgical pain. Those of us that have maintained long term pain care are meticulously monitored by drug tests. Pill counts and forced cold tirkey withdrawal that can result in death for any violation. We are treayed as if we did something wrong because the people that made these guidlines obviously do not understand addiction or know the difference of proper pain management. I wpuld end my lige of i didnt get tje medicines i need to have some quality left to my shortened life thay is guarunteed to invrease in pain and suffering. We dont let our pets suffer like that but its ok to let human beings suffer for misinformed facts about pain medications. Alcohol kills more people and yet its legal and has no consumption monitoring. These guidlines are causing more harm amd not doing anything but adding more people using illicit unsafe unmonitored dosing and administrating dirty drugs to get relief from debilitating pain that never heals. Never goes away. Even in your dreams. And its gets worse and more stronger doses are needed for patients suffering with pain like this. I can work.clean.cook.and participate in life on my medication. Wothput it im in bed crying in pain begging for it to stop even if it means death. My name is [redacted] and you can contact me amytime to go into further detail. [contact information redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eva	None	None	0900006484fa4d4d	Thomas	None	2022-02-25T21:09:43Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Eva	l02-qcv5-nlk0	False	None	False	2022-04-12 03:15:17.535	[]
1504	CDC-2022-0024-1511	https://api.regulations.gov/v4/comments/CDC-2022-0024-1511	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My comments are always long. I’m going to to get straight to the point. Rescind the ‘CDC guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa4d4f	Anonymous	None	2022-02-25T21:09:56Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-qfqk-e4l3	False	None	False	2022-04-12 03:15:17.744	[]
1505	CDC-2022-0024-1512	https://api.regulations.gov/v4/comments/CDC-2022-0024-1512	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Make opioids over the counter. My body my choice. Why can I get a gallon of vodka and shotgun but can’t treat my pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dave	None	None	0900006484fa4d7f	Smith	None	2022-02-25T21:10:20Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Dave	l02-qods-jttg	False	None	False	2022-04-12 03:15:17.947	[]
1506	CDC-2022-0024-1513	https://api.regulations.gov/v4/comments/CDC-2022-0024-1513	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please strictly control opioids. The opioid crisis in this country is absolutely out of control. Prescription opioids are a gateway to fatal fentanyl overdoses caused by addictions that can't be supported by prescriptions anymore. The number of people dying from fentanyl overdoses who started out with opioid prescriptions is crazy. We need to realize that casual prescription of opioids for moderate chronic pain was orchestrated for profit by pharmaceutical companies and is not supported by medical research. Other good options exist to control moderate chronic pain. Please, please help save lives from this awful opioid epidemic and control as strictly as possible the writing of prescriptions for opioids for chronic pain. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelsey	None	None	0900006484fa4e98	Brickl	None	2022-02-25T21:10:46Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Brickl, Kelsey	l02-tcpw-4ybr	False	None	False	2022-04-12 03:15:18.157	[]
1507	CDC-2022-0024-1514	https://api.regulations.gov/v4/comments/CDC-2022-0024-1514	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For 14 straight months from Feb. 2015 to April 2016 I was in agony with debilitating crippling head pain, 24/7. Then a doctor from Seaview pain clinic prescribed small dosage of oxycodone 2 5 mg pills. In 3 days the pain was gone and stayed gone for 2.5 years. Then in September 2018 a different Seaview doctor who'd been prescribing for about a year (first doctor had left Seaview) suddenly with no warning told me I was abusing the med and he switched me to morphine. When I asked, "what if this doesn't work?" he snapped, "then go somewhere else" and bolted from room.<br/>The morphine didn't work. The crippling head pain returned and hasn't abated. For 40 months, 24/7 I have been in agony, most days screaming, crying lying in bed paralyzed.<br/>My PCP says he would prescribe but his hands are tied he's afraid of losing his license and being arrested.<br/>The 2026 Guideline was hijacked by law enforcement DEA and opportunistic state legislatures which have severely restricted opiate prescriptions.<br/>Please get the DEA and politicians out of my doctor's exam room. They are not qualified to dictate what meds I can take. Should be between me and my doctor.<br/>This draconian prohibitionist policy has not only worsened the very real problem of abuse/overdoses, it has created a new crisis--under treatment of pain. Most overdoses and abuse stem from fentanyl, illicit opiates, mixing with heroin cocaine and alcohol. The vast majority of chronic pain patients are responsible patients who take meds under doctors' supervision. Now many are suffering in agony through no fault of our own. <br/>During those 2.5 years I showed NO signs of opioid abuse. I NEVER asked for higher dosage. The Seaview doctor who rudely terminated my prescription didn't even know the medication he had been prescribing me. He said it was Vicodin!<br/>Medical treatment should not be one size fits all. It should be individualized. No one else has lived on this vessel for 68 years. I know what works and what doesn't. Now I am in agony 24/7.<br/>There's a difference between dependence and addiction. I am a chronic pain patient, NOT a criminal and drug addict. This system is condemning me in the last years of my life to agony and torture. Why? Stop this madness. I know I'm not alone. Get the DEA out of my doctor's office!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fa4eec	McGuire	None	2022-02-25T21:14:08Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from McGuire, Kevin	l02-uios-3a4i	False	None	False	2022-04-12 03:15:18.361	[]
1508	CDC-2022-0024-1515	https://api.regulations.gov/v4/comments/CDC-2022-0024-1515	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Afternoon,<br/><span style='padding-left: 30px'></span>As a patient who suffers with chronic pain for the better part of Adult life first from sever Rheumatoid Arthritis as well as psoriasis and psoriatic Arthritis and had both knees replaced within a year of each other as even with pain meds it was dramatically limiting my every day task this was in 2013 -14 and was seeing a pain mgmt doctor and was being prescribed pain meds since 2004 and never had an issue filling them this was until the CDC started there war on Doctord that prescribed them and patients who took them my pain mgmt doctor said he could no longer treat me because he was limited on amount of medication he could prescribed. I went to almost 15 pain mgmt doctors to try and be treated for the non stop pain I had all necessarily documents supporting my disability and use if opuods as some relief frome the non stop pain and all I was told me I needed to stop the Medication and enter rehab I asked the same question if all how is this going to help with my pain not q would fibe an answer all said well cross that bridge when we come to it really I cross that bridge repeatedly on a daily basis so finally was able to get my Rheumatologis to prescribed them but was cutting back amount of .Ed's all while I was having no lef leg above the knee Amputation due to the only replacement becoming infected so now I rec more approx half the amount of medication prescribed Yeats pror to my Amputation yet I sit here today in more pain than wow before and habe contemplated suicide just ro relief the pain bcouse my pain now is worse than ever as my other knee replacement failed and need revision surgery bit know doctor wants to do that kind of surgery on an amputee!! So I sir here with basically no quality of life because off the CDC's war on people who take these medications to make it thru one day and the medication isn't nearby enough and instead of getting help your going to make it harder on Patients like nyself to get the medication and amount needed to try and make it thru the day!! Trust me neither me or may family will forget what you've done and countinue to do to make my life and so many others like me so difficult for a lousy pull that gets them relief try consuntrating on illegal drugs coming across our basically open Border <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fa4eed	Cadugan	None	2022-02-25T21:26:34Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Cadugan , Robert	l02-uom8-rka8	False	None	False	2022-04-12 03:15:18.566	[]
1509	CDC-2022-0024-1516	https://api.regulations.gov/v4/comments/CDC-2022-0024-1516	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who is living with extreme pain right now, being refused any treatment and bounced from doctor to doctor, I don't think the government should decide how a doctor treats their individual patient. I absolutely understand what you're trying to accomplish and I've lost people to the opioid epidemic and I work for a government agency that deals with a variety of clients with substance use issues. Good, honest, hardworking people are being denied basic health-care to alleviate pain by doctors who fear government retribution. I may have to quit work & file disability simply because no one will treat me & even attempt to find the source of my pain. They assume I'm drug seeking. What you're doing is not working.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tamela	None	None	0900006484fa50b0	Robinette	None	2022-02-25T21:27:05Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Robinette, Tamela	l02-wa15-w76b	False	None	False	2022-04-12 03:15:18.786	[]
1510	CDC-2022-0024-1517	https://api.regulations.gov/v4/comments/CDC-2022-0024-1517	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand trying to stop the opiod addiction. It is shameful that so many loved ones have died, however, for those of us that suffer from chroni illnesses, which are EXTREMELY painful and debilitating, I cannot imagine not having access to medicine to treat my pain. I have intercystial cystitis, rheumatoid arthritis, fibromyalgia and NASH which all cause horrific pain which is 100 times more painful when I am in a flare. Pain medicine is not a cure for me, but it helps. I cannot imagine how horrid my life would be without legal access to medicine to treat my pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brock	None	None	0900006484fa50bb	Tamara	None	2022-02-25T21:27:33Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Tamara, Brock	l02-watq-ao3a	False	None	False	2022-04-12 03:15:18.997	[]
1511	CDC-2022-0024-1518	https://api.regulations.gov/v4/comments/CDC-2022-0024-1518	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I do believe that the CDC should let Drs, especially Pain Management Drs decide what their patients need to help them when they are in the Chronic Pain like I've been in since 2000.I don't know how or why it started, but I had a simple back surgery in 2000, & was ready to go back to work, when all of a sudden I started to fall in serious debilitating pain. So bad no one could touch me until it passed. I couldn't go back to work & I worked very hard up until that time. I had so many tests, treatments, & medications given to me & nothing seemed to work. Looking back I was also misdiagnosed so many times it literally made me depressed. The pain was so bad I honestly at times couldn't take much more of it. To live for 10 years with no answers & medication that didn't work until I tried the trial of a spinal cord stimulator. It worked then they put the permanent one in & it was like I was misfiring and kicking and jolting. Remember back then it was fairly new. They finally put in a morphine pump & I can't tell you how that saved my life. Had I had a Pain Management Dr to help in the way they should've, I'd probably still have it today. But health insurance being what it was, I had to go where they told me until I FINALLY met Dr Edward Rubin. But that's getting a little bit ahead of myself. <br/>Due to poor insertions of the pump, gaining and losing weight I had them changed out 3 times. The last time "that" Dr had said lets start over,as I think I can help you more if we start from scratch. I agreed.<br/>Slowly he lowered the morphine in my pump on each refill & every month he would take it down 3 to 5mg so it wouldn't affect me in a bad way. I was down to about 15mg when I doubled over in pain & couldn't get to the hospital he worked out of, & went to the nearest hospital & had to admit me. I was very bad, had infection & a ruptured ovarian cyst. I called my Pain Management Dr & told him what happened. I ended up there for 3 plus weeks. So they suggested while admitted under their Pain Management care, to why not get the pump taken out now, so I wouldn't have to go home to only come back in again in a matter of 2 weeks? Made sense, so I did it. Right before I was discharged I got a message from MY Dr, & he said I was no longer his patient. I was blown away, now what? HE wanted to start over figure out what was going on with me, get the RIGHT diagnosis & go from there, as I've been hurting since my initial surgery in 2000,and we are in 2007 at this point & now I'm left without anybody. I was SO upset! <br/>Thankfully a new Pain Management Dr who "took" my insurance started at WUH before I was d/c'd, & took me on. We DID sort of start over & he found I had RSD (Reflex Sympathetic Dystrophy), but today its called CRPS. (Chronic Regional Pain Syndrome). This is a pain I wouldn't wish on anyone. It's pain all the time, however at times it increases in intensity so badly you just want to cry or die. That coupled with Fibromyalgia isn't fun. It took MANY years to figure out how to keep my pain under control. Although the stimulator in the end didn't work due to scar tissue blocking some nerve receptors, & the morphine pump which was fantastic, is probably the way I should reconsider, but it also has its issues as well. Like my weight up and down, & the machine moving about in placement etc. Now medication. We FINALLY got a regimen that works together for 80% of MY pain. It's a cocktail if you will that works together to bring my pain down to a 4 out of 10. I actually can live my life a little better today without worrying about being an 8 or 9 out of 10 being the worst pain in the world.<br/>Now the CDC says they want to take ppl like myself, or cancer patients, or those in serious daily pain like MS also, & say no more, we want you on homeopathic meds, or going thru therapy or talking to ppl etc. How do you think this will help ppl in chronic pain like myself? I've TRIED & TRIED these avenues, & more, TRUST ME, I HATE taking medications,as I know it can maybe do badly for my body sooner or later or maybe do nothing, NOBODY KNOWS as everybody is "different". And those are the KEY words here, EVERYBODY IS DIFFERENT! Medication should be left to the Dr to decide on a case by case basis. To HAVE TO take my vitals everyday to prove I'm okay is an inconvenience at best, but I'm doing what I must, however I do forget, especially after taking a serious fall just 2.5wks ago. I've added even MORE pain that the meds I'm currently on won't even touch this pain at all, BUT MY DR is limited & can't help me & why? Because the CDC not our Drs are in control of us. So I'm hurting even more now. So are we to suffer for the rest of our lives because their is a drug epidemic out there & has nada to do w/us? The problem the CDC should be watching are the ILLEGAL drugs ppl are taking & let our Drs keep monitoring us in case someone takes more than prescribed & find out WHY & not take our meds away & let us suffer in pain, that's not right is it?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006484fa5215	Fincken	None	2022-02-25T21:32:45Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Fincken , Wendy	l02-x0lc-8q38	False	None	False	2022-04-12 03:15:19.202	[]
1512	CDC-2022-0024-1519	https://api.regulations.gov/v4/comments/CDC-2022-0024-1519	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to urge the public withdrawal of the 2016 CDC Guidelines on grounds that these documents are flawed by weak medical evidence, naive and uncritical anti-opioid bias, gross exaggeration of opioid treatment risks, incorporation of junk science, and misrepresentation of the efficacy and safety of non-opioid alternative therapies. Not everyone that is prescribed opioids misuses or abuses he medications. Countless veterans like me, seniors, and accident victims take opioids responsibly to manage chronic pain. Given the CDC's less than stellar performance in responding to the COVID-19 pandemic, I don't see where those of us receiving pain management treatment should be victimized by the continued adherence to the 2016 CDC guidelines. More trust should be placed in the doctors who prescribe opioid treatment instead of being under constant scrutiny.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paule	None	None	0900006484fa4391	Pachter	None	2022-02-25T21:33:32Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Pachter, Paule	l02-nftb-7kre	False	None	False	2022-04-12 03:15:19.476	[]
1513	CDC-2022-0024-1520	https://api.regulations.gov/v4/comments/CDC-2022-0024-1520	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please, I want my life back!!!<br/>I live in constant pain and anxiety thanks to Prop and the cdcs changes.<br/>PLEASE remove all mention of mme from ALL 229 pages from this document, and PLEASE let doctors and pharmacists get back to doing their jobs without fear again!!!<br/>This was a whim.<br/>No study was done. <br/>No proof was had.<br/>These ppl are after money and not the welfare of the chronically pained or mentally needful ppl!!<br/>Please, please.<br/>We want to live happy lives too!<br/>Because of these laws on opioids we live in suicidal misery.<br/>Have mercy on us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa42ea	Anonymous	None	2022-02-25T21:34:24Z	None	None	1	None	2022-02-25T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-ksyc-qkfh	False	None	False	2022-04-12 03:15:19.693	[]
1514	CDC-2022-0024-1521	https://api.regulations.gov/v4/comments/CDC-2022-0024-1521	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE SEE ATTACHED FILE	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bradley	None	None	0900006484f9eebb	Percell	None	2022-02-26T21:56:41Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Percell, Bradley	l00-iljr-yc6z	False	None	False	2022-04-12 03:15:19.906	[]
1515	CDC-2022-0024-1522	https://api.regulations.gov/v4/comments/CDC-2022-0024-1522	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please take the morphine milligram Equalvnce out of the updated guidelines we pain patients are suffering and have considered suicide because we can’t get pain relief…we have so many pain clinic pushing injections and spinal stimulatiors and making thousands of dollars off of our pain and these things don’t help with the pain at all…they are not even fda approved and yet I had 35 injections last year…if things don’t change and I committed suicide I will have my family sue the cdc and the doctors that caused me so pain…I am a human being and yet I can’t get relief…people are having major surgeries and get no pain medication to help after surgery…the world has become so cruel to human and people with pain…I keep praying to God that he will make a way to help the pain community and lighten your hearts to help us…why should I have to suffer in pain for the rest of my life because I can’t get the medication that could help me work and take care of my family…instead I have to have help with everyday needs because I am in so much pain I can’t do anything for myself and I can’t work because of the pain…and social security thinks I am sutiable to work but I can’t work right now so I am getting screwed over by the United States where I pay taxes…I am begging you to change the policy and help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa02ec	Anonymous	None	2022-02-26T21:57:47Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l01-9n74-eths	False	None	False	2022-04-12 03:15:20.112	[]
1516	CDC-2022-0024-1523	https://api.regulations.gov/v4/comments/CDC-2022-0024-1523	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We write in support of the revised guidelines. Additionally, we refer the CDC to our recently published review of evidence for both pain-related risk for opioid misuse and strategies for minimizing that risk (Nazarian et al., 2021; attached). In that review, we found little evidence to suggest that pain states increase pharmacological abuse potential of opioids. However, pain states can enhance risk of opioid misuse by simultaneously (a) increasing access to opioids (via prescriptions), while also (b) producing functional and cognitive impairment to limit availability or value of alternative activities that might normally be effective to prevent drug misuse (e.g. participation in athletic or social activities). Together, these two pain effects have the potential to bias behavior of a pain patient toward opioid use and away from healthy alternative activities. In view of this evidence, we suggested the following three strategies to mitigate pain-related risk of opioid abuse:<br/> <br/>• Control opioid availability by using non-opioids (e.g. NSAIDs), low-efficacy opioids (e.g. buprenorphine), or abuse-deterrent opioid formulations or routes of administration (e.g. intrathecal) when these are sufficient to control pain.<br/> <br/>• Compensate for lost alternative activities by increasing availability of accessible substitutes (e.g. computer-based activities like video games or social media that require little physical effort but enable diverse options for mental engagement).<br/><br/>• Introduce cognitive-training and/or cognitive-therapy activities that promote retention of cognitive function.<br/><br/>Submitted by<br/>Arbi Nazarian PhD (Western University of Health Sciences, Pomona CA)<br/>S. Stevens Negus PhD (Virginia Commonwealth University, Richmond VA)<br/>Thomas J. Martin PhD (Wake Forest School of Medicine, Winston-Salem NC)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fa39cf	Negus	None	2022-02-26T22:00:26Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Negus, Steve	l01-jtxe-bumo	False	None	False	2022-04-12 03:15:20.325	[]
1517	CDC-2022-0024-1524	https://api.regulations.gov/v4/comments/CDC-2022-0024-1524	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Testimony in the Opioid Trials established patients on long-term Opioid Therapy are not the ones dying from overdose of their medications, which removes the predicate for restriction of long-term pain management. With both side’s acceptance in those trials and the nation’s new Drug Tsar’s testimony, this 2022 Draft CDC Clinical Practice Guideline for Prescribing Opioids is a sham of intentional misrepresentations and obvious agenda! <br/><span style='padding-left: 30px'></span>An example of the countless bias: line 3909-10, you recognize high metabolism for naltrexone (used with $uboxone 3864-5) and allowed increase in dosage, which you deny to pain sufferers with the identical condition. One which I myself suffer! That it does not apply to hospitals, also belies its true intent. <br/><span style='padding-left: 30px'></span>My lack of pain control resultant of the 2016 guideline iteration has destroyed every facet of my life I worked a lifetime to enjoy now in retirement. Maddened by daily hours of egregious pain begat by this CDC intentional machination taking pain control from elderly, Veterans & working caste by academics, I make these assertions:<br/><span style='padding-left: 30px'></span>That it was “misapplied” and no concerted effort to remove the 90MME limit from CMS, which made said limit the national standard of care, instead the CDC opted to hire Public Relations firms to promote the lies rendered in these two Guidelines and CDC’s misleading false statements which justified them. Clearly the intent is the adoption of 50MME as did the former hard limit 90! History will not see saving SSI & Medicare, it will condemn this causing deaths. <br/><span style='padding-left: 30px'></span>This is institutional patricide! The Centers for Disease Control and Prevention is now a Rogue Government Agency! By the cover-up so easily provable, since ignoring the 2018 Congressional Mandate to rectify cause of overdose death reporting errors which misled the nation prescription opioids need restricted, this Agency causing widespread torture and intentional death, must be immediately dissolved as a government funded entity! <br/><span style='padding-left: 30px'></span>Every INDIVIDUAL associated with both Guideline’s development in any way, shape, or form whatsoever are guilty of premeditated First Degree Murder, conspiracy to commit murder, and should be in leg-irons for the rest of your natural lives serving hard-labor to understand what you have done!<br/><span style='padding-left: 30px'></span>Killing me for this is redundant! You will be titillated to know I have regular episodes of pain high enough to mask most organ failures! Day on day, I live in complete [word redacted] without the remotest chance of redress because of CDC! I pray every night to die in my sleep and that all involved in these heinous Guidelines rightly live eternally with the same pain you condemn for myself and others. <br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Douglas	None	None	0900006484fa3ae5	Hughes	None	2022-02-26T22:07:19Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Hughes, Douglas	l01-sba9-yvgx	False	None	False	2022-04-12 03:15:20.567	[]
1518	CDC-2022-0024-1525	https://api.regulations.gov/v4/comments/CDC-2022-0024-1525	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Evening,<br/><br/><span style='padding-left: 30px'></span>So the 2016 cdc <br/>guidelines for doctors issuing pain meds has affected me dramatically I have severe Rheumatoid arthritis as well psoriasis and psoriasic arthritis witch I had both knees replaced as suck witch ultimately led to a leg amputated above the knee. I have been prescribed opiods for many year's and was able to function before you started your war on opioid prescribing doctors since then I had to find a new doctor that would prescribed and you know out of approx 15 doctors all told me that I needed to go to rehab no sorry I need to be able to live in debilitating pain so while my family doctor has been nice enough to prescribed its certainly not with out Hassell as I'm trying to live with the pain as best I van while having the doctor try and cut amount I take a day after taking double that for 10 years how does that help you've helped nobody by starting this war against onions and gaveconly made things much wore were suicide is often a thought now as a way to get out and a stay out of pain will n I help from the cdc	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fa309c	Cadugan	None	2022-02-26T22:08:32Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Cadugan, Robert	l01-wef1-sxic	False	None	False	2022-04-12 03:15:20.772	[]
1519	CDC-2022-0024-1526	https://api.regulations.gov/v4/comments/CDC-2022-0024-1526	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am praying the CDC will consider suggestions from [name redacted] and continue to make necessary changes to the current Draft. The CDC has the opportunity to correct mistakes made using the 2016 Guidelines and Daily MME Limit by removing both the 2016 Guidelines and set MME Limits completely. By doing so the CDC will stop the current Suicide Crisis in the Chronic Pain Community. As a person that suffers from RSD, I know modalities such as Chiropractic Adjustments, Massage and Tai Chi will not be an effective first line approach to Chronic Pain Management. Massage may feel good at the moment, but it does not last and the pain returns. Tai Chi is easier on the joints but when you have back or knee pain you cannot stand to exercise. Adjustments will keep your spine in alignment but if you have a broken bone, tissue damage or a tendon tear or Chronic pain. Adjustments will not relieve the pain and allow the patient to function as Opioids do. I worked for Chiropractors for 10 years and they would not recommend adjustments for Chronic Pain Control. A visit to a Chiropractic can cost $200 or more depending on what therapies or physical therapy is done. Adjustments don't last and are recommended monthly at least with initial visits 3 times a week for 3 to six months depending on the condition. Even Ultrasound, my favorite therapy that reduces inflammation does not last if you are in serious pain. Opioids help the patient to endure chronic pain and soreness during and after physical therapy or occupational therapy. For these reasons these Modalities should be included but not as a first choice for pain control, The goal is to control the pain so the patient can function. Removing the 2016 Guidelines and the set MME limits would correct the damage done with the 2016 Guidelines and give Doctors the ability to treat pain and allow their patients to function giving them back some quality of life. The low dose anxiety mediations such as a 5mg Xanax would help not only with anxiety but works as a muscle relaxer as well. In addition, prescription cost would be lower. Anxiety medications have been prescribed safely with opioids for years. Doctor visits should be every three months instead of every month with drug test done at the doctor's degression. This would lower heath care cost. Many patients are subjected to monthly drug test that has never failed a drug test. The Drug test cost more than the monthly office visit that use to be every three months. Please take these suggestions into consideration and make the added changes to your Draft. You would be helping millions that suffer in pain and save lives. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3b66	Anonymous	None	2022-02-26T22:10:37Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-3229-tn11	False	None	False	2022-04-12 03:15:20.983	[]
1520	CDC-2022-0024-1527	https://api.regulations.gov/v4/comments/CDC-2022-0024-1527	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [names redacted] and I am 40 years old. I first broke my back when I was 18 years old and was prescribed everything they made back in 2000. Because of that is gave me a extremely high tolerance for opioids. Since you put out these guidelines recommending that doctors cut doses back you have made my life unbearable. I had a horrible accident in 2016 and have had to closely monitor my to not end things for good. You need to release information to doctors telling them to no cut there patients that have proven pain and disabilities doses back, but to definitely stop prescribing opioids to people who don't need it and are just seeking drugs. Any person's family that takes there life should be sueing the doctor's and the CDC for causing the person to not be able to take the pain anymore and ending there own life. I 100% see, understand, and know why they commit suicide. So something now to help the people you hurt by saying everyone is the same and no one needs a higher dose.<br/>Sincerely, [name redacted] a man you've put through [word redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Adam	None	None	0900006484fa3b9a	Widner	None	2022-02-26T22:11:20Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Widner, Adam	l02-blw5-oixj	False	None	False	2022-04-12 03:15:21.191	[]
1521	CDC-2022-0024-1528	https://api.regulations.gov/v4/comments/CDC-2022-0024-1528	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My oldest son is a recovering heroine addict. Throughout his treatment, I was able to learn more about the nature of addiction and one of the things I learned was how instantly about one out of five people becomes addicted to opioids. This information came from [facility name redacted] in Utah.<br/><br/>Last summer, another son had to have his wisdom teeth removed. The nurse told me they were sending home a prescription for oxycodone for pain. I asked why, since he had not experienced any pain yet because of the anesthetic. She said that was standard practice for that physician. I told her I did not agree with that and that I thought they should wait until someone actually reported worse than normal pain (what's wrong with pain anyway? ). He usd ibuprofen for two days and was fine. We live in [city name redacted] MO.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa3b9d	Anonymous	None	2022-02-26T22:12:43Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-c4ex-l2y5	False	None	False	2022-04-12 03:15:21.404	[]
1522	CDC-2022-0024-1529	https://api.regulations.gov/v4/comments/CDC-2022-0024-1529	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Would like to submit a response to the CDC proposed clinical practice guideline for prescribing opioids. Where do I send my response since they do not accept email responses.<br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judson	None	None	0900006484fa423c	SPRANDEL	None	2022-02-26T22:36:54Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from SPRANDEL, Judson	l02-j0ya-1j2d	False	None	False	2022-04-12 03:15:21.653	[]
1523	CDC-2022-0024-1530	https://api.regulations.gov/v4/comments/CDC-2022-0024-1530	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived in pain for sect years now and I am now home bound because the pain is so bad I can barely walk…the government wants me to work because I am 36 years old but the pain is so bad no one will hire me…the cdc needs to eleminate the MME and let doctors decide what is best for the patients..this has effected my life so much I can’t work due to the pain… we need help in the pain community…people are dying and it’s because of these guidelines… you are going after the wrong people…go after the cartel and drug dealers….not people in pain… I have thought of suicide because I can’t get my pain treated….people who have cancer are suffering and people who have surgery is suffering and people with chronic pain are suffering and it’s because of these guidelines…we can’t work if our pain is not treated….please eleminate these guidelines and the MME threshold on the pain community…..go after the cartel and the dealers….not us…I can’t keep living like this in pain everyday with no relief….I will end my suffering if y’all won’t help us….or I will go to the streets to find some kind of drug to help with the pain….y’all have taken so my peoples life’s always and the blood is on your hands now…#wedontrecover	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa42db	Anonymous	None	2022-02-26T22:37:26Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-kn0f-7vf0	False	None	False	2022-04-12 03:15:21.863	[]
1524	CDC-2022-0024-1531	https://api.regulations.gov/v4/comments/CDC-2022-0024-1531	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi. I am the wife of a disabled veteran who suffers from peripheral neuropathy, he has many other health conditions, but the neuropathy has destroyed his life as he suffers with severe diabilitating pain daily. After trying 20+ medications over several years, we finally hit on one that worked and gave him about 6 hours of relief a day from the pain. It was great. He was able to do all the things around the house and yard that he needed and wanted to do. It was a 5mg pill of oxycodone. It gave him life, and a break from the pain. A 30 day supply lasted him close to 2 months. Then his world changed they took it away, nobody would help. In the 3 or so years that he hasn't had access to this wonder drug he has suffered eminously in pain 24 hours a day. The neuropathy is in his feet. You walk, stand, drive, etc using your feet think to yourself when you walk out to get the mail about that. My husband only gets on his feet when necessary, they even hurt when he is not on them. His quality of life has suffered greatly, his mental status, his family relations, depression from having to watch his wife do all the things he used to do and enjoyed doing and the things he wants to do. His days are spent sitting in a recliner, gaining weight, suffering in pain, which is even more excruciating after all the walking he has to do for a dr appt at the VA. hospital. He has thought about commiting suicide on several occasions to stop the pain, but that is not in him. The oxycodone gave him a well needed break from the pain. Imagine having to listen to a radio blarring heavy metal music 24/7. The pain never stops. <br/>People should not be punished just because some lives are lost, the people who had opiods taken away from them shouldn't have to suffer in pain just because others lost their lives and were irresponsible. One rotten apple shouldn't be allowed to spoil the whole barrel. People who need pain medication to live life respect it and know that without it they couldn't function and live life pain free. They want to live pain free.<br/>I guess the bottom line is I want my husband back, he wants his life back without pain, so he can live life as any human being has a right to.<br/>Please fix this so my husband can have his 5mg of oxycodone back and come home to his family.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melanie	None	None	0900006484fa55a6	Beeman	None	2022-02-26T22:38:33Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Beeman, Melanie	l02-xpf8-g96u	False	None	False	2022-04-12 03:15:22.072	[]
1525	CDC-2022-0024-1532	https://api.regulations.gov/v4/comments/CDC-2022-0024-1532	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Until we recognize that pain is subjective rather than objective no amount of regulation is going to solve the pain vs addiction issue. [name redacted] took over medical education to promote the sale of their prescription opioids to the extent that we no longer understand the interaction of pain, emotional/mental response, injury and the need for medication. Once again the CDC is looking at this as a “medical” model and trying to “fix” the pain issue rather than strongly pushing for research and education on preventing pain - and the intersection of pain, opioids and addiction and whether “chronic pain” exists objectively. Too many clinicians rely on pain medication as a treatment of first resort rather than exploring other possible treatment options. Patients also want the “easy fix” that opioids provide this disincentivizing their exploration of non-medication treatments. Unfortunately the CDC guidelines continue us to allow insurance companies to make alternative treatments too difficult to access or limit the number of treatment visits (as with physical therapy) and access to alternative pain relief practitioners. In Canada anyone can visit a PT-no prescription necessary sand as a result many pain issues are addressed on the physical level-the primary level- rather than on the mind altering level. So, as usual the CDC is putting the cart before the horse by addressing opioid prescriptions as if they are the end all and be-all of pain treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa55cc	Anonymous	None	2022-02-26T22:39:42Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-xs75-95bo	False	None	False	2022-04-12 03:15:22.290	[]
1526	CDC-2022-0024-1533	https://api.regulations.gov/v4/comments/CDC-2022-0024-1533	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a line-of-duty disabled veteran who suffered a serious back injury that chronically affects my ability to enjoy any sort of “normal” life, I urge the CDC to not only rescind, but also refute its earlier findings of limiting narcotic pain medication by physicians.<br/>For 30-plus years, I’ve suffered from chronic and intractable pain that has only been marginally alleviated by what the CDC considers a high dosage of opiates. I’ve been able to work, rear a family, participate in my community and occasionally, go on family vacations. All without an overdose, dui, or any breach of the law; I’ve never even been arrested …<br/>Now, thanks to current CDC guidelines, my dosage has been reduced more than 60%. I’m no longer able to work and rarely leave my home due to the debilitating pain. My life has been reduced to an 800 sq Ft existence that rarely includes leaving my bed.<br/>An important aside: there is no cure, no operation, no treatment for my situation. It has and will continue to get worse. I’ve tried them all, physical therapy (4x +), chiropractic (5x+), pain management groups, all to no avail. Not only have they been completely ineffective, they’ve caused further damage. Let me reiterate, this will NEVER get better, it will only get worse.<br/>The effect of the CDC “guidelines” has been devastating across the board to those of us with chronic and intractable pain. <br/>The so-called opiate epidemic is an illicit drug problem rather than a prescription drug problem. Fentanyl and other illicit opiate compounds have caused over 90% of the overdose deaths …<br/>I’m required to provide urine and blood samples, to have my medication physically counted, and routinely screened for signs of illicit behavior or face being completely cut off of the remaining bit of relief I get.<br/>It’s past time to rescind these one-size-fits-all “guidelines,” and let doctors treat patients rather than a committee.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DC	None	None	0900006484fa569e	Burch	None	2022-02-26T22:40:44Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Burch, DC	l02-y89w-i66y	False	None	False	2022-04-12 03:15:22.496	[]
1527	CDC-2022-0024-1534	https://api.regulations.gov/v4/comments/CDC-2022-0024-1534	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer, having been born with several deformed vertebrae. I was able to manage my pain myself for a long time, but it had gotten to the point where I wasn't able to work about 11 years ago. My PCP tried several things before going to opioids. He started out slow and built up over the years. <br/><br/>Politicians should have exactly NO input in how chronic pain patients are treated. They should never come between patients and their doctors. Chronic pain patients should never be made to feel like they are drug addicts. Our care should be handled solely between caring and knowledgeable doctors. Those doctors also should not be made to do extra paperwork to try and discourage them from helping their patients. <br/><br/>I support the revision of the guidelines to remove caps on dosages and <br/>to put back control of patient care in the hands individual doctors. <br/>Those doctors should not fear losing their medical licenses or being <br/>fined, just for prescribing what they believe in their medical opinion <br/>is best for their patients. Insurance companies should not be <br/>erroneously using these guidelines as the basis of denying coverage or <br/>increasing the price to patients for doctor prescribed opioids.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa5869	Anonymous	None	2022-02-26T22:41:02Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-z8gc-eiwo	False	None	False	2022-04-12 03:15:22.720	[]
1528	CDC-2022-0024-1535	https://api.regulations.gov/v4/comments/CDC-2022-0024-1535	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i would like to start by saying thank you for revisiting this issue..i was in a serious car accident at 23 years old im now 45 that resulted in damaging both my lower back and neck along with nerve damage.as i have lived through pain every day and also work in retail where i am required to work a certain amount of freight every day where i go home in absolute pain..i was supposed to get surgery but i am not able to get being i am a father of 3 wonderful children and when I'm not working i am taking care of them and work pay check to pay check each week. i depend on my meds oxycodone each month because they are the only thing that helps with the pain..ive been doing this for along time..and i take my monthly doses as directed by my doctor nothing more.when these guidelines came out a few years ago i thought it was wrong to group people with real chronic pain issues to people who went to pill mills for a quick fix and people od ing on illegal street drugs...real doctors with extensive credentials like the ones i go to see should not be told how and who to prescribe medication by the people who never went to medical school .i think that is just wrong..once again thanks to the cdc for looking out for everday people who live unfortunately with chronic pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa5883	Anonymous	None	2022-02-26T22:41:32Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l02-zaoc-q91x	False	None	False	2022-04-12 03:15:22.932	[]
1529	CDC-2022-0024-1536	https://api.regulations.gov/v4/comments/CDC-2022-0024-1536	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider reversing the guidelines for doctors prescribing opiods. The reason people are overdosing is because of illegal drugs like fentanyl!!!!! The categories for tracking needs to be updated with illegal drugs not being classified as opiods as doctors are not prescribing this!!!! My Mom passed away because of chronic pain issues and it was agonizing for our family and her because she was not able to be treated for her pain issues and was begging for her life to be over!!!!! Could you imagine being her daughter and watching this as I was forced to watch because of the CDC !!!!!The CDC needs to understand the need for the different categories as if you checked I'll bet the illegal drugs are greatly higher than any opiods pill. Please do more research but in the meantime let the chronic pain patients who do not abuse their prescriptions not suffer any longer!!!!! And I still have nightmares about my Mom and wake up crying!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fa58d8	McDonnell	None	2022-02-26T22:41:57Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from McDonnell, Mary	l02-zhgj-o891	False	None	False	2022-04-12 03:15:23.145	[]
1530	CDC-2022-0024-1537	https://api.regulations.gov/v4/comments/CDC-2022-0024-1537	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain suffer in 10/10/10 i was hit by a drunk driver in my drivers door at over 90 mph doctors said it should have killed me instead it ruined my life the wreck separated my spine from my tail bone with a large crack in it it also tore my biceps lose ruined my shoulder socket i also have very bad nerve damage in my feet in 2021 i lost my house in the bear fire in berry creek and the state put me in a hotel in a disabled room and the shower bench broke and injured my left knee were i can no longer walk my knee is destroyed my doctor of 20years just retired so now i have to go to pain management to get my meds and all\ the doctors are refusing the meds that i have been taking for years just so i can function and have some sort of quality of like my doctors all give me the same story that they have all been threatened by the DEA that it they give out the meds that ARE NEEDED FOR PEOPLE LIKE ME THAT THEY WILL GO TO PRISON the DEA has told them that they should stick to a morphine schedule of 40 when your guidelines say 90 the doctors are all scared that they will lose there lic and be sent to prison for helping people and there is no mention of these threats by the DEA any where i am scared to death because i have been threatened by doctors and told i cant get the meds that i have had since my accident that i need to function its not fair that everybody is lumped together with the pain meds that they need just to struggle through life every person is different and should be treated as so i have went through hell just to try and get meds without them i am forced to lay in bed crying like a baby day after day i have also given the doctors all my medical records with my MRIS AND CT SCANS were they can see whats wrong and it doesn't matter they just say the DEA and government don't care and i also get told im not cost effective anymore i guess that means i don't deserve to live out the rest of my life i hope this does not fall on deaf ears we need help i know several people who were left with no meds and no choice who are no longer with us and you wonder why the suicide rate is up the system leaves them no choice please help us we deserve to live our lives a be able to have some sort of quality of life ty for your time Iam also diabetic<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	harry	None	None	0900006484fa5938	tatum	None	2022-02-26T22:43:06Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from tatum, harry	l02-zpe3-ti09	False	None	False	2022-04-12 03:15:23.382	[]
1531	CDC-2022-0024-1538	https://api.regulations.gov/v4/comments/CDC-2022-0024-1538	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name did [name redacted], I occasionally suffer from acute calcific tendinitis of both shoulders usually not at the same time. When I have a flare up the pain is unbearable I can not move my arm even a slightest touch is painful. The severe pain can last from 3- 5 days. I am 57 years I do not take any prescription medication, I live a healthy life style. I do not drink or smoke or have any addictions. When I have a flare up I require a pain medication prescription for a few days. It is unfortunate that my doctor is not allowed to prescribe what he deems necessary. I have no choice but to go to the hospital emergency room for treatment.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angela	None	None	0900006484fa598d	Walsh	None	2022-02-26T22:44:10Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Walsh, Angela	l02-zwko-v9qa	False	None	False	2022-04-12 03:15:23.589	[]
1532	CDC-2022-0024-1539	https://api.regulations.gov/v4/comments/CDC-2022-0024-1539	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The removal of 90 MED was welcomed if not late. Many patients suffered needlessly because of this arbitrary dose restriction.<br/>Many physicians were disciplined by their respective medical boards when this level was exceeded.<br/><br/>Hopefully, this will allow patients and physicians to reestablish the personal relationship without governmental interference; and without fear of prose tuition.<br/><br/>Unfortunately, I feel the damage done and the fear instilled in the medical community will be difficult to move on from.<br/><br/>In many patients higher doses are well tolerated, do not result in adverse side effects and allow an independent life and freedom to pursue their ADL.<br/><br/>Clearly I applaud the removal of the arbitrary MED. Now stop prosecuting providers that help their patients and perform random drug testing while checking CURES at each visit.<br/><br/>[name redacted].<br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fa5a69	Smith	None	2022-02-26T22:44:57Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, David	l03-0ld6-wik1	False	None	False	2022-04-12 03:15:23.796	[]
1533	CDC-2022-0024-1540	https://api.regulations.gov/v4/comments/CDC-2022-0024-1540	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am chronic pain patient that was stable on morphine for 10 years. I not only never overdosed, I did not increase dose or run out early. I was able to participate in family life and do chores around the house. When the 2016 CDC guidelines came out my doctor force tapered me below 90mg and referred me to a pain specialist. Over the years I have had back injections, abdominal nerve bundle ablation, physical therapy, chiropractor visits and did little or nothing to help. My doctor admits that I need higher dose morphine, but is afraid to do so because he might lose his license. While the 2022 proposed guidelines attempt to correct some of the damage done to patients and physicians, I feel it is way too little too late. Chronic pain control should be only between doctor and patient. I feel the CDC should update to say that the CDC has no place to regulate - your guidelines became regulation in a majority of states - and should just repeal any guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keith	None	None	0900006484fa5b35	McKenzie	None	2022-02-26T22:45:25Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from McKenzie, Keith	l03-1hcs-wf60	False	None	False	2022-04-12 03:15:24.008	[]
1534	CDC-2022-0024-1541	https://api.regulations.gov/v4/comments/CDC-2022-0024-1541	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. I suffer with a genetic mutation that has caused a lifetime of complicated chronic migraine. Recently, being diagnosed with trigeminal neuralgia, chronic gout from CKD, and spinal stenosis all resulting in chronic pain. The 2016 opioid GUIDELINES have been wrongly interpreted as LAW. Dangerously so. 2021 recorded an all time high in overdose deaths still. These numbers obviously went in the wrong direction causing unprecedented human suffering and loss. Although, I agree keeping opioids out of the wrong hands is vital, these guidelines did more harm than good. These guidelines continue to injure and cause needless suffering and death. This long used class of medications when used properly with education, experience, and proper supervision -- improve the lives of those with chronic pain. The stigma of chronic pain was already overwhelming to bear. But, the stigma of being a pain management patient on opioids is making it unbearable. The resulting prejudice and often cruel treatment from medical professionals is unethical. These are fellow humans charged with our care afterall. This has resulted in a denial of basic human rights. Rephrasing the 2016 guidelines now in 2022, can't undue all the harm done to those living with chronic pain, especially for families that lost loved ones. Untreated, and under-treated chronic pain can and does lead to unnecessary suffering, failing health, often resulting in death and/or suicide. These guidelines were interpreted by insurance companies, medical oversight agencies, medical practioners, and pharmacies as LAW. I personally have been impacted, even financially paying much more for my medical management of chronic pain. Some chronic pain patients have lost employment (or under threat of), lost right to medical privacy, lost right to informed medical consent, lost doctors by being dismissed from care or refused proper medical care, lost personal reputations by being unjustly labeled. Chronic pain effects every part of a person's life, I can attest to that. The very real fact that ANYONE at ANYTIME could be faced with these very situations I've witnessed and/or experienced. Tomorrow is unknown-- illnesses, accidents, surgeries, unforseen events befall us all. The 2016 opioid guidelines not only need be amended, they should be abandoned. This government agency should call on a mix of medical professionals, and chronic pain patients to confer on realistic common sense solutions. I realize these guidelines weren't intended to be interpreted as LAW, but they have been! It's only stigmatized and hurt those already hurting. As a younger person, I never imagined I'd be living in chronic pain. I didn't chose any of this, and am not at fault. I've done everything I could preventatively/alternatively, and was referred to pain management by a trusted physician when all else failed. It's hard to change public opinion that's been conditioned to believe all pain management and opioids are bad now. If it was you, or a loved one would you want responsible pain management and the right to chose what is best? That's nearly been taken away now for all chronic pain patients. I know of terminally ill patients denied end of life pain management. For what was intended as good intentions, it's clearly not what happened. Even emergency situations have been interpreted wrong. My daughter, a 24 year old at the time had a appendicitis. It took a young nurse and myself to convince her to take the opioid pain reliever post surgery in the hospital. She's witnessed how I was treated over the years, and has a fear of taking these medicines. This was NOT the time to refuse pain medicine, a infected organ was removed! She finally accepted the reality of the situation. The last day hospitalized, another nurse purposely withheld her dose. I suppose my daughter's age, and her personal bias was the problem? When I questioned why her dose was skipped, and why is my daughter in tears due to pain? She wanted to explain the "opioid crisis" to me. I abruptly stopped her, explained I was a chronic pain patient, and my daughter just went through a surgery to remove a infected organ. No need to explain her prejudice! I told my daughter, we can get the hospital administrator involved. This was insane! The nurse came back with her pain medicine, and discharge papers, including a prescription for opioid pain medicine for her recovery period. I don't think anyone intended these guidelines to be so misinterpreted, and unreasonablely so. Please take immediate public actions to correct this situation. There's so much sickness, disease, and pain (as the past two years pandemic has proved). Pain management and opioids are necessary treatments for many temporarily, and for some long-term unfortunately. We need clear, reasonable, educated, factual, realistic guidance for everyone involved.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn	None	None	0900006484fa53fb	R	None	2022-02-26T22:47:29Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from R, Dawn	l03-27q8-j1nh	False	None	False	2022-04-12 03:15:24.245	[]
1535	CDC-2022-0024-1190	https://api.regulations.gov/v4/comments/CDC-2022-0024-1190	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484f7f6ac	None	None	2022-02-26T22:53:33Z	None	None	0	None	2022-02-21T00:00:00Z	None	Commenter requested this comment be withdrawn.	None	None	None	None	None	None	None	None	Comment from Bloom, Josh	None	True	None	False	2022-04-12 03:15:24.454	[]
1536	CDC-2022-0024-1542	https://api.regulations.gov/v4/comments/CDC-2022-0024-1542	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Thank you for the opportunity to share the experience of my life without the benefit of relief from chronic and debilitating pain since approximately 2015. Up until that time I had been relatively active and able to perform activities of daily life fairly well with the help of prescribed pain medication. After that time if I wanted any relief from pain my state required me to go to a pain management clinic 60 miles from my residence and as I have no vehicle that option was unavailable to me. All other non-opioid treatment options for my pain, i.e., physical therapy, steroid injections, electrical impulse pads, have been unsuccessful.<br/><br/>Gradually day by day year after year the pain increased to such a level that I am unable to stand for more than five minutes at a time, unable to perform only the bare minimum of activities of daily life and so my quality of life is very poor. As of today I am approximately 50 lb overweight from lack of exercise and overeating since there is little else to do. I am unable to read very well anymore and you can only watch so much TV.<br/><br/>The lack of any meaningful help from my medical providers has more than anything else contributed to a profound loss of self confidence in my ability to improve and an exaggerated sense of defeatism because after all there must be something wrong with me since I cannot overcome the pain on my own. I am old and I will be gone soon and that will be a relief because living like this is misery.<br/><br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sylvia	None	None	0900006484fa73db	Niece	None	2022-02-26T22:56:15Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Niece , Sylvia	l04-fpao-dwa0	False	None	False	2022-04-12 03:15:24.685	[]
1537	CDC-2022-0024-1543	https://api.regulations.gov/v4/comments/CDC-2022-0024-1543	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you updating these guidelines. Being a patient with chronic health conditions it has been very difficult to find providers willing to treat my pain. I have been told to limit both acetaminophen and nsaids but have been given no alternative to treat my pain. I have used other measures such as heat, ice, massage and creams. I’m still in pain daily. It is an exhausting way to survive because I would not call it living. <br/>I appreciate the concern for patient safety but the focus on alternative therapies is cost prohibitive to many patients. Allow the doctor and patient to make the decision on the best course of therapy without government interference.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484fa7378	D	None	2022-02-26T22:56:30Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from D, J	l04-f60x-hbgz	False	None	False	2022-04-12 03:15:24.906	[]
1538	CDC-2022-0024-1544	https://api.regulations.gov/v4/comments/CDC-2022-0024-1544	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer and am being forced tapered off my pain medication I've been taking 20 yrs. The prescribing guide lines must be changed no more mme equivalent. Let doctors do there job protect all pain patients rights to adequate care . To ever allow a human being to suffer is immoral yet it happens every single day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484fa7355	Carson	None	2022-02-26T22:56:47Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Carson, J	l04-eyom-239v	False	None	False	2022-04-12 03:15:25.117	[]
1539	CDC-2022-0024-1545	https://api.regulations.gov/v4/comments/CDC-2022-0024-1545	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should not be issuing Opioid prescribing guidelines. Professional specialty organizations, overseen by practicing clinicians and clinical educators should be issuing standard of care and best practices.<br/><br/>The CDC guidelines will inevitably be interpreted and adopted as hard and fast rules by state and local government, Pharmacies, health plans and third-party payers despite guideline warnings against doing so.<br/><br/>The CDC should abandon its efforts to establish a prescribing guideline and defer to the professional institutions usually in charge of establishing best practices.<br/><br/>The overdose crisis is largely caused by a growing population of nonmedical drug users intersecting with increasingly dangerous drugs being developed for the black market fueled by drug prohibition. Addressing this problem by reducing opioid prescribing has <br/>only made the situation worse by driving nonmedical users to more dangerous drugs and deprives the pain patients of necessary relief. <br/><br/>The 2022 CDC guidelines closely resemble the 2016 CDC guidelines and is based on weak evidence. In the case of Morphine Milligram Equivalent (MME) recommendations, The guideline is pharmacologically unsound and conversion tables are based largely on decades old subjective studies that didn't even examine toxicologic effects such as respiratory depressants.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fa734d	Combs	None	2022-02-26T22:57:23Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Combs, Judy	l04-ewxg-ma9o	False	None	False	2022-04-12 03:15:25.320	[]
1540	CDC-2022-0024-1546	https://api.regulations.gov/v4/comments/CDC-2022-0024-1546	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] I am a disabled civil servant with over 30 years of law enforcement service. As a former Capt. for the Michigan Department of corrections. And deputy sheriff in [county name redacted] Michigan. I have been a chronic pain patient for many year's due health conditions in which most were caused by injuries during my employment I was not able to take prescribed medication for pain at that time. However because of the chronic pain and my wish to continue to work I took over-the-counter pain relievers that caused stage three kidney failure. In 2017 after becoming totally disabled I was prescribed opiates for pain.The opioid treatment gave me my life back. However with my Doctors retiring it caused me too be referred back to the pain clinic's in hopes that they would continue my pain medication therapy. But because of my still required surgeries and current medication dose being over the 91 mg morphine equivalent set by the CDC guidelines. I was refused further medication treatment by all the pain clinic’s I was referred to. I’m now being forced off my opioid treatment. Most of my days are spent in bed with my wife caring for me through the FMLA act. I feel that my life is on the line. All my surgeries that are needed to help in this matter have been pushed back due to COVID-19. After over 20 + surgeries to correct my health conditions and pain I do have surgery scheduled to replace my left shoulder.But the doctor’s have informed me that they can not address all my pain issues by surgeries alone and that I would still require pain medication to allow a good quality of life. It needs to be noted that all the Doctors have informed me that they wouldn’t prescribe the current medication due to the CDC opiate guidelines. Stating they have too many patients and are being “red flagged or are in fear of losing””nine years of schooling and training“.every Doctor that I’ve seen has said the same thing. That the CDC guidelines don’t allow them to take on any more Patients that require opioid medication.or that they are afraid of losing their license or going to jail. I worked my whole life until being disabled and now have no quality of life at the age of 56. This is all due to the current CDC opioid guidelines. I’m asking for you to please reconsider the current guidelines and remove the 91 mg equivalent making exceptions for people with chronic health conditions such as myself! If not for my family I would have taken drastic measures that unfortunately so many people in my situation I have taken. I’m asking. No begging that you please heat my plea for help in this matter. So many people are suffering needlessly! The FDA has approved Opioid medication for the treatment of chronic pain. But are afraid to prescribe because of the CDC and it’s guidelines/jailing of good Doctors. What kind of country do we live in that allows needless suffering? Please remove the morphine equivalent from the guidelines and allow an exception for those document with chronic pain!<br/>Sincerely<br/>[name and address redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa888f	Anonymous	None	2022-02-26T22:59:58Z	None	None	1	None	2022-02-26T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l04-cy2s-7qdq	False	None	False	2022-04-12 03:15:25.526	[]
1541	CDC-2022-0024-1547	https://api.regulations.gov/v4/comments/CDC-2022-0024-1547	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revisiting the 2016 guidelines - it was long overdue. Compared to what many patients with chronic pain live with, I'm fortunate. I only need to rely on pain medications (at a very low dose) a couple of times a month in order to live a full, healthy life (and work full-time). But the 2016 guidelines were even devastating for me. It is nearly impossible to find a doctor who is willing to prescribe pain medications, so rather than seeking out a doctor who can treat you as a whole person, or treat your other various conditions well, or who lives near you, or for various other reasons you might select a doctor, you end up having to make sure first of all that they are willing to see you as a person in pain who is trying to manage it (not as a drug seeker) and be willing to prescribe pain medications. It creates a potentially adversarial relationship before you even walk in the door. When I recently moved and had to find a new doctor this really complicated things, but I was lucky to find a highly skilled, compassionate doctor who not only understood I was taking my pain medications responsibly (and was willing to prescribe them), but also was able to skillfully treat my other conditions as well. Not everyone is so lucky. Especially those with fewer resources, greater pain, and often BIPOC individuals especially experience racism with regards to pain treatment. (I am white and middle class). I'd encourage the CDC to not only undo the damage of the 2016 guidelines but to be a part of undoing the policies that have been created as a result that are damaging to patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa5405	Anonymous	None	2022-02-27T16:15:40Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l03-29io-cmtj	False	None	False	2022-04-12 03:15:25.731	[]
1542	CDC-2022-0024-1548	https://api.regulations.gov/v4/comments/CDC-2022-0024-1548	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a disgusting rewording of the same inhumane treatment of AMERICAN pain patients, CDC had no business butting into to, in the first place!! I graduated top of my class with the Sheriff's Dept, aced range, on 180 mg of Oxycodone, and NO ONE but the Sheriff & instructors knew. We ARE NOT all alike, we ARE NOT drug seekers looking to be doped up all day long, WE ARE human beings looking to get back to living lives and being valid in society! Thanks to the CDC for their non medically accredited "expertise", I'm now suffering from liver disease (amongst others) from all of the OTC Acetaminophen I take daily. Never had a liver, kidney, breathing, uncontrolled blood pressure (on 2 BP meds), or cognitive problems with prescribed pain meds?! And was never NSAID or steroid allergic before this. It now costs the government more in healthcare for my medical expenses, tests, doctor/hospital visits in 1 year, than any cost of Healthcare I've ever had in numerous years previous to Aug 2016. All because CDC couldn't be bothered with actual work, by going to the streets and taking care of the real opioid problem...fentanyl & heroin! It was easier to threaten our physicians to put down their pens and not prescribe, than to get out in the real world and solve the actual problem, which is now even more accessible on the streets partly due to pain relief restrictions, thank you so much for that. Overdose deaths rising daily, crime quadrupled, Meth as accessible as candy in in a store...good job! As many patients as you've killed already between suicide, heart attacks and blood pressure disease, illegal drug abuse etc., you should all be responsible & charged with every death associated with this farce from day one.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484fa5d04	Dubois	None	2022-02-27T16:16:27Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Dubois, Diane	l03-3s6c-f40i	False	None	False	2022-04-12 03:15:25.947	[]
1543	CDC-2022-0024-1549	https://api.regulations.gov/v4/comments/CDC-2022-0024-1549	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a severe sufferer of chronic pancreatitis from a birth defect. I am on PRESCRIPTION fentanyl. It's in my surgically implanted pain pump. Without it, I'd have no quality of life. Since my implantation in February 2021, I have function again.<br/>Please respect and consider us,who are in constant pain,when all of the new guidelines are considered..<br/>Thank you!<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J. Bram	None	None	0900006484fa5e0d	Cast	None	2022-02-27T16:17:00Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Cast, J. Bram	l03-5iuy-d1nr	False	None	False	2022-04-12 03:15:26.193	[]
1544	CDC-2022-0024-1550	https://api.regulations.gov/v4/comments/CDC-2022-0024-1550	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When they changed the rules it killed my father he was in seriouse chronic pain for over 25 years and was prescribed 480 methadone 10mg and 240 hydromorphone 4mg and he was cut down to 180 methadone and 90 hydromorphone he was never the same after that it affected him mentally and physically my father was never the same again he was doing fine until they just cut him off like that with no taper he stoped eating and stayed in bed 20 hours a day and pretty much was in such sever pain all he talked about is how he wanted to die and just wanted to go to sleep and never wake up like I said it changed him he was never his self again he ended up dieing he just gave up so those rules killed my father maybe he was prescribed a Lil too much in the beginning but that's what doctor [name redacted] professor of neurology for the university of Florida prescribed him on his first visit and he continued to see the same doctor till he died and it didn't take a doctor to see how bad my father was doing but in the end the acted like they didn't care but a doctor should be able to prescribe whatever they think is nessasary to treat there patients pain everyone is different the government has no business trying to control medicines people actually need I'm sure my father wasn't the only person to loose there life over the government refusing to let people have the proper medications and the proper amount of medications to treat there chronic pain like I said it also affects people mentally some people can't handle suffering all day everyday the government needs to pay the ones who lost family because of a stupid mistake that has led to alot more people dieing than ever and now the USA is flooded with heroine and fentanyl I seen that coming as soon as they changed the rules but more people will continue to die because it's more important for the government to try to control people if people are in pain and want opioid medication because they are suffering they should be able to go to any doctor and get it it's there body and there life if it helps people live a better life and not have to suffer then it should be available for everyone	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fa6243	Brain	None	2022-02-27T16:18:45Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Brain, Richard	l03-8ahj-4g6j	False	None	False	2022-04-12 03:15:26.436	[]
1545	CDC-2022-0024-1551	https://api.regulations.gov/v4/comments/CDC-2022-0024-1551	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband and I are professionals who worked our whole careers in the radio and Voice-over industry. We have a story about the struggle of the middle class of America. We will tell our story one day and it will ring around the world! We fought for our food and home, money and kids with everything we had! We raised them up to be great kids who are drug free and contributors to the broken system! We have arrived at the age of 60 and 57. We both have debilitating disabilities that were caused from massive stress and determination to not give up! Our children are grown and they help us out tremendously! We were so affected by the cruel and intentional cut off of the meds that gave us relief enough to be able to carry on with our day. We were not those that took so much of it that we had to start crushing and cooking it. We never even once considered heroin. We appreciated the non euphoric relief we had from pain. We were at the same dose for 10+ years. If you follow the directions you will not turn into a heroin addict. People are literally suffering needlessly. Please do not let the seniors and vets and disabled suffer any longer. If you give them back their quality of life, I promise I will help to build the new system. It needs work. But I am so stiff, I can't move too well. I just had my spine rebuilt with rods and screws. I still can't reach very important areas. I feel like the tin man who needs his heart back. I have never been in trouble for misusing. There has to be a way to keep the addicts from ruining life saving medicine therapy. Please contact me for further inquiry.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teri	None	None	0900006484fa6244	McMillion	None	2022-02-27T16:19:24Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from McMillion, Teri	l03-8aiq-gbuq	False	None	False	2022-04-12 03:15:26.652	[]
1546	CDC-2022-0024-1552	https://api.regulations.gov/v4/comments/CDC-2022-0024-1552	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi I would like to know with the opiode problem, do you really think you will be helping patients by cutting them back on meds that Dr's feel need to be given to their patients , If anything by doing this you will be having more of a street drug issue because once someone gets cut back and it's been helping them but a Dr has to listen to guidlines how is this going to help it will not help.i guarantee the epidemic will rise, itsno difference if you could take guns away someone will find a gun, this will never change but sighting li.it to patients that's wrong.if it was you or a family member needing it what would you do if they had cancer or something serious but they have to stay in a ridiculous guidlines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Aleta	None	None	0900006484fa624b	Greene	None	2022-02-27T16:19:44Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Greene, Aleta	l03-8c87-ir3b	False	None	False	2022-04-12 03:15:26.994	[]
1547	CDC-2022-0024-1553	https://api.regulations.gov/v4/comments/CDC-2022-0024-1553	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had Rotator cuff surgery, after the surgery the pain was terrific, I took Percocet for 3 months for pain relief then slowly stopped taking it. No addition or strong urge for more, would have suffered without it. Thanks, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kenneth	None	None	0900006484fa626b	Loach	None	2022-02-27T16:20:16Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Loach, Kenneth	l03-8pss-9gza	False	None	False	2022-04-12 03:15:27.208	[]
1548	CDC-2022-0024-1554	https://api.regulations.gov/v4/comments/CDC-2022-0024-1554	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern <br/> My name is [name redacted], <br/>I am a chronic pain person not paitent because of the CDC guidelines that my pain management doctor misapplied towards me. He forced tapered me starting before the CDC guidelines ever came out starting in 2013. I kept telling him that something was wrong during this tapering period. For 6 months I told him, he dd no tests. <br/>I tried to go back to work while this was happening to me. He was arrogant he told me to suck it up an go to work he wouldn't give doctors motes anymore. Well I lost that job in May of 2014 I continued to tell him I still felt something was wrong. NO TESTING DONE. By July 2014 I had a heart attack I was 47 yrs old. After the heart attack I fired him by September 2014 I then attempted suicide. I'm now finding out that the forced tapering an my mental change is largely due to the treatment I received at the hands of my doctor.<br/>I have been on medication for my chronic pain for years an could not figure out why I was being treated in such a barbaric manner. So here I sit at home with no quality of life because of the guidelines being misapplied, I know I'm not alone . Something needs to be done the pain community is hurting beyond comprehension. My hope is that you all do the right thing for humanity an sanity to restore us back to where we the Pain Community can enjoy our lives to the best of our abilities. Imagine having surgery with no post op pain control, I bet you can't well I have I need 2 more surgeries an am holding off on the hopes that you resind the CDC 2016 guidelines completely an restore our dignity. I'm a daughter a sister, a mother and a grandmother. I want my life back to enjoy them all. One day it may be you sitting in this position. Resind 2016 guidelines an stop calling it an opiate problem it is an ILLICIT FENTYNAl CRISIS that was not taken care of. The numbers have been misapplied all over the place. I WANT MY LIFE BACK . Thank You For Your Time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronda	None	None	0900006484fa627b	Williams	None	2022-02-27T16:22:29Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Ronda	l03-8hpv-o3l8	False	None	False	2022-04-12 03:15:27.428	[]
1549	CDC-2022-0024-1555	https://api.regulations.gov/v4/comments/CDC-2022-0024-1555	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern:<br/>I have had spinal stenosis for over 20 years and had finally decided to seek out help for my chronic and often times debilitating pain with [name redacted] who heads up the Pain Management Department at [health facility name redacted] in New York. I was provided relief with the pain meds being prescribed in conjunction with available procedures at the time. The rule that came about limiting the amount of pain medication that [name redacted] can prescribe to me has negatively impacting me as I am in a constant pain. I am a full-time working mother of two and need to be not only mobile but functioning as well. I commute 40 miles to work both ways 5 days a week and need to be a fully functioning adult. I resent the fact that I am constantly battling pain due to the fact that there has been this ridiculous blanket restriction to how my Pain Management doctor can treat me as he did before for fear of being persecuted by DEA, DOJ, State Medical Boards, Attorney Generals or Prosecutor's offices. The entire thing is entirely unfair.<br/>I, as an adult with a chronic pain condition, demand the public withdrawal of the ridiculous 2016 Guidelines on grounds that these documents are flawed by weak medical evidence, naive and uncritical anti-opioid bias, gross exaggeration of opioid treatment risks, incorporation of junk science, and misrepresentation of the efficacy and safety of non-opioid alternative therapies. Additionally, the US CDC has no legal charter to set practice standards for opioid therapies or any other therapies other than infectious disease. Such standards are best developed by professional medical associations and academies whose membership actually treats patients.<br/>Thank you for your time.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christie	None	None	0900006484fa62c2	Flynn	None	2022-02-27T16:24:35Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Flynn, Christie	l03-9r62-dl0m	False	None	False	2022-04-12 03:15:27.638	[]
1550	CDC-2022-0024-1556	https://api.regulations.gov/v4/comments/CDC-2022-0024-1556	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffered incredible pain with interstitial cystitis but could not access proper medical treatment with pain killers, and was treated as a drug seeker by medical staff. Even people with cancer have been denied painkillers because of this ruling. Opioid should have their place in treating people with severe pain. Severe pain disrupts a person's life so much that they cannot do anything in the way of work, must less concentrating to read a book or watch television. This ruling must be adapted to meet persons with severe pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484fa62ea	Winter	None	2022-02-27T16:24:48Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Winter, Marie	l03-a9du-bi9o	False	None	False	2022-04-12 03:15:27.895	[]
1551	CDC-2022-0024-1557	https://api.regulations.gov/v4/comments/CDC-2022-0024-1557	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain from scoliosis full s curve with rotation and spondylolthesis for 20 years. I have tried injections and radio frequency abulation, physical therapy. Just about every non narcotic medication. Finally got some doctor to try narcotic pain relievers and got to be a part of life again. Until the last CDC guidelines for prescribing opiates. Then I dealt with pharmacys that treated me like a drug addict until my doctor became to afraid to continue opiate treatment. So now I live with pain every day and can not find any help. My daughter was 15 and got hit by a F150 walking to school, after getting metal rods in both legs along with pins and screws for all that. She was given pain meds for 3 weeks. When she went back to the doctor still in pain they flat out called her a addict. They missed the fact that her leg was still broken. Some how 4 different hospitals and several doctors missed a broken leg for four years. They were all to busy lecturing her on how bad opiates are. She is 19 now and walks with a cane. She will probably always have pain due to the mass that grew in the untreated break.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leigh	None	None	0900006484fa5eaa	Jones	None	2022-02-27T16:25:29Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Leigh	l03-ao77-06gj	False	None	False	2022-04-12 03:15:28.103	[]
1552	CDC-2022-0024-1558	https://api.regulations.gov/v4/comments/CDC-2022-0024-1558	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is [name redacted]. I am 33 years old. I was disabled in a car accident at age 19. I have been with the same pain management physician for 12 of those years. When I was prescribed opioids in 2008 I was made fully aware by my physician what these medications can do to the body. My injuries were causing so much pain there was no choice in my mind. I was also required to go to physical therapy and try steroid injections and radio frequency procedures. Also take other medications for nerve damage and migraines. After a few years my doctor found a dose of opioids that worked for me yet he never went too far prescribing. Then in July of 2018 my world was rocked when I was made aware of the new CDC guidelines and the my medication would be drastically cut down. Today in 2022 I am still on the lowered dose of opioids my dr felt he had to prescribe. My life is nothing like it was. The medication dose is only enough to get by. Sometimes not even enough to treat the pain I am in. I know it won’t take it all away but this has been very hard. I am a good patient I see a very reputable doctor. I have radio frequency procedures 2 to 4 times a year. I use other tools to help the pain. With very little relief. I pray you read this and can listen to the patients that need this medication. This isn’t for fun it’s for survival. Please change your guidelines. I understand why this had to be done but the people who are in real pain are the ones who are suffering. Thank you for your time. It is appreciated. <br/> Sincerely. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cailin	None	None	0900006484fa5f0f	Caccavelli	None	2022-02-27T16:26:49Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Caccavelli, Cailin	l03-bupr-2qna	False	None	False	2022-04-12 03:15:28.312	[]
1553	CDC-2022-0024-1559	https://api.regulations.gov/v4/comments/CDC-2022-0024-1559	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines need to be completely done away with because it's hurt a lot of chronic pain patients nationwide. I ask that the naloxone Guideline recommended here gone because chronic pain patients are patients not addicts. I also ask you to get rid of the Guidelines to get the dea out of our Drs offices because the cdc Guidelines have further resulting in the DEA attacking Drs and them get out of our Drs offices because correct use doesn't equal abuse of these medications and ask for the cdc to recuse them from rewriting these Guidelines because this current pushes further issues for chronic pain patients and Drs and ask they be left alone and ask for the cdc, fda and dea untying the sacred dr patient relationship and also stop the production of these meds be stopped and restore normal production like that they were before these Guidelines became law and ask to get the controlled substances act overturned because the countries who don't have low addiction rates and therefore I ask lastly asked the cdc to come clean to the air and admit 1 pill of opioid use causes abuse and that narrative and propaganda is false and the cdc to recuse themselves from writing these all together via various conflicts of interest and ask for the cdc Guidelines be completed undone and allow drs to be drs again and honor the hypocratic oath do no harm by the cdc, fda and dea stop prosecution of drs and the dea, cdc and fda to focus on the illegal illicit Street drug epidemic and not an opioid epidemic.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa5f8b	Anonymous	None	2022-02-27T16:27:51Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l03-e3ia-utq6	False	None	False	2022-04-12 03:15:28.543	[]
1554	CDC-2022-0024-1560	https://api.regulations.gov/v4/comments/CDC-2022-0024-1560	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[name redacted]<br/><br/>Executive Secretary, Centers for Disease Control and Prevention. <br/><br/>Doc. 2022-0024 <br/><br/>Dear [name redacted]<br/><br/>My understanding about your proposal is that clinical practices should revised their prescriptions for opioid pain medicine. I agree with your proposal because the effects of opioid usage can be deadly. Some may argue that patients with chronic pain need higher dosage, however opioids have a record of being misused and harmful to people. <br/><br/>Proposal Summary <br/><br/>Clinics are advised, not mandated to review recommendations from the CDC (Centers for Disease Control) when prescribing Opioids. These recommendations are to help with clinical judgement to prescribe dosages in the best interest of the customer. The CDC funded the Evidence-based Practice Centers at the Agency for Healthcare Research and Quality (AHRQ) to conduct systematic reviews of the scientific evidence in the following five areas: (1) Noninvasive nonpharmacological treatments for chronic pain; (2) nonopioid pharmacologic treatments for chronic pain; (3) opioid treatments for chronic pain; (4) treatments for acute pain; and (5) acute treatments for episodic migraine. The CDC Guideline for Prescribing Opioids for Chronic Pain is based on new evidence. <br/><br/>My Belief <br/><br/>I respect the CDC for funding evidence about the effects of opioids and the alternatives for acute, subacute, and chronic pain. People suffer major injuries and may never recover. Medicine is their only hope to deal with the pain, but the fear of abuse of opioids is a nationwide epidemic. Many people are responsible for their intake but some are not. Having proper evidence of the dose needed for patients will reduce the dangers of opioids. Opioids are considered immensely helpful for individuals with chronic pain and are important for their daily lives. Some individuals have server pain that physical therapy alone is not enough to reduce the pain. The proposal being voluntary portrays the significance of the clinic's decision when prescribing opioids. This proposal is helpful for reducing overdose. According to a new review and analysis by a University of Michigan team, suicides and drug overdoses kill American adults at twice the rate today as they did just 17 years ago, and opioids are a key contributor to that rise. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484fa5f91	Arias	None	2022-02-27T16:29:29Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Arias, Thomas	l03-e6ta-zjmj	False	None	False	2022-04-12 03:15:28.748	[]
1555	CDC-2022-0024-1561	https://api.regulations.gov/v4/comments/CDC-2022-0024-1561	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Attention Contact: [name redacted]<br/>Executive Secretary, Centers for Disease Control and Prevention<br/>Document ID: CDC-2022-0024-0001<br/><br/>[name redacted] I appreciate the document posted showing the proposed guidelines on prescribing opioids to patients over eighteen dealing with chronic pain. I have personally experienced the pain and struggle that opioid addictions can cause. I am a big supporter of the proper use of pain medication in the clinical setting. <br/><br/>My concern<br/><br/>There are not many concerns that I can think of when issuing better practice guidelines for potentially stopping improper use of opioids. I am concerned with how the grading system will be incorporated into the clinical setting. I know that it provides recommendations on the duration and severity of the pain. I am concerned that this does not deal with the problem of falsifying pain to receive opioids. It seems to me that it is an added layer that doctors are suggested to follow but it still requires their ultimate judgment. I am also concerned that, if the guidelines are approved, doctors will simply ignore the new guidelines because there is no requirement to follow them. <br/><br/>My conclusion<br/><br/>I am in agreement with the proposed guidelines on opioid prescription. I am interested in how new and evolving programs for drug prescription will come to fruition in the future. At the end of the day I do want people to feel relief from their chronic pain but without the risk of addiction. I believe affirmative guidelines such as these are paving the way for safer use of opioids. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa6343	Anonymous	None	2022-02-27T16:30:44Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l03-fejk-t8f5	False	None	False	2022-04-12 03:15:28.956	[]
1556	CDC-2022-0024-1562	https://api.regulations.gov/v4/comments/CDC-2022-0024-1562	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In my early 30's I sustained a work related injury, which required back surgery, I was told I would never work as a R.N again. I worked very hard to return to the profession I love.. 2 years after my surgery, and return to work, i started experiencing back pain continuously. I started on Tylenol and anti-inflammatories. They worked great until I could no longer take NSAIDs, due to a significant allergic reaction. This was in 1993. I was started on Darvocet N 100. The drug worked well for me. It was not an issue to receive this medication. It that helped me to live a more enjoyable life. I don't remember the year Darvocet was taken off the market. The provider, as well as the pharmacist, was concerned about using Vicodin/oxycodone with Tylenol, long term use for pain management. . I was also diagnosed with significant degenerative dics disease. At that time my provider prescribed oxycodone for chronic pain. In 2020, my provider left his practice. He stated he sent a referral he to my Hospital systems, Pain Management practice. When I called to schedule an appointment with Pain Management, they stated they did not have a referral for me. My provider was no longer in practice, so there was no one to reach out to. I finally was accepted to the Pain management practice. Late 2021, I was diagnosed with 7 stress fractures, and diagnosed with osteoporosis .When my provider called to tell me I had multiple stress fracture, I was never asked how my pain was. I feel chronic pain, can be as sever as cancer pain,.. Since 2016, I feel chronic pain patients have been made to feel, like we are only seeking narcotics, and the only goal doctors have, is to taper the pain,medication. I can tell you, I would never go to the streets for medication. I don't know how I would live, without pain management, which includes prescribed opioids.. Simply put, its a quality of life issue. . I believe providers are under such pressure, and scrutiny, their main goal is to wean patient's down to the lowest level; of medication, no mater how bad the patients pain is.I feel Chronic pain patients are invisible. I often, do not tell the provider how bad my pain really is.I feel blessed to have the pain medication at the current dose. I feel prescribers are under enormous pressure. The 2016 CDC guidelines, target chronic pain patient's, and the providers who are trying to treat this group of patient's. The goal for providers is "First do no harm" I feel the 2016 CDC guidelines, nullified this oath. I implore the CDC to institute the new guidelines for prescribing opioids,. I believe it is the CDC's responsibility to help to undue the DAMAGE, of the 2016 guidelines for prescribing opioids. I cant imagine how many chronic pain patient's have been harmed. I knew how to navigate the system, to be see a new provider, I would have been in withdrawal. I have heart arrhythmia's. I would have ended up in the ED.Then what?. How many chronic patients had their pain medication abruptly stopped? Many doctors were afraid to continue to prescribed narcotics. How many suicides occurred, or overdoses, due to using illecit drugs, trying to get pain relief..No mater, what I do not find any fault with most practitioner's. I feel the CDC, implemented a global fix, that affected all prescribers, and the patient's they swore to "First do no harm.". My diagnosis is Chronic use of opioids for therapeutic purpose, so quite treating chronic pain patients as drug seeking!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa9e8c	Anonymous	None	2022-02-27T22:05:45Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-jcf3-ffrn	False	None	False	2022-04-12 03:15:29.214	[]
1557	CDC-2022-0024-1563	https://api.regulations.gov/v4/comments/CDC-2022-0024-1563	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patients are being cut off from their pain meds right and left with very little or no warning. Doctors are scared to prescribe and many are quitting/retiring because of it. Many chronic pain patients would have no life or very poor quality of life without their pain meds. This attack on chronic pain patients and their meds is "not" getting these opoids off the streets. The only thing it is doing is hurting chronic pain patients - forcing them to either suffer extensively, go to the streets for meds, or commit suicide because they can no longer endure the pain. Most all chronic pain patients are forced to endure monthly pill counts, drug testing, and humilitation (worst than addicts receive) in order to get their meds. Most are very responsible people. Most are now living month to month in fear their pains meds are going to be revoked any day. How would you like to live in fear that your next day/month might be the day your life becomes a livng hell? It's a shame that our gov't lets our citizens live a life in pain and blames it's chronic pain patients for the drug problem when it won't even close it's borders where the true illegal opiod problem lies.<br/><br/>I am one of those patients whose doctor retired early because he couldn't treat his patients as he felt fit. I have been on pain meds for almost 15 years due to nerve damage in the neck and arms from a neck surgery, soft tissue damage in the back that gets worse every year, a lower disc that is bad, nerve damage in my hand from a tendon surgery, and fibromyalgia. None of these will ever get better - just progressly worse. No doctor will now take me as a new patient because they are afraid to prescribe the meds (which were pretty low dose considering my problems). I've been thru the physical therapy, etc, etc in the past with no improvement (actually made the neck worse). We are begging you to let doctors prescribe as they see fit. Afterall, they know their patients and their problems more than the gov't does and treating chronic pain patients is not a one size fits all solution. We are not drug addicts. We are dependant upon our meds in order to have some quality of life. Please .. let our doctors be doctors again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faa1b9	Anonymous	None	2022-02-27T22:06:41Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l05-ldpj-5gj9	False	None	False	2022-04-12 03:15:29.455	[]
1558	CDC-2022-0024-1564	https://api.regulations.gov/v4/comments/CDC-2022-0024-1564	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffered great trauma after gallbladder removal when my biliary papillae was closed . The pain was rival to child birth . Paramedics documented my pain as a 4. They did not treat me in any fashion once I told them I take pain medicine routinely. Literally walked away from me . I was an acute abdomen at that point. I am a nurse . I was one Vital sign shy of sepsis. I was screaming in pain, begging to breathe. The failure to treat me is a disgrace. I post trauma from this event. I was treated worse than a dog . No oxygen no IV and lying about my pain level. We need to stop treating pain as a desire to obtain pain medication for desire to get high .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484faa20c	Cabrera	None	2022-02-27T22:07:03Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Cabrera , Tracy	l05-lo0b-6ecu	False	None	False	2022-04-12 03:15:29.686	[]
1559	CDC-2022-0024-1565	https://api.regulations.gov/v4/comments/CDC-2022-0024-1565	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a patient reliant on pain medication to manage interstitial cystitis & pudendal neuralgia. Please support doctors at all levels to provide appropriate pain care to patients who are suffering. The pendulum swung too far in a negative direction as a result of the CDC's original set of limits and the pain community is grateful these are being rewritten to be more patient centric. <br/><br/>Thank you for your time & attention supporting doctors who serve patients in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	0900006484fa994b	Sidden	None	2022-02-27T22:07:21Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Sidden , Rebecca	l05-mbt5-7n03	False	None	False	2022-04-12 03:15:29.899	[]
1560	CDC-2022-0024-1566	https://api.regulations.gov/v4/comments/CDC-2022-0024-1566	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was forced tapered rapidly off my opioid medication February 26 2021.As of date February 27 2022 unable to find a provider who will prescribe. I am no longer able to live a normal healthy functioning lifestyle.Disabled widow 62 years old. I am in debilitating pain and no longer able to do housework gardening cooking or tend my Animals. I Am not a drug seeking Addict just a broken person who has worked hard all my life paid my taxes homeowner who had a life on my opioid medication. I feel wronged by the cdc guidelines.Today I am asking the CDC to recognize Pain and the devastation it has caused me without my opioid medication.Respectfully [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484fa9a09	Clark	None	2022-02-27T22:07:56Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Clark , Sandra	l05-n8dp-p2st	False	None	False	2022-04-12 03:15:30.107	[]
1561	CDC-2022-0024-1567	https://api.regulations.gov/v4/comments/CDC-2022-0024-1567	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain. I have degenerated disc disease. In 2020 I was diagnosed with osteoporosis. This came after being diagnosed with 7 stress fractures. Not once did a practitioner ask if I was in pain. I take oxycodone regularly. Recently my pain provider left his practice. He did not refer me to anyone for pain management. Because I was a RN, I knew how to navigate, and get into a pain managemt practice. I wonder how many of my former practitioners, patients ended up in the ER, in withdrawal! My new provider that is a ARNP, wants to decrease my dose. He doesn’t care how it affects my quality of life! Please adopt the new guidelines for prescribing opioids. Many people I know have committed suicide, as they were left hanging, with no access to narcotics for pain! It’s a crime as far as I’m concerned !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484fa87f3	Sterling	None	2022-02-27T22:08:44Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Sterling , Marilyn	l04-cl19-l83e	False	None	False	2022-04-12 03:15:30.315	[]
1562	CDC-2022-0024-1568	https://api.regulations.gov/v4/comments/CDC-2022-0024-1568	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient, it has become impossible to get medication that helps manage pain. We have medical problems that causes debilitating pain. Suicide is rising in our community because the thought of going through another day like this, with no medication or so little that it doesn’t work, we end our lives because the misery that accompanies every day is unbearable. Please help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa7455	Anonymous	None	2022-02-27T22:09:29Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l04-gdw6-z6d9	False	None	False	2022-04-12 03:15:30.537	[]
1563	CDC-2022-0024-1569	https://api.regulations.gov/v4/comments/CDC-2022-0024-1569	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support the use of acupuncture as a non-opioid modality. It's very effective for pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John Paul	None	None	0900006484fa74ac	Liang	None	2022-02-27T22:09:39Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Liang, John Paul	l04-h3mc-pqou	False	None	False	2022-04-12 03:15:30.745	[]
1564	CDC-2022-0024-1570	https://api.regulations.gov/v4/comments/CDC-2022-0024-1570	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a practicing acupuncturist, I would recommend acupuncture being included in the non-opioid recommendations for chronic pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Grant	None	None	0900006484fa74bb	Weidler L.Ac.	None	2022-02-27T22:09:50Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Weidler L.Ac. , Grant	l04-h7ed-cbdc	False	None	False	2022-04-12 03:15:30.959	[]
1565	CDC-2022-0024-1571	https://api.regulations.gov/v4/comments/CDC-2022-0024-1571	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I believe that Acupuncture should be an approved and encouraged form of non-opioid treatment. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashley	None	None	0900006484fa74c7	Simmons	None	2022-02-27T22:09:59Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Simmons, Ashley	l04-hc5e-56wp	False	None	False	2022-04-12 03:15:31.165	[]
1566	CDC-2022-0024-1572	https://api.regulations.gov/v4/comments/CDC-2022-0024-1572	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Acupuncture performed by trained and licensed acupuncturists is very helpful to treat patients with various types of pain conditions. It reduces people's pain and improves function. This would help decrease the need for opioids. Acupuncture must be part of the portfolio of treatment modalities recommended and made available to patients with pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa74c8	Anonymous	None	2022-02-27T22:10:06Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l04-hc6o-4mus	False	None	False	2022-04-12 03:15:31.370	[]
1567	CDC-2022-0024-1573	https://api.regulations.gov/v4/comments/CDC-2022-0024-1573	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Fibromyalgia and suffer greatly with it. Tramadol was the only thing that helped me cope but my doctor has stopped prescribing it out if fear. This witch hunt has got to stop!!!! Allow doctors to do their jobs without fear of reprisals!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bamboochik	None	None	0900006484fa89c3	Ba	None	2022-02-27T22:10:17Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Ba, Bamboochik	l04-jbqo-9s5s	False	None	False	2022-04-12 03:15:31.576	[]
1568	CDC-2022-0024-1574	https://api.regulations.gov/v4/comments/CDC-2022-0024-1574	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a nurse (RN, BSN, DON) of 37 years. I had to give up my career due to Rheumatoid Arthritis, Fibromyalgia and other co-morbidities. I was prescribed many medications, treatments and therapies to no avail, and then got some relief from opioids. Then came “voluntary” reductions, with prescribers <br/>being rightfully terrified of being “raided”. I have a very high tolerance to pain meds, EVERY PERSON’s reactions and needed dosages are different! All mention of morphine prescription limits must be eradicated. Let the physicians who know their patients do their jobs. As you now see, chronic pain patients and their medications had/have nothing to do with the drug problems we have today. We tried this crap in the 70’s! My grandmother died screaming in pain from cancer. When my father asked the Dr. to increase her medication, he responded “No, she’ll become addicted.” She was DYING! <br/>Now MY quality of life suffers. I leave the house only for monthly groceries and appointments which can’t be done via phone. I can’t put on my own socks, tie my own shoes, play with my grandkids…I lost a friend to suicide because no one would address her pain. I cannot schedule a shoulder surgery that I desperately need, because no doctor will ensure that I have adequate temporary post-op pain relief! <br/>Enough is enough.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006484fa8a46	Hughes	None	2022-02-27T22:11:02Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Hughes, Cynthia	l04-kjos-c1a6	False	None	False	2022-04-12 03:15:31.790	[]
1569	CDC-2022-0024-1575	https://api.regulations.gov/v4/comments/CDC-2022-0024-1575	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Nurse Practitioner who is employed fulltime in a Pain Clinic I want to mention several concerns:<br/>1) Despite the fact that prescribing an opioid dose greater than 90 MME is not illegal, the CDC office in our county requests 5 tablets or less per day, and arrested a local physician for increasing a Xanax dose on a phone visit in the height of the early phase of the COVID pandemic when most patients were not yet vaccinated. The prosecutor dropped the charges after the physician's picture was put in the newspaper and legal fees accrued. The DEA seems to operate very independently from the CDC and I have doubts that they will take new CDC guidelines seriously. They seem to be somewhat antagonistic and negative toward providers who are running above board pain clinics. When will this change?<br/>2) The CVS's in all of the counties in my practice area have been out of hydrocodone 10/325 mg for 2 weeks and do not know when foreign shipments will arrive. They report that this is a national back order problem with states surrounding our area also being affected. Our clinic has been out of Depo Medrol and lidocaine for a month, and pharmacists tell me they are out of a number of drugs, What is being done to address the supply chain problem with medications?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484fa8aaa	Cox	None	2022-02-27T22:11:53Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Cox, Nancy	l04-lctb-bibk	False	None	False	2022-04-12 03:15:31.995	[]
1570	CDC-2022-0024-1576	https://api.regulations.gov/v4/comments/CDC-2022-0024-1576	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i have suffered with chronic lower back pain since 1990 after a severe accident. I have had hip replacement also. I use opioids judicially for instances when I have incapacitating pain and a level 7 or greater pain level.<br/><br/>As with most things, opioid use can lead to constipation which is something it is avoided. Therefore I try heat or ice first, then physical therapy, but I if do need Vicodin I take it, making sure I do not not drive.<br/><br/>I think Doctors know their patients and know if a patient is prone to addiction of opioids. Not all of us are.<br/><br/>opioids have a place in the treatment of various injuries and should not be precluded from use in a "one size fits all" format <br/><br/>I think using alternatives first is correct, but use of opioids should be part of a treatment plan. After all, a doctor can prescribe just a few Vicodin to help a patient over sever pain son they control what and how much is prescribed for any individual patient<br/>.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fa8da3	Sims	None	2022-02-27T22:12:17Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Sims, Robert	l04-m0g3-8nom	False	None	False	2022-04-12 03:15:32.201	[]
1571	CDC-2022-0024-1577	https://api.regulations.gov/v4/comments/CDC-2022-0024-1577	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a patient for 16 years! My pain management doctor retired and I have chronic back problems! Degenerative joint and discs spinal stenosis scoliosis. I have end stage degenerative discs in multiple areas.I have a s shaped curved spine. I fractured my pelvis along with my sacrum and my coccyx bone. New doctor came in and told me that he was lowering my medication! I don’t ask for a higher dose! But I need this medication to live a quality of life! I don’t abuse my medication and to lower my dosage is making it harder for me to have any type of quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fa8e6f	Knappenberger	None	2022-02-27T22:12:35Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Knappenberger , Susan	l04-o6eq-2d2m	False	None	False	2022-04-12 03:15:32.410	[]
1572	CDC-2022-0024-1578	https://api.regulations.gov/v4/comments/CDC-2022-0024-1578	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have full body and stomach CRPS/RSD, Fibromyalgia and degenerative disc disease plus arthritis. My pain is at a level 10 almost every day of my life. The only thing that has worked was the Fentanyl patches. I was at 200mcg and now I am on 75mcg and my pain is so bad that the thought of even taking a shower puts me into a panic attack. Because the water hitting my body feels like nails being thrown at me. The reason the Fentanyl patches work better for me is because I also have ulcers, gastritis, GERD and gastroparesis and so many of the pain pills cause my stomach to hurt even worse. It's not my fault that Fentanyl became a dirty word because of the drug addicts. But all 3 of my doctors want me off of it and I know it's because they don't want to lose their license. I have been living with this pain for almost 20 years and if you keep forcing good doctors to stop helping their patients many are going to use street drugs. I would never do that but I also can't live with this pain. I fear that I would take my own life rather than see my husband, 4 beautiful kids and grandkids see me living in this much pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484fa8ef7	Cormany	None	2022-02-27T22:13:16Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Cormany, Cindy	l04-pfkk-6k7x	False	None	False	2022-04-12 03:15:32.629	[]
1573	CDC-2022-0024-1579	https://api.regulations.gov/v4/comments/CDC-2022-0024-1579	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2012 I suffered a work injury. It resulted in 2 major surgeries 1 minor surgery and multiple small procedures. In 2014 I was referred to a pain management doctor. It is now 2022 My dosage has increased 5 mg in 8 years. I work in healthcare. there are days when I spend 16 hours on my feet. I rely on my pain medication to keep me working. I recently rei Jared my foot, the current regulations are making it impossible to increase my pai. medication by 5 mg. My quite of life is deteriorating because my physician does afraid to change my dosage of oxycodone from 10 mg to 15. Those 5 mg will keep me from working in the field and position type I have spent 24 years in. In 8 years not once have I given my Physcian a reason to be concerned about my opiate use. I adhere to pill counts and urinalysis whenever requested and there has never been. problem. I am currently laying awake unable to fall back to sleep because of the foot pain and my doctor is refusing to increase my medication dosage because of the current guidelines. This is about quite of life for me. Not everyone becomes an addict. Not everyone needs to be denied access because others have become addicted to opiates. I take my medication as prescribed and. follow all of my doctors recommendations yet I am being refused a 5 mg increase the will allow me to sleep and take care of people. No one should be forced to live in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terri	None	None	0900006484fa634a	Scott	None	2022-02-27T22:15:42Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Scott, Terri	l03-fjhg-vgju	False	None	False	2022-04-12 03:15:32.834	[]
1574	CDC-2022-0024-1580	https://api.regulations.gov/v4/comments/CDC-2022-0024-1580	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was going through some of the comments and I noticed that some physicians are okay with the guidelines which is crazy they are not suffering and chronic pain like I am and everyone else is they don't know how it feels to be in pain every day and wake up and can't get up because it hurts so bad. Acupuncture that they are saying work does not work at all that does not stop the pain when someone is in chronic pain.i am begging you to please remove all mention of the mme better yet removed the whole guidelines because it's all junk science..u already know that .this is not fare to the sick people .. people on palliative care and cancer are suffering bad yeah it says there exempt for doctors are not listening to that.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fa605b	Guthrie	None	2022-02-27T22:16:09Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Guthrie, Melissa	l03-kydz-k7jy	False	None	False	2022-04-12 03:15:33.047	[]
1575	CDC-2022-0024-1581	https://api.regulations.gov/v4/comments/CDC-2022-0024-1581	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a person who suffers from chronic pain and my life would have been over in 2017 if I hadn't found a plant that saved me. These guidelines are abhorrent. There is no logical reason to tell a patient with severe chronic pain that they cannot have the medicine they need to get from one day to the next. The morphine milligram equivalent limits need to be completely gone. It is the same thing as telling 2 diabetics they can only have so much insulin a day, when no 2 people are alike. Also, allowing [name redacted] to have a say in this or to allow [name redacted] a say here is also doing a huge disservice to the pain community. The CDC never should have been allowed to do anything with leveling off pain medication. Opiates are not as addictive as you are claiming. If an addict wants to get high, they'll find a way, regardless. Taking these meds away have already caused thousands of deaths across the country, which makes the CDC complicit to murder.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fa6f48	Wike	None	2022-02-27T22:17:26Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Wike, Amy	l03-zl8d-sbaz	False	None	False	2022-04-12 03:15:33.278	[]
1576	CDC-2022-0024-1582	https://api.regulations.gov/v4/comments/CDC-2022-0024-1582	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is something that is long overdue but sadly it will have very little effect in helping all of us legitimate, responsible patients that rely on pain medications to obtain some sort of normalcy in their life.<br/>In 2016 when the original set of guidelines were released, they targeted the wrong issues & the wrong people. While there are irresponsible patients and doctors, they are far outweighed by the legitimate and responsible people who’s lives desperately depend on pain medications to have any meaningful level of a quality of life.<br/>When the original guidelines were released the wording was so severe that it costed thousands of people to be effected in some way, shape or form that lead to death in many cases and irreversible damage in others. The language used in the 2016 version and the format it was laid out in was nothing more than a threatening document meant to get every single doctor treating a patient in pain to forget about the Dr. / patient relationships and to adhere to a strict non medical approach to treating patients and scare every single Dr into compliance “or else”.<br/>The opioid issue was never one of responsible patients and doctors but has always and will continue to be one of street drug users and irresponsible patients and doctors. Had this been done properly in the first place, targeting those abusing the system and those taking advantage of the “leeway” Doctors had to DO THEIR JOB properly, there is no telling how many lives would have been saved and to continue having the closest thing to a normal life possible.<br/><br/>The urgency that this new document needs to be released as soon as possible and the importance in changing the language to encourage doctors to get the responsible patients back into a situation where lives will be saved & returned to the best quality of life obtainable can not be stressed enough.<br/>Without actually spelling it out, no changes will be made. The medical community will not return to treating those patients in a way that will have a lasting effect on both the end of live from under treated patients and in general and overall health.<br/><br/>I started out in 1989 taking pain medications, I’ve had several different treatments that included things ranging from herbal remedies to non invasive therapies to physical therapy, chiropractic, braces, non effective treatments and even forced into surgery and other treatments just to be allowed to continue receiving medications that actually helped. I’ve had treatments that have made things worse, treatments that had little to no effect and treatments that were just plain counterproductive.<br/>Since 2016 all that got worse but now with the addition of having my medications constantly reduced to the point of causing my overall health to decline to the point of landing me on deaths doorstep & being placed on hospice.<br/>If I could be returned to effective levels of medication and removed from hospice, allowing me to also seek further treatment to help repair the damage to my overall health in general, I could possibly live much longer than the estimated 6-8 months I’m looking down the barrel at my life being cut to.<br/><br/>Efforts need to be made to deal with the “bad” doctors & patients. Dealing with the issues of illegal drug users and most importantly returning responsible patients and doctors to do what is best for each individual’s health overall.<br/><br/>Please fix this asap & give me the chance to watch my grandchildren grow up, live a semi normal life with the best quality of life possible and to not die way before my time.<br/>Thank you for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	T	None	None	0900006484fa6e0d	J	None	2022-02-27T23:25:57Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from J, T	l03-sj6z-ja3l	False	None	False	2022-04-12 03:15:33.498	[]
1577	CDC-2022-0024-1583	https://api.regulations.gov/v4/comments/CDC-2022-0024-1583	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I want to address the guidelines for pain control. I want to let you know that I have lived with chronic pain since 2004. I was treated with 2 different medications and I also have severe anxiety and was treated with medication. When this first happened I was taken off of my anxiety medication and then I was taken off of one of the 2 medications that help me live my life. I literally was able to walk my dog and exercise! Not now I lay on my couch and do nothing! I can’t help clean, walk my dog essentially I am useless. This is how you and your guidelines have made me feel. I’m sure so many more then me deal with this as well. I had a double mastectomy and already had a hard time due to the way I look but now it’s the way I can’t do anything anymore as well. This is killing people by making people so desperate they are going to the streets for drugs or overdosing to just be done! Blood is on your hands. This needs to change. I won’t give you my list of Disabilities that is for my doctor as I thought my pain control was. Please I beg just get out of the doctors business. The crisis is the street drugs not our doctors helping us have a life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sammie	None	None	0900006484fa781f	Winslett	None	2022-02-27T23:27:09Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Winslett, Sammie	l04-3cwj-abzb	False	None	False	2022-04-12 03:15:33.713	[]
1578	CDC-2022-0024-1584	https://api.regulations.gov/v4/comments/CDC-2022-0024-1584	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Does anyone remember that our 35th president was a chronic pain sufferer? I wonder if he was treated like we are today? Did he have to take a urinalysis every month, every 3 months? Was he forced to go through several expensive alternative treatments before he could receive his pain medications? Was he ever just cut off from his pain medication? Did he ever experience those moments of despair when he was sure there wasn’t a caring person left in the world? <br/>Opioids have been used for millennium but suddenly they are a problem? In America, it seems the “War on Opiates” started in full force around 2010 and has gained steam as the years progress. Why are they a problem now? <br/>I have had a long relationship with opiates from the perspective of a patient and of a health care technologist. After all these years, all I can say is that if people are dying from prescribed opiates, they must be trying to kill themselves, simply put. I’ve certainly never tried to test the overdose limit but I’d imagine it’s more than double or triple my daily dose. So, if people are dying from prescribed opiates, they must be attempting suicide in the first place. After a long 22-year history of using prescribed opiates, I’ve never had to use Narcan nor was I ever close. <br/>What better way to leave this world? Take a good dose of opiates and just drift off into eternal peace. I’m going to make this statement and I will continue to stand behind my words: I think we are looking at a suicide problem in America and just using opiates as part of the subterfuge to avoid the reality of it all. Suicide has been rising, on average, very steadily upward well before opiates were ever part of the problem. It takes a lot more bravery for a suicidal person to use a gun or hang themselves but death by opiates is just too easy and it becomes the preferential choice. <br/>I think officials are taking this death information and are obscuring it intentionally. Let’s make opiates the ugly poster child of American deaths so we have something to cast our stones at. Let’s avoid answering the real reason so many Americans are checking out. You know, the insatiable greed that this country is known for. This greed is causing the disparity in people’s souls because the American dream drifts further and further away for the average person. This fact saddens more and more lives every day and increases our nations suicide death rate. Fix the greed in America first and see how much happier our society will become. But let’s not focus on that, let’s instead create an object that we can focus on to sooth our grief, opiates.<br/>The greed that I’ve witnessed in the medical field would be a good start. The Cures Act of 2016 created the ugliest example of American greed. Doctors can now make money on all the dubious, alternative treatments and charge outrageous fees that only enrich them but often do very little for the chronic pain patient. Prescribing a pill is not a money-maker for doctors, so they avoid going down that road altogether. <br/>If this opiate war in America is about saving lives, then why are authorities okay with the resulting suicides and illicit opiate deaths that are the collateral damage resulting from their own efforts in the first place? Just look at CDC’s own graphs if you are misunderstanding my point. I think it’s all because of our unchecked greed in medicine, don’t you?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fa7868	Cook	None	2022-02-27T23:32:09Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l04-3irg-135h	False	None	False	2022-04-12 03:15:33.931	[]
1579	CDC-2022-0024-1585	https://api.regulations.gov/v4/comments/CDC-2022-0024-1585	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient of 20 years. 12 years ago, I was put on daily pain meds that enabled me to be out of bed to finish raising my family. As you know, a tolerance is built up with this medical. A patient would naturally need some increases in dosage thru many years. But due to the federal restrictions the past several years, docs have refused to increase my pain meds for the last 6 years, even though my list of diagnosis has grown. I grew very depressed due to chronic pain of a levels of 3-7, 24 hours a day. I was allowed to have 20 mgs of percocet to last thru an entire day! I was in bed 20 hours a day. I hear all the harmful effects of addiction and overdoses. But where is the concern for chronic pain patients pushed into sedentary lifestyle? That can't be healthy! My teenage children have even offered to go buy me something on the street because they knew how miserable I was. Of course I refused to allow this, but what child should have to feel this was an option to help mom.<br/><br/>In desperation, I made the sad choice to move several states away from my young I ng adult children so that I could access medical cannabis. In my state of Illinois, I have 10 qualifying conditions for medical cannabis but couldn't even get a 2nd dose of percocet. I have never failed a UA or broke any pain contracts w pain clinics. The victims, chronic pain patients, are being treated as drug seekers criminals for trying to have some quality of life. Very sad.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fa7895	Reed	None	2022-02-27T23:33:32Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Reed, Lisa	l04-3mqp-l8p0	False	None	False	2022-04-12 03:15:34.190	[]
1580	CDC-2022-0024-1586	https://api.regulations.gov/v4/comments/CDC-2022-0024-1586	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This can’t be the only change. This will not repair what you have broken by this “guideline” as you say. It isn’t a guideline when the medical doctor is scared to go to prison for helping his patients. It isn’t guideline when people go to the er with massive injuries and can’t have pain control, or chronic pain patients like my self is cut down on medication. I can’t clean my home,walk my dog or exercise like I use to. I now am on my couch all day unless I am going to a doctor appointment. This isn’t a life and it’s not just me. Your “guideline “ is killing people and sometimes by their own hand. Pain patients who never touched drugs before are going to the street and killing them selves because of this. This madnesses must end. Re write this. Take away the 90mme for chronic pain patients and encourage the doctors to care for their patients as they were taugh in the massive amount of schooling they took. This has to change otherwise the loss of lives due to these awful “guidelines well it’s on your hands. You must clarify the difference in acute pain and chronic pain treatment and get rid of this 90 mme it’s causing so much pain suffering and suicide. It isn’t prescription pain meds killing people it’s the opioid street drugs. This is what we should be fighting all you did was hurt us who don’t do drugs and go to our doctors as we should. The drug dealers are doing great because of you. They are getting new customers some elderly this isn’t the way!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sammie	None	None	0900006484fa79cd	Winslett	None	2022-02-27T23:36:44Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Winslett , Sammie	l04-4ctj-xhij	False	None	False	2022-04-12 03:15:34.397	[]
1581	CDC-2022-0024-1587	https://api.regulations.gov/v4/comments/CDC-2022-0024-1587	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Adequate pain management is a human right. Millions of people have been harmed, been forced to withdraw from society, and died by suicide, as a result of restrictions on prescribing. Since prescribing guidelines were changed in 2011 opioid overdose deaths have increased 400%, with street drugs being responsible for most deaths. When pain patients do not have safe access to necessary medications they are forced to turn to unsafe options. No one should have to gamble with their lives to not have to live in constant pain. 2 years ago my elderly uncle, walked into his back yard in Florida, put a gun to his head in killed him self. He has been living in pain, with a chronic condition and could not take it anymore. This should not be how people are forced to live out their “golden years”. With so much agony and desperation they take their own lives. Pain management is a human right.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fa80f1	Hanlon	None	2022-02-27T23:37:14Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Hanlon, Kathleen	l04-8gmh-xct4	False	None	False	2022-04-12 03:15:34.603	[]
1582	CDC-2022-0024-1588	https://api.regulations.gov/v4/comments/CDC-2022-0024-1588	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in support of the proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids, however, as a resident of Arizona where medical marijuana (as well as recreational) is recognized by the state and has garnered great success for many individuals experiencing chronic pain as well as many attempting to taper off opioid medications. After reviewing the individual studies that included analysis of cannabis' effectiveness in treating pain, I noticed that the only forms of cannabis being used in the research studies were pharmaceutical grade synthetic cannabis such as dronabinol, nabilone, or memantine. I feel like these alternative methods do not create effective data around the efficacy of cannabis as a treatment intervention as these are not necessarily the best methods for administering. I believe the CDC is doing the country a grave disservice by not thoroughly researching alternative methods to opioid medications. It is because of a long history of overprescribing opioid medications as well as an unwillingness to utilize alternative methods that has led to this tragic opioid epidemic in the first place. Hopefully the CDC will take additional steps towards researching treatment methods aside from prescribing more or different opioids to prevent future crises from arising.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Trevor	None	None	0900006484fa8795	Southwick	None	2022-02-27T23:39:09Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Southwick, Trevor	l04-cd1i-uxod	False	None	False	2022-04-12 03:15:34.813	[]
1583	CDC-2022-0024-1589	https://api.regulations.gov/v4/comments/CDC-2022-0024-1589	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing as a caregiver for a family member (the patient) who has a serious illness known as psoriatic arthritis mutilans. There are differing degrees of seriousness of this condition, but doctors who have seen the patient have repeatedly said that this is among the most serious cases they have seen. I have witnessed how opioid medications can help a person who lives with constant pain to gain some control over their life and increase their function. The pain never goes away, but it is imperative that a person have some kind of relief and hope for the future. Pain medication has given the patient both of those. I witnessed over the past 13 years as the patient's dose was increased and then, when the patient received an immunosuppressive antibody drug, the patient voluntarily reduced the dose. However, after 2016 the patient was forced to drastically reduce the dose to the point that life became miserable. In fact, the patient remains miserable despite the fact that we now have found care in an excellent pain institute that has a clinical and research branch. Even in such a setting I can see that the doctors are under pressure. After accompanying the patient on doctor visits for more than 12 years and reading the medical literature on this subject I feel very strongly that pain medication should be a subject between doctor and patient. We must acknowledge that there was an excess in prescribing from 2000-2010. However, since 2010 prescribing has decreased by a factor of two and opioid deaths have increased by a factor of three. Clearly, the hypothesis that prescription opioids have "caused" the opioid crisis is flawed. Since 2010 prescription monitoring software has been implemented and there are strict rules about monitoring patient compliance. The missing part is how we treat addiction. If only our government would acknowledge that addiction is a medical issue first and foremost and treat it as such, it would alleviate the anxiety pain patients feel. Our society has made many pain patients feel that they are addicts. Of course, we need safegaurds in place to provide help to doctors who are concerned about misuse. But, this too could be done by medical professionals or at least in consultation with them. The Physicians for Responsible Opioid Prescribing (PROP) have harmed pain patients by suggesting that pain patients are addicts. The commentary written by [names redacted] in Archives of Internal Medicine in 2012 with the title "Opioid Dependence vs Addiction: A Distinction Without a Difference?" is a case in point. It is not humane or ethical to equate depending on pain medication to be able to sleep or function with an addiction. Dependence is an obvious consequence of treating persistent pain, but that is not at all the same as addiction. We need only look at the DSM-5 manual to see that addiction is defined by behavior, not dose. As a Chemistry Professor I can read the medical literature and I understand what PROP has done to change the criteria for acceptance of valid studies. It is not ethical to change the rules for validity of scientific studies after the fact and then claim that "there are no valid studies." This is precisely what members of PROP and their allies did in an internal evidence review at the NIH in 2014. In addition, blaming medical professionals for the crisis is grossly unfair. Of course, there are cases of abuse and also of lack of training. Doctors would be more willing to seek needed training if the climate were more conductive to an appropriate doctor-patient relationship. Prescribing limits combined with the implicit threat of law enforcement action against doctors have made the climate oppressive for everyone. If there is serious concern about whether doctors will act responsibly, we should handle that type of issue first and foremost through a State Medical Board complaint and not by Drug Enforcement Agency action. If the guidelines reflected the fact that prescription of pain medication is a medical issue that should be handled by medical professionals, it would go a long way towards alleviating the great harm that has been done.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stefan	None	None	0900006484fa72c9	Franzen	None	2022-02-27T23:42:17Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Franzen, Stefan	l04-e0jh-qvtr	False	None	False	2022-04-12 03:15:35.023	[]
1584	CDC-2022-0024-1590	https://api.regulations.gov/v4/comments/CDC-2022-0024-1590	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC, <br/> I have had two back surgeries. I was told I needed a decompression/fusion on four levels of my lower back. had a terrible work-related accident at around 36 YO. Carrying a 2000 lbs. marble jacuzzi tub to be installed with 9 other men. We had 4 flights of stairs to carry this tub up. Unfortunately, 1 guy slipped which caused a chain reaction and every one of the other men lost their grip except me. I had a 2000 lbs. tub in my hands. A massive jolt of pain ripped down my lower back into my legs. I was rushed into emergency surgery because the pain was horrendous, and I was basically paralyzed. Since that accident I've had two surgeries. However, the pain now that I'm close to 60 is so bad I can't stand very long without Morphine Sulphate 100 mg ER. The pain is 70 percent controlled with the morphine. Problem is trying to get this simple drug these days is so difficult. Why is the DEA trying to make me give up? Nothing else works and believe me I've been prescribed everything out there. Only morphine works for me. It's a miracle god given drug for me. Only problem is Drs are scared to prescribe that high of dosage. They see my records and know lower doses dont touch the pain. They know I'm basically completely disabled without it. Why DEA Why????? If I were your brother, would you care.<br/>My kids are grown now and cannot understand why Im having such a difficult time getting the proper meds. My kids see how I'm sinking without it. I cannot get adequate exercise.<br/>I take many vitamins, watch my weight and eat right. I want to live but not without relief. I have considered giving up in this life many times now that I made a move to California. Drs are so scared of losing their livelihood or going to prison. DEA CDC you guys caused this. PLEASE REVERSE IT.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Edward	None	None	0900006484fa8f1d	Beeler	None	2022-02-27T23:43:29Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Beeler, Edward	l04-q2n6-twh2	False	None	False	2022-04-12 03:15:35.237	[]
1585	CDC-2022-0024-1591	https://api.regulations.gov/v4/comments/CDC-2022-0024-1591	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in pain every single day, all day. What I miss most about the proper dose of pain medication is working. I wasn't able to make much due to my spinal damage. I did have the huge life affirming gift of feeling more useful, seeing other human beings and the little extra money I made allowed me to eat the healthier foods I love. Now I am stuck eating substandard foods that I can afford. <br/>While I view opioid addiction as a disease it ultimately begins as a choice to break medical rules. Why punish the sick or injured for the irresponsibility of others? That is illogical.<br/>I did see doctors who functioned as legal drug dealers. It was ugly and angered me. Instead of seeking to hold accountable those doctors who abandoned patients and reopened under CDC Guidelines, our government punished the noble doctors who refused to leave patients in pain. Once again illogical. <br/>If a person chooses to abuse and then suffers addiction, there should be accountability for them and only them.<br/>If a doctor becomes a dealer and cares not for his patients quality of life, punish them. If an addict overdoses due to poor choices it is inappropriate to hold accountable other people in pain, the doctor who prescribed the meds they at some point chose to abuse, or poor severely mentally ill patients whose psych meds were scooped into the opioid hysteria.<br/>At the outset of the opioid crisis I was a hundred percent on board. Then I began to notice numbers weren't adding up. I began to research and discovered the members of PROP and other addiction professionals who met with the CDC too often were major stockholders in the rehab industry. Why were these the experts chosen? Why was the rehab industry represented as a good sized group while pain management was under represented?<br/>I changed my mind and flipped sides. <br/>I began to research why our country was bringing lied to and concluded the guidelines had far more to do with money than saving lives.<br/>Narcotic overdose deaths are up. Legitimate, law abiding pain patients turned to illicit narcotics to control their pain and this killed them. <br/>I volunteered on a suicide hotline and lost people in pain to suicide because their pain was unbearable. This radical reaction to a problem damaged and killed many American people. <br/>Overreacting, radicalization, one size fits all solutions to problems consistently worsen the problem. Why does our government leadership chose to do it so often? <br/>They either do not learn from their mistakes or don't care about their constituents. <br/>Why not hire well educated experts in a well rounded group of fields such as sociology, anthropology, psychology, in addition to those who directly study the issue being decided? This committee of experts should study and "think," before those untrained in what effects the solution will have, make decisions? During interviews make certain these experts have no self serving motives or bias before choosing them. <br/>I suspect we really do not matter to our leadership. To those of us who are decent, honorable and caring, people matter. <br/>I myself made the best of the situation and learned much about controlling pain without sufficient medication. Not all are built to do such things. <br/>As none have developed a time machine the past is gone. The damage can however, be prevented for future people in pain or those with severe mental symptoms. Perhaps keep government out of the medical decisions made by adults and their doctors. Instead police the doctors who prescribe irresponsible amounts of controlled substance medications. <br/>For the US leaders to remove medical freedoms from the citizens stands against all this nation claims to be about.<br/>Thank you for your time. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fa8f57	McCormick	None	2022-02-27T23:48:01Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from McCormick , Kim	l04-qseo-vj8m	False	None	False	2022-04-12 03:15:35.446	[]
1586	CDC-2022-0024-1592	https://api.regulations.gov/v4/comments/CDC-2022-0024-1592	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am (was) a very active (sports related activities) adult, which resulted in (most of) my joints being severely deteriorated or left in a damaged condition. After trying several 'pain-controlling-options' my doctor(s) placed me on an Opioid treatment regiment.<br/>When the Opioid "crisis" became "a thing", my doctor(s) removed me from "maintenance" level Opioid consumption (60 pills per month of 5mg dosage (5/325 mg Hydrocodone ... #520) -- averaging 2 pills per day). I was told "take Tylenol/Advil/similar" OTC medications as the replacement medication for my chronic pain issues. But, since those doctors would not "effectively" help me treat my chronic pain (shoulders, knees & hips), I resorted to "self-medication" .... meaning I now must resort to "whatever" treatments I can access or try... and so far, alcohol has become my chosen "drug" of choice. I will consume 6-9 oz's of 80 proof alcohol (Vodka or Gin mostly) before bedtime (or naps as I am now retired). Most nights, I will consume (guzzle actually, straight from the bottle, 6-9 ounces all in one 'swallow') the alcohol and take an OTC 'sleep aid'.... pretty much "every night". According to the WebMD website, my "alternative pain management" option is a far worse solution than the Opioids I was prescribed before (for nearly 4 years, with NO addiction symptoms). This issue I face now, is that "I" have become my own 'primary care physician' -- I don't have any real medical training, so I am placing my health in my own hands... that can't possibly be a "better" solution/treatment than consulting (and visiting) a licensed doctor on a regular basis. "Training" (knowledge) and monitoring has been (for many, many years) an acceptable method for tracking and regulating "behaviors" (like addiction). But the (stupid) politicians have decided they know more about medicine than the doctors... so I must suffer less effective -- and less healthy alternatives -- as in No Opioids to try and manage my chronic pain issues. I will (apparently) live the rest of my life resorting to "getting drunk" every night (just to try and get 3-5 hours of "sleep" (if you can call it that), just to handle the pain(s) that I suffer, even though proven medical treatments are available (but not to me). Please consider my comments, as I do believe I am not the only "pain sufferer" without any real 'doctor' input. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fa9017	White	None	2022-02-27T23:49:27Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from White, Michael	l04-t1gi-28yj	False	None	False	2022-04-12 03:15:35.654	[]
1587	CDC-2022-0024-1593	https://api.regulations.gov/v4/comments/CDC-2022-0024-1593	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Music https://bir-music.com	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa8bf6	Anonymous	None	2022-02-27T23:49:39Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-0y3j-9o0v	False	None	False	2022-04-12 03:15:35.872	[]
1588	CDC-2022-0024-1594	https://api.regulations.gov/v4/comments/CDC-2022-0024-1594	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have spondylilothesis, stenosis, trigeminal neuralgia. I’ve been had my meds taken away or cut In Half for fusion surgery read about my attached story. The entire state of Hawaii seems to be committing fraud with pain patients we are dying left and right. I’m on 15% of MME I was on before and I’m about to have another spinal fusion. These pain doctors are sick and should be fined heavily for malpractice. I was fainting from the forced tapering and vomiting from pain. Shame on these regulators pain patients don’t do anything wrong.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chelsea	None	None	0900006484fa8c71	Proenza	None	2022-02-27T23:52:02Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Proenza , Chelsea	l05-5rqk-fpud	False	None	False	2022-04-12 03:15:36.097	[]
1589	CDC-2022-0024-1595	https://api.regulations.gov/v4/comments/CDC-2022-0024-1595	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have attached my horrific story because there is not enough room to explain the medical malpractice, gaslighting, forced tapering for a patient with trigeminal neuralgia, spondylilothesis, stenosis, bilateral sclerosis, rotoscoliosis due to a thoracolumbar S curve, I have ovarian cysts and fibroids and plantar fasciitis in top of it. My meds have just been cut again for surgery. The MME needs to be removed I was on 4 x this amount and had an almost normal quality of life minus a bad flare up once a month I’d treat with torodol and prednisone. I have been hospitalized twice from having a seizure and fainting due to forced tapering and sustained whiplash my 13 yo and 4 yo were home alone with me terrified. And when they got me to ER they did NOTHING for me. Fix Hawaii it is BARBARIC here they are all taking advantage and becoming drill mills and have no basis to take us off our meds help us before it’s too late.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chelsea	None	None	0900006484fa8c7a	Proenza	None	2022-02-27T23:53:13Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Proenza , Chelsea	l05-627c-5jvp	False	None	False	2022-04-12 03:15:36.319	[]
1590	CDC-2022-0024-1596	https://api.regulations.gov/v4/comments/CDC-2022-0024-1596	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted], a military spouse (who served 22 years), a certified phlebotomist for years (a hospital is where I belong, finishing my degree to apply for PA), a super cool mom of FIVE and I'm extremely good at riddles...........and I was a normal person until I unknowly had Lyme disease for over 2 years in my twenties. It started with Bells Palsy, which still comes and goes on the right or left side of my face. I began to get migraines but it felt like my skin was on fire from my neck up. I was working full time, my husband deployed and taking care of our baby in-between appointments to figure out what was wrong with the me. Eventually the fire feeling spread everywhere besides the soles of my feet and inside of my hands.<br/>ARE YOU LISTENING? I want you to hear me because I think you have this idea of what people like me are and...you don't. I drop my older kids at the school bus, I take care of my other nonschool aged kids all day....and I go to Sams to buy loads of stuff we probably don't need. The only difference is that most times, after, I'm in so much pain I can't speak. So I Stay in bed....until.... I look normal on the outside, you'd never know. But this body is broken, pain medication gives me temporary relief to do bath night, grocery runs, oil changes. I probably won't change anything by writing this, people are so obsessed with the addicts of the world (who are going to do and get what they want no matter what you write on a sheet if paper), people don't care about my struggles. I wish you did. I wish I could be there more for my babies, I wish I wasn't petrified that at any point my dr may not want to write pain meds and I'll become a useless person to my children. I wish someone sat down with me, in my kitchen and asked questions and not just talked about overdose and addicts, as if responsible, non able bodied adults don't exist. There are SO MANY people who use these medications to LIVE. You keep proposing these arbitrary guidelines and I GET that they're guidelines but YOU KNOW just like I do...just as before, Dr's will use this as concrete rules. How will that work for me, a 105lb person that hypermetabolizes everything? I really wish there was an opportunity for you to hear me, but this comment will go unnoticed. I wish you well. I hope you never have to deal with pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brittany	None	None	0900006484fa923a	Jones	None	2022-02-27T23:54:54Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Brittany	l05-dn2f-cvo6	False	None	False	2022-04-12 03:15:36.535	[]
1591	CDC-2022-0024-1597	https://api.regulations.gov/v4/comments/CDC-2022-0024-1597	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help . I am a chronic pain patient that can not get the medication that allowed me to a better quality of life.<br/>I live in South Carolina and all they have is drs doing spine shots which haven’t been FDA approved.<br/>Fibromyalgia, arthritis ,degenerative disc disease ,chronic migraines ,IBS,<br/>PLEASE HELP !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MichelleMichelle	None	None	0900006484fa924b	Hagan	None	2022-02-27T23:55:05Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Hagan, MichelleMichelle	l05-dvst-8w2h	False	None	False	2022-04-12 03:15:36.741	[]
1592	CDC-2022-0024-1598	https://api.regulations.gov/v4/comments/CDC-2022-0024-1598	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had read a story not too long ago from a local paper in Ireland where the government and the medical community is trying to adopt the same restrictions to opioid medication that we in the States are having to deal with based on the 2016 guidelines. I just finished reading up on the history of symphysiotomies which were performed in Ireland up until 1987 so there are still victims alive today that had that wretched procedure done to them.<br/><br/>Per your new guidelines, with them not being in active cancer treatment, a sickle cell patient, in palliative care, or hospice their ongoing pain resulting from what I consider medical butchery could be viewed as undeserving of pain control. And if they happen to receive pain control, it may not be nearly enough considering that your 2016 guidelines had 90 MME and these new guidelines sprinkle throughout the document the suggestion of 50 MME. These numbers were and will be used as goalposts for the DEA, government bodies, insurance companies, and undereducated doctors and will cause tremendous hardship.<br/><br/>Please, cast a wider net for pain that should be exempt from these guidelines. Many who have chronic pain is a result of botched surgeries which are far too common, autoimmune disorders for which there is no cure, diseases for which there is no cure, medical butchery as notated above, post-operative pain that was undertreated, and the like. Also, just because something is common, such as herniated disc, arthritis, and the like does not mean they are any less painful, and they should be treated appropriately.<br/><br/>Also remove all mention of MME from the document. This will be used against pain patients and it is based on junk studies.<br/><br/>The world is watching what you are doing CDC and are adopting your recommendations. So please, keep in mind those women who had symphysiotomies done without their consent and the long-term consequences they face because of it, and how now, they run a real risk of not receiving adequate pain control. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa929e	Anonymous	None	2022-02-27T23:55:47Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-epue-v8c3	False	None	False	2022-04-12 03:15:36.948	[]
1593	CDC-2022-0024-1599	https://api.regulations.gov/v4/comments/CDC-2022-0024-1599	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why do your guidelines recommend patients use gabapentin and antidepressants for pain without disclosing these medicines cause dependence and require tapering over lengthy periods over time to avoid mental & physical withdrawl. A patient will assume these medicines have less potential for side effects and dependence when in fact the opposite is true. Gabapentin and antidepressants both increase seizure and suicide risk. Will the cdc be liable for the harm caused by recommending prescriptions which cause more harm than good?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa93ed	Anonymous	None	2022-02-27T23:56:00Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-ficr-3g2c	False	None	False	2022-04-12 03:15:37.229	[]
1594	CDC-2022-0024-1600	https://api.regulations.gov/v4/comments/CDC-2022-0024-1600	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please please please stop interfering in medical care between a doctor and their patient. I agree the pill mills need to be stopped, but the over control of chronic pain patients and the medication they need to function in daily life, is devastating to many of us. We didn’t ask to have chronic pain.. it happened to us, whether through accident or illness. Many of us, have tried everything, surgery, injections, nerve blocks, physical therapy ect… at least for me the opioids were a last resort. I exhausted all of the aforementioned. I don’t get “high” on opioids, they just help to take the edge off my chronic pain. If I didn’t have the medication I would be bed ridden… and I can’t be, I am a single parent of an adult mentally disabled daughter. <br/><br/>Please stop the attempt to control dosages and strength of the medication… let this decision take place between doctor and patient. Everyone is different and mandating a remedy for all will not work. Many will suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fa9420	Jacobus	None	2022-02-27T23:56:27Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Jacobus , Deborah	l05-fmdk-95iv	False	None	False	2022-04-12 03:15:37.671	[]
1595	CDC-2022-0024-1601	https://api.regulations.gov/v4/comments/CDC-2022-0024-1601	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband is a 19 yr stage 3 Esophageal cancer survivor with severe pain. Since the original guidelines his quality of life has gone down. No doctor will treat his extreme panic and agoraphobia because he requires pain medication to eat and survive. Noone will prescribe what he needs. A benzodizapine as he was on before his psychiatrist retired. 3 new psychiatrist agree he needs valium but none will prescribe. Pain management he has to go in every 4wks pill count urine to get a new prescription. My husband does not want to live like this anymore and noone will help him because of these guidelines. He should be grateful ti have survived Stage 3 cancer. Instead he is always in a panic in pain and always feeling like a burden in this country. Patients need to be treated humanly and with compassion but does happen in this country anymore.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maggie	None	None	0900006484fa957c	Solsbury	None	2022-02-27T23:57:02Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Solsbury, Maggie	l05-gf9v-apvh	False	None	False	2022-04-12 03:15:37.888	[]
1596	CDC-2022-0024-1602	https://api.regulations.gov/v4/comments/CDC-2022-0024-1602	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had 2 knee replacements in the last few years and severe pain in one shoulder. Knee replacements are very painful since the end of the bones are actually sawn off. The first surgery I was given adequate pain meds but by the time I had the second surgery, guidelines had changed. I was given Tramadol, which works well for me but in very limited quantities. I ended up spending months taking two and three times the recommended dosage of aspirin, advil, and aleve. I experienced a lot of heartburn which concerns me since my mother died of esophageal cancer. I had a similar problem getting enough pain meds with my shoulder pain which was treated with physical therapy. Again, I took much more than the recommended doses of over the counter pain meds and had significant heartburn. <br/><br/>I also have a disabled daughter who is in extreme pain. She would benefit greatly from the ability to get adequate pain meds. She can no longer do simple things like lift a gallon of spring water, or dry her own hair. What will happen to her after I am gone and she can not do such necessary things for herself.<br/><br/>Making prescription pain meds, both opioids and Tramadol, more readily available would improve her quality of life, prevent suicides of people who can no longer live in chronic pain, and prevent the health problems associated with overdosing on over the counter pain meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fa9581	Maguire	None	2022-02-27T23:57:55Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Maguire, Mary	l05-gfi0-dktb	False	None	False	2022-04-12 03:15:38.146	[]
1597	CDC-2022-0024-1603	https://api.regulations.gov/v4/comments/CDC-2022-0024-1603	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please honestly re-think your onerous rules. the MME limits are causing way more damage to the chronic pain community than they are doing good for anyone. Your own statistics proved that legally prescribed and legally used opioids are not causing OD's. We all know that illegal heroin and fentanyl is the problem. Your paid "expert" witnesses have their own axe to grind and their own wallet to fill. The obvious conflict of interests of some of them is so egregious that their opinions about my pain/life should be completely ignored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ray	None	None	0900006484fa95ed	pearson	None	2022-02-27T23:58:23Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from pearson, ray	l05-go59-piop	False	None	False	2022-04-12 03:15:38.357	[]
1598	CDC-2022-0024-1604	https://api.regulations.gov/v4/comments/CDC-2022-0024-1604	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am bedridden because no doctor will treat my pain.I have arachnoiditis and it's extremely painful but the CDC and DEA have doctors terrified to treat us. How can the government practice medicine without a license? Pain meds are not causing overdose it's illicit fentanyl. Why do you think prescribing is down so low but ODs are sky high? It's because y'all have made people turn to the streets or just commit suicide. [name redacted] and the rest on the task force are paid to lie and he's pushing suboxone because I'm sure he's making a lot of money. We need help . The only reason I can think of that y'all don't want to treat our pain is you want us to die off	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fa970d	Soyars	None	2022-02-27T23:59:13Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Soyars, Mary	l05-hbi3-ki9e	False	None	False	2022-04-12 03:15:38.595	[]
1599	CDC-2022-0024-1605	https://api.regulations.gov/v4/comments/CDC-2022-0024-1605	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Once again your attempts to deal with drug ABUSERS by attacking legitimate doctors and pain sufferers is a tactic of fools. I am related to a dea agent and the actual fact is 95 persentage of all opiates used by abusers come from mexico...not doctors offices..perhaps if you supported true security on our borders you would actually be doing something to address the severe drug addiction problem instead of making the lives of law abiding doctors and pain sufferers miserable..I would like to believe there are some members of the cdc that are not corrupted by politics, it is you I address to please bring common sense back into your corrupted institution and restore it to doing good..<br/>Thank you.....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484faaaee	..........	None	2022-02-28T00:00:19Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from .........., John	l05-vb95-xpt4	False	None	False	2022-04-12 03:15:38.849	[]
1600	CDC-2022-0024-1606	https://api.regulations.gov/v4/comments/CDC-2022-0024-1606	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain sufferer for over 10 years. Pain medication is what has allowed me to function daily and keep me from lying in bed hurting. Instead I can a part of my family's daily life, run errands, clean my home and many other things. My pain management clinic has lowered my dose without cause on my end; the provider stated they were worried about the DEA coming after them even though I was on a very low dose and amount. These providers are scared silly to treat legitimate pain because of the strict and harsh guidelines put upon them when it shouldn't even be targeted towards chronic pain, especially if you have the tests/scans to back it up, not to mention follow the rules of the clinic. We still live in fear of our dosages getting lowered or the medication taken away entirely all because the providers' fear of the guidelines. This does not even go on to cover the people having surgery or breaking bones that aren't getting proper pain management. It's barbaric. Something has to be done.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faaa64	Anonymous	None	2022-02-28T00:00:50Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-ukbt-xcls	False	None	False	2022-04-12 03:15:39.111	[]
1601	CDC-2022-0024-1607	https://api.regulations.gov/v4/comments/CDC-2022-0024-1607	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioid medication purchased over the counter would eliminate overdoses, suicides and increase quality of life yet a happy & healthy population is harder to control. <br/>I recommend discontinue reporting opioid prescription statistics to the government. Return to confidentiality. <br/>We are encouraged to risk dying in war yet refused opioid medication since it’s a small a risk to your life. <br/>The reason One is allowed over the other is the prescription only benefits you & your government couldn’t care less about you. <br/>We are no longer fooled, for Generations it’ll be known should you return torn and tattered the same government that sent you will refuse to help you. <br/>No medicine for my veteran it might kill you. Pray whatever disables you kills you. Demand to be left behind.<br/> Don’t join the forces, what you stand for is false sense of individual freedom, the only freedom is for our government to torture & dictate the livelihood of citizens/pheasants both foreign and domestic.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faa9d1	Anonymous	None	2022-02-28T00:01:28Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-ttov-recg	False	None	False	2022-04-12 03:15:39.318	[]
1602	CDC-2022-0024-1608	https://api.regulations.gov/v4/comments/CDC-2022-0024-1608	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How is this new guideline different from the previous guideline, and who besides Board of Scientific Counselors of the National Center for Injury Prevention and Control (BSC/NCIPC) was an advisor to the creation of this guideline? Due to recent lawsuits from drug manufacturers, does this guideline also comment on how doctors must be neutral toward drug marketers? These drug marketers can have an undue influence on doctors because of an unhealthy and often unregulated relationship that can misinform a doctor’s decision making for his/her patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faa909	Anonymous	None	2022-02-28T00:01:54Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-sx7t-vwns	False	None	False	2022-04-12 03:15:39.589	[]
1603	CDC-2022-0024-1609	https://api.regulations.gov/v4/comments/CDC-2022-0024-1609	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who has been on opiates, particularly the fentanyl transdermal patch for years and it has allowed me to live as close to a normal life as possible. However, the requirement to see the pain management doctor ever month is a bit excessive. My health does not change from one month to the next. It is an over utilization of medical insurance to require monthly visits when a prescription can be ordered for 90 days. Please only require a ninety day follow up with the provider of pain medicines for chronic use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faa4fa	Anonymous	None	2022-02-28T00:02:17Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-svbs-uart	False	None	False	2022-04-12 03:15:39.811	[]
1604	CDC-2022-0024-1610	https://api.regulations.gov/v4/comments/CDC-2022-0024-1610	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Unfortunately the revised guidelines came to late for my baby brother who suffered from a botched spinal surgery in which caused him severe pain and he couldn't get any pain medication or help because of those idiotic guidelines and he was found dead sitting on his church steps with his head in his hands because of his untreated chronic pain caused his blood pressure to soar which caused a cerebral hemorrhage and he wasn't even 50. I have had RSDS since I was 21 and I just turned 58 and I was forced to taper 75% in one day. I was told that I was a drug addict and that opioids were the cause of my pain. I was rushed to the hospital with stroke level blood pressure and admitted for 5 days on a morphine drip because of those idiotic guidelines I almost died. I am not sure if these updates are going to work without the CDC specifically telling everyone from law enforcement to doctors that they are not LAW and that pain management has to be between the doctor and patient not anyone else to whom doesn't have a medical degree period. You've known for years that it's street drugs causing the epidemic and I blame the CDC for all the lives lost because of their complete disregard for the medical doctors and patients. So my question is this: when will we pain patients be able to get our proper medication treatment for our individual pain treatment? We've already waited years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484faa420	Kearney	None	2022-02-28T00:03:08Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Kearney , Kathleen	l05-rwm3-pt7a	False	None	False	2022-04-12 03:15:40.049	[]
1605	CDC-2022-0024-1611	https://api.regulations.gov/v4/comments/CDC-2022-0024-1611	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in chronic pain for over 15 years. I have had multiple issues with injuries including my back my neck and a major surgery gone wrong. My surgery was for a disease called Ulcerative colitis. My condition was so bad they removed my whole large intestine and colon.<br/>Due to the Chronic pain I have been prescribed pain medication. I have always been a responsible <br/>When it comes to using them properly and as prescribed. In the recent years I have felt attacked persecuted disrespected and dismissed due to doctors being fearful of Prescribing pain medication’s.<br/>There is a problem and it is with people who abuse medications. It is not fair for upstanding citizens who are legitimately in pain to have to suffer because of others actions. And recent times I have At doctors tell me “you know this won’t help you” and “this won’t fix the pain” <br/>I am very well aware it won’t fix the pain but when there are no options that will this is something that lets me lead a fairly normal life. When I look at what is going on where people are given clean crack pipes to smoke from and clean needles I wonder where does that leave me? A responsible productive person who just wants to be out of pain, be a good family man, a hard worker and a decent person. My treatment has been Appalling and at times quite nasty. Doctors have lied on paperwork just to get rid of me and out of their office because I am on a drug they no longer want to give	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tuck	None	None	0900006484faa82b	Pendelton	None	2022-02-28T03:33:03Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Pendelton, Tuck	l06-305h-tjm6	False	None	False	2022-04-12 03:15:40.260	[]
1606	CDC-2022-0024-1612	https://api.regulations.gov/v4/comments/CDC-2022-0024-1612	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient that suffers from Rheumatoid Arthritis, psoriatic arthritis, lupus, spinal stenosis, and many other incredibly painful and debilitating issues, the pressure you are putting on doctors to not prescribe life giving medications to pain patients is, in my opinion, criminal. Do you realize that suicide rates amping chronic pain patients has TRIPLED since you’ve got involved in their health care? People are taking their own lives because they can’t deal with the very real pain crisis, compared to the completely made up “opioid crisis” YOU HAVE created. We know that 99% of opioid deaths are related to street drugs and NOT chronic pain patients. More CPP have died by suicide than ever died from drug overdoses. Me, personally have not been allowed ANY pain relief in FOUR YEARS. I’ve suffered for FOUR YEARS because of your meddling in my health care. I’m only still alive because I have children that show me, that despite my pain, life is worth it. If I didn’t have them, I’d be one of the suicide statistics. Why aren’t you talking about that, huh? Why not discuss how this is effecting the CP community? Too afraid of the backlash if people knew you were legally torturing people? GET OUT OF OUR HEALTH CARE!!! Let DOCTORS DO THEIR JOBS!!!! GIVE ME BACK MY PAIN RELIEF!!! I was ripped of opioids, with no withdrawal symptoms, FOR NO REASON. Obviously I was not addicted, since I had no withdrawals. I had 60 Lortab that lasted me 3-4 months, yet because of you, I don’t even get that. PT just increases my pain. I can’t take NSAIDS. I can’t take anything BUT opioids, yet I’m not allowed them. You have been torturing me for FOUR YEARS. You should all be charged with hate crimes. You apparently hate the CP community! It is criminal what you are doing to us! I despise you and hope you all lose your jobs when the truth finally comes out that this was all a ploy to sue pharmaceutical companies. You don’t give one flying leap about saving lives. Money, this is all about money. I hope you come back as dumb beetles.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Regan	None	None	0900006484faa834	Kelly	None	2022-02-28T03:34:18Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Kelly, Regan	l06-335k-cag4	False	None	False	2022-04-12 03:15:40.492	[]
1607	CDC-2022-0024-1613	https://api.regulations.gov/v4/comments/CDC-2022-0024-1613	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone with chronic pain I can tell you the CDC ruined my life with the 2016 guidelines. No longer able to function. Why are doctors that belong to prop helping with guidelines? I am a senior citizen and have had 17 surgeries and used to get an amount that let me be close to normal and not I can't do much. I have severe panic attacks but have to make a choice of benzo's or pain meds, even though I have been prescribed this for several decades.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484faa7ec	Wall	None	2022-02-28T03:34:30Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Wall, Pamela	l06-2brb-cl32	False	None	False	2022-04-12 03:15:40.727	[]
1608	CDC-2022-0024-1614	https://api.regulations.gov/v4/comments/CDC-2022-0024-1614	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a caregiver for my husband. Since the 2016 guidelines, my husband has awful anxiety when going to his pain dr appointment. He is in considerable chronic pain. His pain medicine helps so much. He fears his dr. might want to taper him to please the CDC Guidelines and avoid drug enforcement problems. He has heard of others who were force tapered or dropped by their doctors. A pain patient should not live in fear like this. Pain medication is very helpful in maintaining an active life that would otherwise leave him immobile and bed ridden. Please help the people in pain management to live without this fear. Its horrible to see him this way. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006484faa78f	Goering	None	2022-02-28T03:34:54Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Goering, Margaret	l06-1ivr-7u5k	False	None	False	2022-04-12 03:15:40.932	[]
1609	CDC-2022-0024-1615	https://api.regulations.gov/v4/comments/CDC-2022-0024-1615	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings. I am a 63 year old woman with chronic pain. I have severe arthritis in my neck,lower<br/>Back,left hand and both feet. Also I have nerve<br/>Damage in my right arm which was due to my upper spine and resulted in years of paralysis and pain. I have hundreds of lipomas in both my arms<br/>I inherited from my father which sit on nerves and are very painful. I have calcified fat in my spinal cord in several areas and 4 blown discs<br/>In my lower Back due to the arthritis. I have gone thru pretty much every non opioid therapy all my life since the age of 13 to no avail. I had to retire in 2015 due to becoming disabled because of all these problems. My life was over.<br/>I was prescribed an opiate pain medication after begging for relief. It worked. I got my life back. I didn't know anything about the new<br/>2016 guidelines about opiate medication for chronic pain. I was told nothing just hounded and verbally abused into quitting my pain medication for years. Horror stories I call them. I haven't been given pain medication in 3 years now and I am crippled. No one will help me because of fear of the 2016 CDC guidelines and the DEA pulling their license. If I had pain in maybe just one place,even 2 but it's everywhere and I can't control it all over my body like this. I just can't. No one cares what happens to me. I live alone. Please help me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bonnie	None	None	0900006484faa770	Stroik	None	2022-02-28T03:35:59Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Stroik, Bonnie	l06-18br-kk57	False	None	False	2022-04-12 03:15:41.146	[]
1610	CDC-2022-0024-1616	https://api.regulations.gov/v4/comments/CDC-2022-0024-1616	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Congress,<br/><br/>This letter is in reference to the millions of current Chronic Pain Patients (CPP) here in the US who are currently being denied proper medical care/relief due to the guidelines set forth in 2016 by the CDC and DEA. Pain Patients and their families support changes made to curb the amount of high powered medications and bad doctors from making it's way to the streets. What we cannot abide is the needless suffering of millions of Americans who have seen the pendulum swing so far it is cutting off the care they need, deserve, and should have without being treated like 2nd or 3rd class citizens.<br/><br/>Too many patients have already died due to allowing their illnesses to continue without any treatment to hasten their deaths or taking all of their medication to ease them into death in 2017. Some of our Veterans killed themselves with their guns to end their suffering. Men and women who went into battle for their country but upon returning home were told, "Suck it up kid, deal with your searing limb loss pain on your own!"<br/><br/>Supposedly this action was taken to save lives of those dying needlessly of Opioids. Let's check your progress numbers, shall we?<br/><br/>2016 - 63,000+ Overdose Deaths<br/>2017 - 76,000+ Overdose Deaths<br/>2018 - 68,000+ Overdose Deaths<br/>2019 - 80,000+ Overdose Deaths<br/>2020 - 90,000+ Overdose Deaths<br/>2021 - 100,000+ Overdose Deaths<br/><br/>I have three questions for you...<br/>What was your intention? What were your results? Why are we still paying for your overreach that seems to have caused more harm than good? Our Suicide rates have gone up too! "Good job!" dead golf clap...<br/><br/>We do need better laws on prescribing medication and doctors who abuse that privilege should be blacklisted for life and their worldly goods go to pay for rehab for free for their victims. We need to protect our population (not jail them) and save them by offering free treatment and rehab instead of prison. 3 strikes then you do go to a hospital bed facility to learn how to live clean. But we should not make felons out of people for a TREATABLE ILLNESS called "addiction". They are sick! They need help, not a boot on their neck!<br/><br/>Please stop the abuse of Chronic Pain Patients. They are NOT addicts, they are people living in excruciating pain you cannot/will not imagine!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debora	None	None	0900006484faa66a	Gierlach	None	2022-02-28T03:37:15Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Gierlach, Debora	l06-0pde-les0	False	None	False	2022-04-12 03:15:41.365	[]
1611	CDC-2022-0024-1617	https://api.regulations.gov/v4/comments/CDC-2022-0024-1617	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient that has been affected negatively by the 2016 guidelines. <br/> Please remove all mention of the mme limits from these new revised guidelines. <br/> I have had several surgeries including a cervical fusion, shoulder and bicep reattached, knee surgery. Opiod medication helps me function at work and daily activities, but ever since these guidelines were released i have had issues getting the treatment I have been on for years. Some doctors have treated me like an addict and went as far as scolded me or cut me off medication completely. We are chronic pain patients not criminals.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Luis	None	None	0900006484faa660	Salmon	None	2022-02-28T03:37:35Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Salmon, Luis	l06-0lnx-ypp5	False	None	False	2022-04-12 03:15:41.596	[]
1612	CDC-2022-0024-1618	https://api.regulations.gov/v4/comments/CDC-2022-0024-1618	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After six years of chronic pain patients being unfairly forced off their medications (and countless suicides/overdoses) the cdc is finally rethinking their harmful policy on opioids....I have been lucky to have a supportive physician and to have access to the medication I need. Many others are not so lucky. I urge the CDC to move away from reactionary and poorly thought out restrictions that leave patients and doctors hamstrung. Be a voice for patients!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484faa5a6	E	None	2022-02-28T03:37:56Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from E, S	l05-zcvq-tt0g	False	None	False	2022-04-12 03:15:41.809	[]
1613	CDC-2022-0024-1619	https://api.regulations.gov/v4/comments/CDC-2022-0024-1619	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with chronic pain for years half of my Adult life,I was able to make it through the day because my work for a major Shipping company that kept me busy and distracted me until the Pain because hard to put up with, and at times when not truly busy the pain was impossible to ignore and most day's the pain really effected the quality of my work and started to effect my ability to be the best at my job and to work safely ,and by the time I got home to my family I was was completely wore out , when it came time to sleep it was challenging to fall asleep with the pain i was having . After seeing my PCP for my pain and having MRI's he referred me to see a pain management specialist. That visit changed my life for the better. I know that I would not be able still be working or maybe even still be alive if I hadn’t met my pain management doctor <br/><br/>He has worked with me to find various ways to keep my pain under control. At first I had disc decompression surgery and use my opioid medication. I take my doses of pain medication the way they are prescribed to me. I am very cautious with my meds because I don’t want my judgement to be impaired while going about my life day to day . Opioids have that potential to do this , but so does uncontrolled Pain and uncontrolled Pain is more distracting, than controlled Pain!! And I don't want to lose my medication or job and my quality of life i have, please take this into consideration and don't lower the limits which each doctor can prescribe to each individual everyone is different with the pain they have and deal with on a daily basis! Please don't but us Chronic pain patients in the same category as what is happening on the streets, We all just want to work and have the Best Quality of life possible, I've known people who have lost their job of over 25 years due to these limitations of prescribing Pain Medication and it has been horrible to see this happen to someone and I don't want to be another statistic just because I need pain medication to have a better quality of life<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faab0b	Anonymous	None	2022-02-28T03:38:52Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-vgwe-mj4q	False	None	False	2022-04-12 03:15:42.061	[]
1614	CDC-2022-0024-1620	https://api.regulations.gov/v4/comments/CDC-2022-0024-1620	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These modifications will not undo the damage resulting from the 2016 guidelines. Don’t wait for the CDC to modify guidelines, even if they do the DEA has already stripped doctors of their licenses, and if your blessed to find a doctor who will prescribe the drug manufactures have discontinued producing effective medicine, only cheap inconsistent foreign manufactured substitutes which give negative effects before sufficient relief. Equal active ingredients does not equate to equal therapeutic effects. <br/>If you or your loved one isn't currently deprived of the quality of life they could have it’s only a matter of time before your day comes. <br/> These proposed guidelines reenforce why waiting for the government to realize your worthily of relief isn’t logical or likely. <br/>Grow poppies for the day your loved one calls you crying in pain after having a kidney removed and discharged 3 days later without any opiate medication. <br/>When the doctor gives you antipsychotics instead of pain relievers. Grow a natural resource of your own. <br/>Poppies grow like weeds, no special climate or care is required. Papaver somniferum has a purpose on Earth, as we all do. don’t allow yourself or these beautiful flowers go through life without fulfilling their purpose. <br/>Don’t allow another day go to waste waiting on someone to save you or your loved ones.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Grow	None	None	0900006484faa3ea	Papaver somniferum	None	2022-02-28T03:39:40Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Papaver somniferum, Grow	l05-rp3i-sost	False	None	False	2022-04-12 03:15:42.280	[]
1615	CDC-2022-0024-1621	https://api.regulations.gov/v4/comments/CDC-2022-0024-1621	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish to endorse comments separately submitted to the Federal Register and widely published on Social Media by [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Douglas	None	None	0900006484faa3a1	Hughes	None	2022-02-28T03:40:05Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Hughes, Douglas	l05-rcn1-skg9	False	None	False	2022-04-12 03:15:42.492	[]
1616	CDC-2022-0024-1622	https://api.regulations.gov/v4/comments/CDC-2022-0024-1622	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 72 years old and have had eleven major surgeries in the past 15 years. Morphine is the only pain medication that works for me. I wish that were not so, but it is. Living in OK my legislators are dictating how much pain relief I may be allowed, and, it's not enough. Why must I suffer through the rest of my days with pain that is debilitating and crippling, because you are unable to find a genuine solution to a problem that has nothing to do with me? It's my pain specialist who is trained for the the job, and who should be determining how I might find comfort, not my legislature. I'm currently taking the highest dosage of morphine allowed, and it's not enough. I'm at the end of my rope, with no more medication allowed to me. Therefore, I just underwent painful and invasive surgery to have a Spinal Cord Implant for pain put into my body. Battery in my back and wires up my Spinal Canal. Scary stuff. I pray this brings me some level of relief, as I was forced to do this by your draconian policies. This is my last hope, I pray it helps. People who are not doctors should not be allowed to <br/>determine what relief may or may not be available to me.<br/>I am not alone, this is causing unnecessary pain and suffering. <br/>Please reconsider your approach.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joy	None	None	0900006484fa9cb8	Jahn	None	2022-02-28T03:40:57Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Jahn, Joy	l05-q661-wu96	False	None	False	2022-04-12 03:15:42.711	[]
1617	CDC-2022-0024-1623	https://api.regulations.gov/v4/comments/CDC-2022-0024-1623	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Part of the problem of the opiate crisis is our decision makers refuse to listen to their constituents. It seems that certain industries have their complete attention so they refuse to hear or acknowledge the reality before them. Beginning the first of November, 2021, I started writing to my Senator. 5 years before that I wrote a letter to my House Rep. I’ve attended several roundtables with other numerous public officials. In spite of my pleas, my cries aloud, I never had a single official step forward to truly hear my concerns about how chronic pain patients are being treated. I predicted several years ago that this “War on Opiates”, in regards to legitimate patients, would cause various negative consequence. But did anyone care to listen?<br/>The Following is my first, of several, letter written to my Senator starting 4 months ago:<br/>START<br/>Dear (redacted),<br/>(Intro redacted) I’m writing to you to bring your attention to a wide-spread problem that is getting little recognition. It has to do with the “Opiate Crisis” and how legitimate chronic pain patients are being treated in their course of care.<br/>I have been dealing with pain issues related to my spine since I was about 16 years old. I have used prescribed opiate-based medications for the last 21 years. I’ve also worked directly in pain treatment as an imaging technologist running fluoroscopy and have about 6 years of experience specific to pain treatment. So, as you can see, I’ve had a unique “angle” to all of this and its problems.<br/>I’m hoping that you can find the time to talk to me for a length of time. I have much to talk about this problem and I feel 1-2 hours might be required for me to explain all that I will address. The way I’ve been treated as a patient deserves to be heard. The situations I’ve witnessed in professional capacity need to be heard. The dubious care and downright corruption involved needs to be heard.<br/>I feel this problem has grown in such a way that It’s time for the details to see the light. Right now, the “National Narrative” on the opiate crisis eclipses and drowns out the voice of a legitimate pain patient.<br/>Please, I beg of you to at least give me am adequate amount of time to discuss this. I could literally write a very thick book about all that I’ve been witness to and I think it’s time that legislator’s take a closer look at this problem. There are many people like me that have the continual same problem and this is not an isolated situation. <br/>END<br/>So, you would think that such a letter would prompt contact from an elected official, wouldn’t you? You wouldn’t expect a complete rejection but that’s exactly what I got. Why wouldn’t my elected official give me some recognition? I’m a 22-year prescribed opiate user and a former employee that worked directly in the pain management for 6 years. If I were policy maker, I would definitely contact such a person. Why not? Why not learn as much as you can about a legislative subject, especially from someone who has such a vast, unique experience. <br/>This rejection for so many years has only increased my suspicions about this entire opiate mess. I think there’s a lot of blame to spread around here. How much of the responsibility falls on the laps of our elected officials, while the world tries to make me the bad guy? <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fa97f5	Cook	None	2022-02-28T03:42:32Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l05-hufg-ulnm	False	None	False	2022-04-12 03:15:42.933	[]
1618	CDC-2022-0024-1624	https://api.regulations.gov/v4/comments/CDC-2022-0024-1624	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	MY name is [name redacted]. I was permanently injured with an inoperable condition that put me in severe chronic pain for life. The year was 1988. The medical community and myself tried everything they/we could think of to try and relieve the pain without using opiate pain medicine. The only thing that relieved the pain enough for me to function/work was Morphine. It took a very long time to get controal of the pain but with the help of a compassionate doctor I was able to function. I did not turn into a drug addict and I am here to say long term opiate treatment does work to controal pain. I want to say I went through hell the first several years and contemplated suicide many times for pain relief. With morphine treatment I was able to function daily and take care of my family. I might add that I was able to build a successful business and put my children through school. The CDC guidelines have done more damage than good. Doctors and patients should be treating their pain. NOT people that have no comprehension of what it feels like to have to live with chronic pain. Your organization needs to recant the 2016 guidelines and go back to dealing with contagious diseases. YES I HAVE BEEN NEGATIVELY EFFECTED BY THE 2016 GUIDELINES! End of comment.<br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fa9c3b	Macak	None	2022-02-28T03:52:05Z	None	None	1	None	2022-02-27T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Macak, John	l05-prbj-adxt	False	None	False	2022-04-12 03:15:43.164	[]
1619	CDC-2022-0024-1625	https://api.regulations.gov/v4/comments/CDC-2022-0024-1625	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been managing chronic pain for 10 years now and in 2016 cdc put the guidelines out that ruined my life. I have had my medicine dropped down almost every month not knowing what is going to be my obstical next month. It is cruel to limit pain management and according to the disability act against my federal rights now that cdc rewrote the guidelines just makes me wonder what will be the next cruel hurdle I will have to hump over to get my life back. And I believe people who are deprived of safe regulated pain pills will just go to heroine or other street level drugs. Dangerous way to die. You want to curb the opium epidemic let chronic pain people that have proof of a condition accessible so we can get our life which was stripped from us in 2016. Also we the people who do have chronic pain need to be responsible to safeguard these medicines to keep it out of other people’s hands. That’s all I have heard is ween off and cdc guidelines and gotta cut you back. While I don’t like to be on medication I can’t barely move without it. I studied the pros and cons and I chose living a semi normal life on them. I could go on and on about the benefits of pain management but who am I but 1 American living a regulated life due to my government which gave me the very freedom my constitution promised me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fab641	Anonymous	None	2022-02-28T13:26:50Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l06-ofjs-4frr	False	None	False	2022-04-12 03:15:43.388	[]
1620	CDC-2022-0024-1626	https://api.regulations.gov/v4/comments/CDC-2022-0024-1626	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why you must remove all referrals to MMEs:<br/>People are individuals and respond to medications differently. Some people process opioids faster. After joint replacement surgery my primary care physician prescribed only half of what they were going to. They refused to write for every 4 hours which is what my body needs to deal with this kind of pain. As a result, I ended up back to square one with my pain level. They used to tell people that they needed to "stay on top of the pain" because it takes more to deal with the pain if you're not allowed to take it frequently enough to stay on top of the pain. The surgeon had prescribed every 4-6 hours, but I had a pain agreement and my primary care physician is the only one allowed to write my pain scripts. As a result, I was in agony for the last 2 hours of the 6 hours between doses. I would have to wait at least half an hour before the medication took effect again. I know my doctor is afraid to prescribe adequately because of scrutiny of MDs prescribing opioids. I have never had a problem stopping after a surgery once the pain was tolerable, but one should be able to have sufficient pain relief after major surgery. The MMEs don't work, again, because people process meds differently. My mother would hallucinate on one low dose pill. I, unfortunately, am like my father who needed much more medication before it affected him. The MMEs don't allow doctors to treat people as individuals. We are not all alike; doctors need to be able to take these things into consideration. The MMEs do not allow them to do that. The MMEs need to be dumped altogether. That's now how people function. Every one of us is unique. If something doesn't change, I will never have another surgery because the pain was not treated adequately the last time. I am afraid to tell my doctor that I need my pain med increased because while it's working, my pain level has increased due to the involvement of more joints. I've also had degenerative disks in my back and neck for years and it's getting worse - but I dare not ask my doctor for an increase in my pain med because of the fear you have created. As a chronic pain patient, I am also sick and tired of being treated like I'm an addict. I take my meds as prescribed - but the doctor is not being allowed to prescribe as they see fit. I could hear the anxiety and frustration they felt when they wrote out the script for my surgical pain. Again, I only got half of what they said they would provide and I wasn't allowed to take it every 4. Again, I was in agony for two of the 6 hours between doses. Again, I don't feel like I can ask for an increase. The doctor patient relationships have been compromised due to your lack of foresight. I certainly don't trust doctors to be able to deliver on appropriate pain management and fear I will be suffering for the rest of my life. <br/>It is absolutely willful torture of pain patients when appropriate doses are withheld because you wrongfully intimate that we all process meds the same. This is what's happening. IT'S TORTURE when people are inadequately treated for pain after surgery. IT'S TORTURE when you allow pain patients to be cut off, to limit the pain meds because of the arbitrary rule you came up with. You need to get the states that rolled out laws based on your guideline to repeal them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fab618	Anonymous	None	2022-02-28T13:28:13Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l06-npuo-rjat	False	None	False	2022-04-12 03:15:43.599	[]
1621	CDC-2022-0024-1627	https://api.regulations.gov/v4/comments/CDC-2022-0024-1627	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted], of [redacted], [redacted]. I have worked hard all my life, starting at 16 working in my neighbor's orchards and helping at home. I raised a steer during my teens for Future Farmers of America. He stepped on my ankle and broke it. Later, I fell out of a tree, playing "tarzan" with my brother and broke both wrists. I worked for a large tree company trimming trees for [redacted] Gas and Electric for 35 years. I also helped my mom and Dad and my family cutting trees, splitting and stoking our wood stoves. I eventually had rotator cuff surgery on both shoulders. After that my doctor put me on morphine as my back deteriorated-then methadone. My back doctor did 2 back surgeries without telling me of adjacent segment disease which has continued to give me back pain. I also had a dr in [redacted] break my back to get me back in alignment. My foot doctor removed a bone in one foot but still need to remove another as I am bone on bone. Since then my ankle has now disintegrated so I need it fused on March 22, 2022. My shoulder doctor said I need a shoulder replacement if shots quit working. (which they do). I tried physical therapy over and over again. Had a pain pump installed and was getting a little bit of hydrocodone which relieved my pain for about for 4 hours a day, for 2 weeks in a month the other two weeks I am in so much pain that I have gone over and over with my pain drs- and then my pain doctors reduced my hydrocodone which is the only thing that relieves my pain. The pain pump was increased which makes me sleepy but does not touch (oh, yeah, I am also scheduled for carpal tunnel surgery) my hands, my shoulder, my feet, ankle and back. The doctors say they will lose their jobs if they give me any more hydrocodone. What has happened to our government to react to street drug problems and allow good, honest citizens to suffer? I tried to serve my country and was there with my buddy and was singled out because of my asthma (my buddy died in VietNam). I have veteran friends who are suffering also who cannot get pain relief for the same reason. I have researched the AMA, the CDC, but was told Congress as given the decision to remove pain meds indiscriminately--as they took it out of my doctor's hands. I have always been a tea totaller, non smoking Christian family man. No partying-just a hard worker!!!! And I cannot live my life in pain due to Congress and the DEA. I have many MRI s, X rays and whatever else you need for proof. We have become a nation who does not care for the broken, anymore.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ron	None	None	0900006484faa8b5	Henson	None	2022-02-28T13:30:58Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Henson, Ron	l06-eua1-5re1	False	None	False	2022-04-12 03:15:43.864	[]
1622	CDC-2022-0024-1628	https://api.regulations.gov/v4/comments/CDC-2022-0024-1628	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife has suffered from chronic pain for around 20 years. She was doing fine on the level of opioids he doc prescribed. Them your 2016 guide lines came out and her doctor lowed her prescription to max dosage you set in your guide lines. Now she can barely function. Her doctor lowered the prescription because the DEA is using those dosage limits to go after doctors. She has two surgeries to try and fix her but both failed. We have seen several surgeons since those two surgeries. We were told they can not fix her and could only try to manage her pain. Nothing else work except opioids. Prescription medication is not responsible for the overdose deaths. Illicit drugs are the problem not prescription medication. These guide lines are only effecting law abiding citizens for the bad. These guide lines should be gotten rid of so doctors can do there job. The DEA should be told to do there job stopping illicit drugs and leave doctors alone.Because of these guide lines I have to watch my wife suffer everyday because she can't get back on the dosage she was on prior to the guide lines and this new one is no better for doctor patients. I am a veteran of 8 years active duty and ashamed of a government that hands out illicit drug paraphernalia to people breaking the law and punishing law abiding citizens and that's what these guide lines do. Since the 2016 guide lines came out opioid prescriptions have drop dramatically but overdoses have increased so problem is not with prescription opioids.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gregory	None	None	0900006484faafce	Rabel	None	2022-02-28T13:31:53Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Rabel, Gregory	l06-9smk-igy3	False	None	False	2022-04-12 03:15:44.165	[]
1623	CDC-2022-0024-1629	https://api.regulations.gov/v4/comments/CDC-2022-0024-1629	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long term orthopedic spine physician, primarily working in an urban setting, I believe we must link to pain to function. <br/>Pain is experienced differently by every patient. But it's the degree of related dysfunction which is so poorly understood.<br/>[redacted], MD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	shlomo	None	None	0900006484faafa5	mandel	None	2022-02-28T13:32:26Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from mandel, shlomo	l06-9319-zkoj	False	None	False	2022-04-12 03:15:44.378	[]
1624	CDC-2022-0024-1630	https://api.regulations.gov/v4/comments/CDC-2022-0024-1630	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live with chronic back pain (spinal stenosis, broken vertebrae, spondylolysthesis, retrolysthesis and the list goes on) and have for nearly 7 years and am waiting on spinal fusion surgery but have other health and financial concerns that have caused me to hold off on it. I was given high doses of gabapentin for nerve pain which did nothing but mess with my head and did nothing to alleviate my pain. I stopped that crap. Instead, I am encouraged to do nerve blocks which no longer have the same effect, jump through more insurance hoops for the same procedures (no anesthesia, BTW unless you request it now. Ever have a nerve block without anesthesia? That was new. Didn't even know until it started I wasn't being put out) and am told to take OTC meds even though I am a qualified candidate for prescription pain medication. I ended up getting a medical Marijuana card because I couldn't get prescription pain pills. I'm a grown adult, never had any problems with addiction, healthy but for this, never even smoked a cigarette in my life but apparently, I can't be trusted to parcel out even a few pills on my really awful days because some beuracrats at the CDC decided to punish the many for the failings of the few. Now, I have a medical Marijuana card in my late 40s because it's the most relief I can get. I'm sure I'm not the only one who went this route. Even then, I don't have much quality of life, I have less pain. I'm just stoned now when it happens. If my doctor knows what I need, you need to mind your business. I've had my card 5 years now and use only on my really bad days because I still want to function in the real world. That should not be a choice that I have to make. I should not have to decide whether I want want to leave my house or push through the pain today. Only reason I didn't mind the pandemic was because I didn't feel guilty about choosing medicating over life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faaf8f	Anonymous	None	2022-02-28T13:33:27Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l06-8opp-dh0n	False	None	False	2022-04-12 03:15:44.597	[]
1625	CDC-2022-0024-1631	https://api.regulations.gov/v4/comments/CDC-2022-0024-1631	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom this may concern. I have personally been prescibed narcotic pain medication for 10 yrs plus for multiple ailments and injuries. Since the guidelines have changed i have had to jump through hoops to be able to get this pain medication that helps my severe pains that enable me if i dont take the medication. The medication helps me function and increases my quality of life tremendously. I am very unhappy with the way these guidelines have allowed family Drs, pain management Drs and pharmacists etc to treat their patients poorly, judge them, look down on them, give them a hard time when the patient is just trying to get the medicine they need. Most Pain management Drs do not look at the patient or physically touch them to check injuries, they tell the patient unless they let them give expensive treatments like injections, epidurals and surgeries then they will not give the patient any pain medication, the patient is forced to get treatment. Your family Dr will refuse to prescribe any pain medication at all and refer you to pain management, once given the prescription you have to find a pharmacy that will actually fill your prescription, it will take you about 10 pharmacies to find the medication, big chain pharmacies will mostly always tell a new patient they dont have THAT medication and that it is backordered 2 to 3 weeks, or they will make you leave your prescription there for a few days and say they need to contact your Dr for some odd reason, and in that few days they will tell you they ran out of that medication. Most Pharmacist will make up any excuse not to fill your prescription, they treat you like you are a drug addict. Ive seen pharmacists treat dying cancer patients this way as well. They then tell you to try a small neighborhood pharmacy. Neighborhood pharmacies will always tell you they do not carry any narcotic pain medication. Please keep in mind that the pharmacy staff gives bad attitude while they tell you any of this. You also get bad attitude with the Drs office staff, they know you need the medication for your pain but they also know if you do not take your medication on time then you get sick, then you are sick and IN PAIN and they mess up your appointments so you dont get your meds on time, and if you speak up and tell them what they are doing wrong then they will make it worse for you, so then you keep quiet. Then you have to deal with bad medication. Pharmacies switch pain medication manufactures often, and instead of the medication helping you, it makes you feel very ill. The medication seems fake, or it has no pain medication in it, most times you hear other patients at the pharmacy complaining about the same medication with the same complaint, that something is wrong with the medication. But you cant complain, if you do they treat you like you are crazy or tell you to find a new pharmacy, so you learn not to complain. If you do your research, you will see that everything i have said is true with most people on this medication. I understand that there needs to be guidlines for this controlled medication, but most Drs offices and their staff, pharmacist and their staff are NOT practicing the guidlines correctly, they abuse their power and it is out of control. They should not be able to control a patients wellbeing. Also whoever is regulating pharmaceutical companies and the pain medication they are sending to pharmacies IS NOT DOING THEIR JOB CORRECTLY EITHER, they are putting out bad medication that makes patients sick, there are many forums on the internet over "bad pain medication" complaints from people all over the world. When i say bad medication, i mean opioid pain medication that does not help with pain and makes people physically ill. This patient guidlines should also apply to Drs, pharmacies and pharmaceutical companies. Maybe if they were under a magnify glass like patients have been, maybe we wouldnt have this huge problem with people abusing the medication, overdosing or dying. I do have a lot more to say, thank you for reading my comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa5f3d	Anonymous	None	2022-02-28T15:23:26Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l03-csvm-0oeg	False	None	False	2022-04-12 03:15:44.845	[]
1626	CDC-2022-0024-1632	https://api.regulations.gov/v4/comments/CDC-2022-0024-1632	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I noticed something that might change the way these guidelines have been interpreted and will be after revision - they are written in the format of a public danger notice - as CDC is used to for epidemics as opposed to medical guidelines (not their normal perview) - the CDC should only be issuing a "public notice of danger" concerning ALL "street drugs"/non-prescribed with an adjunct concerning opioids (if they absolutely MUST although CHRONIC PAIN TREATMENT is not an epidemic and therefore NOT under CDC authority) mentioning the possibility of addiction with a suggestion to talk to your doctor about the benefits and risks before initiating opioid therapy. The FDA or AMA - those with unbiased (not just one specialty) and fully educated and experienced personnel should write a guideline in the APPROPRIATE format concerning treatment of pain. This is one of the reasons WHY we have different agencies. CDC was tasked with addressing the overdose epidemic - SEVERAL recent studies have proven that the chances of patients on opioid therapy for disease (cancer and sickle cell aren't the only incurable ones) or injury related pain have the LOWEST rate of illegal drug use - of ALL patients (and the only ones subjected to discriminatory forced frequent tox screens) and even that percentage is extremely low - more people die in a single day from alcohol OR tobacco related deaths than addiction concerning or triggered by prescription use IN A YEAR and addiction is TREATABLE as NEEDED. Please swallow your pride and admit a mistake was made in the rush to address the overdose issue and rescind these guidelines and stick to those things that are your responsibility - one of which is admitting that you CAUSED an EPIDEMIC of suicides, overdoses due to forced termination of medical treatment and desperate patients - PEOPLE - who DON'T want to kill themselves but MUST stop the searing agony somehow - they are not looking to get "high" either - they take medicine to function - you can't function "high") and increased disability and deaths due to reduced prescribing and DO YOUR JOB and FIX IT. Reading the other comments - no one trusts the CDC anymore and unless you humble yourselves and admit the mistakes that were made and apologize to the chronic pain community and the medical community and FIX IT post-haste - no matter the wonderful work you do in the future and the lives that could be saved - without trust and respect no one will even pay attention let alone follow your advice - PRIDE is not an objective or professional reason to continue harm. Be humble - admit the mistake and eradicate ALL laws and policies created from it - apologize - and redo it the right way - or destroy the future of the CDC - you NEED the trust and respect back in order to do the job. Call off the DEA as well - they got all the pill mill doctors already and need to refocus on the illegal drugs flooding our country. Heck if you really want to do something about the overdose epidemic that's really exploded since the first set of guidelines and subsequent patient abandonment and physician persecution besides rescind the guidelines and their after effects is allow doctors to prescribe addictive substances TO addicts - similar to other countries "safe supply" policies - then the "addict" can continue being one of that's what they feel they need to survive - no one has the right to tell another how they are allowed to feel nor what things they put in or do to their own body to survive - not everyone likes or can even tolerate alcohol or now cannabis - which are MORE addictive and RECREATIONAL- addiction medicine has not discovered what causes addiction (or why one person can take a single drink and become an alcoholic and another can drink a 6 pack a day and not become an alcoholic) so just WHO is to say "it's ok to destroy your health and get inebriated with this but not that" - that's opinion based not science or medical based thinking - that way doctors can monitor the person, provide Naloxone for overdose possibility and breach the subject of addiction treatment - my goodness I know the author of CRACK and BURN - people who try meth damage their brains by depleting all of their "feel good" hormones and disabling the mechanism to create more WITHOUT an artificial boost (like meth) - forcing them into addiction treatment FAILS more often than not because they are told "you are better off being depressed and miserable for the rest of your life because you broke your brain trying meth ONCE and became addicted - which ISN'T illegal or always dangerous to everyone else - crime would reduce along with the overdoses if people could seek actual HELP from medical care and not be confronted with judgement and stigma and forced into what someone else's ideals are of proper living. This is transparent overreach as well - which is more important -your momentary pride that doesn't want you to admit you are human too or the future of your job and the entire agency?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fa5f57	Anonymous	None	2022-02-28T15:24:52Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l03-dblq-u3f5	False	None	False	2022-04-12 03:15:45.059	[]
1627	CDC-2022-0024-1633	https://api.regulations.gov/v4/comments/CDC-2022-0024-1633	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please let the doctors do their jobs and just abolish these guidelines altogether, or at least get rid of Morphine Milligram Equivalents (MME) because it is based on very flawed studies and is not scientific. It causes more harm than good. Pain patients like myself are under attack.<br/><br/>I am a 27 year old woman. I have had Rheumatoid Arthritis since age 9. I got my left hip replaced at age 19 because my joint was so deteriorated, it was bone-on-bone. I could feel my bones grind when I walked. The surgeon said my hip looked like I was an 85 year old lifelong marathon runner. In my early 20s, I began getting infusions of a biologic drug that was supposed to put my arthritis into remission. Instead, the medication destroyed my immune system and caused my bladder to begin hemorrhaging. My bladder hemorrhaged for 3 entire years of my twenties. I lost those years. I lost part of myself. I've lost so much because of my health, or lack thereof. <br/><br/>I love to write, and arthritis has begun attacking my fingers with much force. My fingers are becoming deformed, swollen, and painful. I have RA in every single joint. I have tried nearly every major arthritis medication available (methotrexate, prednisone, Enbrel, Humira, Orencia, Rituxan, etc, etc.) and have yet to find a medication that slows the progression of my disease and eases my pain.<br/><br/>Opioid medications have been the only thing to help me have a quality of life, and they are also the only medications frequently withheld from patients who need them, besides benzodiazepines. I am still suffering, but with opioids, I can usually get out of bed, do the dishes, and take my dog outside. Basic human things I need to do. I appreciate being able to do these small things.<br/><br/>My kidneys also stopped working correctly because of my bladder issues. My bladder was bleeding so heavily, it was sending urine back into my kidneys. I had to have a procedure to get two nephrostomy tubes placed, one in each kidney, which are attached to bags, that collect my urine. This past summer, I had to get my bladder taken out. A urostomy bag was connected to my stomach to act as a bladder. So, I have 3 bags attached to me and two long tubes. The neph tubes in and of themselves cause me pain because there is a hook in each kidney, and if the line gets tugged at all, it can tear the tissue inside the kidneys. I have had these bags connected to tubes through holes in my back for 3 years. Most people have nephrostomy tubes for 6 to 9 months.<br/><br/>On top of all of this agony I endure, doctors cannot even prescribe adequate pain medication because of fear of the government "cracking down" on them. Doctors quote these guidelines nonstop when it comes to why they cannot effectively treat patients' pain.<br/><br/>I have a very difficult time with all of this. The physical agony, the mental consequences of that, and doctors either dismissing my pain entirely or being too scared to prescribe pain medication due to the "guidelines" and the DEA watching every doctor like a hawk. I am currently able to get a prescription to try and control this pain, and yet, I still have unbearable anxiety:<br/><br/>How long will I be able to get my meds? What if my doctor gets raided or arrested for helping me? What if the pharmacy refuses to give me the medication? What if my doctor cuts me off and I go into withdrawal? What if I get tapered and I can no longer do the small things I am capable of at this time?<br/><br/>It is a life of hell, uncertainty, and loneliness. I would not wish it on my worst enemy. Please be aware that your guidelines often make the lives of pain patients even more difficult. Doctors refer to the guidelines when they decide not to treat you, when they decide to needlessly taper you off medication that helps you, when they decide you're not in as much pain as you say you are. The guidelines have caused more harm than good. If the guidelines must stay, then please, at least eliminate the MME.<br/><br/>Please look at the article here for more information on why the MME makes absolutely no sense, and why having it in the guidelines is reckless and harmful:<br/><br/>https://www.cato.org/blog/lawmakers-really-want-follow-science-they-will-repeal-codified-opioid-guidelines<br/><br/>This article describes the issues far better than I ever could, and posting the important parts within this comment would cause my note to go over the character limit. I beg of you to please, please read and absorb this very knowledgeable article above.<br/><br/>Thank you for your time and consideration.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelsie	None	None	0900006484fa5f66	Finnigan	None	2022-02-28T15:25:58Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Finnigan, Kelsie	l03-djcy-mpty	False	None	False	2022-04-12 03:15:45.274	[]
1628	CDC-2022-0024-1634	https://api.regulations.gov/v4/comments/CDC-2022-0024-1634	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carla Rahn	None	None	0900006484fa81df	Phillips	None	2022-02-28T15:28:35Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Phillips, Carla Rahn	l04-8n87-xre3	False	None	False	2022-04-12 03:15:45.531	[]
1629	CDC-2022-0024-1635	https://api.regulations.gov/v4/comments/CDC-2022-0024-1635	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a member of the Citizens Leaders Group back in 2014 @ [healthcare facility name redacted] our group was very much involved in getting some kind of standard MME without Obama overreach Government. Being a Chronic Pain Patient since 1998 and to this day with a much lower pain level this is my story. My lower pain level, MME was volunteered not from any Doctor, as something moved or to this day Doctors labeled a Miracle improvement. Now lets get back to what went on in 2013-15 with the CDC. On 4-22-2015 from a KU email was a draft on the National Pain Strategy for public comment. My writing was not the best being a Real Estate Developer and not a writer on my comment for the CDC -2015-0112-0011 dated 12-15-2015. Clearly being on a high dose of Xanax with my high level MME dose the writing could have been improved and rechecked. The removal of Xanax in my opinion was the biggest problem with mixing MME with the Xanax. No doubt many folks did the unthinkable, stopped breathing and died. Several years the media would classify the death as an accidental overdose. I have been under medicated and over medicated with that experience from several doctors. 2 of my Doctors lost their license for a full year for reasons never will I know why. As a Pain Patient Advocate and have all the experience needed my opinion still falls into my findings and research. MME should be 150 per day not 90 MME. Somehow the MME was changed from 100 to 90 when someone decided to type in 90. I do believe patients can co-exist with a very low dose of Xanax .25 taken 1 a day. <br/>However, P.A.I.N. Patients, Awareness, In, Narcotics as stated in my post back in 2011 should be enforced. Future treatment must include Psilocybin research. I have some research in this very popular future way of treatment for many. Another major problem is the high cost for people and tax payers having to see a Pain Doctor every month, why ? If a patient has control of their pain levels and pain meds why would any patient need to come in every month and drive up cost for everyone ? All the CDC has accomplished was higher cost less Doctors and more inconvenience for the Patient. Anyone may respond to my post and encouraged, my email address is [email address redacted]. I hope going forward we all can keep hope and improvements with treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fa982a	Martens	None	2022-02-28T15:31:26Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Martens, Steve	l05-hyqt-jfc6	False	None	False	2022-04-12 03:15:45.801	[]
1630	CDC-2022-0024-1636	https://api.regulations.gov/v4/comments/CDC-2022-0024-1636	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient under opioid treatment since 1997. I am a patient of a large pain clinic whose doctors are anesthesiologists. I was in an auto accident in 1996 and sustained 3 pelvic fractures among other injuries. The fractures did not heal as expected so I had surgery in 1997, ORIF but the pelvic pain remained. I also have multiple back ( lumbar) problems causing pain. My auto accident occurred while employed as an RN, medical case manager so this injury and resultant treatment is covered by Worker’s Compensation. I had several medical opinions and was told the pain would remain and require pain management for my lifespan. I submitted to many pain management treatments other than opiods but non provided pain relief. My goal was to return to work as I was 40’s and single. I am on lifetime insurance benefits from Worker’s Comp. Due to the extent of my injuries and need for lifetime pain management. The pain clinic changed my medications many times until I signaled that I received 50% help from my treatment. However, after the CDC’s recommendations came about in 2016 my physician informed me that there would be a significant decrease in my medications, as would be for all patients no matter their level of pain or reasons for the pain. In 2014 I was also diagnosed with Non Hodgkins Lymphoma, Mantle Cell, stage 4. At that time the pain management physician told me he would medicate me to also meet my needs for cancer treatment and associated pain issues. That changed when the 2026 CDC guidelines came out. The pain management company held their physicians to new principals about the amount of opiods, seeing physicians in person every 2 months rather than every 3 months. Their questionnaire asks if pain relieved by 30% rather than previous 50%. He said if a patient said they did not get 30% they would be taken off the meds and discharged as this was not benefitting them. I am of course agreeing that I get 30% relief. Also no other physician is able to treat my pain, including my oncologist for my cancer. I am now in my 70’s and have osteoarthritis along with my pelvic and back pain. At this time I am getting the lowest amount of pain management of my chronic pain years. I feel I am treated as a criminal. I have always followed all their rules and orders, passed every urine test on a yearly basis and kept my appointments. My oncology physician is frustrated with my pain management situation but not allowed to order anything for me. I would take aleve or other non narcotics but had bleeding ulcers and still have chronic gastritis. I have been emotionally upset since this pain management situation has occurred. I constantly tell the pain physician but he says that there is nothing he can do. His 6 billion dollar company does not want to be in trouble legally. <br/>I was extremely happy to see the article by the CDC recognizing the predicament we chronic pain patients are in. It causes more anxiety and anger for me then the cancer diagnosis which is terrible. I am on oral chemo and can’t get any additional pain management for the additional aches and pain it causes. PLEASE change this situation as soon as possible. We don’t deserve to be treated like criminals.By the way, I did return to work in 2000 but was released from my position sinceI could not bill the number of hours they required, that was in 2009. I have had to be on Social Security since then. I am a college educated nurse who deserves a better retirement then this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faa177	Anonymous	None	2022-02-28T15:33:23Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-l45a-beq6	False	None	False	2022-04-12 03:15:46.059	[]
1631	CDC-2022-0024-1637	https://api.regulations.gov/v4/comments/CDC-2022-0024-1637	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to you concerning the limitations you've placed on the American people to be treated with care and compassion by thier trusted physicians. For people to gain the most benefit from thier medicine which IS prescribed for an intractable painful condition and utilized as prescribed, people need to be able to increase thier medications when needed. Meaning you need to drop the MME guidelines. Many people gain functionality, hold important positions, including government personnel, and physicians. These are people we depend on in society. To which you are leaving no options for functionality or quality of life. Opioids aren't bad, prohibition is bad, lack of understanding of how these medications help people of every different background, profession, and creed. Literally all you have done is group all peoples together as having an addiction to opioids so that you can sell the latest addiction drugs/treatments. Problem with this is that we the American people aren't addicted, if you can't titrate medicines up as needed on individual basis JUST LIKE WHAT IS DONE WITH ANTIDEPTESSANTS AND ANTIPSYCOTICS, then where is the benefit? You know the fact that there are people who are born, not aborted, with lifelong painful physical ailments correct? You also must know that for most people that have a true intractable damaged and painful body that they have infact tried multiple modalities to survive and thrive in this world, to be active and present in society. Case in point, I had a friend whom was born with spina bifida. He was very intelligent, opioids allowed him to get through school, med school, and he became an OBGYN. Wonderful person, and his outlook on life was always so positive, he delivered many many babies and diagnosed many cancers and helped many women with his knowledge and experience. He eventually succumbed to a rare cancer himself and died. He left a wife and 2 children. He also left hope and a legacy for people to follow and not let physical health debilitations cause you to be disabled. If he would have been "judged" then the way chronic pain patients and the chronically incurable are now, society would have lost a wonderful human being and his contributions to society far too soon. Opioids weren't "discovered" for the dying, although they help palliative care immensely. Along with born debilitating disease, and the degenerative aging process, there is a place as always has been for long term opioid use. These are not the people out here committing crimes, not the people sticking needles in thier bodies, not the people robbing family members for money for drugs of any kind. And these are the kind of upstanding citizens that when taken off thier therapeutic dose of opioid medications, they still don't use other drugs, they don't steal, or go on some kind of rampage, the pain just becomes uncontrolled again, thier bodies suffer, and the people around them suffer by watching them suffer, they distrust physicians because they are not being treated to thier physical problems anymore, the fda, cdc, dea, gov are being treated at pain patients expense. So quality of life goes down, pain is uncontrolled, can't go to work because if you do, and pain gets worse, because you are pushing your body through the pain, you'll have worse pain and then a heart attack at your job, or in public, which is not what a chronically ill person is trying to do. They are trying to live a civilized life among the healthy. Take a serious look at who you are harming with this drug prohibition MME guidelines toward the chronical intractable pain community. With all the science in the world, and studies of people with bodies that require opioids, you decided to go with psychiatry. A study that can not be based on anything that you can see with the eye. You can not look up the anatomy of the thought process, but a physician with a specialty or primary care can look at the body, the processes of that body and treat, prescribe, they can see the pain. And they are being forced to prescribe drugs now that affect the body, having all side affects on the body to basically mess you up so you don't "think" about what you are currently enduring? Or to help you accept mentally the physical pain they're not allowed to treat. If chronic pain patients are forced to take medications that cause harmful affects on the body just so the mind don't know they are in pain, they might as well go see the drug dealer instead of the physician that has knowledge and experience because they are now getting the same service, and similar drugs. One is just pharmaceutical "experimental aka off label" and the other comes from the street. Pain patients want to trust our educated, experienced, physicians with our disease processes to help us manage them with best results and least harm, so as to be a functional member of society. You've taken that, people are killing themselves rather than trust a government led physician. Society suffers more.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faa271	Anonymous	None	2022-02-28T15:35:16Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-m300-kan7	False	None	False	2022-04-12 03:15:46.274	[]
1632	CDC-2022-0024-1638	https://api.regulations.gov/v4/comments/CDC-2022-0024-1638	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer for more than 15 years I think there should be more latitude given between my Pain Management Dr. & myself. I understand he can’t write or change things like an antibiotic but if there is something that he/she feels would work better but is reluctant to do so because of the red tape that is not aiding in my long term pain management. When the change was originally made that is exactly what happened to me. I also don’t think I should have to see him every 3 months because it was some arbitrary time period someone made up. I have been with my dr for 15 yrs he used to see me every 6 months plus the times when he does injections. If you have a relationship that long when a patient has passed every urine test in 15 years there has to be a point where you have to trust the Dr.<br/><br/>Additionally my grandmother was 102 when she broke her back. They had to call an ambulance to get find out what was wrong with her. The ER Dr was limited to 3 days of pain pills until she could get into see her Dr or pain Dr. They had to use an ambulance to take her home. Can you explain to me how she could go see the Dr. What they ended up doing was putting her on pain hospice until she passed. In this situation there are two thing I think anyone going through this experience could see is wrong. 1. Why are we putting a 102 yo patient through such hoops & hurdles to get help. The ER Dr. felt guilty sending her home because they could not do surgery. 2. Even if she wasn’t 102, what if she was 38 & broke her back from falling of a roof while taking off Christmas lights. But they couldn’t do anything until the swelling went down in a week. Do you want to be the patient who can only get 3 days of drugs?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michele	None	None	0900006484fa9a33	Sims	None	2022-02-28T15:36:05Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Sims, Michele	l05-ne06-u6xh	False	None	False	2022-04-12 03:15:46.491	[]
1633	CDC-2022-0024-1639	https://api.regulations.gov/v4/comments/CDC-2022-0024-1639	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish to endorse comments separately submitted to the Federal Register and widely published on Social Media by [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484faa37e	Hughes	None	2022-02-28T15:36:20Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Hughes, Karen	l05-r8nt-l5zz	False	None	False	2022-04-12 03:15:46.751	[]
1634	CDC-2022-0024-1640	https://api.regulations.gov/v4/comments/CDC-2022-0024-1640	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I cant get any pain meds.Three doctors have shut me right up. Something in my med.records. Will not tell me anything. Sorry.<br/>I was on hhydrocodone and morphine for four years. I have MGUSat or over the clinicle point to prescribe or not. I have periferal neuropothy extremely bad. feet and hands nuumb and extremely painful. Also two back operations that cant fix my sciatica. I have bllood clots in lungs and left leg which causes shortness of breathe. I use an electric wheeel chair to go out. Walker in house. I need someone to tell me why I cant get meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Armand	None	None	0900006484fad30a	Morrissette	None	2022-02-28T16:21:00Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Morrissette, Armand	l06-wf86-sfbp	False	None	False	2022-04-12 03:15:46.957	[]
1635	CDC-2022-0024-1641	https://api.regulations.gov/v4/comments/CDC-2022-0024-1641	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've had 4 back surgeries and none of the bone grafted, so I have loose hardware in my back. I suffer from herniated disc, torn disc,degenerative disc disease, spinal stenosis and spondylitis. I've been taking 240mg of time release o/c and 180 i/r of oxycodone for nearly 20 years. Then the doctors start cutting my meds and my life just went down hill dealing with the pain. I spend most of my day in bed doing nothing. I need my meds back to help me with my pain and to allow me to have a life with my family again. The people that are overdosing aren't the ones that need meds for pain, they take them to get high. You have to do something before good people start looking elsewhere for meds or take their own lives to get out of pain.<br/><br/>Thank you<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Isaac	None	None	0900006484face44	D'Agostino	None	2022-02-28T16:21:49Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from D'Agostino , Isaac	l06-vcx6-tlhs	False	None	False	2022-04-12 03:15:47.170	[]
1636	CDC-2022-0024-1642	https://api.regulations.gov/v4/comments/CDC-2022-0024-1642	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to address my take on the CDC’s 2016 opioid guidelines. These guidelines have definitely caused more harm than good. They have forced people to turn to “street” drugs instead of relying on the medical experience of a doctor. By placing a cap on the medication that doctors can prescribe the guidelines have taken pain management out of doctors hands and placed it on the streets. I’m quite sure that this was not the goal. The silicon 1920’s taught us that prohibition does not work. The other unplanned consequence is that chronic pain patients are committing suicide. Being in pain with no hope of it getting any better is dibilitating and depressing. One can only take so much of that before all hope is lost. the CDC guidelines are in essence causing indirect deaths. Please modify those guidelines so that doctors can accurately treat pain and not be afraid to care for patients. I for one have had my medication cut to a degree where what I am given has very little effect on my pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hyman	None	None	0900006484fac84a	Jarrett	None	2022-02-28T16:22:16Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Jarrett, Hyman	l06-u7xo-tevc	False	None	False	2022-04-12 03:15:47.380	[]
1637	CDC-2022-0024-1643	https://api.regulations.gov/v4/comments/CDC-2022-0024-1643	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s). I have not had a chance to fully read the updated document, but I wanted to send this comment before the deadline in case it is relevant. Essentially only one of the 12 original guidelines refers to acute pain, and that guideline states "3 days or less will often be sufficient; more than 7 days will rarely be needed." We believe this recommendation is too vague given how prescriptions can be written, resulting in a potential 3-fold difference in the amount of opioid tablets dispensed. We therefore recommend that the guideline specify a specific number of tablets instead of a specific number of days in order to decrease this variability. Attached is a manuscript in which approximately 500 emergency medicine physicians were surveyed with a conclusion that a 3 day supply is equivalent to 12 tablets and a 7 day supply is equivalent to 28 tablets. This was the same even in older adults, making it easier for physicians to recall when discharging patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrew	None	None	0900006484faba05	Chang	None	2022-02-28T16:31:23Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Chang, Andrew	l06-r4mm-7623	False	None	False	2022-04-12 03:15:47.593	[]
1638	CDC-2022-0024-1644	https://api.regulations.gov/v4/comments/CDC-2022-0024-1644	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted], 75, of [redacted], [redacted]. I have worked hard all my life, starting at 16 working in my neighbor's orchards and helping at home. I raised a steer during my teens for Future Farmers of America. He stepped on my ankle and broke it. Later, I fell out of a tree, playing "tarzan" with my brother and broke both wrists. I worked for a large tree company trimming trees for [redacted] Gas and Electric for 35 years. I also helped my mom and Dad and my family cutting trees, splitting and stoking our wood stoves. I eventually had rotator cuff surgery on both shoulders. After that my doctor put me on morphine as my back deteriorated-then methadone. My back doctor did 2 back surgeries without telling me of adjacent segment disease which has continued to give me back pain. I also had a dr in [redacted] break my back to get me back in alignment. My foot doctor removed a bone in one foot but still need to remove another as I am bone on bone. Since then my ankle has now disintegrated so I need it fused on March 22, 2022. My shoulder doctor said I need a<br/>shoulder replacement if shots quit working. (which they do). I tried physical therapy over and over again. Had a pain pump installed and was getting a little bit of hydrocodone which relieved my pain for about 2 weeks for 4 hours a day, the other two weeks I am in so much pain that I have gone over and over with my pain drs and then my pain doctors reduced my hydrocodone which is the only thing that relieves my pain. The pain pump was increased which makes me sleepy but does not touch (oh, yeah, I am also scheduled for carpal tunnel surgery) my hands, my shoulder, my feet, ankle and back. The doctors say they will lose their jobs if they give my any more hydrocodone. What has happened to our government to react to street drug problems and allow good, honest citizens to suffer? I tried to serve my country and was there with my buddy and was singled out because of my asthma (my buddy died in VietNam). I have veteran friends who are suffering also who cannot get pain relief for the same reason. I have researched the AMA, the CDC, but was told Congress as given the decision to remove pain meds indiscriminately--as they took it out of my doctor's hands. I have always been a tea totaller, non smoking Christian family man. No partying-just a hard worker!!!! And I cannot live my life out of pain due to Congress and the DEA. I have many MRI s, X rays and whatever else you need for proof. We have become a nation who does not care for the broken, anymore.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronald	None	None	0900006484faa8b4	Henson	None	2022-02-28T16:33:07Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Henson, Ronald	l06-ek0x-ccns	False	None	False	2022-04-12 03:15:47.803	[]
1639	CDC-2022-0024-1645	https://api.regulations.gov/v4/comments/CDC-2022-0024-1645	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was electrocuted in 1988. After being in coma for 26 days I awoke with a massive headache. It has yet to go away. I have a migrainous headache 24/7/365. Without medication my pain level is around 7/8 on the pain scale. Over the last 34 years I've tried many, many different therapies and non-opioid medications. Unfortunately none of these have given me any relief. Opioid pain medications have been my saving grace, without which I would have most definitely ended my life. However over the last few years my quality of life has been greatly diminished. My Doctors have been tapering me to much lower doses to meet guidelines and fear of getting in trouble with the DEA. Obviously the lower the dose the greater the pain. I have been accused of pill seeking, going through withdrawal in months where the pain was so bad I was forced to take more medication then normal then I have to explain every decision with the fear of being released by my Doctor. I now have to go in for urine tests and pill counts every month so no one thinks I'm selling my medications. This is humiliating. All this because irresponsible people are abusing the medications I desperately need. I certainly understand why some people seek out alternative ways to get relief. Even if it means possible death. Life is not worth living when you are in constant high levels of pain. It seems to me that everyone is concerned with the abuse and not for those of us that genuinely need the help from these types of medications. Because of these restrictions my quality of life is at an all time low, I fight depression every day. It effects my attitude, my mood, the way I treat my family etc... changes definitely need to be made. Please help us get back a life worth living. <br/>Thank you for listening <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fae117	Martin	None	2022-02-28T18:57:01Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Kevin	l07-1ohw-oeyi	False	None	False	2022-04-12 03:15:48.021	[]
1640	CDC-2022-0024-1646	https://api.regulations.gov/v4/comments/CDC-2022-0024-1646	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For those of you who may have read my other comments on this topic, it’s time for me to get to the specifics of what I’m talking about. The Cures Act of 2016 created a ripe and rich playground for abuse. Being employed in the field of pain management for 6 years, I’ve seen abuse of all types, whether it be financial, mental, and yes even physical abuse. <br/>The proposed revisions to the opiate guidelines will not change this corruptive arena, in fact, I think it will make it worse. Until we have laws specifically protecting this class of patient (Chronic Pain), we will continue to see this exploitation.<br/>One best example of how patients have been getting taken advantage of Is the drug test. I’ve witnessed several doctors use the 2016 guidelines as a way to increase their profits. Doctors will tell a patient that they must take a drug test every month because that’s what the rules are, poppy-cock! It’s at the doctors’ complete discretion on when to drug test. My doctor tests once a year at my yearly physical. If a patient is being told that frequent drug testing is mandatory then they are being lied to and taken advantage of. Remember, the original CDC guidelines and the new revisions will still be just that, guidelines. It’s not law or rule but simply a recommended set of guidelines and the doctors will be free to interpret it how they see fit and these problems will continue. There is no oversight or policing of doctors, there are no laws guiding them and keeping them in line so they take complete advantage of that fact and will continue to exploit the patient. Like shooting fish in a barrel, like lambs to a slaughter!<br/>My last job was at a pain clinic. It was there that I witnessed the most egregious of examples of greedy abuses. All kinds of abuses and always centered around money. One good example that this office would often do is when there was an appointment cancellation, they would conveniently send it through as missed appointment and insist on a $50 penalty. Sometimes they got paid and sometimes they didn’t. This office also held the opiates up as a bag of Halloween candy that the patient would receive after they complied with all of the requests of their treatment program. If they didn’t go along with the epidural, the PT, the psych therapy, the monthly drug test, they wouldn’t get their bag of candy—that was just plain mental abuse in my opinion but it was their way of maximizing profits. <br/>This office also had a constant pass-through of doctors. Some of them should never have been allowed to operate. After several years of observing epidurals, I could tell which procedures were successful and which ones were not. I knew how to recognize that “sweet spot” of radiopacity that would show up on the fluoroscopy monitor. I worked with doctors whose success was maybe 30 percent at best but they were still employed. No one to police them, no proper oversight. But, guess what, the patient and insurance would be billed for the same amount, regardless of outcome. Why try hard when you can fail and fail again and still get paid?<br/>I could go on and on about the abuses here but I still have 42 more days to do so. I think I’ve painted a good picture here but I plan to add more because I’m tired of seeing these problems again and again. Yes, it will be ad-nauseum until I’m finished. Chronic pain patients must have legal protection because they are a unique class of patient and easy to take advantage of. These problems also abuse the insurance aspect directly and indirectly and raise rates for everyone. The only one who really pays in the middle of all this is the chronic pain patient and this must stop. This absolutely must stop!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fade2a	Cook	None	2022-02-28T18:59:30Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l07-0d71-5y1m	False	None	False	2022-04-12 03:15:48.237	[]
1641	CDC-2022-0024-1647	https://api.regulations.gov/v4/comments/CDC-2022-0024-1647	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had my quality of life greatly reduced since the 2016 guidelines were put into effect. I am a 60 year old female who has had Complex Regional Pain Syndrome, one of the most painful conditions there is for over 15 years. Since the 2016 guidelines were put into effect my quality of life has significantly reduced because my pain medicine was reduced as well as many other pain patients. I used to be a 4 out of 10 on the pain scale now I am usually a 7 or 8 out of 10. My former pain management doctor left her practice because she could not help pain patients with better quality of life with reduced pain. Put the control of pain management back in the doctors hands. They have to train and take the tests that the government mandated they take to prove they are competent enough to prescribe the opioids. Yes pill mill docs need prosecuted to fullest extent of the law if there is evidence to support the arrest. I am allergic to many of the opioids and can only take certain ones. I used to have an immaculent home now I'm lucky if I can do one room a day. Yes as we get older we do have aches and pains and we will never live pain free. Letting the control of pain management should be left to the doctors. Yes once a year naloxone should be prescribed to have on hand for any accidental overdose. I am labeled as having an Opiod Use Disorder which I don't feel like should be on my records at all. I have never failed a drug test or misused my meds. I am not addicted, I am dependent on them. Please make the new guidelines liberal enough the docs can increase the quality of life of pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484fade27	F	None	2022-02-28T19:03:36Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from F, J	l07-0bwl-rrce	False	None	False	2022-04-12 03:15:48.449	[]
1642	CDC-2022-0024-1648	https://api.regulations.gov/v4/comments/CDC-2022-0024-1648	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a certified Pain Management nurse for over 25 years, specializing in chronic pain. I agree completely with the changes that you are proposing but will it be enough to allow those patients suffering from chronic pain, those patients that are not surgical candidates for one reason or another to obtain their prescribed pain medications? The narcotic limitations that are imposed upon the pharmacies directly impact the chronic pain patient as well as actually create "pharmacy shopping" which makes it harder to track our patients usage of narcotics, causing us to have to send in prescriptions to multiple pharmacies, thus also creating more work. I am the manager of a well established hospital based Pain Management Clinic and my physicians are fellowship trained in Pain Management. We have always strived to do the right thing. When it was available, we were accredited by that American Academy of Pain Management. I say all that to legitimize my comments. Educating and requiring training to the Orthopods and the PCP's etc., is paramount, but limiting the availability of the narcotics to the legitimate patient is not and has not been the answer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MARCIA	None	None	0900006484faddb3	GUILFORD	None	2022-02-28T19:04:11Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from GUILFORD, MARCIA	l06-zmsa-n3dh	False	None	False	2022-04-12 03:15:48.666	[]
1643	CDC-2022-0024-1649	https://api.regulations.gov/v4/comments/CDC-2022-0024-1649	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient I have watched my fellow cp's struggle, commit suicide, go to the black market for heroin, and the end up overdosing. All because of the original CDC guidelines on opioid prescribing. I don't think guidelines are a bad thing but the way it was worded and the way doctors used it was improper. You cannot have a one-size-fits-all for any medication really. That's why there's so many different doses of different medications. A 90 mm e for one person would be way too much, for another it would be half enough. I would really like to see changes be made and would like them very clear in how a doctor is supposed to interpret them including ER doctors, Family Practice Physicians, and pain doctors. Please help myself and my fellow chronic pain members. It has been a rough few years for all of us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jamie	None	None	0900006484fad403	Peterson	None	2022-02-28T19:05:02Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Jamie	l06-xrls-9zx5	False	None	False	2022-04-12 03:15:48.905	[]
1644	CDC-2022-0024-1650	https://api.regulations.gov/v4/comments/CDC-2022-0024-1650	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I personally went from being able to walk nearly 1/4 a mile 3-4 times a week and being able to go out to eat with my wife 1-2 times a month to near bed bound due to the 90MME policy. Most doctors want to help their patients and not kill them, the vast deaths by far from opioids are not pain patients. Statistics from 2010-2016 before the 90MME policy bore this out. Patients on steady pain management specialist care rarely overdose on opioids.<br/><br/>I have spoken with pain management specialists from across the states trying to live with a non terminal, incurable, extremely painful disease called Adhesive Arachnoiditis, those with the condition know it is known as the Suicide Disease because most patients can't live with the pain and the pain management regiment is nearly always under-treated, the top specialists have told me they have had patients on near 1100MME doses living near normal activity and life for decades, they stated that proper titration of medication is key to stop overdose. While at a significantly lower dose (between 1/4 and 1/2 of what proper good QoL patients are on) I was getting closer to a descent quality of life when the 90MME policy came out, I was on a near steady dosage for 4 years without issue, and knew many who lived descent lives on near stable high dose MME for decades without issue.<br/><br/>I have lost 100s of people I knew from the pain community who committed suicide due to the 90MME proposal from 2016, due to loss of opioid medication, the CDC and FDA knew about existing pain patients struggles to maintain Quality of Life when being tapered to lower unhelpful doses. <br/><br/>Please also look into adding Marijuana to schedule 2, while it doesn't work for everyone many people have had luck using Medical Marijuana strains, that are designed for pain relief, to have some relief. There is a chance for addiction with Medical Marijuana, but at least it doesn't share the overdose risk that opioids may have for some.<br/><br/>Please also include non terminal extremely painful conditions to your list of exemptions besides sickle cell. Conditions like Adhesive Arachnoiditis, Ehlers Danlos Syndrome, Ankylosing Spondylitis, and a few others, are diseases with pain on par or worse than many cancer pains, we don't qualify for palliative care, and the only recourse without pain management is death from suicide due to the incurable intractable pain, with no current cures. I am sure most if not all of us would love to be able to live long enough to hopefully someday see cures where we can return to full normal productive life.<br/><br/>The original 90MME proposal was spearheaded by PROP, an organization funded by addiction clinics, and included anti-opioid use individuals, this was a huge conflict of interest, and not including any if no long term pain management doctors really hurt many people.<br/><br/>Thank you for finally realizing this is hurting patients who need opioids to survive, until new treatments and options come along we need to make sure as many people as possible can make it to those times.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fac3ae	Parks	None	2022-02-28T19:08:30Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Parks, Michael	l06-tfes-e40x	False	None	False	2022-04-12 03:15:49.130	[]
1645	CDC-2022-0024-1651	https://api.regulations.gov/v4/comments/CDC-2022-0024-1651	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My partner of 17 years had his medication horribly tapered first month 50% next month 50% next month 25% of what was left. Left him bed bound for over 2 years. He was in so much pain our adopted children were forced to watch him die and he did [redacted] next to his 11 year old daughter called 911 because of pandemic they didn't get to say good bye.His physician called me to say sorry but PROP tied his hands he couldn't do anything else. Please take numbers out of guidelines your just killing people you will wrapinize those numverd	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484fad3ff	McCalester	None	2022-02-28T19:10:02Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from McCalester , Cindy	l06-xq1b-aoa8	False	None	False	2022-04-12 03:15:49.345	[]
1646	CDC-2022-0024-1652	https://api.regulations.gov/v4/comments/CDC-2022-0024-1652	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain. I have degenerated disc disease. In 2020 I was diagnosed with osteoporosis. This came after being diagnosed with 7 stress fractures. Not once did a practitioner ask if I was in pain. I take oxycodone regularly. Recently my pain provider left his practice. He did not refer me to anyone for pain management. Because I was a RN, I knew how to navigate, and get into a pain managemt practice. I wonder how many of my former practitioners, patients ended up in the ER, in withdrawal! My new provider that is a ARNP, wants to decrease my dose. He doesn’t care how it affects my quality of life! Please adopt the new guidelines for prescribing opioids. Many people I know have committed suicide, as they were left hanging, with no access to narcotics for pain! It’s a crime as far as I’m concerned !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484fa87f4	Sterling	None	2022-02-28T20:53:47Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-26T05:00:00Z	None	None	None	None	None	None	None	Comment from Sterling , Marilyn	l04-cl1q-gp3o	False	None	False	2022-04-12 03:15:49.596	[]
1647	CDC-2022-0024-1653	https://api.regulations.gov/v4/comments/CDC-2022-0024-1653	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My Name Is [name redacted]. I Live In Deep Southern, Georgia. The 2016 CDC Guidelines Have Destroyed My Life. And The 2022 Guidelines Are Just As Bad. For Starters, THE CDC HAS "NO BUSINESS" MEDDLING IN MEDICATIONS. THE FDA IS OVER PRESCRIPTION DRUGS & THEY DIDN'T WANT ANY PART OF WHAT THE CDC DID TO THE AMERICAN PUBLIC IN 2016. THE CDC HAS "ILLEGALLY OVERREACHED INTO MATTERS THAT "ARE NOT" THEIRS TO REGULATE. THE 2016 GUIDELINES & THE 2022 GUIDELINES SHOULD BE TOTALLY THROWN AWAY. DISCARDED. Ignored All Together. I Have Osteoarthritis, Osteoporosis, Mitral Valve Prolapse & Tricuspid Regurgitation, Fibromyalgia, Migraines, Depression, Anxiety, Ptsd, Spinal Stenosis. I've Had 2 Cervical Fusion Surgeries & The 2nd One Severely Impacted My Life When It Failed. I Need A Lumbar Surgery & Will Be Requiring More Too. I Need My Neck Fixed. I Cannot Have Any Type Of Surgery Because I Can't Even Get Any Desperately Needed Medications As It Is. I Took Lortab And/Or Percocet, Fioricet, Xanax, Valium, Neurontin And/Or Lyrica & Tramadol Along With Inhalers, Nausea Medications, Sinus Medications, Vertigo Medication. I Cannot Go To A Pain Management Doctor Because I Take 5mg Valium & 25mg Elavil That My Nurse Practitioner Prescribes Me For My PTSD, Anxiety & Depression. They Say That It Decreases The Effectiveness Of Pain Medications. Well, I Had ABSOLUTELY NO PROBLEM FOR 15 YEARS. I LOST MY MEDICATIONS & WONDERFUL DOCTOR IN 2018. NO TAPER. JUST COLD TURKEY. I DO NOT KNOW HOW I HAVE SURVIVED THIS INSANITY, THIS TRAUMA, THIS PAIN. I AM READY TO SUE ANYBODY & EVERYBODY INVOLVED IN MY SUFFERING. IT IS INHUMANE TO LET PEOPLE SUFFFER. AND [name redacted] & HIS GOONS DESERVE PRISON & TO LOSE THEIR LICENSES. HE'S NOT EVEN A MEDICAL DOCTOR, FOR GOD'S SAKE!!! AND [name redacted] DESERVES TO BE SUED BY ME & THE ENTIRE AMERICAN PAIN COMMUNITY. HE SHOULD BE FORCED TO GIVE HIS MILLIONS OF DOLLARS, THAT HE'S EARNED FROM HIS STOCK IN SUBOXONE TO PEOPLE IN PAIN. THAT IS A CONFLICT OF INTEREST TOO. I Am Extremely Angry At How I've Been Treated. I Have Been Seeing My Nurse Practitioner For 3 Years, Now & She JUST RECENTLY Gave Me Some Tramadol Because My 2 Orthopedic Surgeons, Gave Me Some For My Bad Knee, My Weak Ankle That Keeps Badly Spraining & My Back Issues. So, It's Taken Me 4 Years Just To Get Some Danged Tramadol. I Have "NEVER" Had The Thought Of Suicide Enter My Head Until I Lost My Medications & My Doctor. I've Told My Family For Years, Now, How I Wish That GOD Would Just End My Suffering & Take Me Out Of This World. I Wish I Was Dead.<br/>I Used To Attend Our Homecoming & Christmas Parades In My Little Town. I Used To Attend Church. Go For A Ride & Visit Friends & Family. Just Ride In The Country. Pick Mistletoe From Trees In December & Share It At Our Christmas Parade. Pick Wildflowers From The Side Of The Road. I Used To Attend All Day Concerts & Watch Military Flyovers On July 4th. I Used To Visit My Friend, [name redacted] & Go Swimming In Her Pool & Spend The Night. I Used To Take Rides With Friends & Go To The River. My Friends Stopped Coming To Visit Me, Altogether, Because I Stay Sick With The Pain & Can't Do Anything But Sit On My Couch. There Are Many Days, That I Can Only Make It From My Bed, To My Couch & Stay There All Day & I Can't Cook Anymore Because I Can't Stand For Long Periods. My Dishes Stay Dirty. My Floors Need Sweeping & Mopping. It's Difficult To Take A Bath & Shave My Legs From The Pain. Other Times, It's Just The Depression From It All That Incapacitates Me. Sometimes, I Would Go To My Moma's House & Get Outside & Pick Up The Sticks In Her Yard, From The Oak Trees. Or Just Sit On The Porch With Her. She Helped Me Through 13 Surgeries, Emergency Room Visis That I Cannot Even Count, Post Operative, Helped Clean My House, Shop For Me, Pay Bills For Me, Take Me To Appointments, To Emergency Rooms To Get A Shot To Be Just Knocked Out & Put Out Of My Misery. I Used To Clean My Daddy's Tombstone & Grave. I Cannot Do These & Many Other Things Anymore. Some Are Just Small Things That I Cannot Do Anymore. I've Already Been Disabled Since 1999. Now I'm Totally Incapacitated With Almost Everything. THIS IS NOT LIVING. THIS IS JUST EXISTING UNTIL DEATH TAKES ME FROM THIS TORTURE. I Am Destroying My Liver & Kidneys By Eating Neurontin/Gabapentin & Lyrica At The Same Time. They're Not Supposed To Be Mixed But I Have No Choice. I Eat 4-7 Goody Powders Daily & 3-4 Of My 600mg Ibuprofen. I Take 5-7 Tramadol Daily. And I Smoke Marijuana. It's Always Helped My Pain. It Should Just Be Legal. I Hate My Life. I Will Not Survive Much More Of This. My Blood Pressure Has Already Been High From The Pain & No Doctors Are Willing To Help. I Have Just Been Waiting For My Body To Just Seize Up & Stop My Heart.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Valorie	None	None	0900006484faa4ff	Jeffords	None	2022-02-28T21:01:26Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Jeffords , Valorie	l05-svx5-afrt	False	None	False	2022-04-12 03:15:49.817	[]
1648	CDC-2022-0024-1654	https://api.regulations.gov/v4/comments/CDC-2022-0024-1654	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in a car accident in 2004 where I shattered my pelvis, broke my femur and severed tendons in my right foot. Before this I was a healthy 40 year old who never took even aspirin or had seen a doctor. My orthopedic surgeon put me on 20mg of ER Oxycontin three times a day with Percocet 5/325mg every 8 hours for breakthrough pain. I was told I would need these for life to be able to function as my injuries were that severe and would be life long debilitating. I developed heterotrophic bone ossification which caused my shattered hip to fuse to my leg. I had multiple surgeries and radiation to try to remove some of that bone only to have it grow back every time. I have major hardware in my pelvis and foot. I have very limited movement to this day and am in pain 24/7. I always try to stay functioning and do pool therapy and stay active.I sleep in a reclining chair-that’s how mangled my pelvis is. That medication made it possibly to function daily. Without it I would give up on life and wait to die in agony. I’ve dealt with pain these past 18 years. I’ve gone to the same pain management practice and have followed all the rules of my contract. I’ve never taken more than prescribed and never took any other medication. I’ve tried the other pain controlling methods offered- spinal ablations, injections, ketamine, other opioids (fentanyl patches, morphine, opana, needling, massage-you name it, I’ve tried it. Nothing worked. So I was kept on the OxyContin and Percocet and IT WORKED FOR ME AND GAVE ME MY LIFE BACK. Now- since the news laws on opioids my pain management has become scared that they will get into trouble for prescribing ANY OxyContin and they tell me that the government is coming down hard on anyone on OxyContin. So after 18 years on the same dosage and being a perfect patient in compliance o was told last month that they would no longer prescribe me OxyContin. They said they would “throw as much Percocet at me as needed” to control my pain and I could go back on fentanyl patches and morphine at a higher dose. They said they could give me up to 50 Percocet pain pills a day!!! This makes no sense as this seems like would be taking an alarming amount of those drugs. None of them are extended release like the oxycontin-which gets me through long hours of the day to provide me with pain relief. They also offered more spinal ablations. I’ve already had SEVEN which have done absolutely nothing for my pain and intakes on one procedure they nicked my spinal column and I leaked CFS fluid and suffered until I had a blood patch to resolve it. The next time they injured one of my nerves to my bladder and made me incontinent for life. <br/>I know there are people who use opiates for recreational use and abuse them. But PLEASE don’t forget about US-people in true need that need relief from pain. I didn’t ask go be hit by a bus driver and end up like this. My life changed in an instant. I was a 17 year life flight paramedic, vet tech professor and part time zoo vet tech. I loved my life. I helped others in need my entire career and now I feel like nobody is helping me when I’m in need. I am not a drug addict or abuser. I am a woman who lost her chance at a good productive life and I just want some modicum of decency extended to me and a chance to still have a purpose in life- although limited. <br/>Without my current pain medication I will have to consider what to do. Do I take my life? Do I become an invalid for my firefighter husband to have to take care of 24/7 when I’m no longer able to function? <br/>My pain management has now decreased my dosage to HALF all of a sudden. I am now in extreme agony every day. It’s been a week since I’ve walked outside my home. I stopped going to aquatic therapy and now I sit in my chair 24/7 unable to do even the simplest of house hold tasks due to being in so much pain. <br/>I am asking that you reconsider the new opioid laws and to think about those of us that are helped immensely by OxyContin and other opioids at higher doses due to severe debilitating chronic injuries. Please don’t penalize innocent patients who have followed the letter of the law to a T. It’s like telling someone that their air is now going to be taken away from them after years of breathing oxygen. This is not right. I am not a criminal, abuser, or immoral-as that is how anyone that takes drugs is seen as. I am a person in pain. <br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484faa9e0	Parquette	None	2022-02-28T21:04:32Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Parquette, Pam	l05-tiko-nb2l	False	None	False	2022-04-12 03:15:50.029	[]
1649	CDC-2022-0024-1655	https://api.regulations.gov/v4/comments/CDC-2022-0024-1655	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in my early 40s and have multiple disabilities. I've had chronic pain much of my life. It used to improve somewhat with physical therapy, but never completely, and now every time I go to PT I come out of it with a new injury that won't heal. Doctors have diagnosed me with fibromyalgia and possible Ehlers Danlos. My joints slip and shift, sometimes crunch and grate. I can no longer ride in a car long enough to see new doctors and daily life is a struggle. My mother needs to help me with basic things I can no longer do, like drying my hair and folding laundry. I can only walk short distances. Standing severely aggravates my pain, but sitting and lying down are also painful. I spend the whole day covered in hot and cold packs and ointments but it's still getting worse. I'm frightened about what is going to happen to me as my mother ages and my pain levels continue to rise. My concentration is going and I have difficulty focusing on books and television. I don't know if I could make it to a dentist's office if I need dental work anymore.<br/><br/>Your current policies have made it harder for me to get medical treatment for pain. I'm not talking about getting opioids, I'm talking about a climate of fear where doctors get a panicked look on their faces when I say I have severe chronic pain, yell, “I don't give out pills!” and try to send me on to someone else. They're afraid to treat chronic pain patients at all. Even short-term pain treatment became an issue for my mother when she needed a knee replacement, and she resorted to taking extra NSAIDs, which is unsafe.<br/><br/>I've tried all sorts of medications and treatments. Four accupuncturists, medical marijuana, red light therapy, magnetic therapy, so many ortho doctors I've lost count, a pain management specialist, and I'm currently on my third rheumatologist (treating me by phone as I can't travel to his office anymore). I'm on Gabapentin at a low dose which is doing nothing for my pain but which seems to be making me sick (I have a lot of adverse medication reactions). I do not know what to do. Every morning I wake up in pain and I feel a weight descend on me when I think of the day ahead of me, struggling through the pain until night comes again and I can take a sleeping pill and get a few more hours of unconsciousness. If assisted dying were legal for non-terminal illness, I would take it.<br/><br/>I'm part of a disability support group and there are people there who talk about how lucky they were to get access to Tramadol and other painkillers and how it changed their lives, how they felt alive again and could think clearly once they were no longer in debilitating pain, and I know I'll never be able to have that. There are clearly so many people whose lives would be changed with better pain management. <br/><br/>Also, I've been told that if I ever do need opioids (and I've learned this the hard way recovering from surgery) that I carry two copies of a gene that makes me require a higher dose to get pain relief. There is a variation in the effective dose between patients, so one size definitely does not fit all.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484faab4c	Maguire	None	2022-02-28T21:05:44Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Maguire, Jennifer	l05-vtqk-jzhk	False	None	False	2022-04-12 03:15:50.248	[]
1650	CDC-2022-0024-1656	https://api.regulations.gov/v4/comments/CDC-2022-0024-1656	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In December of 2018 my vehicle was t boned on the driver side which caused my side airbags to deploy, my vehicle to spin over a median and left me with a condition known as Occipital Neuralgia. <br/><br/>There is no cure for the condition and it has affected my life in ways that I am unable to put into words at this time. I am currently 32 years old living day to day working a full time job and no outside activities that I am able to enjoy due to my level of pain. Over the past 3 plus years I have lost valuable time with my family and my friends and I have suffered every single day since my accident. I have tried every treatment option/recommendation and have gone so far as to taking out a second mortgage to pay for unsuccessful treatments options. <br/><br/>Prior to my accident I attended school to become a drug counselor and was unable to proceed with my career in this field due to my sister being an addict and not being able to properly treat/counsel without my personal feelings being involved on the subject of addiction. With that being said, I never wanted to take pain medication and exhausted every treatment/procedure before finally agreeing to begin taking medication as my last resort. I have been on pain medication since 2019 and have not once abused my medication or not adhered to the prescribing dosage. <br/><br/>The medication I am prescribed is not nearly enough to mask the pain that I feel nonstop but I fear to even attempt to ask my doctor to make changes because of the CDC and it shouldn’t be this way.<br/><br/>Over the past few years I have read countless stories in a Facebook group where pain patients have an outlet to gather information, share feelings and tell their “pain stories” with people who suffer from numerous health conditions which have affected so many lives. I have so much sympathy for these people that come to the Facebook group questioning their doctors decision to stop their treatment in fear of the CDC regulations among other “reasonings”. It’s sad to say the very least and it truly has left so many pain patients left to worry and fear what their future holds should their doctor decide to stop treating their pain. <br/><br/>The current regulations are not going to reduce the number of pain medication abusers and in reality I think it is known that if an individual is truly an addict, they will find another form of drug to feed their addiction which ultimately in my opinion, has nothing to do with pain pills in general. With my family member being a drug addict I have personally witnessed the corrupt mental health system put in place for those who suffer from addiction and it is a matter that the CDC should be heavily investigating. Taking away pain medication from those who suffer daily with chronic pain will only leave them worse off than providing proper treatment/medication. <br/><br/>Addiction is nothing new; it is a disease that the CDC, criminal justice system and the government as a whole has turned a blind eye to instead of helping those who have fallen victim to addiction and it’s saddening for those watching their loved ones suffer and have nowhere to turn for help. Mental health facilities treating patients with addiction require an unreasonable amount of money to treat or go as far as to take situations into their own hands and have the authority to say someone is not qualified for treatment based off of their drug of choice, usage amounts or even based off their history of drug use which is unacceptable. <br/><br/>In many cases addicts have underlying mental health issues that have not been properly treated and end up in the criminal justice system which then leaves them without being able to obtain employment or housing and they have nowhere to turn. I ask you this, if there were a proper mental health system in place for those who truly want to get the help they desperately need would addiction be the only outlet for them? <br/><br/>I am personally raising a child with mental health issues and to be placed in a thriving mental health treatment facility the average cost per a DAY is $800. The issue with opioids is not addicts, it’s the lack of mental health treatment options in the United States and I’m sure other countries.<br/><br/>Pain patients should not have to suffer more than they already have to because of the choice health officials have made to not offer affordable treatment for mental health disorders and I don’t even have to look at numbers or statistics to know that prescribed pain medication is not the underlying issue here and there needs to be some accountability taken here and now. <br/><br/>Stop putting unreasonable restrictions on well educated, honest doctors treating patients who are suffering at the hands of the CDC guidelines put in place. There are doctors who are abusing the system and yes; they should be held accountable for their actions but between insurance companies and pharmacies these doctors can be found and held accountable without good doctors and patients having to suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faab92	Anonymous	None	2022-02-28T21:08:43Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l05-wajj-qfna	False	None	False	2022-04-12 03:15:50.457	[]
1651	CDC-2022-0024-1657	https://api.regulations.gov/v4/comments/CDC-2022-0024-1657	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	LEGALIZE MEDICAL CANNABIS FEDERALLY!! Those of us in illegal states are either a criminal for having marijuana, or chance opioid addiction. My brother is DEAD because of opioids. If cannabis was an option, he’d still be alive today. RIP [dates removed]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484faac98	BortonBorton	None	2022-02-28T21:12:19Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from BortonBorton, Christina	l05-xeb4-7bwl	False	None	False	2022-04-12 03:15:50.703	[]
1652	CDC-2022-0024-1658	https://api.regulations.gov/v4/comments/CDC-2022-0024-1658	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in pain since an accident that was out of my control in 1998. <br/><br/>I have had 4 failed back surgeries, numerous physical therapy sessions, epidural cortisone injections on my cervical and lumbar spine, facet joint injections and nerve ablation. I heve tried every non opioid medication doctors wanted me to try with hope they would help lessen my pain. They didn't and a lot of them had horrible side effects that were very bad for my health. I also use lidocaine patches and many over the counter creams, sprays and supplements to help pain.<br/><br/>I started pain management in 2004. It took a few years to find the right balance of medications and injections that helped my pain. We did it and I was getting more active. My son is my unpaid caretaker. We thought I might get strong enough he could leave me alone long enough to work part time. <br/><br/>Unfortunately, because of the guidelines my medications were tapered and I lost one medication. Since that time my mobility has gone downhill. My strength has waned and my son can't leave me alone for long. Needless to say he still can not work.<br/><br/>The guidlines have caused a lot of harm. Doctors are afraid to help their patients. It isn't just chronic intractable pain patients being harmed anymore. Many types of patients are bring left in horrendous pain like surgical, cancer, end of life, sickle cell and others. <br/><br/>The guidelines still include dosage limitations. That means nothing will change. Doctors will still be fearful of prescribing and people will suffer. The guidlines need to be abolished. It is the only way to make things better. <br/><br/>I also wish to endorse the comments of [name redacted], as circulated in social media and filed with the Federal Register. His comments reflect my own experience and concerns.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484faa851	Christensen	None	2022-02-28T21:14:39Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Christensen, Christine	l06-3bt4-qbf6	False	None	False	2022-04-12 03:15:50.924	[]
1653	CDC-2022-0024-1659	https://api.regulations.gov/v4/comments/CDC-2022-0024-1659	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please have some compassion. I have a auto immune disease called CIDP and fibromyalgia. They cause lots of pain and an opioid is what gives me quality of life. I am not a drug seeker or an addict. I am a 60 year old grandmother who wants to be able to live and interact with my grandkids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angels	None	None	0900006484faeb53	Bowen	None	2022-02-28T22:07:28Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Bowen, Angels	l07-8n8o-klu4	False	None	False	2022-04-12 03:15:51.137	[]
1654	CDC-2022-0024-1660	https://api.regulations.gov/v4/comments/CDC-2022-0024-1660	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 28 year old son died in 2015 from an accidental overdose of heroin. Since then I've become aquainted with so many other moms whose adult children have died from overdoses. I also know many mom's with adult children who struggle EVERY MINUTE with opioid use disorder. They started their unfortunate journeys with legitimate pain medication prescribed by their physician after injury or surgery. Once the prescription was deemed no longer necessary by the physician, many had already developed a physical dependence. In order to prevent painful withdrawal they turned to iliicit drugs. This is a very common story. So many families are struggling. Opioid use disorder has been described as linving in hell. Every member of the family is impacted. <br/><br/>After educating myself about alternatives to opioids, it became very clear the CDC was moving in an appropriate direction. Many doctors stopped prescribing opioids. Instead, they addressed patient's pain with acetaminophen and ibuprofen. Most Physicians, Dentists and Oral Surgeons I have spoken with agree that this protocol is as effective and in some cases more effective than opioid. Why would the CDC reverse course now. More and more people are DYING every day from overdose. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fae63a	Voss	None	2022-02-28T22:09:25Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Voss, Amy	l07-66zd-4qsl	False	None	False	2022-04-12 03:15:51.349	[]
1655	CDC-2022-0024-1661	https://api.regulations.gov/v4/comments/CDC-2022-0024-1661	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wrote a brief for SCOTUS. <br/><br/>https://www.facebook.com/1094599019/posts/10226204480993860/?d=n	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fae775	IbsenMD	None	2022-02-28T22:09:36Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from IbsenMD, Mark	l07-6pwb-axzx	False	None	False	2022-04-12 03:15:51.576	[]
1656	CDC-2022-0024-1662	https://api.regulations.gov/v4/comments/CDC-2022-0024-1662	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors should not be punished for helping patients. The 2015 guidelines were drafted in secret. Throw them out. CDC has no business or expertise in pain management. That is fda territory. <br/><br/>https://www.facebook.com/1094599019/posts/10226187656053247/?d=n	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fae729	IbsenMD	None	2022-02-28T22:09:46Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from IbsenMD, Mark	l07-6lni-ujkx	False	None	False	2022-04-12 03:15:51.819	[]
1657	CDC-2022-0024-1663	https://api.regulations.gov/v4/comments/CDC-2022-0024-1663	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People living with chronic pain and taking pain medicine the way we’re supposed to, we’re being punished because of you all’s decision to prevent our doctors from prescribing or cutting down on the number of prescribed opioids! Don’t you all think that if there was an “alternative option” that actually worked for us, we’d be doing that? Have you ever lived with everyday PAIN? I hope you don’t have to, but let me tell you, it’s life changing! You all have tied our doctors’ hands! This isn’t fair! What’s pushing the fentanyl & heroin epidemic isn’t people like me & others that use our MEDICATION the way it’s intended & prescribed!! It’s from you all forcing chronic pain patients to seek out things that help the PAIN & forcing them to buy off the streets! Are you all that naive that you can’t understand this? Please, reconsider your 2016 guidelines and undo all the problems you’ve caused the rest of us that don’t use & abuse our medicine! We’re tired of being drilled (injections) when that doesn’t help or only helps for 4 weeks! Maybe do some research into the drugs like suboxone that rot your teeth out, or those steroid injections that deteriorate our bones! We don’t want these drugs to get high on, only to be able to cope with the pain & have some similar life we’re use to having. Imagine your life changing- every aspect of it- you can’t take your kids to ball games because you can’t sit that long, you can’t work because you can’t stand or sit long, you can’t go for your runs or biking because the pain says no. Your life in every way is changed. Your 100,000$ a year job is reduced to 10,000$ year. And now, the CDC restricts even what medications you can take for your pain! If I go to the emergency room, I’m treated like a drug addict because I take ONE very low dose pain medication 3 times a day. When I go to get injections, nurses get very frustrated because they can’t get the IV in my veins (such as today, I was stuck a total of 10 times today before the anesthesiologist finally came & put the IV into my foot) and even the doctor was frustrated. I don’t want medicine to get high. I don’t want to be zonked out. I want the edge taken off the pain so I can have a life & even sleep more than 2 hours at a time each night. When you have a loved one go through REAL PAIN, I hope you remember this email and knowing you had the chance to change things but you didn’t. Oh, I’m sure your loved one will get the medicine though, who am I kidding? It won’t always be that way though. Please just consider changing your regulations & guidelines. People are killing themselves because you’ve taken away LEGIT PAIN PATIENTS medication when we’ve NEVER had any problems with our medicine or our doctor’s rules & guidelines! We’re drug tested more than convicts are and I know our doctor would restrict our medicine if we had a problem.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fae57a	Anonymous	None	2022-02-28T22:10:55Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l07-5tug-towy	False	None	False	2022-04-12 03:15:52.033	[]
1658	CDC-2022-0024-1664	https://api.regulations.gov/v4/comments/CDC-2022-0024-1664	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am one person affected by the disastrous "guidelines" set in place, and I hope to see a practical and effective revision to this.<br/>Background:<br/>Approximately 11 years ago I started having problems with intense and protracted muscle spasms in my neck and shoulder areas. These spasms - "charlie horses" - would last for weeks and months. Initial imaging via MRI indicated two neighboring vertebral discs had ruptured, one into the spinal area (about a 40% intrusion into the spinal canal). Added to this was calcification and stenosis of the nerve channel; all in all, this means that the primary nerves feeding my arms, neck, and head were being restricted and crushed as I would engage in my 'normal' day-to-day activities. This nerve irritation would cause the skeletal muscle to spasm and lock, leading to soul-crushing episodes of pain.<br/>When I sought help from the medical community, I was faced with the attitude of "Either we operate and perform a two-level fusion or we do nothing at all", even as I was exhibiting excruciating pain."Pain medication is not an adequate long-term solution" was the common refrain from doctors, while ignoring the short-term relief pain medication would offer. When challenged on the "my way or the highway" approach, pointing out multiple vertebral fusions would fail within 10 years (their words, not mine) and still no relief. If I couldn't get any relief now, why would I think it would be any different when the fusions failed and there were no other options than to go on pain management?<br/>I realized after a futile few years trying to find a doctor that would work with me instead of on me that it would not happen. Every medical 'professional' I talked to parroted the same line: "Pain medication is not an adequate long-term solution", almost like they were reciting organizational policy instead of actually considering the patient's status.<br/><br/>At the end of the day, I still experience incredible levels of pain without any relief. This protracted experience has truly soured me on the medical industry in this country, to the point I no longer have any faith or trust in American medicine. With no legal or rational means of controlling my pain level I have put together what some pain patients call an "exit plan" to remove myself when the pain gets to a level I can no longer live with. Most likely 147 grains of lead.<br/><br/>Congratulations, CDC. Your misguided policies have caused way too much needless suffering and death, with more to come.<br/><br/>My hopes for revision, though would include the following principles:<br/>ANY policy designed around pain medication MUST include stakeholders, i.e. the patients themselves.<br/> The patients know best what works for them and as they have a vested interest in the issue, they deserve a seat at the table.<br/>ANYONE legitimately using pain medication knows exactly what the stakes are regarding addiction and overdose. We don't want to die, so let us partner with the treatment.<br/>QUIT TREATING PAIN PATIENTS LIKE ADDICTS AND CRIMINALS. Leave your moralistic opinions behind. None of us asked for this to happen to us, yet we have to live with it. At least give us the tools to cope as best as we can.<br/><br/>While I was always told "opioids don't work on nerve pain" I now realize that's a trite and shallow excuse. My irritated nerves CAUSE spasms, which opioids DO help with. With a 24/7 constant spasm active, even one oxycodone can "turn down" the level of pain, and the relief granted for those few hours are enough to get me on an even keel again and able to function. Much like being at an arena concert and having a quiet room to sit in when the noise gets too loud, opioids attenuate the pain level back to where I can think. Unfortunately I no longer have an emergency supply of pain medication and can no longer get any, though the spasms are increasing and spreading. This will not end well.<br/><br/>I never thought I would see a day when a person in obvious distress could NOT get any relief by doing the right thing - seeing their medical professional to work out a way to address it; when even one relatively mild pain drug would be withheld due to "policy". Seems like it's more an effort to give cover to reprehensible moralistic posturing than actually helping patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeremy	None	None	0900006484fae466	Audritsh	None	2022-02-28T22:14:21Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Audritsh, Jeremy	l07-59w6-k58r	False	None	False	2022-04-12 03:15:52.253	[]
1659	CDC-2022-0024-1665	https://api.regulations.gov/v4/comments/CDC-2022-0024-1665	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree with the doctors regulations on prescribing them just to anyone and everyone unless it is for a short period like after surgery or something else that may require something for pain in the short term. But for someone who has to live with chronic pain every day and may need it added to another form of medicine to control the pain. I also understand that for a lot of people opioids they can become a real addiction problem. I also believe that there is a lot of people out there that if prescribed opioids don’t have that additive quality in them. It just like when you were young and maybe you smoked marijuana but as you got older you stopped smoking it for one reason or another. It is probably true that these kind of people are few and far between but we are out there. If the drug gives someone a better quality of life then I think that doctors should take that person in account and if they think that the person is not taking there medication as prescribed that is a problem. But I don’t think you should scare all the doctors so bad that they won’t even consider it and educate them on the proper way to make a decision one patient at a time. And if that patient doesn’t understand the why and how to take the medicine than that patient doesn’t need to be prescribed this medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mona	None	None	0900006484fae38c	Hollingsworth	None	2022-02-28T22:14:50Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Hollingsworth, Mona	l07-4u33-aeqm	False	None	False	2022-04-12 03:15:52.553	[]
1660	CDC-2022-0024-1666	https://api.regulations.gov/v4/comments/CDC-2022-0024-1666	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not make it any more difficult to obtain opiate s for chronic pain. It has been very stressful for me over the last 3 years due to [redacted] the quack. I would also advise that the USA move to the Portuguese model of drug control. <br/>Our drug war is only for making $$$$ for a few while failing completely to solve a social and health problem. <br/>Thanks for at least attempting to erase your past wrongs that caused countless suffering.<br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ralph	None	None	0900006484fae279	Atteberry	None	2022-02-28T22:15:37Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Atteberry, Ralph	l07-42sp-g510	False	None	False	2022-04-12 03:15:52.802	[]
1661	CDC-2022-0024-1667	https://api.regulations.gov/v4/comments/CDC-2022-0024-1667	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Revised guidelines for EVERYONE<br/><br/>1. E-scripts need to be transferred to another in house pharmacy when Pharmacy can not fill for several reasons.<br/><br/>2. All class 2 Opioids need to have 5 day prior refill. Many can not go on vacation or other venues because of the 3 day prior fill dates. Nobody fills at 12:01 am anyway so the best a Patient can do would be 4 days early. <br/><br/>3. Stop requesting Doctors to see Patients each month. Go back to 3 month checkups. <br/><br/>4. Allow PCP to write for class 2 opioids once again without CDC / DEA, threats. <br/><br/>5. Allow Patients to work with their doctor mixing Benzo's and Opioids. It can be done with Benzo's at a very low dose. Nobody needs to stop breathing and die from an overdose.<br/><br/>6. Need more time in understanding patients using opioids. Doctors do not have the time nor experienced with a speech about the dangers.<br/><br/>7. All Doctors / PA, etc, need to take classes that are NOT BIAS towards the Patient. Example, people are not addicts they are drug dependent, as many fail to understand the difference. <br/><br/>8. Doctors should have more control on the MME cap. In 2105 the talk was 150 MME, what happened ? <br/><br/>9. Reduce the very high cost for Patients to see a Doctor. Totally out of control having a visit for 10-15 minutes and be charged 370.00 dollars every month.<br/><br/>10. Lets move forward with my above guidelines as my experience goes way way back to 1998. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fae269	Martens	None	2022-02-28T22:16:08Z	None	None	1	None	2022-02-28T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Martens, Steve	l07-3zka-pqm4	False	None	False	2022-04-12 03:15:53.017	[]
1662	CDC-2022-0024-1668	https://api.regulations.gov/v4/comments/CDC-2022-0024-1668	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for 18 years due to a work related injury to my spine. Since the previous guidelines were published, my pain medication has been cut drastically because doctors are afraid to treat patients as they see fit. I never abused my medications, I did EXACTLY as my provider's instructed, going so far as to get a security system on my home and a fire proof safe for my medications. The ONLY people these guidelines hurt are the patients that are truly suffering. Doctors are afraid to treat their patients as they see fit because of these guidelines. I never abused my medication, never failed any of the random drug tests or pill counts (which were many) and had my medication cut to about a quarter of the dose that I had been maintained on for YEARS without issue or increase. The only people these guidelines are hurting are patients that are actually suffering. The people that are abusing these medications are still abusing them, they can buy them on the street easier than a suffering patient can get them from a legitimate prescriber for actual medical treatment. I suffer EVERYDAY due to these extremely restrictive guidelines because doctors are afraid of going to jail for treating their patients as they see fit. I understand all to well that these drugs do sometimes end up in the wrong hands. My 35 year old son has been a herion addict since he was 18 years old, so I do see both sides. Even with that said, my son never had access to so much as one pill in my home. You are punishing chronic pain patients, affecting our quality of life for people that are going to get the drugs they want one way or another. Please STOP making legitimate, chronic pain patients suffer due to addicts that are going to get their drugs one way or another!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allison	None	None	0900006484faf3ab	R	None	2022-03-01T13:43:32Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from R, Allison	l07-xlcm-j9je	False	None	False	2022-04-12 03:15:53.265	[]
1663	CDC-2022-0024-1669	https://api.regulations.gov/v4/comments/CDC-2022-0024-1669	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for allowing me the opportunity that is so near and dear to my heart. <br/><br/>I have Ankylosing Spondylitis and am fortunate that I am able to manage my day-to-day life without the assistance of opiods.<br/><br/>However, I am a care provider for someone who has spinal stenosis and is in constant pain. Through a pain management clinic, she is given 3 Oxycodone per day. As you can imagine, she is in pain at least 10 hours in a 24-hour period. She has been changed over to Hydrocodone and can take it every 4 hours vs every 8 hours with the Oxycodone. This is still not enough to keep her pain free for consistent amounts of time. The medication wears off before the next prescribed dosage. <br/><br/>I understand that there is a true Opioid issue but for this individual, she is basically bedridden because she cannot bear the weight to walk and now, she cannot walk without assistance and is in terrible pain when moving or just lying in bed. The people who live with chronic pain should definitely be accountable for the amount of medications they are allowed to take on a daily/weekly/monthly basis but it should be prescribed so that they are able to remain painfree between dosages. <br/><br/>She was an active woman with a white collar profession. She was able to work 40+ hours a week, enjoy attending grandchildrens' activities and outings. Today, she cannot even make it to the front door to greet them due to the excessive pain she has to live with since the lockdown on Opiods took place in 2016.<br/><br/>Please consider opening up the restrictions specifically for chronic conditions. As we all know, there is a need to govern but perhaps not rule with an iron fist.<br/><br/>Thank you again for allowing me the opportunity.<br/><br/>[redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484faf00e	Bradley	None	2022-03-01T13:44:33Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Bradley, Cheryl	l07-bey5-68f6	False	None	False	2022-04-12 03:15:53.480	[]
1664	CDC-2022-0024-1670	https://api.regulations.gov/v4/comments/CDC-2022-0024-1670	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient writing in support of updating the CDC Opioid Prescribing Guidelines. I knew the 2016 guidelines would be trouble when they were released because we already had similar guidelines in [redacted] state where I live and they made my life hell. <br/><br/>I live with a rare neurological headache disorder called Paroxysmal Hemicrania. NIH describes patients like me as experiencing “severe throbbing, claw-like, or boring pain usually on one side of the face; in, around, or behind the eye; and occasionally reaching to the back of the neck.” I also live with autoimmune connective tissue disease, fibromyalgia, and other chronic conditions. I spent years trying everything from NSAIDs to meditation, from antidepressants to anticonvulsants, but none controlled my pain well, and many came with extreme side effects. When I was finally put on fentanyl patches, my life changed. I no longer had to spend my days reclining in a dark room, but instead could sit up, socialize online, and go for an occasional walk or meal out with friends. <br/><br/>When my doctor gave me bad instructions around my pain patch, telling me to change it more often to get a higher dose (a nonsensical instruction for a patch that gives a measured dose over time), I was kicked out of clinic for correcting him with no assistance finding a new doctor or tapering down off fentanyl. I looked for other doctors, with reactions ranging from being literally laughed at and told it was illegal for a primary doctor to prescribe (a direct result of the 2016 Guidelines) to being screamed at by a pain specialist (who has since been indicted for taking pharma kickbacks) for not being able to fill out 10 pages of forms sitting hunched over a notebook in her lobby. I went through opioid withdrawal on my own, since my primary care naturopathic doctor could not even prescribe benzodiazepines to help with withdrawal. <br/><br/>After that fruitless search, I went SEVEN YEARS without pain medication. I gained weight, watched my body deteriorate from lack of movement, and ultimately tore my rotator cuff because my body was so weak from lack of use. After surgery, I was unable to keep up with my necessary physical therapy because it triggered worse and worse headaches on top of the acute post surgical pain in my shoulder. Finally, over a month after seeing a new pain doctor my ortho clinic connected me with, we received prior authorization for me to start on Butrans patches. These have again been life changing, enabling me to do my physical therapy exercises and knit or crochet for more than a few minutes at a time. <br/><br/>The improvement in my quality of life from being on long term, long acting opioids is undeniable. I don’t expect to be able to work a regular job again without a major medical breakthrough in my rare headache disorder. But I still deserve to be comfortable in my own skin, to be able to engage in gentle hobbies that keep my mind engaged, to tolerate looking at a computer screen to stay in touch with friends online even though I can’t go out in person. I need these medications to remain available without having to go to and pay for weekly appointments, without my working spouse having to take time off to drive me to extra visits that aren’t medically indicated. I need to know that if my doctor moves or retires, I can find a new prescriber without being thrown into withdrawals first. <br/><br/>The 2016 Guidelines predictably led to doctors and insurers taking them as hard rules, not guidelines. I’ve read of insurance companies that pay surgeons a bonus every time they don’t prescribe opioids after surgery. No one should go through surgery and not be sent home with at least a few days worth of pain medication. It’s inhumane. And people like me, people who are in chronic, lifelong pain from injury or illness, we need to have access to doctors in our communities who are allowed to prescribe long term pain medications without their licenses being threatened, without living in constant fear that our meds will be taken away. <br/><br/>The new draft goes a long way towards fixing the problems with the old guidelines, making more clear that they are guidelines, not hard rules, and that no one should be automatically forced into an unnecessary drug taper just to make the numbers match. This communication needs to be not just between CDC and prescribers, but also with insurers and pharmacies that have made their own punishing rules around patients receiving prescribed pain medications. This information needs to be drilled into nursing homes where elderly and disabled patients on pain meds are sometimes denied admission on the basis of their prescribed medications. <br/><br/>I look forward to this loosening of the noose around the neck of chronic pain patients, to all of us being able to access pain medication safely and without abuse. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faf533	Anonymous	None	2022-03-01T13:46:21Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l07-cxnn-o6vq	False	None	False	2022-04-12 03:15:53.735	[]
1665	CDC-2022-0024-1671	https://api.regulations.gov/v4/comments/CDC-2022-0024-1671	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Ankylosing Spondylitis when I was 19 years old. I am now 51. I try my best not to take narcotic pain medication, but the pain gets so bad at times that I am miserable and not able to be active and spend time with family and friends. When the new regulations went into effect it made it very difficult to get refills. I know there are those out there that take narcotics inappropriately and practitioners that over-prescribe. But why does everyone need to suffer for those actions of those folks? My one month supply will last me 2 to 3 months. Those of us living with chronic pain should not be made to suffer further.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candace	None	None	0900006484faf611	Robart	None	2022-03-01T13:46:39Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Robart, Candace	l07-dy0u-sy5l	False	None	False	2022-04-12 03:15:53.966	[]
1666	CDC-2022-0024-1672	https://api.regulations.gov/v4/comments/CDC-2022-0024-1672	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Let me start off by saying people everywhere are suffering because of these rubbish guidelines that was punished in 2016. Hospitals are doing surgery on patients and giving them Tylenol or ibuprofen for major surgeries and this is not ok. Cancer patients can’t get pain medication and chronic pain patients can’t get pain medication and doctors are being locked up because they took a oath to do no harm to patients.I am a chronic pain patient and I can’t get the medication I need because the guidelines.. we need the cdc to take the morphine milligrams equivalent out of the updated guidelines.it is hurting us patients that need these medications to be productive from day to day. I am suffering and I feel like it’s because of these guidelines…many people have been effectived by this and I feel like the damage has been done and doctors are going to be to scared to write these medications again. My doctor knows what is best for me and these guidelines are not a one size fits all. And I think the cdc is going after the wrong people why not go after the cartel and drug dealers for the illicit drugs and not doctors who help people live a productive life.. please try to fix this and help us patients that can’t function without these medications. This is so cruel to people in the United States and I feel like I am treated like a criminal when I go get any narcotics from a doctor or pain clinic and then the pharmacy looks at me I am a drug seeker when I need the medication because I can barely walk. Please help us patients and change these guidelines for the chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faf615	Anonymous	None	2022-03-01T13:47:06Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l07-dyc8-6enr	False	None	False	2022-04-12 03:15:54.215	[]
1667	CDC-2022-0024-1673	https://api.regulations.gov/v4/comments/CDC-2022-0024-1673	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have seen the effects of the opioid crisis from both angles. I am an RN working with opioid addicted individuals. It is true that the effects of over use of opioids are extremely detrimental to mental and physical health and all too often become a death sentence for those who cannot free themselves from addiction. And, as a member of the medical profession, I recognize that overprescribing is our part of the mess. It is not unusual for me to hear from patients that they didn’t have a problem until a catastrophic accident or surgery resulted in starting their downfall. There absolutely needs to be a set of standards or regulations for prescribing but we have to allow prescribers to use their experience and individual knowledge of the patient to also guide how they prescribe. Now the flip side. Since somewhere around 2005 I have developed arthritis that continues to worsen with each passing year. This is well documented with MRI scans over the years. Up to now most of the problem has been in my upper spine but last month moved to my low back. Over the years I have had surgery, steroid injections, all types of anti inflammatory medications and muscle relaxers and other meds with minimal or fleeting relief. I have also tried multiple holistic treatments as well. Again with minimal to fleeting relief. My PCP doesn’t want to prescribe for my pain and referred me to our local pain clinic. I get excellent care and I do believe my doctor is doing his best but not much is working. Since the pain started in my low back about a month ago my ability to function is steadily declining while I wait a month to see my doctor in the pain clinic. While I wait I continue to do the best I can with the tools I’m given. The pain clinic is afraid to prescribe any short term opioids. This pain effects every aspect of my world. Leaving the house is too painful and the only reason I’m still able to work is because I have an amazing employer who lets me work from home (usually my bed). At 57 I am able to tend to my personal cares and that’s about it. I cannot continue moving forward, nor would I want to if this much pain is involved. It’s constant, I am never without pain. Please let’s find some reasonable guidelines so lots of us out here in the world can get our lives back. I don’t want to get “high”, I just want my life back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tami	None	None	0900006484faf6fb	Kray	None	2022-03-01T13:48:03Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Kray, Tami	l07-f5sj-93es	False	None	False	2022-04-12 03:15:54.473	[]
1668	CDC-2022-0024-1674	https://api.regulations.gov/v4/comments/CDC-2022-0024-1674	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern:<br/><br/>Thank you for considering the Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids. It’s very exciting that there might be revised rules about how a physician can treat patient’s health concerns. I think medical autonomy is currently impossible for me. My individual circumstances don’t fit in with the pre-determined health care system. I need my physicians to have the option to examine me, to weigh the pros and cons of different treatment plans, and treat me based on those findings. Every doctor that I have seen in the last few years acts like they are afraid of getting in trouble if they even consider prescribing opioids. They shouldn’t have to operate from fear. I should have a voice in this, but I don’t. It’s my health, my risk. I also want to include a side note— I have been prescribed ibuprofens for years and now I have 5 stomach ulcers that bleed. I have been told by my gastroenterologist to never take ibuprofen again. I suffer from chronic pain. Please vote to put treatment options back in the hands of doctors and patients.<br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484faf772	Anonymous	None	2022-03-01T13:48:26Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l07-fxbw-pt1b	False	None	False	2022-04-12 03:15:54.699	[]
1669	CDC-2022-0024-1675	https://api.regulations.gov/v4/comments/CDC-2022-0024-1675	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 60 years old. I have never done drugs, not even the pot that everyone was doing as kids. Just not my thing.<br/><br/>Five years ago I slipped on the ice. I had a complex spine surgery. They actually lost me on the table. Forty-three minutes of CPR, seven shocks (have the burn scars to prove it), and on a ventilator for 10 days. Now I'm disabled. The huge fusion did not work. He fused my SI joint. Didn't help. May of 2021 I had 2 more very complex surgeries. In through my stomach,moving organs to get to the spine to repair. The next day they opened my back and put an enormous amount of metal in. Almost a year later and I'm prepping for my fifth spine surgery. When I had even a fairly small amount of pain meds, twenty mg/day of oxycodone, I did kind of ok. My wonderful doctor could no longer help me with the meds after a few months. I now am bedridden. <br/><br/>This is so wrong I don't have the words. Punishing we who are desperate to just try and live, because addicts won't say "no". That is not my problem. My problem is, that I doubt I have many years left. I would love to be able to just go for a walk...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacqueline	None	None	0900006484faf9fd	Dimond	None	2022-03-01T13:49:37Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Dimond, Jacqueline	l07-gneo-onl4	False	None	False	2022-04-12 03:15:54.924	[]
1670	CDC-2022-0024-1676	https://api.regulations.gov/v4/comments/CDC-2022-0024-1676	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids have caused harm against lots of communities across America-- however, the blame should lie on companies which lie about the efficacy and addiction capabilities of their products to doctors. Addicts can recover when given a stable support such as safe housing, alternative entertainment, and clean injection sites. Someone who is taking opioids because they are in pain is not an addict, even if they take them their entire lives. People deserve to not be in pain, and then if their pain does fade and the opioid becomes the primary concern, to be able to access treatment without stigma.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annalise	None	None	0900006484fafa66	Kiser	None	2022-03-01T13:50:08Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Kiser, Annalise	l07-h5ua-14kh	False	None	False	2022-04-12 03:15:55.147	[]
1671	CDC-2022-0024-1677	https://api.regulations.gov/v4/comments/CDC-2022-0024-1677	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a genetic disease called ankylosing spondylitis I was born with. With this disease, I am in some form of constant pain from the disease. Opioid medications allow me to live a decent quality of life where I can work and provide for my family without suffering through the entire day in pain. Furthermore, the opioid medication prevents life threatening situations. For example, due to the very strict 2016 guidelines, I could not find another pain doctor willing to write opioids for my condition and as a result, my ribs would not expand and I could not breathe. I was rushed the ER unconscious while the paramedics had to force oxygen into my lungs until I got to the hospital. When I awoke, the hospital administered Morphine so my ribs were able to expand and I was able to breathe on my own again. <br/><br/>Because doctors have become deathly afraid on ramifications for prescribing opioids from the government, most pain management doctors simply won't take the risk. When I cannot find a doctor willing to write opioid prescriptions, I am put in a situation in which I live in agonizing pain, cannot function and am put into life risking situations such as my ribs not expanding and thus not allowing me to breathe. I almost died a few weeks ago because of these overly restrictive policies because there was not one doctor I could find willing to prescribe me the needed opioids to control my condition. <br/><br/>Even if, by some miracle, you find a doctor willing to help you and write you opioid prescriptions, you will usually get an amount that is not enough and will have troubling filling them at the pharmacy because the pharmacies are now deathly afraid to fill these medications. While I understand the desire to stop abuse of these medications, the people like me - the true patients that depend on these medications to live a somewhat normal life are the ones that cannot get the medications while drug dealers and addicts freely buy and sell fentanyl out on the street. Finally, look at the number of suicides of patients who have had medication reduced to an unmanageable level or cannot get the pain medication they need to keep the pain under control. <br/><br/>There are people like myself who have had to take some form of pain medicine to life a decent quality of life and keep the pain at acceptable levels. I have used these medications for over 8 years now without any issues or problems. Many patients who need these medications to keep their pain levels to tolerable levels do not abuse the medicines in any way. They know it's a tool to help control their condition when there are no other options. <br/><br/>I am sure many of the people writing these policies have never had to deal with agonizing pain day and night while doctors tell them that they would love to help you but they are too afraid of the government if they do help. Drug addicts on the street, from what I understand, can get opioids illegally but easily while patients like us who follow the rules suffer in the shadows because the rules say that if the doctor does help, he is going to have to deal with the CDC, DEA, State and whatever other alphabet organization that is going to come after him for helping a legitimate patient who needs the medications. <br/><br/>The patients, like myself, who legitimately need these medications to survive and function because everything else I have tried didn't work are the ones who cannot get the help they need. All while the street drug addicts freely deal drugs on the street. Does that make sense to you? A doctor should not feel like he has to risk his medical license by prescribing pain medications to a patient that needs them. <br/><br/>Until doctors feel like they are not going to be targeted and investigated for prescribing pain medicine, they simply are not going to do it. They are not going to risk their medical license and will move into other practices. This will continue to create a shortage of pain doctors almost no doctors willing to help those who need these medications.<br/><br/>I ask the CDC to either get rid of these policies all together and let a doctor, who is educated for more than 20 years of his life, make the decision between his patient and himself as to whether the patient needs these medications. Otherwise, write the policy and ensure the fear of retribution or medical license revocation are not possible except in rare cases where the doctor is clearly and chronically abusing his prescribing powers. <br/><br/>Please remove the fear from the doctors, the restrictions on the patients and let the doctor determine what is best for his patient with having to worry about government agencies judging his decisions and standard of care. Stop making people like myself needlessly suffer because I can't get the medications I need. And stop making me risk my life when I don't have the pain medications I need and cannot breathe because my ribs will not expand to allow air into my lungs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Scott	None	None	0900006484fafc09	McCarthy	None	2022-03-01T13:51:47Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from McCarthy, Scott	l07-hivs-ky1b	False	None	False	2022-04-12 03:15:55.371	[]
1672	CDC-2022-0024-1678	https://api.regulations.gov/v4/comments/CDC-2022-0024-1678	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am grateful for this. I suffer from an autoimmune arthritis condition. Since 2009 I have undergone countless nerve block and trigger point injections. Many physical therapy and chiropractic sessions, and several biologics, all have been part of my treatment. <br/>Some days these things are still not enough. It is so much better to take 1 or 2 opioids a day than 8 or 12 tylenol/advil. Thank you for finally allowing those of us who really need this to have an easier time of it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fafc17	Anonymous	None	2022-03-01T13:52:03Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l07-hjlb-1v5b	False	None	False	2022-04-12 03:15:55.586	[]
1673	CDC-2022-0024-1679	https://api.regulations.gov/v4/comments/CDC-2022-0024-1679	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a host of painful bone diseases and I was taking opioids which worked well. I was not even weaned off but just stopped after over 10 years on them. I am not able to participate with most outings with my husband in addition I am always tired because at night it seems to even get worse so I don't sleep until I get so tired my body just can't stay up anymore. I am am hoping they will give me my pain meds again so I can participate in life once again. The pain management place is very against giving out opioids regardless how much pain you are in. They want you to have different surgical procedures first which I am against. I may have to change pain management doctors which the rest are more than an hour away.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484fafc32	Walker	None	2022-03-01T13:52:23Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Walker, Kathy	l07-hpym-jrk1	False	None	False	2022-04-12 03:15:55.793	[]
1674	CDC-2022-0024-1680	https://api.regulations.gov/v4/comments/CDC-2022-0024-1680	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	https://www.statnews.com/2022/02/28/data-drift-machine-learning/<br/><br/>This article shows the downside of algorithms:<br/>They fail. <br/>Just as we knew in 2015 these flawed guidelines would fail. They have. I recommend wholesale rejection, with alterations. We were better off without these “guidelines” which were predicted to cause immense harm, and have cause worse harm than we imagined. Just stop it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fafe06	IbsenMD	None	2022-03-01T13:53:00Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from IbsenMD, Mark	l07-ly3i-6h3i	False	None	False	2022-04-12 03:15:56.021	[]
1675	CDC-2022-0024-1681	https://api.regulations.gov/v4/comments/CDC-2022-0024-1681	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 69 year old mother of 3, grandmother of 6 and I am a chronic pain patient. I have been in pain management for 14 years. I have tried all the alternative treatments for pain control without success. My doctor prescribed opioids, small dosages at first, and I finally got to a therapeutic dosage that gave me a quality of life. It was 165 mmes. I was on that dosage for 7 years without any problems until I was force tapered because of the guidelines. I was force tapered out of fear, not medical reasons. It needs to be understood that chronic pain is not just pain that lasts longer than 3 months. It is many, many different illnesses and injuries that have no cure. There should not be any mention of mmes in the guidelines because they are taken as laws. I am a person just like you except I am in pain constantly since being force tapered. It is not the way to treat fellow human beings that deserve any treatment that gives them a quality of life. It breaks my heart when my grandchildren say, while they are crying, “Wah Wah, Is your back hurting, can I please spend the night?” There are thousands and thousands just like me and we are being discriminated against because of the CDC guidelines. You are healthy, normal people making suggestions for unhealthy patients in horrific pain. Please see both sides. Please take any mention of mmes out of the guidelines. I actually believe the guidelines should be rescinded and educated doctors should be able to treat pain patients without any interference. You have got to trust doctors. They are trained in treating patients. When the government stops trusting doctors to treat patients appropriately, there is a problem within our society. Please have chronic pain patients in mind. Addiction and chronic pain are two different medical issues. <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beatrice	None	None	0900006484faf409	Barnard	None	2022-03-01T14:18:39Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Barnard , Beatrice	l07-zvkf-1jqw	False	None	False	2022-04-12 03:15:56.270	[]
1676	CDC-2022-0024-1682	https://api.regulations.gov/v4/comments/CDC-2022-0024-1682	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Young and healthy individuals cannot even begin to understand chronic pain. They must know that along with the physical pain comes the mental and emotional pain of knowing you need to have an end game, knowing that when you have exhausted all of your health management tools of exercise, acupuncture, physical therapy, TENS therapy, etc, and nothing seems to work, there is a way to bring the pain back under control so you can maintain your sanity. <br/><span style='padding-left: 30px'></span>Knowing that your safety net has been pulled out from under you because other individuals have abused prescription pain killers takes away the hope of a better quality of life for the sick and elderly. I also have faith that my physicians are knowledgeable and scrupulous in knowing my needs and prescribing the appropriate medications and treatments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb0cfc	Anonymous	None	2022-03-01T14:19:52Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l08-6eme-mvln	False	None	False	2022-04-12 03:15:56.511	[]
1677	CDC-2022-0024-1683	https://api.regulations.gov/v4/comments/CDC-2022-0024-1683	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I fell and fractured my spine in two places January 17th of 2022. I was sent home with opioids had a low dose, was not instructed to continue taking them. Due to the information I received from CDC sources, I was so afraid of taking the opioids that I ended up having to go back to the ER in severe pain. At that point a home health nurse explain to me the importance of taking the opioids on a schedule to stay ahead of the pain. I've been fortunate to get khyoplasty rather early on, my first doctor who was assigned to me by the hospital wanted to leave me and embrace for 12 months and no khyoplasty. Luckily I was part of a pain clinic, the doctor that was treating me from the hospital wasn't going to write me any pain meds, I was instructed to call the pain clinic. I was so lucky that my pain clinic doctor immediately scheduled a Khyoplasty. I'm in a lot less pain. My Hope is that with the restrictions lifted on the opioids that the alternative Care will still be considered primarily.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristina	None	None	0900006484fb0df4	Giles	None	2022-03-01T14:21:50Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Giles, Kristina	l08-6lze-hbkt	False	None	False	2022-04-12 03:15:56.732	[]
1678	CDC-2022-0024-1684	https://api.regulations.gov/v4/comments/CDC-2022-0024-1684	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope that all MME recommendations are eliminated from the guidelines and supporting documents. I have been trying to get pain care now for 2 years now for the Avascular Necrosis in my ankles, knees, elbows, and jaw, as well as pain in my pelvic bones. I received bi-lateral hip revisions and 7 years later it was determined that I was allergic to the nickel in the acetabulums. I had significant remodelling around the implants and lost a lot of pelvic bone in the process, I was also left with shards of metal in my left hip from the arduous procedure - my tissue was so necrotic around the acetabulums that doctors weren't sure there'd be enough tissue to reattach - I'm sure the shards were easy to miss, but they were sharp and painful and were removed 2 years later. I also have Lupus with a history of Lupus Nephritis which is currently moderately controlled due to flares from pain. <br/>Following difficulty controlling pain post surgically, and after having awoken or awake during surgeries I was finally diagnosed as having a complex case of ultra-rapid metabolism following my 16th surgery. I had wondered why every surgery was so painful, but had been told I was just being weak. Methadone comes close to controlling my pain (I can't take NSAIDs due to NSAID induced gastritis). Since relocating to North Carolina I've tried reestablishing pain care, but have been told by multiple doctors they won't prescribe "that drug". I have no pain care now. Limits and guidelines mean atypical patients like me are subjected to an undue burden of suffering. Please drop all references to prescribing limits, they have effectively separated patients like me from responsible medical care. I've been passing out from pain, I can't sleep. I just want to be healthy and spend time with my family, I'm only 44. I've never even experienced withdrawals from opioids, but I've been labelled drug seeking. The doctor I saw in Washington State said nothing may be effective for me. I'm just looking for a physician who will try, but the guidelines have assured no one will work with me and insurance won't cover it. Please stop hurting the most vulnerable in the medical community.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484fb117a	Flynn	None	2022-03-01T14:25:40Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Flynn, Stephanie	l08-7ba9-6luq	False	None	False	2022-04-12 03:15:56.939	[]
1679	CDC-2022-0024-1685	https://api.regulations.gov/v4/comments/CDC-2022-0024-1685	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 63 year old male. I’ve been suffering with chronic pain for years. The only therapy that makes me comfortable is opioids. I realize that it’s being abused by people in the streets. People like myself need their meds. Now WE have to suffer ? HORSEHOCKEY!!! Make it law with SEVERE penalties if abused by a doctor	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ron	None	None	0900006484fb17c4	Annette	None	2022-03-01T14:49:27Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Annette , Ron	l08-8iit-nzkl	False	None	False	2022-04-12 03:15:57.160	[]
1680	CDC-2022-0024-1686	https://api.regulations.gov/v4/comments/CDC-2022-0024-1686	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a high dose opioid chronic pain patient. After 2017 my pain medication was cut despite my objections. My medication was reduced more than half. Dr said he had to be within guidlines under threat from DEA, insurance companies and pharmacies. I had a semi productive life prior to forced cutbacks. Now I rarely leave the house, no chance of exercising to try to offset further degradation of condition. This has effected me physically and more importantly mentally. I can not understand how everyone has to be limited to 90mme. Everyone has different body weight ,rates of metabolism diffrent ages,sex. This blanket approach and dose limits can not be based on science. How can someone hundreds of miles away say what treatment I get without ever seeing me, or looking at images, tests etc. My Dr sees me every month for years, understands my condition s. My Dr went to med school and attends on going education in pain mgmt. He should be able to prescribe the best medication and dosing. These forced cutback are forcing people to self medicate through street drugs or any one of many scams promising pain relief. And sadly many are choosing suicide as a final pain reliever.......its glaringly obvious the "opioid" crisis should be renamed ...fentanyl...crisis...The DEA should be more concerned with stopping fentanyl, not someone filling a legal script from a qualified Dr.......in closing, please change the CDC opioid guigelines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	0900006484fb2344	ORourke	None	2022-03-01T16:02:14Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from ORourke, Bill	l08-atgy-u4lb	False	None	False	2022-04-12 03:15:57.429	[]
1681	CDC-2022-0024-1687	https://api.regulations.gov/v4/comments/CDC-2022-0024-1687	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A 71 year old Vietnam veteran has chronic pain from a botched surgery at the VA. He can’t get pain control because of these ridiculous •guidelines* this is beyond barbaric. Overdosing is going UP from illicit fentanyl because safe supply has been cut. Please help chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fb249d	Ruhl	None	2022-03-01T16:02:54Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Ruhl, Michael	l08-axat-k7kz	False	None	False	2022-04-12 03:15:57.654	[]
1682	CDC-2022-0024-1688	https://api.regulations.gov/v4/comments/CDC-2022-0024-1688	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer I have been forced to endure frequent if not constant pain. People who are suffering with so much pain should not be treated as if we are drug abusers or drug seekers. <br/><br/>I hesitate to even ask for pain medicine because the doctors are under so much scrutiny they are reluctant to prescribe anything, and if they do it is 10 pills, even after surgery, which gives hardly any relief for a very very short amount of time. Most of the time they won't even prescribe anything.<br/><br/>It is inhumane to make so many people miserable in pain when there are options out there to help them.<br/><br/>When you have chronic bad arthritis or are having kidney stone attack, or other painful medical condition, it is not cured with 10 pills, not even effectively treated with 10 pills of a low dose opioid. You get prescribe 1-2 pills every 6 hours and only receive 10 - the math does not add up.<br/><br/>Please quit making us suffer! Quit labeling all of us as drug abusers. We are pain sufferers and should have access to relief without the stigma the CDC wants to put on us.<br/><br/>Thank you.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb27b4	Anonymous	None	2022-03-01T16:30:58Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l08-bpez-mm7t	False	None	False	2022-04-12 03:15:57.913	[]
1683	CDC-2022-0024-1689	https://api.regulations.gov/v4/comments/CDC-2022-0024-1689	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the writers and peer reviewers of the 2022 draft revised CDC guidelines on prescription of opioids:<br/><br/>My name may be familiar to some addressees. I speak and write widely as a non-physician subject matter expert on public policy for the regulation of opioid pain relievers and of physicians who employ them in treating their patients. I have over 25 years’ experience in this field, with tens of thousands of person to person communications in social media, and over 150 published papers, articles, and interviews in medically oriented journals and mass media. I have spoken and written for several public meetings of the Board of Scientific Councilors of the CDC National Center for Injury Prevention and Control.<br/><br/>Executive Summary:<br/><br/>The February 2022 draft revised and expanded CDC practice guidelines for prescription of opioids are fatally flawed and deliberately misleading. Like their 2016 predecessor, these guidelines misrepresent science that is known widely among practicing clinicians. When taken as directed, prescription opioids are both effective and safe for the great majority of patients with moderate to severe acute or chronic pain. The draft guidelines explicitly acknowledge damage done to millions of patients and clinicians by the 2016 document. They deceptively proclaim that physicians should be free to exercise their own professional judgment in the treatment of their patients. But the writers continue to reinforce their original anti-opioid agenda in a document intended to intimidate physicians and support draconian legal prosecution against any who continue to treat pain by means of opioid analgesics. <br/><br/>It is time for the US CDC to be removed from any role in developing practice guidelines for all medical specialties including pain management. Such guidelines are the proper purview of professional medical specialty academies and associations whose members are clinicians with practical experience in community or hospital practice. The CDC lacks both the legislative charter and the internal expertise to perform such oversight for other than communicable disease. <br/><br/>As written, the 2022 draft follows an old bureaucratic tradition: if you can't convince your audience with evidence and rational argument, then baffle them with a large volume of BS nonsense. <br/><br/>Seven attachments are provided.<br/><br/>1. Detailed comments to the 2022 draft revised/expanded CDC practice guidelines, comprising 27 pages,9400 words and ~40 references.<br/><br/>2. “The Opioid Crisis in Three Charts” – a short paper demonstrating that the so-called “opioid crisis” was not created by clinicians prescribing opioids to patients in pain.<br/><br/>3. Comments on AHRQ Technical Brief on “Prevention, Diagnosis, and Management of Opioids, Opioid Misuse and Opioid Use Disorder in Older Adults” June 2020<br/>4. Comments on “Treatments for Acute Pain – A Systematic Review (AHRQ)” September 2020<br/><br/>5. Methodological Errors in “Treatments for Acute Pain – A Systematic Review” January 2021<br/><br/>6. “ Supplemental Evidence for an AHRQ Research Protocol on Integrated Pain Management Programs” December 2020<br/><br/>7. “Comments on Integrated Pain Management Programs – Systematic Review” June 2021 [ names redacted] <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fa4009	Lawhern	None	2022-03-01T16:39:34Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-25T05:00:00Z	None	None	None	None	None	None	None	Comment from Lawhern, Richard	l02-gk6x-b49e	False	None	False	2022-04-12 03:15:58.120	[]
1684	CDC-2022-0024-1690	https://api.regulations.gov/v4/comments/CDC-2022-0024-1690	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’d like to start out by saying I also am very happy that this issue is open for comments -As a chronic pain patient, living with a painful autoimmune disease and a failed spinal surgery I have been fortunate enough to have a somewhat normal life, thanks to pain medication. It has helped me so much over the years, I was able to do simple things like walk, go on vacations my family, and even take my children on field trips. Not once did I misuse, sell, or give away any of my medication. In fact my doctor insisted we have a locked safe in our home, show it to him and sign a document stating that should anything happen to my medication I am to blame and it will not be replaced. It was not some thing I took lightly, and understanding the dangers that could fall upon me while taking the medication. I’ve taken pain medication for five years now, and can honestly say it still helps me. Over the years my doctor had to decrease the dosage due to restrictions and that has definitely taken a toll, nothing has helped me in the capacity that my pain medication has and we have tried many things. I understand the severity of addiction, and how some people are unable to take the medication without it becoming a problem. I do not feel pain management patients, with medical issues should be punished and treated the same way. A long-term pain management patient has a regimen, and understands how the medication should be used and what it is used for. Because my doctor had to decrease my dosage I have had to try several other medication‘s, had reactions to many of them, along with spending lots of unnecessary funds to try to make up the difference. Most pain management patients understand the rules, and know what you are fighting for. We just would like you to understand that not everybody you allow the medication to it’s going to be an addict, some of us are truly using it for what it is meant for, and thriving. We live a productive lives, we work, we are active members in the community. We’re a success story and there are many many more like me that you would be helping if you what is up on these restrictions for the medication. If you restricted new patients or younger patients without a chronic medical condition that may help, and continue to limit the use of the medication. But for long term pain patients, chronic illness, long-term, or a valid diagnosis from a doctor we should be allowed to take a dosage adequately prescribed by their doctor. For most of us, we would feel like our voices were heard.. finally! You have the opportunity to give us our lives back, along with giving our doctors the hopportunity to properly treat us. opportunity I promise you those of us that will appreciate it most, will never be a reason to cause you worry. I would love to speak with someone should they need information on this very important decision.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristine	None	None	0900006484faae3b	Clark	None	2022-03-01T16:40:31Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Clark, Kristine	l06-53nw-jqsp	False	None	False	2022-04-12 03:15:58.349	[]
1685	CDC-2022-0024-1691	https://api.regulations.gov/v4/comments/CDC-2022-0024-1691	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sweet Jesus! Thank you for realizing how harmful the previous guidelines are. Some I deal with severe osteoarthritis, fibromyalgia, spinal stenosis, only getting worse as I age, 70 years old. There has not been one day in two years that I have not experienced pain in prosthetic left elbow, recovering from 3rd surgery, right carpel tunnel surgery on right hand and not being able to stand for over 15 minutes. I attend a pain clinic where I’m given 3 -10 mg of Percocet per day. Included is 4,000 mg of Tylenol, 2,000 mg of ibuprofen, medicinal magnets, back brace, lidocaine patches and creams. Oh, let’s not forget the quell device strapped to under my knee for 6 hours a day. In the meantime my husband is now my shopper, caregiver and driver. Some days I only need 3 Percocet a day, but there are days I need 5 for harsh pain levels. All physicians are afraid to prescribe any for fear of loosing their license. I don’t know how much longer I have to live, I would like to be pain free. Appreciate any changes and help I can get for my pain<br/><br/>Sincerely<br/>[name and contact information redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484faaec2	Martorana	None	2022-03-01T16:41:28Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-27T05:00:00Z	None	None	None	None	None	None	None	Comment from Martorana , Sharon	l06-6cck-j4io	False	None	False	2022-04-12 03:15:58.573	[]
1686	CDC-2022-0024-1692	https://api.regulations.gov/v4/comments/CDC-2022-0024-1692	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings im currently a chronic pain patient and these new guidelines are not much better than the original ones!We are humans and it so inhumane to take people off their pain meds with no real reason!I would be willing to bet when a higher authority individual needs pain meds they get it no problem!!!! The biggest problem is our southern border!!!Is where all the illegal drugs are how about the DEA get down there and help the boarder patrol and stop playing Dr..... Thanks,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb3317	Anonymous	None	2022-03-01T16:59:48Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l08-d438-h2po	False	None	False	2022-04-12 03:15:58.782	[]
1687	CDC-2022-0024-1693	https://api.regulations.gov/v4/comments/CDC-2022-0024-1693	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Until you've dealt with constant never ending pain that would would make most individuals welt like two week old lettuce, you will never know the struggle that we go through on a daily basis. <br/><br/>There is never any break from it. Never any relief. We don't even have the hope of relief to look forward to. All we have is the medication we're prescribed that provides any measure of relief of the insidious pain, and even then it's only just enough to function like so-called "normal" people. It's just enough to keep our mask in place as we attempt to go through our daily functions. <br/><br/>We are under no illusions. We know this isn't a solution. We know this slight dulling of the millions of daggers attacking our bodies is only temporary. But we also know that without the medication to help us manage the pain, we would have nothing at all. <br/><br/>Those of us who live with chronic pain, along with other chronic issues such as IBS, iritis, migraines, or insomnia, or those of us who are disabled veteran asks that you should a little compassion by allowing our medical professionals to have greater leeway in providing us with the appropriate medical care. They are the front line in our care.<br/><br/>We were not "drug seekers". We are not drug addicts or junkies. We are people who suffer from intense chronic pain, mostly through no fault of our own. We ask for your help in dealing with this destroyer of life until a cure or long term treatment can be found. Thank you.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fb3378	Hosse	None	2022-03-01T17:02:12Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Hosse, Paul	l08-ddxs-qemn	False	None	False	2022-04-12 03:15:59.003	[]
1688	CDC-2022-0024-1694	https://api.regulations.gov/v4/comments/CDC-2022-0024-1694	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Im a Mother and a wife. I'm in pain constantly with Multiple auto immune diseases and fibromyalgia. I no longer can work. I need my medication so I can get out of bed , I need my medication so I can get some sleep, I need my medication so I can have any type of life at all. I'm 52 years old. I cannot and will not live a life where I'm crying in absolute agony all day and all night. You people have to understand the difference between people needing pain medication for real chronic pain for the rest of their lives and then the people who are drug seekers. Don't make us suffer because of drug addicts overdosing. Stop making things harder on us when life is already hard. Living daily in pain is not fun. Trust me, I've been doing it for a very long time. Stop insurance companies and pharmacys from getting in peoples business. If my Dr says I need and i say that i need then I need, end of conversation. Trust that if you guys make things more difficult for people like me there will be a lot more suicides. Why live a live that's unbearable and zero quality?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fb3427	K	None	2022-03-01T19:49:38Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from K, Kim	l08-drof-rc8q	False	None	False	2022-04-12 03:15:59.262	[]
1689	CDC-2022-0024-1695	https://api.regulations.gov/v4/comments/CDC-2022-0024-1695	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 33 yo mother that lives with debilitating back pain caused my scoliosis and bulging disks. Opioid medications have given me quality of life to enjoy my children and family. Please revise 2016 guidelines as they are damaging to those living with daily chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jill	None	None	0900006484fb342d	MCEwan	None	2022-03-01T19:50:12Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from MCEwan , Jill	l08-dtfy-pqfm	False	None	False	2022-04-12 03:15:59.478	[]
1690	CDC-2022-0024-1696	https://api.regulations.gov/v4/comments/CDC-2022-0024-1696	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 56 year old chronic intractable pain patient and a disabled nurse. I was the victim of three rear-end auto accidents from 1991-2000. I have several painful spinal conditions which are degenerative and will only continue to worsen over time. I’m also a diabetic and have neuropathy in both feet. My medical conditions have continued to get worse due to my pain not being adequately managed. I’ve been seeing my current Pain Management Specialist for 17 years and saw a Pain Management Specialist in another State for 8 years prior. <br/><br/>I went through four years of invasive and non-invasive alternative treatments, including CBT, Epidural Steroid Injections and surgery for my pain before my Pain Management Specialist even discussed LTOT with me. Those four years were hell. Alternative treatments were not effective in reducing my pain. As a last resort and my only option left, my Pain Management Specialist prescribed opioid pain medication in 1999. My life changed for the better after starting pain medication. I was able to play with my kids, go on family outings, go shopping and take care of my kids and pets. The medication also gave me the ability to work as a nurse for another eight years. I could do just about everything an able-bodied, normal person could do. Four years after my last auto accident in 2000, my condition worsened and I could no longer work. Even though I had to give up the job I loved, I knew I was still able to be a housewife and mother and I was happy with that. Things went well for me until March 2016 with the release of the CDC guideline and the first step in the reduction of my medication. Over the last six years, and with numerous reductions in my medication, my life has gone downhill and I’m no longer able to do much of anything. Just taking a shower is painful and takes hours to recover from. This is not living, it is merely existing. I no longer have a quality of life. The CDC took that from me with your 2016 guidelines, and with the recommendation of 50 MME on the 2022 draft guideline, I don’t see my situation or life improving in the future.<br/><br/>Not everyone on LTOT or high dose opioid therapy becomes addicted to their medications. Patients on LTOT would have known at the beginning of their treatment, or before if they were treated for acute pain with opioid pain medication, if they were susceptible to addiction/OUD. The susceptibility for addiction/OUD in the population is small compared to the number of people living with chronic pain. You don’t become addicted to opioids when exposed unless you have the susceptibility to addiction/OUD and not everyone in the population is susceptible to addiction/OUD. <br/><br/>My recommendation to the CDC - Remove anything that relates to opioid pain medication dosages (MME). Let our doctors determine what medication and how much we need. Our doctors know us, they are the ones who examine us, review our x-rays and MRI’s, see us in follow up appointments and monitor our medications. Morphine Milligram Equivalents are based on flawed science and should not be used as recommended dosages. (See: We’re Measuring Opioid Strength The Wrong Way - Daily News / Comments To The FDA: Opioid Dosing Based on Milligram Morphine Equivalents is Unscientific - [Name Redacted]).<br/><br/>We’re Measuring Opioid Strength The Wrong Way -Daily News<br/>https://www.nydailynews.com/opinion/ny-oped-were-measuring-opioid-strength-the-wrong-way-20220217-tjmjeevofrdyvj443jvkakmlhe-story.html?fbclid=IwAR0Px2Gz9n9GLRsjX53v-nDx0cjl6hIoK1Pjbg9WGoOpk5R4xcX8CbvQMhw<br/><br/>Comments To The FDA: Opioid Dosing Based on Milligram Morphine Equivalents is Unscientific - [Name Redacted]<br/>https://www.acsh.org/news/2021/05/24/comments-fda-opioid-dosing-based-milligram-morphine-equivalents-unscientific-15561<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karla	None	None	0900006484fb36b9	Rabel	None	2022-03-01T19:53:47Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Rabel, Karla	l08-ehb4-w4go	False	None	False	2022-04-12 03:15:59.702	[]
1691	CDC-2022-0024-1697	https://api.regulations.gov/v4/comments/CDC-2022-0024-1697	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain from severe scarring on one of the nerves in my spinal cord. I have had over 35 surgeries or procedures without benefit. The only treatment that keeps me functional is opioid medication. Most of my doctors have stopped prescribing it because they are afraid of losing their license. Overdose deaths have increased since the initial CDC guidelines and prescriptions have decreased by 50%. So, the guidelines have failed to yield the desired effect and the only people suffering as a result are those that actually need the medication to survive. Whenever I go to the doctor or the pharmacy, I feel like I am being treated like a second class citizen. Please remove ALL mention of MME (Milligrams of Morphine Equivalent) including in the supporting text. Physicians and their licensing boards have misinterpret the initial guidelines and since they don't understand it, they are scared to give it to the people who need it the most. They say, "sorry", the government won't allow me to give it to you even though I know this will help you. Please stop punishing the innocent patients who have no other alternative.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nick	None	None	0900006484fb3a62	Renfo	None	2022-03-01T19:54:56Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Renfo, Nick	l08-fc8g-f19g	False	None	False	2022-04-12 03:15:59.914	[]
1692	CDC-2022-0024-1698	https://api.regulations.gov/v4/comments/CDC-2022-0024-1698	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ask any Dr nurse PA anyone that is honest how to arrive at whatever MME and you’ll get as many different answers as the morphine milligram equivalent is nothing but junk math that fails both Drs and patients and in effect is smoke and mirrors for nothing but one size fits all prescribing and amounts to medical malpractice. MMEs will not prevent ods nor in any way whatsoever put a dent in the disease of addiction. Any mention in the new CDC Guidelines anywhere of MMEs will create the same confusion by the medical profession caused by the 2016 Guidelines. Let Drs treat their patients as they see fit by prescribing in good faith. Every pain patient experiences pain differently and metabolizes narcotic meds differently. The Center for Disease Control knows without question that addiction is a disease that will never be controlled anymore than alcoholism was ever controlled by Prohibition. The CDC also knows the majority of those with addiction do not die from overdoses most live to become seniors, [Name Redacted] is an excellent example of this. It is way past time to stop the current opioid hysteria and admit that Pharma received FDA approval because the drugs work safely and effectively when taken as directed. No pharmacy or Dr is responsible for how anyonetakes their prescription once it is written and filled. The CDC is also aware and knows that for most seniors NSAIDS and Tylenol pose greater risks to their health than narcotic meds. Studies were done that showed unequivocally when patients had control in administering IV pain meds after surgery they used less than when given pain meds by injection every four hours. The CDC is also aware of how detrimental stress is to mist organs in the human body and they know pain is a stressor that untreated or under treated shortens the life span of anyone in pain day and day out. The CDC is very much aware that the witch hunt on narcotic pain meds has seen an almost 50 percent drop in prescriptions and by their logic should have seen overdoses drop rather than rise as they have since ive 2016. So why should anyone trust the CDC MME math of what dosage of opioid pain meds a patient should be given by their Dr. The damage done to millions of pain patients by junk math and science of MMEs should be prosecuted for criminal fraud perpetrated by those in positions of authority who abused their positions with lies obfuscation and deliberate misrepresentation of facts published and disseminated to a trusting public. The results have and continue harming millions of patients thousands of practicing professionals in the medical field. The harm to medical patients by tapering opioid medications has drastically altered their ability to function and caused more harm than good by destabilizing patients many of whom had safely and effectively taken narcotic pain meds for decades successfully having their pain alleviated. Another result has been the establishment of drill mills where patients are medically blackmailed into invasive steroid injections which do not have FDA approval and are known to be a factor in osteoporosis seniors are already at risk for. The CDC also knows the largest number of pain patients receiving opioid pain meds are seniors. Does the CDC actually think anyone in the last 20 or more years of their lives actually care about their risk of addiction as opposed to alleviating pain that dynamically ranges from moderate to severe pain that otc pain relievers do not ameliorate and can cause far more serious medical conditions in aging Americans. The truly pathetic and most hypocritical aspects of the deliberately manufactured opioid crisis is those behind it will get their pain pills when they want or need them while every acute or chronic pain patient is denied safe and effective pain relief opioid meds provide.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484fb2a95	Tubb	None	2022-03-01T19:57:54Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Tubb, Sandra	l08-g8wu-64ip	False	None	False	2022-04-12 03:16:00.121	[]
1693	CDC-2022-0024-1699	https://api.regulations.gov/v4/comments/CDC-2022-0024-1699	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Nice try cutting the opioid dosage from 90 MME to 50 MME daily dose for pain management , but getting the press and JAMA to report that you’re raising the limit. You know damn well THAT’S what the doctors ALL followed in 2014 when you “suggested” 90 MME. But it doesn’t really matter because after you’re exposed for Crimes Against Humanity for approving MRNA spike protein shots that killed people and outlawed ivermectin and Hydroxychloraquin, you’ll be arrested soon anyway. Enjoy GITMO murderers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheila	None	None	0900006484fb2a97	Garcia	None	2022-03-01T20:10:21Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Garcia, Sheila	l08-g9jv-w8ea	False	None	False	2022-04-12 03:16:00.333	[]
1694	CDC-2022-0024-1700	https://api.regulations.gov/v4/comments/CDC-2022-0024-1700	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been living with Chronic Pain for 20 years. This last year being the worse. It took 2 months to straighten out the amount of pain medication I could get in one month. The medication required two prior authorizations to be able to first be approved for the medication and then for 10 pills over the max amount that my insurance company would assist me in paying. If I bought the 10 extra pills it would have cost over $20 a pill and that totals $200 that I do not have retired living on a budget. This situation required hours on the phone. Hours my pain management MD's staff put into helping me get the approvals. This amount of time for one of many medications to control a neuropathic and autoimmune pain was one of the reason's that MDs will not prescribe pain medications period. IT takes valuable time from other patients and money for the MDs who will help a chronic pain patient. IF, your changes will definitely address the issue of prior-authorizations and pill limits I thank you. BUT how can the MDs or the pain patient trust you when you have been so fickle with the vax. I do not believe your wording is strong enough or clear enough on pill limits and this two-stage prior-authorizations. You kicked us under the buss in 2016 so how do we trust you have really recognized our need now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484fb2ada	Shannon	None	2022-03-01T20:11:07Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Shannon, Cheryl	l08-grd2-rbgy	False	None	False	2022-04-12 03:16:00.813	[]
1695	CDC-2022-0024-1701	https://api.regulations.gov/v4/comments/CDC-2022-0024-1701	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a person in Chronic to Severe, CONSTANT PAIN. There were zero reasons to deny pain abatement to people like me. Chronic to Severe Pain Patients are not now nor ever able to become addicts. That's due to zero Degenetative Diagnoses will ever heal. I didn't realize the Quality of Life Tramadol and occasional Percocet afforded me, until they were ceased. 39 or 40 Percocet or Oxy lasted me 3 or 4 months. Tramadol was 1 or 2, 2 to 3 times a day. Then 1 twice daily, then stopped. Now I'm allowed 30 Tramadol a month. Rite Aid calls it an 8 day supply, which is supposed to last 30. In 2018, when Quality of Life was ripped away, I was never tapered, as all my Drs., including [Name Redacted], knew I was not an addict. A few of my diagnoses: C 5/6, C 7/8 herniated discs (neck), with Spinal Cord Impingement. Other end of Spine: L4 is on top of herniated L5, pressing on cord and S1, in turn causing sciatica and at times, am unable to walk. Psoriatic Arthritis severely affecting both feet. Prior controlled, raised Blood Pressure. Hip OA. Hashimoto's Thyroiditis. History of Ulcerative Colitis and Vasculitis. Edema in left arm and hand. CKD 2, then 3, I believe caused by largely untreated PAIN. I'd like to have my semblance of a life back. Merely existing is not an option. Kidneys fail or liver goes due to acetaminophen, I'll be added to the uptick in deaths by so-called Natural Causes. Why would any sane person want to extend unrelenting AGONY?! We need an official ASPCHumans.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fb2af4	Adamson Curlis	None	2022-03-01T20:26:20Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Adamson Curlis , Donna	l08-glnn-zil5	False	None	False	2022-04-12 03:16:01.032	[]
1696	CDC-2022-0024-1702	https://api.regulations.gov/v4/comments/CDC-2022-0024-1702	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the husband of a chronic pain sufferer. I married her when we were both 45. She was an RN and working full time mostly in NICU. She had to try to find work that didn't involve heavy lifting, because of back and neck pain she had since a serious car accident as a teenager. She was treating with chiropractic and took a lot of Ibuprofen to treat the pain and now sciatica, and remain<br/> functional. In 2008 she went to a neurologist who did an MRI and it revealed degenerative arthritis and surgery wasn't recommended at that time, but the Dr recommended Tramadol 50 MG q 4-6 hrs. This allowed her to decrease the harmful constant use of so much IB.<br/><br/>[Name Redacted] was a shift worker and also was dealing with issues with 3 adult children. When insomnia became a problem, her Dr allowed her to have Ativan 1mg as needed, and then years later, added Ambien at hour of sleep.<br/><br/>[Name Redacted] utilized this med regime without any issues or misuse. She tended to have anxiety issues, and a condition called Misophonia, where she is very sensitive to noise. With her med regime she could go on vacations with me, sleep in motels, fly in planes and even ride on my Harley with me. <br/><br/>She took the meds as ordered, usually one Tramadol towards late afternoon when pain would increase. Ativan she had taken since 1995 and was told she would develop a tolerance over time, so was being taken as needed 2-3 times through day or night for nerves and anxiety. The Ambien was a life saver as she was able to get her sleep, even in motels. This was good for both of our quality of life and was not doing her any harm. It all began to unravel in 2018 when we moved and thought we should switch to a closer Doctor. <br/><br/>Immediately the new doctors were bent on stopping [Name Redacted] meds which were so beneficial to our lives. There certainly was no harm occurring. The 1st one tried to switch her to a different Sleeping pill which was very traumatic. She had serious reactions to a couple of the meds, and worse, she didn't sleep. <br/><br/>The 2nd MD told her she had to wean her off of all 3 of her meds, and sent the pharmacy tapering doses, to be completed over 6 weeks. [Name Redacted] was sent into withdrawal, which consisted of periods of extreme anxiety, panic attacks where she felt like she couldn't breathe, and no sleep. It was horrible for her. And it was the 1st she had heard about the regulations prohibiting Dr's from prescribing, she was afraid to say anything. One Dr's assistant told her: ' 'they' are watching us closely!' She was treated as an addict and was stigmatized at the Dr's office AND at the pharmacy, who had served us for years.<br/><br/>She finally was told she could have the sleeping med back if she stayed off of the other meds, so her situation has become more tolerable, but she has her anxiety back. Won't fly, or ride the Harley with me. She has tried counseling which is usually not that helpful, and is expensive, and everyone wants to put her on Antidepressants, though depression is not the issues, even though she lives in fear now which makes her sad, that she is being threatened constantly about deleting the sleep med as she gets older.<br/><br/>I wish the limiting of needed meds would be returned to the Physician and a STOP placed on the fears Mds and Pharmacies have about prescribing and despensing!! So much suffering has been caused by the unnecessary restrictions and threatening oversights!! Of course they fear losing licensure!! We need to get back to treating those who benefit from these meds,and don't abuse!!!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fb2b2a	Stitt	None	2022-03-01T20:33:11Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Stitt, John	l08-hbz9-sjzo	False	None	False	2022-04-12 03:16:01.273	[]
1697	CDC-2022-0024-1703	https://api.regulations.gov/v4/comments/CDC-2022-0024-1703	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started my opiates journey in 2011 with the bilateral replacement of both knees due to osteoarthritis. Top notch surgeon and team prescribed Percoset at dose high enough to allow me to get back to my work life as a C-Suite executive. Due to anti rejection medicine I became infected with Flesh Eating bacteria that was located in my middle body. The bacteria damaged my gonads, kidneys, pancreas, right lung, liver, intestines, abdominal muscles, pituitary gland, and caused me to aquire Addisons disease. The pain is unbearable. I was causing concern to my doctor due to the amounts of Morphine and Percoset needed. I lost my wife and children. I developed DVTs in my right leg. I lost my job and home. I found a delivery job overnight but totaled my car in bad weather. A of the lumbar disks were ruptured or herniated and some just shredded. I started seeing a pain management clinic just before the CDC 2016 guidelines were published. My medicine dosages have been arbitrarily reduced by 65%. I was "functioning" until then Now I spend 18 hours a day in bed while laying on ice blocks to dull the pain. My clinic doctors tell me that their hands are tied by the CDC directives. They tell me that they will prescribe me more if things change. They are caring doctors. One of them was arrested. They are all afraid. Please change this awful system so people like me can get medicine. My right hand was crushed last year. I had repair surgery but no more medication for the healing, just wrapping. Help please. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fb2b40	Bybee	None	2022-03-01T20:58:46Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Bybee, David	l08-hfyt-4q18	False	None	False	2022-04-12 03:16:01.484	[]
1698	CDC-2022-0024-1704	https://api.regulations.gov/v4/comments/CDC-2022-0024-1704	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 70 years old with good health. I have experienced childbirth and open heart surgery. Both were short-term (acute) severe pain experiences. 5 months ago I developed bilateral sciatica after a lot of physical labor remodeling my home. In my life, this is the longest period I have experienced a traumatizing level of pain, 24/7. My formerly active lifestyle is severely curtailed. The constant pain is traumatizing. Have done months of PT and received epidurals. No doctor (PCP, consulting spine surgeon, pain management doctor) has offered a medication that stops pain. I still hope the sciatica will be resolved by healing the disc in my back. From what I have seen, Doctors do not feel free to relieve pain because of the opioid crisis. Many people suffer to get through even a temporary health crisis. My heart goes out to those who have long term chronic pain. I remember being pain-free 5 1/2 months ago, and now I struggle to maintain my even a portion of my former activities and exercises while in constant pain. Even when I am healed again, this will be remembered as a traumatic event in my life. My sister, who is a nurse who has cared for burns injuries patients and emergency patients, is horrified that pain management falls short for SO many patients. She is aware that sometimes an opioid saves lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lucy	None	None	0900006484fb2bbb	Hanna	None	2022-03-01T21:00:42Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Hanna, Lucy	l08-i6ab-laaa	False	None	False	2022-04-12 03:16:01.696	[]
1699	CDC-2022-0024-1705	https://api.regulations.gov/v4/comments/CDC-2022-0024-1705	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello CDC,<br/>I have been a disabled woman living with debilitating pain for almost half my life. I am now at the age where my joints are being replaced which is a new form of hell for me. <br/>I have multiple spinal fractures with multiple disc abnormalities.<br/>I cannot sit for longer than 40 minutes. A trip to the grocery store has now become a two hour event. It takes me a full day to recover with additional pain medication.<br/><br/>Because of the cruel and inhumane meddling in my pain medication therapy, I can do almost nothing, while existing in levels of pain that has me thinking thoughts of suicide. I frequently add OTC like Advil and additional Tylenol to the point of Tylenol and Advil and Aspirin poisoning. As u know, these meds will not only destroy my stomach but my liver and kidneys as well. This is unnecessary. Why would you do this to me??<br/><br/>My physician prescribed me a medication that I can't fill because no pharmacy will carry it. I have been snarked at by pharmacists that are overstressed and bullied.<br/><br/>Stop it. Chronic pain patients have been responsibly taking our pain medication for years without incident.<br/><br/>I don't deserve to live in pain, but because I do, I don't deserve to have my pain meds reduced and forced to endure procedures like nerve blocks and nerve burning that are not helpful and can be billed for much higher rates.<br/><br/>Maybe this is your goal, to rip off Medicare and health insurance providers.<br/><br/>I am so angry that you are responsible for my pain being so unbearable. That my activities of daily living now consist of me laying on my sofa. I didn't have much of a life before but now Im current on all the reruns of Hogan's Heroes.<br/><br/>You are responsible for what I have become. Congratulations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	veronica	None	None	0900006484fb2be0	E henrich	None	2022-03-01T21:02:31Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from E henrich, veronica	l08-ijwm-92ge	False	None	False	2022-04-12 03:16:01.942	[]
1700	CDC-2022-0024-1706	https://api.regulations.gov/v4/comments/CDC-2022-0024-1706	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why did PROP contribute to this? No opiates after surgery and broken bones is substandard care. 50 mme is too low for most severe pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Germaine	None	None	0900006484fb2c06	Pugh	None	2022-03-01T21:03:09Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Pugh, Germaine	l08-iq49-xbvj	False	None	False	2022-04-12 03:16:02.203	[]
1701	CDC-2022-0024-1707	https://api.regulations.gov/v4/comments/CDC-2022-0024-1707	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>In severe cases, traditional treatments are not effective, so drugs like opioids are sometimes needed to treat the disease when other first line treatments fail or as a bridge in transition between different first line drugs. In my own case, I suffered severe RLS for a few months when transitioning my medications. I got no sleep at all for days, and while I did not have opioids to help with the transition, in hindsight, having access to them could have potentially saved me a lot of extreme duress had they been available to me. <br/><br/>Any drug can be subject to abuse, but to just deny access to a drug across the board because it has a large history of abuse is short sighted. It is ultimately a choice between doctors and their patients and quite frankly is not the role of government to get involved. The bureaucracy cannot successfully protect people from every possible form of harm and attempts to do so can wind up denying drugs to people who really need them as is the case of opioids and RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	I	None	None	0900006484fb2c47	Smith	None	2022-03-01T21:05:00Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, I	l08-j7li-84oe	False	None	False	2022-04-12 03:16:02.441	[]
1702	CDC-2022-0024-1708	https://api.regulations.gov/v4/comments/CDC-2022-0024-1708	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There are many well educated who have made comments regarding the new 2022 opioid prescribing guidelines that address each area of these guidelines. They are well versed; I can only speak from personal experiences that I have encountered. Per these guidelines each CPP has been made to feel as though they are a criminal versus a patient. To have regular urine drug screens, pill counts, monthly dr appointments, monitored via narxcare, etc. is costly, redundant , and infringes on ones civil rights. The bottom line is the 2016 guidelines were an epic failure by creating mistrust between dr/patient, creating more bed bound patients/ruining livelihoods, more suicides, more drug overdoses via illicit drug use. It would be one thing if there was a positive outcome but there was not. Many CPP advocates have pointed out why this was an epic failure; now these guidelines need to be redacted without replacement. Dr/patient relationships need to be restored. The DEA needs to focus on the drug cartels and illicit drug trade. The DEA/CDC have no business intervening in physician/ patient relationships or how a physician decides appropriate care for their patients. The FACT that these guidelines were established by those who had a conflict of interest is even more disturbing. I suggest the DEA/CDC investigate the financial records of those involved with the 2016 guidelines….I know because of these guidelines many have suffered because they were unable to get proper pain management thus further complications exacerbated which ended in their demise. The damage caused by these 2016 guidelines will take years to repair; if at all. Definitely created a true distrust of the CDC/DEA/DOJ; incarcerating physicians who were lazor focused on patient care & not paperwork or government bureaucracy…..really despicable when DEA has no formal medical training.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb4de3	Anonymous	None	2022-03-01T21:06:31Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l08-jx1e-pa06	False	None	False	2022-04-12 03:16:02.665	[]
1703	CDC-2022-0024-1709	https://api.regulations.gov/v4/comments/CDC-2022-0024-1709	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The following is a letter sent to my Senate representative’s office. Again, and as always, no reply from their office because they don’t want, nor care, to listen to the plight of a chronic pain suffer:<br/>START<br/>(redacted), it has become very clear to me that you have zero interest in my matter concerning what the opiate crisis is doing to legitimate pain patients. It’s obvious that (redacted) also has no interest either to fully understand what I’m trying to convey. The Mate Act and HB2235 needs my input whether you care to see that or not. <br/>I see the Mate Act driving doctors further to reject pain patients and refusing to participate in opioid therapy, leaving a legitimate pain patient in agony and without proper care. Nothing says a doctor has to treat a pain patient with opioids so most will probably stop all together. Your mandatory training will likely be just enough of a turn off to them and what’s to stop them from refusing opioid treatment?<br/>Wasn’t the Cures Act of 2016 supposed to fix the opiate issue? Looking at historical statistics, I’m going to say no. While the prescribed opiates statistics started trending downward around 2011, the apparent illicit use has been on an interesting trajectory upward. The downward trend for deaths from prescribed opiates looks like the Cures Act was a success on face value. However, I have another credible theory to this. Based upon what I’ve experienced as a medical professional and pain patient advocate, I think it’s because patients were mostly kicked off of opiates by their doctors. Doctors terminated prescriptions for uncountable numbers of patients, thus dropping the numbers of opiates prescribed, therefore reducing associated deaths. Looks like a success until you look deeper. Prescribed opiate deaths did decrease but Illicit opiate deaths dramatically increased starting about 2015. I saw one line item of the Cures Act at 1.8 billion dollars and I’m curious how that money was spent. In all appearances, the Cures Act seems to have created an even bigger problem. Just look at the stats from the CDC. <br/>I’ve witnessed directly where doctors coldly cut patients off without a compassionate, clinical titration downward. Because of this, I’ve seen consequences like a sudden shift to suicide, chronic alcohol consumption, illicit drug use, huffing, psychotic episodes and even heart attacks. No compassion at all.<br/>Interestingly, the suicide trend has preceded and then coincided with the illicit opiate trend. Suicide has been a precipitous incline well before opiate deaths were ever an issue. How many deaths are from suicide by opiates? <br/>From my perspective, as a long-term pain patient and medical worker, I’m appalled at what I continue to see, all supported by a government that refuses to fully understand what’s going on. By cutting off patients from legally prescribed opiates, you are only fueling illicit demands and rising deaths. <br/>Pain patients must have legitimate representation in the Mate Act if you expect it to be successful. I understand what you’re trying to do but you are not seeing what humans will do to adjust in order to care for themselves.<br/>END<br/><br/>It’s a sad day when an elected official shows such disregard for a chronic pain patient. Maybe that’s a big part of the problem?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fb4de8	Cook	None	2022-03-01T21:08:17Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l08-jyop-2cgy	False	None	False	2022-04-12 03:16:02.897	[]
1704	CDC-2022-0024-1710	https://api.regulations.gov/v4/comments/CDC-2022-0024-1710	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 60 year old woman with chronic pain from rheumatoid arthritis, fibromyalgia and chronic disc disease. The only thing that keeps me coming in to work are my opioid medications, methadone and tramadol. I realize that people on the streets are abusing these and and dying from mixing what they shouldn't; your regulations are protecting the addicts on the streets when it should protect us who need them to even move. I'm tired of being third degreed by every pharmacist that handles my scripts.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484fb4e01	Napoli	None	2022-03-01T21:08:49Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Napoli, Lori	l08-k4en-fb75	False	None	False	2022-04-12 03:16:03.109	[]
1705	CDC-2022-0024-1711	https://api.regulations.gov/v4/comments/CDC-2022-0024-1711	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a clinical psychologist with over thirty years of experience working primarily in pain management across many different settings including academic pain clinics, community based pain clinics and in private solo practice.<br/><br/>I have seen the damage done by overprescription and overuse of opioids, as a primary pain management tool, on the overall quality of life of hundreds of people living with chronic pain. I as pleased with the 2016 attempt to regulate this practice, although I agree that overreaction and forced tapering has also been detrimental.<br/><br/>I appreciate the proposed revisions to the guidelines, especially the strong messaging that the use of non pharmacological tools early is an essential component of successful, individualized pain management.<br/><br/>I would add that pain psychology does not just address coping with pain, but also has a direct impact in the reduction of the experience of pain as well. Many pain management professionals see pain psychology as an adjunct, palliative treatment instead of the powerful pain reducer that it can be. Is is often communicated to patients, often inadvertently, that they are being referred to a pain psychologist because they are depressed to anxious, instead of communicating that they may find more benefit in pain reduction by seeing a pain psychology professional. I would emphasize this messaging.<br/><br/>Also, having developed and worked in multiple functional restoration based programs (largely only funded by industrial injury cases and insurers), these programs are well-validated empirically and should be promoted to non-industrial injury practitioners and insurance companies. There is often a gap in the coverage for well-run, interdisciplinary and functionally-based programs, despite the empirical evidence for their value in pain reduction, improved life quality and even long-term cost reduction.<br/><br/>I would strongly add that major health insurers should consider adding FRPs to their covered services in order to more effectively manage chronic pain.<br/><br/>Additionally, I would emphasize the need for more pain psychology training for medical and mental health professionals and the creation of pain psychology certification processes to allow medical professionals to more easily identify qualified pain psychology practitioners.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimeron	None	None	0900006484fb4a98	Hardin	None	2022-03-01T21:10:40Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Hardin, Kimeron	l08-kpzs-d7wb	False	None	False	2022-04-12 03:16:03.321	[]
1706	CDC-2022-0024-1712	https://api.regulations.gov/v4/comments/CDC-2022-0024-1712	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What is needed: Comprehensive discussion as to whether there is addiction in a person's background / maybe do a psychological consultation first? We all know if they're not in a good state of mind, the opioids for whatever reason, e.g.,, pain management, are going to be used for a feel-good reason- subconsciously or not.<br/><br/>Additionally, drs should refer out to other natural, conservative approaches as complementary approaches to continued healing. There are herbs/supplements/exercises we can all do to further promote health and healing. A drugs-only approach is clearly not the answer. We have a gazillion options available to us, and sometimes we need to try multiple things including the use of meds. Don't feel confident in giving nutrition advice? Refer out.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb4aeb	Anonymous	None	2022-03-01T21:13:08Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l08-lhy5-oqql	False	None	False	2022-04-12 03:16:03.538	[]
1707	CDC-2022-0024-1713	https://api.regulations.gov/v4/comments/CDC-2022-0024-1713	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fafca5	Anonymous	None	2022-03-01T21:17:05Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l07-iade-9cu0	False	None	False	2022-04-12 03:16:03.746	[]
1708	CDC-2022-0024-1714	https://api.regulations.gov/v4/comments/CDC-2022-0024-1714	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom it may concern: I have been in chronic pain for as long as I know. My didn't like/trust the doctors, and they overlooked and neglected severe health issues. I was left with the auto-immune system decline that affects so many - Hashimoto's disease; fibromyalgia; piriformis syndrome, Sjogren's Syndrome. The commonalities are fatigue and pain. I wake up each day and wonder why I'm hurting. Next I remember who I am, and where I am. First, it is pain. Every day. I discovered some relief on a pain medication since the late 1990's, among other steps I take to mitigate pain. I was also on a small dose of night time medication for PTSD, but have ceased taking that due to the 2016 guidelines and the terror those guidelines have caused in the medical field. This leads to poorer sleep, which leads to increased pain. With the smalldose of pain meds, I can enjoy a productive life and my pain is under control-never gone, but managable. Is that so very much to ask? Must I be treated like a criminal? In California, finding a pain specialist who prescribes medication is very difficult - moreso by the day. I am required to take urine tests where I have to physically hand my urine to a lab tech in front of other patients. I have to pay for appointments more frequently, try to find a pharmacy who can fill my prescription, have to juggle my refills around holidays and weekends because I can only be prescribed barely enough to manage my pain. I MUST see a pain specialist, some of whom are profiteers benefitting from those 2016 guidelines. They often try to push more medications, and expensive, invasive, often experimental procedures. I am not a lab rat. I don't have a lot of extra time or money. I am a responsible participant in society. I vote. I pray. I love. I care about the people in my life. I think about what's best for others. And I always ALWAYS believe someone when they say they are in pain. We are looking to move, and I have to consider where I move based on the access to medication? This is so messy. I have pain. There is a solution that works for me, and has caused no side effects. Why is there even a question?<br/><br/>The use of MMEs as a standard for measuring is unfortunate. Those 3 letters shouldn't be used in the guidelines, NOR in the text. There is no definitive way to measure MMEs and not every person metabolizes equally. One size doesn't fit all.The mention of 50MME and 90MME thresholds have caused so much harm! Please remove any mention of MME from all guidelines and supporting text.<br/><br/>The use of a timeframe, or number of days, a patient can be prescribed for acute pain is also arbitrary. No quantitative limit should be placed - not 'a few days', nor a week, or 7 days. A doctor and their patient should be the only people making that decision. Please remove mention of that from all portions of guidelines and text.<br/><br/>There must be a plan and funding to de-implement the damaging 2016 guidelines. <br/><br/>Although CDC claims these were "just guidelines" arbitrary limits such as MME limits and 3,5, or 7 day limits are an issue because: <br/>Many state laws have been created based on them. <br/>They are worked into EHR (Electronic Health Records). <br/>Risk score algorithms such as NarxCare use them. <br/>CDC funded an extensive implementation plan for them. <br/>DEA also uses risk scores to flag doctors who "prescribe outside of the CDC Guidelines." <br/><br/>The Guidelines need to be redacted and redone due to bias and conflicts of interest (COI's). <br/>Dr. Roger Chou was involved in every aspect of the CDC Guidelines and has COI's. <br/>PROP members who were being paid by law firms involved in opioid litigation were involved with the Guidelines. <br/>Pain is not one condition and they need to mention there are MANY very painful conditions that might require opioids. <br/>Exclusions didn't work in 2016 and won't work now. <br/>You excluded "cancer pain" in 2016 Guidelines yet cancer patients have been affected. You added Sickle Cell Disease as an exclusion in these Guidelines, and thank you, but you also need to mention there are many painful diseases and conditions. Just saying "palliative care" patients are exempt won't help anyone. It didn't help in the 2016 Guidelines. <br/>There is no scientific basis for the distinction of cancer and noncancer pain.<br/>Mentioning some conditions and not others leads to a lack of individualized treatment plans.<br/><br/>I appreciate you allowing us to make comments and add our voices to the decisions being made around this. Truly!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb4b7f	Anonymous	None	2022-03-01T21:32:35Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l08-mk7z-iqfw	False	None	False	2022-04-12 03:16:04.119	[]
1709	CDC-2022-0024-1715	https://api.regulations.gov/v4/comments/CDC-2022-0024-1715	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [Name Redacted]. I have been a RN since 1994. The 2016 CDC guidelines caused me much harm. I pray the revisions help. Please don’t put a cap on MME of any number. Please remove that peace or repel the 2016 guidelines and start over. I’m going to tell my story. I was an ER nurse starting in 1995. I seriously injured my back saving a patients life. The patient did live. I required 3 back surgeries and started having chronic pain. My surgeon told my family I would alway be in pain. I worked hard the next 2 years just to go back to work. I did NOT get to go back to the ER. My life was forever changed. At the time I injured my back I was 30 years old. I still had a lot of life in me. I found a doctor who took me as his chronic pain patient. Over the next several years I was able to work, a desk job, but I could work as long as my doctor prescribed opioids. I followed all rules. After the 2016 CDC guidelines came out my doctor almost stopped treating me. If he had I would have committed suicide. I cannot live with untreated chronic pain. He kept me as a patient. BUT my insurance stopped covering my long acting medication. Once this happened I could no longer function. I had a small injury, stepped in a hole, and that plus no long acting medicine that worked well ended my career. The medication that is covered under insurance is one that never worked on me. I no longer have controlled pain because my doctor won’t increase my short acting pain medicine and insurance won’t cover the long acting opioid that works. The CDC guidelines cost me my career. I was a contributing member of society. I was a RN/ Transplant Coordinator for 18 years until the CDC guidelines ended my career. Please make sure these new guidelines address chronic pain patients better. Please do not put ANY limit on daily MME. it causes harm whether you think it does or not. It DOES! I pray you all have talked to chronic pain patients like me. I would be happy to help any way I can. I have a BSN and 25 years experience. My chronic pain should have never ended my career. It was controlled for 18 years until the CDC issued their 2016 guidelines. Please do better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484fb4ba6	Welch	None	2022-03-01T21:33:51Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Welch, Barbara	l08-mrmu-snew	False	None	False	2022-04-12 03:16:04.341	[]
1710	CDC-2022-0024-1716	https://api.regulations.gov/v4/comments/CDC-2022-0024-1716	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic back pain with neuropathy since 2003. Since that time, I have tried Physical Therapy, Exercise, multiple steroid injections, multiple medications, traction, stretching, acupressure and herbal remedies. I refused opioids for the first several years, until I could no longer stand long enough to brush my teeth or shower. Opioids make me nauseous and do not make me euphoric, but they allow me to meet my basic needs. Without them, I am in bed for most of the day. Since being tapered, I am home 98% of the time. My body is weaker and I suffered a compression fracture in 2 discs last year, and now believe I have another. My blood pressure spikes and I am on 2 meds which don’t control it well enough. I live in fear every month that I won’t get my monthly prescription for various reasons. Could be that the doctor hasn’t called them in, or called in a lower dose, or pharmacy is out of stock and I don’t drive, or I need a prior auth from insurance company. I have artery disease and am supposed to exercise but I can’t without the opioids. When I was on an adequate dose, I was able to walk around my home and my yard at least. Now, after 5–10 minutes, the pain is excruciating and I can’t do anything. <br/>I am asking that you allow doctors to prescribe what is necessary for chronic pain patients to be able to get out of bed. If doctors over prescribe, they should be held responsible. But I have been harmed by the limits and have more problems with my health now than ever before. I know I would not have a compression fracture in my back if I were in better shape. I also have low platelets due to taking so many Nsaids. My liver and kidney values are off now and I’m sure that is from taking Tylenol. I just want to be able to move a bit more and visit my family. This is a slow death and I am begging you to fix the problem. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb4bba	Anonymous	None	2022-03-01T21:34:57Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l08-n0wj-zger	False	None	False	2022-04-12 03:16:04.554	[]
1711	CDC-2022-0024-1717	https://api.regulations.gov/v4/comments/CDC-2022-0024-1717	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings,<br/><br/>I started my pain management regularly in 2015. My Dr. at the time was concerned and very adamant that he didn't feel this was the road we should go down. I said to him I agree, this is not what I want to do. <br/><br/>Since then I've had multiple surgeries on my right shoulder including two full replacement's. I've had one surgery on my lower back continue with multiple steroid shots. My left shoulder is now in need of a full replacement also. <br/><br/>I'm still in pain management with chronic pain in my left shoulder my lower back sometimes my right shoulder. My doctor has recently told me that he would be tapering me off pain medication. <br/><br/>I've already started looking for alternatives, my concern is that like everyone else I may go looking on the street for something similar to the medication I'm on now. With "deaths involving illicitly manufactured fentanyl on the rise. Overdose deaths involving synthetic opioids." I don't think it's right that patients are taken off their pain medication have to look elsewhere when they're under a doctor's care.<br/><br/>I'm not a patient that has a drug seeking behavioral problem. I proved that to all my doctors and they know I have legitimate pain and I'm telling the truth. I'm not interested in CBD or even smoke and marijuana, that won't help. I need to stay on the pain management regiment with [Name Redacted] in [Location Redacted] until the doctors can figure out all my physical problems and take the pain away. <br/><br/>Regards, [Name Redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484fb4bcc	Keebe	None	2022-03-01T21:36:49Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Keebe, Brian	l08-n5k8-k7ff	False	None	False	2022-04-12 03:16:04.766	[]
1712	CDC-2022-0024-1718	https://api.regulations.gov/v4/comments/CDC-2022-0024-1718	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since June 2006 from a car accident. My doctor of 12 years passed away in August 2018 in the middle of the so called "opioid crisis" (which was really illicit Fentanyl from China problem being made in underground pill mills) and after he passed away no one would really treat me or accept me as patient due to the high dose pain medication I was prescribed. I was mislabeled with opiate use disorder when I have legitimate injuries that make my every day life miserable. I had one doctor lie to me at [Location Redacted], his name is [Name Redacted]. He said there was a new pain medication called Suboxone he could prescribe me to try after being in bed in pain for 2 months waiting for an appointment after my doctor passed away. Ended up vomiting profusely 2 to 3 times an hour, for 24 hours and off and on 3 days after that with a swollen protruding abdominal region that looked like I was pregnant. I found out Suboxone is not pain medication it's for people addicted to opiates. So I have been without a doctor or any help for my medical issues since 2019 and just recently started seeing a new doctor and it's hard to get into any pain management doctor from [Name Redacted] offlabel prescribing Suboxone for pain and I do believe he should not be practicing medicine.. He is biased and judgemental. I am still looking for a pain doctor to see me, thankfully my doctor I have now gave me a small prescription of Norco so I have some sort of quality of life. It seems to me the DEA, CDC, and FDA wanted people to either die in pain or commit suicide, and I know people that have taken their life due to intractable pain... The main one responsible for all this is [Name Redacted], he has murderer thousands of people from his false opinion on opioids that legitimate chronic pain patients are addicts. [Name Redacted] deserves to be put in prison or his license pulled and a huge court settlement from all the deaths, pain and suffering with unlimited funds because every life is priceless... I would like medical help with my pain as well as the psychological damage that's been done not being able to trust doctors. I have Cervical Spondylitis, Cervical Radiculopathy, occipital neuralgia, cervicogenic headaches, discs flattening my spinal cord and impingement on nerve column, herniated discs, and L5 nerve root in my back is making contact causing sciatica, major nerve pain in my head, migraines, and on top of all this I am dealing with Complex-PTSD from being assaulted.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Justin	None	None	0900006484fb4beb	Beck	None	2022-03-01T23:37:33Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Beck, Justin	l08-myxy-vyys	False	None	False	2022-04-12 03:16:04.978	[]
1713	CDC-2022-0024-1719	https://api.regulations.gov/v4/comments/CDC-2022-0024-1719	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Where do I start? Our mother. If it wasn’t for the palliative care our mother received at the end of her journey here, yes, with morphine. The suffering and struggle she would have endured. Plus our family. It was bad enough to see her die.But Mother was peaceful when she was called home. We wouldn’t have had it any other way. Mother had severe RA and bone cancer. Her hands and feet became so deformed from the RA to the point of not being able to walk or feed herself. What pain meds she was allowed really wasn’t enough for her to enjoy the quality of life she did have because of the pain. My dear friend. Seeing her having to have major back surgery in the 70’s from scoliosis(age 16) , which included the titanium rod and other metal objects. Laying on her back in a body cast for approx. 9 months. Learning how to walk ,etc. all over. And now, her entire back is deteriorating so bad that she can barely function to do daily activities. Much worse now that some of her meds have either been taken away or cut back drastically. Technology has changed tremendously from +45-50 years ago. Major breakthroughs now but not then. When one gets established with a pain doctor that treats them with compassion and dignity with adequate pain medication plus monitoring, quality of life is much better. I’m not sure what she will face in the coming days/year if her medications are cut back any more than they have been. <br/>My other dear friend. Has fought cancer 3 times. Lymphoma took her leg from the knee down. Now In a wheelchair. She just turned 84 and lives alone. She asked her doctor for an increase in the NEUROTIN, which is a low dose she takes anyway. She has these “phantom pains”…nerve endings..the foot that isn’t there—itches. Denied. Another friend—2 major hip replacements. Takes a low dose of tramadol so he might sleep. Has a sciatic nerve. 3 failed nerve/tens(?)unit, approximately 4 nerve blocks…acupuncture. Nothing works.<br/>Doctor said he couldn’t increase. He hollers out sometimes, in pain. Yes..my friend is my husband. And I can’t do anything.<br/>Myself—stage 2 breast cancer. Complete mastectomy of one breast. Entire process. Partial hysterectomy. Red devil chemo, the bad stuff. Radiation. If it wasn’t for the adavan(I apologize for my spelling) when I took the chemo thru an IV, I don’t know. It helped me relax. Seeing all of the cancer patients fighting for the lives. It’s tough. Going thru all of the emotions. Losing my hair. Cut from one side to the other. How does one go thru life’s everyday tribulations, rather it be cancer or something broken to just major body breakdowns allowed to struggle with pain that is beyond their control? Chronic pain..that you deal with everyday..with no relief..no one to help..and no one who understands..but due to what others are doing illegally???? I, along with others, are being characterized into the same group. But yet, we are paying a higher price because we are the ones who are suffering, everyday. Doctors are not allowed to treat their patients the way they deserve to be treated for fear of jeopardizing their lifetime dedication to human life’s. We are losing loved ones to suicide. Rather it be them taking their own life because it has become unbearable or taking the wrong street drugs because again, meds have drastically cut back/taken away. I could go on and on. I just hope you walked a little in my shoes as you read this. This is people I know…including myself. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rhonda	None	None	0900006484fb4c10	Allen	None	2022-03-01T23:41:16Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Rhonda	l08-n7wm-vde2	False	None	False	2022-04-12 03:16:05.193	[]
1714	CDC-2022-0024-1720	https://api.regulations.gov/v4/comments/CDC-2022-0024-1720	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for your empathetic ear. I have been taking 20mg of Oxycontin ER twice per day for 22 years and God willing, I will take the same dose for the next 20 or 30 years. There is no fix for my broken body but because of this miracle medication I have been able to operate my company, with 25 employees, in the top 1 percentile nationally for my industry for the past 22 years because I can function at a pain level of 5 out of 10 every minute of everyday instead of a pain level 10 stuck in bed and in a wheel chair and have no life, possibly literally. Unless the CDC, DEA and FDA can fully realize that any legislation, no matter how well intentioned, can can have negative consequences and in turn, the needle can never be moved. Doctors taking a zero prescribing position for fear of loosing licenses has sent countless high functioning people of all walks to the streets for uncontrolled and unmonitored self dosing. Let good doctors be better doctors. The media has lumped pain patients into the same category as heroin addicts and has thus exacerbated the problem due to public perceptions of these miracle drugs. I have a dependency on a medication, not an addiction. Diabetics are no more addicted to insulin than I am to Oxycontin. We each are dependent on our respective treatments to survive and hopefully thrive. My medical condition is not important here, what is important is that the governing agencies understand they are creating street users and illicit drug addicts by forcing insurance companies, pharmacies and doctors to implement zero or highly limited dosing policies and in turn, law abiding citizens are forced to the streets. I pay $400.00 for my 30 day supply and I am fine with that because my personal situation allows me to do so without pause but I am probably an outlier. God forbid however that I should want to travel to Europe with my wife for 3 or 4 months in our retirement. Unless I want to fly home and see my doctor a few times during those months. Let good doctors be better doctors by allowing them to take a full person approach to practicing medicine. Currently, if a pain sufferer's doctor should retire or be too scarred to write appropriate prescriptions for a patient, you may only have to interview 15 or 20 doctors to find a new one that is willing to work with you for your health needs. That is not doctor shopping, it is simply finding a good doctor that is empathetic in his/her listening, compassionate in his/her caregiving and takes his/her oath to help patients seriously. I now have just such a doctor but only after interviewing 9 because my last doctor retired, and it is a blessing. Had I not found a good doctor, then what? Go to the streets? Live in pain from a wheel chair after such a full and successful life? Or just be thankful for the blessings I did have in my life and simply move on? <br/>While my comments may seem to come from anger, it is purely because I know what others are dealing with and that they may not have the blessings I have had in life. I can charter a jet home to see my doctor and get a fresh script filled if needed, most cannot and it is the frustrations they must feel and are dealing with that breaks my heart. Let good doctors be great doctors. Quit forcing mothers and fathers and sisters and brothers to the streets for medications. In any society, we will always have some people that are living life wrong but making the other 99% suffer with pain and tremendously unnecessary hoops to jump through for the 1% is not the answer. Treat the 1% as they need to be treated. One size fits all isn't working, it is making things worse. <br/>Thank you listening and for leaning an empathetic ear towards the concerns of all that are responding. If I can offer more, or testify, or help in any way please let me know.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484fb4c2e	Kruse	None	2022-03-01T23:45:36Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Kruse, Charles	l08-nppz-595g	False	None	False	2022-04-12 03:16:05.405	[]
1715	CDC-2022-0024-1721	https://api.regulations.gov/v4/comments/CDC-2022-0024-1721	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [Name Redacted], and I am from [Location Redacted] . I live with chronic pain, and have had opioids prescribed to help me manage it during the bad flareups and after necessary surgeries. Studies show that with active care and healthy management of the pain meds, it can help us survive as well as allowing us to participate in activities again instead of being bedridden. There is some good things about these guidelines, especially how it is finally showing acknowledgement of the layers of pain people can have. Some issues are discussed in the attached file. <br/><br/>Thank you greatly and have a nice day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Aidan	None	None	0900006484fb4c3e	Zingler	None	2022-03-01T23:48:03Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Zingler, Aidan	l08-nja5-d65p	False	None	False	2022-04-12 03:16:05.618	[]
1716	CDC-2022-0024-1722	https://api.regulations.gov/v4/comments/CDC-2022-0024-1722	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been a chronic pain patient for 13 years. I was able to have somewhat a "normal" life, still pain but manageable, until the new guidelines. I now am just able to do the minable in my life, no going on little travels, not even walking through a store, or I'm up all night with pain. I'm praying that the new guidelines remember that those of us that don't abuse our medication are still here waiting for our quality of life to be given back to us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patterson	None	None	0900006484fb4c44	Mary	None	2022-03-01T23:49:05Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Mary, Patterson	l08-nxgp-29v2	False	None	False	2022-04-12 03:16:05.846	[]
1717	CDC-2022-0024-1723	https://api.regulations.gov/v4/comments/CDC-2022-0024-1723	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a patient with chronic pain. I have Syringomyelia (SM) with my syrinx running from T3 to T11 at roughly 3mm. SM is similar to MS with the difference being SM damages from the inside out where as MS damages from the outside in. This means even the smallest syrinx can cause widespread symptoms. In consultations with pain management physicians, we feel my damage relates back to an automobile accident I had at 19 in 1987. It was a driver side impact and that can be seen with bone spurs and disc degeneration being left centered.<br/><br/>All this finally came to a head in 2015 with tachycardia from pain and possible cord damage. I also have GI involvement if I'm up longer than 30 minutes. This can be short or depending on how long I have ignored, recovery could be 3 days. <br/><br/>That is background for what I face. I'm on SSDI. I had to reach out to a pain management practice located some 60 miles from [Location Redacted]. They are in [Location Redacted]. I drive that every 2 months simply to keep them in the loop and continue with Tramadol, Cymbalta, Gabapentin, and Flexorel. That's the hardship the 2016 guidelines saddled me with. Filling scripts is easy except for Tramadol. [Hospital Redacted] wants to limit my usage at first file to 7 days as most CVS and Walgreen pharmacies do. I can't have that. So I pay out of pocket to Costco and keep a $6/month GoodRX Gold account active to cut that price down. <br/><br/>The 2016 guidelines have made my life Hell. My pain is here to stay. I have too much damage for even [Location Redacted] to try any surgery. So I have to jump through all these hoops so I can have anywhere from 50 to 70% relief from pain.<br/><br/>I'd like to see a relaxation of this for those in chronic pain. I shouldn't have to deal with CVS or Walgreens or my Medicare Advantage provider blocking access to my treatment. I shouldn't have to go every 2 months to pain management. MRIs over the last 4 years show no progression of the syrinx so I am managing myself and listening to my body. Once a quarter with pain management should be enough. I do that with my PCP, Infectious Disease, and Endocrinologist. And lastly, I shouldn't have to doctor shop. I should be able to get most of my care locally. <br/><br/>Once the new guidelines are in place, all parties need to be informed. Get the pharmacy and insurance providers out of my doctor's office. They should not be questioning what prescriptions the doctor and I have agreed to.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ROBERT	None	None	0900006484fb5195	BROWN	None	2022-03-01T23:52:12Z	None	None	1	None	2022-03-01T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from BROWN, ROBERT	l08-qnqd-1a2p	False	None	False	2022-04-12 03:16:06.062	[]
1718	CDC-2022-0024-1724	https://api.regulations.gov/v4/comments/CDC-2022-0024-1724	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached file.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	0900006484fa3ac6	Fuqua	None	2022-03-02T14:48:19Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-02-24T05:00:00Z	None	None	None	None	None	None	None	Comment from Fuqua, Anne	l01-qi3v-tgkk	False	None	False	2022-04-12 03:16:06.272	[]
1719	CDC-2022-0024-1725	https://api.regulations.gov/v4/comments/CDC-2022-0024-1725	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheri	None	None	0900006484f9e771	Mendes	None	2022-03-02T14:50:08Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-02-23T05:00:00Z	None	None	None	None	None	None	None	Comment from Mendes, Cheri	l00-6m2s-ww7c	False	None	False	2022-04-12 03:16:06.495	[]
1720	CDC-2022-0024-1726	https://api.regulations.gov/v4/comments/CDC-2022-0024-1726	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired physician. I am disabled. I also live with a severe chronic pain (CP) disease. I use morphine and I'm not an addict.<br/><br/>I'm probably chemically dependent, although I have had 2 periods where the CP disorder left for a while, and I stopped needing or using morphine at those times. I had no symptoms of withdrawal when I did, so even assuming chemical dependency lacks supporting evidence. However, one thing is clear - The treatment of pain is a human right. https://www.ncbi.nlm.nih.go...<br/><br/>Opiates have an extremely low rate of abuse among pain patients. This is identical to using insulin for diabetes - the patient needs to take it, and it isn't given the inappropriate label that opiates for severe pain have received. There is an unpleasantly large misunderstanding of the simple, appropriate treatment of pain. Such patients have an extremely low rate of abuse, and those who do - rarely more than 2% - have a history of recreational drug use.<br/>ttps://capitolweekly.net/he...<br/><br/>People who live with severe pain are not helped by yoga, mindfulness or vitamins unless the pain is managed first. In cases of mild to moderate pain, exercise, meditation, breathing exercises and diet are often enough to be effective forms of treatment. Unless and until we develop medications that are not opiates for severe pain, however, we are torturing a number of people for no sensible reason.<br/><br/>Opiates work. They have a low rate of abuse and a low rate of side effects among the severe pain populace. Those who live with severe pain only want to be treated effectively and to resume the lives they had before our culture became mindlessly opiaphobic. Opiates are not a horrible death sentence. They are an efficient and effective treatment that needs to be monitored and supported. The same is true for diabetes, Parkinsons, endometriosis, central sensitization syndrome, fibromyalgia and sickle cell disease - all of which may require opiate therapy.<br/><br/>Please stop categorizing severe chronic pain as if the opioid therapy doesn't work or is very dangerous. The deaths from overdose that involve opioids are predominately due to fentanyl, a synthetic opioid that is easily produced in a small illicit laboratory, most of which comes from China or Mexico, and heroin, mostly from Mexico. Legitimate pain patients aren't using street drugs, abusing their medications or otherwise harming themselves. But those severe cases that are forced off their effective medication are faced with three choices: 1. Live in extreme misery, unable to have even a semi-normal life, 2. Find and use dangerous street drugs or 3. Commit suicide. That option is on the rise among such patients. There is no rational reason to treat them so badly that they kill themselves, but this passes for normal treatment. The DEA is arresting honest doctors for using high levels of opiates for the most severe cases of pain, and this is inhuman.<br/><br/>We are not drug dealers, addicts or monsters. We just want to be allowed to live productive lives without irrational interference. It's not an unreasonable request.<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Emmett	None	None	0900006484fb51f5	Smith	None	2022-03-02T17:19:06Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Emmett	l08-rxn7-lqzo	False	None	False	2022-04-12 03:16:06.706	[]
1721	CDC-2022-0024-1727	https://api.regulations.gov/v4/comments/CDC-2022-0024-1727	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I apologize for a few typos in my first comment. Degenerative Diagnoses and it's 30 to 40 Percocet or Oxy lasted me 3 or 4 months. I could cry when I think back on all I was once able to accomplish in a day, but crying helps nothing. To realize there are others in even worse pain than I am, or there are Terminal Patients being forced to suffer until they exhale their last breath, is a horror and travesty! Also, I forgot to mention the lack of restful, restorative sleep due to PAIN. I've begged my PCP and Pain Management Drs. for 4 Restoril or generic Temazepam a month, so I could at least get 1 good night's sleep a week. Am told "I can't." Why are Chronic Pain Patients being treated as less than human? We're not addicts and we don't require treatment or recovery. Meanwhile, heroin addicts are mollycoddled, given methadone for their fake, made up by their addicted brains' "pain" and of course, they're allowed sleep medications CPP are denied! It seems to me and others like me, according to the CDC we should just up and die already. You don't care whether we have Quality of or participate in Life or die, slowly but surely and agonizingly. #PAINkills #ASPCHumans	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fb52fb	Adamson Curlis	None	2022-03-02T17:20:08Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Adamson Curlis, Donna	l08-wumv-1r2s	False	None	False	2022-04-12 03:16:06.958	[]
1722	CDC-2022-0024-1728	https://api.regulations.gov/v4/comments/CDC-2022-0024-1728	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 53 year old professional living in Galveston, Tx. I am begging to ask for a change in attitudes toward people in pain who need improved access to treatments. There are millions of people suffering from chronic pain, cancer and other debilitating ailments that cause severe pain and we are suffering and unable to receive proper medical treatment from our physicians. I am writing to you in hope that you can help with a matter that affects myself and a large number of your constituency.<br/><br/>I need help, I suffer and have suffered for years from severe chronic lower back and coccyx pain that is unbearable.  Some of the issues I have been diagnosed with are chronic pain disorder, lumbar spondylosis with narrowing disc space at every level, there are also anterior and posterior osteophytes at all bubbles, hypertrophic set arthropathy at all levels, degenerative disc disease, lumbar nerve root disorder and along with scoliosis (I honestly do not know what all of this means but I know how bad it hurts). I also had a gastric procedure which limits the kinds of medications I am able to take(such as ibuprofen, muscle relaxers, naproxen and nsaids). Long lasting, slow release medications do not work for me because nothing lasts longer then 3 hours in my system. I have had multiple appointments with neurosurgeons and other doctors to be told I have too much wrong with my back to have any surgical procedure. It cannot be emphasized enough and I've seen many, many highly-acclaimed surgeons, who are absolutely unanimous in what options I have. They've all said the same thing: Surgery is not an option for me and due to the nature of my conditions I should avoid any invasive procedures as they will make the pain worse. This includes spinal injections, radiofrequency ablation, spinal cord stimulators and pain pumps, to name a few. I have stacks of reports, cds and test results justifying my issues. I have had multiple injections with different medications, in multiple locations to cause further issues, drain my bank account, gain weight and still suffer in agony. Those injections have caused me permanent damage. My only option is pain management thru medication and doing physical therapy at home. I can not sit down for any length of time, lying down is excruciating and I can only stand for so long without my legs giving out. In addition, these days I have shooting pain down my leg when I sit. Sadly as much as a body needs rest...I can no longer rest comfortably. My quality of life is almost non-existent due to the debilitating pain and without access to adequate pain relief I have contemplated if the daily struggle is actually worth it.<br/><br/>My pain has caused me to miss out on daily activities and has become extremely detrimental to my quality of life. I have missed family functions, and important events in my children’s and grandchildren’s lives. I have suffered with this debilitating affliction because I feel that I have been discriminated against by doctors and members of the medical community that have been hamstrung by legislation designed to combat the “opioid crisis”. This crisis made doctors fearful of prescribing medication that significantly improves their patient’s quality of life. There have been cases in which doctors are named in medical malpractice suits or even wrongful death suits based on the prescriptions they wrote for their patients. These outcomes have made even legitimate prescriptions seem like too much of a risk for some physicians. The lack of clear guidelines leads many doctors to become more conservative with pain medication than they need to be. This has caused patients that legitimately need these medications to have their medication dosages decreased or cut off completely. This in turn creates another problem that causes otherwise law abiding citizens to seek illicit drugs from the street and drug traffickers. Doctors have increasingly been tightening their standards for opioid prescriptions as the crisis worsens and more regulations are introduced at state and federal levels. Refusal to prescribe pain medication leads to unnecessary suffering. It is becoming more commonplace for physicians to under prescribe medication for fear of litigation. Chronic pain is something every physician should take seriously without fear of repercussions from the DEA or litigation so their patients can be treated humanely. <br/><br/>When people are not able to get their medication from the proper channels they will seek options from the street with hope of finding some relief. Pain relief is a human right and without relief people will end their lives. Living with debilitating pain you have little quality of life and no desire to wake up in the morning. I am suffering severely and sadly need medication to be a functioning adult. I know I will never be pain free but any pain relief is welcomed. Please, please for the love of God stop punishing the patients and the medical professionals trying to help them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484fb57e0	Ravelli	None	2022-03-02T17:30:11Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Ravelli, Lori	l08-xil6-q862	False	None	False	2022-04-12 03:16:07.174	[]
1723	CDC-2022-0024-1729	https://api.regulations.gov/v4/comments/CDC-2022-0024-1729	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've suffered from chronic pain since 2006 and have repeatedly been denied the opiod medications for me to function productively. Since reducing my opioid medication I have had to file for Social Security Disability and can no longer work. If the medication I need to cope with my pain were available to me I could resume work and be productive instead of relying on benefits from the government. I should have the opiod medication which helps me to have a reasonable quality of life. Not suffering with terrible pain and left to wonder if the life I have now should continue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484fb57f4	Dempsey	None	2022-03-02T17:30:29Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Dempsey , Tracy	l08-xr4d-c9ou	False	None	False	2022-04-12 03:16:07.395	[]
1724	CDC-2022-0024-1730	https://api.regulations.gov/v4/comments/CDC-2022-0024-1730	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People who are in chronic pain require their doctor to be freed from the restrictive rules currently in place for opiate prescription. Please allow the private doctor/patient relationship to determine the best form of pain relief. Do not penalize doctors for taking good care of their patients. Do not force suffering patients to make the difficult choice of either going outside of the law for pain relief from dangerous, likely adulterated substances, or else suffering in agony. The relatively few physicians who take advantage of their prescription writing privilege can easily be spotted and stopped, without jeopardizing the lives and livelihoods of physicians who are doing the work of properly caring for their patients. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484fb5393	Fox	None	2022-03-02T17:31:02Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Fox, Cheryl	l09-1io4-dijo	False	None	False	2022-04-12 03:16:07.603	[]
1725	CDC-2022-0024-1731	https://api.regulations.gov/v4/comments/CDC-2022-0024-1731	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why would you keep guidelines in place that have caused all harm and no benefit? What good have you caused? My father is in pain all day & although he’ll never say so he doesn’t need to, he can hardly walk, his stomach has a large hernia from the incision site after kidney removal. He is refusing surgery to insert mesh into his stomach. You’re guidelines are inhuman and I’m not sure how it’s even legal to cause harm without consequence. My father isn’t prescribed pain medicine, not even after discharging him after kidney removal. He’s hurting because of government. FYI nobody trusts the CDC or DEA, only fear you that’s a fact .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb53a5	Anonymous	None	2022-03-02T17:31:29Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l09-1qj7-z1qs	False	None	False	2022-04-12 03:16:07.823	[]
1726	CDC-2022-0024-1732	https://api.regulations.gov/v4/comments/CDC-2022-0024-1732	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t believe your guidelines for prescribing opioids is in the best interest of the American public. Not every individuals response to a medication is the same. Your recommendations are harmful to patients who need help. You have physicians afraid to practice medicine and are harming patients by following your guidelines and fears of losing their license. Medications are not a one size fits all. Let the DEA monitor physician prescribing habits and you let physicians do their jobs. Focus on controlling the true opioid addiction problems heroin and fentanyl. Do you guidelines have applications for increased suicide rates? For insurance to pay polices for suicides for people who can’t get their chronic pain treated? My daughter can’t get help. Her doctors response you could go find street drugs to help you. Is this your goal? To have patients seek out street drugs for help? <br/>I don’t believe your guidelines embrace that no disease, diagnosis, or medication is one size fits all and that is what I believe your guidelines imply.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paula	None	None	0900006484fb53a8	Rickard	None	2022-03-02T17:34:03Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Rickard, Paula	l09-1sng-m9ro	False	None	False	2022-04-12 03:16:08.050	[]
1727	CDC-2022-0024-1733	https://api.regulations.gov/v4/comments/CDC-2022-0024-1733	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Being born with Spina bifida and having tumors removed from the Defect I've been in pain for decades my doctor finally put me on hydrocodon and methadone because I couldn't afford the oxycontin and it worked perfectly I could work I could function like a normal person and after 20 years a politician decides I'm a dope addict the Government needs to deal with other things like the economy or the border where the illegal narcotics are coming across and stop worrying about my agony being 60 yrs old let me deal with my Dr and vise versa.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fb53ab	Miller	None	2022-03-02T17:34:34Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from Miller, Richard	l09-1v3l-r52n	False	None	False	2022-04-12 03:16:08.261	[]
1728	CDC-2022-0024-1734	https://api.regulations.gov/v4/comments/CDC-2022-0024-1734	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in ND. I moved here in [month and date redacted]. At my initial new PCP appointment the first thing the nurse asked me, 'Are you using a Fentanyl patch?' I wasn't. The next thing she said as she read my intake info, 'The dr will never prescribe you opioids.' At the time I didn't understand because I am a Chronic Pain Patient, a legacy pain patient, prescribed opioids as part of my management. I figured once I met the dr and she reviewed my files and examined me she would understand I'm not a drug seeker and I have PM documentation from 2016 to present that includes all urine tests, invasive procedures and pain history. <br/>Sadly the dr didn't even listen to my heart or lungs. And that was it. I figured I chose the wrong dr.<br/><br/>I did receive BP refills. Then I had emergency surgery on my spine in [month and year redacted]. The surgical nurse made certain to tell me she will never prescribe morphine. She discharged me with a prescription of percocet sent to my pharmacy. I contacted the pharmacy and told them the situation. I was still under the care of my former pain specialist via zoom due to Covid. I made sure to explain to hold my new pain prescription bc I wouldn't be filling it for one month.When I tried to fill it the pharmacy told me it had been cancelled.??? Now I was 64 at the time and I'm an educated woman and that seemed like funny business to me particularly bc the last pain prescription filled had 12 tablets missing along with several broken tablets. When I reported it to the pharmacy they blamed me saying I dropped it. I did not.<br/><br/>In June 2021, post surgery, I switched to a different PCP. [doctor name redacted]. During my first visit he told me to drop my pain dr and rescind my pain contract bc he would see to my pain. The second visit with him he humiliated me, shamed me, embarrassed me, called me an addict, referred to my past dr as being a very bad physician, told me my pain was in my brain because my wiring was off. I asked why he lied to me at the first visit and he explained he wanted to avoid any disagreement. He did not wean me down but gave me ten 5mg hydrocodone. I was taking Percocet 10/325 five times a day for breakthrough pain and 10 mg Morphine sulfate for long time relief.I feared a heart attack or other complication from the haphazard way it was handled. I lost a kidney to cancer in 2011 and my specialists warned me no more NSAIDS (hence I became a chronic pain patient). [Doctor name redacted] insisted I return to NSAIDS (low dose) with weekly monitoring via urine samples. This was post surgery. So not only did I have my 'normal' pain but now I had new pain from cauda equina syndrome.He referred me to a pain clinic and they wanted to do an invasive procedure on my spine. I explained Id just had surgery and really wanted to get my meds back. <br/><br/>So I'm now 65 yoa, disabled and have no pain control.My days consist of a recliner and my bed. I hold off on showering, food shopping, walking outside, cleaning house, doing laundry...bc I will hurt too much with no relief. I have an extremely low quality of life.Sometimes I wonder if all the pain is worth living through. Please include a separate guideline for chronic pain patients. And the MME dosage should also be omitted for others like me. Many good drs are claiming fear of losing their license if they help a hurting patient. Suboxone is highly addictive and mood altering as is buponephrine. Those meds are for addicts to stay off heroin not for pain control. I don't understand how street users get free methadone/needles/crack kits yet true suffering goes on affecting millions.I am willing to speak to any of your experts and explain that you're being misled by drs who don't believe in the Hippocratic Oath.Sincerely, [Name and number redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	cynthia	None	None	0900006484fb53d8	thomas	None	2022-03-02T17:42:13Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-01T05:00:00Z	None	None	None	None	None	None	None	Comment from thomas, cynthia	l09-35ug-8hpn	False	None	False	2022-04-12 03:16:08.469	[]
1729	CDC-2022-0024-1735	https://api.regulations.gov/v4/comments/CDC-2022-0024-1735	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Yes Accupuncture is amazing! Please let this be a covered by insurance thing. I have seen it work wonders for several of my patients. I’m an OT and have worked with a lot of chronic pain patients and they say that it is crappy and most of them get better relief from pain with that rather than narcotics which lose efficacy with chronic use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Olivia	None	None	0900006484fb53f6	Martinez	None	2022-03-02T17:42:39Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Martinez, Olivia	l09-495n-3qch	False	None	False	2022-04-12 03:16:08.705	[]
1730	CDC-2022-0024-1736	https://api.regulations.gov/v4/comments/CDC-2022-0024-1736	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Yes Accupuncture is amazing! Please let this be a covered by insurance thing. I have seen it work wonders for several of my patients. I’m an OT and have worked with a lot of chronic pain patients and they say that it is crappy and most of them get better relief from pain with that rather than narcotics which lose efficacy with chronic use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Olivia	None	None	0900006484fb53f7	Martinez	None	2022-03-02T17:43:01Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Martinez, Olivia	l09-495z-evk1	False	None	False	2022-04-12 03:16:08.913	[]
1731	CDC-2022-0024-1737	https://api.regulations.gov/v4/comments/CDC-2022-0024-1737	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Testing	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb540a	Anonymous	None	2022-03-02T17:43:24Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l09-568y-36pf	False	None	False	2022-04-12 03:16:09.133	[]
1732	CDC-2022-0024-1738	https://api.regulations.gov/v4/comments/CDC-2022-0024-1738	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on an opioid pain management for over 5 years. While I would love not to have to be on any medication I do not have that luxury. I am currently at the max dose of 90 mg per day. I have been at this level for approximately 2 years and are starting to feel the need to boost the amount to keep me not necessarily pain free but where I am able to manage my pain and have some kind of active life style. There are times when I do run out early and have to endure the withdrawal symptoms for 2 to three days which are hell in themselves plus the pain on top. I do not go out looking for drugs illegally or try and supplement with alcohol or other methods. I have a family including my wife and 2 young teenage children that understand and try and help me through these periods if they do happen. They do not happen every month. That veing said being able to have an increase in my medication that would allow for better pain relief and remove the need to take more than prescribed would be life changing . Unfortunately these drugs have been abused by some but I believe doctors at least my doctor knows his patients and can differentiate the abusers to the ones who are truly in need. After 6 months to a year it seems like dosage needs to be adjusted and some who have been on these for a number of years will go way above the current 90 mg per day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb59bc	Anonymous	None	2022-03-02T17:44:11Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l09-76gh-uj3r	False	None	False	2022-04-12 03:16:09.364	[]
1733	CDC-2022-0024-1739	https://api.regulations.gov/v4/comments/CDC-2022-0024-1739	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern:<br/>I have been battling chronic pain from many autoimmune diseases for 20 years. I was 18 when they started. I am a very complicated case due to my many conditions contributing to my pain. All of my illness have no cure and I have not been able to control the symptoms enough with biologics or other medications. <br/><br/>I can’t tell you what a nightmare it has been for me. The CDC’s pain medication guidelines have done permanent harm to many pain patients, including myself. I have gotten much worse physically the last few years. I have been bedridden and lost so much daily functioning from the pain. I have had some terrifying emergencies and years of awful pain, but this has become indescribable. <br/><br/>I have been with my pain doctor for over 15 years and he knows my integrity and strength. I’m proud to say that I have never run out of a medication early (in all my 20 years of being so sick). I bet most pain patients know how to manage their meds. Anyway, his pain practice now has a company wide policy and will only give a very small dose of pain medication (and nothing higher for any patient) because they want to cover their ass. Unfortunately, I am not a one size fits all and that tiny dose does not do much for me because of my many diseases, but also because I am an ultra-rapid metabolizer. My liver chews through medicine so I usually need higher and more frequent doses than most people. It is a terrible thing to have as a chronically ill patient. I’d always rather be on as little medication as possible. I finally realized I need to find a new pain doctor because of this across the board limit on meds. My 15 year rapport is useless now bc of what the CDC started. I called many pain doctors in my area and they wouldn’t even make an appointment with me because I’m on low dose pain medication and they say they don’t prescribe pain medicine anymore. How are they pain doctors? What am I going to do? My child says she misses her mom because I can’t get out of bed or even do things with her while laying down because the pain level is too high. <br/><br/>I honestly have no idea how people and doctors care more about 200,000 dead drug addicts than pain patients trying to eek out a life beyond pain. The drug addicts only take away from society in so many ways. Who cares if they die?! They chose to misuse medication (legal or illegal) because they cared more about getting high than their life, while I fight desperately to get a shred of my life. This is unfair. How do 200,000 drug abusers matter more than millions of tragically, unlucky disabled people? I can’t imagine what the rate of suicide is after they created this mess. If the CDC and doctors had a prolonged pain experience, they would be shocked at the level of pain that we have had to endure.<br/><br/>I don’t have any hope and would rather give up on this messed up life. That isn’t an option though because I have a child with a brain tumor who will need surgery and will have significant deficits after. We are in the watch and wait period, the best time we will ever have. Instead of quality time, I am writhing in bed everyday and can’t do anything now. I did not get to see my child at all the last 3 days. I am so scared because I don’t know how I can endure this. My husband wants his wife back and my poor child misses me. <br/><br/>I don’t understand why my pain doctor thinks he has any risk regarding my care. I have a documented 20 year medical history, so the DEA wouldn’t/shouldn’t criticize them. Also, if I die (it would not be from too much medicine bc I know the high doses I was on many years ago and 40 pounds lighter), my whole family would be happy for me that I can finally have peace. <br/><br/>I urge you to please stop this so more damage isn’t done. Please help us. Someone should. <br/><br/>It would be great if someone could get ARISA laws repealed too. Insurance companies are unethically denying so much medical coverage and I am too sick to fight them on it. That would be a full time job. Their denials are crazy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb59e2	Anonymous	None	2022-03-02T17:47:50Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l09-dmee-lipf	False	None	False	2022-04-12 03:16:09.576	[]
1734	CDC-2022-0024-1740	https://api.regulations.gov/v4/comments/CDC-2022-0024-1740	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am totally sick of hearing the CDS’s opinions on what qualifies a person with chronic pain. How about using science and available data instead of opinions. The CDC does not consider chronic pain as a viable just disease, just a symptom of a medical injury or other disease. The human body does not distinguish between chronic pain from sickle cell, cancer, end of life issues, or chronic pain from an injury or disease. The CDC keeps making assumptions that a person with chronic pain from cancer deserves preferential treatment more than a person who suffers from chronic pain because of degenerative disc disease or a prior botched surgery. From the beginning, the CDC has solely used its position and authority to downplay the use of opioids for chronic pain management and control. Because of the CDC’s opinions about chronic pain, it has caused responsible patients to needlessly endure unnecessary pain and suffering. The FDA and MMA, has voiced their concerns about thousands of chronic pain patients who were abandoned, cut off, and forced tapered. It has been over six years since the CDC 2016 Guideline was published and forced upon chronic pain patients and medical clinicians. I have personally reviewed the CDC draft that is currently on the Federal Register for public comments. In a nutshell, nothing has really changed for the better, especially for suffering chronic pain patients. The only thing that has definitely changed, is the increase in opioid overdose deaths, increased suffering and torture of chronic pain patients, doctors being unjustly targeted by the DEA, and an increase in suicides by chronic pain patients who have lost all hope in being able to live a productive life free from unrelenting daily chronic pain. As a retired US Marine, who suffers from high impact chronic pain, and who was negatively affected by the CDC 2016 Guideline, I have lost all faith, respect, and trust in anything that the CDC has to say or recommend. How a government agency was/is allowed to force its biased unscientific garbage upon citizens of the US, is totally beyond comprehension and understanding! The CDC, got involved in a critical medical issue, that it had no right getting involved with.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484fb59e4	Collins	None	2022-03-02T17:48:59Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Larry	l09-dsyn-l9zm	False	None	False	2022-04-12 03:16:09.788	[]
1735	CDC-2022-0024-1741	https://api.regulations.gov/v4/comments/CDC-2022-0024-1741	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I beg you to allow opioid prescriptions for seniors who have been diagnosed with conditions that are very painful to live with. My wife, 71 years old, has pain constantly that was kept under check with hydrocodone pills, is now experiencing pain constantly thanks to being cut off completely from the effective pills. You can’t know how bad this is for our lives. She has told me that she is considering suicide. She has never, not once, taken any illegal drugs, not even alcohol or cannabis. This is how our country treats it’s law abiding seniors who have extreme pain with little relief.<br/>She was given pain patches, which do little. What are we going to do?<br/>We had a comfortable retirement for years, and now it seems like hell. Please help people like her. I wish lawmakers could temporarily experience the debilitating effects of constant, unrelieved pain. I think then the laws would be changed. We have been married 50 years, and now we wait for death to free us from this pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb59fd	Anonymous	None	2022-03-02T18:01:45Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l09-gqhh-pcx5	False	None	False	2022-04-12 03:16:10.002	[]
1736	CDC-2022-0024-1742	https://api.regulations.gov/v4/comments/CDC-2022-0024-1742	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for 21 years. Currently I'm seeing a pain management specialist that is starting to push procedures on me because he is terrified of the DEA arresting him for treating patients with opiates. Even though I have never abused my medication and I pass every drug screen I'm given I'm still at the mercy of the CDC guidelines that's scaring doctors who properly treat patients. I don't have insurance to afford the procedures and I also have heard horror stories from other chronic pain patients about the non FDA approved procedures. Those of us that take our medication properly are being treated like criminals because 11k people have overdosed on their medications. While that number is too high it absolutely should not effect chronic pain patients. We aren't responsible for what other people do. I whole heartedly disagree with the CDC being involved with doctor/patient relationships. The new draft lowered the MME from 90 to 50 which is NOT helpful for a lot of people. Tolerance is something we can't avoid after taking our medication for long periods of time. The CDC shouldn't be able to dictate what dosage of medication is right for a patient. This has gotten so out of hand that even surgeons aren't treating patients after surgeries and the patients are suffering from no fault of their own. I was happy to find out that the guidelines had changed but after reading it I realized it is no better than it was. There is a suggestion for physical therapy before ever prescribing opiates. Anyone that has experienced the amount of pain a lot of us are in could never do PT without medications. It is far too painful. We want nothing more than to have a cure for our problems but that's not the case so the best treatment is FDA approved opiates. Without them I would have no quality of life. I would have to quit my job and lose everything while fighting for disability and at my age that would take years. Please stop punishing chronic pain patients for an epidemic that has nothing to do with us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484fb58af	Blackburn	None	2022-03-02T18:04:46Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Blackburn, Stephanie	l09-j505-fikw	False	None	False	2022-04-12 03:16:10.212	[]
1737	CDC-2022-0024-1743	https://api.regulations.gov/v4/comments/CDC-2022-0024-1743	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I demand the public withdrawal of the 2016 Guidelines on grounds that these documents are flawed by weak medical evidence, naive and uncritical anti-opioid bias, gross exaggeration of opioid treatment risks, incorporation of junk science, and misrepresentation of the efficacy and safety of non-opioid alternative therapies. Additionally, the US CDC has no legal charter to set practice standards for opioid therapies or any other therapies other than infectious disease. Such standards are best developed by professional medical associations and academies whose membership actually treats patients."	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Douglas	None	None	0900006484fb6232	Genesi	None	2022-03-02T18:05:32Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Genesi, Douglas	l09-nmtm-2h54	False	None	False	2022-04-12 03:16:10.421	[]
1738	CDC-2022-0024-1744	https://api.regulations.gov/v4/comments/CDC-2022-0024-1744	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an RN and I struggle seeing patients suffer for the last several years since this fake opioid crisis started. The Dr.’s can’t even assess and prescribe appropriate pain medication because of addicts. So cancer patients, arthritis sufferers, fibromyalgia, etc all of these patients with real pain are suffering because of addicts and people selling their meds illegally. Why are they not allowing MDs and NPs to do their jobs and punishing people who are really hurt? You have these addicts that have never worked a day in their lives on disability for pain that doesn’t exist getting legal meds and supplementing it with alcohol and street drugs and they OD and society and really hurt patients suffer. These beaurocrats and millionaire lawmakers like Trump and Pelosi that never had to work in a factory or move around morbidly obese patients without proper staff get to take pain meds away from the injured working class. In the mean time I see welfare queens with baggies full of a buffet of meds because doctors can’t say no to them that would look racist! Seems like getting pain meds, free medical or Medicaid and disability is for illegals and the non working scam artists. I am sick of watching the fraud and abuse while having to care for these scum bags and get abused by them. This entitled society has gone overboard. We are pushing really hurt and sick people to suicide and or unsafe street drugs. Lawmakers, doctors and pharmacists should do their jobs. Judging the working poor and treating them like shit and looking down on them forcing them to beg for proper pain management and bankrupt themselves by having duplicate tests and multiple doctors and referrals to prove they are hurt is very insulting. I see why healthcare professionals keep quitting we are powerless, not supported, not respected, and you are forcing us to be negligent and to not practice by our oath. The industry is all about money you don’t care about sick or suffering people. The CDC, AMA etc are all a scam. Nobody gives a shit about our suffering. Addicts and those abusing the entitlement systems are the only ones benefiting from any of these BS laws. The welfare queen across the street has her son peddling weed and heroin, she is on section 8, food stamps, works for the city, and doesn’t pay taxes, but guess what she gets her pain meds. BS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hanah	None	None	0900006484fb6234	Thorner	None	2022-03-02T18:08:04Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Thorner, Hanah	l09-nvwf-wxgh	False	None	False	2022-04-12 03:16:10.638	[]
1739	CDC-2022-0024-1745	https://api.regulations.gov/v4/comments/CDC-2022-0024-1745	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an RN and I struggle seeing patients suffer for the last several years since this fake opioid crisis started. The Dr.’s can’t even assess and prescribe appropriate pain medication because of addicts. So cancer patients, arthritis sufferers, fibromyalgia, etc all of these patients with real pain are suffering because of addicts and people selling their meds illegally. Why are they not allowing MDs and NPs to do their jobs and punishing people who are really hurt? You have these addicts that have never worked a day in their lives on disability for pain that doesn’t exist getting legal meds and supplementing it with alcohol and street drugs and they OD and society and really hurt patients suffer. These beaurocrats and millionaire lawmakers like Trump and Pelosi that never had to work in a factory or move around morbidly obese patients without proper staff get to take pain meds away from the injured working class. In the mean time I see welfare queens with baggies full of a buffet of meds because doctors can’t say no to them that would look racist! Seems like getting pain meds, free medical or Medicaid and disability is for illegals and the non working scam artists. I am sick of watching the fraud and abuse while having to care for these scum bags and get abused by them. This entitled society has gone overboard. We are pushing really hurt and sick people to suicide and or unsafe street drugs. Lawmakers, doctors and pharmacists should do their jobs. Judging the working poor and treating them like shit and looking down on them forcing them to beg for proper pain management and bankrupt themselves by having duplicate tests and multiple doctors and referrals to prove they are hurt is very insulting. I see why healthcare professionals keep quitting we are powerless, not supported, not respected, and you are forcing us to be negligent and to not practice by our oath. The industry is all about money you don’t care about sick or suffering people. The CDC, AMA etc are all a scam. Nobody gives a shit about our suffering. Addicts and those abusing the entitlement systems are the only ones benefiting from any of these BS laws. The welfare queen across the street has her son peddling weed and heroin, she is on section 8, food stamps, works for the city, and doesn’t pay taxes, but guess what she gets her pain meds. BS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hanah	None	None	0900006484fb6235	Thorner	None	2022-03-02T18:08:27Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Thorner, Hanah	l09-nvz6-gy1g	False	None	False	2022-04-12 03:16:10.868	[]
1740	CDC-2022-0024-1746	https://api.regulations.gov/v4/comments/CDC-2022-0024-1746	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to submit as a care giver and wife of a patientwith chronicpaindue to massive chemo, radiationandhas had 2 stem cell transplants. The CDC guidelines were not written by or even included Drs and patients that deal with Chronic Pain. They exnore the consequences of long term severe pain. They exore the serious side effects and adverse reactions to alternatives to opioid pain medication. The mme are not based on science.... The government should never have the right to condem my husband or others to severe pain, all of its conquest. You are leaving patients with suicide as the only option left to escape a living hell. In my husband's case if his pain is not controlled he goes from totally independent to bed ridden, in pain. Flares his gva cousing more pain, severe abdominal cramps, uncomfortable diarrhea, internal and external rash, can't eat or drink, can't communicate do to pain. Alternatives almost killed his.. So the only option we have left, if he loses his medication again is suicide. It is redicules that we even have to consider suicide, when he has excellent quality of life on prescribed opioids... The CDC has chosen to deliberately torture and kill disabled patients. This is a true crime against people with disabilities.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484fb62c0	Winterroth	None	2022-03-02T18:10:06Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Winterroth, Debra	l09-oyxx-y5ri	False	None	False	2022-04-12 03:16:11.094	[]
1741	CDC-2022-0024-1747	https://api.regulations.gov/v4/comments/CDC-2022-0024-1747	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a family doctor and addiction medicine specialist. In response to the 2016 guidelines, primary care physicians were shamed, blamed and punished for prescribing opioids, whether appropriately (in retrospect, per the new guidelines) or not. Pill mills were shut down, but at the cost of increased suffering for legitimate low risk patients, and burnout for the primary care physicians to whom chronic pain management has been relegated. It was a struggle to find the behavioral resources and ancillary care needed to treat chronic pain effectively, without opioids. <br/><br/>I expect that the new guidelines will be helpful in rural settings where pain management specialists and comprehensive programs are not available, but they are not enough to cause me to re-think the self-preservation we have needed to develop in primary care. The guideline refers to "clinicians", but this group is diverse. Data indicates, as is stated in the guideline, that opioids should be a last-resort, unusual adjunct to treatment for chronic pain. In my urban community where pain medicine specialists abound, I don't see justification in the guidelines for me or the residents I teach to expand our chronic opioid prescribing, except for patients with opioid use disorder, who benefit from office-based treatment with buprenorphine/naloxone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sybil	None	None	0900006484fb62f2	Marsh	None	2022-03-02T18:11:43Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Marsh , Sybil	l09-pbkv-uymp	False	None	False	2022-04-12 03:16:11.337	[]
1742	CDC-2022-0024-1748	https://api.regulations.gov/v4/comments/CDC-2022-0024-1748	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a physician in my 43rd. year of practice. During that time I've seen the narcotics pendulum swing from one extreme - not prescribing narcotics for terminal cancer pain because of "risk of addiction" in the 1970s to the other extreme "everyone with a little twinge needs unlimited Oxycontin" in the 1990s, back to the other extreme "no more than three days narcotics for a broken leg" today. I doubt that if I live to 105 I will ever seen the pendulum stop in the reasonable middle, which I believe is:<br/><br/>1. Narcotics are dangerous - there is NO WAY to prescribe them with perfect safety.<br/>2. Prescribing narcotics for chronic pain is WRONG.<br/>3. Prescribing a reasonable amount of narcotics for a reasonable period of time for acute pain, while monitoring the patient is the best we can do.<br/>4. "Pain Management" as a medical specialty is one of the silliest things I've seen during my career.<br/>5. The "Pain Scale" is a sham and a humbug devised by the Sackler family to sell more of their Satanic pills, and should be abandoned.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fb633c	Foster	None	2022-03-02T18:12:34Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Foster, John	l09-pt15-8qqw	False	None	False	2022-04-12 03:16:11.547	[]
1743	CDC-2022-0024-1749	https://api.regulations.gov/v4/comments/CDC-2022-0024-1749	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for over 20 years under the care of a pain clinic doctor who previously also was the administrator over the anesthesiology department at a hospital. I want to point that out so it’s clear the level of knowledge and experience my doctor has. I was in a motorcycle accident when I was 13, have had over 30 surgeries from my hips down throughout my body, including bones, arteries, skin grafts etc. My leg is 3/4” shorter from the other due to accident, I have a broken coccyx, and pain has also affected lower back from walking on an angle, even with a lift, after all these years. In 2000 I started going to pain clinic, which in those times took more than three months to get into. My family doctor had already sent me for steroid shots, tried anti-inflammatory medication, and muscle relaxers. It was so severe that I spent one month alone in the emergency room 20 different days and was admitted twice for pain control. The only thing that worked was opiates. That enabled me to raise my four children and work. Over the years, my medications changed and increased due to pain levels increasing. The medicine I took still enabled me to live as much of a normal life as possible. <br/>Then came the opiate law mandated changes around 2018. The medicine I took was way above the new opiate daily allowed amount. My doctor had been preparing me mentally for the changes in advance and the fear it put on me was unbelievable. I thought how will I live in the type of pain that I’m going to have to live in without the medicine I need. As I was going through the process of the medicine being reduced more and more my life was on the couch or bed everyday more and more. I could not eat, sleep, or think. When the pain is that great there is nothing accept pain that doesn’t stop. I again tried anything and everything. I would have to go the emergency rooms again to get iv treatments to reduce the pain for a couple hours. The Medicine I had wasn’t enough any longer to maintain the pain control. At this point, I was ready to move to another state where I would fit into the exception category so I could receive the medication I needed. No one should be put in that predicament. The medication was there to treat me to enable me to have a normal life, but the law said I couldn’t have it. Pain patients have to take monthly urine tests to make sure they are following the proper medicine regiment, be seen monthly, and agree to many other rules and policies. Patients who follow the proper protocol should not be put that type of pain because others break the law, misuse medicine, or steal to get it. I have always said dealing with pain and the medicine needed should be compared to a diabetic or heart patient. You need it to survive, to have a daily life and be a productive citizen. It’s not to get high and have a party. <br/>Due to the suffering and medicine no longer being an option, a spinal cord stimulator was approved for me to have surgically implanted. It must be upgraded and changed every ten years. I need to charge it every other day, and I still need pain medication along with it. <br/>I would like to add that each person has a different pain management scenario, but for people living with a life long pain condition, it cannot be compared to people who are having a surgery or short term condition. No matter what medication a person is on side effects are a truth. Each person needs to decide how to weigh the facts. Also, pain doctors are specialists. They are anesthesiologists who know <br/>More about pain medicine and the treatment for it. A law cannot and should not confine a doctor from prescribing what he or she knows their patient needs. Each patient is different and their pain doctor knows their situation. <br/>I also am a certified counselor and counseled other pain patients. Besides my own situation I have watched so many people suffer due to the pain medicine laws. It’s personally been life altering and watching others suffer has been too. A book of numbers and placing pain people in with outside situations is unacceptable. I hope this gets to someone who truly cares about how these laws have affected pain patients. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484fb63d1	Dingess	None	2022-03-02T18:16:21Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Dingess, Brenda	l09-qrha-qgnx	False	None	False	2022-04-12 03:16:11.768	[]
1744	CDC-2022-0024-1750	https://api.regulations.gov/v4/comments/CDC-2022-0024-1750	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The changes in the guidelines are a must. Intractable/Chronic Pain Patients deserve medical treatment without judgement. Prior recommendations which have been taken as law has caused irreparable damage to those who could no longer live in pain and their families. The supposed guidelines have created a divide between Dr's and their patients, Pharmacies, and Insurance. Those forced to live in pain are now considered suspect, malingerers, fakers even when medical tests prove otherwise. We ask that that regulations be modified to stop the persecution of all being monitored by the DEA. Law Enforcement does not have a medical degree nor do they have a place in treatment. Allow Dr's to treat patients according to their specialty as no two patients are the same. <br/><br/>Please get rid of the old guidelines as they have done irreparable harm to Chronic Pain Patients and people with cancer. Even many surgeries are no longer gotten due to no pain medication post op. Pain cannot be treated the same for everyone therefore the MME limit is torture for some. I’ve been tapered and due to increased pain, no longer have an active life. Nobody should be allowed to suffer like we all are. Please fix this entire problem and let people live a free and fair life. The DEA needs to stay out of healthcare and focus on where we all know the problems are…..illegal fentanyl pouring in across our borders Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C	None	None	0900006484fb6427	M	None	2022-03-02T18:22:25Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from M, C	l09-r9ok-9n2r	False	None	False	2022-04-12 03:16:11.993	[]
1745	CDC-2022-0024-1751	https://api.regulations.gov/v4/comments/CDC-2022-0024-1751	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	“Many patients do not experience benefit in pain or function from increasing opioid dosages to ≥50 MME/day but are exposed to progressive increases in risk as dosage increases. Therefore, before increasing total opioid dosage to ≥50 MME/day, clinicians should pause and carefully reassess evidence of individual benefits and risks.”<br/><br/>Please delete this statement from the guidelines and do nt refer to any particular Mme's that the CDC, not the physicians, considers to be true. It is recommendations such as these that are being used now by zealous anti-opiates and opiate fearers, to coerce and abuse patient. Warning patients of risks that have not been substantiated is wrong. This continues to stigmatize most patients and shame them from getting adequate pain treatment. Focus on treating pain without bullying.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	candy	None	None	0900006484fb642b	garey	None	2022-03-02T18:23:01Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from garey, candy	l09-rck8-pl02	False	None	False	2022-04-12 03:16:12.210	[]
1746	CDC-2022-0024-1752	https://api.regulations.gov/v4/comments/CDC-2022-0024-1752	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	IMPORTANT:<br/>Please include guidance to state law makers. The damage has already been done. This new issuance is headed in the right direction. BUT. States have already made laws based on the 2016 guidance. PLEASE address this!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marina	None	None	0900006484fb6476	Peck	None	2022-03-02T18:34:20Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Peck, Marina	l09-s76s-c49i	False	None	False	2022-04-12 03:16:12.421	[]
1747	CDC-2022-0024-1753	https://api.regulations.gov/v4/comments/CDC-2022-0024-1753	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First, and foremost I wish to endorse the comments of [name redacted], PhD. Now I would like to tell my experience. Since the initial guidelines came out, my life has drastically changed. I was able to function under the proper care of my doctors and the use of opioids. I no longer function the way I use to and often find myself praying to die, for the pain to end. I am not suicidal; I just don't want to live this way. The use of opioids is vital in healthcare and can be used appropriately under the guidance of a properly trained doctor. This decision should be between the patient and doctor only.<br/><br/>I truly hope that the CDC will either completely remove all guidelines or go back to the drawing board and use doctors with clinical experience that do not have a conflict of interest to write the guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fb662b	Kiley	None	2022-03-02T18:37:31Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Kiley, David	l09-tesc-kmyq	False	None	False	2022-04-12 03:16:12.637	[]
1748	CDC-2022-0024-1754	https://api.regulations.gov/v4/comments/CDC-2022-0024-1754	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patients with failed back surgeries, nerve damage, and have taken opioids since 2004, in 2018, my doctor decided that I needed to be reduced by over 50%, even though I was never over the CDC recommendation, because he was afraid of the DEA raiding his office and planned on taking me completely off, but by the Grace of God he retired and the new doctor didn't see the need to completely take me off, I still suffer terribly on the now low doses, and I am afraid to ask for an increase because then they would think I was a drug seeker or worse take me completely off. I don't see the doctor I see NPs who continually try to force procedures on me, and even threatened if I didn't have them they could not continue giving me my medication, even though I have had all these procedures and then some, and they don't work. Now the CVS pharmacy I have been going to for years, told me they no longer can get the medication or know when they will be getting it so my prescription could not be filled, they told me to go elsewhere. Now the doctor's office told me to find somewhere that would take my prescription, and I had to call pharmacies asking if they could fill my prescription, after about 5 or 6 tries I finally found one. But next month I don't even know if I can get my script filled at all. I am normally a fighter, but I feel so defeated, and wonder why I must suffer all because I have pain. And why they are jailing doctors who are trying to help people in pain? And why are they attacking pharmacies just for filled a script from a doctor? I never thought in America this could ever happen to people whose only fault is suffering from pain. I am thankful that the CDC has updated their opioid guidelines. Please stop the DEA from harassing and terrifying the doctors. Chronic Pain Sufferer since 2004	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb6631	Anonymous	None	2022-03-02T18:45:24Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l09-tig7-evf6	False	None	False	2022-04-12 03:16:12.881	[]
1749	CDC-2022-0024-1755	https://api.regulations.gov/v4/comments/CDC-2022-0024-1755	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patients with failed back surgeries, nerve damage, and have taken opioids since 2004, in 2018, my doctor decided that I needed to be reduced by over 50%, even though I was never over the CDC recommendation, because he was afraid of the DEA raiding his office and planned on taking me completely off, but by the Grace of God he retired and the new doctor didn't see the need to completely take me off, I still suffer terribly on the now low doses, and I am afraid to ask for an increase because then they would think I was a drug seeker or worse take me completely off. I don't see the doctor I see NPs who continually try to force procedures on me, and even threatened if I didn't have them they could not continue giving me my medication, even though I have had all these procedures and then some, and they don't work. Now the CVS pharmacy I have been going to for years, told me they no longer can get the medication or know when they will be getting it so my prescription could not be filled, they told me to go elsewhere. Now the doctor's office told me to find somewhere that would take my prescription, and I had to call pharmacies asking if they could fill my prescription, after about 5 or 6 tries I finally found one. But next month I don't even know if I can get my script filled at all. I am normally a fighter, but I feel so defeated, and wonder why I must suffer all because I have pain. And why they are jailing doctors who are trying to help people in pain? And why are they attacking pharmacies just for filled a script from a doctor? I never thought in America this could ever happen to people whose only fault is suffering from pain. I am thankful that the CDC has updated their opioid guidelines. Please stop the DEA from harassing and terrifying the doctors. Chronic Pain Sufferer since 2004	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb6632	Anonymous	None	2022-03-02T18:45:34Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l09-tiga-m3kp	False	None	False	2022-04-12 03:16:13.092	[]
1750	CDC-2022-0024-1756	https://api.regulations.gov/v4/comments/CDC-2022-0024-1756	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Ankylosing Spondylitis about when I was 36 and about 2-3 yrs later the pain was devastating so that began my first experience with Opioids / Vicodin the dosage gradually increased and then Fentanyl was added and also increased w/ time. I was so intoxicated I didn’t know what was going on, and was no longer the Man I used to be. Which caused my wife so much grief she had given up, filled for divorce. Fortunately she redacted it and found the strength to do what she could to keep going & help me find my way out of the Dark place I was in. <br/> We finally searched for a better way to treat my chronic pain, which was through a medical device/ Pain Pump implanted in my abdomen. The device is programmed to periodically send a very small dose of diluted morphine in a tube bypassing all internal organs, the medication travels thru a small tube directly in my spinal fluid and to my brain stem where it reduces the pain sensation. This device has improved my life. <br/> The Evil Corporation and corrupt Politicians that were involved in America’s worst medical disaster have been recognized. <br/><span style='padding-left: 30px'></span>I still believe we still have a place for Opioids in pain treatment and Now It’s time we start trusting our Doctors again so they manage each individuals unique requirements helping those who truly needed pharmaceuticals.<br/><span style='padding-left: 30px'></span>I feel all Doctors should be trained to recognize early signs of addiction, and kept updated on the status of future treatment options medical and pharmaceutical. <br/> They should not be restricted and Fear Federal disciplinary actions when prescribing opioid’s <br/><br/> I am very confident our Medical Sciences will continue improving the Health Quality of many! <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484fb665a	Corrie	None	2022-03-02T18:46:00Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Corrie, Larry	l09-u3ir-zhct	False	None	False	2022-04-12 03:16:13.827	[]
1751	CDC-2022-0024-1757	https://api.regulations.gov/v4/comments/CDC-2022-0024-1757	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The following are examples of some the awful things I experienced as a 22-year chronic pain patient. Most of the suffering I’ve experienced has been from the cold and cruel approach to me throughout the years. I now know what discrimination feels like and it’s a horrible feeling. I can’t help how I’ve been afflicted but I feel like a pariah because of how the medical society has treated me. I can’t even count how many times I’ve cried because of this crazy reaction to opiates. It needs to stop, for God’s sake it needs to stop! <br/>(Scenario 1)<br/>One of the more recent situations I experienced was my last visit to an ER. I’d had Covid a year previous and was hospitalized at this same hospital. During my Covid stay, my chronic back pain really flared up and was causing me serious issues. Lying flat on my back all day was torturous and only exacerbated my pain. My insistence on pain treatment was met by a few anti-opiate crusaders disguised as nurses and this created a bit of conflict. Fast forward to my last ER visit. I thought I had Covid once again and went to the ER. It was the most bizarre experience! After check-in, I was eventually asked to go into the ER waiting area (absolutely no form of Covid precaution was introduced). There was no gurney, no chair, no blanket offered, just a bare room with a cold tile floor. I was so sick I couldn’t do anything but lie on my back. I was 58 years old and nothing to comfort me. I don’t even think I was checked on for nearly 2 hours before I was admitted. <br/>As you can imagine, I was horribly upset about my experience so I called and talked to the CEO of this hospital. Curiously, during our conversation, he made a statement, “besides, your needing pain medication should be nobody’s business.” I hadn’t mentioned anything about opiates or pain so I immediately knew that my poor treatment was about my being an opiate user. It had to be the reason I was treated in such a way! I’ve worked in the ER as an imaging tech and I’d never seen anyone treated like I was. Living in my small city, I knew beforehand the anti-opiate stance that this hospital embraced and I got to experience it first-hand. <br/><br/>(Scenario 2)<br/>As the “war on opiates” began to take shape and the doctors given their marching orders, my doctor seemed to progress, year by year into an intolerable, passive/aggressive jerk in an effort to seemingly boot me from opiates. It really became unbearable and after about 16 years, I made the choice to drop him. I was out of the plane without a parachute! That’s how frustrated I had become but I felt I had no choice and I was too young to go to prison. I could literally write a book about that awful, frustrating journey with just this doctor. <br/>But wait, there’s more! In between doctors, I was pushed to the streets and nearly lost my life because of it. If you suffer pain like I do, you might know that desperation to entertain stupid things. Not a proud moment for me. <br/>So, I find a new doctor who was new to her doctor group but obviously didn’t get the memo on what to do with pain patients. She was always very receptive to my condition and seemed to respect my medical history of back pain. She seemed very empathetic towards me and I felt that I’d found my answer to poor treatment. NOPE! On my third appointment I was confronted instead with the Office Manager who summarily reduced my prescription to 15 pills and to basically get the heck out of their practice. She curiously mentioned something about their insurance didn’t allow opioid treatment. Hey, what!? When does an insurance company get to weigh in on my health care? I also remember her demeanor as being unnecessarily hostile and confrontational. I was absolutely crushed because I was suffering more than ever with my back issue and I just needed some help and understanding. I nearly took my life at this juncture because I was in horrible pain and had grown beyond disgust with how chronic pain patients are treated. <br/>These are just some of the many heartless ways that I’ve been treated. I’m at my wits end after hurting for the 40 years of my 60-year-old body. When will my condition be recognized and treated fairly like any other health issue? When will the discrimination against me stop? Will you be happier if I took my life?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fb6670	Cook	None	2022-03-02T18:46:49Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l09-ufgi-b4it	False	None	False	2022-04-12 03:16:14.043	[]
1752	CDC-2022-0024-1758	https://api.regulations.gov/v4/comments/CDC-2022-0024-1758	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC is not a government agency. Thus it has no business talking about topics that are regulated by FDA, such as medications.<br/><br/>Regardless, any future guidelines about doctoring or prescribing must acknowledge supremacy of the individual doctor-patient relationship over any such guidelines, and over any legislation at all levels of government.<br/><br/>In that context, guidelines must specifically disallow prosecuting or harassing doctors for doing their jobs. Specifically the job of relieving pain and suffering, and supporting patients, through prescribing and other treatments, in preventing disability caused by chronic pain and other permanent or temporary anatomical abnormalities and body dysfunctions.<br/><br/>MME limits must be either discarded or accompanied by unequivocal language acknowledging the realities of chronic pain - that no patient is like any other patient regarding pain level, pain tolerance, and medication effectiveness. The aim is to stop the destructive nature of blanket limits, which make no sense in context of healthcare.<br/><br/>Federal limits on the production of medications are immoral and likely unlawful in restricting fair trade regarding pharmaceuticals. If pharma companies must be attacked, then push back against their obvious regulatory capture, and not against the seventy million Americans with the disability of chronic pain.<br/><br/>Guidelines about prescribing must address federal oversight agencies as well as healthcare practitioners. Guidelines should acknowledge patient concerns about continuity of medical care and access to their medical records in the face of non-legal federal raids and shutdowns of clinical medical practices. If law enforcement must be involved with healthcare, then stop the huge flow of outlawed and tainted drugs smuggled from China, rather than bothering doctors about their helping legitimate pain sufferers.<br/><br/>Guidelines must not allow the appearance of colluding with nor enforcement of regulations that end up torturing Americans through the immoral medical malpractice of denial of treatment, when it comes to unfairly restricting availability of and access to pain medications.<br/><br/>There is a ton of heavily-financed propaganda about opioids. Guidelines must push back against the falsehoods, and encourage returning Americans to non-tortured lives through steady prescriptions of safe and effective opioid pain medication. The best outcomes of treatments for chronic pain happen after "long enough and strong enough" on long-acting or slow-release synthetic opioids. The proposed alternative medications are only money schemes, intended to pump money from people with the disability of chronic pain to pharma companies by pushing new, costly, unproven, and inferior substitues. Guidelines should call out or discourage federal participation in such schemes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	E	None	None	0900006484fb66e4	Mathews	None	2022-03-02T18:47:51Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Mathews, E	l09-vnj9-q545	False	None	False	2022-04-12 03:16:14.254	[]
1753	CDC-2022-0024-1759	https://api.regulations.gov/v4/comments/CDC-2022-0024-1759	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a pain management patient since 1998, when a fall down a flight of stairs at 14 years old left me with a 38 degree c-curvature that was not seen previously, 3 bulging discs and degenerative disc disease. My curvature was progressive, but I had a happy if somewhat limited life. In early 2006 I under went full spinal fusion from T2 to L2 and with the help of my pain doctors and medications I was living a very full life. I had 3 sons and my pain level averaged around 4. In 2016 everything changed. Though I had never had a bad drug screen, I was screened every other month since 2002, and had shown no signs of addiction I was forced to see a therapist and an addiction specialist. Assuming that the doctors were just trying to be safe I happily went to the appointments. Both the therapist and addiction specialist told me that I showed no signs of dependance, depression, or malingering. I was surprised when at my next pain appointment the doctor told me that I would have to be weaned down to half of my dosage. I asked why and they said that although the notes from the other appointments showed I had no addiction warning signs or symptoms it was now the law that no one receive more than 90mg of opioids. My full life disappeared in a matter weeks. I could no longer take my children to the park, or shopping for new clothes. I couldn't crochet or jog anymore. I lost the ability to do any of the things I loved. By the time I was weaned down to the new legal limit (so my doctors told me) I was barely able to wash my own hair once a week. Right now my children have to be careful not to hug me too hard, what kind of a life is it when you have to be afraid of your children's hugs? I was always so careful to follow all the rules, I always thought that if I did what the doctors said I would be taken care of, but now I know that isn't true. These guidelines made me a prisoner to my pain. Without pain medications I have no quality of life. I don't mind all the drug screenings and the pill counts, but to have no recourse at all for this pain is unendurable. I pray everyday that it changes, that the rules will change again so that I can go back to being the happy and fun mother I was for my kids, or at least be able to let them hug me without that worry in their eyes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Haley	None	None	0900006484fb670f	Steve	None	2022-03-02T18:48:16Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Steve, Haley	l09-vs6q-ttx4	False	None	False	2022-04-12 03:16:14.471	[]
1754	CDC-2022-0024-1760	https://api.regulations.gov/v4/comments/CDC-2022-0024-1760	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Child resistant blister packaging should be the only way to distribute opioids. This will greatly reduce illegal distribution and accidental poisoning of children because of the CR blister packs. New technology makes it easier for seniors to open CR blister packs but not children. With blister packaging, there is no need to take opioids out of the bottle and place into the plastic weekly medication strips<br/><br/>60k kids under 5 to the ER every year for poisoning. <br/>@US_FDA has had authority for opioid packaging changes since 2018<br/><br/>Please mandate opioids be packaged in Child Resistant blister packs. <br/><br/>[name redacted]<br/>email: [email redacted]<br/>Twitter: [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	TIMOTHY	None	None	0900006484fb662c	MORRIS	None	2022-03-02T19:12:34Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from MORRIS, TIMOTHY	l09-tf3z-lkv5	False	None	False	2022-04-12 03:16:14.696	[]
1755	CDC-2022-0024-1761	https://api.regulations.gov/v4/comments/CDC-2022-0024-1761	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient,after having 2 discs fused in my neck 15 years ago. I’ve been on all opioids over this period and can say they have absolutely saved my life!! I wish you people would focus on not giving these to kids,and stop screwing up our lives. People need these as we’ve tried hundreds of pain management shots,procedures. My doctors are now prescribing so little I’m getting back to where I was in 2010 contemplating taking my own life at 50. I’m only trying to have a 1/2 way functioning life for the time I have left. The government is trying to ruin the small chance at a decent life for the time we have be4 we are stuck in a bed. Thank you. [name redacted]. [email redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Timothy	None	None	0900006484fb6813	Mcdonald	None	2022-03-02T19:39:22Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Mcdonald, Timothy	l09-xt71-3m3h	False	None	False	2022-04-12 03:16:14.907	[]
1756	CDC-2022-0024-1762	https://api.regulations.gov/v4/comments/CDC-2022-0024-1762	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fb65e6	Rust	None	2022-03-02T20:06:49Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Rust, Robert	l09-sl4b-2y90	False	None	False	2022-04-12 03:16:15.130	[]
1757	CDC-2022-0024-1763	https://api.regulations.gov/v4/comments/CDC-2022-0024-1763	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RE: Docket # CDC-2022-0024<br/>National Center For Injury Prevention <br/><br/>I am BEGGING YOU, to STOP THIS MADDNESS!<br/>Being a Medical Social Worker & Public Speaker, until my autoimmune disease destroyed my body & left me DISABLED, I was a strong advocate for people living with disabilities. Now, I am BEDRIDDEN, not because of my disability, but, 100% due to UNMANAGED PAIN. I can barely walk, I'm unable to work and can't even visit my grown kids or HUG my granddaughter! My life has lost ALL MEANING. WHY????,<br/>due to the CDC, interfering with my Medical Care. I wasn't aware Politicians (whom we VOTE for) had the legal authority to tell the AMA, Practicing MD's & Chronic Pain Patients WHAT they were allowed to prescribe to give patients a QUALITY OF LIFE?<br/>Prior to 2018, I was an actual HUMAN BEING, helping people who "couldn't help themselves ". I was also a "Court Appointed Guardian At Litem, a volunteer in the Public School System, teaching children to read & a member of The Police Athletic Leaque. "That" was when I had ADEQUATE Pain management. <br/>On June 5th, 2018, following a spine surgery, I had my 1st HEART ATTACK, due to increased blood pressure from <br/> UNMANAGED PAIN. Again, in May of 2021, I had my 2nd heart attack (same reason) & I live every day, ABSOLUTELY PETRIFIED that my next heart attack will be FATAL. <br/>When the CDC 1st announced their mistake & vowed to make changes to the "mandated" (Yes, I know they were "recommendations", but they quickly became mandates), MME's allowed for treating chronic pain patients, thousands of us were literally Thanking God, we would soon get our LIVES BACK. <br/>Until today, when I received an email from The National Pain Counsel, informing members, the CDC is ACTUALLY lowering the MME requirements to 50? Enough for a small animal. Is that what we've become to the CDC? A waste of your time & money? <br/>It will be on the shoulders of EVERYONE within the CDC, as thousands more people commit suicide or turn to illegal Street drugs to relieve their CONSTANT PAIN!<br/>SOMEONE needs to understand, those of us in REAL pain, due to documented, serious medical conditions, do NOT abuse our medication. We RELY on it, to get out of bed, to shower, clean the house & FEEL SOMEWHAT like HUMAN BEINGS. <br/>I'm not sure anyone will even hear our PLEA'S, all we can do now is PRAY, with all our might. All we are asking for is to have the same QUALITY OF LIFE, that you, members of the CDC have. "Walk a Day in Our Shoes" is the ONLY way your hearts will be open.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maura	None	None	0900006484fb68ff	Thompson	None	2022-03-02T20:09:33Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Thompson , Maura	l09-zlta-hjju	False	None	False	2022-04-12 03:16:15.346	[]
1758	CDC-2022-0024-1764	https://api.regulations.gov/v4/comments/CDC-2022-0024-1764	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is no basis in Nature or Science for ruling that x MME is too much, owing to substantial variability in the source of pain (i.e., diagnosis) and history of treatment (i.e., tolerance / habituation) not to mention enzyme-mediated individual differences in sensitivity to pain and to pain medication. My wife, who has always been much more insensitive to meds than me, started at the lowest effective dose of oxycodone (5 mg) in 2009 and now requires 12 mg of hydromorphone -- equivalent to 40 mg of oxycodone -- to achieve the same effect. This increase over time is not important. What is important is that her capacity to function and quality of life impacts many others who do not suffer pain conditions but who cherish or depend on her as children, spouses, and employers. Were she to be separated from her medication, my life would be turned on its head. You need to understand that patients are willing to assume the risks in exchange for some quality of life (i.e., for a targeted score on a Karnofsky scale). <br/><br/>To manage the risks associated with opioid use, doctors need only require that their patients review and sign the following set of principles as a one-pager.<br/><br/>A. You should never rely on your feeling to detect and measure how active your medication is in your body. You will only "feel" your medication in your system for 2 - 3 hours (closer to 2 as you get used to it). However, the medication is active in your system for 4. Wait at least 4 hours (not a minute sooner) between doses if you plan on an 8 hour break for sleep. If you plan on dosing at intervals uninterrupted throughout the 24 hour period, leave 6 hours between doses. <br/><br/>B. As your body grows accustomed physically and psychologically to your medicine, there will come a time when you will wonder whether the medicine is still working at the original dose and you will want to take more. Resist the temptation to add pill fragments in the 4 hours between doses. Wait until your next dosing opportunity and consider increasing the dose. <br/><br/>C. How much more you can take safely depends on your starting dose (e.g., adding a second 5 mg tablet to a 5 mg tablet is unlikely to hurt you). However, it is always safe and efficient to go up in milligrams, not whole pills. That 5 mg dose will be effective again as a 7.5 mg dose (possibly even a 6.25 mg dose if you add a quarter pill). That 10 mg dose should work at 12.5 mg. For anything larger than a 5 mg pill, do not just add a second pill. <br/> <br/>D. There's a difference btw habituation to a dose and using so frequently throughout the day as to lose sight of what it feels like NOT to be on it. You may inadvertently create a "New Normal." In that case you may take a higher dose thinking you habituated when you did not -- you're just looking for a higher high to break with what is currently the normal state -- and you end up overdosing. Try to give yourself some islands in the day when you can reacquaint yourself with life without the medication. If the pain is so severe that you can't tolerate medication breaks, talk to your doctor about extended release options, including an extended release formulation with a small short-acting supply for breakthrough pain. You may be a candidate for an fentanyl patch.<br/><br/>E. Avoid taking this medication with other drugs. Talk to your doctor about which medications are safe to take with an opioid, because most medications that depress or stimulate the central nervous system are not. These include common cold medicines containing antihistamines, benzodiazepines, sleep aides, and alcohol. Be sure to avoid alcohol. If you can’t choose between your anxiety (alprazolam) and your pain (opioid) and require round-the-clock-treatment for both, try to stagger the doses so they do not peak in your bloodstream at the same time. You may find you can tolerate both concurrently, and it would be helpful to have that knowledge, but be sure to have Narcan at the ready in the event you experience a reaction more serious than a slightly elevated heart rate.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Matthew	None	None	0900006484faf1df	Giarmo	None	2022-03-02T20:11:22Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-02-28T05:00:00Z	None	None	None	None	None	None	None	Comment from Giarmo, Matthew	l07-npog-8obu	False	None	False	2022-04-12 03:16:15.558	[]
1759	CDC-2022-0024-1765	https://api.regulations.gov/v4/comments/CDC-2022-0024-1765	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After severe injury to my spine and lower back from being rear ended at a stop light by a very elderly man I had to seek out a fix for the pain I was in. After several appointments with an Osteopath who manipulated my spine and prescribed opioid’s for the pain the Doctor recommended a MRI to find the root of the problem. The MRI showed a herniated disc, several options were offered, physical therapy and time to allow the disc to repair it self or surgery, I opted for the physical therapy and time. <br/>After a year of suffering severe pain I chose to have the surgery. My pain post surgery was off the charts! My next move was to visit [city redacted] MA and see Doctor [name redacted], I was told he was one of the best specialists in the country. I was informed that the repair to my back didn’t stop the pain due to damage to my spinal cord and sciatic nerve, I was told there was no repair for the nerve damage and it most likely to get worse as time went on, he was correct.<br/>My family Doctor prescribed me opioids to help with the pain and allowing me to continue working. After 2 years of prescribed meds my doctor reached a limit of prescription strength her group would allow and she assisted me in finding a pain manager. The Pain Clinic I chose was a huge help with my pain management. After 6 years of monthly visits and adjustments to my prescriptions the CDC had my medication removed from the market and forced the company to stop manufacturing my meds, Opana was the prescribed pain medication and it worked very well, two 40mg time release and four 10mg quick release pills took very good care of my pain. The discontinuation of the Opana was right at the same time the CDC changed the prescription laws and I was then put on Morphine Sulfate, two 60mg time release pills that did not help with my pain at all! <br/>Move ahead 6years, I’m still prescribed the same dose of Morphine, every appointment I beg my doctor to change my prescription to help me with my disabling pain and he continues to inform the CDC will not allow it and I have exceeded the recommended dosage the CDC allows. As time went on I developed a very aggressive arthritis though out my body to include neck, shoulders, hands and wrist, spine, hips and knees. I had to give up my career being 100% disabled by the nerve damage and arthritis and still being prescribed the same amount of Morphine.<br/>I live in New Hampshire, our great Governor put into law a bill that took away the CDC’s maximum recommended prescribed opioids to help the people that live with severe pain unfortunately my pain manager and other doctors told me they could not follow the new state law due to the CDC being a Federal law so no relief was to be found.<br/>I beg you to change the regulations on prescribing opioid’s, I am currently 60 years old and would like to enjoy what little time I have left. I have giving up everything I enjoyed though life to try to cope with the constant disabling pain, I never though I would be pain free but I know I could achieve far less pain with the proper medication and amount.<br/>PLEASE HELP all of us who suffer terribly pain and change your guidelines.<br/>Thank you very much….	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dennis	None	None	0900006484fb6d28	Hemeon	None	2022-03-02T20:50:29Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Hemeon, Dennis	l09-zuae-ijok	False	None	False	2022-04-12 03:16:15.779	[]
1760	CDC-2022-0024-1766	https://api.regulations.gov/v4/comments/CDC-2022-0024-1766	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The government needs to step back and let educated physicians treat their patients the way they wish, need and deserve to. Without fear of being put on a list and monitored like a child in detention. We long term chronic pain patients deserve this as well. I have been in full compliance with my prescriptions for the past 13 years of my life, happily complete urine tests when asked, and have been on the exact same, the lowest dose the entire time. I have always said and forever stand by 'they can test whatever they wish to'. I have been made to feel like I, and all long term chronic pain patients, are unfairly being grouped into the stereotypical 'druggie' category! Physicians are not dense, they can see a 'seeker' from a mile away! We are not seekers we are humans struggling all day, every day with pain from EDS, Marfans, Fibromyalgia and countless other ailments, none of which were our choice. I did not ask to be born with shoulders, wrists, hips and knees that pop out of socket, but here I am. I have a small child that has a learning disability I need to care for and without my medications I would be completely unable to do this. I would be unable to get out of bed on a daily basis, not have the strength or energy to do small things like brushing her hair or my own. The only thing I am addicted to is being 70% pain free, able to laugh and be the better parent my child deserves. Chronic pain patients are the strongest people one could know. We smile through the pain and daily agony, avoid going to the E.R. when we fall or hurt ourselves, in lieu of being judged as a 'druggie', seeker or addict and dangerously care for ourselves at home. Chronic suffering could easily causes death among those unable to obtain the medication they need in order to function. Death due to prolonged suffering, suicide. The true addicts will always find their fix and are disgustingly catered to in this county, meanwhile millions of innocent, law abiding, tax paying citizens are made to feel lower than low simply because they are unable to be given the medication they need to live a life as close to normal as possible. Because of addicts behavior. It all comes down to mental health. A person with mental health issues is not going to treat opioids the same as someone with long term chronic pain, who is of sound mind, body and soul. PLEASE allow medical personnel to have the final responsibility to treat their patients as they see fit and not have it dictated by people sitting behind their cushy desk, living a happy and pain free life. The suffering belongs to those unable to find relief for their daily pain struggles.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amity	None	None	0900006484fb6d49	J	None	2022-03-02T20:51:09Z	None	None	1	None	2022-03-02T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from J, Amity	l0a-03kf-bqrl	False	None	False	2022-04-12 03:16:15.992	[]
1761	CDC-2022-0024-1767	https://api.regulations.gov/v4/comments/CDC-2022-0024-1767	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read through the proposed update. Chronic pain patients have enough suffering in their daily lives, and this was made worse by the CDC 2016 guidelines use of 90 MME. I know that an update was made, but it did nothing. My biggest fear about this is the use of 50 MME. First of all, the MME , itself, is not based on accurate scientific studies- it is a "guesstimate" at best, and should not be used at all. I am sure everyone is intelligent enough to know pharmacists and providers will see that number, and run with it- just like they did in 2016. I do not understand why [name redacted], the same doctor who denied any conflicts of interest , when 2016 guidelines first came out, is involved again. Everyone knows that overdoses happen with ALL medications- but chronic pain patients want to LIVE a productive, healthy life. We have been stigmatized to a nearly unbearable amount because of the previous opiate prescribing guidelines, I fear what will happen after the "50MME" comes out! Most chronic pain patients who have taken opiate medications have taken them for years- physical noncomplicated dependence and tolerance is part of a patient taking opiates for along period of time, and is well known. Why is there no inclusion of tolerance/dependence included in the new guidelines? Chronic pain patients are the ones who have been made to suffer to the point that some have committed suicide because of misread dosing MME limits in the 2016 guidelines. Please, please, do not include a number of MME to the new guidelines! Also, there MUST be some allowance for tolerance, and uncomplicated physical dependance added to the new guidelines. Many of us have taken high dose opiate medication for decades, and any doctor would be aware of tolerance!! We jump through every hoop asked of us, we always have perfect drug screens, pill counts, and have tests that are evidence of our diagnosis. We suffer every single day- it is hard to stand, hard to walk, hard to sleep, hard to sit, hard to do just about anything- every hour, of every day- please show us some compassion! Stop recommending any unscientific MME dosing amount. Following the last go around with the 2016 cdc guidelines, I beg you to do us no more harm!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shannon	None	None	0900006484fb7016	McHenry	None	2022-03-03T14:13:30Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from McHenry, Shannon	l0a-456x-dasf	False	None	False	2022-04-12 03:16:16.208	[]
1762	CDC-2022-0024-1768	https://api.regulations.gov/v4/comments/CDC-2022-0024-1768	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the caregiver for my mother, a 62-year-old chronic pain patient. Between battling Crohn’s Disease since she was 19, including multiple intestinal resections, and extraction of all her adult teeth (which she did without a single pain pill) you’d think that’s where the story ends. It doesn’t. She’s so frail from malabsorption that she breaks easy, including when a neighborhood dog got off-lease and attacked her, breaking her hip but also leaving her with massive anxiety and PTSD. After years of surgeries and suffering, she was put on Humira. She felt good, gained weight (something I’d never seen her do in my life) it was a blessing… until she got kidney cancer. We pivoted, thankfully catching it early. She got an ablation which killed the cancer… and significantly damaged her kidney. My beautiful Mother, now in stage 4 kidney failure spends the time she has left explaining why NSAIDS aren’t an option to every pharmacist and doctor she encounters. She is frustrated and bitter. This is not the way to treat people who have done nothing wrong and are already paying with their lives. These people are already suffering, the guidelines on pain management MUST change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annie	None	None	0900006484fb7067	Goss	None	2022-03-03T15:07:25Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Goss, Annie	l0a-555c-a1lu	False	None	False	2022-04-12 03:16:16.452	[]
1763	CDC-2022-0024-1769	https://api.regulations.gov/v4/comments/CDC-2022-0024-1769	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and also a nurse, I have 1 herniated disc and 3 bulging discs in my neck from being a nurse, I have seen a neurosurgeon and an orthopedic but because Of my age (39) they don’t want to do surgery not that I really wanted the surgery but I also can’t live my life in pain everyday none the less they told me to see a pain specialist instead do physical therapy and have injections done! Well here I am 3 years later multiple rounds of physical therapy, multiple bilateral facet joint injections, multiple radio frequency ablations, multiple medial branch blocks all of which provide temporary relief but come with their own set of recovery pain! I have been with the same pain specialist, I have tried gabapentin lyrica muscle relaxers all of which make me drowsy and unable to function during the day! The funny thing about opioids is for someone that is in constant pain and not using it recreationally it allows us to function at a normal level being able to do daily tasks like washing dishes which to a normal human being is easy but to a person who has herniated discs in their neck it literally scares me because I know how much pain I’ll be in during and after or how the day after I work a shift instead of going grocery shopping or doing laundry I have to spend my day on the couch because I can’t lift my arms without shooting pains! I have had to go from being a full time labor and delivery nurse to a per diem outpatient nurse because my body couldn’t handle the job that I loved anymore! I do my due diligence I don’t abuse anything I see my dr monthly I pee in a cup every time she asks me to, I stretch every morning and night using heat packs and ice packs, the opioids don’t even take the pain away completely but it takes my pain level down to a place where I can function and be productive! Now that this new recommendation has come out my pain Dr has now cut my dose and quantity prescribed in half because she is afraid! Because of the people who abuse or take pills recreationally the pain patients are being punished! All this will eventually do is push people to find alternatives illegally which is why the fentanyl overdose deaths have increased because people are pushed to do incredibly stupid things to make their pain go away! Living in a state of constant pain is extremely stressful and demanding, until you’ve been a pain patient you have no idea how it feels!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484fb707e	H	None	2022-03-03T15:12:52Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from H, D	l0a-5fws-nk9x	False	None	False	2022-04-12 03:16:16.665	[]
1764	CDC-2022-0024-1770	https://api.regulations.gov/v4/comments/CDC-2022-0024-1770	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is very good to see the changes allowing physicians more latitude in dosage. There is no "standard" dose possible with human variation and differences in the origin and nature of chronic pain . Pain Physicians have been frustrated by this cap and the underlying threat of DEA interference in their practice. Leave medicine to practitioners.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Douglas	None	None	0900006484fb70f2	Terrell	None	2022-03-03T15:18:31Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Terrell, Douglas	l0a-6j8i-54q1	False	None	False	2022-04-12 03:16:16.883	[]
1765	CDC-2022-0024-1771	https://api.regulations.gov/v4/comments/CDC-2022-0024-1771	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The use of a low dose of opioids is necessary for those with serious RLS. They have tried all other meds and are still not relieved of their symptoms. We request that you continue to approve this low dose for RLS patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Meade	None	None	0900006484fb751a	DeKlotz	None	2022-03-03T15:18:59Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from DeKlotz, Meade	l0a-6qeq-dvcf	False	None	False	2022-04-12 03:16:17.095	[]
1766	CDC-2022-0024-1772	https://api.regulations.gov/v4/comments/CDC-2022-0024-1772	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Make opioids available for the disease RLS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fb751c	Smart	None	2022-03-03T15:19:16Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Smart, Deborah	l0a-6rh8-3n3p	False	None	False	2022-04-12 03:16:17.311	[]
1767	CDC-2022-0024-1773	https://api.regulations.gov/v4/comments/CDC-2022-0024-1773	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to respectfully ask you to modify the CDC Clinical Practice Opioid Prescribing Guideline to address chronic conditions like Restless Legs Syndrome (RLS) that are different from chronic pain. RLS is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. <br/><br/>It is my understanding that nearly 12 million adults and children suffer from RLS, and there is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. Ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a retired actuary who suffers from a severe case of RLS, and the availability of low-dose opioids makes it possible for me to live with this horrible condition. As you may be aware, RLS can become severe enough to cause people to consider suicide, and low-dose opioids can truly be a lifesaver. I am enormously grateful to have this lifeline available. It is my understanding that low-dose opioids have been used successfully to treat RLS for over 300 years. Unfortunately, the opioid crisis has made some physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS.<br/><br/>Thank you for your consideration of this critical health issue.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doug	None	None	0900006484fb751d	Taylor	None	2022-03-03T15:25:01Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Doug	l0a-6ro0-6a1l	False	None	False	2022-04-12 03:16:17.530	[]
1768	CDC-2022-0024-1774	https://api.regulations.gov/v4/comments/CDC-2022-0024-1774	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new proposed guidelines are still much too rigid. Myself and many others live a scary existence with incurable, chronic pain. What works for one person may be way too small a dosage for another person with a pain illness. We are left with the alternative of suicidal if our pain isn’t managed. Please leave matters up to our doctors to determine what opioid dosage is needed. No one wants to be on these meds. Our lives are useless though without them. I thought regulations were meant to save people not kill them. Your current regulations are killing people. Please choose life for those of us in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7528	Anonymous	None	2022-03-03T15:26:06Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-70f9-kzkm	False	None	False	2022-04-12 03:16:17.741	[]
1769	CDC-2022-0024-1775	https://api.regulations.gov/v4/comments/CDC-2022-0024-1775	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I sincerely hope that you will consider the use of opioids in treating chronic RLS (Willis Eckbom Syndrome) Many patients have been on long term use at a low & consistent dose for many years however recently, it has been difficult to continue because of the stringent regulations regarding Opiod prescriptions. Please reconsider so that we are not forced to go to Methadone clinics for treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tina	None	None	0900006484fb752a	Hines	None	2022-03-03T15:27:09Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Hines , Tina	l0a-719t-oq4p	False	None	False	2022-04-12 03:16:17.988	[]
1770	CDC-2022-0024-1776	https://api.regulations.gov/v4/comments/CDC-2022-0024-1776	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As you develop new guidelines for prescribing opioids, please keep in mind the millions of Americans that suffer from Restless Leg Syndrome. I have had this condition for the last 40 years and although my symptoms are under control through the use of a dopamine-agonist, there will in all likelihood be a time where I will need to use a low-dose opioid to keep the RLS under control. <br/><br/>For me, RLS symptoms are debilitating primarily because I can't get any quality rest. The RLS and limb movements wake me every 30-45 minutes when I'm not on medication. Once the other drug treatments stop working, opioids will be the only way I'll be able to get relief. Please keep this in mind for the millions of us that suffer with RLS. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roger	None	None	0900006484fb753a	Jaffe	None	2022-03-03T15:28:04Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Jaffe, Roger	l0a-786r-m4vn	False	None	False	2022-04-12 03:16:18.223	[]
1771	CDC-2022-0024-1777	https://api.regulations.gov/v4/comments/CDC-2022-0024-1777	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a long-term (60+ years) of Restless Legs Syndrome, plus Periodic Limb Movement Disorder. For 40 years, there was no recommended pharmaceutical for this somewhat rare disability. Then, Ropinerole, a Parkinson's drug, was introduced to RLS sufferers; but, as time went on, many undesirable side effects became evident, the most vicious being augmentation. Recently, there has been much success with the use of Tramadol, a pseudo-opioid, or in severe cases, true opioids. Since RLS/PLMD is not recognized by many medical professionals, only those who specialize in sleep disorders are aware of how much these conditions affect the daily lives of those who suffer every day from lack of sleep. For some, having access to low doses of opioids are the last resort to living a normal life, with the ability for a regular good night's sleep. These individuals should not be punished because others misuse a substance; RLSers rarely become addicts when they use opioids, and should be allowed to work with their medical advisers in the way that is most beneficial for them, not what a government agency thinks is appropriate.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Glfngrl	None	None	0900006484fb753e	Bishop	None	2022-03-03T15:32:47Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Bishop, Glfngrl	l0a-7aq1-3pgg	False	None	False	2022-04-12 03:16:18.438	[]
1772	CDC-2022-0024-1778	https://api.regulations.gov/v4/comments/CDC-2022-0024-1778	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Restless Leg Syndrome. It runs in my family. All of us had it from childhood. It was not until I began taking one Tylenol #3 at bedtime in my 50’s did I realize I was having less episodes of RLS. I slept better and the chronic knee pain I have was relieved enough for me to sleep. I am now 72, and it seems my RLS symptoms have increased. I was unable to get Tylenol #3 anymore in 2019. I had been on just one at night for more than 2 decades. I am not a smoker or drinker. I do not use any meds recreationally. I had no side effects from no longer taking the Tylenol #3 but my RLS certainly increased to where I have it more nights than not at this point. <br/>I believe than in the zeal to keep us away from opioids to protect those who are addicted to them was much too heavy handed. Some of us need help with pain, or RLS or other symptom that opioids are appropriate to treat. I cannot tolerate NSAIDS, so Tylenol #3 was a very good option for me. Please back up on the “all or nothing” thinking that seems to be prevalent in Doctor’s offices now. Everyone is seen as drug seeking, if one asks for opioids and that is just not true. Some of us just need that extra relief to find some freedom to sleep or get around with less pain. <br/>Restless Leg Syndrome has no cure. I have tried many different meds to try to exert some control over the symptoms to no avail. Please do what you can to loosen the regulations around opioid meds for those of us who are not misusing them and for whom the meds work. I thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fb7540	Stultz	None	2022-03-03T15:36:55Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Stultz, Linda	l0a-7c3w-26g5	False	None	False	2022-04-12 03:16:18.658	[]
1773	CDC-2022-0024-1779	https://api.regulations.gov/v4/comments/CDC-2022-0024-1779	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ok I would like to first talk about my father. We were in a really bad car wreck when I was 2 years old. My father was crushed by the steering wheel and ended up with plates in his arm and back. He work until he was 61 which is when he ended up having to have a back surgery to have where they yet again had to fuse his back to a steal rod. Well on Dec. 1st of 2021 he was in another wreck and again his back was messed up really bad. Before this wreck he was on oxytocin 5 mg 3 time daily. But after being rehurt they where not even touching his pain. His dr told him to start taking 2 3x a day instead of just one until his next appointment. Well at his next appointment he told the Dr that with even taking 10mg it wasnt helping qnd he was still in alot of pain so they started giving him 10 mg 4 times a day and he was still in pain. So again he called the dr to see what he could do and the dr order more nerve blocks and again they did nothing for his pain. So the next appointment he told them the nerve block were not help and neither was the pains meds. To which he was told he would not give him more than 10 mg 4 times a day and he had to just get use to suffering. My dad has never did drug never drank or anything and now he is told he has to suffer which is not right in any way you look at it. Now let's talk about me I have alot of medical condition that causes pain one of which they compare to cancer pain. So I have been in pain management for 5 years now I start out on 5 mg oxytocin and worked my way to were I am now which is 10mg and it has taken years to get to 10 mg. I have been through 10 surgery qnd count less procedures. I never had any issues until this last year when they made me fill out paper work where they ask if I have been sexauly assaulted as a child. Which I have been but this was the first time in 4 years that I had been asked that. This is 4 year of being treated with pain meds 4 years of never failing a drug test or having any issues with anything. But as soon as they found out I had been sexauly assaulted there is a problem. Even though I have chronic pain issues and will never get better thats why they are call chronic. They want to start to take me down to 3 a day instead of 4. When I asked why their exact words where because I was sexauly assaulted I am at to high of a risk for abusing my meds. Even though I have been on them for 4 years and have never had any problems what so ever. So I start doing my research qnd find out this is a common practice thank to the cdc guidelines they released qnd alot of people where done this way. Even though I have been to therapy and do not have any depression or another mental health problems. That not only do they do this to victims like me were the assault happened more than 20 years ago. But they also do this to rape victims at er all over the US that have been physically harmed along with the rape. There were woman all over the US say they where beat black and blue had broken bones and internal injuries that where sent home with nothing for pain what so ever. So the cdc want to make rape victims not only feel like they are being raped again by this mid evil practice but that if they are really hurt where you might need pain meds its best to lie so you will be taken care of properly. This is unacceptable to say the least. Most rape victims already dont report their rapes and most that do is because they are hurt to the point that they need medical care. Now because of this even the one that need medical care are going to lie because no one wants to wear a Scarlett letter. Even if it not on there chest it might as well be because everyone had gone digital and as soon as it hits the medical chart they will no longer receive the care that normal people do. What part of that sound fair to anyone? Because it sure doesn't sound fair to me or any other girl I have talked to about it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb707f	Anonymous	None	2022-03-03T16:23:20Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-5gbn-wiyl	False	None	False	2022-04-12 03:16:18.886	[]
1774	CDC-2022-0024-1780	https://api.regulations.gov/v4/comments/CDC-2022-0024-1780	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. Opioid use in diseases other than just pain management need to be considered. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484fb7897	Orsborn	None	2022-03-03T16:26:38Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Orsborn, Nancy	l0a-dry5-tc8w	False	None	False	2022-04-12 03:16:19.149	[]
1775	CDC-2022-0024-1781	https://api.regulations.gov/v4/comments/CDC-2022-0024-1781	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have had RLS all my life and did not find relief until I broke my toe and was given hydrocoden. I found that taking a half pill before sleeping and my RLS stayed away all night! Please consider RLS when discussing the changes to these regulations, it would help millions of us who suffer nightly with this awful condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fb7541	Balaam	None	2022-03-03T16:52:43Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Balaam, Deborah	l0a-7c97-8ty2	False	None	False	2022-04-12 03:16:19.366	[]
1776	CDC-2022-0024-1782	https://api.regulations.gov/v4/comments/CDC-2022-0024-1782	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I occasionally need Tramadol to stop the leg jerking from RLS symptoms. It was recommended by someone in a newsletter. <br/>It works SO well <br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	cynthia	None	None	0900006484fb7596	capewell	None	2022-03-03T16:53:33Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from capewell, cynthia	l0a-82se-3y7g	False	None	False	2022-04-12 03:16:19.586	[]
1777	CDC-2022-0024-1783	https://api.regulations.gov/v4/comments/CDC-2022-0024-1783	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make acupuncture a cost effective and beneficial non-pharmacological treatment option for chronic and acute pain. Thank you! -[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carrie	None	None	0900006484fb75c4	Genise	None	2022-03-03T16:54:10Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Genise, Carrie	l0a-8adp-172h	False	None	False	2022-04-12 03:16:19.834	[]
1778	CDC-2022-0024-1784	https://api.regulations.gov/v4/comments/CDC-2022-0024-1784	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a physician who suffers from restless leg syndrome. I have struggled with this for nearly 15 years. My symptoms are reasonably well controlled using the current medications but I find it necessary and extremely beneficial to take a very small amount of a narcotic almost every night in order to be able to achieve restful sleep. I would prefer not to take narcotics but unfortunately there are no other medications that adequately control my symptoms.<br/><br/>As an orthopedic surgeon who treats pain on a daily basis, I believe that the current view of opioids is a significant overreaction to opioid abuse. There are clearly many patients who benefit from chronic opioid use without becoming addicted and for whom they are not other good options.<br/><br/> I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a reasonable option when used appropriately and in carefully monitored situations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484fb762b	Tradonsky	None	2022-03-03T16:55:33Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Tradonsky, Steven	l0a-8m85-t76x	False	None	False	2022-04-12 03:16:20.057	[]
1779	CDC-2022-0024-1785	https://api.regulations.gov/v4/comments/CDC-2022-0024-1785	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I began suffering from severe RLS in 2011 following cervical spine surgery. My physician followed the treatment guidelines of the time and I made the recommended lifestyle modifications. There was literally no relief to be found and [name redacted] at [name redacted] eventually prescribed opioids. I have been taking 5 mg of methadone daily since that time. There has been no tolerance buildup, so no need to increase dosage. Absent opioid therapy, RLS would have made my existence unbearable.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cecil	None	None	0900006484fb769c	Craig	None	2022-03-03T16:58:46Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Craig, Cecil	l0a-8ngc-hmcr	False	None	False	2022-04-12 03:16:20.271	[]
1780	CDC-2022-0024-1786	https://api.regulations.gov/v4/comments/CDC-2022-0024-1786	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in pain 24/7 I don’t use pain pills to get high I take them to have a life,so I can function. They don’t take all the pain away but I can go shopping when I must and do my housework without being in tears. Please don’t punish the people who need them for the sins of the addicts	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerri	None	None	0900006484fb77a9	Fernandes	None	2022-03-03T16:59:20Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Fernandes, Gerri	l0a-9tpn-lkd9	False	None	False	2022-04-12 03:16:20.480	[]
1781	CDC-2022-0024-1787	https://api.regulations.gov/v4/comments/CDC-2022-0024-1787	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a lifelong RLS sufferer. I was prescribed pramipexole and experienced augmentation and impulse control issues. My last hope has been methadone. I take 10 mg and it works great on my symptoms. Methadone has given my life back to me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006484fb77bb	Lindberg	None	2022-03-03T17:05:56Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Lindberg, Wendy	l0a-a5ei-dlfb	False	None	False	2022-04-12 03:16:20.691	[]
1782	CDC-2022-0024-1788	https://api.regulations.gov/v4/comments/CDC-2022-0024-1788	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Huguette	None	None	0900006484fb7823	Leboeuf	None	2022-03-03T17:07:44Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Leboeuf, Huguette	l0a-bosm-s9u7	False	None	False	2022-04-12 03:16:20.949	[]
1783	CDC-2022-0024-1789	https://api.regulations.gov/v4/comments/CDC-2022-0024-1789	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help us with the relentless insanity and pain of restless leg syndrome. A low-dose opiate that can give a person back their daily Life is a miracle so please let me have my life back. Thank you [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vancylee	None	None	0900006484fb784c	Bodenhorn	None	2022-03-03T17:09:32Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Bodenhorn, Vancylee	l0a-cak6-fvd5	False	None	False	2022-04-12 03:16:21.184	[]
1784	CDC-2022-0024-1790	https://api.regulations.gov/v4/comments/CDC-2022-0024-1790	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cdc lost credibility during the past 2 years. They hide data and redact what they let out. They are unreliable and worse than that	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb78a4	Anonymous	None	2022-03-03T17:10:13Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-dzos-q39z	False	None	False	2022-04-12 03:16:21.393	[]
1785	CDC-2022-0024-1791	https://api.regulations.gov/v4/comments/CDC-2022-0024-1791	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a long time chronihis c sufferer of RLS since I was a teenager (Over 50 years). I am on low dose OxyNeo/OxyNorm 10 mg. Ththis has been the only thing in my life that has helped me recover from years of Restlessness through the night. I'm feeling better than ever! I'm able to function again as a "normal" human being...eating/sleeping and functining proficiently through the day. It has been an absolute life saver for me!!! I live as an Expat in Bali Indonesia. I was able to find a doctor here to prescribe this (with great hesitancy and reluctance). Thank God I was able to convince them. I've been using for the past 8 months. I'm writing as a living breathing patient who has benefited by "low dose" opiod use. Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anthony	None	None	0900006484fb78e3	Carlisi	None	2022-03-03T17:17:56Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Carlisi, Anthony	l0a-f5j3-ucq1	False	None	False	2022-04-12 03:16:21.606	[]
1786	CDC-2022-0024-1792	https://api.regulations.gov/v4/comments/CDC-2022-0024-1792	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good<br/>Background includes complexity of treating chronic pain and studying treatments, including overlap of Mental Health and SUD<br/>Highlights disparity in pain treatment based on racism<br/>Highlights difference between new treatments as opposed to ongoing <br/>Great that they spoke with 106 people involved, including 42 patients, 21 caregivers and 43 clinicians <br/>Great that highlighting the importance and clinically separate issue of patients who have been on opioids are extended periods of continuous use. <br/>Good focus on short acting and as needed use <br/>Good that included focus on dentistry – in our regions has been a missed opportunity for education and practice pattern changes<br/>Great that includes starting with opioids should not be required to ‘fail’ all other options and also should have an ‘exit strategy’<br/>Great suggestion on pg 86 to ask about meaningful functional goals like walking the dog or returning to part-time work, etc. <br/><br/>Helpful to include that risk stratification tools show variable accuracy, please keep this in and consider highlighting this more as I think many people think they are more well proven. <br/>Thank you for clearly stating the PDMP data and toxicology results should not be used to dismiss patients from practices <br/>Very helpful detail about benzo use serving as a marker for risk of overdose rather than direct cause<br/>Great that you included how easy buprenorphine is to RX now and included micro-dosing inductions. Pg 160 includes notes on using as needed dosing for acute pain of buprenorphine. I’m curious is there is any studies supporting this. <br/><br/>I really loved the conclusion and summary with a focus on historical disadvantages and how context effects outcomes. Thank you for the statement on page 164 that this guideline should not be misapplied. I really hop the CDC can follow through with getting payers to improve coverage of nonpharmacologic treatments <br/><br/>BAD<br/>“To achieve this aim, it is important that clinicians consider the full range of 174 pharmacological and nonpharmacological treatments for pain care, and health systems, payers, and 9 175 governmental programs and entities make the full spectrum of evidence-based treatments accessible to 176 patients with pain and their treating clinicians.”<br/>No regulatory efforts to insure that insurance payers make these treatments accessable. <br/>List barriers to use of nonpharmacologic approaches including lack of knowledge or expertise but do not highlight that these approaches are often not covered by insurance companies and often not widely available until much later in document – would be good to put these barriers together<br/>Also mention that there is inconsistent evidence for any of the risk mitigation strategies but then highlight how rarely they are used. Why should they be used more often if evidence for their effectiveness is poor? <br/>TCH/Medical Marijuana for pain was barely mentioned – this is one of the biggest changes since 2016 and would be important to highlight the risks/benefits and also the access and legal issues. <br/>No mention about how many people can’t take NSAIDS. Included the risks of CV and GI side effects – but what about anyone with renal disease or post-bariatric surgery? This is a HUGE population of people for whom NSAIDS are simply not an option. <br/>The suggestion that to integrate exercise patients should walk in public spaces or use public recreation facilities for group exercise is an oversimplification and does not acknowledge that in many places outdoor exercise is not possible/safe many months or the year due to extreme hot or cold weather and that access to public indoor recreation is not widely available. <br/><br/>Pg 81 states that in many places there are free or low-cost patient support, self help or other programs that provide stress reduction and mental health benefits. Would be good to cite this as this is not my experience as a PCP <br/><br/>ON page 131 there is a discussion about ensuring depression and other mental health treatment is optimized. It might be helpful to add an acknowledgement of the challenges in many places, particularly rural areas of linking with behavioral health specialists. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Holly	None	None	0900006484fb6418	Russell	None	2022-03-03T17:22:59Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Russell, Holly	l09-r6f0-zkmb	False	None	False	2022-04-12 03:16:21.814	[]
1787	CDC-2022-0024-1793	https://api.regulations.gov/v4/comments/CDC-2022-0024-1793	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is Pam Iles and this is my story though I am sure I have left qute a bit out. I'm not good at talking about myself and even worsae at condensing my words. Please let me know if you have any questions. I am giving you a list of surgeries and diagnoses dating back as far as 1980.<br/>1980 I bgroke me L hand, it is screwed together now<br/>1990- I broke the other one, it is now screwed together also.<br/>1993- blew my L. ACL out and just kept working. And no, I never took pmds.<br/>1994- when my abdominal pain got so bad I couldn't walk I went to the Dr. only to find out I had a huge ovarian tumor- had a hysterectomy. I realize this is normal stuff we all go thru. However, I had been gallping race horses with this going on and I think it is important for people to understand that in my line of work, pain was just part of life in general. But I never relied on pmds for any of it until 1995 when a race horse went down with me. That was the real beginning of all my problems and life has never been the same.<br/>In 1997 my surgeon gave up thinking he could help me and sent me to a PMD, ironically, she not only saved my life but gave me the chance to regain one.<br/>I managed my pain with the same prescription and dose for 15 yrs.<br/>I suffered a punctured lung in 2007, broke all the ribs on my left side and spent a month in the hospital. 2014 I broke my left wrist, it is now plated and screwed together. But, in 2015 I fell down some stairs breaking the other wrist and when they tried to plate and screw it together the doctor cut the medial nerve. That hand is now useless, hyper sensitive and causes me great pain. However, I always managed to return to work despite my pain NEVER being managed. In 2020 I had a horse flip over backwards on me breaking more ribs, my back, and completely crushing my pelvis. It took a complete rotation, six screews, and 2 months in the hospital to learn how to walk again. It left my L. foot dropped and no feeling in any of my toes. I'm recovered from all that but it has left me with back issues that no one seems to have any idea what to do about. And, I am left crippled ony because I can't manage this everyday insufferable pain. It's debilitaing, exhausting, and crippling; but worst of all it is absolutely unecassary. I know the difference between daily nagging pain and chronic pain, however, I can't seem to find a PMD who does. <br/>Again, I am sorry for this being so long, but it has been over 20 years of fighting for my life on a daily basis and I am not good at condensing it. I'm sure I have left a great deal out<br/>I had a great PMD that I trusted, and now, I don't trust any doctor. I have been lied to, treated like a criminal, and flat extorted into dangerous procedures and bad medications, none of which ever helped me. We are lab rats to for doctors trying to make a name for themselves and capitalize from our pain, at the mercy of PMD's who won't listen, and treated like criminals on a daily bases. And, I am one of the lucky ones. Most CPP's have been thru so much worse than I have, abused by their doctors and forced to suicide as their ony alternative for relief from their pain. Our country should be ashamed of themselves for allowing such a travisty. And, this is on all of them as every politician Democrat or Republican, has allowed this to happen. We are the fallout of very misguided, political agenda and fueled by more misinformation than can be measured.<br/><br/>Thank you for your time,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484fb78ee	Iles	None	2022-03-03T17:27:12Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Iles, Pam	l0a-fdtk-9631	False	None	False	2022-04-12 03:16:22.031	[]
1788	CDC-2022-0024-1794	https://api.regulations.gov/v4/comments/CDC-2022-0024-1794	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why ? Are we being punish for being in pain .Alot of people are suffering because of the guide line of 2016 now the revised 2022 isn't any better .i think Doctors should be allowed to be doctors again with out worrying about if there going to be in trouble to help people who really needs help for pain .Also need to take out the mmm.one pill does not fit all .we are suffering because of this .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb78fa	Anonymous	None	2022-03-03T17:27:43Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-fkii-75id	False	None	False	2022-04-12 03:16:22.245	[]
1789	CDC-2022-0024-1795	https://api.regulations.gov/v4/comments/CDC-2022-0024-1795	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I do not have RLS, but my 99 year old mother does. She has tried so many therapies but now only opioids help. Please be sure to consider her and others as you write new guidelines.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ellen	None	None	0900006484fb7902	Brown	None	2022-03-03T17:36:01Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Ellen	l0a-fng2-upe9	False	None	False	2022-04-12 03:16:22.461	[]
1790	CDC-2022-0024-1796	https://api.regulations.gov/v4/comments/CDC-2022-0024-1796	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As restless leg syndrome (RLS) sufferer I am well aware of the need for low dose opioids to treat recalcitrant cases of the disease. I have been taking just 5 mg of methadone for over 2 years now and I can testify that it has changed my life for the better. I can sleep at night, I can sit down and read or watch a program. These are activities I could not do without the drug. I urge you to support legislation that allows the treatment of this debilitating disease. Thank you for your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484fb7937	Tompkins	None	2022-03-03T17:36:46Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Tompkins, Katherine	l0a-hfx7-hswy	False	None	False	2022-04-12 03:16:22.688	[]
1791	CDC-2022-0024-1797	https://api.regulations.gov/v4/comments/CDC-2022-0024-1797	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless leg Syndrome, RLS, is a horrible disease affecting our quality of life. There is no cure and it can be very mild to extremely severe. Opioids is the only medication that HELPS those of us with severe + cases to live a somewhat normal life and not be in agony. It has been very difficult to find drs who are willing to prescribe low doseage Opioids. This needs to change so we don't have to appear as drug seeking people and drs don't have to be afraid of losing their licenses when prescribing. I would love for you to live one day with our legs; you would willingly change you outlook about opioid prescriptions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fb744e	Brown	None	2022-03-03T17:38:04Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Brown , Judy	l0a-j2q7-p6o1	False	None	False	2022-04-12 03:16:22.900	[]
1792	CDC-2022-0024-1798	https://api.regulations.gov/v4/comments/CDC-2022-0024-1798	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had joint issues since childhood which were diagnosed as a joint hypermobility disorder which causes injuries, such as discs being herniated due to being rear-ended while driving, not to heal and to subluxate or partially dislocate with small movements. Doing something as simple as turning over in bed can move multiple ribs and/or my shoulders, collarbones and SI joints out of place. When this all adds up I am in constant pain of some level. I also have multiple types of headaches, including migraines. <br/><br/>Opioid pain medication can make the difference between being able to get dressed, shower, shop for groceries, do laundry or going to lunch with a friend and struggling to even get out of bed. However, opioids are only one tool. My doctors make sure I am doing all of the other necessary things, such as PT when covered by my insurance, cryotherapy when I can afford it, stretching, swimming, icing sometimes six body parts at once, taking the very limited number of anti-inflammatories I am allowed to take due to a history of stomach ulcers, muscle relaxers and migraine preventive medication, documenting each time I take any of these medications, assessing my pain level before taking something for pain, and generally spending a large portion of my life doing everything I can to not take, or take less of an opioid pain reliever. I also have to do all the work to get my prescription filled each month, which is not as simple as clicking a button on my pharmacy's website. <br/><br/>I am also a caregiver for my elderly parents, and in that capacity have had multiple experiences with only two or three days worth of tramadol or vicodin being prescribed for broken bones (tramadol was completely ineffective at controlling pain in my mother's case) which caused her board and care home to not be able to change, turn, bathe or dress her without a tremendous amount of pain following multiple injuries.<br/><br/>On one occasion, because of the current regulations, her PCP would not prescribe anything over the phone. She was in such bad shape we could not get her out of the car at the orthopedist appointment we finally managed to get. He had to send her to the ER again for pain management where she was subjected to hours of unrelated tests (which were insisted upon by her doctor in the ER) and hours of waiting before finally being admitted for pain control, when all she needed was a few more days of Vicodin.<br/><br/>Aside from damaging my own health being stranded in the ER on several occasions and having to pay off hospital co-pays for several months each time, it is quite taxing for any elderly or disabled patient, with no history of addiction to anything, to have to go through this type of treatment and this much effort for life changing, carefully managed pain control.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7453	Anonymous	None	2022-03-03T17:56:34Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-jfkl-eenf	False	None	False	2022-04-12 03:16:23.124	[]
1793	CDC-2022-0024-1799	https://api.regulations.gov/v4/comments/CDC-2022-0024-1799	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I watch my girlfriend daily contemplate whether her pain level is low enough to safely navigate whatever she needs to do for the next few hours without opioid pain medication. I regularly see her struggle to walk, get comfortable enough to sleep, take care of her medical alert dog, cook, shower, dress and do most things in life that others take for granted. <br/><br/>Opioid pain medication is a last resort for her after years of trying everything else available to her. The restrictions placed on her and other patients who are carefully monitored by their doctors have unnecessarily made life considerably more difficult for them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fb745e	Harper	None	2022-03-03T17:57:40Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Harper, Michael	l0a-k0mh-yrue	False	None	False	2022-04-12 03:16:23.524	[]
1794	CDC-2022-0024-1800	https://api.regulations.gov/v4/comments/CDC-2022-0024-1800	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain and RLS patient, I was born with a birth defect and have undergone approx 20 surgeries as an adult that has left me with nerve damage along with the severe RLS. I have gone off all times released OxyContin on my own as far as most of my pain goes, but without the small amount of fast acting I have left in my arsenal to keep from going insane from this disease I don’t know what I would do, as I’m also on 2 Parkinson’s medications one of which has given me an ulcer. If there is another way please tell me or help me, just don’t make this any harder for the people that have nothing else to help as of now. Science needs to catch up on this, it can get to the point of making you suicidal. Thank you. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fb7462	LaFayette	None	2022-03-03T18:03:47Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from LaFayette, Lisa	l0a-kjlp-x9xn	False	None	False	2022-04-12 03:16:23.727	[]
1795	CDC-2022-0024-1801	https://api.regulations.gov/v4/comments/CDC-2022-0024-1801	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If it weren't for access to low doses of morphine sulfate (30 mg daily) I would have died years ago. I was diagnosed with severe RLS in 2010 and prescribed every drug and combination thereof (all non-opioid) in an effort to ameliorate its symptoms, but to no avail. Finally, thanks to the expertise of providers at the Mayo Clinic my symptoms were brought under control and I was finally able to not only sleep but to function normally during the entire day. RLS per se is not life threatening; however, persistent sleep deprivation caused by inadequately managed RLS symptoms can and will kill, and without ready access to therapeutic, life saving, low dose opioids millions of those ravaged by RLS will surely suffer needlessly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patrick	None	None	0900006484fb89a3	Haney	None	2022-03-03T18:27:49Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Haney, Patrick	l0b-bagv-eo6n	False	None	False	2022-04-12 03:16:23.932	[]
1796	CDC-2022-0024-1802	https://api.regulations.gov/v4/comments/CDC-2022-0024-1802	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your “new” guidelines are going to be interpreted in a way that’s even worse. While you say there’s no hard limit you mention 50mme over and over. You say no one benefits above 50mme which is untrue and gives the impression that this is the new limit. I did benefit from from what is now called high doses of opiates (360mme) for 20 years without issues and good functioning. When I was lowered (60mme)I ended up in the hospital 4 times with suicidal ideation. I still have to fight the urge to end it and walk around saying “it’s just pain and you’re ok”. I totally lost function and my husband had to retire to care for me. I gained 50 lbs. and developed high blood pressure and cholesterol (I was fine before and I eat a heart healthy diet, I didn’t even know that was possible). Pain is not been benign. And as doctors you should know that. Heart attacks, strokes, endocrine and organ failure and long term effects of steroids, NSAIDs, Tylenol and alcohol are killing chronic pain patients. That and suicide and OD on illicit drugs from desperation are killing chronic pain patients <br/> I was injured in 1983 and I got worse because of surgery I felt I was forced into because of pain and pain treatment. Some of the treatments you’re fine with are dangerous long term. Steroids caused me to break 2 vertebrae <br/>NSAIDS caused stomach problems. Antidepressants caused depression and a suicide attempt. Electric stimulation caused muscle spasms and more pain. The psychological therapies may help to cope but did nothing for pain. You need to stress that these are not for legacy patients and that when other therapies fail they should do what works. The emphasis on risks is excessive and understandable considering you only had addiction people on your advisory team. But the total lack of emphasis on outcomes is going to lead to more suffering,suicides,medical collapse and drug ODs on illicit drugs out of desperation. You should have talked to real patients and real doctors that have treated pain. Tapering isn’t what kills its uncontrolled pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jackie	None	None	0900006484fb700f	Melcher	None	2022-03-03T19:59:52Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Melcher, Jackie	l0a-41oj-af4i	False	None	False	2022-04-12 03:16:24.150	[]
1797	CDC-2022-0024-1803	https://api.regulations.gov/v4/comments/CDC-2022-0024-1803	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Ehlers Danlos,a connective tissue disease that is genetic and affects my entire body. As a result I have scoliosis, spondylosis, stenosis, kyphosis, loridosis,cervical cranial instability, atlantoaxial instability, interstitial cystitis, severe osteoarthritis in every joint in my body, synovial cysts from joint capsule breakdown that are the size of golf balls in larger joints, bone spurs and nodules,a complete lack of disc space c5-c7, erythromeglia,pelvic congestion syndrome, chronic kidney stones, polycystic kidneys and liver, neuropathy, neuralgia, and to be honest those are just the ones I can think of off the top of my head that I can come up with and only the more continuous problems. I regularly have injuries etc and have even had lungs collapse,have narcolepsy, problems with my stomach and have dysautonomia too.<br/><br/>I cannot take NSAids as they gave me 3 large bleeding ulcers. Antidepressants don't do anything and flare my interstitial cystitis, I have narcolepsy and dysautonomia and drugs like gabapentin and Lyrica just make it hard to think and give no relief. Steroid injections are counter indicated in Ehlers danlos as they erode soft tissue, weakening it even more.<br/><br/>I've been on and off opioids with no problems because of all of my health issues, not only for surgeries and procedures but when my lower back first started degenerating and my disc was torn by a "gentle" traction machine,I was on higher doses for several years, with no sign of addiction. I've also taken other medications known to be addictive for some people without problems <br/><br/>Recently my genetically defective body threw me into early menopause without warning and estrogen affects collagen production. That combined with my faulty collagen from my connective tissue disease proved to be too much for my already frail and painful body. Infact it's how we finally discovered the ehlers danlos, when doctors had thought it was Fibromyalgia my entire life.<br/><br/>I cannot find any Dr to treat my pain, despite it being easy to prove that I have legitimate need. I am now mostly bedbound as my body literally falls apart.Not only that but I am finding that the current fear of treating pain is trickling into diagnostics. Pain patients are now a liability, and even the mention of pain as a symptom makes Dr's immediately get their guard up. I've had Dr's interupt me when I'm simply telling them where amd how it hurts so they know what's wrong, to tell me, we don't treat pain here. Rheumatologist have stopped treating Ehlers Danlos and I fully believe that is because they can't treat us with drugs meant for autoimmune disease. <br/><br/>It's hard for someone to explain pain to someone else. It's hard for a person reading this to comprehend unless they have experienced severe chronic pain. People can only compare pain to the worst they have experienced. When I read the guidelines I see things listed like lower back pain and hip pain. Imagine that pain in every single joint in your body. Every day. Imagine adding nerve pain down your arms and legs so bad that it feels like your veins are full of battery acid. Imagine spraining your ankle every day over and over, except now it's all your joints you're spraining every day. Imagine having arthritis in every joint and having bone spurs and your joints are so overused from being hypermobile your whole life that the joint capsules are starting to break down. Imagine bladder pain, known to be as bad as bladder cancer pain. Its so bad that I cannot tell the difference between that and the kidney stones. And still that's not the worst pain. <br/><br/>The worst pain started when my vertebrae started sliding. Dr's here don't know much about it but it's common in Ehlers Danlos. Most neurologists look for disc problems in your neck. Stenosis, nerve impingement etc. Mris are done laying down and don't show instability. There are measurements that are a clue but Neurologists don't know about them. The pain from this, is something that I had no idea could exist. Thankfully its not constant though I fear it could become constant. It's as if my spinal cord is being crushed.At the same time I get severe coat hanger pain. This pain is so bad that I break out in a drenching sweat and get heart palpitations. <br/><br/>The human body was not made to have constant severe pain from multiple fronts.Ive had to be put on beta blockers to stop the tachycardia. My resting pulse without them is 120 bpm. Constant pain causes high cortisol which causes more inflammation. Most days I have to sit perfectly still to get some tiny bit of relief. You may think I have a low tolerance to pain or something, but I have passed more than 20 kidney stones without even going to the Dr. <br/><br/>I've stopped cancer screenings. I may not kill myself, despite suicidal thoughts but I won't extend life either. <br/><br/>This is torture. Worse than torture. Torture has am end. There is medicine that could help me. But addicts,known for lying, said they started with a RX.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kira	None	None	0900006484fb77ad	Sieni	None	2022-03-03T20:08:59Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Sieni, Kira	l0a-9w49-vdcb	False	None	False	2022-04-12 03:16:24.365	[]
1798	CDC-2022-0024-1804	https://api.regulations.gov/v4/comments/CDC-2022-0024-1804	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have RLS that is quite severe and prevents me from sleep most nights during the week. I was prescribed a very low dosage of Tramadol (50 mg) which I take before bedtime. That has been a lifesaver. Most nights I am able to get at least 6 hours or more of sleep thanks to the Tramadol. This minimum dosage cannot possibly be a problem for opiate addiction as I have been taking it for quite some time without having to increase the dosing at all. Does it work every night? No, but most nights is at leasst a step in the right direction and provides me with some much needed relief. <br/>Please allow doctors treating RLS symptoms the freedom to prescribe the necessary opoids to produce relief for this horrible neurological movements disorder. Thank you for your courtesy and consideration.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fb7963	Campbell	None	2022-03-03T20:11:24Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Mary	l0a-l8bq-xzfw	False	None	False	2022-04-12 03:16:24.578	[]
1799	CDC-2022-0024-1805	https://api.regulations.gov/v4/comments/CDC-2022-0024-1805	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As you are revising the CDC Clinical Practice Opioid Prescribing Guideline, know that the draft does not address the chronic condition of restless legs syndrome (RLS) that has plagued me since adolescence. For me, the discomfort of RLS demands that I move my legs. The symptoms make it extremely difficult for me to get to sleep and to stay asleep. If an episode occurs while driving, I’m very distracted and unable to sit still. I have to pull to the side of the road and stretch my legs frequently. In public, I am often asked to stop shaking the table, booth, pew, etc.<br/><br/>So far, there is no cure. I’ve tried many prescription medications, but low-dose Oxycodone is the only one that consistently helps my severe RLS.<br/><br/>Thank you for your consideration of this vital issue, and please consult the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Louie	None	None	0900006484fb7966	Rossa-Quade	None	2022-03-03T20:12:22Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Rossa-Quade, Louie	l0a-lf70-93lm	False	None	False	2022-04-12 03:16:24.786	[]
1800	CDC-2022-0024-1806	https://api.regulations.gov/v4/comments/CDC-2022-0024-1806	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You absolutely must not specify any set MME for opiates! As you all who are medical professionals were taught, opiates have no ceiling. You should also be aware that thresholds, tolerance, previous use, genetics, and a myriad of other considerations come into play when establishing dosages of opiates for patients. You should be cognizant of the fact that some patients do not have an adequate response, even limited or no response, to dosages that are considered to be “normal.” <br/><br/>Your harmful and disastrous 2016 guideline has caused unjust pain and suffering to everyone including chronic pain patients, oncology patients, acute trauma patients, surgical patients, acute pain patients, pharmacists, nurses, and providers-just to name a few. Pharmacists and providers have lost their licenses to practice for treating pain patients-even long standing ones. They have been prosecuted legally because of this poorly thought out and planned “guideline.” Your guideline has forced legitimate patients to decrease activities to detrimental effect secondary to inadequate pain management. Your guideline has forced many to contemplate suicide and some to carry it out. Your guideline has pushed patients to seek out unsafe, possibly alternated and toxic illegal drugs on the streets-essentially making them criminals to prosecute. Your guideline has caused immeasurable suffering, and, while the intention behind creating it might have been honorable, it’s effects have amounted to cruel and unusual punishment and torture. Post operative patients as well as dying patients have been heard screaming out in pain that is audible to an entire nursing unit. <br/><br/>Steroid injections for spinal pain are not FDA approved, but they sure bring in a lot of money. They are ineffectual in most cases. Displaced surgically implanted devices can and do cause excruciating pain. You absolutely must not push these alternative options onto patients. <br/><br/>Your 2016 guideline set up a spiraling domino effect that culminated in large healthcare organizations writing policies to essentially prohibit providers from ordering opiates for their patients. They are not allowed to treat their patients appropriately due to fear of termination/discipline. This is unacceptable. You have ushered in an era of fear that even your 2022 guideline may not remedy. You have facilitated the creation of cash only pill mills, operating under the guise of “pain management,” which has exasperated an already bleak situation. The number of overdose deaths has done nothing but rise each year since 2016. Your guideline has had a gross negative outcome. The reason for this is simple, less than 1-3% of opiate chronic pain patients become psychologically addicted to opiates. Their incidence of overdose is extremely low-again less than 3%. <br/><br/>You should also not include absolute contraindications for other classes of medications, for example benzodiazepines, used in conjunction with opiates. The data that was used to include this in the 2016 guideline was skewed. And, again, there are many considerations to be made in this scenario and it should be ultimately the providers’ and the patients’ choices as a team to make individual decisions on a case by case basis-not from a black and white guideline. <br/><br/>I implore you to seriously consider and ponder the merits of my arguments that are backed in the literature. Please stop making providers ignore their empathy and their training to “do no harm,” because, harm has absolutely been done and requires righting.<br/><br/>Sincerely,<br/>A healthcare provider<br/><br/>At the end of the day, each provider should decide, with patients, what is appropriate for their care and treatment plan-not a black and white guideline, because, as in all of life, there is no black and no white, only differing shades of gray.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melanie	None	None	0900006484fb796f	Jones	None	2022-03-03T20:16:55Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Melanie	l0a-lv0i-cr7z	False	None	False	2022-04-12 03:16:24.992	[]
1801	CDC-2022-0024-1807	https://api.regulations.gov/v4/comments/CDC-2022-0024-1807	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, like mine, other parts of the body as well. I feel the need to move my whole body. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have suffered for mire than 10 yrs and use low dose opuods for my breakthrough pain as an important part of my treatment. They are so tightly controlled that its hard for me to get refills. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7972	Anonymous	None	2022-03-03T20:18:36Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-m8bx-evyy	False	None	False	2022-04-12 03:16:25.199	[]
1802	CDC-2022-0024-1808	https://api.regulations.gov/v4/comments/CDC-2022-0024-1808	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please keep Opiod therapy available for Restless Leg sufferers. I know many People in my life who have experienced it and my husband, has had it terribly. It’s a very difficult situation and low dose opiod use is extremely beneficial! It’s one of the only things that works for people with refractory RLS. Sadly some of the old time RLS meds create augmentation which spreads it to other parts of the body. After this happens they can’t use these meds and opioids in low dose are the Only thing that seems to work. It allows the RLs sufferers to sleep. This is key! Please keep it available as there are so many people who suffer. Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather "Radha"	None	None	0900006484fb797d	Carlisi	None	2022-03-03T20:19:28Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Carlisi, Heather "Radha"	l0a-mp3z-qbvm	False	None	False	2022-04-12 03:16:25.401	[]
1803	CDC-2022-0024-1809	https://api.regulations.gov/v4/comments/CDC-2022-0024-1809	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>My family’s life has been turned upside down because doctors are afraid to prescribe opioids. I want my wife back! I want my life back!<br/><br/>My wife is the last person wanting opioids. However, opioids are all that help her to lead a semi normal life. Without proper treatment, my wife has lost everything to the pain. Lack of access to opioids has ruined my family’s life. My wife, 38, sees a good pain doctor that is absolutely afraid to prescribe the proper dosage for threat of sanctions, or worse, by the medical board and DEA. This is just not right to put silly guidelines in place to protect addicts over the absolute need to help chronic pain patients.<br/><br/>Our family life has been destroyed due to the policies regarding opioids and lack of action by the treating physicians. For a doctor to see my wife’s well-documented 20-year history of chronic pain, see my wife has never been addicted to opioids, and to see/know firsthand that my wife chose to take herself off all opioids several years back and still not prescribe an adequate dose of medication is barbaric. This doctor and those in their practice should be ashamed how they are ruing countless lives, including our 8-year-old daughter.<br/><br/>My wife is bed-ridden 6 days a week with a few spats where she can get out of bed to bathe or head to a doctor. The pain from those events is enough to sideline my wife for days meaning she loses out on life with a loving husband and wonderful 8-year-old daughter. This means that the world does not get to benefit from the good my wife could do for our community if she were properly medicated.<br/><br/>Please lift all restrictions on opioids. If someone abuses opioids, they will find something else to abuse as well. Do not relegate the absolute needs of chronic pain patients to the basement while elevating worries of addicts to the upper levels. This is not right. This is not just. This is uncivilized. This is un-American!<br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Justin	None	None	0900006484fb7465	Shifrin	None	2022-03-03T20:22:08Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Shifrin, Justin	l0a-kf14-fmv7	False	None	False	2022-04-12 03:16:25.607	[]
1804	CDC-2022-0024-1810	https://api.regulations.gov/v4/comments/CDC-2022-0024-1810	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	So to begin with my husband is 69 year Vietnam veteran who has lived with shrapnel in his back near his spine afte he was hit by a grenade the shrapnel is inoperable and he has a bulging disc and two broken disc. After going to all kinds of different drs that refused to write him a prescription pain medication but offered to do spinal injections that aren’t fda approved. His pcp finally felt bad enough the he wrote him a prescription for tramadol which is worthless. He has been on OxyContin in the past and was abusive of his medication. Then the va stopped treating our elderly veterans with opiate pain medication. The ones who are still lucky enough to find a dr or have a good doctor that will write you fda approved pain medication that hasn’t caused the opiate epidemic. It’s the open border letting all that Chinese fentanyl cross into America where you can order a pill press and the people who have been abandoned are dying trying get pain relief. Now your dropping the mme again. People are committing suicide in dr parking lots! Or turning to the streets to find relief and then they overdose because they have no tolerance for fentanyl. These aren’t drug seeking addicts these are elderly people, veterans, cancer patients can’t get pain medication. You are literally killing off the population by your propaganda and lies while profiting from the loss of someone’s daughter,son,mother,brother! There needs to be no mme guideline period just because you snuck in “optional” you are going to pretend that drs are terrified to treat patients with medication because they don’t want to lose there license or go to jail for helping people. Now more people will be dropped abandoned and completely broken. Also get ready for another raise in the overdose rate.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb781b	Anonymous	None	2022-03-03T20:22:24Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-bklm-f9k8	False	None	False	2022-04-12 03:16:25.815	[]
1805	CDC-2022-0024-1811	https://api.regulations.gov/v4/comments/CDC-2022-0024-1811	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope that the regulation update takes into consideration the need some patients need of low dose opioids for Restless Leg Syndrome.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jose	None	None	0900006484fb7987	Muinos	None	2022-03-03T20:24:15Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Muinos, Jose	l0a-o6n2-sb2k	False	None	False	2022-04-12 03:16:26.033	[]
1806	CDC-2022-0024-1812	https://api.regulations.gov/v4/comments/CDC-2022-0024-1812	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi. My name is [name redacted]. I have been a chronic pain patient since around 2006. I have had at least 6 surgeries on my back and apparently ive been told i have an infection that was from one of these surgeries that i will have for the rest of my life and it will continue to cause problems in my back. I have had what started as a simple fusion, turn into cracked vertebrae and rods holding my vertebrae together. I had the screWs fall out that were holding the rods in and while undergoing the imaging prior to getting that surgery they found more problems which i sm now having to have tests with oncology and hematology. I have been on different methods of pain control. I tried physical therapy which they told me i can only do limited exercise due to the rods in my back. I can keep my head upright for at most 30 minutes before the pain starts to become intolerable. And this is while ON prescription pain medicine. I am using methadone for pain control. It has been the only medicine that doesn't give me the side effects of dizziness and ive been able to live at least a semi decent life. As i said i still only get limited time before it becomes so bad that i have to lay my head down and rest it. I am going to be 50 years old this [month redacted]. I have never had much of a problem. That is until recently. All of a sudden, getting my prescription filled has been like a job in itself. Now they are making me pick up my next prescription on day 31, and this particular month, if they should happen to not have enough, my doctors office will not be open to have them be able to call it to a pharmacy that does have enough. This is insane. Its as if the pharmacy cant count. They assume if you fill on the 6th of one month that the next month you fill on the 6th. If its a 31 day month that makes it even worse. This meeds to stop. This is happening in [state redacted] for me. Im sure there are plenty of people everywhere going through this. If i should ever lose the prescription, my life is over. Ive been through other methods barring any that affect my religious beliefs as a Christian. Please do something to fix this. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484fb7e0a	Murray	None	2022-03-03T20:28:30Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Murray, William	l0a-rnq0-fr29	False	None	False	2022-04-12 03:16:26.245	[]
1807	CDC-2022-0024-1813	https://api.regulations.gov/v4/comments/CDC-2022-0024-1813	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a physician and have had 4 patients of mine commit suicide after I was required by my state medical board to terminate their analgesics due to our state law based on your 90 MME "guidelines." I have personally been subjected to weekly visits by the DEA and harassed for any significant prescriptions. I am thinking about retiring at age 50 prematurely due to seeing the ongoing harm and constant complaints of patients who are suffering needless and significant intractable pain. I also regret specializing in pain management and having to resort to unproven and useless procedures simply because our state chose to adopt your 90 MME "recommendation" and I do not anticipate retraction of our statutory limit. The CDC has done irreparable harm to both intractable pain patients and the practice of pain management in the US. The AMA and multiple organizations have complained and suggested changes ever since the release of the poorly written 2016 guidelines and the draft update now out for review are written significantly worse, expanding in scope beyond the 2016 guideline that was written for primary care physicians but now is extended to every physician including pain management specialists who have both residency training in anesthesiology and fellowship training in pain management, and decades of actual experience treating pain patients. In addition to being more complex, the dose limit has actually been reduced from 90 to 50 MME, and that will likely be adopted by states just like the 90 MME was adopted following the release of the 2016 guidelines. My recommendation is the elimination of the guidelines rather than an update, and I know my colleagues believe the same way. We simply do not need a 226 page guideline to restrain physicians with the training and practical experience to treat intractable and severe pain, and the CDC has done more harm than good, all while knowing the majority and now the vast majority of overdoses have been caused by illicit street drugs including fentanyl analogs. I also noticed none of the "experts" who are credited with this update have any training or experience in pain management, but everyone has addiction expertise, yielding a completely biased document designed to continue to discourage the treatment of chronic pain. I am submitting this commentary because I do not want to experience more DEA raids or harassment. Please do us all a favor and rescind, not amend, the 2016 CDC guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7e0f	Anonymous	None	2022-03-03T20:31:09Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-susw-lelw	False	None	False	2022-04-12 03:16:26.465	[]
1808	CDC-2022-0024-1814	https://api.regulations.gov/v4/comments/CDC-2022-0024-1814	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Revision of the 2016 guidelines is an absolute must. I suffer from a disease called adhesive arachnoiditis. It causes the same level of pain as metastatic bone cancer but it doesn't kill you. You live a life of pure torture with no end in sight. I'm certain these guidelines have a lot to do with the fact that I can't receive proper treatment anymore. Several years ago, I had been on fentanyl 75 mcg patches and MsCotin 15 for years. I was at a functioning level. I was able to care for my home and children. I temporarily discontinued pain management when my birth control failed and I discovered I was pregnant with my youngest child. Well I should say, I forcefully discontinued despite my OBGYN's protests out of fear of a miscarriage. I have not been able to receive adequate pain management since. I've been on oxycodone 10 mg three times a day for over 2 years now. This is a hell that I wouldn't wish upon anyone. I don't have a life anymore. Most of my day is spent in bed curled up screaming and crying. I'm literally trying to survive moment to moment at this point. My doctor doesn't listen. She acts like she has sympathy but will not increase my medication. She acts as if she's almost afraid to do so. She pushes epidural steroid injections on me after correctly stating at my first appointment with her that I cannot have them because of this disease. It could make it worse. I'm going to be frank with you... The only reason I have not committed suicide is because I cannot do that to my children. I think about it often because this pain is relentless. It never stops. I never get a break. Sleep isn't even an escape. I struggle to sleep because of the pain and when I do sleep... I awaken roughly every hour screaming in pain. I wake up every morning screaming. There's no end in sight. But I push through everyday because I have children. To be very clear, I have never nor would I ever abuse my medication. I take it exactly as prescribed. It is just ineffective. Unfortunately my story is not unique. Countless others are suffering needlessly because of the 2016 guidelines. Thousands have committed suicide because they could not receive the proper treatment anymore. The guidelines are literally killing us. Revision is a must. Please give me and so many others a chance to have our lives back because this... This is unbearable. This is a tragedy. This is hell on Earth.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484fb7845	King	None	2022-03-03T20:40:20Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from King, Stephanie	l0a-c8vb-i1dx	False	None	False	2022-04-12 03:16:26.674	[]
1809	CDC-2022-0024-1815	https://api.regulations.gov/v4/comments/CDC-2022-0024-1815	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 55 year old male. I've had 6 joint replacements, and over 17 other arthritis related surguries over the last 20 years. I am writing to say the new laws on opioid prescriptions to stem overdose deaths is not only failing, it's creating an even worse problem for people with chronic pain. I can speak to this as I am one of those people. I've been on and off of opiates for over 15 years, never having a problem while taking them or getting off of them. These pain killers have not only made my life bearable, but have allowed me to continue as a productive part of society. This all ended in 2017 when the new laws went into effect. Since 2017, I've had 3 replacements and 3 other joint repairs. A former [specialization redacted] Engineer for the USAF [base location redacted], I am now a drain on society.<br/>The 7 day rule after surgery and the mg's allowed are a complete joke.<br/>If I was in front of a committee, and they asked me how I'd handle the situation, I'd say, this is between me and my doctor. Isn't that what Republicans always say, less government control. Fyi, I'm independent. <br/>The overdose problem isn't because of doctor prescriptions, it's people buying on the street. And you are pushing people like myself, to go that route. It's either a prolonged painful death, or a quick death, not much of a choice.<br/>I can only speak for myself, my quality of life is near zero.<br/>This policy needs to change, yesterday.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fb7e10	Kobelak	None	2022-03-03T20:49:00Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Kobelak, Michael	l0a-t8fh-bc7j	False	None	False	2022-04-12 03:16:26.881	[]
1810	CDC-2022-0024-1816	https://api.regulations.gov/v4/comments/CDC-2022-0024-1816	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 58 year old son has suffered needlessly because his pain has been undertreated as a result of the CDC guidelines. I know some mothers have lost their sons or daughters due to recreational use of illicit fentanyl, but the US overdose rate is signicantly higher now than it was in 2016, suggesting your guidelines have only worsed the problem, by driving people to resort to illicit fentanyl or heroin. I know two people who are my age and have resorted to buying street drugs because their doctors decided they would rather harm patients than risk losing their license and ability to care for their own families. Stop harming people like my son and destroy the 2016 guideline rather than replace it. You all should be ashamed of yourselves for the people you have driving to suicide and other people you have driven to street drugs, and people like my son who have needlessly been tortured. Also, my son told me your new guidelines went from 90 mme to 50 mme which is an even lower limit, and his doctor is considering cutting his medicine down even further after reading your ridiculous new update. Why do we need a CDC when all you seem to do is harm people?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dixie	None	None	0900006484fb7e1b	Clayton	None	2022-03-03T20:51:43Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Clayton, Dixie	l0a-tdt2-p6cv	False	None	False	2022-04-12 03:16:27.089	[]
1811	CDC-2022-0024-1817	https://api.regulations.gov/v4/comments/CDC-2022-0024-1817	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Delete the 50 MME guideline and change sickle cell anemia to intractable pain, or otherwise rescind the 2016 guideline and do not replace it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7e1c	Anonymous	None	2022-03-03T20:52:00Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-tfvq-ikmc	False	None	False	2022-04-12 03:16:27.299	[]
1812	CDC-2022-0024-1818	https://api.regulations.gov/v4/comments/CDC-2022-0024-1818	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has been harmed and nearly committed suicide because his doctor could not increase the dose he was stuck at for a decade, and he developed tolerance to his medicine. He has severe arthritis, spinal cord damage, severe compression of his nerve roots causing severe shocking and aching pain in his arms, and osteoarthritis in every joint in his body due to some genetic combination that doctors do not fully understand and call generalized or polyarticular arthritis. Why exempt sickle cell anemia instead of calling it intractable or difficult to treat pain conditions like my son has? He also tells me you LOWERED the suggested limit from 90 to 50 MME. Our news stated that you eliminated the 90 MME and said to individualize the dose, yet this draft contains an even more restrictive suggestion that you know full well as addiction doctors that the government, insurance companies, and medical doctors will adopt as the new defacto limit and as a result the suffering will increase. Everyone is different and putting down any limit is a bad practice as you confessed in 2019 when you issued a notice that your guideline had been taken out of scope. Knowing this, why do you persist in suggesting a dose limit that is even harsher? Also, I am told that most overdoses are due to street drugs, not prescription drugs, and overdoses have risen since the release of your 2016 guidelines. It seems the people who profited by the 2016 guidelines have been the Mexican drug cartels, and drug companies that make suboxone and buprenorphine. I do not believe the federal government has any right to attempt to restrict what medical doctors can prescribe. The FDA already gives guidelines tailored for each medication in the published prescribing information. Why write a guideline that conflicts with the FDA's guidelines? Also, my husband said the size of the guideline has grown by three times the former 2016 guideline, and the scope has been expanded to cover every possible prescriber, while the 2016 guideline was supposed to give advice only to family medicine doctors. <br/><br/>I ask you to stop violating the sanctity of the physician-patient relationship. Stop harming people like my husband,and be sure the DEA is told to stop threatening doctors if they prescribe above any single limit, whether it is 90 or 50 MME. Didn't you learn from the 2016 guideline that the government and insurance companies would seize the number you put down on paper and make it into state laws, or even in states like mine, without a state law, the number is used by the state medical license board to pressure doctors into not prescribing more than your 90 or 50 MME recommendation?<br/><br/>I suggest that you delete the 2016 guideline and issue a public apology for all the people you have harmed. Families have lost loved ones to suicide, seniors are using heroin now instead of Tylenol 3, and others like my husband are bedridden and cannot function due to the under-treatment of his pain. Prior to your guideline, he could manage his pain and hold a job. Now he is disabled and suffers greatly, and it breaks my heart to see his suffering you have caused him.<br/><br/>I am submitting this anonymously because thanks to CDC and the DEA I no longer trust the federal government. I also do not listen to your COVID advice either. You ruined your credibility in the eyes of the public, and damaged the reputation of the CDC that won't be easy to undo. Retracting and not replacing the 2016 guidelines would be a good step to earn back the public's trust. States like Oklahoma are passing laws banning the use of CDC guidelines, and if you publish the guideline as currently written, many more states are working on similar legislation to make your new guideline irrelevant, and I'll be working to make it happen in my state.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7e22	Anonymous	None	2022-03-03T20:55:27Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-u6xt-yjr2	False	None	False	2022-04-12 03:16:27.503	[]
1813	CDC-2022-0024-1819	https://api.regulations.gov/v4/comments/CDC-2022-0024-1819	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is [name redacted] and I have been suffering with RLS since I was little. As I have gotten older my RLS has become extremely difficult to live with. I currently take Mirapex but it doesn't always work leaving me crying and in extreme pain several nights each week. The combination of opioids and mirapex bring me significant relief when taken together, but my doctor will only prescribe 7 tablets a month. This is not nearly enough. There are days I contiplate suicide due to the pain and lack of quality of sleep. I don't understand why I'm denied this medication when I could prevent me from doing something much worse than a possibility of getting adicted to a narcotic. That seems pretty compared to taking my own life. There are nights when I want to cut my legs off, lay in front of a train, anything to make the pain go away. I have stabbed myself in the legs with a fork, I've best my own legs so badly I left bruises. You see because feeling anything besides the pain of RLS is better. I suffer on a daily basis. The Mirapex I take cause such extreme drowsiness I cannot work a first shift job because I can't wake up. But, if I could take a opioid for pain I could then take 1/2 of the mirapex giving me a much better quality of life leaving me able to function without being left with extreme tiredness. RLS is dibilitating to say the least and everyday I pray to be able to one-day get someone to understand that being prescribed and opioid for my RLS could quite possibly actually save not only my life but a lot of RLS sufferers around the world..<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fb787f	Childers	None	2022-03-03T20:58:24Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Childers, Jennifer	l0a-d6vw-3fvg	False	None	False	2022-04-12 03:16:27.712	[]
1814	CDC-2022-0024-1820	https://api.regulations.gov/v4/comments/CDC-2022-0024-1820	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 68 year old woman living in Illinois, I've had 18 years of dealing with Wilkes-Ekbom, or Restless Leg Syndrome (better known as RLS.) I've struggled to get adequate care. Earlier this year I was able to consult with [name redacted] of [facility and location redacted] who recommended OxyContin ER in 20 to 30 mg. at night to calm my legs and let me sleep. He explained that with someone like me, low dose opioids are very rarely addicting simply because no tolerance is built, as it is with pain. With pain, opioids lose their effectiveness over time, so that patients ask for more. Not so with RLS! It is not pain; it's a terrible discomfort, much like hundreds of tiny seizures inside your legs, irritating you into moving. No matter how tired you are, you have to keep moving. However, because of the current law and the strictures against opioid use, my home state neurologist is uncomfortable with [name redacted] recommendation and will not prescribe an adequate dose. I'm up anywhere from 3-7x a night with at the most, a three hour stretch of sleep. It has been a nightmare. In the past two years, I've lost my business, my social life and worst of all, the ability to rest. Now my symptoms are worsening. I can't even count on sitting in a car comfortably. It's only with difficulty that I can drive an hour away to help take care of my 94 year old mother-in-law. So with all my heart, I ask that you take people like me into consideration, and encourage our doctors to prescribe the opioids we need—yes, carefully, thoughtfully and with oversight, but also with freedom, so they can provide the care that is in many cases, desperately needed. I ask you, please, please listen as if you were suffering with me. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Val	None	None	0900006484fb78d4	Osaka	None	2022-03-03T21:25:18Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Osaka, Val	l0a-euju-6ixd	False	None	False	2022-04-12 03:16:27.917	[]
1815	CDC-2022-0024-1821	https://api.regulations.gov/v4/comments/CDC-2022-0024-1821	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife's doctor force tapered her off her hydrocodone and now she risks going to prison because she can only get pain relief to function by buying heroin. Is this helping patients by making them use much more dangerous street drugs/ I also know several people who buy oxycontin from street drug dealers, and who knows what that has in it. I've heard the cartels are using elephant-grade fentanyl and pill presses to make pills that look like prescription drugs, but are actually fentanyl pills, and God only knows what strength is in each pill. People are playing Russian roulette thanks to the CDC's prescribing guidelines. I know a deceased Army veteran who committed suicide when the VA force tapered him off his pain medicine because his phantom limb pain made his life unbearable. A child at a major medical university with 3rd-degree burns was being refused any pain medicine due to a cruel "no opioids for children" policy that did not exist before the release of the 2016 guidelines. And despite your guidelines, overdoses are higher than ever. How about doing actual research and find a real solution, such as figuring out why kids are using street drugs for recreation, and suggesting policy changes such as decriminalization of all drugs and improving the mental health availability, instead of more of the same failed approach with guidelines no one will read except the DEA? Is it not time for a very different direction, since it is clear CDC guidelines can only do harm to the public health? And why do all 5 authors of this draft have addiction experience and not one of them has pain management experience, from a doctor who prescribes opioids and hasn't done like 99% of pain specialists and resorting to offering only expensive and frankly useless procedures like epidural steroid injections? Get rid of the 50 MME limit that you know full well by the fact you had to warn against the misapplication of the 2016 edition in April 2019. Any number will only be used to harm pain patients and prosecute physicians or pressure them to even further limit dosages below what individual patients may need. Finally, don't single out sickle cell anemia as an exclusion, and replace it with "those suffering severe, chronic pain due to a disease or injury.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb79ad	Anonymous	None	2022-03-04T03:50:44Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-usnt-m3ab	False	None	False	2022-04-12 03:16:28.142	[]
1816	CDC-2022-0024-1822	https://api.regulations.gov/v4/comments/CDC-2022-0024-1822	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I myself do not need opioids but I am on 2 forums for RLS where I help many people and low dose opioids have been a life saver for many of them when the regular medications don't work.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fb79af	Sinrod	None	2022-03-04T04:00:06Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Sinrod, Linda	l0a-v4df-fhxx	False	None	False	2022-04-12 03:16:28.350	[]
1817	CDC-2022-0024-1823	https://api.regulations.gov/v4/comments/CDC-2022-0024-1823	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, this message is because the draft does not address chronic conditions like my severe Restless Legs Syndrome which is different than chronic pain. It is impossible for me to be still for more than one minute without medication, I currently use 5mg Oxycodone at 11am and 4mg Ropinirole at 4pm, the Ropinirole has started to wear off around 10pm so I have to take another 2 1/2mg to 5 mg Oxy to get any sleep which is usually 2 to 4 hours a night, it's only recommended no more than 4mg Ropinirole a day. My doctor will only prescribe one 5mg Oxy per day so I have asked my family, friends and neighbors for any they have in the medicine cabinet, soon I will be buying them off the street, I don't care that it's illegal, it works and I need them. I have many things wrong with me but if I could cure one thing it would be RLS, it controls me 24 hours a day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fb79b0	Deorio	None	2022-03-04T04:06:16Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Deorio, David	l0a-vknu-3d15	False	None	False	2022-04-12 03:16:28.557	[]
1818	CDC-2022-0024-1824	https://api.regulations.gov/v4/comments/CDC-2022-0024-1824	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC is revising the Clinical Practice Opioid Prescribing guidelines, but the revision does not address conditions other than chronic pain. Restless legs syndrome (RLS) is different than chronic pain. It is a disease that causes the urgent, uncontrollable need to move legs as well as other parts of the body. RLS disrupts sleep which affects every part of everyday life.<br/> I have suffered from RLS for over forty years. I have taken every medication prescribed. They relieve symptoms for a while, then make the condition worse. When the medications were no longer effective, I was referred to a pain clinic, which prescribed sleeping pills and referred me to a sleep clinic. After man years of different medications and non-medication treatments, my RLS is not controlled.<br/> Personal care physicians are fearful of prescribing opioids and refer patients to a pain clinic. Pain clinics only prescribe opioids for conditions causing chronic pain.<br/> Patients with severe, unrelenting RLS would greatly benefit from a low daily dose of an opioid. There is no need to increase the dose, it can be taken for decades.<br/> Please include a section in the 2022 Opioid Prescribing guidelines to include chronic conditions, like RLS, that require a daily low dose opioid. For additional information about RLS refer to the RLS foundation web site, RLS.org.<br/> Thank you for your consideration for treatment of chronic RLS<br/><br/>Respectfully,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mona	None	None	0900006484fb7e4f	Lanier	None	2022-03-04T04:10:54Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Lanier, Mona	l0a-ymir-49sb	False	None	False	2022-04-12 03:16:28.766	[]
1819	CDC-2022-0024-1825	https://api.regulations.gov/v4/comments/CDC-2022-0024-1825	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe RLS. There are nights when I can't sleep and have to walk in order to quiet the jumpiness in my legs. Walking thru my house for hours when I'm exhausted is miserable. I take Pramipexole and gabapentin but on some nights they don't work. If I could take Hydracodone when I have breakthrough RLS, after I've taken my normal meds, my anxiety level would decrease and I would be able to sleep. It is pure torture not being able to sleep or do anything but walk when one is exhausted.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7e53	Anonymous	None	2022-03-04T04:11:36Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-yuj4-enez	False	None	False	2022-04-12 03:16:28.980	[]
1820	CDC-2022-0024-1826	https://api.regulations.gov/v4/comments/CDC-2022-0024-1826	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	DIAGNOSED RLS BACK 2007.PREVIUS INSURANCE I USED 3 PILLS .25 ROPINOLE AND 1 HYDROCODONE FOR OVER 10 YEARS. NEW INSURANCE I HAD TO CHANGE DR. NOW THEY UPED MY ROPINOLE AND TOOK HYDROCODONE AWAY. I HAVE BEEN MISERABLE FOR OVER A YEAR. DID NOT RELIZE MY RLS WAS SO EXTREME TILL LAST YEAR. BAD DRUG ROPINOLE THAT HAS GAVE MY INSOMIA	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MARTY	None	None	0900006484fb7e54	PHELPS	None	2022-03-04T04:12:14Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from PHELPS, MARTY	l0a-z15c-84pl	False	None	False	2022-04-12 03:16:29.197	[]
1821	CDC-2022-0024-1827	https://api.regulations.gov/v4/comments/CDC-2022-0024-1827	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have serious restless leg syndrome. Medications for this condition for we 12 million who have it can be a struggle. A very small dose of an opioid medication can bring relief that makes life livable. The RLS foundation has conducted research over several years of over 500 individuals on low level opioid medication. Substantial increase in needing a stronger amount was minimal. Without opioids the medication for RLS doesn’t work for many of us. Without relief one can’t sleep, sit quietly, or rest while the legs jerk and nerve energy travels up and down the legs every few seconds. You wouldn’t wish this condition on your worst enemy. Please consider making it easier to obtain well managed opioid medication for those who need it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wilma J	None	None	0900006484fb8072	Gormley	None	2022-03-04T04:13:25Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Gormley , Wilma J	l0b-0v9q-ckr4	False	None	False	2022-04-12 03:16:29.402	[]
1822	CDC-2022-0024-1828	https://api.regulations.gov/v4/comments/CDC-2022-0024-1828	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your 2016 guidelines & the draft if left as is singlehandedly created a much bigger illicit drug problem. Do you even realize the number of people you've driven to the black market for pain medications? Making it almost impossible to find a physician to treat pain is because the CDC listened to a hateful, racist anti opioid fringe group. Nobody, especially nobody suffering in pain should have to seek out street pills to be able to live and work, walk, get out of bed, participate in life, cook, bathe, but you've turned so many people to do this and now look what's happening? Congratulations I guess. Was that the original plan all along? It has to be bc I can't for the life of me understand how we've come to third world style pain care. I hope you're all in my shoes one day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	GettingOut	None	None	0900006484fb8075	OfAmerica	None	2022-03-04T04:49:19Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from OfAmerica, GettingOut	l0b-10rg-1tk1	False	None	False	2022-04-12 03:16:29.609	[]
1823	CDC-2022-0024-1829	https://api.regulations.gov/v4/comments/CDC-2022-0024-1829	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have had RLS for 30+ years and started taking Ropinirole as soon as it was approved. While it was beneficial for some time, over the years my condition has exacerbated. I experience RLS all through the day if I am inactive and have a much higher dose of the medication which seems to be less effective. I have to anticipate in advance and take medication if I have to go outside of my home for any length of time wherein I will be inactive i.e., Church, taking and waiting for my husband for appointments, or any long distant driving. Etc. As such I have become more reclusive.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carolyn	None	None	0900006484fb7ae0	Taylor	None	2022-03-04T04:54:00Z	None	None	1	None	2022-03-03T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Carolyn	l0b-2nc1-bq8y	False	None	False	2022-04-12 03:16:29.826	[]
1824	CDC-2022-0024-1830	https://api.regulations.gov/v4/comments/CDC-2022-0024-1830	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from severe pain in my back, my legs, my neck, my shoulders, my feet. I suffer from fibromyalgia I suffer from complex regional pain syndrome. I suffer from chronic pain syndrome. The US government should not control the amount of medication I am allowed to take. My doctor supervises my medication I am taking my medication as prescribed. If I did not have this medication to control the pain I would not be able to live. What right does the government have to tell my doctor he can limit my medication to what they think is suitable . You cannot say that only cancer patients are eligible to be on higher dosages of medication. It is a case by case basis. A Doctor Who is well educated in this field has the right to prescribe the proper dosage as he feels necessary. This is not right that the government thinks they can control our lives. You are going to make us suffer excruciating agonizing pain by telling a doctor how much they are allowed to give ipain medication. I happen to be on a high dose of medication because it is necessary in order for me to live on a daily basis without nonstop agonizing pain. You need to understand that not everyone is on the same level and cannot be based upon a chart that the government feels should be for every patient the same prescription and only equal a certain milligram of medication. This is terrible that the government is trying to control us and our doctors	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marna	None	None	0900006484fb7b17	Bloom	None	2022-03-04T05:00:11Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Bloom, Marna	l0b-2w2k-t53i	False	None	False	2022-04-12 03:16:30.039	[]
1825	CDC-2022-0024-1831	https://api.regulations.gov/v4/comments/CDC-2022-0024-1831	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This confuses me. In one place you say amount should be left up to doctors. But buried deep down in the doc it states 50 MME. I do not understand. Which is it? You’ve stated that the 90 MME is hurting pain patients but take it even lower?? Then you’ll see the suicide stats increase and wonder why. Get the government out of my healthcare. Everyone is different and needs different care. Please uncomplicate the situation and remove any and all MME upper limits.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fb7b1c	Kinion	None	2022-03-04T05:00:53Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Kinion, Kim	l0b-37b6-szi1	False	None	False	2022-04-12 03:16:30.248	[]
1826	CDC-2022-0024-1832	https://api.regulations.gov/v4/comments/CDC-2022-0024-1832	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe, refractory RLS. I was on Requip for over 10 years, suffered horrendous all over body augmentation of RLS symptoms and nearly didn't make it through the horrendous withdrawal. I am a retired corporate lawyer and seriously considered suicide. I was prescribed low dose Oxycontin and pregabalin but still suffered severe RLS. In desperation, I researched extensively and asked for low dose Buprenorphine. It has quite literally saved my life. I had coldly and logically decided to end my life as the constant nightly torture of being woken every hour by severe crawling, worms in my legs was too much. 0.4mg of Buprenorphine has transformed my RLS. No symptoms and I have slept every night since. I have stopped all other medication as my health has greatly improved. Opioids were the first drugs given for RLS in 1670 by Dr. [name redacted] who compared RLS tobeing tortured on the Rack.<br/>I have not become addicted to Buprenorphine. I am dependent on it in the same way that diabetics are dependent on insulin. Without it I will die ( by my own hand). It has been miraculous. I am hoping I will never have to increase the dose. So far, I have been on 0.4mg for 8 months and have not increased the dose. <br/>Please ensure RLS is included in the list of diseases for which opioids should continue to be prescribed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484fb81af	Gould	None	2022-03-04T05:06:42Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Gould, Julie	l0b-39se-jsj4	False	None	False	2022-04-12 03:16:30.455	[]
1827	CDC-2022-0024-1833	https://api.regulations.gov/v4/comments/CDC-2022-0024-1833	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering from chronic pain for over 12 years. I have fibromyalgia, complex regional pain syndrome (CRPS/RSD), chronic back pain with sciatica, severe spinal stenosis, herniated and degenerative discs. 2 Failed knee replacement with minimal mobility, pain in other knees and both feet and ankles from altered gait. I have 4 herniated discs in my cervical spine with degeneration. I walk with the support of a cane. I am not a candidate for back surgery because of the issues with my legs and will not heal properly. If I did not have the pain medication I would not be mobile and would have no quality of life. <br/><br/>The CDC guidelines has harmed me personally by driving your doctor to restrict your treatment out of fear of being persecuted by DEA, DOJ, State Medical Boards, Attorney Generals or Prosecutor's offices. <br/>This has caused me to be in worse pain than before when I was prescribed the proper dosage that was cut down because the government wants to control us. <br/><br/>I am Demanding the public withdrawal of the 2016 Guidelines on grounds that these documents are flawed by weak medical evidence, naive and uncritical anti-opioid bias, gross exaggeration of opioid treatment risks, incorporation of junk science, and misrepresentation of the efficacy and safety of non-opioid alternative therapies. Additionally, the US CDC has no legal charter to set practice standards for opioid therapies or any other therapies other than infectious disease. Such standards are best developed by professional medical associations and academies whose membership actually treats patients.<br/><br/>Thank you in advance for your consideration.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marna	None	None	0900006484fb81e0	Bloom	None	2022-03-04T05:08:39Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Bloom, Marna	l0b-3vo7-xwh7	False	None	False	2022-04-12 03:16:30.668	[]
1828	CDC-2022-0024-1834	https://api.regulations.gov/v4/comments/CDC-2022-0024-1834	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Licensed Alcohol and Drug abuse Counselor and while I praise taking precautions in randomly prescribing pain medications. However I strongly disagree with the current CDC guidelines on prescribing opiate medications. Physicians should be given to use their professional judgment in prescribing medications for people with pain. Especially those with chronic pain. I have severe neuropathy and chronic pain after 2 back surgeries. After a recent hip replacement, I fell due to my pain and shattered my femural head and am only being given 5 mg. Of Oxycodone for pain for all of these issues. Being 6’6 at 280 lbs. this is grossly inadequate for managing my pain. All I desire is to recover in order to get back to work. Inadequate pain management is grossly interfering with my rehabilitation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hiram	None	None	0900006484fb823c	Meyer	None	2022-03-04T05:09:40Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Meyer, Hiram	l0b-48n3-ye5d	False	None	False	2022-04-12 03:16:30.874	[]
1829	CDC-2022-0024-1835	https://api.regulations.gov/v4/comments/CDC-2022-0024-1835	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for updating the CDC Clinical Practice Opioid Prescribing Guideline. Unfortunately, the draft does not address chronic, debilitating conditions like Restless Leg Syndrome (RLS). RLS is different from chronic pain; RLS is a chronic neurological disease that causes a sensation of limb agitation and an urgent need to move the legs. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. It is largely idiopathic. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications actually make the symptoms worse; this is called augmentation. For some individuals there is no effective medical therapy except for low-total-daily-dose opioids. There is efforts to better understand this and growing awareness in scientific studies about the safety of long term, low dose opiods for RLS. <br/><br/>My RLS is correlated to my almost two decades use of citalopram for anxiety/depression. RLS was much less understood at the time and my symptoms were intermittent. It is only recently that it became well known that the SSRIs/SNRIs and many other psychiatric drugs cause or exaccerbate RLS symptoms. It was only this past year, after several years without citalopram, when I was prescribed Cymbalta and experienced severe RLS symptoms, that the connection became clear to me. From my online research and information from rls.org, I gained a better understanding of this condition. Thankfully, with extreme lifestyle changes and cessation of Cymbalta, my RLS is again in remission. However, many souls are not so fortunate - either because of their own physiology, side effects of years of pharmaceutical treatments, or other factors, there is no relief and their nightmare continues. For them, low dose opioids are a lifeline.<br/>There is so much we have learned about RLS and so much we don't know. According to rls.org (the US-based RLS Foundation), the first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. <br/><br/>I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fb8241	Waddell	None	2022-03-04T05:14:25Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Waddell, Michael	l0b-4a35-avtp	False	None	False	2022-04-12 03:16:31.086	[]
1830	CDC-2022-0024-1836	https://api.regulations.gov/v4/comments/CDC-2022-0024-1836	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Three major changes are needed to these guideline:<br/><br/>First: All mention of MME limits must be removed. 50, 90, it's all arbitrary and it all causes vast damage to chronic pain patients. While these may be "guidelines," most states have made laws based on them, and those laws have done untold damage to patients with legitimate need for these prescriptions, and for doctors acting in good faith. The whole idea of limiting a doctor's decreassion to prescribe for the individual patient is absurd- would you limit insulin amounts? Tell a parent "sorry your kid can't focus in school; there's only so many ADHD meds he can have?" Research has shown over and over that chronic pain patients abuse their medication at a rate of less than 1%; we are not the problem.<br/><br/>Second: guidelines must state that patients with a chronic intractable pain diagnosis are excluded from prescribing restrictions. While palliative care should be available for anyone with an incurable disease, it in fact is only for those in hospice or who are dying. Making exclusions only for those with cancer and sickle cell ignores the needs of millions of disabled individuals who just want to be productive members if society. <br/><br/>Third: these guidelines should only apply to General Practitioners, as originally written in 2016. Specialists like pain management doctors treat a myriad of atypical patients who don't conform to a single box. They have much more training than a family doctor and should be able to act in good faith, and at their own discretion. They don't need a government agency to sit between them and their patients with debilitating illnesses. Again, overdose deaths are not caused by pain management prescribing, but by illicit fentanyl.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jessica	None	None	0900006484fb8273	Layman	None	2022-03-04T05:16:21Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Layman, Jessica	l0b-4ky5-qpbd	False	None	False	2022-04-12 03:16:31.304	[]
1831	CDC-2022-0024-1837	https://api.regulations.gov/v4/comments/CDC-2022-0024-1837	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered with RLS since I was a very young adult. For many years episodes were only occasional although when they appeared they were no less debilitating. I was sleep deprived and going to the Movies or Performances became unbearable. As an older adult my RLS have become severe. Medications for me have worked for short periods before the symptoms of RLS return with a vengeance and sooner in the day. I now have episodes where the RLS goes into my arms and hands. Unable to get enough sleep has worsened or caused other health issues me. I have also suffered financially as the fatigue from the RLS episodes has effected my ability to work my full schedule at work. If I am not able to find a medication that has been proven to work on RLS but is not in your Prescribing Guidelines I will likely lose my livelyhood and have to rely on SSDI, Please add RLS to your guidelines and help myself and others to find relief and remain productive members of society. Don't let us to continue to suffer!<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fb8274	Boston	None	2022-03-04T05:18:00Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Boston, Kevin	l0b-4lqa-q7e8	False	None	False	2022-04-12 03:16:31.515	[]
1832	CDC-2022-0024-1838	https://api.regulations.gov/v4/comments/CDC-2022-0024-1838	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I work as a physician and practiced in the rural area with high prevalence of opioid misuse and addiction, as well as chronic pain. Whilst opioids may be benefitial in some patients with chronic pain, the personal and societal risks of chronic oopioid use outweigh benefits in many patients. We have to remember how the opioid epidemic started and by liberalizing opioid use will hinder progress made in combating this epidemic. Most importantly, there is no quality scientific evidence demonstrating definitive benefit of chronic opioid use, but there is plenty of evidene for harms. I encouirage CDC keep science in mind when attempting to revise its guideline.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb829d	Anonymous	None	2022-03-04T05:18:58Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-4zgr-7h3r	False	None	False	2022-04-12 03:16:31.784	[]
1833	CDC-2022-0024-1839	https://api.regulations.gov/v4/comments/CDC-2022-0024-1839	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain sufferer and I can’t get my medication due to doctors scared of the CDC.<br/>Chronic migraines, fibromyalgia, arthritis throughout my body.<br/>Please help!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fb82a4	Hagan	None	2022-03-04T05:23:52Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Hagan, Michelle	l0b-5g0s-iqlu	False	None	False	2022-04-12 03:16:32.015	[]
1834	CDC-2022-0024-1840	https://api.regulations.gov/v4/comments/CDC-2022-0024-1840	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is very important that you remove the mme for chronic pain. All patients respond differently and there is no proof on why it is listed the way it is. The people that you are getting information from have financial motivation for the decrease. <br/><br/>Why are you not taking information from the people suffering and the doctors that have the education on how to handle pain? Pain patients only want to have QUALITY of LIFE!!! How many are loosing their lives from not getting properly medicated. When pain is left untreated the heart stresses so does the brain. I love everyday in acute pain, I can’t always hug my kids do to pain, grocery store is an all day challenge now. So is cooking, cleaning. I only want to have quality of life!<br/><br/>The focus needs to be turned to the open boarders and illegal drugs coming across our borders. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joelle	None	None	0900006484fb82ca	Maloney	None	2022-03-04T05:25:53Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Maloney, Joelle	l0b-5s34-inn6	False	None	False	2022-04-12 03:16:32.219	[]
1835	CDC-2022-0024-1841	https://api.regulations.gov/v4/comments/CDC-2022-0024-1841	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>Please consider Restless Leg Syndrome (RLS) in your guidelines. Opioids are the last line of defense and the only known method to allow me, and many others, to sleep. I'm able to get by on a very small dosage of 2.5 mg of Oxycodone once per day before I go to bed. This small dose is a life saver for me. Without it I will lose 4 hours of sleep per night. There is no other known treatment for me.<br/><br/>John Hopkins researchers studied the use of Methadone for 10 years for RLS. It was effective for 100 patients for that entire time without addiction and without increased dosage. (https://www.sciencedirect.com/science/article/abs/pii/S1389945710003710)<br/><br/>Thanks for you consideration!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronald	None	None	0900006484fb830b	Wright	None	2022-03-04T05:27:21Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Wright, Ronald	l0b-5xdp-f4zc	False	None	False	2022-04-12 03:16:32.431	[]
1836	CDC-2022-0024-1842	https://api.regulations.gov/v4/comments/CDC-2022-0024-1842	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 81 year old woman who has suffered from Restless Legs Syndrome since I was 14 years old! I have seen many doctors and been on numerous medications. My last prescriptions from a physician at The Mayo Clinic in [location redacted] are a combination of Gabapentin and Clonazepam. This combination has worked perfectly for me for more than 5 years. I would suffer immensely without them. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joan	None	None	0900006484fb8349	Marett	None	2022-03-04T05:28:14Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Marett, Joan	l0b-6emf-2dfa	False	None	False	2022-04-12 03:16:32.645	[]
1837	CDC-2022-0024-1843	https://api.regulations.gov/v4/comments/CDC-2022-0024-1843	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for updating the opioid prescribing guidelines. <br/><br/>In your recommendations, please make allowances for the use of low dose opioids, such as for the management of restless legs syndrome (RLS, Willis-Ekbom disease). For many sufferers of RLS, low dose opioid are the only option that works. <br/><br/>Please take into consideration that low dose opioids are much safer than doses used for pain. Studies have shown that low dose opioids do not have the same addiction issues as opioids used for pain. It is not fair for those with RLS to have trouble getting the medication they need and can use safely because of issues at higher does. <br/><br/>I am lucky. I can manage my RLS mostly with diet, exercise, and over the counter supplements. On bad nights I used to take a half of a hydrocodone or oxycodone (1/4 the dose for pain). I now take requip, which increases dopamine (non-opioid, Rx). Because I only need requip a few days a month, I have not developed augmentation (making RLS worse) and it continues to work for me. <br/><br/>Many other people with RLS are not so lucky. They have developed augmentation and cannot take requip or related medications. For them, low dose opioids are the only option that works. Again, these are effective at doses lower than used for pain, so they are safer. I know several people with RLS who are having difficulty getting the low dose opioid medication they need and are suffering greatly.<br/><br/>Please, in the updated guidelines, make allowances for the use of low-dose opioids for people suffering with RLS.<br/><br/>Thank you so much for your consideration.<br/><br/>[name redacted], PhD<br/>Restless legs syndrome sufferer<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bradford	None	None	0900006484fb83d8	Fanger	None	2022-03-04T05:30:35Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Fanger, Bradford	l0b-7rjg-x55x	False	None	False	2022-04-12 03:16:32.851	[]
1838	CDC-2022-0024-1844	https://api.regulations.gov/v4/comments/CDC-2022-0024-1844	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a patient who experiences chronic migraines, with headaches occurring every day in varying intensity. I have tried numerous medications and other treatments to try to reduce my pain levels, including trigger point injections, Botox, vyepti infusions, chiropractic care, acupuncture, yoga, and massage therapy. I even spent $1000 on an occlusal splint to see if that would help the pain I feel on a daily basis. Massage provides some relief, but the most effective treatment is from opioid medications, paired with a rescue migraine medication in the triptan and CGRP classes. Right now I am in a treat the symptom state as preventive care has not been helpful to this point. <br/><br/>As a mental health professional I understand the crisis that has arisen due to overprescription of opioid medications, but all that the restrictions on opioid prescription have done is drive people to other forms of pain relief, such as buying heroin. When they are driven underground to try to get some relief from their pain, they run the risk of obtaining medications that can be laced with deadly substances (like fentanyl). If the point is to truly address the opioid crisis then a new approach has to be taken, as it is obvious the war on drugs and the criminalization of drug use has failed. I believe that there needs to be greater resources devoted to mental health (for those who turn to drugs as a way to self-medicate for mood, anxiety, and thought disorders) and physicians should not have their hands tied by prescribing guidelines for pain medications. Patients should be heard and believed. And there shouldn’t be so many barriers to access for those who deal with pain on a daily basis, who have to find ways to function while dealing with chronic issues. I speak both as a professional and as someone who has to deal with these issues in my personal day to day existence. While I have not sought out drugs on the street, and never would given the history of substance abuse issues that run in my family, I can still understand the desperation that someone may feel for any sort of pain relief which leads them there.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb8444	Anonymous	None	2022-03-04T05:32:26Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-8idf-f3xm	False	None	False	2022-04-12 03:16:33.057	[]
1839	CDC-2022-0024-1845	https://api.regulations.gov/v4/comments/CDC-2022-0024-1845	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What your doing to pain patients is cruel. I go to a pain management clinic run by dignaty health. Everything is documented, every thing is tracted. Leave these doctors alone. <br/>I've see and heard childs screams in the ER because they won't or can't give pain relief. It's insane!<br/> I've read stories of VA patients completely cut off cut their pain medications and committed suicide because they can't live with the pain that defending our country gave to them. Shame shame shame on you! <br/> Yes, I know the real problem is illegal Fentanyl. In all your "good intentions" your creating a market for these deadly drugs. Put your money and effort's where it should be and not with qualifed pain doctors. <br/> My thoughts we need more inspectors at the borders and ports And sanctions for china for not trying more to stop it!.<br/>Perhaps more AMERICAN drug manufacturers here at home so china doesn't control the drug trade???	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlene	None	None	0900006484fb84b5	Norton	None	2022-03-04T05:33:19Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Norton, Charlene	l0b-9dw1-arpi	False	None	False	2022-04-12 03:16:33.273	[]
1840	CDC-2022-0024-1846	https://api.regulations.gov/v4/comments/CDC-2022-0024-1846	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an overwhelmingly uncomfortable feeling or pain usually beginning in the legs, causing an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit still, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. I take tramadol every day because it is the only thing that allows me to live a normal life. <br/><br/>I've been taking a low dose of tramadol for over 20 years. I admit that I am dependent on the opioid medication, but I am in no way addicted. I depend on the opioid to take away the urgent impulses in my body which make it impossible to stay calm and still, and which cause a great deal of aggravation and pain.<br/> <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jerry	None	None	0900006484fb84e4	Schmidt	None	2022-03-04T05:34:23Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Schmidt, Jerry	l0b-9wb2-crb5	False	None	False	2022-04-12 03:16:33.478	[]
1841	CDC-2022-0024-1847	https://api.regulations.gov/v4/comments/CDC-2022-0024-1847	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe RLS for 20 years and have tried all medications over the years with horrible side effects or no help. I am now on low dose of oxycodone and it has been a life saver. It has resolved almost all of the problems and no side effects. I have my life back. This has been a very good option for my RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	matt	None	None	0900006484fb896f	Roslawski	None	2022-03-04T05:38:01Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Roslawski, matt	l0b-ajdv-4kd4	False	None	False	2022-04-12 03:16:33.682	[]
1842	CDC-2022-0024-1848	https://api.regulations.gov/v4/comments/CDC-2022-0024-1848	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from RLS for many years and in my research through The Mayo Clinic and other reputable sites I have seen that the low dose of opioids and careful monitoring of the prescribed drugs have shown vast improvement. As patients within history of drug abuse should be able to try these drugs as an alternative to drugs that have been prescribed in the past like the one I have been on for many years. Requip. I have lately found out that it can easily cause augmentation and I have experienced that. Also it is very difficult to get off of and must be done extremely slowly and something else used in its place. Please consider adding Restless Leg Syndrome to your list of ailments that low dose opioids could be tried as treatment for this very frustrating problem. Some nights I literally have to walk and kick out the creapy crawly felling behind my knees for 8-9 hours. We need new medications for this and I'm asking for you help. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fb8987	Serekian	None	2022-03-04T05:38:59Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Serekian, Lisa	l0b-b1fp-luw3	False	None	False	2022-04-12 03:16:33.886	[]
1843	CDC-2022-0024-1849	https://api.regulations.gov/v4/comments/CDC-2022-0024-1849	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] and I live in [county redacted] in New York State. I have been a big supporter of the CDC until now I have had a serious back problem with several conditions that are inoperable. these conditions are: Spinal Stenosis, Bulging disc, Herniated disc and Arthritis. I have tried every therapy available but nothing works. I have been evaluated by top surgeons at [hospital name redacted] and [hospital name redacted] and they recommend I get pain management treatment. I am on a an opioid at night so I can sleep. NYS Department of Health requires random testing while taking an opioid. <br/><br/>your proposed guidelines take away my primary care and restricts my doctor from treating my pain. Such standards should be in the hands of doctors trained to treat these problems. Please get rid of this m odification to the guidelines.<br/><br/>Thank you,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484fb899f	Saccente	None	2022-03-04T05:41:20Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Saccente, Joseph	l0b-b3by-s8bl	False	None	False	2022-04-12 03:16:34.093	[]
1844	CDC-2022-0024-1850	https://api.regulations.gov/v4/comments/CDC-2022-0024-1850	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I appreciate the effort to address the opioid crisis, I would like to draw your attention to an ignored disease that affects nearly 12 million people in the US. I have had Restless Leg Syndrome for over 25 years, most of those years taking a medication that has actually ended up making my disease worse. Due to my Refractory RLS, the only medication that curbs this horrible condition is a very low daily dose opioid. I wish this wasn’t so, but it really is a miracle drug for many of us whose RLS is not responsive to any other drug. Please include this disease in your analysis of responsible use of opioids, I don’t know what I would do without it. There are many credible websites that describe how people like me are suffering and what works for it, please consider this dibiitating disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fb89de	Franz	None	2022-03-04T05:42:17Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Franz, Patricia	l0b-bm9q-5g3l	False	None	False	2022-04-12 03:16:34.351	[]
1845	CDC-2022-0024-1851	https://api.regulations.gov/v4/comments/CDC-2022-0024-1851	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'd love to comment on the actual updated 2022 guidelines but they are no where to be found on the multiple links that you have at the CDC. Can you send me the link or post it clearly. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fb8a5e	Fricton	None	2022-03-04T05:42:46Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Fricton, James	l0b-cdt5-jz5c	False	None	False	2022-04-12 03:16:34.567	[]
1846	CDC-2022-0024-1852	https://api.regulations.gov/v4/comments/CDC-2022-0024-1852	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>I have a neurologic problem called Restless Leg Syndrome. Each of us who have it will find we have little in the name of medications that help us. Many prescriptions do nothing or make it worse.<br/><br/>I have had this since my early 30's and am now 73. I have been prescribed any number of medications and some have made it worse. Presently the only thing I can get and use that helps with any consistency is cannabis. The only other medication that has helped is oxycodone. When I have taken oxycodone which was only a few nights, I found I needed only a small dose at night before bed. Sadly, I cannot get a script that would cover every night. This means I would only have relief a few days a month. <br/><br/>RLS is a debilitating disease. There is a horrid sensation in my whole body. It gets worse the more relaxed I become. So, for example, when I was working 12 hours overnight in the ER I would come home exhausted, but the amount I was exhausted was no matter because as I fell asleep the RLS would violently awaken me within 45 minutes. Taking a nap is useless because the minute my body starts to relax or I start to fall asleep - the agitation and pain and cramping begins anew.<br/><br/>Those of us who have this go through hell every night and are exhausted because not only are we awake but we have literally run a marathon with our legs out of control all night long, being exhausted and not being able to rest. It can also be painful and lead to vicious cramping.<br/><br/>The lack of sleep along with the exhausting jerking and leg movement for hours makes all of us open to anxiety and other emotional problems.<br/><br/>I cannot find the words to describe how this disease has ruled and changed my life. Never able to get enough sleep, yet, working, taking care of my family and just trying to live is an everyday challenge.<br/><br/>Making very low dose opioids available for every day use would give me and the thousands of people in this country who have RLS a new lease on life. <br/><br/>I suggest you go to the site by Dr. [name redacted] at [university redacted]. He has done years of research on RLS and opioids. <br/><br/>Please, do the research and you will find that opioids are needed by millions of Americans to just get through a day, to survive without pain ruling their lives, to exist. To SLEEP!<br/><br/>There are many for which suicide is the only answer to stop the pain. <br/>Please, I beg you to Stop being a part of another cause for suicide.<br/>Pass fair laws that allow those like me to live without pain.<br/><br/>Sincerely,<br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fb8b6d	Wiley	None	2022-03-04T05:46:24Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Wiley, Linda	l0b-d21a-jcm0	False	None	False	2022-04-12 03:16:34.790	[]
1847	CDC-2022-0024-1853	https://api.regulations.gov/v4/comments/CDC-2022-0024-1853	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You have swung the pendulum too far the other way, you are penalizing and terrorizing otherwise stable chronic pain patients with forced tapering or switching to something that doesn't work. I have read your reply to comments, that you are not making specific dosing recommendations, but you are. The message is loud and clear is that no one needs opioids for chronic pain and providers better find a way to get their patients off opioids because we are tracking your prescribing habits. Reports like this cause health insurance companies to mandate tapering. [insurer redacted] Health Plan is one example. They get their info from you and run with it. This is not a one-size-fits all issue and you have pressured prescribers to cut back, regardless of what is best for the patient. My spouse lives in fear that his PCP will balk at the next refill of his pain Rx that he has been unchanged for 15 years. We don't dare ask for a refill 1-2 days early or pick up at new pharmacy for fear of being branded a drug seeker. The stress of having your lifeline cut off is real. I see no compassion in this report for the real psychological harms you are are causing for chronic pain patients who follow the rules and simply want to participate in life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484fb8b91	A	None	2022-03-04T05:48:15Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from A, Pam	l0b-dg4p-6t5i	False	None	False	2022-04-12 03:16:34.998	[]
1848	CDC-2022-0024-1854	https://api.regulations.gov/v4/comments/CDC-2022-0024-1854	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484fb8b93	Cusick	None	2022-03-04T05:49:01Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Cusick, Larry	l0b-dgvp-8kto	False	None	False	2022-04-12 03:16:35.236	[]
1849	CDC-2022-0024-1855	https://api.regulations.gov/v4/comments/CDC-2022-0024-1855	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like Restless Leg Syndrome that is different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	0900006484fb8ba0	Heyl	None	2022-03-04T05:49:27Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Heyl, Rebecca	l0b-dt4k-nqda	False	None	False	2022-04-12 03:16:35.463	[]
1850	CDC-2022-0024-1856	https://api.regulations.gov/v4/comments/CDC-2022-0024-1856	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MARTY	None	None	0900006484fb8c51	PHELPS	None	2022-03-04T05:49:46Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from PHELPS, MARTY	l0b-ebe7-szqt	False	None	False	2022-04-12 03:16:35.684	[]
1851	CDC-2022-0024-1857	https://api.regulations.gov/v4/comments/CDC-2022-0024-1857	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been a low dose (50mg 2 x day) recipient of Tramadol for over 15 years. Combined with the med Diclofenac, this combination has been the only successful meds to relieve my pain. My pain is a combination of several surgeries and joint damage due to an auto accident in 2003. I've tried to use over the counter pain relief meds such as Tyolenol, Aleve, Exedrin, Asprin to relieve pain, with zero success. I've tried this at least 10 times in the past 15 years, primarily due to the fact that getting prescriptions from my provider for even this low dose of Tramadol has been very problematic. My providers have been driven by the push that Tramadol is 'BAD', rather than working to relieve my pain. I would like to see a change in how providers approach the use of low dose Tramadol to relieve pain. They always time the refills to the exact day I run out, so I have to make a special trip to town to get my refills. Living in the midwest, winter weather does not always allow for this. It prevents me from traveling with my family, if my refil date coincides with my planned travel plans, etc. This is rediculous to be treated like a drug abuser, when all I'm doing is attempting to reduce my constant body pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brad	None	None	0900006484fb8dff	Fiechtner	None	2022-03-04T05:51:07Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Fiechtner, Brad	l0b-g7gn-d5if	False	None	False	2022-04-12 03:16:35.929	[]
1852	CDC-2022-0024-1858	https://api.regulations.gov/v4/comments/CDC-2022-0024-1858	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am always in pain. I asked my pain management doctor for Tramadol 2 pills twice daily. Due to guidelines he won't.. I use to be on Vicodin 10 mg 4 times a day. It was extremely hard to be taken off after 10 years and yet tramadol is not a strong narcotic, doctors are scared to even prescribe them. Many say because of narcotics. They are partly rif right. Not because they are prescribed. It's because they aren't prescribed that Many people seek street drugs to ease their pain because doctors won't help them. I have often been tempted when my pain is unmanageable but fear of getting something that might kill Me stops me from proceeding. Please stop this and give the doctors back the courage to help patients that are suffering in pain. I currently travel a hour and half for a doctor to give me 2 tramadol daily. Wow! Desperate to relieve any pain. Please help those who really need help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484fb8e5d	Malinak	None	2022-03-04T05:52:09Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Malinak, Laura	l0b-h9ct-874r	False	None	False	2022-04-12 03:16:36.240	[]
1853	CDC-2022-0024-1859	https://api.regulations.gov/v4/comments/CDC-2022-0024-1859	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Docket 2022-0024-0001<br/><br/>Thank you for allowing me to comment. I feel like I have lost years of my life due to undertreated pain because of the 2016 CDC guidelines. I used to be a nurse. I hurt my back and had spinal surgery. But I came out worse than going in for surgery. I suffered injuries to my rectus abdominis and left oblique muscles. I have DDD, arthritis, scoliosis, bone spurs. I suffered a stretch traction injury across my pelvis. My fascia is trapped within my muscles. I can't use my core muscles or my left oblique muscles. I had been forced tapered to 1/3 the medication I was on after the CDC guidelines came out. I tried all kinds of alternatives. Chiropractors, blocks, massages, body work. Nothing fixed my pain. With adequate individualized pain care. I could still go out on dates, travel, visit with friends and family. Participate. After the 2016 CDC guidelines and being forced tapered. My life went from having a quality of life to becoming homebound. The pain I suffer is 2$/7, day after day and year after year since the CDC guidelines. I feel that primary care physicians should be able to prescribe opioids for pain. Especially after trying alternatives. I'm not a candidate for the pain pump. And was told not to get a spinal cord stimulator. There needs to be NO MME DOSE THRESHOLDS! NO MENTION OF MME! If mentioned, it can again be misinterpreted. The 3day,5, day, and 7 day supply should be removed. Honestly I feel that the CDC shouldn't be regulating medications. That's the FDA'S job. The authors of the CDC guidelines had CONFLICTS of interest.and they are anti-opioid biased. Chronic pain patients have been harmed. Hundreds of chronic pain patients have taken their own lives. Others have turned to the streets for pain relief. The CDC guidelines were disastrous. And they will be disastrous once again. What about the good of opioids. Pain relief and a better quality of life. Most pain patients don't abuse their medications. I also feel that people shouldn't have to choose between their benzodiazepine and their opioid pain medication. All that's needed is education. The 2016 CDC guidelines were applied by medicare, and Medicaid, insurance companies. The DEA has targeted, raided and prosecuted doctors. Doctors practice medicine to the best of their knowledge and in good faith. They aren't on some street corners selling drugs. The 2016 CDC guidelines weaponized against doctors. Unless you suffer from chronic pain, you can't imagine pain 24/7,day after day. People being forced to without opioids after major surgery. People are afraid to take opioids for post surgical pain because of entertainment propaganda. And the false narrative of pain pills causing the fentanyl poisoning epidemic!. I fully support [name redacted], patient advocate and commentor.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb8eb2	Anonymous	None	2022-03-04T06:03:46Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-i0ic-225i	False	None	False	2022-04-12 03:16:36.457	[]
1854	CDC-2022-0024-1860	https://api.regulations.gov/v4/comments/CDC-2022-0024-1860	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>I have been suffering with RLS for over 20 years. I've tried multiple medications which are not as effective as low-dose Oxycodone. In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. Please include low-dose Oxycodone in your Clinical Practice Guideline for Prescribing Opioids. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dorothy	None	None	0900006484fb8f04	Liston	None	2022-03-04T06:04:14Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Liston, Dorothy	l0b-j69d-mexz	False	None	False	2022-04-12 03:16:36.677	[]
1855	CDC-2022-0024-1861	https://api.regulations.gov/v4/comments/CDC-2022-0024-1861	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I recently have been treated for pain management due to severe back injury. My doctor continues to prescribe dicolfenac and gabapentin. I haven’t been on Lyrica, Ibuprofen, Toradol shots, one round of epidural injections and given tramadol, trazodon and naproxen. I have been to spine specialist only trying to entice me to purchase costly products and not pain resolution. I live in [city redacted] Virginia and never had any issues with addictions. I pay for [insurer redacted] $300 monthly and countless copays to not even get a pain prescription. On [month and day redacted] 2022 my doctor told me to take 4x times a day 1000mg of Tylenol. So as an African American woman I am forced to believe this is racially charged. So doctors can advise a patient to take OTC meds that can potentially kill my liver and dicolfenac which can cause a heart attack but not give me pain medication for relief. Several doctors in [city redacted] Virginia and refusing treatments for pain management care. Please help the public to understand why working citizens are penalized for an opioid crisis? I have been going through sleepless painful nights for the last 3 years with detailed documentation and costly MRIs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tina	None	None	0900006484fb8f18	James	None	2022-03-04T06:07:02Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from James, Tina	l0b-jekr-pk4p	False	None	False	2022-04-12 03:16:36.892	[]
1856	CDC-2022-0024-1862	https://api.regulations.gov/v4/comments/CDC-2022-0024-1862	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having severe r.a for 12 years now I have been thru the hell that the 2016 guidelines made for pain patients cause I was and still am 1. Long story short,after years of getting rid of lyme disease which is what most doctors thought was causing all my symptoms was just hiding the rheumatoid arthritis .so finally a treatment starts a bio logic along with pain meds cause when I flared which for me is almost constant life I flared bad.swollen joints,throbbing pain and it took months to get it under control and finally have a quality of life I could deal with.things I took for granted like moving at all,walking,picking up a cup of coffee,using a restroom and playing with my grandkids.then new guidelines hit ,,,BOOM meds get cut in 1/2 so now I'm back to not moving,crying in pain at night and miserable beyond belief, the meds they left me barely kept withdrawal at bay but did they care? No so I suffered and still do till this day .I've worked my whole life paid taxes and loved my country but I feel like I've been abandoned and when u talk to ur doctor and tell them u hear the same thing,sry I wish we could help but cdc guidelines.i have numerous doctors constant bloodwork to back up all my inflammation and that I benefit from opioids that I've been on for 12 years.i take my meds responsibly cause I'm a pain suffer beyond ur imagination not n addict.i follow the rules a d I hope my doctor will to! Ty Cdc let's hope.they hear you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shane	None	None	0900006484fb90d0	shouman	None	2022-03-04T06:08:43Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from shouman, Shane	l0b-kbfu-sztb	False	None	False	2022-04-12 03:16:37.106	[]
1857	CDC-2022-0024-1863	https://api.regulations.gov/v4/comments/CDC-2022-0024-1863	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This Bull has caused so many people to have decreased quality of life. I was already disabled when a "licensed driver" made a very wide right turn, right in my lane. He accelerated as if he was in the thru lane. I watched, unable to do anything while he crashed right into my dodge caravan, Totaling it. I was taken to the ER by ambulance, in great pain. They gave me flexeril, which I told them I cannot take. And low Alieve! (I had severe pain not cramps or a headache)<br/>Now all I can do is sit in my recliner. Try to sleep in my recliner. Have appointments at physical therapy, ortho, primary care. Yet no pain relief.<br/>I also have No transportation, as the state still has not returned my title, therefore, I still cannot get the money they are giving me for my totaled vehicle. (Not enough to replace the year and mileage I had)<br/>Constant pain and dealing with incompetence in the MVA and the post office is unnecessary irritation and punishment for simply sitting and waiting for the red light to change.<br/>I would say that karma should find the politicians responsible for self serving tactics with no regard for the effects their actions have had on people fighting to cope with pain and ignorance, but we have seen that the politicians have access to an unlimited supply-for theirselves.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L	None	None	0900006484fb956a	Rizzo	None	2022-03-04T06:10:16Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Rizzo, L	l0b-km2q-rg2x	False	None	False	2022-04-12 03:16:37.315	[]
1858	CDC-2022-0024-1864	https://api.regulations.gov/v4/comments/CDC-2022-0024-1864	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS for 20 plus years and for the last 10 have successfully used opiates to manage it and give me quality of life. Not being able to sleep was making it almost impossible for me to be a functional member of society. I thank God for the RLS foundation who put in touch with a qualified doctor that helped me. This legislation could make it difficult for people like me to get help. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sherry	None	None	0900006484fb958a	McCormick	None	2022-03-04T06:11:03Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from McCormick, Sherry	l0b-l53k-wy5k	False	None	False	2022-04-12 03:16:37.519	[]
1859	CDC-2022-0024-1865	https://api.regulations.gov/v4/comments/CDC-2022-0024-1865	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient for almost 20 years, I feel the CDC has not gone far enough to correct the horrifying and disastrous “guidelines” of their 2016 Clinical Report, for this current Guidelines proposal. <br/>The addiction rate for those of us who see a doctor on a regular basis for our pain medications<br/>Is approximately less than 1%, yet we are lumped in with illegal drug users to support the recommendations. <br/>As a result of the CDC Guidelines ( 90MME ), millions of people are living with pain that prevents them from being productive members of society, to say nothing of those who prefer death to living with horrible pain.<br/>I see the Guidelines as a form of genocide. There needs to a concrete separation between the two communities of opioid users. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fb95a6	Hague	None	2022-03-04T06:11:49Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Hague, Elizabeth	l0b-m1t8-q9p7	False	None	False	2022-04-12 03:16:37.723	[]
1860	CDC-2022-0024-1866	https://api.regulations.gov/v4/comments/CDC-2022-0024-1866	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you you for this opportunity to comment on revising CDC clinical practice opioid prescribing guidelines. Currently the guidelines do not include the chronic condition of RLS(restless leg syndrome. In the USA alone nearly 12 million adults and children suffer from this chronic neurological disease. There is no cure. It has been treated with opioids since the middle 1600s by Sir [name redacted] whom the disease was initially and partially named after. Willis-Ekbom disease is now RLS. There are protocol drugs approved for use but the drugs often fail or cause the disease to only worsen. So is the case with me. After 15 years taking dopamine agonist drugs and alpha ligand type drugs I was ready to give up on living having never getting any relief from the Dailey and nightly torture from RLS. I educated myself through through the organization rls.org, It is known as the RLS Foundation. Through one of their 10 Certified Quality Care Centers I visited a Dr. [name redacted] at [university redacted] University. This was 2018. He is a work reknown expert on sleep disorder and RLS. He reviewed my long history and prescribed low dose opioids to treat the refractive RLS. Because of the war in opioids he was not able to prescribe across state lines. I live in Oklahoma. I found no Doctors were willing to risk prescribing opioids with the war against this drug. Finally almost over the edge God himself provided a miracle and I found a local doctor whom listened to my case and studied literature from the RLS foundation and relented to prescribe low dose opioids to save my life. Doctors should have the incentive ti use opioids in low dose without risking their livelihood. PLEASE I urge the CDC to include a section in the 2022 guidelines to address chronic conditions like RLS that require opioid therapy as a last resort in low dose daily doses. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fb91c0	Richardson	None	2022-03-04T06:14:47Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Richardson, Paul	l0b-n52y-pxej	False	None	False	2022-04-12 03:16:37.958	[]
1861	CDC-2022-0024-1867	https://api.regulations.gov/v4/comments/CDC-2022-0024-1867	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC Sirs, My name is [name redacted]. I am one of almost 20 million people in this country that is plagued with Restless let Syndrome. I have had it for 50 years and thanks to RLS Institutes research and findings I have found some relief by taking a medication coupled with Tylenol 3 with codeine. I am in no way addicted to the Tylenol In 50 years I still only take 2 shortly after going to bed and along with the medication I find relief. If I did not have the Tylenol3 I would go mad every night and pace the floor till morning. Many others are the same way. Please use good judgement in regulating the use of the opiot. If you of the CDC required a medication and someone tried to take it away from you how would you feel. Have some empathy. Plus you could force people to seek illegal drugs. Thank you for your attention. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ron	None	None	0900006484fb91f2	Monette	None	2022-03-04T06:15:57Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Monette, Ron	l0b-nef3-4ra1	False	None	False	2022-04-12 03:16:38.170	[]
1862	CDC-2022-0024-1868	https://api.regulations.gov/v4/comments/CDC-2022-0024-1868	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a 73 year old male 6’1” 220 lbs. yes a bit overweight but considering my peak weight of 310 lbs. I’ve done pretty well on reducing weight. My pain issues are two fold mainly worn bone on bone knees from 30 years on concrete. Secondly back pain due to significant scarring from a minor herniated disc surgery. I was offered knee replacements but feared the invasive surgery. I simply dealt with the pain for about 10 years while working but when the Company I worked for closed due to sale when I was 61 yoa I decided to seek treatment. At the time controls were fairly lax but the Clinic Doctor spent an hour and a half with me on our first meeting. He wanted to make sure I knew the consequences and he also wanted to understand my expectations. I did not expect to be pain free or feel as I did at 30. I simply wanted to have some functional quality of life. I found a reasonable balance point with as combination of extended release MSER and fast short acting hydrocodone. Total at the current maximum of 90 mg per day. As pressure increased a new Doctor, after my original Doctor retired, cut my daily dose to 75 mg per day. After some time I finally adjusted and it is better than nothing but I lost a great deal of functionality. Over the years I found we don’t all metabolize these medicines the same, there is no one size fits all possible. The guidelines while I believe are necessary should be just that guidelines. Doctors should have flexibility to prescribe without fearing loss of license. The same goes for Pharmacies, they should not feel threatened. I do not want more than I need but I can have a better life if that were the situation and I was allowed what worked for me. I don’t mind regular testing to insure I’m not selling or using other than prescribed. I’m not looking for drugs for recreation only for relief from so much pain. In closing I thank you for considering the opinions of responsible pain patients. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fb961c	Brawley	None	2022-03-04T06:17:48Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Brawley, Michael	l0b-ohfv-s7xu	False	None	False	2022-04-12 03:16:38.377	[]
1863	CDC-2022-0024-1869	https://api.regulations.gov/v4/comments/CDC-2022-0024-1869	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I recognize this is an improvement over the 2016 guidelines, there is one glaring issue that must be addressed. The current guideline states to keep patients under 90 mme per day and it’s best to keep them under 50 mme per day. The new guidelines only mention the 50 mme. No matter what you include around this statement the doctors will only see the 50 mme and stick to that. We have all seen how the stated 50 mme changed the way doctors prescribe meds since 2016. This needs to be taken OUT of the guidelines. Not to mention the measurement mme is basically a made up unit of measurement with little scientific proof behind it. It doesn’t even mention that every single patient’s body processes medications differently. Some can easily become “toxic” with a normal dose while others need more because their bodies process it quickly. Please remove all mentions of mme measurements out of guidelines. <br/>The other issue I have is that even though the 2016 guidelines were just that..guidelines aimed at primary care doctors etc, the trained pain management doctors adopted them as “law” too. What will you do to advertise, educate, promote that the 2016 guidelines were wrong or not valid and ALL doctors need to forget them! I recently got moved to 30 mme/day. I had successfully taken 40 mme for years before, but they reduced me to 22.5/day. After many visits and test and quitting my job, he moved me to 30 mme. BUT he stated that if I have surgery he will NOT allow me any additional pain meds post op. He knew I have at least 2 surgeries I need. Now I’m terrified to schedule them. One of the surgeries I’ve had before and I know how painful recovery is… how is this in best interest of patients? Especially considering I’m well below 50 mme/day. <br/>Lastly, I want to say that I have a 94 yr old grandmother that is healthy except for chronic back pain due to arthritis. The radiologist doesn’t know how she stands up w the way her back looks. Yet she can’t find relief. This is insane!! My father went to ER w kidney stone last year, his first. He never goes to doctor and has never needed pain meds. Yet the ER wouldn’t give him any narcotic pain medication. How on earth is this right? I want to see revised guidelines without the mme recommendations and a huge campaign to educate doctors, pharmacist etc on new guidelines. We would also love an apology from the cdc. I’m not holding my breath on that one. Thank you for your time!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fb96ab	Busby	None	2022-03-04T06:19:53Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Busby, Melissa	l0b-pzqo-nvp4	False	None	False	2022-04-12 03:16:38.592	[]
1864	CDC-2022-0024-1870	https://api.regulations.gov/v4/comments/CDC-2022-0024-1870	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines were a much needed step to help leverage the opioid epidemic, and these newest 2022 updates do a great job of emphasizing patient centric opioid use within the paradigm of multimodal pain management. <br/>However, there is one big criticism in that along the same lines of tailoring care to patients, interventional pain management options are often a value add. There must be a bigger emphasis on indications for referral to interventional pain management. Interventional pain management is yet another tool we have to help curb the epidemic in an opioid sparing manner. Individualized to patients with varied presentations, the potential value add of interventions must be included. Integrative options, massage, PT, acupuncture, yoga, heat/ice, TENS units, pain psychology, mindfulness, CBT etc are great as are non-opioid pharmacologic options such as membrane stabilizers, nsaids, tylenol, topicals, muscle relaxants, etc. <br/><br/>However, in folks with moderate to severe pain these modalities are often not suffice. If interventional pain management options are deterred, the only feasible remaining option is dose escalation of opioids. This is a huge oversite with these newest guidelines that must be addressed, otherwise, the epidemic will only be further fueled.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb96b9	Anonymous	None	2022-03-04T06:22:27Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-qd6b-4ggn	False	None	False	2022-04-12 03:16:38.801	[]
1865	CDC-2022-0024-1871	https://api.regulations.gov/v4/comments/CDC-2022-0024-1871	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Allowing more usage for opioids for pain management, especially starting at age 18 is not the best way to manage this problem due to the risk of addiction. If this regulation is to be pushed forward, it should be at a higher age do ensure better decision making. There are also other ways/ drugs to manage the same problems. It should be up to the doctor’s discretion and correct prescription to manage this dosage. It does not necessarily need to be a regulation that applies to all.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb997c	Anonymous	None	2022-03-04T06:23:04Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-rrkm-tvdv	False	None	False	2022-04-12 03:16:39.024	[]
1866	CDC-2022-0024-1872	https://api.regulations.gov/v4/comments/CDC-2022-0024-1872	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The quality of generic medication is troublesome. There is no comparison of lack of effectiveness of the newer generic medications that have been produced in the last eight to ten years. Insurance companies make getting a quality medication economically impossible. This is true in many generic medications. Ensure true higher standards on generic medications. Additionally, chronic and acute pain patients have become terrified of surgeries and treatments- of being immediately labeled as drug seeking. I have witnessed Drs. telling patients they were just there for pain meds only to see patients die from undiagnosed illnesses because physicians first and foremost want to work without the threat of their license taken away. Unfortunately, there are always going to be people who create issues. The guidelines punishes everyone. The CDC, “threw the baby out with the bath water.”	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb99da	Anonymous	None	2022-03-04T06:24:07Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-sngx-q23d	False	None	False	2022-04-12 03:16:39.236	[]
1867	CDC-2022-0024-1873	https://api.regulations.gov/v4/comments/CDC-2022-0024-1873	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Screw you. Screw the pill makers, the drs that prescribed meds to their patients without a plan to wing them off the bad pain killers. Screw you because you allowed this to get out of hand in the first place. Now people with real pain taking pain meds are treated like drug addicts because now you give a [vulgar language redacted]. Thank God my Dr followed the law in the first place. I have never abused pain pills and now with many others have to suffer for all of your idiotic mistakes. Screw this and screw you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb99db	Anonymous	None	2022-03-04T06:25:35Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-so9r-9smw	False	None	False	2022-04-12 03:16:39.442	[]
1868	CDC-2022-0024-1874	https://api.regulations.gov/v4/comments/CDC-2022-0024-1874	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a relative who has suffered for over 20 years from chronic pain. The extreme resistance of physicians to prescribe opioids has ruined her daily life. Her doctors have communicated with each other and records are carefully kept. She has never deviated from any of her physicians' orders, has never abused any prescription drug, has never used any illegal drug. She has suffered from several painful chronic illnesses and not once deviated from her doctors' orders. I am begging for relaxed use of prescription pain drugs. Doctors are intimidated about prescribing opioids and patients feel disparaged and discouraged. Many suffer in silence, while their lives are continually ruined from chronic pain. <br/>Please help these patients by revising the overly restrictive policies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Molly	None	None	0900006484fb99dd	Moores	None	2022-03-04T06:26:20Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Moores, Molly	l0b-sqmx-sgut	False	None	False	2022-04-12 03:16:39.650	[]
1869	CDC-2022-0024-1875	https://api.regulations.gov/v4/comments/CDC-2022-0024-1875	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In the state of Utah, there is a severe issue in opioid addiction and overdoses. These medications are being sourced at a high volume which is contributing to the severity of this epidemic. Precise qualifications and thresholds should instead be met in order to be prescribed opioid medication—which will prevent excess prescriptions from being utilized in ways that were not initially intended. Limiting where these medications are going and how much of it, should ideally contribute positively to this issue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	T	None	None	0900006484fb99e3	B	None	2022-03-04T06:27:00Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from B, T	l0b-t10e-p71f	False	None	False	2022-04-12 03:16:39.862	[]
1870	CDC-2022-0024-1876	https://api.regulations.gov/v4/comments/CDC-2022-0024-1876	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started Oxycodone for RLS 9 years ago. I’m still on the “starter dose” according to a report from the Mayo Clinic. I went through augmentation and developed two compulsive disorders on Mirapex. I had severe insomnia from Neurontin and Horizant. Oxycodone is the only treatment that works for my RLS symptoms. I have no side effects. I never crave more Oxycodone for anything other than treating my restlessness. Even with the Oxycodone the restlessness is not fully resolved. However, I can’t imagine that I’d have any quality of life without it. When I have uncontrolled restlessness I just can’t help but cry as I feel so helpless and, at times hopeless. Even With Oxycodone I have to at times alter my lifestyle as I fear that I may have unexpected restlessness. Examples include: Not sleeping over at a friend’s home, not taking long car rides at night, not going to the movies etc. Finally, I implore you to recommend opioids for RLS when indicated	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C.	None	None	0900006484fb99e4	R.	None	2022-03-04T06:28:03Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from R., C.	l0b-t4ky-35jc	False	None	False	2022-04-12 03:16:40.071	[]
1871	CDC-2022-0024-1877	https://api.regulations.gov/v4/comments/CDC-2022-0024-1877	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I appreciate the need to look at practice guidelines for prescribing opioids, this proposal does not take into account the neurogical condition: Willis-Ekbom disease (aka: Restless Leg Syndrome). Anyone who lives with RLS will tell you how damaging it can be to one's life. I developed RLS while pregnant with my third child, and have suffered with it for 19 years. I have tried many treatments for RLS in the past 19 years including a variety of medications (Mirapex, Neupro, Requip, Sinemet, Lyrica, Gabapentin), iron infusions, accupuncture, weighted blankets and natural supplments. None of these treatments worked. I cannot tell you the mental and physical damage you feel when you can't get any sleep night after night after night, or can't sit still during the day or early evening to watch tv or get together with friends/loved ones. Eventually, my neurologist prescribed Tramadol (classified as an opioid) in addition to Gabapentin and finally.....relief. <br/>This comment is to implore that you keep RLS in mind when setting guidelines for prescribing opioids. If you make guidelines that make it impossible for people like me to get medications like tramadol, you will basically be ruining the rest of my life (which I imagine will be shortened due to the damaging effects of lack of sleep). I am not the only one who depends upon an opioid medication to manage RLS. Please consult with neurologists and doctors who treat people with sleep conditions to learn about RLS and it's treatment before setting these guidelines.<br/>Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erika	None	None	0900006484fb99fa	Lynn	None	2022-03-04T06:29:22Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Lynn, Erika	l0b-txms-mbym	False	None	False	2022-04-12 03:16:40.345	[]
1872	CDC-2022-0024-1878	https://api.regulations.gov/v4/comments/CDC-2022-0024-1878	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 50mm guideline needs to be removed. This will cause practitioners to further not control pain. Posting as a memorial to my fil who lost his life after the VA took away his pain medication. No one should have to suffer like that or made to feel like they are doing something wrong to get pain relief. Pain medication is as needed as much as insulin.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb92a7	Anonymous	None	2022-03-04T06:29:54Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-ube2-iuxi	False	None	False	2022-04-12 03:16:40.561	[]
1873	CDC-2022-0024-1879	https://api.regulations.gov/v4/comments/CDC-2022-0024-1879	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the Centers for Disease Control and Prevention,<br/><br/>In the wake of the COVID-19 pandemic and with prevalence of opioid use disorder on the rise, I must object to many of the tenets of this proposed Guideline Update. Although just released, this document is already placing physicians at odds with continuous opioid therapy patients. One of my patients demanded that her daily OME be immediately increased as per this CDC edict. It is both surprising and instructive that my patient knew of this development before I, an academic pain specialist, was even aware. She was furious when I explained that this was not indicated and began to cry inconsolably, her faith in me as her physician now damaged. <br/><br/>Further, the Updated Guidelines disparage beneficial interventional procedures that, in my experience, have been the only therapies capable of helping patients reduce their dependence on opioid medications. As an academic pain physician who has constructed a dynamic Integrated Opioid Curriculum for a School of Medicine, I must object to these Guidelines. The progress the CDC has helped achieve in terms of turning the tide on the opioid epidemic between 2016 and 2019 will be undone and worsened with these new recommendations.<br/><br/>Sincerely,<br/>Concerned Physician	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb92cb	Anonymous	None	2022-03-04T06:31:39Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-vlzv-7xjs	False	None	False	2022-04-12 03:16:40.767	[]
1874	CDC-2022-0024-1880	https://api.regulations.gov/v4/comments/CDC-2022-0024-1880	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How could you do this to so many people, you have basically committed crimes against humanity. People are dying from suicide because they can’t handle the pain any longer. I have many chronic degenerative diseases that I didn’t ask for, because of the cdc and DEA playing dr-judge-jury arresting good drs and harassing the rest pain patients are being left behind. Why has it taken you 6 years to decide to revise these disastrous guidelines. Six years of inhumane treatments because you listen to anti opioid zealots and paid them millions using the money from the very people who dying because of your decision to take over and not let the fda do it’s job. <br/>Millions of people suffering and why, because [name redacted] and [name redacted] wanted to decide the fate of 50 million Americans. I watched my sister die from cancer untreated because her doctor dumped her in 2016, she was on fentanyl, oxycodone, 2 different dosages and 90mg & 60mg. All of a sudden dumped by her pain management dr because the cdc accused him of being a pill mill. She had been seeing this dr 19 yrs. <br/>Thank you for letting me watch her suffer for 6 months Fromm brain cancer, liver cancer, lung cancer, esophagus cancer. <br/>It was bad enough that the woman who raised me that I loved so dearly died a horrible death, what’s really bad is you made me watch it. I was standing by her bedside with her daughter when she took her last breath. Thank God she’s no longer suffering because of the CDC & DEAs bs. Maybe she would have continued her cancer treatments had she had adequate pain medications, her cancer wouldn’t been able to spread throughout her body, More than the Tylenol 3 her family dr gave her after her pain dr abandoned her. <br/>I don’t want these disastrous guidelines revised, THEY SHOULD BE COMPLETELY RECALLED, TAKEN DOWN. PAIN PATIENTS IN THE UNITED STATES SHOUOD DEMAND THE REMOVEL OF THE 2016 guidelines instead of being revised. States and doctors will continue to kill pain patients with these guidelines until you remove them completely and get the heck out of Dr\patients office visits. The cdc DEA [name redacted], [name redacted] need investigated for crimes against humanity and the cruel punishment of pain patients in this nation !!! <br/>REMOVE THE DISASTROUS 2016 GUIDELINES DO NOT REVISE THEM. REMOVE THEM NOW!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb92e2	Anonymous	None	2022-03-04T06:35:05Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0b-wbiq-89n3	False	None	False	2022-04-12 03:16:40.998	[]
1875	CDC-2022-0024-1881	https://api.regulations.gov/v4/comments/CDC-2022-0024-1881	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	20+ yrs. That’s how long I was in pain before I found a dr who treated my pain. I tried everything. I tried so many things that I’m $14,000 in medical debt. I missed college, friends, dating, starting a family, having a career. My career was trying to find answers to my pain. Never once did I ask for pain meds. Then miracle of miracles I received pain care. But now I’m in my forties. I have to redefine what I want from life. It has caused a Great Depression. I had begun working on it when terrible anxiety came in & my dr had to put me on Ativan. My pain dr made me choose. Pain treat or mental health treatment. Not both. I was lied to & told it’s illegal to prescribe both, then told it’s too dangerous, and finally the office told me the truth. They were too afraid the DEA would get them. How do you choose between the ability to move pain free and the ability to not wake up shaking so hard you crack a tooth. Please please let ME & my doctor decide what’s best to treat me. As of right now my quality of life is non-existent. I have an 86 yr old mom that has to care for ME! You can’t imagine the shame. I fear every day she’ll get sick & I can’t care for her. To be honest, I’m exhausted. Exhausted from appointments, rude drs, and constant fear I’ll lose my Ativan too. I never thought a plan to end my life would be part of pain tool kit but then again I never thought I’d be pulled off meds w/no tapering. Life has little meaning now. I just sit and cry. When I lose my mother I have no idea how I’ll be able to work. Sadly I envision a life of homelessness. I wish I never received those 3 years of pain control because now I know what it’s like to feel normal. To sleep, to be able to ride in a car or even take a shower. I’m now just left with memories and fears. I’m tired. So so tired. I seriously doubt anyone will read this. If they do I’m sure it won’t matter. I’m a middle aged woman w/no children & poor mental health. I’m the last person the drs want to help. But at least I can say I tried.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fb9a48	Lamb	None	2022-03-04T06:39:39Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Lamb, Michelle	l0b-zi78-pdh3	False	None	False	2022-04-12 03:16:41.206	[]
1876	CDC-2022-0024-1882	https://api.regulations.gov/v4/comments/CDC-2022-0024-1882	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 83 yr. old retired RN who has suffered with RLS for over 45 years. in the beginning it was an aggravation relieved by reading and rocking in my chair awhile and going back to bed. Progression thru the years leading eventually after different trials of medications to augmentation from Mirapex finds me desperate for relief. Relief from unbearable pain, spams, and cramping of my legs, sometimes my hands are affected. The desperate need to move my legs no longer relieved with movement, no matter how long or how fast I try to move! Now complicated by my age, arthritis in my knees and other factors, my only relief is now Oxycodone. In my desire to limit my use of Oxycodone, metimes cause myself moments of pain while i wait for the medicine to begin to stop the RLS symptoms. I just can not live without medicine to stop the pain and can only hope and pray it will be available to everyone in need of this help! Please listen to our need for this medicine and research for new medications and a cure!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb9360	Anonymous	None	2022-03-04T14:29:30Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-6vgp-rtfh	False	None	False	2022-04-12 03:16:41.425	[]
1877	CDC-2022-0024-1883	https://api.regulations.gov/v4/comments/CDC-2022-0024-1883	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow opioid treatment for Restless Leg Syndrome.<br/>This drug is by far superior to any other drug for RLS, an extremely miserable disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angela	None	None	0900006484fb9361	Pyne	None	2022-03-04T14:29:44Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Pyne, Angela	l0c-6zhq-qi0t	False	None	False	2022-04-12 03:16:41.635	[]
1878	CDC-2022-0024-1884	https://api.regulations.gov/v4/comments/CDC-2022-0024-1884	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a 66 yr old chronic pain patient who in the last six months had my pain meds cut because my pain clinic said they were doing away with short term pain meds...my quality of life has detoriated emensily I can't do anything to keep up with day to day chores... cooking, cleaning, laundry etc. I might as well be dead...my pain level out of this world... what am I to do.. please help me	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fb9b35	Babel	None	2022-03-04T14:33:03Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Babel, Patricia	l0c-76if-aqzd	False	None	False	2022-04-12 03:16:41.839	[]
1879	CDC-2022-0024-1885	https://api.regulations.gov/v4/comments/CDC-2022-0024-1885	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please take all these guidelines away .do all are doing harm to pain patients .and please for the life of God stop these pharmacy s from denying people there medications ... palliative care patient and cancer patients are being denied from pharmacy on filling pain meds ... please fix all of this .like u said it should be between the patient and the Dr. No one else	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fb9b4e	Guthrie	None	2022-03-04T14:33:31Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Guthrie, Melissa	l0c-c6kr-o5yv	False	None	False	2022-04-12 03:16:42.077	[]
1880	CDC-2022-0024-1886	https://api.regulations.gov/v4/comments/CDC-2022-0024-1886	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For more than 20 years I had RLS 24/7 and got very little sleep . Cocodamol used to ease the symptoms slightly. After trying many other drugs my GP finally agreed to prescribe Codeine 30mg, 8 tablets a day, minimum 4 hours apart. Most days I only take 90mg or 120mg and never the maximum of 240. My symptoms are now controlled by the codeine and I have my life back. I sleep between 7-9 hours each night, can travel by car or train and can visit the cinema and theatre - all things I was unable to do before. I in no way feel that I am addicted to this medication as I always take as little as possible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carole	None	None	0900006484fb9b83	Wright	None	2022-03-04T14:33:49Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Wright, Carole	l0c-e1su-38u3	False	None	False	2022-04-12 03:16:42.299	[]
1881	CDC-2022-0024-1887	https://api.regulations.gov/v4/comments/CDC-2022-0024-1887	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 80 yr. old female and have suffered with the condition known as Restless Legs Syndrome (RLS) for 60 plus years. It is my understanding the 2022 revision of the CDC Clinical Prescribing Guidelines does not address chronic conditions like RLS that are different from chronic pain. RLS is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the US, nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse (augmentation.) When all other medical therapies fail, ample scientific research supports the use of low -total-daily-dose opioids to treat severe RLS.<br/><br/>I have been on a combination of the medications mentioned above for nearly forty years for this unbearable disease. My doctor advises my current medication which is beginning to cause augmentation and will need to be discontinued is my last resort with opioids being my alternative. I fear I will not be able to access the needed medication (opioids) due to current restrictions.<br/><br/>The 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLs who had been on the same low daily dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort in low total daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues and please consider RLS Foundation at www.rls.org as a resource for scientifically-based inform about RLS as it is for members like me.<br/><br/>Respectfully,<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alice	None	None	0900006484fb9b84	Lawhorne	None	2022-03-04T14:34:17Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Lawhorne, Alice	l0c-eifi-quut	False	None	False	2022-04-12 03:16:42.504	[]
1882	CDC-2022-0024-1888	https://api.regulations.gov/v4/comments/CDC-2022-0024-1888	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Waiting to fix our opioid agenda will prolong severe chronic pain issues in patients who suffer everyday!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy " Bram"	None	None	0900006484fb9bd2	Cast	None	2022-03-04T14:34:28Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Cast, Judy " Bram"	l0c-fc91-6sge	False	None	False	2022-04-12 03:16:42.712	[]
1883	CDC-2022-0024-1889	https://api.regulations.gov/v4/comments/CDC-2022-0024-1889	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is wonderful that the CDC Clinical Practice Opioid Prescribing Guideline are being revised. However, the draft does not address chronic conditions like RLS. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. It is also accompanied buy extremely uncomfortable sensation which makes it unbearable to function. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects one’s quality of life. <br/>I have suffered with this horrible disease for 45 years. I have refractory RLS which means that all of the medications and treatments that I have tried have been unsuccessful. In fact some medications, dopamine agonists have caused permanent damage. Up until I was prescribed opioids my life was unbearable, constant daytime fatigue, no more than 4 hours of sleep, unable to go out and socialize in the evening, perpetual agitation of the body with no relief, depression and so many other daily life issues. Now that I am taking oxycodone, my life has improved tremendously. It doesn’t completely eliminate my symptoms, but it makes my nights much better. <br/>Please include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fb9453	Brom	None	2022-03-04T14:34:48Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Brom, Mary	l0c-gb87-k5am	False	None	False	2022-04-12 03:16:42.928	[]
1884	CDC-2022-0024-1890	https://api.regulations.gov/v4/comments/CDC-2022-0024-1890	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising your guidelines on opioid prescribing. I am a chronic pain patient and have had my dosage reduced in half after the current guidelines went into effect in 2016. This was not done because my dr thought it was best for me but solely because of the CDC and the DEA. These agencies have never met me nor looked at my medical records yet they determined what was best for me. I struggle daily because of this. It breaks my heart to tell my grandchildren I don’t feel well enough to play with them. I struggle to do many basic chores. <br/>I moved 3.5 years ago but haven’t changed the pharmacy I get my medicine at because of the stigma these regulations have advanced at the pharmacy level. I now drove 35 minutes one way to go to the pharmacy that knows me and my medical history. I live on a fixed income and driving so far is even more of a hardship now with gas prices doubling in the past year. <br/>That’s the thing, well intentioned laws are put into place but they have so many consequences to the people that they affect. Not just my daily struggle with pain but also feeling stigmatized at the pharmacy and financial and transportation struggles too. <br/>Thank you for your time and for considering the ramifications of the 2016 guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fb94c8	Hoover	None	2022-03-04T14:35:11Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Hoover, Lisa	l0c-hx2w-t7ak	False	None	False	2022-04-12 03:16:43.135	[]
1885	CDC-2022-0024-1891	https://api.regulations.gov/v4/comments/CDC-2022-0024-1891	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Physicians spend hundreds of thousands of dollars in education and training experiences to develop a subject AND objective view that few people have. To put LAW ENFORCEMENT in charge of my grandmother's pain medication is an act of insanity!!! We see what we want to see. Law enforcements are looking for criminals and so they see them. Physicians look for objective signs of pain even when the miracles of the human body may obscure the source of the pain. The USA's GOVERNMENT preoccupation with mine or others' medical treatment is OBSCENE and an abomination of the cultural condition of the American people as kind, loving, decent people!!!<br/><br/>HOW DARE YOU arrest a physician who is providing necessary pain relief to a chronic pain patient because YOUR IDIOT LAW ENFORCEMENT WANT TO REDUCE THE STATISTICS ON OPIOD DEATH. MY GRANDMOTHER"S PAIN MEDICATION IS NOT THE FENTANYL THAT YOU [profanity redacted] ARE ALLOWING TO POUR INTO THIS COUNTRY UNCHECKED! You see Grandmothers do not shoot back! Reduce prescriptions for pain meds and the INEFFECTIVE GOVERNMENT can claim success on "OPIOD" problems.<br/><br/>The truth is that ALCOHOL KILLS MORE PEOPLE than my grandmother's hydrocodone prescription EVER did!!!!!!! But alcohol is the drug of choice for the fancy Senators and the incompetent drug interdiction agents!!!!!! Don't take THEIR wine and beer away but for damned sure take the medication from old people that make it possible to go watch Little Johnny's football games on Friday night!!!!!<br/><br/>If I sound angry it is because I am!!! My grandmother just told me 2 weeks ago she wants to die after being on a FORCED TAPER because a large hospital bought out her private practice physician's practice. The Large hospital has OBJECTIVE STANDARDS for writing prescription meds. The attorney wants to see a broken bone or an MRI that SHOWS DAMAGE. Well ask any internal medicine physician....PLENTY of conditions cause difficult pain that is not actually SEEN! My grandmother died this morning YOU [profanity redacted]!!! You took her pain medication away and she could not tolerate living in constant pain. She wrote me a letter and now she is gone but she left this website address and asked that I tell her story here.<br/><br/>UNLESS YOU ARE READY TO CLOSE THE SOUTHERN BORDER AND YOU ARE READY TO STOP SELLING ALCOHOL IN THE FUCKING GROCERY STORES AND PHARMACIES THEN GET OUT OF THE FUCKING DOCTOR's OFFICES!!!!!!!!!!!!!!!!! These are not doctors running pill mills. THEY ARE GOOD AND DECENT HUMAN BEINGS! I wish the WORST PAIN ON ALL OF YOU POLITICIANS AND LAW ENFORCEMENT TAKING THE MEDICATIONS FROM THESE PEWOPLE! I hope YOU and the people you love end up with HORRIBLE CHRONIC PAIN and then YOU will know the loss of hope and the shame and humiliation of being told to leave a doctor's office. ALL OF YOU CAN GO TO [profanity redacted]!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fba002	Anonymous	None	2022-03-04T14:38:39Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-ilwm-vjrz	False	None	False	2022-04-12 03:16:43.348	[]
1886	CDC-2022-0024-1892	https://api.regulations.gov/v4/comments/CDC-2022-0024-1892	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe RLS and have been taking Tramadol at bedtime for a couple of years. It has changed my life!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484fba005	Stoll	None	2022-03-04T15:17:54Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Stoll, Marilyn	l0c-ivdq-dade	False	None	False	2022-04-12 03:16:43.554	[]
1887	CDC-2022-0024-1893	https://api.regulations.gov/v4/comments/CDC-2022-0024-1893	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A major area for improvement would be emphasizing the role of interventional pain management. These techniques improve functional ability and comfort for patients suffering from a wide variety of ailments. Furthermore, as part of a comprehensive treatment plan, these interventions can help reduce the use of opioid medications. Reduction in opioids, and the subsequent reduction in morbidity and mortality associated with them, is worth highlighting.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fba072	Anonymous	None	2022-03-04T15:18:09Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-jsxz-cmd2	False	None	False	2022-04-12 03:16:43.763	[]
1888	CDC-2022-0024-1894	https://api.regulations.gov/v4/comments/CDC-2022-0024-1894	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since 2016, my pain treatment has been awful. I can't seem to find anyone who will continue my pain treatment. I was finally on a regimen that worked well. I was only on 1 pain medicine and a protocol that included Tizanidine, clonidine, Metformin, tordal, and more. As of March of 2021, my primary Dr was prescribing my regimen. I moved from California to Oklahoma for a job. He said he would continue my care for 3 months until I could find a pain doctor. I was referred to one, but it takes time to get in. I have text messages that show he decided not to continue my care, and it was the middle of February. I had to go through the worse pain and withdrawal. I didn't even know I would go through that. Pain patients need to be treated fairly and educated on what our rights are, and doctors need to be able to prescribe without fear. Now, after 22 yrs since my accident, I'm an abandoned patient. I am only under the care of my primary doctor in Oklahoma. He will not prescribe my pain medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484fba07e	Mathiesen	None	2022-03-04T15:18:46Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Mathiesen, Christine	l0c-jz6c-sxgs	False	None	False	2022-04-12 03:16:43.972	[]
1889	CDC-2022-0024-1895	https://api.regulations.gov/v4/comments/CDC-2022-0024-1895	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm in Northern California and the guidlines is now hitting the health care provider I go to as of March 2022. I am being weaned off, thank god my doctor is compasinate enough wean me off rather then cutting me off cold turkey. The reason behind taking me off my pain medication that has helped me in more then one way is due to the fear of the doctor being raided by the DEA. This is not he choice my doctor wants to make, but is in fear. I have been on the same dose for over 30 years and now being forced to be off of it after years of it helping me live a some what normal life. I am law abiding citizen. Not only do we go monthly to our doctors, we are subject to pill count, piss test and have to sign a contract, so why are we being forced off meds if we are following all the guidelines and being monitored. My mother inlaw has been cut off her meds, she is 87 years old and now lays in bed all day long suffering and cruel end to her last years in life. Not fair. <br/><br/>Also any and all MME needs to be removed from the guidelines, the length a person shall be on the medications should be removed as well. Until you are our shoes, please do not control our meds or have them taken away, which is happening all over the USA, we are not a one patient fits all. Some have needs for higher doses some are just fine w/lower doses. One day it might be one of you that has set these guidelines and you may not be able to get your medication, god forbid I hope you are not affected by these guideline. <br/><br/>Meanwhile some people will hit the streets seeking pain relief, I won't be one of those cause I'm scared of what is out there, at least with being under the care of a doctor we are monitored. Do you all not see the reality of this and what is happening. This needs to stop! The ugly truth for us pain patients is most of us are to sick or in to much pain to fight for our rights or you might just see alot more chronically ill people out there fighting for our rights. <br/><br/>Be compasinate, quit making people suffer. Again one day it might just be one of you reading this that will need pain medication, hopefully not and I dont' wishe pain on anyone, but pain is real. I have many sleepless nights due to my pain and will be worst in the next month or so after my doc gives me my final pain medication prescription that I have been so responsible with for over 30 years. Please stop the guidelines that are in place now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fba08f	Anonymous	None	2022-03-04T15:19:35Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-k21l-keq1	False	None	False	2022-04-12 03:16:44.183	[]
1890	CDC-2022-0024-1896	https://api.regulations.gov/v4/comments/CDC-2022-0024-1896	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless legs syndrome is a relentless condition that causes people a huge amount of suffering. Unable to sit down and rest, unable to sleep, medication often prescribed, such as dopamine agonists, can make the condition far worse and can damage the dopamine receptors in the brain. What can help, and bring some relief is a low dose of opiods. My 83 year old mother takes between 4 ml to 8/10ml across two doses a day and is able to vary the dose - one day taking one dose, another day taking two. She has been taking opiods now for over a year and has not increased her dose. I believe research suggests that restless legs sufferers don't experience the risks associated with opiod use to the same degree. Dr [name redacted], who is a world renowned consultant working with restless legs sufferers, has said that opiods may be the only solution for those patients whose dopamine receptors have been damaged by dopamine agonist use. Opiods have, since the 1600s, when restless legs syndrome was first diagnosed, been seen as the gold standard to bring relief to patients from this terrible condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bridget	None	None	0900006484fb79ae	Atkinson	None	2022-03-04T15:55:29Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Atkinson , Bridget	l0a-uyxn-54c5	False	None	False	2022-04-12 03:16:44.391	[]
1891	CDC-2022-0024-1897	https://api.regulations.gov/v4/comments/CDC-2022-0024-1897	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree that the CDC Clinical Practice Opioid Prescribing Guideline needs to reflect the danger that opioids can cause when misused or overused for chronic conditions and urge you to ensure that this issue continues to receive strong attention. However, I believe your guidelines also needs to address medical conditions which can benefit from the use of opioids, especially if opioids can eliminate, or greatly reduce, the condition causing chronic pain. For over 20 years, I have been affected from restless leg syndrome (RLS. For the last (4) four years the effects have been especially difficult and challenging to my over-all life and health and resistant to all medical treatments. During this time, it has been rare that I have been able to sleep through the night and often I only got 4 to 5 hours sleep due to the persistent night-time issues that required that I move my legs by walking to relieve the pain cause by the RLS. <br/><br/>While there is no cure for RLS, there are several types of prescription medications that generally offer relief from the RLS symptoms. Unfortunately, as mentioned, I am one of the individuals for whom none of the recommended non-opioid medications have had an effect on my condition and have not relieved my daily night-time bouts that required walking instead of sleeping. I have been to multiple doctors and have been prescribed many medications, often taking multiple combinations of drugs. Since nothing worked and my lack of sleep was persistently an issue, I have often suffered from depression and an inability to participate in many normal activities of daily life. It wasn’t until late 2021 that I found a neurologist who dealt with movement disorder issues, that I was able to find a medical professional who understood that the latest research has determined that a low dose prescription of certain opioids has been found to be an effective treatment for many individuals like myself for whom the “standard” RLS drugs do not work. My neurologist was aware of the research and testing done at places like the RLS Clinic at Johns Hopkins Medical Center in Baltimore, and after seeing that other doctors had tried multiple other medications with no success, he was willing to try a low dose of methadone. I am now taking a low dose of methadone, along with a prescription for gabapentin, and I am often able to sleep through the night without being awoken by any issues from my RLS. My life has basically been given back to me and I suffer no issues from the low dosage of methadone. (My doctor continues to ensure that I follow, and meet, all required protocols for taking an opioid, to include being subject to random drug testing.)<br/><br/>I urge you to add and address the issue of RLS in your guidance. While it is not classified as chronic pain, it is an ongoing issue that causes chronic issues that are disruptive to everyday life and depression. In certain severe cases of RLS, like mine, a low dose of opioids may be the only avenue to receive relief and a return to a mostly normal life.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484fba0cd	Towne	None	2022-03-04T16:38:43Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Towne, Larry	l0c-ko5v-ht3j	False	None	False	2022-04-12 03:16:44.600	[]
1892	CDC-2022-0024-1898	https://api.regulations.gov/v4/comments/CDC-2022-0024-1898	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am retired on SSDI w severe back & leg pain. <br/>I have gone to a pain management Dr for many years. Last month he decided he was cutting EVERYONE'S medication down, in essence, treating everyone's pain identically. I take 4 - 10 mg Norco a day. That's all. No muscle relaxers, no morphine, no oxycodone or other pain meds. I have severe pain often, even with taking the 4 Norco, I won't be able to tolerate the pain at 3 pills a day. I will spend each & every day struggling with pain. I'll never be able to get it under some semblance of control. When I mentioned this would not be enough to my Dr, his response was take warm showers, etc. <br/>At this juncture I have slept sitting upright for the past 11 years, I can't stand up long enough to cook a meal for myself so I live off of cheese toast & occasionally salad. I have to hold onto a shopping cart if I go in a store to walk around, lately the spasms in my back are affecting how long I can walk, which has gotten shorter. My right leg goes numb. It's burning numbness or aching numbness, it likes to surprise me as to which one. When I walk up stairs I have to lean on the handrail & I pull my right leg up behind me. I'm walking w a limp more & more. I am unable to do many things I use to. Because of the motion, I can't sweep, vacuum or mop normally. I have to hang on to something & drag the handle w one hand. I can't lift very much at all. I can't wear proper undergarments because the band hits a spot on my mid-back & I can't stand it. I can't go anywhere I have to walk, no fairs, no flower shows, art festival, even the mall. The list of what I've had to stop or modify is huge. It affects my relationships on many levels. <br/>Having said all of this, the reason my Dr's gave for lowering everyone’s medication was because of government controls & laws that were in the works. I am begging y'all to make revisions. People who are going to abuse drugs will get them one way or the other. If they can't get one drug, they'll just find another. No amount of laws will change that. Offering affordable drug treatment options & access to Narcan are much better ways to help people who abuse drugs. Don't punish people like me who actually need medicine for chronic pain. We're being punished every day already.<br/>I trust & hope you will remember what we go through each day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tricia	None	None	0900006484fba0d3	Sullivan	None	2022-03-04T16:39:26Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Sullivan, Tricia	l0c-kofa-7cff	False	None	False	2022-04-12 03:16:44.834	[]
1893	CDC-2022-0024-1899	https://api.regulations.gov/v4/comments/CDC-2022-0024-1899	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like you to post any deaths caused by a patient taking only a Dr prescribed doze of pain meds. I know of none! It's ridiculous to have pain & be refused treatment! When you have x rays, MRI, etc to prove your condition & a Dr has hands tied by your nonsense ceilings of NO Pain meds! Go ahead & publicly post any deaths caused from only Dr prescribed pain meds! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fba0dc	Anonymous	None	2022-03-04T16:39:50Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-kxbq-66wm	False	None	False	2022-04-12 03:16:45.281	[]
1894	CDC-2022-0024-1900	https://api.regulations.gov/v4/comments/CDC-2022-0024-1900	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic, excruciating, debilitating pain on a daily basis. I have spondylolishesis, lumbar spine stenosis, severe arthritis of the neck (C4 and C5) and bulging discs in the neck (C-2 to C-7). Additionally, in 2017, I underwent a total spinal fusion to correct a 70 degree curvature of the spine. I am now totally fused from the base of my neck to the bottom of my tail bone. My back has rods, screws and cages made of cobalt chrome and titanium. Every movement I make is painful.<br/>As if all this wasn't enough, I was recently involved in an auto accident (Aug 2021) which resulted in a severe whiplash to my neck and the fracture of one of the rods in my back. This has further exacerbated my pain.<br/>I have a wonderful physician in California who I have been a patient of for over 25 years. He is an well respected and highly qualified MD. My physician understands what I am going through and has been willing to prescribe a minor pain (opiod) medication so that I can at least get through my days. My physician knows me after treating me for over 25 years and knows that I do not abuse pain medications.<br/>Like many people, I left California when I retired to flee the high cost of living, crime, etc. I moved over to a neighboring state (Arizona). I am still within driving distance of my California physician and so chose to stay under his care. Additionally, when the pandemic came and telemedicine became the norm, it enabled me to stay in constant contact with my doctor via telemed. It has worked out well.<br/>I am now facing a real dilemma, however. For some reason, the pharmacies in my state (AZ) are not willing to fill an e-script from an out of state physician. They are forcing me to find a physician in my local area. I do not want to do this as I am comfortable with my current CA physician and have been a long time patient of his. Additionally, the area where I am living in Arizona is sorely lacking in qualified MD's. The good ones who come here do not stay and the few remaining physicians either are not very well qualified or are not taking new patients. And because Arizona is a border state, the powers that be seem to feel every opiod is fentanyl and they are reluctant to prescribe even something as mild as Tylenol 3. They force muscle relaxers on my friends instead. As I do not have a muscular related or nerve related problem, this would obviously not be a good choice for me. I have a breakage of a metal device.<br/>I would sincerely appreciate it if this problem could be addressed during your discussions. I do not know if this is a problem throughout the entire country for people who move from one neighboring state to another, but I do know it is a huge problem here in Arizona. In this telemed world we live in, it should not be a problem to keep your physician even when you move to a neighboring state. <br/>The rules on this issue here in Arizona are painting me into a corner. I do not want to cut ties with my physician who knows me and has treated me for over 25 years for an unknown unqualified person here in Arizona. Without my pain medication (which I only take once a day) I will not be able to comfortably get through my days. It is a horrible situation to be in.<br/>I would appreciate any consideration you may give as to adding this issue to your discussions.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cathy	None	None	0900006484fba52a	Poplett	None	2022-03-04T16:40:43Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Poplett, Cathy	l0c-lslg-ny44	False	None	False	2022-04-12 03:16:45.496	[]
1895	CDC-2022-0024-1901	https://api.regulations.gov/v4/comments/CDC-2022-0024-1901	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If this ‘proposal’ “does not require mandatory compliance”, then what’s the point? We have enough government in our lives. Please STOP with all this nonsense! Whatever government touches turn to shit. We have more than enough ways to control opioid over proscribing presently. This is a State responsibility; not the Federal Government’s. Close that southern border and save lives, if that’s the object of concern. 100,00 of our children die every year from fentanyl coming across that open southern border. Enough is enough! Focus on the most obvious problem and leave us practitioners alone!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fba5b5	Anonymous	None	2022-03-04T16:41:08Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-mqzy-4j6q	False	None	False	2022-04-12 03:16:45.709	[]
1896	CDC-2022-0024-1902	https://api.regulations.gov/v4/comments/CDC-2022-0024-1902	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I personally have suffered with RLS for over 20 years. I have tried every medication and treatment available, only to have my symptoms worsen. The lack of quality sleep has greatly reduced my quality of life. Since being prescribed a low daily dose of opioid approximately 1 year ago, my symptoms are greatly reduced and I am able to achieve quality sleep. Unfortunately, my insurance will not cover the expense of the medication because it has not been approved for use in the treatment of RLS. Please consider adding RLS as one of the conditions approved for treatment with low dose opioids. I have attached a copy of a study supporting the use of carefully monitored low dose opioids for the treatment of severe cases of RLS’<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	0900006484fb8392	Mergener	None	2022-03-04T17:22:20Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Mergener, Tammy	l0b-6tfo-nxoj	False	None	False	2022-04-12 03:16:45.939	[]
1897	CDC-2022-0024-1903	https://api.regulations.gov/v4/comments/CDC-2022-0024-1903	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an RN (RET)caregiver of my sister who has intractable pain due to 10 spinal fractures. She had successful jack system procedure, but inadequate pain control has failed to return her to even the level of activity pre procedure. More jack system is planned but without better pain control,my sister intends to refuse them , making her future and mine one of debility and caregiving that should not be except for poor pain management . The guideline IS being applied as a MANDATE and IS SUPPLANTING the doctors judgement and former standards of care because the doctors are afraid of losing their license.This has been expressed to me by my own former PCP. He said the fear of losing his license is greater than what he will now elect to do for pain control . Please draft a guideline that is humane and reasonable to manage pain. My dog just had surgery. He got better pain management than my sister. That is beyond sad.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patsy	None	None	0900006484fba60e	Pryor	None	2022-03-04T17:30:36Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Pryor, Patsy	l0c-njvx-nqdj	False	None	False	2022-04-12 03:16:46.276	[]
1898	CDC-2022-0024-1904	https://api.regulations.gov/v4/comments/CDC-2022-0024-1904	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Congratulations to the CDC first for providing education and instruction for (primary care) physicians in the 2016 guideline publication. Congratulations again for recognizing that the original guidelines needed re-examination and some revisions.<br/>What is very disappointing is the negligible discussion of interventional pain procedures as a means by which patients can be provided pain relief without the use of systemic medications. Procedures such as spinal cord and peripheral nerve stimulation, rhizotomies, nerve blocks and the like, play a vital role in managing patients with chronic pain, providing them with a pain reduced life, and increasing their abilities to perform activities of daily living. No one modality is sufficient in the chronic pain patient to provide pain relief, so early implementation of a multimodal treatment plan (which includes psychological support and treatment, physical therapy and exercise, non-opioid analgesics and interventional pain procedures) albeit more expensive, has the best chance of avoiding the use of opioids and opioid escalation which we know, in the long run, does not work.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Howard	None	None	0900006484fba6c5	Rosner	None	2022-03-04T17:31:00Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Rosner, Howard	l0c-owfb-9s5n	False	None	False	2022-04-12 03:16:46.483	[]
1899	CDC-2022-0024-1905	https://api.regulations.gov/v4/comments/CDC-2022-0024-1905	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Isn't the attached chart that shows the variation of CYP2D6 phenotypes a solid reason that any 50 or 90 MME limit for everyone is a non-scientific non-medical limit that should never be used? Refer to attached.<br/><br/>Is it also not true that the former director of the CDC refused to document any limit such as 90 MME because he or she stated that any such number should never be included in any CDC guideline because any such number "would become law?"<br/><br/>Is it not true that most states used the CDC's 90 MME and the federal government included the CDC's 90 MME limit in federal law the SUPPORT act?<br/><br/>Are these not valid reasons AGAINST including any MME suggestion in any future update of the CDC opioid prescribing guidelines?<br/><br/>Does the draft guideline include a 50 MME suggestion?<br/><br/>Hasn't some patients not already experienced dose reductions as a direct result of the release of CDC draft guidelines because it includes a 50 MME limit?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb797f	Anonymous	None	2022-03-04T17:36:56Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-mfg8-rkz8	False	None	False	2022-04-12 03:16:46.728	[]
1900	CDC-2022-0024-1906	https://api.regulations.gov/v4/comments/CDC-2022-0024-1906	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to the harm caused by the 2016 CDC guidelines I request a class action lawsuit against the CDC and federal government as follows:<br/><br/>25 million patients with severe chronic pain receive reparations of $100,000 each for torture, loss of jobs, and loss of a decent life.<br/><br/>25,000 families of people who died by suicide or overdose due to being forced to restort to street drugs and died should receive reparations of $5,000,000 each.<br/><br/>The total cost if the assumed patient and physician populations are correct and the award remains the proposed values given totals to $3,125,000,000,000. <br/><br/>If the government resists, the legal feels would likely add 30-40% of that cost. So get this 2015<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb79c4	Anonymous	None	2022-03-04T17:37:47Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-wrp2-8yjk	False	None	False	2022-04-12 03:16:46.949	[]
1901	CDC-2022-0024-1907	https://api.regulations.gov/v4/comments/CDC-2022-0024-1907	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe the attached is fair and equitable reparations that must be paid by the federal government for the harm it has caused to pain patients, families who lost loved ones due to government negligence and malpractice, and their physicians in the United States. It could be paid out in 10 yearly installments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb79d1	Anonymous	None	2022-03-04T17:38:21Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-xfm4-8s9t	False	None	False	2022-04-12 03:16:47.160	[]
1902	CDC-2022-0024-1908	https://api.regulations.gov/v4/comments/CDC-2022-0024-1908	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a starting point for a class action suit for attorneys to pursue, but reflects the torture of patients who survived and loss of years of their lives, reimbursement to families with a family member who died as a result of CDC's poorly written 2016 guidelines for opioid prescribing, and it compensates physicians who lost their medical license, reputation, and imprisonment for merely treated pain victims with compassion. Exclude true criminal physicians in this package but only those who did much moee than prescribe over the CDC guideline. People taking opioids for recreation who got hooked are also excluded and should receive their compensation from states winning lawsuits (without merit) against pharmacological companies.<br/><br/>This version replaces one submitted less than 30 minutes ago with the same chart, because this chart includes more detail so its more understandable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb79d5	Anonymous	None	2022-03-04T17:39:04Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-y3pw-r92p	False	None	False	2022-04-12 03:16:47.393	[]
1903	CDC-2022-0024-1909	https://api.regulations.gov/v4/comments/CDC-2022-0024-1909	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After the original 2016 CDC opioid guidelines were released, [name redacted] admitted to serious conflicts of interest, which he failed to submit before the guidelines were released. Because of this, Mr [name redacted] was supposed to be unable to participate in any future guidelines. So, I'd like to know why [name redacted] was included in the rewriting of the current draft. <br/><br/>https://bit.ly/3K2NH0f<br/><br/>Unfortunately, no pain management doctors were included in drafting these guidelines, no members of the chronic pain community, and the leading addiction neuroscientist and researcher, Dr [name redacted], of [university redacted] University, also wasn't included.<br/><br/>The FDA refused to publish or back the original guidelines because they realized what a disaster they would be. Now, both the FDA and AMA have rallied behind chronic pain patients because the 2016 guidelines were taken as mandates and implemented as though they were law instead of "guidelines". The unfortunate outcome is that chronic pain patients have been treated as though they're criminals and denied opioid analgesics either completely, or denied adequate doses. The original guideline was written ONLY for primary care physicians who were treating their own patients with chronic pain. They were never meant for patients suffering with severe chronic pain, or patients in pain management. <br/><br/>Here's a DIRECT QUOTE regarding the original guideline. "This guideline provides recommendations for PRIMARY CARE CLINICIANS who are prescribing opioids for chronic pain outside of active cancer treatment, palliative care, and end-of-life care."<br/>These were guidelines, never meant to be mandates and they were only meant for primary care physicians! Why wasn't this understood by doctors, insurance companies, state medical boards, pharmacists, policy makers, the DEA or DOJ?!<br/><br/>https://bit.ly/3K451C9<br/><br/>AMA opposition to the 2016 opioid guideline:<br/><br/>https://bit.ly/3K451C9<br/><br/>This is an example of how poorly patients suffering with pain are treated and unfortunately, this is very common, it's not the exception:<br/><br/>https://bit.ly/3stYBGr<br/><br/>The leading addiction expert in the US disagrees with US drug policies for good reason. In over 50 years the war on drugs has only served to create bigger problems, including significant problems with the way pain patients are treated.<br/><br/>Chronic pain is a leading cause of disability. I should actually say, doctors ignoring pain is a leading cause of loss of function and disability. I know this first hand because prior to the 2016 CDC guideline, which was widely misapplied, I had excellent pain management that allowed me to function, work, participate in family life, and do things with our 4 children. My doctor suggested opioid analgesics because I had liver damage due to an anesthetic used during surgery. My doctor was concerned that I would have further liver damage because I had been using high doses of acetaminophen for many years. Before taking high doses of acetaminophen every day for many years, I had tried literally everything to help me manage the pain caused by two serious car accidents. I've been prescribed antidepressants, anticonvulsants, Cox 2 inhibitors, and calcium channel blockers which didn't help and caused additional side effects I didn't want or deserve. I've been prescribed Lidocaine and other topicals that didn't help. And I've been prescribed immunosuppressants which nearly killed me because I couldn't fight off the infections and viral illnesses caused by these drugs. I also developed cardiovascular disease caused by immunosuppressants. <br/><br/>I've never had any side effects from taking opioid analgesics, including the fact that I've never had any issues with addiction. When I've been forced to go off of opioids I've only had a return of the severe intractable pain. <br/><br/>If you've never experienced chronic pain, that's great but anyone can be just a moment away from losing everything, as I have. Since the 2016 guideline, I've lost the ability to do anything. I resent the intrusion by the CDC, DEA, & DOJ. <br/><br/>The most common drug used to treat back pain is also one of the most dangerous! It's commonly injected into the Intrathecal space surrounding the spine. It's far more dangerous than any opioid and yet, for chronic pain patients suffering back pain, it's often REQUIRED. Doctors LITERALLY hold patients hostage and if patients refuse these incredibly expensive and invasive LEIS spinal injections, they're denied any opioid analgesics! And yet, these are incredibly dangerous drugs and shouldn't be used anywhere near the spine. Would YOU want these drugs used on YOUR spine? Or the spine of someone you love?!<br/><br/>https://bit.ly/3K7tO8b	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484fb8b62	Justice	None	2022-03-04T17:46:37Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Justice, Sarah	l0b-d1ve-tzqr	False	None	False	2022-04-12 03:16:47.600	[]
1904	CDC-2022-0024-1910	https://api.regulations.gov/v4/comments/CDC-2022-0024-1910	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>After all other medications failed, I am currently on a low level of methadone. It makes my life livable. But as you can imagine, it is very hard to find a doctor to prescribe it because of the threat of litigation due to your guidance. Opioids are a savior for severe RLS suffers. We are not drug addicts or abusers.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484fba70a	Hoffman	None	2022-03-04T17:52:52Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Hoffman, Laura	l0c-pkk3-uks4	False	None	False	2022-04-12 03:16:47.826	[]
1905	CDC-2022-0024-1911	https://api.regulations.gov/v4/comments/CDC-2022-0024-1911	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Really can't describe the [vulgar word redacted] I'm going through. I can't even work in my profession and can't collect disability if I wanted to. I have abdominal adhesions and my intestines are glued together, sounds painful doesn't it?! I want to work another 15 yrs but how can I? There is no pain fairy nor expiration date on pain. I ride pass clinics where heroin addicts can get taken good care of for 20, 30 yrs no problem nor interruption, and they chose to use drugs, but those of us with health issues even caused by a Drs orders for surgery are made to suffer NEEDLESSLY! The CDC is not even a Federal organization his did that ever gain such influence to painfully alter people's lives and have good hard working Drs incarcerated. Drs are literally in prison with murderers, rapists and those who broke the law for just trying to make life easier with medications that's legal! The CDC has wreaked havoc on millions and killed thousands who chose to end it rather than suffer. One day you or someone you know will be in need of relief with pain medications and our [vulgar word redacted] will turn into yours!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joie	None	None	0900006484fb7821	Canty	None	2022-03-04T18:22:47Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-02T05:00:00Z	None	None	None	None	None	None	None	Comment from Canty, Joie	l0a-bnbi-g9el	False	None	False	2022-04-12 03:16:48.034	[]
1906	CDC-2022-0024-1912	https://api.regulations.gov/v4/comments/CDC-2022-0024-1912	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To those at the CDC who influence the opiate prescribing guidelines, as a 15-year AA member and Sponsor I would like to bring awareness to the increasing number of new AA members who's alcohol over consumption was an attempt to ease untreated pain.<br/>Their attempts to substitute opiate medication resulted in alcoholism, further increasing their pain while spinning their once productive functional life’s out of control. <br/>These members never had a drinking problem previously, yet forced to seek alternatives due to medical negligence. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fba726	Anonymous	None	2022-03-04T18:23:35Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-puko-89i2	False	None	False	2022-04-12 03:16:48.259	[]
1907	CDC-2022-0024-1913	https://api.regulations.gov/v4/comments/CDC-2022-0024-1913	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low-total-daily dose opioids must be included as a viable treatment option for RLS patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christyne	None	None	0900006484fba740	Berzsenyi	None	2022-03-04T18:23:46Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Berzsenyi, Christyne	l0c-q43n-2n77	False	None	False	2022-04-12 03:16:48.465	[]
1908	CDC-2022-0024-1914	https://api.regulations.gov/v4/comments/CDC-2022-0024-1914	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a seventy-four year old trying to manage chronic pain, many of your guidelines and DEA policies are endangering my health and my life. While I am very sensitive to wanting to be helpful in addressing the opioid addiction crisis we face in this country, I would ask for more reasonable policies to allow the senior, aging, and in-pain population to access the drugs found necessary by qualified medical professionals, without needless interruptions.<br/>As an example, the chronic, severe, and arthritis-related back pain that I experience has been managed successfully through the prescription of a morphine-sulphate, time-released pill, with the availability of oxycodone to manage break-through pain when I become "too" active (walking more than my daily, usual short distance, standing on my feet longer than 15 minutes at a time, etc.). The current prohibition on limiting a morphine-sulphate presciption to a 30-day supply, with no ability to renew the prescription until the 30-days have elapsed has severe adverse health effects for me, and I would imagine millions of other seniors who find themselves in my position of trying to manage pain in order to live out our "golden" years in a somewhat normal and active manner. <br/>Nearly every month, there is some reason why I cannot continue the time release morphine-sulphate without interruption. Sometimes it is because I simply cannot get to the pharmacy on the day I must refill the prescription. More often, it is because the pharmacy cannot access the drug in sufficient quantity to refill all of its orders, or because the pharmacy is not open that day, or because the pharmacy is "too-busy" to complete all of the orders it has to fill on that day.<br/>This leaves me trying to manage the pain with the "break-through" pain management prescription of oxycodone, which, unlike the time-release morphine-sulphate, leaves me in a state of confusion and fogginess that prevents me from safely going about my daily life. Nearly every month, I must go through a period of days, or a week, trying to re-stabilize under the time-release morphine-sulphate. During this period of stabilization, I feel and think I am just fine, when actually I am a danger to myself and others.<br/>Your restrictive, and "one size fits all" approach to the opioid crisis is creating other dangers for the responsible utilizers of pain medications, and the many millions of Americans with whom they interface during these periods of withdrawal and substitution of break-through pain management drugs.<br/>Beyond this, your unreasonable guidelines restrict the freedom of movement of the seniors trying to manage their pain. At a time in their lives when they should be able to go on extended vacations and travel, they must limit all such plans so as to be able to return to the location of their pharmacy when the 30-day prescription limit is up. Why????<br/>PLEASE STOP PUNISHING THE RESPONSIBLE SENIOR CITIZENS LIVING IN PAIN IN YOUR EFFORTS TO CURTAIL THE PUBLIC/SOCIAL RAMIFICATIONS OF THE IRRESPONSIBLE DRUG-ABUSING YOUTH!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverly	None	None	0900006484fba31d	Sampson	None	2022-03-04T19:38:10Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Sampson, Beverly	l0c-r7nc-jwrl	False	None	False	2022-04-12 03:16:48.681	[]
1909	CDC-2022-0024-1915	https://api.regulations.gov/v4/comments/CDC-2022-0024-1915	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines recommended routine screening of patients receiving opioids. In the ONE Program we have established a standard for screening all patients receiving an opioid prescription for risk of opioid use disorder and accidental overdose. This is done in the community pharmacy. See manuscripts attached. <br/><br/>The role of primary screening prior to dispensing opioid medications needs to be developed further in the new guidelines. <br/><br/>And of course the importance of primary prevention of opioid use disorder needs to be elevated. The current epidemic will take 10-20 years to subside, because of the chronic nature of opioid use disorder, and the common relapse even after treatment. Therefore, the only solution is to reduce incidence through primary prevention. <br/><br/>Thank you<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fb8e6c	Strand	None	2022-03-04T19:43:26Z	None	None	1	None	2022-03-04T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Strand, Mark	l0b-gzst-vrln	False	None	False	2022-04-12 03:16:48.920	[]
1910	CDC-2022-0024-1916	https://api.regulations.gov/v4/comments/CDC-2022-0024-1916	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain suffer due to Dr. error since the mid-1980s. I tried every kind of injection, therapy, procedure that they threw at me and nothing helped. After undergoing nine years of tests, they determined my Pain was intractable, and curable, and I should learn to live with it. I was then given ibuprofen which destroyed my stomach so I was given opioids, in fact many different types of opioids until I found a combination that worked. I’ve been lived a somewhat normal life, although unemployable due to the damage done by doctors. Then, in 2016 the CDC determined I was a drug abuser, a drug addict, and a drug seeker! My pain medication was then cut by 2/3 and I spent the next year and a half bedridden, and when I begged and pleaded for the doctors to restore my pain meds, I was told in a telephone conference with three supervising department heads at Kaiser Permanente that they would not give me pain meds but would give me assisted suicide medication if that would help me out. After hearing I would spend the rest of my life most likely bedridden, and with my mother in a nursing home and an older sister to look after her, I decided I was going to die on my own. I stopped eating LeDonne water and dropped 70 pounds, then my sister suddenly died. Knowing my mom would be left completely alone in a nursing home, I decided no matter how badly I hurt I could not abandon her. Every day has been a struggle, every day I question why I’m still alive because I don’t want to be here with my pain at this level. Then, in July 20 21 my son William went into septic shock after a doctor botched a hernia surgery and he laid her in an induced coma for four months, and we were told at least six times he would not live the night but he did and he’s a crippled man now after 16 horrific surgeries decimated his abdomen. When he regained consciousness, then my mom‘s UTI at the nursing home was undiagnosed even though I told him he was sick and she died 10 days later. If not for my son living I would have ended my own life with no reason to live. The CDC destroyed me, just like their current Covid bullshit have destroyed so many more! The government refuses to do anything about the drugs crossing our borders illegally cause they decided to attack patients, doctors, and pharmacies! Countless people committed suicide due to the CDC’s vicious lies, including several in pain groups I belong to. The CDC should be disbanded and those who hate this pain and suffering on patients should be prosecuted to the fullest extent of the law! The revision of opioid laws is six years too late and those who could not live with their pain are dead because of the CDC! My hatred of them is ingrained in my soul!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fba82b	Kendrick	None	2022-03-05T20:32:37Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Kendrick, David	l0c-vk13-jetd	False	None	False	2022-04-12 03:16:49.137	[]
1911	CDC-2022-0024-1917	https://api.regulations.gov/v4/comments/CDC-2022-0024-1917	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient of almost 20 years. My issue is related to spinal nerve-related pain. I have worked with my local pain specialist for the last dozen years and am grateful that he has not arbitrarily tapered or discontinued my opioid therapy. He is an anesthesiologist by training and is uniquely qualified to treat chronic pain in our community. Since the 2016 CDC guidelines, at times, I have felt like a criminal at the local CVS where I pick-up my RXs. Despite having a contract with my physician and always taking medications as directed, there are too many entities making judgements on my daily dose of opioids. In January of 2021, my health insurer, Presbyterian, decided that my long-acting medication, Nucynta, would no longer be covered by the plan. Presbyterian gave a list of 5 other opioids (undoubtedly cheaper) to convert to. I ended up choosing OxyContin with the help and suggestions from my doctor. I had been successfully taking Nucynta for about 4 years before the Presbyterian decision to eliminate the drug from coverage. OxyContin works for me, but not as well as Nucynta did. I could understand if Presbyterian wanted to eliminate Nucynta from "new start" patients, but why take away a drug from patients like me who were successfully treated for years? This brings me to the interdiction of the CDC on the prescribing of opioids. Your organization will NEVER eliminate drug misuse for ANY drug classification. There will ALWAYS be abusers out there! Unfortunately, the CDC 2016 guidelines led to pressuring physicians into changing their prescribing of opioids that negatively affected millions of chronic pain patients. My physician had a patient commit suicide because he capped his MME based on the 2016 guidelines. Bottom line: Your agency does not need to make any recommendations regarding opioid use for chronic patients. That's the physician's area of expertise - not bureaucrats that don't see patients daily! I am pleased that the new draft guidelines seem to give physicians space to make individualized decisions based upon patient presentation. That's the way it always should have been!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484fba84a	Hoessel	None	2022-03-05T20:33:14Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Hoessel, Eric	l0c-vmu4-oolt	False	None	False	2022-04-12 03:16:49.427	[]
1912	CDC-2022-0024-1918	https://api.regulations.gov/v4/comments/CDC-2022-0024-1918	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have personally received laser therapy for chronic osteoarthritis in my hip. It is a remarkable non opioid alternative to prescription drugs for pain. I highly recommend this treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Raymond	None	None	0900006484fba88f	Sousa	None	2022-03-05T20:33:26Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Sousa, Raymond	l0c-w70k-noze	False	None	False	2022-04-12 03:16:49.637	[]
1913	CDC-2022-0024-1919	https://api.regulations.gov/v4/comments/CDC-2022-0024-1919	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 cdc chronic pain guidelines are an atrocity implemented by our government to get rid of disabled chronic intractable pain patients and destroy any quality of life a patient had.being on opiate medication as a last resort for over 18 years and then forced tapered to an under 90 mm is cruel and inhumane.the government are not doctors and the proven facts are all been disclosed that the CDC used nothing but anti opiate physicians and psychiatrists who wrote horrible lying guidelines under lying pretense. I support the statements of Dr.[name redacted] also Dr.[name redacted] both have investigated and peer reviewed all data obtained. The CDC is trying to do the same thing with there updated guidelines only destroying patients health even more by starting 50 mm should be implemented.also the crooked anti opiate Dr. [name redacted] had no legal write to again have his hands on any part of a guideline. The American Chronic Intractable Pain Patients have nowhere to go how do we fight crooked agendas that our government is implementing.I as a citizen want to know with all the lies Dr.[name redacted] has been involved in why is the CDC allowing him any part of guidelines.there must be a senate over site and an investigation into the many lives the CDC has severely destroyed and the hundreds of thousands suicides they have caused.there should not be a revised chronic pain guideline it should be torn up and burned and placed in the hands and expertise of FDA and what is left of pain management physicians after our CDC and government used these guidelines to imprison physicians. I endorse [name redacted] and Dr.[name redacted] also saw you tried to also add all physicians as the 2016 chronic pain guidelines were only for GP and you saw how fast they became law for every physician in America. We’re is our health care rights.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Glen	None	None	0900006484fba8c7	Scully	None	2022-03-05T20:37:08Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Scully, Glen	l0c-wteg-myjx	False	None	False	2022-04-12 03:16:49.889	[]
1914	CDC-2022-0024-1920	https://api.regulations.gov/v4/comments/CDC-2022-0024-1920	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to thank the CDC for its efforts in providing these guidelines for opioid prescriptions. As a resident physician, sometimes it is indeed difficult to determine the utility of opioid use for more general pain such as chronic pain and sickle cell related pain for examples. It has been shown that opioids are highly addictive with increasing likelihood of abuse with cumulative use. Hence in situations such as these it can be tough because as a physician, I am trying to alleviate my patient’s pain while at the same time ensuring that I am not creating a situation where my patient can become addicted. These guidelines will be helpful as a resource for reference when needed. This guidelines in addition to the PDMP (Prescription Drug Monitoring Programs) and subsidized programs for opioid dependence will continue to make positive strides to proper opioid prescription and safe use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fba9d0	Anonymous	None	2022-03-05T20:39:06Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0c-zdgl-anbs	False	None	False	2022-04-12 03:16:50.100	[]
1915	CDC-2022-0024-1921	https://api.regulations.gov/v4/comments/CDC-2022-0024-1921	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms are torturous and make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. One of the main frustrations with this disease is the fact that people make fun of and minimize it's effects. I have Multiple Sclerosis as well as RLS. Yet, RLS impacts my every day life much more. If I didn't have the opioid medication I take, which has been the only thing that works to minimize symptoms, my life would be unbearable.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse, as they did for me. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am now 70 years old and I have had RLS for 40 years. For 25 years, at the peak of my productive years, when I was a Senior Environmental Scientist for the State of [location redacted], I never slept more than, at the most, 3 hours a night. The rest of the night was spend, truly, in a state of torture. Fifteen years ago, I was prescribed a dopamine agonist, ropinerole, which minimized the symptoms for several years. Then, it started to make the symptoms worse. I was prescribed several drugs after that that didn't work at all. Then, I found a wonderful doctor at Stanford's Sleep Center that specialized in RLS. After I was weaned from the drugs I was on, he prescribed opioids. He saved my life. I have now been taking opioids for almost 10 years. They have almost eliminated the symptoms with no side effects, except constipation, which I treat. I am on a dose of 45 morphine equivalents a day and never feel "high". This dosage never affected my work and I was promoted to Chief Scientist. I felt so much MORE alert because I was getting sleep. In all of these years I have never had to increase the dose. I am on the same dose as when I started. Please allow me to continue taking the only medication that has ever worked to lessen the awful symptoms I get from RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fbaa97	Taberski	None	2022-03-05T20:42:26Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Taberski, Karen	l0d-2ecj-wtnm	False	None	False	2022-04-12 03:16:50.307	[]
1916	CDC-2022-0024-1922	https://api.regulations.gov/v4/comments/CDC-2022-0024-1922	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help me to live a normal life again by letting my doctor who knows my chronic pain condition prescribe the medication I was previously on to give me back my life on a daily basis...I cannot function on the medicine shes forced now to prescribe me, that doesn't work! Why am I being punished for the people who are getting the illegal drugs off the street that is killing them..I can't help they don't follow the doctors dosage and abuse the system. Please don't punish we who follow the prescribed dosage we didn't ask for this misinformation by the CCD to scare and more or less threaten my doctors from doing their jobs.. this sounds illegal to me and I'm sure others because a doctor takes an oath when becoming doctors to give their patients the best care possible..these guidelines need to be amended so doctors can do their jobs	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fbad19	Babel	None	2022-03-05T20:42:59Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Babel, Patricia	l0d-51ty-d4vk	False	None	False	2022-04-12 03:16:50.518	[]
1917	CDC-2022-0024-1923	https://api.regulations.gov/v4/comments/CDC-2022-0024-1923	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Given that:<br/>-arbitrary increases in MME conversions that do not agree with any other MME guide worldwide, <br/>-suggestions for tapering medications that a patient is stable on knowing the devastating effects on a patient’s quality of life,<br/>-recommendations for 50 MME when the FDA could not make a consensus determination for 90 MME,<br/>-low category evidence,<br/>-the AMA cannot endorse dose thresholds, because we aren't a fascist country,<br/>-portions of the draft reads like fascism,<br/>Therefore: <br/>The CDC should not make prescription guidelines and repeal the 2016 along with this current draft guideline. <br/>Under the HHS Best Practice, individualized care and treatment were recommended. Anything less than individualized plan of care for such a huge population is not practicing sound science or medicine.<br/>Thank you for the opportunity to comment. <br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbad5e	Anonymous	None	2022-03-05T20:43:39Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0d-6d43-udd8	False	None	False	2022-04-12 03:16:50.735	[]
1918	CDC-2022-0024-1924	https://api.regulations.gov/v4/comments/CDC-2022-0024-1924	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient for 10 years the current guidelines are onerous.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484fbaf50	Kamber	None	2022-03-05T20:44:16Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Kamber, Nancy	l0d-7df8-m5h2	False	None	False	2022-04-12 03:16:51.005	[]
1919	CDC-2022-0024-1925	https://api.regulations.gov/v4/comments/CDC-2022-0024-1925	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in an accident in 1989 when I was hit by a drunk driver. I have had too many surgeries to even count and suffer from chronic pain. I became permanently disabled. I was very thankful that I was able to get the proper pain medications which allowed me to even be able to get out of bed. Now because of the new regulations my life has changed so much and I feel like I am being punished all over again for something that wasn't even my fault. I also suffer from panic attacks and they are only getting worse because I had to make a choice to either take my valium or my pain medications! My pain medications had to be lowered significantly because of the laws Now! I find it so hard to believe that our government just wants me to suffer ! I have never abused my pain medications and now I suffer every single day and night for something that wasn't even my fault! All I want is to feel somewhat normal, but with the new regulations it's impossible! I also have lost a lot of weight because of the pain I am in. I simply don't understand why my own government would want me to suffer like this. I also had a heart attack due to the severe pain and the stress that I am going through! We are not drug addicts, but simply want to try to lead a life without suffering from horrible chronic pain! I didn't choose this life for myself, and now my own government is taking away my somewhat normal life just as that drunk driver who hit me! I beg you to please have compassion for all of us who suffer from chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fbab77	Carter	None	2022-03-05T20:51:58Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Carter , Karen	l0d-8g2e-jwn4	False	None	False	2022-04-12 03:16:51.269	[]
1920	CDC-2022-0024-1926	https://api.regulations.gov/v4/comments/CDC-2022-0024-1926	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I was diagnosed with RLS at age 35, after having suffered for several years with symptoms and not knowing what was wrong. My doctor prescribed the accepted first-line medication - a dopamine agonist called Sinemet. I had good results with Sinemet for five years before I developed augmentation, which is a known issue with dopamine agonists in which the medication begins to exacerbate RLS symptoms rather than relieve them. I was correctly changed to a different medication - another dopamine agonist called Mirapex. I successfully used Mirapex for eight years before developing augmentation. I consulted a neurologist for the first time, and <br/>despite my history with augmentation, this doctor prescribed another dopamine agonist - a transdermal patch called Neupro. I had good results for five years before augmentation set in. My symptoms were so persistent and problematic that they affected my ability to travel, to go out in the evening, and to engage in basic social activities such as going out to dinner, watching a movie at night with my husband and son, or attending evening meetings and church services. My career was affected by my inability to work the evening shifts my job as a hospital social worker sometimes required. My neurologist retired, and I was referred to another local doctor who was willing to explore other treatment options. While my symptoms still flare up occasionally, a combination of Neupro, Gabapentin, and Tramadol have been very successful for the past three years. My doctor and I have already discussed the possibility I may need to switch to low-dose methadone if my current regimen becomes inadequate. Without the addition of an opioid to my regimen I would have been disabled at the age of 50. If opioids are restricted without a provision for use in chronic medical conditions like RLS, I will be unable to work or live anything close to a normal, fulfilling life.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alisha	None	None	0900006484fbab7a	Youch	None	2022-03-05T20:52:17Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Youch, Alisha	l0d-8lnd-g12n	False	None	False	2022-04-12 03:16:51.495	[]
1921	CDC-2022-0024-1927	https://api.regulations.gov/v4/comments/CDC-2022-0024-1927	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What has gone wrong? I'm a 78 yr old widow having been force tapered by PM from 90 mmE down to 30 mmE after 12 yrs with no problems from that level. My life has gone downhill since. Medical expenses are much higher compared to before. He told me that 75% of patients do better off opioids and people with my condition improve with Tylenol. The resulting aching, burning and fatigue are slowly killing me. The guidelines have to free doctors to treat patients as they see fit...especially pain management which is supposed to be exempt, but is this not happening. They say they have to adhere to the CDC guidelines, period.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	AltaAlta	None	None	0900006484fbabfc	HanlonHanlon	None	2022-03-05T20:52:32Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from HanlonHanlon, AltaAlta	l0d-9it2-vvm0	False	None	False	2022-04-12 03:16:51.743	[]
1922	CDC-2022-0024-1928	https://api.regulations.gov/v4/comments/CDC-2022-0024-1928	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 51 year old female. I was thrown from a vehicle in a car wreck the driver was killed instantly. I’ve had 12 back and neck surgeries. I have DDD and 2 burst discs in my back. I also have meneires disease. My neurosurgeon was treating my pain he retired abruptly because of the pressure he was getting from the dea for legitimately treating and performing surgeries to keep my quality of life. It has been 7 months since I’ve had any pain medication. I no longer am able to work I barely leave my house because of the pain I am in. My back and neck will never get any better that is what my neurosurgeon has told me. I went to a pain management dr and he told me he wouldn’t do anything for me unless I got injections it’s ridiculous that I have 2 diseases that are not being treated. No ent wants to prescribe the appropriate medicine for meneires disease. I have no quality of life and 2 diseases just left completely untreated. It appears the chronic pain patient has been made to suffer through humiliating treatment by the doctors who have completely abandoned their oaths. Healthcare in the United States is a joke at this point. I will look to another country for my needs. I’m a disgusted with how I have been treated by doctors because of the dea overstepping their boundaries. There is no doctor patient relationship anymore. Things have got to change people are killing themselves bc of government over reach!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suzanne	None	None	0900006484fbac1c	Mitchell	None	2022-03-05T20:52:51Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell, Suzanne	l0d-b84h-p7o2	False	None	False	2022-04-12 03:16:51.989	[]
1923	CDC-2022-0024-1929	https://api.regulations.gov/v4/comments/CDC-2022-0024-1929	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>The need for advocacy on behalf of our profession cannot be stressed enough at this time. And although medication management, including the use of opioids in appropriately selected patients is an important part of our practice, so are interventional procedures. Those procedures, in addition to a multi modal treatment plan, are the reasons we can wean people off of narcotics. Allowing policy makers to ignore current Opioid Working Group and AMA guidelines minimize the role that interventional procedures play in our practice is absurd and will only facilitate a rise in opioid use with a high likelihood for increases in adverse events. I would highly recommend a critical evaluation of the data on interventional procedures in conjunction with adhering to the consensus statements provided by the aforementioned medical groups. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb178	Anonymous	None	2022-03-05T20:53:23Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0d-ff23-3oun	False	None	False	2022-04-12 03:16:52.213	[]
1924	CDC-2022-0024-1930	https://api.regulations.gov/v4/comments/CDC-2022-0024-1930	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The chronic pain community does not take opioids to get high, they take them to survive. Please remove these unreasonable limits and help restore their lives.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fbb203	Uchimura	None	2022-03-05T20:53:37Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Uchimura, Kathleen	l0d-k0kt-8xc1	False	None	False	2022-04-12 03:16:52.491	[]
1925	CDC-2022-0024-1931	https://api.regulations.gov/v4/comments/CDC-2022-0024-1931	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have symptoms that keep me up every night. I've tried three medications for these symptoms and they either didn't work, or they worked for a while then made the symptoms worse. I'm exhausted from the lost sleep. The only thing that's worked is when I had surgery and was given opiates. It eliminated the RLS symptoms. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fbb221	Mannina	None	2022-03-05T20:54:00Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Mannina , Melissa	l0d-nkvw-9lwo	False	None	False	2022-04-12 03:16:52.700	[]
1926	CDC-2022-0024-1932	https://api.regulations.gov/v4/comments/CDC-2022-0024-1932	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had 8 back surgery’s, I’ve reached the point theirs nothing left they can do surgically and are left with just managing my pain which these limits makes it very hard to do. They had finally found the correct meds that allowed me somewhat of a life. I was able to be productive in society, started attending family functions, meds gave me the ability to function with my family, When they changed the limit to the 90mme all that changed. I am back to being non productive in society, I once again am Missing out on family gatherings, I basically spend all day sitting in my chair, having to spread Ben gay several times a day, having several heating pads covering my back an hips, I just sit here day after day waiting for God to take me home. How do you people face the mirror knowing your causing people to commit suicide because their in so much pain? Your turning pain patients into criminals by forcing them to turn to buying off the streets because their in such horrible withdrawals their crawling out of their skin? It’s inhumane what these guidelines are doing to us patients that didn’t ask for this body.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484fbafe2	Peterson	None	2022-03-05T20:54:18Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Jeanne	l0d-s9d9-9uha	False	None	False	2022-04-12 03:16:52.925	[]
1927	CDC-2022-0024-1933	https://api.regulations.gov/v4/comments/CDC-2022-0024-1933	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please please readdress the use of low dose opioids for use in RLS. There arr approximately 12 million of us in the US who suffer 24 hours a day and night! From the horrific disease. It truly is torture with no escape! Drugs now bring used often help for a little while but also make RLS worse in the long run. Since there is no cure, we r in desperate need of help. <br/>Please do the right thing and help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joanne	None	None	0900006484fbb011	Tornambe	None	2022-03-05T20:54:30Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Tornambe, Joanne	l0d-vdlb-ih30	False	None	False	2022-04-12 03:16:53.149	[]
1928	CDC-2022-0024-1934	https://api.regulations.gov/v4/comments/CDC-2022-0024-1934	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have extremely severe Restless Legs. The commonly approved medicines for Restless Legs caused augmentation, with symptoms INCREASING to an unbearable degree. Working with two neurologists, trying many medicines, the ONLY medicine that controlled symptoms enough for me to function was Methadone. <br/><br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does Not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Virginia	None	None	0900006484fbb01e	Bates	None	2022-03-05T20:54:44Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Bates, Virginia	l0d-vzju-m24v	False	None	False	2022-04-12 03:16:53.377	[]
1929	CDC-2022-0024-1935	https://api.regulations.gov/v4/comments/CDC-2022-0024-1935	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have intractable chronic pain in my spine and my wife has terminal lupus all of which are extremely painful and debilitating. For years we found relief from our crushing pain by taking prescribed opioids. We had many good functional happy years together. <br/>When the guidelines came out in 2006 we knew this would eventually lead to much pain and suffering. As the stranglehold on illegal opioids continued to tighten, individual states began a draconian campaign to strip all patients of the needed medications to enable them to enjoy life again. <br/>I view the war on opioids as I do gun control. It's not the patients legally prescribed pain medications that took so many lives it's the criminals who import or otherwise illegally obtain these drugs that have caused so much death. Close the border to do more to control smuggling but let doctors become doctors again to do their sworn duty to treat patients in a dignified and humane manner.<br/>I urge the CDC to undo the irresponsible guidance of forcing doctors into an impossible position of delivering substandard care to the most vulnerable of us. Give us our quality of life back. Please!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fbb01f	Hammons	None	2022-03-05T20:54:57Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Hammons, Michael	l0d-w1jy-36u4	False	None	False	2022-04-12 03:16:53.586	[]
1930	CDC-2022-0024-1936	https://api.regulations.gov/v4/comments/CDC-2022-0024-1936	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I am happy you are revising the opioid prescription guidelines but as a person with Restless Leg Syndrome which is a chronic neurological disease that is chronic all day long disease that affects people differently. As a person with extreme chronic RLS I rely on opioids to get me through the day and allows me to sleep.<br/>With out opioids I would not be able to work, I would be another person who relied on government assistance.<br/><br/>In the US nearly 12 million adults and children suffer from RLS and there is NO CURE. I have been on all the prescriptions that are being used off label for RLS and the augmentation from dopamine agnostic medicine was worse than the RLS when it would augment. Opioids are the one medication that doesn’t augment and low doses work for RLS. <br/>There is ample scientific research that supports the use of low dose daily opioid treatment for sever RLS. <br/><br/>Thank you for your consideration of the vital issues around opioids, please consider the RLS Foundation at www.RLS.org as a resource for scientific based information about RLS, as it is for members like me. <br/><br/>Please consider the people who use opioids for a life long disease and people like me who don’t abuse them and use them as intended.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fbb028	Cadwell	None	2022-03-05T20:55:08Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Cadwell , Melissa	l0d-wc58-s2jn	False	None	False	2022-04-12 03:16:53.798	[]
1931	CDC-2022-0024-1937	https://api.regulations.gov/v4/comments/CDC-2022-0024-1937	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was under neurologist Care for over a decade receiving opioid pain management for atypical complicated migraines and IBM. I'd been on this medication for over a decade and was able to perform daily tasks and function because of the medication. Before I began the medication I was in bed for two years. This medication gave me my life back. Then I moved from Texas to las Vegas to be near family, as my IBM is progressing and mobility will soon be drastically impaired. Upon moving to NV, I couldn't find a single doctor that would prescribe my pain medication. Not one. I ended up having to go to a METHADONE CLINIC...with addicts and heroin abusers... to get the help I need. To function. To not lay in bed crying all day. Your 2016 "guidelines" that have struck fear into the heart of so many, both docs and chronic pain sufferers, has been one of the most detrimental over reaches of this US government I've seen in my 52 years. As you can see, it hasn't helped ANYONE and has caused even more harm. Those who are tasked with the care and trust of the people and patients of this country has done nothing more than forced us to the streets and MORE dangerous situations to get the HELP we need to live and maintain! What an incredible breach of trust. Please find another way and LIFT THE "GUIDELINES" FOR CHRONIC PAIN PATIENTS!!! WE ALL KNOW THE DIFFERENCE!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Renee	None	None	0900006484fbb02e	Stevens	None	2022-03-05T20:55:37Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Stevens, Renee	l0d-wl5z-yqz3	False	None	False	2022-04-12 03:16:54.010	[]
1932	CDC-2022-0024-1938	https://api.regulations.gov/v4/comments/CDC-2022-0024-1938	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As the husband of a woman with severe, refractory Restless Legs Syndrome, I have watched my wife suffer daily for decades. Methadone is the only medicine that provides relief. I ask that you include RLS in your 2022 Guidelines.<br/><br/> The draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484fbb035	Bates	None	2022-03-05T20:55:54Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Bates, Charles	l0d-wug9-2wx9	False	None	False	2022-04-12 03:16:54.225	[]
1933	CDC-2022-0024-1939	https://api.regulations.gov/v4/comments/CDC-2022-0024-1939	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Providers, especially Primary Care Providers need to stop treating pain with opioids on the first visit unless pain is acute, severe, or intractable. Primary care physicians should also not give a high dose of medication these issues. Further more, we need to stop treating the psychological portion of pain with opioid medications. If a person has emotional trauma, opioids should not be started alone, there should be a multimodal approach. <br/>Without a cap, patients will now request more and more medication. A physician cannot "use best judgement" if a patient keeps coming saying they are in pain or the medications are no longer effective. <br/>It should be harder to start these medications, and it should be limited. Too many practices are profiting off of being "legal" drug dealers as many patients are coming just to get euphoria the medications and they become addicted. Also urine screens companies becoming rich off forcing these patients to take drugs tests. Even more so, when a pain practice owns the urine lab (or the private equity group owns the lab), they are being incentivized to run drug tests. This should be illegal and regulated. <br/>Less than 10% of my practice is on opiods. So, I am either the world's best pain doctor, or everyone else out there is over prescribing and undertreating.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb05c	Anonymous	None	2022-03-05T20:56:15Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0d-xw3h-wirk	False	None	False	2022-04-12 03:16:54.435	[]
1934	CDC-2022-0024-1940	https://api.regulations.gov/v4/comments/CDC-2022-0024-1940	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC’s interaction to prescribing opiates for chronic pain is just plain wrong. They have no business messing with peoples lives like that. These decisions should be made between patient and doctor. From someone who lives with chronic pain every day of my life, these guidelines have affected me daily when my doctor cut back my dosage by a large amount. Now my quality of life has gone downhill ever since. I was on a good dose that was giving me the quality of life I want and deserve but not now. My current dose takes some of the edge off but doesn’t do the job. There are probably suicides due to people getting their doses cut back which brings their pain back which makes them depressed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brad	None	None	0900006484fbb2bd	Beyer	None	2022-03-05T20:56:29Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Beyer, Brad	l0e-0qpf-p67n	False	None	False	2022-04-12 03:16:54.647	[]
1935	CDC-2022-0024-1941	https://api.regulations.gov/v4/comments/CDC-2022-0024-1941	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 60 old that has had arthritis since I have been 9 years old. I now have multiple Myeloma and CHF. I am so afraid that my pain will not be managed because of your regulation. I have gone thru this reduction before and it is not pretty. The booze bottle now plays a part in managing my pain thanks to reductions. Something I DO NOT LIKE DOING!! My cancer is very painful and they ae all ready restricting use of pain meds. I see why people commit suicide. Because your regulations make it unbearable. The people who don't need them for pain still get them on the street get them and those of us SUFFER> Let our doctors be doctors!! Let us suffering get what we need. When we are in this much pain sometimes they only take the edge off and that is better than nothing. Walk in my shoes one day and you would leave things alone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484fbb2d3	Fransway	None	2022-03-05T20:56:44Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Fransway, Jeanne	l0e-0xf1-6e7i	False	None	False	2022-04-12 03:16:54.861	[]
1936	CDC-2022-0024-1942	https://api.regulations.gov/v4/comments/CDC-2022-0024-1942	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person with a disorder requiring opioids for control, I wish to state: Do not place patients and doctors in the position of asking permission for every prescription they write. I've been under the care of a pain specialist for over 7 years. I do therapy exercises, yoga, and see a pain psychologist. And I take opioids. My condition is genetic and there is no cure. Without this medication, I would be unable to walk or function.<br/><br/>Insurance companies are quick to jump on any excuse to limit or deny payment for needed medication. This new guideline must be carefully worded to prevent people under the care of pain specialists from obtaining needed medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb2f4	Anonymous	None	2022-03-05T20:56:57Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0e-18uo-r1f4	False	None	False	2022-04-12 03:16:55.072	[]
1937	CDC-2022-0024-1943	https://api.regulations.gov/v4/comments/CDC-2022-0024-1943	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove the recommendation of ANY MME limit on medication. People metabolize medication differently. There is NO SCIENTIFIC PROOF to back up Morphine Milligram Equivalent because ALL Patients are Different and metabolize medication differently.<br/><br/>In Lamens terms: What works for patient 1, won't work for patient 2.<br/><br/>Please remove the perceived idea/opinion that women that have survived any form of abuse or Assault are high risk of addiction and don't deserve their pain treated.<br/><br/>Also, even people with the "Label" SUD or the idea of OUD in their medical records deserve proper pain management. No Bupe/Sub is not a good or safe substitute for Opioid Pain Medications for all of these patients. <br/> <br/>Patients with rare diseases. For Example: Ethers Danlo Syndrome cannot safely take Suboxone/Subutex due to complications.<br/> <br/>Combine these two issues and you have a patient that does not get proper Opioid Treatment due to Recommendations and Stigma of "high risk" placed upon the patient's medical records.<br/><br/>I myself fall into the category of "high risk" due to the Stigma that anyone with mental health problems (PTSD, Anxiety, Depression) is "high risk" and anyone placed on methadone for pain in the past is "high risk". I have chronic intractable painful genetic diseases that don't get treated. I am in constant disabling agony due to my untreated pain because of Stigma. I also cannot take Subutex/Suboxone/Buprenorphine due to my genetic chronic terminal illnesses.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb3e3	Anonymous	None	2022-03-05T20:57:18Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0e-3opx-crcz	False	None	False	2022-04-12 03:16:55.287	[]
1938	CDC-2022-0024-1944	https://api.regulations.gov/v4/comments/CDC-2022-0024-1944	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a DEA license but seldom prescribe due to my field of work. <br/>But my brother lives at a pain level of 9.5-10 every day, all day. He cant sleep, cant walk, his every movement illicits unbearable pain. I fear very much he will end his life due to the overbearing constraints that physicians have been forced to practice under because of an opioid crises that is largely made up of people who dont have an opioid prescription in the first place. Go to the forums, you will find inumerable people who are suffering unnecessarily because of a mis-guided attempt to stop illicit drug use.<br/>Please give doctors back the ability to treat their individual patients as they have been trained to do. <br/>I hear that States are resisting your call to change prescribing guidelines. This must be stopped. I believe their resistance is not based on facts, but on press-driven hype.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fbb463	Millsap	None	2022-03-05T20:57:43Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Millsap, Michael	l0e-4zg8-jf2e	False	None	False	2022-04-12 03:16:55.575	[]
1939	CDC-2022-0024-1945	https://api.regulations.gov/v4/comments/CDC-2022-0024-1945	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I was diagnosed in high school with RLS, and it was so bad we weren’t sure if I was going to make it to college. After several years of trying different medications with only partial success and greatly struggling with fatigue and side effects, my neurologist tried using an opioid medication. It worked like nothing else. I don’t have side effects, I don’t get a high, I am finally able to sleep and I can function in normal society. This medication has been working for me for eight years now. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Isabel	None	None	0900006484fbb4cb	Lines	None	2022-03-05T20:57:52Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Lines, Isabel	l0e-6cuv-f17k	False	None	False	2022-04-12 03:16:55.811	[]
1940	CDC-2022-0024-1946	https://api.regulations.gov/v4/comments/CDC-2022-0024-1946	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. When the government decided they knew how to treat my pain better than my doctor does my life changed drastically. I had to go on disability. Eventually I lost all of my pain care through no fault of my own but insurance reasons. I have no quality of life. My house is a mess. My life is a mess. I went from being a working, productive person to a shell of my former self. I can't even enjoy my grandchildren now and no one understands. That just makes everything worse and the depression starts. It is a vicious circle.<br/><br/>December 9,2022 I had open heart surgery. I was terrified of being in agony after my surgery. I had a long talk with my doctor. He assured me that my pain would be managed. I told him I knew that no medicine could take away the pain completely. I just wanted it to be bearable. It was a whole new level of pain I never knew existed. My pain was never managed properly. I was taken off my pain meds 3 weeks after surgery. When I went back for my 2 month follow up my doctor actually told me that my pain was not managed properly. I was in too much pain to do what I needed to do to heal. So now instead of an 8 week recovery time I am looking at 4 to 6 months. I am experiencing lung issues due to not being able to clear my lungs after my surgery.<br/><br/>Now on to my husband. He has had 29 surgeries. Including 7 back surgeries and a total knee replacement. His pain management doctor had him on methadone for pain. When the government stepped in his meds were cut back to the point they no longer worked. I watched this very active, constantly moving man go from constantly moving to constantly sitting in the recliner. His quality of life went to no quality at all. Just to get help he had to go to the methadone clinic. Now he is treated like a drug addict. It's embarrassing but he got his quality of life back so it's worth it. This is what happens when the government and insurance companies tell our doctors how to care for us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denean	None	None	0900006484fbb933	McMillen	None	2022-03-05T20:58:14Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from McMillen, Denean	l0e-8690-yvrf	False	None	False	2022-04-12 03:16:56.064	[]
1941	CDC-2022-0024-1947	https://api.regulations.gov/v4/comments/CDC-2022-0024-1947	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS is a disease that I inherited from my Mother and has been in my life since I was a child. What started as an occasional annoyance in younger years has grown into a life altering disease in my 60's. There is no cure, only various medications available to make the symptoms tolerable. I am almost 70 and have been through all the meds. I have Refractory RLS and the one and only thing that has brought me any quality of life is my low dose opioid. I am grateful for a Neurologist who is very knowledgeable in this disease and feels comfortable in treating me with close supervision. We (RLS sufferers) did not choose RLS, nor did we cause it in ourselves. It is as devastating a disease to the individual's life as any other neurological disease and needs to be treated with as much importance in considering the patient's health and quality of life. For us, the low dose opioid can make the difference and has been proven over and over that at this amount, addiction has not been a problem but has proven to be a life savor. Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484fbb935	Graber	None	2022-03-05T20:58:26Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Graber, Carol	l0e-86do-0tg5	False	None	False	2022-04-12 03:16:56.272	[]
1942	CDC-2022-0024-1948	https://api.regulations.gov/v4/comments/CDC-2022-0024-1948	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not lower this any more. My brother was hurt 35 years ago, has been seeing the same dr for over 10 years. This Dr has slowly lowered his pain meds to the point he is always in pain. If they are lowered more my brother says he will kill himself. He nor any of us are buying drugs off the street or shopping around for other dr. There has to be a balance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484fbb959	Myers	None	2022-03-05T20:58:35Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Myers, Jeanne	l0e-8p12-ahyq	False	None	False	2022-04-12 03:16:56.481	[]
1943	CDC-2022-0024-1949	https://api.regulations.gov/v4/comments/CDC-2022-0024-1949	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This revision is a much more realistic approach to pain management requiring opioids than the previous version. I have seen too many patients who were literally forced off of opioid regimens that had been working for years because of the former guidelines. Their lives became a nightmare of pain, inability to find doctors willing to prescribe to them and being made to feel guilty and ashamed for feeling like they needed opioids for their pain. While there are many patients who can successfully get off opioids, there are also many who seemingly cannot. For those who cannot, these new guidelines remove some of the stigma such patients have suffered.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb963	Anonymous	None	2022-03-05T20:58:47Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0e-8u4z-9geu	False	None	False	2022-04-12 03:16:56.689	[]
1944	CDC-2022-0024-1950	https://api.regulations.gov/v4/comments/CDC-2022-0024-1950	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hear you are revising the CDC Clinical Practice Opioid Prescribing Guideline. The draft does not talk about my problem. Chronic conditions like RLS which are different from chronic pain. Restless leg syndrome is a chronic neurological disease. It Presents itself as an urgent need to move your legs and sometimes arms. Most of the time it happens at night when you are trying to sleep. A person cannot lay down in bed or sit. One can only walk the floor ALL night. I have had this disease since I was 20 years old. My mother had it also. I am now 76 years young. I have tried all of the medication‘s that doctors have prescribed. When I was younger some worked for a while but not very well. Now that I am older I can find nothing that helps. Most nights I get little sleep. I was contemplating suicide until I found a doctor that would prescribe an opioid for me. It has been a life changer. The bottle says Methadone 5MG/5ML Solution. <br/>PLEASE, PLEASE, PLEASE include chronic diseases like RLS in the treatment guidelines. I cannot express enough how important this is!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol Ann	None	None	0900006484fbb964	Mooar	None	2022-03-05T20:59:01Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Mooar, Carol Ann	l0e-8ufh-8flg	False	None	False	2022-04-12 03:16:56.924	[]
1945	CDC-2022-0024-1951	https://api.regulations.gov/v4/comments/CDC-2022-0024-1951	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a permanent injury to my cervical spinal cord for 10 years it left me with whole body nerve and muscle spasticity problems I take large amounts of opiates for years I have built up a tolerance to the amount I take and my dr.says I'm maxed out and can't give me more thus isn't fair the problem is the people who scam the system so I suffer for it I hope you change the guidelines for people like me I have documents proving what I'm saying	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mario	None	None	0900006484fbb58c	FORMATO	None	2022-03-05T20:59:16Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from FORMATO, Mario	l0e-8v3b-ej3f	False	None	False	2022-04-12 03:16:57.137	[]
1946	CDC-2022-0024-1952	https://api.regulations.gov/v4/comments/CDC-2022-0024-1952	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Speaking from the perspective of a well established surgical patient of many years, I feel the CDC and FDA have fostered the pendulum for pain management to swing way to far... To the point of abuse in some instances.<br/><br/>When much needed pain medications are declined a patient recovering from surgery,it makes sense that the patient may try and obtain the drugs elsewhere... ie, black market, friends or stangers. Not such a good plan.<br/><br/>Patients should not be made to feel ashamed or guilty if their pain continues past the assigned perscripton or be labeled a "drug seeker."<br/><br/>I have worked in the health care field and have often seen patients and friends suffer quietly, and not so quietly,due to the lack of proper pain management.<br/><br/>Please reconsider your present day pain protocol.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484fbb5cc	Robson	None	2022-03-05T20:59:30Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Robson, Christina	l0e-95i4-vflz	False	None	False	2022-04-12 03:16:57.354	[]
1947	CDC-2022-0024-1953	https://api.regulations.gov/v4/comments/CDC-2022-0024-1953	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The current opiod regulations are not adequate in allowing physicians and patients specific personalized treatment for pain.<br/> It has been previously suggested that with acute pain a 3 day supply of narcotics is sufficient. This is not typically the case.<br/>I am a RN and have personally seen patients with severe acute pain not being treated sufficiently and have been forced to reach out to alcohol or illegal substances for pain relief. This is not always the case. I have treated patients who were seen in the ED for acute pain and either not given pain medication or enough for a couple of days. They call in desperation and most often have to deal with the pain with only over the counter meds which are being over-used beyond recommended dosing. Clinicians are often unable to get patients into the office in timely fashion and with current restrictions unable to provide sustainable pain relief.<br/>It is a difficult thing to have patients experiencing moderate to severe pain and unable to provide adequate pain relief due to the current regulations. NOT all patients are addicted or have an addictive behavior. The answer is not to withdraw clinician's freedom to explore the best options for their patients and treat appropriately.<br/>My 32 year old son recently was in an accident with a severe shoulder injury and NO medication was prescribed. He has never had narcotics or is at risk for narcotic abuse. Despite his severe pain awaiting to see a specialist no over the counter option was providing any relief. He experienced a hypertensive crisis which per the ED MD could have been prevented has he been prescribed a pain reliever.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb5d5	Anonymous	None	2022-03-05T20:59:46Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0e-97el-qukq	False	None	False	2022-04-12 03:16:57.572	[]
1948	CDC-2022-0024-1954	https://api.regulations.gov/v4/comments/CDC-2022-0024-1954	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please completely REPEAL these “Guidelines”. Repeated references to 50 mme will continue to cause hesitancy among doctors (even pain mgmt drs) to write out prescriptions at or above 50, or even at all.<br/><br/>Stating that certain conditions (ie fibromyalgia) are’nt helped by opioids is inaccurate and will prevent some doctors from even considering writing an rx to try it. We are aware of many people with fibromyalgia who were successfully treated with opioids in the range of 150-200 mme. They are/were not high or “addicted” BUT able to function.<br/><br/>In fact many people across a myriad of different conditions were helped at dosages way above 50, & the CDC “guidelines” took the medicine (their lives) away from them. These people were FORCIBLY CUT, NOT TAPERED.<br/><br/>These guidelines have destroyed lives. Tortured people. Forced them to turn to suicide and even street drugs.<br/><br/>Not everyone metabolizes drugs the same. Many people with different conditions do well with titration way above 50. They are able to function, contribute to society and they are not high, nor are they addicts.<br/><br/>Stating that anything above 50 is only incrementally helpful is a major disservice to people who are helped at much higher doses who WERE able to get their lives back at these higher doses.<br/><br/>Stating that people over 65 should have lower doses is also inaccurate, AGEIST and inhumane. Again, not everyone metabolizes medication the same. <br/><br/>I have family members who were massively CUT. They have suffered for years now and are unable to function due to inadequate pain control. This has caused further deterioration of health. They were happy, healthy, able to bath, cook, shop, socialize etc and since they were CUT to inadequate dosages they have no lives and days of endless pain and torture. NOW they are being told they take”a little too much for their AGE” without considering the horrendous condition they are in due to being too low from being CUT in the first place.<br/><br/>The CDC cares more about a street addicts quality of live, but in the mean time you have destroyed the lives of people with horrible, painful conditions. The “list” you provide on how to identify an addict as far as withdrawal from society, functioning etc is what THESE GUIDELINES HAVE DONE to people who were previously treated at correct, higher opioid dosages. <br/><br/>The only people i feel sorry for are the people who had their legitimate meds taken away, cut, thereby DESTROYING THEIR LIVES AND THOSE OF THEIR FAMILY MEMBERS WHO STANDBY HELPLESS TO DO ANYTHING. Those who were in so much pain they turned to suicide. And those who were so desperate for pain relief they turned to street drugs.<br/><br/>These “guidelines” are a disgrace.<br/><br/>Doctors need to be able to prescribe these meds without fear of losing their licenses or the DEA throwing them in jail.<br/><br/>Insurance companies have no business limiting a doctors number of pills or dosage.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D.	None	None	0900006484fbb5dc	Ortolano	None	2022-03-05T21:00:12Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Ortolano, D.	l0e-98po-14zp	False	None	False	2022-04-12 03:16:57.793	[]
1949	CDC-2022-0024-1955	https://api.regulations.gov/v4/comments/CDC-2022-0024-1955	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I worked in the field of pain management and have also been a long-term chronic pain patient. Throughout this time, I casually observed a curious little commonality amongst doctors. I refer to it as the “Playbook.” It seemed to me that doctors developed a curious approach to pain patients when addressing their pain. It’s like they all used similar approaches, thus the Playbook reference. <br/>One technique from the playbook was the “make them mad, then fire them” approach. I found that if a patient ever showed any level of hostility, they would often be “fired” from the practice. I’ve witnessed doctors intentionally upset patients in order to create a scenario to get rid of them. One thing that I personally experienced was the “refill” game. If I called in too early, I would be chastised for calling in early and sometimes threatened with disciplinary action for not handling my prescription properly. They would assume I was trying to get my prescription early when the reality is I was just trying to get the process going. It would often take several days to get a refill from the date called in so I tried to plan accordingly. The doctor might be off, or on vacation, and no one authorized to sign off on prescriptions. I often found myself waiting days for my refill. After 16 years with this doctor, it became very clear that this was simply the game I had to play, the “refill” game. Sadly, I never offered adequate opportunity for him to fire me for my behaviors. <br/>Another chapter from the “Playbook” was the “minimize” approach. I would see doctors downplay a condition in order to avoid recognizing a patient’s chief complaint. “Why would they do this,” you ask. Well, the doctors were given marching orders to get rid of opioid prescriptions so they developed many methods to achieve this goal. You can thank the Cures Act of 2016 for that. I know this sounds unethical but who ever said a doctor had to be ethical? Just because they raise their hand up to the “Hippocratic Oath” doesn’t mean they will necessarily abide it. If they recognized a problem, they would be committed to treating that problem, right? So, ignore the problem and avoid the subject, often at the expense of the patient. I have documented proof (X-Ray) and the doctors’ own notes of this very situation should anyone question the integrity of my assertion. <br/>Probably the saddest chapter of the “Playbook” was the “it’s all in your head” approach. I can’t tell you how many times I heard that comment working in the pain management field. Make the patient believe that the pain is imaginary and that it’s some sort of psychological trauma instead. One of my doctors always charted me as “somatic dysfunction” which basically means, “it’s in your head.”<br/>In 2002, I injured my upper back and it has plagued me ever since. I was already on prescription opiates because of a lower back issue and now I had a new injury. Quite the dilemma for this doctor as he now would have 2 pain problems with a single patient. Hmm, might mean more medication so better avoid the problem. My doctor was aware of this injury in 2002 but it was never documented until several years later, which came from my insistence to have it documented. This doctor never ordered any imaging on my back until 2011, which, again, came from my insistence to have it documented. My problems were supposed to be in my head so I was never competently evaluated to look for the real problem. Guess what, I found out nearly 10 years later that I had a scoliosis defect after all. So, I suffered needlessly for years and probably missed an opportunity to truly rehabilitate myself. <br/>There are other chapters to the “Playbook” but I think you can see my point here. When the word went out to “Cure” our country, I wonder if anyone might have foreseen the problems that they would create? Were chronic pain patients simply viewed as collateral damage in the midst of the Great American Opiate War? After all, the end justifies the means, right? <br/>To ignore the data since the Cures Act, is to ignore the reality before us. The doctor/patient relationship was absolutely ruined by the original opiate guidelines and will sadly be damaged further for the patient while leaving the doctors a lot more comfortable to do as they please. <br/>This is the only patient that continually sees discrimination when compared to other medical issues. Is a heart patient hassled for having a bad heart? Does a diabetic person have to wait for days for a prescription? Chronic pain suffers are patients and people just like everyone else and it’s time for fair and compassionate treatment. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fbb625	Cook	None	2022-03-05T21:00:54Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l0e-9p3p-rpmh	False	None	False	2022-04-12 03:16:58.004	[]
1950	CDC-2022-0024-1956	https://api.regulations.gov/v4/comments/CDC-2022-0024-1956	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	we as the usa should have legal heroin you say theres an opiate epidemic but nothing is being done people are still dying every day all day from overdoses not even because of heroin but because of fentanyl more then covid and this why i think heroin should be legal at least people will no what there getting and wont have to worry about dying. I know this isnt the best or well written comment but i hope it will make a difference	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	ty	None	None	0900006484fbb657	c	None	2022-03-05T21:01:16Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from c, ty	l0e-a09v-kn32	False	None	False	2022-04-12 03:16:58.229	[]
1951	CDC-2022-0024-1957	https://api.regulations.gov/v4/comments/CDC-2022-0024-1957	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To you and your colleagues charged with revising the CDC Clinical Practice Opioid Prescribing Guideline I urge you to remain aware that many of your fellow citizens, and I am one of those, suffer from Restless Legs Syndrome (RLS). Only recently in my 60’s did I discover that the judicious use of low-dose opioid medications would give me relief after most of a lifetime of suffering. <br/><br/>I am aware that the draft of your Guideline does not address chronic conditions like RLS that are different from chronic pain. Restless Legs Syndrome is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>I suffer from this condition along with nearly 12 million fellow citizens. For us there is no cure. A few prescription medications have relieved the symptoms for a while, but over time those same medications have actually made the symptoms worse. When all other medical therapies fail, there is plenty of scientific research to support the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have dealt with this insidious syndrome for more than 50 years. The ONLY relief I’ve had has been with low dose oxycodone (.5mg tablets) once or twice a day just before and at bedtime. After all those years of sleeping on floors and walking hallways at night I finally have a great quality of life. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS. I encountered this frequently. <br/><br/>I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bryan	None	None	0900006484fbb681	Stuart	None	2022-03-05T21:01:34Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Stuart, Bryan	l0e-a9y5-5e2p	False	None	False	2022-04-12 03:16:58.469	[]
1952	CDC-2022-0024-1958	https://api.regulations.gov/v4/comments/CDC-2022-0024-1958	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Glen	None	None	0900006484fba927	Wilder	None	2022-03-05T21:01:55Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Wilder, Glen	l0c-xyse-s6zs	False	None	False	2022-04-12 03:16:58.716	[]
1953	CDC-2022-0024-1959	https://api.regulations.gov/v4/comments/CDC-2022-0024-1959	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve suffered with Restless Legs Syndrome (RLS) for the majority of my 60 years. In my 40’s I was officially diagnosed after months of little sleep. I was extremely depressed and unable to function. After some trial and error with my doctor we settled on pramipexol to ease the symptoms and this has mostly worked for many years. However, there are nights (and some days) when the only thing that will allow me to sleep and relieve the symptoms is a low dose of oxycodone. I’ve successfully added this to my treatment protocol as needed, per the Mayo Clinic recommendations, and am thankful my doctor understands and supports my use of this medication. I am certainly aware of the abuse and horrible societal impacts of opioid addiction, but there is appropriate use for this medication. Please keep opioids available for the treatment of RLS symptoms.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb3db	Anonymous	None	2022-03-05T21:02:05Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0e-3nda-wjaz	False	None	False	2022-04-12 03:16:58.923	[]
1954	CDC-2022-0024-1960	https://api.regulations.gov/v4/comments/CDC-2022-0024-1960	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for rewriting these and taking comments, however, a reference to 50 mme will still cause patients to be under treated or not treated at all. It will likely cause hesitancy by doctors to write anything over 50 mme. <br/><br/>Many people w/ different conditions have been able to get their lives back at much higher doses. They are not addicts, nor should they be treated as such. And they need doctors willing to carefully titrate their dosage up-not down to an ineffective dosage.<br/><br/>Pain mgmt is not one size fits all and may times takes a mix of different meds. While people are human, what helps one person may be completely different from another regardless of their condition(s). People are complex individuals.<br/><br/>Please remove references to specific conditions not being helped by opioids because whatever studies you referenced do not reflect those who are really being helped by them in real world practice. Perhaps a survey sent to those in the PMP system would better reflect this? <br/><br/>Please remove the commentary about those above age 65 needing less than 50 mme as this is also inaccurate.<br/><br/>Please allow telemedicine visits for established patients. <br/><br/>Please allow early refill of meds (sometimes you are too sick to go out or are snowed in or at the mercy of a hurricane). <br/><br/>Please stop insurance companies and pharmacies from meddling with pill count, number of days allowed, or dosage, under the guise that they are preventing addiction. They are not the treating physician.<br/><br/>Please stop the DEA harassment of doctors. They need to be able to write out the correct prescription with the correctly titrated dosage without fear of going to jail or losing their license.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C.	None	None	0900006484fbb6cb	Ortolano	None	2022-03-05T21:02:23Z	None	None	1	None	2022-03-05T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Ortolano, C.	l0e-ax4e-9kyn	False	None	False	2022-04-12 03:16:59.134	[]
1955	CDC-2022-0024-1961	https://api.regulations.gov/v4/comments/CDC-2022-0024-1961	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Acute Myelogenous Leukemia in 1991. I was 5. A geneticist was checking foster children with auto immune conditions to experimentally test AZT on. <br/><br/>Yes, I was one of your guineapigs in the early 90's but it did save my life.<br/><br/>The geneticist found my leukemia. He also found my EDS, Turners and the genes for Asperger's.<br/>I was able to tolerate the pain until I was in my early twenties. Once the pain started to wear me down, I could no longer work. I became very sick and the pain worse than childbirth. My pain was a beautifully violent 10+Level. I went to the doctor my AML had come back in 2016 and the cancer was treated but the pain was not. <br/><br/>Out of fear by some miniscule less then .08% chance I might become addicted. <br/><br/>I live in constant agony I was denied pain medication because of PTSD from sexual abuse as a child. With my conditions my life expectancy is 40 to 48. I'm currently 36 and have been home bound and bedridden from my pain for 10 years. <br/><br/>Doctors fear retribution from the DEA if they treat patients in constant agony with QUALITY OF LIFE-giving opiate-based medications. <br/><br/>Then on another note Doctors treat patients like scum of the earth if we say were in pain. We are Shamed, Belittled and labeled Drug Seekers for asking for help with the pain.<br/><br/>For those who don't know since most who wrote the pain guidelines don't treat medical conditions like this.<br/><br/>Ethers Danlo Syndrome: Does Ehlers Danlos have a cure?<br/>There is no cure for Ehlers-Danlos syndrome, but treatment can help you manage your symptoms and prevent further complications. Your doctor may prescribe drugs to help you control: Pain.<br/><br/>Eds causes Degenerative Disc Disease, Arthritis (diagnosed at 11), Congenital Heart Valve Disease and many more.<br/><br/>I like many patients with this condition CAN NOT TAKE Buprenorphine/Suboxone or Subutex. <br/>Physical therapy only helps not to overextend my joints. I can't do acupuncture out of Phobia of needles. OTC meds are dangerous to patients like me.<br/><br/>The few times I have been given low dose Vicodin I could function like a productive member of society.<br/><br/>PLEASE STOP LISTENING TO THESE ANTI-OPIOID ZEALOT BASED HATE GROUPS (PROP/ASAM/Shatterproof/Remmlers) MAKING $$$$ OFF THE SUFFERING OF OTHERS!!!!!<br/><br/>[name redacted]is an EVIL SOCIOPATH. [name redacted] is a Parasite. ASAM is greed based and Shatterproof seeks to kill off anyone who can't take their Demi God Buprenorphine.<br/>PROP w/[name redacted] and [name redacted] are cut from the same cloth. <br/> <br/>I want to live not just exist. You CDC w/Dr [name redacted] saved my life are you going to let these hate groups kill me off too?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbb776	Anonymous	None	2022-03-07T01:26:20Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0e-c607-tv47	False	None	False	2022-04-12 03:16:59.355	[]
1956	CDC-2022-0024-1962	https://api.regulations.gov/v4/comments/CDC-2022-0024-1962	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain mgmt is not an exact science. Please remove references to specific conditions not being helped by opioids, 50 mme thresholds, age thresholds etc.<br/><br/>Doctors need to have all medicines and therapies at their disposal to treat people with horrible, painful conditions. This Includes the ability to write prescriptions well above 50 mme w/o fear of the dea putting them in jail or losing their license. <br/><br/>People need to be able to function. They need to stop being labeled and judged as high or addicts. You should not be condemned for needing medicine to live your life due to physical injuries, medical conditions or age.<br/><br/>Lives have been lost due to these restrictive guidelines. No matter how many times the revision now states these are just guidelines, harm has already been done and doctors will still fear writing out prescriptions at or above 50, or for conditions that are allegedly not helped as referenced, even though there are plenty of people in the real world helped by them.<br/><br/>Please give people back their lives. And please, a few days early to fill prescriptions and telemedicine for established patients would help as well.<br/><br/>Also, the removal of insurance company and pharmacy restrictions on dose, days, coverage needs to be removed. <br/><br/>Do you tell diabetics they can only have half their insulin for just 14 days out of the month?<br/><br/>People on pain medicine really do not want to have to take meds (most people for any kind of illness do not want to have/need to take meds), but these pain meds are needed to function, and they are needed at the correct dosage regardless of how many mmes it is.<br/><br/>Thank youu.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	F.	None	None	0900006484fbb783	Ortolano	None	2022-03-07T01:26:35Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Ortolano, F.	l0e-caio-vcu3	False	None	False	2022-04-12 03:16:59.568	[]
1957	CDC-2022-0024-1963	https://api.regulations.gov/v4/comments/CDC-2022-0024-1963	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop with the MME’s ! Let every physician decide responsible treatment . You call it “recommendations” yet law makers, my medical board and physician associates see “regulations”.<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jon	None	None	0900006484fbb785	Edwards	None	2022-03-07T01:26:55Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Edwards, Jon	l0e-carq-o4o4	False	None	False	2022-04-12 03:16:59.786	[]
1958	CDC-2022-0024-1964	https://api.regulations.gov/v4/comments/CDC-2022-0024-1964	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having battled chronic pain for over 30 years I’ve taken pain relievers from simple aspirin, NSAIDs, to Percocet. Using the codeine enabled me to keep working with manageable pain relief for over four years. As my medical condition worsened from arthritis to rheumatoid arthritis, fibromyalgia, Celiac disease, to the worse pain called Dercum’s disease. Due to CDC’s crackdown on physicians prescribing narcotics to patients with a real need, most of us had to suffer in silence while the street drugs were as prevalent, if not worse, before the crackdown. Illegal drug control is still a major problem that is not under control. Making a deserving patient with confirmed conditions that warrant opioids should be a priority. Quality physicians are more than able to assess their patients receiving opioid therapy <br/>and watch for addictive behaviors without government pressures and unwarranted control . <br/>Since I was forced to stop using Percocet for the last four years, I relied heavily on Ibuprofen , until very recently my kidney function tests came back and I was diagnosed with Kidney disease, stage 3-B. Once would think that a commonly used pain reliever would come with a warning of potential and life threatening side effects and would be of a higher priority than opioid abuse or dependency in the CDC. <br/>I’m suggesting that age restrictions could be placed on the dispensing of opioids to help avoid abuse in the patients that truly need them. With that said I hope that the CDC will lift some of the rules pertaining to helping ease the pain of the elderly and deserving patients dealing with daily chronic pain. <br/>Ping	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terrie	None	None	0900006484fbb9bb	Severson	None	2022-03-07T01:27:13Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Severson, Terrie	l0e-dn6y-e8ui	False	None	False	2022-04-12 03:17:00.151	[]
1959	CDC-2022-0024-1965	https://api.regulations.gov/v4/comments/CDC-2022-0024-1965	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with scoliosis since childhood and have 3 ruptured disc's due to it currently. My back has been in pain for nearly as long as I can remember, but before these guidelines came out my pain was well managed.<br/>I was on 180MME of extended release morphine sulfate and my pain was generally at about a 4. My quality of life was good. <br/>In 2016 everyone panicked. Half of my meds were taken away, with my doctors telling me I definitely required the 180, but that the laws had changed and their hands were tied. <br/>Since 2016 I've lost my job, I've had to quit all of my hobbies and have lost all of my friends because I can never make it to any outings. My children can no longer touch me and I haven't made love to my husband in nearly a year. <br/>These guidelines, the 90MME limit in particular, have stolen my life. My pain stays at a 7 or above, I'm always stiff, and I'm depressed for all the reasons above. I have become a prisoner in my own body and my doctors have become my jailers at the best of times and my torturers at the worst.<br/>Every month I begin to have panic attacks 3 days before my pain appointment because I never know when they'll cut my meds further, but I do know that I am not strong enough to survive having even less pain care. Each month I am literally forced to face the possibility of more agony, more sleepless nights, and less physical human contact. It is horrific and as angry as I get during my appointment each month as I'm turned away with no change to my meds, no new procedure to try, no hope of a return to the life I had, I wouldn't wish this horror on anyone even for a second. No one should have to live like this when the medicine that would fix it exists. <br/>I know that opioids can be dangerous and I agree that doctors should be careful, but when a patient has a clear diagnosis that is known to cause pain, has good drug tests, and can understand and consent to the risks involved then it should be that patient's choice. They should have the freedom to choose what risks to take with their own body. We allow people to risk their livers with alcohol, risk cancer with cigarettes, and have the right to jump out of planes for fun because this is a free country. Why aren't people in unrelenting intractable pain not given the freedom to decide with their doctor's guidance what medications work the best for their own body? <br/>I've lived in this torturous body for 28 years. I've tried every therapy and exercise there is, had more dangerous injections than I can remember, and been cut open from neck to bottom trying for a surgical solution, but when I found the thing that actually worked, the thing that got me off of welfare and allowed me to contribute the powers that be took it away. They didn't take it because I failed a drug test, or forged a prescription (I would never contemplate either). They took away my hard won health because people in pain didn't deserve the same freedoms, because the people who were cheating who were criminals hurt themselves. I'm sorry that people have overdosed, I'm sad for their loved ones, but being in pain is not the same as being an addict. Their deaths, while undeniably tragic have nothing to do with me, and saving their lives won't make a moment of my pain less excruciating. <br/>Until science comes up with a new way to treat pain the only thing that will make my pain less excruciating is opioids. I've tried everything else. I'll continue to try every new pill and procedure, each time praying it works, but until one does I have to take morphine and until the guidelines remove the 90MME limit I will also have to suffer, without a job, without hobbies or friends, without hope.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annie	None	None	0900006484fbba19	Dagen	None	2022-03-07T01:27:39Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Dagen, Annie	l0e-ep5d-xw0k	False	None	False	2022-04-12 03:17:00.380	[]
1960	CDC-2022-0024-1966	https://api.regulations.gov/v4/comments/CDC-2022-0024-1966	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Re: Docket No. CDC-2022-0024<br/>As a longtime person with chronic pain, I urge the committee to implement compassionate prescribing guidelines. It is only through the support of my pain management physician and use of prescription opiate medication that I have enjoyed a successful administrative career and been a contributing member of society. Prior to beginning my current regimen, I was unable to work, sit for more than 20 minutes, sleep or engage in any of life's typical endeavors, and my social engagement was severely strained. For over 20 years, under my doctor's supervision, I have responsibly used opiate mediations as part of my care plan. I am aware that many doctors have recently abruptly stopped prescribing these medications due to fear of lawsuits and losing their licenses, often leaving patients with no recourse but to suffer, and that, as a result, some patients have chosen suicide due to unmanaged pain. I, again, urge this committee to appreciate the challenge that so many Americans face in obtaining and maintaining appropriate medical care for their chronic pain conditions, including access to opiate prescription medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deanna	None	None	0900006484fbba29	Peterson	None	2022-03-07T01:27:51Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Deanna	l0e-eush-dj1t	False	None	False	2022-04-12 03:17:00.601	[]
1961	CDC-2022-0024-1967	https://api.regulations.gov/v4/comments/CDC-2022-0024-1967	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a strong proponent of limiting opioid prescriptions and advocating for alternative, safer therapies like hemp-derived CBD cannabinoid therapy. My father was a disabled Vietnam Veteran that was prescribed significant amounts of opioids from his physician and others over a fifteen year period. The destructiveness of these medicines caused him to trade his pain issues for other issues like severe insomnia, constipation, and mood swings. He became a slave to these constant pills feeling like he couldn’t function without them. In 2020, my family decided that we needed to intervene and provide him safer alternatives, and maybe just maybe, we could help wean him off or to lower the volume he was taking of opioids. We began to provide him our hemp-derived, THC-free cannabinoid therapy in both drops and softgels. The first thing he noticed was being able to sleep more regularly and lessened anxiety levels. After a couple months we noticed less mood swings and overall better engagement. He also began telling us he could do more activities without turning to pills to do normal, daily tasks and activities. Over the next few months, he was skip his normal trips to the doctor as he was able to move to one prescription product vs three. All of the significant bad side effects of the opioids went away over six months with the CBD as the alternative that worked dramatically for him. <br/><br/>I would strongly support adding hemp-derived, THC-free products as a viable option for patients.<br/><br/>Thank you!<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chad	None	None	0900006484fbbb13	Collins	None	2022-03-07T01:28:33Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Chad	l0e-ig3q-y1xk	False	None	False	2022-04-12 03:17:00.854	[]
1962	CDC-2022-0024-1968	https://api.regulations.gov/v4/comments/CDC-2022-0024-1968	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern. I have had RLS for as long as I can remember and I am 75 years old. Until I was diagnosed with this condition in 1993 I thought I must be crazy. I couldn't sit in a meeting, fly on a plane, or drive or ride as a passenger in a car without having an unbearable desire to move my legs. The thought of being tied up without the ability to move was terrifying. After diagnosis some relief was found and I felt it was a miracle. Until each of the various remedies began to lose their effect and/or cause a condition which is horrible called augmentation. Each remedy would lead to this augmentation. It wasn't until I began seeing Dr. [name redacted], located in [location redacted]. in 2010 or 2011 that I got my life back to some form of normalcy. He was recommended by the RLS Foundation and addressed my RLS as chronic. He prescribed a combination of Methadone up to 30mg and a 1mg NeuPro patch daily. The Methadone usage can vary from 20mg to 30mg depending on unknowns but I am notallowed and don't ever take more than 30mg daily. The NeuPro patch milligrams has increased have increased slightly from 1mg Daily to 2.5mg daily. For the past 12 years this has brought the best and most reliable relief. Please understand that the opioid use has no "high" effect to me at all but has been the best treatment I could hope for besides a cure. When I tell people I have RLS there is always a roll of the eyes and a snicker, However, it is much more serious than that. Suicide becomes the only hope for relief without this remedy. Please allow and provide for the use of opioids as a medicine for use with RLS diagnosis. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ralph	None	None	0900006484fbbb34	Albright	None	2022-03-07T01:29:40Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Albright, Ralph	l0e-j14v-qgvl	False	None	False	2022-04-12 03:17:01.068	[]
1963	CDC-2022-0024-1969	https://api.regulations.gov/v4/comments/CDC-2022-0024-1969	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Do people abuse opioids? Absolutely. Do people die everyday due to opioid overdose? Yes, everyday.<br/>Is there a growing number of “Blackmarket” availability? Of course, and more dangerous. Is the situation causing corruption within the medical arena due to limited supply? Oh yeah. Is there an opioid crises effecting our country? Yes, huge crisis. Does it need to be addressed? Absolutely!<span style='padding-left: 30px'></span>The approach the CDC took, in no way benefited anyone. What it did do, is force physicians to fear treating legitimate patients. Fear of jail time, loss of license and humiliation if your standards of care were not followed. These are not your patients and the history of each individual was never considered. <br/>Putting a blanket limit on a medication that legitimate patients have used for decades, was cruel and irresponsible. A “Grandfather” clause was not even an option. Pain patients put their trust in physicians to address their pain. For decades these physicians wrote prescriptions for brand name opioids and helped pain patients continue working and achieving a quality of life that was not there before. <br/>Of course, over time these same legitimate patients, required a higher dose to maintain pain control. <br/>It was a lifesaver for so many. And then, one day, someone woke up and decided it was bad. For whatever reason, with no compassion or interest in how this would effect those high dose, long term pain patients. Those who simply took what was prescribed, by their physicians. Because of the hasty decision you made, you have destroyed lives. You have left people in sever pain and made them feel like criminals because of your guidelines. Due to dependence, not abuse, you have left so many in unimaginable situations. Your guidelines have destroyed patient/physician relationships. You placed them both in very awkward emotional situations. All of a sudden, patients with legitimate long term use were told “No more, we need to taper you off of your opioids.” Physicians were refreshing to see their pain patients. Physicians refused to see you if you were on a pain medication. Overnight, these patients became red flagged and were made to feel like a typical street addict. Even those that were compliant and never asked for early fills, never a blemish on their PDMP. They were even subjected to a urine drug screenings at their appointments. Your guidelines chipped away at the self esteem of many people.<br/>Many have been forced to buy off of the internet or street corners to simply address their pain and dependence. You have given them no choice but to turn to different drugs, legal or not. You have simply lumped everyone together without any consideration for those that truly depend on opioids. <br/>This is not a “One size fits all” situation. It is dire that new opioid prescribing be monitored to protect possible new abuse. Opioids should only be used when absolutely necessary. Opioids should only be used as a last result. Perhaps, if this simple approach was used 25 years ago, I would not be watching my brother suffer to the extent that I no longer recognize him. He is crippled to the point that he can no longer work and is on disability. In just a few short years he has lost all independence. He is the poster child for the effect your guidelines have had on legitimate pain patients. You have the ability to render this situation. You have the ability to show compassion for those that were never told of the dangers of opioids. You have the ability to start fresh and influence physicians going forward, to use caution. You also have the ability to help make opioids available to those that show decades of use and dependence. You have the ability to monitor every patients refills. Please change the guidelines to allow access to all those who were disregarded in this decision. Please “Grandfather” these legitimate people in so they may have access to the vital medications they need to simply function. All the money won from the various law suits, can never repair the damage done to the pain patient community. They were the real victims in this horrible situation, yet they will never see a penny. Instead, they are encouraged to go to one of the new state-of-the-art rehabilitation centers. They did not ask for this dependency, it was given to them, perhaps by a well meaning physician. Some situations are way past the rehab option and those are the ones who need you to go to bat for them. Opioids are very dangerous, they can kill you, but they can also save lives. Stop making good people feel badly for something they would never have chosen, had they known. Long term legitimate pain patients need you to do the right thing, please.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shelley	None	None	0900006484fbbb58	Daughton	None	2022-03-07T01:30:16Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Daughton , Shelley	l0e-joqz-2t0i	False	None	False	2022-04-12 03:17:01.309	[]
1964	CDC-2022-0024-1970	https://api.regulations.gov/v4/comments/CDC-2022-0024-1970	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have put off needed surgery because I'm afraid I won't get enough (or even any?) post-operative pain medication. It happened to my sister. She had open abdominal surgery. They gave her a total of 3 pills to manage her pain at home and that was all. I have never taken them except for the occasional surgery or dental surgery, and neither has she. There is no reason for the federal government to be interfering with a physician's ability to treat their patients and prescribe whatever medication they believe will help - and without threat to their medical license. Please, get out of the way of physicians doing their jobs. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484fbbb66	Doe	None	2022-03-07T01:30:26Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Doe, Jane	l0e-jxwv-7mxn	False	None	False	2022-04-12 03:17:01.533	[]
1965	CDC-2022-0024-1971	https://api.regulations.gov/v4/comments/CDC-2022-0024-1971	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from RLS since I was 4 years old I’m now 52 I had tried everything all medications helped briefly then stopped finally I was given low dose methadone and it worked it has continued to work with no increase in dosage for the last 5 years. I was ready to give up now I have my life back please make sure RLS patients do not lose access to these medications that give us a chance for a normal life.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheri	None	None	0900006484fbbb6a	Jones	None	2022-03-07T01:30:35Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Sheri	l0e-jzki-0txc	False	None	False	2022-04-12 03:17:01.749	[]
1966	CDC-2022-0024-1972	https://api.regulations.gov/v4/comments/CDC-2022-0024-1972	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had extremely bad chronic pain for over 20 years ,due to the last guidelines by the cdc I am so under treated for pain I can barely make it out of bed, but I feel lucky to get any help with medication for pain I have to go every 28 days and take drug tests like a criminal ,there has got to be no one Cutoff limits it should be up to the doctor completely the pharmacist are even afraid to fill your script ,so most chronic pain suffers are barely getting nyy	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484fbbbae	Fugitt	None	2022-03-07T01:30:47Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Fugitt, Brenda	l0e-kzth-thec	False	None	False	2022-04-12 03:17:01.963	[]
1967	CDC-2022-0024-1973	https://api.regulations.gov/v4/comments/CDC-2022-0024-1973	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Lessening the allowed amount of opioids to 50 is just plain cruel. Patients in chronic pain need 24 hour pain meds and the amount most people need is over 90. Why put these limits on doctors? They know what their patients need! I live in the US because we are supposed to be free and I can’t even get the pain relief I need to live a relatively useful life. Why is the government keeping me in pain? I am able to decide whether I want to take opioids or not. I’m in pain, not stupid. The government is getting involved in matters that it doesn’t need to be. I hope that all the people who have decided that pain meds should be controlled by the government never have chronic pain. Maybe I do, then you’d understand what we are being out through. Please back off of these unfair rules.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carmen	None	None	0900006484fbbbb4	Wilton	None	2022-03-07T01:31:06Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Wilton , Carmen	l0e-l2vi-mf7b	False	None	False	2022-04-12 03:17:02.177	[]
1968	CDC-2022-0024-1974	https://api.regulations.gov/v4/comments/CDC-2022-0024-1974	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors need to make their own decision with their hands being tied to be able to help those that need it	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbbcc3	Anonymous	None	2022-03-07T01:31:13Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0e-mzj3-m765	False	None	False	2022-04-12 03:17:02.398	[]
1969	CDC-2022-0024-1975	https://api.regulations.gov/v4/comments/CDC-2022-0024-1975	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My body is loaded with arthritis. I have had both big toes fused. My last surgery on my toe I had to have screws and pins drilled into my bone. Before surgery I asked my doctor how he was going to control the pain. He told me I would be in a lot of pain. He said he was going to prescribe pain meds. After getting out of surgery and waking up I immediately felt HORRIBLE PAIN. The nurse came over and popped a vicodin into my mouth. 45 mins later I was still in HORRIBLE PAIN crying I was in that much pain. The nurse came back and told me I couldn't get anything else for 5 more hours. My husband lost it and went and called my foot doctor for help. Thanks to the CDC laws you people put into place I SUFFERED and I mean I SUFFERED !!! Between the hospital and my doctor they were afraid to give me something stronger and more often. I am not an addict I don't drink alcohol I am 63 years old. I need another surgery done for another part of my body and I refuse to put myself through the [profanity redacted] I LIVED THROUGH after having screws and pins drilled into my toe !!! So I would like to thank the people who wrote the law denying patients the proper medication for pain and treating the doctors who prescribe as criminals. Thanks to the CDC you have created a situation you people need to put a stop to. Tieng doctors hands to the point that they can't treat their patients like humans. DEA and Ice getting involved in the medical practice arresting doctors who do their job taking proper care of their patients. You have created a monster and it needs to stop immediately , stop the doctor's of being afraid to prescribe pain meds for their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicki	None	None	0900006484fbbd0d	Parker	None	2022-03-07T01:34:17Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Parker, Vicki	l0e-oxfa-d1j7	False	None	False	2022-04-12 03:17:02.649	[]
1970	CDC-2022-0024-1976	https://api.regulations.gov/v4/comments/CDC-2022-0024-1976	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am one of many patients whose quality of life is very low due to the reckless guidelines and DEA scaring doctors in my area which is ALLIANCE Ohio. I have children I cannot care for, and pain around the clock and I cannot get treatment for it. It's as if my life, family, and stability don't matter and I'm not even a person. I deserve to be able to raise my child and work a job!! Instead I am reduced to a life that makes me sick!! I am 30 years old and cannot properly maintain my home, take care of myself, and can hardly lift or bend to care for my baby. Even though my injuries are real, every doctor is afraid to treat me and because of that my life isn't really worth living anymore but I am staying strong for my daughter. You wouldn't know now by looking at me that I'm a college graduate who is smart and used to be successful because now I can hardly get out of bed. I can honestly see how dealing with this kind of pain makes people suicidal because it seems there is no hope for a better life. I am asking the CDC to reach out to all providers in Ohio to let them know there are people who are suffering and are about to give up because of this campaign against opioids and it has to stop NOW. It is the CDCs responsibility to immediately reach out to prescribing providers to encourage them to treat people like me because I can't go on this way.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jessica	None	None	0900006484fbb81f	Taylor	None	2022-03-07T01:34:45Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Jessica	l0e-qatr-xlgp	False	None	False	2022-04-12 03:17:02.868	[]
1971	CDC-2022-0024-1977	https://api.regulations.gov/v4/comments/CDC-2022-0024-1977	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a member of the American public which pays the taxes to fund the CDC, and as a person who has lived in severe intractable pain for the last 6 years due to the 2016 Guidelines on opioid use, I do feel pleased that our voices were finally heard. But what about the 6 years I have spent in agony, the friends I had in the Chronic Pain Community who committed suicide? This change, while needed, came too late for many. And after the ruthless interference with patient care since 2016, subjecting Physicians to license suspensions, and labeling them as "drug traffickers", do you have any idea how difficult it is to get pain management? I am blessed to still be alive, but have lost 6 years of my life, so far. And now am older, fighting my doctirs even being willing to give me an antispasmotic (Baclofen)for the severe spasms in my back. I have missed my grandchildren's childhood years, bedbound and crying in pain. I believe those of us who have suffered, and who continually advocated for the individual determination of appropriate treatment to remain between a patient and their Physician, should be compensated for the added stress, lost years and extra burdens placed on our families resulting ftom our loss of function. <br/><br/>However, the CDC prohibiting the use of early therapeutics during the last 2 years, and making health decisions for patients they neither knew nor had any interest in saving, has tainted this "too little too late" move for those of us who have lost so much because of the overreach into our lives by a government organization. As the CDC has no elected positions, it seems to me that they likewise should have no authority over my healthcare decisions. The last 2 years reinforced in practitioners' minds that if they do not rigidly follow "protocols" established by the CDC, most often done without input from them, theymay lose their livelihoods. So I do not see this changing anything in my lifetime. <br/><br/>Thank you, though, for giving us an opportunity to comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fbb870	Holley	None	2022-03-07T01:35:05Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Holley, Judy	l0e-sllh-kew9	False	None	False	2022-04-12 03:17:03.089	[]
1972	CDC-2022-0024-1978	https://api.regulations.gov/v4/comments/CDC-2022-0024-1978	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted], and yes I have been effected by my medication and have no extra money to put towards my dental work even though I am terrified of something getting infected. I will be attaching a picture of my face swelling up on a monthly basis from one of the 5 teeth I’ve had cracked/fallen out and something triggering it to swell up. This is honestly the most pain I’ve ever felt in my entire life and realizing that this is an actual problem with MANY people across the US is convincing me more and more that something needs to be done. This is a serious problem and we need help with our dental bills from taking this medication. I’m from [location reacted] and it’s been about 6 years of the same medication doing the same damage to my teeth.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Krysten	None	None	0900006484fbb876	Williams	None	2022-03-07T01:36:33Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams , Krysten	l0e-savw-rzxy	False	None	False	2022-04-12 03:17:03.334	[]
1973	CDC-2022-0024-1979	https://api.regulations.gov/v4/comments/CDC-2022-0024-1979	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've suffered from Restless leg syndrome for many years. Dopamine agonists destroyed my health and now the only thing giving me my life back is methadone 10mg. I see a rls specialist from johns hopkins and this opiod is saving my life. Please help this community.. we need opioids for restless leg syndrome. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicki	None	None	0900006484fbb8df	Dehne	None	2022-03-07T01:37:39Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Dehne, Vicki	l0e-wm4w-ee1a	False	None	False	2022-04-12 03:17:03.551	[]
1974	CDC-2022-0024-1980	https://api.regulations.gov/v4/comments/CDC-2022-0024-1980	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If doctors are so weak and insecure that they cannot push back against government abuse then their patients should leave and take matters into their own hands. Doctors with a conscience should sue insurance companies and governments agencies that interfere with the doctor patient relationship. I have been personally damaged by the 2016 CDC opioid guidelines! The damage has been done and the revision is just as bad, possibly worse. In my opinion, the CDC guidelines only exacerbate the situation.<br/>Why should anyone let alone a physician, trust the CDC for any guidance? The junk science, lies, and inability to count the numbers are just a few of the reasons not to trust the CDC. From May 2020 to April 2021, the estimated number of drug overdose deaths in the United States exceeded 100,000 over a 12-month period for the first time. But 70% of deaths involved synthetic opioids other than methadone. Thats illicitly manufactured fentanyls, including fentanyl and illicit fentanyl analogs mostly made in Mexico or China! The majority of these deaths are not doctor prescribed or related at all! <br/>The CDC and the FDA allow physicians to push pharmaceuticals of every kind for the pharmaceutical companies. The pharmacies are no better! They sell old cheap opioids at Cartel prices today. I don’t believe for one second that you care if people suffering in pain and then commit suicide or those who suffer from addiction, die from overdose. If you did, you would close the US border and stop the illicit drugs from pouring into America. Then allow Physicians to treat their patients as they see fit. You would pursue guidelines and laws that help —not hurt and kill the population and put doctors in prison. The so called expert say “do we need opioid painkillers at all given that we seem unable to prevent the ones we already have from ending up in the wrong hands?” I ask do the so-called experts say anything about what’s coming over the border and what hands those illicit drugs get into? Do we need these so-called experts that don’t see the real problems? <br/>In my opinion, the experts and government agencies in this nation are a disgrace. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bonnie	None	None	0900006484fbbded	Collins	None	2022-03-07T01:38:11Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Bonnie	l0f-0ujl-deg5	False	None	False	2022-04-12 03:17:03.759	[]
1975	CDC-2022-0024-1981	https://api.regulations.gov/v4/comments/CDC-2022-0024-1981	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While my RLS is under control for now. I know first hand what it feels like to have the symptoms of RLS and the sleepless nights that go along with them. I would like all options on the table, including opioids, when and if I ever need this kind of relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484fbc126	Szemanski	None	2022-03-07T01:38:20Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Szemanski, Tracy	l0f-69zs-mwhx	False	None	False	2022-04-12 03:17:03.971	[]
1976	CDC-2022-0024-1982	https://api.regulations.gov/v4/comments/CDC-2022-0024-1982	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My addiction started at age 16. By age 18 (2008) I was prescribed Suboxone from my doctor. I’ve been inducted a few times in hospital settings and I’ve never, in my life, been told that it would effect my teeth. I’m almost 32 and I had to learn the hard way, and being told by my dentist, AFTER I was told that I have 16 cavities and no dental insurance. My front teeth are literally rotting as I write this and I DO NOT have the funds to fix my mouth. My teeth are basically all I have left from my addiction. As a matter of fact, you “can’t brush your teeth for a half an hour after you take the medication”. By then your teeth are already effected. Why does the cost of being sober have to be losing your teeth?! Also, the withdrawal is way worse than any opiate you’d find on the street. That’s another warning that’s not verbalized by doctors or on the warning label. Let’s normalize telling the truth in this country.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Haley	None	None	0900006484fbbed4	Colburn	None	2022-03-07T01:39:09Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Colburn, Haley	l0f-gl4w-nrd5	False	None	False	2022-04-12 03:17:04.201	[]
1977	CDC-2022-0024-1983	https://api.regulations.gov/v4/comments/CDC-2022-0024-1983	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is criminal what the CDC has done to those who live in chronic pain! Just stop it and reinstate sensible guidelines!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbbedf	Anonymous	None	2022-03-07T01:39:17Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-gvtf-fvlz	False	None	False	2022-04-12 03:17:04.426	[]
1978	CDC-2022-0024-1984	https://api.regulations.gov/v4/comments/CDC-2022-0024-1984	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Im permanantly dissabled- incurable. The 2016 guidelines have destroyed my life by denying me quality of life pain relief that I desperately needed. Every doctor I went to was too scared for their own well-being to do their job and relieve my pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	0900006484fbbeea	Erlinher	None	2022-03-07T01:39:25Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Erlinher, Mike	l0f-h0mn-3xk5	False	None	False	2022-04-12 03:17:04.769	[]
1979	CDC-2022-0024-1985	https://api.regulations.gov/v4/comments/CDC-2022-0024-1985	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	That CDC guidelines of 2016 was the beginning the end for many of us that suffer from chronic pain. I have had 3 neck surgeries and continue to have occipital neuralgia causing headaches and neck pain that are only made tolerable with opiates. Please give patients with chronic pain access to pain meds that can only happen if the ridiculous restrictions put on physicians is lifted.<br/><br/>Sincerely [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vickie	None	None	0900006484fbbf00	Fine	None	2022-03-07T01:39:52Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Fine, Vickie	l0f-hcmg-9ksf	False	None	False	2022-04-12 03:17:04.981	[]
1980	CDC-2022-0024-1986	https://api.regulations.gov/v4/comments/CDC-2022-0024-1986	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines need to be scrapped completely. The government has no business telling doctors how to treat their patients. Illicit fentanyl is what is causing the overdose epidemic, not opioid pain medication! Millions of patients are suffering excruciating pain because of these guidelines. I took pain medication for 32 years and never became addicted to them because I took as directed by my doctor. Not everyone has the tendency for addiction. Stop trying to treat all patients the same. I tried every alternative therapy available before trying pain pills. They helped me to have a productive life. Now I am bedridden since being forced to stop taking them because of these guidelines. Many patients have committed suicide due to their suffering. This is wrong. Treat addicts, absolutely, but opioid medication can help when alternative treatments don’t work. No maximum dose should be included in the revised guidelines. Also the DEA and DOJ needs to stop terrorizing innocent doctors who are too afraid to prescribe because of the mme.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jet	None	None	0900006484fbbf11	Simpson	None	2022-03-07T01:40:07Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Simpson, Jet	l0f-higp-t19m	False	None	False	2022-04-12 03:17:05.192	[]
1981	CDC-2022-0024-1987	https://api.regulations.gov/v4/comments/CDC-2022-0024-1987	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop the coerced forced taper and the "Cold Turkey" cut off of Chronic Pain Patients.<br/>After Forced Taper of over your 90 MME I lost 4 loved ones to Suicide.<br/>After Forced Cut Off of Quality of life-giving opioid medication 3 to suicide.<br/> <br/>All of these people had survived Cancer, Heart Surgeries, Reconstructive Spinal Surgeries and other co-morbidities.<br/><br/>If a patient has to live on a high dose of 90 MME please Allow it. <br/><br/>Also, PLEASE FOR THE LOVE OF ALL THINGS SACRED IN THE BEAUTIFUL MASTERPIECE OF THE COSMOS GET THE DEA OUT OF THE DOCTORS OFFICE!!!! The DEA should go after Cartels not the innocent just because patients and doctors won't shoot at them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbbf18	Anonymous	None	2022-03-07T01:40:31Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-hm37-8hbl	False	None	False	2022-04-12 03:17:05.476	[]
1982	CDC-2022-0024-1988	https://api.regulations.gov/v4/comments/CDC-2022-0024-1988	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop. You have no idea what you are doing to patients that don't abuse our medication. I go to my doctor for it. I submit to monthly urinalysis, pill counts, and procedures that don't work just so my doctor doesn't take away the small amount of medication I'm prescribed because my doctor is afraid to loose his license. I have NEVER had a bad urinalysis or had a pill count be wrong. But I am treated as if I am shooting the stuff up in his office and all becthe government wants to say they know better than my doctor who went to medical school and has seen my medical file.<br/>The drug users/addicts are a different group of oeople,they get High to get high. I get relief so I can function to walk, dress myself, wash my dishes or even simple things like standing up to go to the bathroom. <br/>I just want to get enough relief that I am not sleeping 24/7. I don't want to get high. And I know the longer I am on these meds I am going to need higher doses. But for now I stay as low as possible just so my meds aren't suddenly cut off because someone that doesn't know me or my medical history has decided that I take to much. Just leave me and my medication alone.<br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Affee	None	None	0900006484fbbf1f	Duvall	None	2022-03-07T01:40:48Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Duvall, Affee	l0f-hnuh-hlpw	False	None	False	2022-04-12 03:17:05.689	[]
1983	CDC-2022-0024-1989	https://api.regulations.gov/v4/comments/CDC-2022-0024-1989	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Will SOMEONE IN AUTHORITY PLEASE GET THIS RIGHT!<br/><br/>ACUTE PAIN GOES AWAY…CHRONIC PAIN IS ONGOING! Chronic pain patients should NEVER have been taken down and in some cases off their medications that they have been on for a decade or longer because of the 2016 CDC guidelines!<br/><br/>When it comes to a patients medications, that should be between the patient (CPP) and their PAIN MGMT DRS. CCP’s have to ADHERE to strict guidelines set forth by their drs. including signing a contract and submitting frequent drug tests. Everything was going just fine until 2016 when the CDC made our drs drastically cut our medications which basically turned our worlds UPSIDE DOWN! <br/><br/>PLEASE LOOK INTO THIS ISSUE AND CORRECT IT AND LEAVE US TO THE CARE OF OUR DRS!!! <br/><br/>Sincerely,<br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484fbbf44	Moore	None	2022-03-07T01:41:26Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Moore, Sharon	l0f-ial9-jl98	False	None	False	2022-04-12 03:17:05.899	[]
1984	CDC-2022-0024-1990	https://api.regulations.gov/v4/comments/CDC-2022-0024-1990	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC, <br/>I am asking the question of myself, "Do I truly live in a free country?" I dug a little bit and found your newest leaflet. Said leaflet is talking about a maximum of 50 MME. How on earth are you coming up with these blanket numbers? Blanket pain conditions and individuality matter. The sacred/physician/patient relationship is in jeopardy. <br/>You MUST consider the change of the word Palliative Care, so that free and fair treatment may be given to ALL patients, regardless of being at deaths door. <br/>I participated in your workgroup. I was the second clinician they spoke with. I guess I went unheard? <br/>Circling back - you do not know the patients. The physician does. Why are you dictating how they practice? <br/>I use medication - but I also am in my heated pool every single day. I use massage therapy, acupuncture and medical marijuana at bedtime. This is what works for me - I am now staring down the barrel of TWO necessary surgeries. Will they relieve my pain? No, I doubt it. I will have an opened mind to it and be hopeful, but the ACDF, left me disabled and unable to continue on with my dream job of nursing. <br/>Are we truly a free country? When overdoses are increasing due to street drugs, and yet, we are still addressing these issues of pain relief? Please focus on the street drugs killing people, get rid of the 50MME pamphlet that has already been made and get out of the physician/patient relationship. <br/>Sincerely, <br/>[name redacted], RN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fbbf48	Kronus	None	2022-03-07T01:42:12Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Kronus, Lisa	l0f-icbx-5gll	False	None	False	2022-04-12 03:17:06.171	[]
1985	CDC-2022-0024-1991	https://api.regulations.gov/v4/comments/CDC-2022-0024-1991	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife has several autoimmune diseases, two which h are extremely painful most of the time. She's had everything done that can be done to help alleviate the pain but the doctors have said now all they can do is manage the pain with opiods. She's used opioids for 18 years which gave her, her life back. Since the 2016 guidelines her doctor has quit giving her the pain meds and her life has ceased to be normal again. She's in constant pain. She never abused her medication or took more than prescribed. What the guidelines did to people in need is barbaric and inhumane. People who have chronic pain are not the drug problems in this country. It's the illegal street drugs. Please put in new guidelines to help those living in chronic and tell the doctors to reinstate their medications. Stop the DEA from going after honest doctors that are trying to help their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	0900006484fbc1c8	Smith	None	2022-03-07T01:42:22Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith , Jeffrey	l0f-iq7o-rlnn	False	None	False	2022-04-12 03:17:06.378	[]
1986	CDC-2022-0024-1992	https://api.regulations.gov/v4/comments/CDC-2022-0024-1992	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been abused by the CDC guidelines. Because I wanted to change pain clinics I was labeled a drug seeker. I’m a retired nurse status post spinal fusion. I had 2 SCS which have caused more scarring and pain. Because I wanted to change pain clinics I was labeled a drug addict. So I was turned down by 2 pain clinics. I tried to commit suicide because of what you have created, You have created an atmosphere where the DEA is the prescriber and the doctor so fearful to prescribe have become shrinks. You are killing chronic pain patients. Stop it and let us take the medicine we need. You are responsible for patients committing suicide. The writers of this mess are not pain doctors. They are paid litigants to destroy pain care. [name redacted] himself made $500,000 for legal litigation. PROP is a terrorist organization. No real pain doctors on the frontline have any input into these ridiculous guidelines. Stop killing us for profit,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc212	Anonymous	None	2022-03-07T01:44:19Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-kacs-1e1x	False	None	False	2022-04-12 03:17:06.595	[]
1987	CDC-2022-0024-1993	https://api.regulations.gov/v4/comments/CDC-2022-0024-1993	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	MME limits me to my dosage for 16 years.<br/>Three surgeries canceled because there is no post-op pain management.<br/>Refused treatment in emergency room because "drug seeking behavior " is first concern at times.<br/>Having to pick between anxiety meds and pain meds..<br/>These have all effected my life. Doctors thought 2016 guidelines were gospel.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc219	Anonymous	None	2022-03-07T01:44:31Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-ke8m-vnki	False	None	False	2022-04-12 03:17:06.811	[]
1988	CDC-2022-0024-1994	https://api.regulations.gov/v4/comments/CDC-2022-0024-1994	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is not enough being done to prevent opioid addiction. <br/><br/>My son, [name redacted] was in the hospital for weeks, 15 days, in the summer prior to his death. Numerous doctors came and gave their best thoughts. He saw many specialists and in the end he was prescribed Humira, which our insurance wouldn’t pay for, so instead, he left the hospital with opioids and a prescription for narcon! I did not know. Should I have, yes! And I will forever question why I didn’t know and why I didn’t ask more questions. <br/>He turned to a friend, his friend since 6th grade… and that “friend” gave him percoset laced with fentanyl. He died that night. We went from that could never happen to my family, to oh my God, how did this happen? <br/><br/>If nothing else, I hope this has raised some awareness, We all need to do more to prevent this from happening to anyone.<br/>#forever4 #tylerforever22	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stacey	None	None	0900006484fbc21a	Groome	None	2022-03-07T01:45:27Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Groome, Stacey	l0f-keai-rhdt	False	None	False	2022-04-12 03:17:07.023	[]
1989	CDC-2022-0024-1995	https://api.regulations.gov/v4/comments/CDC-2022-0024-1995	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been living, or should I say, just existing, with chronic pain after being involved in a near fatal car accident (I would’ve been the one who died) since 1987. To date, I have had 37 surgeries. My last back surgery was a botched surgery, so now my pain is even worse than ever. My medications have been knocked down quite a bit because the doctors think my pain doesn’t warrant that much medication, and also because of the guidelines they think they have to go by. How does ANYONE know how the pain I have feels??? I also have to take medication for my severe PTSD due to that car accident and 2 others since. This last back surgery was so bad, the screws and plates in my back are free floating. In other words, the bone is NOT attached to the screws so every time I move, walk, sneeze, etc., they shift and grind on my spine. When I walk it’s like walking on burning hot nails. And this is just one area that causes excruciating and chronic pain. I take OTC medication also to see if I can get some relief between my prescriptions. I have been off and on opiates since 1987, but the last 10-12 years have been the longest I have been on them. As we age, we do not get better, our pain gets worse due to arthritis and other issues. Why should the people that take their medications responsibly suffer just because these younger people find the pill mills that will write them opiates just for a high???? Maybe find a better way for doctors to have proof to write the prescriptions???? Just because someone banged their elbow 5 years ago doesn’t mean they need to be on heavy opiates, in fact, if their elbow hurts maybe they should take some aspirin or Tylenol. My list of medications I have been on for YEARS and I haven’t overdosed once, that should tell you something. The people that are overdosing are the younger people because they’re taking too much and mixing them with other medications. I would know because I see it at least twice a week being that my husband works for the coroner and is a funeral director. I don’t know what the answer is, but I know what the answer is not. PLEASE, do not hurt the ones that really need and depend on these medications just to function, let alone live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484fbc25f	T	None	2022-03-07T01:46:39Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from T, A	l0f-m18y-e8cc	False	None	False	2022-04-12 03:17:07.288	[]
1990	CDC-2022-0024-1996	https://api.regulations.gov/v4/comments/CDC-2022-0024-1996	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was a chronic pain patient on oxycodone for ten years give or take. When the 2016 guidelines came out, the pain clinic dropped my dose to the 90 mme equivalent and then commenced to make me jump through hoops for lack luster pain management and pain control.<span style='padding-left: 30px'></span>Since I had been on a higher dose and dropped back I occasionally need to take an extra dose here and there to make it through the day. With pill counts that doesn’t work out to well so I was given strikes and dismissed from practice. Suicide has been contemplated many times. Quality of life is very low. It would really be nice if you righted your wrong from 2016 before any more people suffer or worse	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gregory	None	None	0900006484fbc278	Simmons	None	2022-03-07T01:46:58Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Simmons , Gregory	l0f-mfac-evnf	False	None	False	2022-04-12 03:17:07.503	[]
1991	CDC-2022-0024-1997	https://api.regulations.gov/v4/comments/CDC-2022-0024-1997	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is absolutely impossible for me to describe the suffering caused by the arrogant, ignorant, callous and inhumane rules that the CDC inflicted upon myself, my family and every single soul in this country suffering from chronic pain without deeply tempering the sheer rage I feel towards everyone involved in crafting those consequential “guidelines”!<br/><br/>Both my parents and I suffer from degenerative disc disease, osteoarthritis, sciatica, my mothers is inoperable due to a botched surgery, and scoliosis. I also suffer from drop foot on my right, spondylitis, spondylosis, spondylolisthesis, and arthritis that has formed lobster claw like growths involving the vertebrae starting at T4 running the length to S1.<br/><br/>Prior to the death sentence, I mean, guidelines you handed down in 2016 my family and I were working with our PCP who was carefully administering Hydracodone-Acetaminophen to us and we were able to function fairly well, actively going to the gym, swimming and doing arthritic exercise classes in the pool. We were able to plant flowers and have a small garden.<br/><br/>Your guidelines, the ones you try to hide behind by saying “everyone took them out of context” destroyed my family! Your guidelines are responsible for the creation of an industry of dangerous and deadly counterfeit pain pills and an insane number of overdose deaths from those pills! Your guidelines are DIRECTLY RESPONSIBLE for every soul who committed suicide because they had their pain medication taken from them and could not go on enduring the inhumane suffering. <br/><br/>Your guidelines have so greatly impacted my health, physically and emotionally. Because you took my medication from me I can’t walk or move without stabbing pain. I no longer am able to go to the gym which has caused my weight to skyrocket from 219 to 327! I’m now pre diabetic and taking over 29 medications. I’m only 58. I’m taking care of my 84 year old parents and, God how I wish you could see and feel the fear and heartbreak I feel watching the people I love decline. <br/><br/>I wish you could see the poor souls that have to go pee in a cup at a “shady pain clinic” in a strip mall to get their prescriptions if they are even lucky enough to be accepted into a clinic. As if suffering from chronic pain isn’t enough, your guidelines have subjected us to the indignity and shame of being treated like untrustworthy addicts and criminals.<br/><br/>The first clinic I went to was shut down because the doctor was running a pill mill! The second clinic I had access to was also shut down for the same reason. I live in a very small town in West Virginia. The nearest clinic is almost 2 hours drive. Try driving for up to five hours every 28 days to get 28 lowest dose Hydrocodone pills that must last 28 days! The “doctor” comes into the exam room, tells me to raise my arms, raise my left leg, raise my right leg and throws a preprinted script on the table and says see you next month. 2 minutes! Each visit costs me $45 + $14 for the pills that you made sure my insurance will not cover, thank God for Good RX, plus the fuel up and back. I have to wait until I cannot stand the pain anymore to take my one Hydrocodone 5-325 to get through the rest of my day.<br/><br/>I shouldn’t have to but I am compelled to remind you of the oath you supposedly took, the Hippocratic Oath, the one that says DO NO HARM. The harm your guidelines has caused; I no longer trust doctors, my father was told “do not mention pain medication or you will be dismissed from my practice” my mother was cut off because a doctor said she was faking her pain, I was refused pain medication by the very surgeon who told me I need a 13 level fusion and the risk of complications included being paralyzed and even death!<br/><br/>So, we live in pain, in fear and with an incredible mistrust of the medical community. Your unbelievably barbaric guidelines must MUST be corrected! Put the treatment of chronic pain sufferers back into the hands of PCPs who know the patients intimately and can treat up and down each individual patient individually, without THE FEAR your draconian 2016 guidelines created in good and descent practitioners that they would loose their licenses and jobs even with the threat of incarceration!<br/><br/>You people have failed us and have created such misery and loathing. <br/><br/>You need to fix this, NOW!<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	T	None	None	0900006484fbc289	Myers	None	2022-03-07T01:51:53Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Myers, T	l0f-n03p-evxx	False	None	False	2022-04-12 03:17:07.722	[]
1992	CDC-2022-0024-1998	https://api.regulations.gov/v4/comments/CDC-2022-0024-1998	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since they cut my meds to almost nothing in the past 2 years I have no quality of life? I have had to come to the realization that I can’t take care of my 2 disabled kids. I’m now looking for a group home for both of them. How does that make a mother feel? Devastated and full of guilt!! What I’m I to live for???? I was a fully functional person before. I had a good quality of life!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	shari	None	None	0900006484fbc2a5	campbell	None	2022-03-07T01:52:07Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from campbell, shari	l0f-nfzm-p3e6	False	None	False	2022-04-12 03:17:07.939	[]
1993	CDC-2022-0024-1999	https://api.regulations.gov/v4/comments/CDC-2022-0024-1999	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Give meds back to chronic pain patients! We are not the problem!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc2bf	Anonymous	None	2022-03-07T01:52:53Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-o1cf-anme	False	None	False	2022-04-12 04:16:48.558	[]
1994	CDC-2022-0024-2000	https://api.regulations.gov/v4/comments/CDC-2022-0024-2000	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You need to let Dr prescribe pain meds I lost my Dr due to your guidelines I lost my meds. I live in chronic pain everyday of my life. I was on SSDI and I lost that due to the fact I was abandoned by the medical field I suffer everyday I have thought about taking my life cuz of all my pain. Do you know what it’s like to get up everyday and your body in so much pain you can’t get outta bed no of course you guys don’t I can’t find a Doctor to take care of me due to your interference and guidelines. I NEED MY MEDS BACK I live in rural Montana I have no idea what I’m doing to do are how much longer I will be on this earth due to what you have done. Doctors won’t prescribe meds due to the fear they will lose their license. The government had no reason to interfere with doctors taking care of chronic pain patients. I was a stable patient who pasted every UA and pill count. I had a life back then. Now my life is in bed most of the time you need to fix this BS. Chronic pain patients had nothing to do with the opiate epidemic and since the guidelines the epidemic has gotten worse 100000 ppl lost their lives to ODs Chronic pain patients might be dependent on their meds but we weren’t the ones dying from ODs	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tami	None	None	0900006484fbc2c1	Duncan	None	2022-03-07T01:53:26Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Duncan , Tami	l0f-o31b-5yl5	False	None	False	2022-04-12 04:16:48.787	[]
1995	CDC-2022-0024-2001	https://api.regulations.gov/v4/comments/CDC-2022-0024-2001	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prevention Education Programs are Essential in Combating the State and Nationwide Opioid Epidemic<br/><br/>Nationally, Americans do not have the ability to choose non-pharmaceutical chiropractic manipulative therapy or acupuncture treatment due to third party coverage limitations. Our current third-party payer benefit coverage fuels the opioid epidemic by limiting and or non- coverage of evidence-based chiropractic treatment.<br/><br/>Recommendation 1: The states should take action, to require all private insurers, Medicaid and Medicare plans to include appropriate chiropractic and non-pharmacologic treatment coverage , which includes examinations, electro modalities, laser, ultrasound, electrical stimulation, spinal traction, exercises therapy, therapeutic procedures, acupuncture, deep tissue work, (all treatments DCs are licensed to perform within their scope of practice), for acute and chronic pain prior to opioid prescriptions, without inappropriate financial or treatment restrictions.<br/><br/>Medicaid and Medicare plans should immediately modify their policies to reimburse for examinations, diagnostic testing, and non-pharmacologic treatment within the scope of chiropractic physicians and other licensed providers at an appropriate rate. This has been shown to improve outcomes and save on healthcare spending. Private insurers should take action to improve their coverage of full-scope chiropractic treatment first for pain to be consistent with current treatment guidelines. Financial and treatment restrictions should be minimized to allow all medically necessary care. <br/><br/>Recommendation 2: VA facilities should take action to promote full-scope chiropractic, which includes examinations, electro modalities, laser, ultrasound, electrical stimulation, spinal traction, exercises therapy, therapeutic procedures, acupuncture, deep tissue work, and acupuncture before opioid treatment. VA facilities need to remove procedural restrictions and educate staff that are preventing injured veterans from receiving non-pharmacologic full-scope chiropractic treatment that is a covered benefit. Timely response for Veterans requesting additional treatment needs to be evaluated.<br/><br/>Recommendation 3: The states should take action to ensure injured workers can access appropriate full-scope chiropractic and non-pharmacologic treatment, (all treatments DCs are licensed to perform within their scope of practice), for their painful work injuries prior to opioid prescriptions. Managed Care Organizations (MCOs) and reviewers working in the Workers Compensation system should be educated on current treatment guidelines and held accountable for adhering to them, which includes the right of the injured worker with chronic pain to seek non-pharmaceutical treatment.<br/><br/>Recommendation 4. The state should take action, to require healthcare practitioners to recommend and provide access to full-scope chiropractic and non-pharmacologic treatment for pain prior to opioid prescriptions, with disciplinary action for non-compliance.<br/><br/>Chiropractic Action step Recommendations:<br/><br/>#1. Employers and the general public should take action to demand better coverage of full-scope chiropractic, which includes examinations, electro modalities, laser, ultrasound, electrical stimulation, spinal traction, exercises therapy, therapeutic procedures, deep tissue work, spinal manipulation, extremity manipulation and acupuncture for pain as an alternative to opioids. <br/><br/>#2. All private insurers, Medicare and Medicaid plans need to include appropriate full-scope chiropractic and non-pharmacologic treatment coverage which includes examinations, electro modalities, laser, ultrasound, electrical stimulation, spinal traction, exercises therapy, therapeutic procedures, deep tissue work, spinal manipulation, extremity manipulation and acupuncture for acute and chronic pain prior to opioid prescriptions, removing all inappropriate<br/>financial and treatment restrictions.<br/><br/>#3. Healthcare payers must acknowledge recent guidelines which mandate that non-pharmaceutical physicians should be utilized first. National and state guidelines have recommended evidence based nondrug treatment: full-scope chiropractic care before medications. These guidelines provide good support for using full-scope chiropractic care first for pain relief.<br/><br/>#4. Information brochures and posters should be presented to every employer in Ohio, stating that the injured worker has the right to choose his/her physician and recommending evidence-based non-pharmaceutical full-scope chiropractic treatment, (all treatments DCs are licensed to perform within their scope of practice), first when an injury occurs. Brochures should list the dangers of prescriptive medications/ opioids.<br/><br/>#5. Hospital emergency rooms should refer patients to chiropractic physicians first when acute musculoskeletal injuries occur, to help stop the ongoing opioid prescriptive medication abuse and misuse.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judson	None	None	0900006484fbc2c7	Sprandel II	None	2022-03-07T01:55:03Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Sprandel II, Judson	l0f-nsxr-c42s	False	None	False	2022-04-12 04:16:49.009	[]
1996	CDC-2022-0024-2002	https://api.regulations.gov/v4/comments/CDC-2022-0024-2002	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, the chilling effect the guidelines have had on chronic pain patients that have been on long term opioid therapy needs to be addressed.<br/>I had my dosage decreased to an arbitrary amount under the cdc "recommended" under 90 mcg. Why do we not protect folks with chronic pain who are stable on their medications?<br/>This is causing such harm and there is no need for it. Make sure this update makes clear that folks who are stable can stay on their medications.<br/><br/>I hope you consider this population as you do the so called opioid crisis.<br/><br/>Do better and make this right!<br/><br/>Concerned citizen <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc2f3	Anonymous	None	2022-03-07T01:55:15Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-omnr-p8df	False	None	False	2022-04-12 04:16:49.233	[]
1997	CDC-2022-0024-2003	https://api.regulations.gov/v4/comments/CDC-2022-0024-2003	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span><br/>By your strick regulations at the CDC, you have caused thousands of people to suffer.<br/><br/>Doctors are so afraid they will lose their license, that they only prescribe mild over t<br/><br/>the counter medications, and not a medication that will help to ease pain. Because <br/><br/>some of the people have abused medicine, why should those of us that are really<br/><br/>experiencing excruxiating pain have to suffer??? Why don't you use common sense and<br/> <br/>allow the doctors to actually help their patients. We do not like to pay $200 per<br/><br/>visit and hear that we should take an aspirin or another over the counter drug.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fbc322	Varner	None	2022-03-07T01:55:29Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Varner, Jeff	l0f-ptn5-inbe	False	None	False	2022-04-12 04:16:49.440	[]
1998	CDC-2022-0024-2004	https://api.regulations.gov/v4/comments/CDC-2022-0024-2004	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had Restless Legs Syndrome for almost 30 years. I have tried many medications to treat this awful condition. I currently have severe RLS that is treated with Gabapentin. My neurologist has informed me that this treatment will eventually fail and the next treatment will be low dose opioid. Please make sure this is available for those of us suffering with RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rhonda	None	None	0900006484fbc324	Mason	None	2022-03-07T01:55:46Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Mason, Rhonda	l0f-pz84-xibz	False	None	False	2022-04-12 04:16:49.646	[]
1999	CDC-2022-0024-2005	https://api.regulations.gov/v4/comments/CDC-2022-0024-2005	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have watched suicides and death follow the 2016 <br/>guidelines- though maybe not intentional but thats what <br/>happened. Chronic and intractable pain is no joke. I have <br/>watched Professors, lawyers, doctors no longer be able to <br/>practice for the loss of a safe, effective medication. A medication <br/>just like if someone needed insulin. <br/>RA, AS, CRPS, EDS - are just a few that are 24/7 relentless <br/>suicidal pain conditions. My last suicide a young man in his 20’s with <br/>EDS almost broke me. He was abruptly cut off. What a waste of a <br/>young persons life! <br/>Get rid of 50mme and add language that adds intractable and <br/>chronic conditions like above.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc32d	Anonymous	None	2022-03-07T01:56:05Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-q87b-kjn9	False	None	False	2022-04-12 04:16:49.861	[]
2000	CDC-2022-0024-2006	https://api.regulations.gov/v4/comments/CDC-2022-0024-2006	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The fact that chronic pain patients are getting less and less medication but overdose deaths keep climbing should tell everyone that the problem isn’t coming from the doctor’s office. I had an incredible PM dr for about 10 years. We worked together to find the right medication to give me some quality of life. I was taking a low-moderate dose but it allowed me to work and participate with family activities. Recently, my PM dr left his practice so I’ve been looking for a new one. One dr actually told me, “you won’t find a dr to prescribe pain meds because the risk is too high and you can’t make money doing it”. PM drs want to do procedures ie. steroid injections, RFA, surgery. I’ve had multiple procedures in the past 10 years and none have given me lasting relief. I finally found a dr to prescribe a small amount of medication but also feel pressured to have more procedures. Since I’ve recently been diagnosed with a bleeding disorder, I have to get a DDAVP infusion prior to all procedures. So, not only do I have to pay for a procedure that hasn’t worked in the past but also have to pay for an IV infusion. It seems like a waste of money and healthcare resources when a small amount of medication would take care of my problem. Government needs to stay out of the dr/patient relationship. Also, it’s not a one size fits all.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc371	Anonymous	None	2022-03-07T01:58:41Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0f-rvd2-uh15	False	None	False	2022-04-12 04:16:50.627	[]
2001	CDC-2022-0024-2007	https://api.regulations.gov/v4/comments/CDC-2022-0024-2007	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long time sufferer, it was like paradise when my doctor finally felt he had exhausted all the pharmaceutical possibilities and prescribed hydrocodone. I had tried every one of the usual medications for RLS and they were either ineffective or caused terrible side effects. Months would pass without my being able to get one good night's sleep. My doctor is so uncomfortable prescribing the hydrocodone that I am fearful when it is time for the next refill that he will deny it and I will be sent back to the hell of nightly suffering. I take a total of 20mg and the RLS is completely under control with that treatment plan. If I couldn't take it, I don't know how I would survive. I hope you will take this and the similar situation that so many people have to endure as something that needs more research and more protection for doctors who prescribe opioids for RLS. Thank you so much	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006484fbc38d	VanDyke	None	2022-03-07T01:58:52Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from VanDyke, Margaret	l0f-sc8r-f49z	False	None	False	2022-04-12 04:16:50.838	[]
2002	CDC-2022-0024-2008	https://api.regulations.gov/v4/comments/CDC-2022-0024-2008	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m miserable. I’ve been able to lead a normal life while on OxyContin. Just 1 in the am and 1 in the pm, I was able to work, etc. Now I can’t get out of bed. 20 years I was fine until the 2016 guidelines came out. My pain management Dr. was so scared of losing his license that he took me off of my meds. Regardless of all of my MRIs and X-rays showing extensive painful injuries, I’m left bedridden. I don’t know what to do.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Corey	None	None	0900006484fbc39d	Wells	None	2022-03-07T01:59:04Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Wells, Corey	l0f-skp0-a9r7	False	None	False	2022-04-12 04:16:51.049	[]
2003	CDC-2022-0024-2009	https://api.regulations.gov/v4/comments/CDC-2022-0024-2009	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC,<br/> I am 67 and soon to be 68 years old. I suffer from Psoriatic Arthritis, Sondylitis, 3 fractured vertebrae, a steel plate in my upper right arm, and I take 4 heart meds. I have been on Norco and I am on timed release Morphine 12 hour. I have had nerves burned in my upper back and steroid injections. I would be home ridden much of the time if I was not closely monitored and had not been on opiod medication for the last 19 years.<br/>I have to go to a Pain Treatment Center to stay on opiod medication. I go every 2 months.. When I had a compound fracture of the upper arm, the ER would not give me any opiod medication because I am on contract at my Pain Center for medication for my chronic disease. I also have been under the care of Rheumatologists since 2003.I get no opiod medication from my Rheumatologist. <br/> I don't use illegal drugs or drink alcohol. I am only on enough pain meds to control my pain, sometimes not alleviate it completely. I believe that 99.9 per cent of Physicians are the good guys and many are afraid to prescribe opiod meds even for a short time. And some specialists in Pain Medicine and their Nurse Practitioners are afraid to give any more meds when the patient has been in an accident and is in acute pain plus chronic pain.<br/>I live with pain everyday of my life. I have been able to continue to live a semi-active life due to my access to opiod medication.<br/> Patients have a right to not live in debilitating pain. Doctors should be able to continue to help these patients.<br/><span style='padding-left: 30px'></span>Thank you, M M<br/><span style='padding-left: 30px'></span>[location redacted]<br/><span style='padding-left: 30px'></span><br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MICHAEL	None	None	0900006484fbc3f7	MASON	None	2022-03-07T02:00:41Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from MASON, MICHAEL	l0f-v4b0-6lia	False	None	False	2022-04-12 04:16:51.341	[]
2004	CDC-2022-0024-2010	https://api.regulations.gov/v4/comments/CDC-2022-0024-2010	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope my input is important. <br/><br/>My husband has chronic pain daily and was cut from 180 Mme of Methadone to 90 Mme Methadone daily. He still is in pain every day and uses all kinds of expensive creams over the counter to take care of his chronic pain.<br/><br/>Why does the CDC not listen to us crying out in pain? Why do our lives not matter to you at the CDC?<br/><br/>I am in pain daily, but I know my doctor won't prescribe from my past experiences with him. So I take Advil over the counter to curb my pain. If it was worse pain, I'd probably be dying from kidney and liver failure as so many people in pain are now due to NSAID use.<br/><br/>Also, why 50 Mme? From what I have learned, 50 Mme is the new standard and you repeat it over and over in your newly released information for the DEA to use as law (or should we say, abuse as law?). <br/><br/>So many people have died from heart attacks and suicide. And yet, the people of the CDC say nothing. <br/><br/>Pain is real. And it destroys lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lanora	None	None	0900006484fbbf9a	Hubbard	None	2022-03-07T02:00:58Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Hubbard, Lanora	l0f-vwb7-aqr9	False	None	False	2022-04-12 04:16:51.552	[]
2005	CDC-2022-0024-2011	https://api.regulations.gov/v4/comments/CDC-2022-0024-2011	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>I just wanted to write my comment, and every time I talk too much, so I'll try to keep it simple.<br/><br/>In my eyes, people are going to seek happiness, it's part of being American, the pursuit of happiness. Now I'm not talking getting high, that's a different situation than on this docket, I'm simply talking feeling normal. If a person feel's they are in pain, and doctor's have determined there is a reason for it, then it should be treated properly. If temporary or acute, give them medicine to get by, until the problem can be fixed however it needs to be, and then wean them off. The best thing you can do is give it to them FIRST, trust them, warn an educate them of possible side effects, addiction etc. Otherwise, you're simply putting up a giant brick wall for patients who need treatment to jump over, before they get what they need.<br/><br/>If you remove that wall, help them first, and are proven afterwards the person can't be trusted (Pill counts wrong, they're selling them, doctors prescribing too much, or the companies pushing doctors to prescribe too much) punish them for the crimes that have already been committed, don't punish us pain patients for being ill. We need to break this curse of "Guilty, until proven innocent," and help people. Focus more on Quality of life than Quantity of life, as long as the patient is properly educated and understands.<br/><br/>Also I believe that there are reasons for large doses of opiates, in very specific circumstances, in my personal opinion, low dosages should be of no question especially for chronic pain patients. Again as long as they're educated, they have only themselves to blame if something goes wrong or they violate a law.<br/><br/>Hyperalgesia is often a big part of the opposing sides viewpoint, and it cannot be denied, hyperalgesia (Feeling more pain because you're brain became used to the pain medication dulling it) is a real thing. That's why again educating about it, and working around it I think would be more helpful than just placing up a brick wall, and blocking everyone.<br/><br/>All that wall did, was make people turn around and look elsewhere, and find other things to "Get through life," now we have an epidemic of people dieing, because they'll do anything to feel normal, some obviously want to get high, but that in my opinion again is a disease, and should be treated accordingly. There are medicines for that, such as suboxone, which is half-analgesic, so they don't go through WD pain, but also prevents them from getting high, so they can recover properly. Giving that to a pain patient is almost insulting in my opinion, so I'm worth half a drug, and if it doesn't work, you're going to raise that brick wall even higher for me to try and climb and survive in life?<br/><br/>Life IS pain, alcohol is legal, people drown their pain, mental or physical in alcohol all the time, but medicinally will they find help at the bottom of that bottle? No, they may find relief, that can arguably be a good thing, but the same goes for any other drug if we're talking that way. It's how we warn people about it, the side effects, and how we control it.<br/><br/>I'm not saying put them on the counter, but reducing restrictions on a mutual agreement between you and your doctor should be absolute. They have the training to deal with this stuff, you have the experience of dealing with it. Insurance is another matter, and should never be involved, they should do their jobs "Properly," and negotiate prices based on needs of patients, Insurance has no right to say anything in their decisions, unless they suspect some sort of foul play, illegal activities etc.<br/><br/>I implore you, please consider this sincerely, help us in pain first, let people be innocent and get the help they need. If they violate the law, sell pills etc. Punish the people doing the illegal things, not the people who just want to survive.<br/><br/>To end, I'll leave my personal experience, since I lost my pain management during this "Crisis," and too many doctors are scared to prescribe the medicines that worked for me (Many work, just different side effects) I've spent now 2 years trying to "Push Through," but really knowing I couldn't do it, I had to sign up for disability. I'm a millennial, and I want to work. If I had the medicines I needed, and now a few accommodations (easy ones) I could work without feeling like I'm walking on fire all day (Main issues are with feet, but I have tones of unchecked problems, including a rare possible genetic cancer) and working with paid for insurance, was a nightmare. Having state health insurance didn't find me many doctors, but we spent time focusing on ME, instead of focusing on "The bill,"<br/><br/>I'd rather have no insurance, see pain management, get my 1 medicine, and be happy paying out of pocket, then arguing with 15 doctors to get a referral to pain management, that "Might," help, only to be denied because I'm "Too Complex," than be robbed blind by insurance, and spend days/months begging for help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Seth	None	None	0900006484fbc421	Blodgett	None	2022-03-07T02:02:15Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Blodgett, Seth	l0f-yu9t-e64r	False	None	False	2022-04-12 04:16:51.764	[]
2006	CDC-2022-0024-2012	https://api.regulations.gov/v4/comments/CDC-2022-0024-2012	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	TO: CDC REGULATIONS 2016 REVISION<br/><br/>HELLO, MY NAME IS [name redacted] AND I AM WRITING TO YOU TODAY TO EXPRESS MY CONCERNS AND FEELINGS ABOUT THE OPIATE GUIDELINES PASSED IN 2016. I AM A CCP (CHRONIC PAIN PATIENT) AND HAVE MULTIPLE INJURIES WHICH KEEP ME FROM HAVING A LIFE THAT IS FUNCTIONAL. I HAVE CHRONIC PAIN EVERYDAY AN AM FIGHTING SEVERE NERVE DAMAGE THROUGHOUT MY BODY. I WAS DIAGNOSED WITH SFN (SMALL FIBER NEUROPATHY) 4 YEARS AGO AS WELL AS OSTEOARTHRITIS THROUGHOUT MY BODY. I ALSO HAVE HERNIATED DISKS AND A NERVE STIMULATOR SURGICALLY IMPLANTED IN MY LOWER BACK WHICH ONLY HELPS 30% OF MY PAIN IN MY LOWER BACK. I AM CURRENTLY ON 10MG OXYCONTIN 1 EVERY 5 HRS. THIS IS BARELY HELPING FOR ALL THE EXTREME PAIN I GO THROUGH EVERYDAY. I AM SO UNDERDOSED WITH THIS MEDICATION. IT IS SO UNFAIR TO LET ALL OF US CPP (CHRONIC PAIN PATIENTS) SUFFER BECAUSE OF OTHERS THAT ARE ABUSING THE OPIATES. I DON'T UNDERSTAND HOW YOU CAN PUNISH THE INNOCENT PAIN PATIENTS BECAUSE OF THE PEOPLE WHO ABUSE THE OPIATES. IT'S NOT HUMANE TO DO THIS TO US. WE ARE DYING AND DON'T WANT TO GO ON SUFFERING ANYMORE. PLEASE REVISE THE GUIDELINES OF 2016 TO SAVE THE REAL PAIN PATIENTS THAT ARE REALLY NEED, TO BE ABLE TO FUNCTION FOR THE FEWS YEARS WE HAVE LEFT. <br/><br/>THANK YOU,<br/>SINCERELY,<br/>[name redacted]<br/>[phone number redacted]<br/>[email redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484fbc438	Flanders-Clendenin	None	2022-03-07T02:04:33Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Flanders-Clendenin, Janet	l0f-z3mq-kypz	False	None	False	2022-04-12 04:16:52.005	[]
2007	CDC-2022-0024-2013	https://api.regulations.gov/v4/comments/CDC-2022-0024-2013	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2016 I was force tapered 85% reduction in my Opioid pain meds. I was in a car accident in 2004. I went to several different types of doctors and tried many different non-opioid treatments. Physical therapy, trigger point injections, chiropractor, pool therapy, traction, physical strength exercise therapy. I also endured several steroid epidural injections to my lower back, SI joints and my cervical spine. I had a rhizotomy in my neck and an SI joint fusion. Right after my surgery, I was in another CC ar accident. The car I was a passenger in, hydroplaned and ended up on the opposite side of the freeway. I was injured further. I have several diagnosis (DDD in back and neck, fibro, osteoarthritis, spondylosis along with anxiety and depression.)<br/>So I DO NEED MY PAIN MEDICATIONS! PRESCRIBED AT AN EFFECTIVE DOSE! I am getting older so my conditions are worse along with new conditions. I don't even tell my Dr about these. What is the point? I am a legitimate pain patient! (There millions of others like me!) We want our pain meds back <br/>Take the 50 mme and any mention of mme OUT OF THE GUIDELINES! Better yet, destroy these guidelines as they have destroyed us! YOU ARE KILLING PEOPLE! SHAME ON YOU!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rochelle	None	None	0900006484fbc451	Estes	None	2022-03-07T02:04:52Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Estes, Rochelle	l0g-08kr-0ex5	False	None	False	2022-04-12 04:16:52.226	[]
2008	CDC-2022-0024-2014	https://api.regulations.gov/v4/comments/CDC-2022-0024-2014	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to the CDC’s regulations I have spent the last 3 months submitting authorizations from my pain management provider to my insurance company (Cigna) in order to have my long acting pain medication approved and paid for by Cigna. This has included a prior authorization, an appeal of the prior authorization, a pain contract with Cigna (which was nearly identical to the one I sign with my pain provider annually), and a quantity approval. I am very I’ll, awaiting a transplant and this has caused a great deal of stress that has exacerbated my symptoms. I am too ill most of the time to leave my bed but this denial has required hours on the telephone with insurance representatives who couldn’t even tell me why my medication was still being denied. Never have I experienced anything like this in trying to get a medication and I blame the CDC guidelines for adding all of these additional requirements by insurance in order to cover pain medications.<br/><br/>I also suffered for months with extreme pain because I needed my pain medication to be increased and my pain provider was extremely hesitant to exceed the CDC’s 90 MME dosage suggestion. I finally had to resort to emailing my provider daily with descriptions of my excessive pain before she was willing to exceed that limit. Because of this “suggestion” I spent about 4 months in extreme pain. The minute my pain medication was increased beyond this arbitrary limit my pain was relieved and I was able to function again.<br/><br/>The CDC needs to remove themselves from the doctor patient relationship. Chronic pain patients such as myself are experiencing difficulty getting pain medication at all or getting adequate pain medication because of the 2016 guidelines. The idea that a 50 MME suggestion is being proposed is terrifying for me and all chronic pain patients are stressed each and every day that the CDC will come up with new suggestions and they will be unable to get any pain medication at all.<br/><br/>I am scheduled for surgery in April to relieve my pain but will make me a diabetic and has a one year recovery time because I am terrified that as the years go by the CDC will find a way to take all pain medications away from all patients and I will be forced to take desperate measures to finally relieve my pain. <br/><br/>Due to the CDC’s guidelines cancer patients are being denied pain medications and doctors are receiving incentives for not prescribing pain medication post op. This situation is already ridiculous and the CDC is poised to make it even worse. <br/><br/>The overdose epidemic is NOT due to prescription pain medications! The best thing the CDC can do at this point is to back off of their previous recommendations and further clarify that they are making recommendations for NEW pain patients ONLY and that the treatment of chronic pain patients is up to the doctor and patient ALONE!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484fbc48c	Maynard	None	2022-03-07T02:05:41Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Maynard, Julie	l0g-16e1-5kgc	False	None	False	2022-04-12 04:16:52.450	[]
2009	CDC-2022-0024-2015	https://api.regulations.gov/v4/comments/CDC-2022-0024-2015	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi i m from [location redacted] .I m 58 yr old I worked as a CNA for 30 years that surgery twice on back .on my neck .3 TIMES ON SHOULDER carpal tunnel surgery on right hand .and 2 other surgeries .i m in constant pain tried everything before going to pain meds to try having a little quality of life .i ve been effect from the CDC guide line from 2016 .The next guideline isn't really any better need to take out the MME .one size does not fit all .We all are suffering because of this .And the Doctors need to be Doctors again with out retribution .Were getting treating so poorly at pharmacy .emergency rooms and doctors office only because everyone's afraid to give out what little medicine to help us to survive .we shouldn't be treated this way .we are human.Alot of people with diseases are suffering. this is so inhumane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc4be	Anonymous	None	2022-03-07T02:06:26Z	None	None	1	None	2022-03-06T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0g-24pm-pdxq	False	None	False	2022-04-12 04:16:52.658	[]
2010	CDC-2022-0024-2016	https://api.regulations.gov/v4/comments/CDC-2022-0024-2016	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have discussed with my clinical care givers the pain experienced with muscular skeletal issues (crushed disks on nerves and osteoarthritis in the knee). I have sought and received treatment for these issues that have involved minor surgery and cortisone. When I suggest a pharmacological option as part of treatment my Doctors literally bolt out of the examining room because they will not consider short term pharmacological care. The pain clinic offers nerve ablation, epidural treatment, or surgery. I feel that these are rather intrusive treatments as a first option. I am working on weight control, rest, physical therapy, heat, cold, and exercise. The pain can at times be debilitating. I am hoping that new guidance will make doctors feel more comfortable adding a regime of pharmacological care in the future for pain mangement.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fbc4f3	Herlihy	None	2022-03-07T14:29:53Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Herlihy, John	l0g-3nwl-izwr	False	None	False	2022-04-12 04:16:52.917	[]
2011	CDC-2022-0024-2017	https://api.regulations.gov/v4/comments/CDC-2022-0024-2017	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Its imperative that the CDC modify its regulations on Opioid prescribing for chronic pain<br/>. Individuals suffering from chronic pain have been denied relief for the last 5 years<br/>because prescribers will not or can not prescribe opioids.<br/> Legitimate prescribers must regain the right to help patients with pain.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	George	None	None	0900006484fbc5ff	Sciolino	None	2022-03-07T14:39:15Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Sciolino, George	l0g-lmlv-inp7	False	None	False	2022-04-12 04:16:53.125	[]
2012	CDC-2022-0024-2018	https://api.regulations.gov/v4/comments/CDC-2022-0024-2018	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To who may concern...<br/>I hope to my lord that every person that is in pain will get there pain meds back as it was .its bad enough we hurt24\7 and deprission hits and then this .its a awfull we have to live like this its a living hell i had 3 back SURGERYS one neck 2 carpull tunnell and still counting i need another one but i wont want tylonal 3. I hope u never have to suffer like we do one size doest fit all .rememember me next time you are in pain and imaginé liviñg like that its a evil feeling let the doctor.s do there job....some day you will Remember all of us!!!!!in jesus name.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sam	None	None	0900006484fbc0fe	Flores	None	2022-03-07T16:34:04Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Flores, Sam	l0g-blge-01vo	False	None	False	2022-04-12 04:16:53.353	[]
2013	CDC-2022-0024-2019	https://api.regulations.gov/v4/comments/CDC-2022-0024-2019	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This comment is for my 85 year old MIL <br/>Since the 2016 guidelines she has been <br/>narcanned for a UTI! I find this torture. <br/>I am seeing paramedics and doctors <br/>reaching and using narcan inappropriately. <br/><br/>In addition she fell broke her femur - her young <br/>resident was not going to give her an opioid <br/>for her pain because “ we have an opioid crisis” These <br/>young doctors have inappropriately been <br/>indoctrinated with this and dont think that a safe effective <br/>opioid CAN BE GIVEN. <br/><br/>You have not created chronic pain patients with these guidelines <br/><br/>Rescind them and do a re-education program- All these deaths are on your hamds	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc973	Anonymous	None	2022-03-07T16:34:42Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0g-keup-z96l	False	None	False	2022-04-12 04:16:53.564	[]
2014	CDC-2022-0024-2020	https://api.regulations.gov/v4/comments/CDC-2022-0024-2020	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am legally disabled due to chronic pain, and I, like millions of chronic pain patient's were unjustly forcibly reduced or removed from our pain medications due to the CDC guidelines initial vagueness regarding the 90mme being intended for acute pain, not chronic pain patient's. I have lived with back, knee, hip and endometriosis pain since I was a pre-teen. I started getting adjustments when I was 10, was diagnosed with chondramalatia of the patella in both knees by age 13,pinched sciatic in both hips and arthritis mid back at age 30. I tried EVERYTHING..physical therapy, sports medicine therapy, chiropractic, massage, osteopathic treatment, yoga, and every non-narcotic and anti-inflammatory my doctors could think of before receiving a pain medication for my hip and back pain. I worked cleaning stalls at 5yrs old,and worked physically demanding jobs for 30 years, until late February 2014 when I herniated 2 discs and bulged 1 in my neck. The pain medication for my hips and back did nothing for my neck pain, and after 4 surgeries in 2yrs, I've been left with vertigo in addition to pinching nerve pain, muscle pain, bone and joint pain, weakness and the inability to do the things most people take for granted. I can't go fishing or hunting, ride my horse, go kayaking or ride a rollercoaster, to even household needs like cleaning and cooking..even a few minutes of vacuuming causes increased pain for days. I've been treated by a pain mgmt specialist since before hurting my neck, I take the same amount every day, feel absolutely no euphoria or high, get random drug tests and pill counts, and signed a contract that only allows my pain mgmt specialist to prescribe medication's. So when the CDC guidelines came out, several pain specialists left out of fear, I received an email stating the facility CEOS were requiring that all patients meds be reduced to 1 type of medication and below the 90mme, despite proven ailments. When the CDC guidelines were "updated", I was able to increase my quantities, but still not enough or near what I had received and done well on. Even now, I have to constantly adjust quantities. For instance to try an extended release version, I had to reduce both my other meds to be as close to the 250mme as possible. For my body, any medication I take, from the very first dose, works half as long as it's supposed to. I don't typically sleep more than 3-5hrs a night, so at most I may skip 1 dose, but usually my pain wakes me and I need to take my meds. The mme needs to be removed from the guidelines so patient's can get a quantity that works for each person's body. We are all built differently, what works for others won't work for me and vice versa, but the facility CEOS are forcing doctors to undertreat patient's because of the mme. I didn't choose this life, and I'd do anything to have my body back and be able to do what I enjoy, and right now the only way I can live a semi normal life is with proper pain treatment, but facility CEOS are going off the mme and against doctors advice, and there's no recourse against the facility..I can file complaints against my doctor, but it isn't her fault. People who don't live with unending pain truly can't comprehend what we live with because people base their views on their own experiences, sure they've felt pain..but it stopped, they didn't have to go through life as normal with an unset broken bone or labor pains, and that's the best way I can describe it to those who don't know. Please imagine everything you enjoy taken away forever and the only form of relief is taken away as well, not because you did anything wrong, but because heroin and illegal fentanyl laced drugs are causing an overdose epidemic, but chronic pain patient's get blamed instead. I hope that whoever reads this, if anyone, tries putting yourself in our shoes, imagining what you would lose the ability to do if you were suddenly, permanently injured. Thank you, ***	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fbc5d1	Vinnard	None	2022-03-07T16:44:50Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Vinnard , Jennifer	l0g-fcde-xluo	False	None	False	2022-04-12 04:16:53.772	[]
2015	CDC-2022-0024-2021	https://api.regulations.gov/v4/comments/CDC-2022-0024-2021	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have suffered with RLS for over 30 years, I now have refractory RLS and the only relief I get is with Temgesic (opioid). I suffered augmentation on previously prescribed medication and went through almost a year sleeping for no longer than an hour at a time. I was in a very dark place. I can't go back there. With Temgesic I am able to sleep and sit still, eat a meal without leaving the table, visit friends and go to the theatre. I hope it lasts, I simply want a normal life. <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L	None	None	0900006484fbc99a	Humphries	None	2022-03-07T16:45:19Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Humphries, L	l0g-nvih-hscj	False	None	False	2022-04-12 04:16:53.993	[]
2016	CDC-2022-0024-2022	https://api.regulations.gov/v4/comments/CDC-2022-0024-2022	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People with legitimate, documented conditions that cause pain and disruption to their lives are being harmed by these ridiculous rules. Why don't you let our drs do their job? Everyone but the government knows all the overdoses are happening with illicit drugs smuggled in across the borders, not compliant patients. Get out of our drs offices and let our drs do their job.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc9d2	Anonymous	None	2022-03-07T16:45:40Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0g-p8vi-wubg	False	None	False	2022-04-12 04:16:54.203	[]
2017	CDC-2022-0024-2023	https://api.regulations.gov/v4/comments/CDC-2022-0024-2023	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Severe Restless Leg Syndrome is not covered in your proposals. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. Research also highlights that RLS has the highest rate of suicide out of sleep neurological diseases. Recommending against the use of opioid medication in severe RLS will bring unnecessary suffering to patients who already face a bleak future with this miserable disease.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	0900006484fbcc86	Hennessy	None	2022-03-07T16:46:17Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Hennessy, Anne	l0g-qgys-kog5	False	None	False	2022-04-12 04:16:54.477	[]
2018	CDC-2022-0024-2024	https://api.regulations.gov/v4/comments/CDC-2022-0024-2024	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient with a complicated rare disease that causes chronic pain, the prescription regulations have very negatively impacted my life. Not only do many doctors in my state, Virginia, refuse to prescribe opioid pain medications under any circumstances, going to the ER with intractable pain is not an option. I am a 50 year old woman with children at home who is frequently limited to bed by intractable pain. The long term effects of other pain medications--like acetaminophen --are catching up with my liver. <br/><br/>Prescriptions need to be decided between a doctor and patient. Ive never been addicted to any meds, am not a street drug user, and have used opioid medications with no desire or need to abuse. Every situation and body is different. <br/><br/>Chronic pain sufferers have been thrown under the bus to protect potential addicts. Specific exceptions aren't going to help those of us with rare diseases with little or no public interest. <br/><br/>Please consider the social costs of automatically considering all chronic pain sufferers as unimportant.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kirsten	None	None	0900006484fbccce	Barre	None	2022-03-07T16:53:12Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Barre, Kirsten	l0g-rebx-b4rp	False	None	False	2022-04-12 04:16:54.699	[]
2019	CDC-2022-0024-2025	https://api.regulations.gov/v4/comments/CDC-2022-0024-2025	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am taking an opportunity to say something about the current regulation. I broke my shoulder in an accident in Germany in 2019. Eight days later I flew home arriving on a Thursday. I did not have an appointment with a orthopedic trauma doctor until Monday. In that in between time I contacted my primary care doctor and she would only prescribe Tylenol and Aleve for the excruciating pain I was having. I then went to Urgent care and got the same answer, then I went to Tele-doc and got the same answer. I do not do well with opioids but nausea was better than the pain I was experiencing. No one would help me those four days of unbelievable pain until I saw the orthopedic doctor. I did not become addicted to the small dose of what he gave me and with the addition of sleep medication I was finally able to sleep. Honestly, this felt like torture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fbcdfd	Straubinger	None	2022-03-07T16:54:28Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Straubinger, Linda	l0g-szcv-dsw0	False	None	False	2022-04-12 04:16:54.912	[]
2020	CDC-2022-0024-2026	https://api.regulations.gov/v4/comments/CDC-2022-0024-2026	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a physician in primary care as well as in palliative medicine. The 2016 guidelines had a number of unintended consequences for patients with both chronic pain as well as acute severe cancer-related pain. <br/><br/>While the 2016 guidelines were not meant to serve as an absolute limit, in practice the MME thresholds were treated as gospel by insurance companies. This impaired access to care and further stigmatized those with chronic pain. Even though the guideline was not meant to apply to cancer-related pain or palliative care, the insurance companies still required prior authorization for nearly every patient I saw in palliative care or cancer-related pain. These prior authorizations caused increased cost out of pocket to patients and delay in care to obtain the medications. <br/><br/>It is my hope that the updated guidelines will reduce the stigma around using these medications for medical situations in which the use of these medications is well-established as being the most evidence-based care, such as cancer pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jesse	None	None	0900006484fbcec6	Blank	None	2022-03-07T16:55:30Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Blank, Jesse	l0g-tkry-e3k2	False	None	False	2022-04-12 04:16:55.161	[]
2021	CDC-2022-0024-2027	https://api.regulations.gov/v4/comments/CDC-2022-0024-2027	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67 yr old woman, and I’ve been living in pain for 1/2 of my life now. When I was 30 I had my 1st of 6 back surgeries. Ive had every procedure known, scs, tens units, therapy, and 3 interthecal pain pumps. At the last refill, the nurse missed the pump and filled ME with Fentanyl and a cocktail of other drugs. I almost lost my life. Then came 2016, and the medicines I was on to function and live MY life got cut to more than a quarter, because that was what someone else, not my docter said I could take. It was 90 MME.<br/>There are so many people, because I have been in pain control groups for 30 years now, that need help. They are suffering. What is good There are so many people, because I have been in pain control groups for 30 years now, that need help. They are suffering. What is good For one person may not be good for another. Medications need to be personal.<br/>I don’t know what the answer is, besides honesty. Which is what Ive always been. Thank you, to whoever is trying to help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dona	None	None	0900006484fbd3ac	Fine	None	2022-03-07T16:56:54Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Fine, Dona	l0g-vi52-5q8o	False	None	False	2022-04-12 04:16:55.406	[]
2022	CDC-2022-0024-2028	https://api.regulations.gov/v4/comments/CDC-2022-0024-2028	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 73 years old and have been using the same low dose opioids for chronic RLS for close to 10 years. It is the only medication available that works and I have been through them all. It is literally saving my life, for without it the quantity of my life is unbearable. Please add RLS to the list of diseases that qualify for low dose opioid use.<br/>I know there are thousands probably millions that suffer as I do without it. I am convinced many will not live without it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484fbd931	Johnson	None	2022-03-07T16:59:03Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Carol	l0g-wsui-ex0m	False	None	False	2022-04-12 04:16:55.625	[]
2023	CDC-2022-0024-2029	https://api.regulations.gov/v4/comments/CDC-2022-0024-2029	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the 2016 guidelines which introduced the 90mme "recommendations" the rate of overdose has rapidly increased. Patients who were previously stable were either rapidly tapered or lost pain medication completely. This left many without life quality, suicidal, and sent law abiding compliant patients to obtain relief by illegal and dangerous means. While increased compliance drug testing and responsible prescribing was important, patients needs were last to be considered. The new guidelines which introduce a 50 mme "recommended" maximum will have the same effect for even more patients. To claim it isn't mandatory is ridiculous considering the outcome of the 2016 guidelines and how they were implemented. It is even more significant as it applies to primary care physicians as large health systems created policy without regard to patient needs to avoid liability. For rural areas pain clinics are often an hour or more away by car if they can find a place at all. For those of us who are disabled, don't drive, and have limited resources this effectively prevents treatment. Any one size fits all recommended dose is clearly not in the patients best interest or best practice. While increased alternatives to medication, education, and patient monitoring is a positive step, treating all patients as drug addicts is irresponsible and misguided. The cost to the individual, family, and society when a patient loses all quality of life due to intractable pain that can and should be controlled cannot be understated. The previous guidelines certainly didn't improve the situation and more restrictions will excerbate it further.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484fbd85c	Massey	None	2022-03-07T17:50:13Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Massey, Sandra	l0g-zmap-xjdb	False	None	False	2022-04-12 04:16:55.843	[]
2024	CDC-2022-0024-2030	https://api.regulations.gov/v4/comments/CDC-2022-0024-2030	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think it is wrong to put any type of MME on opioids,You are causing more harm than good,Theirs no one size fits all here all of our bodys is different,Everyone metabalizes meds defferently and not to mention when the CDC done the the 90 MME every state and insurance company brought it into law and dr stop prescribing and DEA started busting doctors who prescribed more than 90 MME.This has done more harm than good you have many suicides on your hands from these guidelines its unbelievable not to mention you have pain patients running to the street drugs for smoking if pain relief because they can't tolerate their pain and overdosing from on drugs being laced with illicit fentanyl. You now also have pain management dr pushing injections off on people because they are getting kick backs from it and it can bejust as dangerous,Our doctors no longer care for the patients because they are affraid,afraid, health care system when to crop when these guidelines went into place,WE ARE NOT DRUG ADDICS WE ARE PEOPLE IN PAIN TRYING TO LIVE AS MUCH OF A NORMAL LIFE AS WE CAN,Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbc533	Anonymous	None	2022-03-07T17:52:02Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-06T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0g-5mn2-kn00	False	None	False	2022-04-12 04:16:56.058	[]
2025	CDC-2022-0024-2031	https://api.regulations.gov/v4/comments/CDC-2022-0024-2031	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe, unrelenting Restless Leg Syndrome currently under control. However because of the opioid “crisis,” I am living with some degree of fear that should I need opioid therapy as a last resort, it would be denied. If denied, I would have severe sleep deficiency which makes one nearly suicidal. This is deadly serious to me. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. I RARELY, almost never take the time to participate in something like this. Please address and include RLS in your prescribing guidelines because the life you save may be mine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anita	None	None	0900006484fbd7d5	Kirby	None	2022-03-07T17:57:11Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Kirby, Anita	l0g-z6ox-iluz	False	None	False	2022-04-12 04:16:56.321	[]
2026	CDC-2022-0024-2032	https://api.regulations.gov/v4/comments/CDC-2022-0024-2032	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When reading the Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids, I found no mention of one of the most important objective methods for guiding the selection of pain medications, both for achieving efficacy and avoiding adverse drug reactions. I highly recommend that the Clinical Practice Guideline for Prescribing Opioids include the use of pharmacogenomics. <br/><br/>Pharmacogenomic (PGx) guidelines recommended by the Clinical Pharmacogenetics Implementation Consortium (CPIC) are evidence-based and peer-reviewed. The following guidelines are useful for guiding pain management using drug therapy: Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy (doi:10.1002/cpt.2149) and Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti-Inflammatory Drugs (doi:10.1002/cpt.1830). The Food and Drug Administration (FDA) also labels certain pain medications with pharmacogenomic information to guide their use.<br/><br/>The CPIC guideline for select opioid therapy strongly recommends that codeine and tramadol not be used in CYP2D6 ultrarapid metabolizers due to possible severe toxicity including respiratory and central nervous system (CNS) depression and death, and that they not be used in CYP2D6 poor metabolizers due to possible inefficacy. As you know, inefficacy increases the likelihood of dosage increases and the possibility of addiction and overdose. The recommendation for both is to use non-opioid alternatives or, if opioids are necessary, use non-codeine or non-tramadol opioids. Many PGx labs report COMT and OPRM1 results. It is important to recognize that CPIC reviewed these two genes and found insufficient or mixed evidence for an association between either gene and opioids, and recommends that neither be used to guide pain management. The FDA warns against the use of codeine in CYP2D6 ultrarapid and poor metabolizers due to life-threatening respiratory depression and inefficacy, respectively. The FDA also warns against the use of tramadol in CYP2D6 ultrarapid metabolizers because of the risk of respiratory depression and death in patients and breastfeeding babies.<br/><br/>Non-opioid pain medications can be used in place of opioids in some patients depending on the type and source of pain and would decrease the risk of opioid addiction and overdose. The Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti-Inflammatory Drugs makes important recommendations for the use of the non-selective inhibitors, flurbiprofen, lornoxicam, ibuprofen, and piroxicam; and the COX-2 selective inhibitors, celecoxib and meloxicam. The FDA also makes recommendations for celecoxib, flurbiprofen, and meloxicam in CYP2C9 poor metabolizers and *3 carriers due to higher systemic concentrations and adverse effects and for piroxicam in CYP2C9 intermediate and poor metabolizers due to higher systemic concentrations.<br/><br/>Thank you for your consideration of adding pharmacogenomics to the Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484fbd492	Bell, PharmD, MS	None	2022-03-07T18:07:01Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Bell, PharmD, MS, Carol	l0g-w2y9-t8gj	False	None	False	2022-04-12 04:16:56.541	[]
2027	CDC-2022-0024-2033	https://api.regulations.gov/v4/comments/CDC-2022-0024-2033	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please note () indicates a rebuttal or reference to the guideline<br/>First, I would like to introduce myself. I am a 68 year old retired Electrical Engineer at Lockheed Martrin. After graduation, I was hired by General Electric in [city name redacted] Pennsylvania. I enjoyed working on such programs as Landsat, DMSP, MK12/21 Refurbishments, and GPS. I have been on various doses of opioids for at least 20 years. I have Spinal Stenosis of both my lumbar and spinal cord, adhesive arachnoiditis and IBS. I have had acute illnesses such as broken bones, kidney stones, gall stones, and a ruptured intestine. Throughout all of this, I was designing spacecraft, working on jobs for the United States Air Force.<br/>Before I cite certain instances in the document, I would like to tell you that I take extreme exception to this guideline. My first objection is in its’ very existence. My healthcare is to be in part determined by [name redacted] who benefits from my pain?? I do not even give that permission to my primary doctor. These decisions should be mine, not yours. Recently, my spinal stenosis has shown me that, even with kidney stones, I truly did not understand very extreme pain. It is all consuming. At times, I even envy our fallen pain patients. It is torture. You just do not have any idea of how I feel. Why should you make decisions on my pain? I know that you state it is voluntary. So is the 2016 guideline. It is still being used by the DEA and Law Enforcement to seize valuable property. It is still being used as an excuse to revoke doctors’ and nurses’ licenses. It is still being used to determine how much pain relief I need. I have had a few hospital stays.(38) It definitely affected my treatment. By the time it comes down to the patients, it is not voluntary. It must be withdrawn entirely.<br/>Opioids work. I don’t care about studies, I care about results. Allow me to tell you my experience with opioids. I have needed opioids for a long time a few times in my life. Probably, my first experience that I remember is a car accident where I got whiplash. A few days later, I was able to go to the funeral of my friend’s father. After approximate 3 months on opioids, I started a taper and had no problems. Another long period of time involved my diverticulitis and 3 separate operations within a year and a half. Most of that time, I used opioids. After my last operation, I was able to stop using opioids. I went back to work in 6 weeks and was fine until my spinal stenosis woke. Again, opioids work.<br/>I’m not sure how many of you have ever used opioids? A lot of people get high. Like most medicines, this treatment has side effects. Like most side effects, it goes away for approximately 97% of the population. I vaguely remember feeling high the first few times I got an injection in the hospital. Now, I don’t get high. I get this sense of relief as I feel the pain go away from my body. I am able to be myself.<br/>Starting at line 120 : “suicidal ideation also is common among patients with chronic pain” should read “suicidal ideation also is common upon patients with undertreated chronic pain”. That means that 9% (122) of suicides could have been prevented with adequate pain relief.<br/>Line 128 starts mentioning ethnicity. Everyone has the right to self determination. Why not honor that by allowing all of us to determine our own health needs?<br/>Line 202 talks about the risks of opioids for unintended people. What about guns? They kill a lot of unintended victims. What about drinking alcohol? Are we banning that?<br/>Starting at line 205, you use statistics. I will not touch the nonexistent opioid use disorder. You draw a correlation between opioid prescriptions and overdoses. By line 212, opioid prescriptions are declining since 2012(232) yet overdoses are increasing. This contracts itself.<br/>Lines 231 to 245 convince me even further that this will not be voluntary.<br/><br/>The rest of my comments may have to wait. I cannot hold my head up any longer and it is not time for medication.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathryn	None	None	0900006484fbcfa5	Obarowski	None	2022-03-07T22:20:56Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Obarowski, Kathryn	l0g-uix6-lbjr	False	None	False	2022-04-12 04:16:56.748	[]
2028	CDC-2022-0024-2034	https://api.regulations.gov/v4/comments/CDC-2022-0024-2034	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	in 1988 a 440 block engine broke free at work crushed right shouler pulled nerves from head back. went though rebuilds only to fail, then balance was off fell shattered 1 2 3 discs in back,,pain was absolutly increadable. going to pain clincs since. since then diagnoseced as run away rsd, opiods got me uo an voletering again. rsd gives off severe bp swings.after letter from surgeon general my dr. abondonded me as well as pain clinics opoid deaths only answer i got. well i could not get any drs treatment for anything no dr would take me.file said i have rsd.your actions scaeing every dr in america an the result of that. my bp went to 315/129 killed a chamber in my heart an gave me a stroke i cant recover from. how did that help a opiod addict cause it sure didnt help me.pain is a completly differant problem from addiction.after over 30 years on opiates an sudenly abandoned if any of this was even relavent i should have been in rehab that was never offered. no terriable sickness befell me. in time it did.not drug addict time though.its been unhuman since. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	joe	None	None	0900006484fbd417	carolan	None	2022-03-07T22:21:22Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from carolan, joe	l0g-vrhy-9fr6	False	None	False	2022-04-12 04:16:56.984	[]
2029	CDC-2022-0024-2035	https://api.regulations.gov/v4/comments/CDC-2022-0024-2035	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife was a chronic pain patient treated with opiates for over 20 years, with no adverse reactions. She has never failed a UA, never been arrested for street drug use, or admitted for opiate recovery. She meets none of the criteria under Washington states code: "WAC 246-919-950 Tapering considerations – chronic pain" that would require a physician to taper her dosages or to take other action, yet she was force tapered almost 3 years ago by a PAC, because he thought she was a risk, which was never verified by any changes to her medical condition. <br/><br/>My wife has been bedridden now since she received her final 30 day prescription. (which also flies in the face of every single document concerning tapering long term usage patients such as my wife ). Her withdrawal was sheer hell.<br/>I spend all of my day caring for her, trying to stop the pain flares with massive doses of Ibuprofen, topical analgesics, ice, etc,. We know that unmitigated pain is proven to shorten the lifespan of the patient, yet the gov't lets this continue. These actions are sending people to use the street drugs available to them,..that also carry huge risks. <br/><br/>You give them no option......<br/><br/>She wakes up in pain..lives all day in pain..goes back to sleep in pain.<br/>Our neighbors always wonder why they never see her, she never comes out of the house, etc. Our lives are ruined.<br/><br/>Our local hospital in Lincoln County wrote us a letter last year, stating that they would not treat her with opiates. They have flagged her record. <br/><br/>I am also a veteran, and know that they too are being forced off of the only medications that have helped them to deal with the horrible chronic pain that we as a nation, inflicted upon them. This is an attack on legitimate users that has to stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Randy	None	None	0900006484fbdd97	Beamer	None	2022-03-07T22:22:55Z	None	None	1	None	2022-03-07T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Beamer, Randy	l0h-157o-onne	False	None	False	2022-04-12 04:16:57.195	[]
2030	CDC-2022-0024-2036	https://api.regulations.gov/v4/comments/CDC-2022-0024-2036	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Iam a 58yr old female who has been forgotten in the 2022 recommendations, I have been a pain management patient since 1998. I am a a retired Radiologic Technologist as well. I have been on both sides of healthcare as a provider and patient. I made a conscious choice to avoid surgery. And for the most part was living a healthy happy full life until 2016, January 2017 to be exact. My life has suffered tremendously, I am now what can be considered disabled. We run a business from home so I still contribute, but not with regularity or dependability. My pain level is the worst it ever has been I suffer everyday the current Daily dosage is well over %50 decrease, and the word "taper" is not being followed. For patients who want to maintain medical liberty with a consciousness of being dependent not addictive we have not been considered and our survival is being threatened by the continuous CDC's recommendations. I am responsible trustworthy and have given much thought to what my ability to thrive and live my life without overdosing and keeping my flexibility and nerve conduction that too many times are lost post surgery. Pain can be treated, you can never regain flexibility and strength post surgical fusion. I am a candidate for cervical and lumbar 3 levels on both. I also have pelvic instability. My IBS & GRD keeps me from daily Naprosyn or Advil. I need both oral medication 4 times daily and patch every 48 hr. Not all pain patients can find alternatives for pain. I also can tell the difference between my medication and placebo and can categorically deny that my pain gets better without the "large amount" of opioid medication. I would like my personal relationship between patient and MD back, and have final decision be left up to my MD's discretion and not a agency that does not know me. Stop medical tyranny.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fbe19b	Endress	None	2022-03-08T14:18:35Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Endress, Melinda	l0h-4pdy-ccwk	False	None	False	2022-04-12 04:16:57.454	[]
2031	CDC-2022-0024-2037	https://api.regulations.gov/v4/comments/CDC-2022-0024-2037	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Physicians that treat pain are aware of the The Amer. Soc. of Interventional Pain Physicians, WHO Analgesic Ladder, Oncology physician recommendations, etc., for opioid prescribing. The traditional MME for acute vs. Long-term mu-agonist opioid therapy is easier to convert; it is not clear from where the conversion rates for non-mu agonist opioids have come that agrees with MME conversions from other countries (i.e., Australia cites a 1.5x conversion for oxycodone; does not attempt fentanyl or methadone conversion, rather states a general conversion on escalated dose).<br/>Medication manufacturers file research on metabolism/bioavailability of medicines with the FDA, but these are not referenced by CDC. There is no reference to pharmacogenomic med metabolism of the patient as a guide by the CDC, which is researched in literature explaining differences in medication/biochemical metabolism pathways via liver cP450 enzymes ([name redacted] et. al.). Overall, why is the CDC, an infectious disease agengy, undertaken a prescribing guideline that seems severely flawed?<br/>In mitigating risks (in reference to opioid use and benzodiazepines), urine drug screens (UDS) are recommended, but rates of inaccuracies are not discussed. The majority of UDS are a 10-panel antigen test that is embedded with specific antigens and these antigens are mainly for illicit drugs, but are widely used as a medication adherence tool. This presents a problem for clinicians not trained in the results or mechanism of action of these screening tests. Example: the antigen test in UDS for opioids is embedded with a morphine antigen. Any non-morphine metabolite will not bind as well; therefore clinical decisions on false negatives or weak positives cannot be made for a non-morphine medications. This issue exists for benzodiazepines; the antigen contained is for diazepam, and non-diazepam medication patients will not test positive with UDS. Literature examines this issue (BMC Emergency Medicine, 2009, [name redacted] et. al. Interference in drugs of abuse toxicology are in citations). Consider the limitations of any testing when using them as recommendations for an all patients, as screening tools were not created for populations.<br/>The evidence on non-invasive, non-pharmacologic treatments recommended by AHRQ and CDC, are mostly GRADE B or lower recommendations ([name redacted] et. al.). For large populations, these recommendations beyond GRADE A are not considered beneficial. A -0.5 to -1.0 pain reduction is not an improvement in moderate to severe pain. Non-invasive treatments - Lidocaine patches are mentioned. However, prescription lidocaine patches are approved by insurance carriers only for diabetic neuropathy/shingles neuropathy. OTC patches are not as effective.<br/>With conflicts of interests in research, non-profit/profit funding with the original 2016 CDC Prescribing Guideline authors, it is necessary to repeal the recommendation of tapers and hard MME thresholds due to flawed data. <br/>Please be reminded that complex issues require nuance. People exist at the end of data.<br/>Citations:<br/>[names redacted] Pharmacogenomics of Drug Metabolizing Enzymes and Transporters: Relevance to Precision Medicine. Genomics Proteomics Bioinformatics. 2016 Oct; 14(5): 298–313. Published online 2016 Oct 8. doi: 10.1016/j.gpb.2016.03.008 PMCID: PMC5093856<br/><br/>[name redacted] Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am Fam Physician. 2004 Feb 1;69(3):548-56. PMID: 14971837.<br/><br/>[names redacted] Using molecular similarity to highlight the challenges of routine immunoassay-based drug of abuse/toxicology screening in emergency medicine. BMC Emerg Med. 2009 Apr 28;9:5. Doi: 10.1186/1471-227X-9-5. PMID: 19400959; PMCID: PMC2688477.<br/><br/>[names redacted] Chemoinformatic Methods for Predicting Interference in Drug of Abuse/Toxicology Immunoassays, Clinical Chemistry, Volume 55, Issue 6, 1 June 2009, Pages 1203–1213.<br/> <br/>[names redacted] One Hundred False-Positive Amphetamine Specimens Characterized by Liquid Chromatography Time-of-Flight Mass Spectrometry. J Anal Toxicol. 2016 Jan-Feb;40(1):37-42. Doi: 10.1093/jat/bkv101. Epub 2015 Sep 4. PMID: 26342055; PMCID: PMC4731401.<br/><br/>[name redacted] A Difficult Challenge for the Clinical Laboratory: Accessing and Interpreting Manufacturer Cross-Reactivity Data for Immunoassays Used in Urine Drug Testing. Acad Pathol. 2018 Nov 21;5:2374289518811797. Doi: 10.1177/2374289518811797. PMID: 30480089; PMCID: PMC6249658.<br/><br/>[names redacted] False-positive interferences of common urine drug screen immunoassays: a review. J Anal Toxicol. 2014 Sep;38(7):387-96. Doi: 10.1093/jat/bku075. Epub 2014 Jul 1. PMID: 24986836.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MT, MS	None	None	0900006484fbdd9a	Concerned scientist	None	2022-03-08T14:35:03Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Concerned scientist, MT, MS	l0h-15jr-z649	False	None	False	2022-04-12 04:16:57.663	[]
2032	CDC-2022-0024-2038	https://api.regulations.gov/v4/comments/CDC-2022-0024-2038	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have several problems with musculoskeletal pain in my lower back and thoracic area, and suffer from debilitating spasms that leave me hunched over, unable to walk, sit, drive, stand, lie down, or do anything comfortably. Since the new rules were put into place, and since I was without insurance for a couple of years and had to switch doctors, the place that would "take" me for a referral was a joke. I have YEARS of: MRI scans, CT scans, X-Rays, physical therapy reports, spinal surgeries that cauterize the nerve endings, etc., so it was NO QUESTION in my mind that I need help. And for many years my GP was able to provide it for me. But after I lost my GP who had prescribed Hydrocodone and muscle relaxers for YEARS for me with nary a problem, all of a sudden because I had to switch providers to a "Pain Management Specialist" instead of a GP, I was treated like a drug seeking addict. I was expected to "participate" in urine tests paid for out of pocket to "check my blood levels", had to drive an hour each way EVERY month to get the prescription as the visit couldn't be handled remotely, because I didn't have insurance I had to pay out of pocket for the doctor which ran close to $150.00, so I just gave up. But I am in constant pain every day and I cannot work presently because I cannot get a general doctor to prescribe what is necessary for me to function. <br/>What you have done with these rules is make it impossible for people to participate in society and additionally make them feel "less than" because you see THEM as the problem, not the plethora of street drugs available out there. It's hard enough to get adequate medical care in this country and this rule change has just added one more hurdle that people have to jump over in order to access what should be standard.<br/>I feel for the people struggling with addiction, but that is not my issue. My issue is living with daily pain and being told that it either doesn't exist, it isn't as bad as I say, and I should stretch and take an aspirin, despite my years of "proof" via medical records. Please look again at what you are doing to people who live with chronic pain with these "rules".	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe6e3	Anonymous	None	2022-03-08T15:37:00Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-bpxv-0228	False	None	False	2022-04-12 04:16:57.909	[]
2033	CDC-2022-0024-2039	https://api.regulations.gov/v4/comments/CDC-2022-0024-2039	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, My name is [Name Redacted]. I live at [Location Redacted]. My e-mail address is [Contact Information Redacted].. I have been harmed by the 2016, and revised 2020 guidelines for opiods, and narcotics. I believe firmly that doctors need to be able to treat pain, and prescribe medications as they are trained.<br/>I go to the [Location Redacted] clinic. Since there is poor VA care around where I live.<br/>My tramadol has been stopped cold turkey 5 times, and only tapered down once. I have severe pain in my entire back, neck, right hip, right knee, right shoulder, right elbow, and right wrist, plus my feet. I have asked for CBD gummed or drops denied. I am not allowed to drink alcohol, take melatonin, benadryl, alive with benadryl, and listening. I am drug tested every 3 months. Yet, I have never ever had a positive illegal drug test. I have all the labs on file to prove it.<br/>I suggest that the 2916 and 2020 guidelines be revised to allow doctors to prescribe needed pain medications. <br/>The morphine MMe needs to be removed completely. Chron8c pain patients are not responsible for the illegal border drug shipping of fentanyl. Chronic pain patients are Not responsible for the drug overdoses.<br/>We are string encouraging the CDC, DRA, and Veterans Administration hire peoe that help chronic pain patients not torture them. Thank you for your time. God bless!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Whitaker	None	None	0900006484fbe6e8	Diane	None	2022-03-08T15:39:58Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Diane, Whitaker	l0h-bry6-df2u	False	None	False	2022-04-12 04:16:58.194	[]
2034	CDC-2022-0024-2040	https://api.regulations.gov/v4/comments/CDC-2022-0024-2040	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t have it as bad as many of the people here. I had failed back surgery 30 yrs ago and have been coping with hydrocodone 10 mg 6x day for 20 yrs. I think I’ve shown that I’m a responsible drug user. Never asked for any more,never will. So why must I go to my doctor every 30 days and then pay retail at my pharmacy every month for what is obviously a chronic condition? I live in rural area and dread the day my doctor retires.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fbe718	O’Connor	None	2022-03-08T15:41:25Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from O’Connor, Richard	l0h-cg8s-oxzh	False	None	False	2022-04-12 04:16:58.403	[]
2035	CDC-2022-0024-2041	https://api.regulations.gov/v4/comments/CDC-2022-0024-2041	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t have it as bad as many of the people here. I had failed back surgery 30 yrs ago and have been coping with hydrocodone 10 mg 6x day for 20 yrs. I think I’ve shown that I’m a responsible drug user. Never asked for any more,never will. So why must I go to my doctor every 30 days and then pay retail at my pharmacy every month for what is obviously a chronic condition? I live in rural area and dread the day my doctor retires.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fbe719	O’Connor	None	2022-03-08T15:42:40Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from O’Connor, Richard	l0h-cg93-pu16	False	None	False	2022-04-12 04:16:58.683	[]
2036	CDC-2022-0024-2042	https://api.regulations.gov/v4/comments/CDC-2022-0024-2042	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t have it as bad as many of the people here. I had failed back surgery 30 yrs ago and have been coping with hydrocodone 10 mg 6x day for 20 yrs. I think I’ve shown that I’m a responsible drug user. Never asked for any more,never will. So why must I go to my doctor every 30 days and then pay retail at my pharmacy every month for what is obviously a chronic condition? I live in rural area and dread the day my doctor retires.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fbe71a	O’Connor	None	2022-03-08T15:43:01Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from O’Connor, Richard	l0h-cg9c-ug6g	False	None	False	2022-04-12 04:16:58.893	[]
2037	CDC-2022-0024-2043	https://api.regulations.gov/v4/comments/CDC-2022-0024-2043	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	72 years of age and as a person whose life is surrounded by the 'pain of it' day in day out unrelenting this segue from NYT article https://www.nytimes.com/2022/03/07/opinion/opioid-crisis-pain-victims.html to enter my moment of truth. life changing accident(s) I emphasize the plurality for life happens in memories of each. <br/>I was diagnosed with FMS/CFS in the mid-nineties and run through a taxonomy of care pharmaceutically with a modicum of function following form allowed by the right approach. Today, almost 30 years later i struggle without success to avail myself of relief needed and have turned to an alternative. For I! didn't bat an eye when reading about the man who took his life after being refused proper pain management access. <br/>that's how it is for us and no 'subjectivity' can deter the truth for we all suffer on our own very objectively.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Willy	None	None	0900006484fbe785	Krebbers	None	2022-03-08T15:44:29Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Krebbers, Willy	l0h-dhqi-avi7	False	None	False	2022-04-12 04:16:59.099	[]
2038	CDC-2022-0024-2044	https://api.regulations.gov/v4/comments/CDC-2022-0024-2044	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has had Crohn's disease since he was in his teens. He has had many surgeries and only has about eighteen inches left of his intestine. He has chronic kidney stones because of Crohn's and since he is seventy five...he has other problems as well. I have had two back surgeries, two knee surgeries...I have constant back pain and arthritis and many other problems. Used to be my husband could get pain meds for his problems..he can't anymore. I am more fortunate as I can get a supply that I have to fight insurance and the pharmacy for every month. My doctor proscribes these for me but it makes no difference...it is a fight to get the meds. When seniors get together this is a common subject in our conversation and I have middle age friends that also are in despair. These policies on pain meds are so misguided. It appears that the only concerns are with people who voluntarily take these meds...mainly fetanyl (spelling) that seniors are not interested in anyway. The people that search medicine chests, buy on street corners, take the drugs for recreation are taking their lives in their hands voluntarily. Most people my age would rather not take these meds at all....they just want to live as normal and active a life as possible....comfortable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe792	Anonymous	None	2022-03-08T15:46:17Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-dkzg-mwyx	False	None	False	2022-04-12 04:16:59.307	[]
2039	CDC-2022-0024-2045	https://api.regulations.gov/v4/comments/CDC-2022-0024-2045	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new recommendations are a move in the right direction. In an effort to end the opiate crisis in the US our regulators, law enforcement, healthcare agencies and law makers continually focused only on ending the supply of prescription opiates, instead of treatment. As a result addicts and pain patients alike have been forced to obtain black market opiates. The result has only been more death. Everyone in America knows this story. What they don't know is the hidden harm of these policies. Harm that has changed the doctor patient relationship forever. The hidden and continuing outcome of these policies is that healthcare providers have grown un-empathetic, callous and harmful with their patients. They have been given the right to treat every patient as though they are criminal. Patients are seen as the enemy trying to trick the doctor into losing his license or practice. No one is safe from this discrimination. I do not fault most doctors for the opiate crisis.Most were following rules forced on them by policies focused on treating pain as a vital sign. I do, however, blame many doctors for their response when the crisis was finally brought out into the open. Doctors "fired" any patient they thought would bring scrutiny to their door. Doctors who felt patients were addicted to these drugs were not treated for this illness, instead they were kicked to the curb and left with no help or guidance. No medical taper was given to most patients and overnight they became an enemy to each provider they encountered. Not only was this against their oath, it was criminal and irrevocably devastating. Doctors are no longer tolerant of any mention of pain and few are willing to ease it. This,to me, is the worst outcome for all of us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe7bc	Anonymous	None	2022-03-08T16:00:03Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-dz5d-cy71	False	None	False	2022-04-12 04:16:59.514	[]
2040	CDC-2022-0024-2046	https://api.regulations.gov/v4/comments/CDC-2022-0024-2046	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic nerve pain for 11 years. I have 2 masters degrees and hold an executive position but have to be treated like a common criminal to get drugs to provide pain relief so I can function. I am subject to contracts, pill counts and drug tests. I never exceed the prescribed dose and try to take the minimum pills possible. But it's terrible to have chronic nerve pain and then have some nameless, faceless bureaucracy breathing down our necks constantly trying to tell me to not take pills or take less pills. You have no idea of the suffering of this pain. <br/><br/>I hope anyone who makes these decisions and tries to control the pain and suffering of another human has to live through and understand what it is to physically suffer day in and day out. I too have thought of suicide to make the pain stop, but I would never do that to my spouse. I hope the legislators that control these decisions can have the compassion and empathy to try to even understand what it is to suffer so and try to help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charley	None	None	0900006484fbe7e3	Torex	None	2022-03-08T16:01:10Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Torex, Charley	l0h-egv6-yq2r	False	None	False	2022-04-12 04:16:59.744	[]
2041	CDC-2022-0024-2047	https://api.regulations.gov/v4/comments/CDC-2022-0024-2047	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a specialist in family medicine, addiction medicine, & pain medicine, I was very concerned when restrictions were made on the treatment of pain just because of medication equivalence to morphine limiting doses. Many pain patients were left to fend for themselves and physicians were afraid to prescribe opioid drugs. As a result physician prescribing dropped 35-40%, but illicit drug use & the overdose death rate rose by 35-40% which indicates that our nation's opioid addiction epidemic is not because doctors prescribe pain medications directly. Yes, exposure to prescription opioid drugs can trigger opioid craving initially, but that is why the state board guidelines, medical school and residency training have to instill that physicians have a responsibility to monitor patients with regular office visits, urine drug screening, PDPM / CURES monitoring, and total primary care management. The system requires that physicians be given the latitude to manage patient chronic pain without government rigid controls or doctors just won't risk treatment. It is important to remember that chronic pain is a SYMPTOM not a specific disease. Pain is present in every single specialty of medicine from newborn to geriatric, psychiatry to pediatrics, surgery to urology, ER to GI, dermatology to orthopedics, etc. in fact every single specialty except for pathology because the patient is deceased. The other issue is that 80% of pain doctors are anesthesia based interventional doctors who focus on procedures because remuneration is high. Primary care doctors do not feel comfortable treating pain and prescribing scheduled drugs and Interventional Pain doctors return patients to primary care refusing to continue opioid therapy. Patients end up suffering. 1 in 4-5 Americans suffer with chronic pain (100 million people) and primary care is absent. Many doctors use NSAIDS but NSAIDS cause GI bleeding, Renal failure and insufficiency, Stroke increase, Cardiovascular disorders like myocardial infarction. Over 120,000 hospital admissions every year are due to the contribution of NSAID therapy, and at least 10-15,000 deaths (10-15% of the opioid overdose death rate) are indirectly related to CHRONIC NSAID USE. To date, Opioid therapy is the gold standard for pain management. In my 39 years of practice not one patient died due to prescriptions of opioid drugs for chronic pain because every single patient saw me monthly for the first year and every 1-3 months thereafter. Every single patient underwent urine drug screens & the PDPM checked four times a year or more, families were involved, & every 6 months the option for treatment of opioid induced hyperalgesia (after 2005) w/ SUBUTEX / SUBOXONE. (SEE MY DOWNLOADED ABSTRACTS). Chronic pain is always due to multiple tissue types (nerve, tendon, musculoskeletal, joint, psychiatric, impingement syndromes, vascular, somatic, visceral, etc.) & every single complaint of chronic pain must be analyzed by the primary care doctor to identify the target of treatment. Unfortunately, too many doctors want to blame a ruptured disc, or a torn meniscus, etc but unless the pain complaints objectively match diagnostic and examination findings the pain complaint may be related to other issues. Pain is not a curable disease and chronic opioid use can cause opioid induce hyperalgesia which can complicate treatment. If limits of MED are raised, specific approaches regarding safe titration & correct dosing are extremely important. With a shortage of primary care physicians of 35-45 thousand physicians by 2030 the only way to alleviate the treatment of pain is better training. An example is a young veteran who left Wyoming & entered an addiction treatment program in [city name redacted]. He had 18 months of severe 9-10/10 left abdominal & costal margin pain constantly. He had seen 8 different doctors, GI, Primary Care, ER, Psych, Interventional pain, and General surgery. He had an elective lap cholecystectomy even though the pain was over the opposite side of the abdomen & he had no biliary disease. He underwent an epidural & when he arrived he was on 300 mg of OXYCODONE daily, illicit Methadone, & illicit fentanyl, & ALPRAZOLAM 2 mg TID along w/GABAPENTIN. I consulted via TELEMEDICINE & immediately diagnosed an uncommon condition Accessory Nerve Impingement Syndrome w? Severe opioid induced hyperalgesia due to withdrawal symptoms of diarrhea, Nausea, vomitting, sweats, etc. Long story short, after 1 week of treatment his pain was <4-5/10 & by 3 weeks it was 0/10. I spoke with his VA doctor 3 weeks ago after his discharge & on SUBOXONE maintenance 24 mg SL daily, LYRICA 25 mg TID, IMIPRAMINE 30 MG DAILY, LIDODERM PATCH AND VOLTERAN GEL OVER HIS LEFT abdomen & left lower chest. A well trained pain oriented primary care, even by telemedicine, can treat an individual this complex. He was thrilled & his fiancee was grateful. If she had not made him come out for rehab, his fate was likely very poor.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rick	None	None	0900006484fba8b7	Chavez	None	2022-03-08T16:03:25Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-04T05:00:00Z	None	None	None	None	None	None	None	Comment from Chavez, Rick	l0c-wcbk-5g4s	False	None	False	2022-04-12 04:16:59.957	[]
2042	CDC-2022-0024-2048	https://api.regulations.gov/v4/comments/CDC-2022-0024-2048	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read the new revised 2022 Guideline for opioid prescribing very carefully. I applaud the CDC effort to soften the language from the earthshaking 2016 Guideline. But it does not go far enough to undo the damage. There needs to be strong wording to prevent more patient harm. Doctors are trained to determine if a patient is a drug abuser. The doctor/patient relationship has been badly torn. There is no longer trust be doctors and their patients. <br/><br/>It should be worded like this:<br/>“No entity, whether a pharmacy, an insurance company, state legislature,local police or your friendly neighborhood busybody, shall interfere with the sanctity of the doctor/patient relationship. This includes medical licensing boards. The Board of Medical Examiners is responsible for the prevention of sexual misconduct, criminal activity, gross medical errors, unnecessary surgeries and procedures, insurance fraud and extortion. They are not meant to discipline a doctor or revoke the license of a doctor simply because he prescribes an opioid Furthermore, no doctor shall be imprisoned solely because he prescribed pain relievers for his patient. No doctor shall be imprisoned for the death of a patient.<br/><br/>These kinds of measures have created terror among doctors. Doctors and nurse practitioners are afraid to continue important treatments if a patient is old enough to die naturally. No doctor wants to care for a potentially terminal patient. <br/><br/>I,also, strongly disagree with the listing of specific illnesses that justify the use of opioid pain relievers such as cancer, sickle cell anemia and end of life. That, by default, excludes many other diseases and conditions. I don’t believe opioids should be given for ordinary back pain. There are many modalities to effectively treat muscular skeletal conditions. They now call it “evidence based”. That is a trendy euphemism to mean non-opioid and does not belong in a government issued document. I have strong stubborn pain in the front tops of my legs due to multiple sclerosis. There is no exercise, epidural or meditation that can relieve it. Therefore, I recommend the elimination of specific diseases unless the guideline lists every rare painful condition possible. I understand that the diseases were mere examples just like the recommended opioid limits. But they became law. End of life is very different. Since no doctor can precisely determine the date and time a patient will die pain treatments are routinely withheld. Wouldn’t you like to have the assurance that your pain will be treated while you are dying?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484fbe1c7	Limahelu	None	2022-03-08T16:19:33Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Limahelu , Carol	l0h-4zko-lk06	False	None	False	2022-04-12 04:17:00.248	[]
2043	CDC-2022-0024-2049	https://api.regulations.gov/v4/comments/CDC-2022-0024-2049	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Release our medication... We have worked hard for America... Our bodies are broken... Many have died under current laws, seeking street drugs.. All those deaths are on you! Funny your grandparents have pain??? Let our family Doctors give us meds they know who we are... They know our illnesses.. You force us to see Dr. Who don't care... We are a prescription...A fee.. They look at us as money.. Not people.. How dare you treat us like trash... We are not throw aways.. We are people... Hopefully one day you will suffer... Like us... I want to play with my grandchildren I want to cook family meals I want to play on the trampoline with my kids I want to work in my garden I want to have flowers.. you are preventing this instead I lay on the couch and pain because of your loss.. you have took my life and you've took millions of others' lives and reduced us to nothing that can participate in life... How is that... okay... Change the laws let us see the doctor that has known as for 20 years and they know our illnesses they know our pain.. quit making us go to doctors that only see money signs and they don't even give us enough pain medicine that we can participate in life.. what gives you the god-given right to take responsibility for ensuring that we have pain that we can't walk that we can't run that we can no longer participate with our families...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fbe207	Lowder	None	2022-03-08T16:19:53Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Lowder, Donna	l0h-5ac4-4elg	False	None	False	2022-04-12 04:17:00.464	[]
2044	CDC-2022-0024-2050	https://api.regulations.gov/v4/comments/CDC-2022-0024-2050	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand that you are taking comments in advance of revising guidelines for prescribing opioids. I would like to implore you to add Willis-Eckbom Disease or Restless Leg Syndrome (RLS) to your list of diseases which merit the use of Opioids. RLS is a particularly debilitating disease, it is known to be a central nervous system disease which causes the legs to have a strong desire to move which is alleviated by moving the legs. As the disease progresses moving the legs does not provide relief, one must get out of bed and walk to alleviate symptoms. It takes 20 to 40 minutes of walking to completely eliminate the symptoms after which you return to bed, only to have the cycle bag in again almost immediately. As the disease continues to progress you get less and less sleep. In severe cases there is almost no sleep, anxiety is very high as well as deep depression and thoughts of suicide. There would be no relief were it not for many drugs most of which are used “off label”. Drugs that are prescribed in the early stages are; sleeping pills and muscle relaxers, while these may have been found effective in some cases, these drugs did nothing for me. Gabapentin is sometimes effective but had limited effect in me. Ropinirole, a drug designed to treat Parkinson’s is very effective in treatment of RLS but in a subset of perhaps 20% of patients, Ropinirole increases the severity of the disease over time, and causes the symptoms to effect other parts of the body. The arms, the torso and sometimes the face. Severe symptoms are quite painful and will not resolve quickly. They require constant walking. The severe RLS patient spends many hours of the day pacing the house although completely exhausted, and walking all night, being forced out of bed 6 or more times a night with no nap possible. This leads to enormous stress for the spouse of the zombie. I’m not exaggerating one iota. The other medications that have proven effective are benzodiazepines which worked initially for me but then lost their effectiveness, and opioids. Beyond that there is nothing. Fortunately, some prominent physicians have found that opioids like methadone work well to control the disease and provide sleep and are well tolerated. The first of these doctors was [name redacted] in 1672. In 1685 he wrote in the “London Practice of Physick”. “ Wherefore to some, when being abed they betake themselves to sleep, presently in the arms and legs, leapings and contractions on the tendons, and so great a restlessness and tossings of other members ensue, that the diseased are no more able to sleep, than if they were in a place of the greatest torture.”. I wholeheartedly agree that it is a place of the greatest torture”. [name redacted] of Johns Hopkins Medical Center has had much success with his severe patients using methadone. One year ago, my doctor prescribed methadone for my severe RLS. It has truly changed my life. I can sleep with only a few episodes and I feel more energy during the day. I learned a long time ago that methadone was effective in treatment of difficult RLS. It has taken years to find a doctor who was compassionate enough and willing to take on the burden of prescribing methadone for me. I understand the concern over the tragedy of opioid addiction caused by over prescribing of opioids but people who have abused the use of opioids have made it very difficult for patients who genuinely need the powerful effects of opioids when used appropriately. Doctors and pharmacies have been reluctant to release these drugs but under the tightest of circumstances which has made it a difficulty for the patient to obtain their prescription. I guess that is just the way it is but PLEASE, do add severe or difficult Willis-Ekbom Disease, RLS, to the list of diseases for which the use of opioids is appropriate. Thank you. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484fbe21a	Leeuw	None	2022-03-08T16:21:45Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Leeuw, Charles	l0h-5ctd-8bkk	False	None	False	2022-04-12 04:17:00.686	[]
2045	CDC-2022-0024-2051	https://api.regulations.gov/v4/comments/CDC-2022-0024-2051	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For appx. 10 years, I seen multiple Dr.s, tried almost every suggestion ever given to me but other than a MVA in 2003 where I fractured a vertebrae in my back and multiple ribs, no single Dr. ever got me figured out. I always heard oh its musculoskeletal pain, not much we can do. Yet every year, the pain continued. My neck and back were obviously shot from the accident, but I continued to have chronic unrelenting flank pain. YEARS into this, in 2019 I got a CT scan done as I was having extreme flank pain. That CT scan showed multiple kidney stones and a pelvis full of vein stones called phleboliths. After doing some research, I came across a syndrome that was very rare but it matched so well I went back to urologist and asked him about it. We then did another ct scan but this time an angio CT to look better at the vessels. BAM! 10 years later and I had to diagnose MYSELF with a Nutcracker Syndrome. It is compression of your left renal vein by your aorta and SMA(2 arteries) This compression has a prevalence last I checked of like 0.072%!! This compression stops the blood from flowing through your body accurately. It cannot get through the left kidney…..its blocked. That blockage cannot be opened and therefore blood starts pooling, refluxing and then pain worsens. It’s like having severe varicose veins inside your abdomen and back! That and chronic hematuria(blood in urine) and chronic kidney stones. There are NO GUIDELINES FOR RARE DISEASES! There are some for kidney stones which everyone knows is extremely painful. My PCP said if it was normal stones, it would be short term and then he could prescribe pain meds but since I get them often, then I have to go to pain management and he will not help me.<br/>So I finally had a diagnosis but had no idea the hell it opened! Good luck finding a Dr or surgeon that even knows what it IS let alone treat it! I traveled out of state to a specialist at 1st, recommended to have a renal autotransplant but due to the low numbers of those performed and the fact that I work in surgery, I am a circulating RN in the Operating Room....unless there is a surgery that is very well researched, done multiple times and has a high success rate, I am not/will not just jump into ANY surgery! The only thing that has remotely helped me through these years has been opioid therapy. Its seemed as if all Drs wanted to do though was put you on 5-10 other medications for different things instead of just the opioid (Ex.s:anti-depressants, muscle relaxers, anti-inflammatories, nerve meds, sleeping meds, etc) I want to take as little of medications as I have to and if over the years I have tried almost every therapy, injections, medications, etc and If I tell you that through all of that I know what has worked best for ME, then WHY in AMERICA can I not find a Dr. to help me?! Why is my word doubted in MY BODY?! This is MY health right? Why are Doctors and the CDC deciding how I should be treated medically or medicinally? I was told that due to the rareness of my syndrome and the realization that it’s going to continue to be hard to find a DR to treat me, I was told I needed to switch onto Suboxone and get off opioids cause “I could not be on opioids any more long term”. I researched Suboxone better and decided no way in hell was I going to switch to something just as bad and harder to get off of?! I was sent on my way with a taper script!! Since that time, I have NOT went into the Dr office other than the 2 times required for other med check. I refuse! I'm a nurse and yet I've been on "medical strike" now over a year! I have no faith or hope in the medical field anymore! I am living in agony and pain and yet I'm supposed to feel good enough to travel across the country to find someone who may be able to help me!? I paid $1,200 for a consult in Germany to confirm all my findings here in US.....over a year and multiple times asked, this report has yet to get into my medical chart STILL!! I am angry. I am bitter. I’m so fed up! Feels like nobody gives a damn in this world anymore and nobody cares how many suicides are occurring in chronic pain patients since CDC overstepped and created hell on earth. Only stats people hear are the overdoses! Report accurately CDC! Majority of the O.D.s are from street drugs NOT chronic pain patients.....it is from Fentanyl, not prescribed opioids!!! And shame on you also for trying to convert pain patients over to Buprenorphine, Suboxone & Methadone!!! Majority are NOT addicts and these medications are EQUAL OR WORSE!!!!<br/>These guidelines absolutely need to REVERSE!!! Doctors should be the ones deciding about their patients need for pain control! If things don’t change, keep on tallying deaths people cause it’s only going to get worse! <br/>WHO CARES though right?!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denesa	None	None	0900006484fbe71c	Lutterman	None	2022-03-08T16:22:23Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Lutterman, Denesa	l0h-chde-i67e	False	None	False	2022-04-12 04:17:00.911	[]
2046	CDC-2022-0024-2052	https://api.regulations.gov/v4/comments/CDC-2022-0024-2052	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>The Food and Drug Administration (FDA) Notice: Patient-Focused Drug Development on Chronic Pain; Public Meeting; Request for Comments<br/><br/>Submitted 3/7/2022<br/>Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain.<br/>I am aware that RLS is not recognized as a chronic pain condition. However, it is a chronic condition that severely restricts basic life functions and negatively affects quality of life. In many cases, RLS can be treated effectively with a low-dose opioid. Thus, I am requesting that any opioid regulation or legislation recognize the validity and efficacy of opioids to treat RLS. Commonsense regulation or legislation must rely upon doctors and pharmacists who responsibly prescribe and dispense medications that are needed by patients. To explain why, I would like to recount my experience with RLS and various drug regimens over the past 10 years.<br/>About 10 years ago at age 50 I was suddenly unable to sleep through the night. Each morning I woke up groggy, tired, and unable to do all the things in life that I enjoy – exercising each morning, working full-time as a county library director, attending evening meetings, and enjoying time with my family. <br/>Following a sleep study, I was diagnosed with RLS. Hundreds and hundreds of involuntary leg movements kept waking me up and preventing me from sleeping. At that time, my internist prescribed a dopamine agonist, Requip. After a year or so, my symptoms (and sleep) worsened. My internist thought the answer was to take a higher dose of the drug. I was leery of doing so. She had already increased the dosage once during the past year, and my symptoms only got worse. Fortunately, I found an RLS specialist [name redacted] at Johns Hopkins University, 90 miles from my home. <br/>[name redacted] confirmed my diagnosis and explained that Requip was doomed to fail as its half-life was 4 hours. This would not allow me to sleep 8 hours. He recommended another longer-acting dopamine agonist, Mirapex. However, he warned me that eventually Mirapex might also become ineffective as studies had shown that while most patients initially responded well to dopaminergic drugs, their efficacy diminished and symptoms actually worsened over time. <br/>This happened to me. Three years ago Mirapex was no longer effective and my symptoms worsened. This meant that I couldn’t sit and read a book in the afternoon, sit comfortably through meetings, watch TV, or sleep through the night without needing to get up and walk or move to relieve my legs’ painful, twitchy, jumpy, involuntary muscle spasms. <br/>I returned to [name redacted] for help. He explained that I needed to take a 10-day “drug holiday” from any dopaminergic drugs, and then move to new drugs. I stopped taking Mirapex and shortly experienced the worst 10 days of my life.<br/>Due to the severity of my RLS symptoms, I was unable to sleep at all for at least three days, pacing constantly through the night. I was exhausted, but unable to sleep due to painful, involuntary muscle spasms in my legs. By the fourth day, my body crashed. I slept for an hour or so that night, and then was up again pacing the house, desperate for any relief. For the next six days I slept intermittently for 10-20 minute periods, totaling about 1 ½ hours, each night. I thought I might lose my mind. I was unable to work or do much else. (In my 25-year career as a librarian, I had never taken a sick day. Suddenly I was unable to work for a month.) In addition, my condition not only affected me, but also my family's activities as they cared for me.<br/>After 10 days, [name redacted] moved me to a new class of drugs, alpha-2-delta ligands (Gabapentin). After testing various dosage levels, we settled on 1600 mg/day. However, my symptoms were still not entirely under control. [name redacted] then prescribed a low-dose (10 mg) of Oxycontin to be taken with the Gabapentin. Finally, I experienced relief. I could now return to normal, everyday activities. I have been on this drug regimen for 3 years now and have found it to be very effective. <br/>Thus, as new guidelines are developed, I am asking the FDA to recognize the validity and efficacy of an opioid to treat RLS. <br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jonelle	None	None	0900006484fbe239	Darr	None	2022-03-08T16:23:48Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Darr, Jonelle	l0h-5in1-q5x2	False	None	False	2022-04-12 04:17:01.123	[]
2047	CDC-2022-0024-2053	https://api.regulations.gov/v4/comments/CDC-2022-0024-2053	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opiate drugs have the potential for harm, but they also have the proven ability to relieve pain, particularly in the short term. I recently had surgery and was surprised, upon waking up from anesthesia, to hear that I would not be prescribed opiate painkillers to deal with the pain and discomfort that the doctor has told me would last for about a week after the procedure. (This surgery, in years past, would have generally always called for a short-term prescription.) The result was days of teeth-clenching pain and a panicked call from my partner to the doctor, who eventually did prescribe a week's worth of opiate painkillers. As expected, I remained comfortable on the new drugs for the several additional days it took to heal; the drugs worked as they were intended. I know from talking to others that have had medical procedures in recent years (including one friend who broke her leg and was urged to double-up on Advil) that my case is far from the exception. <br/><br/>Denying regular patients proper treatment for pain and instead treating them like potential drug addicts in an effort to avoid liability is both unconscionable and unnecessary. Short-term opiate prescriptions allow people to heal in comfort, rather than in pain, and avoid the potential for addiction and abuse. Let's not throw the baby out with the bathwater—there are appropriate, safe uses for opiate painkillers, and not simply as a last resort.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dylan	None	None	0900006484fbe254	Kerr	None	2022-03-08T16:24:23Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Kerr, Dylan	l0h-5r0e-bjmk	False	None	False	2022-04-12 04:17:01.347	[]
2048	CDC-2022-0024-2054	https://api.regulations.gov/v4/comments/CDC-2022-0024-2054	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I know of three people who were in terrible pain because of sudden restrictions on painkillers. Two of them committed suicide and the third left the US.<br/>They were in terrible pain that opiods managed, allowing them to have fuller lives, to be with their loved ones, to work and to stay alive.<br/><br/>Unreasonable restriction killed them. Their doctors were afraid to prescribe. Please make this stop. I realized there was abuse, but we need to figure out how to deal with abuse WITHOUT HURTING PEOPLE!<br/><br/>a. we need a way to QUICKLY verify that people are in pain that cannot be controlled with other methods.<br/>once that happens, and can be noted, doctors and prescribers should be safe from harassment and prosecution.<br/><br/>b. we need protections for doctors who prescribe so that they are innocent until proven guilty - not put out of practice over allegations.<br/><br/>c. for Christ's sake, find something useful for the DEA to do. This feared and corrupt agency has caused enough pain and death. Teach them to fill potholes and convert paper to digital data.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe2b4	Anonymous	None	2022-03-08T16:24:56Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-62dm-4z6v	False	None	False	2022-04-12 04:17:01.561	[]
2049	CDC-2022-0024-2055	https://api.regulations.gov/v4/comments/CDC-2022-0024-2055	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The original opiate guidelines of 2016 basically painted targets on the backs of chronic pain sufferers. We were a captive audience at the mercy of doctors, insurance companies, the DEA, pharmacies, politicians and anyone else who wanted to weight in. In the meantime, our voice, our input, our experience was shouted down and completely ignored. <br/>If someone would have paid attention to what we were saying and included our concerns as patients in the process of making policy (opiate guidelines), we would not be seeing this crazy problem with opiates. Policy makers were convinced that drastically cutting prescriptions would cure the slow rise in opiate related deaths but the reality of it created the exact opposite result. So many patients were just cut loose and basically sent to the streets in search of pain relief. Since 2016, the deaths from illicit opiates have skyrocketed upwards. <br/>Let no one be fooled here with these updates to the CDC opiate guidelines. You’ll hear in the news that this is some attempt to be conciliatory towards the patient and make for a better doctor\patient relationship but make no mistake here because that simply isn’t true. Don’t buy this narrative. <br/>The intent of the guidelines, old and new, are really designed to get control of the opiate issue and nothing else. I frankly don’t see any real olive branch being extended to the chronic pain patient so it will likely be business as usual just like before. These new guidelines, coupled with SB 2235, will further turn off even more doctors, leaving patients in the lurch once again. <br/>Given the recent opiate settlements with its millions and billions of dollars, I encourage everyone to follow this money very carefully. The smell of this money is tainted with the stink of greed and it will be very interesting to see exactly where it all goes. How much will go the individual and the supposed damage done to them? How much more of it will pile into a government coffer and where will it go from there?<br/>If our leaders truly want to cure this opiate issue, then they need to take the blinders off and face up to the reality. Right now, all they are seeing is their own myopic narrative. It’s almost as if they refuse to see the correlation of CDC graphs that show the results of the 2016 effort. They are blinded by their own ignorance and driven by their own narrative. They will let down by their own stubbornness once again. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fbe2b8	Cook	None	2022-03-08T16:25:40Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l0h-659y-gptc	False	None	False	2022-04-12 04:17:01.798	[]
2050	CDC-2022-0024-2056	https://api.regulations.gov/v4/comments/CDC-2022-0024-2056	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>I am a 52 year old woman who has been diagnosed with Hemi Crania Continua. I have not been with out a headache in seven years. I am allergic to several medications including all nsaids and aspirin. I have even tried being desensitized to Indomethicin the drug commonly used for my condition. I had a reaction with only a very small dose. I have tried so many different medications. I have had several allergic reations, dystonic reaction, adverse reactions or they just didn't work. About two years into this disease I was hospitalized twice for suicidal ideation. After being released I found a doctor who wanted nothing more to help me. He could see my pain and decided that in addition to topirimate and gabbapentin that he would prescribe MS Contin. It helped within two days. I was able to function normal activities, get sleep and take good care of my family...fast forward to 2017 the doctor I was seeing moved and I got a new doctor. She asked if I was comfortable weaning off my meds and I was feeling so much better I agreed and was prescribed 32 hydrocodone a month. That doctor moved to new clinic and now have a doctor who wants me to "suffer" through my migraines. I am down to six hydrocodone a month and just got out of the hospital for suicidal ideation. I have been labeled a "drug seeker" with our local ER. I am hopeless, angry and not knowing where to turn. Just because I have a silent illness, doest that mean I am not worthy of pain relief as someone who has cancer. I should just suffer because of that. Please reconsider the guidelines. People with chronic pain don't neccessarily want to die, they want to live, they want to do just normal everyday things. Thank you for your time in this matter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe2d3	Anonymous	None	2022-03-08T16:26:03Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-67uk-sfqt	False	None	False	2022-04-12 04:17:02.066	[]
2051	CDC-2022-0024-2057	https://api.regulations.gov/v4/comments/CDC-2022-0024-2057	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife, [Name Redacted] had a Sprint PNS implant in her right popliteal on November 24, 2021 and it was removed on February 8, 2022. <br/><br/>Prior to the PNS implant, she had experienced increasing pain in both feet since 2008 and the severity progressed until by 2010 whenever she walked or stood for more that 10 - 15 minutes. The pain had been diagnoised as arthritis and cartilage degeneration and was so severe that she was unable to function in normal housewife functions such as shopping for food, cooking meals or doing general housework. After visiting several orthopedic surgeons in 2013 she had her right foot rebuilt with several fusions in an attempt to relieve the pain. After a 6 month recovery period, the pain reoccured as soon as she attempted normal duties. We tried many anti inflammatory drugs and had several injections of steroids, Gadodiamide, Lidocaine & Kenalog 40mg medications, but with no lasting pain relief. <br/><br/>Finally in November at [Location Redacted] she had the Sprint PNS implant in back of her right knee. It has been a little over a month since the implant was removed and the results have been more than we could have hoped for. Her pain, which I would rate as a 9 when she was active is now a 1 in her right foot. Additionally, the pain in her left foot has diminished to a 2 or a 3 when she is active. We are so pleased with the results of this procedure that we wanted others who suffer from arthritis or cartilage degeneration foot pain to be aware of our success with this treatment<span style='padding-left: 30px'></span><br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Russ	None	None	0900006484fbea75	Goldstein	None	2022-03-08T16:26:06Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Goldstein, Russ	l0h-gviv-6vmj	False	None	False	2022-04-12 04:17:02.273	[]
2052	CDC-2022-0024-2058	https://api.regulations.gov/v4/comments/CDC-2022-0024-2058	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my name is [name redacted] and I have been affected by the guidelines I’ve had 2 back surgeries need a neck surgery I’ve had a stroke I was out on 4 oxycodone and I was doing good then one day they cut me in half for no reason at all I went by all their rules pill counts urine screens and I got so scared because I knew 2 pills would not help my pain so a friend referred me to a dr and all he offered was subutex and I wasn’t in the position to turn it down however it does nothing for pain and now I have great insurance and been trying to get pain management but no dr will see me now because I took the subutex I’m not an addict however I need pain meds daily.. please help us people that are suffering I’m only 45 years old I shouldn’t be living the way I am…	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tonia	None	None	0900006484fbe033	Hawkins	None	2022-03-08T16:26:40Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Hawkins , Tonia	l0h-7ee5-q5kl	False	None	False	2022-04-12 04:17:02.484	[]
2053	CDC-2022-0024-2059	https://api.regulations.gov/v4/comments/CDC-2022-0024-2059	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please ensure your recommendations take into account people like myself that have chronic pain that will never go away due to permanent disabilities and injuries. I wish to remain a useful and functioning member of society. I have been taking the same LOW dose of Tramadol for 10 years now. I haven't increased my prescription- in fact it's been cut in half thanks to your [vulgar word redacted] guidelines. So now I'm back to supplementing the Tramadol with higher levels of ibuprofen and cbd ointments in order to manage my pain levels enough so that I can continue to work.<br/><br/>Your ill-thought out recommendations mean I have to jump through hurdles every time I need to refill a prescription and heaven forbid if my primary care physician doesn't have an open appt when I need it and I have to see another doctor. It is past time you stop treating the many that use pain medication responsibly like the opioid addicts who don't.<br/><br/>We work and live almost normally with the benefit of pain medication. Without it- our lives are nothing but day after day of endless pain and depression. As it is- I ensure I take only the amount I need to keep the edge off the pain. I want and need to function without impairment for my job so I have no desire to use any more Tramadol than I need. But without it, I can't. Until I was prescribed this effective pain management option- I too considered suicide as an alternative to the pain.<br/><br/>Until you've lived your life battling severe and constant pain every day- you have no idea. Please stop interfering in our RIGHT to live our lives pain-free or pain-reduced. The whole point of medical care is improve lives and help care for patients. When your regulations cause undue pain and suffering- you are failing in that job. <br/>Stop hurting us under the pretext of "saving us".	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe050	Anonymous	None	2022-03-08T16:27:42Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-7hku-63mt	False	None	False	2022-04-12 04:17:02.723	[]
2054	CDC-2022-0024-2060	https://api.regulations.gov/v4/comments/CDC-2022-0024-2060	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to ensure that your new rules allow patients in pain to get the drugs they need. I know people who were not at all "addicted" to opioids, but had their medication arbitrarily reduced. For most people on long term opioids, this is the only way they can survive. And survive, they do, going for decades without overdosing, or encountering any other problems. They must be allowed their current medications since they obviously need them.<br/><br/>I know what you're afraid of: death by overdose.<br/><br/>When does this occur? With street heroin, where the strength is not known; with street fentanyl, where the strength is not known. With street meth, where the strength is not known.<br/><br/>That is the beauty of prescribed opioids. Doctor and patient know exactly what is prescribed, and how and when to take it. In these cases, overdoses are extremely rare.<br/><br/>The CDC and DEA have such done such a terrible job by threatening doctors with loss of license and jail, that not only do they not prescribe, but manufacturers do not make enough!<br/><br/>I know for a FACT that in December 2021, CVS, the world's largest pharmacy chain and Optum, one of the largest, if the not The largest drug plan, had Completely run out of Oxycodone, in any strength. Optum had a tiny bit of Hydrocone to tide people over so that they did not DIE from sudden withdrawal.<br/><br/>This outrageous restriction must stop.<br/><br/>You are punishing some of the most vulnerable people in America - people who must have pain medication.<br/><br/>Naturally, a few doctors are criminals. Very few. The rest are working honestly to give people the opioids they must have. Alcohol is far worse, and has only age restrictions, which stop no teen-ager from getting it.<br/><br/>Let doctors prescribe the opioids their patients need without CDC over-restrictions.<br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark A. KoppelPh.D.	None	None	0900006484fbe07d	KoppelPh.D.	None	2022-03-08T16:28:28Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from KoppelPh.D., Mark A. KoppelPh.D.	l0h-7t4m-lzqt	False	None	False	2022-04-12 04:17:02.936	[]
2055	CDC-2022-0024-2061	https://api.regulations.gov/v4/comments/CDC-2022-0024-2061	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with Complex Regional Pain Syndrome or CRPS, (also known as Regional Sympathetic Dystrophy, or RSD), since 2015. It is regarded as the most painful condition known to medicine. It is more painful than cancer, amputation, and childbirth. It is called the “the suicide disease,” for good reason - the pain is unrelenting, measured at a 48 on the McGill Pain Index of 50, and is incurable while inevitably getting worse over time.<br/><br/>Many patients with complex regional pain syndrome (CRPS) have been known to be at high risk of suicide, due to severe pain and its comorbid conditions. Suicides, for CRPS sufferers, started climbing after the CDC released its 2016 opioid prescribing guidelines, and pain medication became harder to get.<br/><br/>The opioid rules need to be adjusted, so chronic pain patience, that desperately need this medicine to survive, are not lumped into the same category as addicts. Specific legislative protection protecting CRPS and other chronic pain patients and their physicians from rigid regulatory interpretation WILL SAVE LIVES. The problem is not restrictive laws, it is restrictive regulatory action, and chronic pain patients and their doctors need special protections. Exempting CRPS and chronic pain, from 30-day refill and dosing limitations compounded with physical physician visit requirements, which literally prevent us from travel, family functions and other quality of life activities, will clear the way for physicians to adequately treat CRPS victims.<br/><br/>I live on the [Location Redacted] Colorado, in a rural area. All the doctors here are either, at their limit of prescribing pain pills, or they are terrified they will lose their license. I have no other choice, but to travel 6 hours to Denver, every 90 days, to meet with a pain management doctor, that is willing to prescribe pain pills. This is a hardship that I am willing to go through, instead of spending one day in hell on earth, without pain pills. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jana	None	None	0900006484fbeb1a	Powell	None	2022-03-08T16:28:38Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Powell, Jana	l0h-icua-q3rb	False	None	False	2022-04-12 04:17:03.147	[]
2056	CDC-2022-0024-2062	https://api.regulations.gov/v4/comments/CDC-2022-0024-2062	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	During my career as an Internal Medicine physician, I once had a patient transferring into my practice from another state. Her chief complaint was the complications of Reflex Sympathetic Dystrophy (RSD), now known as Complex Regional Pain Syndrome (CRPS). Doctors are always concerned about patients who "doctor shop." I was initially fearful that she was one of them...until I read the medical records she brought with her. A motor vehicle accident(MVA) had left her with severe nerve damage in her neck. Even though I read her records, I still wondered how much pain she really had. As fate would have it, a year later, I was involved in a MVA in which my left leg was crushed. I soon learned how much pain could be inflicted on the human body. Through physical therapy, surgeries, and medication, I am able to endure. My medication regimen includes opioids administered by a pain clinic. Anybody who says that opioids are not appropriate or helpful for chronic pain has never experienced the pain I have had since 11/28/1996. I hope that the prescribing regulations regarding opioids will be revisited so that people with real physical pain are not punished because others have abused this medication. I appreciate the time you will take to study this matter. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe0e6	Anonymous	None	2022-03-08T16:29:21Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-8eko-cdfs	False	None	False	2022-04-12 04:17:03.377	[]
2057	CDC-2022-0024-2063	https://api.regulations.gov/v4/comments/CDC-2022-0024-2063	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 49 yo woman who has already had bi-lateral hip and bi-lateral knee replacements. I have anklydosing spondylitis, horrible arthritis pain, plantar fasciitis, and many other ailments. I quit going to a pain management doctor because all they wanted to give me was steroid shots. I have tried these numerous times with no relief. I know just live with the pain because I feel that I have no where to go. Most doctors I know refuse to prescribe any type of opioid for fear. IMO it doesn’t matter because look at the death rate. If an addict wants it they will ding it and usually on the black market where it can be laced with something else. Please consider lessening the guidelines so that people like me have a place to turn to!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn	None	None	0900006484fbeb59	Satterfield	None	2022-03-08T16:29:32Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Satterfield , Dawn	l0h-iyju-zuhh	False	None	False	2022-04-12 04:17:03.621	[]
2058	CDC-2022-0024-2064	https://api.regulations.gov/v4/comments/CDC-2022-0024-2064	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in a bad accident in 2021- on my bicycle, struck by and pinned under an SUV. 12 surgeries in, and in chronic daily pain, I struggle to find adequate pain management. My pain clinic has reduced me to one 5mg oxycodone a day. I have been in even more spiking, terrible pain for a month, reduced from being able to go up to 1 mile a day to barely making it to my bathroom. My latest CT scan shows I now have bone fragments rattling around in my pelvis and need a hip replacement. I begged my pain management to please hear me about my suffering, yet no prescription change was made. <br/><br/>I suffer daily. The pain makes it hard to concentrate on conversations, prevents me from actively parenting my children, and I struggle with actively participating in my own life. I make a calculation daily about whether I should use my allocation to be able to get any physical activity during the day….and get almost no sleep because I’m so uncomfortable or save my pill so I can sleep, or try to go a couple of days so I can get out of my bed on weekends to go anywhere with my kids. <br/><br/>Worries about my pain results in huge spikes in anxiety; yet despite a diagnosis of both general anxiety disorder and PTSD, my pain management clinic prevents my psychiatrist and primary care doctor from prescribing anti-anxiety medications, which only compounds my stress and further reduces my quality of life. In desperation for any relief from anxiety, I can’t turn to marijuana, which has been legal in my state for a long time for medical purposes and for general recreational use for a few years. I have brought NIH studies to appointments to show that anxiety and pain are two separate things, and I deserve help as the two go hand in hand. My escalating pain gives me unmanageable anxiety. <br/><br/>I am suffering and penalized for others’ addictions. I have nowhere to turn for the help I need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anna	None	None	0900006484fbeb5f	Moser	None	2022-03-08T16:31:55Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Moser, Anna	l0h-j0w2-pzdj	False	None	False	2022-04-12 04:17:03.829	[]
2059	CDC-2022-0024-2065	https://api.regulations.gov/v4/comments/CDC-2022-0024-2065	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a mother. I work. I am in chronic pain with a rare genetic condition. My daily opioids are prescribed by a pain clinic. Am I addicted? To the pills no but I am addicted to being able to have a life. To laugh. To be able to focus. Also without pain medication I cannot do physical therapy which allows me my only chance to stall a degenerative condition. This describes almost everyone I know who is a long term opioid patient. This hysteria has left those of us in long term care stranded and afraid. There are many medical conditions which might seem rare and strange to doctors which is why those who are trained to work with us need latitude. They are experts and should not be sidelined by general regulation that only looks at post operative care.<br/>If by removing opioids the idea is to save lives this is not what will do it. The reverse is true. The rise of pain related suicide is a steep cliff. Until there is a solution as effective as opioids on the general market this is the only tool disabled and chronic pain patients have. Please do not remove the one way we have to live the fullest life we are able to.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monica	None	None	0900006484fbeb6d	Laipple	None	2022-03-08T16:34:17Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Laipple, Monica	l0h-j5ea-q1ge	False	None	False	2022-04-12 04:17:04.064	[]
2060	CDC-2022-0024-2066	https://api.regulations.gov/v4/comments/CDC-2022-0024-2066	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket Number:<br/>CDC-2022-0024<br/><br/>It’s nice to see the 2022 draft CDC guideline a little different than the 2016 guideline and that you acknowledge the harm it has caused pain patients, but there are still a few concerning things in it. Many pain patients have already gone through the alternative treatments you recommend and are already seeing a Pain Management Specialist because the alternative treatments failed to relieve their pain. You should stress in the final 2022 CDC guideline that these recommendations are NOT for Pain Management Specialists and bring it to the attention of Law Enforcement (DEA), other Government agencies and State Medical Boards that a Pain Management Specialist is most likely to be a higher prescriber than other Physicians, Nurse Practitioners and Physician Assistants and this is not a reason to threaten, coerce, charge, prosecute or imprison a Pain Management Specialist.<br/><br/>Morphine Milligram Equivalent (MME) should not be mentioned or recommended anywhere in the final 2022 CDC guideline. Using 90, 50 or any MME dosage as a recommended dose will inevitably cause doctors to restrict or limit medication for patients who need a higher dose of pain medication due to their metabolism, genetic factors, and/or the severity of their pain condition. Since the MME was based on flawed science, it should be removed altogether and the recommended dose should be left up to the patient's physician to determine. Treating patients with a “One Size Fits All” dosage is not patient centered individualized care. Removing Morphine Milligram Equivalents on the final 2022 CDC guideline would also ease the threats and coercion on our physicians by the DEA. Because of your 90MME recommendation in the 2016 CDC guideline, the DEA is charging, prosecuting, imprisoning and stripping physicians of their livelihood for prescribing above your recommendation. When physicians are charged and imprisoned for prescribing above your recommendation of 90MME, (now 50MME in the 2022 draft CDC guideline), it not only negatively affects the physician and their family, it negatively affects the patient and the patient's family. Physicians have also been charged and imprisoned for prescribing outside the usual course of medical practice or for prescribing without a legitimate medical purpose. I find this quite appalling and disgusting that government agencies are determining what a “legitimate medical purpose'' is or what “the usual course of medical practice” is when they are not physicians who see and examine patients and if they are a physician, they have no experience in actually seeing and examining patients.<br/><br/>The authors and anyone involved in the draft 2022 CDC guideline who have ANY conflicts of interest, like [Name Redacted], should be removed from participating in any guideline, policy or law in reference to pain management and/or prescribing of opioids for chronic pain. He has ties to PROP, Physicians for Responsible Opioid Prescribing, which is quite biased against using opioids for chronic pain. He also cites and reviews his own work throughout the 2022 draft CDC guideline, which should not be allowed. Others like [Name Redacted] should also be removed if she hasn’t seen patients in the last ten years and/or has no experience seeing chronic pain patients. When creating a guideline on a particular medical condition, those involved in the creation and writing should have experience in treating patients that have that particular medical condition. You would not have a cardiologist making a guideline for a gynecologist.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484fbeb6e	R	None	2022-03-08T16:41:04Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from R, K	l0h-j5hb-gf20	False	None	False	2022-04-12 04:17:04.271	[]
2061	CDC-2022-0024-2067	https://api.regulations.gov/v4/comments/CDC-2022-0024-2067	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When I was a child, around five years old, I had to have surgery on my bladder. It wasn't growing with the rest of my body. In 2014 I was diagnosed with Interstitial Cystitis, I had suffered for the year prior terribly with pain, bleeding, unable to hold a job, unable to have sex with my husband, unable to go on family trips, the only way I know to describe it where you can get a picture of how bad this is, is to think of Tom Hanks in the movie The Green Mile. Thats the way I was every day. I had been treated with antibiotics, Tylenol, and ibuprofen thinking that it was a continual bladder infection for the year following up to surgery. I had point break in 2014 when I started passing blood clots the size of quarters through my urethra. My husband and daughter took me to an urgent care where they catharized me and it was nothing but blood, no bacteria, so they forwarded me straight to a urologist the next day. The urologist did a cystoscopy in office and showed me the bleeding tumors that were in my bladder. Four of them. He then told me that he needed me to be in surgery in two days, as this was severe, and I could hemorrhage out and there was also the fear of cancer, which I have also had in my cervix. I got into surgery within 4 days of this event. Four tumors were biopsied, and the urologist did a hydrodistension on my bladder, I continued to see this urologist for treatment following up surgery and when the pain and bleeding came back. Thats when i was diagnosed with chronic interstitial cystitis with hunners lesions. There really isn't a specific cure for this condition, so with this information, instructions on diet change and the need for pain control, I went to my GP. I gave him all information and discussed pain management for my condition. I advised that I did not like the way the pain meds made me feel that were given right after surgery because i felt i could not really be active, they worked for pain but I didn't want to feel nauseous, so I started on a low dose. It worked. It really worked, I had low pain, I was able to do the things I could before i developed this condition, I was not nauseated, constipated, irritated, sleepy, or erratic in any way. This allowed me to be close to who I was before this condition took such control over my life. In 2015 I went to school, I obtained a state license, and in 2017 I also started trying different treatment options, some that were kind of out of the box. I tried massage therapy, acupuncture, hyperbaric oxygen chamber, reike energy work, however, when i tried the alternate treatments and didn't use my opioid medication, the pain would return, it would be just as it was before the surgery and if i waited to take medication it would intensify. Which I've found out it's a lot harder getting ahead of it once you "wait it out". Then 2019 I was injured at work. I crushed L5 and S1, i am active, it just happened, i was picking up a box. I could not move my right foot, it was as if it was dead, I had mris to see and the pain with that was something i wouldn't wish on the devil. I was given steroids, ibuprofen, steroid injections, all this medication did was cause my IC to flair and cause more bleeding to my bladder and burned my stomach. So, i tried anti-depressants, and those made me suicidal. I was advised to have surgery, but workers comp wouldn't pay for it. I waited for my body to heal to what extent it would, it took eight months to walk without a cane, I didn't get medication titrated when I definitely could have used a higher dosage to get through the injury. I was told that his hands were tied because of the CDC, guidelines. My experience is that I've used this medication and changed my life to deal with Interstitial Cystitis that without opioid medication pain cannot be controlled, and the back injury just was a waiting game of torture. A doctor unallowed to manipulate medication that works with my body to help me through this injury so that I could heal appropriately. I'm not opioid naive, and all the steroids cause IC flairs. The point of using the medication at all is to help with pain, that is what it does, when you can't use Cox2 inhibitors. I am educated, aware of my body, aware of what it needs, I would not be walking today if did not push myself at it. I want to work, that's what I want to do for myself and my family, I want to be active every way i can for My life. Physical injuries happen and that can't be blamed on anyone. The body breaks, we adapt, and the practice of medicine is to help and do no harm. I take the medication that I take for the pain I have. I do not blame my body breaking on anyone. The lack of effective treatment however can be attributed to MONEY and the judgement placed on this medication. If you endure an injury and you take opioids already as a therapy, you are automatically judged. There IS a place for this medication, it works for me w/o side effects. End the MME for those that require titration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484fbebbb	L	None	2022-03-08T16:44:56Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from L, J	l0h-job2-wwvt	False	None	False	2022-04-12 04:17:04.483	[]
2062	CDC-2022-0024-2068	https://api.regulations.gov/v4/comments/CDC-2022-0024-2068	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There are people that are in pain and need pain medication. You are torturing people by not letting them have pain medication. Stop be inhumane! I have suicidal thought everyday because of my pain. The only thing that keeps me going are my kids and husband. Maybe tell doctors to make sure patients need the pain medication before giving them but for God sake give them to the people that need them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lindsey	None	None	0900006484fbebc1	Smith	None	2022-03-08T16:46:24Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Lindsey	l0h-jqes-92yn	False	None	False	2022-04-12 04:17:04.710	[]
2063	CDC-2022-0024-2069	https://api.regulations.gov/v4/comments/CDC-2022-0024-2069	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While volunteering at the WTC after 9/11,2001, I fell pushing a handcart filled with boxes. <br/>This injury has required 2 spine surgeries., the last placing a rod and screws in my lumbar spine. <br/><br/>My medication has been drastically cut due to the new laws and I have been excruciating pain since. Further, I am unable t<br/><br/>I have never abused opioids and always take as prescribed and feel as though I’m being punished for the irresponsibility off others. <br/><br/>Federal and state (I’m in Massachusetts) laws limit my medication and it is too low.<br/><br/>I am too much pain to perform the tasks of daily life on my current opioid dosage. Pain creates other health issues including severe depression. <br/><br/>Please allow doctors to prescribe appropriate opioid medication based on the individuals needs; To do otherwise is torture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fbebd2	Sidel	None	2022-03-08T16:47:14Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Sidel, Susan	l0h-jvng-0e26	False	None	False	2022-04-12 04:17:04.926	[]
2064	CDC-2022-0024-2070	https://api.regulations.gov/v4/comments/CDC-2022-0024-2070	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The proposed draft does not contain sufficient language warning against stigmatization of people with opioid use disorders and/or chronic pain. People with opioid use disorders are subjected to multiple forms of stigma, including internal and external stigma, as well as structural forms of stigma. See, for example: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002969	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ali	None	None	0900006484fbebf2	Anandi	None	2022-03-08T16:48:33Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anandi, Ali	l0h-kcbp-5cup	False	None	False	2022-04-12 04:17:05.136	[]
2065	CDC-2022-0024-2071	https://api.regulations.gov/v4/comments/CDC-2022-0024-2071	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who has only been tapered involuntarily once back in 2017. In 2019 I was forced into withdrawal once because of overwhelmed staff could not get the right medication to my pharmacy. Otherwise, during the last seven years I have been very fortunate to find compassionate primary care physicians in the 2 states I have resided in. I have REST syndrome which attacks multiple joints throughout the body. In my case the toes, feet, ankles, cervical and lumbar spine, and wrists are affected. I take my opioid medications as directed, take my urine test, was forced to buy a a Narcan pen, and follow all the rules and regulations. I am encouraged that the CDC is beginning to open its eyes to reality. Fentanyl is and has been the main cause of death from overdoses.<br/>Yet, after 7 years, I still have to jump through hoops every month to get legal medications. If I wanted to OD it probably would have happened by now. I could walk into the pharmacy and also buy enough alcohol to kill myself. At the end of every day, the CDC cannot legislate what people decide to ingest into their own bodies. The best and least you should do is educate the public about the benefits and dangers of any ingestible substance. After that, it is between the doctor and patient what course of treatment is taken. Thank you for listening to all my wonderful doctors.0	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484fbec1b	Chappell	None	2022-03-08T16:53:54Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Chappell, Stephen	l0h-kv95-elak	False	None	False	2022-04-12 04:17:05.454	[]
2066	CDC-2022-0024-2072	https://api.regulations.gov/v4/comments/CDC-2022-0024-2072	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS is a neurological disease which causes much suffering through sleep disorder, and involuntary motion. 5mg or or less of vicodin easily relieves the symptoms, but at a cost. The opoid IS ADDICTING perhaps to some more than others. Withdrawl took me 6 weeks of violent nightmares, night sweats, restlessness and anxiety. I was not warned of addiction, instead assured addiction was not possible. There are other drugs now which are effective. Opioid should come with clear warnings.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lois	None	None	0900006484fbec31	Kropp	None	2022-03-08T16:54:21Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Kropp, Lois	l0h-l8lc-ntsc	False	None	False	2022-04-12 04:17:05.669	[]
2067	CDC-2022-0024-2073	https://api.regulations.gov/v4/comments/CDC-2022-0024-2073	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe back issues. Always live under the fear of not being able to keep my pain medication. I watched my son suffer thru major dental surgery being prescribed nothing for relief. Doctors are so afraid to prescribe...what happened to do no harm! This has been a knee-jerk reaction to an opioid epidemic that has put people in legitimate pain in the crosshairs. My life would not be bearable without the relief provided by pain medication. Doctors need to be able to do their jobs without insurance companies and CDC misguided regulations. Please change this archaic fear you have put into place for Doctors. I hear in Europe they address peoples pain. What is going g on here.? My nuerologist won't even prescribe sufficient pain medication after spinal surgery. I feel we are just collateral damage. If a person's pain can be clearly seen on medical procedures .MRI..XRSY .doctors need to know they can treat that pain. The few druggie have made life absolutly miserable for a large portion of society that lives would be bearable just with pain meds. Please reconsider current guidelines and address the fear you have put into the physicians. You've made people with legitimate pain issues ...debilitating pain feel like criminals for wanting relief. Someday it may be you who suffers. Most sincerely!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbec4d	Anonymous	None	2022-03-08T17:38:10Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-lo2j-g5ux	False	None	False	2022-04-12 04:17:05.896	[]
2068	CDC-2022-0024-2074	https://api.regulations.gov/v4/comments/CDC-2022-0024-2074	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We have over tightened the restrictions on opioid use for people in chronic pain. They now live their lives in the agony of constant and unremitting pain, unable to contribute to society in meaningful ways. It is time to acknowledge the difference between addiction and physical dependance and loosen the restrictions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484fbec50	Spitz	None	2022-03-08T17:38:34Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Spitz, Katherine	l0h-loc3-4th9	False	None	False	2022-04-12 04:17:06.114	[]
2069	CDC-2022-0024-2075	https://api.regulations.gov/v4/comments/CDC-2022-0024-2075	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and am on Hydrocodone, 4 times per day. This has enabled me to live a somewhat normal life. I do have breakthrough pain, but it is not bad. I've been on pain meds for ten years. My doctor is now trying to convince me that I shouldn't be on Hydrocodone any more. I'm not going to be able to function at work or sleep at night without it. He gives me the strong impression that he's been pressured to reduce the pain meds his patients are on by the federal government. People in a similar position to mine are four times more likely to commit suicide when pain relief meds are taken away. I'm very scared. PLEASE HELP PEOPLE LIKE ME. I have never abused my medication and it has enabled me to live a normal life, which is now being threatened. There shouldn't be pressure put on long term pain management patients! Please take people like me into consideration. If there's no history of abuse, it should be 100% up to the doctor and patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fbec58	MacLemale	None	2022-03-08T17:39:18Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from MacLemale, Richard	l0h-ls08-8hzk	False	None	False	2022-04-12 04:17:06.358	[]
2070	CDC-2022-0024-2076	https://api.regulations.gov/v4/comments/CDC-2022-0024-2076	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support the new guidelines. A close family friend had chronic pain from NS related pain throughout he body. He needs pain meds to have a reasonable amount of pain vs unbearable pain. These guidelines will help him. Please adopt these guidelines for my friend [Name Redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fbec85	Conway	None	2022-03-08T17:40:10Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Conway, Mary	l0h-mbjx-gy02	False	None	False	2022-04-12 04:17:06.571	[]
2071	CDC-2022-0024-2077	https://api.regulations.gov/v4/comments/CDC-2022-0024-2077	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's about time. The political overreaction to the crisis has been disgusting. Some of us only manage to survive because we have pain meds. My dose is small compared to most--an average of 5 mg oxycodone/day--but I have still had to beg for that, and have been humiliated by doctors in the practice I go to refusing to see me. What's happening on the streets has nothing to do with those of us suffering from chronic illness or recovering from trauma, and punishing us to make politicians look good by "doing something" about the crisis has been an easy out. <br/><br/>I normally respect and pay attention to the CDC, but the opioid crisis and then Covid have shown that you guys need to up your game. I know you haven't enough money, but please, get it together.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	TRACY	None	None	0900006484fbecab	HODSON	None	2022-03-08T17:40:41Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from HODSON, TRACY	l0h-mxwc-3tdf	False	None	False	2022-04-12 04:17:06.801	[]
2072	CDC-2022-0024-2078	https://api.regulations.gov/v4/comments/CDC-2022-0024-2078	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I am a retired nurse and worked in the field more than 36 years. I had to retire after this time due to my chronic pain level getting very sever. I have Osteoarthritis, extreme lower back pain, neck/shoulder pain, bilateral knee pain, (most related to injuries on the job), etc. I see [Name Redacted] pain management specialist,monthly. When I was explaining to [Name Redacted] about my pain he really understood this. Most other doctors were in fear to even discuss my pain and it's severity due to the very Restrictive CDC guidelines. I could barely walk without a cane before seeing [Name Redacted]. Now, with Opoid treatment, I can walk without my cane and even care for my everyday needs and the needs of my home/family. <br/><br/>The CDC, a government department, forgot about the chronic pain suffering of the older population and those severely injured during their life time. The CDC have been the "Big-Bad-Wolf" in too many lives. The CDC is now telling doctors, (who went to school multiple years and were licensed to practice),how they can or cannot treat their patients.<br/><br/>The CDC is more politically motivated then patient oriented. Please leave the medical community alone! Let the doctors do their jobs. Until you sit in the doctors seats and attend to real patients, quit trying to please the Politicians.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484fbecac	HUFFMAN	None	2022-03-08T17:42:36Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from HUFFMAN, Debra	l0h-mxy0-usb5	False	None	False	2022-04-12 04:17:07.018	[]
2073	CDC-2022-0024-2079	https://api.regulations.gov/v4/comments/CDC-2022-0024-2079	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with chronic back pain for 12 years.. It's called degenerative because it only gets worse over time.<br/>Ihad spinal injections, radio frequecy leisoning. The back epidurals used to help for a week or two. The last one I had a month ago didn't help. In fact it made my already excruciating pain worse. The epidural caused permanent damage.<br/>Before the CDC decided to make decisions that only my doctor should I actually had a life.<br/>I was on 120 mg. of Morphine. Then I was abruptly taken down to 60mg of Norco. After 2.5 years I was abruptly taken down to 40mg. of Norco.<br/>I used to lead a productive life. I could take care of chores and repairs around the home. My wife and I had a nice garden every year. Now all I can do is lay in the bed or on the couch. It has put a strain on my marriage.<br/>Doctors are scared to death to give the proper dosage needed even though they know we need it.<br/>The only way the CDC can make this crime on pain oatients right is to lift the 90 MME and asure doctors they won't be arrested.<br/>Your mandates have done nothing to curb overdoses. <br/>Many chronic pain patients have had to rely on fentanyl laced heroine by seeking relief.<br/>I hope for the sake of many of us legitimate pain sufferers the CDC makes this right so our doctors can treat us and we can lead a more productive life instead of living in agony.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fbeceb	Raia	None	2022-03-08T17:43:28Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Raia, David	l0h-nmo3-av9t	False	None	False	2022-04-12 04:17:07.225	[]
2074	CDC-2022-0024-2080	https://api.regulations.gov/v4/comments/CDC-2022-0024-2080	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Many doctors have become too afraid of the dea to make balanced judgements on narcotics. They are often making knee jerk responses to appropriate requests for pain relief. This is not easy, but rigid rules often backfire …. So no surprise here that od’s and suicides are up. And narcotics are sometimes irreplaceable antidepressants … when antidepressants alone aren’t enough. Unintended consequences can be lethal. O, I know this because I am an experienced physician.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbed21	Anonymous	None	2022-03-08T17:44:13Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-oich-i93n	False	None	False	2022-04-12 04:17:07.434	[]
2075	CDC-2022-0024-2081	https://api.regulations.gov/v4/comments/CDC-2022-0024-2081	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You worry about opiates?<br/>How about the grim life-destroying side effects on un- or under-treated pain?<br/>Suicide, lost productivity, destroyed families, depression, multiple types of physical deterioration and damage... <br/><br/>STOP torturing pain patients!!!<br/><br/>I will NOT include my personal information as I am already in trouble with Facebook for advocating for chronic pain patients, of whom my daughter has been one for 16 years. <br/><br/>I no longer trust that sharing who I am will not eventually cause the people you have been empowering with your hideous regulations to come after me or my suffering child.<br/><br/>229 pages of revision will NOT undo the damage you have done. <br/><br/>How about 5 pages that re-empower physicians to treat their patients humanely?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbed22	Anonymous	None	2022-03-08T17:45:59Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-oj9g-5mn9	False	None	False	2022-04-12 04:17:07.644	[]
2076	CDC-2022-0024-2082	https://api.regulations.gov/v4/comments/CDC-2022-0024-2082	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband and I have chronic pain for years and have followed every guideline they have thrown at us along with our pain management doctors office. It feels like they target the ones doing the right way. They need to ease up. Let the doctors and patient have some say in their care. Not one persons pain is the same.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe867	Anonymous	None	2022-03-08T17:46:59Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-oois-xnot	False	None	False	2022-04-12 04:17:07.875	[]
2077	CDC-2022-0024-2083	https://api.regulations.gov/v4/comments/CDC-2022-0024-2083	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, <br/><br/>I am a paraplegic ( T-11) and have been wheelchair bound for twenty two years. I fell from trimming a tree in 2000 when I was 30 years old. I was already in the VA healthcare system from a injury from my military service years. After two surgeries and rehab in [Location Redacted] Florida I was discharged.<br/><br/> I have had more problems with pain than I could have ever imagined. I have not had a day without pain since the day of my accident. I don’t want to walk again, I just want to enjoy my life a little and not be howling in agony every day. I have fought with doctors, pharmacies, and pretty much every one in the VA health care system over pain medication. I have had one suicide attempt due to not being able to take being in so much pain about 10 years ago. Since then I have finally found a great doctor who realizes that my pain level is more important than my cholesterol level or any other metric. It’s pain that has ruined my career, and it’s pain that will ultimately drive me to murder myself if not treated correctly. <br/><br/> Opioids work. They are a godsend and although not perfect they work. I can cook, split wood, do woodworking, love my girlfriend, and basically have a life. Does it take the pain completely away? Not a chance. I’m in pain from when I wake up to when I go to sleep, if I go to sleep. Opioids dull that pain. They make it bearable and even tolerable sometimes. I hope you are able to help doctors make the right decision for patients with chronic pain. It’s to bad decisions about pain treatment are made by people who are not in serious pain at the moment. Just take a hammer and hit yourself in the thigh with it every hour, every day, every night sometimes, and repeat for twenty years and see how you like your pain meds taken away because they are opioids. <br/><span style='padding-left: 30px'></span>I hope this does some good because people are killing themselves over some pills. That’s horrific.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anton	None	None	0900006484fbe86a	Leimbach	None	2022-03-08T17:49:22Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Leimbach, Anton	l0h-p3nx-446t	False	None	False	2022-04-12 04:17:08.135	[]
2078	CDC-2022-0024-2084	https://api.regulations.gov/v4/comments/CDC-2022-0024-2084	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [Name Redacted]. I am 64 years old and live by myself in a home I own, about 25 miles north [Location Redacted], Alaska. I lead a quiet life and rarely go out. <br/>Approximately 15 years ago, my primary care Dr and I decided opioids were the best option for me. I have degenerative disc disease. Some days were good and others I was in so much pain I was lucky to get out of bed. I tried steroid injections, osteopathic manipulations, and other options which didn't help. Since then I have had a total knee replacement that causes pain just like it did before. The surgeon can't explain it, the hardware is as it should be. I also have a problem now with my right hip. They say I need a hip replacement, after what has happened with my knee I am not willing to put myself through that.. I tried an injection/ procedure and since they did it in Sept. I have pain when I move, it even wakes me up if I move in my sleep. <br/>I also suffer from depression.<br/>Taking the opioids has worked for me. I have been comfortable most of the time and if I wasn't, I would take it easy and wait for a better day. It's being taken away from me.<br/>I am a victim of your opioid crisis. I never had a problem with my prescriptions, or with taking them as prescribed. But now what has worked is being taken away from me, more every month. I am in more pain that I have been in a long time and it just keeps getting worse.<br/>I have been seeing a psychiatric nurse practitioner for about 10 years because of my opioid use, my pain doctor sent me to her.<br/>My last appt my dr mentioned that people who suffer from anxiety and depression have more problems with opioids being removed from their lives. He also mentioned procedures and, injections which have never worked, I am not willing to go down that road again. He also talked about other options, surgeries. I am not open to any more surgeries. Surgery means pain and no guaranteed outcome. All of these also have a much higher cost. As my opioids are decreased every month, my pain has increased and I get more frustrated and angry. I have done nothing wrong, and am being treated not like and individual but like a number which is 90 MMEs. I am being treated like a drug addict.<br/>Living alone in rural Alaska I MUST depend on myself. I do all snow removal and everything else. I have no close neighbors. If the power goes off, I have to be able to use options for heat. I have an on demand water system that has to be kept up daily. If something comes up I have to be able to take care of it, I have no one to help me.<br/>I want you to know what it is like to be another type of victim of your opioid crisis. I'll be 65 this summer and all I want to do is go on living the rest of my life as I was, at home and at peace, relatively pain free, taking my opioids are prescribed daily. <br/>Thank you for reading this.<br/>[Name Redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484fbfc57	Crowden	None	2022-03-08T17:51:54Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Crowden, Nancy	l0h-r01c-xfx5	False	None	False	2022-04-12 04:17:08.343	[]
2079	CDC-2022-0024-2085	https://api.regulations.gov/v4/comments/CDC-2022-0024-2085	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been under the care of several respected chronic pain specialists since 2008 because I suffer from ankylosis spondylitis, Crohn’s Disease and post herpetic neuralgia (after a severe case of shingles). During this time I have managed to excel at two highly competitive and stressful careers in education and journalism. I could NEVER have done this had I been denied my need for prescription opioids to control the intense, chronic pain I face every day of my life. This pain is the result of conditions that cannot yet be cured and that I did nothing to cause.<br/><br/>While I have been physically dependent upon these drugs for more than a decade, I am not a drug seeker. The evidence of this is that the dosage amounts and frequency of my prescriptions have remained the same for years at a stretch. I have only needed an increase in my meds once during the course of my 14-year treatment in spite of the fact that I need significant quantities of these medications. These drugs do NOT alter or impair my cognitive functions nor have they had any negative impact on my busy social life and stable marriage. These medications enable me to function like most normal, healthy people do. If my doctor were forced to reduce or halt my opioid medications, such an action would have a devastating impact on my quality of life. If my tolerance for these drugs changes and I need an increase of dosage strength, I pray that my doctor will have the freedom to exercise his best medical judgement. I have no problem being drug tested as part of my treatment and I support the tight enforcement of prescription filling protocols. But I object to my doctor and patients like me being treated with suspicion or having our successful doctor/patients relationship terminated because the government can’t be bothered to find the courage and wisdom to medically treat drug addiction. Every patient’s access to opioids should be judged on the basis of that patient’s documented medical needs as well as that patient’s proven ability to manage those drugs under proper medical supervision. My doctor has proven himself to by trustworthy with regard to dispensing opioids and I have proven myself trustworthy with regard to taking these medications. <br/><br/>Here is what my first-hand experience has taught me There is a way to manage drug addiction without treating sufferers as criminals and without penalizing law-abiding citizens like me who have a legitimate need for significant doses of opioids to manage relentless chronic pain. Please protect us from mindless bureaucrats and hypocritical moralists who know very little about chronic pain or the illness called drug addiction. Do not approve blanket caps on opioid prescriptions and place arbitrary limits on what doctors treating pain patients can do. Remember this fact: Drug dependency is NOT drug addiction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vance	None	None	0900006484fbfc59	Hiner	None	2022-03-08T17:56:40Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Hiner, Vance	l0h-rigv-vco7	False	None	False	2022-04-12 04:17:08.586	[]
2080	CDC-2022-0024-2086	https://api.regulations.gov/v4/comments/CDC-2022-0024-2086	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 72 year old who lived a full, active younger life raising 4 children, a business owner and active in civic and social affairs. <br/>I first began my neuropathy experience about 15-20 years ago. I now have chronic advanced peripheral neuropathy and autonomic neuropathy. I’ve had testing at [Location Redacted] and my condition worsens over time. My hands and feet are totally numb, but I have constant pain with intermittent excruciating pain. I have tried every medication for neuropathy with no positive outcome, acupuncture, CBD, massage and everything recommended to get relief. The only thing that helps is Oxicodone 15 mg. 4 times a day. The pain never leaves, but this medication dulls the pain and allows me some peace.<br/>I sleep only 2-3 hours, spread during the day; never at one time. My balance is gone and I require a Walker.<br/>I cannot enjoy my hobbies of genealogy, jewelry making and cooking. My hands are difficult to control as they are numb, but still have pain. I can’t even cut up my own food and require special eating utensils to eat. I have had many complications of neuropathy; neuropathic ulcers, toe amputation and burns from heating pads. I can’t travel any longer. My days consist of staying in a recliner, watching TV and doing things on my IPad. I type with one finger since my hands are painful, yet numb. I sleep in the recliner because I keep my husband awake by my pain. I am blessed that he does all he can to help me, with simple cooking, laundry etc. I have a housekeeper once a week.<br/>My point is that last week my pain doctor said that legally he must cut my dosage of Oxicodone, which I have successfully taken for years. It causes no negative effects, no nausea, no “high” feeling…only dulling of the pain so I’m not as miserable. <br/>I understand there are opioid problems and there are those who abuse it. I am not one of them. My pain management center checks me every 2 months and I have had no negative issues. Now, suddenly, my medication is to be cut. I’ve cried myself out, in apprehension of worsened pain the rest of my life. I just want to be able to live my life as best I can.<br/>PLEASE give pain physicians the leeway to treat patients on a personal level according to need and tolerance. I am 72, soon 73. Pushing me into more pain at this time of life is difficult to understand. I’m sorry for such a lengthy comment, but I want you to understand how stricter laws, across age and need, is not fair. Allow doctors, who know patient’s circumstances, to treat them as individuals. <br/>Thank you for your consideration.<br/>[Name Redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martha	None	None	0900006484fbfc60	F Poplin	None	2022-03-08T17:58:50Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from F Poplin, Martha	l0h-t8tg-2ull	False	None	False	2022-04-12 04:17:08.825	[]
2081	CDC-2022-0024-2087	https://api.regulations.gov/v4/comments/CDC-2022-0024-2087	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had previously been on opioids for a chronic pain condition for over a decade. This was before the absolute freeze out for patients in chronic pain - currently you have to beg a doctor for a few pills for a serious injury. Even then, I was still made to feel like a drug addict by uncaring doctors and pharmacists. I always filled my medication when due, and only had one doctor prescribe them. The medication helped me live a full and active life. I eventually had to go off opioids because doctors refused to prescribe them to me without paying for outrageous bi-monthly office visits, and jump through ridiculous hoops. It became exhausting and very costly just to get a medication that made my life better. Eventually, I found a compassionate pain management specialist who weaned me off my medication. Do I feel better now? Not particularly - I pop Advil like candy, which is especially hard on my kidneys. It's not an opioid, so I guess who cares? I did not have these issues on opioids. I have friends who've been in car accidents and family members who have had major surgery and doctors refuse to give them anything but extra strength ibuprofen, while they suffer in pain. How does this help patients in pain? The lack of safe pain medication will either drive them to purchase unsafe and unregulated pills on the street, or do something even worse. I have no issue with doctors and pharmacists going into a database to make sure patients are not doctor shopping or filling multiple prescriptions. What I do have an issue with is the stigma being thrown on people living in chronic pain not being able to get or fill their medications because doctors or pharmacists are afraid that their license will be revoked. The numbers speak for themselves - we still have an opioid crisis and people are dying. They are not dying because they are picking up a legal prescription for Percocet at Walgreens. They are dying because patients have been pushed to unsafe blackmarkets with pills laced with dangerous chemicals like fentanyl. That is what killed Prince - one of the most famous entertainers in the world was too ashamed to be judged by his doctor. Instead he had someone buy him pain medication on the blackmarket and because it was not regulated he died. If someone in his position cannot obtain legal access to pain management, what is the hope for the rest of us?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Matt	None	None	0900006484fbfc64	Bertram	None	2022-03-08T18:00:39Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Bertram, Matt	l0h-tg51-lp0n	False	None	False	2022-04-12 04:17:09.037	[]
2082	CDC-2022-0024-2088	https://api.regulations.gov/v4/comments/CDC-2022-0024-2088	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am the Director of External Affairs for the National Pain Council. I have over 10 years experience in State and Government service which required me to interpret and explain Laws, Regulations and Guidelines to State and local government officials, members of the regulated community and the general public. I am both a patient with Intractable Pain and a Caregiver for my daughter who has High Impact Chronic Pain. <br/><br/>Due to the issues listed below and in my attached full comments, I am requesting that the 2016 Guidelines be revoked, and the 2022 Guidelines be paused and redrafted with a new Opioid Work Group that will be advised by a Group of Patients with Lived Experience. The harms to many people with Chronic and/or Intractable Pain and their families at this point are irreversible as they are no longer with us. Should the CDC decide to proceed, there must be a plan in place to take action to address the needs for the millions of patients who have been abandoned and need, yet no longer receive appropriate Pain Management treatment. <br/><br/>The 2022 Guideline suffer from some of the same fatal flaws as the 2016 Guidelines. A lack of transparency & Conflicts of Interests in Research and development, and heavily weighted with a focus on Addiction/Substance Abuse with a lack of substantial participation by members of the people who will be most affected: Patients with Painful Diseased & Debilitating Injuries. Over 60% of the Opioid Work Group's area of Research Interests is Addiction, Substance Use/Abuse or Opioid Reduction Focused. <br/><br/>While the proposed 2022 Guidelines are an improvement, I don't see them having a meaningful impact on improving health equity or Individualized Care. Nowhere in the Proposed Guidelines is it shown that the recommendations contribute to greater safety or to diminished harm. The sole purpose of the Guideline appears to be to limit Medical Access to Opioids. Not to promote safety or "Patient Centered Care". <br/><br/> "Safety is the foundation of opioid analgesic prescribing and a basic principle of good medical practice, but misinformation has influenced current assumptions of opioid analgesic prescribing safety, risk, and efficacy. These assumptions are dispelled by data; some are unreported or obscured". <br/><br/>All clinical guidelines should be balanced to reflect both Benefits and Risks of any treatment modality. These proposed guidelines appear to heavily emphasize potential risks while minimizing benefits and discouraging use of this vital treatment modality. Risks of non-opioid treatment modalities have been de-emphasized while use has been encouraged. <br/><br/>The Risk of Overdose and Addiction in Medical Use (see Attachment 1) is grossly overstated, to the point that it could be considered propaganda. Risk is commonly determined based on Death Certificate data which does not accurately reflect risk associated with Medical Use, and has been shown to be notoriously unreliable. <br/><br/>Pain severity varies with a number of medical conditions & including several commonly referred to as "Suicide Diseases" (Complex Regional Pain Syndrome, Cluster Headaches, Trigeminal Neuralgia). This could potentially be considered discrimination based on Disability Status and a violation of the American's with Disabilities Act. <br/><br/>The Misapplication of the Guidelines have resulted in stigmatizing a vital treatment modality, patients have faced disability discrimination and death via suicide due to the inability to obtain appropriate medical treatment. <br/><br/>Acute & Non-Acute Pain are treated as though they are a single condition for which a single category of treatment is appropriate is always appropriate is in conflict with the Guidelines emphasis on individualized care. No treatment should be recommended as preferred. or non-preferred. Instead, a Risk/Benefit for each potential treatment option should be made based on the individual patient's health care situation including comorbidities and risk factors for adverse health events. <br/> <br/>Whether the CDC chooses to proceed and revise this version or to pause and proceed with another version with the assistance of an Advisory Committee with Lived Experience Implementation will be key to ensure Health Equity for all patients who need medical assistance to treat pain. A focus on flexibility and individualized care with Bias-neutral wording in communications and training modules will be critical to undoing previous harms and avoiding future unintended consequences. Clearly communicating to policymakers, payers, quality metric providers, law enforcement, ect... that dosage and supply thresholds should be removed from their polices.<br/><br/>Full Comments attached<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Samantha	None	None	0900006484fbbccd	Adcock	None	2022-03-08T18:09:12Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-05T05:00:00Z	None	None	None	None	None	None	None	Comment from Adcock, Samantha	l0e-mu64-npbr	False	None	False	2022-04-12 04:17:09.257	[]
2083	CDC-2022-0024-2089	https://api.regulations.gov/v4/comments/CDC-2022-0024-2089	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Need to take out the meme.from the guideline .i m suffering because I can't get the proper quality care I need	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe50d	Anonymous	None	2022-03-08T18:09:19Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-8jw6-y1wu	False	None	False	2022-04-12 04:17:09.490	[]
2084	CDC-2022-0024-2090	https://api.regulations.gov/v4/comments/CDC-2022-0024-2090	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow doctors to be in charge of prescribing applicable medicine to their patients. Most of us use our medication responsibly and should not be punished for the few who don't. Most doctors prescribe resonsibly and monitor their patients use of pain medication and should not be punished for the few who don't. Leave the doctoring to the doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Helen	None	None	0900006484fbe548	Wagner	None	2022-03-08T18:09:28Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Wagner, Helen	l0h-8ukq-lvq8	False	None	False	2022-04-12 04:17:09.697	[]
2085	CDC-2022-0024-2091	https://api.regulations.gov/v4/comments/CDC-2022-0024-2091	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 95 year old mother has severe osteoarthritis and has tried various treatment modalities,over the years, all of which were eventually unsuccessful. She currently takes Hydrocodone 10-325mg twice a day for her chronic pain. We supplement breakthrough pain with regular acetaminophen because the clinicians will not prescribe more of the opioid medication.<br/>When I was told mom needed a pain management specialist, despite having been on this medication for a few years, I had difficulty finding one once I mentioned the opioid. I was told that the doctor said that he could not help my mom and wouldn't return my calls. I even went to the local pain management specialist office to advocate for my mom and it made no difference. No provider wants to prescribe opioids. When I ask why I am told it is too much paperwork and a headache for the provider. When I realized I should not mention the need for an opioid I was able to get an appointment, with a pain management practice, in another town. At that appointment we were made to feel like we were drug seeking. Mom had to provide a urine test and at 95 years old signed an opioid pain management contract. Initially the doctor we saw did not want to give mom the dose of the Hydrocodone that had been helping her for the past few years. He said that "it was too high of a dose and he never prescribed that much." He eventually prescribed the requested dose of the medication. I was told by office staff that they were surprised that he gave mom an opioid prescription because he never does that and they also shared that there was a physician, in the practice, that will not provide any opioids to seniors because of the risk of respiratory depression in the elderly. That does not sound like an individualized approach to pain management.<br/>Mom is now required to have monthly visits or calls with a pain management specialist as opposed to having her Primary physician oversee her pain and order the medication. I have argued that these visits or calls are unnecessary when no change in condition is expected and it is costly for those on a limited income. There has to be a better way and care plans need to be individualized. Mom is beholden to these visits or calls in order to get her refills. <br/>I believe families can be and should be educated to contact the physician if there is a change in condition or a concern regarding the patient. Families should be incorporated into the plan of care as each situation is unique. For example; I am my mom's care coordinator and am a board certified geriatric RN and I am not part of mom's pain management care plan yet I am part of the Primary Care physician's care plan. If I was part of the pain management care plan I surmise that these monthly visits or calls would not be needed. <br/>The practice guidelines are not flexible and I am told, by physicians, that there are state mandates so those too need to be reviewed and revised. Care should not be a one size fits all plan. I have read that the current pain management practice guidelines are voluntary. I am told that the guidelines, at least for monthly visits or calls, is a state mandate. <br/>In summary I would like to recommend that the Primary Care physician be responsible for chronic pain management, unless the patient and physician choose differently, without the additional burden of opioid mandated paperwork. The primary knows the patient best and can make the necessary recommendations and referrals.<br/>Reduce the number of office calls or visits, regarding pain management, to once or twice a year or when there is a change of condition reported by the patient, significant other or caretaker. This would also reduce the out of pocket cost to the patient.<br/>Develop individualized pain management care plans which include the patient, family, significant other and/or care taker.<br/>Review and revise individual state opioid mandates to align with the CDC recommendations and reduce the paperwork for providers.<br/>Provide geriatric education to pain management specialists in an effort to enhance their understanding of this population with respect to acute vs chronic pain and the risks benefits associated with opioid use. A clinician should not refuse to prescribe opioids solely based on age.<br/>Provide additional education to the pain management specialist on ways to include the patient's family member, significant other and or caregiver in the plan of care in an effort to individualize the care plan.<br/> Finally chronic pain affects the body, mind and spirit and the pain management specialists are appreciated for all that they do as they help relieve suffering for many.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fbe563	O'Neil-Meyers	None	2022-03-08T18:11:41Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from O'Neil-Meyers, Kathleen	l0h-8xl1-k7pi	False	None	False	2022-04-12 04:17:09.904	[]
2086	CDC-2022-0024-2092	https://api.regulations.gov/v4/comments/CDC-2022-0024-2092	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings-<br/><br/> I have lived with chronic, severe back pain caused by an injury for years. My doctors tried several non-narcotic medications initially, but none provided significant pain relief. The pain was intolerable, took over my life. I'm not the sort of man that considers suicide, but I'm not religious, only an optimist, pragmatic and stubborn.<br/><br/> When the docs finally tried narcotic meds, despite my initial reluctance, I was impressed. Once we found a dosage that helped a lot, to me it felt like I had my life back. Yeah, I still hurt some, but it became tolerable, enough that my pain wasn't always on my mind. Over time I needed a bit more, which I'm told is common, but the doctors were careful to assess me well before upping a dosage. I trusted them to apply it as medicine, not as a drug dealer might.<br/><br/> Then came that day when, thinking they knew better than real doctors, the government decided that all of us who took narcotic pain meds, prescribed by real doctors for genuine severe chronic pain, were considered addicts, and must have our meds denied. This arbitrary decision simply sucked. It hurt!<br/><br/> Of course, I recognize that many people became addicts, and many have died as a result. I get that part, though I see little has been done to help them recover by the government. No compassion, no kindness, little more than the denials and platitudes.<br/><br/> Me, I found it easy to stop taking narcotic pain meds. I suffered none of the typical effects of addiction withdrawal. Nevertheless, I was addicted to the diminution of my pain, for which I've had little relief since. The closest I can come is by smoking marijuana. The pot helps, not by actual pain relief, only by allowing me short periods where I care a lot less about it. No, medical marijuana isn't an option, it's too weak and too expensive for me, and I live in a state(MN) where marijuana is otherwise still illegal. I'm left to buy my pot from black-market sources, only one of whom I trust to bring me only un-adulterated, strong cannabis.<br/><br/> I'd gladly give it up. I wasn't allowed to smoke pot when I was taking the narcotic pain meds. I used the herb then just to relax, play guitar. I want the good narcotic meds back, CDC! I'm not an abuser. I haven't the sort of addictive personality that would abuse/overuse/overdose on narcotic meds. I DO have a genuine chronic severe mind-numbing back pain that doesn't respond to any other medications or treatments my physicians and I have tried. I NEED my good, effective narcotic meds back, folks. Punish [name redacted] severely, but apply their penalty money to genuine help for those chronically addicted. Give them real help, not just "treatment" that inevitably fails because they receive no sincere ongoing support after treatment. Oh, and let the [name redacted] see some real prison time.<br/><br/> For me, my life is in many ways a prison since the best medicine was denied. I'm back to where my back pain controls many aspects of my life. My sleep comes irregularly and rare. When I'm well past merely tired, and/or when my pain level permits it, I get some restless, oft-interrupted sleep. If I move, it wakes me up sharply, like a knife. That sort of thing is aging me fast, and isn't necessary. I was a lot closer to OK when I had some real pain relief.<br/><br/> So, I need help. My health insurance and the State of Minnesota Medical Board oversight, won't help me, citing Federal guidelines and dictates. I'm forced to resort to marijuana, and the medical pot is wimpy and grossly overpriced, and even really good illicit pot isn't nearly a substitute for genuine pain meds. You have the power to make it once again possible for me, and for a huge number of others, to get some genuine relief from chronic pain that no non-narcotic provides. Please, don't lump me, us, in with the addicts, abusers and fools. I'm none of those things. I'm an old man, aging faster than I oughta, suffering because of those fools, and it's just WRONG. Help me, help us, please?<br/><br/> -Name withheld only because my personal info will, by govt. policy, be shared with any viewer on the Web. I started to complete the form as an individual, willing to prove myself to the government, but I can't approve sharing it with any random person on the internet. So, I remain anonymous,but the text above is entirely sincere and factual. Sorry I can't affix my name and info. Thanks for reading!<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe642	Anonymous	None	2022-03-08T18:13:35Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-a1fx-mm23	False	None	False	2022-04-12 04:17:10.125	[]
2087	CDC-2022-0024-2093	https://api.regulations.gov/v4/comments/CDC-2022-0024-2093	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm glad to hear that common sense is finally being paid attention to, once again, after all those of us who've been made to hurt unnecessarily because of some draconian rictus as handed down from Mt. Olympus, as it were.<br/><br/>I've been having to deal w/ pain for decades. that's DECADES! <br/>& I still can't get release. <br/>From palliate care doctors, doctors at pain clinics, to neurologists, they've all told me how opioids are NOT an option for the likes of me, despite their being the only agents that have a proven track record. Is it because I've nothing to show for it? Pain does not register in x-rays, nor MRIs, fMRIs or the like. I'm not a drug fiend, nor do I find that having to live w/ pain like this will brand me up to some kind of ascetic elevation.<br/><br/>Everyone who's in the field of health care swore to uphold the Hippocratic oath to do no harm, well, by denying patients like me access to pain medication relief that only opioids can provide they're in conscious violation of said oath. THEY'RE CAUSING HARM!!!<br/><br/>Change must come. It cannot come soon enough. At this point it's likely I'll go to my grave still stuck in a world of hurt.<br/>It's unconscionable how others have resorted to suicide or the black market because of a squadron of highly compensated lobbyists!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DAVYDE	None	None	0900006484fbe672	X	None	2022-03-08T18:13:53Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from X, DAVYDE	l0h-afr5-2dyt	False	None	False	2022-04-12 04:17:10.335	[]
2088	CDC-2022-0024-2094	https://api.regulations.gov/v4/comments/CDC-2022-0024-2094	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in pain management care for nearly a decade. When my dosage was abruptly halved with no tapering down period, I contemplated suicide. Not only was the pain unmanageable but also the side effects were equally atrocious. For a doctor to be required to do this to their patient, when they took an oath to do no harm, is unconscionable. The government has no business dictating how a doctor cares for his or her patient--it's not as though the government spent all that time and money obtaining the MD and all that time working in residencies to get the practical knowledge of how to be a good doctor.<br/><br/>I'd tell you what I deal with on a daily basis and why I need pain management just to get through the day. I am single, after all, and have no help from any family, and my cat is pretty useless when it comes to doing chores. But there aren't enough characters in this comment field to allow me to describe the difficulties of my day. Suffice it to say that if I didn't have the mediocre pain management I have right now, I'd be jobless and living off the government's teat.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fbe674	Bridgens	None	2022-03-08T18:14:06Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Bridgens, Jennifer	l0h-ah22-1ex9	False	None	False	2022-04-12 04:17:10.606	[]
2089	CDC-2022-0024-2095	https://api.regulations.gov/v4/comments/CDC-2022-0024-2095	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Not every person has an addictive personality.<br/><br/>I am a 71 year old retired elementary teacher and have many chronic pain conditions that are no fault of my own. I call it “bad genetics”. Severe joint disease is very common in my family background.<br/>My hands look deformed and I have difficulty doing any simple daily task. Before 20 17 I had a muck better life with a Vicodin 10/325 available to me if I needed it.<br/>I could make 60 tabs last 3 months. Some days I could alternate Tylenol and Advil. I was much more productive and involved. If I wasn’t feeling pain, it didn’t occur to me to take anything. There are a lot of health problems that affect me. Open wounds on my ankles are the most painful. And to give you a picture of my degenerative joint disease, I had 3 joint replacements while I was in my 50’s. I most recently had a spinal fusion last October. I was given a 6 day script of Vicodin which helped tremendously. However, that was it. They refused to give me any more. So the rest of November I recuperated at home, slogging along in a nauseated haze from pain. I lost 21 pounds and became anemic and Vitamin D deficient. It would have made a huge difference just to have 2 tabs a day for a month after spinal surgery. I would have been able to get around, eat, and go outside. Three months later I am still having these secondary problems that I have to work to clear up.<br/>By the way, I was never into drugs as a teen or young adult. I never smoked.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbie	None	None	0900006484fbe684	Page-Sutter	None	2022-03-08T18:14:44Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Page-Sutter, Barbie	l0h-aonk-0836	False	None	False	2022-04-12 04:17:10.839	[]
2090	CDC-2022-0024-2096	https://api.regulations.gov/v4/comments/CDC-2022-0024-2096	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The prescribing guidelines to curb addiction, as usual hurt more people than they help. My husband was electrocuted at work, his left arm damaged by a live electric wire while cutting a tree. Doctor's were surprised he survived, but only prescribed Gapapatin in increasing doses. He is now up to 2400 milligrams (800 x 3 times per day). It used to be supplemented with Tramadol, yet given the new guidelines, this too is a controlled class 3 narcotic in Louisiana. I fear for his liver and kidneys because doctors here can only prescribe two weeks of anything stronger in Louisiana My husband continued to work for 12 years after this accident, until the pain got so bad and the arm so week he couldn't hold a saw and "had to" go on workman's comp. Workman's comp got him into pain care for two years, yet now he is cut off in spite of pain so bad, he doesn't sleep many nights and still goes to his part time job working on handed and in pain. I have watched my sister-in-law and step father die in pain after their stomach cancer spread to their livers and only in their final week of life be offered pain relieving drugs stronger than 7mg hydrocodone. Doctors are afraid to prescribe medications even when their is a medical need to do so because apparently, the agency who made the 2 week rule doesn't know the difference between dependency on a drug necessary to have quality of life, and die pain free and drug seeking addiction. In the case of death, thank God for hospice, yet they, too have their hands tied until the person's final days in Louisiana.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484fbe697	G	None	2022-03-08T18:15:42Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from G, S	l0h-ayvw-jap8	False	None	False	2022-04-12 04:17:11.047	[]
2091	CDC-2022-0024-2097	https://api.regulations.gov/v4/comments/CDC-2022-0024-2097	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC opioid guidelines have had unintended consequences for people with chronic pain. Too many doctors and health institutions have taken those guidelines and turned them into rules that ignore the individual needs of patients. Don't let the sins of the pharmaceutical companies and a few unscrupulous doctors ruin the lives of patients that have a legitimate need for opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terry	None	None	0900006484fbe6b2	Ross	None	2022-03-08T18:16:28Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Ross, Terry	l0h-b74e-ph8m	False	None	False	2022-04-12 04:17:11.256	[]
2092	CDC-2022-0024-2098	https://api.regulations.gov/v4/comments/CDC-2022-0024-2098	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 40 and have had chronic pain for 10 years. I have systemic lupus which has caused small fiber neuropathy and various other issues. I have had severe side effects to antidepressants, lyrica, and neurontin which are typically used for neuropathy pain and can not take them. For 10 years I have had daily pain 24/7 in muscles, joints, and nerves. Previously Tramadol was not considered a narcotic and my rheumatologist had no problem prescribing it and a muscle relaxer. Now all of my doctors are too scared to even prescribe a muscle relaxer! I have to take more time off work and pay a large copay to see a pain specialist who also seems too scared to write for Tramadol and prescibes 1 a day. So I do not have any pain relief all day. This is not fair that I, along with other chronic pain suffers, should have to suffer because of other peoples poor choices in life. I didn't choose chronic pain and there are ways to help if only the government would allow the doctors to do their job.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbe6d8	Anonymous	None	2022-03-08T18:16:44Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-bmuy-22q4	False	None	False	2022-04-12 04:17:11.671	[]
2093	CDC-2022-0024-2099	https://api.regulations.gov/v4/comments/CDC-2022-0024-2099	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been taking Percocet since 2007, to manage the pain of Crohn’s Disease. My dosage has stayed roughly the same - 5/325 per day, taken throughout the day to keep the pain managed. Percocet allowed me to continue working at my position as a policy and management analyst for Minnesota State Government, and also enabled me to be a present mother, wife, friend, volunteer. Percocet kept me functional. Without it, I would have had to retire and likely stay in bed for much of my 30s and 40s. <br/><br/>The most stressful part of taking Percocet has been over-anxious physicians who didn’t understand that I wasn’t “addicted,” that the Percocet managed my pain. Having to count pills and argue and feel that I was being treated as a criminal were not good for me or my body from a stress perspective. <br/><br/>I had the education and wherewithal to make my case, but I know that many people don’t, and are suffering. I have spoken to my state senator about this and written letters that were published in our statewide newspaper. However, I still read too many horror stories about people in constant pain, because doctors are so afraid of prescribing. <br/><br/>Please be clear with this guidance - chronic pain needs to be treated. If PT or other methods don’t work, then opioids are absolutely indicated. They enable living our lives as fully as possible.<br/><br/>Thank you for your consideration,<br/>[name redacted]<br/><br/>[city name redacted] MN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fbe6e1	Koren	None	2022-03-08T18:17:56Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from Koren, Donna	l0h-bpha-syyv	False	None	False	2022-04-12 04:17:11.884	[]
2094	CDC-2022-0024-2100	https://api.regulations.gov/v4/comments/CDC-2022-0024-2100	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My back has been fractured in 5 places.. I have been on pain meds for 20 years.. As needed for pain..Now I can't find Dr's to prescribe MEDS. When pain comes I always think this will be the Day I Blow my brains out......	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	joseph	None	None	0900006484fbe6f3	hurley	None	2022-03-08T18:22:47Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-07T05:00:00Z	None	None	None	None	None	None	None	Comment from hurley, joseph	l0h-bu6c-x432	False	None	False	2022-04-12 04:17:12.099	[]
2095	CDC-2022-0024-2101	https://api.regulations.gov/v4/comments/CDC-2022-0024-2101	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	1. Bureaucrats have no business dictating policy on prescribing pain medication for people who suffer chronic pain, as they are neither experts on the matter, nor do they typically have experience with chronic pain of their own. <br/>2. Almost no one overdoses and dies from taking too many opiate pain pills. This is part of the big lie. Most die from heroin or heroin laced with fentanyl. Those who do die while taking opiate pain pill, almost always die because they take a lot of opiate pain pills, in consort with a lot of benzodiazepines and a lot of alcohol. This is a lethal cocktail. <br/>3. The worthless DEA has no business intimidating or threatening doctors who prescribe pain medication, when they are so inept at stopping actual illegal drugs, like heroin, meth and counterfeit pain pills, that are often laced with fentanyl. They need to concentrate on doing their job, going after illegal drugs, and leave doctors and pharmacist alone, unless they can prove that doctors are unnecessarily pushing pain pills on patients who don't need them, simply to collect large bonuses from drug companies, as some have done. <br/>4. It is insulting and offensive to see the government providing heroin or meth to addicts, free of charge, and providing them with needles and a safe place to shoot up, simply to make sure the drugs they are getting are safe, simply because they feel that their citizens who die of overdoses makes the cities look bad. What kind of idiot liberal gives drugs to an addict to make sure the drugs are free form fentanyl because they think that drug addicts dying in their cities is bad for their reputation. How about returning to the days where drug addicts were arrested, held in jail until they dried out and then were released with the expectation that the addicts would stay clean and become productive members of society. Encouraging drug addiction is totally irresponsible and an actual crime itself. And start taking a much harder line with illegal drug manufacturers, smugglers and dealers. These should be capital crimes. <br/>5. I worked with drug addicts for over 30 years. I know a hell of a lot more about drug addiction than bureaucrats do. People like me should be making policy, not dumbass bureaucrats. I have been taking opiate pains pills for years, have been told by my doctors, all of them, that there is no cure for my neurological disorder, and that I will die in pain and on pain medication. I have never abused my pain medication, take as little as possible, have never been high or impaired, and have never once taken an illegal drug in my life. Only certain people with the brain chemistry of an addict get addicted to drugs, or alcohol, or food, or gambling, or anything that can be addictive. Most people never get addicted to pain medication, and I will never be addicted to it.<br/>6. Pain medication for me, which includes Oxycontin and Norco, is as important to me as insulin is to a diabetic. It allows me to live independently, meet all of my needs and have some semblance of a life. Without it, I would be living in an assisted living home and doing essentially nothing, as my pain can be quite debilitating. I and my doctors know what I need to live as full a life as possible. Not bureaucrats and certainly not the DEA. <br/>7. Finally, stop going after companies like Purdue, forcing them to pay huge, multibillion dollar settlements to families or the government for manufacturing opiate pain medication. Again, they allow people like me to live as full a life as possible. They are not responsible for reckless people, abusing their medication and risking overdosing and dying, simply to get high or escaped reality. They do not force addicts to take and abuse their drugs, any more than tobacco companies force people to buy and smoke cigarettes and die of lung cancer or emphysema. Smokers can quit smoking if they want to bad enough, and drug addicts can quit taking drugs if they want to bad enough. If they choose to continue to use drugs and die, that is their choice. It is not the drug manufacturers fault. When people over eat and get obese, and die of heart attacks, it is not the food manufacturers fault. If drivers drive recklessly or drive drunk, and crash their cars and get killed, it is not Ford's or Chevrolet's fault. Stop allowing people who are irresponsible to consider themselves victims. They are perpetrators, not victims. End of discussion.<span style='padding-left: 30px'></span><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fbfc67	Hanson	None	2022-03-08T18:29:19Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Hanson, Mark	l0h-uoks-ea92	False	None	False	2022-04-12 04:17:12.324	[]
2096	CDC-2022-0024-2102	https://api.regulations.gov/v4/comments/CDC-2022-0024-2102	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My understanding is that the CDC "drafted recommendation statements in the clinical practice guideline focused on assisting clinicians in determining whether to initiate opioids for pain; opioid selection and dosage; opioid duration and follow-up; and assessing risk and addressing potential harms of opioid use." Unfortunately, those guidelines were insufficient to keep lawmakers in states from turning them into laws which were then upheld by the medical community. This left those with chronic pain who were not abusers of opioid medications without adequate pain management and, therefore, left to suffer in agony or try to purchase pain medication by other means, illicit or otherwise.<br/>Two precious people in my life, my brother and my spouse, both suffered unrelenting, chronic pain due to terminal disease. This led to terrible suffering both physical and mental. As a result, my brother, a Vietnam Vet, was unable to obtain sufficient pain medication to manage the pain from Stage 4 kidney and bone cancer. He died at home in poorly managed hospice care and left a traumatized spouse who later took her own life. My spouse, who could no longer tolerate the anguish and pain he suffered managed to go missing for three days and was found by search and rescue with a gunshot wound through his head. This left me a traumatized spouse who was then treated for three years by an analyst to try to overcome the grief and pain from the loss.<br/>These incidents are but a few that have occurred over and over as a result of self righteous lawmakers who try to control the lives of others when they know nothing about pain and suffering and cannot bear to leave medical decisions to those that do ... the physicians who treat.<br/>All I ask is that you do not set limits on how much of a pain medication (opioid) can be given to a patient for certain conditions when that decision should be left entirely up to the treating physician. Make sure that laws that have been enacted as a result of loose recommendations are no longer possible and are stopped. You can do this through more thoughtful, specific, and flexible guidance that produce more than just recommendations that can be badly interpreted by those who have no qualifications to do so.<br/>Thank you for your courtesy and cooperation in fixing this messy opioid problem which has become more of a street drug problem than a physician prescribing problem.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbed42	Anonymous	None	2022-03-08T18:31:11Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0h-y2hp-e9hj	False	None	False	2022-04-12 04:17:12.540	[]
2097	CDC-2022-0024-2103	https://api.regulations.gov/v4/comments/CDC-2022-0024-2103	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good morning, <br/>I've been an under treated chronic pain patient for many years. It is urgent that we get back to doctor/patient decisions when it comes to prescribing opioid medication. There shouldn't be a hard line for prescribing opioid medication to chronic pain patients one size does not fit all. We need the mme chart and supporting text removed completely as they tend to be misused and misapplied. We also need t o remove all thresholds and limitations on prescribing opioid medication and let the patient/doctor relationship decide what and how much is appropriate. We need to be really careful about wording in the new guidelines as these tend to be misunderstood and misapplied. The new guidelines should be clear and leave no room for any misapplications. Most importantly any mention of the mme and supporting text should be removed. Thresholds and pill limitations and supporting text needs to be removed. Stop the unnecessary suffering of us chronic pain patients and let us get the proper care we so desperately need. The 2016 guidelines need to be tossed out in it's entirely so there's no confusion between the two.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484fbfc90	Piselli	None	2022-03-08T18:31:54Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Piselli , Denise	l0h-zjdp-racj	False	None	False	2022-04-12 04:17:12.757	[]
2098	CDC-2022-0024-2104	https://api.regulations.gov/v4/comments/CDC-2022-0024-2104	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband is a recovering alcoholic (NOT opioid addict) and excessive drinking in his early 20’s means that he has a much physical tolerance for medication; even local anesthesia at the dentist doesn’t do much in the way of pain relief. After one day of post-surgical pain, it was clear his prescription would not be enough to make his pain bearable. My husband called his doctor and left an unreturned voicemail; he knew they had flagged him as a drug-seeking patient and wouldn’t believe him. I called the doctor repeatedly just so that when I finally spoke to him I could beg him to extend my husband’s prescription. <br/><br/>This was major, invasive gastrointestinal surgery — I shouldn’t have to go into into the unpleasant details to convey the pain he was experiencing. I needed to advocate for him because they were rationing his pain management from the start and simply didn’t believe him when he tried to advocate for himself. And we were lucky — this was one surgery. Real pain deserves real pain medication. Chronic pain sufferers aren’t drug-seeking, any more than someone taking anti-depressants or heart medication. Their dependence on medication can be compared to dependence on glasses for vision impairment or insulin for diabetics. The key factor is the same with my husband, and is printed in every bottle of any medication out there: use as prescribed. Please, help chronic pain sufferers — they deserve respect and a decent quality of life. <br/><br/>Sincerely, <br/>[Name and Location Redacted]<br/>(Last name withheld to protect my husband’s anonymity as a recovered alcoholic.)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbfc93	Anonymous	None	2022-03-08T18:34:57Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-05al-nvdv	False	None	False	2022-04-12 04:17:12.985	[]
2099	CDC-2022-0024-2105	https://api.regulations.gov/v4/comments/CDC-2022-0024-2105	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a long time pain patient over 20 years with multiple chronic pain illnesses. I have had my live improved so much from these medication s . I could not get out of bed at all do any type of physical therapy. Since opioids I now go to pool for therapy play with my granddaughter ride in a car some light chores. I do still have some really bad days but my doctor had to take away my breakthrough pain dose as it would make the mm per day. too high. I was doing just fine on that dose but that stupid regulation would put his practice at risk and I would never want that. I see doctors in jail for trying to help pain patients.<br/>I believe the mm equivalent number should be taken out altogether in new guild lines. The new ones should not specify any disease should just say all so that none are left out.<br/>I also have to drive 45 min to see pain clinic every month when my primary dr could easily refill my prescription . I could continue with pain clinic for my injections and see him every 6 months like all my other specialists. The guidelines need to go back to let any doctor prescribe just as long as they follow guidelines <br/>I am a retired nurse of 40 years besides my own experience people call me for help. I can’t bear another call from cancer patients that is being denied pain relief. This is so wrong you people need to fix this. Addiction was not caused by pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbfc94	Anonymous	None	2022-03-08T18:36:13Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-0ohm-p4h4	False	None	False	2022-04-12 04:17:13.196	[]
2100	CDC-2022-0024-2106	https://api.regulations.gov/v4/comments/CDC-2022-0024-2106	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have watched an 85 year old friend suffer needlessly. He continues to have pain from a repair to a hip replacement surgery. He fell and snapped the metal hip socket out of the top of his femur. During the six hour procedure, wire was wrapped around the end of the femur to reinforce the socket in place. After a long recovery he is able to walk freely. However he is plagued with very painful muscle spasms. The doctors have not fully ascertained the reason for the spasms. Although he suffers greatly he has been denied any prescriptions for pain. The doctors have been instructed to be very selective and restrictive in their use of opioids, he has been told. And he suffers now. 85 years old and wasting away now, beaten down day after day from the pain. There is a difference between drug addiction and drug dependency. He is not an addict yet he clearly needs strong pain medications; he depends upon them for relief yet he is denied a prescription. I clearly hope that policies can be re-written so that individuals like my friend can be given relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484fbed71	Knight	None	2022-03-08T19:01:41Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Knight, Charles	l0i-3pg8-r4bx	False	None	False	2022-04-12 04:17:13.416	[]
2101	CDC-2022-0024-2107	https://api.regulations.gov/v4/comments/CDC-2022-0024-2107	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Something has to give. Doctors are now so afraid to even prescribe opioids in situations when the patient truly needs it. I have had multiple surgeries and most recently a car accident and was given no more than 5 days of pain medication. Excruciating pain that lasted far beyond. In addition, I have lived with chronic health issues including pcos.and debilitating migraines for years now. Because these conditions vary in their presentation, severity, and frequency of symptoms, it is very hard to judge how much pain I may be in at any given point in time. I have never had true pain management. I always feel like I have been halfway listen to and doctors are so scared to be sued that they won't truly acknowledge that your pain is real. This is absolutely ridiculous. Addiction is real and I know this. I am a recovering alcoholic. But I have never ever had a problem with pain pills, and only wished that during the most excruciating times, when my pain has been far beyond control with over the counter medications that my doctors would have actually giving me something stronger that could have improved my quality of life	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbed72	Anonymous	None	2022-03-08T19:02:16Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-3r3o-4kh4	False	None	False	2022-04-12 04:17:13.630	[]
2102	CDC-2022-0024-2108	https://api.regulations.gov/v4/comments/CDC-2022-0024-2108	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids have provided me quality of life for about 20 years. After suffering fractures from a fall in my thoracic region, agreeing to surgery that took place three months later and only heightened the pain, I spent a few years trying every possible injection (to the great profit of so-called pain specialists). I tried every possible nonnarcotic medication, acupuncture, and the entire gamut of conventional and nontraditional therapies. I finally resigned myself to sticking with opioids.<br/><br/>I have thoroughly researched opioids. I worried I would become too dependent. I worried needlessly because eventually several facts became clear to me:<br/><br/>1. Properly dosed and taken, opioids control the pain that once made dressing or doing chores quite difficult. The pain is constant but opioids reduce the severity which reduces the distractions pain causes.<br/><br/>2. If I did not eventually decide to try opioids, the chances are significant that I would be on disability and not a productive worker or able to enjoy family/friend relationships.<br/><br/>3. Addiction is awful and I feel for each family who had lost one to opioids. But, aside from addiction that occurs when people are either incorrectly prescribed or monitored and from the desire some people have for illicit/recreational use, opioids have fare fewer harmful side effects than many of the alternative medications. When I tried, for example, Lyrica and gabapentin, I lost my motor skills. I could not think coherently or comfortably drive and similar. It was awful.<br/><br/>4. Depriving pain treatment of the wonders of opioids have given way to a plethora of “pain management” clinics that perform often high risks injections - some that could puncture a lung or other organ. The CDC basically opened the gate for highly profitable procedures to be performed by not always competent people - many of them entering pain management because they recognized the demise of opioids and the opportunity for financial largesse. Profit is great - but not when it is derived from capitalizing on human beings who would do just fine without being forced to use a service that leads to the profit - pain patients should be able to make a choice in consultation with their medical care providers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fbfcc3	Farrell	None	2022-03-08T19:03:53Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Farrell, Kim	l0i-3wde-8t5r	False	None	False	2022-04-12 04:17:13.848	[]
2103	CDC-2022-0024-2109	https://api.regulations.gov/v4/comments/CDC-2022-0024-2109	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC has ruined and hurt so many lives with the 2016 guidelines, knowingly as we’ve learned, that I believe they should be repealed 100%. Their attempt to show they are changing them for the better is ridiculous at best, but we know what they are doing, back pedaling, making it look like they are trying, but not changing anything. Why when we have medications that work well, have very few side effects, are they targeting us? It’s all about law suits and money. It has nothing to do with patients care. They should be held liable in a court of law for all the lives they’ve ended and ruined, and made to repeal the guidelines that they had no business making in the first place. So many people hurt, in the name of greed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbfcc5	Anonymous	None	2022-03-08T19:05:50Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l0i-49aq-u8pu	False	None	False	2022-04-12 04:17:14.064	[]
2104	CDC-2022-0024-2110	https://api.regulations.gov/v4/comments/CDC-2022-0024-2110	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired physician and sadly my wife is a patient in chronic and unremitting pain. She now uses high doses of opiates, above the threshold in previous recommendations for use, and though her pain continues, it is largely abated with the regimen she currently uses. I help her by laying out (and overseeing) her medications. I can attest she is not misusing the drugs and has not escalated her dose in over five years. I also can attest she is not diverting the drugs for sale or distribution to others.<br/><br/>Nevertheless, she and her doctor have been constrained in the use of this medication with more and more regulations and requirements in place.<br/><br/>Her biggest anxiety is the tenuousness of the lifeline these drugs have provided her and she fears her doctor, her pharmacist or the government will cut these medications off.<br/><br/>--------------<br/><br/>As a physician having practiced for over 42 years, I have seen the affects of drug addiction and can agree drugs have an abuse potential. But there is a world of difference between addiction and habituation. All opiates often show tachyphylaxis wherein effects seen initially at lower doses fade over time.<br/><br/>I know no physician who would deprive any patient of any amount of opiates were he or she at the end of life with advanced cancer. But few physicians treat chronic non-malignant pain (such as my wife experiences with failed back surgeries) with the same care and concern.<br/><br/>--------------<br/><br/>Both as a husband and a trained physician, I implore the CDC to continue to support the best care which I ardently believe includes higher than expected doses of opiates for a small number of unfortunate patients for whom they are the difference between suffering and a constrained but acceptable quality of life. We must treat patients as an eminent doctor from the late 19th century, Edward Trudeau, penned: “To cure sometimes, to relieve often, to comfort always.”<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Douglas	None	None	0900006484fbfcc7	McNeill	None	2022-03-08T19:08:08Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from McNeill, Douglas	l0i-4a8c-ivjk	False	None	False	2022-04-12 04:17:14.297	[]
2105	CDC-2022-0024-2111	https://api.regulations.gov/v4/comments/CDC-2022-0024-2111	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There should never be any red-tape involved in prescription drugs that are proven to work within a given patients diagnosed/adjudicated physical condition due to debilitating issues. It is true that there are bad actors among the population. But, when it comes to a vetted physician diagnosis and remedies, there should be no outside interference.<br/> period.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Todd	None	None	0900006484fbfcc8	Scarbrough	None	2022-03-08T19:08:33Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Scarbrough, Todd	l0i-4auv-pxk8	False	None	False	2022-04-12 04:17:14.518	[]
2106	CDC-2022-0024-2112	https://api.regulations.gov/v4/comments/CDC-2022-0024-2112	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for 15 years and, since all other non-opioid pain medications caused severe mental confusion, have been on low doses of Vicodin. With this medication I was able to work, take care of my family, and lead a fulfilling life. Over the past five years, however, my physician has been reluctant to continue to prescribe this medication. She often failed to renew the prescription in a timely manner, has accused me of being addicted (despite a lack of evidence that such is the case), and eventually stopped prescribing it at all. Not only have I felt shame because of her treatment of me, but I am in constant pain. I had to quit my job and stop doing many of the activities I enjoyed. My relationships are strained. I feel depressed and often think I'd rather be dead. All because the CDC over-reacted and made recommendations based on incomplete evidence. I was not addicted or at risk of over-dosing. Had my physician continued to manage my pain I wouldn't be experiencing the intense physical and mental suffering that I do today. Instead, I am in survival mode with no hope for a better future.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbfccb	Anonymous	None	2022-03-08T19:09:35Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-4ltv-zfsf	False	None	False	2022-04-12 04:17:14.735	[]
2107	CDC-2022-0024-2113	https://api.regulations.gov/v4/comments/CDC-2022-0024-2113	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has spinal stenosis from years of physical labor as a plumber. He was given a prescription for hydrocodone and it worked. He was able to continue with his life in much the same way as he was before. Without notice or warning, his prescription changed. He is now in pain constantly. His doc is reluctant to "re-up" his dosage and so he is suffering needlessly. My husband is not an addict. At the end of his prescription, he often has pills left over as he takes them as needed. An addict would not have pills left over. <br/><br/>On the other side of the coin my brother is an addict. He abused opioids and lost everything. He now lives in chronic pain because he's been black listed from receiving any pain meds. <br/><br/>This is a complicated issue. We were handing opioids out like candy and now we're not. I think each case needs to be looked at and decided upon. Checking a patient's history, talking to family members, and coming to the middle will save people's lives. Please consider all angles before mandating across the board "one size fits all."	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484fbfd21	Cartwright	None	2022-03-08T19:10:21Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Cartwright, Brenda	l0i-4yuq-6nv5	False	None	False	2022-04-12 04:17:14.947	[]
2108	CDC-2022-0024-2114	https://api.regulations.gov/v4/comments/CDC-2022-0024-2114	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My family has been negatively affected by the war on opiods. My husband has suffered from multiple kidney stones. When he is passing stones, he needs oxycodone to stay out of the emergency room for pain control. I am a nurse, and along with my husband, [Name Redacted], work closely with his physician to manage his pain through multiple methods, including at times opioids. There were multiple times that we had to fight to get his prescribed dose due to the regulations (28 day prescriptions, etc.) It is an onerous system which fortunately as a health care provider I can navigate and advocate. We have followed all of the rules. During the times he is most vulnerable, when he is in excruciating pain, is when I am making multiple phone calls to get him what he needs and is prescribed. Trying to manage chronic pain is a challenge, adding all of the additional stress for someone who is NOT abusing the system is a burden. In a country where we have amazing physicians and technology it is unfortunate folks need to fight to access the care they need. My husband is fortunate to have a physician who listens and assesses appropriately and prescribes what he needs. He is fortunate to have someone in his corner to advocate and help him through the system. I fear for those who do not have either and are forced to manage their own pain-sometimes committing suicide or turning to drugs on the street. This is the opposite effect the laws are intended for.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484fbfd22	Breidt MSN, RN	None	2022-03-08T19:11:39Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Breidt MSN, RN, Sharon	l0i-52o8-cua8	False	None	False	2022-04-12 04:17:15.157	[]
2109	CDC-2022-0024-2115	https://api.regulations.gov/v4/comments/CDC-2022-0024-2115	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My doctor [Name Redacted] at [Location Redacted] in April 2019 cut my pain meds.<br/>After over a decade of successful protocol<br/>[Name Redacted] took over practice changed everything<br/>Told me you now have medical Marijuana <br/>We are not going to give you any pain meds<br/>Then she said go find someone who does. <br/>Thank God I found a doctor who prescribes only part of the meds I once received.<br/>As far as I’m concerned [Name Redacted] has probably done this to many others <br/>[Name Redacted] needs to have a malpractice case against her.<br/>I worked hard every day of my life<br/>I’m poor <br/>Old <br/>The finish line is close<br/>I’m not as independent as I was when I was prescribed my original dose which was cut.<br/>I suffer every day <br/>Why she cut my meds I’m not sure <br/>I wasn’t near the recommended 90 number <br/>Please help	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Albert	None	None	0900006484fbfd26	Sailler	None	2022-03-08T19:13:08Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Sailler, Albert	l0i-5qhc-zatn	False	None	False	2022-04-12 04:17:15.384	[]
2110	CDC-2022-0024-2116	https://api.regulations.gov/v4/comments/CDC-2022-0024-2116	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I am a 68 year old retired attorney with chronic back and knee pain due to severe osteoarthritis. I can only take anti-inflammatory on a limited basis due to compromised kidney function. I have taken hydrocodone for 20 years, although never on a daily basis. I have controlled my use of this drug and never become addicted. There have been many times when I took only one pill, when I would have liked a stronger dose. <br/><br/>Now my osteoarthritis flare ups are increasingly severe and frequent. Why at this age should I be denied a drug to alleviate pain when I have always used same judiciously and have suffered rather than increase the dosage? People like me who have been responsible in using this medication are being punished because people in West Virginia are able to obtain and use unsafe quantities of opioids. A great approach by the CDC: punish responsible, often elderly, patients who are suffering for the behavior of unscrupulous physicians who overprescribe, and drug dealers who are selling these drugs.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karla	None	None	0900006484fbfd28	Holomon	None	2022-03-08T19:14:50Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Holomon, Karla	l0i-5sw8-79ef	False	None	False	2022-04-12 04:17:15.603	[]
2111	CDC-2022-0024-2117	https://api.regulations.gov/v4/comments/CDC-2022-0024-2117	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thought about suicide when my Dr. cut my prescription almost in half. He told me that 120 m.m.e. was a new limit at that pain clinic and nobody was going to exceed that. Two months later he dropped the limit to 90 m.m.e. My family Dr. sent me to them because he didn't want to get in trouble with the DEA in the first place. I'm a burn victim. Some of us hurt.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fbee0d	Garber	None	2022-03-08T19:15:26Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Garber, David	l0i-62af-vgu8	False	None	False	2022-04-12 04:17:15.818	[]
2112	CDC-2022-0024-2118	https://api.regulations.gov/v4/comments/CDC-2022-0024-2118	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My former Primary Care Physician moved on to another position and I was referred to a new doctor who stated that his clinic does not prescribe opoids. Period. He referred me to the local pain management clinic, but the nurse-practitioner who is working with me is not really listening to me when I tell her that the Tylenol 4 tablets I take on a daily basis (5 tables/day) greatly improve the quality of my life. I am able to get out and garden, play cards with my friends, volunteer at the library, etc. My pain is well controlled. I do not abuse the codeine, which I have been taking for many years. I am 75 and have suffered the slings and arrows that might be anticipated for someone my age: breast cancer; arthritis; a broken neck; ulcerative colitis. The nurse-practitioner's goal is to wean me away from what she considers to be a dangerous opoid. My goal is to live the rest of my life as free of pain as possible. This dichotomy--this disagreement over what our long-term goal should be is causing me a great deal of anxiety. I hope you will be able to make clear to my medical providers that opoids are not always an evil to be eliminated.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc09ee	Anonymous	None	2022-03-08T19:42:44Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-javl-7eai	False	None	False	2022-04-12 04:17:16.029	[]
2113	CDC-2022-0024-2119	https://api.regulations.gov/v4/comments/CDC-2022-0024-2119	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When my dr. Discontinued my opioid medication (because of the mass opioid phobia, misinformation, and CDC policy)my ability to manage my chronic pain and function was removed, and I’ve suffered hell, really. I cannot describe the damages done. My diseases and injuries are not going to get better, and it’s such a waste of life to live so tortured and disabled when I could be helping my kids and grandson instead of a burden to them, these draconian policies are unforgivable and I am ashamed of the entire medical establishment letting patients be so harmed, I expect it will take years , possibly decades to undo the propaganda and address chronic pain patients, and be willing to help them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fbee10	Kelley	None	2022-03-08T20:32:14Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Kelley, Linda	l0i-6gdw-ifvs	False	None	False	2022-04-12 04:17:16.272	[]
2114	CDC-2022-0024-2120	https://api.regulations.gov/v4/comments/CDC-2022-0024-2120	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I applaud this rollback. People are turning to street drugs like heroin and fentanyl out of desperation because doctors are not helping these pain patients. These new policies can allow people to get help from doctors and not drug dealers on the street. Thank you for helping people get their lives back cdc!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joshua	None	None	0900006484fbee11	Vest	None	2022-03-08T20:53:19Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Vest, Joshua	l0i-6irf-3b3x	False	None	False	2022-04-12 04:17:16.489	[]
2115	CDC-2022-0024-2121	https://api.regulations.gov/v4/comments/CDC-2022-0024-2121	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I applaud this rollback. People are turning to street drugs like heroin and fentanyl out of desperation because doctors are not helping these pain patients. These new policies can allow people to get help from doctors and not drug dealers on the street. Thank you for helping people get their lives back cdc!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joshua	None	None	0900006484fbee12	Vest	None	2022-03-08T20:54:02Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Vest, Joshua	l0i-6irn-yiaa	False	None	False	2022-04-12 04:17:16.718	[]
2116	CDC-2022-0024-2122	https://api.regulations.gov/v4/comments/CDC-2022-0024-2122	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This proposed new Practice Guideline for Prescribing Opioids, is supposed to do something to unwind the damage done to people in pain by the CDC’s 2016 Guideline: which — although, like the current document, a “recommendation” or set of “preferences” — triggered a whirlwind of patients being summarily cut off from the medication that had kept them stable and functional for years; patients being ejected from practices; practices and medical organizations abjuring the prescription of narcotics at all.<br/><br/>To be clear: the 2016 Guideline killed people, pushing some of my comrades in the-sibship-of-pain into the streets to fend for themselves, where many of them died — ironically: adding to the toll of the Overdose Epidemic the keeps fueling greater restrictions. Some have even committed suicide.<br/><br/>Does this draft Guideline represent a meaningful shift in direction?<br/><br/>Not as far as I can see.<br/><br/>The first two — of twelve — planks in the proposed new Guideline begin with “Nonopioid therapies are preferred for many common types of acute pain” and “Nonopioid therapies are preferred for subacute and chronic pain” [emphasis added].<br/><br/>So, from “Just Say No,” to providing adequate pain relief, to “Almost Always Say No”?<br/><br/>In Recs 1 and 2, and several others, what comes after is boilerplate, “unless the benefits outweigh the risks,” presumably meant to cue prescribers that they have some “flex” if they can justify their decisions “adequately.”<br/><br/>Isn’t it standard medical practice to only do things where the benefits outweigh the risks?<br/><br/>Do medical professionals really need to have this impressed upon them at the federal level?<br/><br/>If I have a core message to the CDC, it would be: Please stop trying to prevent my caregivers from . . . taking care of me.<br/><br/>They are dedicated, educated, licensed professionals.<br/><br/>If you don’t trust them? Don’t license them.<br/><br/>If they violate the terms of their licenses? Censure them or revoke those licenses.<br/><br/>If you do trust them? Let them do their jobs.<br/><br/>Lives — families, quality of life — depend upon their ability to do so.<br/><br/>Killing people in pain does nothing to protect people with addiction issues--and their families, all of whom deserve every support they can be given.<br/><br/>Please re-focus on care.<br/><br/>Remember: First? Do no harm.<br/><br/>You need not listen to me; listen to Hippocrates; hear your oath as a genuine commitment.<br/><br/>Better? Do something to genuinely unwind the harm done by the 2016 Guideline.<br/><br/>This draft?<br/><br/>Doesn’t do it.<br/><br/>[Name Redacted], MFA, PhD<br/>[Location Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donald	None	None	0900006484fbee15	Unger	None	2022-03-08T20:57:21Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Unger, Donald	l0i-6nd9-gi7s	False	None	False	2022-04-12 04:17:16.929	[]
2117	CDC-2022-0024-2123	https://api.regulations.gov/v4/comments/CDC-2022-0024-2123	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/><br/>I recently had major knee surgery. I was in severe pain and after 3 days (20 pills) of treatment, I was denied a couple of days of more oxycodone. It was brutal and totally unnecessary. 8-12 more pills would have made those 3 or 4 days much more comfortable.<br/><br/>I can not imagine the chronic pain sufferers. The CDC and insurance companies have completely taken judgment out of the equation. There is no evaluation, no recourse, no avenue for appeal.<br/><br/>Obviously, these drugs are dangerous and have been abused before. But the 2016 CDC edict is heartless, short-sighted, and wrong.<br/><br/>Respectfully<br/><br/>[Name Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fbee24	Anonymous	None	2022-03-08T20:58:42Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-6ooc-vpik	False	None	False	2022-04-12 04:17:17.143	[]
2118	CDC-2022-0024-2124	https://api.regulations.gov/v4/comments/CDC-2022-0024-2124	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just had two stents put in my brain. During that procedure the doctors somehow hurt my shoulder and caused bruising and by pinching a nerve and I was in so much pain at night I could not sleep yet the doctor would not give me anything. I suffered for 3 weeks. I only asked for something at night so I could sleep. I had to keep my arm tight against my chest and I was still in SEVERE pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484fbee27	Keeney	None	2022-03-08T20:59:08Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Keeney, Cheryl	l0i-6ovh-1tmm	False	None	False	2022-04-12 04:17:17.357	[]
2119	CDC-2022-0024-2125	https://api.regulations.gov/v4/comments/CDC-2022-0024-2125	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a vascular surgeon who has also worked as a wound care specialist. I have performed hundreds of major amputations, cared for spinal injury patients, and have seen many people with chronic pain from a variety of conditions.<br/><br/>The larger issue relating to opioid prescribing is true, that in the last 40 years, physicians of all specialties have prescribed narcotics in too great a quantity, resulting in not only addiction, but diversion as major social issues.<br/><br/>The response, limitation of "ideal" daily dosage to a certain quantity of MME, as a general guideline, has its merits.<br/><br/>On the other hand, there are patients who are grossly mis-served by these guidelines. Patients with exceptional conditions, where opioid use makes sense as a component of compassionate and effective care, should receive necessary dosing of whatever medication is needed to alleviate their suffering. For a physician to engage in such practice should not be counted as a black mark against that physician's practice.<br/><br/>Who are these patients? Obviously, there are types of patients with severe cancer-related pain. It is this group for which the very high dosage compounds of extended release oxycodone were invented.<br/><br/>In my practice, I have advocated for unlimited dosing for people with:<br/><br/>1. Irremediable ischemia of an extremity. These people are often offered amputation, but many can be more functional living with the painful extremity under medication. Such activity can be far less onerous and expensive than is live with a prosthesis.<br/>2. Chronic spinal injury patients with paradoxical pain. Some patients with traumatic paraplegia have horrid pain.<br/>3. People with certain cutaneous autoimmune syndromes and ulceration.<br/>4. People with calciphylaxis, a destruction of skin circulation causing horrid ulceration, often related to chronic renal failure.<br/>5. Post-ischemic neuropathy. Certain patients, after what seems to have been a successful overall revascularization for acute ischemia (as after spontaneous embolization), will go on to have severe chronic pain. The source for this is probably microembolization that has occurred within tissues, and it may not be treatable other than with narcotics.<br/><br/>These patients need to receive their narcotics under a sort of "green pass" of certification that they have a severe condition, chronic, and carefully monitored. Prescriptions under this certification should be logged into pharmacy and DEA computer systems and NOT count as part of a physician's computed mean MME dosing in her/his practice. <br/><br/>How one monitors these patients is a problem. My practice has extended over all of western MA, so getting some of the patients into a lab for urine screening and having the patients come to the office just for pill counts has always been a problem. To have someone, often in a wheelchair, spend over 1 1/2 hrs driving from home to my office just for this monitoring is impractical. <br/><br/>It has been said that all patients receiving large doses of narcotics should be seen by a pain specialist. That assumes that such a specialist exists. It also assumes that such a specialist knows about some of the uncommon reasons for pain to exist in the first place. I have worked with pain specialists closely. They have been my close colleagues. They have been overloaded with work, primarily from their cancer population. They have not had time for my unusual patients, and I have sought to avoid overburdening them. Instead, it has been my viewpoint that even a vascular surgeon should be able to handle the sequelae of severe vascular disease and chronic severe wounds without hindrance, even if that means the use of chronic opioids. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	0900006484fbee2b	Kaufman	None	2022-03-08T21:00:20Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Kaufman, Jeffrey	l0i-71va-3jbp	False	None	False	2022-04-12 04:17:17.578	[]
2120	CDC-2022-0024-2126	https://api.regulations.gov/v4/comments/CDC-2022-0024-2126	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>From personal experience: <br/>Several times I have been prescribed Oxycodone following surgery, and been prescribed hydrocodone for severe headaches. Taking as directed reduces pain, and--again, "as directed"--does not result in dependency. These are good drugs, the doctors need training.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	j	None	None	0900006484fbee53	a	None	2022-03-08T21:00:37Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from a, j	l0i-7dky-iofm	False	None	False	2022-04-12 04:17:17.795	[]
2121	CDC-2022-0024-2127	https://api.regulations.gov/v4/comments/CDC-2022-0024-2127	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was prescribed hydrocodone beginning in April 2006 for a back injury that ultimately left me permanently disabled at the age of 52. As the pain in my back got worse, I was prescribed Morphine Sulfate Extended Release, along with Hydrocodone for break through pain. Then in 2013, according to my Pain Management Specialist (PMS), my pain medication needed to be kept within 120 MME pursuant to the CDC's recommendations, and my pain medications were cut in half. Then in 2020, I moved from Florida to Virginia wherein I was completely denied opiates and was even told by one PMS's office staff member, "People are dying!" How insulting to categorized amongst drug seeking morons without sense enough not to take more medication than what the prescription states! I am now forced to take over the counter pain medication (OTC). The are only two OTC pain medications, Acetaminophen and NSAIDS. Acetaminophen causes liver damage. NSAIDS cause kidney damage. Opiates DO NOT cause any physical harm to to body, with the exception of constipation which is easily managed with Relistor. If you require further information/input, please do not hesitate to contact me via email [email address redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheri	None	None	0900006484fbee55	Stewart	None	2022-03-08T21:01:25Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Stewart, Sheri	l0i-7gno-0983	False	None	False	2022-04-12 04:17:18.009	[]
2122	CDC-2022-0024-2128	https://api.regulations.gov/v4/comments/CDC-2022-0024-2128	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached file.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fbeeaa	Cummings	None	2022-03-08T21:03:10Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Cummings, Michael	l0i-7vqc-kcs8	False	None	False	2022-04-12 04:17:18.226	[]
2123	CDC-2022-0024-2129	https://api.regulations.gov/v4/comments/CDC-2022-0024-2129	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with chronic osteoarthritis pain for 35 years. Until 2019 I was treated with Oxycodone and was able to function, be productive, take care of my chronically I’ll husband, and actually enjoy life. I was abruptly (and dangerously) cut off from the Oxycodone, accused of being a drug seeker, and treated as if I were a worthless entity. For what? I don’t understand the point of requiring me to live in pain. It benefits no one - not society, and certainly not me or my family.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joan	None	None	0900006484fbeeae	Hunt	None	2022-03-08T21:04:07Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Hunt, Joan	l0i-8c8l-ng1o	False	None	False	2022-04-12 04:17:18.465	[]
2124	CDC-2022-0024-2130	https://api.regulations.gov/v4/comments/CDC-2022-0024-2130	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	With respect to severe chronic pain treatment, the medical system is a disgrace. The treatment for my wife's nerve pain has been inhumane. <br/><br/>Denied, Delayed, Difficult, Desperate. <br/><br/>Doctors will no longer take the professional risk of prescribing opioids, and who can blame them. All downside and no upside. Request for treatment denied. <br/><br/>Ever try to see a pain doctor? Expect delays. Expect to hear: we are not accepting new patients, your insurance is a problem, due to unprecedented demand, we do not answer the phone or return calls and we can schedule an appointment is 3+ weeks. <br/><br/>When you see a pain doctor, expect difficult treatment. Expect to sign a pain management contract, expect to receive periodic and perpetual "random" drug testing, expect to get limited doses, expect frequent appointments and expect high medical care cost. Expect to be treated like a jail yard junkie. <br/><br/>Patients have only two real options - 1) suffer and 2) suicide. If the medical system is unwilling to treat suffering, it should be accountable suicides. Severe chronic pain is death in slow motion.<span style='padding-left: 30px'></span><br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484fc0096	Stern	None	2022-03-08T21:04:29Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Stern, William	l0i-8vdb-g7mi	False	None	False	2022-04-12 04:17:18.681	[]
2125	CDC-2022-0024-2131	https://api.regulations.gov/v4/comments/CDC-2022-0024-2131	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 30+ year caregiver to a chronic pain patient who was in an auto accident the month after she graduated highschool. Her spine was crushed in part, and it left her paralyzed from the waste down for a year. Inept medical treatment after the accident caused further damage and excessive scarring of her nerve sheaths, leaving her with horrific, pain levels, which often also suddenly spiked due to nerve pinching. After many years of battling the stigma, and difficulty in dealing with "large-dose" oral opioid medications, and then years more of rigorous "testing", and horrific tortures by multiple doctors to see if she "qualified" for an implanted pain pump, she FINALLY got one about 13 years ago.<br/><br/>The change in quality of life for her was immediate, amazing, and the dosages of medication - administered by the machine all day, rather than having to take them in a lump orally - were much less, and evened out the effects so that she was never "wiped out" or "high" (so much improved safety at several levels).<br/><br/>Sadly, when the CD issued its unreasonable, factually/clinically unsupported 2016 "guidelines" (written in part by ethically compromised anti-opioid crusaders with clear conflicts of interest), not only were her medications abruptly and significantly reduced without her consent, but she was subjected to an onslaught of "pain doctors" trying to talk her into various surgeries etc (which, of course, are very profitable for them) by telling her there was no alternative since they would be cutting off her medications. Worse, the State of Oregon imposed draconian mandates and laws based upon those guidelines, such that many true pain specialists simply exited the field of practice, while the quacks espousing stuff like acupuncture, chiropractic, etc were enshrined as go-to "alternatives" to effective opioid treatment. There needs to be clear mandate to Oregon and other states to repeal that nonsense.<br/><br/>Along with working to undo the great damage done by the 2016 CDC "guidelines" there needs to be some actual protection and outreach to pain doctors who need to use opioids for patients. Now I hear all the time from doctors about how now that the CDC is backpedalling from the 2016 guidelines that "the DEA is still all over us - threatening to yank our licenses if we don't conform to the 2016 levels - or even less". This jack-bootery must be stopped if true, and if false, doctors need to know they are protected in their treatment decisions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484fc00c1	Harrell	None	2022-03-08T21:05:37Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Harrell, Peter	l0i-93qd-phym	False	None	False	2022-04-12 04:17:18.898	[]
2126	CDC-2022-0024-2132	https://api.regulations.gov/v4/comments/CDC-2022-0024-2132	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	20 years ago, my husband suffered a ruptured disc in his lumbar spine. Following surgery to repair the disc, his condition degenerated over several years, with further herniations, stenosis and chronic pain. He followed all protocols, physical therapy, icing, medications, including hydrocodone, which he uses carefully and judiciously. Eventually, he needed to have spinal fusion. The condition of his spine has continued to deteriorate, and as he is a carpenter and does extremely physical work 5 days a week, hydrocodone allows him to do his job, and not have to go on the dole, sell our house, or become a drain on society. He has his monthly doctor visits, as is protocol, and dreads the day when, and if, his medication will no longer be available. Real people in real pain benefit from this medication. It allows them to be productive members of society, and most importantly, to reap the great benefits of actual pain relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Evie	None	None	0900006484fc00c8	Maxfield	None	2022-03-08T21:06:01Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Maxfield, Evie	l0i-9hda-xsrk	False	None	False	2022-04-12 04:17:19.112	[]
2127	CDC-2022-0024-2133	https://api.regulations.gov/v4/comments/CDC-2022-0024-2133	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had 7 major foot surgeries on my right foot along with another 4 procedures that did not require sedation. I live in chronic pain and I am still and active employed senior. The stigma around the hydrocodone acetaminophen 7.5/200 and the forced reduction to 40 per month, which is one a day and then on 10 days when the pain is too much, I take 2/day; has ore to do with these guidelines and the fear my doc has than it is about relieving my chronic pain. <br/><br/>How can 2 pills a day, which gives me the relief I need be addictive? Why must I suffer for 20 days because of some arbitrary rule. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alan	None	None	0900006484fc00fc	Ross	None	2022-03-08T21:06:17Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Ross, Alan	l0i-9k0s-74u2	False	None	False	2022-04-12 04:17:19.330	[]
2128	CDC-2022-0024-2134	https://api.regulations.gov/v4/comments/CDC-2022-0024-2134	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow the ability of private physicians to prescribe buprenorphine. By limiting physician access to only larger methadone clinic or creating training hurdles for physicians keeps it from chronic long term opioid patients who need it to regain their lives and exit their existence of social and emotional isolation. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc00fe	Anonymous	None	2022-03-08T21:06:29Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-9nln-nx61	False	None	False	2022-04-12 04:17:19.567	[]
2129	CDC-2022-0024-2135	https://api.regulations.gov/v4/comments/CDC-2022-0024-2135	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What the 2016 guide lines has done to me .No more getting up and moving around .In constant pain .morning noon and night .No cleaning my house .No more taking care of myself .no more hugs from my grandkids or playing with them .No more socializing with friend .Just no more .no more .Just in pain 24 7 .No way to live .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc00ff	Anonymous	None	2022-03-08T21:06:52Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-9pgl-ma1q	False	None	False	2022-04-12 04:17:19.797	[]
2130	CDC-2022-0024-2136	https://api.regulations.gov/v4/comments/CDC-2022-0024-2136	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The pain in my left arm was unbearable. The only thing that I can compare it to was the pain from waking up the morning after a surgery, after the pain medication had worn off - although this pain was worse. Believing that I must have broken my arm, I found online an orthopedic doctor who offered same day appointments.<br/><br/>The doctor correctly (and rather immediately) identified the pain as coming not from my arm but from a c6-c7 herniated disc. Despite telling the doctor that my pain was unbearable ("level 9") and a correct diagnosis of the pain's origin, I was prescribed what I later learned was 1/3 of an adult dose of a medication indicated for moderate pain, and I was told "it's ok to take Tylenol and Advil at the same time."<br/><br/>The pain decreased a few weeks later; however, my left tricep and pectoral atrophied, and I required neck surgery, which fixed the issue. The pain that I felt and that I reported and for which I was not treated was agonizing. I gained over thirty pounds from eating candy as an attempt to take my mind off of the pain. I think that there is something extremely wrong with leaving people in that much avoidable pain, and it is scary that this is what occurs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fc0102	Grossman	None	2022-03-08T21:07:19Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Grossman, Michael	l0i-9sef-vxak	False	None	False	2022-04-12 04:17:20.018	[]
2131	CDC-2022-0024-2137	https://api.regulations.gov/v4/comments/CDC-2022-0024-2137	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Need to change the meme.let doctors be doctors again .pharmacy Has no right treating us chronic pain people like animals .we want are dignity back and our life .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0181	Anonymous	None	2022-03-08T21:07:26Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-9ts0-ubmg	False	None	False	2022-04-12 04:17:20.231	[]
2132	CDC-2022-0024-2138	https://api.regulations.gov/v4/comments/CDC-2022-0024-2138	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a psychotherapist in private practice who has been working for about 10 years with a client in chronic pain from multiple back surgeries. Her opioid medications for this were significantly reduced when the government guidelines changed in order to address the opioid addiction epidemic. My client is not an addict, she is in excruciating chronic pain for which there is yet to be any medical intervention other than pain medication to address. She periodically ruminates on suicide to end her suffering. This should not be her only choice to end her pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484fc0183	Callaghan	None	2022-03-08T21:07:48Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Callaghan, Thomas	l0i-9uy3-g6es	False	None	False	2022-04-12 04:17:20.444	[]
2133	CDC-2022-0024-2139	https://api.regulations.gov/v4/comments/CDC-2022-0024-2139	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We support modifying the current guidelines so patients in severe chronic pain can have adequate help. A friend of mine’s husband, a physician, after a stroke has a severe pain syndrome that is incurable. They’ve been coping for 14 years. I personally had a neurological disorder causing severe intermittent pain. <br/><br/>There are legitimate uses for these medications. Consider the many veterans who suffer daily with pain l from injuries sustained to serve our country. <br/><br/>Please modify this regulation to accommodate legitimate use. <br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fc0189	Neubert	None	2022-03-08T21:08:19Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Neubert , Patricia	l0i-a4qx-ngpz	False	None	False	2022-04-12 04:17:20.659	[]
2134	CDC-2022-0024-2140	https://api.regulations.gov/v4/comments/CDC-2022-0024-2140	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024 Due 4-11-22<br/>In 2016 the CDC released the guidelines for prescribing opioids to chronic pain patients. On (MM/YY) my doctor (cut, rapid taper) my pain medication. The CDC must give me and millions of pain patients our pain medication back. The CDC must add this information in the 2022 update were it is easy to find by our doctors. Without adding this in the rewrite nothing changes and the CDC is still responsible for destroying millions of the lives of chronic pain patients and their families.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc08bc	Anonymous	None	2022-03-08T21:10:36Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-mcjd-noxj	False	None	False	2022-04-12 04:17:20.870	[]
2135	CDC-2022-0024-2141	https://api.regulations.gov/v4/comments/CDC-2022-0024-2141	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish to comment on these proposed regulations. I am a chronic pain patient and I have gone thru the torture of being titrated down to ridiculously low level of dosage in a not very scientific process. The situation with me is that a genetic test was ordered by my Pain Doctor and the results were that I have a genetic variant --- thr A11G variant which interferes with the proper absorption of the opiod Mu RECEPTORS. Hence the net effect is that my genetic structure requires additional amounts of opiods in order to " achieve proper analgesia ". Even though this information is available to my pain management doctors, they will not accomadate the dosage to give me the proper relief in order to have a quality of life where I can function and be active. This is a sad tragedy and I have been regulated to a stay at home patient barely getting by. When you are finalizing your regulations I requesting that you include provisions to account for the person with the genetic variant to prescribe the adequate dosages beyond the 90 MME in order to provide proper analgesia.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fc0885	Salamon	None	2022-03-08T21:10:50Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Salamon, David	l0i-m6yo-jcex	False	None	False	2022-04-12 04:17:21.095	[]
2136	CDC-2022-0024-2142	https://api.regulations.gov/v4/comments/CDC-2022-0024-2142	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a very large woman who is likely not to become smaller without some miracle. I am large, always have been and, despite lifetime efforts on my part, I have only managed to stop gaining weight and am losing all of a few pounds a year. I will never be "small".<br/><br/>Having a large body brings quite a bit of joint pain. Since 2008 or earlier, I have been on a 5-day-a-week moderate dose of Hydrocodone. Basically, it takes enough edge off my pain to get me up and moving so I can maintain a 5-day traditional work week.<br/><br/>Since I turned 50, I've noticed that I'm not getting as much relief from the Hydrocodone as I used to. When I spoke with my doctor about it, he said he would be hesitant to prescribe a higher dose, mainly because of the limitations put on opioids. I understand his position because the current rules around opioid prescriptions have made me feel like the government thinks I'm a drug abuser. Based on the same governmental rules, I guess he would feel like a criminal, prescribing a slightly higher dose. <br/><br/>I've never felt the urge to take more Hydrocodone than what's been prescribed to me because there are side-effects I do not want to experience. If my pain weren't increasing, I wouldn't ever think to change my prescription. <br/><br/>I'm a little afraid of what comes next if the rules around opioid prescriptions for pain do not change. If it comes to the point where my current prescription isn't helping at all, and my dose cannot be slightly increased, I don't think I have any other types of paid meds to turn to - I am on a blood thinner because I developed blood clots years ago - I can't take any NASIDs or non-natural anti-inflammatory drugs to help joint pain. <br/><br/>Right now, I am a contributing member of society. I have a house, a full-time job, and I both spend and save money as normal. I'm only in my 50s; I should have at least 15 more years to contribute to taxes, social security, etc. If my pain becomes too great, though, I know I will have to consider an early retirement. No one wants to not work and be in pain all the time. <br/><br/>Please consider altering the prescription rules around opioids to give people in chronic pain the relief they need to continue being productive citizens. <br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lora	None	None	0900006484fc0883	W	None	2022-03-08T21:11:33Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from W, Lora	l0i-m54p-uuzk	False	None	False	2022-04-12 04:17:21.334	[]
2137	CDC-2022-0024-2143	https://api.regulations.gov/v4/comments/CDC-2022-0024-2143	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in pain! Why do other people's problems like addiction and abuse have to adversely affect me? I don't care if people are overdosing..... I hurt and need pain relief. I have been seeking illegal drugs in Oregon because I can't get them prescribed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc087e	Anonymous	None	2022-03-08T21:11:44Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-lzwj-pdzx	False	None	False	2022-04-12 04:17:21.555	[]
2138	CDC-2022-0024-2144	https://api.regulations.gov/v4/comments/CDC-2022-0024-2144	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include low-total-daily dose opioids as a viable treatment option for Restless Legs Syndrome patients. I am a patient and it is a terrible condition. We need access to all the options doctors have found useful.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	0900006484fc0848	Segal	None	2022-03-08T21:11:53Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Segal, Rebecca	l0i-lu5x-w8dw	False	None	False	2022-04-12 04:17:21.776	[]
2139	CDC-2022-0024-2145	https://api.regulations.gov/v4/comments/CDC-2022-0024-2145	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was injured as a letter carrier in 1997. I was presented with two options, surgery or “pain management “. I chose surgery. I had a spinal fusion and spinal cord surgery. The fusion failed. I was sent to pain management. A simple foot step resulted in excruciating pain. I was given OxyContin and told it was “time released “ and “non-addictive “. It became clear that was not true. I was switched to MScontin. It worked very well and allowed me to take a small part time job. I would still be on it if the constipation had not ruined the quality of my life. For it was not an addiction, it was a dependence. I weaned myself off the MScontin . However, I could not tolerate the subsequent pain. I was mean spirited. I hardly slept. I was cranky at work. I spoke with my MD. And bless him. Even in the new found hysteria concerning opioids, he prescribe them. I have been able to administer just enough to keep the pain at bay without constipation and to get some sleep .I think you should know that even with pain management the pain is still there. It just takes a little longer to hit the brain.Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	0900006484fc0a30	Howard	None	2022-03-08T21:12:08Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Howard , Catherine	l0i-kau0-tux7	False	None	False	2022-04-12 04:17:21.990	[]
2140	CDC-2022-0024-2146	https://api.regulations.gov/v4/comments/CDC-2022-0024-2146	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who has been dealing with chronic pain since a car accident in 2012. I have had 2 spine surgeries and looking at another in the near future. I have been sent from Dr to Dr just to be told that there is nothing that can be done for the pain. Been put on every nerve medication, muscle relaxer and anti inflammatory known to man. Some take a little of the edge off but none of which help the pain. I am 42 years old and can not work due to the constant pain. I can't even enjoy a family outing without having to cut it short or be laid up for days after due to pain. The existing guidelines are cruel to say the least. Something must be done about this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C	None	None	0900006484fc0a2c	Blackwell	None	2022-03-08T21:12:21Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Blackwell, C	l0i-jzkf-me4a	False	None	False	2022-04-12 04:17:22.205	[]
2141	CDC-2022-0024-2147	https://api.regulations.gov/v4/comments/CDC-2022-0024-2147	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am concerned that this will allow physicians to unethically prescribe (sometimes) unnecessary, and highly addictive, medications and keep patients reliant on them for additional prescriptions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0a02	Anonymous	None	2022-03-08T21:12:32Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-jtkq-7guy	False	None	False	2022-04-12 04:17:22.418	[]
2142	CDC-2022-0024-2148	https://api.regulations.gov/v4/comments/CDC-2022-0024-2148	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Much more research must be done into opioids. Scant knowledge is available weighing the analgesic and the positive mental effects against the negative effects. We need to better understand how social isolation impacts opioid craving as well.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fc01bd	Solomon	None	2022-03-08T21:12:41Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Solomon, Steve	l0i-a6cs-1ti0	False	None	False	2022-04-12 04:17:22.655	[]
2143	CDC-2022-0024-2149	https://api.regulations.gov/v4/comments/CDC-2022-0024-2149	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The lack of doctors willing to prescribe pain medications in adequate dosages has caused enormous harm to those who have legitimate chronic pain lays solely on your doorstep. The backlash from the opioid “clinics” should never have spilled onto the legitimate need for compassionate care of pain sufferers. The fact that you are still limiting doctors in family practices shows you are not cognizant of the lack of pain management specialists, many of whom are making their money from “shots” that many times do not work. Doctors are limiting pain prescriptions after major surgery and patients are being treated like affects if they need more than prescribed. <br/>The pendulum always swings way too far when there is a “crisis” and it always hurts the innocent. You need to do more research and talk to more people who have been hurt by your guidelines rather than sit on your pedestal and dictate. Otherwise, don’t issue guidelines!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc01c0	Anonymous	None	2022-03-08T21:13:57Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-ab2l-ovxi	False	None	False	2022-04-12 04:17:22.878	[]
2144	CDC-2022-0024-2150	https://api.regulations.gov/v4/comments/CDC-2022-0024-2150	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I was born with Charcot Marie Tooth disease, type 4H, one of the rarest congenital neuropathies known. I have had chronic pain as long as I can remember. From the ages of 6 to 21, I had 12 surgeries to correct some of the other issues this disease caused- bilateral club feet, one leg smaller than the other, and several other orthopedic issues like scoliosis. I also have chronic nerve pain and lack of sensation in my periphery. It's not fun, but it's all I know. <br/><br/>I did not have a normal childhood, nor have I had a normal adulthood. What is normal when you are disabled? For me, my childhood is a blur, between hospital stays and chronic pain, life in a wheelchair, etc. I didn't find much joy. As a young adult, I knew that I needed to better control by pain, and my mental health, to live a happy life and try to find fulfilment. <br/><br/>I have worked with a pain management doctor now for 12 years- one at [name of health facility redacted] Hospital, and another private one as an adult. They have helped me manage traditional treatment, like physical therapy, with alternative therapies like chiropractic and massage. As I tell people, those in chronic pain are willing to try just about anything to feel better. Throughout my life, medication has been a crucial part of my pain control, especially opioids. I started on lower types, with stronger ones after surgery, but as my pain and physical condition degenerated, I have had to use stronger medication in order to live a somewhat normal life. <br/><br/>Starting in the mid 2010's it got much harder for me. Despite my conclusive genetic diagnosis and medical charts a mile long, doctor's were all of a sudden hesitant to prescribe pain killers. Insurance companies denied Rx coverage for pain killers. It seemed that if you needed an opioid, you were a pariah, and doctors wanted you off their rolls. Ultimately I found a great doctor willing to work with me with a combination of medications (antidepressants, nerve blockers, and opioids working in synergy) that has helped. As I tell my family, it takes the pain from a 6 or 8 daily to a 4 or 5. The opioid I take is buprenorphine- a relatively new option that is much stronger but less addictive than morphine. <br/><br/>I always stress- I have never felt "high" in my life. I have never once abused my medication. I treat my disease and my treatments very seriously. Despite the cutting edge therapies and medications, I still live with severe chronic pain that limits my ability to work and live. Every time my medication is reduced or I go without, I can't walk. I can't work. I have contemplated suicide many times. <br/><br/>Those of us with chronic pain have not made this choice. Due to an accident of birth or fate, we have been dealt a raw hand. We need medications like opioids to help make our life even partially normal and worth living. These CDC guidelines that tell doctors to avoid opioid prescription are far too simplified, and do not treat chronic pain patients fairly. It's like punishing the innocent for the crimes of the guilty- those who have abused opioids made a CHOICE to use those drugs illegally, whether they have an addiction disease or not, no one forced the pill down their throat or needle into their arm. So why do I have to suffer?<br/><br/>My hope is that our government can pass guidelines that allow people with chronic pain to have equal access to the medical advancements and medications that we should be entitled to. I believe this is a matter of ADA access- that in denying us medication, we are denied quality of life and access to a happy life- and that is wrong. I also feel that those of us with chronic pain deserve to be listened to, and treated as an individual. Good doctors do this, and the CDC guidelines should encourage such. <br/><br/>I would even support some sort of registry for people with chronic pain. If you have a provable diagnosis (cancer, MS, neuropathy, etc.) resulting in chronic pain, you could be put on a registry that allows access to opioids without the hassle. It's worth a thought. I just hope we move on from this nightmare period and start thinking about all the disabled folks who have suffered for the sake of addicts or bad policy. <br/><br/>I am happy to contribute further or provide more information as needed. <br/>Thank you,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brandon	None	None	0900006484fc09bf	Jenkins-Moak	None	2022-03-08T21:14:32Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Jenkins-Moak, Brandon	l0i-ivwc-46d5	False	None	False	2022-04-12 04:17:23.090	[]
2145	CDC-2022-0024-2151	https://api.regulations.gov/v4/comments/CDC-2022-0024-2151	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband who is 81 years old has chronic pain due to multiple injuries and surgeries (three knee replacements, two back surgeries, elbow surgery, peripheral arterial disease, and nerve neuropathy). His doctor prescribed Tylenol III for him for many years to help control the pain. He takes only when the pain is so severe that he can no longer function. He gets to the point that he can't even walk because the pain is so intense. His PC has cut back on the number of pills he will prescribe to the point that my husband is afraid to take one of the pain pills until he is to the point he can barely stand or walk.. Prior to the restrictions on opioid prescriptions, he was able to better manage his pain. Now, he feels he must be to the breaking point before he will allow himself to take a Tylenol III. Considering the fact he has been prescribed and used Tylenol III off and on for close to 40 years due to his various injuries and surgeries, I do not believe at this point in his life that he should be denied pain medications that improve his quality of life. His PC is adamant about the reduction in the prescription. When we have talked with his cardiologist and his orthopedic doctors, they do not feel Tylenol III should be in the controlled substance category. Exceptions need to be made for patients with chronic pain in order to better manage their pain and have a higher quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Evelyn	None	None	0900006484fc01ff	Hanauer	None	2022-03-08T21:15:30Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Hanauer, Evelyn	l0i-axjn-09gp	False	None	False	2022-04-12 04:17:23.304	[]
2146	CDC-2022-0024-2152	https://api.regulations.gov/v4/comments/CDC-2022-0024-2152	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 69 year old manager of a manufacturing facility. I have had 3 lumbar surgeries from L4 to S1, the last one with brackets and screws to secure my spine. <br/><br/>The company had a revolving door of insurance providers to keep insurance costs down. Every time my insurance changed, I was forced to change Primary care Physicians (PCP) to one that was in their insurance plan. <br/><br/>After the CDC Opiate Guidelines changed and I needed I change my (PCP)I would have to jump through the What I call the "Hoops". Each PCP would either send me to a pain management clinic who would reduce my dose and send me to (physical therapy) that didn't work, and inject steroids into my spine nearest to the offending nerves which again didn't work for very long, maybe a week or The (PCP) would do the same thing. Eventually sending me to have an MRI or CT scan to find out that I have severe spinal stenosis all down my back. Then I would be put on a dosage that would work for me for a few hours a day. My daily pain levels were from 4 to 9 on a scale of 0 to 10, the standard scale used by most doctors and clinics. I currently have a spinal cord stimulator implanted, which helps. But now I'm going through the dosage reduction Hoops again. <br/><br/>The changes to the CDC recommendations was and still is a boom for "Pain Management Clinics" (PMC). Some of them were a joke, come in, urinate in a cup, and get your medications. Others were revolving doors of doctors and PA's coming in and leaving every couple of month's. Each time the Dr. changed it was jump through all of the Hoops again. Go through the dosage reductions again. Then Covid-19 came and the Pain Management Clinic Closed, Gone. I and many others were left high and dry.<br/><br/>I, the insurance companies and many others paid a lot of money to pain clinics MRI/CT scan providers, just to relive a hell of pain and anguish <br/><br/>I believe that physicians should be allowed to do their job without fear of reprisal from over zealous government officials, and insurance companies. Take out the bad players and let all others do what they were trained to do.<br/><br/>[name redacted]<br/><br/>I sincerely felt/feel sorry for all of the other people who were suffering as much or more than myself <br/><br/>Each time I would have to jump th	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Walter	None	None	0900006484fc09da	Priebe	None	2022-03-08T21:16:25Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Priebe, Walter	l0i-j2yz-qz40	False	None	False	2022-04-12 04:17:23.536	[]
2147	CDC-2022-0024-2153	https://api.regulations.gov/v4/comments/CDC-2022-0024-2153	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75 year old male and a Navy Veteran of the Vietnam War and I need my opioids to have quality of life. Revised the guidelines to make it easier on the Patient and the Doctors. Right now you have Doctors running scarred of prescribing worried someone will become an addict at my age "who cares" and every other Vet out there in pain. We need quality life and if opioids give that to use then so be it. We are all God fearing people.<br/>The guidelines have been so destructive that I think they should be demolished entirely and those involved in writing them should be held accountable in court. <br/>Any MME (morphine milligram equivalent) is ridiculous because every patient is different and that every patient doctor relationship is unique and personal.<br/>Please stop following the [name redacted] and [name redacted] narrative and help us Vet.<br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc09bd	Anonymous	None	2022-03-08T21:17:13Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-iu9m-jta4	False	None	False	2022-04-12 04:17:23.757	[]
2148	CDC-2022-0024-2154	https://api.regulations.gov/v4/comments/CDC-2022-0024-2154	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [Name Redacted] and I am a person with a disability. I am dealing with constant pain due to spinal stenosis and I am in support of the latest 2016 update to opioid use based on patient needs. I know that as a person who is dealing with constant pain it is helpful to use opioids at times so I can continue to work and be productive. I am very happy with the 2016 guidelines because it places care of patients more squarely between a doctor and a patient so that doctors and patients can be more in charge of pain and disease management. Thank you for making this update to your guidelines. Docket Number CDC-2022-0024	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484fc021e	Alexander	None	2022-03-08T21:17:15Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Alexander, Julie	l0i-b4fo-zkau	False	None	False	2022-04-12 04:17:23.969	[]
2149	CDC-2022-0024-2155	https://api.regulations.gov/v4/comments/CDC-2022-0024-2155	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient because I have Psoriatic Arthritis, which is a progressive disease. With the avalanche of "Pain Centers" and doctor's reluctance and refusal to continue to prescribe pain medication, people like me ARE FORCED to go to these, dare I say, HORRIBLE, facilities. You are NOT REDUCING CRIMINAL OPIOD USE. You are subjecting patients to mistreatment. These places almost bully the people. I actually went to a psychologist largely because of the mistreatment I received. I was a professional and earned a master's degree, yet was treated like some drug addict because I have a disease which causes pain treatment. The prescription guidelines you have created has caused people with chronic pain a lot of time, money, and humiliation. My disease progresses, which means I might need a higher dose in the future before I die. I have come home in tears many times because the pain center people are in a position to threaten you AND THEY DO! <br/>My friend's mother was 89 years old and had a very bad back, which left her bedridden. She had to go to a pain center, they cut her meds, and she tried to commit suicide. While in the hospital, they gave her pain meds and she got in trouble with the pain center because they make you sign a contract that says you can't take pain meds from someone else.<br/>In addition to the obvious problems described above, the entire experience makes pain even more painful. IT IS HUMILIATING. IT IS AN AVENUE FOR MEDICAL CROOKS TOO. START LOOKING INTO THOSE PAIN CENTERS. EVERY MONTH YOU HAVE TO PAY, TAKE A URINE TEST, AND WASTE A LOT OF TIME. I RARELY SEE THE RICH IN THE WAITING ROOMS??????????????????M MOSTLY PEOPLE ON MEDICARE AND SOCIAL SECURITY. IT IS A RACKET! THEY CHARGE INSURANCE COMPANIES AN EXORBITANT AMOUNT FOR A URINE TEST TOO.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484fc09ab	Starnick	None	2022-03-08T21:18:11Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Starnick, Pamela	l0i-igjz-3dsz	False	None	False	2022-04-12 04:17:24.190	[]
2150	CDC-2022-0024-2156	https://api.regulations.gov/v4/comments/CDC-2022-0024-2156	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The result of the ignorance of physicians and New York state lack of care or concern for patients in pain cannot be swept under the rug. I have a back stimulator that doesn't do anything but in order to continue my pain meds at the time it was forced on me. <br/><br/>Also, on a night in November of 2019 I was assaulted at [healthcare facility name redacted]. A place that had treated me in the past, sent five security goons to escort me off the hospital property. I was in pajamas and it was cold they could.not have cared less about my need to limit the pain.<br/><br/>I want retribution.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stan	None	None	0900006484fc09a7	McDannold	None	2022-03-08T21:18:55Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from McDannold, Stan	l0i-ic40-7cd2	False	None	False	2022-04-12 04:17:24.431	[]
2151	CDC-2022-0024-2157	https://api.regulations.gov/v4/comments/CDC-2022-0024-2157	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband's Father was terminally ill with cancer in the 1970s. He was in the hospital beating himself in the head with a metal water pitcher, trying to knock himself out because they would NOT give a dying man pain medication "because he might get addicted.<br/>Things are still not any better. <br/>People in pain DESERVE relief and are NOT the ones selling on the corner. Get some humanity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc09a3	Anonymous	None	2022-03-08T21:19:10Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-i6rl-ryct	False	None	False	2022-04-12 04:17:24.650	[]
2152	CDC-2022-0024-2158	https://api.regulations.gov/v4/comments/CDC-2022-0024-2158	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67 year old woman. I suffered a back injury when I was 50 and over the decades often had recurring attacks of extreme back spasm that left me literally physically and mentally congealed with pain. With appropriate pain medication I gave it my all .. Physical therapy, exercise, a healthy and happy lifestyle that includes pets, travel and friends. As I grew older the pain episodes are wider apart but alarmingly debilitating.. and I do not have adequate pain medication to carry me through to the other side. I am unable during these periods to understand the callousness of a political and medical policy that paints everyone with the same brush: addicts. We in chronic pain are not addicts. We are , for the most part highly functioning members of society. Our families depend on us. Cutting us off at the knees so that we are paralyzed is cruel and makes no sense at all. <br/>Although my PCP is an understanding and caring doctor in all respects, during pain prescription time she becomes a deer in the headlights, making me feel as if I am the problem, when in fact I am trying to resolve a problem that will let me get on with my life.<br/>Please, I implore you: develop and communicate a clear and compassionate policy on this issue. The suicides should be a warning bell not just about the harm caused but also the legal implications.<br/>Thank you,<br/>[Name Redacted]<br/>[Location Redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bhol	None	None	0900006484fc0223	Rand	None	2022-03-08T21:19:23Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Rand, Bhol	l0i-bcuj-t2cw	False	None	False	2022-04-12 04:17:24.865	[]
2153	CDC-2022-0024-2159	https://api.regulations.gov/v4/comments/CDC-2022-0024-2159	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic lower back pain caused by a disc injury at the the L5/S1 location in 1991, and subsequent surgery. Until 2016 when the Opioid Protocol came into full force,I was able to sleep in spite of the pain by taking Tramadol daily. <br/>.<br/>After 2016, I was not able to obtain a prescription for Tramadol, and my sleep was reduced to 4 or 5 hours a day. That chronic lack of sleep has negatively impacted my health and my quality of life in general.<br/>.<br/>The proposed changes to the protocol need to assert that the medical needs of the chronic pain patient must be the primary driver in prescribing opioids, not the public health goal of denying opioids to addicts taking the drugs for recreation.<br/>. <br/>Currently, practitioners will not prescribe opioids for fear of legal actions that <br/>could result in the loss of their license to practice medicine. That situation is deeply unfair to the great majority of chronic pain patients who use opioids in a disciplined way, and need the drugs to be productive on a day to day basis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc09a2	Anonymous	None	2022-03-08T21:19:39Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-i4ad-dasj	False	None	False	2022-04-12 04:17:25.079	[]
2154	CDC-2022-0024-2160	https://api.regulations.gov/v4/comments/CDC-2022-0024-2160	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Medically Necessary Opiods<br/>I am a physician in practice for almost 50 years<br/>The government's ruling is affecting physicians and patients. Having personal experience, after 50 years as a radiologist, interpreting regular xrays, and for the past 18 years Mammograms,after being the first in the world to prove that Mammograms could be transmitted via the internet, I have been and am sitting in front of viewboxes and now computers, my back and neck degenerated to the point where I needed emergent neck surgery to prevent paralysis and then extensive lower spine fusion surgery , repeated several times by a top neurosurgeon to prevent further degeneration, which has left me in agony. Without opiods (and major ones -Dilaudid), and I am not abusing, but it is only good for 6 hours. Other pain docs tried to put me on 24 hr meds, that were 1/10 the strength because they are scared of being watched by the FDA and government. I am saving many women's lives, reading and picking up early cancers but I have definitely contemplated ending it because i can't function aside from sitting and working. Something has to be done to revise the ridiculous guidelines put in place by CDC and Government. There are actual people , who do not abuse but NEED the meds to function and the primary care or pain docs are scared that they will be tagged for prescribing what is an absolute necessity	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alan	None	None	0900006484fc024e	Melton	None	2022-03-08T21:20:28Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Melton, Alan	l0i-bqns-ecp1	False	None	False	2022-04-12 04:17:25.302	[]
2155	CDC-2022-0024-2161	https://api.regulations.gov/v4/comments/CDC-2022-0024-2161	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines have been so destructive that I think they should be demolished entirely and those involved in writing them should be held accountable in court. Anyway, here's the link. Having any MME (morphine milligram equivalent) is ridiculous because every patient is different and that every patient doctor relationship is unique and personal. The Regulations you pose on the people who need opioids just to have quality of life needs to be change to benefit the Patient not the government. The Doctors have been educated in taking care of their patient but the government ties the doctor hand and he cannot practice without fear of his license being taken away and his attitudes goes to the patient. If you feel the doctors are not intelligent enough to understand the opioids they prescribe then give them a must have class to learn. Stop hurting the Veterans and the patients who need opioids for pain. All of you who make decisions on the guidelines need to be in pain to see what it's really like. You need to listen to patient advocates to help you with your guidelines. Us pain patients cannot help it opioids are not a billion dollar industry now that the [name redacted] family is gone and they no longer need Afghanistan. Change the guidelines so a PCM can prescribe for his patients and stop overloading pain center who can not handle the pressure they get from their patients. Plus your guidelines make the Pain Center Doctors look at each patient as an addict and they are not addicts. They just want relief from pain. You know the [name redacted] Family started all of this an the [name redacted] made it so people had to go to the streets and get relief. You can change this with better guidelines. My daughter has had a reduction in her opioids by her pain doctor because he said he can not lose his license this is in [city redacted] Florida. She is in pain 24 hours. These patients have to beg the doctors to no avail. My husband had his pain med taken away from him from a PA can you imagine a PA.which put him in automatically withdrawals. The people have suicidal thoughts and I realize you all do not care about their lives after all the Cabal and [name redacted] is getting the population down to 500 million people and the more [name redacted] kill the better.. I am pretty sure[name redacted] have donated monies to help you reach your guideline according to his plan. Wake up this is America. By the way my husband is a veteran of the Vietnam war and needs his medication. If you are reading this and care at all you will encourage the regulations be made easier for the Doctors to prescribe for the Patients. Help the people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc09a1	Anonymous	None	2022-03-08T21:22:19Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-i2pc-c8ci	False	None	False	2022-04-12 04:17:25.529	[]
2156	CDC-2022-0024-2162	https://api.regulations.gov/v4/comments/CDC-2022-0024-2162	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to make a comment for a group that I suspect you do not often hear from — sufferers of “small” or “incidental” but persistent pain. Our pains are inadequately but easily “mostly” treated by small daily doses of narcotics, and poorly or not-at-all treated by alternative approaches. <br/><br/>As a long-term sufferer of what some others might consider “small” or “incidental” pain, originally related to my lower back, but now primarily in my arthritic hands, I have long relied on small dosages (around 2.5-5.0mg/day) of hydrocodone. While I understand that the drugs I rely upon can be misused, isn’t this true of many drugs? And NO, OTC painkillers do not provide an adequate substitute. My use of these OTC drugs when it became hard to get hydrocodone caused an ulcer in one case (from ibuprofen), and a severe allergic reaction in another (from naproxen).<br/><br/>Could I live without these drugs? Yes, that is possible. Would I suffer withdrawal? No, I have not, when the ridiculous policy changes of recent years have made it impossible to get these pain management tools. But at what cost?<br/><br/>Do you like coffee? Do you ever take aspirin or ibuprofen? Or what about alcohol? Do you ever enjoy a glass of wine or a bottle of beer? What would it do to your productivity and/or enjoyment of your daily round if government policy decreed that these substances were being abused by some, and in consequence ALL had to give them up, except maybe in cases of terminal cancer? My guess is that you would put your head down and slog on. You’d still live. You could still do most of your work, maybe not as quickly or as well as you used to. You’d grumble, and you would be unhappy. Because “getting by” is not the same as “living.” And living with persistent pain, untreatable because of misguided government policy, is a lot more frequently “getting by” than it is “living.”<br/><br/>Reasonable long-term use of narcotic painkillers to make it possible for ordinary people to live ordinary lives, centered ON those lives rather than centered on trying to manage what some others (others who _don’t_ have to live with daily pain) may consider “small” amounts of persistent pain… this is what recent government policies have made difficult to impossible. Cutting off virtually all access to narcotic pain management tools in most circumstances is like removing knives from the public sphere: yes, sometimes people stab others, or hurt themselves with knives. But do you really want to eat your steak with a butter knife? Pardon my pun, but this is a blunt policy — in aggregate it hurts as much as it helps. <br/><br/>There are many possible analogies, none of which adequately contain the conditions and complications associated with these marvelous, troublesome drugs. For the truth is these drugs are both: profoundly useful when used carefully and correctly _and_ quite dangerous when taken for granted and used carelessly or incorrectly. I understand that policy must balance these dimensions. My point is that narcotic pain-relief policy has swung too far towards prohibition, and like most extreme policies, has caused unnecessary & avoidable consequences — in this case literal pain & suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dale	None	None	0900006484fc024f	Lowery	None	2022-03-08T21:22:28Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Lowery, Dale	l0i-bs2k-wu4q	False	None	False	2022-04-12 04:17:25.761	[]
2157	CDC-2022-0024-2163	https://api.regulations.gov/v4/comments/CDC-2022-0024-2163	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make it better for physicians to write prescriptions for opiods because in December the neurologist I was getting my prescription for Methadone decided to retire. He never warned me he was even thinking about it. At the time I tried to find someone in the Indianapolis area to find someone who would continue to write the prescription. This didn't happen and I had to go off of it cold turkey. This is something that a law abiding citizen shouldn't have to experience. Methadone is being touted as the best thing since sliced bread. [name redacted] is a well respected physician who has been an advocate of it. I watched videos of him saying this medication was the best way to treat Restless leg syndrome so I decided to try it. I am located in Indiana where everything is illegal that might have helped me. Please don't let this happen to anyone else! I am 63 years old with a stent in my heart. That being said it has been very difficult to go through this cold turkey and I don't want anyone else to have to do so. Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0966	Anonymous	None	2022-03-08T21:23:04Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-huau-jwkf	False	None	False	2022-04-12 04:17:25.974	[]
2158	CDC-2022-0024-2164	https://api.regulations.gov/v4/comments/CDC-2022-0024-2164	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been taking Tramadol for chronic arthritis pain for over 10 years. Originally, the prescription was refilled just like any other. Then, I had to present a physical hard copy script to the pharmacy. Now, the pharmacy requests the script electronically directly from the Doctor’s office. This last time I submitted a refill, the pharmacist refused to fill the prescription because it exceeded the CDC guidelines. My doctor called and spoke to the pharmacist, but he could not be persuaded. Against my will and the will of my doctor, my dosage has thus been reduced from 150mg 3X day to 50mg 2X day. This new dosage is insufficient to control my pain on a daily basis.<br/><br/>I also have a prescription for Hydrocodone, taken as needed when my pain is especially severe. I use this sparingly as it makes me groggy. If I can not get enough Tramadol to control my pain, I will have to switch to Hydrocodone and live with being in a permanent fog.<br/><br/>In a desperate attempt to find a replacement for Tramadol, I have just received a Medical Marijuana card. I am currently trying different products but have yet to find a suitable substitute for Tramadol. I find the Medical Marijuana difficult to accurately dose, and can end up loopy if I am not careful.<br/><br/>I would greatly appreciate a loosening of the CDC guidelines, so that I may return to the medication that works best for me and my particular arthritis pain.<br/><br/>Thank you for your time and consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynor	None	None	0900006484fc0277	Lisi	None	2022-03-08T21:24:21Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Lisi, Lynor	l0i-c0x9-phfz	False	None	False	2022-04-12 04:17:26.188	[]
2159	CDC-2022-0024-2165	https://api.regulations.gov/v4/comments/CDC-2022-0024-2165	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This js hard for me to write without letting my emotions get the best of me. 1st let me say thank you for FINALLY allowing our voices be heard. But be "Heard" and someone actually LISTENING are 2 different actions.<br/>I am a 50 year old female who lost her ability to continue supporting herself due to several medical conditions. All that are very PAINFUL and alters my ability to live a quality of life I was use to. I have been in PM for several years and had a honest and sincere relationship with my doctor until his hands became "tied" back in 2016. We had worked on a regime that worked best for my situation and to be able to reach a quality of life I could Somewhat accept. Bit in 2016 I had my medication (pain) decreased to a 1/3 of what was working. Simply because my dosage was based on "points" set by the CDC. I was forced to choose between my MENTAL HEALTH meds or PM. Now I I'm on the VERY BARE STATE MINIMUM , also choosing to receive STEROID INJECTIONS,that also is being controlled by my insurance, to try and minimize my pain level. Mind you one of my Medical Conditions I've currently been diagnosed with is a rare and severe painful disease that MOST DOCTORS have NEVER seen or know how to treat, there is NO CURE! Will only worsen over time!! ARACHNOIDITIS! <br/>Bottom line I reckon, WE ARE ALL DIFFERENT!! Your PAIN LEVEL is 100% different than MY PAIN LEVEL! Metabolism plays a KEY ROLE! Note I've also been diagnosed with Crohns and I don't metabolize like "You". There are those who's narcotic tolerance is HIGH, me being one. I've woke up from procedures. Stop grouping us pain sufferers as ONE!!! STOP PLAYING DR!!!! ALLOW THOSE WHO HAS DEDICATED THEIR LIVES TO HELP US DO THEIR JOB!!!! <br/>I do agree the heroine epidemic is bad. But putting us in that group is WRONG!!! There is a difference in ADDICTION vs DEPENDENCE. We are not seeking a "High"....we are only seeking relief. Seeking the same quality of life we deserve!! Instead of just "HEARING US" PLEASE "LISTEN TO WHAT WE ARE SAYING!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484fc02de	Johnson	None	2022-03-08T21:25:33Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Christine	l0i-co9n-tjh1	False	None	False	2022-04-12 04:17:26.401	[]
2160	CDC-2022-0024-2166	https://api.regulations.gov/v4/comments/CDC-2022-0024-2166	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a life threatening trauma event in June of 2019. I fell 20 feet off a ladder onto asphalt. My entire left side was affected. I shattered my left foot almost beyond repair. It is permanently fused with 2 pins in the heel and all my nerves have been damaged. I also have a rod in my calf from the foot connected to my artificial knee. My femur was broken and has 2 pins and a rod connected to my knee. I have constant pain in my left foot with swelling after walking. My pain meds have been reduced to 3 50mg tabs of Tramadol per week. So I must managed my meds to ensure I have at least some through allotted period. <br/>So my quality of life has been diminished during my retirement and it affects my daily outlook on life. I have managed opioids throughout my life with no issues.<br/>Would really benefit from more opioid meds to manage my pain and improve my quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kenneth	None	None	0900006484fc0301	Horgan	None	2022-03-08T21:28:36Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Horgan, Kenneth	l0i-cn7k-9grj	False	None	False	2022-04-12 04:17:26.625	[]
2161	CDC-2022-0024-2167	https://api.regulations.gov/v4/comments/CDC-2022-0024-2167	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment on this sensitive subject. <br/>While I understand the need for caution, due in part to the recent opioid crisis that included gross mismanagement on both the medical and patient sector, I am personally frustrated, confused and tired of being made to feel like a criminal or a beggar when the need for a prescription medication arises in my life.<br/>I am a 62 year old, retired (due to health challenges) elementary school teacher whose background also includes 20 years spent working as an OR scrub assistant. <br/>I have been diagnosed with Rheumatoid Arthritis, Lymphedema and also struggle with a compromised left hip issue due to a failed joint replacement that included 2 dislocations & 2 subsequent revision surgeries. <br/>Everyday is a challenge for me and having a day where I am able to somewhat function as a “normal” human being is a true gift. <br/>I currently use a walker to get around my home and have recently been reduced to using a wheelchair in public. This is because of the gross enlargement of my legs due the Lymphadema, the progressive damage to my joints because of the rheumatoid arthritis, and the tenuous condition of my left hip. I am doing my best to maintain some normalcy here and having to use a wheelchair in public is heartbreaking to me.<br/><br/>The daily pain that goes along with my disease(s) and conditions can be debilitating. On my good days, I am able to maintain a balance by either dealing with the pain and not taking anything for it or taking extra strength Tyelenol if needed. However, nighttime is the enemy. There are evenings, when an especially busy or challenging day catches up to me and no amount of Tyelenol, hot or cold assists, meditation, deep breathing, etc can help with the pain. I have gone to sleep while crying with the pain, I have been awakened during a sleep period due to the pain, my husband has had to awaken me due to my moaning and thrashing because of the pain. THIS IS NO WAY TO LIVE! <br/><br/>The toll of these life altering challenges is immense- I must have my husband assist me getting in and out of bed, showering and personal cleansing after using the toilet. I no longer drive, teach, fly, and can only comfortably travel short distances. I pay, out of our own retirement funds, for my Lymphadema specialist and treatment services. A recent $8000.00 speciality lift device was fitted into our family vehicle and it was not covered by insurance. Thank God my husband and I are able to afford these things, life would be much worse without them.<br/><br/>So, I ask you - faced with all these challenges and medical issues why it is so very difficult for me to obtain pain medication to take, when I need it, to enable me to finish the day or even to “get thru” something like a holiday together with my family? Don’t those of us, who struggle with physically debilitating conditions, deserve a shot at some daily normalcy and enjoyment too? <br/><br/>I dread having to ask for a refill of prescription pain medication when I see my nurse practioner. My rheumatologist and lymphedema doctors always refer me to my nurse practioner if I approach the subject of prescription pain control. And, while I stress over the need of asking for controlled substance pain control, I see the trepidation and concern in my NP’s eyes. Office protocol dictates that I must sign a form so that they can “track” my usage of these pain meds. <br/>As I sit there and we work through the process of how many I might need ( how do I know? I have no idea what my future time might hold!) I am left feeling like I am asking for something dirty or illegal. I am left feeling like I am a failure for having to “resort” to using prescription pain medication. <br/><br/>While I sympathize with the toll that the unchecked misuse of pain medication has taken on the world, I am just asking for the occasional chance to function my way through a “normal” day without being made to feel ashamed for asking for a small amount of prescription pain medication.<br/>I ask that Congress please, please, please take all of this into consideration, including those of us that do struggle with chronic, daily pain, when making their decision. Please remember that those of us, who have medical conditions, sometimes require more than an OTC option.<br/>While I can never return to my life before these serious medical challenges arose I do not believe it is wrong for me to want to be able to enjoy some time with family and friends, occasionally sleep un-interrupted through the night and turn aside thoughts of depression and suicide based upon the future that I see ahead of me. <br/>Chronic pain is a curse that does not go away, it will continue to haunt me until I die. Please ask yourself how you might deal with it? I ask also that it is remembered that not all of us, who need prescription medication, become or are addicts. <br/>Thank you for your time.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484fc024d	Phelan-Mangen	None	2022-03-08T21:43:27Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Phelan-Mangen, Kathy	l0i-bpxi-arz3	False	None	False	2022-04-12 04:17:26.852	[]
2162	CDC-2022-0024-2168	https://api.regulations.gov/v4/comments/CDC-2022-0024-2168	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer due to severe spinal injury and lupus, I have encountered difficulties getting my modest and standard dosages of hydromorphone, often due to the additional hurdles of national and local regulation in a misdirected effort to reduce opioid addiction. Being unable to fulfill a prescription for just a few days resulted in terrible pain and triggered withdrawal symptoms! No patient should have to go through that. The press reports some patients who cannot stand the problems of delays in the supply of needed medication, and seek relief through suicide! However rare that might be, one case is too many. More patients may suffer less, but they should not have to suffer at all.<br/>The government should not generally be prescribing to physicians what the physicians prescribe for their patients. Instead, efforts should be made to identify individuals and industry organizations that distort the medicines' uses and abuse the distribution and prescription process. Track prescription by prescriber and recipient. Find those that clearly over prescribe, offer multiple untimely prescriptions and prosecute violators. Do not interfere with the legitimate practice a doctor sees fit. Likewise, review the pressure and deceptive tactics by manufacturers which promote unnecessary or extensive prescriptions. Empower pharmacies to inquire of seemingly excessive dosages or number of prescription and report suspected abuse. See out those how attempt to gain access an over-supply of the drugs and prosecute them. But do not tell pharmacy they should not provide for a legitimate prescription. In short, treat violations and harmful behaviors, not regulate doctors.<br/>The other essential component of combatting the national opioid problem is to provide recovery for those unfortunate to have become addicted already. Without public health programs for detoxification, many will not be able to afford to combat their additions. My recent experience suggests that I am now physically dependent on my pain killer in ways beyond suppressing my substantial pain. As a disabled citizen, I can only hope that medicare could asset me if I shoudl ever recover enough from my other problems to be able to forego my hydromorphone. Others may be better off than I and only need opioids for a short period. Even so, they too may need assistance to move away form their medication when it is no longer needed.<br/>Regulation is not always the answer. Law enforcement and public health are better approaches to these problems. Regulation is already causing difficulties for those who genuinely need these medications. Please do not make it worse.<br/><br/>[Name Redacted], Ph.D. [Location Redacted] USA	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R J	None	None	0900006484fc02fe	Rockefeller	None	2022-03-08T21:45:00Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Rockefeller, R J	l0i-cu0e-ict9	False	None	False	2022-04-12 04:17:27.078	[]
2163	CDC-2022-0024-2169	https://api.regulations.gov/v4/comments/CDC-2022-0024-2169	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'd like to address the restrictions on all controlled substances that has been a result of the opioid crisis. I suffer from an acute and debilitating psychological fear of flying. For many years, I never flew- until a doctor prescribed a small amount of lorazepam to take when I fly. I got my life back; I was able to travel to Europe for the first time in my life. Around the time of the opioid crisis backlash, it became impossible to find a doctor who would prescribe lorazepam to me. Even though the amount I require is so small- I had 8 1mg doses that stretched out over six years. When I ran out I was desperate to find more, as I just haven't found any other way to deal as well with my phobia. I was treated by two different clinics as under suspicion of drug seeking, was forced to "establish care" and jump through the hoops of scheduling a mammogram and a Pap smear, just to be granted 2 .5 mg doses for a trip that encompassed three long distance flights. It was humiliating and degrading, and I had to carefully consider how much of each pill to allow myself for each flight. I think that not only opioids but all controlled substances are being treated so carefully, to the detriment of the patients' wellbeing. I understand doctors are very concerned about how they look to the DEA but it is not in the best interest of patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carroll	None	None	0900006484fc0355	Ott	None	2022-03-08T21:45:54Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Ott, Carroll	l0i-d18b-0tql	False	None	False	2022-04-12 04:17:27.298	[]
2164	CDC-2022-0024-2170	https://api.regulations.gov/v4/comments/CDC-2022-0024-2170	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Physicians Assistants and Nurse Practioners should be allowed to prescribe opiods until a Doctor can be seen. Living in a rural area, those are the health care providers that are available at first. They are trained to know when a patient needs pain management help, but are not allowed to give help.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leah	None	None	0900006484fc03d5	Jones	None	2022-03-08T21:46:41Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Leah	l0i-dh5g-73d3	False	None	False	2022-04-12 04:17:27.513	[]
2165	CDC-2022-0024-2171	https://api.regulations.gov/v4/comments/CDC-2022-0024-2171	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your actions have caused doctors to treat everyone as junkies. People are suffering needlessly because you tried to simplify a complex problem, reminiscent of "just say no".	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fc03ed	Close	None	2022-03-08T21:47:03Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Close, Michael	l0i-dvya-kanm	False	None	False	2022-04-12 04:17:27.768	[]
2166	CDC-2022-0024-2172	https://api.regulations.gov/v4/comments/CDC-2022-0024-2172	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am happy to comment on the new clinical practice guidelines for prescribing opioids. I recently had my gall bladder removed for a polyp and the Surgeon prescribed Tramadol which did absolutely nothing for the post operative pain. I left my surgeon a bad yelp review because it also isn't recommended medication for someone with moderate to severe asthma. I had to call to ask for something different for post operative pain and received Norco. Norco slightly helped for the few days after surgery. I welcome the guidelines to ease up and be more geared towards the patient. Treat people how you would like to be treated.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484fc03ee	O	None	2022-03-08T21:47:37Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from O, S	l0i-dx17-eocm	False	None	False	2022-04-12 04:17:27.980	[]
2167	CDC-2022-0024-2173	https://api.regulations.gov/v4/comments/CDC-2022-0024-2173	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was a San Francisco Fire Captain who suffered severe damage to my spinal system (6 fractures cervical, thorax and lumbar) from a building collapse. I was stable on 60 mg of Methadone HCL. Oxycodone 10mg. for breakthrough pain and Clonazapam 1mg for muscle spasms. <br/>Then the CDC restrictions nearly killed me when most of my medicines were cut to pediatric “one size fits all” dosages. <br/>This was the equivalent of sending my doctor into a gunfight with a knife and no bullets! <br/>I was blessed to find a pain specialist who could increase the prior dosages upward slightly but these dosage caps need to be reconsidered and removed. Opioids have no ceiling dose. Patients develop some tolerance and body weight ( I weigh 220 lbs) plays a huge role in dosage effectiveness. <br/>Please remove dosage limits on prescription opioids for chronic unrelenting pain. <br/><br/>Thank you. <br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484fc0b97	Spanne	None	2022-03-08T21:48:23Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Spanne, Tom	l0i-nxrq-430i	False	None	False	2022-04-12 04:17:28.190	[]
2168	CDC-2022-0024-2174	https://api.regulations.gov/v4/comments/CDC-2022-0024-2174	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a cancerous tumor removed from inside my spinal cord, C-6 to T-1, in December 2003. I was left with chronic nerve pain which left my right side, upper back and neck always "on fire". I was prescribed hydrocodone for that and took it for 16 years. Then when this opioid "epidemic" came into being, my primary care physician would not prescribe it for me anymore. In it's place he prescribed Tramadol....needless to say, I had to get accustomed to living with pain 24/7 since Tramadol does not do for me what hydrocodone did. I also can say that I am an alcoholic and have not had a drink in over 38 years. I must say I never abused my prescription. Recently I fell and cracked some ribs. My PCP prescribed 30 hydrocodone pills. I then discovered "real" pain management once again that I had been missing since the switch to Tramadol. The "fear" of everyone becoming "addicted" to certain opioids has cost me almost 3 years of my life living in pain that I should not have had to. With new regulations being discussed, I am going to try once again to get back to my original prescription of hydrocodone. I hope my PCP will not be "afraid" of any "government reprisal" and help me to get back to the level of pain management that I was able to maintain before the switch. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fc042d	Knipler	None	2022-03-08T21:48:37Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Knipler, Paul	l0i-ewfx-nu8c	False	None	False	2022-04-12 04:17:28.406	[]
2169	CDC-2022-0024-2175	https://api.regulations.gov/v4/comments/CDC-2022-0024-2175	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-2024. DUE 4-11-22<br/>I am a chronic intractable pain patient. Before 2016 I was able to (list what you could do). After 2016 I live (pain, torture , no quality of life ect). I was able to (what could you do?). Now I live (how?). I want my life back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0b76	Anonymous	None	2022-03-08T21:48:42Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-nrgd-jrtj	False	None	False	2022-04-12 04:17:28.619	[]
2170	CDC-2022-0024-2176	https://api.regulations.gov/v4/comments/CDC-2022-0024-2176	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-2024 DUE 4-11-22<br/>When the CDC released the guidelines all it did was destroy lives of millions of chronic intractable pain patients. In the update the CDC is writing it does not help any of these patients. Unless the CDC corrects this by adding a section increasing our pain medication. Millions of patients will continue to live in pain and torture, many of us will continue to die by suicide. Many of us were forced into the street and died because of overdose on street drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0b5a	Anonymous	None	2022-03-08T21:48:54Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-nje4-pfy2	False	None	False	2022-04-12 04:17:28.839	[]
2171	CDC-2022-0024-2177	https://api.regulations.gov/v4/comments/CDC-2022-0024-2177	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Before laser treatment, I couldn't even lift my arm without pain in my shoulder. My range of motion has improved greatly and I am delighted!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elaine	None	None	0900006484fc043e	R	None	2022-03-08T21:49:01Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from R, Elaine	l0i-ex6i-yi2a	False	None	False	2022-04-12 04:17:29.049	[]
2172	CDC-2022-0024-2178	https://api.regulations.gov/v4/comments/CDC-2022-0024-2178	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the changes in the laws in 2016 the only people that were considered were people with addiction problems or people with potential problem. The patients with chronic pain like myself that have successfully followed my doctors orders for 10 years have had their lives turn into a further nightmare. Patients are treated like drug addicts whether they are or not. Doctors are forced to reduce dosages on medication for no reason except that the government says so. Therapied that have been working and no issues occurred are being forced to be reduced. Patients are finding it impossible to find pharmacies to get the medication at. <br/>Mail service with greater risk is being used because of no choice.<br/><br/>Patients are being demeaned and treated as if they have done something wrong. Chemo hurts your body but pharmacies do not talk down to patients. The situation needs to improve. Suicide should not be the only answer to reducing pain and at times it is. If good doctors are careful who they prescribe to and monitor carefully they should successfully treat patients with the dignity they deserve.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fc0b4e	Lukowicz	None	2022-03-08T21:49:14Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Lukowicz , Susan	l0i-neis-9kay	False	None	False	2022-04-12 04:17:29.289	[]
2173	CDC-2022-0024-2179	https://api.regulations.gov/v4/comments/CDC-2022-0024-2179	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the Center Director of [Location Redacted] and I only have great things to say about laser treatment. I've been witness to countless patients' success stories. Laser therapy improves their acute OR chronic conditions. Their range of motion improves, their pain level decreases, and they are often amazed (as am I).	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jordan	None	None	0900006484fc0441	Chick	None	2022-03-08T21:49:58Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Chick, Jordan	l0i-f0b8-nfvs	False	None	False	2022-04-12 04:17:29.511	[]
2174	CDC-2022-0024-2180	https://api.regulations.gov/v4/comments/CDC-2022-0024-2180	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Laser treatment has definitely helped with reducing the pain and swelling in my knee after surgery!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ericka	None	None	0900006484fc0444	Rollins	None	2022-03-08T21:50:14Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Rollins, Ericka	l0i-f1wr-q247	False	None	False	2022-04-12 04:17:29.727	[]
2175	CDC-2022-0024-2181	https://api.regulations.gov/v4/comments/CDC-2022-0024-2181	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for your acknowledgement that the initial CDC guidelines were hastily drawn and hysterically applied with devastating consequences for pain sufferers. Until now, the national response to the "opioid crisis" can be characterized as a complete unawareness or disregard for people/patients that could, or used to, benefit from pain medications but are currently denied them. I used to have prescriptions for opioid-based medications that greatly improved my quality of life - diminished pain and suffering for leg, shoulder and hip problems, alleviated depression, and surprisingly palliative effects that helped with life-long stomach problems. Both direct and indirect benefits. However, as I mentioned previously, because of the hysteria associated with intial abuse of opioid prescriptions by a few bad actors early in the crisis (and the lack of digital monitoring), the pendulum has now swung widely in the opposite direction.<br/><br/>When I moved to Washington state recently I started looking for a new primary care provider that would continue my treatments and prescriptions. It was impossible. In fact, from a review of my medical records and published articles, I've found two things: First that anyone previously using opioids for any medical reason is now labeled as having an Opioid Use Disorder (OUD). A "disorder" - whereas I would have characterized my previous treatments as an Opioid Use "Regimen" (OUR). I never abused my medications. Never used them for euphoric/recreational purposes. Never allowed them to take control of my life in any diminished/destructive way. Yet I was characterized as having a "disorder" simply because I had been using these particular classes of medications for several years. Second, I've found that simply talking about the benefits that I experienced while on my opioid medications, let alone asking to see if they could be re-prescribed was viewed as "drug seeking behavior". So patients have no opportunity to even discuss their problems and make their own judgements on risks vs benefits, they are simply turned away, or counseled to "get more exercise", or directed to investigate suboxone treatments for withdrawal symptoms, none of which address the medical help I was seeking, ie. just a continuation of my prescription.<br/><br/>I'm not aware of all the "guidelines", laws, restrictions, training certifications, and reporting requirements doctors have to go through these days to write opioid prescriptions, those are not transparent to patients. However, I do know their effects. Which are at best burdensome (30 day supply or less, with repeated Dr. visits for refills, if you are lucky - to complete refusal). Patient's have no agency in decisions about their own personal care any more. No ability to balance risk vs benefit as personal decisions. They are simply told no. And from surveys I have read, and any number of articles, many/most doctors find all of these restrictions and oversight requirements too burdensome to bother with and just avoid prescribing opioid medications altogether (and I can hardly blame them). Thus the Hippocratic Oath becomes the Hypocritic Practice (or lack thereof). <br/><br/>As with most things in life, problems are usually more nuanced than black and white, and this is especially so with respect to healthcare and physical isses - each person's situation is different. Yet, all people using these medications, or that have used them, are now treated the same way. Which is, not at all. The issue of addiction is alway brought up as a mitigating factor. But again, there is no nuance - no distinction between dependency and addiction. <br/><br/>This country has a completely dysfunctional view of addiction, especially since the 'opioid crisis' became a thing. On the one hand you have black and white punitive measures intended to criminalize addiction (War on Drugs, incarceration, Prohibition, restricted drug prescriptions, etc.), none of which worked or are working. On the other, bars, liquor stores, tobacco sales, legalized gambling, social networks, and many other forms of 'acceptable' addictive behaviors (not to mention nearly every commercial on nightly news being a drug commercial). Is a diabetic that needs insulin every day an addict? How about dialysis? Any person, whether dependent or addicted should be able to live a normal life, but instead all are lumped together - stigmatized and forced to suffer with little resources to change their situation, help unravel why they need 'whatever' to cope with every day life, or be allowed to access safely regulated products. <br/><br/>It just doesn't make any sense. <br/><br/>So, I am urging you today to not only pass the newly revised CDC guidelines, but also actively work to rescind all the restrictive policies and laws that have been passed since the initial guidelines were passed in 2016. Stop pushing people into the streets and making the problem worse. Please.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fc0b22	Kuwada	None	2022-03-08T21:50:26Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Kuwada, Mark	l0i-n3eu-ixp3	False	None	False	2022-04-12 04:17:29.945	[]
2176	CDC-2022-0024-2182	https://api.regulations.gov/v4/comments/CDC-2022-0024-2182	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidance on opioids was a misguided attempt at solving illicit drug use by curbing legitimate patients who already had and have to jump through multiple hoops just to get the medication their doctors prescribed. The current guidance on pain management are unnecessarily difficult. Furthermore, most states already have strict rules for dispensing opioid medication and those regulations need to get another look as well.<br/>My local CVS refuses to fill my prescriptions even after multiple conversations with my multiple physicians, they use the fact that my dosage ‘approaches the 90mg level.’ It’s embarrassing for me to get a prescription filled and even worse, being told to man up by strangers.<br/>Lastly, one of the alphabet soup agencies seized the records of a doctor in my area, with their records held by the federal government, all of the patients were unable to get their prescriptions. Many of the patients who had their records taken were elderly as was the provider who it turned out committed the crime of being technically challenged and no files were charged. This guidance needs to be rescinded and individuals and their doctors deserve the discretion they’ve earned and deserve.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A.	None	None	0900006484fc0b1b	James	None	2022-03-08T21:50:55Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from James , A.	l0i-mx1q-cii3	False	None	False	2022-04-12 04:17:30.170	[]
2177	CDC-2022-0024-2183	https://api.regulations.gov/v4/comments/CDC-2022-0024-2183	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for reconsidering the previous regulations on the use of pain medications for chronic pain patients. I had spinal surgery 6 years ago that reduced spinal pain, but introduced painful neuropathy in my ankles and feet. The burning sensation gets progressively worse throughout the day and makes sleep nearly impossible without the assistance of a relatively low-dose hydrocodone each night before heading to bed ( 2-5/325 doses; one earlier in the evening and one at bedtime). My family doctor has been very helpful in continuing to prescribe this (and seek other remedies for nerve damage) but I can tell it creates a paperwork and monitoring burden that makes the process more difficult than it should be. It can also be humiliating having to take a drug test every 6 months. I don't use other drugs, don't drink and don't smoke. Please separate the war on illegal drugs from those that are actually improving quality of life for those with chronic pain. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0471	Anonymous	None	2022-03-08T21:50:58Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-fixi-27b3	False	None	False	2022-04-12 04:17:30.389	[]
2178	CDC-2022-0024-2184	https://api.regulations.gov/v4/comments/CDC-2022-0024-2184	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-2024<br/>CDC-2022-0024 Due 4-11-22<br/>In 4-2017 my doctor of 12 years cut off my pain medication I’ve been on for 15 rears Without warning told me my clinic will not prescribe opioids to any patients and said I would need to find another doctor. He basically abandoned me. It took me <br/>7 tries to find another clinic to take me. I was treated like a new patient. I can not live like this any longer and like millions of patients I’m barely hanging on. <br/>If the CDC does not change the guidelines and give our pain medication back soon I’m not sure what will happen to us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc08c0	Anonymous	None	2022-03-08T21:51:09Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-monj-c1v0	False	None	False	2022-04-12 04:17:30.600	[]
2179	CDC-2022-0024-2185	https://api.regulations.gov/v4/comments/CDC-2022-0024-2185	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate a valued place where I can comment on this topic.<br/>I am 54 years old and suffered from a painful thoracic aortic dissection in August 2021, followed by an even more painful abdominal aortic dissection in September of 2021. This was in [city redacted] Arizona. After leaving the hospital in late September, I had an open incision in my stomach of 12 inches with a staple every inch, barely closing it. Plus I was recovering from open heart surgery 3 weeks earlier than that. I was sent home with three days of pain medication, due to the new laws set up to protect me. I suffered, and suffered, and suffered. Was only prescribed Tylenol and was told due to the new law was unable to take pain medication they would normally give me. No doctor wanted to suffer the burden of being the doctor that prescribed it. Not my primary care, or even the doctor who performed the surgery who was responsible for my postcare. No one would help me. So I suffered. I am honestly a bit surprised I lived through that. It was torture. I think now I would rather die than receive major surgery and be released like that again.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marina	None	None	0900006484fc0963	Sollars	None	2022-03-08T21:51:51Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Sollars, Marina	l0i-hpgl-i7yz	False	None	False	2022-04-12 04:17:30.818	[]
2180	CDC-2022-0024-2186	https://api.regulations.gov/v4/comments/CDC-2022-0024-2186	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an RN, I was an eyewitness to the phase when every patient was asked to evaluate their pain level on a scale of 1-10. I’m not sure if this was partially responsible for the “opioid epidemic “, but most likely it was that, unregulated pill mills, and/ or an elderly population.<br/>Personally, I have suffered from chronic pain for 48 years. Believe me, we haven’t made much progress in pain relief throughout my career.<br/>In Florida, where I reside, we have the “ pharmacy crawl.” It refers to the situation where patients go from one pharmacy to another trying to get their prescriptions filled. My record is 11 pharmacies for one prescription! You can’t call ahead to see if a pharmacy has the drug you need in stock, because I guess they think you might rob them. But even worse, it is the law here that if say my prescription is for 60 pills, and they only have 35, and the patient buys them, the patient has to “ forfeit “ the remaining 25 pills for that month! You can’t pick them up later. It is inhumane!<br/>On a positive note, the electronic prescriptions have made it easier for patients. Until they were implemented I had to go to a Dr every month to get my pills. What a waste of healthcare dollars!<br/>Yes, we have cut down on opioid prescriptions in the US, but at what cost? Patients in real pain who can’t get access, many times end up buying relief on the street. With all the fentanyl laced drugs, it’s disasters waiting to happen.<br/>In addition to pain pills, I’v e tried physical therapy many times, biofeedback, hypnosis, massage therapy, nerve blocks and nerve ablations. Until we find better treatments than opioids, there is not much a patient ( or Dr) can do. I think medical students should learn more regarding pain management. It’s cruel to deny patients in real pain treatment.<br/>I’ve taken narcotics off and on for 48 years, and I’ve never overdosed. If taken correctly, as prescribed, they are a God send. I don’t think I could live life without the relief from them	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484fc04ff	Logan	None	2022-03-08T21:52:46Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Logan, Tracy	l0i-gdpj-so7d	False	None	False	2022-04-12 04:17:31.030	[]
2181	CDC-2022-0024-2187	https://api.regulations.gov/v4/comments/CDC-2022-0024-2187	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is important that the CDC recognize that there are millions of people who need opiods to manage chronic pain. These are not people who abuse their medications or who are "addicts." They are simply people who have diseases that they have to live with every day. These diseases create situations where people are dependent on a level of pain medication to simply do the best they can to live a somewhat normal life. A life with minimal pain. It should also be noted that most of these people still live with high pain levels even after taking their medications, and as with any medication taken long term, tolerances become a reality and increasing the dosage is not out of the whelm of possibilities. None of these people would have ever chose to live a life where they need daily pain medication just to get through the day. All medications have side effects and these side effects are not pleasant for the people who have to take these pain medications. The CDC must take into account that chronic pain is a very real issue for many, many people and these are good people who have had the unfortunate circumstance to be living with diseases that create chronic and daily high levels of pain. It should not be up to the Federal Government to tell pain doctors how much pain medication they should and can prescribe to their patients. Every patient is different and pain doctors are in the field they are in to try to help with suffering. The CDC needs to increase the daily 90 MME's for patients dealing with chronic pain and allow pain doctors to do what they feel is best for their patients in order to do all they can to improve that patient's quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc045e	Anonymous	None	2022-03-08T21:53:59Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-ffj4-l6xi	False	None	False	2022-04-12 04:17:31.272	[]
2182	CDC-2022-0024-2188	https://api.regulations.gov/v4/comments/CDC-2022-0024-2188	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 30-year old daughter is presently in the hospital with acetaminophen toxicity and at risk of serious liver damage. Oxycodone was withdrawn for treatment of insufferable pain from peripheral neuropathy due to an infection of etiology unknown. When spinal nerve blocks could no longer be performed due to massive scar tissue from the injections, she was cut loose. Not one pain management doctor or g.p. or neurologist would prescribe oxycodone - which she tolerated well prior to nerve block and had a fully engaged life of work and school and friends. She now wants to have her foot amputated. Pain should not be a disabling punishment when it can be successfully managed. I should know. I have been taking oxycodone for over 15 years and I am a college administrator, full time wheelchair user, single mom, M.Ed, home owner, children's author, and contributor to my community. Hardly addict behavior. Please correct the guidelines and if the Sacklers could convince the country that pain should be managed (for his own financial benefit), surely the CDC can convey that pain is treatable and each person deserves a shot at a life. Thanks.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	claudia	None	None	0900006484fc095e	obrien	None	2022-03-08T21:54:39Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from obrien, claudia	l0i-hcv1-yemj	False	None	False	2022-04-12 04:17:31.490	[]
2183	CDC-2022-0024-2189	https://api.regulations.gov/v4/comments/CDC-2022-0024-2189	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am so relieved that the CDC is going to revisit these guidelines. I am a nurse practitioner in hospice and palliative care. I have numerous examples of these guidelines being used as strict rules, both personally and professionally. So many of our colleagues are afraid to prescribe opioids to patients who could actually benefit and have improved quality of life. It is almost impossible for people in chronic pain to be believed and treated adequately. So many people have suffered as a result of these guidelines. Even patients in acute pain are suffering. After a severe motorcycle accident, a friend of mine was prescribed 7 days of narcotics and was never prescribed beyond that. Our healthcare system have stigmatized people with pain as being drug seekers or abusers. Patients with cancer have to jump through hoops to get medications. Pharmacies refusing to fill Methadone and a short acting opioid because they consider them both to be "short acting" medications. These guidelines created the polar opposite affect that was intended. Since so many people with legitimate pain were no longer able to have their pain treated (which is what has happened with these guidelines), many of them have taken to illicit drugs in an effort to find some relief. Prescribers should not be stating "the CDC states people with chronic pain should not be on opioids" which is what I hear time and again from colleagues all over the United States. I hope that before you or someone you love is need of pain management that these guidelines are revised and patients can once again be treated according to their individual condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484fc092c	Fehrman	None	2022-03-08T21:55:10Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Fehrman, Stephanie	l0i-h3ly-0kg5	False	None	False	2022-04-12 04:17:31.706	[]
2184	CDC-2022-0024-2190	https://api.regulations.gov/v4/comments/CDC-2022-0024-2190	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was taking 100 mg of oxycontin successfully for many years. During that time, I had been functioning well and I was promoted as a Managing Director with Goldman Sachs, a well paid and highly coveted position. In 2017 my pain doctor cut my oxycontin back to 60 mg per your guidelines, even through they didn't apply to my situation. I tried to work at the reduced dose but repeatedly warned my doctor my lower dose was insufficient. After two years, I retired at age 57 because my pain was no longer managed. I live alone, and my earned income plummeted from over $1 million annually to $0. The day my doctor heard about my retirement, he restored my therapeutic dose. It helped manage the pain but my job was gone.<br/><br/>Since 2009, my dose has been increased only 20 mg, and that increase occurred 7 years ago. I can no longer request that my dose increase when my body naturally builds up tolerance. Experience has shown that I am able to work on a therapeutic dose of opioids and unable to work without it.<br/><br/>Your guidelines have made my life an unnecessary living hell. I have consistently used the same pharmacy, never shown up in public in any altered state, never asked for an early refill, never claimed that I lost my prescription or that it was stolen -- the only thing I did when properly treated with opioids is accept great work and get promoted and highly paid for doing it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fc0926	Kleehamer	None	2022-03-08T21:55:58Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Kleehamer, Melinda	l0i-goqe-exot	False	None	False	2022-04-12 04:17:31.932	[]
2185	CDC-2022-0024-2191	https://api.regulations.gov/v4/comments/CDC-2022-0024-2191	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain victim for over 10 years.<br/><br/>Up until the time of injury I was an active athletic person and manager of sales for an international software company. I was a hiker, skater, hockey player, biker, jogger, wilderness boater, camper and explorer. I was able to continue to do many of these activities for several years with the help of the medication oxycodone. I am now 68 years old. I still am prescribed oxycodone, but the dose is so low, 15mg per day, that I run out of medication and then have to suffer 7 to 10 days without medication until my next refill.<br/><br/>My Dr is not a pain Dr and will not prescribe more pills. However, she had prescribed other medications like Gabapentin, Lyrica, and several other medications that actually cause great depression and does not help with my pain. I find it ironic that these other medications are handed out like candy when in fact they made me worse and at times give me suicidal thoughts. (Please note that I stay with this Dr for fear that if I go to another Dr I wont be given ANY pain medication. Its disgusting to be treated this way.)<br/><br/>When I am on a regimen of pain meds that lessen the pain I can live a fairly normal life. When I run out of my medication I become home bound. I miss family activities like Thanks Giving, Christmas, birthdays etc. I no longer tell my family why I miss these events as opioids have become so so vilified I don’t want them to know that I take them. <br/><br/>I have found that oxycodone has been so vilified that even mentioning it to Drs can be scary. Its like their first thought is “this guy is a drug seeker’. Many young Drs wont prescribe oxycodone at all and many “PAIN CLINICs” goal is to get you off the drugs all together. I find this almost criminal<br/><br/>You name it and I have done it when it comes to pain relieve. Yoga, acupuncture, meditation, massage, physical therapy daily walking, other non-opioid drugs etc. I still do many of these things but nothing is stopping the pain except oxycodone.<br/><br/>In 1973 I was in an industrial accident that nearly killed me. (As far as I know my current back pain is not related to this accident.) I severely broke both arms and wrists. Compound fractures. I was in the hospital for weeks. At that time I was given low doses of Demerol which didn’t help with the pain at all. My Dr was fresh from Viet Nam and saw many people get addicted to morphine, so I had to suffer due to his bad experience. Now Im suffering due to an overreaction to the so-called Opioid crisis. I don’t know how much longer I can endure this and its pretty clear to me the Drs and an ill-informed society don’t care what happens to people like me. If they could walk a week in my shoes this country would be a different place.<br/><br/>Im 68 years old, now retired. I was a manager of an international software company. I could not have done my job without the help of oxycodone and as my condition worsened, I could no longer do my job as I have been under medicated for many years now. I now completely understand why desperate pain patients go to the streets only to be killed by drugs tainted by fentanyl. <br/><br/>Chronic pain patients are victims! It is time we brought compassion back to our society and medical profession. People like me are depending on it or we will be the next victim of a society that does not care about needless pain and suffering.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brad	None	None	0900006484fc04fc	Wellman	None	2022-03-08T21:56:57Z	None	None	1	None	2022-03-08T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Wellman, Brad	l0i-gcwx-k5kc	False	None	False	2022-04-12 04:17:32.151	[]
2186	CDC-2022-0024-2192	https://api.regulations.gov/v4/comments/CDC-2022-0024-2192	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	IMO (In my opinion)�I don’t think it will matter and we need to realize what the updated guidelines may not do is get our pain medication back. They will not help CPP lives destroyed by the 2016 guidelines. Doctors are still cutting CPP down more than the 90MME. It does not help to tell the CDC over and over what they did to us and I believe it’s time to ask what they are going to do about it. Right now there is nothing unless we all bring this fact up in the comments we leave when the CDC posts the next request for comments on the rewrite on the 2016 guidelines.�If they don’t address this fact somehow in the rewrite what will happen? Even if they do add this in the rewrite how will they change what they have done? Will they bring our doctors out of retirement or release the wrongly accused and in jail doctors? Will they retrain the doctors, surgeons and pharmacists who will not prescribe or fill pain medication that they need to go back to the way it was? Will they change the curriculum for new students starting medical school? They would need to go back at least 10 years or more. I did not read anything that was clear or pointed out that the guidelines are written for primary care doctors and new (opioid naïve) patients. If they added this information it would be huge for CPP community. It would make it so clear who the guidelines are for.�Again IMO�We need to address this fact when we comment for the rewrite. If most of us do this it will be in public comments. We need to get our doctors, caregivers and family to comment. Maybe a short description on what they saw happen to you and how will the CDC correct it. This time we know it will happen.�I know that many, many of us left comments on the previous requests by the CDC and fell like it did nothing to help us. This may be true but don’t let that stop you now. Write a comment now, save it and get it ready to post. Get other CPP to get ready. These request for comments are hard for find so spread the word to get ready. The comments are open for 60 days. The last time we got a chance to comment was about 2 years ago. Out of 50 million we had just over 5,000 comments. There was over 20,000 views. This is why we need to change and get The CPP community off their butts and comment.�I’m not sure how many know this the 2016 guidelines for prescribing opioids for chronic pain patients included how to continue treatment for CPP already on long term over 90MME. The guidelines have 8 sections or recommendations a little more than 1/2 way through them. Section 5 includes treatment for current CPP but it is mixed up with instructions for new patients. I think they make it confusing on purpose. In recommendation section 5 paragraph 4 covers established, legacy, grandfathered patients and transferring ones. In gives instructions that any taper is VOLUNTARY and the CPP patient must agree to it. The doctor can go over or instruct the dangers of long term pain medication over 90MME but the CPP must agree to the taper.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484fc0ba6	Jolley	None	2022-03-09T15:26:00Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Jolley , Chris	l0i-o934-efts	False	None	False	2022-04-12 04:17:32.364	[]
2187	CDC-2022-0024-2193	https://api.regulations.gov/v4/comments/CDC-2022-0024-2193	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since 1984, my wife and I have each experienced professional pain management care from within Tricare and commercial frameworks, under several differing protocols covering chronic health conditions and trauma. In all cases, individual health care professionals tried to balance optimum patient life quality against existing regulations and guidelines. But we noticed after the current set of guidelines following the opioid crisis a definite fear among practically all our caregivers of career-ending sanctions when prescribing ANY pain medication (opioid or not) for more than a few days or weeks. As a result, we both live in reduced circumstances. Many days we are homebound when we might otherwise walk or ride our bikes. Many days we experience sadness. Every day we experience pain on an unacceptable level (4 or more on a scale of 10). Our pain management team makes sure we do our urinalysis but is unable or unwilling to treat with effective pain meds most of the time.<br/><br/>We welcome this opportunity to support an improved risk/benefit set of guidelines that pays more attention to the benefit side of the calculation. Thanks for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fc0bad	Lilley	None	2022-03-09T15:40:13Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Lilley, Steve	l0i-odj2-rg3j	False	None	False	2022-04-12 04:17:32.591	[]
2188	CDC-2022-0024-2194	https://api.regulations.gov/v4/comments/CDC-2022-0024-2194	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow doctors to decide the MME level of their patients. It is highly unfair for there to be a max for ALL, as we, the CHRONIC PAIN SUFFERS are all different. We have different needs, metabolism and illnesses. Yes, there may be some abusers of the pain meds, let the doctors weed them out. You're making those of us who do not abuse our pain meds, suffer with these restrictions! If you had to live my life of chronic widespread whole body PAIN, you would want your doctor to decide with you, what you need. You wouldn't want to fix in a one size fits all box. Well I don't wither. I deserve to have a life outside of bed rest. Please allow my doctor to handle my care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lona	None	None	0900006484fc0bd7	Marsh	None	2022-03-09T15:42:31Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Marsh, Lona	l0i-ozn3-qmqs	False	None	False	2022-04-12 04:17:32.818	[]
2189	CDC-2022-0024-2195	https://api.regulations.gov/v4/comments/CDC-2022-0024-2195	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-2024. DUE 4-11-22<br/><br/>A Day In The Life Of A CPP<br/><span style='padding-left: 30px'></span>"My doctor was fired for what he did to me"<br/>I was with my pain doctor for 20 years at the same clinic and on the same dosage when on [date redacted] the medication that controlled my pain were stopped. I arrived for routine follow-up when a new doctor I have never seen walked in to tell me he is stopping all pain medicatinth. It took me six months to find clinic to accept me as a patient and he treated me like a new patient.<br/><br/>My worst pain is from 4 different migraines including chronic cluster migraines, several ruptured disks from a back injury and severe disk degeneration. Spinal Bifida, Scoliosis, Fibromyalgia , chronic kidney stones and more.<br/><br/>[Date redacted] I had one of the worst cluster migraines on it’s 5th day, the pain, a flair up from my disk rupture was acute and my chronic kidney stones started dropping. This was my 4th kidney stone episode this year. I was in horrific pain.<br/><br/>I have a pain contract so my son called the clinkic to let them know he was taking me to the ER. He was told he could take me but under no circumstances could they give me any pain medication. My son called 3 more times; on the 3rd call was told we needed permision from the doctor and he already left for the day. No one told him about me. The next day he was told the same and the next appointment we were told the same thing. I mentioned it doctor and without a word left the room.<br/><br/>No one should suffer horrific pain. Our doctors abandon us pharmacists profile us and refuse to fill our prescriptions even for cancer. A family pet would never be allowed to live in pain. The family would show mercy and let the pet go to sleep.<br/><br/>Before April 2017 I was happy, able to work, involved in many craft projects and saw my daughter and grandchildren often and they live 40 miles away and I could go swimming, one of my favorite things to do. QBecause of the migraines my husband created a dark room and I spend most of my time in there. My back and other causes make me change positions every hour. I do not get much sleep. After months of appointments I said to that doctor I think about suicide every day sometimes every hour because of the pain. He did not evan look at me and walked out the door.<br/><br/>This doctor was fired for what he was doing to me and other patients. The doctor who took over the clinic on my next appointment gave me back most of my pain medication. Now I needed to find a pharmacy to fill the prescription which I did after 4 months of trying. I found a local chain pharmacist who agreed to fill my prescription and I’ve been there for 2 years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0be0	Anonymous	None	2022-03-09T16:30:43Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-p92t-9sit	False	None	False	2022-04-12 04:17:33.044	[]
2190	CDC-2022-0024-2196	https://api.regulations.gov/v4/comments/CDC-2022-0024-2196	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2023-2024<br/>A Day In The Life Of A CPP<br/><span style='padding-left: 30px'></span>"My doctor was fired for what he did to me"<br/>I was with my pain doctor for 20 years at the same clinic and on the same dosage when on [date redacted] 2017 the medication that controlled my pain were stopped. I arrived for routine follow-up when a new doctor I have never seen walked in to tell me he is stopping all pain medicatinth. It took me six months to find clinic to accept me as a patient and he treated me like a new patient.<br/><br/>My worst pain is from 4 different migraines including chronic cluster migraines, several ruptured disks from a back injury and severe disk degeneration. Spinal Bifida, Scoliosis, Fibromyalgia , chronic kidney stones and more.<br/>[Date redacted] I had one of the worst cluster migraines on it’s 5th day, the pain, a flair up from my disk rupture was acute and my chronic kidney stones started dropping. This was my 4th kidney stone episode this year. I was in horrific pain.<br/><br/>I have a pain contract so my son called the clinkic to let them know he was taking me to the ER. He was told he could take me but under no circumstances could they give me any pain medication. My son called 3 more times; on the 3rd call was told we needed permision from the doctor and he already left for the day. No one told him about me. The next day he was told the same and the next appointment we were told the same thing. I mentioned it doctor and without a word left the room.<br/><br/>No one should suffer horrific pain. Our doctors abandon us pharmacists profile us and refuse to fill our prescriptions even for cancer. A family pet would never be allowed to live in pain. The family would show mercy and let the pet go to sleep.<br/><br/>Before April 2017 I was happy, able to work, involved in many craft projects and saw my daughter and grandchildren often and they live 40 miles away and I could go swimming, one of my favorite things to do. QBecause of the migraines my husband created a dark room and I spend most of my time in there. My back and other causes make me change positions every hour. I do not get much sleep. After months of appointments I said to that doctor I think about suicide every day sometimes every hour because of the pain. He did not evan look at me and walked out the door.<br/><br/>This doctor was fired for what he was doing to me and other patients. The doctor who took over the clinic on my next appointment gave me back most of my pain medication. Now I needed to find a pharmacy to fill the prescription which I did after 4 months of trying. I found a local chain pharmacist who agreed to fill my prescription and I’ve been there for 2 years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0be4	Anonymous	None	2022-03-09T16:32:15Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-pioc-mvgc	False	None	False	2022-04-12 04:17:33.266	[]
2191	CDC-2022-0024-2197	https://api.regulations.gov/v4/comments/CDC-2022-0024-2197	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Subject: access to opiates for chronic pain needs modification to better serve patients.<br/><br/>I am an elderly male utilizing Social Security and Medicare with issue of chronic pain complicated by significant other diagnoses dependent on low dose opiates to treat chronic pain.<br/>I have severe osteo-arthritis of hands and knees and am not a candidate for replacement surgery, diabetes M with neuropathy (both of which severely limit my mobility - dependent on walker), chronic renal disease not ESRD, CHF, along with bouts with renal calculi and gout both of which are extremely and acute painful. I must limit the use of NSAIDs because of renal toxic effects and potential blood dyscrasias. Occasional (like 2 or 3 times a week, low dose oxycodone is really helpful, keeps me mobile and improves my endurance. I have a pretty good threshold for pain but when the pain is more than my threshold it is physically tiring, affects my personality and interactions with family and friends, affects my ability and willingness to perform ADL's, and effects my judgement. The dosage effective for me is 2.5 mg (the form available to me is Percocet 5/325 mg, because that's what's available). The acetaminophen component is renal toxic in effective doses, as are ibuprophen, naproxsin, Celebrex, and others. Aspirin complications of note in effective doses for me include gastric and bleeding issues. I have been using Percocet in this way for about 6 years until last year when my prescriber would not prescribe them anymore because of "policy", then after some delay sent me to a pain clinic. So far this has been effective and my medication usage has decreased to about 1/3rd of what I had been using because of therapies provided and consulted. It is important to note that I have never been high on this drug.<br/>In conclusion dependence is not addiction, and current regulations punish (providers and clients) when they provide effective treatment that is cost effective. <br/>I hope you can change the rules to promote better and more cost effective care for patients like me. Thank you for the opportunity to comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	CHARLES and	None	None	0900006484fc0bf2	COLWELL	None	2022-03-09T16:36:45Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from COLWELL, CHARLES and	l0i-ps95-7shc	False	None	False	2022-04-12 04:17:33.480	[]
2192	CDC-2022-0024-2198	https://api.regulations.gov/v4/comments/CDC-2022-0024-2198	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Laser therapy has been a game changer in my practice for post op pain and other painful musculoskeletal conditions. The ability to be able to prescribe a non opioid therapy for pain has reduced the number of narcotic prescriptions in my practice. It has also provided another treatment option for difficult to manage cases.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0bfa	Anonymous	None	2022-03-09T16:37:26Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-q59c-hkgf	False	None	False	2022-04-12 04:17:33.932	[]
2193	CDC-2022-0024-2199	https://api.regulations.gov/v4/comments/CDC-2022-0024-2199	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband died by suicide in 2020, age 71, on opioids for chronic pain due to neuropathy for 15 years. He was a recovering alcoholic in AA, 'sober' from drinking for 40 years (40 year chip) when he died. I don't blame the opioid rules, although I think the fear of rules continuing to get tighter were part of what led Russ to kill himself. He had gone off oxycontin and was on methadone for several years before he died. He continued to get prescriptions and take other opioids along the way, as well as multiple antidepressants, anti-anxiety and anti-histamine meds. I think the issue is in the complexity, which I believe you are incorporating into the new regulations. Every case is different and requires a caring and informed and objective human mind to consider. No one realized that Russ had become an addict again, but in retrospect, the should have. He had been an active alcoholic and battled that disease for decades. If someone had looked closer, they would have seen that his chronic pain stopped being the issue, finding and taking drugs did. He painted himself and his life into such a bad corner that he saw no way out. Thank you for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fc0dc8	Knight	None	2022-03-09T16:48:46Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Knight, Susan	l0i-r3kx-hc0o	False	None	False	2022-04-12 04:17:34.153	[]
2194	CDC-2022-0024-2200	https://api.regulations.gov/v4/comments/CDC-2022-0024-2200	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is truly unreal reading the new guidelines. You claim to understand that there were problems with the first ones, (problems I should add that you were warned would happen from multiple sources) and yet you have actually expanded them. There are soooo many things wrong with the guidelines I hardly know where to start, but I'll start with this. You tell Dr's that thru should weigh risks and benefits and then spend 200 pages saying there are no risks and rewards and lower the mme to 50. You also expanded them to include all Dr's rather than just primaries, yet your official statements are how its somehow better for pain patients. From there I'm going to list them.<br/><br/>-You say you aren't allowing PROP to contribute, yet Chou and his studies are still a major foundation of the entire guidelines. He has written several papers with PROP, signed off on a petition on PROP letterhead,and made money off his studies and recused himself. Many of his studies are not scientifically sound.hes made clearly biased statements that show he is anti-opioid. And yet he's driving the guidelines. <br/><br/>-many studies that show opioids don't work are using low amounts to skew results. If you give someone a Tylenol 3 who is in severe chronic pain, and it doesn't work, does that mean opioids dont work? <br/><br/>-the numbers used to frame chronic pain patients as the problem are manipulated by these anti opioids zealots. Massachusetts did a study and only around 8% tops had a prescription at the time of death. Of 17000 that is 1600 people. If you look that's the same amount of people who died from COVID YESTERDAY,yet you are lifting restrictions for COVID. How many also had illicit fentanyl? We don't know. How many were suicide? We don't know. We do know 1600 is extremely low. We were never the problem. Shouldn't the burden of proof be on you? Show us proof that pain patients were overdosing in any kind of significant numbers. <br/><br/>-MME is not a scientific number. It was literally formulated by asking patients how they felt, which doesn't take type of pain, weight of patients, genetics or really anything into account. Yet it's a bedrock of the guidelines. <br/><br/>-16000 people die from NSAIDS each year yet that is what is being pushed. If 1600 die (maybe) to prescription opioids then it's not really about the deaths if you are moving us to something deadly. <br/><br/>-you say that you have removed PROP from the equation but much of the old guidelines remain (including Chou) and several people have bennifited financially. Are we expected to believe that wasn't always their plan? <br/><br/>-You say you include patients, pain Dr's and advocates but they have yet to be able to change anything. They read and comment and the guidelines remain mostly unchanged. <br/><br/>- overdoses continue to rise while pain patients are thrown into suffering. Many are bedbound now. I have a multitude of irreparable painful conditions and not one Dr will take me on because I've done everything but opioids at this point. This alone shows that we weren't the problem in the first place. <br/><br/>The entire guidelines were created under dubious science. The studies they mention do not pass scrutiny. You can give someone low enough doses and guess what, they don't work. The people who are writing them have extreme conflicts of interest and have made their bias clear, if they arent literally profitting. Millions of people are suffering needlessly. Some are turning to the streets so they can have some semblance of an end to the torture, others are committing suicide in record numbers, still more are trying to tough it out because they don't want to break the law and finding themselves with heart issues and even heart attacks. Others are having gastro bleeds from nsaids and severe side effects from other meds. Many Drs will no longer prescribe AT ALL. And despite knowing this now, YOURE EXPANDING THE GUIDELINES, while trying to pretend that you're not. <br/><br/>You literally let them frame this as an epidemic to get involved. Again. Only a very small percentage of people had prescriptions. The average amount of drugs in their systems were 6. 50% had alcohol. It's likely a high number had illicit fentanyl but you can't tell us those numbers. It's also likely that many heroin doses were included as it breaks down the same as morphine. A small percentage of 17000 is NOT an epidemic. And this idea that addicts started with prescriptions? That comes from asking addicts. Not checking if they were lying which addicts are prone to do as part of their disease to deflect responsibility. Not checking when they had a prescription. TAKING THEM AT THEIR WORD AND CALLING IT SCIENCE. Strong enough science to condemn the most vulnerable of our society to torture. <br/><br/>I don't think you will even read these. Or care. Not using my name because im afraid of retribution. Email is valid. I'm just a person in severe pain abandoned and bedbound despite never having addiction problems. Don't even drink.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0de2	Anonymous	None	2022-03-09T17:00:18Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-rr5v-c7gy	False	None	False	2022-04-12 04:17:34.399	[]
2195	CDC-2022-0024-2201	https://api.regulations.gov/v4/comments/CDC-2022-0024-2201	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Let me tell you about my RLS (Restless Leg Syndrome) journey. I have been a sufferer of RLS for over 40 years. I am only 46 years old and started suffering with RLS at the age of 4. RLS was not something heard of back then, doctors always called it growing pains, but no other children I knew had suffered like this. From that age forward, despite my going to over 100 doctors and specialists, I was not diagnosed with RLS until I was 26 years old. Once diagnosed I tried so many medications that were both prescribed for RLS and some that were not. All those did was increase the RLS symptoms, mess up my body, and mind but never actually worked for my RLS. Some of these medications gave me such horrific side effects such as compulsive obsessive disorder, suicidal thoughts, and hallucinations. Those medications again did nothing for my RLS. My RLS doesn’t just effect my legs, I get it all over my entire body. It doesn’t just happen when I rest, sleep, or at nighttime - it’s a constant everyday, all day living nightmare especially for someone who suffers with RLS to my degree. One day I was having an emergency health issue that required surgery and due to the surgery they prescribed me an prescription opioid pain medication. During my time on that opioid medication I noticed I had not one RLS symptom. When the prescription opioid medication was done my RLS symptoms started back immediately. I pointed this out to my doctor who knew how much I suffered so he suggested we try a prescription opioid for a little bit and see what happens. We had exhausted everything else so we had nothing to lose. We did a “trial” for 6 months and in those 6 months I had not one RLS symptom. After years of treatments and medications not working we had finally found something that worked. I have been on the same opioid medication now for 15 years and in that time I’ve only had 3 RLS flare-ups which occurred when I forgot a dose of medication. Please hear me when I say opioid medications work for RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charity	None	None	0900006484fc0de3	Chamberlain	None	2022-03-09T17:03:35Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Chamberlain , Charity	l0i-rtb1-7kng	False	None	False	2022-04-12 04:17:34.638	[]
2196	CDC-2022-0024-2202	https://api.regulations.gov/v4/comments/CDC-2022-0024-2202	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband had two massive strokes in 2010 that left his left side paralyzed and his body wracked with painful spasms, particularly at night. He cannot take aspirin or ibuprofen because he is on blood thinners. His doctors prescribed Norco so he could rest at night. We are able to keep him supplied, but are made to feel like drug-seeking criminals in the process. After a fall where he broke four ribs, (hospital name redacted) CA sent him home with nothing for pain. He needed more than his one pill per night, and it was traumatic and maddening to see him suffer until we could reach our GP. Because he was in too much pain to breathe deeply, he developed pneumonia and other complications and spent a week in the <br/>ICU. Please remember that many fine, upstanding citizens depend on opiods to deal with chronic, disabling pain and roll back the draconian laws that prevent them from getting relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fc0ded	Medine	None	2022-03-09T17:05:20Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Medine, Donna	l0i-s4zc-84v3	False	None	False	2022-04-12 04:17:34.863	[]
2197	CDC-2022-0024-2203	https://api.regulations.gov/v4/comments/CDC-2022-0024-2203	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The current restrictions and mandated reductions in opioid use are harmful and represent an overreaction to the "opioid crisis". If it were not for massive doses of opioids to assuage his pain, my father's last days would have unbearable. He had prostate cancer that metastasized and one of the places a tumor grew was in his hip bone, notoriously painful. Radiation only worked for a time. Then there was nothing else to make his life livable except for oxycodone,fentenyl, and morphine. The pain never stops in this type of cancer, it only grows worse. He used to say it was as if a grizzly bear was clamping its teeth into his leg and would not let go, and sometimes shaking him. Were it not for the opioids he would have suffered horribly, and he did sometimes anyway when he experienced breakthrough pain. He passed away ten years ago, in peace for the most part, thanks to his pain management. The doctors met every request for more medications and spared him the agony which, due to the change in laws and over-reaction by many people, many patients today are not receiving, leading up to and including suicide, to escape an agonizing, horrible, life.<br/><br/>I, too, needed opioids after I broke my femur. The pain was unendurable and they were the only thing that helped. It is unimaginable that one could get through a crisis like that without proper pain medication. The 90 MME is a joke since their is no ceiling for doing opioids. <br/><br/>Neither doctors nor health care administers should have to cap the medication level. The thought that the "National Committee for Quality Assurance, which provides standards for insurers, government agencies and medical organizations, made keeping doses within the guidelines into a metric — incentivizing doctors to taper or stop seeing high-dose patients" is heinous and detestable. Now hospitals and insurance carriers will be able to use these rules to refuse offering proper care to patients. And patients cannot fight these organizations, thus it effectively removes the patient from the equation of participating in their care. Pain is a subjective experience, felt intensely by the person it affects. To be denied proper dosage, or any pain medication at all, is a dereliction of duty on healthcare providers. This situation needs to be rectified. Providers need to be incentivized to supply proper care, not to withhold it. <br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	GD	None	None	0900006484fc0def	Dess	None	2022-03-09T17:07:40Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Dess, GD	l0i-s6cf-43vx	False	None	False	2022-04-12 04:17:35.077	[]
2198	CDC-2022-0024-2204	https://api.regulations.gov/v4/comments/CDC-2022-0024-2204	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I as well as everyone else on very effective dose of opiate pain medicine was forced dropped because of the 2016 CDC Guidelines. Why? I did nothing wrong(as probably most haven't). I was told because of the CDC guidelines, ALL doctors are being made to drop their patients doses below 90mme. Where or who came up with that number, 90mme? There is absolutely NO scientific proof that everyone below 90mme is safe from whatever. Someone just pulled that number out of nowhere. The problem isn't with prescription pain medicines, its with illegal street drugs!<br/>Everyone is different & requires different medicines at different doses & has different levels of pain. Some have less pain & are fine with a smaller dose. Some have much higher pain & a higher tolerance & need a higher dose. I require a much higher dose of any kind of medicine I am prescribed. I never had a problem with receiving higher doses of any other meds. It took years to get to a higher dose of pain meds, that finally gave me somewhat of a life back again. I could get up out of bed(which most days I have a really hard time doing from being dropped so low now), I could clean, cook, shop, take care of my family, etc. Being dropped so low now I can barely do anything other then sit/lay in bed or on couch. From all the trauma from guidelines my anxiety/panic are much worse & now ptsd too. Of such being looked at/treated like I'm a "druggie" by pharmacies & some doctors. <br/>I'm grumpy now cuz I have bad pain ALL the time which keeps me from being able to do almost anything. I have degenerative disc & bone disease, arthritis, neuropathy and patches of small fractures throughout my body causing me a great deal of pain all the time & other problems they're trying to figure out. I tried pretty much everything like physical/occupational therapy, chiropractic, acupuncture, forced injections(that are not FDA approved & made me worse), forced surgeries(that I didn't want, failed/didn't help & made worse) & many others as well as many different medicines. The opioid pain medicine was the only thing that helped the pain(on a higher dose) & gave me quality of life back again. I did NOT get high on them, being the pain to counteract the medicine. It just helped the pain so I was able to move & do things & feel more normal again. <br/>From CDC opioid guidelines the DEA/DOJ started going after doctors that prescribe pain meds, taking licenses, closing them down, that left hundreds of their patients, for every doctor, forced drastically cut off from their pain meds. All other doctors are SO afraid now they won't take new patients, so that left NOWHERE for them to go but to self treat with illegal street drugs or suicide. I know several who have gone to both, unfortunately.<br/>How does the CDC who is supposed to be for infectious transmissible disease write opioid guidelines? How do they(CDC) get this group of people(most or all dont treat pain or really know much about it & have also lied) get to make these "guidelines"(that are false & very misleading, hurting doctors & pain patients) that are supposed to be just "guidelines" for PCP docs for the onset of pain. But some how have turned to law for ALL docs? How is that even legal? Everything is really wrong with that! <br/>I just wanted to write about how I/we have been harmed & put through a lot of torture from the CDC guidelines. I/we've had a horrible life the past 5 years or so since.<br/>These "new" guidelines seem to correct some of the lies & problems with the original. But there are still some things in there that still need to be taken out. Such as ANY/ALL mention of any cap on mme's, that need to be taken out(even in the supporting documents). As you seen with the original, its just going to cause even more problems again.<br/>Again, EVERYONE is DIFFERENT! Their pain is different, there tolerance is different, the kind of medicine they need is different & the amount they require is different. Everyone is different & needs to be treated individually according to their medical conditions & needs. There is not & cannot be a one size fits all, like the old one. & doctors need to be given space to treat accordingly without threat of prosecution.<br/>Just like people with addiction should be treated individually according to their conditions/needs, so should people in pain.<br/>The only way you're going to get a handle on the opioid epidemic is to treat addiction as a disease. & treat people in pain as a disease. Treat both according to each individual. You cannot force, nor should someone be forced into or out of something. People in pain should not be forced into getting injections or surgeries if they don't feel it will help them, in order to receive pain medicine that really does help them. Especially since they're invasive & could & do sometimes cause more harm then good. It should be "our" choice. Its "our" bodies after all. We should have more of a say in our treatment since most know what works/helps best. <br/>Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candace	None	None	0900006484fc0dfb	P	None	2022-03-09T17:15:27Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from P, Candace	l0i-swsl-u79c	False	None	False	2022-04-12 04:17:35.375	[]
2199	CDC-2022-0024-2205	https://api.regulations.gov/v4/comments/CDC-2022-0024-2205	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines against appropriate and compassionate pain relief have caused death and untold suffering to millions of Americans, . The loss of income, loss of family and social life, loss of time with our loved ones all things that we will not get back as we must contend with bed rest to fend off chronic pain. As an Addictions Specialist RN and a chronic orthopedic pain patient myself, I have had my life and ability to work damaged by the CDC pain management guidelines.I beg and plead; please provide adequate medication so that people like me can go back to being productive citizens and our patients be treated with respect, understanding, and compassion.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006484fc0e03	Ross	None	2022-03-09T17:15:53Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Ross, Maria	l0i-t2xq-kfc0	False	None	False	2022-04-12 04:17:35.591	[]
2200	CDC-2022-0024-2206	https://api.regulations.gov/v4/comments/CDC-2022-0024-2206	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a 65 year old woman that is in constant pain from Lupus, Rheumatoid arthritis, sjorgens and severe osteoarthritis. I live in constant pain and it’s so hard to get proper pain medication due to doctors being afraid to prescribe due to being targeted by the government. I truly believe our drug problem is illegal drugs coming into this country, not from patients who are in constant pain from diseases or injuries. It’s not just people with cancer who need pain medicine. Lupus and rheumatoid cause excruciating pain! Please think of patients like me, who have no quality of life, without being treated properly with pain medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fc0e08	Parkman	None	2022-03-09T17:17:22Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Parkman, Patricia	l0i-tde3-zgsb	False	None	False	2022-04-12 04:17:35.803	[]
2201	CDC-2022-0024-2207	https://api.regulations.gov/v4/comments/CDC-2022-0024-2207	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to say I don’t think this should be a one size fits all . I have many autoimmune disorders/disorders that causes me to be in horrible pain every day. I have RA, Sjögren’s syndrome, fibromyalgia, lupus, nerve damage, bulging disks, tears in my shoulder, and fibromyalgia. Most days I feel like I’m not a great mother, wife, person. I just lay in bed crying because of the pain. Thinking how can I continue being in horrible pain for the rest of my life. I rarely work anymore because some days I just can’t even put a bra on. <br/>I went to the Er last week because I knew I had diverticulitis. I was told to take Tylenol, and he prescribed me Pepcid for pain. By Tuesday I thought I was going to die from the pain . <br/>What these doctors are doing is so wrong on so many levels it’s disgusting. They take these other to do no harm. But that’s what they are doing because of these guidelines. <br/>More people are dying from suicide because of the poor treatment. Doctors look at us like we are horrible humans with such judgment. <br/>It’s not easy living in our bodies, and I really wouldn’t wish it on anyone. But maybe some of you need to feel what we feel for a hour. Then maybe things will change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0e0f	Anonymous	None	2022-03-09T17:24:23Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-u86b-danw	False	None	False	2022-04-12 04:17:36.020	[]
2202	CDC-2022-0024-2208	https://api.regulations.gov/v4/comments/CDC-2022-0024-2208	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a severe chronic pain patient with debilitating chronic pancreatitis. I've gone through eons of procedures and surgeries with no help to my illness. I am now on digestive enzymes, nausea and vomiting medication, and a surgically implanted pain pump with fentanyl as my pain control. <br/>I am finally able to control my severe attacks and daily pain. My doctors are Wonderful, and my quality of life has been changed dramatically. <br/>Please consider my story when you decide to control my medication. There are many like me out here,and the DOCTORS should be making the decisions on medication!!<br/>Thank you.<br/>J. Bram Cast	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J. Bram	None	None	0900006484fc0e13	Cast	None	2022-03-09T17:25:15Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Cast, J. Bram	l0i-ug5y-kdmz	False	None	False	2022-04-12 04:17:36.234	[]
2203	CDC-2022-0024-2209	https://api.regulations.gov/v4/comments/CDC-2022-0024-2209	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You must remove the 50 MME guideline - it will cause even more harm than the 90 MME guideline did in 2016. It will be used as the new law! And be devastating!<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	0900006484fc0c4b	Terrell	None	2022-03-09T17:26:32Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Terrell, Rebecca	l0i-usv2-1bog	False	None	False	2022-04-12 04:17:36.467	[]
2204	CDC-2022-0024-2210	https://api.regulations.gov/v4/comments/CDC-2022-0024-2210	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am not addicted to painkillers, nor do I take them very often.<br/><br/>However, now that no doctor wants to prescribe them, and my own doctor and dentist tell me to take advil (which is useless for real pain), I am thankful I have not thrown out my old prescriptions.<br/><br/>Sometimes I have incredible back or knee pain, where I cannot move. Only an opioid painkiller makes it possible for me to move even a little bit.<br/><br/>Last year I had a root canal issue, that was so painful I cried and paced and had to keep moving because it hurt so much. The recommendation for advil was again useless, and only an opioid painkiller could help. Thank the good Lord I still have those pills from years past.<br/><br/>When doctors won't prescribe a painkiller because they don't want the regulators to come after them, this is wrong. If someone uses perhaps 30 painkillers in ten years, trust me, they are not addicted. There has to be a middle ground between thousands of pills being prescribed, and dozens. Look at the history of the patient, and the need. Hydrocodone and oxycontin serve a need and a purpose, and should not be denied for real pain.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lydia	None	None	0900006484fc0c50	Medici	None	2022-03-09T17:27:10Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Medici, Lydia	l0i-va4m-5zvs	False	None	False	2022-04-12 04:17:36.677	[]
2205	CDC-2022-0024-2211	https://api.regulations.gov/v4/comments/CDC-2022-0024-2211	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a middle aged chronic pain sufferer that has been disabled due to debilitating pain since 2016. Most days I can’t leave my chair, let alone work. My wife and I lost our home and had to move in with her parents. Thanks to the CDC guidelines that doctors are taking as law, no matter how bad my pain gets, there can be no increase in dosage because the pain of a 250 lb man is treated the same as that of a 100 lb woman, a one size fits all limit. While I’ve only ever taken my medication as required and instructed, I (and other legitimate pain patients) am treated like junkie looking for a fix when I pick up my meds. Steroid injections don’t help. They’re expensive and do nothing. The only other option I’m given is spinal cord stimulators that may or may not work, and given the way our government approves medical devices based on old patents with no real trials when new technologies are incorporated into these things, the answer from me will be no, I think not. The solution is pretty simple: allow my doctor to treat ME based on my problem, not based on someone else or some junkie that started taking his mom’s meds or someone that went to an unscrupulous doctor that ran a pill mill. That’s not me. My doctor does the right thing. My meds are taken to the letter and are never off in their count. I’m regularly tested to make sure I’m taking them. I know the government wants to stop opioid deaths, but there are people that need these medications to manage their pain, and the 2016 CDC guidelines are harming us because of their one size fits all limits. Pain management specialists are afraid to treat us as we truly need it cause they don’t want to go to prison. Besides, most opioid deaths are now due to heroine laced with illicit fentanyl. Crack down on Chinese fentanyl being brought into Mexico then transported to the US, not pain management patients being treated by professionals. This isn’t our fault, yet we are being punished because of the actions of others. It’s not right. No one has the right to say my medical problem can’t be treated because some stranger that has nothing to do with me might misuse an illegal drug. Does that make sense? Cause that’s the problem that the 2016 CDC guidelines have created. Guidelines are treated as law. These need to be changed or outright repealed. Why not let board certified doctors decide what’s best for individual patients. Quit punishing people that are already suffering for the criminal behavior of others, and that includes the Purdue people that told doctors that their opioid drugs were non addictive, and how they were ever allowed to claim that is beyond me. Punish them, not us. They actually did something criminal, yet they’re free and still wealthy while I’m just surviving on SSD and can barely walk for any distance without extreme pain. Who is more at fault, the drug company that put money over safety, or the pain patient that needs opioid medication for some semblance of a normal life? Cause I can tell you who is being punished by the 2016 CDC guidelines, and it isn’t the Sacklers. Please fix this problem. Prove people wrong and show them that the government can do the right thing for the little guy. Consult with real pain management doctors and patients before drafting guidelines that will just make the problems worse. Do the right thing! Get rid of the 2016 CDC guidelines. They’re wrong and are hurting people that suffer enough already.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484fc0e48	Gray	None	2022-03-09T17:29:37Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Gray, Daniel	l0i-vfzk-2kxx	False	None	False	2022-04-12 04:17:36.917	[]
2206	CDC-2022-0024-2212	https://api.regulations.gov/v4/comments/CDC-2022-0024-2212	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	All I have to say is what ever happened to compassion? I never was an addict. I never abused my meds. Only took as prescribed. But yet I got punished anyways and quality of life has diminished! I am now furious! I willl just leave it at that…. I don’t have anymore energy to battle this out. I prey you never have chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stefan	None	None	0900006484fc0e50	Max	None	2022-03-09T17:29:51Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Max , Stefan	l0i-vz8j-ga8c	False	None	False	2022-04-12 04:17:37.133	[]
2207	CDC-2022-0024-2213	https://api.regulations.gov/v4/comments/CDC-2022-0024-2213	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in an accident and have undergone multiple surgeries but still have continued pain. Because of my age and prescribing by doctors, I can’t get methadone now ease it. Specialists should be allowed to treat conditions in older people who need opioids so they don’t have to contemplate suicide to ease pain <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1379	Anonymous	None	2022-03-09T17:30:28Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-zrcl-nl3f	False	None	False	2022-04-12 04:17:37.377	[]
2208	CDC-2022-0024-2214	https://api.regulations.gov/v4/comments/CDC-2022-0024-2214	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please clarify in the opening statements: "The clinical practice guideline includes recommendations for primary care clinicians (including physicians, nurse practitioners, and physician assistants)"; it should read ...(including physicians, advanced practice nurses with prescriptive privileges, and physician assistants). The rationale for this recommendation is that in some states, advanced practice nurses, including nurse practitioners and clinical nurse specialists have prescriptive authority.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maureen	None	None	0900006484fc1394	Cooney	None	2022-03-09T17:35:58Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Cooney, Maureen	l0j-0ut7-n5bs	False	None	False	2022-04-12 04:17:37.593	[]
2209	CDC-2022-0024-2215	https://api.regulations.gov/v4/comments/CDC-2022-0024-2215	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have taken opioids for several years for pain. I take the lowest dose possible but have sometimes have had to double up when one tablet isn't enough. I have had 4 lower back surgeries with a 4-level fusion and a mechanical device imbedded in my lower back plus a metal plate and cadaver bone at the C3 level in my neck. Add to that osteoarthritis in back, shoulders, knees, wrists, and I could not function if I did not get monthly pain meds. Chronic painsuffers need to be able to have some relief in order to have some quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donnie	None	None	0900006484fc13b0	Shankie	None	2022-03-09T17:36:34Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Shankie, Donnie	l0j-1zil-v6wz	False	None	False	2022-04-12 04:17:37.924	[]
2210	CDC-2022-0024-2216	https://api.regulations.gov/v4/comments/CDC-2022-0024-2216	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic back pain I’m 79. My dr can, and does, prescribe pain meds, but the pain can be so bad that it causes despair. Sure, I’ve contemplated suicide. THAT pain would be too bad for others for me to do it.<br/><br/>I’ve volunteered at a nursing home and seen how people suffer and suffer before they die, because sometimes their doctors do not even consult charts before they prescribe—or don’t — too many meds or too few.<br/><br/>Federal opioid law us a disaster.<br/><br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484fc0e71	Straffin	None	2022-03-09T17:46:17Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Straffin, Judith	l0i-xcmb-awaj	False	None	False	2022-04-12 04:17:38.183	[]
2211	CDC-2022-0024-2217	https://api.regulations.gov/v4/comments/CDC-2022-0024-2217	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Almost 3 years ago I was forced of my pain medication. I have RA, fibromyalgia and neuropathy, three very painful diseases. I live my life one hour at a time. I have lost all my friends, family and any quality of life I use to have. I had successfully taken pain medication for 15 years with no issues. Then the CDC put their so called recommendation out and what life the diseases didn’t take from me the CDC took the rest. Why? It was all about money! The people who did this to us should be held responsible for their experimentation on people who are all ready suffering enough. The CDC, PROP, and all who participated in this farce that was perpetrated on the American people should be held liable. The last time in history people were experimented on in a large population, just to see what it would do to the human body, was in Nazi Germany! This is when the Nazi did experiments on Jews in the concentration camps. I guess in the United States the phrase, WE MUST NEVER FORGET, has been forgotten. We are not all Jewish, or Christians or one religious group, we are many. Maybe that is why it’s easy to ignore what our government has done, and is is still doing to the chronic pain community. I often wonder if this would have even happened if those responsible had any pain at all. <br/>I hope that the government will someday do the right thing and not the, money to be made thing and return our MEDICATION without making me feel like a felon who was never tried or convicted of a crime. How about we make politicians pee in a cup monthly to keep their jobs!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484fc1396	Wade Chalifoux	None	2022-03-09T17:48:52Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Wade Chalifoux, Tracy	l0j-0ys9-po5j	False	None	False	2022-04-12 04:17:38.397	[]
2212	CDC-2022-0024-2218	https://api.regulations.gov/v4/comments/CDC-2022-0024-2218	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic leg pain since having bilateral knee replacements 10 years ago. After many medical tests, etc. I finally was told that I likely have Chronic Regional Pain Syndrome (CRPS). This syndrome has been called the suicide disease because of the difficulty of diagnosing and treating it. In my case I was fortunate because we finally found a pain regimen that works and it gave me relief like a light was suddenly switched on. I take both Gabapentan and TraMadol. My dosage has been steady for 5 years and works. While TraMadol isn't the same as Hydracodone or Oxycontin it's still a pain medication that has been targeted as likely to be abused. <br/><br/>My physician recently left her practice and while I have found another physician in the large clinical system it has consisted of my having to explain myself to another doctor who was solely focused on "reducing your pain meds". I've luckily found an experienced doctor within the system who seems like she's going to partner well with me. She's focused on treating my pain, not reducing my pain meds. If we can do both then of course we will, but reducing my pain is the higher priority. <br/><br/>I hate that doctors are being so pressured and scrutinized that they end up violating their oath " first do no harm". <br/><br/>Please make sure that you give guidance but understand that if you suggest some dosage as a guide it will become a RULE by legislative bodies and insurance companies. This isn't helpful to people with chronic pain that is much worse than mine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484fc139d	Buchanan	None	2022-03-09T17:54:04Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Buchanan, K	l0j-173p-d4do	False	None	False	2022-04-12 04:17:38.610	[]
2213	CDC-2022-0024-2219	https://api.regulations.gov/v4/comments/CDC-2022-0024-2219	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/>I’m tired of living without my pain medication. I live with 4 different migraines including chronic cluster migraines, several ruptured disks from a back injury and severe disk degeneration. Spinal Bifida, Scoliosis, Fibromyalgia,chronic kidney stones and more. I have lived like that for over 30 years. I was with my doctor for 15 years and on the same medication for 12 years. My pain is one of the most painful types to live with without pain medication. I understand there will be an update and I want to know what will you do for me?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1424	Anonymous	None	2022-03-09T18:12:25Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-5rcm-zdzr	False	None	False	2022-04-12 04:17:38.842	[]
2214	CDC-2022-0024-2220	https://api.regulations.gov/v4/comments/CDC-2022-0024-2220	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC 2022-0024 Due 4-11-22<br/>The CDC is updated 2016 the guidelines for prescribing opioids for chronic pain. The CDC must add in the update to give my pain medication back. The CDC must add this where doctors can find it. There is no way any doctor will have the time to read this mess of 229 pages this is why it needs to be easy to find. Add a link in pages 26-27.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1426	Anonymous	None	2022-03-09T18:12:49Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-65fq-7lch	False	None	False	2022-04-12 04:17:39.053	[]
2215	CDC-2022-0024-2221	https://api.regulations.gov/v4/comments/CDC-2022-0024-2221	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/> In 2016 the CDC released the guidelines for prescribing opioids. In 2019 the CDC released a clarification to the 2016 guidelines by this time all established patients had their pain medication cut off years ago. The clarifications covered what the 2016 guidelines did to millions of pain patients and nothing changed. The 2022 update is also for the damage the guidelines caused to millions of chronic intractable pain patients. No where in the 2022 draft does it talk about these patients. If these patients do not get their medication back the CDC might as well shred the blue print. In fact It should be shredded and have the right people write a guideline that is correct, helps the chronic pain community and gives them their pain medication back. Give my pain medication back	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1428	Anonymous	None	2022-03-09T18:13:11Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-6rbj-a9de	False	None	False	2022-04-12 04:17:39.262	[]
2216	CDC-2022-0024-2222	https://api.regulations.gov/v4/comments/CDC-2022-0024-2222	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2023-0024<br/>A Day In The Life Of A Chronic Pain Patient (CPP)<br/><span style='padding-left: 30px'></span>"My doctor was fired for what he did to me"<br/>I was with my pain doctor for 20 years at the same clinic and on the same dosage when on 4-23-17 the medication that controlled my pain were stopped. I arrived for routine follow-up when a new doctor I have never seen walked in to tell me he is stopping all pain medicatinth. It took me six months to find clinic to accept me as a patient and he treated me like a new patient.<br/><br/>My worst pain is from 4 different migraines including chronic cluster migraines, several ruptured disks from a back injury and severe disk degeneration. Spinal Bifida, Scoliosis, Fibromyalgia , chronic kidney stones and more.<br/><br/>8-23-2018 I had one of the worst cluster migraines on it’s 5th day, the pain, a flair up from my disk rupture was acute and my chronic kidney stones started dropping. This was my 4th kidney stone episode this year. I was in horrific pain.<br/><br/>I have a pain contract so my son called the clinkic to let them know he was taking me to the ER. He was told he could take me but under no circumstances could they give me any pain medication. My son called 3 more times; on the 3rd call was told we needed permision from the doctor and he already left for the day. No one told him about me. The next day he was told the same and the next appointment we were told the same thing. I mentioned it doctor and without a word left the room.<br/><br/>No one should suffer horrific pain. Our doctors abandon us pharmacists profile us and refuse to fill our prescriptions even for cancer. A family pet would never be allowed to live in pain. The family would show mercy and let the pet go to sleep.<br/><br/>Before April 2017 I was happy, able to work, involved in many craft projects and saw my daughter and grandchildren often and they live 40 miles away and I could go swimming, one of my favorite things to do. Because of the migraines my husband created a dark room and I spend most of my time in there. My back and other causes make me change positions every hour. I do not get much sleep. After months of appointments I said to that doctor I think about suicide every day sometimes every hour because of the pain. He did not evan look at me and walked out the door.<br/><br/>This doctor was fired for what he was doing to me and other patients. The doctor who took over the clinic on my next appointment gave me back most of my pain medication. Now I needed to find a pharmacy to fill the prescription which I did after 4 months of trying. I found a local chain pharmacist who agreed to fill my prescription and I’ve been there for 2 years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484fc142a	Jolley	None	2022-03-09T18:13:50Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Jolley, Chris	l0j-76hd-oe73	False	None	False	2022-04-12 04:17:39.486	[]
2217	CDC-2022-0024-2223	https://api.regulations.gov/v4/comments/CDC-2022-0024-2223	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Something has to be done with all these pharmacy s turning people away and stop the DEA from cutting manufacturing as well every year. I went to 40 different pharmacy s in one day for my sick husband who is on palliative care.who is dieing and not one pharmacy would fill his meds they either said he is on too many or we can't fill over 20 miles u will have to find a pain clinic in Berkeley county which is impossible there is two here they won't help .and the pharmacy s know this .these guidelines have created a mess for people .all these people committing suicide and taking their own lives because they cannot get adequate pain relief. This is just unfair and not right.u guys have a chance to fix this and do away with the guidelines for chronic pain.. throw the whole guy line out the window it doesn't make sense most of it is not true and all it's doing is causing problems for the truly sick people.i thank u for taking the time to listen to my comment	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc142c	Anonymous	None	2022-03-09T18:25:01Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-8ibh-7wip	False	None	False	2022-04-12 04:17:39.773	[]
2218	CDC-2022-0024-2224	https://api.regulations.gov/v4/comments/CDC-2022-0024-2224	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand that the Federal government agencies in charge of these matters is finally reviewing the rule from the last decade that set a maximum dose of opioids, irrespective of the needs of the patient, the patient's prognosis, his/her quality of life, & the opinion of the patient's doctor. After doing as much research as a layman can manage on her own, I've yet to discover where the standard of 90mm came from to begin witg. Did I overlook some large randomized study that established with scientific certainty that this number was correct for everyone? I was raised in a small isolated community on the [location redacted]. Although my mother's family was quite large, I was the first member to complete a four year degree. I did this by working, and with scholarships &grants. Then I worked my way thru law school, graduating from the UW with several awards. Choosing trial work and public law, I worked as a public defender, a city prosecutor, a felony prosecutor, and in private practice. An injury in a car accident caused the 1st chronic pain issues. These were exacerbated at my last job by an attack of bursitis that became chronic. The pain forced me to leave a profession I loved. I still dream about trying cases.The chronic pain has been increased by several medical issues requiring five surgeries in the past 7 years. Each time I was hospitalized, my pain treatment was inadequate. The hospitalists & surgeons quoted the CDC numbers like they were magic, ignoring my tears. When I had to have emergency surgery a year ago, I begged the nurses to medicate me and let me die. It was the 1st time I'd even had that thought, but it was very real. My pain levels some days are so bad, I find it hard to get up, much less do anything. My pain meds make life bearable on those days, but I keep getting told I'm taking "too much". Who decides that? Some government nudge who's never had to live with extreme pain? My husband provides me the support to keep going, but it's frustrating being constantly treated like an idiot &being lectured about my drug use. I don't take any illegal drugs, follow all the rules, &still live in pain because of this arbitrary rule.i don't take drugs to feel "high"; I take them to feel alive. Please do away with the old rule &stop trying to micromanage medical care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathryn	None	None	0900006484fc0ed6	Lee	None	2022-03-09T18:29:48Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Lee, Kathryn	l0j-8uds-j6s8	False	None	False	2022-04-12 04:17:39.991	[]
2219	CDC-2022-0024-2225	https://api.regulations.gov/v4/comments/CDC-2022-0024-2225	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I also want to address what the hospitals are now doing to patients. I was there when a 86 year old woman came in with a broken shoulder they sent her home of Tylenol Tylenol this lady was screaming because of the 2016 guidelines all hospitals are stop prescribing opioids for pain and emergency department now they're doing surgery and not prescribing opioids for pain because of these guidelines this is cool and inhumane to do something like that and something needs to be done it is not right now insurance carriers are also through the State Medicaid and Medicare are putting limits on medication well Medicaid doesn't pay for any narcotics but Medicare is putting limits on medications and if your insurance doesn't fill your medication because the limit is too high the pharmacist will then turn around and tell you he cannot fill he will not have to pay cash that is not fair and not right please fix these guidelines and throw them out.my husband lost both of his legs and one arm I had to fight to get him pain care ..I should not have to do it ..we are already sick people and we have to worry about the DEA taking down our pain care .and now we have to worry about pharmacy s not filling our medication s ...no wonder people kill their self ..I know if this does not get better u will have a whole lot more people taking their life and over doses will go way up more	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0ed7	Anonymous	None	2022-03-09T18:39:33Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-8v2c-gqkx	False	None	False	2022-04-12 04:17:40.211	[]
2220	CDC-2022-0024-2226	https://api.regulations.gov/v4/comments/CDC-2022-0024-2226	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been prescribed oxycodone for pain management for the last 6 years after a bad heel break, subsequent surgery and increasing arthritic after effects. A year later I also had a perforated colon and subsequent septic shock with multiple abdominal abscesses and internal adhesions which all cause constant pain with each breathi take. I have only 1 kidney, the other lost to cancer, and cannot take over-the-counter pain medication as an alternative. I am 69 years old and would be unable to be mobile without the pain therapy. Despite regular scripts from my doctor the pharmacies have constantly, every single month for 6 years, obstructed my access by being chronically under supplied. I have been 3 times to the ER to request oxycodone to fill the gap while the pharmacy restocks. The pharmacy explains these constant difficulties having to do with the difficult and multiple bureaucratic processes they are forced to follow each month. Numerous other pharmacies have refused to fill the prescription at all And so I am hampered in my ability to travel anywhere. I am obligated to remain close to the one pharmacy that knows me and, though with constant hiccups and issues, continues to supply my opiate pain medication. I live in constant fear that this monthly supply will be cut off for some bureaucratic reason And I would be forced to seek relief from some corner drug pusher at my ripe age as a single, disabled woman. The monthly act of practically begging the pharmacy not to abandon me because of their own bureaucratic issues connected to the current regulations is humiliating, anxiety creating, debilitating and exhausting.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Giulia	None	None	0900006484fc0eda	Latini	None	2022-03-09T19:03:19Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Latini, Giulia	l0j-a7vd-gxcv	False	None	False	2022-04-12 04:17:40.449	[]
2221	CDC-2022-0024-2227	https://api.regulations.gov/v4/comments/CDC-2022-0024-2227	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain due to severe scoliosis, CRPS,osteoporosis, retroarthelis, bone on bone, 3x broken back and a host of other diseases 2 pages long. The 2016 CDC Guidelines have done more harm to people in chronic pain due to the following: Dr's. are departing from treating CPPs due to government overreach making it nearly impossible to find a Dr. to treat pain out of fear of the DEA; They have adapted the CDCs guideline of unscientific MME as a law in many States. The suggested MMEs do NOT work for everyone and MUST be removed as not only is it a silly one size fits all no. But it is not based on any reliable source of data!Further people with Intractable pain should be exempted from this nonsense! No one wants to take pain meds but there is NOT ANY ALTERNATIVE! I have tried literally every modality available and not one of them work except for pain meds.Your nonsensical Guidelines have literally destroyed my quality of life as year after year the cutback of pain meds has made it impossible to obtain. The pharmacists are now practicing medicine without a license by withholding, manipulating prescriptions; denying them based on thier clinical judgement when they are NOT licensed to diagnosis? Forced tapering has become rampant and caused both physical and mental hardship wherein thousands have committed suicide. The harm is egregious, yet you are AGAIN taking another swipe at the pinyata that clearly still puts the prescribing Dr. in jeopardy? This is surely not in your expertise as pain is NOT contagious and you're peer group lacks the appropriate parties to design clinical treatment. FACA requires an unbiased and reasonably balanced group without conflicts ofvinterest yet we have numerous individuals with conflicts of interest ONCE AGAIN! WHY?Where are the PM Drs., advocates and CPPs in this panel? I see little to no CHANGE from the original Guidelines that some States unknowingly made laws. Please retract any and all mention of MME suggestions we are not all the same! Some of us require more than your formula of 90 MME and some do not butvlet the Dr. Practice medicine and decide that free from the threat of prosecution! Your Guidelines are Governmental Genocide for the purpose of opioid litigation. Opioids have worked for literally hundreds of years without harm! Why has the narrative changed? Your own data indicates prescribing is are an all time low but OD are at an all time in youths! That is because there is not an opioid crisis, there is an ILLICIT FENTANYL CRISIS. The DEA should focus on that and leave the practice of Medicine alone! Please remove all notions of MME from your Guidelines; exempt people with Cpp and tell the DEA to stand down this is the only logical answer to this debacle the FDA refused to pass and you picked up. It's not your field! You have done enormous harm to the CPP community. stop this NOW! The AMA and 50% of qualified Dr's. do not agree with your ridiculous Guidelines the only ones that do are profiting from them! It is all so transparent. I agree with and support the comments of [name redacted] previously posted as they present my own experience and are supported by science and l therefore endorse his comments on this register	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martha	None	None	0900006484fc0ee8	Swezey	None	2022-03-09T19:16:01Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Swezey, Martha	l0j-cqhm-u51y	False	None	False	2022-04-12 04:17:40.670	[]
2222	CDC-2022-0024-2228	https://api.regulations.gov/v4/comments/CDC-2022-0024-2228	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I have been a chronic pain patient since 1987. I was a nurse, I injured on the job. I have had 14 back surgeries, the last in 2019. I am fused, with hardware from T-2 to my pelvis. I use a walker. <br/>Before the so-called "guidelines" my pain was well controlled with extended release morphine. I was able to to most things myself, my quality of life was manageable. <br/>Now, however, being taken off all but the most minimal of pain meds, I am basically bedridden, only getting up to go to the bathroom. I can rarely get up to eat. My quality of life is zero!<br/>How on earth can a government agency such as the CDC decide what type of treatment I need? That should be left strictly up to me and my doctors!!!<br/>I believe that the CDC guidelines, both the 2016 and the 2022 should be destroyed and the medical decisions left with the patients doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fc145c	Williams	None	2022-03-09T19:16:26Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams , Susan	l0j-fjvv-h98j	False	None	False	2022-04-12 04:17:40.881	[]
2223	CDC-2022-0024-2229	https://api.regulations.gov/v4/comments/CDC-2022-0024-2229	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines need to be updated with NO rcommended MME and also need to be updated to allow all of the patients who were harmed by your original guidelines and cut off completely or tapered to be able to get the treatment and medication that they need. The guidelines shpuld be completely revised to state clearly that this is NOT a law and therefore all states that have adopted them need to reverse the damges being caused. There are millions suffering and dying from suicide or going to the streets since the doctors will not treat them and state because of the guidelines. This is harming millions and will only het worse unless the CDC stops this and makes it clear that there are NO limits and that drs are allowed to treat patients as needed based on individual needs. Please correct your mistakes so that people can get the help they need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0f0e	Anonymous	None	2022-03-09T19:17:46Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-h55s-92mc	False	None	False	2022-04-12 04:17:41.096	[]
2224	CDC-2022-0024-2230	https://api.regulations.gov/v4/comments/CDC-2022-0024-2230	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain as a problem of survival has only existed for humans a few thousand years. <br/><br/>For hundreds of millennia (and millions for our mammalian predecessors), pain was a warning to stay away, & if you get hurt: DON'T MOVE & MAKE IT WORSE.<br/><br/>But, an inability to move is an immediate existential threat. So, endogenous opioids evolved to get us from the place of injury to a place of safety, where we'd survive or die in a matter of days.<br/><br/>Now, our survival from injury to death is often measured in decades. Endogenous opioids are massively insufficient to keep us functional through our social commitments to spouses, children & employers over those decades.<br/><br/>Neither did these neurochemicals evolve to prevent suicides of surrender to pain, which is what we have seen en masse since the nation-wide, broad and deep misapplication of the 2016 CDC Guidelines.<br/><br/>We have not physically evolved to meet the demands of a modern life that can keep us alive in pain & infirmity long past our ability to care for ourselves & others.<br/><br/>Rigor is required for social and economic survival in America, yet without opioids, many chronic pain patients will spend decades of unwanted survival as an isolated, bedridden wretch.<br/><br/>We lose the collegiality of coworkers & the intimacy of friends & family. There is no part of our life that is not affected. Yet we are expected to simply endure, with no quality of life.<br/><br/>If we even mention a desire to no longer simply exist in agony, with fully aware minds trapped, with physical pain, in bodies we cannot use without opiates, we are labeled as "depressed" rather than acknowledged as facing the only decision left to an autonomous human with agency: to stop paying the too dear costs of life when we have been entirely denied its benefits.<br/><br/>And what is more rational than that?<br/><br/>Yes, opiates are powerful drugs, but the risk of all medications is measured against their benefit. Turning a bedridden slug like me, who pre-taper was a taekwondo blackbelt, wife, mother, employee & caregiver to an adult mentally ill son, back to something approaching function will take something powerful.<br/><br/>But its benefit is even greater: it restores a functioning human being with a desire to survive & contribute to society.<br/><br/>So, unless you think we're worthless to society, or somehow undeserving, or unless you believe we have evolved past endogenous opioids to rationally choosing suicide as an alternative, CDC must:<br/><br/>1) do all it can to reverse the 2016 guidelines, and, as important,<br/><br/>2) it must actively proselytize legislatures, doctors, hospitals and insurance companies/HMOs to reverse the application of the 2026 GLs as dangerous blanket law/policy, and to restore the medication of involuntarily tapered patients, and to treat prospective pain patients with dignity and adequate opiate pain management where they would otherwise be crippled & ultimately despondent.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484fc0f21	Thompson	None	2022-03-09T19:18:11Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Thompson, J	l0j-jyc3-b837	False	None	False	2022-04-12 04:17:41.322	[]
2225	CDC-2022-0024-2231	https://api.regulations.gov/v4/comments/CDC-2022-0024-2231	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Response of the American Society of Pain and Neuroscience to the Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids<br/><br/>See attached file(s)<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc0f92	None	None	2022-03-09T19:18:44Z	American Society of Pain and Neuroscience	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from American Society of Pain and Neuroscience	l0j-l1u7-wmd7	False	None	False	2022-04-12 04:17:41.531	[]
2226	CDC-2022-0024-2232	https://api.regulations.gov/v4/comments/CDC-2022-0024-2232	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove all mentions of MME from the guidelines. What is considered a high dose for a 140lb person is not enough for 300lb person.<br/>Any mention of MME can be weaponized into Law just like last time. This will result in more deaths. <br/>In some cases, Long Term Opioid Therapy is the only therapy that can make life bearably for some patients. By easing the pain, the patient can use other therapies to manage the pain safely.<br/><br/>PLEASE REMOVE ANY MENTION OF MME FROM THE GUIDELINES!!!<br/><br/>LTOT CAN BE BENEFICAL TO PATIENTS WITH PERMANENT PAINFUL ILLNESSES/DISEASES.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ruth	None	None	0900006484fc16b6	Sisk	None	2022-03-09T19:21:06Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Sisk, Ruth	l0j-m9bh-zckg	False	None	False	2022-04-12 04:17:41.756	[]
2227	CDC-2022-0024-2233	https://api.regulations.gov/v4/comments/CDC-2022-0024-2233	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please give our doctors the rights to prescribe opiates to their patients that need them. Pain clinics are getting rich and not treating us with the integrity that our primary care doctors do. They're cutting people off meds due to fear of getting shut down, they treat chronic pain patients as if they're lepers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fc0fe2	Kipp	None	2022-03-09T19:21:15Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Kipp, Melissa	l0j-n8a1-d7g0	False	None	False	2022-04-12 04:17:41.987	[]
2228	CDC-2022-0024-2234	https://api.regulations.gov/v4/comments/CDC-2022-0024-2234	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient with multiple rare spinal diseases and since the CDC guidelines went into effect, I can no longer be a productive member of society. My cervical spine is completely fused from my Ankylosing Spondylitis which is an autoimmune disease that causes inflammation in my whole body. It affects my bones, organs, tissue and nerves. I also have a disease called Syringomyelia which causes cysts in my spinal cord. I have small fiber neuropathy which is causing my feet and hands to have numbness pain and electric shocks and loss of use. I have an osteophyte pressing on my spinal cord and esophagus. I also have central Sensitization Syndrome(a pain disease) and I am missing a kidney and cannot take NSAIDs. My doctors refuse to treat my pain like it was treated prior to the CDC guidelines. They will no longer treat each patient as an individual and have a strict 50mme limit due to DEA over reach. Please get rid of the mme recommendations and also the limits to only sickle cell, cancer palliative and hospice care to the guidelines! There are thousands of painful<br/>Diseases that cause pain and by putting this in your guidelines it prevents people like me from<br/>Receiving treatment for pain! Stop trying to punish people in pain! We did not ask for chronic pain and deserve humane treatment and pain control. I believe the following link explains all the reasons these should be changed! https://www.painnewsnetwork.org/stories/2022/2/8/a-rising-storm-preparing-for-a-revised-cdc-opioid-guideline?format=amp	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0dc9	Anonymous	None	2022-03-09T19:46:47Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-r9aa-xgqo	False	None	False	2022-04-12 04:17:42.206	[]
2229	CDC-2022-0024-2235	https://api.regulations.gov/v4/comments/CDC-2022-0024-2235	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to post my comments using the pdf file I have attached, as it it 230 characters over the limit, and the limit wasn't stated until I had finish my comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0dd1	Anonymous	None	2022-03-09T19:50:00Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0i-qxlc-soqs	False	None	False	2022-04-12 04:17:42.415	[]
2230	CDC-2022-0024-2236	https://api.regulations.gov/v4/comments/CDC-2022-0024-2236	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted],<br/><br/>I'm not going to bore you with medical details other than these policies have hurt all chronic pain patients. opiates taken under supervision of a doctor is the gold standard of care, and has been for 100 years. I find it disturbing anyone who wants to see others suffer is CRIMINAL. There is a distinction between addiction and dependence. We are all dependant on any life sustaining medications we need. Would you like it if you or a.family member had their quality of life taken from them??? That is what has and is happening to chronic pain patients. <br/><br/>I would also like to ask why has tobacco and alcohol not made virtually illegal???? the combination of all drugs have not killed the amount of people that smoking and drinking causes. How is it legal that in order to have a prescription written we ate asked to be subjected to all kinds of injections that don't work. Twice upon a first visit for a new doctor, I have been told that they will not prescribe medicine unless I recieved them. I called my insurance company to see the cost. Over 5,000.00 dollars they billed per shot. <br/><br/>The whole medical system is a mess, please don't muddy the waters further by compromising our health and pain management. People are committing suicide because there are days you wake up knowing your hole day will be painful and bedridden. Atleast with our pain medicine we have the ability to face the day and regain a quality of life<br/><br/>Thank you for your time,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Adam	None	None	0900006484fc0e07	Trosell	None	2022-03-09T19:51:29Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from Trosell , Adam	l0i-t6qh-6727	False	None	False	2022-04-12 04:17:42.644	[]
2231	CDC-2022-0024-2237	https://api.regulations.gov/v4/comments/CDC-2022-0024-2237	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC’s 2016 GL were the worst thing to happen to pain management in the US. Full stop. The GL are directly responsible for the abandonment and deaths of thousands of chronic pain patients, or CPPs, across the country. These “recommendations” have become hard, fast rules/laws. Over 50% of primary care clinics refuse to take on CPPs due to bias and stigma caused by the GL. CPPs cut off of their medications are literally dying from cardiac events due to untreated pain, driven to suicide, or forced to the streets to seek relief where they often die due to fentanyl poisoning. This is one of many ripple effects the 2016 GL have caused.<br/><br/>The GL, along with gatekeeping doctors and prohibition in general, are directly responsible for the staggering number of overdose deaths occurring each year. Prescriptions have been reduced to levels not seen since the 1990s, yet a record number of ODs occurred in 2021. We do not have an “opioid crisis” in this country, we have a drug poisoning crisis caused by illicit fentanyl flooding the black market drug supply. And not only people with SUD are dying, it’s occasional users too: A teen tries one pill at a party; a nightclub-goer unknowingly uses cocaine adulterated with illicit fentanyl; post-op patients with undertreated/untreated surgical pain seek relief on the street; abandoned CPPs desperately seeking relief from pain are forced to the streets.<br/><br/>The updated CDC GL is far too little, far too late.<br/><br/>Not only do the GL still recommend a hard MME threshold, they've now lowered that from 90 to 50 MME. CPPs are already suffering with the 90 MME limit; to lower it even further will most certainly cause additional harm. MME is an arbitrary threshold based on junk science and needs to be thrown out.<br/><br/>Also, [name redacted]'s research is referenced nearly 100 times! Considering [name redacted] is also an author of the original and revised GL, I’m not sure how anyone could possibly argue that this isn’t problematic. [name redacted] is funded by the CDC and anti-opioid special interest groups to do his own highly questionable research. He cites that research nearly 100 times in the updated GL, despite COIs that should bar him from authorship altogether. Does it seem ethical to allow a man with a vested interest in anti-opioid research and clear COIs to create new policies that directly interfere with patient care with virtually no oversight? It's absolutely absurd.<br/><br/>Additionally, I’d like to address the GL as they relate to benzodiazepines. Most ODs are due to IMF and/or polysubstance use. No one denies that benzos can be risky when mixed with opioids. HOWEVER, they can also be safely co-prescribed in low doses and used responsibly under the guidance of a physician. In point of fact, they were commonly co-prescribed for decades prior to the 2016 GL.<br/><br/>I'm a legacy patient. I remember the pre-2016 era when patients were actually listened to and pain/anxiety was adequately treated. I have severe chronic pain due to Ehlers-Danlos Syndrome, cancer, fibromyalgia, small-fiber neuropathy, and herniated discs. I'm in pain constantly. I suffer from have debilitating anxiety and panic attacks. I'm no longer allowed to treat both conditions, largely due to the CDC GL and the opioid and benzo hysteria that has ensued.<br/><br/>Pre-2016, I used both a low-dose opioid and benzodiazepine safely for years without incident. Many family members and friends did the same, all without incident. After the 2016 GL was released, many of us were forcibly tapered off of pain and/or anxiety medication. We're now forced to choose between treating two legitimate medical conditions. There is no longer room for individualized medicine. We must decide which is more "deserving" of treatment: pain or anxiety. Imagine telling someone with asthma and high BP that they must choose between an inhaler or beta-blocker. It sounds insane, yet we're forced to choose between treating pain and anxiety, and no one bats an eye. <br/><br/>The updated GL do note that some patients can and should be co-prescribed opioids and benzos, exceptions can be made, and cutting CPP off of a benzo can be destabilizing. I appreciate that. However, the GL emphasize potential harms without acknowledging the significant some patients reap from both medications. There is no mention that at LOW DOSES, without alcohol / other CNS depressants, opioids and benzos CAN be used safely together. They make zero distinctions between someone on 90+ MME opioids and 10 mg Xanax daily, and a person on 10MME opioids and 0.5 mg Xanax used as needed, not daily. There is a significant difference between those two patients, yet the GL makes no distinction. Dose and frequency of use do matter. <br/><br/>Ultimately, I think the updated GL is a vast improvement from the previous 2016 GL. However, MME thresholds, overexaggeration of risk with co-prescribing benzos and opioids, and [name redacted]'s excessive citation of his own work are problematic. There is room for improvement.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Emma	None	None	0900006484fc0e0c	W	None	2022-03-09T19:54:35Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from W, Emma	l0i-ts8g-piiu	False	None	False	2022-04-12 04:17:42.874	[]
2232	CDC-2022-0024-2238	https://api.regulations.gov/v4/comments/CDC-2022-0024-2238	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 70 year old female dealing with an above elbow amputation (5 years) and degenerative and disintegrative spinal issues caused by an MVA. I have undergone 10 spinal surgeries including fusions, discetomies, rods/screws and removal of rod/screws which were replaced with individual metal utensils on each vertebrae. I have lost 3 inches in height due to the degeneration and disintegration of spinal bones (as well as gravity aging.). The pain is constant and interferes with normal life. Prior to the stiff regulations on opioids I was on three 10mg Hydrocodone tablets a day, plus fentanyl and Dilaudid. I told my Doctor to stop the Dilaudid and fentanyl as those two did NOT help relieve my pain. (I have strange reactions to pain meds and cannot take morphine either.) After the severe regulations came down, my doctor cut me to three 7.5 mg hydrocodone per day and eliminated the clorazapate I was allowed two a day as it was prohibited together with hydrocodone. I'm disabled, homebound so I don't drive or operate any machinery. I urge you to rethink the hellish existence I am forced to live through constantly. I also am prescribed four 350mg Soma per day as the pain causes muscle spasms throughout my body. Prescription potassium and magnesium help a little I suppose but not enough. It is difficult to keep me anesthesized for surgery as my body metabolizes medications very quickly. This is in all my medical records. The drug that relieved my pain the most is Demerol but it's not prescribed often, perhaps because the newer drugs, fentanyl and Dilaudid are supposed to be more effective though they give me NO RELIEF. There are thousands of elderly people who suffer crippling chronic pain and government has tied the hands of our Medical providers to help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MARYHOLLOWAY	None	None	0900006484fc0e0e	LOVE	None	2022-03-09T19:58:18Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-08T05:00:00Z	None	None	None	None	None	None	None	Comment from LOVE, MARYHOLLOWAY	l0i-u2ir-z96g	False	None	False	2022-04-12 04:17:43.086	[]
2233	CDC-2022-0024-2239	https://api.regulations.gov/v4/comments/CDC-2022-0024-2239	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Imagine feeling tired and wanting to put your feet up for just five minutes before you move on to the rest of your day. But once you sit down and prop up your feet, something happens. An indescribably uncomfortable feeling comes over your legs--they begin to jump and twitch. The twitching and jerking gets worse as you sit there until finally you give up and go back to work. Now your legs are still acting up and you can't sit at your desk any longer. You move to your standing desk for relief. A momentary reprieve, and then away you go again--now you must swing or flex or rise up on your toes to keep the contractions at bay. A short walk might help, but chances are your day is probably over and you will have to stay on your feet for the rest of the day occupying yourself with some task that does not require careful, undistracted thought. All of this happens before lunch. But, you are tired from the night before, when you cold not fall asleep because of your legs. The more tired you get, the more exacerbated your symptoms. A vicious cycle ensues and you soon cannot find relief anywhere. RLS is a chronic, painful neurological disorder that is still not well understood, nor is there a cure. Treatments vary, with varying degrees of success, but it is imperative that low-dose daily doses of opioids are available as an option for doctors trying to help their patients deal with the debilitating symptoms of the disease. Do low-dose opioids work for every RLS sufferer? No, but they can be very effective for a good many, which is why it is imperative that this treatment option be made a part of the opioid prescribing guidelines from the CDC. I strongly urge you to include this vital treatment option in those guidelines. Remember, RLS is something I would not even wish for my worst enemy. RLS is akin to torture and doctors need every tool available to them to help treat their patients with RLS. Thank you for your time and consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Douglas	None	None	0900006484fc10a5	Hinson	None	2022-03-09T20:00:58Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Hinson, Douglas	l0j-on6v-ze8x	False	None	False	2022-04-12 04:17:43.339	[]
2234	CDC-2022-0024-2240	https://api.regulations.gov/v4/comments/CDC-2022-0024-2240	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The changes made to supposedly combat the "opioid epidemic" did nothing to stem that, but instead negatively impacted patients - such as myself - who rely on properly prescribed opioids to manage chronic pain.<br/><br/>My doctor used to be able to prescribe a 90 day supply of vicodin for me. After the law changed, he had to get creative just to be able to prescribe 30 days worth of medication. The pharmacies also stopped stocking as much, due to smaller allowed amounts, so on more than one occasion I had to wait several days for them to be able to fill my prescription.<br/><br/>Those who abuse drugs will continue to find a way to do so. Those who improperly prescribe these medications for financial gain will also keep trying to find a way to do that. These ill-considered guidelines have ended up punishing those of us with legitimate medical issues that require opioid-level pain medication.<br/><br/>Please change the guidelines to make it easier (once again) for doctors to properly treat their patients who suffer from severe, chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fc10d5	Grossman	None	2022-03-09T20:01:17Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Grossman, Deborah	l0j-pfyq-1yo0	False	None	False	2022-04-12 04:17:43.549	[]
2235	CDC-2022-0024-2241	https://api.regulations.gov/v4/comments/CDC-2022-0024-2241	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines should be REMOVED. Let our doctors decide what's best for us. Please and thank you!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484fc10f8	Rodgers	None	2022-03-09T20:17:42Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers, A	l0j-pynv-wsy1	False	None	False	2022-04-12 04:17:43.763	[]
2236	CDC-2022-0024-2242	https://api.regulations.gov/v4/comments/CDC-2022-0024-2242	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This has gone way too far and gone on way too long. End the suffefing and medical PTSD that's been created!<br/><br/>In addition, I wholeheartedly support [name redacted]'s comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484fc1909	Rodgers	None	2022-03-09T20:18:05Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers, A	l0j-q1lw-pajr	False	None	False	2022-04-12 04:17:43.985	[]
2237	CDC-2022-0024-2243	https://api.regulations.gov/v4/comments/CDC-2022-0024-2243	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CSC, remove the blood from your hands by backing off of this topic completely. You've done immeasurable harm to millions of people with chronic illness and pain & their doctors. <br/><br/>We need some regulation of medications, but that is up to the FDA, not you. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484fc190b	Rodgers	None	2022-03-09T20:18:18Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers, A	l0j-q4so-kawp	False	None	False	2022-04-12 04:17:44.220	[]
2238	CDC-2022-0024-2244	https://api.regulations.gov/v4/comments/CDC-2022-0024-2244	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is exhausting and heartbreaking to see your child, even at age 24 he is my child, combat chronic pain daily. Finding doctors to diagnose and effectively treat his Small Fiber Neuropathy has taken us through 3 neurologists in two states over 4 years. Adding insult to injury is being unable to get prescriptions the doctors recommend but are unable to write, or pharmacists are unwilling or unable to fill. Being treated as suspect when filling and picking up the prescriptions that can be written/filled is demoralizing. Having to plan travel around when prescriptions have to be filled, with no leeway to get it a day or two sooner is absurd. When the medical professionals who should be there to help him have one hand tied behind their back and have someone looking over their shoulder, they cannot look after the patient's best interest or quality of life. No one wants to live with chronic pain, but people with chronic pain need enough relief so they can live. My son was working and going to college when this pain started, his life has been stalled for 4 years. It's time the medical professionals have the freedom to help him and others like him to be able to jump start their lives instead of having their medication held hostage by pharmacists that are afraid to do their job. I am grateful for the doctors we have found at UCLA Health who have made more progress in the last 6 months than in the last 3 years in Chicago. I am grateful that both Illinois and California have legalized marijuana because most times, there is no other relief available. We need to do better, we need to be helping chronic pain patients instead of shaming them at the doctor's office and at the pharmacy. We need to help them take their lives back. We need to let doctors and pharmacists do their jobs without fear of raising red flags. We need to do better!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachel	None	None	0900006484fc190d	Mitchell	None	2022-03-09T20:18:44Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell, Rachel	l0j-q702-9t50	False	None	False	2022-04-12 04:17:44.455	[]
2239	CDC-2022-0024-2245	https://api.regulations.gov/v4/comments/CDC-2022-0024-2245	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The regulations on opiates is outlandish. How can the government tell a doctor how to treat his patients? Denying doctors to offer pain relief to patients should be criminal. Ask any doctor about any medication. It can help or harm you. Everyone has a different threshold. A medication that helps one patient will kill another. Hence why the doctors are "practicing " medicine. So when the government steps in and try's to take away pain medication that has been around for thousands of years? Personally I would have never known about this absurd idea until I was diagnosed with Trigeminal and geniculate neuralgia, nicknamed the "suicide disease " . I did not want to take opiates Nevertheless I was rendered completely useless because of the horrible pain in ear, face, neck, and head. I couldn't function due to the pain. I consider myself extremely fortunate that my oral surgeon encouraged me to take my pain medication, and it made me a functional human again. Unfortunately even opiate therapy does not help some neuralgia patients. They have to take extremely toxic anti-seizure medications. I was given an anti-seizure medication gabapentin, that is supposed to have the least amount of side effects it was a complete nightmare. I literally had every side effect including dementia at 48, and it made my pain significantly worse. Weaning off that medication was The worst experience of my life complete with insomnia, cold sweats, Nausea to the point where I could not eat. I sought treatment in the ER and was turned away as a drug seeker when I had MRI results that clearly said I have Trigeminal and geniculate neuralgia. I finally found a pain doctor who was willing to give me one and a half tablets a day. This was such a game changer, I literally had a quality of life back. I would prefer to take a Couple tablets a day rather than have brain surgery. The best brain surgeon in the country said that it would be 50-50 if the surgery would work, and by working that means 50% of the pain would be reduced. I have considered relocating to Costa Rica because the environment is better, but mainly their Doctors are not restricted by their government and told how to practice medicine. I think like ever met needs to stick to covering and the doctors practice medicine. Allow them to use the medication that's been around for multiple decades and since literally the beginning of time. Ibuprofen literally gave me a stomach ulcer because I took so much of it. Over-the-counter drugs are not without sometimes severe side effects.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484fc191c	Bellrose	None	2022-03-09T20:19:10Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Bellrose , Christina	l0j-qd3d-fvll	False	None	False	2022-04-12 04:17:44.711	[]
2240	CDC-2022-0024-2246	https://api.regulations.gov/v4/comments/CDC-2022-0024-2246	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Here is a link and breakdown of everything that is wrong with your guidelines and what needs to be changed. It puts into words everything that I believe needs to be changed to help people like me who have degenerative and disabling chronic pain and illnesses. Five minutes ears ago I was able to spend time with my family, clean my home and even get out to grocery shop. Things that people take for granted. Now I am stuck in bed 80% of the time. I have lost over 40 pain doctors in three years due to DEA overreach most of my doctors stopped practicing or were arrested for prescribing to people who fall under palliative care! The guidelines need to be dissolved because people like me can no longer receive proper pain control and soon there will be no doctors left. https://www.painnewsnetwork.org/stories/2022/3/9/the-devil-is-in-the-details-of-revised-cdc-opioid-guideline	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc194c	Anonymous	None	2022-03-09T20:19:26Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-r04i-4aie	False	None	False	2022-04-12 04:17:44.945	[]
2241	CDC-2022-0024-2247	https://api.regulations.gov/v4/comments/CDC-2022-0024-2247	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Her battle with pain began after a fall and an undiagnosed hairline fracture. The journey took her to the [locations redacted], and numerous local pain doctors and hospitals. It was diagnosed as RSD and in later years Chronic Regional Pain Syndrome It began in 1999 and ended with her suicide in 2019. She lasted that long as a single mother to see her boys grow to independence . They were horrible years for her but also for her young boys and her family . Especially after they introduced her to OxyContin in 2003. Every doctor, every clinic, every hospital had a different opinion about pain medication. She was constantly on an up and down yo-yo and one doctor actually took her off all medication . This talented reading teacher with a masters degree as a reading specialist spent most of those twenty years in bed. Life revolved around trying to alleviate pain and the emotional stress of the ever changing prescriptions and pharmacies that either didn’t get the medication in before that holiday weekend or judged her harshly for needing the pain medication in the first place , treating her as if she was just another addict. She was in pain. It was not her fault. And yet she received very little in the way of empathy or understanding from the medical community or from the community at large. There was skepticism that amounted to cruelty. She was lumped in with addicts with no real attention to how pain had taken over her life. She is gone from us now but we continue to suffer. What could we have done, we ask ourselves. How could we have helped to make it better?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gabrielle	None	None	0900006484fc19ac	Nadal	None	2022-03-09T20:20:46Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Nadal, Gabrielle	l0j-riui-j2pt	False	None	False	2022-04-12 04:17:45.164	[]
2242	CDC-2022-0024-2248	https://api.regulations.gov/v4/comments/CDC-2022-0024-2248	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Alternative, non-opioid treatment options for pain cannot be stressed enough. As the draft guideline mentions, laser therapy can be an effective, life-changing option. Laser therapy should be in the conversation for all stages of pain treatment. I am currently using laser therapy in my practice as an adjunct to acute injury pain relief and post operative pain relief as well as chronic pain relief. There are few things from a treatment perspective that I can say work so effectively and immediately. When a patient steps down after treatment and says "Oh my god" because their foot or ankle feels so much better, it is quite gratifying as a practitioner. Outside of local aensthesia, laser therapy is the only modality that can provide this type of relief for my patients. Laser therapy also lasts longer than local anesthesia blocks. As a podiatrist who does foot and ankle reconstructive surgery, regularly prescribes opioids and attempts to limit narcotic use, laser therapy has changed my prescribing habits.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fc17ae	Repko	None	2022-03-09T20:21:01Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Repko, James	l0j-rof1-062c	False	None	False	2022-04-12 04:17:45.389	[]
2243	CDC-2022-0024-2249	https://api.regulations.gov/v4/comments/CDC-2022-0024-2249	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a doctor at working in a [location redacted] department of Emergency Medicine. I do not feel that an artificial limit by an agency not in the business of direct patient care is appropriate. Patients are coming in with real pain after injuries and surgery having had little or no opiate medication, even when, in my opinion, it is indicated; 5 oxycodone pills after major surgery, for example. We get “ feedback “ on our prescribing that I believe puts fear of loss of livelihood into doctors decision making regarding treating patient’s pain.<br/> I fear for what may happen as I age, should I ever need opiates for pain control. <br/> The street is too easy to access for those desperate for relief. Lets not drive people to the streets by misguided limitations on clinical decisions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Caren	None	None	0900006484fc17b2	Euster	None	2022-03-09T20:21:47Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Euster, Caren	l0j-rx29-ezgo	False	None	False	2022-04-12 04:17:45.636	[]
2244	CDC-2022-0024-2250	https://api.regulations.gov/v4/comments/CDC-2022-0024-2250	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I present this comment as a physical therapy practice owner (BioMechanic Physical Therapy) and as a practitioner. Personally, I hold a doctorate in physical therapy, have over 25 years of experience, and own 2 physical therapy practices with 27 employees. In our clinics we have used "cold lasers" also known as low light laser therapy for 15 years (the Med-X Laser) and within the past 2 years I have upgraded our lasers to the multiple low level light lasers, the MLS Laser. Although we have always had successful pain relief with all of the lasers, the MLS laser gives dramatic pain relief. The company (Cutting Edge Lasers) reports their outcomes research shows 80% of patients receive 80% pain relief in just one treatment. Me -- and all of my therapists -- note that the LLLT or cold laser therapy is not only effective, but an impressive pain relief tool.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc17cc	None	None	2022-03-09T20:22:09Z	BioMechanic Physical Therapy	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from BioMechanic Physical Therapy	l0j-s85n-dal2	False	None	False	2022-04-12 04:17:45.846	[]
2245	CDC-2022-0024-2251	https://api.regulations.gov/v4/comments/CDC-2022-0024-2251	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for recognizing that chronic pain suffers have beared some very punitive circumstances such as be8ng put in a position of losing jobs due (my situation) to the strict limits on pain dosage guidelines. Not only did I lose the ability to work which led to severe financial hardship but daily activities have also been limited by these guidelines which brings a terrible mental toll on patients. I want to thank you for taking the time to read this and hope it is helpful.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bruce	None	None	0900006484fc17e8	Smith	None	2022-03-09T20:22:26Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Bruce	l0j-spnx-blbt	False	None	False	2022-04-12 04:17:46.074	[]
2246	CDC-2022-0024-2252	https://api.regulations.gov/v4/comments/CDC-2022-0024-2252	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I provide Class IV low level laser therapy to patients experiencing chronic pain. So many of these patients have never heard about this option until they are deep in the chronic pain journey and many have fought battles with addiction by that point. It is imperative that alternative treatment options to opioids for pain management exist. Low level laser is one of those options. As the draft guideline mentions, laser therapy can be an effective, life-changing option that patients often are not aware of until their pain journey has been long and arduous. Laser therapy should be in the conversation for all stages of pain treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristie	None	None	0900006484fc1807	Carter	None	2022-03-09T20:22:47Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Carter, Kristie	l0j-swg5-x2x4	False	None	False	2022-04-12 04:17:46.319	[]
2247	CDC-2022-0024-2253	https://api.regulations.gov/v4/comments/CDC-2022-0024-2253	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Losing a kidney to cancer and being overexposed to radiation therapy left me with a partial colon removable, a dead right hip now housing a total hip replacement, my gallbladder imbedde partially into my liver, scoliosis along with 5 disc removals along with rods/plates removed due to the rod pertaining through my spinal radiation skin/burn and MRSA<br/>devouring my spine leaving me with a spinal wound the size of an egg being treated since 2018 as the wound <br/> won't heal as it surrounds radiation burns. I have both osteoporosis and spondylitis along with fractures in my spine that has collapsed and I can no longer hold myself up. Since my pain meds have been reduced I no longer enjoy independence. I lay in bed waiting and praying for a miracle. Before my opiods were reduced I could clean myself, clean my house, socialize and go to church and work in my flower garden. You took my life away from me. I never abused my pain meds nor used alcohol or other ellicts drugs. I always had my pill count and passed over 100 drug test. I want my life back. I want to live again. The dose of pain meds that I'm on now only helps a hour. I want and need more activities and less pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary C	None	None	0900006484fc180a	wright	None	2022-03-09T20:23:02Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from wright, Mary C	l0j-t2gm-azcv	False	None	False	2022-04-12 04:17:46.573	[]
2248	CDC-2022-0024-2254	https://api.regulations.gov/v4/comments/CDC-2022-0024-2254	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file with my comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dean	None	None	0900006484fc180e	Kurath	None	2022-03-09T20:23:29Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Kurath, Dean	l0j-su3j-0rwn	False	None	False	2022-04-12 04:17:46.808	[]
2249	CDC-2022-0024-2255	https://api.regulations.gov/v4/comments/CDC-2022-0024-2255	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing for my husband and family that have been devastated by cdc so called guidelines that have been turned into law to oppress all patients with painful disease and conditions. My husband has adhesive arachnoiditis chronic kidney disease, degenerative disc anemia low testosterone and more..He had had same family doctor and pharmacy for over 2 decades when guidelines can out.<br/>The family doctor that used to see my whole family started to change and everything became about my husband dosage and getting him off that dosage that he had been stable on no increases for over 2 decades. She stopped treating his other symptoms and started making changes without discussing anything with my husband. She ended up firing him for a medical crisis she created..new np of course gave him no option but suboxone that ended horribly because new np didn't stabilize my husband before she started suboxone. He responded so bad that he crashed and 911 needed called in front of our whole family and the clinic resulted in more trama for my family..they don't care every time they mess with his function we lose money,trama and depression and more ...Doctors expect u to move forward with life when u have no control over ur function!! Now even tho my husband has no history of addiction we fear every month because 2 nurses watch him pee for drug test, monthly pill counts, chance of taking medication out every month..not knowing when our lives will be taken by someone we don't know and my husband ability to provide for his family. <br/>All forms off milligram equivalents will continue to be weaponized against patients!! We cannot continue to live like this with someone else having power over my husband ability to provide for his family..He has worked his whole life with many incurable painful diseases and is high functioning as long as he alone has power over his function!!these are incurable patients they won't be healed, as a family we should have power over all medical decisions and what works best for our family. <br/>These patients are forced to go to every appointment as a liability without having anyone to protect them!!since guidelines I have had to advocate for every family member in my family with pain, because none of them feel believed!! This is what guidelines have done to American medicine!! I as advocate have also developed medical induced PTSD and I am not the patient!! Is this how we want American medicine?? Shame guilt fear are all our most vulnerable population of citizens feel due to these guidelines..my husband and myself have already decided, if they take his function again, we will both choose to no longer fight!! I will not let him go through this alone!!our adult children all have medical PTSD due to what they have seen thier father go through!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leticia	None	None	0900006484fc188c	Gomez	None	2022-03-09T20:23:53Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Gomez, Leticia	l0j-u7t6-dirg	False	None	False	2022-04-12 04:17:47.037	[]
2250	CDC-2022-0024-2256	https://api.regulations.gov/v4/comments/CDC-2022-0024-2256	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for 20 years due to a botched hysterectomy and multiple surgeries. The last surgery I suffered severe nerve damage. I had managed to maintain a job, win an award at the hospital I worked at and function somewhat normally. But this was not without being treated like a drug seeker or criminal when I had high flares of pain, especially by the ER doctors. I lived in constant fear that my medications would be taken away. After the nerve damage on my last surgery I was unable to go back on the Fentanly patch because my doctor didnt want to deal with it and was probably afraid to prescribe. I tried injections but they didnt work great. I was laid off from my 25 year job and dealing with high pain, financial issues, and depression. I had to call 911 when I couldnt take it anymore seeking help. That was a mistake. I was sent to a psych facility. All my meds were taken away and wasnt given a taper. Now I was basically a pariah in my town and couldnt get help. I ended up going to a methadone clinic and told them I would have to go to the streets. They saved my life. And I realized how undertreated my pain had been because I hadn't felt that good pain wise in a long time. It's been a hard process and that one surgery ruined my life. I now deal with anxiety, depression and PTSD. There is so much more I could say but it would be a book of the things I've endured having pain. It not only ruined my life but my husband's and affected my family greatly. I used to read some pain sites and there are so many hard working decent people whose lives were turned upside down by this new protocol because doctors were afraid to prescribe. Patients who were on less than 90 mg had their meds taken away for no reason or titrated down so low it was pointless. I would cry reading the stories about people in so much pain, so desperate for help and ready to commit suicide. Offices were calling patients telling them unless they were there in 2 hours for pill count they would be fired. Do we treat our diabetic or heart patients like that. There would be a huge uproar if we did. Unless you have had pain 24/7 you can't imagine the toll it takes on you financially, physically, mentally, socially. Pain patients should not be punished because others abuse medications mostly illegal. There are more alcohol related deaths yet that is acceptable. We are not closing liquor stores because people become alcoholics, get into horrific car accidents, and up with medical issues. And what function does alcohol play except to get people buzzed or drunk<br/><br/>My mom was just discharged from a hospital in Massachusetts. She had to wait 15 hours for pain medication for a gallbladder attack. My family is looking into filing a complaint as that is just making someone suffer because of a policy that doesnt even apply to hospitals. I hope this time when you make your recommendations you have a board certified pain specialist and not an addiction one. The whole process was so wrong. Thanks for letting me comment on this website. I'm not sure anything will change but I hope they do. Laying in bed all day in severe pain is no life. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	CHERYL	None	None	0900006484fc18f1	CUNNINGHAM	None	2022-03-09T20:24:19Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from CUNNINGHAM, CHERYL	l0j-va8h-0ldn	False	None	False	2022-04-12 04:17:47.766	[]
2251	CDC-2022-0024-2257	https://api.regulations.gov/v4/comments/CDC-2022-0024-2257	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My life has been destroyed by the harsh guidelines drawn by the CDC. I am in a 10 out of 10 pain every day. I’ve been bedbound for 7 years. I cannot function. Doctors are terrified to write pain medications due to these guidelines. Please help us. Please fix this. One day you will very likely also go through pain that is severe as we all get old and the human body can only take so much. You are one accident away, one surgery away, one disease away from suffering in a torture chamber of a body without getting adequate medical help. These guidelines must change. Chronic pain patients can’t live like this. We can’t do it. Please stop forcing us to suffer unimaginable torture. It is devastating.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fc1b06	Aven	None	2022-03-09T20:24:39Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Aven, Elizabeth	l0j-w0hm-b4n8	False	None	False	2022-04-12 04:17:47.975	[]
2252	CDC-2022-0024-2258	https://api.regulations.gov/v4/comments/CDC-2022-0024-2258	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please be aware of and address a serious omission to the Clinical Practice Opioid Prescribing Guideline which is the failure to address other chronic conditions like Restless Legs Syndrome (RLS) which is completely different from chronic pain. Restless legs syndrome is a chronic neurological disease that causes an urgent need to move the legs, and in some cases, other parts of the body as well. The manifestations of RLS make it impossible to sleep or even to sit quietly which seriously affects every aspect of life.<br/>In the U.S., nearly twelve million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve symptoms for a while, but over time those same medications can cause the symptoms to worsen. When all other medical therapies fail, the use of low-total-daily-dose opioids to successfully treat severe RLS is supported by ample scientific research.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>I have had RLS all my life. Being sleep deprived is known to cause serious health consequences. I was not diagnosed until I approached a physician with my complaints at the age of 45 and requested a sleep study which confirmed my condition. I am now 71 and have taken every FDA approved medication for the treatment of RLS as well as multiple off-label prescription meds to treat this miserable neurological condition. Failure to sleep is not only a health issue, but also a quality of life issue. Having failed all prescription treatments for RLS and having had the symptoms worsen while under treatment, a low-dose-daily-opioid is now the only treatment that helps to mitigate this condition. The current restrictive guidelines, both national and state legislated, drastically hinder successful treatment of RLS. An example is the absolute requirements limiting the number of tablets to be dispensed or the ability to get a "vacation override" for opioid meds. When we traveled to Hawaii from Oklahoma for a week for vacation, there was no way for me to get a refill because it was "too soon"; no way to get a vacation override; and/or no way to get an increased quantity in my prescription even as a one-time exception.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Yet, the 2016 CDC Opioid Prescribing Guidelines, the "war on drugs"; and individual states blindly following same mentioning only chronic pain treatment as a condition necessitating opioid treatment places great personal suffering, physical and mental, on patients who need opioids for relief of valid medical conditions. Many patients with severe, unrelenting RLS have been on the same dose of low-total-daily-dose opioid treatment for decades. I am a person with that severe, unrelenting condition. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thanking you in advance for your consideration of these vital issues. Please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS. There is much medically and scientifically-based information about RLS based on years of research and clinical trials at this resource.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fc1b0a	McPherson	None	2022-03-09T20:24:57Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from McPherson, Lisa	l0j-w0wn-4atv	False	None	False	2022-04-12 04:17:48.219	[]
2253	CDC-2022-0024-2259	https://api.regulations.gov/v4/comments/CDC-2022-0024-2259	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate the working group's attempt to update the CDC Guidelines for opioid prescribing from 2016. What I am concerned about this the harm that has already been caused by the misapplication of the 2016 guidelines which include clinicians refusing to continue prescribing opioids to patients with chronic pain on long term opioid therapy without aberrant behavior; insurance company denials for continuation of treatment with opioids above certain morphine equivalent doses EVEN when patients have previously been on these doses for years; and the resulting harm to patients with reports of increased suicides and increased aberrant drug use with illicit substances to treat pain. So while I appreciate this step to clarify the guidelines as just being this 'guidelines', I wonder how the CDC plans to communicate with insurers, pharmacies, clinicians this newer data in a succinct manner to try to undo this damage. I work in palliative care and do believe that opioid risk assessment and management is absolutely essential in this population as well, but I would not advocate to include this population in this guideline as I worry it is already being misapplied to those with cancer and serious illness. [name redacted], DNP, ANP-BC ACHPN, CPE, FPCN, FAANP	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fc1d96	Broglio	None	2022-03-09T20:25:34Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Broglio, Kathleen	l0j-wsyf-rmrq	False	None	False	2022-04-12 04:17:48.446	[]
2254	CDC-2022-0024-2260	https://api.regulations.gov/v4/comments/CDC-2022-0024-2260	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a pain patients for 20 years, same amount of pain medicine the entire time, never needed an increase, was doing well, never was above the CDC guidelines, but doctor became afraid because of CDC guidelines 2016 and forced tapered me to 30mg a day. Now I am not able to have a life. Doctor said the DEA harasses him even with even low doses of opioids, and he didn't want to lose his license. I get treated like a drug addict, even though I never flunked a urine test or pill count in all those years, never lost my medication, never missed an appointment, been a model patient. Now even the pharmacy treats me like a drug addict, asking me why I need this medication, giving me a hard time saying they don't have enough to fill, making me wait, even suggesting other drugs I should take. Please stop the DEA from harassing good doctors for helping people with legimate pain. Also, they are forcing me to have procedures, even though I had them before and they don't work, I feel so helpless and vulnerable. Thank you for changing the guidelines. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484fc1ddd	Martin	None	2022-03-09T20:26:08Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Thomas	l0j-xwsa-paxw	False	None	False	2022-04-12 04:17:48.657	[]
2255	CDC-2022-0024-2261	https://api.regulations.gov/v4/comments/CDC-2022-0024-2261	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ther should be no cut with the mme everyone is different this is harmful to people that need extra relief health care needs to be put back in the hands of physicians like it was befor the 2016 guideline change I have Ankylosing spondylitis fibromyalgia osteoarthritis ect and cannot find a physician to treat me without injections that give me more issues and more pain all due to a false urine test said I had morphine in my system and never took morphine in my life some days it’s hard to even walk or function these guidelines make me suffer tremendously unable to function like I did when I had pain relief	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	0900006484fc1be7	Siegfried	None	2022-03-09T20:26:22Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Siegfried , Shirley	l0j-yf3l-8mgp	False	None	False	2022-04-12 04:17:48.883	[]
2256	CDC-2022-0024-2262	https://api.regulations.gov/v4/comments/CDC-2022-0024-2262	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve heard that the maximum amount of pain meds is being lowered. The only thing that was keeping me going was the belief that all these unfair rules would be done away with soon. Hearing that they will be even less has made me very depressed and feeling no hope. This is the US! I think we should be able to get the meds we need. Doctors who are responsible shouldn’t be monitored. Please end this nightmare. We are in pain, not looking to get high. We need pain meds to live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1bf7	Anonymous	None	2022-03-09T20:26:45Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-yrkf-3nhr	False	None	False	2022-04-12 04:17:49.111	[]
2257	CDC-2022-0024-2263	https://api.regulations.gov/v4/comments/CDC-2022-0024-2263	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a retired health care provider who has lived with chronic pain for 40 years I would like to comment that whenever pain medication is determined to be "bad" that the chronic pain patients suffer. I have used pain medication responsibly for 40 years- there have been times where I did not need to take any but a few times/month and times I needed it daily for a few weeks. Never have I been addicted, or sought pain medication except through my physicians. The pain medication has allowed me to work, travel, socialize. Without it I would probably not be able to any of the above. Having some control over the severity of the pain has a profound psychological benefit. <br/>I realize the addiction to narcotics has ravaged our country but also know that most of the deaths from opioids are due to imported and contaminated products obtained illegally. <br/>Let's not deny the life giving relief of pain to patients who need it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1c20	Anonymous	None	2022-03-09T20:26:55Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-yyus-xi9t	False	None	False	2022-04-12 04:17:49.358	[]
2258	CDC-2022-0024-2264	https://api.regulations.gov/v4/comments/CDC-2022-0024-2264	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2004 I was diagnosed with trigeminal nerve craniofacial pain syndrome accompanied by 24/7/365 burning, stinging, sharp, knife digging, ripping, pulling, bee stinging, ant crawling, freezing type intractable pain. Over the next six weeks the facial pain turned my world upside down in ways I never could have imagined. I was no longer able to care for myself and at age 37 I lost my home, career, friends, financial freedom, everything and ended up moving in with my parents as they graciously took care of me, cooking, driving, laundry, housing, shopping, appointments, they did everything for me; I was completely disabled from my pain. After many years of searching for a “cure”, finding there was not to be one for me and having endured two brain surgeries, multiple medical treatments and traditional medications later, nothing was helping me get better, my neurologist referred me to pain management. They were my savior who was able to get my pain under control and allowed me to have a functional quality of life. As much as I resisted they prescribed opioid medications, which completely turned my life around. At 55 years old I’m now being forced tapered due to the CDC guidelines. Why do I have to live the rest of my years in pain? WHY? I have never asked for dosage increase, in fact I have decreased my dosage over the last four years, never lost a prescription, or asked for early a refill. Please let our doctors treat us appropriately. Reducing pain medication doesn’t make the pain go away. My facial pain won’t suddenly disappear, I’ll still be living with the effects and pain of my condition. <br/><br/>Legitimate pain management doctors and clinics are being run out of business and the new “pain management” clinics that are setting up offices, but are only there to take people’s money, force taper patients off opioids and/or force people to have injections. Some are prescribing suboxone or buprenorprine in lieu of opioid medications.<br/><br/>After my pain management doctor of 13 years retired I saw the new pain management doctor once. All follow up visits have been over the phone with a nurse, what a con job they have going on and my pain clinic is not the only one doing that. For those who don’t have insurance coverage one must pay an exorbitant cash fee for a three minute nurse phone call to have your medications forced tapered. <br/><br/>Legitimate pain management doctors are being run out of business due to the CDC opioid prescribing guidelines and DEA’s strong arm. CDC can fix this disastrous situation and reinstate doctors right to prescribe opioid pain medications, but choose not to. Instead of removing the 90 MME they add a 50 MME opioid prescribing threshold. If CDC doesn’t rescind the opioid prescribing guidelines they need to at the very least remove all wording related to 90 MME and 50 MME.<br/><br/>Legitimate pain patients are being forced to the streets to find illegal drugs to relieve their pain and the CDC wonders why the opioid crisis is escalating. There’s your answer, right there in front, and it goes unanswered, completely mind boggling!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1c24	Anonymous	None	2022-03-09T20:27:21Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-z2i1-yk5z	False	None	False	2022-04-12 04:17:49.592	[]
2259	CDC-2022-0024-2265	https://api.regulations.gov/v4/comments/CDC-2022-0024-2265	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Our pain management practice offers not only pharmacological management for pain but education in conservative management of pain and muscle spasms as well as offering Acupuncture and MLS Laser Therapy in addition to trigger point injections and referrals for Physical Therapy, Chiropractic care and interventional pain management if indicated. We have found MLS Laser to be very helpful in managing and decreasing pain and muscle spasms to the cervical and lumbar area as well as pain related to neurons and plantar fasciitis. By using the MLS Laser as a treatment option less or no narcotics , muscle relaxers and NSAID’s are prescribed or needed. More patients would consider MLS Laser as a treatment option for pain if it was covered by insurance. Please consider MLS Laser as a treatment option for pain and muscle spasms.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1c7f	Anonymous	None	2022-03-09T20:27:30Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-0a04-zfvp	False	None	False	2022-04-12 04:17:49.840	[]
2260	CDC-2022-0024-2266	https://api.regulations.gov/v4/comments/CDC-2022-0024-2266	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Morning Sir or Madam,<br/>I am writing as a ST4 Breast Cancer patient, a MOM, a wife, a daughter, an accountant of 22 years. My Palliative care team at [location redacted] now wants me to try accupuncture and physical therapy. They say the goal was to get me off narcotics. They are more worried about me misusing than about my terminal illness and the effects that it not only has on me, but also my family as well. I can honestly tell you I am terrified about my EOL treatment.<br/>The "one size fits all" grading of the pdmp system is seriously flawed. Example: if you do not work, you are given a mark against, if you make less than 55K, you are given a mark, if you have anxiety, you are given a mark. I am on disability, due to my terminal illness, I have a 13yo son, that my biggest fear is leaving....I am a dying mom, am I not supposed to have any anxiety???? I fear not being around for my son.<br/><br/>So, while at the same time acknowledging they never intended this measure to be normal, and it has harmed patients.... NOW they mention "50 MME". We ENDURED and SAW what happened when they mentioned 90 MME and now they want to lower it AGAIN??? The 50 MME limit is mention in ALL the supporting texts of the revisions.<br/><br/>When did a DYING person become the face of the opiate crisis? It's Fentanyl, not patients. Also, last year I was T-Boned by a person driving 60 miles an hour that ran through a red light. He hit my big truck so hard, that I broke 3 ribs..... on the side that I sleep on. Even though my doctor wrote a prescription for 7 days (when in reality I should have gotten one for a month the pain was so bad), Walmart would only fill 5 days of meds. Please remove the day limits for acute pain. Some pain does not go away in 7 days. Especially if you have broken bones. That's common sense.<br/><br/>Fund and execute a plan for how to de-implement the 2016 CDC Guidelines.<br/>Although CDC claims these were "just guidelines" arbitrary limits such as MME limits and 3,5, or 7 day limits are an issue because:<br/>Many state laws have been created based on them. They are worked into EHR (Electronic Health Records). Risk score algorithms such as NarxCareuse them. CDC funded an extensive implementation plan for them. DEA also uses risk scores to flag doctors who "prescribe outside of the CDC Guidelines." <br/><br/>The Guidelines need to be redacted and redone due to bias and conflicts of interest (COI's). [name redacted] was involved in every aspect of the CDC Guidelines and has COI's. PROP members who were being paid by law firms involved in opioid litigation were involved with the Guidelines. [name redacted], an author of both 2016 and 2022 CDC Guidelines was listed as a PROP member at a meeting with FDA regarding PROP’s 2012 petition.<br/><br/>They excluded "cancer pain" in 2016 Guidelines yet cancer patients have been affected.<br/>They need to mention there are many painful diseases and conditions. Just saying "palliative care" patients are exempt won't help anyone. It didn't help in the 2016 Guidelines.<br/><br/>[name redacted] "Panic in PROPville."<br/>Nearly 40 states have codified the 2016 guideline in some way, often by limiting the number of opioid pills that can be dispensed for an initial prescription to seven days’ supply or less. [name redacted] hopes those states will review and revise their laws and regulations to better reflect what the CDC recommends in its revised draft – that enough opioids be prescribed for “the expected duration of pain.”<br/><br/>He also thinks the Department of Justice (DOJ) and Drug Enforcement Administration (DEA) should reconsider their aggressive prosecution of doctors for prescribing high doses.<br/><br/>“The work that the DOJ and DEA is doing, I want to believe is done in good intent,” he said. “I think that many of their cases will look at the prescriptions or the doses, but they might not look at the context for why the patient was receiving that care or why they were receiving those medicines.” <br/><br/>Please, ask yourself WHY are women given 3 points against for childhood sexual abuse and men are given a 0. That is bias. Do you really believe being sexually molested is any less traumatic for a boy??? Why do they grade women and not men?<br/><br/>HOSPICE patients are having their meds taken away as well! I have attached two files for your reference. The USA now ranks 43rd in how well we treat our Hospice patients. That is terrifying. When did we lose our compassion for the dying?<br/><br/>Thank you for your time,<br/>A Dying mom, trying to live her best life for her child who is watching.<br/><br/>PLEASE, PLEASE remember WHY these are being revised. PLEASE remember the 2016 guidelines were misapplied BECAUSE of the express limitation written into them. Please remove ANY mention of MME limitations, even in the supporting documents. AND, limitations for acute pain. Also, sickle cell patients have not been added to exclusions. <br/><br/>We are glad all the pill mills have been shut down. You have done your job. Please let our doctors take over now. Much love.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mom dying	None	None	0900006484fc10f5	Stage 4 Breast Cancer	None	2022-03-09T20:30:16Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Stage 4 Breast Cancer, Mom dying	l0j-pl7h-p9d2	False	None	False	2022-04-12 04:17:50.049	[]
2261	CDC-2022-0024-2267	https://api.regulations.gov/v4/comments/CDC-2022-0024-2267	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm in suicide pain from being taken down on my pain medication. Please do not put caps on pain medications we are all different i need a higher dose to get pain relief. Do you really care about us out here suffering and being tortured to death .so many beautiful pain patients committed suicide because they were taken down or off their pain medications because of the 2016 CDC guidelines.doctors clinics were shut down for help us .no doctor will take a pain patients now .we need help this is a medical emergency it should have been dealt with right away to save lives on innocent pain patients and our veterans who are out here crying and begging for help. I can not live in this much pain if someone does not help me. I will no longer be on this earth to suffer. You are making so many end their lives because we can't take the pain. You new guidelines probably don't have anything in to help us .we will still not have any protection or the medications we need to lives Please help us if you care .but so far it shows you do not care if we suffer or commit suicide. You would of done something years ago. You know the [profanity redacted] we are going through if you care you won't put hidden comments in you 2022 guidelines that will harm us worse than we are now. Don't betray us .please help us and our doctors who have been destroyed along with us. Who would do such a thing to innocent citizens who need help....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fc0ec6	Buchholtz	None	2022-03-09T20:44:19Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Buchholtz, Kim	l0j-4tl6-lla6	False	None	False	2022-04-12 04:17:50.278	[]
2262	CDC-2022-0024-2268	https://api.regulations.gov/v4/comments/CDC-2022-0024-2268	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi,in 2004 I started taking 60 mg of m s contin and 4x50 mg of tramadol daily.The m s contin dosage was raised to 90 mg daily several years later.I was told when I started on m s contin that I would have to have that dosage raised later on because my system would become tolerant to it.About 10 years ago I told provider that my low back pain was getting worse.I was told that I was at the limit allowed and I would not be able to have dosage increased.I am to the point now where I think of suicide every day.I do not have a gun but when I am able to get one it will only be a matter of time before I use it.I just read the article in the N Y Times about [name redacted] who ended his life when his meds were cut in half.18 years of chronic pain that keeps getting worse makes me think why go on like this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc0f94	Anonymous	None	2022-03-09T20:45:44Z	None	None	1	None	2022-03-09T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0j-lgyh-5pqj	False	None	False	2022-04-12 04:17:50.557	[]
2263	CDC-2022-0024-2269	https://api.regulations.gov/v4/comments/CDC-2022-0024-2269	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I pray that as you are reviewing all these comments and that you will take to heart what we are all saying; We are normal hard working people who have to take opioid pain meds just to get through the day ! Our pain is not imagined and it won't miraculously go away. When you are in so much pain that the pain meds only take the sharp edge off, the pain long enough for you to work, make dinner, take a bath, and or just sleep. All these normal everyday tasks anyone else would take for granted as being easy to accomplish can be Mountains for someone in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc2130	Anonymous	None	2022-03-10T14:53:46Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-23zx-p984	False	None	False	2022-04-12 04:17:50.780	[]
2264	CDC-2022-0024-2270	https://api.regulations.gov/v4/comments/CDC-2022-0024-2270	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines have been misinterpreted as mandates and used to deny pain victims medications needed to conduct normal lives.<br/><br/>I have a friend with a liver condition that causes her intense pain. For more than twenty years her pain meds have helped her lead a somewhat normal life. After her primary care physician retired, no one would prescribe for her because of the CDC 'guidelines'. She was forced onto a brutal 'taper' regimen that put her through cold turkey hell. The pain? She has to deal with it. She doesn't sleep. She passes out from exhaustion. A couple of hours later, the pain wakes her. The medical system has failed.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fc213c	Prenis	None	2022-03-10T14:55:12Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Prenis, John	l0k-2gcp-yqr0	False	None	False	2022-04-12 04:17:50.989	[]
2265	CDC-2022-0024-2271	https://api.regulations.gov/v4/comments/CDC-2022-0024-2271	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a practicing pain management specialist, we see chronic patients on a daily basis and there is no single therapy modality that is infallible and effective in relieving the pain. The opioid crisis was resulted due to lack of proper knowledge about the opioid agents, and as we learn more about this, the risks of any adverse effect have been reduced significantly. There is always going to be abuse potential with any pharmacologic agents but proper education and awareness should curtail this problem. In addition, use of opioid alone is not adequate, and more appropriate therapy is multidisciplinary, multi modal approach with oral analgesic agents, physical therapy, acupuncture, chiropractic manipulation, and interventional pain techniques to better control the pain and reduce use of opioid agents. Therefore, just by limiting the access to opioid alone will not solve the core of the chronic pain and opioid crisis. This type of therapy should be available for pain management specialists for proper and judicious use in conjunction with other therapy modalities to help our patients. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fc21ad	C	None	2022-03-10T15:26:07Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from C, Paul	l0k-440c-qdcm	False	None	False	2022-04-12 04:17:51.225	[]
2266	CDC-2022-0024-2272	https://api.regulations.gov/v4/comments/CDC-2022-0024-2272	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	HI<br/>It would be helpful if a "safe harbor dose" was included in the guidelines so that <br/>a low dose of opioid could be prescribed without doing drug testing, extensive documentation, etc. <br/>A recommendation such as hydrocodone 5 mg twice a day for breakthrough pain for long time patients of physicians would help patients have access to opioids and help physicians defend themselves when regulatory agencies investigate them. <br/><br/>Also, it would be helpful if the guidelines could comment on prescribing for new patients who are seeking opioids. Patients may be started on opioids by one doctor who becomes uncomfortable continuing to prescribe and the patient seeks prescriptions from another doctor. Some physicians feel obligated to continue opioids while others do not. <br/>I think the prescribing doctor should be the one responsible for tapering opioids if they don't feel comfortable continuing to prescribe opioids. It would be helpful if the guidelines would comment on this. <br/><br/>I think the draft guidelines are excellent and are consistent with the earlier version and add new information that is constructive. I don't see the new guidelines as a reversal of the previous guidelines that was reported in the media.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc21ae	Anonymous	None	2022-03-10T15:35:50Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-46h4-e63o	False	None	False	2022-04-12 04:17:51.486	[]
2267	CDC-2022-0024-2273	https://api.regulations.gov/v4/comments/CDC-2022-0024-2273	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please don't make this any more difficult than it needs to be. Just give chronic pain patients their rights back to their meds that helped them live their life as best they could. Just give doctors their rights back - their right as a doctor to prescribe what they deem is needed. It should be a simple fix even though it was major mess. Also let's get the government out of medicine!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fc21ca	Niemeier	None	2022-03-10T15:38:55Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Niemeier, Donna	l0k-4yy1-h4en	False	None	False	2022-04-12 04:17:51.714	[]
2268	CDC-2022-0024-2274	https://api.regulations.gov/v4/comments/CDC-2022-0024-2274	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a male, 75, in reasonably good health, and was prescribed hydrocodone about 17 years ago for moderate to severe cervical spine pain caused by stenosis and various other spinal diseases. The prescribing physician is a neurosurgeon who wanted me to have enough of this drug so that I wouldn't be in continual pain. At a certain point, the doctor recommended that I go off this medication and try diazepam instead, since it's less constipating and tends to relax the cervical spine muscles just as effectively. Over the past 5 to 8 years, I've used both drugs regularly, but rarely more than 15 pills per month, and mostly the diazepam. Beginning about 2 or 3 years ago, the most I'm able to get from my local pharmacy is 7 pills per month of hydrocodone, and 15 pills per month of diazepam. This, despite a greater number of pills as prescribed by my primary physician, who oversees my health care. While I don't need more of the hydrocodone than that, I really do need more of the diazepam. Plus, each month I'm required to request a new prescription for both meds, since neither one is permitted to be renewed automatically. I'm very tempted to order these drugs illegally from an offshore pharmacy, despite the nearly prohibitive cost. I believe, as a responsible patient who has never been addicted to anything, that this situation is shameful. And while my cervical spine issues are significant, I'm able to cope reasonably well. But I'm certain that other patients aren't able to cope with their pain nearly as well, and that makes me feel very sad. My cervical spine conditions were caused by sports injuries that I experienced over many years playing basketball and football. One orthopedic doctor told me, when I asked why I hadn't realized how bad my cervical spine was, that I was "a tough guy," meaning that I was better able to handle the obvious pain than most people. So, if my pain threshold is relatively high, I can just imagine how difficult it must be for others who aren't nearly as strong nor as fortunate. Therefore, I would encourage government regulators to consider situations like mine, and many that are far worse, when deciding how to proceed with the regulations not only of opioids, but of all controlled substances for use in pain management. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barry	None	None	0900006484fc21e0	Kushner	None	2022-03-10T15:44:10Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Kushner, Barry	l0k-5glk-gces	False	None	False	2022-04-12 04:17:51.960	[]
2269	CDC-2022-0024-2275	https://api.regulations.gov/v4/comments/CDC-2022-0024-2275	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a great forum, so thank you. As a chronic pain patient my drs are always changing my meds because of the opioid laws. I have a genetic disease that leaves me in pain, 24 surgeries, countless procedures and treatments along with 5 cancers. Yes, I have residual pain with no consistency in meds because my drs are more afraid of losing their license and going to court then treating patients. Not fair, right? I hope this helps to open some eyes to why these meds are needed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deb	None	None	0900006484fc2223	Lydon-Taylor	None	2022-03-10T15:45:05Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Lydon-Taylor , Deb	l0k-65xj-lqxa	False	None	False	2022-04-12 04:17:52.187	[]
2270	CDC-2022-0024-2276	https://api.regulations.gov/v4/comments/CDC-2022-0024-2276	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Something must be done to bring some relief to all who suffer!! We are not begging anymore!!! We deserve & demand quality of life!!! Monitor all you want but don't torture!!!! Your policies are KILLING people!!!!!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc2226	Anonymous	None	2022-03-10T15:45:25Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-6bgy-famx	False	None	False	2022-04-12 04:17:52.395	[]
2271	CDC-2022-0024-2277	https://api.regulations.gov/v4/comments/CDC-2022-0024-2277	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My father suffered a broken back and neck that resulted in permanent nerve damage after several failed surgeries and alternative medication regiments. He was placed on opioids for chronic pain for two and half decades. He was able to function and had quality of life and independence that allowed him to enjoy life. When the new regulations came out, my father suffered. His doctors got so scared of the DEA and their jackboots coming down on them that, in spite of being 100% compliant for 2.5 decades, they started a forced taper. For no other reason than fear.<br/><br/>Now my dad doesn’t leave the house, he’s lost so much independence. His wood shop has gathered dust from being untouched. He feels like he’s taking up space and can do nothing about it. He’s lost so much quality of life. He never abused, diverted, or misused his medication…but he got punished anyway. Yes, it IS a punishment. Don’t try to spin it. The CDC and the DEA jumped the gun and came out with a Machiavellian, ill-thought out plan to curb opioid abuse that amounted to treating everyone like a drug addict. You threw the baby out with the bath water, and having no recourse for chronic pain patients who now suffer for it. My dad has lost so much, and he is in so much pain he can’t function anymore. But you put so much fear into the doctors under threat of losing their licenses that that fear replaced their compassion. My father’s not the same anymore. He can’t play with his grandkids, he can’t enjoy the sunshine outdoors, he can’t create the amazing jewelry boxes and tables anymore that he used to. Your policies are to blame for that. You did it. You thought you were deterring addiction but you cut the legs out from under innocent patients. I’ll never have my father back, because I can’t take his pain away or make it better. You took the only thing that allowed him to live a quality life, and left him to suffer waiting for death. <br/>Good job, you’re a bunch of heroes. Please take that with utmost sarcasm intended. Whatever you do now, you still can’t give him those years back. But at the very least, don’t set other innocent people up to suffer like you made my father suffer. You’re not ignorant of these things either, there were outcries for years, you just didn’t care. You wouldn’t listen. Please listen now. Chronic pain patients deserve better. Like my father deserved better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Zoe	None	None	0900006484fc2229	S	None	2022-03-10T16:30:10Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from S, Zoe	l0k-6ias-eair	False	None	False	2022-04-12 04:17:52.610	[]
2272	CDC-2022-0024-2278	https://api.regulations.gov/v4/comments/CDC-2022-0024-2278	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband, a US Air Force veteran, has suffered with CRPS/RSDS (Chronic Regional Pain Syndrome / Reflex Sympathetic Dystrophy Syndrome) since March of 2003. He had been treated at the Veteran's Administration until approximately 2017, when they required him to be weaned off opiates due to the new directorates. While they weaned him down in dosage the VA required him to join a weekly group therapy session where he and other veterans with chronic pain were advised to substitute yoga, tai chi and/or mindfulness for their pain medications. Within weeks my husband went from a vibrant man to a shadow of his former self. On opiates he was able to have an active life, which included daily exercise, 50-70 miles a day on a recumbent bike, several miles on a treadmill, weight training, etc. All this DAILY. <br/>After he was weaned down to 50mg of morphine a day he could not do anything but lay on the cold tile floor trembling. Several members of his support group experienced the same. Many attempted suicide. One was successful, ending his suffering just outside the VA hospital's doors. I could not see my husband suffering like that, so we consulted a pain management clinic outside of the VA that still prescribes opiates. We have been visiting that clinic every four weeks for the past four years. My husband has his quality of life back, but the clinic does not accept insurance and is becoming too expensive now that we have both retired. I carefully manage his meds so that he does not overdose. Except for the period where the VA enforced his meds he's been on prescribed opiates for 19 years, with no ill effects or incidents of even near overdosing. We're hoping the updated CDC guidelines might allow the VA and other pain management organizations to once again prescribe the only medication that provides relief for those with chronic neurological pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	KJ	None	None	0900006484fc1f4d	Fairlie	None	2022-03-10T16:33:56Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Fairlie, KJ	l0k-7pck-wd3q	False	None	False	2022-04-12 04:17:52.823	[]
2273	CDC-2022-0024-2279	https://api.regulations.gov/v4/comments/CDC-2022-0024-2279	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why don't you leave it alone. It's just fine	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc1f78	Anonymous	None	2022-03-10T16:40:01Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-8ote-br3g	False	None	False	2022-04-12 04:17:53.052	[]
2274	CDC-2022-0024-2280	https://api.regulations.gov/v4/comments/CDC-2022-0024-2280	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. I have arthritis throughout my body, small fiber neuropathy, and sjogrens . Im in pain everyday and opiates are the only thing that helps with my pain and can live my life. I am having a knee replacement and it scares the crap out of me .I had a knee replacement on my other knee in 2012 and I was in so much pain I was crying. Now I need the other knee replaced and find they are cutting the pain medication down, I'm thinking of not even getting it done because of cutting opiates down. You need opiates to heal and do PT. Having a knee replacement or chronic pain is putting people through torture, in in humane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484fc1faf	Rowell	None	2022-03-10T16:43:35Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Rowell , Nancy	l0k-azel-cn2o	False	None	False	2022-04-12 04:17:53.285	[]
2275	CDC-2022-0024-2281	https://api.regulations.gov/v4/comments/CDC-2022-0024-2281	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have chronic RLS for years and it is torture to not be able to sleep every night. It has effected my quality of life. I have tried many treatments and found that a low dose of codeine like Tramadol has been very effective in getting consistent sleep. Unfortunately not every doctor will prescribe it. It's a horrible feeling to know there is a way to treat this crippling disease and not be able to obtain.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joe	None	None	0900006484fc22b3	Barbella	None	2022-03-10T16:45:11Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Barbella, Joe	l0k-bmd0-kn4p	False	None	False	2022-04-12 04:17:53.495	[]
2276	CDC-2022-0024-2282	https://api.regulations.gov/v4/comments/CDC-2022-0024-2282	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been dramatically impacted by the guidelines inflicted upon chronic pain patients. I have been both a provider of care and a patient of pain. I have had negative consequences of the CDC guidelines imposed by physicians who are threatened scared and polarized by this bureaucratic agency. The guidelines do not take into account patient outcomes nor is the review panel comprised of “addiction specialist“ a fair and reasonable approach to chronic pain care. The issue of pain management and care should be between a provider and patient. As a result of the draconian guidelines imposed by the CDC in 2016 and the current proposed 2022 guidelines the physicians whose long-term care I had been under are weary and scared to provide treatment and care. I have had problems finding a care provider willing to prescribe appropriate medication. I live in San Francisco I also have access to major universities and research facilities with regard to pain management. Unanimously everyone says their hands are tied to provide adequate relief and good patient care as a result of guidelines that are unrealistic and are not scientifically supported. For me as a patient all I know is my pain is worse my quality of life is worse ever since the CDC has been involved with a guideline for proposed management I have lost care providers willing to manage my chronic pain condition. I would only hope that a topic as important as this is to a quality of life for many suffers there would certainly be a moratorium on a more restricted level of medication management until there is more public input.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484fc2320	Gilbert	None	2022-03-10T16:52:11Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Gilbert, Brian	l0k-e0ap-6lrd	False	None	False	2022-04-12 04:17:53.739	[]
2277	CDC-2022-0024-2283	https://api.regulations.gov/v4/comments/CDC-2022-0024-2283	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/>This is my 43rd hour of the forced cold turkey with drawl from 30 mg three times a day of Oxtcotin I have been taking opiates for 12 years. I have been on Oxy for 5. Prior to the Oxsee I was on Opana which was completely pulled off the market five years ago. <br/>I’m sitting here scrolling through tons of information because I’m really more mad than anything. How does it happen that a pain management doctor just stops prescribing refills? They didn’t offer me a doctors visit, they didn’t offer me any exclamations even though I called him three different days, just nothing from them at all. I feel the least they could’ve done instruct me how to taper off and how to manage the pain after. <br/>Doctors do not care. They are liars and do not care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc2337	Anonymous	None	2022-03-10T16:56:24Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-fao1-6dzu	False	None	False	2022-04-12 04:17:53.963	[]
2278	CDC-2022-0024-2284	https://api.regulations.gov/v4/comments/CDC-2022-0024-2284	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have the following diseases, disorders and syndromes: IgA deficiency and anti-IgA antibodies, Rheumatoid Arthritis, Osteoarthritis, Raynaud’s disease, Hashimoto’s disease, Erythromelalgia , Crohns Disease, Colitis, Dyshidrotic eczema, Chronic Pain syndrome, Fibromyalgia, CPPD (calcium pyrophosphate deposition disease)(pseudo gout), Migraine with aura, TMJ, Willis-Ekbom Disease (RLS - restless leg syndrome), bi-lateral Sciatica, Bilateral Sacroliliitis, and Sacroiliac Joint Dysfunction. I have also had several surgeries since 2018. I am scheduled to have 2 more surgeries in the next few months. <br/>I have been refuse opioid pain relief for all the issues that warrant it, and the combination of all of the issues with the lack of pain relief has cause sleep deprivation, memory loss, house bound, and a worsening of all conditions. <br/>Most of my doctors now state they are “opioid Free” offices. <br/>I am a retired Law Enforcement Officer (31 years) who is being tortured by the medical establishment. I am being told to take tylenol. <br/>I am on two medications Tirosint and Stelara. I am not a drug seeking junkie. I am a Retired LEO! <br/>They keep sending me to pain management but those doctors have proven to be committing fraud against insurance companies. They run you through every quackery they can come up with then refuse you the only drug that works. I sleep one night out of 7-10. All I ever asked for was two Percocet a week = two nights of sleep a week. If I can sleep I can handle daytime pain. I’ve taken every sleep medication on the market and via prescription but they don’t work when you are in pain. Not even after surgery would they prescribe an opioid. Some doctors even said they couldn’t because they would be arrested. How do you arrest a doctor for giving someone with my illnesses relief? <br/>The medical establishment has become a sadistic hell for patients with pain. I am 59 years old with at least 20 more years of life left. Am I supposed to spend it trapped in my house in agony? <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lise	None	None	0900006484fc2510	Stinger	None	2022-03-10T17:08:35Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Stinger, Lise	l0k-g1da-7cfa	False	None	False	2022-04-12 04:17:54.180	[]
2279	CDC-2022-0024-2285	https://api.regulations.gov/v4/comments/CDC-2022-0024-2285	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had Cronic Pain for 7 years Paripheral Neuropathy Fibromyalgia and Chronic Neck Pain. I also have panic disorder Adhd Borderline Bipolor and Gen Anxiety I think you need to address The fact that most people are not allowed to take Benzodiazepine Drugs because they also have chronic pain they should not have to choose being in physical pain or suffering with mental issues. I also think that Dr's shouldn't constantly be threatened with losing their license jail etc for prescribing to help their patients. There should be better Wprding when talking about addiction versus Chemical dependency. The real problem with oeople overdosing should be addressed a majority of people dying of overdoses is because of illicit fentynol not because of legitimate prescribing of pain medication. After Surgery Dr's should not be rewarded for inly prescribing Tylenol etc as it is causing more problems when people need pain medication period. Pain medication after surgery should be common sense protocol. People should not be constantly turned away from ER if they have legit pain. A patient should never be abruptly cut off pain medication period. The CDC needs to treat chronic pain patients with dignity and treat them less like addicts because we are not. We just want quality of life and should be treated with dignity instead of being gaslighted and pur Dr's being punished they know better than anyone what our needs are. Our treatment as legacy pain patients needs to be a whole lot better not just a little. Removing the mme 90 threshold helps but it's not enough. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fc251e	Hanner	None	2022-03-10T17:12:10Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Hanner, Karen	l0k-gxju-qb2v	False	None	False	2022-04-12 04:17:54.404	[]
2280	CDC-2022-0024-2286	https://api.regulations.gov/v4/comments/CDC-2022-0024-2286	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Been in avg. level 7 sciatic pain just over 34 yrs.,thru 4 major MVA's from mid 20's to age 40( none my fault),Now have lower extremity constant neurological pain, ( numb from both knees down, thru feet). Remnants of severe whiplash, AND Arthritis now, in hands elbows, shoulders. Been through 7 Dr.s ,4 of them licensed pain physicians, 3 of whom never should have been graduated thru a doctoral program... a chiropractor ( fraudulent, & dishonest, w only cursory hrs. of relief, for over 3 years),an acupuncturist, 2 neurologists,( both excellent Docs) and 15 + yrs. on a pain program, incl. 27+ "procedures"(!) (none lasted more than 2 days. 400mg. morphine sulphate ER,( 4 TID) 40 mg. Oxycontin, (2 TID / or breakthrough pain as needed) as well as other meds, & anti inflammatories --AFTER numbers of batteries of anti depressants, which completely separated my ability to conceive, edit, & physically produce art.. in sculpture. So even though it's a protocol for many Dr.s, to sift out those whose minds create pain for any # of reasons...Anti-depressants were always ineffective & dibilitory in the extreme. Living with this level pain daily ( cannot imagine being wounded in service..!) is I believe, like physical & mental torture, whereas "Opiates" came to be a way--not being, or getting high, but, just to actually be able to work, & allow function without feeling literally as if a knife was in my back. I fully comprehend ( and have studied research journals [Spine, etc., etc.] The crisis of over- prescribing, along with those whose lives are so destitute, in many ways, income notwithstanding, that taking an overdose & dying were thoughtless side effects of a nation viewing "getting high" vs. those who VERY consciously took meds, on schedule.. and continue to HAVE to be on them --to function. The recent CDC, DEA backlash "war" on opioids, did real harm in it's sidelining of 'genuine' patients, those whose tolerance to these medications is significant. I 've always said--"I'll trade EVERY single pill taken (over 15 yrs.) ..IF this pain would just stop". By the way, being on these medications-- PLEASE HEAR THIS-- Is NO vacation, NO fun, NO 'walk in the park'. They, early on & [over time] loose the minds ability to rationalize, they wear a persons' instincts down, play hell on the internal, gastric organs--and for these descriptions, I know the medical terms, but this comment bar is for everyone...lets face facts: being a high tolerance patient is NOT for the faint of heart, or easily amused, or for those who want [choose] a recreational weekend. Receptors become scarred, scar tissue becomes scarified. I've NEVER --due to the piss poor success rate, chosen surgery...[ over 20 + yrs.][52% avg.,{!?!} without taking into consideration-- post operative infection rates..] of surgeries on the spine, & discs. So,NO, enough damage done w/out a scalpel adding to it.( In my case) Morphine is an ancient remedy, pain is an ancient enemy. Well trained & COMPASSIONATE , thoughtful physicians are the separation, but scaring the hell out of Dr's & pharmacists, by threatening hard earned livelihoods, is NOT the answer. It's hard to indure pain, and hard to live with meds, at least we can be a more mature country, let relief live-- with the knowledge we've gained from overdoing --& look at the symptoms that initiated that, and deal with it like informed adults, vs. knee jerk authoritarianism . thank you .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C. L.	None	None	0900006484fc2318	Burke	None	2022-03-10T18:17:42Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Burke, C. L.	l0k-dtdn-kdqu	False	None	False	2022-04-12 04:17:54.676	[]
2281	CDC-2022-0024-2287	https://api.regulations.gov/v4/comments/CDC-2022-0024-2287	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please address the attacked Alford letter written by CDC on April 10, 2019.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fb7e11	Anonymous	None	2022-03-10T19:06:30Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-03T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0a-t0xd-o4jr	False	None	False	2022-04-12 04:17:54.929	[]
2282	CDC-2022-0024-2288	https://api.regulations.gov/v4/comments/CDC-2022-0024-2288	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my background is exercise physiology, followed by physical therapist, and then I became a Chiropractor. We use rehab, nutrition, functional kettlebell based fitness programs, Chiropractic and any tools that help our patients feel and heal better without the use of drugs or surgery. <br/> <br/>Over the past 8 years, we started with one and now use two Class IV MLS laser therapy units with great success. Many of our patients come to our clinic as a last resort from not getting long term pain relief with pain meds or injections.<br/><br/>I believe that our patients would agree (based on over 500 positive online reviews for our clinic) that using laser therapy is a great option to help relieve pain, improve function, and ultimately improve their quality of lives because of Laser therapy. Our lasers can be reviewed at www.celasers.com<br/><br/>Please add laser as a safe and effective means of helping people feel better without negative side effects.<br/><br/>Yours in health,<br/>[name redacted]<br/>[phone number redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teon	None	None	0900006484fc21d2	Kowalyk	None	2022-03-10T19:10:09Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Kowalyk, Teon	l0k-522j-e56u	False	None	False	2022-04-12 04:17:55.152	[]
2283	CDC-2022-0024-2289	https://api.regulations.gov/v4/comments/CDC-2022-0024-2289	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in a severe car accident in 2019 fracturing my acetabulum requiring 7 hours of surgery to repair that has left me with crps in my afflicted leg. I suffer everyday from intense burning unbearable pain. I am so thankfull to have found a doctor that will prescribe me any kind of opiod pain medication, while other avenues of treatment have failed. I manage with the pain with the medicines given but am at my maximum allotted mme. If it were not for these medicines I could not work to support my family and my two young daughters and wife would be on the streets. It is shamefull the guidelines put in place restricting literal life saving medications, it is not the CDC that should be determining the course of treatment for chronic pain patients. These treatments should be the decision of the doctors and patients. I am so thankful to have some semblance of my old life, to provide for my family and manage this pain but others may need varrying degrees of care beyond what is recommended by the CDC. This organization and set of guidelines has excacerbated the opiate epidemic to epic proportions causing legitimate pain patients to turn to illicit substances desperately hoping to find some relief instead of getting the treatment needed for relief from their doctor. I personally would turn to the streets or do anything to obtain this level of functionality again. Im sure many others would as well. Not only do the current guidelines condem pain patients to a life of misery and pain they undoubtedly cause more needless death in the form of suicide. I am medicated and on a routine that works for me but if my treatment required any more medication I would be denied under current guidelines and easily go to illicit street substances or commit suicide. There would be no choice in that matter and I'm sure many others are forced to face this reality from current guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc229a	Anonymous	None	2022-03-10T20:46:32Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-9o0j-advh	False	None	False	2022-04-12 04:17:55.361	[]
2284	CDC-2022-0024-2290	https://api.regulations.gov/v4/comments/CDC-2022-0024-2290	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/><br/>Here we are three years later, deep into the nightmare. After bring forewarned there has been unbelievable widespread misapplication of the CDC GL that has caused stigma, harm, suffering, abandonment and death to many innocent pain patients simply living their life whom are now pushed into a life of pain & misery, disability and suicide. All due to blanket legislation created out of hysteria due to the CDC.<br/><br/>Also, a clear violation of FACA law as PROP members were on the panel of advisors when those GL’s were written yet at the same time offer expert witness testimony to Pharma litigation. A clear conflict of interest. Baffling, that a radical group like PROP who are prohibitionist except for Suboxone, addiction experts, are involved in writing pain management GL’s?<br/>This was clearly a manufactured crises as the CDC did not distinguish the difference between illicit street drug overdoses and medically prescribed. Particularly illicit fentanyl analogs were counted as prescription drugs overdoses to pad the numbers to manufacture an prescription Opioid.<br/><br/>epidemic. This greatly benefits PROP Drs waiting for that big Pharma rainfall. As majority of pain patients in US and Canada are thrown under the bus treated like criminals on parole.<br/>A horrific time in modern medicine when history will look back at the bias agenda driven CDC Director [name redacted] collaborating with the president of PROP causing a massive new crises of under-treatment of pain resulting in a genocide of innocent citizens whom are our vets, elderly, diseased, chronically ill, and sick citizens who’ve had their quality of life diminished to pain and suffering being punished for non medical users.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc2327	Anonymous	None	2022-03-10T21:37:12Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-ejmb-rhe5	False	None	False	2022-04-12 04:17:55.572	[]
2285	CDC-2022-0024-2291	https://api.regulations.gov/v4/comments/CDC-2022-0024-2291	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/><br/>In response to the question about people not wanting to try anything but pills for pain, all the people here commenting in pain are already using alternative methods to pain medication; for the most part, you are required to try many other things first, fail those, then keep using those other methods in order to receive pain medication, then of course if you lose access to what truly helps the most, you continue using those other methods because they do a little good, just not nearly enough. Addiction is when you take a substance to feel high, not to relieve pain, you cannot control the amount you use or the circumstances or what you will do to get it, and you cannot stop taking it. People with addiction take substances to escape life; people in pain take medication in order to participate in life as much as possible. People who have prescriptions for pain medication and have never abused substances must prove they take the correct amounts of the correct substances only by coming in for random and frequent pill counts and drug screens within a window of time set by the physician, sometimes requiring them to never leave town. Law enforcement have access to their medical records without warrants or subpoenas in many states. They can be accused of addiction and involuntarily committed. This is the tip of the iceberg. If any of this sounds like a good idea to you, please try it out.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc233c	Anonymous	None	2022-03-10T21:38:50Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-fjzb-zq52	False	None	False	2022-04-12 04:17:55.848	[]
2286	CDC-2022-0024-2292	https://api.regulations.gov/v4/comments/CDC-2022-0024-2292	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The changes in the guidelines are a definite must. Intractable/Chronic Pain Patients deserve medical treatment without judgement. Prior recommendations which have been taken as law has caused irreparable damage to those who could no longer live in pain and their families. The supposed guidelines have created a divide between Dr's and their patients, Pharmacies, and Insurance. Those forced to live in pain are now considered suspect, malingerers, fakers even when medical tests prove otherwise. We ask that the regulations be modified to stop the persecution of all being monitored by the DEA. Law Enforcement does not have a medical degree nor do they have a place in treatment. Allow Dr's to treat patients according to their specialty as no two patients are the same.<br/>I have suffered two strokes and have severe pressure and pain in my head as well as now I have spinal problems as well that cause severe pain in my arms wrists hands legs and feet and when I had my stroke my body rerouted the blood flow so that my brain could get blood flow and now the blood flow is coming from my spine because I have a 100% blockage in my brain and I cannot have spinal injections at all, my stroke doctor said absolutely not and any other medications that pain management was giving me made me deathly sick to the point where I felt like I was going to die and the only thing that has helped is opioid medication, recently I was put on them for a month and a half, the lowest dose possible and only 7 a week but they cut me off, this has to stop I'm only 55 years old and I'm going to die because I can't get up and exercise and move around because I'm in too much pain which then causes my blood pressure to go sky high and I'm supposed to be exercising and moving around so that I don't have another stroke, please get rid of all these guidelines, chronic pain patients need medication to function, this is no joke and I am extremely extremely upset and all I do is cry, please for the love of god, help us and get rid of these horrible horrible guidelines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Theresa	None	None	0900006484fc2529	Niksick	None	2022-03-10T21:56:02Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Niksick, Theresa	l0k-h301-gdaz	False	None	False	2022-04-12 04:17:56.058	[]
2287	CDC-2022-0024-2293	https://api.regulations.gov/v4/comments/CDC-2022-0024-2293	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived in pain for 49 years. I was in an auto accident while pregnant. I crushed both TMJ's, crushed my pelvis and pubic synthesis. I was in traction for 5 months. Ive had over 35 surgeries. 50 years ago they did surgeries they sholdnt have done. I have lived with chronic cluster/migraines, and chronic pain my back, hips, legs. I am now completely laid up now and I live to just pass on peacefully. My Pain Dr whom I was blessed to find has dove literally everything he could to help me live in peace. Every dr I had been to has been judgemental of my taking dilauded... I thank God for this pain med, it has helped me live. PLEASE stop making it so hard on pain patients and the drs that treat them. They are life savers. PLEASE realize that there are people that live in pain every day of theiir lives like me. My granddaughter is a police Detective here in Utah..the problems lie with fentynal... not pain paitients. Too many pain patients are killing themselves because their drs are taking them off their meds. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dotti	None	None	0900006484fc2547	Wilkerson	None	2022-03-10T21:58:46Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Wilkerson, Dotti	l0k-irxv-a1fz	False	None	False	2022-04-12 04:17:56.269	[]
2288	CDC-2022-0024-2294	https://api.regulations.gov/v4/comments/CDC-2022-0024-2294	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is imperative that all references to the poorly researched and misused MME in your revision of the Opioid Guidelines, be eliminated! Nevada has established the CDC’s MME limits in their state law and this will result in stable patients, who have already suffered the trauma of having their doses cut to 90 MME, being further reduced to 50 MME if this is not removed! <br/> The CDC’s 2016 Guideline resulted in patients who were stable for years on dosages above the restriction being cut to 90 MME against their wishes and having to live their lives in pain and unable to continue to work or enjoy the reduced pain lives they once had.<br/> Our doctors were brought up before the board and had their licenses threatened if they did not comply by cutting ALL patients to a maximum of 90 MME. This included myself and my doctor, who had 15 years as a pain and rehabilitation physician, with no complaints and well monitored and tested patients!<br/> Our Nevada law for prescribing Opioids currently reads, “For the purposes of this paragraph, the daily dose of a controlled substance must be calculated in accordance with the most recent guidelines prescribed by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services.”<br/> Unless any reference of MME is removed, it WILL be used by states as a law and pain patients WILL be harmed. Doctors WILL be threatened!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484fc2379	Coyle	None	2022-03-10T22:01:04Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Coyle, Sandra	l0k-kw9n-t8nn	False	None	False	2022-04-12 04:17:56.487	[]
2289	CDC-2022-0024-2295	https://api.regulations.gov/v4/comments/CDC-2022-0024-2295	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider that we are real human beings that live in dire chronic pain And the only thing that helps us get through the day To live is to have A little relief from the pain with When It's started being the war on opiates It truly meant the war on Chronic pain Patients And I am disabled and still I worked all my life was born with a Club ' After I retired because the pain was too much I started using Pain killers For some pain relief never I never abused them because regardless The government trying to label we the pain Patient As abuses or addicts When Illicit drugs Are killing addicts on the street And Chronic pain patients Are made to suffer I do not agree with the mmes When size does not fit all I feel enough is enough for the pain in the suffering that the government is putting this through We are real people we know what works for us And we also know that There's a lot of propaganda out there Thanks for your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484fc237a	cotrone	None	2022-03-10T22:02:27Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from cotrone, Teresa	l0k-l2qt-0pgh	False	None	False	2022-04-12 04:17:56.696	[]
2290	CDC-2022-0024-2296	https://api.regulations.gov/v4/comments/CDC-2022-0024-2296	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new guidelines statement. This has no standard measurement. With this made up crisis, it has destroyed my ability to be living life. My abilities have been greatly reduced.<br/>The doctors have refused treatment due to the possibility of losing their license.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deb	None	None	0900006484fc2619	Good	None	2022-03-10T22:02:55Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Good, Deb	l0k-m8gu-kfti	False	None	False	2022-04-12 04:17:56.907	[]
2291	CDC-2022-0024-2297	https://api.regulations.gov/v4/comments/CDC-2022-0024-2297	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>opiod deaths have NOTHING TO DO WITH PRESCRIPTIons<br/>How STUPID can this get ???<br/> 1. overdose deaths are FROM STREET DRUGS, not Doctors<br/> 2. Why does the government have A FRONT ROW SEAT during my medical appointments? This USED to be Priviliged Information.<br/><br/> 3. Chronic Pain does not run on a schedule. Bean counting pharmacysts should NOT BE ALLOWED to say " you should have enough for 2 more days " when presented with a legal (28 days) prescription. ($10,000 a month lung pills come Every 28 days..I take 9 lung pills per day...18 extra every 29 days: I have over a thousand extra pills, after years, can I cash in my 4 Spare $10,000 bottles? <br/>The Real Drug Cartels (wall st) ALREADY GOT PAID<br/><br/> 4, Sole Surviving Sons of " The War On Drugs Fiasco " sit in prison Via our<br/> Stupid Courts ; " Public Defender " ( YOUR COUNTY RICCO ) when these young men could be the backbone of our workforce...heip care for elderly parents<br/><span style='padding-left: 30px'></span>Especially Now Americans<br/> 5. Republican or Democrat ??? They are all crooks...fighting over OUR MONEY<br/><br/>Thanks for any consideration<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Frank	None	None	0900006484fc261f	Lempera	None	2022-03-10T22:05:20Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Lempera, Frank	l0k-mz3r-qfrn	False	None	False	2022-04-12 04:17:57.361	[]
2292	CDC-2022-0024-2298	https://api.regulations.gov/v4/comments/CDC-2022-0024-2298	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please no reference to MME .. The new guidelines and the repercussions from the doctors that have been affected have truly put havoc on my pain management..<br/>I'm worse then ever due to these guidelines and the ill effects they've had on my care..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc2629	Anonymous	None	2022-03-10T22:05:52Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-o3s4-dew0	False	None	False	2022-04-12 04:17:57.579	[]
2293	CDC-2022-0024-2299	https://api.regulations.gov/v4/comments/CDC-2022-0024-2299	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I sat here and went through all these comments on here and after seeing some of the Drs going against opioids makes me clearly upset .as a doctor u take an oath to do no harm and to help your patients..after reading some of these drs comment s it's clear to me that they have never been in pain in their entire life. Me and my husband have been on opioids pain meds for well over 25 years we met at a pain clinic.these drugs do work for long term pain .I have came off my meds afew times and had to go back on I could not stand the pain .I'm bed bound because of the cut back s .I have done every possible therapy there is nothing has worked except for pain meds ..u am on palliative care and still have problems keeping my meds.if it's not the Dr it's the insurance or it's the pharmacy s ..these pharmacy s need to stop turning people away like they do. People are out here killing them self because of pharmacy s and Drs..this needs to stop all the opioid guidelines needs to be thrown out .it should be between the Dr and the patient not the CDC or DEA ...now u are saying u are dropping the 90 mme off the guidelines but what about the 50 mme Drs are going to drop patients down insurance is going to drop it down .I'm really starting to think this was done or purpose ..please prove me wrong get rid of the guidelines .these drs say physical therapy and acupuncture works for chronic pain stimulator none of that crap works none of it. Like I said these doctors have never been in pain have never took pain medication and does not know how it feels to live in pain day in and day out. The opioid crisis did not come from the pain medication it came from the illicit fentynal and heroin ..as long as they keep limit s on opioids pain meds like this people are going to continue to run to the black market and buy drugs people are going to continue committing suicide from not being able to get the proper pain treatment.overdose rates will continue to sky rocket through the roof ...it's a shame that I see 80 year old people on heroin because they can't get the pain meds they need to be pain free ..please listen to the sick people we should not have to live in pain every day .without my meds I'm bed bound I can't move can't walk or anything .with my meds I'm able to get up and try to do house work and go shopping ...please listen and fix this .thank u for letting me comment ..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fc2650	Guthrie	None	2022-03-10T22:08:46Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Guthrie, Melissa	l0k-sr1k-6srh	False	None	False	2022-04-12 04:17:57.791	[]
2294	CDC-2022-0024-2300	https://api.regulations.gov/v4/comments/CDC-2022-0024-2300	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was forced off Tramadol 2 years ago by a new provider, after 3 years of perfect companies. I have spent the last 2 years in daily agony. I can barely work, let alone any other activities. I was so shocked, given the fact its not like other opiates that would normally be associated with abuse. I had been prescribed it originally because my original prescriber couldn't prescribe true opiates because his hands were tied from the barbaric guidelines. I long for the chance to have my pain treated properly and compassionately. I am 60 years old and don't want to live my golden years like this. Please make the necessary changes and make sure that doctors are all fully informed of new prescribing guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindi	None	None	0900006484fc23b9	Griggs	None	2022-03-10T22:09:44Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Griggs, Cindi	l0k-x7wn-zzcb	False	None	False	2022-04-12 04:17:58.018	[]
2295	CDC-2022-0024-2301	https://api.regulations.gov/v4/comments/CDC-2022-0024-2301	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a pain patient who was cut from 90 down to 30 mmE because of govt interference in the medical profession and I'm paying for this dearly. Please get rid of the 50 mmE altogether because it will be considered unlawful to go over it by many entities. Please do something noble...make it possible for doctors to use their professional judgement in deciding what is best for their patients...no more limits for chronic pain patients! Obviously the CDC guidelines of 2016 did not produce good results, since we now have over 100,000 drug deaths in 2020 with 83%. being from illegal fentanyl.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc23fa	Anonymous	None	2022-03-10T22:10:34Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-zuuw-n7m2	False	None	False	2022-04-12 04:17:58.251	[]
2296	CDC-2022-0024-2302	https://api.regulations.gov/v4/comments/CDC-2022-0024-2302	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am forced to have procedures, forced to taper my opioids, forced now my a NP that I must get a Intrathecal pain pump because they can no longer give me opioids, even though I never once abused them. I had all these procedures before and they don't work. I had spinal cord stimulator which caused me to have a spastic bladder, and when I tell my pain doctors this, they pretend not to hear, or say we never heard of this before, one doctor wanted it to be replaced even though he knew the problems I had from it before. The CDC must put in their guidelines that the people with chronic pain forced off their opioids must be put back on their medication, and tell the doctors they will not be arrested or harassed for helping chronic pain patients. I have been abused my doctors because they are afraid of the CDC and DEA, this should never be, they went to medical school and now can't practice. Please help the Postop patients suffering from too little pain medicine, my husband had major surgery from a gangerous gallbladder, and they sent him home with low dose opioids and then only 15 pills, he sat in a chair for a week rocking himself because the pain was so bad. Also please stop the pharmacies from harassing and profiling patients that need opioids for pain. I safely took opioids for 20 years never once abused them always took as prescribed. I don't understand why I now have to suffer and be treated like a drug addict?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lee	None	None	0900006484fc249e	Martin	None	2022-03-10T22:17:44Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Lee	l0l-2p0j-e2bw	False	None	False	2022-04-12 04:17:58.466	[]
2297	CDC-2022-0024-2303	https://api.regulations.gov/v4/comments/CDC-2022-0024-2303	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been dealing with very bad chronic pain for a couple years now due to herniated disc in my back. I can’t get out of pain, I have had injections, done PT, trying to avoid surgery but I had a stroke a few months ago and don’t want to consider surgery at this moment. Throughout the day I am in pain all the time. I am awakened almost every night multiple times from severe back pain and I feel like my doctors hands are tied as far as him helping me at all. I have spent thousands and thousands of dollars and I still suffer daily. I think this revision is a great idea. I think personally that doctors not being able to prescribe pain medicine has caused a lot of people to seek street drugs that are fentanyl laced and it is literally killing as many people if not more than before 2016. I hope people can be more empathetic to other pain and suffering. I love life, and my quality of life is terrible due to pain 24/7. I appreciate you hearing my comment. Have a great day and thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484fc24bd	Lance	None	2022-03-10T22:18:54Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Lance , Chris	l0l-31pg-8el7	False	None	False	2022-04-12 04:17:58.813	[]
2298	CDC-2022-0024-2304	https://api.regulations.gov/v4/comments/CDC-2022-0024-2304	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should reconsider the recommendation of prescribing gabapentin and antidepressants for pain. These medicines like opiates cause dependency and require a patient to be tapered upon discontinuation. Also the side effect profile is much greater then opiates. My mother was given an antidepressant and it caused her personality to change dramatically. Not only was it an insufficient pain reliever she experienced discontinuation symptoms for many months while tapering. Months matter to the elderly with a limited time left. The cdc is doing more harm than good and harm to others should not be without consequence.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc24c1	Anonymous	None	2022-03-10T22:19:44Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-3fsz-388y	False	None	False	2022-04-12 04:17:59.029	[]
2299	CDC-2022-0024-2305	https://api.regulations.gov/v4/comments/CDC-2022-0024-2305	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person with several neurological disorders including MS and an in-operable tumor on my spinal cord this redrafting policy doesn’t cut it. For patients that have been in pain for years the 2016 guidelines and the currently proposed reviewed ones still treat the patient as an addict. We are medicated we are not addicted. By tying the hands of physicians you increase the possibility of suicide and self harm. My recommendation is that only doctors treating the actual patient with some oversight to make sure that they are not just selling drugs, but are actually treating the patient should ALWAYS be on an individual needed basis. Government should suggest guidelines but not expect it to be strict policy for 100% of the population. The government needs to remove itself from the medical treatment of patients and allow only their physicians and that patient to decide what works to alleviate their pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fc24c3	F	None	2022-03-10T22:21:34Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from F, Kathleen	l0l-3n4f-1r06	False	None	False	2022-04-12 04:17:59.243	[]
2300	CDC-2022-0024-2306	https://api.regulations.gov/v4/comments/CDC-2022-0024-2306	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/> I AM A RETIRED PAIN MANAGEMENT PHYSICIAN<br/><br/> I DO BELEVE THE OPIOIDS PERSCRIPTION SHOULD BE ALLOWED FOR CANCER PAIN AND CLOSE TO END-OF-LIFE PAIN ONLY, LIKE THE REST OF THE WORLDS.<br/>WHY?<br/><br/>BECAUSE THERE IS A LOT OF POSSIBLE CORRUPT PHYSICIANS OUT THERE.<br/><br/>THE OPIOIDS PROBLEM STARTED BY SURGEONS AND FAMILY PRACTITIONERS, BEING UNAWARE OF THE RISK, SHOWER THEIR PATIENTS WITH OPIOIDS, ON DEMAND.<br/>OR<br/><br/>APPLY A TOUGH STANDARD OF CARE FOR THOSE SURGEONS AND OTHER PRACTITIONERS WITH STRONG LIMITATIONS ON THEIR ABILITY TO PERSCRIBE.<br/><br/>WHEN PATIENT END UP IN CHRONIC PAIN PROGRAM, HE IS DEPENDANT AND OR TOLORANT, NEED TOUGH MONITORING (UDT) TO KEEP HIM INLINE, NOT TO MENTION DRUGS COUNTS, PSYCH EVEALUATION, LIFESTYLE, FREQUENT EYE TO EYE VISITS, ETC...<br/><br/>HIGH DOSES ON SOME PATIENT NOT ALL, ARE REASONABLE BECAUSE OF TOLORANCE, GENETICALLY MEDIATED DILEMA, BUT SHOULD NOT BE A PATERN FOR ALL PATIENTS IN THE PROGRAM.<br/><br/>ALL OTHER REMEDIES PROPOSED AS ALTERNATIVE TO OPIOIDS HAS FAILED DRAMATICALLY, BESIDE DENIALS FROM INSURANCE COMPANIES TO COVER.<br/><br/>MORPHINE DOSE EQUVALANT, SHOULD BE LIMITED FOR PRACTITIONERS OTHER THAN CHRONIC PAIN PROGRAMS.<br/><br/>GOOD LUCK.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc2a0a	None	None	2022-03-10T22:22:53Z	the pain management clinics, LLC	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from the pain management clinics, LLC	l0l-3zb4-pqsf	False	None	False	2022-04-12 04:17:59.460	[]
2301	CDC-2022-0024-2307	https://api.regulations.gov/v4/comments/CDC-2022-0024-2307	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a former oncology RN with 20 years of hospital nursing experience. In 1997, I was diagnosed with breast cancer, and had two surgeries, chemo, and radiation. I developed severe neuropathy from the cisplatinum. I struggled with the pain, sleep, and memory issues concurrently. I was put on disability. I took two vicodin a day, which never eliminated the pain, but allowed me to walk and sleep better. I was sent to pain management clinics. One MD placed an injection into my foot without fluroscopy, and his assistant did mot hold my foot, resulting in the severing of the nerve, and pain and disability. Suddenly, I was changed to methadone, 5mg twice daily. Another MD also tried a foot injection without any local anaesthetic, and would not stop through my tears and begging.Most MDs suggest spinal implants, which I know make them the most money, and I refuse due to their abysmal record of complications, and minimal relief for chemo induced peripheral neuropathy (CIPN).<br/> Its been a nightmare of MD experiences. Never have I asked for more than two doses a day of anything. I know the pain is chronic.When I developed shingles a second time, over my face, with stabbing ear pain, my primary send me tomy pain MD. I called four times, and he never returned my calls, I suffered horribly. Chronic pain sufferers are ignored when acute pain episodes occur. Legitimate pain sufferers are assumed to be drug seeking.<br/> Its been a horrible, never ending nightmare.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	linda	None	None	0900006484fc2a43	schuller	None	2022-03-10T22:25:00Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from schuller, linda	l0l-4jz5-pdmt	False	None	False	2022-04-12 04:17:59.675	[]
2302	CDC-2022-0024-2308	https://api.regulations.gov/v4/comments/CDC-2022-0024-2308	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC GUIDELINES NEED TO BE SCRAPPED ON THE GROUNDS THAT COUNTLESS PATIENTS WITH SEVERE OR EXCRUCIATING PAIN ARE BEING FORCE TAPERED OR LOSING THEIR PRESCRIPTIONS ENTIRELY.PEOPLE ARE DYING BECAUSE OF THIS INCLUDING THE COUNTLESS ADDICTS THESE RIDICULOUS GUIDELINES WERE ALSO SUPPOSED TO HELP. THESE GUIDELINES HAVE ALSO HURT COUNTLESS DOCTORS WHO CAN'T ALWAYS TELL IF A PATIENT MIGHT BE PREDISPOSED TO ADDICTION TENDENCIES. THOSE WHO WROTE THESE UNSCIENTIFIC GUIDELINES MUST KNOW THEY AREN'T RIGHT, AND BY NOW THAT THEY HAVE ONLY CAUSED GREAT HARM AND DEATH TO PATIENTS WHO FOLLOWED THE RULES WHICH SAW US TREATED LIKE CRIMINALS SUBJECTED TO PILL COUNTS, URINE SCREENS AND HAVING TO DRAG OURSELVES BACK EVERY MONTH, INSTEAD OF EVERY 3 MONTHS LIKE IT WAS BEFORE. THESE GUIDELINES HAVE HELPED GENERATE OUTRAGEOUS PROFIT FOR UNSCRUPULOUS PEOPLE. PLEASE, MONEY MADE BY FORCING PATIENTS INTO THE STREET SO THEY CAN BE PUT ON ANTI-ADDICTION DRUGS AT SOME POINT ASSUMING THEY LIVE? THAT WON'T WORK IF BUPRENORPHINE DOESN'T HELP WITH SEVERE PAIN IN MOST PATIENTS AND IS FAR MORE ADDICTIVE THAN PAIN MEDICINE WAS. STOP TORMENTING US. WE ARE PATIENTS, NOT CRIMINALS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc2a81	Anonymous	None	2022-03-10T22:26:32Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-5m0k-8inv	False	None	False	2022-04-12 04:17:59.902	[]
2303	CDC-2022-0024-2309	https://api.regulations.gov/v4/comments/CDC-2022-0024-2309	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from Restless Legs Syndrome (RLS). My case is unrefractory, meaning that I have tried all the available medications for RLS, and my symptoms no longer respond to them. (This is especially a known issue with the main class of RLS meds, the dopamine agonists.) Finally, I was prescribed low-dose methadone over three years ago.it has been a lifesaver for me: it controls my symptoms without any measurable impact on my life, the clarity of my thinking, etc. Opioids have been enormously helpful for those of us with refractory RLS cases. This has given me my life back. Finally, I can sleep through the night. I have not had to increase my low dosage at all, once my doctor and I settled on the lowest effective dose. Please include RLS and other chronic diseases in your guidelines for opioids. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484fc2abc	Warren	None	2022-03-10T22:27:26Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Warren, Peter	l0l-6yi0-af4t	False	None	False	2022-04-12 04:18:00.128	[]
2304	CDC-2022-0024-2310	https://api.regulations.gov/v4/comments/CDC-2022-0024-2310	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have extreme nerve pain 24/7 due to a motorcycle accident 20 years ago that paralyzed my right arm. The pain is so bad I often struggle to keep going. I have been in pain management for 20 years and a few years ago my doctor told me he was retiring because of increasing stress over regulations and I have not been able to find a doctor in my state willing to accept me as a patient so I drive over 2 hours each way to an out of state doctor who helps me but not enough. They say they only try to reduce the pain by 40%. When you have pain 24/7 with spikes that that are so bad that you can't hear because the pain is preventing you from processing what you did hear the 40% reduction is not enough. Government should not be interfering with doctor's ability to treat pain without worrying if they are going to get in trouble or lose their license. At minimum there should be an exemption form or waiver that allows people like me to acknowledge the risk and continue without risk to the doctor. I have never taken illegal drugs and don't drink and take my pain medication as prescribed. I should not be punished for the actions of others. For 15 years I was getting strong pain medication along with Valium and then all of the sudden the doctors stopped allowing any of their parents to take that and a narcotic pain medication. There is nothing else that I have found that helps anywhere near as good with relaxing my muscles that ball up and constrict the nerves and cause worse pain. The stuff they give me that only works about 25% as good makes me sleep for almost two days. I have not been able to work since 2016 when I started having problems getting enough relief from doctors. Every doctor I have talked to about this said to same thing that the regulations are why I can't get what I need. Government is not only preventing me from being able to work it is also making it so I hurt in what could best described as torture and cruel and unusual punishment for the actions of other people. My nerve pain feels a lot like being electrocuted from the inside and if a cop did that to someone in a jail who wasn't doing anything wrong that would be considered cruel and unusual punishment or torture but because you guys do it with a pen and paper it's acceptable and your minds	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jason	None	None	0900006484fc2b41	Green	None	2022-03-10T22:30:16Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Green, Jason	l0l-83ze-gpc7	False	None	False	2022-04-12 04:18:00.349	[]
2305	CDC-2022-0024-2311	https://api.regulations.gov/v4/comments/CDC-2022-0024-2311	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] I am a resident of West Virginia and I am a chronic pain patient. 2016 regulation or whatever you wanna call it has taken my life away from me. I had to retire early because the pain that I live in is no longer managed. I have diabetes with spikes of over 300 because of uncontrolled pain. My blood pressure spikes also over 95 to 100 on the bottom number. I do not know why that I have worked 40 years of my life in a free country I have never had even as much as a speeding ticket and I am left to suffer because of idiots that do illegal drugs not the drugs they come off a prescription pad at a doctors office. If you’re a drug attic they fall over you to help you out to make you comfortable and give you all the care and support and medicine you need to make you comfortable. But if you’re a chronic pain patient it’s like they say to you screw you you’re not getting anything from us. I think it’s cruel and it’s criminal what is being done to good people that are sick and have always played by your rules and dictations. I don’t know how you people lay your head down at night knowing that there are people taking their lives because I can’t physically and mentally handle this pain that they’re living in anymore. I hope it’s someway somehow that you people are held criminally responsible for the pain and suffering they use have inflicted on innocent people. It’s no different than what Russia is doing to the Ukrainians. People like you that no nothing only what is written or the [vulgar language redacted] you learn in school about pain try living in it every day and try to function and put on that face to make it through a day then tell me you understand pain but until then you know nothing. It makes me sick to see program after program to help drug Addicts With clean needles and injection sites but yet for my diabetes I have to reuse my needles over and risk myself for infection because I can’t afford all my needles for the month. I don’t know what the answer this message is but you should all be ashamed of yourself and I hope one day that all you people responsible for this no matter who you are I hope one day that you beg for relief For pain and you think of all the people that you’ve hurt on your journey for the so-called opioid crisis like I said I gave my name I don’t fear none of you people because you’re cruel and inhumane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fc2b42	Tranum	None	2022-03-10T22:34:27Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Tranum, Paul	l0l-86ob-e4gk	False	None	False	2022-04-12 04:18:00.630	[]
2306	CDC-2022-0024-2312	https://api.regulations.gov/v4/comments/CDC-2022-0024-2312	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a registered nurse who has been practicing for 42 years. The opioid crisis has certainly turned medicine on its ear and caused a great deal of suffering that I am aware of. More research is needed to establish safe guidelines for pain management. <br/>The New York Times article about [name redacted] needs to be looked at very closely. Anytime a patient commits suicide, there is a failure in the system. His doctors are paying a heavy price for following arbitrary guidelines that are only now being acknowledged as being based on false information. The whole opioid crisis started with doctors being told they were at fault if they were not managing pain properly by prescribing these highly addictive drugs. Now the pendulum has swung to the other extreme.<br/>There are no guarantees in medicine. Outcomes are by nature highly individual and unpredictable when it comes to individual tolerances and the assumptions of physicians. Add to that, hastily implemented guidelines and both patients and providers are suffering very unfortunate consequences. If Mr. [name redacted]'s story was an isolated incident, you would never hear about it. I am personally aware of many such incidents where pain relief was inappropriately prescribed with poor patient outcomes. <br/>Patient’s who require pain medication and pain management deserve to be treated as individuals with unique needs. Doctors need to have freedom to prescribe appropriately based their assessment of a patient and their professional judgement based on experience and education. They cannot have their hands tied by reactionary legislation and fear of prosecution. Why else would they risk a lawsuit from harming a patient?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christa	None	None	0900006484fc2b90	Eisenmann	None	2022-03-10T22:37:36Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Eisenmann, Christa	l0l-9ghv-76ps	False	None	False	2022-04-12 04:18:00.843	[]
2307	CDC-2022-0024-2313	https://api.regulations.gov/v4/comments/CDC-2022-0024-2313	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Revised guidelines for Everyone <br/><br/>1. Relax the guidelines towards Doctor - Patient relationship in continued treatment of opioids. <br/><br/>2. Stop the DEA/CDC from taking good doctors with good intentions license away. We have lost many good doctors out of fear in writing for opioids.<br/><br/>3. 3-day fill for surgery or pain related injuries should increase to 5 -7 days with 1 refill. This will cut down on phone calls and paper work for all involved.<br/><br/>4. All class 2 need to have a 5 day early fill date. Many can not go on vacation or other venues because of the 3 day early fill date. Nobody runs to their Rx store and fills at 12:01 am. This was done before our government decided to change early fill dates. <br/><br/>5. Patient should not be required by many doctors to make appointments each month. We need to go back with the 3 month checkups for patients with chronic issues. <br/><br/>6. E-scripts need to transfer to another in house Rx store when primary are out of stock and can not fill the Rx. This happens a lot.<br/><br/>7. For new patients who never experienced opioids, they could use a much better understanding from people who have experience with them. This could be 1 of the biggest issues as Doctors do not have the time nor have much experience in taking opioids for any length of time. <br/><br/>8. Doctors, NA, PA, etc take courses in opioids without being bias towards addiction, should be able to write without fear. <br/><br/>9. Reduce the very high cost our government has imposed on people to see a higher tier doctor. Far less of them than PCP.<br/><br/>10. My opinions on this very important issue comes from experience that spans on and off use of opioids for decades.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fc2b9f	Martens	None	2022-03-10T22:39:41Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Martens, Steve	l0l-9n1a-kf3o	False	None	False	2022-04-12 04:18:01.064	[]
2308	CDC-2022-0024-2314	https://api.regulations.gov/v4/comments/CDC-2022-0024-2314	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Yes, I just wanted to let the panel know that there are still millions of chronic pain sufferers. It seems no one is listening. With dehabilitating conditions, we are reduced to immobility, more pain, no quality of life and rules imposed by an agency that has no idea the extent of our agony, or if they do, don't care enough to rock the boat of the status quo. SHAME!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fc2bc4	Walke	None	2022-03-10T22:40:16Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Walke, Mary	l0l-ab52-gzbw	False	None	False	2022-04-12 04:18:01.280	[]
2309	CDC-2022-0024-2315	https://api.regulations.gov/v4/comments/CDC-2022-0024-2315	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Already, the high cost of required monthly pain management visits are outside my financial abilities. More restrictions bring a higher cost to the individual. Without opioids, I am reduced to inactivity and I avoid performing routine tasks and movements that most people take for granted. After trying several alternative treatments that were of no help, the small relief from opioid medication has made a huge difference in my activity and quality of life. Please leave healthcare to the patient & doctor relationship. The government should not be allowed to dictate the use of proven and effective medications. And it is not the responsibility of the government to babysit its citizens.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3194	Anonymous	None	2022-03-10T22:41:21Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l0l-axs1-nsl9	False	None	False	2022-04-12 04:18:01.498	[]
2310	CDC-2022-0024-2316	https://api.regulations.gov/v4/comments/CDC-2022-0024-2316	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and these so called guidelines are ruining my life. I have Fibromyalgia & Rheumatoid arthritis and am in moderate to severe pain CONSTANTLY. I am currently UNDERTREATED and still working a 20 hr/week job. It's literally killing me. I have lost mobility, strength and can't even maintain my weight because of the pain. Within a year I will be in liver failure from the massive amounts of OTC acetaminophen I'm taking daily just to barely keep up with my ADLs. I have zero quality of life. I have tried every non pharmaceutical treatment available as well as the gabapentin, Lyrica, & Cymbalta that nearly killed me by shutting my brain down to stupidity level. I could not even function on those meds. I also do my best to stay active and stretch every day. (It's torture) So far the ONLY thing that adequately mitigates my pain is opiate pain medicine. I was on them and did great for many years until I was forced off in 2016 due to the CDC GL. Withdrawals alone nearly killed me & permanently damaged my heart. I am sick & tired of people telling me that opiates don't work for chronic pain, when in FACT they work very well. Ask the millions of patients like me who've been forced off of them. Many are now dead from suicide or their bodies giving out from untreated chronic pain. IT'S NOT ALL IN OUR HEADS AS YOU IMPLY!. The CDC used bad data to write the original GL & these new ones are the same thing, re-worded on steroids. The work group has NEVER seen a pain patient so they are not experts and have zero business being involved in this process. These GL have only made the overdose crisis worse, not saved any lives. If anything MORE people are dying of illicit fentanyl overdoses trying to find anything to relieve their pain. YOU HAVE DONE THE CARTELS A HUGE FAVOR HERE! By basically implementing PROHIBITION on opioids, you've given the cartels a chance to expand & cause more death & destruction. FACT: Prescription opiates are NOT responsible for the overdose crisis. Only 1% addict and that hasn't changed in centuries. Its time to fix the REAL cause of addiction. Like fixing the SOCIOECONOMIC situation in this country so people aren't stressed to the max trying to survive on inadequate wages, no health care, etc... Who's to say that these new GL won't be weaponized against us by Insurance companies, corporate owners of hospitals & clinics, & most of all the DEA! The did it with the 2016 GL, they will continue to do so until you all tell the truth. This is about MONEY, not about saving lives. The moneyed stakeholders seem to be more important than the PATIENTS well being. If you need a study to determine if opiates work for chronic pain it would be very easy to do. Do a retroactive study of patients who've been forced off of their opiates & compare it to the ones lucky enough to still be getting their same dose. Just look at how quickly the health declined of those who were forced off of their opiates. Literally forced into Disability organ failure, lost mobility, bed bound with zero QOL. Especially those of us in our 50s & above. We've worked our bodies into oblivion & now we are being forced to suffer through what is supposed to be our Golden Years of retirement. PLEASE put yourselves in OUR SHOES! We are being treated like pariah. Stigmatized & traumatized at every Doctors appointment and every time we pick up meds at the pharmacy. Many CPP have been medically ABANDONED. NO DOCTOR WILL SEE THEM. Too complicated. These new HL will not make any Doctors give us back our pain medicine. You hold the threat of the DEA & "overprescribing" over their heads with this ridiculous MME requirement that doesn't take into account INDIVIDUAL patients needs, metabolism, weight or anything. There is no one size fits all way to treat pain. These GL need to be tossed in the garbage. The DEA needs to back off of Doctors,band Doctors should be able to do their jobs without LAY people threatening them about what they prescribe or take away their license. CDC needs to stay in its own lane. Infectious diseases. You know nothing about treating pain and have done a LOUSY job trying. Thanks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather'	None	None	0900006484fc31c2	Barrett	None	2022-03-10T22:46:26Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Barrett, Heather'	l0l-bduf-5k2l	False	None	False	2022-04-12 04:18:01.714	[]
2311	CDC-2022-0024-2317	https://api.regulations.gov/v4/comments/CDC-2022-0024-2317	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain management is not a one size fits all approach. What has happened to pain patients has forced people into a miserable quality of life. I completely understand that some people have abused opioids, but what about the patients that depend on pain relief to be able to work and contribute to society? Those people have been left in the dust so to speak. Please stop handcuffing doctors. They took an oath to help patients, not harm them. Imagine if someone you loved committed suicide because living in pain and seeking death to stop that pain is the only choice they are left with? Pain patients need to be protected and not thrown to wayside. There has to be a common sense approach to this mess. Please let the doctors help their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc31c3	Anonymous	None	2022-03-10T22:47:52Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-bgxr-v9sq	False	None	False	2022-04-12 04:18:01.940	[]
2312	CDC-2022-0024-2318	https://api.regulations.gov/v4/comments/CDC-2022-0024-2318	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2015 Opioid CDC guidelines have been an abysmal failure. The stunning increase in drug overdose deaths is only one indicator. When the guidelines were proposed the number of deaths stood at under 50 thousand. In 2021 that number had exploded to more the 100 K! if the intent of these guidelines was to reduce overdose deaths, they have surely and catastrophically failed. The less than obvious tragedy is the suffering and death of chronic pain patients who have been left untreated and stigmatized as drug addicts. The guidelines unintended consequences include sky rocketing fentanyl deaths, suicides by those subjected to unbearable yet treatable pain, and a growing loss of confidence in the government agencies involved and the medical community in general. <br/>Those in authority should apply every means at their disposal to rescind these misguided guidelines completely. Revision is not enough.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerald	None	None	0900006484fc322e	Andersch	None	2022-03-10T22:49:28Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Andersch, Gerald	l0l-csib-fcqk	False	None	False	2022-04-12 04:18:02.245	[]
2313	CDC-2022-0024-2319	https://api.regulations.gov/v4/comments/CDC-2022-0024-2319	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I, along with several million other Americans, suffer with a chronic, incurable, neurological disease called Restless Legs Syndrome (RLS). RLS causes an uncontrollable urge to move one's legs and occasionally the arms as well. <br/><br/>In most cases the disease manifests as a sleep disorder as the need to move the legs impairs one's ability to fall asleep and stay asleep. The resulting daytime fatigue negatively impacts the ability to work and to function normally during the day. <br/><br/>The problems associated with RLS can also occur during the daytime as well. When the symptoms are peaking it is literally impossible to sit still and, as you would guess, that causes significant discomfort while riding in an airplane or vehicle, watching a movie, or in any other setting that would require the affected individual to sit still for any period of time.<br/><br/>There are a number of medications that are commonly prescribed for RLS, but none are particularly helpful. One class of drugs, called dopamine agonists, were considered for many years to be the first line of treatment. Unfortunately, however, these drugs turned out to be counterproductive. Over a period of years the drugs not only stopped thwarting RLS's symptoms, the drugs actually made the symptoms worse. Withdrawing from these drugs is a horrific experience, trust me.<br/><br/>Other drugs, such as Alpha 2 Delta Ligands help some but they have several serious and unpleasant side effects. <br/><br/>So, the only other option that "refractory" RLS sufferers like myself who have unsuccessfully tried all the other forms of drug therapy have is to use small doses of prescribed opioids on a daily basis. These drugs do flatten the compulsive need to move the legs thereby allowing the recipient to get some sleep and to have a normal existence. Comparatively speaking, the side effects of this pharmaceutical protocol are slight. Studies have shown that the addiction potential faced by RLS suffers who take opioids is far smaller than that of patients who take opioids for pain.<br/><br/>While I understand and recognize the harm that opioids and other drugs cause in this Country, opioids have a uniquely beneficial and irreplaceable use in treating RLS sufferers such as me. Accordingly, I ask you to recognize the damage that you will do if you place unworkable limitations on the prescription of opioids for use in treating RLS. I don't want to find out how the baby felt when he was thrown out with the bathwater.<br/><br/>In closing, I encourage you to review a recent (July, 20210) Mayo Clinic article authored by the world's foremost authorities on the care and treatment of Restless Legs Syndrome. The article is entitled "The Management of RLS: An Updated Treatment Algorithm," and it describes the disease's nature and all possible treatment regimes including the use of opioids for refractory cases. The article can be found online at www.mayoclinicproceedings.org/article/S0025-6196(20)31489-0/fulltext. <br/><br/>Thank you for your kind attention to my comments and for considering them in your deliberations.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484fc324d	Pattinson	None	2022-03-10T22:55:47Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Pattinson, William	l0l-d56a-v8na	False	None	False	2022-04-12 04:18:02.474	[]
2314	CDC-2022-0024-2320	https://api.regulations.gov/v4/comments/CDC-2022-0024-2320	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel the CDC is literally killing people by their restrictions. People that are suffering will do things such as suicide to permanently stop the pain. We are not talking about accute pain, we are talking about pain that is constant. I have tried physical therapy, accupuncture, chiropractic and spinal injections that did not help but, I felt I could not refuse because the Pain Management Dr would refuse the pain meds that were proven to work. It is so sad that people are being cut off from legal meds and are forced to go to illegal forms just to survive. I have been in Pain Managemet for years and taken my meds as prescribed and had drug tests I always pasted. I even have my meds counted and this I have always pasted. Oh yes, I forgot to mention 2 back surgeries and now because of cutting back on my meds just had a pain stimulator implanted a almost 2 months ago. Which I was told there would be over a thousand settings that now when I go to get it programed they act as if I am expecting a miracle just to get it to the places that I need it. Please help us that have done everything to live and not cause us to feel the only way to get relief is to commit suicide or to buy drugs that could possibly kill us. Please go after the true drug dealers not Dr's and Pharmacist. What has the World come to that people are denied the right to not suffer?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	V H	None	None	0900006484fc3251	Dalton	None	2022-03-10T22:58:45Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Dalton, V H	l0l-d7mp-5ezt	False	None	False	2022-04-12 04:18:02.717	[]
2315	CDC-2022-0024-2321	https://api.regulations.gov/v4/comments/CDC-2022-0024-2321	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2003 I almost died from menijocol minigites I was in a coma for 3 days I had blood clots all over my body! I had to learn how to walk all over again and the pain I had was so bad I screamed! Befor that ugly day I had dreams to be a emergency doctor. I played basketball and baseball. After that day my life changed for ever. I was in so much pain I wanted to die! Finley in 2005 they got me on a good pain medicine routine and I was slowly coming back to my old self. And let me tell you this was not a very high dose! We’ll come 2016 I was forced tapered and back to my bed I went! I wasn’t able to coach my kids basketball team or soccer team anymore I wasn’t able to keep working as a cna. My health went down heal I never suffered with high blood pressure untel they forced tapered me now I take 2 meds for that. Because of the gidelines I won’t have a life I won’t be able to play with my grandchildren I won’t be able to work! The new updated gidelines are good but that mme has to go! When will you guys realize that it’s not CCP suffers that are the problem it’s the street it’s the fent that’s on the street. You know how many kids yes kids died in my town because of this street drug in a week 6 yes 6 kids… it’s not us CCP patients why through so please do the right thing! People ask what do you like about American I say nothing the way the medical doctors treat people because of these updated gidelines is so low I wouldn’t even treat a dog that way! DO THE RIGHT THING!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eileen	None	None	0900006484fc2ce1	Jimenez	None	2022-03-10T23:01:08Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Jimenez , Eileen	l0l-e929-u9f6	False	None	False	2022-04-12 04:18:02.943	[]
2316	CDC-2022-0024-2322	https://api.regulations.gov/v4/comments/CDC-2022-0024-2322	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Now that the CDC and PROP has destroyed so many lives and have taken so many lives due to their negligence. How do they propose to return pain sufferers back to their lives? They have made it impossible for us to be a productive member of Society. They have made it impossible for us to have friends. They have made it impossible for us to be part of our families. They have made it impossible for us to hold a job. They have made it impossible for us to even have a real smile, all because they refuse to treat our pain! Pain is real, you can’t se it on someone unless they are bleeding or a bone is protruding out of the skin, but it’s real. Pain is dangerous, it makes you think of ways to stop it, even it those ways are to end your life. I have rheumatoid arthritis, fibromyalgia, neuropathy, horrible ringing of the ears, can’t taste or smell anything. I live in constant pain, and the only thing I know for true is when I wake up tomorrow the pain will still be there, Knawing at me. It takes small pieces of you every day, until it devours all common sense. Then you are left with, how much longer will I let this go on before I end the madness. In the end that’s all you have, pain and madness!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484fc350e	Wade Chalifoux	None	2022-03-10T23:05:48Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Wade Chalifoux, Tracy	l0l-eqxv-z4g5	False	None	False	2022-04-12 04:18:03.165	[]
2317	CDC-2022-0024-2323	https://api.regulations.gov/v4/comments/CDC-2022-0024-2323	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Us cpp are suffering because of the 2016 guidelines and the Mme you put in there.Doctors are afraid to treat us even though we need help with pain .we are told sorry can't describe you medicine that you need I could loose my license.we are suffering from this .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3516	Anonymous	None	2022-03-10T23:06:58Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-f2yw-3fbt	False	None	False	2022-04-12 04:18:03.381	[]
2318	CDC-2022-0024-2324	https://api.regulations.gov/v4/comments/CDC-2022-0024-2324	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The restrictions in place now are actually causing me more pain! As my refill date loomsI find myself dreading the calls to the pharmacy and doctor's office.<br/>I want to travel with my husband as we had planned. <br/>My own chronic pain has been ongoing for years. I am responsible with medication. I am a 65 year old woman, but I feel as like an addict when "that time of the month comes". <br/>Please loosen the restrictions on controlled drugs. Take a stand for all chronic pain sufferers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maureen	None	None	0900006484fc3525	Burke	None	2022-03-10T23:07:46Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Burke, Maureen	l0l-fco7-sy6d	False	None	False	2022-04-12 04:18:03.600	[]
2319	CDC-2022-0024-2325	https://api.regulations.gov/v4/comments/CDC-2022-0024-2325	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 81 year old, white female who has suffered with debilitating pain, ME/CFS, Fibromyalgia and arthritis for over thirty years. I had a fabulous career as a Real Estate salesperson, then a broker/manager/trainer until I became disabled at age 55. My medical history: in 1972 I had a disc and a half removed between L 3,4 & 5 (at the time they had no replacement discs and the doctor did not fuse). Ten years later the pain was so bad I had a spinal fusion of my L 3, 4 & 5. In 1991 my horse tripped, did a forward roll, I went off and he fell on top of me breaking the L2 from the fusion. After appointments with three top orthopedic doctors, they all told me the same, there was no surgery to correct the damage, don’t let anybody surgically touch my back. I started having joint pain all over my body, brain fog, memory problems, concentration problems, word find problems and awful fatigue. For 15 years I went from doctor to doctor trying to find out what was wrong with me. I was tested for MS, Lupus, Lyme and rheumatoid arthritis. The tests always came back negative. My OB/GYN recommended a doctor who after ruling out the MS, Lupus, Lyme and Rheumatoid arthritis, started pushing on different parts of my body as I cried “ouch” and said I had Fibromyalgia, and chronic fatigue. I had never heard of Fibromyalgia, but felt relieved to know I wasn’t crazy and was confident I could have improve health. Information was limited and most doctors were still in denial that FM existed. I said I would not take a narcotic, so I was put on Tramadol, gradually working up to 400 mg a day, along with Cymbalta, because I was having anxiety problems trying to deal with the daily physical problems. Besides working 6 days a week in RE, caring for a 22 acre farm with sheep, chickens, steer, 3 horses, a donkey, cats and dogs, riding and showing my horse, playing in two tennis leagues, country dancing one or two nights a week and managing a large Real Estate Office, I was dealing with these worsening daily problems of pain and fatigue. Four years after the horse accident, I was unable to work or participate in any of the joys I previously had. After three, then six months off from work trying to feel better, I went on disability. Mentally, I went into a tail spin due to no income, and a total loss of the wonderful life I had been living. I was sent to the [treatment provider name redacted] for evaluation. After being evaluated by a number of doctors and technicians, I was told I would never get better, because the FM/CF had gone too long before diagnosis and that my back was fueling the FM/CF. I could not get better, but I could work to have a better quality of life. It’s now 2022 and I basically have very little left that I can do.<br/>Maybe 9 years ago Tramadol was reclassified as a schedule one drug and when I turned 75 my primary care physician said I could no longer have 400 mg of Tramadol a day and was reduced to 300 mg a day, and also could not have Cymbalta. I was switched to Buspirone. As the years have moved forward my arthritis is everywhere, the FM has gotten worse, the ME/CFS is so bad I can barely walk my therapy dog around one small block in the little town I live in. The last MRI showed every disc in my back to either be ruptured or bulging, stenosis in my lower back and arthritis up and down my spine. The back pain is so bad I can’t stand up straight or hold my head up where it belongs. I have since been diagnosed with AFib, PAC’s and PVC’s. I have a loop recorder under my skin over my heart for 24 hr monitoring. My right hip had osteoporosis and arthritis and was finally replaced in [month redacted] 2021. Rehab was not very successful due to PT causing more pain to my back. Because NJ’s rules for pain drugs are strick my primary care physician referred me to a pain doctor in Pennsylvania where their rules are more lenient. I am in the process of being weaned off Tramadol each month and adding oxycodone. I have had no decrease in pain yet. I’m currently down to 100 mg of Tramadol and on 40 mg of oxycodone. I’ve had numerous surgeries over the years including removal of my thyroid, colon cancer, etc. and take a lot of medications everyday, together with many supplements. <br/>My quality of life is very poor. I am very fortunate to have my little dog, a lot of incredible friends and living in a little walkable river town. Each morning when I get up the pain and fatigue makes me wonder how I will get through another day. I live alone and don’t know what I will do when I can’t stay here anymore. I have had no income since 1995 and live by picking out of my savings and on reduced SS, because of stopping work at 55. <br/><br/>I<br/>Because of the opioid crisis/drug addicts making it impossible to get what we need to have a better quality of life & leaves us daily with frustration, gloom and a wonder of how much longer can I fight each and everyday.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maryann	None	None	0900006484fc35a8	Ranson	None	2022-03-10T23:14:09Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Ranson, Maryann	l0l-gecx-dle7	False	None	False	2022-04-12 04:18:03.827	[]
2320	CDC-2022-0024-2326	https://api.regulations.gov/v4/comments/CDC-2022-0024-2326	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic back pain for most of my life, from my mid-teens till now (aged 63). Creams, lotions, acetaminophen, gabapentin, stretching exercises, diet, chiropractic, physical therapy, back braces, three surgeries. Nothing, nothing has worked. After starting oral morphine four years ago I am able to enjoy life, all be it with limitations, that I had to give up due to limited mobility. The downside is I now must nap in the afternoon, and I have lapses in short term memory. Is it ideal, of course not. Opiates, when not properly managed, without proper oversight, are dangerous and as we have all seen, fatal. It's not ideal, no, but on the whole my life is better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484fc3614	Holmes	None	2022-03-10T23:15:19Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Holmes, Thomas	l0l-i0s1-ughv	False	None	False	2022-04-12 04:18:04.046	[]
2321	CDC-2022-0024-2327	https://api.regulations.gov/v4/comments/CDC-2022-0024-2327	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been suffering from LAS, tight pelvic floor muscles. I can’t sit for more that 30 min. My muscles just won’t stop spasming. I am 62 years old. Why do I have to suffer from Chronic pain? I don’t want to live my life, whatever is left of it, in pain. Seems like only people that are suffering can understand. People that are not in pain making decisions for people that are in pain. It’s mind blowing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Natalie	None	None	0900006484fc33ad	Zolotova	None	2022-03-10T23:16:04Z	None	None	1	None	2022-03-10T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Zolotova , Natalie	l0l-ixdg-zlff	False	None	False	2022-04-12 04:18:04.294	[]
2322	CDC-2022-0024-2328	https://api.regulations.gov/v4/comments/CDC-2022-0024-2328	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to stay out of my relationship with my Dr. My chronic pain will never ever be cured. I’m doomed for life. My dr is the only one that keeps me walking and living a semi normal life. The opioids are the key. I’m not an addict I’m a sick person who needs help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keva	None	None	0900006484fc3d22	Wolfe	None	2022-03-11T10:23:34Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Wolfe, Keva	l0m-66ad-9sa1	False	None	False	2022-04-12 04:18:04.507	[]
2323	CDC-2022-0024-2329	https://api.regulations.gov/v4/comments/CDC-2022-0024-2329	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m an 80 yr old female. 12 yrs ago a doctor put a long needle in my right leg after I told him my “leg hurt.” That night I had difficulty walking without pain. For the next 10 yrs. I walked with pain in my right leg. I withstood the pain and went on with my life. Eventually the pain became much worse and I went to a pain Mgmt. Doctor. He referred me to a plastic surgeon who works on nerves. I was so excited to find a doctor who can relieve me of the nuisance I was living with for those many years. <br/><br/>Today, I cannot walk at all. I’ve been in bed for almost two years. The plastic surgeon literally crippled me. My husband wants to sue him, but I’ll be dead by the time it reaches a courtroom. I was on oxycodone and it did nothing to relieve my pain. Each time I stepped down on my right foot it felt as a knife was going into my calf. My pain doctor increased the oxycodone from 10 mg. to 20mg. It eased the excruciating pain, but I still couldn’t step down without a shot of pain. In fact, as I’m writing this, my leg is throbbing in pain. My husband is afraid to touch me in fear of hurting me. We have been married 40 yrs. and until this happened we had a loving and active sex life. Today we are as roommates and he cares for me with magnificent love. He had to learn how to do laundry, food shopping, [Name redacted] clean our home. I can see how his heart hurts when I get up to go to the bathroom and he sees on my face how much I’m hurting. <br/><br/>I’m writing this because I keep telling my doctor that I’m 80 and I’m not addicted. In fact I don’t like the way the pain pills make me feel. I was what friends would call me a “doer.” I haven’t seen my friends in a while due to being bed ridden. It’s going on 2 yrs. and my doctor is so fearful of prescribing pain pills higher than 20mgs. At times I take 2,which slightly,very slightly eases the major pain, but if I continue to do that, I’ll run out of them and have nothing. <br/><br/>Please advise me what I can do to have my doctor be allowed to prescribe a higher dose and amount. I’m in bed 24/7 and in a wheelchair when visiting a doctor. Please help me have the little life I have left to be pain free with a higher dose of medication and my doctor alleviate his fears. By his going by your law hurts me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	joyce	None	None	0900006484fc3d10	Shepard	None	2022-03-11T10:27:46Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Shepard, joyce	l0m-47if-7jik	False	None	False	2022-04-12 04:18:04.724	[]
2324	CDC-2022-0024-2330	https://api.regulations.gov/v4/comments/CDC-2022-0024-2330	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a non abusive opide pain patient, I have proved myself over and over that I have never abused my opied medication. But for those that have abused their opied medications, have made it the worst times in our lives, that haven't abused our opied medications. No human should ever suffer from any pain, while the pain patient is being monitored by their physicians.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc34ee	None	None	2022-03-11T10:38:14Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from NA	l0l-y5i4-qxei	False	None	False	2022-04-12 04:18:04.941	[]
2325	CDC-2022-0024-2331	https://api.regulations.gov/v4/comments/CDC-2022-0024-2331	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for taking patients comments into consideration! I am an RN, BSN. I suffered a severe neck sprain in 1991 which the doctor described as a ruptured ligament. The pain was severe for about 13 years. Then, I had pain off and on for 10 years. Recently, I suffered from cervical myelopathy (cord compression) and cervical radiculopathy, Plus, I had occipital neuralgia (debilitating headaches). <br/>When I first got hurt, my patients who had suffered from back pain said, “The pain will go away. The addiction to the drugs never does, and it starts with the muscle relaxers.” So, when I was offered muscle relaxers and narcotics from 4 doctors, I said no. Having suffered from asthma as a child, I had learned guided imagery, a form of biofeedback and yoga. This along with physical therapy and NSAIDS controlled my pain. Later, when I had the myelopathy and occipital neuralgia, I was offered muscle relaxers and narcotics again. I had read that studies show muscle relaxers are effective if taken for 7 days and past that there’s no difference. When I stopped taking the muscle relaxer the 7th day, I could understand why the patients had told me it starts with the muscle relaxers. The pain was excruciating. Worse than before I had taken it. Plus, I was terrified that I would have that pain forever. Determined, I listened to my patients and believed that the pain would go away if I could just get through this. After about 24 hours, I was able to control the pain with guided imagery.<br/>It is common sense to me that you should not give narcotics to someone with neck or back pain. We know that this patient will be in pain for years. It is inevitable that the person will end up addicted to narcotics. After time, they will build up tolerance seeking stronger narcotics and then chances of overdose increase. I truly believe that if I had taken the narcotics as ordered that I would have been one of the overdose statistics that died.<br/>In my opinion as a nurse and as a patient, we need to treat the patient’s Total pain. We need to address the physical, psychological, social, spiritual, and cultural needs of the patient. <br/>1)Physically - Mind/body interventions such as biofeedback, meditation, music therapy, guided imagery, massage and yoga have all proven to reduce pain and help with depression. This along with physical therapy and NSAIDS helps control pain so its tolerable. Pain protects one from hurting themselves. Sometimes there is no cure. I’m not fatalistic. I’m realistic. We can care for ourselves but not cure.<br/>2)Psychologically – Patients in pain all suffer psychologically. Psychiatrists can help by acknowledging the pain and treating depression and fear.<br/>3)Socially - We need to help patients with chronic pain realize that there are still jobs that they can do. I was told by my doctor that patients with neck and back pain who work do better and feel better in all aspects of life. I worked all my life. <br/> Plus, we need to encourage their family and friends to support them and provide support for these same family and friends to help them cope with this patient.<br/>4)Spiritually – My personal relationship with God helped me tremendously. Plus, I found joy and purpose in helping others. This also helped me to forget about the pain.<br/>5)Culturally – Each culture expresses pain differently. We need to understand and address this. My great grandfather was German. So, I tend to be stoic. My physical therapist was shocked when after 1 month of physical therapy I told him I had been in pain every day since my injury. He said I never complained or cried.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bonnie	None	None	0900006484fc34eb	Payne	None	2022-03-11T10:39:33Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Payne, Bonnie	l0l-xkyt-9wwg	False	None	False	2022-04-12 04:18:05.178	[]
2326	CDC-2022-0024-2332	https://api.regulations.gov/v4/comments/CDC-2022-0024-2332	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I found the link to the public comments in The NY Times recent opinion piece, “What the Opioid Crisis Took From People in Pain.” I write in support of the proposed revisions. The United States Department of Justice is prosecuting licensed medical providers that prescribed opioids for their patients that suffered from chronic pain. This is wrong and the opposite of justice. My former wife, an Advanced Nurse Practitioner, was jailed on trumped up charges. She practiced medicine for nearly 20 years at her clinic, had no criminal history and cared deeply for her patients. Her clinic is now closed, the employees let go and her patients were forced to find other providers. The tactics of the DEA and DOJ are truly shocking and unbelievable. She will likely spend her life savings on her defense. This unjust prosecution has devastated our family. How do we tell our 11 year old son that his mother may spend many years in prison for trying to help her patients? The war on drugs is a total failure. We are truly at war with ourselves.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jonathan	None	None	0900006484fc34e9	Page	None	2022-03-11T10:40:33Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Page, Jonathan	l0l-xdwq-95y5	False	None	False	2022-04-12 04:18:05.398	[]
2327	CDC-2022-0024-2333	https://api.regulations.gov/v4/comments/CDC-2022-0024-2333	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a nurse for 32 years, twenty of which have been as a geriatric and palliative care nurse practitioner. The misapplication of the 2016 CDC guidelines have destroyed many trusted provider-patient relationships. The CDC guidelines have caused irreparable harm and should be rescinded immediately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	carolyn	None	None	0900006484fc34e7	c	None	2022-03-11T10:41:00Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from c, carolyn	l0l-x8h8-upf5	False	None	False	2022-04-12 04:18:05.609	[]
2328	CDC-2022-0024-2334	https://api.regulations.gov/v4/comments/CDC-2022-0024-2334	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	03/10/2022<br/>Commenters Request: removal of CDC opiate guidelines, and restoration of quality of life care for pain patients.<br/>Relation to pain patient: 14 year employee & Personal Executive assistant to President & CEO / business owner of construction & heavy equipment machinery. <br/>The Unintended consequences of the CDC guidelines goes beyond the patient & care takers, extending to the pain patients employees & their families, as well as the industry and non-profits they serve. <br/>In 2017 my boss’s opiate prescription was discontinued against his will. Shortly after his calendar went from tightly packeted to nearly empty, his flights to our out of state locations lessened & eventually ceased all together.<br/>1) Resulting in 3 locations permanently closed and 100’s of my coworkers at those locations became unemployed.<br/>2) My boss’s non-profit annual golf outing which raised an average of 200,000 is no longer held after 10 successful years, the Children’s Village & many community organizations no longer have our support. my boss can no longer golf or entertain & host an all day outing.<br/>3) our company annual profit is shrinking yearly. my boss cut his own pay 25% two years in a row in an attempt to compensate for the lost revenue resulting from untreated pain.<br/>4) his 10 hour work days have turned into 12-14 hour days <br/>5) I receive calls and emails from clients, vendors, and associates questioning my bosses well-being, 2020 was easier to dodge these inquires due to covid restrictions on gatherings. Weakness is a death sentence in our industry. <br/>6) should my boss ever decide to take legal recourse to recover financial losses for the hardship caused by the CDCs guidelines I am prepared with ample documentation supporting the discontinuation of his prescription resulted in millions of dollars of lost revenue and hundreds of jobs lost due to my boss’s inability to function at the level he could If his pain would’ve been adequately treated. <br/>Your guidelines caused negative consequences for many. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3493	Anonymous	None	2022-03-11T11:29:36Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-qqgl-kn09	False	None	False	2022-04-12 04:18:05.835	[]
2329	CDC-2022-0024-2335	https://api.regulations.gov/v4/comments/CDC-2022-0024-2335	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Any MME recommendations - particularly for CHRONIC PAIN PATIENTS - is UNscientific. <br/>Research clearly indicates that the range of individual response and tolerance for opiate pain medication is incredibly wide. <br/><br/>It is horrifying the damage that has been, and is being, done by regulatory authorities imposing arbitrary and universal caps (or recommendations) at the dawn of the age of individualized medicine. <br/><br/>Note - <br/>I just heard a horror story in one of my pain management groups, a direct result of YOUR POLICIES, from a mother reporting the death of her daughter from leukemia, whose pain was undertreated until the end. <br/><br/>How can you look at yourselves in the mirror each day?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484fc346a	Kahn	None	2022-03-11T11:30:24Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Kahn, D	l0l-ptgu-0u5j	False	None	False	2022-04-12 04:18:06.051	[]
2330	CDC-2022-0024-2336	https://api.regulations.gov/v4/comments/CDC-2022-0024-2336	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please change these guidelines. I have had numerous surgeries, leaving me without multiple organs and with major scar tissue. I take my meds as prescribed, I see my dr monthly and have clean urine tests. Cutting medication and/or taking it away completely leaves me with a poor quality of life. This isn’t fair or just. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mindi	None	None	0900006484fc344f	Gustafson	None	2022-03-11T11:30:55Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Gustafson, Mindi	l0l-pchv-o1lm	False	None	False	2022-04-12 04:18:06.266	[]
2331	CDC-2022-0024-2337	https://api.regulations.gov/v4/comments/CDC-2022-0024-2337	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to raise awareness about the Opioid laws and Guidelines. I have been in Chronic pain since 2012. I have several health conditions that are on the top five list of most painful conditions.I am bedridden and have a poor quality of life due to them. Even though my pain is so high I have been forced to fight for pain control. I have been subjected to other treatments through my pain management Dr. Treatments that have had horrible side effects and have increased my pain. I have had to fight constantly with my Insurance companies over Prior auths that were already submitted and approved, but still my medicine was not covered. My primary Dr. Understood my pain and had documentation from Five specialist that supported that I need Opioid to increase my quality of life. But, still was scared of the regulations. Theses rules prey on the sick!!! The people that need them the most. It should be up to the treating Dr. To recommend the pain meds and dosages not the government!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3744	Anonymous	None	2022-03-11T11:31:41Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-njvz-8mho	False	None	False	2022-04-12 04:18:06.484	[]
2332	CDC-2022-0024-2338	https://api.regulations.gov/v4/comments/CDC-2022-0024-2338	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The opioid crisis has little if nothing to do with patients with chronic and severe pain. Over 55 years of migraine that has kept escalating means pain now keeps me in bed most of the time. I’ve taken medications that have left me with permanent danger… Topomax took away cognitive abilities, CGRP meds have left me with constant vertigo and falls. Lyrica affected my vision so much I dared not drive, brought on extreme depression and fluid retention. I’ve spent a month inpatient at a headache institute, I’ve tried Botox and had nerve blocks. Nothing has worked and when pain is out of control, I’m sentenced to weeks of torture, trying to get by on as little medication as possible. I’ve got stage 3b kidney disease, I’m not supposed to take ibuprofen but there are times it’s all I have left so I take it, knowing it could lead to needing dialysis. I feel I’m being pushed to unintentional suicide by not being able to have scarcely a day without severe pain. Right this moment I’m in a hotel room as my husband awaits doctor appts tomorrow at Mayo Clinic to learn what scans will show about his cancer. He’s having to be my caretaker and we don’t know how long we have until that is no longer possible. <br/><br/>PLEASE - pain patients are not addicts. I’ve accounted for every last pill, I’m forced to go to appointments that take f four hours to accomplish when I’m in too much pain to move. I know people who have finally given up on life because they could no longer cope with pain with no relief. I’ve nearly been there myself but I know first hand the devastation left behind so I continue to suffer every day because those who love me want to keep me. <br/><br/>I wouldn’t wish this on anyone but I do wish each of you could have the experience got as long as it takes to understand. I’ll enclose a photo of me on a “regular” day [personally identifiable photo redacted]. Now tell me to go take an Advil.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc252b	Anonymous	None	2022-03-11T14:44:10Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-h3tf-o7oy	False	None	False	2022-04-12 04:18:06.702	[]
2333	CDC-2022-0024-2339	https://api.regulations.gov/v4/comments/CDC-2022-0024-2339	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People that utilize opioid medication and have used it long term successfully are the people that are still alive and functioning. As we get older and our chronic conditions deteriorate with age, we need to have the ability to titrate our medications as needed for functionality. When a provider no longer has the ability to do his job, people will no longer use thier unnecessary services, they will stop paying for insurance that no longer suits thier needs, they will no longer seek care from hospitals, I know many now that will not seek care. They will not be able to work, thier families will be affected, and they won't go for care either or pay into a system that does not benefit them or thier families plain and simple. There is no law in this land that allows government to interfere with the relationship between physician and patient, which is factually what these government agencies are doing. You will cause mass loss of life, of money for stakeholders, which hold stock in these companies because the general mass public sees what you are doing. And the legacy that is left behind is generations that do not trust medical professionals to help them at all. If you drop the MME of medicines that help people to below a therapeutic level meaning 50 MME or below and make that a standard, and it does not benefit the patient, many families will sue just as the [name redacted] family did, and they should, and you will lose control completely of your war on pain patients. All of your medical systems that you profit from now will be lost, and Noone will trust any government agency or financially support it. People are watching senators, govenors,and they will not be financially supported for allowing this to happen to the disabled that have pain. The overdose crisis is not with those trying to function, it is with illicit drugs, and the lack of care from providers for painful intractable disease with opioids that have been used for 100s of years. You have the data, you are deliberately ignoring the truth, and you are allowing a problem to be exaggerated by psychiatrists that have no training on the human body. Just know, as you torture the disabled, with fake science, and accuse innocent people of being drug addicts, this will backfire in the face of all the propagand pushers, it will cause a chain reaction starting with suffering, then family members sueing agencies up to the Supreme Court level. And then heads will roll in Washington. Harming the disabled intractable diseased with limited care of thier choice is against the law, and does not benefit the patient at all. Do the morally right thing for chronic pain patients, do not remove opioid treatment or limit the treatment that has worked for us for decades. Remove all mention of MME from the guidelines. Patients see what is happening, what pain you intend to inflict for no just cause, your group incentivises and encites non treatment of pain and stigma to those that are chronically ill. Our loved ones wont stand for this discrimination. The same problem that envoked pain as the fifth vital sign was undertreatment of pain. You are literally creating the same mistake, this time the repercussions will be catastrophic.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	GUIDELINE lie of 50 MME	None	None	0900006484fc2536	Concerned citizen	None	2022-03-11T14:49:51Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Concerned citizen, GUIDELINE lie of 50 MME	l0k-hjfa-a1yh	False	None	False	2022-04-12 04:18:06.923	[]
2334	CDC-2022-0024-2340	https://api.regulations.gov/v4/comments/CDC-2022-0024-2340	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Neurologist, so I frequently manage many patients, with neuropathic pain. I have started using non-invasive photobiomodulation therapy, and it seems that patients respond more favourably than with opioate, or non-opiate agents, for neuropathic pain. The CDC needs to update the pain treatment algorith, to include options, such as photobiomodulation therapy, early on in the treatment algorith, to prevent chonic medication overuse, adverse effects, and eventually, lack of treatment effect. I have attached some relevant articles, on its use, in chroic pain syndromes	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashleigh	None	None	0900006484fc268d	Bhanjan	None	2022-03-11T14:58:00Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Bhanjan, Ashleigh	l0k-ympc-32l7	False	None	False	2022-04-12 04:18:07.143	[]
2335	CDC-2022-0024-2341	https://api.regulations.gov/v4/comments/CDC-2022-0024-2341	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Government Torture. That is what force tapers brought on along w suicides, broken marriages, broken families, never trusting a govt institution again, lost employment, lost careers, etc. Unfortunately credibility takes years to build yet can be destroyed by one lie. I’ve dealt w chronic pain since 1997 when I was first prescribed pain meds but for some reason (politics hiding fentanyl shipments from china/mexico) the Dr decided to put me in a force taper in 2017. Why would this be done? I was a chronic pain sufferer for 20 years at this point & had never abused pain meds yet was told the pain meds actually were causing my pain. Govt propaganda! The end result: had to quit a very lucrative 6 figure salary profession that took me 25 years to build. I feel my body has been tortured by medical & govt community while also taking away my ability to earn a living. This isn’t America anymore when govt targets it population. I see the opioid 2017 crackdown as an [name redacted] venture that would be a precursor for the COVID scamdemic. When a govt tortures & targets vulnerable people then the govt is no longer serving the people -it is nothing more than an evil disguised as good. The Dr ran scared because their medical license were threatened, just like the govt did during china virus scamdemic. Never again will I trust any institution whether it be medical, govt, education, media, etc. Whoever was behind the initial force taper is purely evil & should experience what chronic pain sufferers have endured. Yes, this isn’t America ANYMORE.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc24be	Anonymous	None	2022-03-11T15:01:26Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-2vrf-61ox	False	None	False	2022-04-12 04:18:07.380	[]
2336	CDC-2022-0024-2342	https://api.regulations.gov/v4/comments/CDC-2022-0024-2342	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[name redacted]<br/>[contact information redacted]<br/><br/>Photo of me just before my 71st birthday [personally identifiable photo redacted]. I thought i could defeat age by continuously getting in better shape and stronger. I was mistaken. That was a little over 8 years ago. I'll be 79 in a few days. I still stay in shape as best i can.<br/><br/>Abruptly one day in 2014 shortly after that photo was taken i felt a popping in my head while out camping and wound up in the hospital for 3 weeks. All they could find wrong with me was a "vesitbular occlusion". They didn't know how that related to the nerve problem i started getting in my leg. Since then i've had 2 back operations (because neuro surgeon said it was a pinched nerve in lower back - i've had a lot of sports injuries) and 2 other related operations, 15 1/2 epidural injections (the 1/2 was because they couldn't get the needle in past the metal i now have in my back), 4 nerve block injections, other injections and so many other things i don't even know what they're called.<br/><br/>My worst problem is the pain in my leg and foot which keeps getting worse. The pain clinic will only give me tramadol which no longer works on me. <br/><br/>[name redacted]<br/>[contact information redacted]<br/><br/>Photo of me just before my 71st birthday [personally identifiable photo redacted]. I thought i could defeat age by continuously getting in better shape and stronger. I was mistaken. That was a little over 8 years ago. I'll be 79 in a few days. I still stay in shape as best i can.<br/><br/>Abruptly one day in 2014 shortly after that photo was taken i felt a popping in my head while out camping and wound up in the hospital for 3 weeks. All they could find wrong with me was a "vesitbular occlusion". They didn't know how that related to the nerve problem i started getting in my leg. Since then i've had 2 back operations (because neuro surgeon said it was a pinched nerve in lower back - i've had a lot of sports injuries) and 2 other related operations, 15 1/2 epidural injections (the 1/2 was because they couldn't get the needle in past the metal i now have in my back), 4 nerve block injections, other injections and so many other things i don't even know what they're called.<br/><br/>My worst problem is the pain in my leg and foot which keeps getting worse. The pain clinic will only give me tramadol which no longer works on me. <br/><br/>Yes, i can testify.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lawrence	None	None	0900006484fc2b72	Lief	None	2022-03-11T15:05:10Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Lief, Lawrence	l0l-8o3o-4lwl	False	None	False	2022-04-12 04:18:07.614	[]
2337	CDC-2022-0024-2343	https://api.regulations.gov/v4/comments/CDC-2022-0024-2343	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Don't tie doctors' hands to treat their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484fc3e0d	Fields	None	2022-03-11T15:16:22Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Fields, Tom	l0m-hfbj-f5sb	False	None	False	2022-04-12 04:18:07.833	[]
2338	CDC-2022-0024-2344	https://api.regulations.gov/v4/comments/CDC-2022-0024-2344	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for 25 years. Until 2016 I was treated with opiods with no problems, no side effects. Now I am unable to do half of the work I used to do caring for myself and my affairs. Please do not regulate my doctor's ability to treat me successfully.<br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484fc3e0b	Sawyer	None	2022-03-11T15:17:05Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Sawyer, Chris	l0m-h6d9-tykj	False	None	False	2022-04-12 04:18:08.094	[]
2339	CDC-2022-0024-2345	https://api.regulations.gov/v4/comments/CDC-2022-0024-2345	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 66. I have been on opioids for 30 years for chronic global pain from fibromyalgia. I was finally diagnosed by seven different doctors in 2000. I am an exampl.e for the need for individualized pain treatment. I have been on several different medicines but opioids work the best, very effective and give me the chance to have a quality of life. Because of the new laws, my medicine has been lowered to the point of being ineffective. My pain doctor said his hands were tied. I need my doctor to have authority to adjust my medication for me - to help me, to be able to give me what I need instead of cutting meds across the board. Although I sympathize with those that got caught up in abuse of the meds, I am tired of suffering their consequences. I am a woman with chronic pain and I want some life back. Please please give doctors more authority to treat pain. That is their speciality. Please let them do their work. Thank you for your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dian	None	None	0900006484fc41e7	Fraley	None	2022-03-11T16:56:54Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Fraley, Dian	l0m-mmer-8krz	False	None	False	2022-04-12 04:18:08.342	[]
2340	CDC-2022-0024-2346	https://api.regulations.gov/v4/comments/CDC-2022-0024-2346	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to the MSP, the local government and all others combined, I suffer every day with chronic pain. I have RA, lupus, fibromyalgia, osteoarthiritis and many other ailments. I was barely managing my pain with pain meds until the above entities decided to take my Doctor down. It is a shame that you can ruin so many lives by trying to eliminate pain medication. This nation has a lot of elderly sick people and I guess you just want us to die and go away, so you can pretend you are helping by taking away what keeps them going.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3f0a	Anonymous	None	2022-03-11T16:57:34Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0m-l3o8-orhv	False	None	False	2022-04-12 04:18:08.631	[]
2341	CDC-2022-0024-2347	https://api.regulations.gov/v4/comments/CDC-2022-0024-2347	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	.The underlying bias and predetermined agenda of the CDC writers is apparent in the wording of the draft: The words “risk” or “risks” appear 512 times, while “benefits” appears 167 times. Clinicians are repeatedly admonished to evaluate “risks versus benefits” of opioid therapy when deciding to prescribe opioids or increase the dose. But the draft acknowledges that “there is no validated, reliable way to predict which patients will suffer serious harm from opioid therapy and no reliable way to predict which patients will benefit from opioid therapy.” In more accurate words, clinicians are on their own when they prescribe these medications.<br/>“Taper”, “tapering” or “tapers” are mentioned 200 times. Although “abrupt discontinuation” of opioids is discouraged, clinicians are still advised to “appropriately taper and discontinue opioids” for patients on high doses.<br/><br/>The writers repeat their false claim from 2016, that opioids are not a proven long-term therapy because there are few long-term randomized double-blind trials for opioids versus placebo. They ignore the fact that the rarity of long-term trials reflects high dropout rates among patients who experience breakthrough pain when treated with placebos. This error can be corrected by the use of enriched enrollment trials, which is unmentioned in the draft.<br/><br/>The writers also assert that “additional dosage increases beyond 50 MME/day are progressively more likely to yield diminishing returns in benefits relative to risks to patients.” However, they offer scant scientific evidence for this assertion. They fail to reference case reports from patients who do well on high doses exceeding 100 MME.<br/><br/>Most fundamentally, the entire CDC draft is organized around the concept of “Morphine Milligram Equivalent Dose” which is now known to be junk science unsupported by any real data.<br/><br/>Errors and distortions of the CDC draft are also apparent in the wording of their 12 recommendations:<br/><br/>Seven of the recommendations are identified as “Category A recommendations [which] indicate that most patients should receive the recommended course of action.” Any reasonable clinician will recognize these words as a standard of practice that they violate at their own peril. <br/><br/>The 2nd recommendation is that “nonopioid therapies are preferred for subacute and chronic pain.” <br/>Ignored in this phrasing is the fact that several of the CDC referenced studies on non-steroidal anti-inflammatory drugs (NSAIDs) employed deeply flawed protocols. Likewise, there have been no trials of non-drug therapies as substitutions for opioids in moderate to severe pain. Thus, non-opioid therapies cannot possibly be “preferred.”<br/><br/>Also glossed over by the draft writers is the strength of evidence supporting seven of the recommendations is rated as “type 4 evidence” (clinical experience and observations, observational studies with important limitations, or randomized clinical trials with several major limitations). Freely translated, this level of evidence simply represents the opinions of the writers, rather than any general consensus among actual practitioners. <br/><br/>The revised guideline is almost as interesting for what it does not discuss as for what it does. Missing from the draft is any mention of the World Health Organization’s “Pain Ladder.” First published in 1986 and oriented to cancer pain, it is now widely used in both doctor training and common practice for all types of pain.<br/><br/>The first level of the ladder is Tylenol (ibuprofen) and other NSAIDs -- which are used in the short term for mild to moderate pain.<br/><br/>Second level of the ladder is weak opioids like tramadol, used in longer lasting or more intense moderate to severe pain.<br/><br/>Third level is strong opioids like hydromorphone or medical fentanyl, used in very severe or treatment-resistant pain.<br/><br/>Non-drug treatments like acupuncture or massage can be integrated with pain therapy at any level of the ladder, to assist patients in managing pain and increasing function. These are not, however, replacements for drug treatment.<br/><br/>Interventional treatments like nerve blocks, epidural corticosteroid injections, spinal cord stimulators or fusion surgery may be used when pain is resistant to drug therapy. <br/>The rationale for excluding discussion of this framework from the CDC guideline is nowhere made clear in either the 2016 or 2022 documents. The implied reason for this policy choice seems to be that prescription opioid analgesics were assumed by the writers to carry significant danger of addiction and misuse, even when administered at low doses and for short periods. <br/><br/>It is now clear, The development of practice standards for pain treatment should be taken entirely out of the CDC and allocated to medical specialty boards and academies whose members are practicing clinicians rather than public health bureaucrats who have never treated patients face-to-face.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484fc3d5e	Hugi-Woodberry	None	2022-03-11T17:00:17Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Hugi-Woodberry, Laura	l0m-egcw-eoiy	False	None	False	2022-04-12 04:18:08.852	[]
2342	CDC-2022-0024-2348	https://api.regulations.gov/v4/comments/CDC-2022-0024-2348	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have multiple autoimmune diseases that include Scleroderma, Lupus, and Dermatamyositis. They're extremely painful conditions that have robbed me of my ability to stand or walk for longer than 5 minutes. My pain medications helped me and allowed me to do small things like the dishes, and maybe even go out to dinner. But that's all ended. The war on chronically ill people is robbing us of the chance to at least be somewhat productive. Now I spend my days curled in a ball literally dying from the horrific pain I'm being forced to endure. Fentanyl laced street drugs are what's driving the opioid crises, NOT doctor prescribed medications for chronically ill people. What's being done to pain patients amounts to torture. My dear friend has bladder cancer and even he is being denied pain relief. He has chosen not to fight the cancer because of that. Rather than suffer endlessly, he's chosen to die. Many of us are choosing that path rather than being forced to suffer endlessly with no relief in sight. Our lives have been destroyed, and we've been forced to live in absolute misery since the CDC's 2016 guidelines robbed us of a chance to live without horrific pain 24/7. <br/><br/>[Name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Toni	None	None	0900006484fc4241	Taylor	None	2022-03-11T17:03:59Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Toni	l0m-o2qa-othb	False	None	False	2022-04-12 04:18:09.115	[]
2343	CDC-2022-0024-2349	https://api.regulations.gov/v4/comments/CDC-2022-0024-2349	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Registered Nurse with over 20 years experience in Emergency Medicine and someone with experience with acute and chronic pain, I'd like to thank the CDC for reviewing these guidelines. I have seen Physicians afraid to prescribe what they KNEW was needed to control a patient's pain because they were afraid that "the DEA would take away" their ability to prescribe controlled substances or the Medical Board of the state of North Carolina. <br/>Yes, their are providers who have been too "kind" with their prescribing habits of opiates based on the assurance that they were safe. However, having been a part of the medical field prior to the crackdown, during the crackdown, and now dealing with the repercussions of the crackdown, I can say that the majority of prescribers are very cautious with their prescribing habits of any medication, but specifically controlled substances. <br/>Pain needs to be handled. Untreated pain leads to the detriment of mental health in persons with chronic pain. I have had patients tell me on NUMEROUS occasions they would rather be dead than deal with their chronic pain. This coincides with suicide now being a top 10 leading cause of deal since 2016. <br/>While I do not believe opiates should be the golden standard for chronic pain management, prescribers need to be able to provide the appropriate pain medication for sufferers of acute pain without worrying about their livelihood being taken away. The DEA grants prescribers the ability to prescribe opiates and other controlled substances based on their training and abilities. We, as the public and government, need to trust a prescriber in being able to treat acute pain based on their training and experience and NOT some "cookbook" provided by the CDC or Insurance. We also need to trust providers to be able to treat chronic pain appropriately as well. Sometimes, opiates are needed to augment other non-traditional methods in chronic pain patients. It's hard to perform painful physical therapy if your pain isn't controlled. If someone's pain is a 10/10 when they wake up in the morning, exercise isn't going to happen unless we give them something to take away their pain, even if it's only for a little while, so they can perform physical therapy and/or exercise. In the hospital setting, it is expected that patients are premedicated for their pain prior to physical therapy arriving-yet we expect patients who are outpatient to go to physical therapy unmedicated? <br/>There is also another issue with addiction. In my experience with acute and chronic pain, there is not "euphoria" when there is a pain stimulus. When I had pancreatitis (no, I do not drink alcohol), I was given hydromorphone. I was still in pain, only I was tired and slurred my words. There was not any euphoria. There was still pain, the medication simply made me tired. When I've had dental surgery and needed mild opiates as I cannot take NSAIDS, there is no euphoria. There is only pain control so I can still work from home and be productive and not have to take FMLA and risk loosing my job. When I've had orthopedic surgeries, again, no euphoria from opiates, only pain control so I can do my prescribed exercises and go to physical therapy. <br/>However, when I've had complications and my pain has lasted longer than "expected," I've been told "I can't give you anymore pain medication, that's how you get addicted and die." I've received opiate pain medication numerous times in my 51 years. I've never been addicted. I've taken it when needed and that's it. However, I'm put in the same "bucket" as folks who did get addicted. Then, I'm told to go to physical therapy and "use ice." Well, it's kind of hard to work with ice on a major joint. This is inappropriate. Providers should be able to treat each patient's pain individually, not according to some standard, hard lined, protocol. Humans are individuals. Medical Providers should be trusted to treat their patients individually.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006484fc3a04	Weaver	None	2022-03-11T17:08:19Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Weaver, Christina	l0m-glep-lcr8	False	None	False	2022-04-12 04:18:09.344	[]
2344	CDC-2022-0024-2350	https://api.regulations.gov/v4/comments/CDC-2022-0024-2350	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guideline was used in Montana to shut down all actual pain clinics moving their treatment to surgery or procedure only.<br/>I know, because the “Pain Clinics” in Missoula MT do not want me as a patient because I am contra indicated for procedures and stable on opiates for over a decade.<br/>The crazy way, no common sense, that the doctors are applying these guidelines are not ok.<br/>They discriminate against those of us with diagnosable painful conditions. <br/>I was mis diagnosed all my life…until we replaced my hip and then found scoliosis. I had been locked into the pain I had been trying to avoid all of my life. My only way thru this is opiate and move. I did not want this but it is my reality. People, like me, are not being helped. They are being left home, in pain, because of it. <br/>This careless and cruel way to treat anyone in 24/7 pain needs to stop. So much human contribution is being wasted. Everyone that feels better can do better. It really is that simple.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fc4289	Halvorson	None	2022-03-11T17:22:57Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Halvorson, Kim	l0m-opqv-wevz	False	None	False	2022-04-12 04:18:09.570	[]
2345	CDC-2022-0024-2351	https://api.regulations.gov/v4/comments/CDC-2022-0024-2351	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I have been a CPP for over 20 years. I was blessed with a great PMD who I credit with saving my life.. I now credit the CDC to ruining that life she saved with taking everything I had worked so hard to build away from me. Ive lost relationships that were dear to me, jobs that were essential to me, and now my own dignity. I don’t have files to attach and I won’t be quoting statistics as I think the staggering number of deaths in the Chronic Pain Community should speak volumes to the harm for which the 2016 CDC guidelines have inflicted upon CPC. Thousands of CPP’s are loosing their family structures, being denied the tools required to allow them to work, manage their families, and deal with debilitating pain. I had been on the same dose of pmds, held down a job, and put my son thru college before these guidelines put my life into perpetual hell. I wasn’t forced tapered, but I was completely cut off from pmds sending me into instant, life threatening, withdrawals and I have never been the same. I lost my job, my home, and was forced into a living situation I never dreamed possible. I have since been thru 3 surgeries,, bounced from one PMD to another, and every time I end up in a switch with my medication. Thrown back into withdrawals because no PMD cares that I am out of pmds while I wait for them to make me an appointment. These guidelines are so ambiguous that all they have done is cause harm, PMD’s can’t treat CPP’s because they fear going to jail and the CDC has caused all of this. Moreover, the CDC has contributed to largest influx of illicit drugs in our country’s history and that fact is well documented and supported by the spike in overdose deaths. Illicit drug use and the use pain medications are two very different things, a fact which the CDC seems ignore or doesn’t understand. Because of being bounced around, medications denied, and the inability to even find a PMD, my blood pressure continues to be a problem, one which I had never had in the past. I can only hope that the stories and facts which other CPP’s convey to you will clarify the importance of how dire this situation is and help you understand that thousands of CPP’, many of whom are not aware of the CDC’s actions or simply are unable to respond to this atrocity, are counting on you to take the steps necessary to restore our quality of life and give us back our dignity. Allow us to work, to raise our families, and give back to the community.<br/>Thank you,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484fc42c5	Iles	None	2022-03-11T18:29:43Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Iles, Pamela	l0m-p8p4-4qgo	False	None	False	2022-04-12 04:18:09.790	[]
2346	CDC-2022-0024-2352	https://api.regulations.gov/v4/comments/CDC-2022-0024-2352	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	6 years from now we’ll all (those who managed to survive the CDC guidelines, at least) be sitting here reading the “long awaited revision” of the 2022 guidelines to correct the fact that everyone was tapered to 50 “MME” as suggested. Nothing else matters in this revision because that is all that will be looked at and applied. You’re about to take your initial gross negligence and double it. You’re about to make life twice as awful as you made it the first time and kill twice as many people. How it’s possible that you could screw this up so badly after what happened the first time is beyond me. This is why you should leave the “guidelines” for the experts. No one needs you to “guide” them on a topic you don’t have proper knowledge on. Let’s get one thing straight, MME DOES NOT EXIST. MME is anti science and not based on reality and the term should not even be allowed in the medical field. These are proven facts based on actual science that you are blatantly ignoring. People are dying of cancer without pain meds. People are having open chest surgery and brain surgery without pain meds. You are literally the cause of actual torture. I hope I live to see the day where this country and the world acknowledge how the CDC started a war against the most vulnerable among us and those responsible are charged with crimes against humanity because that’s exactly what all of this is. One day this will be looked back on as a dark part of this country’s history where the CDC literally created a fentanyl crisis and exterminated both the addicts and the sick and injured at the same time. How you ignored science and facts and continued to push a false narrative for at least a decade. Going against the experts in a field that doesn’t apply to you. These guidelines killed people. The CDC killed people. It should have been withdrawn completely and replaced with a statement acknowledging just how wrong each and every sentence was. Those who created it should be forced to step down. Instead you’re about do this all over again and worse than the first time. What you’ve done is criminal and will be seen as such once the country is able to break free of the false narrative you’ve created despite all of the experts in the field telling you it’s not true. When the inevitable comes and you or a loved one falls victim to your own creation you’ll finally understand first hand what you’ve done to all of us. By then it very well might be too late to correct your errors and you’ll have to live with that	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484fc4339	Puiia	None	2022-03-11T18:35:09Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Puiia, Nicole	l0m-q2cn-sgy4	False	None	False	2022-04-12 04:18:10.044	[]
2347	CDC-2022-0024-2354	https://api.regulations.gov/v4/comments/CDC-2022-0024-2354	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These rules have affected me and so many other to the point our lives have been affected majorly.My poor Granny can’t get any help for her cp and so she never leaves the house!! You go to the doctor with pain and you are automatically a drug seeker, it’s sad! This is the reason people are dying not over prescribing but not prescribing so that many will head to the streets for unsafe alternatives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc43d0	Anonymous	None	2022-03-11T18:45:48Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0m-relz-py9r	False	None	False	2022-04-12 04:18:10.258	[]
2348	CDC-2022-0024-2355	https://api.regulations.gov/v4/comments/CDC-2022-0024-2355	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cold laser ortho therapy has restored use of my painful and arthritic thumb with painless non-invasive treatments that lessened my thumb pain with each successive treatment. I could not grip anything before treatments with my dominant hand, and now I have full pain-free use of my dominant hand and thumb!<br/><br/>After the successful treatment program for my thumb, I decided to have treatments done on both knees that have been inflamed due to pseudogout, an autoimmune disorder. I have been amazed and very happy with the improvement in knee function as well as reduction of inflammation and elimination of pain. I can sleep through the night again without waking up in pain. <br/><br/>Ortho laser treatments have worked for me, and I wish they were covered by insurance so more people could afford to have them without resorting to powerful opioids. The opioid epidemic in our country is so unnecessary. <br/><br/>Our health care system is broken and overwhelmed with people having a healthier option for healing and pain management, but because the healthier options are considered alternative medicine and not covered by insurance, they can’t afford to pay out of pocket. That is a shame!<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sherry	None	None	0900006484fc4466	Shaffer	None	2022-03-11T18:47:33Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Shaffer, Sherry	l0m-rqcy-9lim	False	None	False	2022-04-12 04:18:10.484	[]
2349	CDC-2022-0024-2356	https://api.regulations.gov/v4/comments/CDC-2022-0024-2356	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain since 2008. I had breast cancer and had to take a pill every day for five years. This medicine gave me arthritis in ALL of my bones. I have pain in my entire back, neck, hands, wrists, fingers, feet, toes, ankles ,hips, and knees. The hydrocodone I take allows me to function as a human being. Without this medication I cannot clean my house, work in my yard, or take care of myself. I have managed to go from 10mg three times a day down to 7.5mg two to three times a day. It is disgusting to be treated like a drug addict by peeing in a cup once a month when I use to get three refills. It can be proven that I have NOT abused this medication and I want to know why I am treated like this for something that medication side affects caused! Also, I have witnessed people older than me who are in chronic pain going once a moth for their meds that have to come in wheelchairs. It is inhuman to treated people like this because of DRUG ADDICTS!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martha	None	None	0900006484fc4535	Brazier	None	2022-03-11T19:06:29Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Brazier, Martha	l0m-sey2-3p8r	False	None	False	2022-04-12 04:18:10.703	[]
2350	CDC-2022-0024-2357	https://api.regulations.gov/v4/comments/CDC-2022-0024-2357	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a nurse practitioner and have practiced pain management in Oregon for 21 years. I thought long and hard about what I would write in this comment section and although I could go on and on about the damage that has been done and the lives that the 2016 CDC guidelines have destroyed but I don’t know what good that would do. The bottom line is the CDC guidelines need to be rescinded entirely and they need to let medically trained individuals who treat pain treat patients on and individual basis and that means that some will require high doses of opiates to control their pain. Unfortunately I have seen suicides associated with patients having their medication’s reduced and deaths because of the medications that they are now forced to buy on the Internet which are laced with illicit fentanyl. We don’t tell providers how to treat hypertension or diabetes please don’t tell us how to treat chronic pain. The opiate crisis is no longer about legitimately prescribed pharmaceutical medication’s. Please let us get back to practicing medicine because at this point in time we are doing harm. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484fc371a	Knaus	None	2022-03-11T19:36:55Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Knaus, Joseph	l0l-mk0x-lwvo	False	None	False	2022-04-12 04:18:10.916	[]
2351	CDC-2022-0024-2358	https://api.regulations.gov/v4/comments/CDC-2022-0024-2358	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was SEVERELY damaged by a pharmaceutical. It required multiple surgeries and after one of them they SEVERELY under-treated my pain. It was so bad I planned my suicide: I was going to hang myself by my robe strap. I was set to do it after being in agony for days but all I could see in my mind was my child coming home to find me.<br/><br/>You must believe in some form of karma - most people do. If you continue to withhold pain relief then evil will come back on you. I've seen it.<br/><br/>I hope that whoever reads this grasps that you will not be spared - just like the thousands of patients who have suffered, your turn to suffer will come. Call it karma, or reaping what you sow, you may want to think carefully about what you're doing to vulnerable patients and good doctors as one day you will reap the consequences of harm inflicted on patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3d29	Anonymous	None	2022-03-11T19:44:09Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0m-cls2-s5ny	False	None	False	2022-04-12 04:18:11.157	[]
2352	CDC-2022-0024-2359	https://api.regulations.gov/v4/comments/CDC-2022-0024-2359	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just want to say that your 2022 guidelines or not enough they are too little too late and possess those of us who were already abandoned by our doctors And we have no other resources or doctors in our areas that will accept us this does us no good especially since you said voluntary and you haven't taken the dea or the other people like narrate out of the equation the doctor still will not be helping and that's a fact and for some of us who can't even get a doctor still.you have destroyed our lives and you did it without any investigation into it what's truth.you lose you used data that were lies and you did not even consider what consequences you would bring about you have a bigger crisis of people committing suicide now than you ever have before. The suicide crisis is almost bigger than a crisis you created with patients being abandoned like me. and now we are killing ourselves left and right because we can't live in pain for the rest of our lives 24 hours a day with no help I was a wife I no longer a wife I'm no longer a mother and no longer grandmother Im no longer a foster mom I no longer anything or grandmother because you took that all the way and all you left in place was pain and more pain 24 hours a day so unless you change the new guidelines to take away all this mme's and all the DEA and the words like voluntary out of the equation things are going to stay the same nothing is going to change and we still won't be getting help. I can't live with this pain.this is not living.this is being tortured while waiting to die.but death don't come for years.no organization on earth should be allowed to have the power over my life to decide that I should live our my years being tortured.no one should have that much power.like Hitler tortured the Jewish people ,we are now being tortured by our own country.who gives you the right to decide who gets to live and who dont.cuz that's what you are doing.i lost my whole life.now I'm a shut in.i was a very active person before this.now I have gained alot of weight and have diabetes because I can't be active anymore.i can't bathe.i can't see anyone .I have no life you took my life and all you left in its place was this mass of pain.im 65 yrs old.im not a drug addict or drug seeker.this could happen to you.i just woke up and discovered I had a tumor in my spine.nothing I did contributed to this.now I'm condemned to go through my so called golden years with nothing but pain.we work our whole lives waiting for the day we can retire and enjoy life,then some damn people like you come along and decide we should not enjoy one day of no pain for the rest of our lives.you didn't just ruin my life.you also ruined my grandkids lives and my kids lives and some foster kids lives because I can no longer be a foster pardnt.unless you take out the words like voluntary and 50mme and any words that can be misconstrued it will be the same as before.also the Dr who abandoned me as a patient was the only pm in our area.they should be forced to take us back as patients.otjetwise alot of us will still not have Drs.no one will take new pain patients.i beg you to do the right thing and give my life back please.only you can take me out of this [language redacted].and it is [language redacted] on earth believe me it's not fair.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc250f	Anonymous	None	2022-03-11T19:51:07Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0k-fvjy-huco	False	None	False	2022-04-12 04:18:11.381	[]
2353	CDC-2022-0024-2360	https://api.regulations.gov/v4/comments/CDC-2022-0024-2360	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to add the suggestion that putting in guidance around appropriate weaning schedules for patient who have been on opioids for more than 5-7 days would be crucial. I work in Palliative Medicine in the hospital and am often asked to weigh in for patients who have been here for over a week, on moderate to high doses of opioids, and there is never a plan for a long term wean after discharge. <br/><br/>It has been taboo to prescribe opioids for so long, that I suspect health care providers are out of practice, and will need some reminding as to the importance of weaning for physical dependence which can happen quite quickly	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tiffany	None	None	0900006484fc428e	Pajic	None	2022-03-11T19:51:21Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Pajic, Tiffany	l0m-or6j-tiqw	False	None	False	2022-04-12 04:18:11.604	[]
2354	CDC-2022-0024-2361	https://api.regulations.gov/v4/comments/CDC-2022-0024-2361	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The valid issue of previous cares for preventing disease famine and pestilence come from long hours of great monies expedited to maintainance of pipes sanitation and well cooked food prepared by health board standard so we may be in right mind to make righteousness work for our lands.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc21c3	None	None	2022-03-11T19:52:14Z	LMAC	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-09T05:00:00Z	None	None	None	None	None	None	None	Comment from LMAC	l0k-4b5t-q72r	False	None	False	2022-04-12 04:18:11.817	[]
2355	CDC-2022-0024-2362	https://api.regulations.gov/v4/comments/CDC-2022-0024-2362	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I will be 75-years old in May. I was born with spinal birth defects (kyphosis and all 3 types of scoliosis). In 2004 I was in an elevator that fell 30 feet and damaged every disc in my spine. Cervical Spine (Neck): C2-3 - loss of normal lordotic curvature with cervical kyphosis centered at approximately C2-3 & mild circumferential disc bulging, C3-4 - disc protrusion, circumferential protrusion with osteophyte formation mildly encroaching the bilateral neural foramina. circumferential protrusion with osteophytes which cause anterior impression on the thecal sac, C4-5 - circumferential protrusion with osteophytes causing anterior impression on the thecal sac encroaching right neural foramen and mildly encroaches left neural foramen, C5-6 - circumferential protrusion with osteophytes that moderately encroaches left neural foramen and mildly encroaches right neural foramen, C5-6 - circumferential protrusion with osteophytes causing moderately encroachment of left neural foramen and mildly encroaches right neural foramen, C-6-7 - right foraminal herniation with circumferential protrusion with osteophytes resulting in moderate to marked encroachment of right neural foramen and may impinge C7 nerve root. Milda encroachment of left neural foramen. Mild stenosis of spinal canal narrowing the spinal canal to approximately 1.0 c C7-T1 - circumferential disc bulging. LUMBAR SPINE: multilevel degenerative disc disease with exaggeration of kyphotic curvature of thoracic spine centered approximately at T11-12 Anterior disc protrusion at T11-12, T12-L1 - anterior disc protrusion wit disc bulging, L1-2 - anterior disc protrusion with mild circumferential disc bulging, L2-3 - chronic anterior disc herniation with osteophytes circumferential disc bulging, L2 is sublexed posteriorly on L3 by approx 0.5cm consistent with grade 1 retrolisthesis, likely based on presence of degenerative disease. Circumfretial disc bulging with osteophyte formation mildly encroaching right neural foramen. L3-4 - circumferential disc bulging with osteophyte formation present, mildly encroaching bilateral neural foramina causing anterior impression on the thecal sac. L4-5 - circumferential disc bulging with ostepophye formation and left lateral disc herniation extending into left neural foramen. Together, these findings result in moderate to marked encroachment of left neural foramen and may impinge the left L4 nerve root as it exits. There is mild encroachment of right neural foramen. L5-S1 - circumferential disc bulging w/osteophte formation mildly encroaches left neural foramen. Note that levoconvexed scoliosis of lumbar spine is also present. THORACIC SPINE: thoracic kyphosis and alevoscoliosis with osteopenia. T1-2 -to T7-8 - disc desiccation. T8-9 There is a 2mm anterolisthese and disc desiccation. T9-10, T disc desiccation. T11-12 and T12-LI - posterior disc bulge. L2-3 - multisegment disc disease of upper thoracic segments and mild retrolisthesis at L2-3 - thoracic kyphoscoliosis with osteopenia. I experience cervical pain and headaches, chronic intractable pain every minute of every hour of every day and night. I cannot live with a proper does of pain medicine and muscle relaxers of which I was denied by my Pain management doctor in 2017. The minimum dose I exist on lets me survive, not thrive. I am no longer a productive citizen, but a burden on the system -[name redacted] [location redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Saundra	None	None	0900006484fc3ed0	Navarro	None	2022-03-11T19:53:48Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Navarro, Saundra	l0m-kh43-igza	False	None	False	2022-04-12 04:18:12.055	[]
2356	CDC-2022-0024-2363	https://api.regulations.gov/v4/comments/CDC-2022-0024-2363	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I live in [location redacted]. I have a chronic pain condition caused by collateral damage from multiple leg and hip surgeries. I have been seeing doctors for years for treatment and doctors will not prescribe pain medication for me despite reporting an 8/10 on a pain scale. I am not interested in begging a doctor, groveling almost, for relief from pain. This is very frustrating and often leads me to think animals are treated better than people. Animals would not be left to suffer unnecessarily but for some reason it is easy for a doctor now to ignore the pain claims of a patient. Reading the old CDC guidlines where doctors are instructed, given an out or an excuse from responsibility, to not see a patient who continues to seek treatment for pain because the seeking behavior is construed as addiction behavior is outrageous. It is humiliating for patients with pain and frankly inhumane. It is no wonder patients are seeking illegal relief and risking further imperiling their health to get it. I cannot get a regular prescription for tramadol for chronic so drag myself to work every day praying to make it through to tomorrow. My life is a house of cards without relief. It isn't reasonable to work with the level of pain I experience on a daily basis but I have no choice. Quitting my job will not relieve me of my pain and would put me in fianancial straits. Thank you for opeing this forum to the public. I don't know what other people are doing for help. I have a therpaist who specializes in chronic pain patients and she is equally baffled by the current CDC guidelines. I hope you are moved by the suffering of chronic pain patients who are being sideined and can speed a course correction for those in need. Kindly [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fc3d0d	Rivet	None	2022-03-11T20:00:32Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Rivet, James	l0m-33xa-5w4y	False	None	False	2022-04-12 04:18:12.313	[]
2357	CDC-2022-0024-2364	https://api.regulations.gov/v4/comments/CDC-2022-0024-2364	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket (CDC-2022-0024)<br/><br/>Thank you for addressing the 'war on drugs'-type mentality that, since the crackdown, has resulted in people with chronic pain being treated like drug addicts and/or denied their long-prescribed medications. I developed chronic pain after a botched surgery over 20 years ago. For years and years I safely took my opioid medications. Because of managed pain, I went from crying on the couch all day and often ending up in the ER every weekend, to being a productive member of society. With proper doses of opiates onboard, I was even able to go back to school and get my BA and MA. I would get 4 or more refills every time I saw my doctor so I didn't have to keep going back. Then everything changed.<br/><br/>The false narrative of the opioid crisis meant I had to go to my doctor every month (paying $100 out of pocket each time because the doctor wasn't in my network). No more refills. The prescription was suddenly triplicate. Now I was subject to random drug tests. My local pharmacist, where I'd been having the prescription filled all along, suddenly treated me like an addict, sometimes refusing to fill a prescription for medication I had been taking safely for over 15 years. One pharmacist forced me to buy Narcan before he'd fill my prescription, convinced I was an addict who would eventually overdose. These actions were all based on FEAR and politics. The real substance abusers were out on the street, dying of illegal Fentanyl.<br/><br/>Please do whatever you can to undo the damage that's been done and to remove fear and stigma. Doctors should have the final say and pharmacists should not be able to overrule them. Chronic pain patients should not be treated like junkies. The substance abuse problem in this country should be handled as they do in Portugal - with laws and policies that are actually effective.<br/><br/>And PLEASE do not focus your guidelines on "alternative methods" like acupuncture or TENS units or whatever you have in mind. Many patients are paying their pain management doctors out of pocket. They/we cannot afford the expensive alternatives that you propose. And, frankly, when patients have been safely taking the same drug year after year, and have never had a problem or any ill effects, why SHOULD they seek alternatives and "diverse approaches" to their medications? For what other medication would a doctor look at a patient history, say, "Well you've been taking this med for years, it has safely and effectively managed your pain, you've had no ill effects from this medication, it's affordable and covered by your insurance - but let's look at ALTERNATIVES. Let's get you off this."<br/><br/>In closing, let me add: You DO know that this crackdown on pain patients and their doctors - years of fear and stigma and increased rules and regulations and oversight - all in the name of stopping opiate overdoses, has done nothing to actually stop opiate overdoses? <br/><br/>From this New York Times article dated March 7, 2022:<br/><br/>"If these policies had reduced the death toll, some might argue that they are warranted. But they have not. Measured by the number of prescriptions written per capita, medical opioid use rates in 2020 were down to levels last seen in 1993, before OxyContin marketing helped spark the crisis. However, overdose deaths are still increasing dramatically, driven by illegally manufactured synthetic opioids and many who formerly got pharmaceuticals from doctors and now resort to dealers."<br/><br/>https://www.nytimes.com/2022/03/07/opinion/opioid-crisis-pain-victims.html?fbclid=IwAR39WiYQlQydK4gtksV3paiWYccZQf2wtopSgSoNi-0ySH27mUeTyXsVO4c<br/><br/>Please stop this insanity. Thank you.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3c94	Anonymous	None	2022-03-11T20:37:33Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0m-ig9u-sd5k	False	None	False	2022-04-12 04:18:12.535	[]
2358	CDC-2022-0024-2365	https://api.regulations.gov/v4/comments/CDC-2022-0024-2365	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket (CDC-2022-0024)<br/><br/>Thank you for addressing the 'war on drugs'-type mentality that, since the crackdown, has resulted in people with chronic pain being treated like drug addicts and/or denied their long-prescribed medications. I developed chronic pain after a botched surgery over 20 years ago. For years and years I safely took my opioid medications. Because of managed pain, I went from crying on the couch all day and often ending up in the ER every weekend, to being a productive member of society. With proper doses of opiates onboard, I was even able to go back to school and get my BA and MA. I would get 4 or more refills every time I saw my doctor so I didn't have to keep going back. Then everything changed.<br/><br/>The false narrative of the opioid crisis meant I had to go to my doctor every month (paying $100 out of pocket each time because the doctor wasn't in my network). No more refills. The prescription was suddenly triplicate. Now I was subject to random drug tests. My local pharmacist, where I'd been having the prescription filled all along, suddenly treated me like an addict, sometimes refusing to fill a prescription for medication I had been taking safely for over 15 years. One pharmacist forced me to buy Narcan before he'd fill my prescription, convinced I was an addict who would eventually overdose. These actions were all based on FEAR and politics. The real substance abusers were out on the street, dying of illegal Fentanyl.<br/><br/>Please do whatever you can to undo the damage that's been done and to remove fear and stigma. Doctors should have the final say and pharmacists should not be able to overrule them. Chronic pain patients should not be treated like junkies. The substance abuse problem in this country should be handled as they do in Portugal - with laws and policies that are actually effective.<br/><br/>And PLEASE do not focus your guidelines on "alternative methods" like acupuncture or TENS units or whatever you have in mind. Many patients are paying their pain management doctors out of pocket. They/we cannot afford the expensive alternatives that you propose. And, frankly, when patients have been safely taking the same drug year after year, and have never had a problem or any ill effects, why SHOULD they seek alternatives and "diverse approaches" to their medications? For what other medication would a doctor look at a patient history, say, "Well you've been taking this med for years, it has safely and effectively managed your pain, you've had no ill effects from this medication, it's affordable and covered by your insurance - but let's look at ALTERNATIVES. Let's get you off this."<br/><br/>In closing, let me add: You DO know that this crackdown on pain patients and their doctors - years of fear and stigma and increased rules and regulations and oversight - all in the name of stopping opiate overdoses, has done nothing to actually stop opiate overdoses? <br/><br/>From this New York Times article dated March 7, 2022:<br/><br/>"If these policies had reduced the death toll, some might argue that they are warranted. But they have not. Measured by the number of prescriptions written per capita, medical opioid use rates in 2020 were down to levels last seen in 1993, before OxyContin marketing helped spark the crisis. However, overdose deaths are still increasing dramatically, driven by illegally manufactured synthetic opioids and many who formerly got pharmaceuticals from doctors and now resort to dealers."<br/><br/>https://www.nytimes.com/2022/03/07/opinion/opioid-crisis-pain-victims.html?fbclid=IwAR39WiYQlQydK4gtksV3paiWYccZQf2wtopSgSoNi-0ySH27mUeTyXsVO4c<br/><br/>Please stop this insanity. Thank you. <br/><br/>PS - Because of the fear, I have to submit this as "Anonymous." I don't like doing so, but that's the kind of climate that has been created around these medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3c93	Anonymous	None	2022-03-11T20:37:50Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0m-icxd-7jtm	False	None	False	2022-04-12 04:18:12.769	[]
2359	CDC-2022-0024-2366	https://api.regulations.gov/v4/comments/CDC-2022-0024-2366	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When the CDC makes these new Guidelines at the end of 2022 is the DEA going to quit arresting Doctors for writing prescriptions over the limit listed in the Guidelines I've seen too many lawsuits on the CDC's page against pain management doctors who lost their liscense to prescribe medicine for going over a guideline meant for primary care physicians. How is the CDC going to give these doctors their lively hood back, their practices, their homes...How is the CDC going to pay back the chronic pain patients who have taken their own lives because of the Guideline or their families...How is the CDC going to give all of the people their quality of life back all of the time they have missed with their families because they are to sick to get out of bed.....How is the CDC going to pay back all of the cancer patients who died in horrible pain because their doctors were to afraid to give them anything How do you people sleep at night	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	linda	None	None	0900006484fc46c7	Donaldson	None	2022-03-11T20:54:27Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Donaldson, linda	l0m-uoqz-7zsd	False	None	False	2022-04-12 04:18:13.018	[]
2360	CDC-2022-0024-2367	https://api.regulations.gov/v4/comments/CDC-2022-0024-2367	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have worked as a PA-C in pain management for 15 years and prior to that in family practice x 16 years. The 2016 guidelines have been misused by insurance carriers and government agencies to be punitive to patients and providers.<br/><br/>I have read all 211 pages of the draft 2022 guidelines. The most significant statements in the revised guidelines are in the box on page 2 between lines 26 and 27. If appropriately applied, the statements there should improve the care given to patients with chronic pain and help the providers who care for them.<br/><br/>Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484fc45cc	Pasquarello	None	2022-03-11T20:55:13Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Pasquarello, Tom	l0m-t6h4-7k5v	False	None	False	2022-04-12 04:18:13.239	[]
2361	CDC-2022-0024-2368	https://api.regulations.gov/v4/comments/CDC-2022-0024-2368	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 34 year old male, I would not have been able to:<br/>1) get through my economics degree without low dose opioid treatment due to bad joints, cartlidge missing in both knees, Post Herpetic Neuralgia from having shingles TWICE by age 28, and the dozen or so sports injuries I've had over the years.<br/><br/>Without opioids, I might have well committed suicide to be frank because of the varying ype of pain I experience.<br/><br/>Even now at a 70% reduction in pain meds (from 180 mg of MS Contin per day, and 30 mg percocet for breakthrough down to only allowed the breakthrough med) I am at least 30% more functional and better in my career (managing tens of billions of dollars of real estate) than without. The 70% reduction which is the result of the CDC guidelines (and dont kid yourself, the DEA won't allow us to be back on our pain meds - they control the exact amount allowed into the united states for production - it is DEA's call, not the CDC and def not the White House.)so back to the CDC Guidelines - they have harmed my ability to care for myself, my former partner, my CURRENT partner, my ability to move quickly, take on extra work tasks, explain to my employer why I struggle sometimes.<br/><br/>If I could even be allowed up to the 90MME hard limit allowed by CDC, I would be fairly okay, but I'm not. <br/><br/>My Dr runs scared, he suggests things I've done and tried over and over.<br/><br/>I've lost 30 lbs of MUSCLE since these mandatory cuts, and while I would be fine in a dose range of 90-150 mg of the least popular painkiller among critics around, I suspect that won't be allowed even on my deathbead.<br/><br/>What has our country become? If you're an addict, you get to steal grannies' meds. get meds from the dr including mixing MAT with tons of xanax (Ive read some addicts are getting 6-12 mg a day of xanax while I have to beg for two mg total per day. THe actual cost to make and produce an MS Contin is about six cents a day, probably ten cents a day with inflation.<br/><br/>Another alarming item is the fact that the rescheduling of hydrocodone products caused many people to switch from hydrocodone to oxycodone since they became considered the 'same' even though for many hydrocodone works betters (inlcuding me!) I'd rather be able to have up to 6 10/325 Vicodin per day than 4 10/325 percocet per day, but according to the CDC and DEA, they are equal and 90 mme and more than 120 tablets are red flags, so which pain med do you think I went with?<br/><br/>yup, the "stronger" one that causes bloating, irritability, and mild to moderate constipation if you don't manage it well.<br/><br/>When I was on a higher dose of pain meds, I could HIKE, BIKE, SWIM, LIFT WEIGHTS, PLAY BASKETBALL< JOG, RUNetc.... now my pain is not managed well enough..<br/><br/>I'm not ashamed, but it was never anyone's business until big brother stepped in. Now I am angry beyond belief. I hope some day these bi partisan politicians get told they can only have a 3 day supply of pain meds after a vastectomy that took four hours to perform due to complications (and a 3 day supply equates to 5 mg norcos allowed half of one every 6 hours - then tell me how addicted you think you are or could be and whine and complain)<br/><br/>I have some of the best dr's in the world, and even they won't change back to what they were actually taught in school from the likes of Stanford, Harvard, etc (the teachings being that you MUST treat your patients' pain)<br/><br/>We are in sad times.<br/><br/>We can recognize the disease state of addiction without having to attach stigma to those whom are not addicted but are experience physical diseases that need pain medication regardless of dose. <br/><br/>Kindly,<br/>a millenial who is happy grandma was treated well in regards to pain mgmt in her last days of life before the awful, horrible, and shameful 2016 Opioid CDC Guidelines were thrown out with the worst possible level of science involved and layer upon layer of COI (conflict of interest) [name redacted] and [name redacted] are in the top of the list	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc3497	Anonymous	None	2022-03-11T21:01:44Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0l-r6wk-fnk1	False	None	False	2022-04-12 04:18:13.449	[]
2362	CDC-2022-0024-2369	https://api.regulations.gov/v4/comments/CDC-2022-0024-2369	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Docket number 2022-2024-0001<br/><br/>OPIOIDS WORK FOR NONCANCEROUS CHRONIC PAIN. CHRONIC PAIN PATIENTS WHO DON'T HAVE CANCER WILL TELL YOU THAT. WE'RE THE EXPERTS. HUNDREDS OF CHRONIC PAIN PATIENTS HAVE TAKEN THEIR OWN LIVES! SUICIDE,OR TURNED TO THE STREETS LOOKING FOR PAIN RELIEF. NO MME DOSE THRESHOLDS. NO MME IN THE CDC GUIDELINES. IT HAS BEEN MISINTERPRETED AND CHRONIC PAIN PATIENTS HAVE BEEN HARMED BY THE CDC GUIDELINES. IM A NURSE AND A CHRONIC PAIN PATIENT. I'D KILL MYSELF IF I WAS FORCED TO SUFFER INHUMANELY AND CRUELLY. ANTI-OPIOID BIASED AUTHORS OF THE CDC GUIDELINES. THEY ALL HAVE CONFLICTS OF INTEREST. THEREFORE THE CDC GUIDELINES SHOULD BE ABOLISHED! THE CDC HAS NO BUSINESS REGULATING MEDICATION AND THE PRACTICE OF MEDICINE. THE HUMAN EXPERIENCE IS BEING REMOVED, REPLACED WITH ALGORITHMS. TREAT THE HUMAN BEING!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fc3446	Smith	None	2022-03-11T21:02:15Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Smith , Kim	l0l-oncf-ybob	False	None	False	2022-04-12 04:18:13.669	[]
2363	CDC-2022-0024-2370	https://api.regulations.gov/v4/comments/CDC-2022-0024-2370	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Like millions of Americans, I suffer from chronic pain. With regular workouts, Pilates, and 10-325mg hydrocodone-acetamine administered by my pain specialist, I have been able to enjoy a normal quality of life.<br/>The disapearance of the supply of effective medication has worsened my condition from a pain scale of 2-3 with meds. to 6-7 using the ubiquitous Mallinckrodt Pharmaceuticals product which I find ineffective.<br/>Please reconsider a return to allowing and making available hydrocodone-acetamine pain medication with effective opioid derivative formulas once available to pain sufferers like me.<br/>Thanks for all you do.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc4377	Anonymous	None	2022-03-11T21:37:28Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0m-ql4q-t43f	False	None	False	2022-04-12 04:18:13.882	[]
2364	CDC-2022-0024-2371	https://api.regulations.gov/v4/comments/CDC-2022-0024-2371	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a CPP. I wrote a comment for this entry but its 1400 characters too long. The opioid guidelines have ruined my life. I have submitted complaints to the CDC many times before. Review my comments. Stop punishing pain. Opioids have saved my life and improved quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tiffany	None	None	0900006484fc4a17	Thomas	None	2022-03-11T21:41:01Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Tiffany	l0m-xscb-43af	False	None	False	2022-04-12 04:18:14.094	[]
2365	CDC-2022-0024-2372	https://api.regulations.gov/v4/comments/CDC-2022-0024-2372	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a licensed acupuncturist and President of the Wisconsin Society of Acupuncture; I support alternative therapies, such as acupuncture, for those suffering from pain and disability as a frontline treatment. Acupuncture is an effective and affordable modality that helps the body to alleviate pain by stimulating the body's own endogenous opioids. There are thousands of studies that detail acupuncture's biochemical effect on the body in regards to pain. As with any therapy, everyone's chemical makeup is different and patients respond differently to different modalities. That said, referring patients to acupuncture is a responsible way for practitioners to help them find relief, and decrease opioid dependence in America. Studies show patients experience as much or more pain relief using acupuncture as they do opioid pain medications. <br/><br/>Acupuncture works on the whole body, it is also an effective way for chronic pain patients to experience mental health benefit as well. This helps them cope more effectively with their diagnosis and feel as though they have control in their pain management. <br/><br/>Thank you for allowing comment on this issue. I'm hopeful for the future of pain management in America.<br/>Sincerely, <br/>Megan Bielinski, L.Ac<br/>WI 852-55, NCCAOM 156725<br/>WISCA President	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Megan	None	None	0900006484fc4309	Bielinski	None	2022-03-11T21:54:39Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Bielinski, Megan	l0m-phj1-4y8l	False	None	False	2022-04-12 04:18:14.331	[]
2366	CDC-2022-0024-2373	https://api.regulations.gov/v4/comments/CDC-2022-0024-2373	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	All legacy patients that have not had any signs of addiction should not have to keep proving that their stable dose pain medication is working for them..Power over function must be completely patients, if America wants to get fear out of clinics and patients stop being considered a liability!! My husband had been on same high dose no increases for 26yrs..He has been forced by insurance companies, doctors and pharmacists to taper!! Never was he or our family asked what we feel or think about taper. This is our family and loved one, we are supporting him because he impacts our lives,not the doctors lives!! These doctors are in so much fear they are destabilizing patients with out a care for patients, family, jobs, life, and so on..this has negatively impacted every level of American medicine!! My husband has adhesive arachnoiditis, chronic kidney disease, degenerative disc disease, aniema, low testosterone and more..I have seen doctors making the most terrifying decisions out of fear that its almost to hard to believe!! 2 nurses watch my husband pee every month with monthly pill counts..forced to try suboxone that ended in my husband crashing 911 call and more trama for my family..<br/>Please give power over function back to the patients we cant live with someone else having ability to take my husband's life away..and I won't let him leave this earth alone because our government no longer cares for his life!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leticia	None	None	0900006484fc439b	Gomez	None	2022-03-11T21:55:41Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Gomez, Leticia	l0m-raax-u88z	False	None	False	2022-04-12 04:18:14.556	[]
2367	CDC-2022-0024-2374	https://api.regulations.gov/v4/comments/CDC-2022-0024-2374	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has radiation burns to his bladder, urethra and nerves near his tailbone. He feels like he's peeing razor blades and he pees every 15 minutes or so. We lost all our retirement and home to cancer treatment before ACA in 2008 we both have to work to save to retire. He is 74. We want to move near our kids but he can't work without pain pills and most states Dr's are scared to death to prescribe pain pills so we are stuck in [city redacted]. He has been on pain pills for 9 years and has no psychological addiction to them. <br/><br/>I have been on 30mg for 4.5 yrs. I have excruciating rls that keeps me awake thru the night. Even with the 30mg I have to lie in bed 12 hrs to get 6 or 7 hours of sleep. After taking gabepentine my pain actually worsened, I gain 20 pounds and my dosage had to be doubled almost monthly with little relief. The only relief I got from gabepentine is that it made me drowsy enough that I would sleep through some of the pain. I have also tried another med for rls that was some dopamine something or other and I found I was losing memories and had foggy brain. Alzheimers runs in my family and this was very frightening to me. I also gained 10 pounds while on this drug. Hydrocodine is indicated for severe rls but I cannot get an increase on my meds because Dr is scared. I am 63 and do merchandising. I need proper sleep, I need less hours of pain in my day. If my hydrocodone loses some effectiveness and must be increased every 4 yrs by 10 MG my Dr should be able to feel comfortable doing that. If she increased my meds by 10mg every 4 years I would be 90 before I reached the 9mg point that cdc caps them at but she is afraid. In the meantime my quality of life and the pain I suffer increases yr by year. Why? I have no psychological dependence on opiods. I just want quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hedide	None	None	0900006484fc4a88	Fossum	None	2022-03-11T21:58:18Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Fossum, Hedide	l0m-yh4y-376l	False	None	False	2022-04-12 04:18:14.783	[]
2368	CDC-2022-0024-2375	https://api.regulations.gov/v4/comments/CDC-2022-0024-2375	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids<br/>Document ID: CDC-2022-0024-0001<br/><br/>Comment:<br/>TO: CDC REGULATIONS 2016 REVISION HELLO, MY NAME IS [name redacted] AND I AM WRITING TO YOU TODAY TO EXPRESS MY CONCERNS AND FEELINGS ABOUT THE OPIATE GUIDELINES PASSED IN 2016. I AM A CCP (CHRONIC PAIN PATIENT) AND HAVE MULTIPLE INJURIES WHICH KEEP ME FROM HAVING A LIFE THAT IS FUNCTIONAL. I HAVE CHRONIC PAIN EVERYDAY AN AM FIGHTING SEVERE NERVE DAMAGE THROUGHOUT MY BODY. I WAS DIAGNOSED WITH SFN (SMALL FIBER NEUROPATHY) 4 YEARS AGO AS WELL AS OSTEOARTHRITIS THROUGHOUT MY BODY. I ALSO HAVE HERNIATED DISKS AND A NERVE STIMULATOR SURGICALLY IMPLANTED IN MY LOWER BACK WHICH ONLY HELPS 30% OF MY PAIN IN MY LOWER BACK. I AM CURRENTLY ON 10MG OXYCONTIN 1 EVERY 5 HRS. THIS IS BARELY HELPING FOR ALL THE EXTREME PAIN I GO THROUGH EVERYDAY. I AM SO UNDERDOSED WITH THIS MEDICATION. IT IS SO UNFAIR TO LET ALL OF US CPP (CHRONIC PAIN PATIENTS) SUFFER BECAUSE OF OTHERS THAT ARE ABUSING THE OPIATES. I DON'T UNDERSTAND HOW YOU CAN PUNISH THE INNOCENT PAIN PATIENTS BECAUSE OF THE PEOPLE WHO ABUSE THE OPIATES. IT'S NOT HUMANE TO DO THIS TO US. WE ARE DYING AND DON'T WANT TO GO ON SUFFERING ANYMORE. PLEASE REVISE THE GUIDELINES OF 2016 TO SAVE THE REAL PAIN PATIENTS THAT ARE REALLY NEED, TO BE ABLE TO FUNCTION FOR THE FEWS YEARS WE HAVE LEFT. THANK YOU, SINCERELY, [name redacted] [contact information redacted]<br/><br/>Uploaded File(s):<br/>No files uploaded<br/><br/>For further information about the Regulations.gov commenting process, please visit https://www.regulations.gov/faq.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484fc4a80	Flanders-Clendenin	None	2022-03-11T22:00:38Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Flanders-Clendenin, Janet	l0m-yf57-0ihb	False	None	False	2022-04-12 04:18:15.004	[]
2369	CDC-2022-0024-2376	https://api.regulations.gov/v4/comments/CDC-2022-0024-2376	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a result of the initial guidelines:<br/>I have to go in for a visit 4x a year. That’s over 200$ deductible for each visit. My deductible is 3k a year so it’s all oop.<br/>I am drug tested. Non participation lab with my health plan so that’s 600$ Oop 2x a year. <br/>I am stuck going to a clinic with rotating physicians who I have to educate re my medical history. Each new physician want to run all the tests the prior ones did. More money. <br/>I can’t transfer to any other physician in my area. They won’t see me. The rejection letters aren't specific but I have lived in this tiny community 30 years. Word gets around. Docs aren’t taking new patients if they require pain management. <br/>I am in a leadership position with the same health plan that I pay for my medical insurance. I work amongst people who see my claims including the drug testing. I know what goes on, I’ve worked at this health plan over 25 years. It’s humiliating. <br/>I’m am constantly being assessed by friends, family, health professionals and/or front office staff. The news coverage and constant messaging about opiate abuse does not point out the data collected about drug abuse and overdoses include include recreational drug users, heroin addicts, methadone and other illegal combinations. <br/>I had four crowns, 2 root canals, 2 extractions and infected gums last summer in a very short timeframe. I was told I could have aspirin. It was beyond what 1000 mg of aspirin was going to treat. <br/>I developed pre ulcerative conditions (also a pre existing condition) because I was taking aspirin and/or ibuprofen for more than a day or two at a time. I felt I had to take the risk. That ER visit was 6k. I still 600$ to pay. <br/>I’ve been going to the same pharmacy for nearly 30 years but some invariably hands the the opioid abuse pamphlet or gossips with me about folks who are popping their meds unnecessarily. [how would a CLERK know that)<br/>I’m no longer allowed to enjoy an Occasional alcoholic drink. I mean one drink with dinner less than 2x a month. I’m 56. I can read the bottle. <br/>I’ve been told by three physicians that they are being audited so that is why they are afraid.<br/>I hate complaining about how I feel. I resent having to struggle to walk as people stare at me. It is disheartening to me that I am being viewed a whiner, or someone that has an obvious condition. My loved ones do not want to hear how bad I feel. It’s depressing to me that I am not an actual person anymore. Now I’m just a set of symptoms and complaints .<br/>I do yoga, I meditate, I am preset, I have whit noise machines, I drink loads of water and all my vitamins, I stretch, I walk, I try to eat healthy. I do my part to manage pain yet I still feel victimized and judged over and over. This occurs almost daily and has gone on the past four years. <br/>I am angry and resentful at how I’m being treated. <br/><br/>Thank you for listening. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverly	None	None	0900006484fc4a55	Lynchcasey	None	2022-03-11T22:03:29Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Lynchcasey, Beverly	l0m-y0w7-745c	False	None	False	2022-04-12 04:18:15.220	[]
2370	CDC-2022-0024-2377	https://api.regulations.gov/v4/comments/CDC-2022-0024-2377	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	On August 4'th 2016 [name redacted] [city redacted] IL removed my left leg above the knee after having MRSA eat up 6 inches of bone & 3 holes eaten from inside to outside the size of quarters or larger in leg. it was a horrible 3 yrs that led to the most horrible days of my life.Had i had a gun i wouldn't be here to write this. They only gave me dyladid for 2-3 days & then told me i would no longer be receiving anything other than the meds i had been on for a few yrs with the MRSA.I not only didn't receive any extra for the NEW pain of having my leg chopped off above knee, but i didn't get my pain meds every four hours!! It was for longer periods of time. I couldn't stop screaming so they moved me to an empty bed at end of hallway. They took away my walker & ignored my pressing the button. i managed to use the portable walker to go down hallway to nurses station crying for help & they told me i was acting like a pathetic junkie & were of no help.<br/>they then tried to get me to sign myself into their nursing home. They wouldn't even give me my glasses to see!!No other drs could help me as he did the surgery. i still suffer mental trauma from this & the day he signed off as my dr i told him there was a special place in hell for him. <br/>the stress was so bad wen i got into the car to go home i fell over & my father drove me up to the ER where they treated me for a heart episode. I now have to take things easy because i was fortunate enough that it didn't scare my heart. i now get chest pains when stressed. i have a whole nother story about that & i plan to share that story as well. theres almost 3 months of my life i barely remember. i remember screaming myself to sleep & waking up to someone screaming bloody murder only to discover it was me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	tonya	None	None	0900006484fc46ee	ryan	None	2022-03-11T22:03:49Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from ryan, tonya	l0m-v53q-sk2h	False	None	False	2022-04-12 04:18:15.458	[]
2371	CDC-2022-0024-2378	https://api.regulations.gov/v4/comments/CDC-2022-0024-2378	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE REMOVE ANY and ALL MENTION Oof MME from the CDC Guidelines.<br/><br/> https://t.co/owqFKYuinA<br/><br/>https://www.acsh.org/news/2018/10/23/opioid-policies-based-morphine-milligram-equivalents-are-automatically-flawed-13529<br/><br/>MME is being used as Law and has hurt millions of patients. Forced tapers have pushed patients to suicide. The 2016 guidelines were put into state Law so the DEA could use it as a reason to arrest doctors. This in turn left patients abandoned. <br/><br/>https://www.acsh.org/news/2021/07/19/2020-drug-deaths-spiked-30-and-pain-pills-had-nothing-do-it-15669<br/><br/>These unscientific 2016 based 2022 guidelines are no different than before. They will be used again as new laws to hurt patients and arrest doctors who treat patients in pain.<br/><br/>https://www.acsh.org/news/2017/06/22/dear-cdc-why-are-you-torturing-pain-patients-11469<br/>https://www.inquirer.com/opinion/commentary/opioid-use-pain-patients-coronavirus-regulations-20201216.html<br/>https://www.painmedicinenews.com/Commentary/Article/04-21/Undertreat-Postop-Pain-Surgery/63125<br/>https://www.inquirer.com/opinion/commentary/opioid-prescriptions-overdose-doctors-20210816.html<br/>https://www.pilotonline.com/opinion/columns/vp-ed-column-singer-bloom-1003-20211002-l5dxjc4d3rfyhomfklwv6wxh3e-story.html<br/> <br/>Also, if a patient is on seizure, anti-anxiety or anti-depression medications with opioid medications they shouldn't be Forced to choose between mental stability or their Chronic Cancer/Non-Cancer Pain.<br/><br/>Please Stop ANY and ALL PROP members from writing policies dealing with medicine they have NO Clue about and especially since NONE OF THEM HAVE EVER TREATED A CHRONIC PAIN PATIENT.<br/>https://www.acsh.org/news/2021/07/01/props-self-serving-letter-ama-must-be-addressed-my-comments-15641<br/><br/>I hope I'm very informative for CDC with my comment please take your time to read the attached information. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fc60af	Allder	None	2022-03-13T13:22:08Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Allder, Melinda	l0p-8kl9-6qwi	False	None	False	2022-04-12 04:18:15.671	[]
2372	CDC-2022-0024-2379	https://api.regulations.gov/v4/comments/CDC-2022-0024-2379	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm not understanding why my comment was took down but I'm reposted again ..I'm 43 year old female who is on palliative care.my meds have been cut way down where I'm bed bound ..my Dr knows I'm exempt from the guidelines but she won't up my dose .I don't have much time left here on this earth .it's not fare that I have to suffer like this .please take away all mme s out of the guidelines ..the 90and the 50mme . matter of fact please throw out the whole guidelines period..this should be between a Dr and a patient ..now since these guidelines went into play.pharmacys don't want to fill..my pharmacy closed I was there 20years getting the same meds for 20years .I went to go to a new pharmacy and 35 pharmacy s denied me .all the ones in [redacted] county where I lived turned me away because my prescription comes from Maryland. I'm not far from MD ..I'm on palliative care .but they don't care.because of these guidelines .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fc5801	Guthrie	None	2022-03-13T13:23:46Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Guthrie, Melissa	l0p-6g5p-pb84	False	None	False	2022-04-12 04:18:15.891	[]
2373	CDC-2022-0024-2380	https://api.regulations.gov/v4/comments/CDC-2022-0024-2380	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been without pain medication since the end of June 2021 and my quality of life has steadily gone downhill. I only leave my house for a dr. visit and I suffer afterwards even worse for 2 or 3 days. I have not been able to attend any family get togethers or go out to lunch or shopping.<br/>My primary care dr. who was monitoring and prescribing my pain meds decided to retire because of all this opioid bs. No other dr. will prescribe them, not because they don't think I need them, but because of being scared to even write them for legitimate pain patients. This is so unfair that I have to live with pain 24/7 when it could be eased somewhat with a prescription opiod. I many times wish I would just die so it would be over.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fc57c1	Stewart	None	2022-03-13T13:24:08Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Stewart, Linda	l0o-vb0i-kcmj	False	None	False	2022-04-12 04:18:16.143	[]
2374	CDC-2022-0024-2381	https://api.regulations.gov/v4/comments/CDC-2022-0024-2381	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have never been more frustrated and dissatisfied with the pain management industry. I knew you were over doing medication on patients and intentionally kept mine lower and dealt with it even with CRPS, fibromyalgia, damage to my lower back from injury, and bilateral knee pain only to be prescribed Buphrenorphine with the suggestion it could help delay long term renal damage. This drug is dangerous. It might have saved some peoples lives, but the pain and agony it caused will never be forgotten. Not enough doctors are licensed for it and have blurred the lines between pain management and addiction. The intentional lack of supply at pharmacies only compounded things resulting in multiple Emergency visits, chest pain, respiratory depression, etc. I had to fight to lower the dosage. I had to fight to remove myself from this medication because Doctors are so pumped full of nonsense at this point in the pain management industry and fear that is the only thing they would prescribe. I felt like I was going to literally die and lost a marriage in the process. You knew what you were doing when you wrote those guidelines and now you go to the other extreme. I have no idea how you are able to sleep at night knowing the damage you have done to citizens of this country.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dana	None	None	0900006484fc57b4	Lloyd	None	2022-03-13T13:31:12Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Lloyd, Dana	l0o-ts69-dtka	False	None	False	2022-04-12 04:18:16.359	[]
2375	CDC-2022-0024-2382	https://api.regulations.gov/v4/comments/CDC-2022-0024-2382	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please ...help us all. Not just me .some day you will be in pain and how would you like to live like that 24/7 one size dont fit all i had 3 back SURGERYS and still in pain God help us all and let the doctor do his job....not the CDC or prop.etc ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5fee	Anonymous	None	2022-03-13T13:31:27Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-s4uh-bg3l	False	None	False	2022-04-12 04:18:16.612	[]
2376	CDC-2022-0024-2383	https://api.regulations.gov/v4/comments/CDC-2022-0024-2383	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While we should acknowledge the suffering of patients hurt by overly aggressive opioids, the reality is today's healthcare system only really treats acute injury well. With chronic care we're a dismal failure.<br/><br/>Limiting the options for patients with intractable pain, whether on the path to recovery or stuck with it for an indefinite amount of time, is ridiculous. As a patient who's not only spent a fortune of my own and my health insurance company's money desperately trying to find the cause of my pain and to find relief, I can assure you without diazepam and pregabalin I would not have gotten particularly far. Whether because of functional inability to do anything besides lying in bed, or because suicide would've been the best option.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nikolay	None	None	0900006484fc578c	Valtchanov	None	2022-03-13T13:31:54Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Valtchanov, Nikolay	l0o-p4zi-yu5k	False	None	False	2022-04-12 04:18:16.836	[]
2377	CDC-2022-0024-2384	https://api.regulations.gov/v4/comments/CDC-2022-0024-2384	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Buprenorphine can be used successfully. The need to state that someone has an opiate addiction on a prior authorization to precribe it for pain needs to end. Buprenorphine patches/ Belbua films should not require a prior auth with trial of higher opiate analgesic medications such as morphine or Fentanyl. The amount of prior authorizations that now are needed are obnoxious. One for dose, one for an override for dose of if on a benzo, and to deal with barely literate people from the PBM is annoying. The excessive shortages of some opiates and wholesalers not allowing private pharmacies medications is out of control. A pharmacy should be able to do a partial fill without requiring another script. Pharmacies need to he held responsible for missing/losing electronic scripts.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	P	None	None	0900006484fc5779	S	None	2022-03-13T13:32:18Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from S, P	l0o-o8wb-j2mg	False	None	False	2022-04-12 04:18:17.047	[]
2378	CDC-2022-0024-2385	https://api.regulations.gov/v4/comments/CDC-2022-0024-2385	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 76 years old and have a genetic connective tissue disease called Ehlers-Danlos. I have pain in all my joints and my digestive tract, but mostly in my back because of severe scoliosis. Over the years I have tried various pain medications, acupuncture, at least 10 different physical therapists, chiropractors, injections, radio frequency ablation and medical marijuana. None of these have helped my pain in any way. The only way I get up in the morning and live a halfway normal life is with Oxycodone. I have to practically beg for prescriptions, put up with drug tests and in general fight for the right to get relief. I have never tried to get more pills even when going through a particularly tough stretch with the pain.<br/><br/>I've read all of the information about addiction and the lack of evidence that prescription opioids are causing the rise in overdoses in America. I want the CDC to recognize the harm they have inflicted on chronic pain patients and work to clean up the mess they made with their unproven opinions in 2016. I even read an article by CDC researchers that criticized the conclusions that were made in the past. I want to be able to fill my doctor's prescription without the hassles I face from the pharmacies!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484fc5762	Schutte	None	2022-03-13T13:32:56Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Schutte, Nancy	l0o-m8da-hrtb	False	None	False	2022-04-12 04:18:17.264	[]
2379	CDC-2022-0024-2386	https://api.regulations.gov/v4/comments/CDC-2022-0024-2386	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with two club feet and what turned out to be bilateral slipped capital femoral epithesis, pistol grip hips as commonly called...at 20 I started drinking vodka to cope...I worked until 1994 as much as I could by 21 I was downing about 5 shots of vodka to allow me to sleep 4 hours...I have suffered in deep pain for most of my life...I was born in 61 and never touch anything like heroin ( legal or not) I stopped drinking in 2001 completely and have never gone back or even wanted to( I quit by myself no help )for 9 years I took nothing but NSAIDs, but would break down every week from exhaustion ...in 2010 I finally after being yelled at by this orthopedist who did them, for suffering that long hip replacement wasn't available to me in the 80s or 90s they were not good and it would have been to many revision surgery... In 10 I started narco 10s 5 times a day. ...after about a year of that...i reduced to 5s and have been on them since..since the last decision I wanted to re up to ten...but the doctor wouldn't do it...fear of being jailed...i have never asked begged or otherwise demand he risk it....since...i had a afib attack on my hospital stay for neck fusion surgery...after I wasn't throbbing in mass pain anymore the afib stopped just like that from the high dose of opiates I received for the operation( [redacted] Nevada if you want proof...your last decision is basically cutting my life way short in my opinion and that of most of the doctors who watched it happen...others don't even know this can happen like I didn't ...not myself but I believe this last rule was poorly researched and the doctors and members of the cdc who allowed it should be open to legal harm suits (just my opinion)...please stop this nonsense...put medicine where it belongs...in my physicians hands like it should be...children you have every right to protect but adults consider most of the harm against the value of living extra year's... I sincerely thank you for your time...i hope nobody you know has to suffer in this much pain continue to have a blessed life and once again thank you...[redacted] Nv	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donald	None	None	0900006484fc5719	Weiss	None	2022-03-13T13:36:03Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Weiss , Donald	l0o-l62k-1bnq	False	None	False	2022-04-12 04:18:17.505	[]
2380	CDC-2022-0024-2387	https://api.regulations.gov/v4/comments/CDC-2022-0024-2387	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife has been under pain management for over 30 years now. In her twenties she was involved in a car accident where a car landed on top of her and it's catalytic converter burnt her down to spine. we have been through the whole process of treatments spinal fusion, physical therapy, lidocaine, various spinal injections,TIMMS units, several non opioid drugs that made no improvements.<br/><br/> My wife [redacted] has been in severe pain for a very long time and seen many Doctors. I expect barring a miracle she will be in pain the rest of her life. she used to take four to six ten milligram methadone pills a day for years and she functioned pretty well. Not too long ago the recommendation about opioids became 90 MME which allowed her only 3 pills a day which now leaves her on the couch or bed most of the time. To reduce her further would leave her no functionality, a dose of 50 MME is way to low. There are people that really need these drugs to live, [redacted] is one of them . This constant war on opioids has been distorted by politics into a nightmare for some people and the Doctors that treat them. my wife has never overdosed, has never exhibited any addictive behavior, and never been in trouble with the authorities. People that have been on long term pain management should not be lumped in with Street addicts or patients that have been over prescribed or prescribed incorrectly. They should not be treated like they are bad people shunned because they use opioids this is the 21st century using MME comparisons is hurting a lot of patients from getting the medications they need. For many years we had more then enough problems just dealing with Doctors and her treatments but these last few years we at times have been treated like pariahs and we are mistrusted because we have a prescription for an opioid. It is a mistake to anthropomorphize opioids as bad or evil. Cars , planes, boats, can all be dangerous if misused . There are thousands of long term pain management people that need these drugs for quality of life and not misusing them please let us not forget them, these people take the opioids not because they want too but because they need too . thank you for your time please help I believe the phrase I am looking for... is do no harm....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rory	None	None	0900006484fc5714	Rios	None	2022-03-13T13:37:32Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Rios, Rory	l0o-kxbr-bvl6	False	None	False	2022-04-12 04:18:17.752	[]
2381	CDC-2022-0024-2388	https://api.regulations.gov/v4/comments/CDC-2022-0024-2388	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from other types of chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in other parts of the body as well. The symptoms are sometimes painful and make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I am 79 years old and have suffered from RLS and insomnia for much of my life. By 2016 my symptoms had become severe and painful. I was getting little sleep – some nights none. Last year I was finally able to find a doctor with RLS treatment experience. After trying a few other treatments with little success, he prescribed a low dose synthetic opioid, buprenorphine. I have been on this medication for three months and the results have been nothing short of miraculous. No apparent side effects, no RLS symptoms, and I now usually sleep more than seven hours each night. I expect I will need to take this medication for the rest of my life and need for it to remain available to me.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically based information about RLS, as it is for members like me.<br/>[redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484fc56d1	Ferguson	None	2022-03-13T13:38:51Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Ferguson, Gary	l0o-jtvp-x65l	False	None	False	2022-04-12 04:18:17.982	[]
2382	CDC-2022-0024-2389	https://api.regulations.gov/v4/comments/CDC-2022-0024-2389	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC I'm commenting in regards to the new guidelines, I've suffered from the 2016 guidelines,I've been in pain management for over 18 years,I have many painful chronic illnesses,one being bone on bone in my lower back L-4&5,chronic pain syndrome also known as the "suicide" disease,I fight in pain daily,and in all honesty the Mme isn't working for everyone, one size fits all doesn't work for everyone as each of us have pain that responds to different dosages.Also the tapering of patients is hard on the body,in my case I suffered severe pain,chest pains,and a poor quality of life,we need to have our pain specialists able to treat and not be afraid after all they've gone to school to be the specialists and today my Dr. Doesn't feel he's doing enough, but is afraid of insurance company's and these new guidelines. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484fc56cc	Pryor	None	2022-03-13T13:39:10Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Pryor, Pamela	l0o-jh6s-9ie9	False	None	False	2022-04-12 04:18:18.197	[]
2383	CDC-2022-0024-2390	https://api.regulations.gov/v4/comments/CDC-2022-0024-2390	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 72 year old retired psychologist and have been prescribed opioid short and long acting medication for the past 5 years. I also take neurotin. In the past few months I have had 10 bolts put in my neck and a plate in my lower back. I have fibromyalgia, neuropathy, arthritis and Cervical spondylosis. I do not abuse my medication. I take it as prescribed. My doctor and I have tried many things over the years. Acupuncture, acupressure, water therapy, physical therapy, occupational therapy and bio feedback. We have tried numerous other pain medications. He does not prescribe this for others patients, but has been my doctor for over 25 years and knows my pain is real. Nothing has given me relief like the opiod pain medication. I have tried mot using it and the pain is so devastatingly intense I start having suicidal thoughts, because I am like a vegetable on the couch. I know I can't live in this pain without relief. This is the only medication that allows me to live a relatively normal life. Please consider the legitimate pain sufferers. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bunny	None	None	0900006484fc56a2	Campbell	None	2022-03-13T13:39:36Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Bunny	l0o-hug6-n1rw	False	None	False	2022-04-12 04:18:18.446	[]
2384	CDC-2022-0024-2391	https://api.regulations.gov/v4/comments/CDC-2022-0024-2391	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The recent years of having my 3rd spinal fusion due to spina bifida, scoliosis, pars defect, spondylolisis, spondylolthesis, DDD and getting care has been an absolute nightmare. Due to needing disability me and my daughter were forced to move states cause we would be homeless. So can’t get housing help can’t get my meds and can’t get docs. What is happening here? I’ve safely used opioids for 22 years and suddenly the whole system fails me come 2019. Every month is drama! Every single month. I had a lawyer review my Med records to show proof I have never been rated “at risk” I’ve never been in trouble with the law, not even a speeding ticket: but yet I’m currently being treated like an awful person who doesn’t deserve care. What happened to AMERICA? I was only 12 when I had my first spinal fusion and I have been absolutely miserable trying to get current care at 40. The fact I have had to share my story to millions of people on social media is absolutely ridiculous! The 2016 guidelines including these MME guidelines have absolutely destroyed the chronic pain/disabled community. 2020 I won my disability case FINALLY after trying since 2005. To just get treated like I’m absolute trash. What is happening here? Being forced into withdrawals while I just had another 6 screws and rods added into my spine! Are you serious? This whole situation has made me feel you all want people like me to die and the message has been very clear. Why are you all allowing this to happen? Please fix this! NOW	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brandy	None	None	0900006484fc5694	Novicka	None	2022-03-13T13:41:13Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Novicka, Brandy	l0o-gpu1-8wmc	False	None	False	2022-04-12 04:18:18.702	[]
2385	CDC-2022-0024-2392	https://api.regulations.gov/v4/comments/CDC-2022-0024-2392	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 85 year old woman with COPD and suffer with sciatica and severe lower back pain. I have tried physical therapy and chiropractic therapy and over the counter pain pills all to no avail. The only relief I get so I can get a few hours sleep at night is from Vicodin. If this medication were to become unavailable to me I would consider suicide.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carole	None	None	0900006484fc539c	Nobel	None	2022-03-13T13:43:14Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Nobel, Carole	l0o-gupl-2hto	False	None	False	2022-04-12 04:18:18.922	[]
2386	CDC-2022-0024-2393	https://api.regulations.gov/v4/comments/CDC-2022-0024-2393	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Without my doctor being able to prescribe Vicodin I would need surgery that could compromise my life because of my age and underlying health conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carole	None	None	0900006484fc5398	Nobel	None	2022-03-13T13:43:24Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Nobel, Carole	l0o-gera-9it3	False	None	False	2022-04-12 04:18:19.136	[]
2387	CDC-2022-0024-2394	https://api.regulations.gov/v4/comments/CDC-2022-0024-2394	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Seniors like myself are suffering from Chronic Pain without an effective pain medication. Prescribing a low dose Opiod would improve my quality of life. I am 71 years old and have Chronic Pain since I was in my late 50s. Osteoarthritis is the worst and the doctors tell me I am old and there is nothing they can do. Before eliminating all Opiods due to laws, a low dose Opiod worked perfectly. Please help us seniors with pain; it is not fair that controlling all Opiods by law ruined life for all of us seniors and any hope of relief .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nan	None	None	0900006484fc5384	Mehan	None	2022-03-13T13:43:41Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Mehan, Nan	l0o-g5gc-ndvp	False	None	False	2022-04-12 04:18:19.353	[]
2388	CDC-2022-0024-2395	https://api.regulations.gov/v4/comments/CDC-2022-0024-2395	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's obvious that there is a bias towards prescription related vs addiction related deaths. This guideline leans very heavily on the assumption that there is a prescription opioid crisis, which there is not. The fact is that only about 5% of opioid deaths are from those with a valid script. Lumping street drugs like heroin and meth into the opioid equation and calling it a prescription problem is the equivalent of a bold face lie to the public. Your actions are sus.<br/><br/>Your exclusion of any pain support groups is telling. And your inclusion of "experts" in the field of prescription opioid abuse is a complete joke since there is not, I repeat NOT an epidemic of prescription abuse. This also falls into your narrative of complete bias against those in the smallest minority of responsible opioid patients. Here you have 95% of deaths to addicts (whom I might add are most likely self-medicating because available health care is lacking, and need help) but are vilifying the small 5% and we are being treated like criminals. <br/><br/>I have been in constant pain for 12 years. I have been taking opioids to help with pain the entire time. I do not get high. I feel relief. I would be more inclined to accept the findings of these new regulations if the board, medical professionals, data collectors, ect., were filled with a true representation of those who are experiencing: acute, chronic and cancerous pain, addiction, loss of loved one. In other words, real people with a voice that can speak the reality of directly living with a chronic pain condition. Currently the members creating these guidelines appear to be the most likely to gain financially. Why should the BSC be involved? "CDC’s Injury Center BSC works with other institutions to study the causes and strategies related to the prevention of violence and injuries" This has NOTHING to do with opioid related pain management.<br/><br/>I could go on about the biased direction this regulation is headed. Without representation within the pain sufferers community, this will be a failed regulation. In the end, those who are affected most by pain and depend on it for an acceptable quality of life, will be the most to suffer by it. Those who are most responsible will be the most to be treated like a criminal.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tim	None	None	0900006484fc5353	Nelson	None	2022-03-13T13:44:20Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Nelson, Tim	l0o-eig8-67n9	False	None	False	2022-04-12 04:18:19.566	[]
2389	CDC-2022-0024-2396	https://api.regulations.gov/v4/comments/CDC-2022-0024-2396	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to be heard. Current policy damages the physician/patient relationship and harms patients with chronic pain. Worse, it pushes patients into exploring illegal drugs as they feel they have no choice. Not everyone who asks for pain medications is seeking drug thrills.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5345	Anonymous	None	2022-03-13T13:44:30Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-e7tr-wnj1	False	None	False	2022-04-12 04:18:19.786	[]
2390	CDC-2022-0024-2397	https://api.regulations.gov/v4/comments/CDC-2022-0024-2397	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to start off by saying the guidelines for pain patients are hurting us and we can’t get pain medication that we so desperately need and this has gotten out of hand. I am suffering everyday since these guidelines have come out in 2016. My quality of life has changed for the worse. We need the MME removed from these guidelines and we need the CDC to be removed from doctors offices. I am in constant pain with no relief. And I am suffering every day and I don’t believe this will ever end. The opiate epidemic is from herion and Fentanyl not prescription medication.we need you to go after the cartel not pain patients.I don’t understand how the government says we care about everyone but yet can watch a pain patients suffer and blame it on the prescription medication when it is bad drugs and cartel to blame.how can a person have cancer or a major surgeries and be prescribed nothing but Tylenol or ibuprofen to take or gabapenten and illegal injections. This is genacide and no one seems to care about us. Please remove the morphine milligrams equivalent from the updated guidelines and let doctors do there job to protect us patients. We already suffer from our conditions and now you want us to suffer with pain mentally,emotionally and physically this isn’t fair we should have to suffer like this. Why does these people get to profit from our pain. This world has become so cruel to people and yet the CDC thinks this is ok. PLEASE STOP THE CRUELTY AND START CARING FOR PAIN PATIENTS AND THERE DOCTORS. Remove the morphine milligrams equivalent from the guidelines. Stop putting doctors in jail for caring for their patients. I am suffering and I am dying and yet no one seems to care. I hope these guidelines change if you won’t change these guidelines then maybe you will give us chronic pain patients cards that exclude us from these guidelines and that way these guidelines won’t apply to use and doctors will be able to give us life again.I AM SUFFERING SO BAD AND HAVE THOUGHT OF ENDING IT ALL BECAUSE I AM SUFFERING…PLEASE HELP US PAIN PATIENTS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5329	Anonymous	None	2022-03-13T13:46:13Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-d4e9-euxn	False	None	False	2022-04-12 04:18:19.997	[]
2391	CDC-2022-0024-2398	https://api.regulations.gov/v4/comments/CDC-2022-0024-2398	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I applaud the revision of the CDC Clinical Practice Opioid Prescribing Guideline, however, this draft needs to include chronic conditions, like RLS which I am suffering from, which is different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and sometimes arms as well. This makes it impossible to sleep, watch a movie or simply sit quietly alone or with family and friends. Given the nature of this disease, it impacts all aspects of ones life.<br/>Nearly 22 million adults and children suffer from RLS in the United Stayes. With no cure,, symptom management is crucial.for quality of life. A few prescription medications may improve symptoms but overtime stop their effectiveness and often times make symptoms worse. Ample scientific research supports the use of low total daily dose opioids to treat moderate to severe RLS.<br/>As a 57 year old married and full time working mother, I have struggled to manage my adult onset RLS for over three years. RLS has taken over my life and daily thoughts. After being prescribed Tramadol for an acute pain condition, I realized that my sleeping had greatly improved as my RLS symptoms had seemingly vanished. I was able to sleep soundly with my husband again! Not knowing about the research to support the use of Tramadol to control symptoms, I was baffled by the apparent reluctance of my doctor to consider my anecdotal and objective data regarding my personal experience. The effects of the alternative medications she prescribed were short lived, and within 6 weeks the unbearable symptoms returned. Doctors should not be afraid to prescribe medications with proven efficacy out of fear of retribution. Patients deserve to be treated as individuals and with compassion and respect. Medicine is not a one size fits all approach. I loathe the dark and long nighttime with anxiety and dread. As you can imagine it is extremely difficult to be productive, effective and nurturing in my daily roles with such little sleep. <br/>The first physician to diagnosed RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the successful same low dose opioid maintenance therapy for decades. I strongly urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a treatment option in low total daily doses routinely monitored as is best medical practice. In considering these vital issues, please consult the RLS Foundation- at www.RLS.org as an outstanding resource for scientifically based information specific to RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484fc5306	Stew	None	2022-03-13T13:47:57Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Stew, S	l0o-b4i5-lwa0	False	None	False	2022-04-12 04:18:20.406	[]
2392	CDC-2022-0024-2399	https://api.regulations.gov/v4/comments/CDC-2022-0024-2399	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC Docket No. CDC-2022-0024 <br/>As an untreated patient with severe pain I need to comment on your update on opiod guidelines. I was on opiods for 5 years combined with benzodiazapenes with no complications. I took myself off for I was aware that the government was taking away my rights (2016) to be a productive member of my family and community. My pain is so severe now I spend the majority of my time in bed. <br/>I have been to all the pain clinics in [redacted] and have been denied due to your wording on benzodiazapenes taken with opiods. I have empathy for those who have loved ones who have died from overdose,however, there seems little empathy or understanding for those us who are not addicts trying to live with severe chronic pain. Death is not always the worse case scenario for those of us with chronic pain who try to hang on for the ever elusive day we can get out of bed with the help of opiods. Furthermore, the CDC is fueling the overdose rates by denying people pain meds and they turn to the streets and get fentanyl and die.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484fc55f6	Poland	None	2022-03-13T13:48:41Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Poland, Kathy	l0o-9ur6-sgel	False	None	False	2022-04-12 04:18:20.658	[]
2393	CDC-2022-0024-2400	https://api.regulations.gov/v4/comments/CDC-2022-0024-2400	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an Orthopaedic surgeon who has used the MLS M8 dual wavelength cold laser for one and a half years. Although skeptical at first about its efficacy, I have come to believe that this laser has a role in the armamentarium of non narcotic pain modalities. I can not speak to the efficacy of other lasers on the market, but the MLS (multi wave locked system) M8 laser has had a lasting benefit on the majority (about 70%) of my patients.<br/><br/>I have seen success in patients with chronic conditions (such as hamstring tendinosis, Supraspinatus tendinosis, and adhesive capsulitis) that have not improved with months of rest, physical therapy or cortisone injections. I know the modality to be helpful in alleviating pain, safely and noninvasively, with other inflammatory conditions. <br/><br/>Not only does the M8 laser work at the cellular level to decrease pain by limiting inflammatory cytokine production, it also has a vasodilatory effect which makes it useful to heal chronic wounds in vascularly compromised individuals.<br/><br/>On the other hand, it is not a panacea. Although it will temporarily help with pain from the following conditions, it will not cure arthritis or repair a torn tendon. <br/><br/>Overall, though, as a shoulder surgeon, I have found it beneficial in my patients both in the non operative setting of rotator cuff tendinosis and adhesive capsulitis as well as the early post operative period in alleviating the inflammation and pain that is common with shoulder surgery. I believe it has decreased the need for post operative narcotics in many or my patients.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mayo	None	None	0900006484fc52bd	Noerdlinger	None	2022-03-13T13:49:05Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Noerdlinger, Mayo	l0o-79bk-uv8h	False	None	False	2022-04-12 04:18:20.923	[]
2394	CDC-2022-0024-2401	https://api.regulations.gov/v4/comments/CDC-2022-0024-2401	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Stop hurting all of us who are in pain! Let my Dr’s prescribe Opioids! I am allergic to Nasads and can only take opioids for my pain! Do the right thing stop hurting us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicci	None	None	0900006484fc52aa	VicciSaesan	None	2022-03-13T13:49:15Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from VicciSaesan, Vicci	l0o-6i2r-5cv1	False	None	False	2022-04-12 04:18:21.133	[]
2395	CDC-2022-0024-2402	https://api.regulations.gov/v4/comments/CDC-2022-0024-2402	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffered a spinal injury in 2005. I've had countless surgeries and injections. My quality of life is minimal at best. Doctors are terrified to prescribe opioids to patients out of fear of the DEA. As a chronic pain sufferer opioids give me a life. They allow me to function. To see my daughters graduations for high school and college. I have never misused my prescriptions. I submit to regular urine and blood tests. One of my prescriptions no longer relieves my pain but due to current regulations my doctor can not prescribe a different medication to help me. My state has legal medical marijuana which I did try legally. I tried several different strains and got absolutely no relief. Chronic pain patients do not use opioids to get high or escape life we use opioids to have a life. I'm 49 and it is horrible to suffer. Every doctors appointment I fear will be the appointment that my doctors hands will be tied and I will no longer receive the prescriptions I need to have some sort of semblance of normalcy. I hope and pray that the government and DEA will stop putting such stringent restrictions on doctors who prescribe opioids to patients who are suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc529c	Anonymous	None	2022-03-13T13:49:38Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-63am-0uw6	False	None	False	2022-04-12 04:18:21.559	[]
2396	CDC-2022-0024-2403	https://api.regulations.gov/v4/comments/CDC-2022-0024-2403	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First recommendation;<br/>Use all possible means to communicate to the public & media the negative consequences caused by the 2016 guidelines (suicide, despair, desperation, shorten lifespan, reduced quailty of life, overdoses 3x higher & growing)<br/>Second: Inform citizens that the opioid epidemic is currently & always has been addiction of heroin & illicit opiates. <br/>That opiates when taken as prescribed will not cause death or guaranteed dependence, that improve healing & recovery outcomes. <br/>A coworker of mine lost his only son due to the campaign against prescription opiates.<br/>His son was nominated most valuable linemen, honor role student, at age 17 in 2019 his son tore ligaments in both legs playing football. <br/>His mother over fears of addiction withheld his prescription pain medicine or gave him only half a tablet at a time. <br/> His son was in termedous pain but mother believed he’d become addicted to the pain medicine he was prescribed.<br/>His son obtained pain medicine, what he thought to be pharmaceutical pain pills online, i believe social Media.<br/>His mother found him dead in his bed. The fear of potential addiction killed her only son, my coworkers only son. <br/>They shared custody and he was unaware his son being forced to tough out the pain. <br/>Regardless the opioid prescription hysteria caused the believe that forcing someone to live through pain is less risky then treating their pain with a small potential of addiction.<br/>That’s not always the case it seems	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5282	Anonymous	None	2022-03-13T13:50:13Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-5ak8-oj8l	False	None	False	2022-04-12 04:18:21.773	[]
2397	CDC-2022-0024-2404	https://api.regulations.gov/v4/comments/CDC-2022-0024-2404	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am thrilled to see these changes! I had a third of my right lung removed on Jan. 13, 2022, and the surgeon refused to prescribe any oxycontin despite the fact that I have never had any substance abuse issues. During surgery, I had a cryo nerve block, but I was still in a lot of pain for weeks! After six weeks of recovery, he told me that was one of the most painful surgeries you could have. TELL ME ABOUT IT!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J.	None	None	0900006484fc527f	Gelormine	None	2022-03-13T13:50:29Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Gelormine, J.	l0o-55np-g661	False	None	False	2022-04-12 04:18:21.988	[]
2398	CDC-2022-0024-2405	https://api.regulations.gov/v4/comments/CDC-2022-0024-2405	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to share my experience. When my doctor suddenly decided that opioids were no longer the best option for me, I was devastated. I had been on them for over 10 years. I had no negative issues with them. They made my life easier due to chronic pain. I followed the instructions. <br/>I have had 3 C-spine surgeries, right hip replacement, and I have arthritis throughout my body. <br/>The spine surgeries resulted in much arm and neck pain which continues. The way the FDA just forced doctors to stop prescribing was horrible! I am only one of many this happened to. It is still an issue to this day. <br/>I was treated like a drug addict from multiple doctors. There should be a better way to separate addicts and chronic pain patients. <br/>Of course after years of use I was physically dependent on the meds. But that did not make me an addict. Never once did I think that I should go buy heroin or any other pill. <br/>I believe a lot of people committed suicide after being cut off by their doctors. It seems to me the pendulum swung way too far.<br/>In my humble opinion, this was a disaster and a lot of innocent people suffered.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc55c2	Anonymous	None	2022-03-13T13:50:50Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-47j9-rh54	False	None	False	2022-04-12 04:18:22.214	[]
2399	CDC-2022-0024-2406	https://api.regulations.gov/v4/comments/CDC-2022-0024-2406	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a home health nurse of many years, I've seen that this policy, stripped down to the bare bones is just harmful. Patients that have just had massive surgeries are being sent home with 3-7 days worth of pain meds, and that's it. I would love for anyone to imagine being run over by a semi truck, which stripped all the skin, fat, and muscles from your leg, and required surgical fixation of the bones. Then imagine being given a week's worth of pain meds. That's all they were allowed. In case you are wondering, this was a real patient's story. That patient cried almost all the time, suffering needlessly, as they were not able to get any doctor to extend the prescription. They just kept pointing to those guidelines and saying "go to a pain clinic". They were homebound.... did I mention the semi? When going to a regular doctor's appointment was tortuous. I cannot tell you what they ended up doing to control their pain because I only have suspicions, but they stopped crying every day...<br/>So, yes, an overhaul really is needed. Increase education, increase home testing, increase support for those who really are addicted. But stop shooting these people in the foot and telling them "sorry". It's not working.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc55a9	Anonymous	None	2022-03-13T13:51:20Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-35h7-h9pm	False	None	False	2022-04-12 04:18:22.428	[]
2400	CDC-2022-0024-2407	https://api.regulations.gov/v4/comments/CDC-2022-0024-2407	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would hope that the guidelines make it clear that buprenorphine, as a partial agonist with a wide margin of safety, whether prescribed for chronic pain or for Medication Assisted Treatment, is in a category by itself. Many regulatory agencies, providers, and pharmacists lump it with full agonists such as oxycodone, etc, which can hinder access to MAT.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484fc559c	Strickland	None	2022-03-13T13:51:56Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Strickland, Daniel	l0o-28bj-rpmm	False	None	False	2022-04-12 04:18:22.644	[]
2401	CDC-2022-0024-2408	https://api.regulations.gov/v4/comments/CDC-2022-0024-2408	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a parent who's 26 year old daughter became addicted to opioids and overdosed after given a prescription for percocet after surgery.<br/><br/>I would like to see in the guidelines, that alternative approaches be used as the first line of treatment before narcotics are given. I would like the CDC to do an exhaustive research of what other options are out there and provide those options with in the guideline to help guide the practitioners in their treatment of pain. The Michigan OPEN (opioid prescribing engagement network). Has a lot of resources and research on the topic). I provided on such example from their website to which is a resource directed for dental pain.<br/><br/>https://michigan-open.org/wp-content/uploads/2021/04/Managing-Pain-After-Dental-Care-FINAL-03.2021.pdf<br/><br/>I would like to see a resource for each specialty and each surgical procedure.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484fc5575	Keane	None	2022-03-13T13:52:16Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Keane, Janet	l0o-1c0x-bsuf	False	None	False	2022-04-12 04:18:22.860	[]
2402	CDC-2022-0024-2409	https://api.regulations.gov/v4/comments/CDC-2022-0024-2409	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	03/12/2022<br/>Commenter’s request: CDC to campaign treating pain as needed and remove any guidelines putting limits on the amount of pain relief a patient will receive.<br/>Reason: In July 2019 I (33-year-old female, mother of two, full time employee) had an elective surgery (breast lift & implants).<br/><br/>I cannot recall the amount or type of pain medicine I received in 2019 but it was not effective taken as prescribed & i turned into a desperate person, one whom i hope to never become again. My surgeon’s office said they could not prescribe more or another medicine for my pain.<br/><br/>I am confident i spent those day in 2019 in the worst pain i have ever experienced due to the 2016 CDC guidelines. I can say with confidence that untreated pain negatively impacted my recovery.<br/><br/> I have only had pain medicine three other times in my life prior the birth of my sons in 2009 & 2011 & when I had impacted wisdom teeth removed around 2013.<br/> In 2009, 2011, 2013 the pain was treated & I focused on my healing & recovery.<br/>In 2019 I focused on how to stop the pain, I turned to google & soon after was drinking leaves called kratom, it stopped the pain & I am so grateful I found it, but I vomited every time, felt sick and healing from surgery was still not my focus.<br/><br/>i could not imagine the torture of those who's pain does not end, who spend their days searching for a way to stop the hurt.<br/>up until 2019 I would have agreed with the guidelines, but no I don't, i could not imagine untreated pain after birth, how do you care for your newborn?<br/>Also, I disagree with regulation of medicine as we know few in society become addicted to all types of things and most people use as a tool or entertainment.<br/>cell phones, social media, video games, gambling, medicine, alcohol.<br/>Plenty of things have an addictive potential but are used as tools when needed, as an opportunity to network for advancement or as entertainment in moderation. kids spend all day on video games, others neglect their health and loved ones to stare at screens & social media all day. <br/>You removed a valuable tool required to properly heal & function assuming it would have positive results? <br/><br/>Stop causing suffering, in fact campaign to end the suffering. I still can’t believe i drank leave powder, i can’t believe a surgeon i paid $13,500 was allowed to cut me open, implant foreign devices yet was not allowed to give effective pain medicine because it's too risky.<br/><br/> I am not mad at my surgeon but the CDC/DEA who prevented him from ending my suffering, and the campaign convincing my surgeon it is okay to leave me in pain. where is the logic? <br/><br/>The only explanation I can think of is our government turned into our terrorist, I hope that is wrong and like me until 2019 the CDC assumed pain would still be adequality treated under the 2016 guidelines.<br/><br/>Either remove the 2016 guidelines that cause suffering, or if not at least stop pretending your intentions are for the best interest of society. It is embarrassing you say you care.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5571	Anonymous	None	2022-03-13T13:57:08Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-1825-akhl	False	None	False	2022-04-12 04:18:23.074	[]
2403	CDC-2022-0024-2410	https://api.regulations.gov/v4/comments/CDC-2022-0024-2410	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who has had a very difficult time getting adequate pain management for over 5 years. I have cancer, celiac disease, and osteoarthritis. 2 surgeries. I was denied pain medication and given Tylenol after a total hysterectomy to remove cancer. I live with medical ptsd as a result of trauma from the medical community. I am gaslit and accused of seeking drugs when I am seeking pain relief. <br/> Please amend the guidelines- they are being misused and flat out abused nationwide in every area of healtcare. No one should have to have surgery without pain medication. I was used as profit and given way too many steroid injectionsin replacement of appropriate opiate therapy expediting my degenerative diseases. I'm worse off and have spent hundreds of thousands of dollars to be in pain all the time. This must change. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Holly	None	None	0900006484fc556f	Roblee	None	2022-03-13T13:57:28Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Roblee , Holly	l0o-16ph-6pcj	False	None	False	2022-04-12 04:18:23.288	[]
2404	CDC-2022-0024-2411	https://api.regulations.gov/v4/comments/CDC-2022-0024-2411	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is [redacted]. I have a degenerative spinal disease that causes severe pain from head to toe as the nerves throughout my spinal column are affected. I have tried all of the alternative therapies such as Cymbalta, Gabapentin, both caused severe side effects inhibiting my ability to take care of myself and 2 children. I had injections, years of physical therapy, sought out alternative medicine, even tried Suboxone to which I had a severe reaction to. I have been in a long-term contract with my PM and on a stable regimen in which I was thriving. Due to my stable regimen of Opiate therapy I was able to graduate from college with a BS with high honors, return to work after being on disability for 4 years, I was able to enjoy physical activities such as kayaking and biking, even join a gym until I was force tapered due to the CDC 2016 guidelines. Since then, I no longer enjoy physical activities due to pain, I am not able to go to the gym, and I am strongly considering going back on full disability, not to mention I have three grandchildren that I am not able to play with and enjoy because I am in too much pain. I have zero quality of life as a result of the morphine mg equivalent (MME) restriction listed in the CDC 2016 guidelines and the other strong language outlining how those who have no place in prescribing guidelines have detailed how inhumanely we as chronic pain patients should be treated. We deserve humane treatment, we deserve dignity. I am asking that the CDC remove all biased contributors to the guidelines and cease their inhumane guidance, be transparent about every step in the process, who is providing input, what their affiliations are and how they stand to benefit in any way. Finally, bring reason and CARE back to the new guidelines, patient care and decision back to the doctor-patient relationship not the government. Look at the real evidence regarding drug overdoses, publicly renounce the 2016 guidelines and bring hope, dignity and humanity back to the chronic pain patient community who have lost so many due to suicide as a result of your guidelines because no one would help them anymore. Make it right.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candice	None	None	0900006484fc5245	Bryant	None	2022-03-13T13:58:22Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Bryant, Candice	l0n-z5dt-jygd	False	None	False	2022-04-12 04:18:23.501	[]
2405	CDC-2022-0024-2412	https://api.regulations.gov/v4/comments/CDC-2022-0024-2412	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mom is a pain sufferer. She takes opioid medication to control her pain from her medical condition. She has taken it for years. It helps her physically live. I remember when she had to start the meds. She would stay in the bathroom holding herself and she would pee blood and cry. She didn't work, cause she couldn't, she didn't move around much because she couldn't. she missed out on alot of our school activities that she liked to do because she couldn't find out what was wrong for the longest time. But before she got this condition of bleeding, and pain she did do so much. Shes the strongest person I know. It was hard watching her go from busy happy mom to hurt mom. My family hurt watching her suffer and then she had emergency surgery and was told what was wrong. She also was told they cant fix it. She decided to take the meds to be able to be herself. So she did and attended my graduation, and my sisters two graduations. Is able to work now, and she is happier because she can live like she did. She don't get drunk or act weird or anything. She goes to her doctors that monitor her condition. one time I went with her and she had to see a different doctor in the office she goes to. She pees in the cup and they test it for blood levels in her pee because that's what she has, well that doctor told her that she was just a controlled drug addict and I cussed him out. my moms never taken drugs, she don't drink cause it makes her bleeding worse so she don't even celebrate with alcohol. The strongest woman I know in this world has taught me to be strong, deal with issues as they come, be the best person you can be, and don't let anything stop you from being the best person you can be, and that you're not weak if you need medicine to stop the pain, its a part of her life, but she don't let her condition define her, and I don't let people label her either, if she wouldn't have went to hospital when she did, she probably wouldn't be here today with us. I want my mom to be here and functional as long as possible, I don't want to have kids and her not be here to help me. She's a great mom. If she has to suffer any more because of people abusing medicines that she takes and needs to not be in such pain, or if she is called bad words again. I will do something about it. I pray I'm not ever in a place to have to need meds because I've seen firsthand with doctors how they will say stuff to you out of meanness. That doctor got fired. You can't treat people like that, and say stuff like that to people that really have body conditions that need medicine. As long as she's living, I'm gonna protect her because that's my mom and she's an important part of our family. We need her, we love her, and as much as she's raised us and taught us good lessons of life, she shouldn't ever be judged, or treated as less that a human because of her condition. So stop making people that take medicine accused of being a drug addict, my best friends uncle is a drug addict, he drinks all the time, he's got in trouble with the law. Thats the person my mom has taught me not to be. My best friend also broke her back in a cheerleading competition before we graduated, and she was given medicines to treat her and guess what, she's not a drug addict. My family wont allow anyone to treat our mom like trash. Nobody treats my cousin like a drug addict and he has to take needle insulin like 2 times a day. is he a controlled drug addict, nope, he takes the medicine he needs. people really need to stop calling people stuff they aren't and stop treating people bad if they have sicknesses. I'm only 18, and if I grow up and have something wrong with me, I don't know if I wanna go to a doctor or not. It makes you not wanna live in a place where they judge you if you're sick. Seen it firsthand, and it pissed me off, my mom, when that doctor said that to her, she just held her head high, and asked if they had dipped the stick in the cup to see how much blood she was passing. She never raised her voice, and she actually got onto me for cussing him out. She said compassion is never taught through anger so stop acting out. She said some people just don't understand, and you gotta be patient with them. I don't have the patience she has yet, but if she's here long enough with me, maybe I'll learn that. But one thing I won't let happen is her be made to feel less than a person because of the medicine she takes. And that is what I learned from that doctor visit with her and that awful man she had to see that time. I learned so far that no one is gonna hurt my mom, or treat any one of my family like a dog because they need medicine. Fact	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5240	Anonymous	None	2022-03-13T13:59:30Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0n-yxbc-yy76	False	None	False	2022-04-12 04:18:23.725	[]
2406	CDC-2022-0024-2413	https://api.regulations.gov/v4/comments/CDC-2022-0024-2413	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I moved out of the country for better pain care and health care in general. THE MME IS Torture and needs to be abolished<br/>I will not waste another 6 more years with suffering in agony with 21 years of chronic pain and over 15 surgeries. I left my own country with its corrupted agencies and faulty agendas. I will no longer be a victim in your bloody hands. You must abolish the guidelines in general. And start making guidelines for drug addicts themselves we are not in the same category. But you refuse to listen to any chronic pain patients. So I will see what you do from afar and will see how nothing will change in the 2022 guidelines.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Samantha	None	None	0900006484fc5207	Stiess	None	2022-03-13T13:59:48Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Stiess, Samantha	l0n-wtom-5vrr	False	None	False	2022-04-12 04:18:23.959	[]
2407	CDC-2022-0024-2414	https://api.regulations.gov/v4/comments/CDC-2022-0024-2414	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please add RLS to your opioid guidelines. RLS is a terrible disease that make life miserable. I dread going to sleep every night. Low dose hydrocodone helps as an addition to my other meds for RLS. Thank you so much for helping the RLS community.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484fc4ce8	Itk	None	2022-03-13T14:01:01Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Itk, D	l0n-qw7w-7c20	False	None	False	2022-04-12 04:18:24.171	[]
2408	CDC-2022-0024-2415	https://api.regulations.gov/v4/comments/CDC-2022-0024-2415	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain patients have suffered horribly for many years due to the unfortunate "guidelines" provided by the CDC based on faulty research conclusions. Most opioid addicts are not pain patients. Most people with chronic pain do need to resort to narcotics for ameliorating severe distress. Most of them do not abuse it. And yet, so many physicians treat them as if they are drug-seeking lowlifes who need to be monitored like children, deny them humane treatment and make them endure stringent conditions (like repeated office visits with 2 hour waits, repeated urine tests with out of pocket costs, zero compassion for approaches such as forced tapers, abandoning patients who are in too much pain to get by without stronger doses, etc. that amounts to a terrible kind of torture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lilly	None	None	0900006484fc5108	F	None	2022-03-13T14:01:19Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from F, Lilly	l0n-eyni-18cv	False	None	False	2022-04-12 04:18:24.430	[]
2409	CDC-2022-0024-2416	https://api.regulations.gov/v4/comments/CDC-2022-0024-2416	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/>My name is [redacted] and I am one of the people that you undoubtedly get to control the decision of whether I get to have relief of the pain I suffer with everyday of my life or not. I suffer with Fibromyalgia, SLE Lupus, Crohns Disease, Gout, degenerative disc disease, plus, I have had both of my knees replaced multiple times. I suffer constantly. I can't stand or walk very long at a time or set in one position for long periods and I have problems sleeping because of the pain. I cant do daily chores around my house like i use to, which, makes everything fall on my husband's shoulders. I can't work anymore, because the pain gets even worse with stress. This is a daily thing for me. However, I am forced to suffer because of you. You have a life that doesn't require pain management, because if you did, you wouldn’t make rules like you have. You get to go to family outings, shopping, fishing (if you do that), out to eat, etc. because you don't have to suffer. I don't get to do anything. I don't even leave my house because I'm in to much pain to even get dressed. This could be helped if I could have medication to help me. I have tried everything else and nothing works. Pain medication gives me some of my life back. But I'm limited to what I can have. My Dr is so afraid to prescribe anything he even abruptly stopped the medication I was on for years for anxiety. After some er visits and terrible scares, I finally got past that, but I still suffer with anxiety. Please, stop forcing us to suffer. We deserve better lives than this. There are medication to help us and we deserve to have the opportunity to live what life we have to it's fullest. Please consider how you would want to be treated if you were in our shoes. You wouldn't want to live a life of pain so please don't force us to either.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fc50df	Secrease	None	2022-03-13T14:03:07Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Secrease, Lisa	l0n-drs0-orcs	False	None	False	2022-04-12 04:18:24.641	[]
2410	CDC-2022-0024-2417	https://api.regulations.gov/v4/comments/CDC-2022-0024-2417	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've dealt with chronic pain for 35 years due to a progressive familial autoimmune condition. Over the years I took (with the guidance of my doctors) NSAIDS for the worst of my pain in order to continue working in my very physically demanding jobs. I was treated with every kind of non-opiate, non-NSAID pain medication through the decades with the best being ineffective, most causing severe negative side effects. In 2006 I had a total proctocolectomy & eventually had a j-pouch made, at which time I was told no more NSAIDS ever. Meanwhile the neuropathies I'd had for years were worsening from the diabetes caused by the steroids I was given in an attempt to make the ulcerative colitis remit, and I found that I had ankylosing spondylitis. I got to the point where I couldn't do my job as a meat packer though I desperately needed & wanted to. 50 years old, having always worked full-time+ along with raising my 5 children mostly alone, I found myself unemployable, bedbound and in unrelenting pain. In hopes that my first failure with Gabapentin had been a one off, my physician put me on it again. It was a terrible few months. I gained 50 pounds, was groggy & unable to think clearly, my xerostomia became almost intolerable, I felt drugged. These effects didn't go away with time as hoped, nor did any of my pain. I developed peripheral edema, had an episode of acute kidney failure, stopped the gabapentin and in a few weeks could think again. My doctors had suggested opiates many times but I'd found tramadol to be ineffective; percocet & morphine made me feel "on edge" and gave me terrible headaches. I had an rx for Vicodin which I could take every 8 hours that I'd use once the pain became severe enough that I couldn't be quiet through it. It did help some. I wasn't interested in becoming an "addict" and I already took more than enough medicine so I didn't take the Vicodin regularly. At one of my regular 3 months check-ups my doctor suggested that I might take it more regularly and see how that went, explaining that pain meds tend to work better if taken before pain is an 8 or 9. He was right, and I did take the Vicodin more often - though still not every 8 hours or necessarily even daily. I continued to wake my husband at night with my crying though we no longer slept in the same room due to these issues. My doctor suggested a Butrans patch. What a difference this made in my life! It took a few adjustments to get the right dosage and then it was like being a human again. I could sleep some at night. I could get up, get dressed, do household errands again as I'd been unable to do for years! I had the Vicodin for occasional excessive extra pain and took at most a few of those a week. The Butrans was very expensive but the pharmaceutical company had a promotion so it was manageable for 2 years. And then it was not. With me now on disability and my dear second husband our main provider there was no way I could pay 100$ a month for pain relief! My doctor switched me to the Fentanyl patch. No noticeable difference from Butrans except that there was much less skin irritation from the patch's adhesive. I never "got a buzz" or became drowsy from either patch, nor from the Vicodin. I never had any desire to take more than prescribed (in fact with the pills I couldn't remember to take enough before the pain was too high) In all the time I've been on these meds I've never run out early, lost a prescription, had anything in a urine test I shouldn't have. I don't smoke marijuana, drink alcohol, do any "recreational" drugs. I've never felt that my Rx is not enough (except for in the hospital after my last surgery, in 2021, when a young night shift nurse refused me a prn opiate I had ordered because she felt I was "on more than enough meds already".)<br/><span style='padding-left: 30px'></span>My mme is well over the arbitrary limit the CD came up with in 2016 though. This became a problem and is now the source of much stress & anxiety in my life. The pre-auth issues are crazy for meds I've taken with no problems that clearly increased my quality of life & abilities for 9 years. Pharmacy is consistently out of patch,pharmacists question my drs office. In 2020 my awesome doctor retired early, rather than changing to doctoring under the guidance of the DEA. He assured me that his replacement in the practice was someone who would treat me well. (I am and always have been a one doctor person - for me, the relationship with my pcp is almost as important as those with my family members. Changing drs & having to explain my medical hx is a nightmare even when voluntary) She's been fine but she's elderly. I don't want to even think about going back to where I was before my pain was treated effectively. I'm not asking to be pain free, I don't want to get high. Your guidelines aren't appropriate for everyone as if humans are one size fits all. The difference in how the medical community treats chronic pain patients now is shocking and scary..the guidelines need to be revised.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484fc5025	K	None	2022-03-13T14:04:10Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from K, Laura	l0n-81wd-k775	False	None	False	2022-04-12 04:18:24.872	[]
2411	CDC-2022-0024-2418	https://api.regulations.gov/v4/comments/CDC-2022-0024-2418	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket Number:<br/>CDC-2022-0024<br/><br/>In the Controlled Substances Act of 1970, it says, “many drugs have a useful and legitimate medical purpose and are necessary to maintain the health and general welfare of the American people.” “On the other hand, illegal importation, manufacture, distribution, possession and improper use of controlled substances have a substantial and detrimental effect on the health and general welfare of the American people.” The CSA also says it aims to protect public health from the dangers of controlled substances while also ensuring access to controlled substances for legitimate purposes. In my opinion, the CDC, DEA and other U. S. Government agencies are in violation of the CSA by limiting and restricting controlled substances (Pain Medications) that are necessary to maintain the health and general welfare of the American people. Those people being our US Military Veterans and disabled Americans who have incurable, disabling, painful injuries and illnesses that require controlled substances (Pain Medications) for daily physical functioning and quality of life. Another violation may be not ensuring access to controlled substances (Pain Medication) by cutting the supply of them that are needed for legitimate medical purposes such as stated above. Of course this is just my opinion, but I’m sure there are many who would agree with me.<br/><br/>I find it quite disgusting that US government agencies, such as yourself and the DEA, are limiting and restricting access to medications that have gone through clinical trials, were approved by the FDA and give so many chronic pain patients the ability to live their lives. You do this while letting illegal drugs cross the border, come through our ports and through the mail and package delivery companies. According to you, the CDC, illicit fentanyl is the cause of the majority of drug overdoses in the United States. It should be common sense that this issue is dire and should be taken care of but you continue to insist on restricting and limiting needed medications. When you limit and restrict pain patients from their effective pain reducing medications, prescribed and monitored by their physician, you in fact push them to the black market or to suicide for pain relief. Then you all are bewildered as to why the overdose and suicide rates have gone up. The 2016 CDC guideline caused this, and I am thankful you acknowledged this, but the 2022 updated CDC guideline will continue to cause harm to those in the chronic pain community as well as acute pain patients. The 2016 and 2022 updated CDC guideline has and will continue to harm law abiding patients who are strictly monitored by their physicians and follow all the rules.<br/><br/>I find it appalling that chronic pain patients still have a recommended dosage of opioid pain medication in the updated 2022 CDC guideline. Many of us have permanent, incurable injuries or illnesses that will last a lifetime and continue to worsen over time. But we are not given the same compassion, empathy or caring as those with addiction or other medical conditions. Why do we have to settle for inadequate medical treatment of our unending and disabling pain? It is literal torture to live with severe pain every day without adequate relief. Years ago there was public outrage over the cruel, inhumane, degrading treatment and torture of detainees, who were enemies of the United States, at The Guantanamo Bay detention camp. Many detainees endured unnecessary pain and suffering and the public outraged over the treatment of our enemies. Now the cruel, inhumane, degrading treatment and torture has been thrust upon law abiding American Citizens with chronic, disabling, incurable daily pain. And our own U.S. government agencies are inflicting this torture on it’s own disabled population. What you’re doing is NOT okay!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	KJ	None	None	0900006484fc5006	R	None	2022-03-13T14:04:50Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from R, KJ	l0n-7dap-vso0	False	None	False	2022-04-12 04:18:25.099	[]
2412	CDC-2022-0024-2419	https://api.regulations.gov/v4/comments/CDC-2022-0024-2419	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is generally thought that there are two types of patients in regards to opioids, tolerant and naive, but even within those two categories are a number of other subsets. While there are patients that do well on higher doses of opioids and other patients that do better on lower doses, each patient is different and should be treated as such. The recommendation that was put forward with a hard number of 200mg MEDD is widely thought of as a rule and not a recommendation by physicians and leaned on by the DEA and other governing bodies. With that being the case and by putting a rigid number on something as fluid as pain/pain management could force patients into boxes where they do not fit. Forcing patients to taper when a significant amount of pain is still present is not only sometimes harder on the patients, it could possibly lead to a misdiagnosis of OUD as well. The current language in the guidelines focuses more on limiting doctors to staying inside certain parameters even when it’s not the right move for that particular patient. The language should be amended to focus more on individual care and doctor/patient autonomy while continuing to relay pertinent and accurate information and remembering that the doctor is the one with the training and experience to make the proper decisions for their patients. No system is perfect but if you have the ability to make changes and do a little better then you also have the responsibility to make those changes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fc4c5b	H	None	2022-03-13T14:05:21Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from H, John	l0n-5tp7-b2k4	False	None	False	2022-04-12 04:18:25.315	[]
2413	CDC-2022-0024-2420	https://api.regulations.gov/v4/comments/CDC-2022-0024-2420	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Many Americans have chronic pain, especially elders. Prescription opioid medication can be addictive and dangerous. The first in line therapies including acupuncture, PT, massage, chiropractics, and others don’t just help patients relieve pain but also helps them improve the health of their mind and body. The FDA and CMS also recommend that patients seek alternative therapies for pain management, and we strongly suggest these alternative therapies be written in the guidelines for the doctors and patients. There is a lot of evidence based studies on how acupuncture can treat pain in the NIH databases. We collected them here into this website at https://www.hr6.us for your reference.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc4c48	Anonymous	None	2022-03-13T14:05:34Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0n-5emn-rdgi	False	None	False	2022-04-12 04:18:25.527	[]
2414	CDC-2022-0024-2421	https://api.regulations.gov/v4/comments/CDC-2022-0024-2421	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient I would like to see the new guidelines remove any mention of MME's and all bias. I would like my healthcare decisions to be between my physicians and myself. The government has done a huge disservice to chronic pain patients.<br/><br/>The drug problem the government needs to address is illicit drugs and fentenal coming into our country.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fc4bfc	Dickerson	None	2022-03-13T14:05:44Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Dickerson , Susan	l0n-3qb6-gjpn	False	None	False	2022-04-12 04:18:25.758	[]
2415	CDC-2022-0024-2422	https://api.regulations.gov/v4/comments/CDC-2022-0024-2422	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sirs: While I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, I am concerned that the draft does not address chronic conditions like RLS that are different from chronic pain. Opioids are, for many of those of us to suffer from unremitting Restless legs syndrome (RLS), the only option that works to relieve our condition. RLS is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. This option has had wide acceptance internationally for many years and should be an option that is available in the U.S. <br/><br/>I have suffered from severe RLS for over 45 years. During this time, I have worked with medical practitioners in Australia and in the U.S. and have tried countless prescription medications (developed for use by patients with other conditions like Parkinsons), dietary supplements, modalities such as acupuncture, Rolfing, massage, Alexander technique, forms of exercise ----- all to no avail. A neurologist that I consulted put me on low dose opioids and that protocol has alleviated my symptoms. I have been on this protocol for over 10 years now and have not had to increase my dosage of opioids. In my opinion, opioids should be part of the accepted standard of care for RLS, so long as physicians are knowledgeable about RLS before prescribing, are thoughtful, explain the benefits and potential issues to their patients and follow their patients. <br/><br/>Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484fc4bef	Levine	None	2022-03-13T14:06:04Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Levine, Jane	l0n-3gbo-61ke	False	None	False	2022-04-12 04:18:25.975	[]
2416	CDC-2022-0024-2423	https://api.regulations.gov/v4/comments/CDC-2022-0024-2423	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My left knee is bone on bone. I had been limping for over 2 years. Any rotating of my foot was extremely painful in my knee. I had steroid shots which lasted about 3 weeks but really hurt. I really don't want a knee replacement yet so I thought I would try Ortho Lazer. After the first few treatments I felt a difference and now experience a lot of painless days. Took me a while to learn to walk without a limp again. I still have some uncomfortable days but not as painful as before and it usually only lasts part of a day. I do go back about once a month but there is no pain from the treatments unlike the shots.<br/><br/>I play Pickleball 3 times a week. I used to have to, at times, stop chasing down a ball because my knee hurt too much. Now it may hurt a little sometimes but not bad enough to slow me down.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronald	None	None	0900006484fc4b97	Fish	None	2022-03-13T14:06:17Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Fish, Ronald	l0n-1zxe-vu8k	False	None	False	2022-04-12 04:18:26.214	[]
2417	CDC-2022-0024-2424	https://api.regulations.gov/v4/comments/CDC-2022-0024-2424	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I personally do not need opioid therapy and will not be affected by this Proposed Clinical Guideline for Prescribing Opioids, I completely support it and find it demanded. With the development of different social media platforms, I have heard and seen many heartbreaking stories of people who simply cannot perform their daily functions due to their unmanageable pain and constant suffering. Non-opioid pain reducers do not work for those who suffer from chronic or acute pain. Their lives are becoming miserable, and they lose interest in everything. The loved ones of people who need opioid therapy also experience lots of pressure and stress since they cannot help in any way. How can we even talk about the pursuit of happiness claimed in the United States Declaration of Independence if some people are deprived of the opportunity to receive effective treatment to reduce their pain? Of course, there should be some restrictions in place, and doctors will have to discuss the potential side effects of opioid therapy. The specialist will need to ensure that only patients have access to opioid medications. However, people should have a chance to live their best lives possible and decide what is in their best interests. All in all, I believe that every person whose pain can only be reduced with opioid therapy should be prescribed one in order to be engaged in daily and simple activities that healthy people sometimes even do not notice doing because every individual deserves to have a good quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daryna	None	None	0900006484fc4b89	Y	None	2022-03-13T14:06:38Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Y, Daryna	l0n-1sx0-sfxc	False	None	False	2022-04-12 04:18:26.428	[]
2418	CDC-2022-0024-2425	https://api.regulations.gov/v4/comments/CDC-2022-0024-2425	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing because I am chronic pain patient that can't get adequate care because of the 50mme guideline. I think it should be up to your Dr who once established a working relationship to increase your dosage. I am suffering to the point some days I just want to give up. I have two boys and a girl who I want to watch grow up and I need to be healthy with my pain control to do so. Having pain has limited my job opportunities to very few jobs. It has been a struggle to be happy and play with my kids as I once could before the 2016 guidelines. I also believe that the overdose are not from prescription medication rather heroin once the 2016 cdc guidelines were put in place and people got cut off and had no choice to go to street meds. I hope cdc guidelines are much more lenient so doctors can prescribe like they want to and make the mme much higher!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jay	None	None	0900006484fc4b65	Mattson	None	2022-03-13T14:06:56Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Mattson, Jay	l0n-17wy-hwzi	False	None	False	2022-04-12 04:18:26.657	[]
2419	CDC-2022-0024-2426	https://api.regulations.gov/v4/comments/CDC-2022-0024-2426	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The voluntary nature of the guidelines should be obvious upon review and encourage follow up appointments with the patients. Prescribers should be empowered in their decision making, I work with many who are reluctant prescribe opioids now and it is not surprising when patients seek other methods of pain relief. The CDC should ensure their recommendations do not unintentionally deter prescribers, established or new, who know their patients best and their treatment plans and goals.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc4ad8	Anonymous	None	2022-03-13T14:07:06Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0m-ze57-ffoz	False	None	False	2022-04-12 04:18:26.888	[]
2420	CDC-2022-0024-2427	https://api.regulations.gov/v4/comments/CDC-2022-0024-2427	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024<br/>Im 39 years old, I was born with a birth defect called spina bifida. Doctors said I would never walk but I did. But In doing so torn up my joints. I have no cartilage left in my knees and they grind bone to bone when I walk. I have 2 herniated discs and all of my discs are bulging and will herniate eventually. I have chiari malformation II and my cerebellum tonsils are herniated. I can't get a knee replacement because it won't last with the way I walk, and it's too risky to do any fusions in my back, I've already had 1. Another one will cause everything to herniate much quicker. For over 15 years I was on the same dose of opioid medication because it worked. 2 80mg oxycontin a day and 6 Norco per day. I had 3 15mg oxycontin for bad days if needed. I took my medication responsibly and never had a single issue of overdose or misusing my medication. I never had to increase that dose once we found what worked for me. For all those years it controlled my pain very well. I was able to work a full time job even and lead a close to normal life despite my disability. Then the 2016 guidelines came out. My doctor eventually had to lower me even though I was the perfect pain patient and did everything I was supposed to do. Even though we have documentation showing my issues. I'm not eligible for injections due to my spinal cord issues, I also have a syrinx and a tethered cord and it's too risky because of the swelling and stretching. I also can't have a pain pump because it's too risky. So my only help in relieving this pain is opioid pain medication. I am no longer able to work, I sit at home in pain. My quality of life has been severely reduced due to having to be lowered on my medication. I'm currently lowered to 2 60mg oxycontin a day and 2 Norco per day. Lowering has not reduced my pain, it is much worse, I've been lowered now for a few years but this is the lowest so far and it's absolutely horrible. I can't even go outside to enjoy my garden anymore because it hurts too much to move around. I pretty much live in my chair. This is in no way fair to me, I always have followed rules and have been responsible yet I'm still being punished. It's just not fair to make someone live in that much pain. I should be able to have a good quality of life and not be in torturous pain daily. I wish I could be part of a study to prove opioids really do help with chronic pain and don't make pain worse. Everyone is different, you can't group everyone into a single group and think everyone will experience the same results. I need a higher amount of medication to be able to live a better quality of life and experience pain reduction. My issues are different than others and theirs are different than mine. I was on the same dose for many years because it worked and I didn't need to be increased. I didn't experience any negative side effects on my higher dose. The higher dose worked great for me, which is why I didn't need increased, my body didn't develop tolerance and make it so it wasn't effective, after 10 plus years it still worked great! Doctors need to be able to prescribe what they feel is necessary for their patients without the fear of having their license pulled. If there is documentation of the issues and that pain meds are needed they should be able to do what is needed. My doctor has even said he doesn't want to have to lower me but has no choice. So what am I to do? It's not fair to me. So please give doctors the ability to treat their patients as they feel is needed to give them a good quality of life. If the DEA wants me lowered based on my file, they need to send someone to come sit in the room during a doctors visit and see me 1 on 1 and go over my issues with me instead of making decisions from a desk based on my file. They don't know me like my doctor and shouldn't be making him make decisions like that. My case proves that opioid pain medications are effective at higher doses and it proves lowering them does not decrease the pain, it makes it worse. When redoing your guidelines please take into consideration that everyone is different and needs different care. And that higher doses do work and don't create problems for everyone. Don't leave us out to suffer because it's just not right and not fair. I hope someday I will get the treatment I deserve and can experience lower pain levels and and have a better quality of life redoing your guidelines gives me some hope, just please don't forget the ones that really do need a higher dose. Because there is no way 90mg equivalent to morphine per day will even come close to controlling my pain. I just want to live a good quality of life and be able to work again and not be in so much pain every single day. I've been through enough medical issues in my life and I think I deserve to not be in so much pain. I've had over 17 surgeries, if I have to have another one the pain would be unbearable. Please remember us and please help us. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christopher	None	None	0900006484fc4ad5	Krohe	None	2022-03-13T14:08:09Z	None	None	1	None	2022-03-13T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Krohe , Christopher	l0m-zddg-ajvl	False	None	False	2022-04-12 04:18:27.114	[]
2421	CDC-2022-0024-2353	https://api.regulations.gov/v4/comments/CDC-2022-0024-2353	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic Pain Management Comment:<br/>I am Quadriplegic, completely paralyzed below my shoulders. I had a car accident about 40 years ago, when I was just 29 years old - I am confined to my wheelchair from a Spinal Cord Injury at the C-6 level. As a Quadriplegic, I am very fortunate to be in good general health. With the constant strain on my body from sitting in my wheelchair for so many years, I suffer each and every day with unrelenting and debilitating chronic pain. <br/><br/>For many years, I have been under the compassionate care of my Pain Management Specialist who is Board Certified in Anesthesiology and Pain Management. Together, we have tried many possible forms of pain management, both medical and non-medical, including 2 surgeries, various injections, accupuncture, massage, and others. <br/>I experienced very little or no relief from my pain with the exception of my current pain management medicine which includes Opioids. I also get weekly massages and use heat or cold packs, as needed.<br/><br/>At every regular appointment, my pain doctor assesses any changes in my condition, my pain status, reviews my medication, dosages, including side-effects which I am able to manage. Over the years, my doctor & I have been successful in reducing the dosages of my medication. <br/><br/>I have been on my current regimen for several years - I am stable and functioning very well. I have not required any more tablets or a higher dose. When we have attempted to go below my current dosage, however, it was not successful in controlling my pain.<br/>I am very responsible in managing my medicine and I do not exceed my prescribed dosages.<br/><br/>While I understand the problem of drug abuse in our country, without my current pain medicine I, quite literally, could not function! This medicine is THE only thing that prevents me from staying in bed every day, curled up in a ball, with throbbing, burning and overwhelming pain. In my case, the proposed guidelines are completely unrealistic. I have a very real fear if this medication is no longer available to me.<br/><br/>My general pain level varies between 6-9. With the help of my pain medicine, however, most days I can "function" at level 6-7 and I am able to enjoy some activities with the encouragement from my (angel) husband of 45 years. An example of the activities I enjoy are my computer, reading, having lunch with friends among others.<br/><br/>If I am to continue with my quality of life, any government restrictions are totally and completely unrealistic! In fact, any government interference terrifies me! Those decisions should only be made in the privacy of the doctors office between the doctor and the patient.<br/><br/>The CDC, HHS and the Pain Management Taskforce need to acknowledge people like me and allow us to continue with our quality of life. As a person who has been in chronic pain for about 40 years, I feel my pain is being successfully managed with the help of my Opioid medicine and there is no need to interrupt that management to my detriment.<br/><br/>Thank you very much for your time in reading my comment. I sincerely hope you will conclude that people with legitimate quantifiable chronic pain should be allowed to continue with their pain management regime while under the care of their Pain Management doctor.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M.	None	None	0900006484fc43a8	Caplan	None	2022-03-14T14:21:51Z	None	None	1	None	2022-03-11T05:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Caplan, M.	l0m-rbdc-fwqf	False	None	False	2022-04-12 04:18:27.332	[]
2422	CDC-2022-0024-2428	https://api.regulations.gov/v4/comments/CDC-2022-0024-2428	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was totally cut off of opioids in 2017. The year before I was cut DOWN for some type of number system I did not understand. Once I waa cut down I was no longer sleeping and was becoming bedbound so I began asking for help. Unfortunate the help became pressure to get epidurals or a pain pump to which my nsg said absolutely not. <br/>I began asking the np’s I had seen for tge last 5 years to see a “doctor” in the practice since it had been so long— <br/>I finally did and she came in with attitude and unfortunately I was let go from the practice after over 10 years of full compliance of UDTs. <br/><br/>Im totally bedbound now not going to church- missed most of my family activities and mainly wait to die. <br/><br/>I have seeb over and over those terribly impacted by the guidelines that now have become law in many states. <br/><br/>The death of many and Im sure me will go down in history as the worst medical torture. <br/><br/>Rescind the guidelines and do what you must to fix this nightmare thats been created.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	kathy	None	None	0900006484fc57bd	add	None	2022-03-14T15:37:40Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from add, kathy	l0o-ubsb-bmke	False	None	False	2022-04-12 04:18:27.545	[]
2423	CDC-2022-0024-2429	https://api.regulations.gov/v4/comments/CDC-2022-0024-2429	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	None	None	None	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc3542	None	None	2022-03-14T15:57:30Z	None	None	0	None	2022-03-14T00:00:00Z	None	did not redact contact information for individual	None	None	None	None	None	None	None	None	Comment from American Nurses Association	None	True	None	False	2022-04-12 04:18:27.803	[]
2424	CDC-2022-0024-2430	https://api.regulations.gov/v4/comments/CDC-2022-0024-2430	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a dentist in Texas and agree with the recommended guidelines set forth for acute pain. After review of these recommendations, there is some close correlation with what the proposed guidelines have discussed and what the state of Texas has implemented in regards to opioid prescriptions. Of course there is more we as clinicians can do before we supply patients with opioids. We need to ask about current and past drug use. We need to open the platform up to discuss the misuse and abuse and possibility for overdose or even death if the medication is not used as prescribed. We need to incorporate the need for follow ups after controlled substance prescription even if it was just for acute pain. The role of a dentist should not just be a prescriber or oral health provider, but an educator to help our patients make the best informed decisions about their health. I believe it should be strongly encouraged to have a follow up with patients that are prescribed controlled substances. If patients were prescribed opioids for dental pain relief after a procedure, a one week follow up should be made for the patients and patients should bring in their medications that were prescribed to the appointment so that the dentist can evaluate the site of surgery and then evaluate to see how many remaining tablets are left of the controlled substance and ask the patients if there are any questions or concerns with the medications they are taking. This once again can open the platform for the dentist to have a conversation about proper use and proper disposal of any remaining medications. A simple 20 minute follow up can help. Although this does take extra time in the day, it could be beneficial in providing this follow up to reemphasize responsible opioid use. Dentists prescribe 12% of immediate release opioids in the United States. (Denisco, 2011). I could possibly be more now, but we need to be more aware and methodical in how and why we prescribe opioids for acute pain. Documentation and education are the key to helping our patients be fully informed as well as knowing we are doing our part by providing that information. Finding a way to incorporate these improvements on our own can make us a better dental provider and may even help save a life from addiction and/or overdose. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Luciana	None	None	0900006484fc4f79	Ramirez	None	2022-03-14T16:25:50Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Ramirez, Luciana	l0n-7961-5njd	False	None	False	2022-04-12 04:18:28.014	[]
2425	CDC-2022-0024-2431	https://api.regulations.gov/v4/comments/CDC-2022-0024-2431	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish to endorse the comments of [name redacted] as circulated in social media and filed with the Federal Register. His comments reflect my own experience and concerns.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5316	Anonymous	None	2022-03-14T16:28:16Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-c0cy-y8h9	False	None	False	2022-04-12 04:18:28.239	[]
2426	CDC-2022-0024-2432	https://api.regulations.gov/v4/comments/CDC-2022-0024-2432	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No one has a solution or reason for my pain, and even if I was to receive help it is too late for me, I lost too many years spent distracted searching for solutions, it is all I have invested my time into. Searching for relief that does not exist.<br/> I have cut off all relationships and refrain from developing new relationships to prevent any guilt when i take my life and remove the burden I am on society, the waisted space I am, the water I drink all a waste to stay alive. My mother, I love her deeply, I pretend to be happy for her, she is my only relief, no hurry to lose her but when she goes, I will be right behind her. in peace, i have chosen hanging, it is the least likely for survival & won’t traumatize a train conductor. <br/>Losing me is a positive but I am confident some who are in pain are worth treating and keeping around, help them, or don’t. after all population control is an issue, and you have a means to purify it just by declining medicine. That’s all it takes, out of sight, out of mind and a healthy strong population remains.<br/>Pain doctors will need someone new to inject and implant. CDC will need a new epidemic, and population to control who’s next?<br/>those with learning disabilities, take away their life improving meds, or anti-depressants and anxiety meds, or remove the internet, staring at screens all day is not healthy and internet is very addicting to some and video games, and cannot forget alcohol.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc5328	Anonymous	None	2022-03-14T16:30:25Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0o-d2x2-mkl9	False	None	False	2022-04-12 04:18:28.449	[]
2427	CDC-2022-0024-2433	https://api.regulations.gov/v4/comments/CDC-2022-0024-2433	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider including chronic diseases, specifically Restless Leg Syndrome (RLS) to the new CDC Clinical Practice Opioid Prescribing Guideline revisions. Millions like myself suffer from RLS and there is no cure. Medications work for a time then the condition becomes worse, much worse than before the meds were prescribed. It severely affects my ability to sleep or even relax. I hate to say I am suicidal because I don’t feel I am. But after several days without sleep, the thought for permanent relief does cross my mind. I strongly urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fc6116	Ostler	None	2022-03-14T16:31:19Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Ostler, Michael	l0p-cjuq-tug4	False	None	False	2022-04-12 04:18:28.659	[]
2428	CDC-2022-0024-2434	https://api.regulations.gov/v4/comments/CDC-2022-0024-2434	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First off Id like to say im so grateful and excited your looking into these outdated guidelines and thinking of those of us who have chronic conditions. Although, MME was taken out you clearly still state MME im the supporting text and throughout the document. These need to be completely taken out. As a patient with chronic pain and a rare disease called Adhesive Arachnoiditis my quality of life is based completely on pain management. Due to restrictions that we have now i am unable to get proper pain management to have any good quality of life. I would love to tell my story and advocate for those of us who depend on pain management. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ericka	None	None	0900006484fc613b	Fischer	None	2022-03-14T16:31:34Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Fischer, Ericka	l0p-dx1v-hklt	False	None	False	2022-04-12 04:18:28.874	[]
2429	CDC-2022-0024-2435	https://api.regulations.gov/v4/comments/CDC-2022-0024-2435	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a provider who has been using non-opioid pain treatment options in practice for over 12 years. Low level laser therapy has been one of the most effective tools I have found for chronic and acute pain symptoms. I was very glad to see this therapy mentioned in the draft guidelines. It’s an incredibly valuable tool.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fc5868	Henry	None	2022-03-14T16:31:52Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Henry, Michael	l0p-gl63-kqmq	False	None	False	2022-04-12 04:18:29.173	[]
2430	CDC-2022-0024-2436	https://api.regulations.gov/v4/comments/CDC-2022-0024-2436	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE REMOVE ANY AND ALL MENTION OF MME FROM THE GUIDELINES THERE IS NO SCIENCE TO BACK IT UP. <br/>The idea of MME is not based around individual patient care. Everyone metabolizes medications differently. Especially immunocompromised patients because our insides can't absorb the medicine properly. <br/><br/>https://t.co/x4zVoVimYJ<br/><br/>Please keep anyone affiliated with PROP, Shatterproof, ASAM, and Remmler Foundation of Hope. These groups fall under the FBI definition of Hate Groups. <br/><br/>https://en.wikipedia.org/wiki/Hate_group#:~:text=Hate%20group.%20According%20to%20the%20United%20States%20Federal,from%20that%20of%20the%20members%20of%20the%20organization.%22.<br/><br/>Proof of my statement: [name redacted] of PROP "Let them Die Off"<br/><br/>https://youarewithinthenorms.com/2021/12/04/let-them-die-off-united-states-government-expert-andrew-kolodny-md-the-most-dangerous-physician-in-america-and-exposing-the-opioidgate-medical-scandal/	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ruth	None	None	0900006484fc23fb	Allder	None	2022-03-14T17:37:40Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Allder, Ruth	l0l-0ekn-uhfe	False	None	False	2022-04-12 04:18:29.389	[]
2431	CDC-2022-0024-2437	https://api.regulations.gov/v4/comments/CDC-2022-0024-2437	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe the cdc/dea and whoever else is regulating opioid prescribing for long term chronic pain issues and conditions should change the current policies. There are now so many people suffering because they can’t get their pain properly treated because doctors are being watched to the point of fear of losing their license. But who really suffers and loses? The patient. The current mme amout is ridiculous. Everyone isn’t made the same or metabolism isn’t identical. Some people with chronic conditions have no other options than opioids like OxyContin. I feel like patients with chronic pain who have been using these drugs long term without complications or overdose issues plus have had their quality of life improved while using them should not now be forced to stop using them because of doctors who mismanaged acute pain symptoms with dangerous prescribing. Treat these patients who benefit from opioid prescribing with the medication that works for them so they don’t suffer. People now are turning to illicit drugs, suicide, and other reckless ways because they can’t live a quality life any longer. Change the policies for the right patients!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dennis	None	None	0900006484fc7187	Kistulinec	None	2022-03-14T17:40:15Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Kistulinec, Dennis	l0q-xmtt-9ky5	False	None	False	2022-04-12 04:18:29.604	[]
2432	CDC-2022-0024-2438	https://api.regulations.gov/v4/comments/CDC-2022-0024-2438	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support [redacted] in his comments for the revisions to the CDC guidelines.<br/>Pain sufferers need to be treated as disabled citizens and not be discriminated against.<br/>There are already Medical offices which are applying the 50 MME guideline to prescribe. Many need much higher dosage to get any relief at all.<br/>You would think professionals who are educated in pharmaceutical treatment would be more knowledgeable about the benefits of dosage in treatment.<br/>Please listen to the pain sufferers who discuss the benefits vs risks of Opioid therapy, instead of so called experts who do not have the personal experience to be making decisions that affect millions who will undergo pain.<br/>I hope the comments submitted are being considered seriously and not just an exercise to gaslight those with painful conditions into thinking their voice is being heard, when it will make no difference in allowing effective treatment, which needs to include Opioids.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc7242	Anonymous	None	2022-03-14T17:41:52Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0q-zik9-7f41	False	None	False	2022-04-12 04:18:29.827	[]
2433	CDC-2022-0024-2439	https://api.regulations.gov/v4/comments/CDC-2022-0024-2439	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why do chronic pain patients have to suffer?.we deserve to be treated for are pain and not treated like we are addict .We are suffering every second of the day .struggling to be normal again with little or no help thanks to the 2016 and Mme guide lines that was put in to law .we are human being but are treated worse then a animal .This is so inhumane .i think Doctor need the rights to treat pain without thinking there going to loose there licence.what happen to the oath they took .oh right you took that away to.The 2022 version isn't any better I.m fact it is worse .Now we have pharmacy talking nasty to us .Er will not treat us for anything .We are treated as drug seeking if we go an for a uti .They talk down to us as soon as they are told we take pain meds for pain .Why are we treated like this it so inhumane.i have stenosis of the spine bulging disk cadaver bones and plate in my back and neck .also have Degenerative disk disease .bone spurs up and down my back .i ve had 2 surgeries on my back the last one was the worse with the plate and screws .Now my neck is coming a part and hurts like crazy along with my back .i cough and it feels like my neck is separating.had 3 surgeries on shoulder bone spurse and another tear in it .last time I had surgery on it they had to pull my muscle up and sew it back in to place .i afraid to have any more surgeries because of pain I m going to insure.i worked at a nursing home taking care of my resident for 30 years .i would never dream of talking or treating them inhumane .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc7245	Anonymous	None	2022-03-14T17:43:05Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0q-znzt-re8m	False	None	False	2022-04-12 04:18:30.041	[]
2434	CDC-2022-0024-2440	https://api.regulations.gov/v4/comments/CDC-2022-0024-2440	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Sirs, I would like to share part of my pain journey. In 14 days I will be 62 years old, to date I've had over 150+ procedures mainly orthopedic procedures I've had 22 joint replacements/revisions and have another scheduled replacement this March 30th, partial list both knees several times, both hips replaced my left hip became infected in 2015 I had several emergency surgical washouts then went through months of IV antibiotics also several right shoulder replacements to where now I have a reverse shoulder replacement on the right side. My spine is fused I've had 2 broken necks I've had a brain tumor, currently I have a severe aortic aneurysm 54mm at the top of my heart, Aneurysmal dilatation of the bilateral common iliac arteries. This is the short list of my health issues. I currently take Oxycontin for pain. However my pain Dr. is taking away the pain medication since I've had less pain medication I mainly sit in a chair all day due to pain, I now have heart failure from lack of activity my legs are swollen as are my feet. I have 6 adult children and 22 grandchildren that I cannot be active with due to severe pain. Please don't take away peoples pain medication since my pain medication has been reduced my quality of life has gone down the toilet. Please don't take my pain medication away or I believe I will soon die. Thank you, Sincerely [redacted] Minnesota 55918.<br/>[redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	mark	None	None	0900006484fc7160	pearce	None	2022-03-14T17:45:12Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from pearce, mark	l0q-x8yl-58m9	False	None	False	2022-04-12 04:18:30.287	[]
2435	CDC-2022-0024-2441	https://api.regulations.gov/v4/comments/CDC-2022-0024-2441	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi,<br/><br/>Thank you for creating this open forum for public comment. I'm a Covid-19 "long-hauler" since November 2020 who has developed neurological symptoms which include daily headaches and severe migraines. I've become somewhat functional again where I'm able to work part-time to pay my rent and bills. However, this makes my headaches worse. I've tried a dozen different medications for this including weekly at-home IV infusions of magnesium, Emgality injections, Triptans, and trigger-point injections with a neurologist and pain specialist at USC Keck Hospital. About four months ago, when I was in severe pain that was a 9/10 and debating on going to the ER, my husband, who had Percocet from a former surgery left, gave me one to take to see if it would help. I immediately felt relief from this and was functional again. I was able to watch television where the noise wouldn't hurt and stay up, converse and spend time with him. The pain was all of a sudden manageable. <br/><br/>I brought this up to my neurologist and she immediately denied that any type of opioid medications were a viable solution to help my chronic pain. I've been referred to a pain specialist who is also reluctant to give me this kind of medication -- even though I've told her that it's repeatedly helped provide relief and become functional. This reluctance has left my severe bouts of pain untreated and has affected my functionality, my ability to work full-time and my quality of life. <br/><br/>I know pain management is a complex and nuanced issue but doctors should not be ruling out something that has provided relief to their patients. I also know that some patients who live in chronic pain end up with suicidal ideation due to their untreated pain. This should be avoided at all costs. As someone with Long Covid, a new and not well understood illness, doctors should be open to trying a variety of treatments, including Opioids to provide relief, functionality and quality of life. <br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc6db0	Anonymous	None	2022-03-14T17:46:11Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0q-w2tz-9ya5	False	None	False	2022-04-12 04:18:30.506	[]
2436	CDC-2022-0024-2442	https://api.regulations.gov/v4/comments/CDC-2022-0024-2442	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi, I believe the pendulum has swung from oversubscribing opioids to vastly undersubscribing them and needs to be brought into a sensible and better balance. <br/>There are millions of people who need them, rely on them & don’t abuse them and are needlessly suffering great pain - day in and day out. Their quality of life has suffered tremendously, sometimes to the point where they decide to end their life rather than live it in excruciating pain. How is this at all online with “Do no harm” and “alleviate suffering”? It isn’t. At all.<br/>I have one small personal story that pales in comparison to others but was still needlessly caused me great pain, last suffer I broke my foot. I went to my doctor who had seemed like a reasonable and caring one. I had an X-ray in hand clearly showing the break but he refused to write a prescription for any pain medication, which I have used sparingly and as directed over the years for incidents when opioid pain medicine was needed. He recommended Advil and Tylenol. I was already doing that, to no effect. I told doctor that and he came up with brilliant suggestion of taking them both at the same time and upping the dosage which was already at recommended limit. He said well this is a special situation. I said I don’t want to harm my liver bu following your advice and my broken foot is a “special situation”! He was unmoved by my plight. I suffered excruciating pain for several weeks. Completely unnecessarily. I am not a drug addict, have used pain medication as directed before for it’s intended use with no addiction issues ever, just for the temporary alleviation of pain. He is now my former doctor but I live in MA which apparently has draconian opioid prescribing laws on the books. I’m getting older and I fear, knock on wood, if I find myself in another situation requiring opioids the medical community, taking their lead from the CDC, will fail me once again. I’m scared.<br/>I humbly submit that you just use common sense and allow doctors more case by case discretion when prescribing opioids for people who really need them.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc6d29	Anonymous	None	2022-03-14T17:47:22Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0q-uxwr-zoim	False	None	False	2022-04-12 04:18:30.734	[]
2437	CDC-2022-0024-2443	https://api.regulations.gov/v4/comments/CDC-2022-0024-2443	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Government should not regulate what a Dr. thinks is best for his/her patient. My spouse has Ulcerative Colitis, Crohns, & pancreatitus- was super healthy, ate right, exercise.. etc. but unfortunately has severe pain associated with the illnesses mentioned. we have and still continue to try other methods but until then he suffers. There are others like this.<br/><br/>His Dr. over time has come up with the right dosage that helps him maintain his pain levels while still being able to work. Who are you to decide what works best based on what? Drug addicts on the street being able to purchase just about anything they want?<br/>these are not people who are going to a Dr's office.<br/>Not only is it very inconvenient to go to a Dr. office every single 28 days, but it also has an embarrassing stigma associated with it for people who didn't ask to be sick.<br/><br/>If you really want to fight the war on Drugs- CLOSE UP THE BORDER! Let Cops do their jobs and take down the street dealers. and Last Focus on Dr.s who are making money off the Fake Patients.. Most Doctors I know are legitimate Doctors trying to care for their patients.<br/><br/>Attacking people with disabilities is not the right way. If any of the people sitting in offices had to deal with the pain my husband does, would most definitely not want government telling them to just suffer because we want to be sure the common drug addict on the street is restricted. And if you look around.. criminals still get what they want!<br/><br/>Let the Doctors care for their patients without all the restrictions and let the Doctors decide if a 3 month supply for pain medication (like it use to be) will work for their individual patients. For people I know with severe back issues- let them get treatment before it gets so bad that multiple surgeries are necessary. <br/><br/>We are productive citizens and don't need a babysitter to control the intake of medications.<br/><br/>Thank you for your time. As you can read, I'm very passionate about this subject.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	riley	None	None	0900006484fc6d08	fairchild	None	2022-03-14T17:48:16Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from fairchild, riley	l0q-uq6m-z7lv	False	None	False	2022-04-12 04:18:30.953	[]
2438	CDC-2022-0024-2444	https://api.regulations.gov/v4/comments/CDC-2022-0024-2444	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to leave a comment about Doctors being so afraid of the DEA due to the CDC Guidelines that they are using drugs like Ketamine and Haldol on patients in the Emergency Departments, Intensive Care Units and Pain Management. Sometimes it's forced and sometimes patients pay for infusions out of their own pocket in desperation for pain control. The CDC has made it where entire hospitals do not use opiates period. They have a purpose and it is pain control. The general public is not aware that Ketamines main ingredient is Phencyclidine which is also the main ingredient for PCP. Can you imagine if they gave Grandmother PCP in the ER. This medication is making people have horrible hallucinations and causing PTSD and the Doctors prescribing it are well aware of what it does but what else are they to do. Haldol is an anti-psychotic medication also being given. Why would a Doctor give a normal mentally stable individual Haldol...sounds like a lawsuit to me. This whole mess the CDC has started reminds me of when my brothers meat packing union was busted. They started hiring teenagers and all kinds of people with no experience. Then people start dying, cutting off their arms with chainsaws and all kinds of lawsuits developed and guess what...they brought the union back. The CDC needs to get back to reality and let the Doctors do their jobs. Quit listening to your PROP members. They are lying through their teeth about opiates. The Real Doctors of the American Medical Association are the ones we should listen to not a group of people being paid to speak out against what we all know works. What is going to happen to these PROP people when they get into car wrecks or get colon cancer are they going to be excluded from the anti-opiate movement...I bet they are...Karma	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fc68d4	Donaldson	None	2022-03-14T17:49:23Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Donaldson, Linda	l0q-u65m-lv6v	False	None	False	2022-04-12 04:18:31.169	[]
2439	CDC-2022-0024-2445	https://api.regulations.gov/v4/comments/CDC-2022-0024-2445	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing as a physician to say what a disaster the 2016 CDC opiod guidelines were and to protest the needless suicides and suffering that was wreaked upon chronic pain patients as a results of those same guidelines. Shame on all involved especially PROP doctors who betrayed their hippocratic oaths.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martha	None	None	0900006484fc68ce	Oreilly	None	2022-03-14T17:49:57Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Oreilly, Martha	l0q-u5t4-3hj7	False	None	False	2022-04-12 04:18:31.398	[]
2440	CDC-2022-0024-2446	https://api.regulations.gov/v4/comments/CDC-2022-0024-2446	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This report and recommendations are troublesome at best and criminal at worst. Chronic pain patients shouldn't be the scapegoat for addicts who abuse medication. After the guidelines were published in 2016, and used by the DEA to illegally and immorally arrest doctors, the death rate by opioids has NOT decreased. The number of addicts have not decreased. The opioid crises is not and was not caused by pain patients, it was caused by illegal and illicit drug users and abusers, and mainly the illegal drugs pouring across our borders. The DEA should do the real job of stopping the cartels from other countries from selling their poison drugs laced with fentanyl to our citizens. That's what is killing people.<br/><br/>I am attaching a document that outlines the problems with this report, including people who should never have been on the committee and the use of studies conducted by people on the committee without real controls over their outcomes. They are biased and you would have to be blind not to see their bias.<br/><br/>Get the DEA out of the business of coming between doctors and patients. Get people with a vested financial interest in other avenues of pain relief (THAT ARE NOT SUCCESSFUL), off these committees and get real doctors with real experience in treating pain. YOU are creating an inhumane recommendation that has and will affect the livelihood and quality of life for hundreds of thousands of people who have real pain and need real opioid medications!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fc68c7	Bartlett	None	2022-03-14T17:52:43Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Bartlett, Jennifer	l0q-tplm-vep9	False	None	False	2022-04-12 04:18:31.629	[]
2441	CDC-2022-0024-2447	https://api.regulations.gov/v4/comments/CDC-2022-0024-2447	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please rethink your restrictions, I want a chance to live again. I want to play with my kids. I want to be happy. I'm in pain every second of my life and there's no fix for it!! Myself like so many others would rather die then continue this!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc68a6	Anonymous	None	2022-03-14T17:53:33Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0q-tph0-1427	False	None	False	2022-04-12 04:18:31.886	[]
2442	CDC-2022-0024-2448	https://api.regulations.gov/v4/comments/CDC-2022-0024-2448	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have permanent nerve damage from a misdiagnosed herniated disc back in 1997. I've had 2 spinal fusions and cannot walk without a cane and for a short time. I used to be able to do small chores and was not stuck in a chair waiting to pass. Nerve pain can't be cured and the only relief I had were my pain medications. The guidelines are not a one size fits all, I have never abused them and I've never been high on them. They allow me to shower without crying and allowing me some sort of life. Listen to pain Drs and their patients. This has to stop with the MME limits. I am not the same as everyone! I have played by the rules yet somehow I am in a living nightmare.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484fc6821	Mayers	None	2022-03-14T17:53:58Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Mayers, Diane	l0q-s9er-cow3	False	None	False	2022-04-12 04:18:32.117	[]
2443	CDC-2022-0024-2449	https://api.regulations.gov/v4/comments/CDC-2022-0024-2449	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was misdiagnosed for years, this was 1995 -97, with minimal arthritis in my back. I told them if I have minimal arthritis then why are there not people with arthritis throwing themselves off buildings. They gave the ok for an MRI. Having many since that day I realize that the way the MRI tech acted was a bit out of character. I believe they are not to say anything about what they see but this woman kept coming on with a controlled but deep concern and compassion asking me if I was ok. I got through it and went to a neurosurgeon who is very well known in the Boston area. He said I had the biggest herniated disc he had ever seen yet he said because of the holidays I had to wait until January 13th of 98. This was December, I begged him to do it asap. He said I had waited this long I could make it until the 13th. So I was a 37 year old mother of 3, had quit my job because the misdiagnosis was not going to give me a medical leave reason, I was caring for my elderly legally blind mother and taking care of a beautiful home with my husband. There was no Google to look up what COULD happen but I found out soon. On the 7th of January I woke up with bones and skin flapping on my legs. The disc cut through leaving me unable to stand or walk. I had emergency surgery but I had permanent nerve damage. It took me over a year to walk with a walker or a cane. I had to move from my big house as I was getting around by scooching on my rear. Thankfully I was half the size I am now. I did not sue the Dr as he said they would keep me free from pain and I was afraid if I sued they would leave me to suffer. Sadly that came later with the 2016 guidelines deciding what is the perfect amount of pain medication for everyone. I was on twice what I am on today and I was still in pain but I could get around and do minor chores and see my kids do things that I could no longer join in with them. I had some use though minor. Since 1998 I have had many other surgeries including 2 spinal fusions that were thankfully done before people were left to suffer post operation. I also had the not wanted but forced spinal injections. The first two I had I ended up with Bells Palsy. The next set of 2 were the tainted injections from the New England Compounding Center. I believe I still have my letter informing me that I was one of the unfortunate people to now have to get a lumbar puncture to see if I had menengitis. All so I could get enough medication to let me shower and walk more than a few steps. As I was tapered down so did my activity level. I sit in the same chair day after day. Seeing my grandchildren which used to be a joy is now too painful for words. Just riding in a car for an hour and a half is an hour too much. I'm going to be 62 this year, I feel my life ended in 2017. People complain about the lockdowns recently, I've been doing it for years and my once spotless home, even after we had to downsize, is a mess. My husband has been wonderful but he works and already is now the shopper and cook. We can't afford a cleaner. Had I known the misery my life would turn out to be I definitely would have sued the Dr that rather celebrate Christmas than save my life. I have had a spinal cord stimulator implanted as I could not sleep with legs going crazy , feeling like they were on fire, had ants crawling on them or worse and freezing all at the same time. We need to let caring, knowledgeable Drs prescribe for us that have no relief and no cure. Get rid of any mention of MME limits. I had one very serious surgery that the Dr kept upping my pain meds in the ER, he said he needed to do it slowly as most people taking what he had given me would be dead. I have a high tolerance for pain meds , probably because I am a larger framed person. I am overweight but I can't exercise at all , except swimming but I can only do that 3 months a year. I don't eat badly, actually I don't have much of an appetite at all. I just want to live as normal a life as I can. My poor husband has to take time off once a month to take me to my pain clinic which is really just wrong. I have never abused my meds , I don't drink alcohol, I safely guard my medications as I have pets and grandkids but I don't see them often. I'm a Christian woman who would never take her life but since these guidelines I can't wait to pass on and I love my family, this is not right. I want to LIVE LIFE with them and not just smile and suffer so they don't worry about me. Stop harassing pain Drs, look at the reason someone needs relief, it is not living it is surviving. Some of these pain meds have been around hundreds of years in different forms, why say nope! More people due from alcohol abuse but try taking away that and see what happens. It happened once and then they realized not everyone is abusing. People abusing pain meds are buying them off the streets and are not prescribed they are from China and other countries and are not made for pain management. I have never been high on a pain meds	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484fc6b97	Mayers	None	2022-03-14T17:55:16Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Mayers, Diane	l0q-rhl6-y7cw	False	None	False	2022-04-12 04:18:32.424	[]
2444	CDC-2022-0024-2450	https://api.regulations.gov/v4/comments/CDC-2022-0024-2450	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What you have done to Doctors who treat pain has profoundly affected my life. I have degenerative disc disease, avascular necrosis and severe osteoporosis. Every bone in my body hurts and is subject to fracture because of the weakness. Now that you have limited the doctors I can not even perform my household chores and am on the brink of a divorce after 30 years of marriage. The Doctors are all well educated and an agency comes in and limits the relief they can give you? I think it is absolutely terrible. I feel like I am in another country where freedom doesn’t exist. The absolute nerve of the government to cause you pain is unheard of. I am 59 years old and have worked my whole life. The last few years of my life should be pain free! I am so disgusted with the CDC. I wish I could take legal action against you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484fc6b95	Birmingham	None	2022-03-14T17:56:10Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Birmingham, Jeanne	l0q-rfb9-g3hq	False	None	False	2022-04-12 04:18:32.658	[]
2445	CDC-2022-0024-2451	https://api.regulations.gov/v4/comments/CDC-2022-0024-2451	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who's life is currently IN RUINS due to this crackdown on opioids...i literally have gone from a good quality of life to ABSOLUTE ZERO!! I don't leave my house except for the 5 ER visits & cpl pain clinic appointments FOR NOTHING!! No one will prescribe opioid drugs anymore, especially to chronic pain pts like me! I spent several years trying the non opioid medications, most tried 3-4 times and it is WELL DOCUMENTED that I can't take them! But recently, through no fault of my own, my meds were stopped abruptly and I of course went into withdrawals at the same time my pain was going through the roof! As stated, I was sent to pain clinics who said they couldn't help because they felt I was in withdrawals ( but my PCP gave me a "bridge Rx" of Methadone until I got there so they obviously don't know pain from withdrawals!) Oh, I DID go through withdrawals at home from my main pain med, so I definitely know what it's like. But I DIDN'T feel that way when there!! These places are supposed to be for this very reason. Then 2 different detox places were called because of what they said & THEY SAID they couldn't/wouldn't take me because I was a "chronic pain patient...OMG!!! Something MUST BE DONE, THIS HAS BEEN TAKEN TOO FAR!! I AM SORRY that people have lost loved ones to this problem & there's MANY DIFFERENT REASONS WHY,BUT others, with REAL CHRONIC PAIN need this medication to live our lives. Without it, our quality of life is NONEXISTENT!! I AM CURRENTLY SUFFERING & I wasn't able to spend the last 2 weeks of my 2yo Grandson's life with him when I had been at his house EVERY DAY!! I even missed saying my last goodbye on the day he died on 2/22/2022! I have been writing this forever because I hurt so bad BUT I JUST HAD TO SAY MY PEACE!! You NEED to change something here because I now understand WHY people commit suicide..I am not saying I am going to, just that I UNDERSTAND WHY!! I AM IN AWFUL PAIN AND THIS IS INHUMANE to do to someone who TRULY NEEDS IT!! I AM NOT a person who gets " high" from the medication, in fact,I don't even remember a time that it affected me like that...it only let's me live a decent life, be with my kids & grandchildren & not HATE LIFE as I do now!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fc66d7	St.Germain	None	2022-03-14T17:57:16Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from St.Germain , Michelle	l0q-m33m-0oyi	False	None	False	2022-04-12 04:18:32.897	[]
2446	CDC-2022-0024-2452	https://api.regulations.gov/v4/comments/CDC-2022-0024-2452	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don't understand that if I'm taking prescribed Opioids for pain every day, why would I still have RLS when I try to go to sleep. Why would medication for RLS (Requip), not work for me anymore? If Opioids help anyone with RLS, let the doctors prescribe them. RLS is Hell. There is no sleep. Your next day is always ruined from lack of sleep. What kind of life is that? Think about it as if it were you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fc66cf	Hoffman	None	2022-03-14T17:57:49Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Hoffman, Lisa	l0q-kzj3-iqwm	False	None	False	2022-04-12 04:18:33.145	[]
2447	CDC-2022-0024-2453	https://api.regulations.gov/v4/comments/CDC-2022-0024-2453	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	“I wish to endorse comments separately submitted to the Federal Register and widely published on social media by [redacted]”. <br/><br/>Please repeal the guidelines and allow physicians who examine and treat their patients to treat them as individuals and without fear of reprisal. Stop putting limits on what doctors can prescribe as each person is different! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc66c6	Anonymous	None	2022-03-14T18:02:00Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0q-k618-2fya	False	None	False	2022-04-12 04:18:33.383	[]
2448	CDC-2022-0024-2454	https://api.regulations.gov/v4/comments/CDC-2022-0024-2454	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My good friend ([redacted], since deceased) was seriously injured in a 1 story headfirst fall onto a tile floor. Fractured skull, broken eye socket, broken jaw, fractured 2 cervical vertebrae, top of rotator cuff sheered off, broken clavicle, ribs, lumbar vertebrae, pelvis split in half and damaged knee. He was 6'5" and 300 pounds and hypertensive. There were multiple surgeries and physical therapy. After his second heart attack, (one during reconstructive surgery) he had a pacemaker / Defibrillator implant. He also developed diabetes. Those conditions ruled out NASIDs for pain management. He was in pain, and rotating through various opioids kept him somewhat functional. He did develop stenosis, and had back surgery with a metal cage implanted. Unfortunately, his spine broke, possibly due to osteoporosis. at the repair. He was in terrible pain, and signed up for pain management. Somehow this "management" included drastically reducing his pain medication and treating him like he was an addict. The pain management service dropped him while helping him to bed, and he was screaming in pain, bleeding from a broken nose. They still refused to provide pain medication. His wife called an ambulance - they refused to - but he died shortly after he reached the hospital. Pain medication needs vary by things such as weight and built up tolerance, and lack of alternatives. Some people will never be able to do without.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484fc72a6	Weston	None	2022-03-14T18:03:42Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Weston, Marilyn	l0q-zuow-dknu	False	None	False	2022-04-12 04:18:33.648	[]
2449	CDC-2022-0024-2455	https://api.regulations.gov/v4/comments/CDC-2022-0024-2455	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support [redacted]'s comments about the CDC's new guidelines. Lowering MMEs and basically worse than 2015 and will make pain meds obsolete which they almost are.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fc63f9	Howe	None	2022-03-14T18:04:30Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Howe, Amy	l0q-hkob-oirc	False	None	False	2022-04-12 04:18:33.893	[]
2450	CDC-2022-0024-2456	https://api.regulations.gov/v4/comments/CDC-2022-0024-2456	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC Docket# 2022-0024 Anonymous, I am writing to express concerns I have with the new version of the updated guidelines. There was to be no hard limits on dose due to the misapplication from suggestions made in the 2016 guideline. The reference to 50 MME is present more than 20 times. It's been shown that state government and Insurer's will take any number and misapply it to make laws and policy. The DEA will take any number as a limit as a reason to continue to harass doctors. Doctors fear prescribing until they are comfortable they will not be attacked by the DEA. For these reasons the 50 MME must be removed. Also the DEA must be told to back off. FDA has warned that NSAIDS can cause heart attacks, strokes, and may cause Gerd. Yet the CDC recommends there use numerous times over the use of Opioids. Tylenol has little or no effect on most Chronic or Intractable pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc669d	Anonymous	None	2022-03-14T18:04:59Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0q-baiy-3z8l	False	None	False	2022-04-12 04:18:34.133	[]
2451	CDC-2022-0024-2457	https://api.regulations.gov/v4/comments/CDC-2022-0024-2457	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been a Registered Nurse my whole adult life working in all areas of nursing from the elderly, oncology, surgery, critical care and nurse education, home health/hospice and school nursing. I spent years improving my skills and continually learning and was thrilled to finally receive my Masters degree in nursing because this meant I can do more for my patients, hospitals, education and my community. I had high hopes and aspirations. My dreams as a little girl becoming [redacted] had finally come true. <br/><br/>Unfortunately, in 2007 & 2008 I suffered two workplace injuries while caring for dying and trauma patients at my local hospital’s (San Diego County) CriticalCare Unit. I was never able to return to hospital work and spent the next 13 years disabled and trying to live a quality life while suffering with severe chronic pain and anxiety. During this time I also developed some health issues as most people do with chronic illness. <br/><br/>Fortunately, and because I must due to finances, I’ve been able to return to work, in some measure, in my community but still live in pain daily. Without pain management this would not be possible. I also suffer from chronic anxiety and see a therapist twice monthly as well as visit my pain management doctor monthly and my primary doctor every 3 months. I eat healthy, exercise regularly and still just barely make it through my days due to pain. <br/><br/>Since the publishing of the 2016 Guidelines and their subsequent misapplication, my medications have been reduced both by my health insurance prior approval process, as well as the DEA, and state medical board’s intimidation of my exceptional pain management physician. I’m fearful that soon my medications will be non existent due to the restrictions and fear from the doctors and pharmacists to relinquish opioids due to this “opioid crisis”. <br/><br/>I beg whoever reads this, to please have compassion on those of us who just want to lead ordinary lives, work hard, contribute to society, enjoy our family and friends and not be a burden to our loved ones or the government. To accomplish this, I rely on pain medication. I’ve tried and still do alternate types of pain relief but nothing works as effectively as pain medications. That’s what they were created for. Please don’t treat me and others like me as abusers and addicts. That’s the real problem. Not persons like myself. I challenge you to differentiate between us and don’t treat us as abusers. Your war on opioids has left a stain on all of us who suffer and those that abuse…continue to do so. The problem is not getting resolved in fact it seems worse. Not to mention the suicide rate increasing in those populations of chronic pain patients because they can no longer live with their suffering. <br/><br/>I will not stop writing and educating everyone I can on what the true crime is...our rights to a fair and pain free life because of those that abuse the system and the powers that be not seeing the difference. <br/><br/>Please cancel these CDC guidelines altogether, or at least eliminate the illegitimate, unscientific MME numbers for chronic pain sufferers, and suspend the current guidelines until the revised guidelines are finalized and published.<br/><br/>Please hear our cries and help us. Don’t make us suffer any longer. <br/><br/>In hopes of compassionate changes, <br/>[redacted]<br/>CPP (chronic pain sufferer) <br/>Registered Nurse <br/>Voting U.S. California Citizen <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lesley	None	None	0900006484fc6360	X	None	2022-03-14T18:06:16Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from X, Lesley	l0q-3pcu-yyq0	False	None	False	2022-04-12 04:18:34.364	[]
2452	CDC-2022-0024-2458	https://api.regulations.gov/v4/comments/CDC-2022-0024-2458	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain from Multiple Sclerosis, specifically severe (pain scale 7-10), with nightly pain in my legs. This pain can wake me from sleep or prevent me from sleeping. Between 2016 and 2019 I was prescribed 10 mg Oxycodone/650 mg Acetaminophen (aka Percocet), which I took at bedtime. This therapy did suppress the pain and allowed me to sleep. In 2019 I moved to a different city and had a new physician. On her advice I discontinued this drug we began to look for a non-opioid effective substitute. We tried many other drugs over the course of the past 2 years, (including muscle relaxants and anti-seizure medications) as well as Physical Therapy and exercise but none were effective. I cannot sleep more than an average of 4 hours per night. None of my current physicians will prescribe an opioid drug. My quality of life is miserable, and I feel as if I am a victim of the opioid abuse epidemic.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484fc6359	Moses	None	2022-03-14T18:06:44Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Moses, Carol	l0q-35mn-92bw	False	None	False	2022-04-12 04:18:34.630	[]
2453	CDC-2022-0024-2459	https://api.regulations.gov/v4/comments/CDC-2022-0024-2459	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is time to get the DEA and CDC out of the practice of pain management. Some people require a lot more medication in order to start to have the same effect that another person achieves. They call it the practice of medicine because it requires judgement of the doctor to determine the treatment. <br/><br/>I have been under treatment for over 20 years. A reduction in my doses would send me to bed forever or worse kill me. In other times when the medication last some effectiveness it would either be increased or changes to a different medication to allow it to continue to work. Being on this medication allowed me to work 10 years beyond when my primary doctor began to recommend I go on disability. Those 10 years were years that I was productive benefit to society. <br/><br/>I am now well past that point and can barely do normal household things like laundry and dishes. Loss of my medication would end my ability to do those things. An increase might allow me to return to some of my hobbies that I can no longer do, increasing my quality of life. I have a physician who would give me an increase if she didn't have the DEA \'s thumb on her practice. Why does a law enforcement person with no medical training have the right to dictate the treatment of a pain patient. If I tried to do that I would be thrown in jail for practicing medicine without a license. The DEA should be treated the same way.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dennis	None	None	0900006484fc6358	Ewing	None	2022-03-14T18:07:30Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Ewing, Dennis	l0q-32ml-uxb7	False	None	False	2022-04-12 04:18:34.853	[]
2454	CDC-2022-0024-2460	https://api.regulations.gov/v4/comments/CDC-2022-0024-2460	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain warrior. I’m 65 years old and deal with high levels of pain daily. I have experienced varying levels since I was in my 30’s. For decades I have seen my medical team on a monthly schedule. I have tried and found relief with a combination of treatments. My medications are a combination of anti inflammatory, anti depression, gastrointestinal, anxiety and pain prescriptions. My body has a neurological condition that causes tremendously damaging symptoms. As with many diagnoses my bodies reaction to my illness causes additional health issues. I have been treated for decades with opioids at the lowest dose that is somewhat effective without any signs of addiction. I have a extremely well trained team of doctors who treat my illness's with great care and excellent experience. All of them agree the need for pain medication is warranted so I can be my most functional. They also believe a higher dose at this time would help now that my health has declined. I have always agreed that a balance is needed when taking any pharmaceutical medications. They are hesitant to prescribe due to the restrictions listed in the CDC guidelines. The cap of 50mg morphine equivalent keeps them for increasing my dose above 40mg daily. The fear their corporate owners and the DEA. If they prescribe higher amounts even when documented as very warranted. We have discussed being sent to a pain clinic where I will be reevaluated and forced to receive steroid injections. I was treated with high doses of steroids for years when my autoimmune illness attacked my eyes and skin. I can not tolerate that medication any longer. There are no drs willing to prescribe higher doses due to guidelines and the 50 mg comparison to morphine. The CDC is aware of the harm affecting pain patients and are working on a new guideline to help doctors and medical personnel prescribe necessary pain medication. As long as there is any mention of a ceiling on milligrams the clinics, doctors and insurance companies will use that as a firm rule. Even tho it isn’t intended to be one. I am suffering as are millions of patients due to this comparison. Drs are fearful of being targeted by the DEA who have focused heavily on our Medical groups and pharmacies. I trust the training of policymakers to correct and confirm that the harm being done should not continue. Please help me and others who need our drs to be able to treat us with continued care as humanely as possible. We have the best medical care in the world we should trust our Drs to do the what is necessary.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484fc6145	Ryan	None	2022-03-14T18:08:14Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Ryan , Pamela	l0p-eidj-5dso	False	None	False	2022-04-12 04:18:35.078	[]
2455	CDC-2022-0024-2461	https://api.regulations.gov/v4/comments/CDC-2022-0024-2461	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The data is clear that overdoses are increasing, not because of prescribed opiates, but because of illegal drugs. Yet, the powers that be keep trying to solve the problem of street drug by denying adequate pain relief for those in chronic, unrelenting pain. It’s time to reverse this cruel policy and allow, and encourage, providers to prescribe opiates in adequate dosing to their patients. No provider or family member should have to watch people suffer because of draconian, puritanical policies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	0900006484fc6356	Golden	None	2022-03-14T18:20:43Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Golden, Anne	l0q-2z2u-4vsz	False	None	False	2022-04-12 04:18:35.303	[]
2456	CDC-2022-0024-2462	https://api.regulations.gov/v4/comments/CDC-2022-0024-2462	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket CDC-2022-0024<br/>I was born with the most rare and severe digestive disease known to doctors. It's a motility disease called pediatric pseudo obstruction syndrome. I have been waiting to die since I was 12 years old. I have had as much intestine removed as medically possible. I'm now 53 years old and nobody can explain how I'm alive. I know need a multivisceral transplant, live on daily IV's and a tube in my stomach to pump it to help with decompression. I can eat very little. The bowel that I still have left is full of pseudo obstruction which also means malabsorbtion. The pain I live with every single day makes me want to stop living. Without buccal opiods I lay and sweat and yell out for someone to please end this nightmare. I have been lucky enough to have a pain doctor who prescribes me fentanyl citrate lozenge lollipops that dissolve on the inside on my cheek. This medicine helps to not only give me relief but to be able to function and have somewhat of a life to enjoy. My doctor said without it the pain would cause my body to deteriorate and I'd die. So yes pain kills. I'm on disability. People with chronic illnesses deserve a life and without their pain medication they are being denied of a life and many are committing suicide. Because my pain is not cancer related medicare will no longer pay for it. I have spent 25 grand in under 2 years for my pain medication and don't know how much longer I will be able to.pay for it. Nobody will help me get this resolved. My doctors have all wrote letters but they continue to say no. Once I run out of money to pay out of pocket for my medication I will die and medicare will have to live with my death. Thanks to medicare my days will be numbered. I need a 23 hour transplant of 3 organs and they don't feel I suffer enough to cover pain medication. I have letters from the top doctors in the world from the [healthcare facility name redacted] and it still isn't enough. Please help us severely chronically ill patients that suffer so much. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484fc3d0e	Wolfe Gonzales	None	2022-03-14T18:42:20Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-11T05:00:00Z	None	None	None	None	None	None	None	Comment from Wolfe Gonzales, Denise	l0m-371c-icc2	False	None	False	2022-04-12 04:18:35.525	[]
2457	CDC-2022-0024-2463	https://api.regulations.gov/v4/comments/CDC-2022-0024-2463	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cancer is a painful, excruciating disease to have. It is painful before, during and after having cancer. Chemotherapy causes pain in the body even after the active cancer is gone. Treating only active cancer pain is unethical and morally wrong on every level. Cancer patients should have full access to all the pain meds they need to live a quality functional life.<br/>My twin flame [name redacted] was a fellow Cancer survivor. She had a very malignant form of breast cancer that moved into her lung and intestines. She had to have half of her intestine, both breasts and one lung removed. She was able to live a quality form of life on 280MME. Once the 2016 Guidelines were put into LAW her doctor retired and the new doctor cut her pain medicine from 280MME to 160MME in a week. She went from functional, happy, outgoing to sad, physically broken and bedridden. The pain was unbearable. She went back to her doctor and requested to stop tapering. The doctor said the New 2016 CDC Guidelines said I have to. The doctor cut her down to 80MME. [name redacted] died one week later from the FORCED TAPER TO 90MME OR LESS THE CDC GUIDELINE LAWS PUT IN PLACE.<br/>Now the 2022 CDC Guidelines are saying only active cancer pain can be treated with opioid pain medication.<br/>Why did we survive cancer just to suffer at the hands of the CDCs recommendations and the BIASED "Opinions" of PROP Members?<br/>PLEASE on ALL that is SACRED REMOVE ALL MME recommendations and the 2022 Guideline Law that only Active Cancer Patients can get their Pain treated.<br/>These Opinion based Guidelines are killing people. This onslaught needs to end.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fc5871	Allder	None	2022-03-14T19:07:12Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Allder, Melinda	l0p-h271-rcax	False	None	False	2022-04-12 04:18:35.742	[]
2458	CDC-2022-0024-2464	https://api.regulations.gov/v4/comments/CDC-2022-0024-2464	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to remove ALL mention of MME (whether it be 50 or 90) from the revised “guidelines”. Doctors should be able to treat each patient individually. What works for one patient doesn’t necessarily work for all patients and doctors need the flexibility to treat patients with whatever is necessary for that individual.<br/><br/>You had 90 MME as a hard number in the 2016 “guidelines” which you stated wasn’t supposed to be interpreted as that, but it was. States enacted laws banning doctors from exceeding 90 MME’s (with lower limits in some states), insurance companies and pharmacies are denying legitimate prescriptions that are over 90 MME and the DEA is harassing licensed physicians who determine that a patient requires more than 90 MME’s to adequately treat their documented medical conditions. This has had and is having devastating consequences for people who truly require more than 90 MME’s. <br/><br/>Now, in addition to the 90 MME’s, these new “guidelines” have 50 MME’s mentioned numerous times. Based on the atrocities that occurred when you came up arbitrarily with the 90 MME number, the 50 MME number will be turned into state law and countless patients who are over 50 MME will have the medications that help them function taken away or severely cut back because the 50 MME will be the new 90. Insurance companies and pharmacies will deny prescriptions over 50 MME and doctors will be too afraid to write those prescriptions because the heavy handed DEA will harass, if not arrest them. So please remove ALL mentions of MME from this entire document. It is the least the CDC can do after the harm and suffering you caused to millions of patients in this country when you veered out of your lane by publishing the 2016 “guidelines”. <br/><br/>You really just need to admit that you misrepresented (lied) about the actual numbers of prescription opioid overdoses, which in fact are very low. You included illegal substance overdoses in the “opioid” overdose numbers, which made it look like the US had a prescription opioid overdose problem. However the truth is that less than 1% of opioid overdoses are prescriptions. Over 99% of overdoses are illegal substances. Despite the CDC knowing this, they lied to the American people. Those lies caused immeasurable suffering, patients being neglected and literally tortured by not having access to a legal medication that could help them. This shouldn’t happen in the United States of America. The CDC single handedly denied patients their right to adequate medical care. The people who wrote the 2016 guidelines and are also involved in the 2022 revisions are addiction treatment “specialists” and mental health “professionals” who financially benefit from the false prescription opioid overdose agenda and whom have significant conflict of interests. The CDC doesn’t have any pain management doctors, anesthesiologists, oncologists or surgeons consulting on these guidelines. These types of doctors are the experts and they should have a significant impact on the 2022 guidelines. They undergo extensive training on narcotic pain medication and they should be consulting and not some PhD. Not to mention, the CDC isn’t even supposed to be involved in prescription drugs…that’s the FDA’s job. You need to completely revoke the 2016 guidelines and stick to your responsibilities as well as the DEA needs to stop harassing licensed physicians and throwing them in jail. If they did their actual job and stopped ILLEGAL drugs, the overdose numbers would drop.<br/><br/>So to sum this up, please completely rescind the 2016 guidelines. However since you won’t have the guts to admit you were wrong and do that, you must remove ALL mentions of MME and don’t give more ammunition to the states and insurance companies to continue the torture of patients. Give doctors back the power to treat their patients as individuals and restore patients rights to individualized and adequate medical care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leesa	None	None	0900006484fc5873	Smithton	None	2022-03-14T19:13:51Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Smithton, Leesa	l0p-h9f9-9fw2	False	None	False	2022-04-12 04:18:35.957	[]
2459	CDC-2022-0024-2465	https://api.regulations.gov/v4/comments/CDC-2022-0024-2465	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started with back pain in high school. Sitting in chairs at school was painful for me. I couldn’t understand why i was the only one who would shift myself, constantly moving. Fast forward to age 20 and a day where for no apparent reason I could not get up from my work chair. I had to have someone drive me to an emergency appointment with my primary care. This started my chronic medical treatment of muscle relaxers, rest, missing time from work, physical therapy, chiropractor tx, and eventually pain management. I have treated with four pain management centers. Each gives a prescription of limited opioids which relieves the pain enough to get some productivity out of life. But these prescriptions come with an exchange of painful injections. As soon as the injections do not work or you max out on the limit medically necessary, your scripts are ended and you are discharged from their practice. To search for additional help, you are labeled a dr shopper. I waited 10 ling years to finally have a fusion at L5/S1. I got more than 50 % relief for the symptoms that were being caused ny that disc. However the need for opioids was still present for the facet syndrome in my thoracic area and my SI joint dysfunction. These are all very painful and cause loss of sleep, loss time from work, but more importantly, loss time living life. The opioids my primary care prescribed for me from 2014-2020 gave me the ability to work, the ability to get out of bed, and sometimes even enjoy time out with family and friends. No they do not fix the source of pain, but neither does injections, and physical therapy or other forced treatment in exchange for the life needed medication that provides some normalcy to a chronic pain patient. My dr decided to retire and i was forced to find yet another pain management center. Luckily my new dr understands that the opioids are working enough to give me a quality of life until such time as I will eventually have additional surgery on two discs above my fusion and an SI joint fusion. I urge the CDC to<br/>Remove all mention of MME. All<br/>Patients process medication differently. And not all medications work for every patient. The physicians, along with patients should decide the best standard of care. My experience is that drs hang their hat on the CDC recommendations. The 2016 guidelines have been extremely detrimental to so many chronic pain patients. Many physicians refuse to prescribe opioids at all, even when medically indicated. They will simply say “Im sorry, I can’t help you” How is that holding up to the oath of due no harm? There should be no mention of cancer vs non cancer. There are so many chronic pain conditions that are appropriately treated with opioids. Chronic pain patients did not cause the opioid crisis. Infact, cutting of millions of chrinic pain patients from fda approved medications that work for them forces people to take am action necessary to get relief from<br/>Relenting pain we feel every single day. You dont need opioids until you do. And them and only then can someone understand the impression of getting these guidelines right to protect the millions of chronic pain suffers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484fc5876	Maxwell	None	2022-03-14T19:18:17Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Maxwell, J	l0p-hchg-k27p	False	None	False	2022-04-12 04:18:36.172	[]
2460	CDC-2022-0024-2466	https://api.regulations.gov/v4/comments/CDC-2022-0024-2466	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] a board certified [occupation redacted]. Physicians need to step up and educate themselves about the differences between addiction and dependency. Opioid Use disorder is a genetic disease. 10% of the population have the gene. Doctors need to take a through family history. Patients on a stable dose of pain meds without early refills or escalating doses should continue their pain meds at the dose that keeps them comfortable! Those with Opioid Use Disorder can be managed with Suboxone. I have many patients whose lives have changed in a very positive way using Suboxone for their pain. The pain pathway is different than the pleasure pathway in the brain. 1 mg of bup= to 30 mg MME. Thus 16 mg is equal to 480 mg MME (Equivalent to 4 oxycontin 80 mg. 24 mg bup= 720 mg MME 6 oxycontin 80 mg). Using this for pain Q6-8 h can be used for constant pain relief and even for major surgical procedures. I have done this for over 15 years so this is not a "suggestion". This is a proven fact. PLEASE, pay attention to what I am saying and approach the experts on this; the physicians treating addiction in the American Society Of Addiction Medicine and American Osteopathic Association of Addiction Medicine. Educate doctors now and in training. We are physicians! We must use our knowledge to help people. You have 'suggested" decreased dosing for pain meds and now we have an increase in overdose deaths! My practice is in Philadelphia, [location redacted]. I know what I am telling you. I live it every day in my office	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jan	None	None	0900006484fc5881	Widerman	None	2022-03-14T19:22:08Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Widerman, Jan	l0p-hytm-zud0	False	None	False	2022-04-12 04:18:36.389	[]
2461	CDC-2022-0024-2467	https://api.regulations.gov/v4/comments/CDC-2022-0024-2467	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 57yo male diagnosed with RLS 10y ago. I’ve suffered with RLS since childhood and my mother also has this disease. It has kept me up countless nights and has adversely affected many aspects of my life. <br/>After turning 45 the disease became more severe and i finally sought specific medical care to treat it. <br/>I tried several drugs, ropinirole, pramipexole, gamapentin, Horizant…These worked initially but eventually made the condition worse! Finally, my neurologist tried Tramadol which was the first drug that eliminated my symptoms. Since 2014 I’ve been on 100mg of Tramadol which I take near bedtime and which consistently eliminates RLS symptoms for me. <br/>Unfortunately, due to relocation I had to find a new medical team. Most doctors do not want to prescribe Tramadol either because they do not know how to treat it or because they are afraid of losing their license and I don’t blame them. <br/>I realize the opioid epidemic is real and many deaths have resulted from it. Our nation must deal with it. But it must do so without compromising effective treatments for patients with a valid need for opiates for RLS. I take Tramadol responsibly. I never exceed the order specified by my doctor. For me Tramadol is not for recreation… it doesn’t get me high.. it merely gives me back control of my life. <br/>Please allow doctors to freely prescribe opiates when indicated for severe RLS without fear of severe discipline. It is easy for them to ensure abuse and diversion do not occur and I highly doubt patients with RLS would want to abuse something they rely on to control their condition.<br/>Thank you for your consideration!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicholas	None	None	0900006484fc5898	A	None	2022-03-14T19:25:37Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from A, Nicholas	l0p-ig2d-wlxg	False	None	False	2022-04-12 04:18:36.599	[]
2462	CDC-2022-0024-2468	https://api.regulations.gov/v4/comments/CDC-2022-0024-2468	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	#1-until the United States gets the fentanyl that is coming from china and Mexico bye smuggling it across our southern border? I was in a very bad construction accident 30 years ago leaving me paralyzed from the waste down and I have had 18 back surgeries. <br/>Leaving me unable to go to the restroom normal as well as the pain I live with 24/7 <br/>Not being able to be the father I want to be as well as not being to do things for myself <br/><br/>2- before I was able to get my pain under control with meds,physical therapy and injections I was not able to be a contributing member of society but with the help from meds ,physical therapy and injections <br/>I am able to be more active a better father and husband as well not be depressed <br/><br/>3-I also believe that a patient and doctors should be the ones to make good and responsible decisions that makes patients lives more productive and lower physical and mental pain <br/><br/>5- I also believe that only qualified and trained in pain management <br/><span style='padding-left: 30px'></span>And make the patient responsible my Dr has patients sign a contract and drug test<br/>If the patient doesn’t hold up to there end of the contract will not be a patient <br/><br/>To whomever we need to separate the chronic pain patients from the recreational drugs <br/><br/>Please fix the fentanyl coming from china and smuggled across our border killing Americans<br/>If you do that I believe the overdoses will help end the problem	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rich	None	None	0900006484fc6346	Hea	None	2022-03-14T19:30:58Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hea, Rich	l0q-1xol-muw9	False	None	False	2022-04-12 04:18:36.811	[]
2463	CDC-2022-0024-2469	https://api.regulations.gov/v4/comments/CDC-2022-0024-2469	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a registered nurse for 20 years now. When the laws changed years ago, that we were not to question pain but to just treat, we ALL saw this coming and the epidemic that exists today. I would encourage the CDC to look at pain in a more complex manner. People are different, tolerance levels are different, etiologies are different and I believe that you could be more successful in the treatment of pain if you included non-medication therapies such as cognitive behavioral therapy AND worked on the etiology along with the prescription of medication as needed, with the goal to decrease the dose rather than increase the dose. Each person needs to be treated individually and physician's hands need to be untied.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bonnie	None	None	0900006484fc6308	Cator	None	2022-03-14T19:32:04Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Cator, Bonnie	l0p-zxud-khg0	False	None	False	2022-04-12 04:18:37.023	[]
2464	CDC-2022-0024-2470	https://api.regulations.gov/v4/comments/CDC-2022-0024-2470	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove the MMEs for Chronic Pain Patients! And I am referring to patients that have been diagnosed with 1 or more chronic intractable pain condition. The majority of us that have already been grossly harmed by the previous CDC guidelines!<br/><br/>We have already tried EVERY modality given to us to exhaustion, including phsycatry and behavior modification therapy, physical therapy, bio feedback, acupreessure, acupuncture, meditation, and the list goes on. We've also undergone painful facet injections, steroidal injections ect. All of these modalities are no help to certain conditions after suffering from them for countless years! <br/><br/>To regulate an arbitrary number of MMES for EVERY chronic pain sufferer is tantamount to torture! <br/>What we've been asked to endure these past years under the current guidelines has degraded us to non existent citizens! I for one went from being able to actively care for my family and do volunteer work to being mostly bed ridden. <br/><br/>The problem IS NOT WITH PRESCRIPTION OPIATES! IT'S WITH THE ILLICIT DRUG TRADE!! Withholding and limiting the relief for legitimate chronic pain patients has forced many of them to seek other ways to cope with their pain, whether that be the streets or by taking their own lives!! 100,000 Chronic Pain Patients have died since the CDC GUIDELINES were released! This must end!! We aren't the enemies!! The illicit drug trade is!! <br/><br/>Anti-opiate zealots have demonize all opiate users and have used over inflated numbers to make news stories more dramatic! They fail to differentiate between medical grade Fentanyl and the fentanyl coming across the southern border that killing 1000's!! <br/>That's the CDC's, DEA's and FDA's real enemy! Not law abiding Chronic Pain Patients and their doctors! <br/><br/>We need to establish trust again in the doctor/patient confidentiality again and the government needs to let our physicians treat their patients as needed according to their diagnosis and conditions. One pain recommendation do not fit for every condition! <br/><br/>Either remove the MMEs from the new guidelines or start over with the knowledge that we aren't the enemy and one size absolutely does not fit nor help all intractable pain patients!<br/><br/>Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fc6226	Strange	None	2022-03-14T19:34:26Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Strange, Jennifer	l0p-yrpw-2fi7	False	None	False	2022-04-12 04:18:37.237	[]
2465	CDC-2022-0024-2471	https://api.regulations.gov/v4/comments/CDC-2022-0024-2471	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a disabled nurse with cauda equine syndrome with intractable pain which became in 1994, along with other chronic pain diagnoses. Never prior to my injury did I use illegal or legal drugs. I worked for 15yrs after my injury until I was unable to practice due to increasing pain and decrease in functionality. My pain is now uncontrollable and has decreased my quality of life. Due to the decrease in pain meds that was implemented by the 2016 CDC opioid restrictions. The imposed changes of CDC 2022 are on the right track but still need adjustment. The 50meq need to be taken completely out shouldn’t have any mention of meq restrictions. Chronic & intracranial pain patients shouldn’t have an in posed restrictions. A clinical treatment plan should be between the prescribers & pt. No one’s pain is the same, we all have different thresholds. Only regulations should be imposed on Primary care settings they don’t preform drug screening and it’s very easy to acquire opioids in that setting. Where as Pain Management monitors behavior and preforms routine drug screen. States shouldn’t have an say in management of meds ie. Insurance company / worker’s comp imposed regulations. We pay for our insurance and they aren’t MD’s, have no working knowledge of our diagnoses. Worker’s compensation is the worst, they have an independent reviewer look at the prescription and based on a note make life changing decisions. We aren’t all the same!! Our individual needs r different, there is not a one prescription fits all !! This need to be left to qualified pain management MD’s! I have been tapered to a dose of opioids that has left me in terrible pain and has affected my ADL’s, has severely affected my QUALITY OF LIVE !! No one deserves to live the rest of their lives in intractable pain!! Please hear our voices and consider our request. The opioid epidemic isn’t from Pain Management clinics, it has been caused by these street use and unregulated PCP. I do believe there is a need for some restrictions but it should only be applied to PCP, as they don’t monitor the use of opioids. If they’re going to prescribe opioids they need to implement drug screening. Any pain lasting longer than 3 months should required a Pain management MD. Physicians shouldn’t be afraid to properly tx patients, be in fear of loss of license. If they remain in fear then no changes made will alleviate it. CDC caused Suicide rate to increase astronomical with the implementation of guidelines in 2016, so please construct each word carefully in 2022 guidelines . We can not afford any further deaths!! The problem is the streets not physicians offices. Thank you [name redacted] (disabled)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fc6223	Solomon	None	2022-03-14T19:35:57Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Solomon, Melinda	l0p-yi7k-q42l	False	None	False	2022-04-12 04:18:37.467	[]
2466	CDC-2022-0024-2472	https://api.regulations.gov/v4/comments/CDC-2022-0024-2472	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	REGARDING CHANGE FOR THE CDC GUILDLINES 2016, (FOR OPIATE MME CHANGE).<br/><br/>WE MUST CHANGE TO SAVE PEOPLES LIVES!!!!! WE MUST REVISE TO INCREASE MME's ON LEVELS THAT ARE SANE NOT INSANE!<br/><br/>THE WAY IT IS WRITTEN IS KILLING THE INNOCENT PEOPLE SUFFERING NOT HELPING THE OPIATE PROBLEM.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc6546	Anonymous	None	2022-03-14T19:36:39Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0p-x4nh-zmkq	False	None	False	2022-04-12 04:18:37.694	[]
2467	CDC-2022-0024-2473	https://api.regulations.gov/v4/comments/CDC-2022-0024-2473	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	FORMAL SUGGESTION ON CDC GUIDELINE 2016 TO CHANGE THE DAILY MME ACCORDINGLY. PLEASE I MUST GIVE YOU MY INPUT ON THE MME 50 DAILY DOSE. I FEEL THIS NEEDS TO BE REVISED TO (AS PER PATIENTS INJURIES/DISEASES). THIS IS A MUST TO CORRECTLY GIVE THE RIGHT DOSAGE AS PER THE INDIVIDUALS CIRCUMSTANCES. TO LUM ALL DISABLED CCPS IN THE SAME CATEGORY IS TOTALLY NOT THE WAY IT SHOULD BE WRITTEN. PLEASE HELP ALL OF US HUMAN BEINGS BY REVISING THIS ABSURD, UNFEELING AND UNBELIEVABLY RECKLESS GUIDELINE. THIS IS TOTALLY BACKWARDS!!<br/><br/>THANK YOU FOR YOUR TIME AND UNDERSTANDING!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc653e	Anonymous	None	2022-03-14T19:38:23Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0p-wyca-wtog	False	None	False	2022-04-12 04:18:37.951	[]
2468	CDC-2022-0024-2474	https://api.regulations.gov/v4/comments/CDC-2022-0024-2474	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>I have suffered with restless leg for many years and tried all the pharmaceutical "remedies" which either worked for a short time or had such side effects (such as worsening symptoms - augmentation) that they were counterproductive. I also tried other remedies such as acupuncture, hot and cold treatments, a vibrating mat and many other things that would bring minimal or temporary relief. My life suffered immensely from the sleep deprivation and associated problems. <br/><br/>Then I was prescribed an opiod and my symptoms were immediately controlled. I deal with the minimal side effects easily. My life has changed for the better now that I have a viable solution to my restless leg. <br/><br/>I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roy	None	None	0900006484fc7027	Willman	None	2022-03-14T19:41:06Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Willman, Roy	l0r-3hqt-ffz4	False	None	False	2022-04-12 04:18:38.222	[]
2469	CDC-2022-0024-2475	https://api.regulations.gov/v4/comments/CDC-2022-0024-2475	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Inclusive Body Myositis (IBM). I have had it for over 20 years. It’s a rare progressive muscle wasting disease. It was diagnosed through blood tests and muscle biopsy. <br/><br/>I am in terrible pain by the end of the day. Just getting dressed is a workout for the remaining muscles and the one weak hand that hold me together. Holding my self upright for hours at a time puts an enormous strain on my back and legs yet l must keep going because resting too much just weakens the muscle that remains. Imagine tying one hand behind your back and attaching very heavy weights to your legs and your back. Now run to the market, put the groceries away, do the dishes, sweep the floor, vacuum, do some freelance work on the side because you need the money, Cook, clean, take a shower, wash your hair (one hand remember), crawl into bed, struggle to turn over, can’t sleep! Cramps in legs till 3 am. Your back hurts so badly you’re in tears. Get up next day and do it all again THERE IS PAIN with IBM, chronic, every day pain.<br/><br/>My doctor prescribes pain medication responsibly. I take it responsibly. I receive 14 tablets of 5mg tablets of Oxycodone per month. I’ve been taking this for over a year and l have not abused it, or become addicted to opiates. It has enabled me to have occasional relief to give me the strength to go on.<br/><br/>Please know that this disabling disease is very painful for many of us. We need help managing that pain. Opiate therapy needs to be an approved option for doctors treating this rare and misunderstood disease.<br/><br/>I’m an in an online support group for People with IBM. What l have discovered is that l am not alone. Many of us suffer with debilitating pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484fc7059	deal	None	2022-03-14T19:55:32Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from deal, Kathy	l0r-45h1-wd36	False	None	False	2022-04-12 04:18:38.440	[]
2470	CDC-2022-0024-2476	https://api.regulations.gov/v4/comments/CDC-2022-0024-2476	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My situation is a unique one. One in which hundreds of hours, procedures, trial treatments, trial medications and a ridiculous amount of doctors and specialists have been involved. My condition is so unknown that I essentially became a guinea pig for the medical field. A condition that was informally coined "[redacted] Syndrome", because nobody in any medical field had seen this at that point. <br/><br/>Thanks to the knowledge (as well as determination and genuine care for my health) of [redacted], I only had partial amputations on 2 of my fingers. Originally it was believed that i might have lost 7 fingers and a couple of toes. <br/>[redacted] was referred to me by a rheumatologist, who knew that he would go above and beyond to help me. Although the original cause is still unknown, my health has fortunately leveled out, due to [redacted]'s persistence to not give up. He tried everything from medications Viagra, Lyrica, Gabapentin, amongst many others, to try to calm the nerve pain my in my hands and open blood vessels. Despite 5 surgeries within 6 months, several long term hospital stays and pain that I would not wish on my worst enemy, he patiently navigated many options to save me. Under [redacted]'s direction, I was put through chemo and ultimately 125 sessions (at 2 hours each visit) in a hyperbaric oxygen chamber, to stop the progression of my quickly necrotizing digits.<br/>[redacted] thought outside of the box, as my fingers were literally turning black and necrotic in front of our eyes. He wanted to try every route possibly without having to resort to controlled substances.<br/>Over the past 7 years, I've sustained constant and unimaginable pain. However, to err on the side of caution for my health, [redacted] had me meet with a neuro psychologist, in order to confirm that my need for long term pain medication for chronic pain was legitimate. <br/><br/>Thanks to his aggressive efforts, knowledge and patience, I am still here today to tell you this incredible story. Since he has surrendered his license to prescribe opioids, I have been through multiple doctors, none of which have been able to help me with the personal care of [redacted] and his team. I am forever grateful for them for their perseverance, and would appreciate more than anything if I would be able to continue to use him as my pain management physician.<br/> <br/>Should you request any further information, please contact me at [redacted]<br/><br/>Thank you for your time, <br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fc7062	Kwiecinski	None	2022-03-14T19:59:10Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Kwiecinski, Karen	l0r-498o-68cp	False	None	False	2022-04-12 04:18:38.676	[]
2471	CDC-2022-0024-2477	https://api.regulations.gov/v4/comments/CDC-2022-0024-2477	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern, <br/><br/>My name is [redacted] (yes, [redacted] without an "h"). I am a union electrician that specializes in roadwork. That being said, i perform heavy construction on a daily basis. My past history regarding my health is extensive. I've had knee surgery, back surgery, bilateral carpal tunnel surgery, disc replacement in my neck, amongst other issues that are consistent with a person of my size (I am 6'7"). Every time i have had an issue, [redacted] has always diagnosed and steered me in the right direction as to which specialist or treatment I should pursue, in order to avoid controlled substances. Of all of the doctors that I currently see on a regular basis, [redacted] is the one that i have the most faith in, not only because of his knowledge, but his genuine concern for my health. He has never steered me in the wrong direction. I am so grateful for all of the help and time that he and his staff have given me. I am so fortunate to have found such an amazing, knowledgeable and caring doctor.<br/>I would recommend [redacted], without a second thought, to anybody that was in need and has suffered even remotely what i have endured.<br/>In closing, [redacted] should be highly commended, rather than ostracized, for his lifetime of service. <br/>Should you request to discuss this further, please feel to contact me at [redacted]. <br/><br/>Best regards, <br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Antony	None	None	0900006484fc7080	Kwiecinski	None	2022-03-14T20:01:55Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Kwiecinski, Antony	l0r-4fgl-8lqf	False	None	False	2022-04-12 04:18:38.896	[]
2472	CDC-2022-0024-2478	https://api.regulations.gov/v4/comments/CDC-2022-0024-2478	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and have been directly impacted by the CDC 2016 guidelines. The current attempt at a re-write is a positive step, however, I question the need for government interference at any level in my personal health. <br/><br/>In 2003, I broke my back leading to ongoing and long-lasting severe pain. One of many techniques used to reduce my pain is prescription pain medicine including opioids. When the 2016 CDC guidelines were published, my pain doctor said she needed to reduce my opioid usage to bring me in line with the CDCs 'rules.' She said, “I don't want to raise any red flags.” The 'threat' whether real or perceived on the part of the CDC was very real to pain doctors. Now, I am forced to choose whether to function during waking hours or sleep at night. Not both. <br/><br/>I have lived with pain every day for almost 20 years. I continue to receive relief from my prescription pain medicine and other complementary techniques. I am not an addict. I am not the problem of what many call an opioid epidemic. I have never taken more Rx pain medicine than my dosage nor have I taken it more often than prescribed. I realize the serious nature of these medicines and take and store them responsibly. I have never doctor or pharmacy shopped. I am not the problem. <br/><br/>I respectfully encourage the CDC to stop being part of the problem for those of us with chronic pain where opioids provide significant help with no negative side effects. Pain management decisions should be made between the doctor and patient. I believe the government should not be involved at all – especially as specifically as done in the 2016 guidelines. However, if for some unexplained reason, the CDC believes some form of guidelines are necessary, I ask you to make sure you are on the legitimate pain person's side and are not negatively affecting our lives. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candy	None	None	0900006484fc70b4	Pitcher	None	2022-03-14T20:03:01Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Pitcher, Candy	l0r-4tkq-gsf7	False	None	False	2022-04-12 04:18:39.121	[]
2473	CDC-2022-0024-2479	https://api.regulations.gov/v4/comments/CDC-2022-0024-2479	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s<br/>This is a recent x-ray of my spine. <br/>I have suffered from back pain for at least 10 years.I have endured several painful injections, 3 rounds of physical therapy, and surgery, all resulting in no relif from pain. I was treated at a pain clinic for several years with opiods that gave me relif from pain and allowed me to lead a productive happy life. I complied with all the rules and took my medication as reccomended the entire time I was a patient. When the CDC guidelines came out in 2016, I was told by my Doctor that she received a letter from the government saying she is no longer allowed to prescribe my pain medication, and I was taken off all pain medication. I have suffered in pain ever since. This has had a huge impact on my quality of life. Unable to work, due to the pain, I had to leave my 35 year career as an Ultrasound Tech. I am unable to participate in many social activities, gardening, taking walks, excersizing, housework and other activities that I enjoyed. Because if this I have depression, feelings of hopelessness, weight gain, all adding to the decrease in quality of life. I have made an appointment to see another pain specialist and I feel like I will be labeled a "drug seeker" if I bring up opiods as treatment. All I am asking is to be able to get adequate pain relif to be a productive member of society. and have some quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrea	None	None	0900006484fc704d	Cordell	None	2022-03-14T20:37:36Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Cordell, Andrea	l0r-3j95-61gb	False	None	False	2022-04-12 04:18:39.342	[]
2474	CDC-2022-0024-2480	https://api.regulations.gov/v4/comments/CDC-2022-0024-2480	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my Name is [redacted] i live in Michigan. I am writing this comment because i am concerned that people such as myself are being Targeted and to be pushed of pain medications. Ive been labeled a drug addict not only by the police in my community and the two Senators who wrote the bill that was passed to stop all opioids in the united state unfairly to people like myself who have chronic pain leaving us no where to turn i have back chronic pain as well as chronic pain on bothe my legs and arms. I am also an amputee and have a complete right knee replacement. And now im being told i have stage 4 COPD with my left lung failing. Imagine enduring pain in your body with no pain medication and to boot one doctor after another passing you on to the next only to be denied by all of them. People sir or mam are dying out here not from pill over doses rather from the lack of treament which leads some to suicide.the legalization of Cannabis in most states is not enough cass in point people like me with a failing lung. Even the lung doctor who knows first had my lung is failing passes the buck to someone else to treat and none will do that because they have been made afraid to even try to help anyone. Please at least consider people who are hurting bad like myself. And good Doctors like Dr [redacted] in [redacted] Michigan who followed all tge rules to treat people like myself. Thank you sincerely [redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roberto	None	None	0900006484fc50f3	Hernandez	None	2022-03-14T20:39:00Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Hernandez, Roberto	l0n-e89f-yw3c	False	None	False	2022-04-12 04:18:39.566	[]
2475	CDC-2022-0024-2481	https://api.regulations.gov/v4/comments/CDC-2022-0024-2481	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing this to leave evidence for someone to find one day. I’ve been filling those things out for 6 years. You know you’re killing us. You know overdoses are in fact up because there are only fake pills on the streets now. Anyone lucky enough to have medications is on crumbs. 2 different hospice companies were too scared to treat my mom on her death bed. Remember when “legacy patients” weren’t supposed to be affected? Well that’s another lie you told. At this point you’re pushing a genocide & you know it. Even your eugenicist propaganda friend [name redacted] suggests a generation of us need to die off. Well I’m going to stay alive out of spite & I am never going to stop screaming to the world about what you guys did to the disabled. You took their quality of life, you encouraged doctor to abuse them and abandon them. The only people who could possibly be proud of what you all have done here, must be people who want the disabled dead. Therefore this is nothing more than a eugenics program you sick [name redacted] . Many who have lead the disabled here are making a ton in blood money. Our story will be told…. & I won’t forget what you all have done. When even a successful disability lawyer advocate felt so hopeless her only option was death…. R.I.p [name redacted] . Killed by Prop, CDC, DEA & the pathetic doctors who let politicians take over healthcare	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc550d	Anonymous	None	2022-03-14T20:40:27Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0n-ubag-hdgn	False	None	False	2022-04-12 04:18:39.780	[]
2476	CDC-2022-0024-2482	https://api.regulations.gov/v4/comments/CDC-2022-0024-2482	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Re: Importance of PCP referrals for important consultations i.e. rheumatology <br/><br/>In relation to multidisciplinary evaluation and management of chronic non-cancer pain, the 2022 CDC draft needs to more specifically state the importance of PCPs utilizing certain specialty services such as rheumatology which includes disorders comprising a large segment of the chronic pain population such as osteoarthritis, rheumatoid arthritis, fibromyalgia and chronic back pain. Furthermore, the draft only mentions nociceptive and neuropathic pain and not the common type of chronic pain of central sensitization which defines fibromyalgia; this can also occur in combination with the nociceptive tissue-derived pain of various types of arthritis. Many PCPs have difficulty in diagnosing and differentiating between these types of chronic pain which are managed differently, emphasizing the importance of obtaining quality rheumatological consultations.<br/><br/>In addition, mental health co-morbidities are common in rheumatological disorders, especially fibromyalgia and non-structural LBP, and can generate or amplify chronic pain, pointing to the importance of obtaining adequate behavioral/mental health assessments and management. Unfortunately, important mental health variables such as depression have often been minimized or unrecognized while pain has been misattributed to a somatic structure such as degenerative discs, bone spurs, 'arthritis,' etc.which is then used as the indication to prescribe opioids.<br/><br/>Regarding the proper management of the above disorders after correct diagnosis, this should also require good rheumatology input, especially related to the benefits of non-opioid multidisciplinary therapies recommended in established guidelines and multiple publications in the field of rheumatology. Unfortunately, in my experience, the prescribing of opioid painkillers by many PCPs became a simple, easy and timely way to 'treat' these complex patients with chronic pain on their own, without first consulting with specialists such as rheumatologists or mental health providers if indicated. Especially during the early years of the opioid epidemic, there was a rather blind adherence to the false narratives and medical propaganda of Purdue Pharma and the [name redacted] family regarding OxyContin, greatly enhancing the volume of opioid prescribing, addiction and overdose death, especially with prolonged use. Additionally, there has been primary care resistance to warnings about the risks and dangers of this pro-opioid approach compared to the benefits of more labor-intensive non-opioid multidisciplinary therapies, including the self-help management programs of the Athritis Foundation developed prior to the onset of the opioid epidemic.<br/><br/>These therapeutic strategies have been shown to be safe and effective in multiple research studies and by experts in the fields of rheumatology, behavioral health and medical education for many years. This started well-before this deadly public health epidemic was ignited by pharma's profit-driven marketing and over-promotion which led to the massive over-prescribing of OxyContin and other opioid painkillers, particularly for chronic non-cancer pain disorders which many PCPs lacked the training and knowledge to appropriately diagnose and successfully manage.<br/><br/>[name redacted] <br/>Consultant in Rheumatology (retired)<br/>[city redacted] SC	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484fc5337	Gelfand, MD	None	2022-03-14T20:44:35Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Gelfand, MD, Stephen	l0o-digg-an5q	False	None	False	2022-04-12 04:18:39.995	[]
2477	CDC-2022-0024-2483	https://api.regulations.gov/v4/comments/CDC-2022-0024-2483	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The following article, which was written by ACSH advisor [name redacted] , was published today in Pain News Network and the International Pain Foundation and shared with ACSH.<br/><br/>[name redacted] was 53 years old and a former registered nurse. Her family has granted permission to share the story of her last days. [name redacted]'s story is both horrifying and highly representative of many people in pain. These are patients who – in effect, if not from deliberate intent – have died in entirely avoidable agony because of the CDC’s 2016 opioid prescribing guideline. <br/><br/>[name redacted] was diabetic. She also suffered from kidney disease. She had lost both legs and one eye, resulting in severe pain for many years, which until recently was managed with opioid pain relievers. Her pain management physician – [name redacted] -- is no longer practicing medicine. [name redacted] was recently convicted of healthcare fraud and awaits sentencing for billing insurance companies $3.5 million for services he didn’t deliver. [name redacted] reportedly had “pill mills” in 11 states, from which he dispensed very high volumes of opioids. <br/><br/>When [name redacted] was barred from further treating patients, [name redacted] sought help from multiple pain management doctors in her area. She found that many were no longer accepting new patients. Among the few who would see her, none would treat her with opioids at the dose levels that had been effective for her in the past. Several were transitioning their patients to addiction treatment with Suboxone or recommending steroid shots. <br/><br/>[name redacted] most recent pain management doctor refused to prescribe above 90 morphine milligram equivalents (MME) per day, citing the CDC guideline as a de facto maximum allowable dose level.<span style='padding-left: 30px'></span><br/><br/>Like many patients with chronic pain, [name redacted]’s medical situation was complex and involved several interacting medical disorders and issues. She had a history of MRSA – a highly aggressive antibiotic-resistant staph infection. [name redacted] had also personally observed many patients in whom spinal injections had led to worsening pain. She refused both Suboxone and the steroid shots<br/><br/>FOR THE COMPLETE ARTICLE: https://www.acsh.org/news/2019/03/19/pain-patient%E2%80%99s-death-was-state-sanctioned-torture-13893<br/><br/>... what is clear is that this woman died in needless agony. ...she should never have been forced to taper from effective dose levels because legitimate doctors were intimidated by CDC and state regulators into refusing effective — and largely safe — opioid therapy. <br/><br/>By any other name, this was state-sanctioned torture. <br/><br/>It is not accidental that the American Medical Association recently repudiated the CDC guideline. But the government dinosaur’s bureaucratic brain is in its tail and it hasn’t gotten the message yet. CDC has merely doubled down on the mythology that doctor over-prescribing caused our “opioid crisis.” They are running away from their own overdose data, which demonstrates the falsity of their assertion.<br/><br/>There is very little relationship between physician prescribing and either opioid addiction or overdose deaths. But the only metric CDC seems willing to use to measure the success of the war against drugs is reduced prescribing to [name redacted] and other people in pain.<br/><br/>It is time for this madness to stop! Opioid prescribing guidelines need to be taken away from the CDC and rewritten from the ground up by more competent agencies or by professional groups within medicine itself. And this time, multiple patient advocates need to be voting members of the writers’ group.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484fc5697	Kahn	None	2022-03-14T20:49:01Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Kahn, D	l0o-h415-j4tb	False	None	False	2022-04-12 04:18:40.215	[]
2478	CDC-2022-0024-2484	https://api.regulations.gov/v4/comments/CDC-2022-0024-2484	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As I've already commented previously, & I've read that over 1000k comments have since been deleted, I feel my commenting again is therefore warranted in this case of such importance.<br/>As an individual with chronic intractable pain & as a nation of over 100M chronic pain pts whose lives were turned upside down by the 2016 gdlns, it's imperative that someone whose in charge of policymaking hear our pleas for help. The 2016 gdlns AND THIS REEVALUATION of same are not good, they will serve the very same purpose as the past 7 yrs, to injure to harm, to force pain pts to commit suicide as doctors will mistake this document for law as they have been, that bcuz of PROP SHATTERPROOF CERTAIN DRS WHOM IF I MENTION THEIR NAMES WILL B REMOVED FROM THIS COMMENT, will continue to PREY On us, force taper LTOT therapy, cause more harm than good. The drs today coming out of med school have not been taught EMPATHY. They r told that patients in pain don't matter, they are giving drugs that harm in emergency departments post-operatively in the office setting they are dismissed as having histrionics especially women, especially young women with severe and rare diseases, and young men have been injured in accidents, veterans who have sustained traumatic war injuries, women and children and men with cancer pain been abused by this guideline, and it cannot continue. The ROP movement has failed miserably, it was aimed solely at addiction with the sole purpose of marketing and selling a drug much more potent THAN ANY opiate pain medicine named Suboxone. That drug is a terrible choice for both those addicted and those in pain. There is no substantial medical evidence proving otherwise. These drugs have caused IRREVERSIBLE damage. People have not been allowed to walk into a pharmacy freely with a prescription in hand including myself a person on long-term anti-anxiety medicine 40 years being grilled like a street corner drug addict, being told I could pay cash if I wish to take my prescription with me, this occurred yesterday in fact & I will address this with the Board of Pharmacy tomorrow. This guideline will serve no purpose other than to harm people in pain from all walks of life, from every city in this nation, from every ethnic background, and the doctors will continue to practice Bad Medicine and people will continue to die by way of suicide by way of overdose from illicit street drugs which is the sole cause of death today from opiate overdose. What the [name redacted] did with the drug Oxycontin was unconscionable in their marketing practice, they took a good drug and they marketed it as benign, when they knew it was addictive to those that have the propensity to addict. Evidence shows that that is less than 5% of the population using prescription opiate pain medicine. The word that should be used is dependence. I depend on my pain medication to give me relief, quality of life, hours without major breakthrough pain, I do not seek it, I do not pay for it outside of the pharmacy setting, I do not sell it, I am a responsible 65 year old grandmother of 3 mother a wife, cancer patient with autoimmune disease who is immunocompromised who has anxiety disorder and whose anxiety is made worse every month that I have to go to the pharmacy for the past 6 years. My husband comes from a communist country Cuba, he is 80 years old and a cancer patient with Advanced cancer, and he is taking Advil for pain because our oncologist refuses to RX opiate pain medicine. My husband's bone pain is mostly due to severe arthritis but he also has Barrett's esophagus which is made worse by Advil, Celebrex raises his blood pressure & there is nothing for his pain but ointment and creams and nothing works. PCP is anti opiate as well we have nowhere to turn for medication for my husband. I have a very caring rheumatologist for my psoriatic arthritis Sjogren's disease serum positive RA, fibromyalgia, and severe neuropathy of the feet and legs. However with that said he is still prescribing 75 m m e for the past 5 years. He is under the impression that the federal government mandated him to do so. Urine drug screens are often negative for me I have to repeat them I have to be questioned I don't like it I would rather not live like this. In one week I have scans to see if my cancer is still in remission which gives me great anxiety. I have six pills left for my anxiety medicine and the pharmacist will not fill it because he lied and said that he needs to consult with my doctor when in fact the insurance company told me he is supposed to counsel me on the co commitment use of benzodiazepine and pain medicine and then he can put in a DUR code and override it but he won't & ASKED ME IF I WANT HIM TO LIE & SAY HE SPOKE TO MY DR? He'll be dealt with after I report him to the Department of Health & the Board of Pharmacy. I will not be abused I will not be mistreated I am a human being with feelings law-abiding tax-paying US citizen. Remember me words matter. We matter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc588f	Anonymous	None	2022-03-14T20:51:22Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0p-hu6x-9mez	False	None	False	2022-04-12 04:18:40.444	[]
2479	CDC-2022-0024-2485	https://api.regulations.gov/v4/comments/CDC-2022-0024-2485	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Diagnosed with chronic pain after 4 spine surgeries, 2 fusions neck and lower back and few spinal injections, never prescribed opioids, in fact I didn’t want them but sometimes i am in excruciating as i get crisis and this comes from what i was just diagnosed. Adhesive Arachnoiditis a rare disease with no cure causing you to live in excruciating pain with many many horrible symptoms that i already have that is caused after spinal surgeries or injections, my point is that seems that as rare decease is coming more and more frequently diagnosed included myself and I am thinking that the reason is that Pain Management Doctors never helped me, they just give injections and don't even bother in following up if they helped or not, and now is even worst they don't even see you if you don't want injections, like me as the decease is caused by injections and of course I went to neurologist and could not helped he send me to neurosurgeon and pain management as they are the ones that should know about it but is really bad when initially the decease caused by surgeries or injections and what they want is surgeries or injections. <br/>I am now disable to work even though i can work from bed as programmer software consultant because I have memory problems and focus problems from being in pain 24x7 and i lost everything my career was successful had my own company but lost everything and even got denied from social security disability application and even temporarily disability when I am dealing with this since 2012-2016-> <br/>All I am saying I am caught in a loop and cant even get help or a break from pain feel live is over for me even when I am still young. <br/>The fact is bad decisions as this one affected me and many people, besides the fact I never took drugs in my life and when I went to hospital to look for help in horrific pain the doctors treated me like an addict and no help, is just horrible what have been done and the damage have no cure for me. As i though surgeries or injections would be solutions as no other help is provided or allowed and doctors whose names are pain management don't do that they just inject and get you out of their way.<br/>Please think and make good decisions, i beg you even thought I have the decease already, maybe with good decisions there can still help. I have documentation on mri report with decease if needed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M	None	None	0900006484fc589a	Perez	None	2022-03-14T20:52:06Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Perez, M	l0p-ije0-vqph	False	None	False	2022-04-12 04:18:40.661	[]
2480	CDC-2022-0024-2486	https://api.regulations.gov/v4/comments/CDC-2022-0024-2486	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The changes in the guidelines are a must. Intractable/Chronic Pain Patients deserve medical treatment without judgement. Prior recommendations which have been taken as law has caused irreparable damage to those who could no longer live in pain and their families. The supposed guidelines have created a divide between Dr's and their patients, Pharmacies, and Insurance. My personal relationship with my doctor and my medical condition which clearly warrants the use of the medication I’m properly using prescribed from my doctor allows me to continue to work everyday and thrive with my family and children. These previous guidelines put in place are a serious concern for every doctor, patient, pharmacy, they really pose a huge concern for the patients who have their lives back after after being helped from their doctors!!!! But with the DEA involved in the peoples medical help with even knowing the patients medical condition left up to a doctor which has a medical degree and is trusted with helping people with their health and medical conditions and should be left at that!!!! Please understand that these changes are necessary to help the patients with medical conditions and give the doctors and pharmacies the understanding that they are actually helping the patients they attend, so please thank you to the CDC for implementing the new guidelines!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	V	None	None	0900006484fc58a9	Nov	None	2022-03-14T20:52:36Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Nov, V	l0p-j8b2-5lok	False	None	False	2022-04-12 04:18:40.879	[]
2481	CDC-2022-0024-2487	https://api.regulations.gov/v4/comments/CDC-2022-0024-2487	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75 year old retired male who has had relentless non-terminal illness pain for 15 years. Prior to starting narcotics prescribed by a pain management MD, I had tried almost all other approaches to dealing with the pain including thorough work ups by a variety of specialists, physical therapies, acupuncture, self-calming techniques, injections and ablations of spinal nerves, cervical fusion, lumbar laminectomy, multiple trials of non narcotic medications and other. I was diligent in following my physician’s treatment plans. I have never had a drug/ alcohol problem.<br/>Over a decade ago I was started on narcotics and the dose was gradually raised to the point of significant benefit with no side effect other than constipation.<br/>My quality of life was reasonably improved.<br/>When the 2016 guidelines came out my doctor was told by authorities that none of his patients should be taking more than 90-100 mg a day of morphine equivalent. I tapered down from the 240 mg/ day that had helped for years to 90 mg/day and had significant increase in my pain ( thumb joints, back, neck, headache) and a lower quality of life. I spent more time napping or resting than ever before.<br/>I strongly support allowing my physician and me to make the decisions about my healthcare including whether and how much narcotics have a role to play ( as long, of course, as my doctor and I follow applicable laws and rules regarding public safety.)<br/>Thanks for your consideration.<br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	0900006484fc58aa	Hamilton	None	2022-03-14T20:53:08Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hamilton, Bill	l0p-j942-r7in	False	None	False	2022-04-12 04:18:41.093	[]
2482	CDC-2022-0024-2488	https://api.regulations.gov/v4/comments/CDC-2022-0024-2488	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My entire family have been devastated by cdc guidelines. My husband is a legacy patient, before guidelines he had been on same dose no increases for 2 decades. after 2016 guidelines he had same family doctor and pharmacy for also 2 decades. The family doctor after guidelines started to change the way she treated him by not treating him until he volunteered to taper..She forced him without discussion and along with her the insurance company did same..so we were not only defending my husband to doctor but also insurance company. He lost time at work during tapers and became housebound during that time..along with the trama of not having control over our lives..my husband had been only one supporting our family at the time so we had our electricity shutt off no food .and doctor didn't care she was only concerned about his dosage not his health!! My husband declined so bad that she ended up firing him for missing work , because she refused to cover fmla days to keep his job!! After 27yrs with one doctor its tramatic after that to get another..but my husband has lifetime of complicated medical history. He has adhesive arachnoiditis chronic kidney disease,degenerative disc, low testosterone, anemia and more..He is not overweight, muscular, and eats healthy..He looks very healthy..and works 40+ hours a week when he has power over function!! Please give back power over function to patients. All pain patients have become a liability..to get fear stigma out of clinics, power must be given back to patients..we all metabolize meds differently and no one size fits all approach will work. Please give legacy patients back thier power over function..when someone else has that power then that power will always be abused!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annonomous	None	None	0900006484fc58ae	Annonomous	None	2022-03-14T20:53:54Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Annonomous , Annonomous	l0p-k39b-xh66	False	None	False	2022-04-12 04:18:41.322	[]
2483	CDC-2022-0024-2489	https://api.regulations.gov/v4/comments/CDC-2022-0024-2489	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with spinal birth defects (kyphosis & all 3 types of scoliosis) in 1947. I suffered pain on and off for almost 60 years until 2004 when an elevator I was in fell 30 feet and damaged every disc in my spine and I was put on opioids (hydrocodone) and muscle relaxers. I was well taken care of by my PCP until the DEA stopped him from treating his pain patients in 2017 and I was sent to a Pain management doctor who tapered my meds by one-half the dose (from 40mg/day to 20mg/day). I remain under medicated and lost my quality of life. I can only shop for food and water, go to doctor appointments, the pharmacy, the laundromat, and the library. I live alone (no family or friends) on the 2nd floor and make 3-4 trips up 15 steep stairs with food, laundry, medicine, and books. Since 2021, my PM doctor has threatened and coerced me to switch from opioids that I've been stable on for 17 years (even with the tapering) to addiction drugs Suboxone and this year to Buprenorphine which will cause serious complications or kill me because I have a mechanical heart valve and take Coumadin, Lasix, Potassium Chloride, and Magnesium. This is torture and Elder Abuse. He should lose his medical license. I want my initial dose of pain medicine and muscle relaxers returned so I can have my quality of life back and be a productive member of society.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Saundra	None	None	0900006484fc6181	Navarro	None	2022-03-14T20:57:26Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Navarro, Saundra	l0p-lhiv-r3b6	False	None	False	2022-04-12 04:18:41.544	[]
2484	CDC-2022-0024-2490	https://api.regulations.gov/v4/comments/CDC-2022-0024-2490	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] . I have Multiple Sclerosis, migraine headaches and degenerative disc disorder. I was prescribed a fentanyl patch in 1992 after having a second back surgery failed. I did very well having my painful medical conditions managed with a medication that was controlled and effective in pain levels. Over the years the dose was adjusted as my body got used to the dose as well as my condition worsened. I was prescribed break through pain meds for controlling pain that was not responding to the fentanyl patch. I enjoyed a career in public service, started a 501c3 non profit animal rescue group that continues today, maintained a garden that produced blue ribbon quality vegatables, engaged in many community events and was able to care for my granddaughters when the occasion arose. I was active, happy and productive! In 2018 that all changed when I was force tapered off all break through pain meds, anxiety meds and the patch dose lowered to 1/10th of what I was prescribed. I was forced to retire, had to step down from the non profit, cannot care for my granddaughters and barely spend time with them now and lost my ablity to walk unassisted. I am not living, I am existing. My heart is being affected now by the extremely high pain level I am at. My Dr. said that eventually this will cause cardiac arrest. The heart is reacting to untreated, excrutiating pain. I cannot sleep due to my inablity to breathe and am exhausted from fighting this pain. I have always taken care of myself. I am a vegatarian, don't drink alcohol, don't do drugs, have always been on the slender side, always been active and have excellent health otherwise. My life is empty now. I am biding my time, just waiting for this all to end. I never thought my government would turn its back on an entire population of people who have done nothing but have medical conditions that are painful. The medications I was prescribed allowed me to enjoy a great quality of life! Today I don't have any quality of life, I barely have a life! If this is living I don't want it! I have looked into humane euthanasia since suicide is something I cannot consider. My son took his life in 2018 and left 2 little girls behind. Those girls are the only thing I have left of him. I want my life back! I cannot understand how allowing people to suffer is okay? This is wrong! The drug problems in this country are not related to chronic pain patients! The media and my government have convinced the public that prescription drugs created this epidemic when in fact we know now that it did not. Opioids are a wonderful way of managing painful medical conditions! People who use them as prescribed are given a great quality of life! Those patients don't abuse them or sell them! Why punish people because they hurt? I call this "legalized torture". And it's wrong. Suicides among patients who have been force tapered have never been documented by the State of Mn. The state uses autopsy reports and if there is a trace amount of pain medication in the blood of the deceased they label it as "overdose". This is why the numbers are so high! Details they have hidden from the public! The media has done the same. I am an example of when medications to manage pain are prescribed correctly they allow people to enjoy a productive, active life!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484fc6184	Johnson	None	2022-03-14T20:59:26Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Laura	l0p-lkst-vv6g	False	None	False	2022-04-12 04:18:41.758	[]
2485	CDC-2022-0024-2491	https://api.regulations.gov/v4/comments/CDC-2022-0024-2491	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern: I was diagnosed with RSDS/CRPS when I was thirteen years old. Before that I was a happy child who loved sports and running. This chronic pain disease took that from me. <br/>Over time, with medication, I became able to do things like going to the store for short trips, cooking a simple meal, and taking a shower without assistance. <br/><br/>I suffer greatly every day of my life, and when these new guidelines were being forced upon me after years of having this illness my pain and discomfort grew to horrifying levels. My doctor's became fearful and uneasy, and the Hippocratic Oath they took was now being compromised. They couldn't help but follow the guidelines even when they could see their patients were suffering greatly. <br/>Because of these guidelines I have to spend hours in a great deal of pain before I can take any more medication. <br/><br/>My days are no longer as consistent and I have to limit myself more than ever before. I didn't think it could get any worse, and then these guidelines were put in place. The stress and anxiety that has caused my mother, as my caregiver, had been enormous. <br/>As a pain patient, I have felt that those who implemented these guidelines had no empathy for the millions of Americans who suffer from chronic pain. I have never felt so disregarded and judged for something I had no control over. <br/>I love my country, but I have been very hurt by those in leadership who began treating chronic pain patients as drug addicts. I couldn't believe that those at the CDC thought I was an untrustworthy criminal and was jeopardizing my healthcare. <br/>I understand that a lot of people don't understand many neurological pain disorders, so please listen to those that do. Doctor's and Patient's. If you or a loved one was in pain and told there was no cure, what would you do? And what is there was/is relief for you or your loved ones, but no one would help you? If anyone was in that situation they would feel psychological stress of not only their physical pain but the emotional pain of being judged and abandoned. I'm heartbroken at the damage that has already been done. I hope and pray the CDC or those in charge of these decisions correct the wrongs that's have been done here. <br/>We deserve better. <br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C.	None	None	0900006484fc6185	Lemmon	None	2022-03-14T21:00:19Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Lemmon, C.	l0p-lovo-2lu7	False	None	False	2022-04-12 04:18:41.973	[]
2486	CDC-2022-0024-2492	https://api.regulations.gov/v4/comments/CDC-2022-0024-2492	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi, I started my opioid journey three years ago as a result of severe lower back pain. I am a 62 yr old male living in mid Michigan. Literally went to bed one evening healthy and woke up the following morning with back pain that progressively got worse throughout the day. After three days with no letup in symptoms, I decided to see my primary care physician. Long story short, ended up with two surgeries (both laminectomies). Second surgery was at the [healthcare facility name redacted] in [city name redacted] Mn. Surgeon there explained to me that they do surgeries to relieve symptoms, not to relieve pain. Pain relief is a bonus, not a goal. As a result of my surgeries I am left with serious pain in my upper buttock area. Opioids (Oxycocodone/Acetominophen 7.5/325) taken 5 times daily has allowed me some relief in that I can resume some activities for short periods that give me a sense of normalcy that without, leave me confined to the sofa/ bed most of the time. I take my opioids as prescribed even though I have points in my day where the meds have worn off but I have to wait until the next prescribed time to take them. This, I believe is what has kept any addiction worries at bay. Please keep people like me in mind as you look at possibly changing these regulations. Hopefully common sense will prevail and the lives of honest law abiding citizens will not be further disrupted. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lyle	None	None	0900006484fc6192	Popp	None	2022-03-14T21:08:08Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Popp, Lyle	l0p-m21b-nuz2	False	None	False	2022-04-12 04:18:42.183	[]
2487	CDC-2022-0024-2493	https://api.regulations.gov/v4/comments/CDC-2022-0024-2493	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC admitted their recommendations had hurt chronic pain patients and some chronic pain patients quality of life was affected and some died . I am not dead , but if my quality of life goes any lower . I will have no life left . I was once able to work , and care for my family while taking opioids to manage my pain. Since my pain medications were cut to 1/3 or less . I now have high blood pressure that can’t be control because of the pain I am in . I have gain 30 pounds because it hurts to move . I can’t even drive 6 hours to see my grandchildren due to my pain not being controlled . Epidurals do not help , burning the nerves does not help , our pain management does not give anything more than 3 Percocet 10/325 a day . That is not pain management for chronic pain. One patient has a plate and pin in his hip and a back fusion . He is allowed three 10 mg Norco a day . He walks like a 3 year old because of the pain not being controlled . Chronic pain patients use opioids for quality of life. Addicts use illicit fentanyl and other drugs to escape life . That is a big difference ! These pain management doctors wants to force epidurals and other procedures that do not work on the patients ,because they make more money . Patients are told you must do this so they can continue to get their small amount of pain medications . Your data is incorrect . Seniors to not overdose , the overdoses on your books is illicit fentanyl , not opioids . You said your guidelines were being misinterpreted . Then remove them ! Pain is not a disease . Why are you trying to pretend it is . The FDA can write warning on the medications. Doctors should be able to treat their patients . There is no one size fits all ! You never publish the complaints you receive from the chronic pain patients . I had a neck fusion C-3 to C-7 I woke up screaming from the surgery . They had given me 1 pill for my pain. I said dear god I can’t stand the pain. They had to call to get proper pain control until the doctor could place another order. The CDC guidelines have caused me to get worse. My neurologist said no to a pain pump they said I could travel 4 hours away to get ! I have never taken a drug or opioids not prescribed for me . I take as directed . Why a pain clinic would rather a patient travel to another state for a pain pump instead of treating their pain with oral pills is beyond belief. Pain is a symptom. Doctors treat symptoms ! Worn out bodies , ruptured disk , nerve damage . You can’t cure it ! It’s not a disease !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kay	None	None	0900006484fc61a4	Williams	None	2022-03-14T21:09:27Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Kay	l0p-mc7z-4vyh	False	None	False	2022-04-12 04:18:42.395	[]
2488	CDC-2022-0024-2494	https://api.regulations.gov/v4/comments/CDC-2022-0024-2494	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You are condemning pain patients to a life of unbearable pain because of an overdose rate of .04!! Why? I really need to understand because the flawed rules you are currently using are maddening and cruel. Do you really understand what kind of pain we are dealing with? I guess you don’t have a clue because you couldn’t possibly make doctors rx only 50 m of opioids to people who are suffering. We are not addicts, we don’t want to get high. We just want some relief. Please reconsider the new limits. There should not be any limits on rx’s for pain meds. The fear you have instilled in doctors has left us with no hope of living a pain free life. Or even a limited pain life. We are condemned to life with inexorably intense pain. Please do not condemn us to a pain filled life because of an overdose rate among pain patients of a mere .04%.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc61b1	Anonymous	None	2022-03-14T21:09:48Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0p-nivn-fv7d	False	None	False	2022-04-12 04:18:42.650	[]
2489	CDC-2022-0024-2495	https://api.regulations.gov/v4/comments/CDC-2022-0024-2495	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Re: Docket No. CDC-2022-0024<br/><br/>To whom it may concern:<br/>In December, 2002, I had a very bad fall, resulting in a broken right leg in the Tib/Fib area, with 4 compound fractures. I was rushed to the hospital, with the type of pain I have never experienced in my life, including delivery of my son. I also have normally had a very high tolerance for pain, but this was something that I had never experienced before in my life and I hope I never experience again.<br/><br/>After receiving a diagnosis and find out that I needed an emergency surgery, I was given Dilaudid for the pain initially. After surgery, in which the doctor had to insert an external fixator, with six pins surrounding the fixator, I was placed on OxyContin 40mg 2x’s a day. After a short stay in a rehabilitation facility, I came home. I am not sure I would’ve made it without the 40 mg 2x’s times a day. I literally watched the clock until the 12th hour time limit was up so I could take another pill.<br/><br/>And this comes from a person who was a product of the 60s, never smoke marijuana or took any other drug and hardly ever took pills. I knew how addictive OxyContin was, and I was determined to get off it as soon as possible. In fact, against my doctor’s advice, I tried to go down to 10 mg twice a day after about six weeks. I couldn’t do it… I literally was screaming out in pain. Sometimes I thought think that death would be better; however I had a sick son with tetralogy of Fallot, and needed to stay alive and get better for him.<br/><br/>If I had gotten that same injury now, some doctors would be incentivized not to give me the dosage I really needed. I have friends and relatives who have suffered unnecessary pain because they are being limited in the amount of opioids they can take. It’s ridiculous… Because some people abused opioids, those who really need it, those it was designed for, are suffering. <br/><br/>I urge you to change your guidelines so that like me, people that are in pain, can get the relief they deserve. I was able to totally stop my OxyContin 3 1/2 months later. Yes, there was some withdrawal symptoms that I had, and I had a rough couple of days, but it certainly was worth it, because as I said,I needed to get healthy as quick as possible for my son. Thank you for your consideration.<br/><br/>[name redacted] <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rosemary	None	None	0900006484fc61b2	Reichard	None	2022-03-14T21:10:56Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Reichard, Rosemary	l0p-nj2c-qyhw	False	None	False	2022-04-12 04:18:42.860	[]
2490	CDC-2022-0024-2496	https://api.regulations.gov/v4/comments/CDC-2022-0024-2496	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don't understand why the CDC guidelines are making it harder for the chronic pain patients?<br/>We are the ones following the rules. I always go into an appointment expecting to have a urine test or having my doctor say that my pain medicine is too high and doesn't fall within the guidelines of 50 mme. What I can't understand is why someone that I have never met and doesn't know my story can say that I am using or abusing opioid drugs. I know that there are millions out there that are just like me who take our opioid medication EXACTLY as prescribed. However, there are days that I can't get out of bed because my pain level is too high. I would like to call my doctor or go to the emergency room for some relief but I know that will only cause more problems in the long run. I will be labeled as a drug seeker or abuser, so I just suffer at home with uncontrolled pain.<br/>My goal is to be able to work at least part time so I don't feel like a burden to my family. How can I do that when I can't control my pain? There are so many more examples that I could give but I don't want to bore you. In conclusion please let the doctors choose what they think is right for their patients. Please listen to the CIAAG and implement their ideas.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc61c9	Anonymous	None	2022-03-14T21:12:03Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0p-ns2m-2gff	False	None	False	2022-04-12 04:18:43.077	[]
2491	CDC-2022-0024-2497	https://api.regulations.gov/v4/comments/CDC-2022-0024-2497	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/>This is a step in the right direction. The 2016 guidelines have hurt many chronic pain patients. You really need to state somewhere that if someone is a legacy chronic pain patient and has been on a higher dose of opioids for many years without any issues that the physician can leave them on the higher dose if needed and not have to lower dosage. If there have been no issues for many years then its safe to assume they are responsible and can handle a higher dose just fine. Why lower someone if they are experiencing relief? You need to state that this shouldn't be a guide for the dea to pull licenses because not every patient is the same. Some patients need a higher dose and it harms them when you lower them. It needs to state that legacy patients can be prescribed doses over 90mme if they are experiencing a benefit. I was on 250mme per day for many years and had no issues at all and was able to function great and had no pain. Now I'm reduced to 140mme per day and can barely move and they want to continue reducing me due to the dea wanting them to do it because of the 2016 guidelines. There is a need to understand everyone is different and some people need a higher dose. And if some have been on that higher dose for many years without a single issue, why is there a need to lower them and cause them more pain? Please state somewhere that legacy patients can continue higher doses if it is beneficial to them and they have experienced no issues. I don't get a "high" feeling anymore. When you have been on high doses for a long time you experience pain relief but no side effects and the "high" feeling that some get that are new to opioids. This needs to be realized because legacy chronic pain patients use it for pain relief. If it's not broke, don't fix it. Seriously if we have relief and no issues at higher doses then leave it be. This needs to be stressed because pain management specialists are being forced to lower their patients to doses that cause them extreme pain and it's not right or fair to do when those patients have done nothing wrong and have been very responsible with their medications. You need to make sure these new guidelines are not misinterpreted and will cause harm to chronic pain patients like the last time. It's not fair or right to cause us to be in torturous pain around the clock. So please make sure you protect legacy pain patients and do not cause us harm. Please fix the issue of the last guidelines being misinterpreted. Let doctors prescribe what they think is best for their patients without the fear of having their license pulled due to prescribing a higher dose. It is very effective to take a quick acting opioid like Norco and then follow it with an extended release. This forces the pain down quickly and then the extended release carries the relief longer. Every so often throughout the day a quick release is needed for rescue to keep it at a lower level so the long acting can continue to keep it controlled throughout the day<br/> And sometimes on bad days a little extra is needed. This has worked out great for my pain. Also need to take into consideration that some do not qualify for other types of pain relief. Some can't do injections and pumps and chiropractors. For some the only treatment available is opioids and this needs to be recognized. If that's the only way they can be treated then they deserve to have a higher dose if needed to achieve pain relief. Thank you for your time. Just please clearly state legacy patients can continue higher doses if it benefits them and they have never had any issues with side effects or overdose, and they have proven they are responsible. <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christopher	None	None	0900006484fc61cb	Allen	None	2022-03-14T21:14:22Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Allen , Christopher	l0p-o4y4-q29g	False	None	False	2022-04-12 04:18:43.467	[]
2492	CDC-2022-0024-2498	https://api.regulations.gov/v4/comments/CDC-2022-0024-2498	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a provider with multiple locations and multiple Class IV lasers, we have had the opportunity to experience the expedited pain reduction this modality provides patients who would have otherwise resorted to medications, and in some cases potentially highly addictive opioids. It is painless and effective. Patients deserve and need alternatives to these dangerous drugs, and lasers should be a necessary component of the alternative choices.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc58c7	None	None	2022-03-14T21:14:32Z	Sandstone Health	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Sandstone Health	l0p-p46u-qalv	False	None	False	2022-04-12 04:18:43.676	[]
2493	CDC-2022-0024-2499	https://api.regulations.gov/v4/comments/CDC-2022-0024-2499	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have degenerative dis disease, avascular necrosis, severe osteoporosis which makes all my bones break. My pelvis fractured in two places just sitting at work. [name redacted] made my life livable, now because of CDC my life is painful and miserable. Attack to teenagers, not someone 60 years old. Shame on CDC! Disgraceful to have to live this way.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484fc58db	Birmingham	None	2022-03-14T21:15:04Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Birmingham, Jeanne	l0p-qjbf-4fvp	False	None	False	2022-04-12 04:18:43.882	[]
2494	CDC-2022-0024-2500	https://api.regulations.gov/v4/comments/CDC-2022-0024-2500	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Can some one please tell me where I can find Doctoer who would write a script for norco? I am on 15 mg a day, 30 mg would be better, but dr won't go higher, now, she s retired, and Dr who took over her cases, Wil, not write Any Rx s for norco. I went to the pain clinic, hearing that they were writing Rx s now,,,no, they re not. They wanted to do nerve blocking, insert wires into my back,,,you see,, It s all well and good that the CDC is in the process of rewriting it s recommendations. But it s too late, the war on opiods is too well entrenched an idea,,,and the pain clinics are making too much money doing procedures, when all is needed is an Rx for an opiod, that would cost the chronic pain patient little to next to nothing at the pharmacy. My Dad is 94, and my sister has chronic fatigue syndrome, and severe depression. I m 66, and on dissability, am diabetic,,from taking hiv antivirals. Who is going to take care of this household, if I m is so much pain I can't function, or am so tired from taking MORE than 400 mg gabapentin to cover the pain that I can t get out of the bed? I m at the point of,,,why should I keep taking insulin and the hiv antivirals anymore, if that is simply going to lengthen my life,,,so that I can suffer more?<br/>My life has been hell the last 7 years, since the war on opiods started in earnest. What I m going to do now,,,I don t know.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fc58f1	Nawrot	None	2022-03-14T21:15:37Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Nawrot, Mark	l0p-rfu9-uas0	False	None	False	2022-04-12 04:18:44.110	[]
2495	CDC-2022-0024-2501	https://api.regulations.gov/v4/comments/CDC-2022-0024-2501	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a pain patient with chronic nerve damage, 3 failed low back surgeries. Broken hip, with 3 rods down leg. Arthritis. And several other issues...<br/>I was taking opiods at a much higher level for over 10 years.<br/>Worked full time, had some quality of life then. Managed over 34 agents, was a manager, bookkeeper, assistant. Did so many things I can no longer do.<br/>My life has gone down hill. No longer can get out of my pain!<br/>I never did illegal drugs, alcohol, or over took my pain meds.<br/>I never took any mood elevating drugs, nor took to zone out as addicts do!<br/>I Want my life back!<br/>I am the most honest, n legal person with my doctor of over 17 years!<br/>But your guidelines made my doctor scared, he took everyone either off of them or cut down to hardly anything!<br/>Which I guess I was one of the lucky ones that was tapered down!<br/>I live in he'll now!<br/>My whole family would tell you they don't take drugs, but I need them to have some quality of life.. <br/>The drug overdoses, the illegal drugs, the mental health issues out there are the problems!!<br/>Not the actual sufferers who have been down the gauntlet of so many needles, surgeries, pills and side effects, physical therapy and I don't know how many or how much money I've spent on over the counter herbs, vitamins and creams!<br/>What was working is no longer available to me.<br/>Because another decided that I am a nuisance, a statistic of opiates!<br/>So I suffer, cry, n have gone downhill!<br/>And not from not trying, one foot in front of the other! <br/>Stop this insanity! Stop harming those who are helped by opiates.<br/>Mental health is what has to be addressed! The users are the ones who want a high, to get away from their problems, to get the illegal ones that they overdose on!<br/>I have never tried to get illegal ones, even when I can't walk hardly!<br/>I know where they are, n where I could get but never would!<br/>I'm Sorry for those that abuse them, overdose on them! But Mental health is the start, not taking them away from those who really do get help with opiods.<br/>There has always been abuse, not going to stop that.<br/>Illegal substances are out there, being fabricated everyday, and the abusers need Mental health, rehab places, which there is not enough help out there for them.<br/>I'm not going to change my issues, but hope this letter gets to someone who can help others that Truly needs these!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peggy	None	None	0900006484fc61fc	Gillis	None	2022-03-14T21:18:35Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Gillis, Peggy	l0p-sel5-y6nx	False	None	False	2022-04-12 04:18:44.345	[]
2496	CDC-2022-0024-2502	https://api.regulations.gov/v4/comments/CDC-2022-0024-2502	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in a motor vehicle accident and suffered 2 broken legs, both ankles shattered, and a broken hip. My ankle is fused and my legs don’t work like they used too. I am in severe pain every day. All mentions of MME should be removed to allow for personalized individualized care. My doctor has a ru fly tapered my dose of pain medication due to fear of being judged for treating me properly. I was able to lead a semi normal life while my pain was being managed appropriately. Now, I suffer every day and am unable to provide for my family. My mental health has suffered greatly due to the pain I’m in. Please allow doctors to do their jobs without fear of punishment. Also, the CDC needs a plan to deimplement the 2016 guidelines and undo the suffering thousands of pain patients experience.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc61ff	Anonymous	None	2022-03-14T21:19:04Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0p-sn2p-66e0	False	None	False	2022-04-12 04:18:44.551	[]
2497	CDC-2022-0024-2503	https://api.regulations.gov/v4/comments/CDC-2022-0024-2503	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had severe chronic pain for 30 years come September. For 17 of the years I was able to function, work full time and enjoy grandkids. In 2016 after yet another surgery I went on disability. I was in pain management saw the doctor one time then monthly his PA with drug screens and pill counts. At 56 at the time I’ve never been treated like an addict until the 2016 guidelines came out. The pain doctor force tapered me off my long acting pain meds and he said I had no choice but to have a stimulator put in which I’d have to be completely off all meds. I was lucky enough to go back to my regular physician to get a small amount of meds before I was completely taken off. I live in Wisconsin and our medical board has a 90 mme limit made law from the cdc 2016 guidelines. I know that the there is no science behind the mme and it should be completely taken out of the guidelines. I was once able to function and enjoy my grandchildren to a certain extent. Now I spend a good portion of my day in bed unable to function. It’s cruel and inhumane to not let doctors properly treat their patients. I need surgery for my shoulder now and they only give Tylenol and gabapentin after surgeries, I already am having severe stomach, liver, pancreas problems from taking Tylenol and ibuprofen daily which does not help. The mme needs to be completely taken out of the updates. There is absolutely no study that proves the mme is correct. [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Connie	None	None	0900006484fc4cf8	Nasett	None	2022-03-14T21:19:48Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Nasett, Connie	l0n-tj44-tig8	False	None	False	2022-04-12 04:18:44.760	[]
2498	CDC-2022-0024-2504	https://api.regulations.gov/v4/comments/CDC-2022-0024-2504	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	#CDC2022. I’ve been on pain medication for years and it’s the only thing that lets me have a normal functioning life. Since my doctors have tapered me and continue to taper me, I can’t sleep or do my daily activities without pain. I don’t understand how people who are addicted to heroin can get 3x more pain medication than I get for my Chronic pain. I don’t think people who don’t have a medical background can tell the doctors what to prescribe for pain medicine. Every person is different. What they prescribe for one may not be suitable for another. This really has to stop. I cannot live without pain medication so if they taper me any more, I will be thinking about suicide. This has gone on long enough, please stop the abuse of people in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joanne	None	None	0900006484fc6511	Hamman	None	2022-03-14T21:20:19Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hamman, Joanne	l0p-uiwk-0k85	False	None	False	2022-04-12 04:18:44.979	[]
2499	CDC-2022-0024-2505	https://api.regulations.gov/v4/comments/CDC-2022-0024-2505	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the 2016 guidelines with the 90MME, I’ve suffered with being cut off abruptly for 2yrs which caused heart & kidney damage from both the abrupt cut off as well as all the Tylenol & ibuprofen that was pushed on me so much. I’d been living a very productive, active life until then. The MME limits have & continue to take so much of my life away from me & my immobility has been causing yet more health issues that I never had before & are most definitely the direct cause of not having my pain under control. I’ve got deteriorating disc’s, neuropathy, fibromyalgia & now 30% less kidney function & an enlarged left atrium of my heart. Nothing about the 2016 guidelines has been good or healthy for me. We must rescinded the MME limits as we’re all individuals with various metabolisms , weights heights & pain levels. One size does NOT fit all. We need to be treated as individuals. Please please rescind the dangerous & often deadly consequences of the MME. We all desperately need the DEA back on our streets to rid us of the illicit poisonous adulterated drugs & we need our Drs back in their offices to see their patients without non-medical people telling them how to treat their patients. I understand the need to want to try something but we’ve all seen that the 2016<br/>Guidelines with the MME limits have been an unfortunate failure & the only way to correct that is to, rescind that mistake & allow our Drs to care for us again without the MME limits. We can all learn from this and move on once the MME limits have been rescinded. MILLIONS upon MILLIONS of patients are counting on you to correct this & do the right thing for everyone. Thank you kindly	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006484fc6191	Sieving	None	2022-03-14T21:20:41Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Sieving, Cynthia	l0p-m1mo-t4q9	False	None	False	2022-04-12 04:18:45.201	[]
2500	CDC-2022-0024-2506	https://api.regulations.gov/v4/comments/CDC-2022-0024-2506	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC guidelines for the prescribing of opioids. <br/>I had hoped that the guidelines would consider RLS (Restless Legs Syndrome) as well as chronic pain.<br/>I have suffered from both conditions and unfortunately have not tolerated traditional antiepileptic medications such as gabapentin or Lyrica.<br/>The dopamine agonists such as Requip and Mirapex help but can cause a paradoxical worsening called augmentation.<br/>I know from personal experience that low dose opioids, carefully monitored, can literally be a lifesaver for patients like myself whose RLS is difficult to control. Please consider adding Restless Leg Syndrome to the guidelines.<br/>Thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484fc6526	Hollingsworth	None	2022-03-14T21:20:53Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Hollingsworth, Denise	l0p-virp-e44e	False	None	False	2022-04-12 04:18:45.954	[]
2501	CDC-2022-0024-2507	https://api.regulations.gov/v4/comments/CDC-2022-0024-2507	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm happy, as a chronic pain patient to allow my family provider to feel comfortable to write my opioid medication. While everything has to go through years of control, to see that the patient, once again need to control what goes in my system,provided by my physician and there's a lot of treatments I've been under, to find out patient expenses are on the line of unaffordable, and not as successful as when I was on my script, of 10mg of oxycodone every 4 hrs as needed for pain.<br/>Never sold,or miss took my meds, but have suffered dearly for others who did	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tony	None	None	0900006484fc6533	Tilley	None	2022-03-14T21:21:11Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Tilley , Tony	l0p-w79k-5r0p	False	None	False	2022-04-12 04:18:46.166	[]
2502	CDC-2022-0024-2508	https://api.regulations.gov/v4/comments/CDC-2022-0024-2508	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC isnt wholly qualified to make decisions on pain medication especially with anti opioid zealots on board that aren't knowledgeable about pain medication and how they work. Pain Drs a pain patient or two, and others knowledgeable about MMEs and how pain medication works need to be part of the people making decisions. We are individuals with different DNA and need what works7 for us individually. To put everyone on the same amount MME will never work because everyone is different <br/> We need our pain treated individually with what works. <br/>Thousands of pain patients have written in and told their stores of being tapered or cut off completely And they are suffering. Many have committed suicide. <br/>People cannot I repeat cannot live life in unbearable unrelenting pain. We are human beings and we aren't made to live in pain every day for the entire span of life in unrelenting nonstop pain. Its inhumane and the CDC is torturing people to death or forcing them to commit suicide or go take their chances on illegal street drugs. <br/>You cannot tell me that absolutely no one in government -Senate, DEA,FBI,CDC lives without chronic or chronic intractable pain. Some of you know what were going through or you have a friend or loved one that suffers in pain. I'm not talking about minor pain either but chronic intractable pain that wont stop with out pain medication. <br/>Also stop the false narrative that opioids are bad and don't work because they absolutely do and mean the difference between living a decent life with a good quality of life or living in bed in agony or killing themselves. The government wants people to accept something we know is a lie and we're not going to. Certain people say pain meds don't work long term but that's a lie. Do some long term studies before you say that. That's right you need to first do multiiple long term studies not just short term studies and include people in different types of pain along with different diseases and issues that cause pain before you say opioids don't work. Include people from all walks of life and occupation to see what is really going on. I became disabled working as a nurse but the next person may have HICP pain from a different cause or condition People are truly in pain and need pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484fc653a	Cashman	None	2022-03-14T21:21:47Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Cashman , Teresa	l0p-wr5i-2iib	False	None	False	2022-04-12 04:18:46.382	[]
2503	CDC-2022-0024-2509	https://api.regulations.gov/v4/comments/CDC-2022-0024-2509	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We are in a period of time in which the United States is quickly losing its place as the reigning power in the world. We have become decadent in n my any ways, and the opioid epidemic is one symptom of this decadent. To be diligent guardians of the health of our country, it is crutfor us to avoid prescribing opiates unnecessarily, and without proper supervision. That being said, as our medical system is overtaxed, one visit per quarter or semiannually is adequate. Once a month results in Drs having little time for anything but opiate supervision.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484fc7554	Carbonell	None	2022-03-14T21:22:28Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Carbonell, Eric	l0r-6qhv-l5qx	False	None	False	2022-04-12 04:18:46.598	[]
2504	CDC-2022-0024-2510	https://api.regulations.gov/v4/comments/CDC-2022-0024-2510	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines were devasting to those if us who are long term pain patients who require opioid meds. Our Dtr are terrified of losing their license if they do what's right for the patient. We have been treated like children overseen by parents. We can't go anywhere as we are required to have monthly office visits and can only get 1 month supply at a time. The gvt has way overreached their involvement in our personal lives as have insurance and pharmacy companies. We have a medical problem of chronic pain not a drug abuse problem. We should not be treated like criminals. We already have it hard dealing with pain so why make it 10 times harder with all these restrictions. Plus it really is not changing the number of drug overdoses. That is not our issue though we are sorry for it. Please treat like with respect and dignity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484fc7544	Doner	None	2022-03-14T21:22:40Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Doner, Christine	l0r-6f15-eo55	False	None	False	2022-04-12 04:18:46.809	[]
2505	CDC-2022-0024-2511	https://api.regulations.gov/v4/comments/CDC-2022-0024-2511	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to be trusted as the responsible adult I am by the HMO (Kaiser) I participate in. The difficulty of acquiring the opioid I’m prescribed has been difficult since day one. Letters to the company people who determine & enforce the protocols around opioids have been unsuccessful. I have never had a single incident of attempting to get a prescription early; this is about getting Rxes on time. Patients are treated like children or street addicts. I would like consideration of a dose over the guideline in a reasonable manner. The pain clinics offered are pathetic. I guess the 1-10 table to access pain is useful to some; another person cannot judge another’s level of pain. There has to be a better way!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dianne	None	None	0900006484fc7538	Kelly	None	2022-03-14T21:23:06Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Kelly, Dianne	l0r-68od-h2sc	False	None	False	2022-04-12 04:18:47.015	[]
2506	CDC-2022-0024-2512	https://api.regulations.gov/v4/comments/CDC-2022-0024-2512	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support allowing the doctors to prescribe any and all pain medications available to help people with short term pain to overcome their medical condition and for chronic pain patients to be more comfortable in their daily life. Pain medications can help people continue to work and contribute to society when they would otherwise be forced out of the work force. Pain medications can also allow people to be comfortable with chronic life altering disabilities. There are many conditions that provide lifelong horrible pain that only opioids can help. Suicide should not be option due to pain when there are available pain medications for treatment. The fear for people being addicted is so rampant that it seems like people within the system would rather a pain patient commit suicide than be addicted to opioids. Just because someone needs opioids on a daily basis does not make them an addict. It makes them a person who deserves compassion and access to affordable medical treatment. Please don't allow a narrative of addiction to prevent all people from getting the pain treatment that they need and deserve to function and to simply exist. Please do not criminalize or restrict pain treatment or access to opioids. Please allow doctors to treat their patients as they determine based on their knowledge of the patient. Doctors should not fear prosecution or fees related to treating their patients. The small percentage of people who are addicted to opioids should be provided treatment for their addiction rather than restricting access to opioids for the majority of pain patients who need opioids to remain functional or reduce the pain that they face on a daily basis. Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006484fc7534	L	None	2022-03-14T21:23:32Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from L, A	l0r-665k-2kba	False	None	False	2022-04-12 04:18:47.232	[]
2507	CDC-2022-0024-2513	https://api.regulations.gov/v4/comments/CDC-2022-0024-2513	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thought that the 2022 updated guidelines are supposed to be an improvement. The fact that they are trying to lower the MME to 50 mg a day is ridiculous. Based upon the 2016 guidelines of 90 MME a day and the fact that it was essentially made law, there should be no stated MME daily equivalent. The 50 MME will become law just like the 90 MME did. Any mention of a max daily dose needs to be removed, this is a decision between the patient and doctor! Doctors are already scared to prescribe opioids, and this will only make matters worse. MME equivalents are only good for the use in changing a patient's medication from one opioid to another, not to limit dosage.<br/><br/>There are so many other painful conditions that are not listed, remove anything that mentions specific conditions! This is also a doctor-patient matter. Allow the qualified doctors to work with and treat their patients. <br/><br/>I believe that the authors of this revision guideline truly believe that Americans are flat out stupid. They believe that by continuing to give false, cherry-picked studies that we will not notice. Then to bury the information in an extremely lengthy guideline thinking that we will not notice or hoping we will not read. Get authors that are not funded by anti-opioid groups and that have clinical pain management experience.<br/><br/>This updated guideline is a travesty.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc751e	Anonymous	None	2022-03-14T21:23:59Z	None	None	1	None	2022-03-14T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0r-5xyv-vak6	False	None	False	2022-04-12 04:18:47.449	[]
2508	CDC-2022-0024-2514	https://api.regulations.gov/v4/comments/CDC-2022-0024-2514	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	VERY IMPORTANT ! ! ! copy & paste...<br/><br/>“I wish to endorse comments separately submitted to the Federal Register and widely published on social media by [Name Redacted]”. <br/><br/>IMPORTANT, IF you'd like to Support, [Name Redacted], Advocating for all of the CPP Community, his time, expertise, and all he does.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc7589	Anonymous	None	2022-03-15T14:36:27Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0r-737t-8xt1	False	None	False	2022-04-12 04:18:47.676	[]
2509	CDC-2022-0024-2515	https://api.regulations.gov/v4/comments/CDC-2022-0024-2515	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Diagnosed with spinal stenosis at age 45. Pain is unbearable and doctors refuse to prescribe narcotic medications. As horrible as I feel I have been made to jump through so many hoops CBT, physical therapy, psychiatric medications, injections I’ve had NO relief. I began having suicidal thoughts because I felt so neglected and didn’t want to live in such pain. I can’t even sleep. Can’t work. It’s TORTURE. Please restore compassionate care and let doctors treat their patients. Stop interfering in patient care as it is causing much more harm than good.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006484fc75c0	Basurto	None	2022-03-15T14:37:12Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Basurto, Maria	l0r-7t1p-5jx8	False	None	False	2022-04-12 04:18:47.885	[]
2510	CDC-2022-0024-2516	https://api.regulations.gov/v4/comments/CDC-2022-0024-2516	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who suffers from daily pain, I will never understand how someone who has pain in their abdomen versus my spinal and nerve pain can successfully be treated with the same dose of medication. Or how a male weighing 275 points will only be allowed to get the same MME equivalent as my 110 pound body. I will never understand how my government has worked against me and my doctors in my painful journey through life. How I literally had no where to turn when my pain got so bad at 3 am and I was forced to wait until 6 am to take my first dose of medication. How I had to decide if I could attend my daughter's graduation or the party I threw for her and her friends and family because there is no way I would be able to enjoy both because my pain medication only works so long before it begins to wear off and again, we don't get extra for occasions like that. Instead, we have to pick and choose while fully knowing there is medication oit there that is safe and effective but the DEA says we can't have them because some politicians son ODed on herion.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc7601	Anonymous	None	2022-03-15T14:38:20Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0r-8koy-p8wk	False	None	False	2022-04-12 04:18:48.109	[]
2511	CDC-2022-0024-2517	https://api.regulations.gov/v4/comments/CDC-2022-0024-2517	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	“I wish to endorse comments separately submitted to the Federal Register and widely published on social media by [Name Redacted]”. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc7602	Anonymous	None	2022-03-15T14:40:50Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0r-8lmw-lx5c	False	None	False	2022-04-12 04:18:48.317	[]
2512	CDC-2022-0024-2518	https://api.regulations.gov/v4/comments/CDC-2022-0024-2518	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While it is a smart decision to regulate opioid prescriptions due to the prevalence of drug addictions, it should also be taken into account that some people need them to function. Some citizens, for example veterans who suffered severe injuries overseas, need opioids to function on a day to day basis. The CDC should also take into account the amount of suicides that are caused by unbearable pain. In some circumstances, these medicines could be life-saving. The regulations could be stricter in an effort to not let addicts get their hands on them as often, but some people need them for medical reasons. I believe that opioids should be attainable for patients who have illnesses or injuries that require a strong pain suppressor to function.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Isabella	None	None	0900006484fc7611	Waters	None	2022-03-15T14:42:07Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Waters, Isabella	l0r-96m2-hpdd	False	None	False	2022-04-12 04:18:48.530	[]
2513	CDC-2022-0024-2519	https://api.regulations.gov/v4/comments/CDC-2022-0024-2519	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe that there should be restrictions on options but not on one that really need the medications due to severe trauma. My husband has had 15 back surgeries and has severe pain. Has tried all ways to help the pain with little to no relief. He was getting some relief for breakthrough pain with opiods but can't get them because of the regulations put on opiods.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	0900006484fc763c	Nichols	None	2022-03-15T14:43:43Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Nichols, Tammy	l0r-9pz4-k5q3	False	None	False	2022-04-12 04:18:48.766	[]
2514	CDC-2022-0024-2520	https://api.regulations.gov/v4/comments/CDC-2022-0024-2520	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have 5 years of experience as an RN specializing in opioid use disorder, providing effective care through MAT programs. In our county's health clinic, we worked closely with patients on high doses of narcotics for non-cancer-related chronic pain and were able to help most of them reduce their opioid use. This required the ability to teach about hyperalgesia and the consequent ineffectiveness or inappropriateness of the current very high dosing regimen. The most important ingredient in helping patients cut down on or withdraw from opioids, or to transition to another, safer opioid like buprenorphine, was TIME. RNs are best suited to providing the time, education, and support, once a plan has been made with the patient and prescriber. This is often a long, arduous process for patient and clinician alike. In some cases, the narcotic has to be decreased by as little as 5 mg MME each week for the patient to be willing to continue over the months or even year it can take. <br/><br/>The crucial importance of movement/exercise, mindfulness, and psychological support for the patient with OUD cannot be overstated. Additionally, social and peer support are highly recommended for long-term maintenance of lower dosing, substitution of buprenorphine, or termination of narcotics for pain management. <br/><br/>It is dangerous and cruel to halve or stop narcotic medications suddenly. All it takes is one time for a patient to experience unmedicated withdrawal and they will be sure to resist this process again. The suicide discussed in the NY Times article of March 13, 2022 ("The Other Victims of the Opioid Crisis"), came as no surprise to me, as I've witnessed patients in inadequately -medicated withdrawal--several have begged me to "kill them." It is a violent and wholly unnecessary process. We can do much better at educating prescribers and local/state agencies in cruelty-free ways to "follow the guidelines." RNs with training in addiction medicine and a trauma-informed approach can be a lifeline to these patients--and to the providers they work with.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marion	None	None	0900006484fc7932	Brodkey, RN	None	2022-03-15T14:45:03Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Brodkey, RN, Marion	l0r-dmmc-5x0w	False	None	False	2022-04-12 04:18:48.975	[]
2515	CDC-2022-0024-2521	https://api.regulations.gov/v4/comments/CDC-2022-0024-2521	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a victim of NSAIDS overprescribing. For over 36 years I was always prescribed advil, Motrin, naproxen, aspirin. Most of the time 800mg per dose. Having chronic pain NSAIDS and acetaminophen were what worked for me. Until roughly 13 years ago when I developed severe stomach pain. Being diagnosed with GERD, ulcers, acid reflux due to overuse of NSAIDS. I am no longer a candidate for most medications that treat my conditions. Doctors at [Location Redacted] as well as local have said there isn’t anything more they can do for me. I am on a low dose of opioids that have not been changed for many years. I’ve never misused nor asked for more. I’m under medicated and my quality of life is diminished more than I care to admit. I have had forced injections, SCS as well as DRG surgeries to only have them removed and not work. Something needs to give.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc794e	Anonymous	None	2022-03-15T14:46:23Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0r-ee92-14nf	False	None	False	2022-04-12 04:18:49.191	[]
2516	CDC-2022-0024-2522	https://api.regulations.gov/v4/comments/CDC-2022-0024-2522	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I think everyone can agree that the opioid crisis in the US continues to be a serious concern, the CDC guidelines set in 2016 have caused undue hardship on legitimate chronic pain patients like myself. I was a victim of malpractice in 2005 which nearly cost me my life and resulted in the surgeon losing his license to practice medicine (several people lost their lives under his care). So even though my pain care provider has helped me tremendously with physical therapy and injections, there is only so much you can do and I will be on pain medication for the rest of my life, unfortunately. Many times over the years since, I have been told by my local pharmacy that they do not have enough medication to fill my prescription since they are allotted a set amount of medication and I have had to wait until they were restocked to get my prescription filled. As Latina females, we battle frequently with racial and gender discrimination and these guidelines have added yet another obstacle for us to overcome as we strive for the social justice the President has challenged our country to eliminate. I respect all the hard work the CDC has done to help solve the opioid problem in our country and much has been accomplished but I humbly ask for consideration of future guidelines to be relaxed for chronic long-term opioid therapy patients like myself. Thank you for your time and consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bella	None	None	0900006484fc799d	Flores	None	2022-03-15T14:47:38Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Flores, Bella	l0r-grqs-v28v	False	None	False	2022-04-12 04:18:49.397	[]
2517	CDC-2022-0024-2523	https://api.regulations.gov/v4/comments/CDC-2022-0024-2523	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient, I’ve found the most helpful form of treatment to be non-pharmaceutical. Specifically, things like physical therapy, mental healthcare, dieting, social activity, and other lifestyle changes took me from a debilitated state to a happy and functional individual.<br/><br/>I appreciate that the new CDC guidelines highly emphasize non-opioid therapy, but the reality is that some of the more alternative and specialized treatment options I mentioned are inaccessible to a large part of the American population suffering from chronic pain. Opioid-use has risen to critical levels because it is an immediate and simple solution for the average patient. If the CDC would like to push harder towards proactively mitigating the opioid crisis, it should strive towards making non-pharmaceutical medicine more accessible and normalized across the country.<br/><br/>A specific solution would be to provide educational resources and self-pain-management programs publicly available online for free. As of writing this, on the CDC’s website under ‘Managing Chronic Pain’ there are just broken hyperlinks to paid pain management programs. Since the CDC has so much scientifically-backed data on chronic pain, it seems like they should invest in producing digestible help for individual patients online just as much as they work on prescription guidelines for doctors to help fight and end this epidemic.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc79ad	Anonymous	None	2022-03-15T14:49:13Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0r-higi-uys8	False	None	False	2022-04-12 04:18:49.646	[]
2518	CDC-2022-0024-2524	https://api.regulations.gov/v4/comments/CDC-2022-0024-2524	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern please let the doctors do their job I've had three back surgeries I'm in pain 24/7 remember when you're in pain and see how it feel for you to be in pain 24/7 quit playing God and let the let the doctors do their job	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sam	None	None	0900006484fc7d03	Flores	None	2022-03-15T14:50:50Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Flores, Sam	l0r-jba9-rkyd	False	None	False	2022-04-12 04:18:49.853	[]
2519	CDC-2022-0024-2525	https://api.regulations.gov/v4/comments/CDC-2022-0024-2525	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Have you not learned your lesson from 2016? Why refer to 50 MME as a new limit? Patients are already being reduced for no other reason than the draft guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	50 MME	None	None	0900006484fc7d23	Must GO	None	2022-03-15T14:51:31Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Must GO, 50 MME	l0r-klo6-9k67	False	None	False	2022-04-12 04:18:50.072	[]
2520	CDC-2022-0024-2526	https://api.regulations.gov/v4/comments/CDC-2022-0024-2526	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why are taxpayer dollars paying for these worthless guidelines? Didn't you cause enough harm with the 2016 guidelines? REVOKE THEM. Do not replace or revise.<br/><br/>Also, why attempt to control supply and not demand? Did you not read History 101 and that prohibition failed?<br/><br/>Are not the majority of overdoses for the last 10 or so years due to street drugs, many of which are the result of pain patients resorting to them because thanks to the CDC and DEA, physicians stopped prescribing them or cut dosages to ineffective levels?<br/><br/>Why did the CDC single out opioids while tobacco kill 5 times as many annually and alcohol kill as many or more than opioids?<br/><br/>What percent of 2021 overdoses were due to prescription opioids vs street drugs? Isn't it about 80% illicit drugs, mostly fentanyl that is illegal? If so, isn't this a waste of taxpayer money?<br/><br/>https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/index.htm#:~:text=Cigarettes%20and%20Death,-Cigarette%20smoking%20causes&text=Cigarette%20smoking%20is%20estimated%20to%20cause%20the%20following%3A&text=More%20than%20480%2C000%20deaths%20annually,including%20deaths%20from%20secondhand%20smoke)<br/><br/>https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/alcohol-facts-and-statistics	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc7d29	Anonymous	None	2022-03-15T15:03:12Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-14T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0r-kusz-rxl1	False	None	False	2022-04-12 04:18:50.282	[]
2521	CDC-2022-0024-2527	https://api.regulations.gov/v4/comments/CDC-2022-0024-2527	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines have caused MORE deaths because good law-abiding chronic pain patients are going to the streets to find drugs now!! And they’re laced with fentanyl! Our doctors are terrified to prescribe and many are retiring early as mine has (age 57!) because of all the threats and the fact that he cannot treat his patients the way he knows works for them without the fear of going to jail or losing his license, home, etc! HEALTHCARE IS BARBARIC NOW!!! Because you treat chronic pain patients like drug addicts—which we’re not! We don’t share our medications, sell them, and take them as prescribed! GOVERNMENT NEEDS TO GET OUT OF MY TREATMENT PLANS WITH MY DOCTORS!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelly	None	None	0900006484fc7a4e	Callahan	None	2022-03-15T15:04:33Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Callahan, Kelly	l0r-reai-t99a	False	None	False	2022-04-12 04:18:50.495	[]
2522	CDC-2022-0024-2528	https://api.regulations.gov/v4/comments/CDC-2022-0024-2528	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has an incurable, progressive, chronic pain disorder which can leave him paralyzed for hours at a time and bedridden for days. He was just beginning treatment when the newest CDC guidelines for opiate control began in 2016. <br/><br/>We felt utter despair at the idea that there was a limit on the relief he could obtain. Since then I have witnessed my husband go days without any pain medication because he is afraid to run out. Many times I see him in constant pain and say "did you take any pain meds?" his reply is often "no i took 4 yesterday and I need them to really work tomorrow for an important activity ". <br/><br/>His important activities include, medical visits, grocery shopping and social visits. So you can see that these regulations are preventing my husband from participating in LIFE! <br/><br/> He is getting worse every year and I fear he may eventually be permanently hospitalized. Currently, there is no hope for his future because he does not have access to the pain medication that can at least make his last few years tolerable.<br/><br/>Please adjust the guidelines to allow my husband to receive the medication he needs in the amounts he needs for him to have a future.<br/><br/>[Name Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fc7a87	Elder	None	2022-03-15T15:06:02Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Elder, Lisa	l0r-yv3b-loqf	False	None	False	2022-04-12 04:18:50.706	[]
2523	CDC-2022-0024-2529	https://api.regulations.gov/v4/comments/CDC-2022-0024-2529	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My sister, aged 69, has been a chronic pain patient for over 20 years after a botched surgery left her with severe and debilitating nerve damage that cannot be repaired.<br/><br/>She and others like her must have unfettered access to these medications that are their only way to have some semblance of a quality of life. It is has been inhumane to limit use of these medications for people like her -- especially "legacy" patients in their elder years.<br/><br/>My brother in law - age 75-- who was also a chronic pain patient after 3 hernia surgeries that left him in severe pain committed suicide a few years ago when his doctor started withholding needed medication.<br/><br/>I urge you to loosen the restrictions on these medications for thousands of people like them that continue to need them but have been thwarted in recent years because of the guidelines.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fc7aa9	Doner	None	2022-03-15T15:08:55Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Doner, Susan	l0s-14qk-r6eh	False	None	False	2022-04-12 04:18:50.922	[]
2524	CDC-2022-0024-2530	https://api.regulations.gov/v4/comments/CDC-2022-0024-2530	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve had short bowel and chronic pain since 1993 due to 2 abdominal bowel resection surgeries. I was treated with pain medication that helped tremendously and gave me quality of life and ability to function. I’ve been a compliant patient and never failed a urine drug test.<br/>Because of the CDC guidelines my medication was reduced to such a low dosage that it is virtually ineffective.<br/>This is so wrong!<br/>There are others out there that have had it much worse than myself and I can’t imagine the terrible harm it has caused so many patients.<br/>Please rectify the harm your guidelines have caused. <br/>Sincerely,<br/>[Name Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlotte	None	None	0900006484fc7aaa	Troyer	None	2022-03-15T15:11:03Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Troyer, Charlotte	l0s-1l8i-qnel	False	None	False	2022-04-12 04:18:51.139	[]
2525	CDC-2022-0024-2531	https://api.regulations.gov/v4/comments/CDC-2022-0024-2531	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient of 17 years with CRPS, I have never Abuse my prescriptions, I follow my pain contact with my doctor. The guidelines have done nothing but decreased my quality of life, not improve them. The pain community shouldn’t be punished by the guidelines, CDC you should’ve never used Street drugs to come up with the guidelines. There should never be guidelines for chronic pain patients, cancer patients. It should be individual care between the patient and the doctor. The government should not be involved. I have lost many friends to suicide since the guidelines have started because they have not received the adequate care they deserved! I do not want to lose any more friends because you’re lowering the MME 50! Let our doctors take care of us! Pain is a medical condition!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc8254	Anonymous	None	2022-03-15T15:12:12Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-5q4s-g5fe	False	None	False	2022-04-12 04:18:51.349	[]
2526	CDC-2022-0024-2532	https://api.regulations.gov/v4/comments/CDC-2022-0024-2532	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	"Lines 1778-1779: Patients with co-occurring pain and depression might be especially likely to benefit from antidepressant medication (see Recommendation 8 )." Suggest the inclusion of additional information regarding non-medication options for depression. <br/><br/>"Lines 2692-2702: A specialty clinic offering opioid tapering services for patients receiving high-dosage opioids (defined in 2694<span style='padding-left: 30px'></span>this study as >90 MME/day) for chronic pain found that 44.6% of patients referred for opioid taper were able to successfully taper to <90 MME/day, and an additional 18.8% who were unable to taper were able to successfully transition to sublingual buprenorphine (Sturgeon et al., 2020). Different buprenorphine products, available at different doses, are approved for the treatment of pain (e.g., [Name Redacted]) and for the treatment of opioid use disorder (e.g., Suboxone). While prescription of buprenorphine for treatment of opioid use disorder requires the clinician to have a waiver from the Substance Abuse and Mental Health Services Administration (SAMHSA) (see Recommendation 12), prescription of buprenorphine for treatment of chronic pain does not require a waiver(Name Redacted] et al.,2019)." Feedback received has indicated that providers consider utilizing buprenorphine for pain management as an off-label use and therefore will not prescribe it/will not consider it for this reason/in this situation. Additional education is needed in this area. As discussed, there are patients who have severe difficulty tapering high-dosage opioids. Feedback from patients, who are interested in tapering, has indicated that it can be challenging to identify a provider who has expertise in this area and/or who is willing to work with patients are receiving high-dosage opioids and/or potentially dangerous combinations of controlled substances. <br/><br/>"Lines 3331-3334: Discuss information from the PDMP with their patient and confirm that the patient is aware of any additional prescriptions. Occasionally, PDMP information can be incorrect (e.g., if the wrong name or birthdate has been entered, the patient uses a nickname or maiden name, or another person has used the patient’s identity to obtain prescriptions)." Additional guidance may be added to these lines. When discrepancies in a PDMP system are noticed, providers should be encouraged to take patient concerns very seriously and work closely with the patient, pharmacies, and state PDMP administrators to correct or verify information. PDMP systems can contain errors and it can be dangerous for patients to be abruptly cut off medication due to a system or human error.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather	None	None	0900006484fc830d	Myers	None	2022-03-15T15:32:52Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Myers, Heather	l0s-6e9o-5fxo	False	None	False	2022-04-12 04:18:51.578	[]
2527	CDC-2022-0024-2533	https://api.regulations.gov/v4/comments/CDC-2022-0024-2533	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope one day to learn why I have been treated like a low life drug addict every time I try to get help with the cronic pain that I suffer with every day. After years I finally was able to get a low dose of pain medicine that has given me some much-needed relief for a few hours a day, but that is about to end because I refuse to undergo an injection into my spine that the FRA has refused to approve, and the Pfizer company has said that this drug should not be used in this way. The way that I have been treated by the people that I must rely on for help continues to erode my soul. My untreated pain has caused me to research the best way to end my life. It is so hard to except why you have used the DEA to terrorize the medical community. I have done some research on how you let PROP tell you how to destroy the lives of so many people like myself. Please use some advice from the true experts on not assigning a maximum milligram limit every person is different. Please stop your cruelty.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fc83b3	Motteler	None	2022-03-15T15:33:55Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Motteler, Mark	l0s-6qnl-vrse	False	None	False	2022-04-12 04:18:51.792	[]
2528	CDC-2022-0024-2534	https://api.regulations.gov/v4/comments/CDC-2022-0024-2534	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	REGARDING CHANGE FOR THE CDC GUILDLINES 2016, (FOR OPIATE MME CHANGE).<br/><br/>WE MUST CHANGE TO SAVE PEOPLES LIVES!!!!! WE MUST REVISE TO INCREASE MME's ON LEVELS THAT ARE SANE NOT INSANE!<br/><br/>THE WAY IT IS WRITTEN IS KILLING THE INNOCENT PEOPLE SUFFERING NOT HELPING THE OPIATE PROBLEM.<br/>PAIN MANAGENT SHOULD BE SOLEY BETWEEN THE PATIENT AND THE PHYSICIAN.<br/>MY BROTHER HAD 4 BACK SURGERIES AND SUFFERED TERRIBLY DUE TO LACK OF PAIN CONTROL. HE COMMITTED SUICIDE DEC 2021. HE CONSTANTLY STRUGGLED AGAINST THE STIGMA OF BEING A DRUG ABUSER. HE WAS ONLY 64.<br/>MAY HE REST IN PEACE.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc87d7	Anonymous	None	2022-03-15T15:34:30Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-8yvu-735p	False	None	False	2022-04-12 04:18:51.996	[]
2529	CDC-2022-0024-2535	https://api.regulations.gov/v4/comments/CDC-2022-0024-2535	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I went over a year with chronic intractable pain after a traumatic fall because I couldn’t find a pain management dr to treat my pain. So many Drs are afraid to treat pain due to the CDC/DEA & the guidelines. Remove all MME’s & allow Drs to be Drs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc88be	Anonymous	None	2022-03-15T15:35:07Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-9fbr-o785	False	None	False	2022-04-12 04:18:52.205	[]
2530	CDC-2022-0024-2536	https://api.regulations.gov/v4/comments/CDC-2022-0024-2536	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The rigidity with which the 2016 Guideline was implemented is explicitly acknowledged in the new version. Although belated, an attempt to correct course is made in regard to shared decision-making, individualized treatment planning, and acknowledgment that access to a full range of therapeutic options is incomplete across populations. The 2016 prescription duration limits for acute pain and the upper threshold dose based on scientifically inadequate morphine milligram equivalent data have been removed in the update. These changes are good insofar as they go. Now, the Guideline update drafters must go further and address how the same rigidity has been misapplied in legal and regulatory proceedings targeting clinicians. The 2016 Guideline and policies created in its image have been misused by prosecutors, the Drug Enforcement Administration, and government expert witnesses, a situation that was fully predictable and was, in fact, predicted. It is not enough to state that the new version is not intended to be used as such. There must be acknowledgment of the harm caused and an explicit statement that the Guideline should not be introduced as legal evidence of standard of care, nor should failing to adhere to any particular detail of the recommendations be misused to infer criminal action. This statement must apply to the 2016 version as well as to the update. Please see the attachment for more detail regarding these and other important issues.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc35cd	None	None	2022-03-15T16:20:37Z	Center for U.S Policy	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-10T05:00:00Z	None	None	None	None	None	None	None	Comment from Center for U.S Policy	l0l-gu18-4ivd	False	None	False	2022-04-12 04:18:52.420	[]
2531	CDC-2022-0024-2537	https://api.regulations.gov/v4/comments/CDC-2022-0024-2537	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc5324	None	None	2022-03-15T16:26:15Z	Massachusetts General Hospital - Department of Oral and Maxillofacial Surgery - Orofacial Pain	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-12T05:00:00Z	None	None	None	None	None	None	None	Comment from Massachusetts General Hospital - Department of Oral and Maxillofacial Surgery - Orofacial Pain	l0o-ce2h-vg6q	False	None	False	2022-04-12 04:18:52.634	[]
2532	CDC-2022-0024-2538	https://api.regulations.gov/v4/comments/CDC-2022-0024-2538	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC is suspect in all of their research reviews they're withholding of names of peer review and research that is outdated more than 10 years old. This is ridiculous. The CDC should not be incorporating members who have a conflict of interest in this discussion. They also should not be using these members Publications to push their agenda. I believe that that doctors and patients should be able to choose the method that is best and works the best for them be it opioids or other forms of pain management. This should not be controlled by the government but by medical doctors and their patients. I am a member of the Chronic Illness Advocacy & Awareness Group (CIAAG). Please see the attached summary.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fc653b	Sansone	None	2022-03-15T16:31:27Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Sansone, Deborah	l0p-wi1v-qalr	False	None	False	2022-04-12 04:18:52.844	[]
2533	CDC-2022-0024-2539	https://api.regulations.gov/v4/comments/CDC-2022-0024-2539	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughters both suffer from multiple connective tissue diseases that cause intractable pain. I have watched them both suffer immensely due to doctors force tapering all in response to the 2016 CDC Guideline.<br/><br/>In my opinion the only organization that should be involved in writing prescription medication guideline is the FDA. A new set of guidelines must NOT be unilaterally formed by a single agency, especially the CDC, which lacks the chemical and pharmacological insight and knowledge to formulate a policy regarding drug use. <br/><br/>The FDA has a far greater knowledge base about drugs and pharmacology and should form a task force composed of in- and outside pharmacologists, chemists, pain management physicians, neurologists, primary care physicians, surgeons, and pain patients.<br/><br/>The task force should formulate a science- and medicine-based set of recommendations that are focused on treating and preventing pain, not stopping addiction - an endeavor that been shown time and time again to make matters only worse. The task force should submit its plan to the Commissioner of the FDA for review<br/><br/>All MME (an unscientific measure) references should be removed from ALL the guidelines<br/><br/>No matter the said intent, Laws and Policies will be enacted and cause FURTHER harm to patients. The CDC in one hand recognizes the value of patient centric care and in the other hand distinguishes it by recommending MME.<br/><br/>The 2022 Opioid Prescribing Guidelines "caution" against the use of opioids in excess of 50MME's. Effectively reducing the maximum daily dose recommendation nearly an additional 50%. Yet, the recommendation still stands and is greatly reducing daily maximum dosing even further despite the widespread harms from the original guidance.<br/><br/>All MME references should be removed, it’s an unscientific calculation. Everybody metabolizes medication differently there is no one size fits all. There are differences in the absorption of different drugs into the bloodstream, half-life of different drugs, the impact of one or more other drugs on opioid levels, and large differences of the rate of metabolism caused by genetic factors<br/><br/>NO OPIOIDS FOR PERSONS OVER 65 YEARS OLD<br/><br/>The revised version of the Opioid Prescribing Guidelines recommends against the use of opioids in persons over 65yrs old. The authors should not be providing any guidance that outright denies an entire class of citizens’ access to medication. Instead the author's should be recommending "caution" in this community rather than outright recommending this entire population be denied access to vital medications. This recommendation is a direct violation of a patient's right to receive individualized care. The care they receive should be dictated by their unique situation, not by recommending a blanket removal upon reaching a certain age. In addition, this recommendation fails to address patients’ already on opioid medications and sets the stage for them to be forcibly removed from their pain medications upon their 65th birthday for no other reason than their age.<br/><br/>CONFLICTS OF INTEREST-especially [name redacted] <br/><br/>The CDC appointed numerous individuals with well-known personal and/or financial conflicts of interest. The most disconcerting is [name redacted] <br/><br/>A dominating theme throughout the report is the authors' use of their own personal research projects as "supporting evidence" for the recommendations they are making. Particularly, [name redacted]'s work was cited 99 times of times alone. In addition, both [name redacted] and [name redacted] research was also frequently cited throughout the report as well. <br/><br/>The CDC MUST NOTIFY ALL State Medical Boards, Governors, Insurance Companies including Medicare and Medicaid, and Pharmacies and request that they delete/remove all policies and laws that have been created based on the CDC’s Opioid Prescribing Guidelines, both in 2016, past, present and future, specifically where MME has been implemented <br/><br/>Physicians must be given the required independence and tools necessary to empower them to treat individual patients as they see fit without undue interference from punitive legislation and overzealous law enforcement.<br/><br/>The DEA and other law enforcement agencies should stop harassing Doctors who do their noble duty and treat patient’s pain. We have clear laws which separate doctors from drug dealers and we need to prohibit law enforcement from distressing physicians who are treating pain Drs take the Hippocratic Oath which explicitly mentions relieving pain and suffering<br/><br/>The 2016 Guideline was embedded into the Healthcare record system, which informed doctors to TAPER to an “appropriate dose”. The CDC MUST REMOVE ITSELF FROM THE HEALTHCARE RECORD SYSTEM. The CDC keeps saying these are “just guidelines “but by being involved in the patient/doctor relationship the CDC is causing insurmountable harm to those suffering in pain<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Yvonne	None	None	0900006484fc654c	Helmick	None	2022-03-15T16:33:33Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Helmick, Yvonne	l0p-xppb-azkl	False	None	False	2022-04-12 04:18:53.051	[]
2534	CDC-2022-0024-2540	https://api.regulations.gov/v4/comments/CDC-2022-0024-2540	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a citizen of the United States of America, born and raised. I live, work, and raise a family here in the United States. I have family, a job, friends, and am active in my community. I enjoy living my life to the fullest and being a stable human being in this world. There is one small thing with my life that may differentiate me from others, I have a chronic condition, it is a physical condition that causes pain. In order to live my life to the extent that my family and I enjoy, I need to be able to control the pain of this condition. I utilize opioid medication, just as I have for ten plus years. I do not wish to have an unnecessary surgery to my body at this time, because the practice of medicine cannot 100% promise me that it will stop my pain. I along with my physician decided a long time ago to initiate this therapy and see if it worked, ONLY AFTER, I had surgery to try and correct this physical condition, which it failed. The surgery did not work, and will not work on a degenerative condition, but it was worth the information learned as if only to get a better grasp on what is wrong with this body. How to change certain things in my life to better symptoms, and to slow the progression of this disease. So, my medication has been adjusted through the years as needed for the condition that I live with. I do not let my condition rule over me. I take the required medication and keep on living. Now, in this last 4 years, I have had new physicians' assistants see me for my refills, and have been degraded, I have been treated like I am a bad person for the treatment that I have used for ten plus years! I know that I cannot change the course of this degenerative disease, I can only manage my symptoms, live a healthy lifestyle, stave off the inevitable as long as I can, however, it does not make it any easier being treated in such a way by anyone due to my illness or the therapies that I have tried and the opioid therapy that I do use for my situation. Through these years, I've adapted to the legally required changes, from three-month checkups to one-month checkups, to added monthly drug screens, and now to demeaning and derogatory remarks. What is a hopeful process for treating pain from my disease, successfully through the years is now being demonized? The problem with this is when you already have a disease that could devastate you, but you choose not to allow it to, and you fight for your best life after a lifelong diagnosis has been handed down, and you make that decision to make the best out of the hand you're delt. The last inhumane treatment you need to receive is accusation of weakness, being a degenerate, or being forced to medical destitution. The last few years I have been tried on many anti-opioid medications to remove opioid therapy from my maintenance therapy. I complied, because why not. If it works, I'm game. as the disease is still the disease. I cannot change what my body is doing to itself. Upon being given an antidepressant, I became suicidal, extremely agitated, and highly irrational. I was foggy minded, couldn't bring myself to get up out of the bed, became depressed, and above all, it never helped pain, I would be in severe pain, doped up in my mind, missing important events and business appointments, which caused great embarrassment, caused people to lose faith in my dependability, and that's when my physical condition started to affect my family. I tried these alternative approaches to appease the rules and guidelines, the opioid therapy only affected the pain from the condition, and I function quite well without other side effects that most people have with opioid therapy. I feel grateful for that. Maybe Gods way of helping me through because I do strive to be in the best health, I can be in. For myself, for my family, and for the people that depend on me in the position I hold for my profession. I understand also that there are people that cannot control themselves for whatever reason. I do feel that I should not be treated like one of those individuals when I have a long-standing professional relationship with my provider that trusts I use this medication for the benefit of my life functions. If I did not have access to this medication, and the ability to be titrated with this medication, I know my life will be affected detrimentally. I have unfortunately endured that process already due to the guidelines that are now being enforced on all patient with chronic physical ailment. And being pushed to take medications that caused harm to me, caused sadness to my family, and also, I had to repair professional relationships that affect my ability to care for my family. All due to guidelines that required changes to my therapeutic medication, does this sound like medical practice? Just because the government wants to curb a drug problem, that I do not possess. My medical treatment turned upside down. My family has a medical malpractice lawyer now because of this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn	None	None	0900006484fc6350	L.	None	2022-03-15T16:41:34Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from L., Dawn	l0q-2fe8-84tg	False	None	False	2022-04-12 04:18:53.270	[]
2535	CDC-2022-0024-2541	https://api.regulations.gov/v4/comments/CDC-2022-0024-2541	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Agency/Docket Number:<br/>Docket No. CDC-2022-0024<br/><br/>Document Number:<br/>2022-02802<br/><br/>I’m adding an additional comment here because I found out some information yesterday in reference to the updated 2022 CDC guidelines. If this is true, everyone involved, including the authors, should be ashamed of themselves for the harm they have inflicted and continue to inflict on their fellow disabled Americans with this guideline.<br/><br/>I overheard that the CDC has no intention of changing the final 2022 guideline and it will remain the same as the draft, no matter how many comments you receive from patients begging you to change it. That the CDC has already informed doctors there will be no change in the draft guideline and the only reason you cannot publish the final guideline now is because you legally have to have a comment period before it is published.<br/><br/>I want to say this plainly and simply to all involved in this 2022 updated CDC guideline. You are signing a death sentence for many in the chronic intractable pain community, including myself. <br/><br/>In pain management, we are strictly monitored. We sign pain contracts, submit to urine drug screening and pill counts, we are required to schedule follow up appointments, our private information is put into the State PDMP’s, we are accessed for addiction and nefarious behavior at every appointment, we have algorithms assigning us a “score” and much more. We are monitored as strictly or more strictly than most prisoners. Why do we consent to all this invasion of privacy? Because we are legitimate sufferers of incurable, disabling, lifelong chronic intractable pain and seek relief to help us be somewhat physically functional and to live as close to possible as normal human beings. I am proof that opioid pain medication does work and it has worked for two decades, even though there is “limited evidence” on opioid pain medication being effective for chronic pain. I have never overdosed and I have never been diagnosed with addiction or OUD.<br/><br/>Even though the CDC states this guideline is “voluntary”, “not a replacement for clinical judgment or individualized, person-centered care”, “not intended to be applied as inflexible standards of care”, “not a law, regulation, and/or policy that dictates clinical practice or a substitute for FDA-approved labeling” and “not applicable to the following types of pain treatment: sickle cell disease-related pain; cancer pain; palliative care; or end-of-life care, doctors will ignore this like they did with the 2016 CDC guideline and will continue to reduce and/or cut patient's medication because of your numerous recommendations to not increase dosage above 50 MME and your continuous mentioning of tapering. You knew the 2016 guideline would be misapplied and used against pain patients and you know this guideline will be misapplied in the same way. Did you know not long ago, 50-90 MME was the average daily dose of Morphine for a 50 pound dog for chronic pain? (See 5th paragraph under Morphine Sulfate here: https://vasg.org/opioid_analgesics.htm ).<br/><br/>I’m really not sure why you updated the 2016 CDC guideline. You should rescind it along with the updated 2022 guideline. The 2016 CDC guideline has not helped the overdose crisis and the updated 2022 guideline will not help it either. The 2016 guideline has caused nothing but harm, increased pain and suffering, and additional disability to Americans with chronic intractable pain.You should not have the authority to dictate patient care for a non-communicable, non-infectious chronic medical condition. It is not chronic intractable pain patients, who are strictly monitored by their doctors, that are causing the majority of overdoses. The overdose crisis is mainly caused by illicit drugs that the United States Government continues to allow to flow into the Country. It’s time to rescind the 2016 and 2022 guidelines. The 2016 guideline has not achieved what it was supposed to and the 2022 guideline will not either. America is supposed to be the “Land Of The Free” and that should mean we have the freedom to choose our medical treatment without interference from government or government agencies.<br/><br/>I endorse the following:<br/><br/>Commentary of the draft 2022 CDC guideline by CIAAG - Chronic Illness Advocacy and Awareness Group: By [name redacted] https://t.co/jK5aLDllgs<br/><br/>And:<br/><br/>CDC's Revised Opioid Guidelines: Devil Is In The Details<br/>By [name redacted]: https://www.acsh.org/news/2022/03/10/cdcs-revised-opioid-guidelines-devil-details-16176?fbclid=IwAR10H1M5qHcGsffTOOqguZmNgvTxrLmYQzRoFx978EhDExNMDPY5ynEmVdI	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484fc6351	Rabel	None	2022-03-15T16:43:14Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Rabel, K	l0q-2hto-t6mi	False	None	False	2022-04-12 04:18:53.479	[]
2536	CDC-2022-0024-2542	https://api.regulations.gov/v4/comments/CDC-2022-0024-2542	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider those who have chronic pain illnesses. We are handcuffed already.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allison	None	None	0900006484fc9389	Becker	None	2022-03-15T17:07:54Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Becker, Allison	l0s-c9m6-p2jz	False	None	False	2022-04-12 04:18:53.689	[]
2537	CDC-2022-0024-2543	https://api.regulations.gov/v4/comments/CDC-2022-0024-2543	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From ohio the destruction you have caused with the guideline of 2016 is inhuman .acute chronic pain is real .i hurt 24 7 .i m not a drug addict I a real person in pain that has been treated so inhuman from pain .From doctors to pharmacist to insurance company .They all treat us like animal why?cause the can .the Mme is bad now you want it to be lowered .Believe it or not I want to live but not in so much pain .i receive very little pain meds .i can't hardley walk or move because I m in so much pain .No quality of life what so ever .This is because everyone is afraid to treat us because of the guidelines and the DEA coming in to take there licence.Let the Doctors be doctors again let us have some dignity and quality of life .i m not going to get better from shots and implants that aren't FDA approved .ive done everything to not halve to go on Medline but pain has gotten so bad because of my condition .i ll probably will end up in a wheel chair soon .i don't think we should have to live in so much pain if there is medicine that can help with that .one pill does not fit all .we ve had MRI and ct scans and x rays and ever time I been told yea my pain is probably worse because of this or that but unfortunately we can only give you this much so sorry .or you taking another medication and I can't give you anything else with it .i m sorry that is so inhuman .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc95fe	Anonymous	None	2022-03-15T17:08:37Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-dapb-d928	False	None	False	2022-04-12 04:18:53.896	[]
2538	CDC-2022-0024-2544	https://api.regulations.gov/v4/comments/CDC-2022-0024-2544	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a personal suffered of RLS for 25 years I am feeling hopeless since the treatment they put me on 15 plus years ago has made it worse. The medicine causes augmentation of the symptoms and makes it so much worse after being on it for a time. Now I find out it is VERY difficult to get off of it. If I had known back then about what this does I NEVER would have gone on it. Wrestling every afternoon and night with restless body movements makes it impossible to get quality sleep, if any. Please consider the low dose opiods for us who need to have a little bit of normalcy in our lives. I speak for the many out there who suffer from this and the myriads of chronic pain sufferers out there.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484fc9669	Kruger	None	2022-03-15T17:10:38Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Kruger, Cindy	l0s-dh7x-kheq	False	None	False	2022-04-12 04:18:54.106	[]
2539	CDC-2022-0024-2545	https://api.regulations.gov/v4/comments/CDC-2022-0024-2545	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioid medication has many good alternatives. One such alternative is laser therapy. As a practicing doctor of chiropractic I treat patients with chronic pain every day I'm in practice. Since 2016 I have utilized laser therapy on hundreds of patients. I keep statistical analysis of each patient that I use laser therapy on. In 2021 I utilized it on 136 separate patients. Most of these had some type of chronic pain. We had an 88% overall success rate in relieving these patients pain by at least 50% or more. Most of these cases were challenging cases and had in many instances tried other means of pain relief. These type of results have been typical of what I have seen since 2016. Several good studies back up what I am seeing in my patients in clinical practice. Laser should become a recommended and mainstream treatment option for people in chronic pain. It is a viable alternative to opioids in many instances.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kyle	None	None	0900006484fc90f3	Pankonin	None	2022-03-15T19:01:17Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Pankonin, Kyle	l0s-fti5-6m3w	False	None	False	2022-04-12 04:18:54.335	[]
2540	CDC-2022-0024-2546	https://api.regulations.gov/v4/comments/CDC-2022-0024-2546	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to thank-you for giving me this opportunity to comment on the revision of the 2016 guidelines for prescribing opioids. I am a chronic pain patient for the past 25 years. I have many chronic issues that cause excruciating pain. I’v been on pain medicine(opioids) of one kind or another during this time. But I’v been on the same dose for about 10 to 12 years now. And it was giving me a pretty good quality of life, until the 2016 guidelines came out that the CDC issued. Then my life , as I knew it, fell apart. Don’t get me wrong, I would love not having to be on pain medicine, and going to the Dr. once a month to get the pills and having to do all the things we chronic pain patients have to do, just to have some king of quality of life. But I love being able to get off my bed and once in a while watch my grandchildren play basketball, volleyball, or go to their graduations or weddings!! All the things that make my life worth living. My Dr. took all of that away when she took three fourths of my dose of pain medicine away. And she’s not done. I haven’t been able to participate in anything for the past three years. I’v missed so many milestones and things that are so dear to me. I am isolated and can’t do much more than get out of bed for a few hour. I’v lost any quality of life I had. I’v lost weight and am very depressed. <br/> The new guidelines do not change anything to help the chronic pain patient. The guidelines still rely on MME dose recommendation, even if there’s no pharmacological or biochemical basis for relying on equalgesic conversion factors. Patients vary genetically in how they metabolize various opioids. Body mass index also plays a role. The MME of any kind needs to be thrown out of the new guidelines. There’s no standard way to count MME. The hard thresholds mentioned in the 2016 Guidlines of 50 to 90 MME have caused great harm to both doctors and patients. <br/> The overdose crises is largely caused by a growing population of non medical drug users buying increasingly dangerous drugs being developed on the black market, “fueled by drug prohibition.” Efforts to reduce opioid prescribing only led non medical users to dangerous drugs and left chronic pain patients without relief. <br/> I do not think the CDC should be telling Drs. how to take care of their patients. You have put all chronic pain patients in the same barrel. Drs.<br/>are the ones the need to analyze their patients and treat them accordingly. I feel the 2016 guidlines did terrible harm to myself. From what I understand there are patients that have committed suicide because of the horrible pain that was brought on them. <br/> So in the 2022 guideline's, I think the MME should be left out of any part of it. And leave the prescribing up to the Drs. Thank-you again for this opportunity to comment. Chronic pain patients!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc9d88	Anonymous	None	2022-03-15T19:04:08Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-g3l2-p1m0	False	None	False	2022-04-12 04:18:54.542	[]
2541	CDC-2022-0024-2547	https://api.regulations.gov/v4/comments/CDC-2022-0024-2547	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Let pain patients decide how much medication they need. They're the ones who are suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc9e30	Anonymous	None	2022-03-15T19:04:20Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-ggbb-g2pp	False	None	False	2022-04-12 04:18:54.756	[]
2542	CDC-2022-0024-2548	https://api.regulations.gov/v4/comments/CDC-2022-0024-2548	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have SEVERE RSD have had it for 20 years I have been on opiates the entire time but got cut down to almost nothing and my doctor has told me he is retiring soon and no other Dr would allow me to be on what I am on so 8 days ago I went cold turkey and I am fighting withdrawals like you would not believe I am alone over ½ the day all the time I am fighting a battle that I can't even explain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc9f9f	Anonymous	None	2022-03-15T19:04:50Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-h8u1-lzd8	False	None	False	2022-04-12 04:18:54.966	[]
2543	CDC-2022-0024-2549	https://api.regulations.gov/v4/comments/CDC-2022-0024-2549	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient with a broken back (L-2, L-3, L-4, L-5 & S-1) along with nerve root damage, I have had 2 failed back surgeries, a failed fusion and live in a constant state of chronic pain along with debilitating physical disabilities. When this recommendation came that the Fed Gov was going to “take control” of my pain management instead of allowing my doctors and myself to agree on my course treatment...my stress level went sky high...which changes my pain level too! <br/>DOCTORS and patients know how to best treat...t he Federal Government needs to stay OUT of peoples health care! Hippa law dictates that yet they did it anyway!!! Please change this immediately to state that the doctors and patients make the decisions and the government stays OUT. <br/>(Insurance companies need to honor the doctor prescriptions and not try to change or intervene on the treatment course!! <br/>Respectfully,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jana	None	None	0900006484fca38b	Fedon	None	2022-03-15T19:39:06Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Fedon, Jana	l0s-j6hy-hps6	False	None	False	2022-04-12 04:18:55.207	[]
2544	CDC-2022-0024-2550	https://api.regulations.gov/v4/comments/CDC-2022-0024-2550	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	you have got to remove the MME or fully exclude it for all CHRONIC PAIN PATIENTS, It is inhumane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	lisa	None	None	0900006484fca470	aguilar	None	2022-03-15T19:49:14Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from aguilar , lisa	l0s-jn6f-3l6l	False	None	False	2022-04-12 04:18:55.429	[]
2545	CDC-2022-0024-2551	https://api.regulations.gov/v4/comments/CDC-2022-0024-2551	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cold laser therapy has vastly improved my life to the point that I have days that I forget that I have been living w/ chronic pain in my neck. In the past 3+ years I have been a patient in a pain management practice and have had at least 8 radio frequency ablations(RFA) w/ mixed results and the relief provided only lasted a few months. This type of treatment is quite a hassle:1st I would have to have a medial branch block, then an in office follow-up, then wait for approval for the RFA, then arrange transportation to and from a surgical center for the treatment. Additionally I had to follow the usual preparations for surgery and an additional follow-up office visit. With the laser therapy, there is no preparation or post-treatment follow up. The treatments are painless. I can drive myself to and from the the appointment. I have been receiving treatments since 8/2021 with no adverse effects at all. The level and intensity of my pain has decreased from an 8 out of 10 to a 2 or 3 out of 10 most days. Sometimes I even forget that I have several herniated disks in my c-spine. While my actual physical condition will never get better, these laser treatments really have improved my life without surgery or medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fca48a	Golden	None	2022-03-15T19:50:22Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Golden, Donna	l0s-jp1x-w4se	False	None	False	2022-04-12 04:18:55.670	[]
2546	CDC-2022-0024-2552	https://api.regulations.gov/v4/comments/CDC-2022-0024-2552	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 71 yr old male being forced to live in pain due to unrealistic guidelines and laws aimed at opioid prescriptions. Forced tapering has made my life a living hell! Chronic pain patients are being treated like criminals because of a few bad apples. the time to change these archaic recommendations is now. How many more elderly people must suffer before something is done. We need these potent pain medications to have some semblance of a normal life. why are we being forced to spend the last few years of our lives in agony after we spent our entire lives working to have a decent retirement and not be a burden to anyone. I would like you to look at the website painnewsnetwork.org and read the articles and comments written by medical professionals and pain patients to get an idea of how many people are being made to suffer. The way I am being treated makes me feel I have nothing to look forward to but a life of bedridden agony instead of having a reasonable quality of life. Let our elected officials know we need them to change the harmful laws restricting pain medication and pain management professionals. I could go on forever with statistics and testimonials but you can find plenty of that elsewhere. Please do the right thing and act quickly to end our suffering!<br/><br/><span style='padding-left: 30px'></span>Signed, Another chronic pain patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fca52c	Anonymous	None	2022-03-15T20:12:09Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-k0ui-uiwd	False	None	False	2022-04-12 04:18:55.879	[]
2547	CDC-2022-0024-2553	https://api.regulations.gov/v4/comments/CDC-2022-0024-2553	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please take the proper measures to ensure those with a confirmed diagnosis of a medical issue such as myositis have access to pain medicine. I live in Florida and due to the pill mill era, regulations make it very difficult for primary care doctors and specialists, who are familiar with my rare disease to treat me. Even though I have been their patient for years and they know I do not abuse drugs. Going to a pain care doctor and/or physical therpy is extremely difficult and of little help when you are disabled. The only suggestion to trat my chronic pain was methadone, and my CVS drug store trated me like a drug addict. I understand there have been addiction issues that have ruined peoples lives and I sympathize, however, there are people who consider suicide daily due to lack of pain relief. Please dedicate more resources into helping people today!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gail	None	None	0900006484fca6b0	Moore	None	2022-03-15T20:26:02Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Moore, Gail	l0s-kril-s5ir	False	None	False	2022-04-12 04:18:56.084	[]
2548	CDC-2022-0024-2554	https://api.regulations.gov/v4/comments/CDC-2022-0024-2554	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is an all out war against chronic, intractable,palliative (has no cure) pain patients . you can't do physical therapy when you can barely walk to your kitchen without agony. You can't go to the gym either. You can't do a lot of things when your pain is an 8/10 to 10/10 at any given moment of the day or night. This includes waking up from psychiatric medications that could (and should) knock out king kong. And not falling asleep for another 3 hours. This time the sleep med has worn off , of course. <br/><br/>I don't know why people associate chronic low back pain as something that can be fixed (or even alleviated) with a few exercises. You're not the one who has had paid the spoon man (limited units of energy per day\things that can get done) for anywhere from a week to 3 weeks for doing something as simple as going to the beach or another pleasant activity. I have a slipped disc at L5-S1 .i have degenerative disc disease . I have possible ankylosing spondylitis and am symptomatic of adhesive arachnoiditis, the culprit of which is 6 steroid shots that I endured over a one month period.<br/><br/>The slipped disc specifically is from repeated falls, possibly even an epidural even though all things considered , it only took them the 1 try to do it. Sometimes backs just don't like it. I mean there's a trillion nerves there.. I frequently slip on ice in the winter. This has lessened since being able to throw my garbage down a chute, short distance from the door to my ride , and fairly well maintained salting and shoveling. <br/><br/>But to be completely honest , I think what did me in was slipping on a wet patch of concrete in the basement. I was carrying a load of laundry and slipped backwards with no time to "brace". I landed square on the small of my back. 5hat lovely L5 S1 that was already aggravated. In all the times (no insurance then, insurance now but undx'd) I've had MS and POTS (post orthostatoc hypotension syndrome)related falls, I think my back finally had enough. I had this gigantic bruise which healed , but it was never the same. A year later I slipped on black ice and smacked my back off of a concrete step. The edge of the step. <br/><br/>Aside: slipped . (louder for the people in the back. ) an exacerbation is it physically, tangibly being out of place, and frankly just living on a day to day basis leaves reslipped discs wide open. As an example , if I'm waiting for the bus, as I'm putting my grocery bags down; the disc will slide to whatever side I lean towards in doing so. Same for picking them back up. Doing dishes \sweeping a 1 br apt is agonizing. I'm not exaggerating. Agonizing. <br/><br/>I've never been able to deep clean it and that makes me ashamed. . Pain changes you. I'm alive in this body . but my spirit is broken beyond repair. I'm staying in this body for my daughter (who, for a ton of reasons , we decided on an open adoption. I see her 3xs a year and it sustains me. It gives me life for a few day. I try to smile, I do my damndest because he's been through so much with me and put up with so much. But I have to go looking for a reason to smile. It's in my photo gallery of course ;) my sweet baby girl. Us . but it's like trying to swim with stones around your neck. <br/><br/>Pain has truly DEVASTATED my life. And ruined it to a great extent. I wanted to do ems for long time . and between this and the fibromyalgia, its just impossible. one day, I didn't realize how much I was suppressing . I had a massive cry in the car. My logical mind has torn those sails clean off, but my emotional mind, oh my god. I am the jettisoned remains of that boat. I'm hanging on to the flotsam , but I am truly losing any sense of direction. Sense of hope. On the verge of tears thinking of what's been stolen from me. My dad was a police dispatcher and after he died in 2001 ,a few friends of mine got jumped at the pier. From that moment I wanted to be an emt. I've always been much younger in my mind than my age on paper and it killed me to see my "big brother" cut up and banged up like that. <br/><br/> My heart aches for it . like losing someone too soon to death. I'm sorry this has turned out to be a novel. But at the same time, things work out in interesting ways. You now have commentary from someone living on the extreme end of chronic pain. I just feel like after 19 years of fibromyalgia and roughly 10 straight years of spinal pain, I deserve to think outside the box. The status quo ain't cutting it. I don't think there's anything I wouldn't do to be out of pain for just one whole day. These conditions have wrecked my mental health. It is pointless going to an ER. To not be in unending chronic excrutiatimgpl pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fca75f	Anonymous	None	2022-03-15T20:29:50Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-l1u2-xmpl	False	None	False	2022-04-12 04:18:56.289	[]
2549	CDC-2022-0024-2555	https://api.regulations.gov/v4/comments/CDC-2022-0024-2555	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The deeply buried (as if to hide it) reference to 50 MME must be removed or patients will be harmed and the CDC and federal government will be liable for damages. Individualized care means individualized care. I have heard the former Director of the CDC refused to put any number such as 90 MME or 50 MME down on paper "or else it will become a defacto law" and that is exactly what happened. CDC MUST REMOVE THIS REFERENCE TO ANY MME. Besides that, MME is not a medically proven metric of opioids since different opioids bind to different receptors and are metabolized differently by different HLA-B27 allele variants so as to render any single number impossible from a medically scientific basis. The only basis is poliitical which has no place in dictatating patient care. REMOVE IT.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fca865	Anonymous	None	2022-03-15T20:51:32Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-lkak-0dq6	False	None	False	2022-04-12 04:18:56.497	[]
2550	CDC-2022-0024-2556	https://api.regulations.gov/v4/comments/CDC-2022-0024-2556	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Today I got a letter saying I will no longer have a pain management doctor because I have been repeatedly trying to tell them I’m in horrific pain and the pain medication I have been on was not lasting as long as it needed to. I have had to use Kratom to make up the difference. So they decided not to increase my pain medication and instead stop seeing me. I have Harrington rods full spine from idiopathic scoliosis. My rods were placed at the age of 16. I am now 41. The few vertebrae at the bottom and the top of my fusion are beginning to get degenerate disc disease. On top of that I have herniated disc’s. And I’ve had several hip surgeries due to my hips trying to make up for my back. I’m in constant pain. In fact I’m on permanent disability due to the pain and lack of range of motion. Because of this idiotic CDC guidelines I can’t find a doctor to treat my pain adequately. I’m suffering. I have children at home and I can tell you with 100% certainty that they are the only reason I’m still here because this pain is too much to bare. Please help us. Please bring back doctors that are not afraid to treat us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fca8c1	Anonymous	None	2022-03-15T21:11:17Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-lqt6-wwnx	False	None	False	2022-04-12 04:18:56.703	[]
2551	CDC-2022-0024-2557	https://api.regulations.gov/v4/comments/CDC-2022-0024-2557	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Stop punishing people like me. I never had a health issue as a kid or a teenager. I played sports, i was in sharge of school clubs, i love band n chorus. I started wirjing frim 14 to i could not anymkre due to pain at 23. I got an degree in human service's in college. At 21 i had my first child by er section performed by a very bad on call ob. It took them 14 tries to get an epidural in my spine before it took. My husband pointed out that my back was 4 different colors and the ob said not my issue. I am 43 noe i have ddd, a.s.,fibro,mfpds, Chronic migraines, rls, endometriosis, oa in my hands n feet, bone spurs in my spine in shouder. I have haf 2 goiter n my thyroif removed, a melon szed cyst n a ovary removed an d my gall bladder. All before the age of 34. I am a good mom, a good military wife and a good human. Why should i have my meds cut(in obamas tern by 1/3) and now The meds i an on by the government my familiy proudky serves. I dont break laws, i dont derisive period.i follow my pain contract to the t. So i dare one if tou wal a day in my shies or hela hiurk	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wen	None	None	0900006484fca810	Berk14423	None	2022-03-15T21:22:35Z	None	None	1	None	2022-03-15T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Berk14423, Wen	l0s-lem9-6nna	False	None	False	2022-04-12 04:18:56.910	[]
2552	CDC-2022-0024-2558	https://api.regulations.gov/v4/comments/CDC-2022-0024-2558	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a chronic pain patient for over 10 years. I was on opiods then entire time and was able to work 14 hours a day. Then came the CDC and DEA raids and they took away the only thing that helped me to have a productive life. I tried to regain my life after my pain meds were taken away and couldn't. It is so hard to get out of bed every single day. I was forced To go on disability due to not being able to function. I have spondylitis dds and am diabetic so I have pain from all 3. I was told by the Disability Dr that she didn't know how I was doing that job for 25 years. I never abused my meds or wanted more stayed on the same dose for all these years. Now I have no quality of life at all. I have such pain I can't even stand for more than 10 minutes at a time without feeling like I would pass out from the pain which I have done. I now have anxiety about going out to the grocery store or out with my kids. They have taken away my quality of life and they have no idea about my diagnoses. How can they know what's best for us chronic pain patients? Please get them both out of our lives. They have made so many of us housebound now due to their involvement. They need to change their categories of "opiod" overdoses and deaths. We all know it's fentanyl and the street drugs that are causing these deaths. A true pain patient is not the one overdosing. Make them change the info they are putting out and get rid of these "paid" supposed specialists who are not Doctors either. I beg you on behalf of many many pain patients who have had their lives turned upside down by these "recommendations". Have some Real Doctors be the ones giving the information as they are the best ones to ask. I have seen my Doctor, many specialists each one for each different disease and had a zillion tests procedures etc. That I'm sure the DEA and CDC have no knowledge of nor do these people who are supposed to be Doctors but are being paid thousands and thousands of dollars to give information. I've never met any of them but they apparently know more about how to treat me than all of my Doctors do. I don't want to be a prisoner in my own home. My children watch me cry every day just trying to do simple household chores. They watched family members die horribly from diseases that were so painful and they were denied anything for pain. I will never know how traumatized they are from seeing this. Or how my illnesses not being treated is traumatizing them helping me get out of bed, shower, get dressed and basically help me with the most basic things. Did the DEA and CDC think about the effects that would spiral from their recommendations? My guess is no they didn't at all. Or when I came home from having my knee replaced with no pain meds either. How my kids had to step up and help me try to walk after my leg was basically sawed apart and drilled while I literally cried from pain. It seems they both have taken away our Doctors taking their Hippocratic Oath serious. They're hands have been tied so bad they can't treat their lifelong patients. It's a horrible experience for the good doctors and chronic pain patients all caused by 2 agencies who have no business being in our treatment plans. Maybe their time would be better going after the illegal street drugs that are what is killing the patients who have had addiction issues that make them seek out street drugs. Please please get them out of their crucifixion of true Doctors who are not doing anything wrong but treating the pain patients with what works for them. Look at me because of these recommendations I couldn't do a job that I did for 25 years and the last 10 my pain was tolerable. Now because of this I was not able to work and forced to go on disability and have lost my quality of life. I'm not making what I was when working causing me to rely on my kids to help with the bills I can't do simple household chores like dishes without taking a break after a few minutes due to my pain. Having my life completely taken away from me when they took away the only relief I had. And then anxiety and depression set in due to being stuck in my house every day. The pain is so intense I can't take it some days without help from my kids. They have watched a woman in her early 50's who always worked long hours and 6 days a week to make a good living being a single mother since 1991 go from that hard working strong person to basically a person who cries daily and is housebound because her anxiety of passing out from pain in public is too real of happening. Please help me go back to what I used to be and what I used to be able to do!!!!!! The chronic pain patients are suffering daily and no one cares about us. We have no quality of life anymore. I feel like I'm 80 years old right now. Please keep in mind the chronic pain community or reach out to [name redacted] she has such horrible stories of people reaching out to her it will break your heart. Thank you for helping us!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fc9c5d	McDonnell	None	2022-03-16T15:14:04Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from McDonnell, Mary	l0s-o0eg-ct4v	False	None	False	2022-04-12 04:18:57.143	[]
2553	CDC-2022-0024-2559	https://api.regulations.gov/v4/comments/CDC-2022-0024-2559	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Crohn’s disease at the age of 13. From that time forward I have undergone 15 bowel resection‘s, a temporary ileostomy for about a year, TPN, multiple NG tubes, electrolyte depletion and almost died several times … Way too many stays in the ICU and the CCU. Today at 64 years old I am in constant every day abdominal pain. After my seventh bowel resection I had horrible complications. For the last 20 years in order for me to have a normal life I have been taking Norco to control the pain and to slow my diarrhea. I have severe Short gut syndrome. If I did not have pain medication to control my chronic abdominal pain, I could never leave my house. I am so grateful for my pain management specialist, MD who is very conservative and listens to me and believes me. I have never asked for pain medication before it’s time, I have never abused my pain medication. When I report to my pain management specialist, MD, I am on time and do whatever tests he requires of me. I take these prescriptions extremely serious. I installed a safe in my home so that I can store my pain medication in a safe place. I am more than grateful to my pain management specialist for giving me my life back. I was a VP of a national healthcare company and I had to stop working because I became disabled with severe Crohn’s disease. I’ve lost everything and I was in horrid, everyday grinding pain. I do not like putting substances in my body. I don’t smoke, I don’t drink and I don’t take illicit drugs. In order for me to have a life I take Norco on a daily basis and thank God I have it. I went from being an avid runner, very dedicated to my career and raising two beautiful children to being in bed every single day.<br/> Over the years I have been called an addict, a drug seeker, a liar, I have been denied pain medication after having a double bowel resection. I was put on ketamine which was listed in my medical records that I was allergic to it because I do not want to hallucinate. It was horrific. I hallucinated for seven days before I was given any type of pain medication. This is because of what the CDC did in 2016. Your actions have taken a horrendous toll on chronic pain people like me. I can imagine there is not one chronic pain suffered on your panel. I urge you to speak to chronic pain patients to understand that we are not addicts, all we want is a life. Please remove ANY wording regarding upper limits of the MME equivalent for pain medication. I am one of the lucky ones that my pain is managed at a relatively low dosage however I do know quite a few very good people who need more pain medication and putting any kind of limit on what physicians can do to treat that patient could very well result in suicide an early death to the patient. STOP HARMING CHRONIC PAIN PATIENTS!! It’s unfair. To those patients who manipulate the system and are truly addicts, shame on them but I believe there’s probably very few. Please help us help the chronic pain patient! Do not continue to slander and downgrade us as human beings. Not one of us wants to be in this position. Last year I went to the emergency room with a perforated colon. They denied me any kind of pain medication, me?? I was shocked! I have lived with Crohn’s disease for over 50 years and to be called an addict and denied pain management when I have a perforated colon going into surgery was abominable. When I came out of surgery with an ileostomy I was continue to be denied appropriate pain medication until my pain management physician called the surgeon and read him the riot act. This should never have happened This is all the results of your thoughtless 2016 CDC recommendations, which physicians took apparently as law. <br/>In Attachments below is a picture of me coming out of having a double bower section. I was in so much pain all I could do was cry and my cry sadly went unheard. At least until my pain management position called them confirmed I am not an addict and I was in pain. And of course I was given appropriate pain medication but I should not have to do that! <br/>I have so many stories that I could share with you that happened because of the 2016 CDC guidelines they have been an absolute nightmare. Please change them please take the cap off of the enemies please see us as human beings just want to help! thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484fcad2b	Squires	None	2022-03-16T15:21:04Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Squires, Pamela	l0s-o2zb-jeza	False	None	False	2022-04-12 04:18:57.352	[]
2554	CDC-2022-0024-2560	https://api.regulations.gov/v4/comments/CDC-2022-0024-2560	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 80 year old mother was just denied a benzodiazepine because she was also taking hydrocodone 5 mg for severe pain. She was told she could not have both due to "CDC guidelines" and the DEA. You people are causing needless human suffering in people at zero risk of addiction and this decision should be strictly left to the physician and patient without government interference. You have hurt the health and welfare of millions of Americans. Fully rescind your guideline that has only caused an increase in overdoses which are almost twice as high now vs when the guidelines were written. You have lied and been manipulated by anti-opioid zealots who could care less about anything except addiction, and most addicts die due to street drugs and drug dealers and addicts don't give a rip about your cruel guidelines. You should be ashamed of yourselves.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Johnny	None	None	0900006484fcad90	Smith	None	2022-03-16T15:21:44Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Johnny	l0s-om67-j67z	False	None	False	2022-04-12 04:18:57.565	[]
2555	CDC-2022-0024-2561	https://api.regulations.gov/v4/comments/CDC-2022-0024-2561	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines are restricting physicians by fear. <br/> Try living with chronic pain.<br/> Understand restrictions. <br/>Flawed studies. <br/>Overdoses by people that aren’t prescribed.<span style='padding-left: 30px'></span>We have to take medicine for pain. <br/>Addicts take out of other issues.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katie	None	None	0900006484fcadb4	Hilderbrand	None	2022-03-16T15:23:13Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Hilderbrand , Katie	l0s-oowa-j39f	False	None	False	2022-04-12 04:18:57.773	[]
2556	CDC-2022-0024-2562	https://api.regulations.gov/v4/comments/CDC-2022-0024-2562	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The Illegally done CDC Guidelines<br/>Have caused me much Harm<br/>States wrote there own Guidelines<br/>Insurance Companies wrote there own Guidelines<br/>Medicaid Doctor has No Opioid guidelines.<br/>Qaulity of medicine is ineffective now.<br/><br/>All my projects stopped.<br/>All family visits stopped.<br/>Lost most friends.<br/>I'm totally isolated and alone.<br/>No Operation can be done.<br/><br/>Preventative Maintenance gone and many new deadly ailments are forming.<br/>Very close to A Heart attack now from not being able to move.<br/><br/>I had Qaulity of Life 2012-2015.<br/>2015 cuts began and they knew it would HARM folks and did it anyways.<br/>2017 No Xanax has damaged my heart.<br/>My Doctor Patient relationship has been hampered.<br/><br/>I don't need Mental Health for A bad back I need medicine restored to proper qaulity and qaulity.<br/>Neurologist said can benefit from Opioids for rest of my life.<br/>I've lost last 7 years of qaulity of Life.<br/>It's CRIMINAL what all this has caused and No Attorneys can help.<br/>Modern Medicine has been DESTROYED.<br/>Opioids Work/ Benzodiapines Work<br/>Nothing else does I've tried to many.<br/>Restore Balance NOW or mark another DEATH down caused from reductions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484fcb2e7	Zbikowski	None	2022-03-16T15:25:33Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Zbikowski, Brian	l0s-r56v-1833	False	None	False	2022-04-12 04:18:57.989	[]
2557	CDC-2022-0024-2563	https://api.regulations.gov/v4/comments/CDC-2022-0024-2563	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mother in law is a good Christian woman. Has been all her life. She was married for 51 years until widowed last year. For the last 4 years she has fought breast cancer, torn her rotator cuff, developed bone spurs in her feet, She hurts. She also has worked all her life and stayed an active member in her church. Till six months ago, she handed out food every Saturday at the church food drive. Her Church, love of God, and family have kept her going. When she had breast cancer and went through treatment, she got rheumatoid arthritis from the treatment, and age. Rather than put her on opioids, they put her on Methotrexate for the rheumatoid arthritis, bone spurs, all the likes, as they said THIS will help with inflammation and pain. It did not, has not, and will not. However, she kept taking it because that's what her DOCTORS told her to do. It's so much safer than opioid medication they said. Well, she took it for the 4 years, and NOW wears a wig, because they didn't tell her that METHOTREXATE can make your hair fall out if they keep you on it long term for pain. This sweet elderly Christian lady TO THIS DAY suffers pain, from SURVIVING cancer, and has rheumatoid arthritis. She paid all this money to these doctors, and took the medicine they said to take FOR THE PAIN THAT NEVER RESOLVES, and now she's too ashamed to bring herself out the house to attend church, because it made her hair fall out. This could have been avoided to some degree by treating her like a human being, there IS NO CURE FOR RHEUMATOID ARTHRITIS. THE MEDICATION SHE TOOK TO REMEDY CANCER AND HER BEING 76 YEARS OLD CAUSED IT, THE MEDICATION SHE TOOK TO ALIEVIATE PAIN DID NOT WORK BUT CAUSED HER HAIR TO FALL OUT. At her age, and for all the work she's done in her church, her community, she told me that the medication she was taking just about killed her. She told me what it was by name so I'll know to never take it, it weakened her lungs, she has a hard time breathing AND SHES NEVER SMOKED. Through everything, she NEVER complains, NEVER, shes just ashamed that her hair fell out and her body has been so damaged by the immunosuppressive drugs she took for pain. INSTEAD OF PAIN MEDICATION. She has been so very strong, she's done everything a doctor has told her that is FOR THIER BEST INTERESTS, she now suffers at home, alone, in silence, because at 76 and her going to church every week, we really have to worry about her becoming an addict. This woman's never had so much as a drink. But it's all the easier to push her and her insurance aside for the sake of not writing a prescription that would allow her to be able to GO BACK TO CHURCH, continue to help her community, LIKE SHES ALWAYS DONE, which IS WHAT MAKES HER HAPPY. Her feeling like she's serving the Lord, being a good person and helping others is what keeps her, giving her some ability to live her life, the rest of it as she deserves to. It's not in her heart to complain, it's not in her heart to ask for anything. And she is 100 percent against doing any drugs that has been considered or thought of as illegal. She has given so very much, and to think she's suffered ALL OF THIS at 76 years old, that she will die suffering this pain, and such a tragedy it is that there is something that will relieve it, so she can go to church for Christ sakes! This woman is the embodiment of Mother Teresa her morals are sound, so because of this, I can not sit and allow her to be punished by a community that she's served, just because she's old, or she's worn herself out, giving and caring for community. Should the generations now learn that they should NOT work hard or do anything to damage themselves. That time will deteriorate them to a point so don't work your body no more than what you wish to suffer when you're old? She would not ever allow herself to act unethical in regard to her health, however, it is morally wrong to treat her this way. It's morally wrong to not allow her medication to help with pain in her daily life so that she can fulfill her life to the extent her faith allows. It is morally wrong for Doctors to keep her on a medication that did not do what it was intended for just to curb a number, or political agenda that doesn't even affect her. It is unethical and imorral to judge her on no basis of her own at all, but of that of society to deny her medications that can help her with her inflictions and painful geriatric conditions.<br/>1 Timothy 5:8 Acts 20:35 Psalms 71:9 1 Timothy 5:4 James 1:27<br/>1 Timothy 5:17. Hebrews 13:16 Deuteronomy 27:19<br/>Sirach 38:1-15	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcb3e6	Anonymous	None	2022-03-16T15:30:10Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-s74f-3fv2	False	None	False	2022-04-12 04:18:58.204	[]
2558	CDC-2022-0024-2564	https://api.regulations.gov/v4/comments/CDC-2022-0024-2564	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First, to even suggest that physicians/clinicians or the practices for whom they are employed may read these “Guidelines” and NOT implement them as hard and fast rule is disingenuous, at best, and an outright, purposeful attempt to ignore the reality of both the past (misapplication of the 2016 Guidelines) and the extent to which the written word of the CDC is taken as “law” by those in every day practice, at worst. To this date (March 15, 2022), three different pain management practices here in the state of New Hampshire have already implemented the 2022 DRAFT CDC Opioid Prescribing Guidelines as “policy” in anticipation of their confirmation. “50 MME” is now the maximum opioid dose these practices will consider regardless of the individual patient condition. If you are surprised by this at all, you are ignoring the realities of the concern physicians have for the potential for loss of license. Purposely leaving “50 MME” thresholds for the supporting commentary will not lighten the impact of such language. As soon as 50 MME is written, wherever it is written, it becomes the focus and then the default rule. This is the reality of life in the real world. <br/><br/>When a physician/clinician reads the word “justify” when explaining what they should do when considering titration to 90 MME, they read, “don’t even consider it”. These are the words of a prominent pain management physician, also from the state of New Hampshire. Again, the focus will always shift from “This clinical practice guideline is not a replacement for clinical judgment or individualized, person-centered care” to THE NUMBER, that being, 50 MME. If the authors of this draft guideline ignore this reality you are condemning hundreds of thousands of people in pain to a life not worth living. <br/><br/>It is absolutely irresponsible and a challenge to any notion of integrity in practice for any organization to allow for those with documented and admitted conflicts of interest to directly take part in the writing of guidelines for the use of a medication they are so well known for arguing against. This alone should be just cause for the dismissal of these guidelines. In the context of a court of law, this is exactly what would happen.<br/><br/>Lastly, let us understand exactly what “50 MME” means to the person who suffers with diagnosed, documented illness or injury. By the CDC’s own calculation tool, a patient being prescribed Oxycodone would be allowed NO MORE THAN one (1) 15 milligram immediate release tablet, twice per day. In practice, one (1) 15 milligram Oxycodone tablet in the morning, one (1) 15 milligram Oxycodone tablet in the evening. Given the effective period of Oxycodone is 4-6 hours, and assuming one (1) tablet is sufficient to provide relief, this covers twelve (12) hours of a day. What is said patient to do with the remaining twelve (12) hours of each day? <br/><br/>These draft guidelines are clearly not intended to be patient centered care at all. These draft guidelines are an obvious attempt at a “one size fits all” approach to delivering healthcare and clearly written by those who have a built in bias and no experience at living with a painful illness or injury for which there is no cure. We all agree a multi-modal approach to treatment is best. These draft guidelines fail to acknowledge the important role opioid analgesics play in enabling a person in pain to take part in those non-medication related therapies. Without some level of effective relief provided by opioid analgesics, the ability to participate in other therapies is almost always impossible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	0900006484fcb438	Murphy	None	2022-03-16T15:34:26Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Murphy, Bill	l0s-sr7e-75vs	False	None	False	2022-04-12 04:18:58.612	[]
2559	CDC-2022-0024-2565	https://api.regulations.gov/v4/comments/CDC-2022-0024-2565	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have multiple sclerosis which comes with severe chronic pain,fatigue severe muscle spasms and severe insomnia. My quality of life has been severely affected since the opiate guidelines/law in Oklahoma of 2016. I had to choose what medication I needed most because of the opiate guidelines/law. I chose pain medication, which I am only allowed to have at most 8 hours a day of relief of my soul sucking pain. Im not allowed to have anything else with my pain medication. For example, after my medicine for extreme anxiety was taken from me I have suffered since October of 19, from no sleep, only sleeping after days without sleep from exhaustion. My doctor has given me 10 different medications at low dose that didn't work at all. From this insomnia I have developed hereditary macular degeneration, glaucoma, severe fatigue that leaves me in bed unable to function. I am suffering from severe depression because of the continued pain and suffering and fear of losing my eyesight forever. I know we have a opiate crisis I've seen it in my own town and state of [city redacted], Oklahoma. But I'm now seeing more overdoses more alcoholism, and suicide! I know the statistics will show all this. I have never since I had to start taking opiates in 2002 missed use my drugs in any way. I feel with all my heart that there should have been exceptions made to these guidelines / laws for those who have chronic pain due to diseases with no cure!! Please hear my voice and make changes to these guidelines so that I may someday be able to live a life without pain and suffering. Sincerely, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stacy	None	None	0900006484fcb63f	Bayley	None	2022-03-16T15:35:50Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Bayley, Stacy	l0s-ubnx-c6u9	False	None	False	2022-04-12 04:18:58.821	[]
2560	CDC-2022-0024-2566	https://api.regulations.gov/v4/comments/CDC-2022-0024-2566	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines in 2016 were an opportunity to bring to national attention the importance of providing improved and safer care for individuals suffering from chronic pain in the face of a growing epidemic of opioid overdose deaths. The call to "flip the script" around opioids not being considered first line treatment for chronic, non-malignant pain and clarifying that other treatment modalities should not be relegated to "adjunctive care" was crucial. However, in some instances the manner in which aspects of the guidelines have been applied resulted in unintended consequences and less person-centered care for those suffering from pain. My sincere hope is that the updates will assist in restoring more person-centered approaches to care, while continuing to highlight the importance of mitigating very real risks associated with chronic opioid use for many individuals. My fear is that there is still insufficient emphasis on education and training around proper pain management. There also continues to be a gap in our healthcare professional education around the potential risk of opioid use disorders and the evidence-based approaches for assessment, risk evaluation, risk mitigation, and timely, person-centered treatment when an opioid use disorder emerges. Until these knowledge gaps are filled and stigma is reduced, simply applying guidelines as a means of addressing our nation's heart-breaking overdose death epidemic will likely fall short of our desired outcome - to save more lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fcb8e4	Delisi	None	2022-03-16T15:37:41Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Delisi, Steve	l0s-uzzb-6k5m	False	None	False	2022-04-12 04:18:59.042	[]
2561	CDC-2022-0024-2567	https://api.regulations.gov/v4/comments/CDC-2022-0024-2567	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted] and for 10 years I was on pain medication and 2020 I was forced on Suboxone because my doctor refused to adjust my dosage of pain medication I was only allowed two pills and a 24 hour timeframe if I did not go to physical therapy or sub mitt to injections then she threaten to stop at all together so because she refused to up my dosage I was forced to stop which led to the Suboxcin and now that has damaged my teeth severely and I still suffer in pain because I have a congenital spinal fusion and spinal stenosis	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcba42	Anonymous	None	2022-03-16T15:38:22Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-vcg5-xxfi	False	None	False	2022-04-12 04:18:59.269	[]
2562	CDC-2022-0024-2568	https://api.regulations.gov/v4/comments/CDC-2022-0024-2568	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer and I have been collecting stories from chronic pain patients, veterans, & cancer patients who have been suffering due to lack of proper pain control. I have talked to more suicidal chronic pain sufferers than I care to admit, alot of people have lost their will to live. These guidelines are harmful to anyone that suffers with chronic pain. Patients are being forced to choose between pain control and needed anxiety medications. Lives are being literally destroyed. I've talked to alot of elderly people who are suffering in their golden years, most fear this will shorten their lives due to under treated pain and the high blood pressure that it creates. I've talked to moms that can not take care of their children or play with their children. Lots of grandparents that can not enjoy their grand kids. Besides all of the suffering that is happening, the over dosing epidemic is steadily climbing in over doses as chronic pain patients have been striped of their NEEDED medications. Most of us have pain so severe we can not sleep, which just adds to our health problems. We feel these guidelines are slowly killing us and ALL chronic pain patients should be EXCLUDED from the guidelines all together. Some severe pain can only be effectively treated with opioids. The addiction medications that we have been left with pale in comparison to opioid relief when it comes to pain. Besides being highly addictive they are not approved by the FDA for the treatment of chronic pain and there is a reason for that, they dont work. The disabled Americans of this country are pleading with you to restore our quality of life again. We did nothing to deserve this, we broke no laws, we are simply guilty of being in pain. We beg and plead with you to do the right thing and exclude us from these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fcba83	Phillips	None	2022-03-16T15:39:54Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Phillips, Lisa	l0s-vhoh-x600	False	None	False	2022-04-12 04:18:59.502	[]
2563	CDC-2022-0024-2569	https://api.regulations.gov/v4/comments/CDC-2022-0024-2569	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS since my 20's, and in the last 14 years, it has gotten much worse. (I am 53.) I tried every available medication but either found the medication ineffective or developed a tolerance to it. After two years, I had no options left. So I began treatment with a small dose of oxycodone, and it has worked very well. Without oxycodone, my life would hardly be worth living and the impact of my RLS on my family would be severe.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fcc16c	Krasnyanskaya	None	2022-03-16T15:42:58Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Krasnyanskaya, Amy	l0s-x9fi-dr7g	False	None	False	2022-04-12 04:18:59.735	[]
2564	CDC-2022-0024-2570	https://api.regulations.gov/v4/comments/CDC-2022-0024-2570	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe that this is a good step for patients that require opioids to relieve their pain because there is only so much the average painkillers can do. It is also essential for doctors, pharmacists, physicians, and other medical professionals to prescribe the recommended amount they believe is best for their patient, without the regulations restricting them. Although I am not a person that currently requires opioid medication, I have heard stories from extended family members that either had cancer or a condition where opioids would greatly benefit them. They complain about how their doctors are unable to give them the right amount of medication to alleviate the pain that they go through. They also talk about how their bodies hurt at times that they choose not to move in fear of it worsening. I understand that these guidelines are in place to reduce opioid addiction, however this has been so strict to the point where people are unable to get the amount of medication they need. There are numerous responsible patients that know how to take the correct dosage, and equally responsible doctors that are in medical school long enough to prescribe the amount their clients need. People should not be restricted to the amount of medications they must take, if it means being able to perform normal daily tasks without feeling like their bodies are giving out.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484fcc1ef	T	None	2022-03-16T15:43:47Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from T, K	l0s-y9j2-0q84	False	None	False	2022-04-12 04:18:59.941	[]
2565	CDC-2022-0024-2571	https://api.regulations.gov/v4/comments/CDC-2022-0024-2571	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer and I have been collecting stories from chronic pain patients, veterans, & cancer patients who have been suffering due to lack of proper pain control. I have talked to more suicidal chronic pain sufferers than I care to admit, alot of people have lost their will to live. These guidelines are harmful to anyone that suffers with chronic pain. Patients are being forced to choose between pain control and needed anxiety medications. Lives are being literally destroyed. I've talked to alot of elderly people who are suffering in their golden years, most fear this will shorten their lives due to under treated pain and the high blood pressure that it creates. I've talked to moms that can not take care of their children or play with their children. Lots of grandparents that can not enjoy their grand kids. Besides all of the suffering that is happening, the over dosing epidemic is steadily climbing in over doses as chronic pain patients have been striped of their NEEDED medications. Most of us have pain so severe we can not sleep, which just adds to our health problems. We feel these guidelines are slowly killing us and ALL chronic pain patients should be EXCLUDED from the guidelines all together. Some severe pain can only be effectively treated with opioids. The addiction medications that we have been left with pale in comparison to opioid relief when it comes to pain. Besides being highly addictive they are not approved by the FDA for the treatment of chronic pain and there is a reason for that, they dont work. The disabled Americans of this country are pleading with you to restore our quality of life again. We did nothing to deserve this, we broke no laws, we are simply guilty of being in pain. There us an opiate crisis but it is STREET drugs and NOT descriptions. It is FENTENYL NOT descriptions. The statistics for of on rx opiates is extremely low. We beg and plead with you to do the right thing and exclude us from these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcc275	Anonymous	None	2022-03-16T15:45:35Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-ze49-klrh	False	None	False	2022-04-12 04:19:00.170	[]
2566	CDC-2022-0024-2572	https://api.regulations.gov/v4/comments/CDC-2022-0024-2572	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For the last 22 years I have spent miserable nights fighting RLS, in hopes of a few hours of sleep. I am now 91 years old and haven't found any real relief. Small doses of hydrocodone acetaminophen (5-325) are the only thing that makes any difference at all, and that is certainly not a satisfactory cure. I don't have to walk quite as much at night but at least I can usually get three to four broken up hours. RLS definitely gets worse with age and I'm constantly seeking some kind of relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Clara	None	None	0900006484fcc280	Lutz	None	2022-03-16T15:46:07Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Lutz, Clara	l0s-zh9m-v7ga	False	None	False	2022-04-12 04:19:00.390	[]
2567	CDC-2022-0024-2573	https://api.regulations.gov/v4/comments/CDC-2022-0024-2573	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and the CDC Guidelines have made life absolute hell. I often now feel like I have committed a crime and I am on probation with my Dr. The Guidelines have made the majority of once caring physicians not want anything to do with CPP's due to the threat of losing their licenses and being raided for over prescribing. People are all not the same and the same dose does not work for everyone-the suggested MME amounts must be removed from the Guidelines! I can't even find a scientific explanation of MME! Your "War On Drugs" has obviously backfired and has caused irreparable harm to chronic pain patients and to those who suffer from addiction. If these Guidelines are the Be All, End All solution then why are so many more overdoses occurring? The Guidelines obviously need to be rescinded and I believe should be handled by the FDA-not the CDC. Please stop torturing those of us who suffer with unrelenting and incurable diseases!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R.	None	None	0900006484fcbed0	Powers	None	2022-03-16T15:47:49Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Powers, R.	l0t-2y8o-ilhh	False	None	False	2022-04-12 04:19:00.616	[]
2568	CDC-2022-0024-2574	https://api.regulations.gov/v4/comments/CDC-2022-0024-2574	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a disabled veteran from proudly serving our country. The VA used your previous guidelines as set in stone by their OSI. My active, social, and every other aspect of my life has been destroyed by this headset approach. Most of my life is spent on bed unable to sleep or get comfortable. My blood pressure is now dangerously high, and I actually welcome a heart attack because this is not living. All because I decided to freely enlist to protect a country that I loved. Yes, many changes need to be made to help and save the people like me who are clinging to life, all because your guidelines were taken and set in concrete. The barrier to getting help for severe pain is too thick and too tall to break through. You created this mess and many, 3 I personally knew, committed suicide from living in too much pain after their pain meds were force tapered. So fix your mess before more give up. Respect<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Freedom	None	None	0900006484fcc366	Taken	None	2022-03-16T15:50:56Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Taken, Freedom	l0t-9k95-toc5	False	None	False	2022-04-12 04:19:00.823	[]
2569	CDC-2022-0024-2575	https://api.regulations.gov/v4/comments/CDC-2022-0024-2575	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband was badly injured in the military. Now his life, what's left of it. Is spent mostly in bed suffering. He managed very well for over 30 years until he was force tapered by the VA. Now I worry that he can't take much more because it has taken a terrible till on his body. How can you allow this, everyone that knows and knew him just doesn't understand. No matter how much we have asked, the VS always cites your guidelines like they are law. These soldiers protected our country and deserve so much better than what I have seen daily since his force taper. Pain may be invisible, but I sure see every day the impact it has. It's time to very quickly clean up your mess because too many have given up from being in pain and doctors citing your guidelines as why effective medications that worked, are now denied. Shame on all who did this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcc39e	Anonymous	None	2022-03-16T15:56:50Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-a733-ipuq	False	None	False	2022-04-12 04:19:01.029	[]
2570	CDC-2022-0024-2576	https://api.regulations.gov/v4/comments/CDC-2022-0024-2576	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I WANTED TO START BY SAYING THANK YOU CDC.NOW I DON'T HAVE A DOCTOR. I WAS DIAGNOSED WITH SPINAL STENOSIS AND I HAVE 2 HERNIATED DISC IN MY THORACIC PART OF MY BACK AND DEGENERATIVE DISC DISEASE AND AN ANNUAL TEAR AND ARTHRITIS. I COULD GO ON. I WAS ON OXYCODONE 30 MG. 3 TIMES A DAY , WHICH I COULD AT LEAST HAVE A LITTLE BIT OF LIFE. THEN HERE COMES THE CDC GUIDELINES AND MY DR. CUT ME BACK TO 15MG. OXYCODONE 3 TIMES A DAY. WELL NOW I SUFFER ALL DAY, I DON'T HAVE A LIFE ANYMORE AND NOW A FAKE URINE TEST, SO MY DR. LET ME GO. WELL I DON'T EVEN HAVE A DR. ANYMORE. I HAVE TRIED TO COMMIT SUICIDE 3 TIMES BUT I'M STILL HERE. THANK GOD I GUESS. I JUST WANTED TO SAY THANK YOU FOR ALL THE MISERY YOU GAVE ME....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcc045	Anonymous	None	2022-03-16T15:58:34Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-fqs7-jw8j	False	None	False	2022-04-12 04:19:01.237	[]
2571	CDC-2022-0024-2577	https://api.regulations.gov/v4/comments/CDC-2022-0024-2577	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My comment addresses an author that helped to draft the CDC guidelines. [Name redacted] has admitted he has a financial conflict of Interest as well as his extreme bias to opioid pain medication. In view of this [Name redacted] should have been removed from the committee that authored the 2022 guidelines. Pain patients have been harmed stated by the (AMA) American Medical Association. [Name redacted] is a member of Prop. This group has an extreme biased view on the treatment of pain and the use of opioid pain medicine. This I believe has an unfair influence as a whole. There are many people and pain patient that are suffering. This issue needs to be resolved fairly as quickly as possible. Thank you for listening to my views on this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fc9b64	Anonymous	None	2022-03-16T16:00:31Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0s-niy1-tmwq	False	None	False	2022-04-12 04:19:01.457	[]
2572	CDC-2022-0024-2578	https://api.regulations.gov/v4/comments/CDC-2022-0024-2578	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tamara	None	None	0900006484fcc367	Anderson	None	2022-03-16T16:02:27Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anderson, Tamara	l0t-a0y1-smz2	False	None	False	2022-04-12 04:19:01.689	[]
2573	CDC-2022-0024-2579	https://api.regulations.gov/v4/comments/CDC-2022-0024-2579	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a friend dying from multiple myeloma. The University Hospital in [city redacted] Ohio had a pain management nurse try to convince my friend he should try to take less pain medication for fear of addiction. My friend's PET scan shows the cancer is everywhere in his body. Common sense would suggest addiction is his least concern. My personal belief is the Federal Government has overreacted to the drug crisis in this country to the point people in need of pain relief are denied treatment. It is past time for the Federal Government to allow medical doctors the ability to treat the legitimate needs of those in pain without feel of reprisal. <br/><br/>[Name and Address redacted]<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fcc48c	Kane	None	2022-03-16T16:04:15Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Kane, Robert	l0t-jz4l-3426	False	None	False	2022-04-12 04:19:01.903	[]
2574	CDC-2022-0024-2580	https://api.regulations.gov/v4/comments/CDC-2022-0024-2580	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a physician with restless leg syndrome secondary to nerve injury in my left leg. I am able to manage my symptoms without opioids. However, I can attest to the severity of uncontrollable leg movement preventing sleep. It is immensely disruptive to both my daily functioning and my spouse's sleep. <br/><br/>There is literature supporting the use of opioids for severe RLS not controlled by non narcotic means. I hope never to progress to that level of uncontrollable symptoms. However, if low dose opioids are required someday, I hope they would be available for my use and for others so afflicted.<br/><br/>I have seen first hand the ravages of opioids on human life. I practiced in a local jail for several years and on an Indian reservation. I have seen the pain and suffering and disrupted lives caused by opioids. I also experienced the pressure to prescribe opioids from the drug reps. I wholeheartedly agree that harm came from that and I appreciate guidelines that help me educate patients that long term narcotics are often not a solution. <br/><br/>There are chronic conditions where opioids are beneficial, including RLS. I recommend that RLS be added to the list of chronic disease which long term low dose opioids are indicated for.<br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Caryl	None	None	0900006484fcc929	Gorman, MD	None	2022-03-16T16:05:26Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Gorman, MD, Caryl	l0t-l8y1-lz8s	False	None	False	2022-04-12 04:19:02.119	[]
2575	CDC-2022-0024-2581	https://api.regulations.gov/v4/comments/CDC-2022-0024-2581	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Born with spinal birth defects (kyphosis and all 3 types of scoliosis) which have gotten worse as I age (75 in May). Was in an elevator that fell 30 feet in 2004 damaging every disc in my spine. My medicine was tapered in 2017 making all things in my life more difficult: grooming, grocery shopping, driving which means getting to doctor appointments, the pharmacy, and grocery stores. This is Elder Abuse. My life was easier before the 2016 CDC guildelines and the DEA began practicing medicine without a license. Please help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcca28	Anonymous	None	2022-03-16T16:06:00Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-nty8-bcj9	False	None	False	2022-04-12 04:19:02.324	[]
2576	CDC-2022-0024-2582	https://api.regulations.gov/v4/comments/CDC-2022-0024-2582	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. PLEASE SPECIFICALLY INCLUDE RLS IN THE CDC GUIDELINES FOR PRESCRIBING OPIODS FOR THUS OF US WHO CANNOT GET RELIEF THROUGH ANY OTHER MEANS. RLS IS DEBILITATING TO ME. <br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have used all of the different prescribed medications for RLS. Unfortunately they either did not provide the pain relief I needed to be able to sleep and take care of myself. Two of them, over time, even produced “augmentation” or a worsening of symptoms. I am desperate for a medication that will work and relieve the pain, thus allowing me to sleep well. Please help!<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fccdeb	Conrad	None	2022-03-16T16:06:47Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Conrad, Richard	l0t-pv3t-vtd5	False	None	False	2022-04-12 04:19:02.544	[]
2577	CDC-2022-0024-2583	https://api.regulations.gov/v4/comments/CDC-2022-0024-2583	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I endorse the comments of [name redacted], PhD, as filed with the Federal Register. His comments reflect my own experience and concerns.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dana	None	None	0900006484fccf0e	Miller	None	2022-03-16T18:27:29Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Miller, Dana	l0t-rw40-xajl	False	None	False	2022-04-12 04:19:02.748	[]
2578	CDC-2022-0024-2584	https://api.regulations.gov/v4/comments/CDC-2022-0024-2584	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The reclassification of Tramadol into the schedule for opioids has made an unnecessary and undue hardship on persons such as myself who use Tramadol for relief of diabetic neuropathy. I have been on a limited dose of four a day at the most(most often only two at night) because of the difficulty of getting to sleep with the feet and the associated pain associated with the neuropathy. <br/><br/>Sending a person of my age to a "pain management" practice is not unlike being sent to adult probation where one has to pass a UA as well as be grilled by doctors who may be skilled at proscribing pain medication but have no understanding of aging, pain, the issues that come with those folks. Every trip I make I see folks who drag themselves to the drug nazi to be interrogated before they are given their prescription. <br/><br/>In the Austin area, two notable things happened this past week: "Bones" actor [name redacted]'s autopsy results were revealed: his death was caused by large doses of fentanyl, oxy, hydro, cocaine; morphine, xanax and alcohol. So, I am trekking to a pain doctor asking for a meager amount of tramadol while ODs like this are common. Second, a pharmacist was arrested and indicted for distributing over 1M oxy and hydro through the back door. <br/><br/>In my private practice, I am working with a client whose PCP prescribed large doses of oxy, hydro, morphine and suddenly closed up shop and fled to Tennessee. <br/>Your scheduling Tramadol as a opioid has placed a hardship on aging patients with chronic pain and has not, that I can tell stemmed the tide of the epidemic. The only pharma implicated in this epidemic(Stacker)is not the only company overproducing opioids.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fccfed	Chancellor, LPC-S	None	2022-03-16T18:28:58Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Chancellor, LPC-S, Michael	l0t-tdbk-q4is	False	None	False	2022-04-12 04:19:02.958	[]
2579	CDC-2022-0024-2585	https://api.regulations.gov/v4/comments/CDC-2022-0024-2585	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Nurse Practitioner and have been practicing pain medicine with pain doctors for 8 years. I believe the 2016 opioid prescribing guidelines did so much more good than harm. I see hundreds of chronic pain patients every month and believe that before the guidelines were published, opioids were being prescribed irresponsibly without consideration of long term management. Only in extreme cases, is more than 90 MME per day needed - this represents at best, 5% of the patients I have seen. I am constantly asked to adopt treatment plans of patients over 90 MME that have been prescribed by primary care providers, physicians about to retire, or other prescribers outside of pain management. The guidelines were clear and the 90 MME recommendation was completely justified - taking it away, limits my ability to practice responsibly because now, I am going to be pressured to raise doses of either opioid tolerant, opioid dependent, or opioid use disorder patients. Opioid prescribing is a necessary tool but it needs to continue to be done responsibly with appropriate surveillance. The CDC guidelines were the only tool I had as 'chronic pain' is a subjective measurement. If you take the guideline away or modify it to 'use best judgement' we are going to go back to the opioid prescribing world pre-2016. The guidelines are perfect how they are. Pathology and treatment need to be aligned instead of subjective measurement being the standard as it was in the past. The majority of prescribing over 90 MME is opioid tolerance, not exacerbated or severe pathology. If you are going to take the 90 MME cap away, please recommend all chronic pain prescribing to be done by chronic pain specialties and not by primary care providers padding their monthly visit numbers. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd011	Anonymous	None	2022-03-16T18:29:42Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-topw-n76y	False	None	False	2022-04-12 04:19:03.175	[]
2580	CDC-2022-0024-2586	https://api.regulations.gov/v4/comments/CDC-2022-0024-2586	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have personally tried every medication currently designated for RLS and experienced augmentation over time from every one. The only medication that continually works is hydrocodone. I take the smallest does available but even that is difficult to get approved and covered by insurance because it's difficult to get more than a 10 day supply at a time. I understand the concerns about addiction, but from everything I've been reading it can be controlled with the proper monitoring and by keeping the dosage low. My RLS is so bad that it affects me not only at night but all day at work and not just in my legs but my arms and at times throughout my entire body. Any relief is welcome, but the only relief that works consistently without bad side effects has been the hydrocodone.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fcd012	Allen	None	2022-03-16T18:29:56Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Donna	l0t-towo-5m3c	False	None	False	2022-04-12 04:19:03.387	[]
2581	CDC-2022-0024-2587	https://api.regulations.gov/v4/comments/CDC-2022-0024-2587	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone living with severe chronic pain I feel compelled to comment on this website in relation to the opioid crisis in this country. I am 68 years old, retired and have lived with various stages and levels of pain since I was approximately 18 years of age. The pain initially started due to a car accident when I was 17 years old. My genetics predisposed me to an arthritis condition when I was of high school age as well. My employment also had a detrimental effect on my body due to a job that required alot of driving and lifting. Over the years I was not privy to information and education via medical resources in utilizing various methods to combat the conditions I have been afflicted with. In my early fifties my pain was becoming more than what over-the-counter medications could help with. I was using tylenol and motrin to relieve the pain and the end result of that usage resulted in chronic kidney disease. <br/> About 10 years ago I sought treatment at the local pain clinic here in [location redacted] due to lower back pain. Since that time I developed spinal stenosis, which is beyond surgical repair as well as fibromyalgia. I was being treated with various cortisone shots and was prescribed various levels of opioid medications. These pain medications allowed me to live my life on a 90% functional level and allowed me to participate in daily activities and live my life accordingly.<br/> A year ago in February of 2021 I was assigned a new GP doctor due to my former doctor leaving the Mayo medical clinic here in [location redacted]. My new doctor, Dr. [name redacted] took it upon herself to accuse me of being addicted to drugs on my very first visit with her and informed me she was going to wean me off these drugs. Since that time I have complied with her request to seek alternative methods to deal with the pain I have everyday. The problem is her methods are not working. I am now confined to my home in severe pain 24 hours a day. She claims she is helping me, but I beg to differ.<br/> I consider myself to be an intelligent person and certainly understand the opioid crisis in this country. I realize the CDC needs to rein in the abuse of drugs and rampant overdose deaths due to the illegal uses of drugs. However, those of us living or should I say merely existing everyday due to these drugs being taken away from law abiding citizens just simply is not fair or something that should happen. I have never abused the drugs prescribed to me and always complied with additional rules and regulations placed upon me in order to receive these drugs. My former doctor and I discussed the risks of taking opioids on a long term basis and I decided the risks were worth having some quality of life. If my lifespan was cut shorter in terms of how many years I lived, I decided that was okay with me. I am a strong person who has faced many trials in my lifetime, but, living as I am now laying in bed with pain 24 hours a day is not really living. I can't help but question how many people are taking their own lives that are living with the kind of pain that I am living with.<br/> I implore the CDC take my perspective into consideration in re-writing the guidelines for opioid medications for severe pain. There has to be a better way for those of us dealing with such horrible pain. Thank you for allowing this comment period of time and know that I will be following your website as well as contacting my legislatures, namely Congressman [name redacted] as a follow-up to this issue. Sincerely, [name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon L.	None	None	0900006484fcd550	Williams	None	2022-03-16T18:33:46Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Sharon L.	l0t-vp5d-5o7b	False	None	False	2022-04-12 04:19:03.599	[]
2582	CDC-2022-0024-2588	https://api.regulations.gov/v4/comments/CDC-2022-0024-2588	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider pain patients when making the opioid rules. Without them, I am bedridden, with them, I cook dinner, swim, walk, clean, take care of my pets. Please do not harm me and countless others due to some addicts who have no control. I use my rx responsibly and have never failed a urine or drug count, which at my age I find humiliating, but I adhere to all ridiculous hurdles you have placed on me and others.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Loretta	None	None	0900006484fcd588	Ranieri	None	2022-03-16T18:33:59Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Ranieri, Loretta	l0t-w9d4-b735	False	None	False	2022-04-12 04:19:03.818	[]
2583	CDC-2022-0024-2589	https://api.regulations.gov/v4/comments/CDC-2022-0024-2589	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m not sure what to say anymore regarding CDC and the damage they’ve created for us chronic pain patients and their families. There’s nothing that us patients, have said or can say, that will reverse the damage already done and the little quality of life we once had, be restored. CDC along with most states, have made sure that we no longer have access to competent, willing, compassionate doctors that still take “do no harm” as a serious matter. The guidelines have frightened physicians to the point that their responsible 20 year patients, have been dropped, referred to a collection of Drs, lost the quality of life they did have and no longer have any faith and trust, in physicians no matter the area of practice. Disabled, chronic pain patients have been forced to treat themselves to the best of their ability. What’s the need in so called “pain management physicians” anymore? There is no need. I had been with my same orthopedic surgeon for 14 years due to the need of periodic surgeries because of the rods and screws in my entire spine. HE is the one that gave me back some quality of life and allowed me to get out of bed and enjoy my grandbabies. Had kept me on the same dosage of pain medicine for 8 years without one single issue. The only other Dr that I had was my primary care Dr. I’ve been seeing literally 2 physicians in all those years UNTIL my orthopedic surgeon, who is like family to us because he cares and interacts as such. HE is the epitome of what every physician should be. However, he was distraught when he had to inform me that he could no longer see me every 3 months, nor prescribe my regimen of medications as had been done all those years. I’m not sure who was more upset but I did know at that time, my life would never be the same again and would revert back to living in the bed with the walls closing in. <br/>Yes he referred me to a pain management group and my very first appointment the Dr said that my case was so involved and they would not be able to treat me. Wow! Pain management can’t treat me?! So my surgeon sent me to another pain management practice, which was 1 year ago. They immediately cut my medication by 85% as well as completely eliminating 2 medications that had been a successful part of my regimen. Now 1 year later, I have been 100% compliant, followed every order, have had clean drug screens every single time. And where has that gotten me? Absolutely nowhere. I haven’t gained their trust obviously and they certainly haven’t gained mine. All of my compliance was for nothing. Both NPs there stated “oh we do not prescribe more than 3 pills per day, period”. And this is what pain management is for?! Do you have any clue how extremely difficult it is to search and locate a pain management physician as it is? It’s impossible and my area of expertise is “research” and I have spent hours upon hours, days upon days, researching and reaching out for suggestions from any and everyone. The chronic pain patients were NOT the driving force in the so called “opioid epidemic”. We take and have always taken our medications as instructed otherwise we couldn’t get out of bed, eat, sleep, think etc. And depression? You cannot begin to know the half of it. And the CDC wonders why the overdose numbers have not gone down since their 2016 guidelines that were perceived as serious threats to physicians. Several reasons. Pain patients weren’t the ones overdosing. Pain patients that have lost access cannot live in tortuous pain day in and day out and absolutely reach a breaking point. Pain patients that no longer have access CDC has FORCED the poor suffering patients to go to the street for any kind of relief and then end up getting something deadly. That blood will forever be on CDCs hands! They can never reverse the damage they’ve done and the fear they’ve forced upon decent doctors. <br/>Pain management groups, not only is a joke, it’s the most shameful thing I’ve experienced. How dare they automatically label someone or treat ALL of us as “addicts”, “drug seekers” etc! They have all of my records, films, surgeries from all these years so what you’re telling me is that my medical file, films, hardware in my spine, that’s all false, you don’t believe what you’re seeing or you just don’t care to properly treat a patient? Most of them at pain management are NPs that are young enough to be my child and I can guarantee you that I KNOW more about my disability, what’s helped, what hasn’t etc, than they do. I don’t give a [profanity redacted] how long they went to school to get that NP behind their name. They have NOT lived in MY body, walked in MY shoes, felt what MY life feels like, endured the multiple surgeries and fractured spine that I have! How dare them tell me that they know what’s best. There’s only so much you can learn from the medical books, the majority of knowledge comes from experience, hands on and years of it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Phyllis	None	None	0900006484fcd257	Bradberry	None	2022-03-16T19:27:13Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Bradberry , Phyllis	l0t-xdmv-euqf	False	None	False	2022-04-12 04:19:04.024	[]
2584	CDC-2022-0024-2590	https://api.regulations.gov/v4/comments/CDC-2022-0024-2590	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was able to secure safe self-help meds last week, after 14 months bedridden, sleepless, & in severe pain, post-INVOLUNTARY opioid taper. I am now physically functional (opioids help function more than pain, but they are about 50% effective against my bone & soft tissue pain); however, I am now experiencing waves of suicidal ideation unlike any in my 44yrs of chronic pain, or 20+ yrs on opiates, because: <br/><br/>The thought that I could lose access, AGAIN, and be thrown down into that hole of solitary confinement & exiled from family/friends/community, is absolutely unbearable. I can't do it.<br/><br/>I never expected to be a criminal, especially over necessary MEDICATION. I was an executive with 4 degrees and a blackbelt before my doctor retired, but her replacement decided my dose (at the CDC's 90MME threshold) was "proof of recklessness" & I must be tapered.<br/><br/>I was put on that dose - I didn't ask for it. The meds came in min. 10mg, and it could not stretch 12 hours. If I wanted to keep working, it had to be TID.<br/><br/>I have a degenerative & inoperable skeletal defect that is slowly laying waste to all the soft tissue in my left ass-cheek: my gluteal tendon is almost completely severed, and the tension imbalance is pulling my vagina and colon about 15° out of alignment. My vagina and left labia are hard-cramped 24/7, but my doctor thinks ibuprofen &; Tylenol should take care of it, because 2016 CDC guidelines "told him to."<br/><br/>He does not "agree" that the Guidelines were only supposed to be advisory. (CDC emailed me back that I should "explain to him they were never intended to be blanket policies." Guess how that went?)<br/><br/>Doctors follow path of least risk/resistance through the regulatory minefield the fed govt has constructed around opioids. Between DEA's addiction to arrest & conviction stats (regardless of actual mens rea) that keeps agents pointed at good-faith doctors rather than cartel fentanyl; CDC conflating illicit fentanyl & Rx opioids in overdose statistics for >decade (WHY?); and, 2016GL holding out 90MME as a real std, when the "science" those equivalents are based on is 60 years old, & has never been subject to peer review: patients don't stand a chance. <br/><br/>MDs with too many patients & not enough time, already, saw CDC GL not as patient care support, but as an exit ramp from the biggest stressor in their practice: a roadmap to involuntary tapering, so they never have to expose themselves to prescribing scrutiny again.<br/><br/>For patients, GL have been a nightmare: we've seen our caregivers, turn & walk away in favor of perverse incentives of law enforcement + employers/insurance payors. DEA prosecutes doctors when street fentanyl is responsible for 98%+ ODs; and, following this false logic, insurers give bonuses to docs who don't prescribe opiates. DOCTORS ARE BEING PAID NOT TO RELIEVE PAIN, FFS. (Mengele, anyone?)<br/><br/>And in the meantime, the magical non-opiate medications CDC promised us back in 2015 are still, by your own admission, 5-10 years out.<br/><br/>Most of us won't make it 5-10y. It's not just suicide, it's pain-induced stroke, HBP, heart attack, high blood sugar, & the corrosive affects of persistent cortisol on all soft tissue.<br/><br/>There has not been an involuntary experiment on a vast swath of vulnerable, stigmatized & socially despised patient class like this since Tuskegee - and make no mistake: the 2016 GL WAS an experiment. There was no sound basis for any of its policy choices; but, as co-author [name redacted] said about the "overdose crisis" "We had to do SOMETHING." <br/><br/>What happened to, "First, do no harm"? If you don't know what the outcome is going to be, it's an EXPERIMENT, and you know you are risking harm. It's completely unethical. And CDC passively buried any negative results by failing to measure patient outcomes, including the thousands of post-taper suicides Univ. of Alabama is trying to measure ex post facto. (Fortuitous that this data will take years to aggregate: once it's available, CDC can blame it on old GL. Move along: nothing to see here but a bunch of pain in the [profanity redacted] dead cripples anyway.)<br/><br/>CDC excuses this saying the GL weren't a treatment methodology but only advice to physicians; but, if CDC did not understand its target audience, and the medical/economic sea in which we all are forced to swim, it shouldn't have the power or authority to publish such guidance in the first place.<br/><br/>Go away for a while and think about what you have done to literally MILLIONS of patients like me: You have made our lives, and the lives of our families, friends, and employers, materially WORSE since 2016.<br/><br/>I don't think that's in your mission statement.<br/><br/>CDC MUST SCRAP THE IDEA OF OPIATE GL ENTIRELY. American physicians have proven they cannot be trusted not to race to the bottom (many cut off ALL their opiate patients - how can that be medically justified?) to avoid responsibility/liability, and it is directly and severely harming patients, their families, communities.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd27b	Anonymous	None	2022-03-16T19:29:27Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-y134-ne7l	False	None	False	2022-04-12 04:19:04.266	[]
2585	CDC-2022-0024-2591	https://api.regulations.gov/v4/comments/CDC-2022-0024-2591	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Major Issue's. Why are the Same Authors of the 2016 CDC Opiod Guidelines Medical Disaster being allowed yet again to "Revise" the 2022 Opioid Guidelines? The Authors of these Guidelines are well known Extremist of the Anti-Opioid Group "PROP" and yet these are the same authors chosen yet again to write "National Opiod Prescribing Guidelines"? The Conflict of Interest is HUGE. Extremely Biased and quite frankly it is appalling. New Unbiased Specialists & Anesthesiologists who treat in the actual field of Pain Management need to brought in. The old PROP group authors do not treat in the field of Pain Management, are not trained in the field and have absolutley no business writing any type of National Opioid Guidelines. None. In fact it has been found that these very "Guidelines" and the Entire basis of their Junk Science MME they have wrongfully created was solely based off of a single very old outdated JAMA study back in a 1974 JAMA Article (Refrence: Dinerstein,Chuck MD, MBA 2022 "The True Story of Morphine Milligram Equivalents" American Council on Science and Health) and that very study was "Rebutted" 2 Months Later. The First Opioid Guidelines in 2016 that have been wrongfully interpreted as "Opioid Prescribing Law" and widely adopted by every State Medical Board, Insurance Companies/Payors even the D.E.A. which has created so much harm to Patients and Physicians and Changed the entire way Opioids are prescribed for pain be it acute or chronic. The Suffering of Patients and the Staggering Number of Overdose Deaths which has Skyrocketed to Unforseen Numbers and here we are again, using this very same group of authors to revise 2022 National Opioid Guidelines. Patients are Suffering. Physcians are under continous scrutiny. People have been pushed to the streets due to the 2016 CDC Guidelines. It has created Suffering, Despair, and Overdoses. People are dying as a direct result of the 2016 Opioid Guidelines written by PROP. The PROP group of authors writing these guidelines have a particular interest to see that Opioids are Failed on every level for the treatment of pain acute or chronic. Their own Studies refrenced throughout the 2022 Revision are highly Cherry Picked and "Heavily Opinionated" which one could not possible take seriously. The New "Language" of the CDC Opioid Prescribing Guidelines is Dangerous and Reckless in my Opinion. In fact after reviewing the 200+ Page Document of the New Revised language sure, I no longer see the 90 mg MME dose threshold. Instead, What I do see is a 50 Mg MME dose threshold. Why is ANY Opioid Dose MME Threshold being quoted in the revision? To allow the CDC again to randomly throw out another unscientific backed Morphine Milligram Equivalency Threshold is Reckless. The entire basis of this MME is unfounded and unbacked by any type of science. These "Revised Opioid Guidelines" are just as Dangerous, Reckless, and Appalling as the 2016 Guidelines. New Authors who treat in the Field of Pain Management need to be brought in. Until then, we will continue to see the Dire Consequences and fallout from using PROP Group Members to write National Opioid Prescribing Guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd2db	Anonymous	None	2022-03-16T19:30:46Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-yi80-uli9	False	None	False	2022-04-12 04:19:04.478	[]
2586	CDC-2022-0024-2592	https://api.regulations.gov/v4/comments/CDC-2022-0024-2592	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I (33f) got my gallbladder out; lack of pain management made it more traumatic than any other surgery I’ve experienced.<br/> <br/>I have a history filled with procedures and chronic health issues including CPTSD, BP2, GAD, PCOS, migraines, widespread muscle/joint pain and abdominal/lower back pain (pursuing diagnosis), recurrent diverticulitis (caused appendicitis and other infections), kidney stone lithotripsy, exploratory laparoscopy (suspected endometriosis w/ no findings), and now cholecystectomy. <br/><br/>My gallbladder became inflamed at the end of 2021. Mid-level pain was constant with at least two high pain attacks resulting in vomiting. Despite lifestyle changes I was in pain for months and was given nothing to deal with it. OTC pain meds heating pads barely helped.<br/><br/>When I went to the ER in mid January 2022 I was at my wits end with the pain and could not wait for a surgical consult. Ultrasound showed that a stone was stuck in my bile duct and they got me into surgery quickly.<br/><br/>I made sure to tell the anesthesiologist that I use THC edibles for chronic pain relief and that it can be hard to control my pain levels. I said I was scared of waking up in uncontrollable pain. They did not seem phased.<br/><br/>I expected surgery and post-op pain control to be difficult, as I’ve experienced it before. But that was before the new guidelines were in place. <br/><br/>This experience was comparatively much more traumatic. It all came down to how my pain levels were treated.<br/><br/>I woke up in more pain than I’ve ever been in my life. Nurses made me feel like I was overreacting. I was writhing, shivering, and unable to stop moaning. My BP skyrocketed and I don’t remember much after that.<br/><br/>They kept me comfortable overnight with IV opiates until my BP went down. <br/><br/>Then in the AM my pain increased as I was switched to a low dose opiate. It wore off very quickly and I was in agony again. They refused to switch the dose or give me anything else.<br/><br/>I explained over and over to anyone who would listen how much pain I was in. <br/><br/>“There’s nothing we can do, it’s not time for more meds. Oh you can have some Tylenol.”<br/><br/>Post-op recovery pain relief for routine lap surgery was nothing like this a few years ago. They were always able to adjust my meds and keep me comfortable until I healed.<br/><br/>What changed? Why weren’t they able to keep me comfortable? Why did I have to feel like I was going insane, like a caged and wounded animal?<br/><br/>I guess I know this is reality now. The government tells doctors how to manage their patients’ pain relief to a detrimental degree. These restrictions are creating so much unnecessary trauma. Patients who don’t fall in line with the guidelines, be [profanity redacted].<br/><br/>I called my dr asking if it was normal to be in so much pain one week post-op and whether or not I might get some stronger meds to see me through a more comfortable recovery. <br/><br/>I also explained how my mental health was taking a huge hit, because I have a history of struggling with depression and intrusive thoughts.<br/><br/>He lectured me about the dangers of opiates, reiterated (unhelpful) things I was already doing for pain relief, and offered no other guidance.<br/><br/>If I didn’t have access to medical cannabis my recovery would have been so much worse.<br/><br/>I only rely on opiates to get me through these acute situations. I can’t imagine what life would be like if I needed them more often.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd311	Anonymous	None	2022-03-16T20:19:22Z	None	None	1	None	2022-03-16T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-z6zo-1qmd	False	None	False	2022-04-12 04:19:04.699	[]
2587	CDC-2022-0024-2593	https://api.regulations.gov/v4/comments/CDC-2022-0024-2593	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines set down are cruel and unnecessary.The harm that has been done to me ,Sr Citizens and others with chronic pain is assume. Is there no critical thinking at the CDC? I have chronic pain and there is no treatment .The pain is increasing and in my case will only get worse. The CDC needs new skills in critical thinking . Do betters	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linds	None	None	0900006484fcd409	Bennett	None	2022-03-17T12:34:14Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Bennett, Linds	l0u-0jzb-iyyq	False	None	False	2022-04-12 04:19:04.912	[]
2588	CDC-2022-0024-2594	https://api.regulations.gov/v4/comments/CDC-2022-0024-2594	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an active 70 year old woman who has suffered chronic neck and upper back pain for the last 20 years. I have had 4 discs removed from my cervical spine with fusion. I have also had cancer. To treat my pain I have tried home traction, physical therapy, medical massage, acupuncture, chiropractic, monthly steroid injections into my spine, a breast reduction, meditation, yoga and medical marijuana. Nothing has provided extended relief. My dear doctor has worked with me carefully and prescribes a 5 mg. oxycodone tablet that I am permitted to take up to 3 times a day as needed. I have been on this same dose for over 10 years. I have found that this dose allows me to maintain a quality of life so that I can function daily. But I hide the fact that I take oxycodone because of the stigma. When I travel out of state for any period of time, I have to have my sister get my medication and mail it to me because the state where I visit won't honor my doctor's prescription. This is very limiting plus I worry every time that the medication will get lost in the mail. I recently had shoulder surgery and the surgeon said I could take 2 of my 5 mg. tablets if the pain was severe. But I was afraid to take two because that would leave me short for the month. He had to make special arrangements and the pharmacist had to do some math to figure out how to cover me after surgery with enough medication. This does nothing to help me, a genuine patient under the close care of a doctor. Please realize that many of us are NOT ADDICTS. We are dependent upon an opioid to live our lives. Please adjust the guidelines so that we are not penalized. I am afraid to attach my real name to this comment because I live in a poverty stricken area where opioid abuse is a problem and I fear for my safety. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd439	Anonymous	None	2022-03-17T12:45:19Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-18ye-k3if	False	None	False	2022-04-12 04:19:05.120	[]
2589	CDC-2022-0024-2595	https://api.regulations.gov/v4/comments/CDC-2022-0024-2595	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	HELLO!<br/>I AM A 62YR OLD FEMALE THAT IS IN CHRONIC PAIN EVERYDAY. I HAVE ALWAYS TAKEN MY MEDS CORRECTLY AND AM NOT AN ADDICT. I AM ONLY GETTING 1/2 OF THE DOSAGE THAT WOULD HELP ME TO BE ABLE TO FUNCTION EVERYDAY WITHOUT HELP! IF THE GUILDLINES AREN'T CHANGED I WILL BE FORCED TO GO INTO A PALLITIVE CARE FACILITY. THE PAIN RIGHT NOW IS BARELY BEING HELPED AND I AM BED RIDDEN WITH PAIN SO BAD THAT MOST DAYS IT HURTS TOO MUCH TO GET AROUND. TAKING CARE OF MYSELF IS GETTING TO BE TOO MUCH.<br/>PLEASE HELP ME AND OTHERS THAT ARE SUFFERING. PLEASE REVISE AND CHANGE THIS HORRIBLE GUILDLINE!!!<br/><br/>THANK YOU<br/>SUFFERING CHRONIC PAIN PATIENT	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd43d	Anonymous	None	2022-03-17T13:17:10Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-1bfb-w22h	False	None	False	2022-04-12 04:19:05.333	[]
2590	CDC-2022-0024-2596	https://api.regulations.gov/v4/comments/CDC-2022-0024-2596	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You must take out the mme doses. The CDC is not a medical provider. Put medical care back in the hands of the physicians and leave them alone. Your restrictions are killing people and causing suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006484fcd4c9	Gilbreath	None	2022-03-17T13:21:48Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Gilbreath, Cheryl	l0u-2etl-sppw	False	None	False	2022-04-12 04:19:05.803	[]
2591	CDC-2022-0024-2597	https://api.regulations.gov/v4/comments/CDC-2022-0024-2597	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I went to the emergency room because I hurt my back. I was in severe pain. The dr would not give me an opioid for pain. I stood up for 2.5 hours because I couldn't sit or lie down. When the dr was discharging me he gave me a shot of dilauded which instantly stopped my pain. Then he sent me home. I filed a complaint against the dr to the TN State Medical Board and it has been over nine months and I never heard a word from them. This dr was negligent with my treatment and the state board covered for him.<br/><br/>Then I go to a pain management center and they would not give me opioids because I have been on .25mg of Xanax for twelve years. This is wrong. I am disabled with severe anxiety and you should not have to choose between your pain and your anxiety.<br/><br/>So I was forced to get three nerve blocks and a nerve ablation by [name redacted]. He has made m pain worse suffering muscle spasms all the time.<br/><br/>I am terrified of hospitals and drs because they won't treat your pain and you have to suffer. We are now living in barbaric times. It is very frightening to know if something happens to you your pain won't get treated and you are treated like a drug addict.<br/><br/>I am allergic to aspirin. Aleve and ibuprofen gives me ulcers so what am I supposed to do?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leecie	None	None	0900006484fcd908	Butlet	None	2022-03-17T13:27:02Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Butlet, Leecie	l0u-3khu-1jd2	False	None	False	2022-04-12 04:19:06.032	[]
2592	CDC-2022-0024-2598	https://api.regulations.gov/v4/comments/CDC-2022-0024-2598	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	67 yr old female suffering from fibromyalgia, HBP, type 2 diabetes, myofacial pain syndrome, severe osteoarthritis, GERD, essential tremors and asthma. I have been on 10/325 Norco since about 2006 and was on Fentanyl 75 mcg transdermal (methadone/morphine sulfate first) from approximately 2007-2018. I was placed on Fentanyl due to break through pain along with continuing the Norco as prescribed. I finally had a life, which stopped as my driver license was suspended due to the medication I was taking. I’ve been off fentanyl since 6/30/2018 with no addiction issues. I couldn’t bear the chronic pain 24/7 as the quality of my life meant suffering every moment of every day and sitting/sleeping in a recliner. Therefore I remained on Norco so I could move and attempt to sleep. <br/><br/>Please do not stop individuals like me from seeking relief from chronic pain, otherwise you’re condemning us to a life of hell and depression. Please note that I worked 33.5 years for a large telecommunications company and have a family of 4 to take care of and been married 47.5 years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484fcd992	Black	None	2022-03-17T13:41:41Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Black , Sharon	l0u-5t57-s1nt	False	None	False	2022-04-12 04:19:06.244	[]
2593	CDC-2022-0024-2599	https://api.regulations.gov/v4/comments/CDC-2022-0024-2599	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My comment is to get the misapplied and DISinformation of the ICD codes T codes information to the WHOLE public. An apology for making this so called opioidhysterias overdoses on the narrative it’s the legit Opioid Rx and their doctors fault. WHEN all along it’s the street Fentanyl analogs. Get the apology to all death caused by SUICIDE DUE 2 PAIN, end of life patients/cancer who was and are refused pain medication in an attempt to say THEY MIGHT GET ADDICTED!!! They are dying.!! Who cares if addicted!!<br/>I myself raised a 3 kid family, built my house (I’m a woman) had 3 acres of coffee to take care of and a zoo of animals. For the first 4 yrs being a CPP (botched surgery and botched reconstruction surgery) I was prescribed every combination and treatment possible. Lost my gallbladder cuz steroids shots to many. GI bleedings from Ibuprofen. And liverproblem from Tylenol4. The next 20 years on my opioidRX I functioned LIVING WITH MY PAIN as well as I could, until I got tapered down. 3 years back . Then I Can’t work, can’t even do simple household maintenance or I get intense pain flares for days and going to a doc appointment or the store is excruciating pain for days after! <br/>My PM doctor for all those years treated me good. Then he retired 2019. I would like to get to live again NOT ONLY EXIST. Can’t even go see my grandkids in another state! I want my medication back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kicki	None	None	0900006484fcda27	Carlson	None	2022-03-17T13:57:18Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Carlson, Kicki	l0u-8tgv-7wpr	False	None	False	2022-04-12 04:19:06.461	[]
2594	CDC-2022-0024-2600	https://api.regulations.gov/v4/comments/CDC-2022-0024-2600	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lost 1 family member and 2 friends, who were in so much pain, they took their own lives. Because either they couldn't afford to go to a Dr. Once a week. Or their prescriptions were cut down so much. Treatment should be inbetween Doctor and patient. Not the government.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mae	None	None	0900006484fcd794	Rivet	None	2022-03-17T13:57:52Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Rivet, Mae	l0u-a8np-7hkp	False	None	False	2022-04-12 04:19:06.675	[]
2595	CDC-2022-0024-2601	https://api.regulations.gov/v4/comments/CDC-2022-0024-2601	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to know why we have to suffer when we have pain all the time every moment of the day .it like we are living in hell .we need a new and improved guideline to help us people who have pain and no surgery no shot no implants are going to help <br/>.we are suffering .what if this one of your family member what would you do .Set there and watch them suffer in pain? This is so inhuman .No Mme.one size doesn't fit all some of us need more to control are pain <br/>Let Dr be Dr again let the pharmacy do what the were meant to be fill the script the doctor order not to be mean and condensing to us .and taking a pill every 6 hrs after it wears off at 4 hrs is ridiculous.So now where in total unfuntion able for 2hrs so when it 6 hrs later are pain is back up to a10 how is this helping us ?it isn't .lot of lying going on to us .no science behind it what so ever .So who's getting paid the big bucks to lie and hurt us that need this medicine?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd7b7	Anonymous	None	2022-03-17T14:30:12Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-azfi-35fh	False	None	False	2022-04-12 04:19:06.893	[]
2596	CDC-2022-0024-2602	https://api.regulations.gov/v4/comments/CDC-2022-0024-2602	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am laying here in agony from an amputation surgery that went wrong. No pain medication after they cut my leg off and gave me nothing for pain! Barbaric! I have such severe pain and no one will treat me. My life is useless now! Is this how people are supposed to be treated? It's so wrong and it's so sad that we even have to comment. I would think their would be common sense somewhere along the line. Not a hard line of no pain medication. It's wrong !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd7b9	Anonymous	None	2022-03-17T14:31:14Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-b3kv-amtx	False	None	False	2022-04-12 04:19:07.113	[]
2597	CDC-2022-0024-2603	https://api.regulations.gov/v4/comments/CDC-2022-0024-2603	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am disabled and when my pain management doctor died suddenly December 2020, I have been unable to find another pain management doctor or a primary care doctor no one wants to deal with an EX pain patient. We are expected to have dental procedures,surgeries and many other painful procedures done without pain medication. Things have gotten so wildly out of hand that it has been surpassed pain patients. I now have the fear that my grown children will have some kind of medical emergency and not get the adequate pain care they need if anything at all. Pain patients were the first to be targeted now it is our parents, children, grandparents, our best friends all the people we love and care for. It doesn't matter if someone is an ex pain patient or not no one is safe from the worry that they will have a surgery, or a dental procedure and be sent home to suffer without a care one from their dentist or doctor. Yes us pain patients were the ones they have put the blame on and it hit us first and the hardest. Now we have to worry for our loved ones as well when will this end.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tamatha	None	None	0900006484fcd7e1	Manning	None	2022-03-17T14:38:26Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Manning, Tamatha	l0u-bvz2-dj23	False	None	False	2022-04-12 04:19:07.327	[]
2598	CDC-2022-0024-2604	https://api.regulations.gov/v4/comments/CDC-2022-0024-2604	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Long term opioid use becomes the only course of treatment when all else fails it’s called palitive care. Withholding appropriate doses and schedules amounts to torture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484fcd817	Sepulveda	None	2022-03-17T14:40:24Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Sepulveda, Daniel	l0u-dqst-262s	False	None	False	2022-04-12 04:19:07.551	[]
2599	CDC-2022-0024-2605	https://api.regulations.gov/v4/comments/CDC-2022-0024-2605	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in Maine,where i have been sexually assaulted,beaten unconciouss,resulting in a permanent traumatic brain injury inducing daily blinding and deafening<span style='padding-left: 30px'></span>Cluster headaches.My doctors do not practice medicine, all they do is assault me and steal my pain meds.I have been a Palliative Care chronic pain patient since i was assaulted by medical students in a teaching hospital in 1984,and have been on Social Security Disability since 1987 My Pain Management doctor retired.I met his replacement once.He promised to ensure that i would never receive any medical treatment,ever again.In strict violation of Federal Law, he stole my pain meds,and told me to kill myself.He refused to refer me to a noncriminal doctor.He refused to tell any other doctor that,as a Palliative Care patient,the CDC clearly states that Palliative Care patients like me are exempt from any limits on the responsible prescribing of life saving opioids,which i have taken as directed,in full compliance with all laws and manufacturers instructions,with NO evidence of Substance Use Disorder,for 38 years.I was in shock after my meds were stolen, and i woke up at night to use the bathroom,walked into a wall,fracturing multiple bones in my left foot,tearing two shoulder tendons almost off the bone,a hip injury,and another spinal injury,then was dumped by my doctor from an Orthopedic Practice.My new doctors have never heard of pain,Pallative Care,or my Treatment Plan,which saved my life , but only after being tortured in Maine for 22 years.I have been bedridden for over a year.My new Pain Management doctor was immediately fired for suggesting that i use HEROIN. I refused.I refuse to use suboxone,which is only clinically indicated for heroin addiction,NEVER for Intractable,[redacted] Chronic Pain,which i have had for decades.I have Central Sensitization from torture. [redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fca84e	Foley	None	2022-03-17T15:17:30Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-15T04:00:00Z	None	None	None	None	None	None	None	Comment from Foley, Michael	l0s-ljda-slj0	False	None	False	2022-04-12 04:19:07.782	[]
2600	CDC-2022-0024-2606	https://api.regulations.gov/v4/comments/CDC-2022-0024-2606	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First, thank you for opening up this topic for discussion again. Writing about medication is not something I typically do and my knowledge of pharmaceuticals is very finite so please pardon my limitations, I’m really just expressing my thoughts through experience. I’ve given this a lot of thought and I’ll try to be candid and constructive.<br/>First, I’ve really never understood how the CDC pain exemptions for long term opioid therapy is only acceptable for active cancer treatment, palliative care, EOL care and sickle cell. Pain is pain, I’ve never seen any scientific research that says the brain/central nervous system can differentiate what is causing it. Be it from cancer, disease, surgery, injury or some other chronic disorder. <br/>I think a lot of my frustrations and experience has been covered numerous times by many in this forum. But I’d like to add that because there is such divide in people’s opinions, deep passions on every front and the overwhelming access to information to get and comment on, our society has created a lot of stigmas. Whether in my own mind or reality, there is an incredible amount of judgement. I personally don’t want to be labeled as dependent, an addict or any other bias from my insurance company, my work or even the local pharmacy, yet I’m constantly concerned about it. We’ve created a space where opiates are considered very bad in our society and yes they are dangerous but they are a tool in combating pain, albeit with defined risk. <br/>My PCP has been really fair with me, I know I’m not an easy case and I am so appreciative. We have good communication which is so important. She’s compassionate, empathetic, realistic and flexible just to mention a few of her great attributes. I know by our conversations that dealing with prescribing narcotics is fluid, every year something changes and I think it frustrates her a lot too.<br/> There certainly should be education, proper standardized training for medical professionals, mental health assessment/screening, and other substance screening as a part of opioid therapy. And there should be easily access to buprenorphine for those folks that feel they want to exit opioid use, meaning you shouldn’t have to have a special certification/permission as a medical professional to prescribe.<br/>Finally, I’d like to finish by thanking the Doctors and professionals who have supported opioid therapy and for the CDC for taking the time and recourses to try to make the process better. I know it’s very stressful for everyone involved and a lot of work, but it’s very much appreciated. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Liam	None	None	0900006484fcd4f5	Panasuk	None	2022-03-17T16:49:18Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Panasuk, Liam	l0u-34z2-41x7	False	None	False	2022-04-12 04:19:07.994	[]
2601	CDC-2022-0024-2607	https://api.regulations.gov/v4/comments/CDC-2022-0024-2607	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/> I can tell you EXACTLY WHY DOCTORS DID THAT. Three letters, DEA. This law enforcement group took the CDC "guidelines" as gospel. So did state legislators. But the DEA has raided many doctors resulting in many being charged with various crimes including murder. A number are sitting in jail now having been convicted. Others they didn't end up charging still were raided. DEA officers in full tactical gear with guns drawn. They then interogated all patients and staff present, then took the doctors DEA prescribing license so he couldn't practice. Many times the DEA would close the offices for months while they investigated. This would bankrupt most doctors, between overhead, and trying to retain employees they would lose hundreds of thousands of dollars. All the patients desperately trying to find new doctors. It was a total action against HIPPA, and our rights as patients. It so reminds me of McCarthyism, where they were guilty on say so alone and had to prove Innocence. <br/>It's our extra conservative legislators who passed the state laws parroting the CDC guidelines. <br/>I've talked and had contact with several here in Oklahoma but they just give lip service then go on to quote the inaccurate statistics from the CDC and go on and on about the "opioid crisis". But since they passed all these laws, addiction and overdose rates have risen. So effectively, all that happened was that many disabled, ill and elderly chronic pain patients have had health complications, gone to the black market and many have died from fentanyl or suicide or damage from blood pressure spikes, etc. It was never about dope, it was an attempted genocide to get many off social security and Medicare. We have lost thousands of chronic pain patients due to this "crackdown", in some shape or form.<br/>Also, the doctors, medical boards and pharmaceuticals would have normally fought this, they knew the statistics were skewed. Did they get bonuses from reducing prescriptions? I sure would like to know.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fcd4fb	Kirkwood	None	2022-03-17T17:10:12Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Kirkwood, Amy	l0u-38s5-sv5n	False	None	False	2022-04-12 04:19:08.212	[]
2602	CDC-2022-0024-2608	https://api.regulations.gov/v4/comments/CDC-2022-0024-2608	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My life has been a living nightmare for the last 5 years. I have worked in the healthcare field for over 20 years. 2016 is when my nightmare started. I had back surgery for bulging disc, pushing on my spinal cord. I was in so much pain, with numbness, burning, and sharp stabbing pains. I put my life in the hands of well-known neurosurgeon, and he guaranteed I would recover better than I could expect. 2017 I had to have a second back surgery, same area failed again. I was left broken, worse than before first surgery and thrown away. I lost everything, my job, home, relationships, everything I owned, and any quality of life I had. I ended up having two more major surgeries from post-operative complications. I’m now in so much pain; just taking care of my basic needs is a daily battle. CDC and FDA put out MME and opiate guidelines, which made every hospital, doctor offices and etc. put policy into effect. I have been with the same doctor’s office for 20 years, now I can’t get help with my pain. They put me on a force tapper, and tell me they are sorry but it the policy to keep everyone under 50MME. I have tried everything, I will post list at bottom of this letter. I am only 40 years old, I don’t want to die. The pain I battle daily has, been hurting my health in so many way. I have high blood pressure, chest pains, blood clots, weight gain loss of mobility and so on. My whole body is out of control, due to the pain. The doctors just keep giving me more medications;(no opiates) they cause even more problems with side effects. If they would treat the problem (PAIN), I could live a somewhat normal life. I feel like I am one step away from a heart attack or stroke. Doctors are too scared to stand up for their patients, and tell me they feel sorry for me, but nothing they can do to help me. I have been to specialist after specialist, with no relief. The only relief I have found that helps is Oxycodone 90mg a day. What is the point of being alive; if all you can do I lay in pain 24-7. This is NOT LIVING, it is suffering and I wouldn’t wish it on anyone. Treating pain patients like drug addicts should be a crime. We have the right to be treated with respect and fairness. I think the risk opiates come with, out weight the alternative of not being able to live with the pain, or side effects from not having any pain relief. The overdoses, suicides, and mental health cases are up with these guidelines. The lies form overdoses being from prescription medications are hurting CPP and not helping with the overdose crisis. I want to see the real number of overdoses from opiate only prescription vs. illegal drugs, or mixed illegal and prescriptions.<br/>•<span style='padding-left: 30px'></span>Surgery<br/>•<span style='padding-left: 30px'></span>Tens unit<br/>•<span style='padding-left: 30px'></span>Physical therapy<br/>•<span style='padding-left: 30px'></span>Acupuncture<br/>•<span style='padding-left: 30px'></span>Pain shots<br/>•<span style='padding-left: 30px'></span>Epidural injections<br/>•<span style='padding-left: 30px'></span>Pain creams<br/>•<span style='padding-left: 30px'></span>Pain patches<br/>•<span style='padding-left: 30px'></span>Over the counter medications<br/>•<span style='padding-left: 30px'></span>Chiropractor<br/>•<span style='padding-left: 30px'></span>HF10 spinal cord stimulator<br/>•<span style='padding-left: 30px'></span>Hand massagers<br/>•<span style='padding-left: 30px'></span>Adjustable bed<br/>•<span style='padding-left: 30px'></span>Hot and cold packs<br/>•<span style='padding-left: 30px'></span>Prescription medications<br/>•<span style='padding-left: 30px'></span>Personal massage therapy<br/>•<span style='padding-left: 30px'></span>Herbs & Vitamins<br/><br/>Please stop hurting and killing us chronic pain patients! The 50 MME will be pushed as policies at doctors offices. We need no MMEs period, 1 size doesn't fit all!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd93d	Anonymous	None	2022-03-17T17:21:46Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-4ehs-mw8i	False	None	False	2022-04-12 04:19:08.435	[]
2603	CDC-2022-0024-2609	https://api.regulations.gov/v4/comments/CDC-2022-0024-2609	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop putting all limits on perscribing from pain medication. We all metabolize meds differently and are made differently. No one size fits all approach will work..We all also have different disease and conditions, Science hasn't changed, the only thing that's changed. Any mention of limits will continue to be weaponized against patients! Also legacy patients must, be protected on stable doses. How many times must a patient prove what works for them? Everytime a patient gets their function ripped away its trama to them and the ones who love and depend on them..palliative care must be specified for all patients with incurable painful diseases no matter stage , like the real definition! Doctors refuse to give patients a palliative status even though most pain patients are palliative!! <br/>Legacy patients on stable doses must not have to find pain doctors, there aren't any to find..Stable patients, must have power over function so they can move forward with life .Not be in fear function will be stolen and they will be left in agony every single month..<br/>Palliative care must be defined as all patients with incurable painful diseases at any stage, like the real definition so doctors can't refuse to give these patients exemptions..even palliative care providers are refusing patients saying they are not pain management..how is this legal or ethical? All pain doctors have limits lower than ur guidelines now , so it sets the patients up for poor outcomes ..Monthly appointments have become dreadful probation like appointments..Where all pain patients need advocates to feel safe and heard..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcd93f	Anonymous	None	2022-03-17T17:36:26Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous , Anonymous	l0u-4ftd-p758	False	None	False	2022-04-12 04:19:08.652	[]
2604	CDC-2022-0024-2610	https://api.regulations.gov/v4/comments/CDC-2022-0024-2610	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Eliminate any MME limits from the new guidelines. The FDA has already approved all narcotic pain meds with the directions for prescribing them. No Dr pharmacy or drug company has any control after a prescription is dispensed to the patient. It is the responsibility of the patient to follow the directions printed on the label of how many pills to take and at what interval. I challenge the CDC to find one overdose by anyone who takes their pain meds as directed. Prescription have been nearly cut in half leaving millions of pain patients undertreated yet overdoses have risen which is greatest argument against hard limits on pain meds according to MMEs. I was stable and had been stable for about ten years and on a low dose of OxyContin with OxyCodone for breakthrough pain. The pain switches in my brain had been successfully turned off. As of 2016 I lost the OxyContin thanks to those guidelines that said a PCP physician couldn’t prescribe those. In 2018 I slipped fell and broke my T10 and compressed my T9. That was the second time I broke my back. In 2021 I was hit by car that knocked my vehicle 40-45 feet and my thigh got jammed into steering wheel I could not move that leg and had to be removed from my car by an EMT. Time doesn’t heal bodies over 65 very well if at all. For the last 6 years time and under treatment of pain was eroding the pain off switches in my brain the last two accidents in last four years accelerated that process. Like so many others I can’t function as I was once able to and spend most of a 24 hour day in bed because I don’t hurt and due to my Dr who is board certified in Internal Medicine but is described as my PCP if terrified of the State Medical Board and refuses to prescribe an ER pain med with and IR pain med for breakthrough pain. The 20mg Oxycodone I’m given of 4 a day I’m given do not last 3 hours much less six. This opioid hysteria is slowly killing me and millions of other seniors that want to be as pain free as possible and be able to spend quality time with our kids and grandkids before we are called home from this plane of existence. I will refuse all invasive surgeries that could help improve my quality of life or even save my life until the hard mme limits are abolished and the clause in most pain contracts that disallows any other Dr Dentist or surgeon to prescribe additional pain meds for acute post procedure pain is done away with. It’s said karma is a monster. I hope you understand there are millions like me suffering daily and get an idea of how much karma that is coming for you all in the future. Trust me when I tell you not in a million years did I see myself as I am today. It doesn’t take all that much to have to live in daily pain. So best of luck to you all at the CDC that has created this train wreck for cpps whom the vast majority of us are seniors. And who also have lowest overdose rate of any group. We aren’t taking drugs for a high we take them to alleviate the pain of illnesses and injuries that aging has on the body.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484fcd79a	Tubb	None	2022-03-17T18:06:06Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Tubb, Sandra	l0u-affp-0i1l	False	None	False	2022-04-12 04:19:08.868	[]
2605	CDC-2022-0024-2611	https://api.regulations.gov/v4/comments/CDC-2022-0024-2611	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/> Before prescribing an opioid, prescribers must document in the medical record <br/> that a conversation occurred with the patient (or guardian) about the risks of <br/> the opioid medication. <br/><br/> Prescribe Electronically and Proportionately: Use electronic prescription <br/> software that is compliant with federal and state confidentiality and security <br/> requirements. Only prescribe the amount of pain medicine reasonably <br/> expected to be needed. If you expect 3 days of severe pain prescribe only 3 <br/> days worth of medication. Acute Pain (< 5days) can often be managed without <br/> opioids.<br/><br/> Documentation of International Classification of Diseases (ICD) 10 Diagnosis <br/> Code(s) on Controlled Substance Prescriptions: State law requires prescribers <br/> to include ICD-10 diagnosis codes on any controlled substance prescriptions. <br/> Electronic Health Records (EHRs) can accommodate this documentation <br/> requirement; however, for cases when a clinician might not use an EHR, the ICD- <br/> 10 code must be entered on the prescription in a visible location for the <br/> pharmacist. The visibility of the ICD-10 code will enable pharmacists to <br/> appropriately counsel patients based on the prescriber’s diagnosis/diagnoses.<br/><br/> Monitor Your Patients Opioid Utilization: Use the Prescription Monitoring <br/> Program before each appointment. ENROLL LOGIN Positive Prescription Monitoring <br/> Reports should be reviewed with the patient. Additionally, it is important to <br/> conduct random urine drug screens as well as have patients bring back pill <br/> bottles to monitor supply remaining.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Evelyn	None	None	0900006484fcd7a3	Martin DNP	None	2022-03-17T18:09:29Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Martin DNP, Evelyn	l0u-afyx-2ecw	False	None	False	2022-04-12 04:19:09.120	[]
2606	CDC-2022-0024-2612	https://api.regulations.gov/v4/comments/CDC-2022-0024-2612	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I acknowledge the opioid crisis and agree it needed to be reigned in, but people who need it cannot get it now. I know someone who goes to the street to get what he needs. We need to on one hand watch carefully who we are giving prescriptions to and the reason, but on the other hand, people with chronic illnesses or in cancer treatment or have chronic pain (I fall into this category) must be able to have access to what we need to survive. Pain is debilitating. I don't take that much and actually I don't like how I feel on Norco, but I am suicidal when the pain is excruciating. I'm in therapy and would not do that, but its no life wishing you were dead because the pain wont stop. I am tired if being treated like an addict by doctors and it is frustrating when I cannot get what I need. My doctor understands but is VERY reluctant to give me an opioid prescription... not even Norco .. because he is afraid of the laws and a lawsuit. I only take it as needed but doctors do not trust their patients. Laws have to change and there needs to be support and management of our care. I have tried so many different kinds of non-opioid options, anti-inflammatory medications help but nothing works like Norco despite the side effects.<br/><br/>I recently had 2 knee replacements. They would not give me enough opioids to kill the pain and I was treated like an addict by several people. Management of opioids is ESSENTIAL. I had horrible pain and it was not necessary. In the end, I was given no guidance on how to ween myself off and had horrible withdrawal symptoms... also wanting to die but not because of pain because your whole body aches and feels "wrong" and you cannot crawl out of your skin. I needed help getting off. I did not get any and I made it through on my own, but it was horrific... and I wasn't even taking an extraordinary amount, just for a long period of time. I see how people get hooked and I see how they have to go to the streets to get it. I'm educated and in therapy but regular folks... they get addicted.<br/><br/>Something has got to change. Patients need to get what we need and get the proper support to help prevent addiction and manage withdrawal. <br/><br/>Thank you for your time.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484fcd84d	Wierus	None	2022-03-17T21:00:50Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Wierus, Debra	l0u-f6n8-9g5i	False	None	False	2022-04-12 04:19:09.331	[]
2607	CDC-2022-0024-2613	https://api.regulations.gov/v4/comments/CDC-2022-0024-2613	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. <br/><br/>The 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fcd867	Adamson	None	2022-03-17T21:02:09Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Adamson, Jennifer	l0u-fzsj-dk5s	False	None	False	2022-04-12 04:19:09.546	[]
2608	CDC-2022-0024-2614	https://api.regulations.gov/v4/comments/CDC-2022-0024-2614	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for 30 years .I have been on higher doses of opiates. That have kept me alive for my children grandchildren for years.. when I was cut off in.the past the pain was so bad I attempted suicide 3 times. I was no one. I was depressed crying and would no leave my home. My family went crazy with guilt and helpless to bring me back to me.. I wasn't dad I was a suffering fool.Then came my dr who I have been with 15 years who save my life for me and my whole loving family. I am stable now because of his care. We work together to conroll the evil pain problem.. 15 years I've done well.. what would I do without him...?? That is so scary and I think about it every day.. one day my dr.will be gone and I am sure that will be the end of my days with my loved ones.. My family knows that this will happen so do I. Just when we never know.. thank you for listening and I hope you or you family are in our situation. Prayer and go bless you.. Pa pa Batman. Aka [name redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anthony	None	None	0900006484fcde95	Strong	None	2022-03-17T21:04:48Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Strong, Anthony	l0u-hrwb-9sdc	False	None	False	2022-04-12 04:19:09.762	[]
2609	CDC-2022-0024-2615	https://api.regulations.gov/v4/comments/CDC-2022-0024-2615	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who was successfully treated with opioid pain medication when nothing else helped. I want any mention of MME amounts removed. That action alone will help millions of chronic pain patients currently suffering from forced tapering and total removal of life altering medication that gives those of us with no other alternative, a way to live a decent life. Without opioids our lives have suffered greatly. The majority of us that have had our medication reduced or withdrawn are now bedridden. We are unable to have any quality of life at all. <br/><br/>I have followed [name redacted] and his tireless advocating on behalf of all chronic pain patients. He has written and published many papers on the so called “opioid crisis”. Facts and statistics do not lie. They have proven that the individual chronic pain patients who are prescribed opioid pain medication are not the ones labeled as being addicted or dying from opioid use, it is the individuals that are buying off the streets that are getting illegal drugs laced with fentanyl. I believe in [name redacted] and suggest you all educate yourselves on the real facts, not those that are politically motivated. The pressure that has been put on doctors to stop prescribing opioids is unjust and unfair. Your persecution of doctors is unlawful and insane. The CDC wants to be able to oversee opioid products. This is already being done under the FDA and DEA. Clinicians that have the knowledge should be allowed to treat patients with life saving and life altering medication. People in chronic pain should be allowed to live without overwhelming misery.<br/><br/>Chronic pain patients have been suffering ever since the “Guidelines” have come out in 2016. The CDC should remove all guidelines and ant MME requirements going forth in the future. <br/><br/>I am advocating for myself and other immediate family members that are currently suffering from any type of chronic pain. I suffer failed back syndrome from 2 back surgeries. I also suffer from fibromyalgia, arthritis and many other conditions. I also suffer PTSD, chronic depression and anxiety resulting from the guidelines and the miserable existence I now have as a direct result of the lack of pain relief I am now given. I exist bedridden and with unrelenting excruciating pain 24 hours of every day thanks to the CDC. <br/><br/>Please consider [name redacted], with all of his research and publications as an advocate I am choosing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	SherriSherri	None	None	0900006484fcd8ab	Bradley	None	2022-03-17T21:08:37Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Bradley, SherriSherri	l0u-j7y8-3xpq	False	None	False	2022-04-12 04:19:10.017	[]
2610	CDC-2022-0024-2616	https://api.regulations.gov/v4/comments/CDC-2022-0024-2616	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dr [name redacted] had expertise in addiction medicine, not pain management. MME May be helpful treating addicts but it has no place in pain management. [name redacted] does not have training in<br/>Pain management. He told me himself. The regulations are harming pain patients. The guidelines are arbitrary and inappropriate. A doctor and her patient should be the only parties to proper treatment. Don’t punish pain patients. Don’t punish the doctors who treat us. Doctors for responsible opioid prescribing is a misnomer. There is nothing responsible about making pain patients suffer. The MME guidelines have no basis in science or good medical standards of practice. So called Pain management( more often (mismanagement because of the old and new guidelines). The new guidelines are worse than there old sure to three decreese in recommended MME from 90 to 50.<br/><br/>Pain management is the only specialty I have ever encountered in which we are getting recommendations to have invasive procedures ( injections etc) in favor of non invasive such as medicine. This is there only specialty where doctors aren’t trusted to determine appropriate dosage. <br/><br/>Pain patients who could manage before the regulations can’t anymore. Suicides are up in our community. We look for things like marrijuana and Kratom because we can’t get relief from what our docs are allowed to prescribe. I know these are guidelines only but some states made them law and doctors are afraid to deviate. They are worried that you will take away their licenses. This is not how medicine should be practiced. Some pain patients are forced to take illicit drugs because there is no other way to get relief. Some of us die because the safety of the supply is unreliable.<br/><br/>Addiction and Pain are completely different issues and they should not be lumped together. Drug makers do market aggressively. That is not illegal and not necessarily irresponsible. Heroin was originally marketed as not addicting and therefore safer than other pain meds. Lo and behold. OxyContin was marketed as a drug with extended release properties. What’s wrong with that? Several such drugs are on there market. Perdue Pharma was disappointed when docs and’s patients noticed that there formula lasted 8 hours not 13 as advertised. Before all the concern with the opioid epidemic there stumble solution was to prescribe 3 pills daily instead of 2.<br/><br/>Guidelines also recommend short acting over long. Long actually works better as there is less likely good that you will forget to take pills as they are needed to stay in top of these pain. The only problem with three long acting is that people abused them by crushing etc in order to get a high but these are not three pain patients. They are three addicts and pleasure seekers. Don’t punish pain patients.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Helen	None	None	0900006484fcdeb2	Smith	None	2022-03-17T21:16:30Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Helen	l0u-k9le-i1ii	False	None	False	2022-04-12 04:19:10.232	[]
2611	CDC-2022-0024-2617	https://api.regulations.gov/v4/comments/CDC-2022-0024-2617	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the 2016 opiate prescription guildlines (which doctors take as absolute LAW), has opiate use, abuse, or overdose deaths decreased? NO! They’ve risen! They reached their all time high TODAY, 6 years later.<br/><br/>Have pain patients been made to suffer far more? YES!<br/><br/>The problem of some bad apples should not impact the entire nation or dictate the policies that give us relief from pain. Acute or chronic. <br/><br/>Pain patients now are looked at by doctors as addicts first and to cover their own liability. Pharmacists do the same. Nobody wants to be in pain. Especially long term chronic pain. We have so many medications to help people but we are now restricting them and what’s the result? More suffering, still an Increasing opioid abuse epidemic but now from illegal opiates crossing our borders. Not the intention of the 2016 guildlines I’m sure. So now that you see how flawed they are please reverse them and instead spend the money and resources on education,<br/>And border security, and treatment for those wanting to come off the drugs. Don’t penalize patients, Doctors, pharmacists, dentists and their families! <br/><br/>It’s ridiculous to hold the entire population to the MME standard! Let doctors who are working in the trenches WORK! As if everyone’s body is the same. Last time I checked we were all different sizes, shapes, have different ethnical backgrounds, different metabolisms and response to every medication out there. So applying a point blank MME requirement (“guideline”) is just wrong and not well throught through. I do appreciate the intent but it’s done FAR more harm than protect the American people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doctor	None	None	0900006484fce161	Schulze	None	2022-03-17T21:18:13Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Schulze, Doctor	l0u-l98z-bno5	False	None	False	2022-04-12 04:19:10.448	[]
2612	CDC-2022-0024-2618	https://api.regulations.gov/v4/comments/CDC-2022-0024-2618	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi<br/>Please take out any mention of the mme. There is no evidence or scientific proof this is relevant to patients pain management. The amount of opiods are between the chronic pain patient and their pain management doctor.<br/>I’ve been in pain management for 13 yrs. I have MALS ,10 herniated discs ,complement deficiency,ulcerative colitis,stage 4 endometriosis and osteoarthritis. I suffer greatly . Had to stop working at 39 and go on ssdi.<br/><br/>My pain dr had me on 25.mg fentanyl and oxycodone for 5 years which helped. Intros my daily chronic pain .<br/>Well after the 2016 guidelines my dr took me off of the pain patch bc she was afraid of the drs and stated the 2016 guidelines made her have to take away. My fentanyl pain patch !<br/>Well I noticed immediately I couldn’t do much of anything as I did with the patch . Thank god I still had the oral pain pills but they only last a few hrs . So I am now bedridden 80 percent of each day . I am waiting on a hone health nurse to help take care of me. I’m only 50 years old .. <br/>if I had the appropriate paid medication I’d be able to take care of myself . <br/>Please underserved are people who live in chronic nonstop pain who need adequate pain medication.<br/>Please take the government out of the relationship and care between dr and patient!<br/>Get rid of the mme. It only makes drs not prescribe chronically ill pain patients adequate medication.<br/>Also understand people in chronic pain do not overdose on our opiod medication. We take them as prescribed BECAUSE WE ARE IN DAILY CHRONIC PAIN.<br/>please correct to the guidelines and be compassionate!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Danielle	None	None	0900006484fce16a	Strong	None	2022-03-17T21:20:16Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Strong, Danielle	l0u-ludl-c1p5	False	None	False	2022-04-12 04:19:10.660	[]
2613	CDC-2022-0024-2619	https://api.regulations.gov/v4/comments/CDC-2022-0024-2619	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2016 my bilateral surgeries for PERONEAL Decompression and Tarsal Tunnel - Failed and instead gave me Bilateral CRPS Type 2. MY SURGEON ABANDONED ME . DENIED crps AND SAID HE CURED ME AND TO EXPECT SOME PAIN AND GOODBYE. All Pain Clinics have refused to treat my pain with Opioids - CRPS treatments for PAIN Insist that Opioids be used immediately if all other methods of PAIN control FAIL.<br/>In almost 6 years NOT ONE physician was familiar with CRPS TYPE 2 AND I have Suffered FOR 2100 DAYS with Pain that prevents me from sleeping. CRPS is the Most Painful DISEASE EVER KNOWN TO HUMANS and is NICKNAMED THE suicide disease AS THERE ARE no treatments AVAILABLE. Insomnia is KILLING ME AND I HAVE BEEN TRYING FOR YEARS TO addressing Physicians to help ME WITH insomnia caused by PAIN.<br/>My opinion is that Physicians are afraid, prevented, and fear losing their MEDICAL LICENSE if they Prescribe Opioids - even though there is no law preventing them from treating me (CDC).<br/>I have been Diagnosed with intractable pain AND High Impact CHRONIC pain with COGENTIVE Impairment.<br/>CRPS CAUSES brain DAMAGE TO THE LIMBIC system and Insular Cortex. DAMAGED My ENTERIC system.<br/>I HAVE BEEN REFUSED TREATMENT at the ER, KICKED OUT of 2 Psychiatric Hospitals because They Do Not Treat Pain Patients. I know that I need an Opioid Trial to see if We can control my Insomnia in order to return me to Physical Therapy.<br/>EVIDENCE SHOWS I should have received treatment IMMEDIATELY IN 2016.<br/>Instead I have been abandoned by Pain CLINICS WHO REFUSE to treat me for Pain.<br/>I AM A Medication Seeker JUST FOR THE RIGHT to have my CRPS Treated PROPERLY.<br/>2100 days I lived in torture physically and MENTALLY. No Quality of Life.<br/>PLEASE CONSIDER CRPS FOR as ADDITION to CDC Policy FOR IMMEDIATE CARE.<br/>PLEASE HELP ME...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Craig	None	None	0900006484fce16d	Reynolds	None	2022-03-17T21:23:50Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Reynolds, Craig	l0u-lzk3-0jxd	False	None	False	2022-04-12 04:19:10.875	[]
2614	CDC-2022-0024-2620	https://api.regulations.gov/v4/comments/CDC-2022-0024-2620	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dr.s have been prescribing pain medication for 100yrs. Now chronic pain patients are being treated like they're nothing but, drug addicts which is unreasonable and so many Dr.s now so afraid they will lose thier license to practice if they prescribe them at all period.. Those Dr.s have forsaken thier patients because of how the media portrays the opioid crisis which in my opinion all have negative connotations towards even prescribing the new lower doses even when thier patient tells them they're suffering more due to the negativity towards pain meds. The Dr.at O.H.S.U. should not write the guidelines since he is getting grant money for his research which is absolutely a conflict of interest. It's time Dr.s used thier common sense and give thier patients lives back so they can at least function again and try to lead thier lives in less pain. It's cruel and unusual punishment perpetrated upon chronic pain patients by the low dose guidelines. One word would be TOTURE. TORTURE THAT NEVER ENDS	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcdec9	Anonymous	None	2022-03-17T21:25:11Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-n8zx-thnn	False	None	False	2022-04-12 04:19:11.098	[]
2615	CDC-2022-0024-2621	https://api.regulations.gov/v4/comments/CDC-2022-0024-2621	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	MY HARM STORY <br/><br/>The CDC caused significant harm to me with their 2016 guidelines. Due to space limitations I am attaching that story. <br/><br/>OVERALL IMPRESSION OF GUIDELINES <br/>As I review the 2022 guidelines, I am concerned that the same types of harm could occur to me again. They have many of the same pitfalls as the 2016 guidelines. I’ve outlined just some of my concerns below. I have many, many others but have to limit how much I can write given that sitting at a computer flares my pain. <br/>Personally, I think the CDC should shred the guidelines and a different group should be charged with developing them from scratch – ideally academies or associations of practicing clinicians in various medical specialties with no conflicts of interest. The CDC has had two chances now to get this right and in my opinion has failed miserably both times with significant harm to chronic pain patients. <br/>I bring up the conflict of interest point because one of the authors of the updated guidelines, Dr. [name redacted], has a significant conflict of interest. This is sufficient enough information that the process to develop the guidelines should be considered corrupt and the output biased and Dr. [name redacted] should not be allowed to vote on any matter relating to these guidelines. <br/>DOSE THRESHOLDS AND DURATION LIMITS <br/><br/>I strongly recommend that all references to dose thresholds and duration limits should be removed from the guideline document. The phrase MME needs to be removed from the document in its entirety. I agree with the workgroup members that felt that specific opioid doses or durations would be misapplied as absolute cutoffs or thresholds for policies or practices. <br/>History has already proven this to be true based on the following examples: <br/>•<span style='padding-left: 30px'></span>States passed laws that placed hard limits on prescription opioid dose and/or duration<br/>•<span style='padding-left: 30px'></span>Insurers set policies limiting the dose/duration of opioids they will pay for<br/>•<span style='padding-left: 30px'></span>Some doctors force tapered chronic pain patients below the MME threshold levels noted in the 2016 guidelines <br/>•<span style='padding-left: 30px'></span>Many pharmacies have refused to fill prescriptions above a certain MME. There is a class action lawsuit underway against Walgreens, CVS, and Walmart. <br/>•<span style='padding-left: 30px'></span>NCQA added a metric that penalizes providers for prescribing patients 90 MME or higher. These quality metrics can impact provider salaries, networks, and publicly available quality reports.<br/>All references to dose thresholds and duration numbers MUST be removed from the guidelines. They are not well supported in any of the scientific literature and have clearly harmed patients. Furthermore, the CDC must find a way to get duration and dose limits removed from laws, quality metrics, pay for performance programs, insurance limits, and pharmacy policies. These limits were the direct result of the 2016 guidelines. The CDC owes it to the citizens of the United States to fix the damage they have done. Simply updating the flawed guidelines is not enough. <br/><br/>LOW QUALITY OF EVIDENCE <br/>I am also concerned about the low quality of evidence for many of the recommendations. For example the first recommendation pushes non-opiod treatments but it is type 3 evidence defined as observational studies or randomized clinical trials with notable limitations. The third recommendation tells clinicians to prescribe immediate release opiods instead of extended release opiods yet it has the lowest level of evidence. Extended release opiods are an important part of my chronic pain toolbox and I think it should be up to my doctor whether to use immediate release and/or extended release opiods. Not to the CDC which notes level 4 evidence that are noted to have several major limitations. Recommendation 5 – which could result in stable patients being tapered from their meds – also has the lowest level of evidence. If you continue looking through Box 1 you’ll see that most of them have low quality recommendations. Do we really want to risk people’s quality of life based on low quality research? <br/><br/>CONCLUSION<br/>I hope that you take to heart my concerns as well as the concerns of many of my colleague such as [name redacted], PhD whose comments I endorse. I recognize that multiple groups of people spent hours of their lives trying to make these guidelines better. But unfortunately they did not succeed and the draft guidelines as they are written today will harm many chronic pain patients. Their quality of life will diminish significantly if these are implemented and we will see some commit suicide. You have the power now to stop this from occurring. Please get rid of the 2016 guidelines and do not approve the revised guidelines. <br/><br/>Thank you,<br/>[name redacted]<br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anna	None	None	0900006484fcdeca	Phelsp	None	2022-03-17T21:33:39Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Phelsp, Anna	l0u-n6s3-425o	False	None	False	2022-04-12 04:19:11.309	[]
2616	CDC-2022-0024-2622	https://api.regulations.gov/v4/comments/CDC-2022-0024-2622	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove any mention of MME with reference to chronic pain patients as it is armpit not passing any scientific logic. The damage caused by the writing of these fatally flawed Guidelines is doing severe harm to CPPs! The AMA letter which sets forth many resolutions should be considered in your clinical guidelines as over 50% Of medical Drs. believe in retraction due to the amount of suicides and harm done to people in pain who require opioids for quality of life! I would suggest that ANY GUIDELINES AT ALL exempt legacy patients in totality! Let a pain management Dr. diagnosis and treat without fear of the DEA! Tell the DEA to stand down and stop arresting pain management Drs. for this unsupported law of ‘overprescribing’. We are at an all time low in prescribing yet the ODs continue to increase. The opioid crisis is patients not receiving thier meds! The CDCs own data supports this fact! Then attempting to obtain ur medication we are face with pharmacists practicing medicine. Stop pharmacists from interference in diagnosis and treatment they are violating our HIPPA rights tel them to fill the prescription without question bc there are no viable and working alternatives. Further, stop allowing individuals with COIto be part of the peer group writing clinical treatment as they have a vested interest in addiction and are therefore using PROP, Shatterroof ideology! There is amply no correlation between describing and ODs! This is admitted in your own data. Let the FDA handle this as pain IS NOT in your purview, it is NOT a contagious disease nor a psychiatric issue unless you possess the addiction gene so we must allow Drs. to treat pain adequately without fear of retribution! Lastly, free the jailed Drs charged with overprescribing based on the draconian laws of [name redacted]'s war on drugs. Tell the DEA and JOD to go after the illicit fentanyl crisis, and to stay out of our Drs. Offices. I have lost several years of quality of life due to being force tapered causing significant destabilization physically and emotionally. Without my needed medication l am bedridden and unable to see my grandchildren and participate in society. With my pain medication l am able to participate in life. Please stop insinuating Drs. Must maintain s certain level bc metabolism in each individual is different. We are not a one size fits all individual and each individual is different. Please retract the Guideines in thier entirety and form a balanced error group with Physicians, CPPs and advocates. This is governmental genocide and malfease and it must stop now before more harm is done.<br/>I reinforceand support the comments of [name redacted] which largely represent and support my opinions and are supported by science.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fce196	Anonymous	None	2022-03-17T21:37:54Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-rdcz-lp5q	False	None	False	2022-04-12 04:19:11.536	[]
2617	CDC-2022-0024-2623	https://api.regulations.gov/v4/comments/CDC-2022-0024-2623	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The opioid guidelines are based on selective research that serves its others purpose to control the narrative of opioid reduction based on their personal opinions. They are strangers in your doctors office dictating medical treatment for disease they know nothing about.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcdf1f	Anonymous	None	2022-03-17T21:38:47Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-x7r8-pac3	False	None	False	2022-04-12 04:19:11.748	[]
2618	CDC-2022-0024-2624	https://api.regulations.gov/v4/comments/CDC-2022-0024-2624	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Pain Management Specialist practicing for 22 years, I have come across many unfortunate patients suffering from chronic pain. Non-opioid treatment options are limited but necessary in helping these patients live a comfortable life. Acupuncture treatments and MLS Laser Therapy are two options that I have found to be very helpful in helping people stay independent and reduce or eliminate need for opioids. These treatments are helpful for numerous types of pain issues including arthritis that can be debilitating. They have helped my elderly patients especially who live alone and improves their quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Meeru	None	None	0900006484fce751	Sathi-Welsch	None	2022-03-17T21:39:28Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Sathi-Welsch, Meeru	l0u-zhvw-7je9	False	None	False	2022-04-12 04:19:11.960	[]
2619	CDC-2022-0024-2625	https://api.regulations.gov/v4/comments/CDC-2022-0024-2625	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	So many suicides from people in chronic pain and doctors refusing to prescribe opiate medications that are, and have been effective. Too many people now considering suicide as their only way out. This can't be what your goal was. WAS IT. BECAUSE THIS CURRENTLY IS, WHAT YOUR GUIDELINES HAVE DONE. All while supporting anti opioid doctors and their questionable research, WITH MILLIONS OF DOLLARS IN GRANTS. All while people hold on waiting for your help. YOU NOW HAVE YOUR ONE OPPORTUNITY TO HELP, AND MAKE DOCTORS ABLE AGAIN TO HELP PEOPLE IN PAIN, OR ... LOSE THE LAST BIT OF CREDIBILITY AND FAITH, THAT HUMANS HAVE IN YOUR AGENCY. SO MAKE THIS RIGHT. YOU HAVE A LOT OF DAMAGE TO CLEAN UP.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fce778	Anonymous	None	2022-03-17T21:40:43Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-01t7-nvpr	False	None	False	2022-04-12 04:19:12.171	[]
2620	CDC-2022-0024-2626	https://api.regulations.gov/v4/comments/CDC-2022-0024-2626	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think you people have done enough damage & think you best let physicians & patients decide what sort of pain care is appropriate on a case by case-individualized basis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fce7ee	Anonymous	None	2022-03-17T21:41:06Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-0rwe-fzvl	False	None	False	2022-04-12 04:19:12.381	[]
2621	CDC-2022-0024-2627	https://api.regulations.gov/v4/comments/CDC-2022-0024-2627	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Making the post op surgical patient feel like a drug addict is cruel. Having just had a left total knee replacement 1 week ago, I know the importance of pain management especially prior to physical therapy. Some common sense needs to be utilized. If a person has just had a procedure where the bones were cut, narcotics are needed. Conversely, if a person has chronic pain from a chronic condition, narcotics are not a long term solution. Please use common sense. Patients have enough to deal with after surgery, they shouldn’t have to worry about running out of pain pills. If I had taken my pills as prescribed ( 1 or 2 tabs every 6 hours, dispensed 40), I would have run out of meds in 5 days. Not even enough to last until my first scheduled therapy session. I had to call the MD office, request an additional prescription and then have my husband drive the 15 miles to my surgeon s office to pick up the paper prescription. Because of course narcotics can no longer be sent via electronic prescription methods in WI. Ridiculous. Let the surgeon order what is appropriate. Let the office and pharmacy to communicate electronically.(electronic seems much more secure than the paper prescription. Was this done to make it more inconvenient to the patient? Stop treating everyone as a potential addiction, aside allow the MDs to make their own determination. Lastly, making patients go to a pain management office is an additional financial burden many of us can’t afford. In your attempts to manage the opiate crisis, you over-corrected and forgot what should be the primary factor- good patient care. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fce7fe	Tieman	None	2022-03-17T21:43:55Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Tieman , Jennifer	l0v-12zp-olsw	False	None	False	2022-04-12 04:19:12.596	[]
2622	CDC-2022-0024-2628	https://api.regulations.gov/v4/comments/CDC-2022-0024-2628	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello;<br/><br/>I am writing about the Revised CDC Non-Opiods guidelines. These guidelines have impacted ny whole life. I have constant sharp, and sometimes achy pain. I have difficulty walking, doing daily errands, and have no pleasures in life, because of the excruciating pain.<br/>I recommend suspending the CDC 2020 guidelines immediately. There are over 11 million chronic pain patients in the USA. These guidelines are being used to torture, and make patients suffer. The doctors are so afraid they will get some to prison, they do not do their jobs.<br/>Please, please re-clsssify opiods separate from fenranyl, and Marijuana<br/>Our military veterans are taking the blunt of no opiod prescriptions.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Whitaker	None	None	0900006484fce800	Diane	None	2022-03-17T21:44:57Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Diane, Whitaker	l0v-16t5-6rvy	False	None	False	2022-04-12 04:19:12.813	[]
2623	CDC-2022-0024-2629	https://api.regulations.gov/v4/comments/CDC-2022-0024-2629	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have MS that causes nerve pain in my arm. I have jumped through every hoop my Dr's told me to. Saw countless specialists. Spent Money I didn't have, only to be left surffering. Denied by 3 pain management centers because I wasn't a candidate for steroid injections. Anytime I saw my PCP or Neurologist and asked for help with the pain, I was made to fill like a drug seeker. I was always told "I don't prescribe narcotics". I responded with, I'm not asking for narcotics, I just need help with my pain. I was left to suffer in pain. I could not work for several months. My Dr finally found a non narcotic med to help with my pain. I have PTSD and don't even want to go to the Dr anymore for anything. I was treated horribly by no less than 10 specialists. No one seemed to care. I have days where my pain is worse. I'm afraid of when my current meds stop working. What will I do. Dr's are afraid to prescribe narcotic and just leave their patients suffering. This has to stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanell	None	None	0900006484fce90c	Abell	None	2022-03-17T21:45:58Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Abell, Jeanell	l0v-3gcp-81tw	False	None	False	2022-04-12 04:19:13.040	[]
2624	CDC-2022-0024-2630	https://api.regulations.gov/v4/comments/CDC-2022-0024-2630	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 70, female and one who has experienced pain...lots of it, due to excessive exercising and time in the gym. I now endure ongoing distress from a failed shoulder surgery. We're I to go through my life these days without narcotics, I would be depressed, sleepless and miserable. I am on Percocet 10mgs 4 times a day. This dosage helps keep me somewhat comfortable...I can live my life! I am extremely careful with my med at this stage of my life. Please be very aware....many seniors are in pain simply from life. Kindly help them instead of adding to their problems.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Meredith	None	None	0900006484fce9f0	Brittain	None	2022-03-17T21:50:11Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Brittain, Meredith	l0v-55zk-yov6	False	None	False	2022-04-12 04:19:13.254	[]
2625	CDC-2022-0024-2631	https://api.regulations.gov/v4/comments/CDC-2022-0024-2631	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	https://www.federalregister.gov/documents/2021/12/02/2021-26227/established-aggregate-production-quotas-for-schedule-i-and-ii-controlled-substances-and-assessment<br/><br/>The DEA and FDA NEVER SET STRICT MME requirements on the American people, If you read the federal register from 12/02/21. <br/><br/>Prescribing Hesitancy<br/><br/>Issue:<br/><br/>Many commenters, most of whom self-identified as chronic pain patients, expressed general concerns that the <br/><br/>CDC Guidelines for Prescribing Opioids for Chronic Pain,<br/><br/>issued in 2016, are preventing doctors from prescribing pain medication in dosages that adequately control chronic pain, forcing them to taper opioid medication dosages inappropriately, and causing them to refuse to prescribe opioid prescriptions to chronic pain patients. These comments also raised concerns that some health insurers have mandated that opioid medication dosages be tapered for continued insurance coverage or have denied coverage for prescriptions from out-of-network providers. Commenters noted that worker's compensation insurers have denied opioid medication coverage for pain patients. One commenter raised concerns that chronic pain patients are not allowed to self-pay for opioid medications.<br/><br/>DEA Response:<br/><br/>Provided that the prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice, neither the CSA nor DEA regulations impose a specific minimum or maximum limit on the amount of medication that may be prescribed on a single prescription, or limit the duration of treatment intended with a prescribed controlled substance. DEA has consistently emphasized and supported the authority of individual practitioners under the CSA to administer, dispense, and prescribe controlled substances for the legitimate treatment of pain within acceptable medical standards, as outlined in DEA's policy statement published in the <br/><br/>Federal Register<br/><br/>on September 6, 2006, titled Dispensing Controlled Substances for the Treatment of Pain. 71 FR 52716.<br/><br/>Please advise whom, what entity has caused this to be a problem in the year 2022? Is it in fact the CDC? Health and Human Services? Whom and for what reason are people in Chronic Pain having their medications lowered to nontherapeutic levels? What entity has been the main cause of harming actual chronic pain patients, what entity inserted itself in the Healthcare of the General public and has caused health insurances to not cover medications at therapeutic levels, to decrease medications to non therapeutic levels, to cause an overall detriment to people with chronic intractable physical degenerative disease state. The FEDERAL LAW is as follows above. So by what authority do any other agency have to cause such discrimination in the health care community. The DEA has and does its job finding physicians that abuse patients on all levels of harm, be it pillmilling - over prescribing opioids for no physical ailment, or drillmilling - harming patients by threatening to remove their opioid therapy unless they receive an unnecessary and not helpful steroid shot multiple times which makes them extra money through insurance or extra pay but does not benefit the patient. I sincerely pray that the DEA take on the entity that has acted on their behalf, made a mockery of the DEA and FDA. Not only has the healthcare system been made a mockery of, the judiciary system has been blamed for the suffering of American peoples with disabilities, the chronically ill, the cancer patients, the elderly, and the veterans. All have been treated as less than human because of their physical deterioration, chronic disease state, and the need for the adequate pain care which is provided by opioid therapy. The physicians are stating CDC and DEA have come for them in regard to prescribing or continually holding prescriptions for the medically infirmed. I see it is not the FDA, it is not the DEA, the CDC has acted as DEA and judiciary law over physicians de facto. It is never, has never, been the Center for Disease Controls right to act as a department of justice over health. The CDC exists for the sole purpose of public health regarding infectious disease. Had they did the job they are just intended to do, and stop trying to play police in order to drum up money from the government for drug policy which is the DEA actual position. The Covid 19 pandemic might have been different. The DEA can utilize the money from the government to control a drug problem more so than that of a Center for Disease Control which fumbled a pandemic due to easy money from government over an opioid epidemic. The actual numbers do not lie. Chronic pain patients are not overdosing on their medicine. Illegal drugs are pouring into our United States. STOP ALLOWING THE CDC TO TAKE THE DEA AND FDA MONEY. They are obviously incapable of handling what they are meant to do, CONTROL DISEASE. Eliminate this agency, and the quack [name redacted] that fed it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcea34	Anonymous	None	2022-03-17T21:57:43Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-5qbj-hqzy	False	None	False	2022-04-12 04:19:13.467	[]
2626	CDC-2022-0024-2632	https://api.regulations.gov/v4/comments/CDC-2022-0024-2632	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an interventional pain management physician on the front lines of the war against pain (and also the war against opioids), I cannot express enough how encouraged I am to see that non-invasive low level laser therapy is being considered as an addition to the pain treatment algorithm.<br/><br/>I have witnessed the profound anti-inflammatory effects that laser therapy can have on both acute and chronic pain syndromes of all types, including chronic spinal pain --- one of the chief reasons patient are (erroneously) placed on opioids, to this day!<br/><br/>I am also and enthusiastic user ablation therapy for treatment of my own musculoskeletal aches and pains. Many times, when I have had a shoulder or a knee condition that would have the past required a steroid injection, I have been able to mitigate--- an in many cases completely eliminate --- symptoms solely by using laser therapy.<br/><br/>Laser therapy is both clinically effective and cost effective. Although it is not currently covered by most insurance policies, we are able to provide treatments to most, if not all of our patients at a reasonable cost, and many times provide laser treatments completely free of charge when patients are unable to afford this valuable therapy.<br/><br/>Unlike many medical procedures and medications, laser therapy has very few if any risks. Of course precautions must need to be taken to ensure the patient's safety prior to and during treatment, but the learning curve for providers with laser therapy is very steep and most clinics can be up and running with a laser device within days of institution of the device.<br/><br/>I would be very pleased to see that laser therapy was included in the permanent updates for guidelines for treatment of pain. I'll be happy to speak with anyone who has any interest in discussing these matters further.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fcea79	Knab	None	2022-03-17T21:59:47Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Knab, John	l0v-6a8j-qcu2	False	None	False	2022-04-12 04:19:13.694	[]
2627	CDC-2022-0024-2633	https://api.regulations.gov/v4/comments/CDC-2022-0024-2633	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	12 point comment for the 12 guidelines<br/><br/>1. Opioids are a medically necessary treatment for pain. We don’t have any scientifically proven replacements for opioid medications. Rather than tossing aside some of the most powerful medications we have for managing severe pain, we should focus on defining the optimal use of these drugs and realize that taking away prescriptions will not solve our overdose crisis.<br/>2. The CDC must demand the suspension of all State laws, rules, regulation, legislation based on the original guidelines. Stop arresting doctors who know much more about treating pain than the CDC, DOJ and DEA. Stop criminalizing prescription drugs and prescribers.<br/>3. Recommendations for opioid prescribing for treating pain should be put together by a Core Expert Group of professionals which include patient advocates, anesthesiologists and expert physicians with successful opioid prescribing experiences. Psychologists and addiction specialists do not have the expertise to recommend pain treatments and are biased against opioid prescribing. PROP supporters are physicians with an extreme bias against opioid prescribing.<br/>4. The CDC must take ownership of its role if the overdose/opioid/pain management crisis and raise awareness of the true causes. Include information about how overdose deaths are NOT mainly from prescriptions or diversion. The data clearly shows that a majority of overdose pe deaths are caused by illicit dregs, primarily those laced with powerful, illegally manufactured fentany derivatives.<br/>5. Remove all mention of MMEs which are not based on solid scientific evidence. Opioid doses should be based on individual patient needs, NOT arbitrary MMEs. Any reference to MME can easily be used for the mandates of legislators, law enforcement and insurance agencies.<br/>6. To balance the revision and change the direction of physicians, government officials and insurance agencies who continue to misapply the guidelines, the benefits of opioids in healthcare should be clarified on every page where risk warnings appear: Prescription opioids relieve the most severe pain where other methods often fail. They provide comfort and prevent the absolute agony of severe pain. They give chronic pain patients functional improvement, quality of life and a break from the everyday pain and agony they have to endure. By lowering the extreme stress of having severe pain, opioids can reduce the incidence of pain related cardiovascular and adrenal problems, chronic pain, long term disability and death. This is proven by scientific evidence.<br/>7. Exclude the 20 million plus patients with severe intractable chronic pain conditions from CDC’s recommendations against using opioids for pain. Exclude ER, post surgical, or other severe acute non-cancer pain for for people with incurable degenerative, chronic, intractable, high impact painful diseases!<br/>8. Warn against under treating pain, which can lead to the development of chronic pain, cardiovascular adrenal issues, disability and death. Warnings against under treatment should be on every page where the risks of over treatment appear in the guidelines.<br/>9. More clarification is needed regarding the degrees of pain on a scale from 1-10 which might require opioids analgesia. There are certainly risks involved with not evaluating and treating the degree of pain a patient is having, especially when severe, high impact pain is not treated effectively.<br/>10. Guidelines warning against risky opioid prescribing are unnecessary for pain management specialists, ER doctors, surgeons... Prescribing guidelines should be only for GPs, NOT specialists.<br/>11. Include information about the low instance of abuse and OUD among chronic pain and acute care patioents. <br/>12. Repair and improve doctor/patient relationships by make opioid contracts, urinary screens, pill counts completely voluntary. Patients are not addicts and shouldn’t be forced into unnecessary and expensive addiction testing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fcea80	Fimrite	None	2022-03-17T22:04:01Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l0v-6c33-bw5x	False	None	False	2022-04-12 04:19:13.911	[]
2628	CDC-2022-0024-2634	https://api.regulations.gov/v4/comments/CDC-2022-0024-2634	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. I want to briefly share with you my story. I am fighting for my life every single day. It’s getting to where I can no longer fight & it is so frustrating when what is going on is completely avoidable. <br/>I am a 42 year old mom of two. I’ve struggled with many painful medical conditions since I was 18 years old. One painful condition that I have struggled with is endometriosis. It got so bad that I had to have a complete hysterectomy at age 22. That completely changed my life. I continued to have pain and other issues. Fortunately I had a caring doctor that prescribed opioid pain medication. I was able to work full time, (despite undergoing 15 surgeries for this condition) provide for my family, take care of my home, garden, spend time with my family, and enjoy my life. I was a productive person. I was a good mom. <br/>As I have gotten older I have developed lupus & multiple autoimmune diseases. My pain medication was discontinued in 2016. I never abused the medication. I was just informed that they were “no longer allowed to prescribe it.” <br/>I had to go to part time work. I became a single mom. I found a PCP that was willing to prescribe three Tylenol 3 a day. Things were improving. I found a job close to home and worked full time. I was regaining my life. I did everything that I was supposed to do. Unfortunately the PCP was purchased by a hospital system that frowns on the use of opioid pain medication so they discontinued it. <br/>I have had to go on disability. I am in bed 22 hours a day. I have gained weight. I have developed diabetes. I have high blood pressure and have been told that I am at a very high risk of developing coronary heart disease. At 42 I feel as if my life is over. <br/>This is unacceptable. We need these medications to live our lives. To care for our families. To spend time with our friends. We aren’t criminals. We are people trying to make it through each day. <br/>Please remove these cruel guidelines. Allow patients to get their medications. Teach doctors, especially the new ones, that opioid pain medications are NOT bad. Remove the MME restrictions. Remove the limits on how long a patient can receive them. Remove the stigma attached to opioid medication.<br/>I wish that my doctor would allow me to use opioid pain medication for six months. I can guarantee that so many of my current conditions would improve. Doctors should be allowed to see what positive changes a patient can make while using these medications. They shouldn’t be afraid of losing their licenses and getting into trouble for helping their patients. <br/>Thank you for your time and for reading this. Please help us. Please help those of us that want to live long and fulfilling lives. Patients are dying because of these guidelines. It’s time to make a very real, very positive change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angie	None	None	0900006484fcea97	Blevins	None	2022-03-17T22:06:48Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Blevins, Angie	l0v-6qfa-xzyl	False	None	False	2022-04-12 04:19:14.143	[]
2629	CDC-2022-0024-2635	https://api.regulations.gov/v4/comments/CDC-2022-0024-2635	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If your plan was to drive people off the deep end, use physical pain as a form to torture to drive them to commit suicide, turn to the deadly illegal street drugs and die. Get everyone to believe that all pain is a mental issue. Hire Hiter style "Shrink" to push half truth to create more depression and drive people to commit suicide, turn to the deadly illegal drugs that are created and supported by the gov, get in trouble and die. Then all I can say is CONGRATULATIONS, your plan is working.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	dianna	None	None	0900006484fceabd	dixon	None	2022-03-17T22:07:26Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from dixon, dianna	l0v-71c7-u5uz	False	None	False	2022-04-12 04:19:14.356	[]
2630	CDC-2022-0024-2636	https://api.regulations.gov/v4/comments/CDC-2022-0024-2636	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Every single day I fight to push myself to do more or get done what needs to be done, usually ends in a flare up but if I have the medication that helps me get these things done then it helps reduce flare ups & extra pain from pushing my body over its limits. Chronic Pain robs us of nero chemistry, pleasure chemicals like serotonin & increases stress hormones. Chronic pain patients are left physically dependant on pain meds. The pain were in is the biggest risk of suicide not addiction. <br/>It's time to end the stigma surrounding pain meds, chronic pain patients have the right to treatment just as every other patient does. <br/>The opioid epidemic is on the streets its not rx opioid chronic pain patients. <br/> Everyday there is pain. It's not like we turn it on & off. We have no control & so many things trigger more pain like stress. <br/>For example now my fingers are numb trying to type this but I'm gonna continue as I have to fight ever day to do things that most ppl take for granted. <br/>I have done every therapy, hundreds of medications & injections, proceedures that have caused more damage to my body because they weren't done properly, for the last 22 years so I know what works for my body & what don't. <br/>I've lost alot of parenting moments w/ my children & now Grandchildren. My fiance is thankfully understanding & see's how much I have to struggle daily just to get through a day w/ minimal medication pain relief. As I was tappered down last year & its caused alot of extra issues & stressors on my body. <br/>I don't have a social life either so literally I'm lucky to get done what needs to be done daily & alot of the time I have to over do it & that puts me in a flare up for days to some times weeks. I'm always having to choose between priority over what I'd like to do. <br/>I use the spoon therory & you only get 12 spoons a day, everyrhing you do is a spoon. Sometimes taking a shower takes 2 spoons as showers are very exhausting to someone w/ chronic pain. Please Google spoon theory. <br/>I didn't ask for this pain & I didn't deserve this pain from a work injury in 2000 but I do deserve some quality of life. <br/>When I take walks (which I love nature) or try to do simple stretches or over do cleaning, making wkly meals or simply driving too long , it can put me into a intense flare up & extra pain. If I don't move enough it can do the same. Finding the right amount is nearly impossible. Now I also have to put in affect the weather, the storms, wind (worse for me) stress of life & fight or flight that I constantly live in. <br/>The limited medication I do get is helpful enough for me to get some things done, some days are better then others (rarely) most days are a huge struggle & I feel blessed I have a home to clean, family to care for & im alive but most days barely alive. I'm just living, not barely functioning as I would wish.i want to do more, I want to help others & teach gardening or help teens find themselves as w/ c19 our teen/kids are suffering so much. The affects this has put on the world is huge as suicide is at its highest. As is the chronic pain community if you haven't seen those numbers you should look. <br/>All of our lives matter & putting wrong terms & control on anyone is unacceptable. <br/>Chronic pain patients have suffered for so long now & being discriminated against, being judged & red flagged for just trying to live day to day. <br/>Some of you should try to come hang with us chronic pain patients for a day or 5 & personally witness how we have to live. It would be very eye opening to you all. <br/>Also imagine your loved one or yourself having to fight every single day of your life. Deal with the medical trauma & stigma that we have & also be ignored by medical professionals that took an oath then be called fat, lazy, liars & that there is no way your pain can be that high, it's impossible. We can't even give accurate pain levels as the usual pain chart reads cause we exceed that chart. Look at the McGill pain chart that will give you a better idea of our pain levels. <br/>Just know pain don't discriminate, it can happen to anyone. <br/>Thank you for taking the time to read this if you did & please know we're fighters & will help others before ourselves because we know how deep the pain goes & the toll it takes on chronic pain patients. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fceb0d	Anonymous	None	2022-03-17T22:17:14Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-899w-vl0j	False	None	False	2022-04-12 04:19:14.568	[]
2631	CDC-2022-0024-2637	https://api.regulations.gov/v4/comments/CDC-2022-0024-2637	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for taking our comments. Since the 2016 guidelines were introduced I have been forced rapidly tapered twice which has led me to a nonfunctioning very poor quality of life. Due to the rapid tapers, I was forced to the ER multiple times. This was a mistake, I did not think I would be labeled stigmatized and SCREAMED at by doctors. In an effort to cover their butts with rapid tapers an OUD is placed in the record without any reason but to get the patient down to the 90MME. These docs looked at the NUMBER of the MME and panicked abandoning patients. Or rapidly taper the medications. I don't recognize myself. I am surviving not living. I have been tortured. the high levels of pain and the steroid injections have caused my body to RAPIDLY deteriorate. Due to not getting proper pain relief after surgery, I haven't received the life-saving surgery for my crumbling neck. I am now passed the point of reconstruction for my neck. My spine will not hold up to hardware. I am risking stroke and paralysis. Please allow me to live in as little pain as possible. I don't understand how AMERICA can do this to a human being. I need to have the proper dosage of opiates so I can function with simple everyday tasks for as long as I can hold out. Physicians are very upset their hands are tied and can not help their patients. Again the MME of 90 and now you want to change it to 50. My physician has already quoted 50MME I will die. I suppose you want to kill off the patients who have SURVIVED the 2016 genocide. I don't believe for a second the ODs are from pain medicine. I have lost 7 yrs due to this nonsense that is supposed to be for the greater good. I have multiple diagnoses that cause pain throughout my body including abdominal pain from surgery. I have been offered so many steroid injections knowing they are eating my body and are responsible for the rapid deterioration. I was introduced to the injection factories in 2010. I thought GREAT I will no longer need to take medicine. NO, not only did I receive 3 misplaced injections rupturing cyst but I was dismissed abandoned when I complained. Pain patients are treated as criminals. The interrogation using lightning round gotcha questions that I have been a victim of. I am in pain I'm not a drug addict. Many pain patients have rolled the dice and have gone to the street. It's a desperate move they don't want to commit suicide although its a possibility so they take the chance. The pain is too much to handle. Lying in bed with excruciating pain in your brain is torture. With hospitals adopting NO meds in the ER and sending patients home after day surgery with NO pain relief is human rights abuse. I think your guideline will kill more human beings. I believe since the guideline was released suicide has gone up in pain patients alone by 470% this is your doing! This country has taken a stance against all that worked and is good for its citizens. WHY? Please take the MME out of the guideline and adopt a plan for those who have wrongly been stigmatized as having OUD due to panicked doctors. Doctors who tell you I'm not losing my license. Buprenorphine does not help a patient in serious pain. Especially a legacy patient who was taking high-dose opiates. it will kill me. Why should we be labeled for your mistakes that panicked a country? Patients are desperate! the zoom call on 7/16/21 should have spelled it out. 2 hours listening to SUICIDE Plans in which families have adopted with their children. SHAME ON YOU!!!<br/>Please lift the Hard Limit and allow doctors to prescribe the proper dosage. DEA has weaponized these guidelines. States have weaponized these guidelines. WE already see in articles from State AGs quoting 50MME. Please stop the madness that CDC has created.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fceb61	Anonymous	None	2022-03-17T22:21:38Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-8w25-orwu	False	None	False	2022-04-12 04:19:14.792	[]
2632	CDC-2022-0024-2638	https://api.regulations.gov/v4/comments/CDC-2022-0024-2638	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sadly the ‘changes’ will only allow further suffering for millions of chronic pain patients. The overdose rates will not diminish. On the contrary it might rise. I’m a former police officer and have experienced the flow of street drugs. Can you offer a statistical analysis of ODs among pain patients vs illegal street use? I’m certain the results will show minimal events from CPPs vs drug addicts. Of course any OD is tragic. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006484fcf544	Thomas	None	2022-03-17T22:22:16Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Cynthia	l0v-a9qe-xdn0	False	None	False	2022-04-12 04:19:15.004	[]
2633	CDC-2022-0024-2639	https://api.regulations.gov/v4/comments/CDC-2022-0024-2639	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have treated PTSD patients for 15 years. Many, if not most, have suffered significant injury in service to their nation and community, and have subsequently been grievously harmed by the medical system — providers who did not sufficiently communicate or treat them, providers who lied about their outcome, providers who have lied in their records.<br/><br/>Most traumatic injuries are life-long and will not be resolved with time or further surgical intervention. The only way to restore any quality of life is through analgesic intervention. I will not teach my clients to lie to themselves; that disrupts their trust in themselves and in me, and exacerbates their deep distrust of all providers. The patients do not want further damage to their bodies caused by acetaminophen’s hepatic toxicity, or ibuprofen’s renal toxicity; our job as their providers is to avoid iatrogenic damage. The safest long-term drug for chronic pain are unadulterated opiates via oral delivery. While most patients do develop a tolerance, this is also true of patients on SSRIs and SNRIs, of patients on cardiac medications, and hormonal replacements. Transdermal patches produce inconsistent dosage that can put a patient into an overdose state if they spend time outside on a warm day, have a fever, or take a hot shower; they become useless at the end of the patch’s life and trigger severe pain including nausea. Oral dosing is the most effective, patient-controlled method of pain control available to most patients. <br/><br/>Our goal as providers is to aid our patients in reclaiming the highest possible quality of life given their altered circumstances. This goal requires us to be humble and admit that injuries do not always fully heal. Our job is to recognize that suffering is the enemy, not the patient, and definitely not their needs. A patient who can participate in their child’s life, who can sleep and maintain a career, who is active in their community and regularly takes opiate medication to control pain is in a better emotional and social place than someone who cannot leave their bed or house because their pain is uncontrolled. I, as a mental health provider, cannot teach my clients to cope with their injury and trauma if their trauma is ongoing because the pain has not ended. Your opioid protocols are literally making my clients suicidal and slowing their progress. <br/><br/>Give my patients pain medication. Your prescribing guidelines are killing people. Stop acting like you understand my sphere. Stay in your lane and treat the pain. I’ll take the mental health from here.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcfa0d	Anonymous	None	2022-03-17T22:27:34Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-bpfu-rhb0	False	None	False	2022-04-12 04:19:15.223	[]
2634	CDC-2022-0024-2640	https://api.regulations.gov/v4/comments/CDC-2022-0024-2640	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with chronic pain my entire adult life. I have multiple conditions that affect my ability to function productively. Pain management has been a constant struggle. I have been denied medication after oral surgery, had doctors suggest Electroconvulsive Therapy instead of believing that I was suffering from pain, and told that my weight was the cause of my pain. Different doctors different problems, but also the same problem- lack of pain relief, lack of understanding from doctors about how pain medication, especially opiods affect quality of life. My hope is that doctors realize how patients lives are affected by lack of effective medication, when opiods are withheld. There have been many days when I have considered suicide, due to the persistent & unrelenting pain I live with. Chronic conditions, flares, procedures are all sources of negative stimulus, they cannot always be managed by OTC medication. The stigma of opioid use must end, for the benefit of chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fcfa2b	Holmes	None	2022-03-17T22:28:52Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Holmes, Amy	l0v-btcp-oulm	False	None	False	2022-04-12 04:19:15.446	[]
2635	CDC-2022-0024-2641	https://api.regulations.gov/v4/comments/CDC-2022-0024-2641	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Alternative, non-opioid treatment options for pain cannot be stressed enough. As the draft guideline mentions, laser therapy can be an effective, life-changing option that patients often are not aware of until their pain journey has been long and arduous. Laser therapy should be in the conversation for all stages of pain treatment.<br/><br/>As a medical doctor, I can attest to the benefit of laser therapy to help improve pain symptoms and function for my patients. This can be a game changer in trying to reduce dependence on opioid medications with all their risks and harms.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fd063b	Robinson	None	2022-03-17T22:29:33Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Robinson, Paul	l0v-f391-t14l	False	None	False	2022-04-12 04:19:15.660	[]
2636	CDC-2022-0024-2642	https://api.regulations.gov/v4/comments/CDC-2022-0024-2642	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had Gallbladder surgery. In stage one recovery, I stopped breathing multiple times from the fentanyl. They pushed me to stage 2 recovery early and before I was ready for safety reasons. While I was at morphone/fentanyl level pain, they gave me one 7.5mg hydrocodone. I am a chronic pain patient with migraines and fibromyalgia. The dosage was not nearly rnough. I spent 3 hours full body shaking and crying uncontrollably. The doctor refused to give more. My prescription was also half the dosage I was told I would get pre-surgery. I tried to get help from the doctor, but he refused more meds in the hospital as well as at home. It was also only 1 week worth of medication. I spent 3 weeks in the fetal position at home in bed. I used every alternative treatment I could manage, but it was little help. I now have PTSD about any surgery. I was already anxious about surgery when I had my gallbladder out, because of under medicating issues these days, but it is way worse having gone through worse than what my anxiety could imagine. I also do not get medication for my daily pain issues. It is almost impossible to get Fioricet for my migraines, even though I have tried all the other medications my insurance covers, fioricet is the only one that works. The opioid epidemic and addiction issue is the excuse I am given when refused. All of this has made my daily life very difficult, and has made parenting my children very difficult.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heidi	None	None	0900006484fd0767	Rochon	None	2022-03-17T22:31:26Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Rochon, Heidi	l0v-fkn5-wtv7	False	None	False	2022-04-12 04:19:15.874	[]
2637	CDC-2022-0024-2643	https://api.regulations.gov/v4/comments/CDC-2022-0024-2643	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please let the doctors who know us take care of us and prescribe what they deem fit. Not a bunch of bureaucrats who think one size fits all. My doctor feels his hands are tied and I suffer. We are not all the same. I would show up with a new painful disease dx and be in so much pain, crying at my pain mgmt visit and he could only say, “I’m sorry. There is nothing else I can do.” Have you ever lived in 24/7 pain? It wakes me up at night. I suffer. Why? Because someone else abused their meds and died? I’ve been on pain meds with the same doctor since 2003 ish. I’ve ever failed a urine test. I’ve never run out early. I don’t want to get high. I want to mop my floor and do laundry!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484fd0896	S	None	2022-03-17T22:32:34Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from S, S	l0v-fuey-wtqn	False	None	False	2022-04-12 04:19:16.084	[]
2638	CDC-2022-0024-2644	https://api.regulations.gov/v4/comments/CDC-2022-0024-2644	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want you all to know how much I have suffered and how much my family has suffered watching me in unrelenting pain. I was doing fine prior to your alienation of the wrong people. You had to pick a bad guy and chronic pain patients were it. My family has watched me cry, laying in bed unable to do much else because my medications were cut back so far that I couldn’t function anymore. I lived like this since 2017 even though I am a long established, compliant pain patient and my doctor knows me. He’s watched me every visit and tells me he is doing all that he can for me. Endless pain with no help in sight has caused so many that I know to commit suicide. They died because they couldn’t live in never ending pain anymore. I’m not sure how I survived it as I has three surgeries within this hellish period. It’s nearly impossible to do PT and walk to heal post op! We aren’t the problem. Illegal fentanyl from Mexico and China are classifies opioid deaths yet WE get blamed for it. I k ew patients in the end of their lives in hospice who SUFFERED thanks to [name redacted] and others who sure don’t seem to care if we live and die in pain. This caused desperation in pain patients who would never go to the street for pain relief. I’d love to know what you all would do if you suffered day in and day out in pain. This is the United States of American. It’s not supposed to be like this here. Please stop torturing us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Na	None	None	0900006484fd0a39	Na	None	2022-03-17T22:34:20Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Na, Na	l0v-gawb-jp6r	False	None	False	2022-04-12 04:19:16.293	[]
2639	CDC-2022-0024-2645	https://api.regulations.gov/v4/comments/CDC-2022-0024-2645	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	One day the people taking pain medication away from those who need it for pain relief and quality of life will be where I am now.They will beg for someone to listen and they will be told Sorry but I can't help you.Go home and take tylenol.<br/>I'm a intractable pain patient that's been tapered and the 45MME I have doesn't touch the amount of pain I face every day. I have adhesive arachnoiditis degenerative joint and disk disease, arthritis, fibromyalgia to name the most painful issues I face.<br/> <br/>I wish I could be a fly on the wall to know what Congress/government/ and the others making the rules for pain patients take for pain. I will never believe they move around so good and take little to no pain medication.<br/><br/>We are all genetically different and one medication wont work for the next and one person will need more or less medication than the next person. Please stop torturing pain patients and let us have what we need to live a quality of life instead of screaming and crying and wishing for death to hurry up and do its job. I have no life living in bed. This is inhumane	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd0b87	Anonymous	None	2022-03-17T22:35:28Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-gky5-xx59	False	None	False	2022-04-12 04:19:16.506	[]
2640	CDC-2022-0024-2646	https://api.regulations.gov/v4/comments/CDC-2022-0024-2646	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop torturing the legitimate pain patients with your unscientific guidelines! People are dying from illegal, illicit fentanyl poisonings and your organization knows the REAL TRUTH!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd0cfe	Anonymous	None	2022-03-17T22:35:47Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-gwzz-gmek	False	None	False	2022-04-12 04:19:16.717	[]
2641	CDC-2022-0024-2647	https://api.regulations.gov/v4/comments/CDC-2022-0024-2647	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for giving the chronic pain community the chance to let our voices be heard. I am the owner of a chronic pain group on Facebook with more than 25K members from around the world. My story is extremely long but I have to shorten it as best as I can.<br/><br/>At the age of 19 I started to experience pain and pressure in my mid spine. I had an MRI and it showed that I had kyphosis and degenerative disc disease. The doctor suggested injections. The epidural was not only an extremely painful procedure but it made my pain worse. After that I went on what seems like and still to this day a search for answers and a cure. Every single pain management doctor I’ve seen would only look at one MRI and not all of my MRIs. They lacked education and knowing that not all radiologist get the scans correct and sometimes there are other findings on different MRIs.<br/><br/> I’ve been told that I’m too young, I have been a victim of prejudice because I’m a woman. I have been through a lot and that’s why I made a chronic pain group because I felt like I had nobody. Today as I write this some 39 years old and I have been disabled for three years. I have a list for of spinal conditions that are not normal. The only doctor that’s ever taken me seriously is my current primary care doctor. I have been under his care for four years but since he is in primary care he is unable to prescribe me anything other than tramadol or Tylenol with codeine. I’m bed bound 75% of the day and have depression caused by my untreated pain. I live on ice packs and heating pads. I use mindfulness meditation, gentle yoga, therapy band stretches and exercise on my stationary bike 3-5 times a week. I do what everyone says to do but it’s not helping the relentless pressure and pain on my spine and I am not a candidate for surgery. Every doctor says my conditions are too complex. It’s ridiculous. I’m considering pallative care.<br/><br/>I have been on tramadol for 12 years. It does not effectively treat my pain. But the pain is so bad I put up with the lack of pain relief and the horrible side effects from tramadol. There’s not a day that goes by that I don’t cry because of my pain being untreated. I have yet to be able to find a pain management doctor to take me seriously and actually help me with a medication that would give me some kind of quality of life.<br/><br/>I have woken up with chronic back pain for two decades and I am sick of it. I’m frustrated, angry at the medical community, and disappointed in our government. The lack of empathy and the lack of care for actual patients dealing with issues that caused them to have chronic pain. It is not our fault if doctors prescribe to patients that don’t have any illnesses. It’s not our fault their are doctors prescribing for more money in their pockets. It is not our fault that people are overdosing. We chronic pain patients take our medication as prescribed and we are sick and tired of people using these drugs to get high when people actually need them to live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484fd125a	Lopez	None	2022-03-17T22:38:47Z	None	None	1	None	2022-03-17T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Lopez, Teresa	l0v-ibpk-bszu	False	None	False	2022-04-12 04:19:16.996	[]
2642	CDC-2022-0024-2648	https://api.regulations.gov/v4/comments/CDC-2022-0024-2648	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern:<br/><br/>I’m writing to draw your attention to the increasingly concerning state of chronic pain care in Wisconsin. Since the 2016 CDC opioid prescribing guideline was released, many providers misinterpreted the guidelines and took an extreme anti-opioid position. The pain management group in the healthcare system where I am treated decided to no longer offer opioids AT ALL for chronic pain treatment. Even after the FDA, AMA, and CDC tried to clarify these guidelines in the subsequent years, the conditions on the ground for chronic pain patients have continued to worsen. I know, I’m one of the afflicted.<br/><br/>I would like to share a little of my experience and explain what this abrupt policy shift has cost me. In 2016, I was still able to work full-time as a software engineer only because I had adequate access to opioids to manage my pain. I had been managing my pain for 15 years with opioids and found them to be effective and well-tolerated. After the CDC released its opioid prescribing guidelines, my quality of life was immediately under siege. I was forced to exist on a less than adequate dose, constantly pressured to reduce my dose, and eventually forced to taper. I complained. I begged for empathy. I appealed to Science, data, and reason. I read and printed out articles and studies challenging the notion that opioids have no place in medicine. I was told that opioids didn't work well for managing my pain. Imagine the absurdity of that for a moment. I was told that my inherently private conscious experience (pain) was not being helped by opioids, after 15 years of personal experience to the contrary. Of course, when my dose decreased, my pain increased.<br/><br/>I was forced to reduce my working hours to part-time, and, in 2017, I had to stop working altogether because my pain was no longer adequately managed. I had to rely on disability, and still do to this day. At the same time, my wife was suffering from late-stage breast cancer. Unable to obtain adequate pain control, I was robbed of the opportunity to take her “dream” vacation with her before she died at the age of 45 in 2018. <br/><br/>I now live in a state of perpetual suffering and drastically reduced functionality. I wish I was the only one with this experience, but social media groups of chronic pain patients with similar experiences have been growing by the thousands in the last couple of years. Yet, we all feel powerless and despondent. Most of us are incapacitated to such a degree, that we are unable to adequately fight against this. All we can do is communicate the personal damage this anti-opioid paradigm shift in policy has caused us and hope for a more rational and empathetic response.<br/><br/>Please refrain from suggesting one-size-fits-all dosing limits in your follow-up clarification. These will only be used as "hard limits" by many physicians. Please also consider that many of us have no other feasible options for managing pain on a day-to-day basis, and that denying us access to the one treatment that works can completely destroy our quality of life. You must be explicit that opioids can be a viable option for long-term chronic pain management for certain patients. I worry every day that this will not get fixed and that my increased suffering will be permanent.<br/><br/>Thank you for your time,<br/><br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fd1f26	Wundrock	None	2022-03-18T09:18:45Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Wundrock, Steve	l0w-6xfv-mp68	False	None	False	2022-04-12 04:19:17.209	[]
2643	CDC-2022-0024-2649	https://api.regulations.gov/v4/comments/CDC-2022-0024-2649	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone who suffers from chronic neuralgia which causes debilitating pain in my feet, I know my doctor would like to treat me with opiates but feels constrained by the current back lash against these viable medications. He has told me the best treatment for my level of pain and disability is an opiate but has confided in me his fear of loosing his license. My pain level is a constant 5 which peaks to an eight or nine at times and has turned my life upside down (think of having your toes being cut off with garden shears as you walk on hot coals). I can not exercise and fear my sedentary life will lead to an early death. Well, I do not want to die. I have too much to live for. I know that this treatment could lead to an opiate misuse disorder but I would gladly trade that disability for the torturous life I am currently living. I did have a brave doctor who was willing to prescribe opiate medication to address the periods of brake-out pain but even she felt the pressure to stop and referred me to a pain specialist. My specialist is a wonderful doctor and we have tried a dozen or more prescriptions (many off label) to treat my condition. I’m still in debilitating pain as nothing has worked. Please please reassess the draconian restrictions on the use of a class of medications that are literal life savers. I have no doubt (although I have no data to back it up) that a good many if not a majority of overdoses or deaths in the people with a valid medical need are due to them seeking relief by purchasing illicit medications or suicide. Unfortunately many of these street drugs are made using fentinal, an extremely dangerous narcotic. Good hearted people are in effect driving a population of patients to their death. As long as opiate treatment is prescribed and controlled by a doctor, the drug can be monitored but as soon as the desperate pain patient goes to the black market all bets are off.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd32e9	Anonymous	None	2022-03-18T09:26:09Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-zuy2-0nki	False	None	False	2022-04-12 04:19:17.427	[]
2644	CDC-2022-0024-2650	https://api.regulations.gov/v4/comments/CDC-2022-0024-2650	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 78 yr old widow with a house and 1/2 acre to keep up to community standards...on SS income only, so I need adequate pain control in order to accomplish necessary tasks. After being force tapered by PM down to 30 mmE from 90 mmE I am struggling for the past year since having been tapered. I can't go on like this or it will kill me. The guidelines apparently have been seized by other entities to validate their reasons for denying legacy patients such as myself adequate pain control. How to fix this? Maybe it is now beyond CDC control. <br/><br/>Doctors need to feel free to treat each patient as they see fit with no limits such as 50 mmE...especially for legacy patients such as myself who had been on 90 mmE for 12 yrs. after trying many other treatments first.<br/><br/>Please remove the 50 mmE limit from your guidelines because it will only hurt many patients in the end. Heaven help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd1e3d	Anonymous	None	2022-03-18T09:45:32Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-t3rw-3kma	False	None	False	2022-04-12 04:19:17.645	[]
2645	CDC-2022-0024-2651	https://api.regulations.gov/v4/comments/CDC-2022-0024-2651	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to begin by noting that it is not realistic to expect patients to read a 211-page document in order to comment on it, much less to read the supporting documentation such as the working group report. I understand agencies are bound by APA guidelines, but I urge the CDC to consider promulgating summaries or other "helper" documents if it is serious about receiving public comments from patients rather than merely industry and interest groups.<br/><br/>That being said, and having read the draft guidelines and supporting documents, I am generally supportive of the draft guidelines. My experience as a patient has reflected the detrimental effects of the 2016 guidelines, which, out of a commendable desire to accomplish beneficial public health goals in reducing opioid addiction and overdose, overcorrected and placed meaningful pain management out of reach for many patients who needed it. The proposed updated guidelines, by recognizing and highlighting (1) that opioid pain medication may be necessary for addressing acute pain, (2) that alternative pain management is often financially or logistically out of reach, and (3) that patients should be involved in the decision to prescribe opioid medication for acute pain, would, I believe, improve treatment for patients like me. I think the guidelines could and should go farther, however, in recognizing that patients have a role in decisions about pain management. For example, Recommendation 1 does not mention patient involvement in the recommendation itself, but only at the end of the implementation considerations.<br/><br/>Three times in the last three years, I have had surgery or dental work that caused significant but short-lived acute pain during recovery. In all three instances, when I inquired about pain management, I was told by the provider that there would be little pain during recovery, and that acetaminophen would be adequate to manage that small amount of pain. In all three instances, this was not true: the pain I experienced on the day of surgery and the day after was sufficiently severe that I could not sleep or complete basic daily activities such as cooking and doing laundry. Acetaminophen was inadequate to address the pain (because of a pre-existing condition, I cannot take NSAIDs, which the medical professionals in question were aware of). <br/><br/>In the third instance, because this was the second surgery of this type I had undergone, I knew from personal experience that acetaminophen would be inadequate, and I successfully advocated to receive a short-term prescription of opioid pain medication. This made a huge difference in my ability to function the next day, after the pain woke me up at 4:00 in the morning. But few patients will be assertive enough to advocate for themselves in this way (I am a lawyer, so more comfortable in this kind of advocacy role), especially when a provider, as in this case, attempts to "talk you out of" prescription pain medication. And it is not reasonable to expect patients, who are arguing from a disadvantage because doctors are seen as authority figures, and because doctors have specialized expertise that patients lack, to take on this kind of advocacy role. This is especially true when many patients are aware that a notation of "drug-seeking behavior" in their medical record can make it difficult or impossible to receive future treatment. To put it bluntly, I felt some minimal level of comfort in challenging the doctor who performed my third procedure because I was a white woman in professional attire. Patients who do not meet that description take a far greater risk when involving themselves in decisions about their treatment.<br/><br/>For that reason, although I believe the draft guidelines are an enormous improvement over the 2016 guidelines for patients like me, I think they should go farther in expressly stating in the text of each recommendation regarding acute pain that patients should be meaningfully involved in the decision about prescribing opioid medication. In my experience, doctors--even good doctors!-- start from the twin premises that: (1) patients don't know anything; (2) the pain caused by whatever they're doing to you is not that bad. Unless you explicitly tell doctors to consult patients and take our opinions seriously, they will not do it. This is especially true when the patient is a woman, a person of color, or a member of another underserved group. The burden should not be on patients to elbow their way into a discussion with intimidating authority figures. The burden should be on medical professionals to consult the people who are actually hurting, even and especially those who don't have advanced degrees or the confidence or societal privilege to assert ourselves unasked.<br/><br/>Thank you for your attention to my perspective.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katharine	None	None	0900006484fcf0e3	Roller	None	2022-03-18T14:59:52Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Roller, Katharine	l0v-kryp-z6xs	False	None	False	2022-04-12 04:19:17.856	[]
2646	CDC-2022-0024-2652	https://api.regulations.gov/v4/comments/CDC-2022-0024-2652	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Since probably age 20 I have been prescribed medications like Vicodin, Tylenol/Codeine, Soma, in addition to the triptan class of drugs for migraine once they became available. This and NSAIDS were much of how I have managed my lifetime history of body pain/migraine prior to seeing a specialist (psychiatrist) two years ago. I can honestly state to anyone that I have not once ever taken any medication ‘for a high’ or for any reason other than its medically intended purpose. Thirty Vicodin might last two months. Or most of a year or more. <br/><br/>Sometimes I would have migraines bad enough that my Rx's could not help me, so I asked my Dr. for an Rx for ONE Percocet. So I might have a chance to not go to Urgent Care or god forbid the ER vomiting uncontrollably. He looked at me like I was a piece of filth out of a 19th century opium den and said “No”. That was my first experience with being utterly humiliated by a Dr. for what I suppose was deemed ‘drug seeking behavior’ and the experience sent me into a depressive tailspin. I could not bear to look at him again. My integrity means a great deal to me and this was devastating.<br/><br/>Fast forward, my doctor wrote me a refill, a year ago. It went through insurance. The pharmacist sent me a letter refusing to refill the Tylenol with codeine, because I should only need a 7 day supply. And if I need more there needs to be evidence from my doctor as to why. Now pharmacists who are dispensing are also the arbiters of these medications. What became really special was when the pharmacist’s refusal over the course of 3 months led to me having one tablet remaining, and needing an emergency prescription written to a local pharmacy. Then I found out that the cost of the medicine we had all been haggling over was….$1.50. That’s back to you, CDC, and the effort all of these assorted entities were going to in order to keep opioids out of the hands of me, the responsible lifetime low-level pain patient because other people were addicted to oxycontin or because kids were getting hooked on fentanyl and dying. <br/><br/>The last thing I would like to mention is how this issue of opioids becoming a 'trust battleground' in my medical care when it was not one before caused me to stop seeking preventive medical care. In order to keep being prescribed my thirty tablets of Tylenol with codeine that I refill about once a year I was required to sign my medical group’s equivalent of an opioid patient prescriber agreement when this was something that had never been asked before. I was already struggling with a devastating anxiety/depression complex that was not being successfully managed when this was presented to me. Among other things, it required that I submit to annual drug testing, which cost me over $200 out of pocket not covered by insurance…except I was not clearly warned how this would take place. I was so angry because the test was meaningless...what use is a urine test that you can plan for ahead of time? But my logic is, don't go to the office = no urine test. It worked for 3 years, hyperlipidemia, who cares!<br/><br/>What had been my excellent relationship with my doctor was destroyed over this. Balanced? No. But I am struggling with my mental health and this tipped over the cart. It is what it is. Whatever you do from here, I sincerely hope it sends a clear message that people who are actually in pain should not be made to feel like they are scum for wanting to be out of pain, and that opioids are not in fact the enemy. You really kind of blew that messaging. Abuse of any medication is the enemy. Maybe you could restore some of the dignity you ripped away from thousands of us. <br/><br/>We have many dichotomies here in America, and how pain is viewed culturally is among them. In the older generations, a man ‘handled pain.’ He ‘gritted his teeth and bore it,’ he endured, he ‘toughed it out’ because that was what men did. That defined a man, and that defined the culture that many now deem an aspect of ‘toxic masculinity.’ As a society we now pay lip service in elevated circles to the concept that it is wrong to cause the vulnerable to exist in pain, especially in medical circumstances. That is why we have hospice; so that the dying do not suffer while they pass of cancer and other excruciating conditions. The truth is, we really do not fully stand behind the idea that freedom from pain is fully necessary. The result? Pain. The patient simply must endure. I spent my life in veterinary medicine where we give more than lip service. We wholeheartedly endeavor to keep animals out of pain and discomfort. Funny how we unthinkingly will do for our pets what we won't do for our fellow humans because we stand around and agonize over whether they will get addicted or not, because too many don't comprehend addiction vs. dependence.<br/> <br/>Or maybe we all just need more science classes in medical school?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd1d80	Anonymous	None	2022-03-18T15:02:15Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-n2ph-531d	False	None	False	2022-04-12 04:19:18.095	[]
2647	CDC-2022-0024-2653	https://api.regulations.gov/v4/comments/CDC-2022-0024-2653	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>I'm I veteran of the Marine Corps whom has become extremely ill from Gulf War Illness, my unit was exposed to sarin gas in the Gulf. Currently I'm unable to work anymore because of all my terrible diagnosis because of service to this country. I suffer from terrible chronic pain which all my Dr's won't control my pain with opiods even though I've said over and over again that's the only thing that works for my pain. I was forced tapered off opiods because Dr's won't prescribe them anymore because government is taking complete control. As an American Combat Veteran who is to tell me we don't offer opiods even though study after study show they can and do work. I'm now Currently suffering daily with uncontrolled pain because of these laws. What a slap in the face. Please help us!<br/><br/>[name redacted]<br/>Cpl USMC <br/>100% DISABLED VETERAN FOR LIFE	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Highland	None	None	0900006484fd2f22	Scott	None	2022-03-18T15:35:41Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Scott, Highland	l0v-qcc8-39cl	False	None	False	2022-04-12 04:19:18.312	[]
2648	CDC-2022-0024-2654	https://api.regulations.gov/v4/comments/CDC-2022-0024-2654	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on Opioids for over 18 years (begin in 2004) for Congenital scoliosis. I had a lumbar section of the Milwaukee Brace as a teenager, which reduced my curve from 21to 13. As an adult now, working and walking All Day, every day, my pain came back and my back is at 40* curve. Chronic bone aches, along with muscle spasms and pain continues to make my life miserable. Until a doctor put me on OxyContin. Now, it has changed to an abuse-deterrent variety called Xtampza. It has worked AWESOME for me all these years. I’ve been at the same dosage and frequency for over 15 years with no social or physical problems. Lately the doctors have been trying to lower the dosage. It is Ok when I don’t work, but the lower dose on workdays does NOT allow me to get on top of the pain and then I can’t get rid of it during the evenings/bedtime like I normally do. I’ve had to cut back on my work hours in order to deal with the stress and pain. I really feel that a patient who is a hard working, cooperative, compliant and is NOT seeking higher dosages should NOT be forced into invasive therapies because someone considers me addicted. At/On my initial dosage, I used to get 5 weeks out of each prescription. Now I feel like nothing is working at this lower dose. I’m tired of being called an addict, when I could walk away from doses if I didn’t feel as much pain. I’m not an addict. I can skip days without these medications. I proven it to myself multiple times. I HAVE to work. And standing and walking in surgery (2-4 miles per day) can cause a lot of pain and stress. I feel forcing me to do a pain pump (I need T11-L5 fusion eventually) will cause nerve problems in my back when I don’t have any nerve issues. <br/>I am a compliant patient who has NEVER asked for more meds or higher doses. I feel it only fair to leave me alone until such a time these meds are no longer helping me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jolyn	None	None	0900006484fd39a3	Zimmer	None	2022-03-18T15:43:41Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Zimmer, Jolyn	l0w-icxu-w5ly	False	None	False	2022-04-12 04:19:18.546	[]
2649	CDC-2022-0024-2655	https://api.regulations.gov/v4/comments/CDC-2022-0024-2655	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This Guideline MME Equivalent, Thing should not exist for us severe chronic Intractable pain patients! One size does not fit all ,! Also some of us have been on medications for RSD/CRPS, Which unfortunately does not respond to procedures such as epidurals other injections etc.I just wanna say it's been unethically a rocky road for pain patients and doctors who are scared basically into submission and do not wanna prescribe pain medications whatsoever, Oxycontin and other medications personally saved my life allowing me to participate in physical therapy extensively. In 2018 4 medications were completely stopped by pain management, which nearly killed me, not only that but set me back to day one This has tured into a total tragedy not just myself but many others,some have literally took there own lives from similar circumstances likei mine I just am beside myself how about illicit Fentanyl a dirty drug that doesn't ,have anything whatsoever to do with prescriptions for us pain patients, as we don't have pill problems we have pain problems! I also would invite you to acknowledge the fact that most of the claims that alot of us researched stated by the CDC are false ! Please stop the suffering of us pain patients..Its not only unethical but also a Human rights issue, Cinil rights issue also it is inhumane, If you careto elaborate do not hesitate to contact me and other pain patients like myself,..Thank You for reading are comments...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484fd336e	Bednarz	None	2022-03-18T15:51:40Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Bednarz, Eric	l0w-3q05-3epv	False	None	False	2022-04-12 04:19:18.802	[]
2650	CDC-2022-0024-2656	https://api.regulations.gov/v4/comments/CDC-2022-0024-2656	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi here from [location redacted] where suffering because of the guideline .How about we get rid of guide line and let Doctors be doctors.We the pain communities are fed up with being treated so unfair because of these guidelines.How long has street drugs been around ?How many street drug has killed alot of people that was the problem not Doctors doing there jobs and being compassion and treating us acute pain people who by the way needs this medicine .would you take a diabetic patients meds away from them? We are suffering for no reason other then unfair lies that were being told with nothing to back this up with .And your cutting the Mme more .why ?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd31b2	Anonymous	None	2022-03-18T16:17:15Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-s1w5-zytb	False	None	False	2022-04-12 04:19:19.042	[]
2651	CDC-2022-0024-2657	https://api.regulations.gov/v4/comments/CDC-2022-0024-2657	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Some people have chronic conditions that make opoids the only pathway to some quality of life. Without it they would be confined to bed contemplating suicide. There must be a consideration for folks in this situation, who do not abuse the medication. One rule for everyone is not acceptable. Doctors know what is best for their patients. A rule that doesn't take exceptions into consideration is plain wrong. <br/>Thank you for your time and the opportunity to express and point out that there is a whole population that has suffered from withholding opiods from them and their right to have a life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd31ca	Anonymous	None	2022-03-18T16:17:54Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-smlk-neob	False	None	False	2022-04-12 04:19:19.267	[]
2652	CDC-2022-0024-2658	https://api.regulations.gov/v4/comments/CDC-2022-0024-2658	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had been prescribed oxycodone for many years under maintenance for a debilitating neuropathic condition. Because of a medical malpractice suit against the prescribing doctor, unrelated to oxycodone, I was forced to locate another physician. This proved to be an impossibility, as every physician I went to see refused to prescribe, even though I had ample evidence to show that I required the medicine. Because of the crackdown from the opioid epidemic and its backlash, no one was willing to risk taking on a new patient. Therefore, I am left with a condition that is under-treated, and causes me untold distress. This has been the situation now for over 7 years, and my quality of life is very poor. The opioid therapy was allowing me to have pain free hours during the day where I could feel okay. <br/><br/>I want to stress also that on most occasions when I went to a doctor's office to request opioid therapeutics, I was looked upon as suspect, and felt as though I had to defend my life just in order to get pain relief! It's a horrible feeling, and the measures the DEA has gone to shut down the over-prescribing of these medicines has forced doctors to look at new potential patients as probable addicts. To let it be known, there is a vast difference between an addict and someone who is dependent on something. Anyone that I know who is using these medicines for a pain condition, truly wishes they didn't have to, me included.<br/><br/>Currently, I find myself in the same situation, suffering needlessly on a daily basis, without any doctor that I had located willing to prescribe. It has stopped me from trying. In my opinion this is a violation of my right as a human being to be treated for an illness where medicines exist that can help relieve some measure of suffering. I am very clear that there needs to be a better solution, but in the meantime, we have to use what works. And these medicines do help. I urge the FDA to please consider those with chronic pain illnesses that have been caught up in the DEA's dragnet, and restore dignity and respect to us. <br/><br/>I appreciate your time.<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fd3c2f	Lipset	None	2022-03-18T16:58:57Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Lipset, Mark	l0w-n3wz-slac	False	None	False	2022-04-12 04:19:19.541	[]
2653	CDC-2022-0024-2659	https://api.regulations.gov/v4/comments/CDC-2022-0024-2659	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fc617a	None	None	2022-03-18T18:29:05Z	PA Chapter of American Pain & Disability Foundation	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from PA Chapter of American Pain & Disability Foundation	l0p-kx0e-b320	False	None	False	2022-04-12 04:19:19.765	[]
2654	CDC-2022-0024-2660	https://api.regulations.gov/v4/comments/CDC-2022-0024-2660	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To deny someone access to pain medications is the worst form of cruelty Americans in pain are currently being denied pain treatment by doctors who have been terrorized by the DEA and uneducated prosecutors. This harm is a direct result of the CDC Opioid Guidelines<br/><br/>DEMOCIDE “the killing of members of a country's civilian population as a result of its government's policy, including by direct action, indifference, and neglect”<br/><br/>Our Governments goal is to “reduce the burden of chronic pain” and through its actions it seems their answer to that goal is the elimination of the lives of those who suffer with chronic pain through no fault of their own? Isn’t this DEMOCIDE? It’s considered culling a population. Isn’t this a Human Rights Violation?<br/><br/>As an Intractable Pain patient suffering from multiple autoimmune and rare diseases since 2003 I can honestly say that the original 2016 CDC Guidelines hurt me severely. I was force tapered from a stable dosage of opioids that I had been on for 13 years to a dosage that took away my quality of life. This tapering was recommended due to the CDC Guideline. I went from being able to function to being bedbound.<br/><br/>I lost the connectivity I had with my family, no longer able to leave my house, couldn’t even handle the pain of riding in a car. It limited my ability to function and increased my pain.<br/><br/>The 2016 guidelines stated they were just guidelines for primary care, yet they were misapplied to patients with intractable pain, cancer etc. <br/><br/>The 2016 Guideline was embedded into the Healthcare record system, which informed doctors to TAPER to an “appropriate dose” The CDC keeps saying these are, just guidelines, but by being involved in the patient/doctor relationship the CDC is causing insurmountable harm to those suffering in pain<br/><br/>How do you unwind all the damage, such as policies, laws etc. that were created from the 2016 Guideline? <br/><br/>How do you help the millions that are suffering from abandonment, lack of passionate care, even loss of life due to the original guideline?<br/><br/>There are two faces of the opioid crisis and overdose deaths and pain remediation. These are very different and must not be conflated. <br/><br/>A personalized, patient centered approach to pain management can prevent iatrogenic harm and death, but it will take time and require the perseverance to develop trusting relationships between patients and clinicians. <br/><br/>Force tapering has taken away a viable option for pain sufferers and forcing them to choose suicide or street drugs when they could live a life with their pain managed. Another option becoming more available, assisted suicide. <br/><br/>Personalized, patient centric medicine is the hallmark of the 21st Century. Personalized medicine is commonplace in oncology and cardiovascular disease yet in pain therapy it lags behind. By utilizing a genetic profile we are able to identify the genes that make fast- and slow-metabolizers of opioid drugs. This profile can be used to identify a safe and effective dose for individuals who are at risk of an overdose and those who need higher doses or medication simply because their personal metabolism requires them. <br/><br/>Medication for pain is no less important for that of cancer or heart disease<br/><br/>All MME, an unscientific measure,references should be removed from the guideline<br/><br/>No matter the said intent, Laws and Policies will be enacted and cause FURTHER harm to patients. The CDC in one hand recognizes the value of patient centric care and in the other hand distinguishes it by recommending MME.<br/><br/>The 2022 Opioid Prescribing Guidelines "caution" against the use of opioids in excess of 50MME's<br/><br/>THE 2016 CDC GUIDELINE FOR PRESCRIBING OPIOIDS AND ALL ITS FINDINGS SHOULD BE IMMEDIATELY WITHDRAWN. THE ONLY AGENCY THAT SHOULD BE INVOLVED IS THE FDA<br/><br/>EVIDENCE QUESTIONS:<br/><br/>The authors acknowledge a lack of evidence for:<br/>The effectiveness of opioid dosing strategies.<br/>The effects of combination therapy versus opioid or non-opioids.<br/>The benefits & harms of different methods for initiating or titrating opioids<br/><br/>The authors acknowledge that the evidence used to create their recommendations on opioid tapering was limited to 1 trial. <br/>The CDC needs to provide the pubic a citation for the study used to create these recommendations given their serious impact on the public's health and well-being.<br/><br/>When the authors are not referencing their own work, they make bold, authoritative statements regarding the evidence-base and other research outcomes without providing the necessary citations<br/>The authors also cited "a short term study, there was no difference between opioids and no opioids in short-term pain, function, health status,quality of life. Yet, in another section of the draft 2022 Opioid Prescribing Guidelines, they clearly state that no studies on the difference between opioid and non-opioid medications have been completed	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006484fc654d	Higginbotham	None	2022-03-18T18:36:48Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-13T05:00:00Z	None	None	None	None	None	None	None	Comment from Higginbotham, Maria	l0p-xd0y-xf35	False	None	False	2022-04-12 04:19:19.978	[]
2655	CDC-2022-0024-2661	https://api.regulations.gov/v4/comments/CDC-2022-0024-2661	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why is the CDC reacting the names of those who are responsible for the anti opiate propaganda that has brain washed this country? These people are paid via huge grants-from the CDC-yet their names along with their well known Conflicts of Interests are being deleted from comments!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcdef0	Anonymous	None	2022-03-18T18:38:19Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0u-uq8i-wdoz	False	None	False	2022-04-12 04:19:20.204	[]
2656	CDC-2022-0024-2662	https://api.regulations.gov/v4/comments/CDC-2022-0024-2662	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an allied health care professional, I have often the opportunity to treat patients utilizing opioids on a long term basis. 95% or better do not over utilize their prescription and I have never found one patient using it as a recreational drug. Does this happen? Of course. The problem I see currently is that these people are being forced off a medication that allows them to live a normal life and they really have no alternatives. Their doctors are running scared and will not prescribe any more opioids for fear of reprisal or sanctions. I understand we have a problem but we need to be careful we are not throwing the baby out with the bath water. I have several patients now looking to get these drugs from the street and that is worse. Please look at both sides and try to come up with a solution.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fd419b	Brewer	None	2022-03-18T18:45:09Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Brewer , Mark	l0w-ojng-ihuw	False	None	False	2022-04-12 04:19:20.424	[]
2657	CDC-2022-0024-2663	https://api.regulations.gov/v4/comments/CDC-2022-0024-2663	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	50 MME is not supported by research. Any numbers present temps misapplication. This needs to be removed from the guidelines. No drug, dose, quantity's or days of treatment should be included, this should be left to our doctors discretion using there wisdom gained through years of medical training.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4182	Anonymous	None	2022-03-18T18:45:36Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0w-oayc-dois	False	None	False	2022-04-12 04:19:20.640	[]
2658	CDC-2022-0024-2664	https://api.regulations.gov/v4/comments/CDC-2022-0024-2664	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	DON'T FORGET ABOUT THE CURSE	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keith	None	None	0900006484fd3c36	Brown	None	2022-03-18T18:46:03Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Keith	l0w-nbga-7c71	False	None	False	2022-04-12 04:19:20.862	[]
2659	CDC-2022-0024-2665	https://api.regulations.gov/v4/comments/CDC-2022-0024-2665	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Line 78 – “should avoid dismissing patients from care”<br/>This needs further definition/clarification and if possible, please provide examples. There will certainly be some “patients” such as drug traffickers/diverters once exposed who should be dismissed and offered OUD treatment? Treating a patient with non-opioid therapies after stopping opioid therapy is clearly not patient abandonment?<br/><br/>Lines 965 & 966 – “Opioid Risk Tool ([names redacted] 2005).”<br/>Any reference to [name redacted] does a disservice to your great draft document because of [name redacted]'s history and the numerous deaths (20) linked to his practice as admitted by [name redacted] during an interview at a 2013 Milwaukee Journal Sentinel article found at https://archive.jsonline.com/watchdog/watchdogreports/top-pain-physician-acknowledges-patients-fatal-overdoses-o78m2jb-191945161.html/ <br/><br/>Line 1219 through 1222 – “(Pain News Network, 2017).”<br/>[name redacted] is one of two medical contributors to the Pain News Network.<br/><br/>Lines 2014 through 2017 – “Therefore, opioid therapy should not be initiated without consideration by the clinician and patient of an “exit strategy” that could be used if opioid therapy is unsuccessful. <br/>Great sentence and standard; however, it somewhat conflicts with line 78 about “should avoid dismissing patients.” Maybe add a sentence or clarification similar to “deciding to treat a patient with non-opioid therapies after discontinuing opioid therapy is not patient abandonment?” <br/><br/>Lines 2164 through 2167 regarding methadone.<br/>Great job on calling out the dangers of methadone when prescribed for pain. There has been too many tragic and preventable deaths from methadone prescribed for pain by many clinicians due to their lack of knowledge regarding the drugs pharmacology.<br/><br/>Lines 2276 through 2291 regarding opioid dosages greater 50 MME/day.<br/>Great job including a OME “threshold.” [name redacted] et al. 2010 image ([attachment redacted] A) should be all one needs as a OME reference point to safely prescribe opioids. There has been too many past patient deaths due to high OME prescribers.<br/> <br/>Lines 2451 through 2453 – “Clinicians should not abandon patients.”<br/>Please consider definition/clarification or consider providing a example(s). Without a definition/clarification a clinician might keep a patient on that is a diverter under this draft statement? Treating a patient with non-opioid therapies after stopping opioid therapy is clearly not patient abandonment? What are examples when a clinician can terminate a patient? A referral to a OUD treatment provider is clearly not abandonment?<br/><br/>Lines 3059 through 3016 – “Clinicians should use PDMP data”<br/>Well done. Maybe add a reference regarding a clinicians state's laws which might require PDMP use on initial prescription, etc.<br/> <br/>Lines 3305 through 3308 – “Ideally, PDMP data should be reviewed before every opioid prescription…..”<br/>Well done. The PDMP will always be the clinicians’ most objective tool. Many clinicians follow the creed, “trust but verify” when prescribing opioids with the PDMP providing the verification.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fce9ee	Anonymous	None	2022-03-18T18:46:47Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-4sbk-083e	False	None	False	2022-04-12 04:19:21.075	[]
2660	CDC-2022-0024-2666	https://api.regulations.gov/v4/comments/CDC-2022-0024-2666	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	3/18/2022<br/>Observations from a 25 year Alcoholics Anonymous Member and Sponsor.<br/>Recommendations to CDC: resumption of quality of life care for pain and increased resources and awareness of resources for addiction.<br/>- consequences of CDC guidelines and under treatment of pain.<br/>There is an increasing number of new members who’s overconsumption and alcohol dependecy originated in attempts to ease untreated pain. Prior to 2012 I don’t recall ever a member who’s alcoholism was the result of self medicated pain relief.<br/>Also all of new members with both opiate and alcohol addiction for the last 3 years did not originate from prescription pain medication, all of the members in our meetings have admitted this yet tell their family it was a result of opiate prescription.<br/>You’re breeding a new generation of alcoholic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alcoholics	None	None	0900006484fd3a44	Anonymous	None	2022-03-18T18:46:52Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous , Alcoholics	l0w-jydf-zv9a	False	None	False	2022-04-12 04:19:21.290	[]
2661	CDC-2022-0024-2667	https://api.regulations.gov/v4/comments/CDC-2022-0024-2667	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment on the revised and updated CDC Clinical Practice Guideline for Prescribing Opioids. I find them to be much improved with a clear intention of ensuring these are not misapplied as the previous ones were to the detriment of patients with chronic pain functioning well on opioid therapy. I have 5 brief comments to offer:<br/>1.) Chronic post-surgical pain, both as a motivator of continued opioid use following surgery, and as an outcome of pre-operative opioid use, should be mentioned. With respect to acute pain management, pre-operative opioid taper may decrease opioid requirement post-operatively. And if patients require a longer course of opioids post-operatively, it may be because they have developed chronic post-surgical pain, rates of which are quite high following certain types of surgery for acute post-operative pain ([names redacted] Predictors of persistent pain after total knee arthroplasty: a systematic review and meta-analysis. Br J Anaesth. 2015 Apr;114(4):551-61. doi: 10.1093/bja/aeu441. Epub 2014 Dec 26; [names redacted] Chronic postoperative pain after primary and revision total knee arthroplasty. The Clinical Journal of Pain 31(1), 1-6. doi: 10.1097/AJP.0000000000000146; [names redacted] (2016).<span style='padding-left: 30px'></span>Postoperative pain mechanisms assessed by cuff algometry are associated with chronic postoperative pain relief after total knee replacement. Pain 157(7), 1400-1406. doi:10.1097/j.pain.0000000000000531; [names redacted] Risk stratification for the development of chronic postsurgical pain. Pain Rep. 2017 Oct 31;2(6):e627. doi: 10.1097/PR9.0000000000000627) - they are experiencing pain chronification - supporting that post-operative prescriptions should not be time-limited. <br/>2.) A recently published screening tool with excellent sensitivity and specificity for predicting OUD in patients with chronic pain ([attachment redacted] below) is overlooked and deserves mention.<br/>3.) Although I appreciate the experts preferring to say naloxone should be "offered" as opposed to "prescribed" fearing access issues, I believe the importance of getting naloxone in the hands of these at risk patients warrants saying "prescribed", thereby pushing the insurers and pharmacies to provide access.<br/>4.) Lines 3827-3830 should be bolded or underlined or otherwise emphasized.<br/>5.) Perhaps most importantly, although in the conclusions, the panel promises to publicize these guidelines to the same degree as the 2016 guidelines, much damage has already been done at the level of state guidelines, health system policies, insurance company and pharmacy restrictions with respect to restrictive opioid prescribing and provision limits. Due to the harm caused by the 2016 guidelines, I would like to see the CDC take a more active role in reversing these restrictive policies - now that these have been put in place, adopted and implemented, what strategies will be utilized to "swing the pendulum" back to a more reasonable approach?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	peggy	None	None	0900006484fceacf	compton	None	2022-03-18T18:57:11Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from compton, peggy	l0v-6ue3-5664	False	None	False	2022-04-12 04:19:21.501	[]
2662	CDC-2022-0024-2668	https://api.regulations.gov/v4/comments/CDC-2022-0024-2668	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am so happy for this opportunity to inform whomever of the living nightmare and [redacted] pain patients are going through. Our life is totally engulfed in trying to find relief from pain. If pain enters into your life it does not just vanish into thin air, there is no expiration date on pain, and some things cannot be addressed without pain medication which is our situation we find ourselves in now. Pain patients most likely if inflicted with a condition will spend the rest of their life in need of pain medication as my situation, I have adhesions in my abdomen. They don't just disappear, there is no pain fairy to take them away, and there is no cure! I'm still trying to figure out how the CDC which is not a federal entity has so much influence on people in pain, where is the connection? Our lives are so compromised and changed in ways you could never imagine, our family lives are upside down and we are in the worst situations imagined because of interference in us trying to obtain relief. Why someone felt the need to interfere in our world of living I will never understand but it has brought upon millions pure hell and some of those millions have opted to no longer be on this Earth because of the severity of the interference by those who have no clue on what they are doing. And to imprison doctors who took an oath to care for their patients to the best of their ability is mind-boggling. You have imprisoned doctors who have not stole a car, shot someone, endangered anyone's lives but just did their job and given them years of imprisonment with murderers rapist kidnappers and child abusers that's insane! Why are we even having to plead our case due to the situation that is beyond our control to people who have nothing to do with the medical aspect of pain patients. A lie was perpetuated that our medication was killing people and overdose and it actually ended up literally killing people who decided to kill themselves or turn to other methods to relieve themselves of pain. You have no clue of the devastation you have inserted into everyday hardworking people's lives unnecessarily there was no reason to even indulge yourselves in the lives of pain patients. We can no longer raise our families, travel or work participate in everyday living due to your unnecessary interference which has caused a major devastation on a whole community and the only way you can fix it is to allow us to get access to our pain medication. Adhesions has my intestines glued together literally there's a film that covers them which they cannot constrict and keeps me in pain 24/7 I can't find one doctor to give me relief on top of that I have arthritis in my back. It's horrible and shame on you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joie	None	None	0900006484fd3a80	Canty	None	2022-03-18T19:00:59Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Canty, Joie	l0w-ketr-wnr6	False	None	False	2022-04-12 04:19:21.782	[]
2663	CDC-2022-0024-2669	https://api.regulations.gov/v4/comments/CDC-2022-0024-2669	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From ohio .as I m sitting here crying because I m in so much pain .not able to so stand or walk only for about 15 .i have stenosis of the spine bulge disk that are deteriorating everyday I can feel them just pop out which hurts alot .i have had back surgery twice I have cadaver bones and a plate holding back in place so my [word redacted] pops out below and above where plates are .i can not bend very fair over .also have a couple plates in my neck which is coming apart so when I sneeze or cough or try to turn my head my disk pops out and it feels like my neck is apart one part goes one way and the other goes the out way very very pain full .i also have bone spurs .arthritis in my back neck and my should which I ve had surgery on three time the last time my muscle was completely torn apart the doctor pulled it back in place and sew it back on .i m in pain 24 7 I hurt so bad and can't get the proper pain meds to help stop the pain so I suffer .This is so inhuman .why to we have to suffer .Doctor should be aloud to end are suffering but there scared they will loose there licence..so they give us a low dose that doesn't help I was on a higher dose which helped me to be some what normal .But now I can't do hardley anything at all .Sometime I wish I wasn't borned because of the pain .The Mme needs to be remove .actually there shouldn't even be a guideline at all for people like us that are suffering .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd31ce	Anonymous	None	2022-03-18T19:02:42Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-sotw-6xfi	False	None	False	2022-04-12 04:19:21.995	[]
2664	CDC-2022-0024-2670	https://api.regulations.gov/v4/comments/CDC-2022-0024-2670	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC tried to hide the initial 2016 guideline altogether. There were never any open meetings. The medical community at large didn't even know about the meeting or the guideline. They didn't even publish the guideline on the CDC website until journalists found out about the deception and started criticizing the CDC. The CDC tried to hide the names of all the people who sat on the panel of the CDC anti-opioid guideline both in 2016 and when they started to rewrite the 2022 anti-opioid guideline, they tried to hide those names as well. How can anyone trust the CDC? They ADMITTED to releasing false information with regard to the actual prescription overdose deaths, increasing those numbers by over half! <br/><br/>The AMA and the FDA have stated these 2022 draft guidelines aren't an improvement over the 2016 guidelines, as [name redacted] pointed out in his article in The Hill:<br/><br/>https://thehill.com/opinion/healthcare/594726-the-cdc-should-rescind-not-update-its-2016-opioid-guideline<br/><br/>“It is clear that the CDC guideline has harmed many patients. The CDC has the obligation and opportunity to take aggressive measures to put the treatment of chronic pain patients back on the proper course."<br/><br/>Must read articles:<br/><br/>(EVERYONE NEEDS TO READ THIS ARTICLE!)<br/>Patient Z and the Criminalization of Pain Care<br/><br/>May 17, 2021<br/>By [name redacted], PNN Editor<br/>(THANK YOU, [name redacted] FOR ALL YOU DO!)<br/><br/>https://www.painnewsnetwork.org/stories/tag/Jane+Ballantyne<br/>____________________________<br/><br/>PROP Helped Draft CDC Opioid Guidelines<br/>September 21, 2015 <br/>By [name redacted], Editor<br/><br/>https://www.painnewsnetwork.org/stories/2015/9/21/prop-helped-draft-cdc-opioid-guidelines?format=amp<br/>____________________________<br/><br/>Monday, May 3, 2021<br/>PROP’s Disproportionate Influence on U.S. Opioid Policy: The Harms of Intended Consequences<br/><br/>https://www.pallimed.org/2021/05/props-disproportionate-influence-on-us.html?m=1<br/>____________________________<br/><br/>CDC Won’t Say Who Is Writing Update of Opioid Guideline<br/>April 5, 2021 [name redacted]<br/><br/>https://www.painnewsnetwork.org/stories/2021/4/4/cdc-wont-say-who-is-writing-update-of-opioid-guideline?format=amp<br/>____________________________<br/><br/>Because of their deceptive practices the CDC drew heavy criticism.<br/><br/>What is the CDC Trying to Hide?<br/><br/>https://www.painnewsnetwork.org/stories/2020/4/15/what-is-cdc-trying-to-hide?format=amp<br/>__________________________<br/><br/>The CDC was incredibly dishonest with regard to both the 2016 CDC opioid guideline and the current 2022 draft guideline. People who know what the CDC has done, and know what the CDC is capable of, are aware of how deceptive their drafting of both the 2016 and 2022 draft anti-opioid guideline. Prior to employing members who sit on the board of openly, and very highly anti-opioid groups, <br/>the CDC decided to have board members from the anti-opioid group PROP and Shatterproof draft their anti-opioid guideline in secret, without any notifications to the medical community at large. Their guideline wasn't posted on the CDC website and no copies were made available. This is all incredibly deceptive!<br/><br/>Initially they went to the FDA and asked them to write the anti-opioid guideline that would cut prescriptions to patients who needed opioid analgesics. The FDA refused to take part in drafting the initial anti-opioid guideline because of the harm it would cause to people suffering with chronic pain. The FDA also realized how deceptive it was to try to hide the proposed guideline from the medical community. The FDA also realized how deceptive it was to try to hide the proposed guideline from the community at large.<br/><br/>The CDC was also completely dishonest with journalists, policy makers, doctors, insurance companies, the AMA, FDA. It's truly unfortunate because people want to believe they can trust the information published by the CDC and yet, the CDC has admitted to publishing false information with regard to overstating the numbers of deaths from prescription opioid overdose deaths by more than half. The CDC also had to publish findings regarding the harms done by the 2016 CDC anti-opioid guideline and the vast misapplication of the 2016 anti-opioid guideline. <br/><br/>People want to believe the CDC does what's in the best interest of the general public but, as we've seen this isn't at all true. These guidelines have FAR more to do with addicts and addiction, and very little to do with chronic pain patients. <br/><br/>Both the 2016 CDC guideline and the 2022 draft guideline need to be completely revoked and we need to allow doctors who treat chronic pain to do their jobs using their own discretion, without and interference from the CDC.<br/><br/>Thank you for reading my comments. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd081e	Anonymous	None	2022-03-18T19:02:45Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-fq6n-qnaz	False	None	False	2022-04-12 04:19:22.213	[]
2665	CDC-2022-0024-2671	https://api.regulations.gov/v4/comments/CDC-2022-0024-2671	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Well if this is true then a lot of us have a good case for lawsuits because I was in my pain management and me and my palliative care both talk to them and told them not to taper me down and they would refuse to talk to my palliative care and they kept on taping me down and took me out of my Crohn's remission and put me in a major flare and I've been in [redacted] ever since I'm still getting something but I had to go through all kinds of hoops and still not getting what I need none of us are getting what we need the DEA needs to be integrated with the border patrol and let each City deal with their drug problem the DEA has done nothing but harm our communities and ever since they've been in existence there are more drugs coming into this country than ever before so they go after the doctors and patients so make them look good and they have lobbyists which DEA does not need to lobbyists and they have a place where you can donate money to the DEA which they do not need money donated but they get lots of money donated to them and they get to keep all the money that they confiscate and all the houses cars and everything else and sell it and keep those monies and all they do is destroy our community and now they've gone after our doctors and the chronic pain patients conspired with the CDC the attorney general's office and the politicians and the private corporations that run the prison system in the pharmaceutical companies so they can get people that are easier to get onto Suboxone methadone bupromorphine which are more addicting and pay off the fines that the pharmaceutical companies have agreed to pay for the fake opioid war they just figure it's easier to pay than fight the government so we have to suffer because of it	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martin	None	None	0900006484fd1e12	Schindler	None	2022-03-18T19:04:12Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Schindler, Martin	l0v-opy6-xzui	False	None	False	2022-04-12 04:19:22.437	[]
2666	CDC-2022-0024-2672	https://api.regulations.gov/v4/comments/CDC-2022-0024-2672	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Peer Recovery Support Specialist 5 years into recovery from opioid addiction. I wonder if you have a voice from a Peer with lived experience to add perspective to this revision. I think it would be of great value and if you would like to speak further about it, I am going to provide my personal email below although I work for an organization that works in Addiction Research and has many Grants dedicated to ending the opioid crisis especially in the Appalachian Region. <br/>I however would like to also give the perspective of my mother who has been on prescription opioids for over 10 years as she is a post-polio victim but does not suffer from the disease of addiction. Although the heritability of addiction is 50% she somehow managed to miss it. When the 2016 guidelines hit prescribers and scared them out of practice, my mother suffered greatly. After her third attempt at a new pain clinic when hers closed she came to me crying asking "am I an addict, because that's how they make me feel". I had to explain to her that while she was physically dependent upon her medications she was not an addict because on days when she couldn't get out of the bed and was crying out in pain and I begged her mom please just take your medicine early, she wouldn't. I can confidently say she has never knowingly taken her medication early, extra, or in any other way than prescribed. She is at the lowest does she has been at in about 7 or more years, despite she has a metal cage around her spine, had 12 surgeries by the time she was 12 on her legs and feet, ruptured disks, fibromyalgia, arthritis and more I cannot recall off hand, she is at such. low dose and her doctor is demanding she gets her back injections done there at that clinic instead of where she has been receiving them for years, which terrifies her. She does everything asked of her and more including chiropractic, steroid injections, water exercise, acupuncture and passes all screens and counts yet they say they cannot raise her does to where she was when she moved with me to Memphis when my son was diagnosed with cancer to help me with his 10 months of treatment at St.Jude. In trying to transfer back home she called her old clinic expecting to be accepted back at minimum the does she's at but hoping for her old (last May) dose, and they said they could only offer her half of her current does, cutting her to 2 15's a day. She couldn't function at all at that dose with the pain she's in This should be a public Health concern left to doctors on a patient by patient basis and screen patients with something such as SBIRT instead of assuming they are "pill-seeking". I pray this changes the way my post-polio mother is treated moving forward and I also hope this revision will do the opposite of what it did previously and DECREASE the overdoses. it has been studied that chronic pain patients are not the ones that typically suffer from Addiction or Substance Use Disorder. Thank you for taking this revision into account and I hope you will have the voice of a peer to bring lived experience into it because we have much to offer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fd1e45	Childress	None	2022-03-18T19:05:25Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Childress, Elizabeth	l0v-t5g3-7gac	False	None	False	2022-04-12 04:19:22.678	[]
2667	CDC-2022-0024-2673	https://api.regulations.gov/v4/comments/CDC-2022-0024-2673	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to you to inform you of the harm I have experienced since the 2016 CDC Guidelines for prescribing opioids was published.There has been great harm done to many chronic pain patients (CPP); some have committed suicide or gone to the black market only to overdose. Although they are supposed to be guidelines, as a CPP you would never know it. Physicians don't want to prescribe opioids even though solid research has proven them to be safe. My current Doctor has forced tapered me by 60% & has mentioned that she wants to reduce me further. Since I have been forced tapered, my medical condition has greatly worsened plus my quality of life is non-existent. I have to limit what I do & often need to change my day due to my suffering with pain. There are thousands of people with chronic pain due to incurable diseases & physical conditions that can't be fixed. We shouldn't have to suffer with pain. Just because some of us benefit from being on opioids under the supervision of a Doctor doesn't mean we should be treated as addicts or scum and unable to be prescribed opiates. Most CPPs are not addicts. Generally speaking, CPP don't abuse their medication because it is needed. Without it, CPP live in torture. (Note: there shouldn't be a cancer & non-cancer pain distinction nor limits to days prescribed & no differences in short or long acting opiates.) This is part of the reason there's been an increase in the number of overdoses now. Some patients go to the black market since it's not available through the proper channels. I have been perplexed as to why there hasn't been a new plan of action to combat the overdose problem. Clearly the current plan that has been taking place going on 6 yrs. is NOT WORKING. This country's overdose problem has gotten so much worse which many experts who were against the CDC guidelines at the onset warned against. Also the manner in which the CDC guidelines came about was very shady & underhanded.  Folks who have worked on the original & its version have conflicts of interest ([name redacted]) who shouldn't be contributing to the CDC guidelines at all. Furthermore many of the folks who had worked on them are not even Pain Management Doctors. In my opinion, the CDC honestly should be ashamed of themselves for taking on the 2016 guidelines since it was rejected by the Food & Drug Administration (FDA) where drugs are their jurisdiction.<br/>As for the revision, once again I am very disappointed in the CDC.  Although they introduce a few improvements, it's contradicted in the 211 pg document that follows. There are 22 times that 50 MME & 4 times that 90 MME are mentioned. The chart for converting MME is still also included which isn't even scientifically sound. There should be NO references to MME whatsoever. What is unbelievable is that the guidelines haven't been suspended by now.  Much scientific evidence & recommendations has been presented to the CDC listing all the problems with the guidelines in addition to the harm it has caused. Yet it's ignored. Stanford reported that force tapering shouldn't be an option. My force taper is reckless since it has proven to better my quality of life due to less pain & with no complications. My time here on earth is getting less & I would like to have a decent quality of life for what I have left. It has already taken 6 yrs of my life. It is bad enough to suffer with pain 24/7/365 but knowing you have had access to medication that does help is unconscionable. I have tried multiple alternative medicines, etc.. to help alleviate my pain. The only thing that truly helps is taking morphine. I always thought that the government and its entities were supposed to be for the people & their well being. CPP are being tortured & nothing is being done about it. I am asking you to PLEASE suspend the guidelines. This so-called revision is only going to cause more harm & the number of overdoses will continue to rise. Don't allow the guidelines to remain in place while it has proven that it's not working & causing great harm. Thank you for your understanding. I pray you will listen & take action. In closing, I wish to endorse the comments of [name redacted], who has filed with the Federal Register.  His comments reflect my own concerns. This holds true also for [name redacted] of the American Council on Science & Health & [name redacted] (a pain management Doctor in private practice who also is a lawyer). As [name redacted] points out in his comments, there are 2 weak areas of concern.  The first is that the CDC continues to "advise" physicians about prescribing opioids. It is pointed out that what medication & dosage is a matter between the physician & the patient. Secondly, MME's  are still used in the revised guidelines.  When one is considering MME, the pharmacokinetic principles, e.g. adsorption & metabolism makes a big difference in the needs of the patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annie	None	None	0900006484fcd464	Shoger	None	2022-03-18T19:05:47Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Shoger, Annie	l0u-1ky1-uqvp	False	None	False	2022-04-12 04:19:22.892	[]
2668	CDC-2022-0024-2674	https://api.regulations.gov/v4/comments/CDC-2022-0024-2674	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was referred to pain management 10 years ago (2011) after a failed back surgery (bilateral laminectomy L4/L5). <br/><br/>5 years ago (2017) I lost Medical insurance and was forced to become a “cash patient”. Shortly after that my doctor skipped the country due to a Workman’s comp scandal and I was absorbed by the partnering physician. <br/>That new dr was investigation and voluntarily surrendered his prescription abilities during his investigation. I was moved to a new office and absorbed by his fellow colleague.<br/><br/>This new (2018) doctor ONLY takes cash so when I became eligible for Medi-Cal, I started to looks for a new doctor! That has now become literally impossible. I’m currently dealing with Medi-Cal trying to find a Pain Management doctor that’s still willing to write opiates. Currently they have all stopped dispensing opiates and now rely on Injection procedures and other therapies only. I’m happy to reduce my opiate use and I’m more than willing to look at new therapies but it’s needs be a transition, too many of us have just been cut off and left out in the cold. I have never misused my medication nor had any addictive issues. I am NOT able to work, live or function normally without pain. <br/><br/>I understand the opiate crisis in this country. But we are not the issue and there has to be a better way. You can’t just cut us off and chuck us into the streets with nothing. How is that solving this crisis???<br/><br/>Trust me this is just a basic overview of my situation. It does not reflect any of the additional issue like, being treated like addict (or dealer), being repeatedly denied medication due to manufacturing reductions. Having to go to ghetto strip mall pharmacies and doctors because that’s all there is. <br/><br/>Thank you-	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tami	None	None	0900006484fcd993	Carson	None	2022-03-18T19:06:14Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Carson, Tami	l0u-5v5w-jsb0	False	None	False	2022-04-12 04:19:23.106	[]
2669	CDC-2022-0024-2675	https://api.regulations.gov/v4/comments/CDC-2022-0024-2675	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Beside the obvious flaws of the 2016 Guidelines I think it’s vital to consider that many don’t seek medical assistance (CPP or not). The 2016 Guidelines set a precedence on how people in pain are viewed/treated by physicians, nurses and pharmacists. The fear of repercussions from the DEA has stigmatized CPP and treating anyone experiencing any type of pain. Consequently people are not properly diagnosed, many are fearful of under treatment of pain for surgery therefore needed surgical interventions are not done. I currently have failed equipment in my back, screws poking through my skin. This will be my 3rd surgery. I live in pain daily that is grossly under treated. I was a medical professional but can no longer work. I am being told Tylenol is what they use post operatively; sorry but that’s not gonna work. Was also told I would have to be tapered way back preoperatively from my already undertreated pain for the Tylenol to work…..this is my pm dr……When I was in nursing school I was taught if my patient was in pain I wasn’t doing my job correctly. Apparently that is no longer the school of thought since these guidelines have been instituted. Physicians, Pharmacists and nurses have practiced pain management centuries without guidelines; guidelines that now have created havoc with millions of lives. Huge increases in illicit fentanyl overdoses and suicides are the most obvious results of this EPIC failure. I am certain my fellow CPP can discuss the conflicts of interest employing anti opioid zealots to develop guidelines that line their pockets…..which has got to be illegal at some point. My suggestion is to rescind the guidelines & promote medical professionals to treat pain as they should. No revision , no DEA , no cdc interventions.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd39a0	Anonymous	None	2022-03-18T19:06:16Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0w-i9fy-eg9b	False	None	False	2022-04-12 04:19:23.353	[]
2670	CDC-2022-0024-2676	https://api.regulations.gov/v4/comments/CDC-2022-0024-2676	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No. CDC-2022-0024<br/><br/>The CDC guidelines that came into place in 2016 have really hurt my life and the life of my family. Here’s what they did.<br/>When I was properly medicated with higher then the 90 MMEs I was able to do things around the house like laundry, clean kitchen, help cook, eat at the dinner table with my family and sleep. These are just some things that come to mind. After these guidelines went into effect and my meds were tapered without my consent I was rushed to the hospital with a very high blood pressure of 214/120 and a migraine that lasted the whole time I was in the ER. The care I was given there was the worse I have ever had.<br/>They treated my like a drug addict seeking meds and all I asked for was something to ease the pain but since they saw my scripts had been tapered that made them not want to give me anything that would help with the pain. This is so inhumane and unethical and it’s forced the doctors who took an oath to care for patients with the compassion they went to school to do. So with that said <br/>I’m writing to you in so much uncontrolled pain and desperation to beg you to please eliminate the MME’s all together in the new revised guidelines so people like me with Intractable Chronic Pain will no longer have to go days without being treated properly for diseases we did not ask for. I just want to enjoy life again without being in so much pain that all it does is ruin my life and the life of my husband and two boys that wait on me like I’m some kind of child. It’s just not fair and it’s crimes against humanity at this point in time. Please do your job and stop letting people like [name redacted] dictate what clearly is a lie and get richer off the suboxone he’s pushing for.<br/>Thank you for your time! <br/><br/>Intractable Pain Patient	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd362f	Anonymous	None	2022-03-18T19:07:56Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0w-f2ey-8j17	False	None	False	2022-04-12 04:19:23.571	[]
2671	CDC-2022-0024-2677	https://api.regulations.gov/v4/comments/CDC-2022-0024-2677	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is absolutely unethical that the CDC redact a Guideline authors name, especially one who is being cited for conflicts of interest, from comments provided by those expressing concern regarding the draft guidelines. This a clear admission by the CDC that they find the exposing of [name redacted] COI’s to be damning. <br/><br/>The CDC censored at least 15 comments by redacting [name redacted] name from negative references to [name redacted], a guideline co-author. The university for whom he works has received almost $2 billion in federal grants from the CDC and other agencies much of which goes directly to research headed by [name redacted]. <br/><br/>Time and time again [name redacted] himself references his own research throughout the draft guidelines. How is this practice allowed? How are references by an author to his own research documents considered valid points of data?<br/><br/>If this were not such a serious concern that could result in great harm to hundreds of thousands of seriously ill patients it would be laughable. <br/><br/>In any other universe this would call for a Congressional investigation. In fact, I have already written my U.S. Congressional representatives and U.S. Senators asking for an inquiry. <br/><br/>The hiding of an authors name with the obvious goal being to limit exposure to his already admitted conflicts of interest is unethical at best and bordering on illegal. During my interview tomorrow, March 17, 2022, with a journalist from the leading news agency in my state I will expose this attempt to conceal facts and ensure this is highlighted as part of the resulting publication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	0900006484fcd7a7	Murphy	None	2022-03-18T19:09:04Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Murphy, Bill	l0u-aln4-ve3a	False	None	False	2022-04-12 04:19:23.784	[]
2672	CDC-2022-0024-2678	https://api.regulations.gov/v4/comments/CDC-2022-0024-2678	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/>My pain story started in 2013.<br/>I am a retired firefighter/EMT.<br/>At being at 125lbs at the time that I was working on my past fire department.<br/>I used to carry an air pack on my back 12+ hours at a time, doing things that men twice my size was doing (example, carrying men twice my size off of the roof, to name one thing).<br/>In 2014 my husband (also a retired firefighter/EMT) my husband suffered 5 strokes in less then 48 hours (again more then twice my size), for a year I help lift him, and help him recover.<br/>I only talk about this to give a bigger idea of partly when I went through, to get me to the point of where I am now.<br/>As said my pain started in 2013, I have to retired from the job that I enjoyed the most because of the pain I was living with 24/7.<br/>At this time, I was trying to find a doctor that would listen to me.<br/>I went to doctors offices, the hospitals, urgent Care.<br/>Not one doctor heard me.<br/>One doctor even dismissed me when I had a UTI without treatment.<br/>I started to go to one doctor office that I have been at for the past 5 years, and yet they still don't listen the way I need them too <br/>I finally got this doctors office to do a MRI, and blood tests.<br/>However they still will not give me the one medication that would help me each day.<br/>It has been horrible for almost 10 years <br/>This started even before the 2016 guidelines was put in place.<br/>I get treated like a drug user, even through I will not touch drugs.<br/>Right before this pain hit in 2013 I would not take any type of medications, over the counter or prescribed.<br/>I even had 4 children without no type of pain meds, one being a miscarriage.<br/>If I had my way, ai would not take anything at all.<br/>The pain I live with now is the worse pain that I have ever dealt with.<br/>I had natural child birth 4×s with nothing.<br/>I have also dealt with countless other really bad pain without any pain meds.<br/>However when I have said this is to much, then I am not listen to, and treated horrible for asking, and get put through a nightmare, on top of of the worse pain I have ever felt in my life.<br/>I don't have an alcohol issue or and drug issues.<br/>Please fix the guidelines, so that doctors have the full day, and they are not scared to death to prescribe meds that are needed.<br/>The CDC,and DEA should never be part of this, they are not the ones with medical licenses.<br/>Also the MME should be completely taken off. The decision to be prescribed opiates should be between the doctors and the patience, no one else.<br/>Only the patient truly know their pain, and knows more what is wrong.<br/>Right now all doctors are scared to death to do the right thing.<br/>Also please don't delete this comment, as others need to understand how bad others are doing.<br/>My pain is 24/7, it never goes away.<br/>I can't sleep, or eat right given what I live with 24/7.<br/>Please make this better <br/>Thank you in advance for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JD	None	None	0900006484fd3f97	Kal	None	2022-03-18T19:09:14Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Kal, JD	l0w-s5pw-uqsw	False	None	False	2022-04-12 04:19:24.034	[]
2673	CDC-2022-0024-2679	https://api.regulations.gov/v4/comments/CDC-2022-0024-2679	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because of how heinously the CDC has treated pain patients, it's hard for me to really believe anything the CDC says about Covid-19, even. The CDC's guidelines for pain patients has caused me and others immense harm. So much so, I am currently contemplating suicide.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fcc331	Anonymous	None	2022-03-18T19:12:06Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0t-69yo-gdo3	False	None	False	2022-04-12 04:19:24.247	[]
2674	CDC-2022-0024-2680	https://api.regulations.gov/v4/comments/CDC-2022-0024-2680	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been in pain management for over 15 years. My Quality of life has gone from good to acceptable to unacceptable. The CDC guidelines for Methadone are so strict that my medication has been reduced in half and then reduced in half again. I'm in so much pain everyday that I've thought of killing myself. I have such horrible anxiety now about seeing my pain specialist each month because I don't know what's next. I went from no anxiety and a good quality of life with moderate pain reduction to now having severe anxiety, near suicidal and constant poorly treated pain. All this was brought on by suggestive opioid guidelines. Numerous doctors have told me that the guidelines aren't suggestive and that there threatened with jail if the go over these guidelines. Please fix the damage that is being caused by the 2016 CDC Opiod guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Justin	None	None	0900006484fcc32e	Crafton	None	2022-03-18T19:13:01Z	None	None	1	None	2022-03-18T04:00:00Z	None	None	2022-03-16T04:00:00Z	None	None	None	None	None	None	None	Comment from Crafton, Justin	l0t-643z-3fdn	False	None	False	2022-04-12 04:19:24.462	[]
2675	CDC-2022-0024-2681	https://api.regulations.gov/v4/comments/CDC-2022-0024-2681	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because of the CDC guidelines my doctor forcefully reduced my medication that I had been on for 16 years, even though it was below the CDC guidelines. Now I live in constant pain, and can't sleep because of the pain. I don't understand why I am being punished and can't get pain relief, even though I have done everything right, never abused them, always passed urine tests and pill counts. Every visit from my doctor they threaten to take away my medication if I don't have procedures, I leave the doctor office feeling like I just been through a prison shake down. Please let the doctors treat the CPP without fear of losing their licenses. I don't get where the CDC says the doctors should try everything else before giving opioids, they always did this in the first place, I have tried everything before I ever received opioids, three surgery, steroid injects, PT, spinal cord stimulator, you name it. The doctors went to medical school let them practice medicine, and please leave the pharmacies alone. Every time I get my prescription filled they treat me like a drug addict, and question the doctor, even though I am on a low low dose, or pretend they don't have it. I feel every month that I am going to battle just to get the little bit I am on now. Please change those guidelines to the way they were before. Tell the DEA to leave the doctors, CPP, Post op patients alone, and get the real criminals who are selling them on the streets. The CPP are not criminals, they are people who are in agonizing pain and need relief, and need their pain taken seriously by the medical community. Thank you for giving me a voice on here.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janice	None	None	0900006484fd4383	Lee	None	2022-03-21T13:27:29Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Lee, Janice	l0w-tt6n-xboy	False	None	False	2022-04-12 04:19:24.693	[]
2676	CDC-2022-0024-2682	https://api.regulations.gov/v4/comments/CDC-2022-0024-2682	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello.my name is [name redacted] . I have fluroquinlon tocity. Severe neuropathy. Avascular necrosis due to steroids instead of opiods eagles syndrome. Complex regional pain syndrome. For 7 years. <br/>I have not been given any opiods in year. Toradol. The pain has destroyed me. Suicidal at times. <br/>My PC told me I need pain management due to severe constant pain. <br/>4 clinics refused pain medications. Told me the war on opiods does not allow them. I can't walk. Sit. Hip replacement ahead. Throat surgery.<br/>Is this what you meant? Drs are using your recommendations abandoning patients like me. I scream in pain. Daily I cry. No life left. I have legitimate pain chronic for years. I only hear steroid injections which I can no.longer have. Please do something to stop drs from ignoring legitimate pain patients. I have heard my PC say " we can't help you. War on opiods won't allow it" <br/>I lost 3 people to suicide from extreme pain last two years. Please help us. <br/>[name redacted] <br/>[address redacted] <br/>[phone number redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tanya	None	None	0900006484fd4398	riley	None	2022-03-21T13:29:14Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from riley, Tanya	l0w-uac9-yppb	False	None	False	2022-04-12 04:19:24.913	[]
2677	CDC-2022-0024-2683	https://api.regulations.gov/v4/comments/CDC-2022-0024-2683	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As the Director of the Office of Drug Control Policy for the state of WV (the hardest hit state by the opioid epidemic), and a practicing primary care and addiction medicine physician, I urge the CDC not to relax the recommendations for opioid prescribing. There are people with chronic pain, yes, but we know that long term high dose opioids are not the solution to that chronic pain. There is a very little role either in primary care or pain management medicine for high dose opioids such as oxycodone and others. The small numbers of people with chronic pain refractory to conservative treatment are able to get opioids under current regulations. With the rise of fentanyl on the back of the prescription pill crisis, now is not the time to relax the regulations. <br/>Matthew Christiansen MD MPH	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fd43ab	None	None	2022-03-21T13:30:15Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from WV Office of Drug Control Policy	l0w-uhdy-7bxa	False	None	False	2022-04-12 04:19:25.175	[]
2678	CDC-2022-0024-2684	https://api.regulations.gov/v4/comments/CDC-2022-0024-2684	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my name is [name redacted],I have been in chronic pain since 2010 due to accident at work that injuries my neck and wrist along with my back I am 68 years old and I have a really hard time with my opioid medication lasting me a whole month.I have been without medication for whole week. I live at home by myself and I have suffered in pain and deadly withdrawl at times. This in inhumane and not acceptable. The guidelines have caused my doctor not to give me enough medication to last i have to go to Emergency room to be only given a shot that only last one day .so the rest of time I have to take way to much Tylenol and get nausea .If the new guidelines I feel it want be better but worse simply due to the MME threshold. 50 MME is not enough at all .I'm asking and decree to get rid of MME threshold .Simply leave my doctor patient relationship alone .this feeling of me that feels like I'm dieing.Why make me suffer .The internet database is available now in every state to see if a doctor is getting out of hand on overprescribing. Stop this GUIDELINES for states are adapting laws with these guidelines .Revise the wording in the proposed guidelines or do away with it altogether. Get out of my medical care and prevent the illicit fentanyl that's causing alarming overdose rate .its not prescription drug from a doctor . So do the right thing and let my doctor care for me without the fear of him or her going to jail for caring properly for me.Thank you and God Bless the USA.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	kathy	None	None	0900006484fd43d5	Harris	None	2022-03-21T13:30:54Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Harris, kathy	l0w-v6z3-amfd	False	None	False	2022-04-12 04:19:25.407	[]
2679	CDC-2022-0024-2685	https://api.regulations.gov/v4/comments/CDC-2022-0024-2685	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain for the last 16 years. I suffer from degenerative disc disease with 3 bulging discs, spinal stenosis, vertebral osteoarthritis, and bilateral SI Joint Nerve compression. I had to go on permanent disability in 2009, giving up my loved RN career due to insufferable pain. I was prescribed 10 mg oxycontin twice daily as well as oxycodone - acetaminophen 15mg 5 times daily to control the excruciating pain enough to allow me to get out of bed, perform daily chores, and personal daily hygiene by myself. In 2016 my world came crashing down as my meds were cut in half due to the CDC's so called "guidelines". My pain control went from a 1 out of 1 - 10 to 4 to 6 out of 10 and my ability to perform daily chores and personal hygiene decreased more and more to not being able to do much of anything except maybe clean the kitchen and take a shower once a week with a great deal of difficulty. My husband has had to take over all the household duties and I can barely walk with a cane. I also suffer from chronic depression and severe anxiety which increases my pain even more. I have had difficulty getting my meds filled, had them paid for by my insurance company, and have been treated like a drug addict by pharmacy personnel. Now, after reading your new, so called "guidelines", I am afraid my medications will be cut even more and my pain level will increase even more. If this occurs, I will become totally bedbound, with unbearable pain. In my opinion the CDC and the DEA have no business in the relationship between a physician and their patient when it comes to the type and amount of treatment that takes place. I have followed my physicians directions to the letter all my life. I believe most sane, and competent people do so. The so called "opioid crisis" is really due to illicit drugs and the CDC and the DEA should be concerned with dealing with that and leave law abiding people that follow physicians orders alone to collaborate with their physician in their medical treatment. I am in pain management and if I didn't follow my orders to the letter, I would lose my medical treatment by them. Why don't your "guidelines" urge all patients be in pain management treatment and support those institutions to guarantee patients are not misusing their opioids. The alternative, non-opioid treatments you want patients to institute are not paid for by insurance companies. Many to most people cannot afford these treatments and in my case, and many other cases, they don't work. I, and many others I have spoken to, believe your "revised guidelines" will only cause the chronic pain patients more trouble. I feel all chronic pain patients feel this way and just don't know how to let you know or are too frightened to do so. Believe me when I say, if you were me, or were in half the pain I am in, you would do away with all of these "guidelines" altogether.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484fd43e1	Noel	None	2022-03-21T13:31:59Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Noel, Chris	l0w-vg90-svak	False	None	False	2022-04-12 04:19:25.665	[]
2680	CDC-2022-0024-2686	https://api.regulations.gov/v4/comments/CDC-2022-0024-2686	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain management with a low dose of oxycodone enhances my quality of life beyond measure.I have 2 merged facet joints, bone on bone, with a nerve jammed in between the joints. This is chronic, daily, without end. I've had this for a long time. With unending exercise, the right shoes, P/T as necessary,and injections and pain meds, I live a full, active life. My livelihood depends on my being able to walk up/down many flights of stairs daily. <br/><br/>Changing these laws will turn my life upside down. I remain anonymous to protect myself against medical insurance companies, employers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4437	Anonymous	None	2022-03-21T13:32:19Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0w-vz9n-8z41	False	None	False	2022-04-12 04:19:25.883	[]
2681	CDC-2022-0024-2687	https://api.regulations.gov/v4/comments/CDC-2022-0024-2687	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Get out of my medical care. That's for me and my doctor. Forced to do shots that's not approved by the FDA , being told lies that Suboxone work for pain when the FDA did not approve for pain but it did for addiction . However I'm dependent on my medicine to do everyday tasks such as cooking cleaning washing clothes washing dishes which is hard to do with my back . These guidelines are made into laws eventually which is even worse . I feel this is also being done to push an agenda by two of the Authors to get Suboxone push on every one . They have money tied into the company that makes this worthless medicine that they want approved for pain study shows it starts good for pain and eventually it doesn't work for pain at all only addiction . Do away with the MME . It's wording is wrong cause you state one thing but later go against it .. This is wrong on so many levels for the pain community we think about suicide as a resort to escape this torture . So end these guidelines so States want make laws by these recommendations. It's only making our life pure inhumane treatment and looked at as if we have done wrong by getting opioids. Thank you and God Bless the USA . The land of FREEDOM	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4438	Anonymous	None	2022-03-21T13:32:43Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0w-w1mb-iijg	False	None	False	2022-04-12 04:19:26.095	[]
2682	CDC-2022-0024-2688	https://api.regulations.gov/v4/comments/CDC-2022-0024-2688	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I take care of my wife fir the last 12 years . She got sick at 38 yrs old. She has debilitating chronic pain which puts her into flareups at last up to 34 weeks at a time. She’s in bed with her heating pad in the fetal position on most days. I’ve watched her go from a healthy strong beautiful young woman who worked like a workhorse 12 hours a day and her advertising career to a woman whose hunched over with 10 herniated discs chronic spinal stenosis, Osteoarthritis, stage four endometriosis of which she had nine surgeries over eight years including a complete hysterectomy which threw her young body into surgical menopause which then ruined her back and gave her osteoarthritis along with anxiety and insomnia and hot soaks every single night. She also has medium arcuate ligament syndrome which is a rare vascular disease which she’s going to need a major surgery soon. She also has complement deficiency which is a rare auto immune disease. She had C diff But she caught in 2014 while having her fifth colonoscopy and had to be flown out of state to have a fecal transplant just to save her life.<br/>She’s been in pain management for 12 years. She’s been on the same opiate for 12 years which work very well for her same dose 12 years. She was on a 25 µg of fentanyl for the first six years. Unfortunately due to the 2016 and accurate guidelines from the CDC her doctor was afraid and made her come off of the fentanyl pain patch. Since that. My wife cannot go anywhere she can barely get up and shower and make yourself something to eat. The opiate pain pills she takes only last a few hours so by taking the fentanyl pain patch away which was a long-standing pain reliever she is now unable to do much of anything. For instance my father died of coronavirus well my wife couldn’t even travel six hours in a car to attend his funeral.<br/> My wife has been unable to attend any of the weddings that I have attended. When she was on the fentanyl pain patch with her Oral oxycodone breakthrough meds she was able to at least take a walk around the block or Possibly attend a family function. <br/><br/>The CDC or Fda needs to take away the MME- do you see needs to fix the failed 2006 guidelines. Which failed miserably. We personally know folks that committed suicide due to the fact their doctors force tapered or just stopped their opiate treatment. These people are in chronic daily pain and depended on their medication. The government has zero business to be in between a chronic pain patient and the pain management doctor. Never in history have we not adequately treated our chronically ill human beings adequate pain medication !<br/>Take out the enemy in your updated 2022 guidelines as there is no scientific proof or literature to any basis to reference 90 MMER 50 MM me? It’s absolutely junk science.<br/>My wife is a prime example as she’s been on the same opiate medication for 12 years. She’s never overtaken her drugs and she takes them as prescribed.<br/>Fully her pain management doctor still allowed her to be slightly over 90 MMA and even with that she’s bedridden. But again due to the 2016 CDC guidelines, my wife was forced off of her 25 µg fentanyl pain patch which has greatly caused her to suffer and be bedridden on most days.<br/>Would we take away insulin or lower the correct dosage for a diabetic patient? Would we take away a heart patients heart medicine?<br/>So please note that there’s been more overdoses from illicit fentanyl and heroin since your 2016 failed guidelines.<br/><br/>It has been steady have to study showing that the chronic pain community who are on opiate medication’s to control their daily chronic pain do not abuse their opiate medication. I believe the number is less than one and a half or 2%. So that means 98% of the chronic ipain pain patients Take their medication as prescribed.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jim	None	None	0900006484fd4461	Buenavista	None	2022-03-21T13:34:00Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Buenavista , Jim	l0w-wgpo-qjtz	False	None	False	2022-04-12 04:19:26.314	[]
2683	CDC-2022-0024-2689	https://api.regulations.gov/v4/comments/CDC-2022-0024-2689	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to advocate for the inclusion of acupuncture into clinical practice guidelines as a non-pharmacologic pain management strategy. As a Licensed Acupuncturist, the majority of my patients come to the clinic seeking treatment for chronic pain. Over the years, I've seen a wide range of pain-related conditions whereby most patients have had some experience with pharmacologic interventions, in particular, opioids. In my clinical practice, I find that most often, patients seek out acupuncture either to avoid pharmacologic pain management, or because they have tried opioids or other pharmacologic interventions with little to no success. Every day, I witness the profound success of acupuncture in the treatment and management of pain conditions. Acupuncture is safe; it's effective; and it's withstood the test of time. It is a much more cost-effective strategy for pain management, as it works to address the root cause of a person's pain while avoiding any potential for negative consequences (i.e. addiction, overdose). Opioids were NOT brought to market in order to address acute or chronic pain; they were intended to manage severe pain in palliative/end-of-life care. Opioids do not work to correct the root cause of a person's pain, and they come with grave side effects. In addition to my private clinical practice, I have given acupuncture in residential treatment centers and recovery residences, where opioid addiction was prevalent - and, former opioid users are still in pain. There may be a time and a place for opioids, but practice guidelines for their prescribed use must consider alternatives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4c20	Anonymous	None	2022-03-21T13:34:27Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0x-0j85-5h89	False	None	False	2022-04-12 04:19:26.540	[]
2684	CDC-2022-0024-2690	https://api.regulations.gov/v4/comments/CDC-2022-0024-2690	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting as a patient and a registered nurse. Seeking my nurse practitioner license at the moment. I have had two back surgeries and other than post operative medications the many doctors I have seen have even admitted to being “scared” to prescribe any type of opioid to me. I have had back pain since an accident in my teens so for over 15 years I’ve had the pain and the last 4 years have been horrible. I’ve had to go on short term disability and take time off work for days I can hardly move. I hope my comment will provide some insight to providers and the CDC about patients and limiting the fears of prescribing. I’ve done extensive research and honestly met the recommendations for being prescribed an opioid even before my first surgery. I wouldn’t have even had my surgery I believe if I would’ve just gotten some relief instead of daily pain and missing out on life and work opportunities. It is heart breaking for me to hear patients of mine say they are on long term opioid medications with no end date and have not had one surgery or the history I do. So, I am asking why me, why are some patients treated differently, and why are providers and practitioners terrified to prescribe for people who are in pain everyday and depressed about the pain they are in? I think there needs to be a major revision on the stigma with opioids and help those who are in pain with chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brianna	None	None	0900006484fd4ccd	Beaton	None	2022-03-21T13:35:26Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Beaton, Brianna	l0x-0xt7-ybao	False	None	False	2022-04-12 04:19:26.753	[]
2685	CDC-2022-0024-2691	https://api.regulations.gov/v4/comments/CDC-2022-0024-2691	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on pain medication for 28 years and methadone for 22 years. I have always taken my meds<br/>As prescribed and never had any issues until my doctor was forced to cut my meds by half causing me<br/>To stop living. I wish I could get off pain meds but I can't and I'm grateful that I have something <br/>I can take and get relief. My doctor basically had his hands tied and I really believe most doctors do<br/>What's best for their patients. Please let the doctors decide what their patients needs after all they know the patient <br/>And they know what is needed. Overdose deaths are caused by people getting illegal drugs not doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tiffiney	None	None	0900006484fd4d83	Barrett	None	2022-03-21T13:35:51Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Barrett , Tiffiney	l0x-2ij5-uzs1	False	None	False	2022-04-12 04:19:26.981	[]
2686	CDC-2022-0024-2692	https://api.regulations.gov/v4/comments/CDC-2022-0024-2692	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In regard to the medication guidelines set forth on America, on the clinically ill, on the physically damaged which are irreparable, on the incurably diseased "regardless of what disease it may be" the results have been horrific. For any one person, having a condition or ailment which requires pain care or management, and has indeed been diagnosed with a condition of such, it should not be up to any persons not involved directly with that person to manage that persons disease or bodily damage. In the beginning, I am quite sure, for those afflicted, they have been tested, reassessed, tested more, photographed, x ray, ct scan, and physically cut "surgery" upon. With the diagnosis of diseases and damaged states as they are, and people being in a painful state before, during and after diagnosis, I am quite sure all peoples have been pushed through many modalities to attempt cure, remission, correction, and healing if at all possible. The process before diagnosis, and after is painful. If it was not, we would not seek assistance to begin with. A healthy body needs no physician. <br/> Public Comment Theme from <br/>BSC/NCIPC meeting<br/>CDC's Response<br/>For more details, please also refer to the above discussion of <br/>CDC’s response that was related to community engagement <br/>FRNs.<br/>Reduced opioid use through diverse <br/>approaches<span style='padding-left: 30px'></span>THE DIVERSE APROACHES WERE TAKEN DURING THE DIAGNOSIS, PEOPLE WERE <br/><span style='padding-left: 30px'></span>TAKING COPIOUS AMOUNTS OF OTC MEDICATIONS CAUSING THEMSELVES <br/><span style='padding-left: 30px'></span>OVERDOSES AND MORE ORGAN DAMAGE BY WAY OF OTC FOR PAIN MANAGEMENT. <br/><span style='padding-left: 30px'></span>ALSO, PEOPLE HAVE PRAYED, MEDITATED, "mindfulness" CHIROPRACTIC, MASSAGE <br/><span style='padding-left: 30px'></span>THERAPY, PHYSICAL THERAPY "exercised, paid others to rub or push on our bodies till they <br/><span style='padding-left: 30px'></span>pop" ACCUPUNCTURE " the act of causing pain to another part of the body to alleviate the pain <br/><span style='padding-left: 30px'></span>you are feeling for the moment in the diseased/permanently damaged part"<br/>CDC added text to re-iterate and emphasize the importance <br/>of patient preferences and values being understood and used <br/>to inform clinical decisions and of involving patients in <br/>decisions about whether to start opioid therapy.<br/><span style='padding-left: 30px'></span>Since the 2016 guidelines, there has been no discussion to patients about their <br/><span style='padding-left: 30px'></span>preference, the option has been flat out denied, we as Americans have been <br/><span style='padding-left: 30px'></span>prescribed anti depressants for which we are not depressed, again placing us in <br/><span style='padding-left: 30px'></span>harm and then advising us that because it acts on different chemicals in our brains we <br/><span style='padding-left: 30px'></span>wont have the pain. The pain is not in our brains, and if we wanted to be out of our <br/><span style='padding-left: 30px'></span>minds, we could just go to the streets, drink copious amounts of alcohol, <br/><span style='padding-left: 30px'></span>do street drugs, flop around on the ground, and act against our moral and ethical respects. BUT STILL HAVE PAIN, from the unresolved, or <br/><span style='padding-left: 30px'></span>incurable condition. <br/>CDC discusses the issue of access and insurer coverage of <br/>noninvasive, nonopioid therapies throughout the guideline<br/>(e.g., “Implementation Considerations” under <br/>Recommendation 6 and “Conclusion and Future Directions”).<br/><span style='padding-left: 30px'></span>How much more does the burden of the controlled working pain patient that pays into the insurance system, and does work and utilize opioid pain medication cost the health care system? How much do you think it will cost when the working pain patient decides the healthcare system he pays into will not afford him medication that allows him to do the work which he pays his insurance for? <br/>I believe quite surely you have affected the wrong group of people with these guidelines. If you were going to "impact change" for the American society, you do not do it by harming the unwell, attacking the sick, elderly, disabled, veterans, people with disease conditions. Even people that have AIDS hold a job and have pain. And I see your angle, thinking that people are diverting their drugs, but they are actually taking the drugs they are prescribed in order to function to societies "acceptable for employable" As to your point of addiction? People form very different and odd affections to many different things in this world, examples are sex, gambling, drugs of all kinds, I've even seen some people addicted to cell phones and attention. THE THING SOCIETY DOES NOT WANT TO BE ADDICTED TO IS STIGMATISM, CONTROL, JUDGEMENT, AND SHAME. On any account and toward any peoples of any creed, race, sex, DISABILITY, or religion. this guideline has accomplished just that	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Advocate of US Disabled	None	None	0900006484fd4da4	Stakeholder and Concerned	None	2022-03-21T15:49:00Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Stakeholder and Concerned, Advocate of US Disabled	l0x-3qsr-mhey	False	None	False	2022-04-12 04:19:27.200	[]
2687	CDC-2022-0024-2693	https://api.regulations.gov/v4/comments/CDC-2022-0024-2693	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	really can't take the every day pain I suffer .was on something that was helping but was cut down to hardley anything .because of the Mme in guideline from ??2016 .Now you want to cut it further .what are we acute chronic pain people suppose to do .we are suffering .we need guideline gone the DEA out .and let are doctors be doctors again .I m sure they know who needs meds and who doesn't .also we are sick of being treated like dogs from pharmacies and Er.doctors .Nurses who are just as bad .it so stressful for us to get to the Doctors office because we hurt so badly the getting are perscription filled is a nightmare they will make you wait and wait to get your perscription and then sometime they love to play game .i hate that I have to be great like a drug seeking addict .instead I m a pain person in alot of pain that has to be put through this ever month .This is inhumane and needs to stop .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4f43	Anonymous	None	2022-03-21T15:49:20Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0x-4mzx-7atf	False	None	False	2022-04-12 04:19:27.418	[]
2688	CDC-2022-0024-2694	https://api.regulations.gov/v4/comments/CDC-2022-0024-2694	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You might as well have said “the new limit is 50mme”. Your statement that no one benefits above 50mme is a lie. Your reliance on low quality studies that are only on mild pain to make guidelines for everyone is cruel. People in severe pain aren’t allowed in studies because we skew the results. You brag about pain doctors and pain patients being part of the process but I didn’t see any on the list. But I did see a great many addiction people and a doctor with conflicts of interest and no practical experience with the treatment of pain. The recreational drug use issue has been used to destroy the treatment of pain. And it had led to astronomical increases in ODs and suffering and deaths of legitimate patients. Legitimate patients have medical records that you can easily use to prove that many patients benefited from what is now called high doses of opiates. It can also prove what happened when our meds were lowered or discontinued. They can also prove our loss of function, health decline and mental health issues because of lack of pain relief. If you had actual pain doctors on your board you would know that pain is not benign. Pain patients are dying from heart attacks, strokes, endocrine and organ failure,long term effects of steroids, NSAIDs and alcohol. The majority are dying from suicide but others are ODing out of desperation. If you don’t remove the 50mme you might as well give links to assisted suicide or drug dealers. I can’t do this much longer. I want to be able to clean my house,shop,garden,see my kids, grandkids and friends,go out to eat,go on vacation and have an intimate relationship with my husband of 25 years. I want my life back and unfortunately none of the available treatments in the last 38 years have helped and many have caused more damage (NSAIDS, steroids,antidepressants, electric stimulation therapies and surgeries). The psychological therapies (CBT, mindfulness, meditation, biofeedback, hypnotherapy and guided imagery) have helped for coping but not for pain relief or function. I could go over all the others,if you like. Why is our actual experience not valued? Why are our lives and our families lives not valued? With so many addiction people I would assume you would realize addiction is complicated,not just exposure.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jackie	None	None	0900006484fd4f4a	Melcher	None	2022-03-21T15:50:10Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Melcher , Jackie	l0x-4wr7-p46o	False	None	False	2022-04-12 04:19:27.648	[]
2689	CDC-2022-0024-2695	https://api.regulations.gov/v4/comments/CDC-2022-0024-2695	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If you do not get these guidelines reversed or withdrawn totally then you are killing pain patients and you all in charge of this madness will have to live with yourselves. I hope some of you are brave enough to stand up to these in charge of dictating what can and can not be taken to function in life the way they deserve. There’s more compassion for the heroine addicts and homeless people that your willing to give them clean needles and crack pipes with a “safe” place to get high but you won’t and don’t take care of the ones that are truly in need of doc prescribed medication so they can live a productive live. You are leaving these humans in harms way of seeking street drugs or just plain taking their own life do to being in constant pain. Please stop the politics and do the right thing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4fc0	Anonymous	None	2022-03-21T15:51:09Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0x-hz4c-rz9x	False	None	False	2022-04-12 04:19:27.862	[]
2690	CDC-2022-0024-2696	https://api.regulations.gov/v4/comments/CDC-2022-0024-2696	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter has been struggling for 32yrs. about 21yrs ago finally seeked out pain management. Was doing very well, for about 13 yrs, then 2016 guidelines came out. She has not been doing well at all. She has a very highly stressed, responsible, active, 24/7 career. I don’t know how she does it and how she can in her amount of pain. I actually started working for her 3 yrs ago. It’s incredible how she manages all this with her pain. <br/>I’ve watched abd have gone to multiple drs appts w her. She has lost all her meds in 4/2016. Navv B aged to five dr to keep most of her meds. 2yts after that, dr retired & covid was here. She managed to get help from primary. After 8 mths primary decided enough time went by. Primary stated she wasn’t willing to lose her license for prescribing to my daughter. She started tapering her , without warning! And drastically too. Daughter then started seeing multiple drs, none would help her!! After 6 or 7 dr appts, found 1 who was 2 hrs away. Agreement to treat but with a slow taper - dr said due to govt regulations she couldn’t be over 50mme. GLs say 90mme, but WI med buses says 50mme. <br/>Well that lasted 1yr. Now she has to find another dr. Saw 4 more drs. None would help. 1 gave her 1/3 of a script, that she was last on. Don’t know how she managed on this fir 2.5 mths and wirking thos job she has, but she did. With half the hours at work, trying to work from home, not that all it can be, she has to go out meet people daily, she manages 6 apartment complexes, has over 300 units and 600 tenants. But she did it! She was not in best of spirits. Abs did nothing but try & work. She lives alone & has no choice but to fend for herself. She also is highly active in advocating for herself & all other CPPS. <br/>She finally found a dr to help. Although on half of her usual dose from yrs ago. This may be better than nothing to get by, but no reason she can’t have the proper medication fir her conditions. <br/>She didn’t ask for this!! She’s been in multiple vehicle accidents, always someone else driving. Or hit from a drunk driver. Abs many years spent in paoer mills, work related injuries , which have all progressed in pain over last 35 yrs. <br/>These guidelines need to revised or revoked! This MME is not fitting for each abd every patient. All patients are unique & need individualized care. Inly then can patients be treated properly & correctly. I’ve read other comments, many by physicians, they agree to individualized care. MME is not proper for each patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fd5929	G	None	2022-03-21T15:52:08Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from G, Karen	l0x-r2p4-4mg9	False	None	False	2022-04-12 04:19:28.311	[]
2691	CDC-2022-0024-2697	https://api.regulations.gov/v4/comments/CDC-2022-0024-2697	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a hospice RN. There just has to be a way for Drs to prescribe more meds for actual terminally ill patients. Addicts have no problem whatsoever getting opioids but my cancer patients with uncontrollable pain must wait ridiculous amounts of time to get their meds. It’s not uncommon for someone with cancer to have an agonizing night and take an extra pill. But then that makes them short on the last day of the wait period so then they go without meds for a whole day. When you are in that much pain suicide comes to their minds. No one should have to suffer line that. Drs should be able to notify the pharmacy that the patient is terminal and the patients should be able to get their meds as they need them. If there’s no illness involved that is noted to the pharmacy by the Dr then the wait rules can apply. Right now Drs are so terrified about the opioid rules that they don’t think twice about yanking people right off their meds without any kind of taping them down. This means people will hit the streets since Drs won’t help them slowly get off their meds. For people with chronic illness, they need help too. There has to be a middle ground for this. I am well aware of the addicts coming in crying ‘back pain’ to get opioids. If an MRI clearly shows a physical issue that warrants pain meds then that’s one thing but too many Drs give them meds on their word alone. And obesity is not a good reason for opioids either but I see many of my patients getting them who are only obese. We need to work with patients in chronic pain more to get them back to a functioning pain free life. But terminally ill persons should never have to wait for pain relief because someone else abused the system.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fd59a7	David	None	2022-03-21T15:52:43Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from David, Karen	l0x-wfpj-qvlm	False	None	False	2022-04-12 04:19:28.526	[]
2692	CDC-2022-0024-2698	https://api.regulations.gov/v4/comments/CDC-2022-0024-2698	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have taken Hydrocodone for 23 yrs since 2016 my Dr has cut me down on my amount of medication and I am in constant pain I travel with my working have to fly back home monthly to get my prescription filled as they won't fill out of state.with the guidelines now in place please make medication available no matter where I am interested us like it used to be it is very taxing and expensive to fly home from work to get my prescription every month please change you guidelines so people can get the medication we need . [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Randy	None	None	0900006484fd502b	Ross	None	2022-03-21T15:53:19Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Ross, Randy	l0x-xta6-18v0	False	None	False	2022-04-12 04:19:28.735	[]
2693	CDC-2022-0024-2699	https://api.regulations.gov/v4/comments/CDC-2022-0024-2699	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi, I am a 61 year old female. I have had about 15 surgeries in my life. Many injuries and illnesses in my lifetime. I have been prescribed opiates for over 20 years and they have helped me recover from many painful surgeries and also live with chronic pain. <br/>I do however suffer from terrible arthritis and pain from injuries. I have had to take prednisone for over three years and was able to wean off of this terrible medication. I have had trigeminal neurolog attacks in my cheeks and nose. I believe these are caused by dental work gone bad? The drug they want to treat me with would be high doses of meds when I do not need them every day. <br/>My doctor will prescribe me very little opiate medicine. About half of what I need to live a normal life.<br/>I exercise daily, I try to eat right, I do not drink and I do not smoke. I have worked my entire life and now retired. I am terrified that my pain will end up ruining my “golden years”<br/>I have been treated terribly by doctors, nurses, pharmacists and people for just needing pain medication. <br/>I feel like I am being treated like a child and even a drug addict just because I need pain medicine.<br/>I need to have knee replacement surgery and refuse as I will not be given more then a week of pain relief. <br/>That is insane! <br/>I am considering living in or close to Mexico so I can obtain pain medicine from doctors there. Will I have to buy drugs on the street? <br/>Please consider keeping us safe with opioid medicine available. Please do not punish my doctor for helping me. Please make it easier to obtain my medicine so I can live out my golden years with less pain. <br/>I beg you to help us. Thank you <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tana	None	None	0900006484fd59c9	Pippin	None	2022-03-21T15:53:47Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Pippin, Tana	l0y-10c0-lvca	False	None	False	2022-04-12 04:19:28.944	[]
2694	CDC-2022-0024-2700	https://api.regulations.gov/v4/comments/CDC-2022-0024-2700	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had numerous lower back surgeries and this all resulted in constant critical pain for me, I need opioids just so I can sit down and even lay down When I can. Just because some IDIOT wants to commit suicide you’re not gonna stop them ! So why should we have to be the ones to suffer because of the stupidity of others ! I can’t even function without my opioids I don’t think you people really even know what pain is , Except for reading it in a book	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Guy	None	None	0900006484fd505e	Karow	None	2022-03-21T15:54:03Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Karow, Guy	l0y-1nz3-adhw	False	None	False	2022-04-12 04:19:29.199	[]
2695	CDC-2022-0024-2701	https://api.regulations.gov/v4/comments/CDC-2022-0024-2701	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The cruel reduction of opiod prescribed drugs for chronic pain patients is only fostering the pop up industry of Rehab Facilities! Look online, you will see the obvious connection. If doctors were better at their surgical procedures then their patients would be cured of their pain and would not need long term treatment post surgery.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5063	Anonymous	None	2022-03-21T15:54:13Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-1t2t-xilo	False	None	False	2022-04-12 04:19:29.408	[]
2696	CDC-2022-0024-2702	https://api.regulations.gov/v4/comments/CDC-2022-0024-2702	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opiates were created to help control physical pain, after serious surgery or injury. There are patients that are not getting anything after serious surgery or injury. Which is causing cruel and inhumane actions As well first the big pharma gets blamed for the drug problems, now it's the big medical tech who is bribing doctor to not prescribe pain meds, and to push their medical devices, which are not considered a failure becuse they are not helping most patients who try them. I myself accepted 25 of those injection in one area of my spine, not one did any good,but the doc just keeps pushing them, how many injections does it take for a doctor to realise this is not working. There is a problem with the opiates, but let's implant a mechanical implant the does nothing but pump opiates into the body. And the other one, an over glorified tens unit, just shocks the body. I mean really how is that treating a crooked spine caused by Degenerative Disc Disease. And now the physical pain I suffer from this, is a 'MENTAL ISSUE" and that a councillor is going to help with all of it. Hello, a councillor does not have the ability to fix, treat, cure a crooked spine. All your doing is showing the world, just how stupid your being. Your guidelines state, doctors are allowed to prescribe pain meds for legitimate reasons, so what are those reasons. I dr telling their patient who they just did a double mastectomy on, tells her she does not need pain meds, because he just removed the cancer. Honestly how stupid do they think we are. There is a real thing called surgical pain. You need a bit of educating, go make a deep long cut in your arm, and then tell yourself what your feeling is a mental issue and go see a counselor.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	dianna	None	None	0900006484fd5066	dixon	None	2022-03-21T15:55:06Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from dixon, dianna	l0y-1v60-g264	False	None	False	2022-04-12 04:19:29.621	[]
2697	CDC-2022-0024-2703	https://api.regulations.gov/v4/comments/CDC-2022-0024-2703	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Stop what you are doing to Chronic Pain Patients and our doctors. Your failure is blatant with the so called "Opiate Crisis" numbers going UP not down since you initiated this attack on patients and our doctors. Chronic pain induces high blood pressure, sugars, hypertension headaches and numerous other issues if proper adequate care is not possible. YOU know that yet ignore the "science"? Why? If the government was so serious about the opiates in our country, they would secure our borders and stop taking shipments from China. You have destroyed patients lives with you MME requirements and you have destroyed good doctors who are compassionate to help us maintain as we suffer. You are evil in your attempts to kill us slowly. Stop it, stop the madness. Enough is enough. Go after China, Mexico and drug dealers and leave CPP's and our doctors alone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fd507c	Cooksey	None	2022-03-21T15:55:29Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Cooksey, Karen	l0y-2xct-op6i	False	None	False	2022-04-12 04:19:29.832	[]
2698	CDC-2022-0024-2704	https://api.regulations.gov/v4/comments/CDC-2022-0024-2704	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I have had chronic pain since 2007. I went through therapy and was sent to many surgeons, all agreed I needed surgery, but had a lot of damage and was high risk. I was turned away everywhere I went and have felt useless. I went on disability and my doctor agreed to treat my pain. Injections are not going to help me. I have severe neuropathy and nerve damage and have constant incontinence. My opiates were the only thing that gave me any sort of quality of life. I have now been forced tapered against my will and my doctor is anti opiate now and there are no doctors who will help me.please tell us how people like me supposed to do now?? Is it constitutional to deny us what works? Is it fair or humane to force us into therapies and expensive treatments that only hurt, not help. Why are we being treated with drugs made for seizures that does not work. Such a witch hunt. I have been treated like a drug addict when sick being accused of drug seeking because I was at the Er with symptoms and I hD my own medication. Something needs to be done about it and soon. Pain patients are not the problem, drug cartels are and it is about time the government let's the doctors treat patients. My doctor is scared to help now, period! Please advocate for people in legitimate pain. We cannot live like this. It is denying our right to life, liberty, and the pursuit of happiness. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484fd5080	Allen	None	2022-03-21T15:56:20Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Lori	l0y-3fyh-pwhg	False	None	False	2022-04-12 04:19:30.041	[]
2699	CDC-2022-0024-2705	https://api.regulations.gov/v4/comments/CDC-2022-0024-2705	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on Oxycodone since 2005. I had cancer as a teenager and have long suffered the side effects of the treatments that I received. I understand the need for guidelines for narcotic medications but for a patient like myself, there should be exceptions. I am not a candidate for surgery and I have severe pain in my back, legs and right shoulder. I go to pain management every month. I take my medication as prescribed. My pain was being well managed with my pain medications until guidelines caused my doctor to cut my medicine dose in half. I am now in pain most of the day due to circumstances that are not due to anything that I have done wrong. I go to my doctor every month. I pass my urine screening every month. I keep my medications in a locked container that requires a code to open. I do everything that is required of me and beyond but I am being punished for abuse by others. There should be a strong reference to doctor discretion. The doctors should be able to make exceptions for some patients without feeling that they are breaking guidelines. I know that the CDC guidelines are just that, guidelines but doctors feel that they have to follow them exactly or face consequences. There are people who actually take the medication to help with pain and these are the people being punished and having their quality of life diminished due to the opioid crisis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sara	None	None	0900006484fd71ef	Monahan	None	2022-03-21T16:37:46Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Monahan, Sara	l10-wn0a-jyth	False	None	False	2022-04-12 04:19:30.270	[]
2700	CDC-2022-0024-2706	https://api.regulations.gov/v4/comments/CDC-2022-0024-2706	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 55 year old disabled woman writing to ask the CDC to change their 2022 Guidelines to take out the MME limits that they have pretended to lower from the 90 MME but have already set in stone a 50 MME. What kind of game is this...so many problems have been caused by your previous guideline. So many suicides and people who are medically and legally allowed to get these kind of medications are undermedicated or not medicated at all and suffering horribly. However the drugs are still on the streets and obviously the real addicts have complete access to them and are still overdosing. No chronic pain patients were getting pain meds without appropriate MRIs, CT scans xrays etc to back up their illnesses in my area anyway. Drs. in my area were never just handing out pills. Everyone I have ever witnessed at a pain management office had a whole list of problems or they would not have been allowed to be patients. We are already the only patients in the whole medical field who get scrutinized and treated like criminals just for being on these meds. No one else is required to go through this kind of treatment. I didnt ask to become disabled or to be a part of this movement but I am still able to speak up for my fellow man. The Guidelines have caused major harm to the weakest individuals in this country. No one wanted to be on these meds. It was a last resort to have some kind of quality of life that lasts for a couple of hours along with every other treatment we have tried. Last year I developed six ulcers because of the NSAID Meloxicam I was taking for inflammatory arthritis and other conditions. Since my pain meds were cut so low due to the guidelines I cannot function without help from NSAIDs which I know are damaging to people my age. The pain meds. are much less damaging. If I get cut lower the CDC may as well sign us all up for Hospice care because I cannot imagine a life without pain care for surgeries or anything else as my problems get worse with age. Please drop the MMEs from the Guidelines my Dr. was already telling me only stage 4 cancer gets 60 MME which was untrue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fd68ed	Donaldson	None	2022-03-21T16:40:13Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Donaldson, Linda	l10-v83i-4ixu	False	None	False	2022-04-12 04:19:30.501	[]
2701	CDC-2022-0024-2707	https://api.regulations.gov/v4/comments/CDC-2022-0024-2707	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I will kill myself if I am refused the opioids that I take every day. PLAIN SIMPLE TRUTH. <br/>To withhold my medications would mean such pain that I would have to stay in bed. And staying in bed does not give me relief, it's just too hard to stand, sit, or walk, and if left without relief the result is terrible spasms that are electric, repeating every 8 seconds. <br/>I was first given Percocet by my GP about 10 years ago, so that would be 2012. That doctor moved away and the one lectured me and then refused to continue at all. <br/>I eventually found a GP that would take me after being flat-out refused without even meeting 3 other doctors whose front desk just said NO because I was honest about my chronic pain. This new GP also refused to prescribe any opioid or benzodiazapine (I take 1 mg of Lorazepam every day). He kept saying it was bad for me. When I argued that no doctor knew whether all the other meds I take are as bad for me, he became angry and said he would not speak with me if I used that tone. HOW ARROGANT! But I needed a GP so I had to kowtow, and just be a good girl. How DEHUMANIZING! <br/>I had attended [redacted], headed by [redacted], at the [redacted] complex in [redacted], Ontario, Canada since the mid 1980s and I was welcomed back and he was able to give me the Percocet that had been taken from me. Then [redacted] came into office as the Premier of Ontario and put pain clinics of every sort on the chopping block, without having any knowledge or understanding of the special and unique work [redacted] has done since he founded the Musicians' Clinics of Canada. In order not to be closed down totally ([redacted] is not intelligent or human enough to know or care about the reality and importance of [redacted]) [redacted] reorganized his programs until he met all of the 'new' requirements. Unfortunately for me, those requirements were so stringent that [redacted] felt he could not prescribe opioids, because it would imperil the continuation of the Musicians' Clinics of Canada. His life has revolved around helping musicians since 1985; he is world famous, and is one of the founders of PAMA [redacted]. <br/>I moved away from the Niagara Region in 2020 and my new GP prescribed Percocet shortly thereafter. Even so, at 3 tablets per day (5 mg/325 Acet) it is barely enough, despite the fact that I also take 300 mg of Gabapentin 5 times a day. I take as much as 2000 mg of acetaminophen and at least 4 ASA every single day. AND when needed I supplement with OTC Tylenol 1 equivalent, taken two at a time. I write down every single dose and keep those records. <br/>If Canada lets the US make its decisions about the future of all of us who suffer extreme chronic pain, then there will be terrible and deadly consequences. It's high time common sense prevailed; decisions should be entirely up to family physicians or pain specialists, considering the difficulties and pain endured by each patient.<br/>Thank you, Chronic Pain Association of Canada!<br/>[redacted] [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eleanor	None	None	0900006484fd6c47	Lawrie	None	2022-03-21T16:54:31Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Lawrie, Eleanor	l10-sqp2-67in	False	None	False	2022-04-12 04:19:30.715	[]
2702	CDC-2022-0024-2708	https://api.regulations.gov/v4/comments/CDC-2022-0024-2708	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe Restless legs syndrome (RLS), a chronic neurological disease that is making my life unbearably agonizing. I have not yet found a doctor that will prescribe the opioids needed to get me off these horribly augmenting dopamine agonist pills. I beg you to please add chronic conditions like RLS to the new CDC Clinical Practice Opioid Prescribing Guideline. My life and others are at risk if this issue is not addressed	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacque	None	None	0900006484fd6ba8	Robinson	None	2022-03-21T16:55:24Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Robinson, Jacque	l10-rel1-as7u	False	None	False	2022-04-12 04:19:30.931	[]
2703	CDC-2022-0024-2709	https://api.regulations.gov/v4/comments/CDC-2022-0024-2709	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I teach a type of yoga that has been very beneficial for reducing chronic pain and the mental issues associated with it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd6b83	Anonymous	None	2022-03-21T16:56:54Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l10-r25f-k64m	False	None	False	2022-04-12 04:19:31.153	[]
2704	CDC-2022-0024-2710	https://api.regulations.gov/v4/comments/CDC-2022-0024-2710	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	America is currently undergoing several “Feel Good” fads that include the opioid ban. Thousands if not millions of people must now undergo excruciating pain that is unnecessary since there are medications that allow them to function normally, but which have been banned by those that want to blame opioids instead of the increasing number of people looking for an escape from life. The CDC did nothing by banning opioids other than move those that will abuse any drug, many who now have moved on to fentanyl and because of this they are no longer getting input from their doctors who might be able to treat the root cause of the problem. I have taken opioids off and on for over 40 years, due to numerous injuries and joint replacements but have never become addicted because a doctor was always there to give educated advice. Many more people have moved to heavy use of marijuana, which again has no input from doctors and multiple side effects. Castrating the use of opioids which have been medicinally used for hundreds of years has not lessened the number of deaths or helped addiction, only transferred it to unmonitored and unreportable drug use while causing emotional and physical pain for those in need. Please restore the opioid control to the educated, qualified doctors that know their patients best.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fd668f	Nelson	None	2022-03-21T16:57:09Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Nelson, David	l10-nedr-ffsw	False	None	False	2022-04-12 04:19:31.368	[]
2705	CDC-2022-0024-2711	https://api.regulations.gov/v4/comments/CDC-2022-0024-2711	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2010, I broke my neck at C1, and underwent intensive surgery to repair it. When I woke up from my chemically-induced coma, they put me on a cocktail of several different opioids with a total MME around 110. My surgeon felt comfortable doing this because (a) the pain after a fusion at C1 is one of the worst pains in the world, (b) testing of my metabolism and weight indicated it was safe, and (c) I was being constantly monitored. As I began to heal, the level was slowly reduced. When I went home, it was roughly 80 MME. That continued to be slowly reduced. When I started taking medical marijuana,, I was able to reduce it even further (to roughly 90 MME per week, then per month). <br/><br/>Unfortunately, due to the ridiculous restrictions on medical marijuana, I was forced to switch back to opioids when I moved. <br/><br/>Words cannot describe the pain I was in after surgery, and I'm grateful that my surgeon was able to determine the correct dosage for me without having to worry about state regulations based on bad/incomplete science. <br/><br/>These days, many surgeons won't prescribe opioids to their patients at all after surgery due to their fear of violating the laws. This is downright cruel. As such, a number of people I know refuse to get medically-important surgeries because they're scared of the possibility that they might not be given any pain relief afterwards. This is not only cruel, but research indicates that pain can reduce the body's ability to heal.<br/><br/>Many patients with chronic pain are also forced to undergo surgeries that won't help them because the state requires that the doctor must try "alternative methods of pain relief," regardless of whether or not the doctor thinks it will help. Some patients are unable to get opioid pain relief at all because their doctor doesn't want to risk being accused of being a 'pill mill' and getting shut down. <br/><br/>The state of things is extremely frustrating to pain patients. In fact, evidence shows that more pain patients commit suicide (whether by intentionally overdosing or another method) since these laws (based on CDC guidelines) went into effect. The quality of life for those in chronic pain has been reduced by these laws and they have not had the intended effect: overdose deaths and suicides have increased rather than decreased. <br/><br/>Please help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	June	None	None	0900006484fd62a7	Brown	None	2022-03-21T16:57:35Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, June	l10-9re0-9lbk	False	None	False	2022-04-12 04:19:31.578	[]
2706	CDC-2022-0024-2712	https://api.regulations.gov/v4/comments/CDC-2022-0024-2712	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 73 year old woman who was diagnosed with Ulcerative Colitis in the Army in 1976.<br/> While I was in remission for many years, off and on, my UC came back full force in 2000. <br/> In 2002 I was given Vicodin, twice a day, as needed by my Primary Care doctor at the time. Only took them when I was having a bad flair-up. I started using 2 a day, everyday, in 2007 prescribed then by my GI doctor. I also medically retired and went on disability as my flairs had become to much for me to work. I was declared 100% disabled by the VA and yet for years had to fight to get my Vicodin from one of the VA's in NH. They refused so I transferred up to the VA in [redacted] in VT. I finally found a Primary Care at this hospital who is very caring and am receiving them there and still do.<br/> I am still taking 2 pills a day. If I didn't have this medicine, I would be in pain constantly(not just from flair-ups but I also have copious amounts of adhesions from a previous resection of my colon) and not be able to function. I have never abused this medicine and have never doctor shopped or done anything illegal to obtain my medicine. And I never would. I am sent 58 tablets every month, no less, no more. And I am tremendously grateful for this.<br/> Please, don't make it any harder for folks like us to have to plead and make ourselves look and sound like drug addicts. We just want to be pain free from our chronic illnesses.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Virginia	None	None	0900006484fd661c	Luce	None	2022-03-21T16:58:30Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Luce, Virginia	l10-68gx-4e4e	False	None	False	2022-04-12 04:19:31.817	[]
2707	CDC-2022-0024-2713	https://api.regulations.gov/v4/comments/CDC-2022-0024-2713	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The mme should be done away with. There’s no science backing it up. Everyone is different and has different metabolism, weight, height, trama etc… mme is NOT a one size fits all. Patients are suffering and dying because of these guidelines. Stop the torture!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484fd65f6	Rutledge	None	2022-03-21T16:58:41Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Rutledge , D	l10-2kck-3ah0	False	None	False	2022-04-12 04:19:32.037	[]
2708	CDC-2022-0024-2714	https://api.regulations.gov/v4/comments/CDC-2022-0024-2714	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've already commented once but I've looked deeper into a few things within the context of the opioid revised "guidelines". The new one needs to be scrapped along with the 2016 "guidelines" and clearly we need an unbiased entity to create ANY guidelines regarding pain management in the US. The CDC has gotten much wrong throughout the years and these opioid "guidelines" are the pinnacle. My mother was a clinical psychologist at the University of Georgia and was a consultant to the CDC 25 years ago. She was quite concerned about the culture within the CDC and said to me that we would be in trouble (The USA) if we ever really needed the CDC. She has been correct on a number of occasions I'm sad to report. She had NO confidence in the CDC and clearly she had no reason to have any. I don't either and I'm spreading the word as best and as fast as I can. The CDC is causing FAR more harm than any good it may have done and should be shuttered. The CDC is causing more misery in the US than anything at all I can think of. The CDC has no business in our doctor's offices and hopefully will be removed at some point. Publicly RECIND ANY and ALL "guidelines" and an apology is in order to those that have had increased misery and those that have committed suicide due to the 2016 guidelines. How many more must literally put themselves out of misery, how many more suicides, because of the arrogance of the CDC? How many more must live in torture due to untreated or undertreated chronic/intractable pain because of the CDC? NOW MANY? What's the number?! I've never been a hateful person but I hope and pray that anyone that has anything to do with these guidelines gets to experience unbearable pain and be forced to NOT have their pain managed properly. And I hope this happens sooner than later.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C.	None	None	0900006484fd61e8	Lawson	None	2022-03-21T16:59:10Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Lawson, C.	l0z-zlmn-aiic	False	None	False	2022-04-12 04:19:32.267	[]
2709	CDC-2022-0024-2715	https://api.regulations.gov/v4/comments/CDC-2022-0024-2715	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The statistics used to justify the original guidelines were flawed and used incorrectly. They lumped illicit drug use in with legitimate prescriptions and thus the numbers looked very bad. It was done for political purposes and hurting millions of Americans for politics cannot be excused.<br/>There should be no MME mentioned AT ALL in these, since everyone's body is different, different weights, different years on the medicines, etc., it simply cannot be put inside a box and labeled as one size fits all. <br/><br/>I am a legitimate pain patient, I have an incurable genetic condition that causes much pain that will never go away (hypermobile Ehlers-Danlos Syndrome). I am a larger sized lady, as well. I take a "large" dose of medicine and the doctors at my pain management clinic are afraid to give me what I need for fear of the DEA! As a result I am UNDER-MEDICATED and SUFFERING in AGONY part of the month!<br/><br/>Most medicines cause a tolerance over time, especially pain medicines. They MUST increase a little every now and then, no matter what one does to try to manage it. I have tried everything I could to reduce my tolerance and I only take the least amount needed for my pain, so I can function. Where is the compassion and caring that doctors used to give? It's gone now. I feel like I have been betrayed both by my government and by my providers. It hurts (emotionally).<br/><br/>Government should not get between doctors and patients - period. These guidelines need to be removed entirely and doctors should be able to make their own decisions on what to prescribe and how much, especially since insurance companies will take any excuse to not pay for something and they are definitely doing so. I have to pay out of pocket for one of my prescriptions because they simply won't cover it at all due to the "MME guideline". The other long-acting medicine I take is extremely expensive and requires a prior authorization, where they are trying to force patients to take the cheaper, more dangerous drugs with severe side effects and/or horrific withdrawal symptoms like methadone or fentanyl instead of the ones that work safely.<br/><br/>These guidelines don't just affect patients, it also affects their families. My life is messed up because I cannot function half the time due to being under-medicated. I have to sit on the couch instead of doing things with my children, cooking and cleaning for them and my husband. This is affecting their lives very much and I know millions are having the same thing happen with them.<br/><br/>Please remove these guidelines, they should never have existed in the first place. You got your point across very well, every single doctor in the country knows that they should be careful with pain medications now. <br/><br/>If you do not remove them, at the very least remove any MME mention, as this article snippet below from "What the Opioid Crisis Took From People in Pain" on March 9, 2022 states:<br/><br/>"But these changes may not be enough. While the guidelines explicitly reject dosage caps, they continue to warn doctors to be wary of dosing over 50 M.M.E. per day, which could still be misread as a rule. Moreover, these revisions by themselves can’t undo all the laws, metrics and regulations that codified the old guidelines.<br/>If policymakers really want to prevent suicides like Mr. Slone’s as well as overdose deaths, addiction and pain must be treated with compassion and science, and the assumption that we can solve either problem merely by slashing the medical supply must end."<br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tonia	None	None	0900006484fd5cf6	Hall	None	2022-03-21T17:54:59Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Hall, Tonia	l0z-j8eu-g59o	False	None	False	2022-04-12 04:19:32.486	[]
2710	CDC-2022-0024-2716	https://api.regulations.gov/v4/comments/CDC-2022-0024-2716	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern:<br/>My husband (who will be 76 this year) has suffered with chronic back pain due to an injury since the late 1970's. He managed it via various modalities (excercise, PT, mindfulness, radiofrequency ablation, steroid injections, etc). About 2007 the arthritis set into his back making the pain worse and severely impacting his ability to work and time off which lead to the loss of his job. He began Oxycontin/Oxycodone 40mg ER 4 times a day which improved his quality of life along with every three month cortisone injections. By 2014, spinal stenosis at L4-L5 became so severe that he required surgery. After that, he was able to taper to the same medication and dosage 3 times a day while continueing the cortisone injections every three months. The pain contiues to worsen with most of the day spent in his recliner where he sleeps now most nights. There may be a time soon when he will need to increase this dose to 4 times a day, but we don't know if he will be able to do this based on the current guidelines, let alone these new restrictions on the morphine milligram equivalent limits being proposed. Please do not do this! For the mental health of those who must depend on these pain medications as well as those who care for them, please eliminate this restriction from you proposal. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	0900006484fd6107	Henning	None	2022-03-21T18:06:15Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Henning, Shirley	l0z-jwcr-jh6x	False	None	False	2022-04-12 04:19:32.702	[]
2711	CDC-2022-0024-2717	https://api.regulations.gov/v4/comments/CDC-2022-0024-2717	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	With regard to the proposed 2022 CDC guideline on prescribing of opioid analgesics for chronic pain, the CDC has been incredibly deceptive & has employed members of openly anti-opioid groups to write these guidelines. These guidelines need to be stricken and the determination on the use of opioids, as well as dosage, needs to return to the judgement of physicians and patients suffering with chronic pain. This needs to be without interference of the DEA or DOJ.<br/><br/>Intrathecal injections are often forced on patients suffering with chronic back pain. These injections are dangerous and have serious long term health consequences. <br/><br/>https://www.advisory.com/daily-briefing/2018/08/17/injection <br/><br/>"While FDA did not ban the epidural use of Depo-Medrol, the agency in 2014 authorized a stronger warning that steroid injections near the spine could lead to injuries or death. FDA's warning applied to Depo-Medrol and "the entire class of epidural steroid injections. This class of drugs is injected into the epidural space within the spinal cord, but when injection is not administered appropriately and a target is missed, patients can sustain direct injures to their nerves."<br/><br/>https://nervedisc.com/the-5-top-reasons-to-avoid-epidural-steroid-injections/<br/><br/>"The 5 Top Reasons to AVOID Epidural Steroid Injections<br/><br/>Epidural Steroid Injections are NOT FDA APPROVED!<br/><br/>Epidural Steroid Injection’s are harmful, have been proven dangerous and can irreparably injury your spine with severe health consequences. <br/><br/>Epidural Steroid Injection’s were never designed as a solution for the CAUSE of your pain or inflammation. <br/><br/>Only treating your pain, using Epidural Steroid Injections, is what allows your condition to get worse."<br/><br/>Because doctors have become reluctant to prescribe opioid analgesics for chronic pain, many of us are also forced to use high dose acetaminophen which is incredibly dangerous.<br/><br/>https://www.webmd.com/drug-medication/news/20150302/does-long-term-acetaminophen-use-raise-health-risks<br/><br/>"Acetaminophen may not be as safe as previously thought, with larger doses and long-term use linked to increased risk of health problems, a new report contends..."<br/><br/>"Heavy use of acetaminophen is associated with kidney disease and bleeding in the digestive tract, the paper reports. The medication also has been linked to increased risk of heart attack, stroke and high blood pressure..."<br/><br/>https://www.google.com/amp/s/www.practicalpainmanagement.com/amp/12513<br/><br/>Because doctors have become reluctant to prescribe opioid analgesics for chronic pain, many of us are also forced to use high dose NSAIDs, which is far more dangerous than the use of opioid analgesics. <br/><br/>https://www.practicalpainmanagement.com/amp/12513<br/><br/>"Mortality reported with NSAID use is generally linked to NSAID-associated GI bleeding, and the reported incidence is quite variable. Much of the literature reports 16,500 deaths annually as a result of NSAID-induced GI bleeding."<br/><br/>The annual rate of deaths attributed to the use of NSAIDs is higher than the rate of deaths due to prescription opioids. <br/><br/>Very few studies have actually been done in the long term use of opioid analgesics in the treatment of chronic pain. Despite what the CDC would like you to believe, the studies that have been done support the use of opioid analgesics in the treatment of chronic, non cancer pain.<br/><br/>https://www.frontiersin.org/articles/10.3389/fpain.2021.721357/full<br/><br/>Please make your comments regarding your experience with chronic pain, your mistreatment since the 2016 guideline, how your life had been affected by chronic pain, and your inability to get adequate treatment since the 2016 guideline was published. The following is a link to the Federal Register. PLEASE DO NOT copy and paste my message or both my comment and yours will be stricken. You may however, use my links to formulate your comments:<br/><br/>https://www.regulations.gov/document/CDC-2022-0024-0001<br/><br/>The US government, the CDC, DEA, DOJ, insurance companies, Medicaid, and Medicare, as well as physicians owe it to patients who are suffering with chronic pain to do numerous long term studies on the use of opioid analgesics, without limiting the dosage or daily MME of opioid analgesics. They owe it to us to use as many chronic pain patients as possible, recruiting from Facebook, Twitter, and other social media chronic pain forums.<br/>Anyone who suffers with chronic pain should be able to participate in these long term studies. Again, these studies shouldn't be limited in dose or daily MME. Anecdotal evidence, based on patients on social media chronic pain forums, refutes what the CDC works have you believe. Thousands of chronic patients have proven that the use of long term opioid analgesics is not only incredibly effective, their use of also very safe. Otherwise those of us who've benefitted greatly from the long term, high dose prescription opioids would be dead. We're not. We're very much alive and willing to take part in long term studies. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	SA	None	None	0900006484fd6139	Justice	None	2022-03-21T18:12:31Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Justice, SA	l0z-m2co-4hhz	False	None	False	2022-04-12 04:19:32.921	[]
2712	CDC-2022-0024-2718	https://api.regulations.gov/v4/comments/CDC-2022-0024-2718	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an intractable pain patient your guidelines are atrocious . Medicine been using opiates since Civil war and now they magically don’t work? Stop the bs already . You’ve got zero acnecdotal evidence or science based studies that prove they don’t work. The OD issue is an illegal fentanyl issue . I’m at the end of my rope here stop playing God already	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chuck	None	None	0900006484fd60b5	Rogers	None	2022-03-21T18:18:39Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Rogers, Chuck	l0z-p2m9-chdx	False	None	False	2022-04-12 04:19:33.164	[]
2713	CDC-2022-0024-2719	https://api.regulations.gov/v4/comments/CDC-2022-0024-2719	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The February 2022 draft revised and expanded CDC practice guidelines for prescription of opioids are fatally flawed and deliberately misleading. Like their 2016 predecessor, these guidelines misrepresent science that is known widely among practicing clinicians. When taken as directed, prescription opioids are both effective and safe for the great majority of patients with moderate to severe acute or chronic pain. The draft guidelines explicitly acknowledge damage done to millions of patients and clinicians by the 2016 document. They deceptively proclaim that physicians should be free to exercise their own professional judgment in the treatment of their patients. But the writers continue to reinforce their original anti-opioid agenda in a document intended to intimidate physicians and support draconian legal prosecution against any who continue to treat pain by means of opioid analgesics.<br/><br/>It is time for the US CDC to be removed from any role in developing practice guidelines for all medical specialties including pain management. Such guidelines are the proper purview of professional medical specialty academies and associations whose members are clinicians with practical experience in community or hospital practice. The CDC lacks both the legislative charter and the internal expertise to perform such oversight for other than communicable disease.<br/><br/>As written, the 2022 draft follows an old bureaucratic tradition: if you can't convince your audience with evidence and rational argument, then baffle them with a large volume of BS nonsense.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484fd726f	Naeve	None	2022-03-21T18:21:24Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Naeve, Nicole	l10-ycup-nn4e	False	None	False	2022-04-12 04:19:33.380	[]
2714	CDC-2022-0024-2720	https://api.regulations.gov/v4/comments/CDC-2022-0024-2720	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Afternoon unless you are a chronic pain patient. I was a productive member of society until my doctor wouldn't increase the dosage of my opioid pain medication. I had to retire 7 1/2 years early with a big financial loss and loss of my livelihood. I was deemed disabled and recieve ssdi benefits. After 2 back surgeries the second one having a cage with 8 screws holding it in place only to find out 4 of the 8 screws fractured and needs replaced. My retirement consists of sitting on my couch holding my breath as it is less painful not breathing. I was unvoluntarily weaned down to the point of the amount of pain medication didn't help at all. I asked my doctor if pain had a limit and he said no and I asked him why limit pain medications if pain has no limit. My only hope now is to try and build up the courage to end my suffering since doctors can but won't help us. The damage is done to the millions made to suffer for the action of others. I thought doctors creed is cause no harm.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fd6e48	Dax	None	2022-03-21T18:22:39Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Dax , David	l10-zicf-ehx5	False	None	False	2022-04-12 04:19:33.591	[]
2715	CDC-2022-0024-2721	https://api.regulations.gov/v4/comments/CDC-2022-0024-2721	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To any and all concerned, I believe there has been a miscarriage of justice regarding the previous and upcoming CDC guidelines. There is genocide occurring in this country of chronic pain patients all hidden under the guise of addiction. This must stop. As a senior veteran who lives in constant pain, I would appreciate these guidelines to be thrown out. They have caused so much further damage to those who have already suffered more than enough. It is ludicrous for the CDC, FDA, or DEA, be in our doctors offices. Perhaps, these agencies could do their real job of addressing illegal, not prescription drugs.<br/>Honestly, with the difficulty of finding a competent doctor that will prescribe, I doubt sincerely that there is any diversion going on. Myself, having been tapered to an amount that couldn't get a gnat out of pain, no longer have mobility or a life. The experiment has failed! Please allow chronic pain patients access to their proper dosage of medication and start paying attention to the illegal fentanyl crisis.<br/>Thank You For, hopefully, Considering My Comment	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd73dd	Anonymous	None	2022-03-21T18:32:35Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-12cl-3phn	False	None	False	2022-04-12 04:19:33.823	[]
2716	CDC-2022-0024-2722	https://api.regulations.gov/v4/comments/CDC-2022-0024-2722	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted].<br/>I had two car accidents in 2019-2020, I have been through hell and back. To make a long story short, I was put on opioid pain medication in July of last year, and it worked enough that I could work, enjoy my family time, and I was able to sit/stand for longer periods during the day. I did everything you can think of, epidurals, trigger points, steroids nerve conduction studies, tried every anti inflammatory and muscle relaxer under the sun, nothing worked and the withdrawals from “oipiod alternatives” were the worst in my life, since nerve pain medication (lyrica, cymbalta) act as SNRIs, the withdraws are the worst thing that have ever happened to me. <br/><br/>I was taken off my chronic pain medication in November, I had surgery of my L4-L5 from the surgeon that my neurologist referred me to. My neurologist took over my pain medication since I was awaiting surgery and my pain management was not doing any epidurals or trigger point shots until I was done. The night of my surgery I was given 2 scripts, bacofen and oxycodone. My wife got the scripts and I was later called by neuro that he would no longer give me my pain medicine and that the office was upset that I had gotten post surgery medication, so I went to a new pain management because I had to have specific shots done (diagnostic faucet injections) and was referred by my surgeon. After one appointment, I had to pay $282 just for one appointment and it would be $280 for each shot, I have to have 10. She was not in my network, I cannot afford that, so I went to a different pain management that was under my insurance. They will not give me my opioid medication, and put me back on Lyrica, lyrica does not work for me, and the withdrawals are from hell. Since they didn’t give me proper pain meds, I have to take lyrica, they will call me for an appointment for my shots, insurance denied my shots, so I am awaiting a call, in agony and labeled as a drug seeker, since I got meds from my surgeon, and then got 10 pills of hydrocodone for a month from the pain management that wasn’t in my network, because of the flags that the government sends I’m sure that according to them I’m at “high-risk” addiction since I’ve had different doctors give me my medications. This is not my fault, I am 33 and have tattoos, they have judged me from day one, and because of these judgements I have to live this way. If you could only imagine the horror these years have been, think of someone burning your nerves and gnawing at your back muscles, not just for a week or two, for two and a half years, every second of every minute of every day. It’s sickening for me to talk about because it has completely ruined my life and my goals for a career. THIS IS JUST THE SHORT STORY. Please help those of us who need pain management from opioids. Some of us have tried everything like lab rats and sometimes it’s the only thing that helps. Before this happened to me I ran a memory care department full of residents with Alzheimer’s and dementia, I was excelling in my career and going back to school. I have had to stop because I can’t sit for more than 5 mins without having to move from pain. WE NEED OUR VOICES HEARD.<br/><br/>I will be attaching my MRIs as well as some pictures of who I used to be, an advocate, a friend and a voice for those with dementia.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Geneva	None	None	0900006484fd6c4a	Detommaso	None	2022-03-21T18:51:32Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Detommaso, Geneva	l10-sjvo-smos	False	None	False	2022-04-12 04:19:34.036	[]
2717	CDC-2022-0024-2723	https://api.regulations.gov/v4/comments/CDC-2022-0024-2723	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a documented painful spine condition that has affected me on a daily basis the majority of my adult life. For thirty years I have been unable to simply purchase or access treatments that work for me when and where we're needed ( as a diabetic has rights to access insulin all citizens have the same and equal rights) For ten years and especially since the opioid guidelines were published I have not been allowed reasonable access to safe simple effective medications even when doctors recommended use and the historical opioid, muscle relaxant and benzodiazepines combos used for almost a century were prohibited without cause. When access to treatments is taken from the patient or provider and only the permitted and promoted interventions are expensive unproven and inaccessible as well (spinefusion, spine stimulator, epidurals, etc. ) affecting day to day life and requiring starting at step one all over each time I move or change providers. When citizens find government overlap limits access to reasonable or even historical treatments deemed safe, effective and inexpensive, that is tyranny.Just as a diabetic has rights to access insulin All citizens have the same and equal rights.<br/><br/>The CDC has now had two epidemic failures. <br/>The Opioid and COVID 19. <br/><br/>I grew up reading and understanding the point of agencies in our US history but the CDC, FDA and Dea no longer or never did function and in fact damaged the nation. Real life Example:<br/><br/>I can go to church with the town pharmacists and the town doctor bu I can’t purchase pain or any medication from them due fear from undue oversight by CDC, FDA, DEA etc . That's not protecting or defending citizens' health, that's tyranny.<br/><br/>Just as a diabetic has rights to access insulin <br/>All citizens have the same and equal rights <br/><br/>My direct experience upon Returning home to America and not getting reasonable access to treatments since 2010 was life altering. Eventually it became clear that the CDC,FDA and DEA do nothing at the local level except scare off good doctors and providers. Last year the toll of these conditions and the inability to access treatments meant I began losing my ability to walk at all. The years of pain have now turned into legs that won’t react.Just as a diabetic has rights to access insulin All citizens have the same and equal rights <br/><br/> Show me why the CDC, FDA, DEA needs or deserves to have any input into my opioid medications? Nothing in the past 5 years demonstrated they need to exist in 2022 as agencies. The simple fact that I have never been required to have an opioid reversal or had one offered with a prescription in two decades shows the absurdity of these agencies. (Just as a life jacket is required while boating simple basic governance is not happening) . I never once was offered anything to improve my health or keep me safe. But I was told no, denied access, would and could have been punished for possession of a simple medication or treatment. Just as a diabetic has rights to access insulin. All citizens have the same and equal rights.<br/><br/>Citizens have a duty to throw off such governance. Citizens rights and duty call for action and reform or abolishment of the cdc, dea, fda. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marcus	None	None	0900006484fd725e	Huffman	None	2022-03-21T18:51:55Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Huffman, Marcus	l10-y04t-hsy2	False	None	False	2022-04-12 04:19:34.318	[]
2718	CDC-2022-0024-2724	https://api.regulations.gov/v4/comments/CDC-2022-0024-2724	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	On January 11, 2022 I underwent a lazer corneal surgery. I had this surgery 10 years prior on my left eye and was treated with large amounts of percocet due to the level of pain this surgery causes. This was what the surgeon at the time ten years ago prescribed even though I was already taking percocet for other pain conditions. Fast forward 10 years same surgery new surgeon tells me a bandage contact lens prevents all pain from this surgery. I had faith in this surgeon. I was sent home with a numbing agent. for the next 3 days I was in excruciating pain. The pain was no different than 10 years ago. The only differece was that the first surgeon was honest. I went for my follow up appt. and raised 10 kinds of hell. The Dr. I saw said "Well of course you're in pain you have a 4 mm hole in your eye" WTH this surgeon is bound by the DEA because of your Guidelines to lie to patients and tell them there is no pain involved. This is a lawsuit but how can this happen when they are so bound. When I complained about this on a chronic pain site a lady who had her leg amputated responded saying she was given no pain meds. and she got infection had to have revision surgery on her leg and again no pain meds. WTH is this world coming to. Amputations with no pain medicine all because of your CDC Guidelines. You have Doctors and surgeons afraid to go to prison for doing their jobs. Please keep the CDC and DEA out of medicine. You are making our country look so barbaric.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fd6e09	Donaldson	None	2022-03-21T18:52:47Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Donaldson, Linda	l10-yn6z-lxxd	False	None	False	2022-04-12 04:19:34.552	[]
2719	CDC-2022-0024-2725	https://api.regulations.gov/v4/comments/CDC-2022-0024-2725	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient with multiple health conditions and symptoms, making finding the right diagnosis difficult. Just last month my doctor told me he had to justify to the government why I'm still in the same amount of pain as last year but on a higher dose and if he couldn't he had to start to taper me off or risk losing his ability to prescribe any pain meds. He's a pain management specialist! I got lucky and another Dr decided to check my hormones on a hunch and that explains the rise in pain, but it could have easily gone the other way and has in the past. Just because we don't know why a patient is in more pain isn't a reason to cut them off from treatment! I've been dealing with this for 24years and every time a Dr has said that I couldn't possibly be having a symptom or it's all psychosomatic within 5 to 10yrs studies come out showing I wasn't making it up or just stressed out but it's a real thing. Most people don't lie about their symptoms and it's pretty easy for a doctor to tell who's drug seeking and who isn't; mainly because we're alot more focused on getting answers and our lives back than higher doses of meds and willing to suffer through painful and degrading tests and procedures. <br/>Ex: in fall 2019 I had my gallbladder removed, by winter I was dealing with daily cataplexy and fainting regularly. Nuero misdiagnosed me with a rare autoimmune condition, referred me to Mayo and then retired. Mayo doesn't take my insurance, Dr 2hrs away couldn't see me for a year bc his testing machine was down/was overburdened due to the pandemic. Finally got in Sept '21, discovered misdiagnosed in Dec, different Dr tested hormones in Jan '22, and been trying to get in to see endocrinologist since. I still need an EEG and I can't get that booked because everything is still backed up from the pandemic. All this and yet the state wants to take me off the medicine that's keeping me from being in so much pain I can't catch my breath because I'm not getting better fast enough for them? Had a Dr try to label me as malingering because her treatment of b12 and physical therapy didn't work and this feels just like that. Any recommendations for limiting medication must take into account so many different factors it's irresponsible to suggest an actual numerical limit, and the negative effects of the previous higher limits are still being felt by patients and doctors nationwide. The drug manufacturers lied to everyone, especially medical providers, on the safety of these drugs and it seems instead of adjusting recommendations based on how the medicine actually works this agency is more interested in appearing to be engaging in the so called war on drugs. Since you can't attack or kill an inanimate substance, the people being targeted are innocent patients and doctors doing their best with what information they have available. Seems to be it'd be a better use of everyone's time and money to create independent testing regulations and stop letting the company selling the medicine be the one who checks to make sure it's safe. We don't trust the dealership that the used car they're selling is safe, but get an independent inspection. Heck when buying a house it's a requirement to have it inspected by a 3rd party! Limiting and punishing patients and doctors is no different than if you were ripping people from their homes because the previous owners did their own inspection and everyone signed off but now you've changed the rules to say the ceiling is the wrong color.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	AprilDawn	None	None	0900006484fd6e36	Bennett	None	2022-03-21T18:53:19Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Bennett, AprilDawn	l10-z6ca-oynz	False	None	False	2022-04-12 04:19:34.777	[]
2720	CDC-2022-0024-2726	https://api.regulations.gov/v4/comments/CDC-2022-0024-2726	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic migraines (now about 8 per month) since age 16 with no good results and/or adverse side effects from all known anti migraine meds and treatments. Put on Dilaudid 4 mg in 2009 with excellent results. Used as needed only. Not a daily occurance. Resolved the migraine in 15 minutes 90% of the time. After the CDC guidelines, everything changed. I had to do contracts and urinalysis etc but that was fine with both me and my doctor until he retired in 2019 and there were no compliance issues etc. The new doctor sent me to several pain med specialists and a new neurologist. The pain doctors told her to taper me off the Dilaudid. She did not even taper. She just took it. The neurologist told me he would have let me stay on them because of my extensive history with literally everything else and to go elsewhere and get the pain meds but I haven't. Why couldn't HE prescribe them to me since he agreed I needed them? No idea. These migraines have been the absolute bane of my existence and they are just not taken seriously. I've been told to use marijuana for them, which is useless on migraines, except for nausea and is laughable since I've been using it for migraine nausea since I was 20 years old anyway. If they had worked for migraine, I'd not have spent so much of the past 40 years in agony.. I'm 61 now. And still hoping that I'll age out of them. <br/><br/>So for 10 years I had no problems and good pain management for a few dollars a month, and now I am where I was before this mess. Completely without any tools to fight them. When I get one, I just suffer. I don't even bring up my migraines anymore and I will never forgive the medical profession for this abject failure and violation of their duty to first do no harm for they have done much to me alone. Please fix this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teri	None	None	0900006484fd6e66	Peters	None	2022-03-21T18:53:44Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Peters, Teri	l10-zpil-ndn2	False	None	False	2022-04-12 04:19:34.987	[]
2721	CDC-2022-0024-2727	https://api.regulations.gov/v4/comments/CDC-2022-0024-2727	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a disabled nurse and it’s been 35 yrs I’ve needed opiate medication for my treatment and I have zero issues taking them all these years and I can NOT take mind altering drugs. I do massage for 2 hrs per mth I pay for and I eat Organics and drink only filtered water…I’ve done chiro and also take a laundry list of supplements each day. I have tried everything suggested and nothing works for me except opiates as I have pain all over my body of all different types and I will never participate in polypharmacy again bc that nearly killed me and I have long term permanent issues from these OTHER drugs. The CDC had no business brainwashing the population and Drs against the sick and disabled with fraudulent studies published for that soul purpose. We are NOT addicted to our pain medication and we DO NOT suffer the side effects they list. I for one as sick and tired of begging for my long term proper medical care for my diagnosis of IP and I was denied surgery last year bc I could not get into PM bc I was blacklisted by 187 pm drs in BCBSNJ and I only was able to have one…the re do of my bad foot surgery and I have several others still to ge5 through and can’t and will not have them if I am not allowed to continue my pain care as I NEED and not what’s comfortable for the dr. I AND WE NEED THE CDC TO GET OUT OF OUR BUSINESS AND THAT OF OUR DRS SO WE CAN AGAIN HAVE PROPER MEDICAL TREATMENT!!!!! Same with medical insurance companies…they MUST stop questioning every single order s drs writes for bc they then deny all requests for treatment and that’s not why we are paying hefty premiums each mths. GIVE US BACK OUR MEDICATION AS WE NEED AND LET US LIVE AGAIN!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fd736c	Zucker	None	2022-03-21T18:54:18Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Zucker, Donna	l11-0b0u-v2v4	False	None	False	2022-04-12 04:19:35.256	[]
2722	CDC-2022-0024-2728	https://api.regulations.gov/v4/comments/CDC-2022-0024-2728	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted].<br/>I live in Colorado.<span style='padding-left: 30px'></span><br/>My wife is one of those harmed by the unauthorized and baseless CDC set of new standards and one-size-fits-all "rules” for treating my long term painful disease called severe osteoporosis, severe osteo-arthritis and spondylolisthesis.<span style='padding-left: 30px'></span><br/><span style='padding-left: 30px'></span><br/>The CDC’s position is, long-term use of opioid pain medications do not work and are dangerous and has discouraged doctors from prescribing pain medicines. The result is what happened to me.<br/> <br/>My wife’s life used to be manageable with traditional FDA-approved opiate pain medications. Now with her<br/>medicines taken away, without my consent, her pain is no longer managed. My doctor fears arrest and practice closures by the DEA. <br/> <br/>She has had her condition/s for 26 years. It was controlled well from 1993 to 2015 with the help of properly dosed opiate pain medications. She had no side effects. She has not become addicted to opiates. She did not misuse them, abuse them, or overdose. She used to have less pain, was able to sleep, and could carry out the roles she had chosen for herself and her future. <br/><br/>The American Medical Association, (AMA) has confirmed harm is being done by the CDC. www.ama-assn.org/press-center/press-releases/ama-urges-cdc-revise-opioid-prescribing-guideline/ this horror of a reality, has ruined lives over the last four years, believing the CDC Guideline was legitimate and mandatory. <br/><span style='padding-left: 30px'></span>PLEASE SUSPEND THE CDC OPIOID GUIDELINES -- IMMEDIATELY! <br/><span style='padding-left: 30px'></span><br/>Signed,<br/> <br/>[name redacted] <br/> ___________________________ <br/><br/>[name redacted] <br/>White House <br/>Office of National Drug Control Policy<br/>ONDCP<br/>[address redacted] <br/><br/>AND <br/><br/>[name redacted] <br/>CDC<br/>[address redacted] <br/><span style='padding-left: 30px'></span><br/><br/>March 20, 2020<br/><br/>RE: Immediate Suspension of the CDC Guideline for Prescribing Opioids for Chronic Pain, March 15, 2016.<br/><br/>Dear Mr. President and Ms. Director:<br/><br/>I am writing to you as a caregiver for a patient harmed by the CDC “Guideline”. We are asking you to suspend the Guidelines of 2016 to stop the documented harm reported by the American Medical Association (AMA). www.ama-assn.org/press-center/press-releases/ama-urges-cdc-revise-opioid-prescribing-guideline/ <br/> <br/>The AMA letter, sent June 16, 2020 to the CDC said, “It is clear the CDC Guidelines have harmed many patients, with 72% of doctors having reduced their patients' pain prescriptions,” without medical reason by the urgings of the informal regulation attempt by CDC failing miserably with great harm and no impact on the opioid crisis.<br/><br/>Nearly 80% of the federally defined ten million patients with serious medical diseases needing daily opiate stabilization, have been cut off from their proper doses based on what was thought to be legitimate CDC guidelines, “to fight the opioid epidemic.” It has not worked. Overdose deaths are worse, and now it looks like millions of uncounted patients harmed by CDC will go down in history as a tragic attempt at prohibition. <br/><br/>The CDC is not a medical agency and does not have a statutory grant from Congress to conduct business outside of its charter, which does not include prescription drugs nor research into pain issues reserved for NIH and FDA. <br/><br/>The discontinuation of pain medication regimen has led directly to suicides and wrecked lives ,after forced discontinuation of their existing pain regimens by doctors following CDC guidelines and frightened by real and perceived enforcement of the guideline, as adopted by the federal drug police (DEA).<br/><br/>CDC knew their plan could not work as it was reviewed and rejected by the FDA. FDA 2012-P-0818). <br/><br/>Serious concerns were raised by Congress, AMA, Washington Legal Foundation, American Cancer Society and others before publication, many predicting a medical catastrophe from forced withholding of medical treatment. <br/><br/>The CDC "Guidelines,” cannot be continued one more day. The harm will not stop with the CDC saying “we are working on revision next year”. There is no reason to allow one more person to be harmed unnecessarily. <br/><br/>The “CDC Guideline for Prescribing Opioids for Chronic Pain” must be SUSPENDED IMMEDIATELY. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5cf9	Anonymous	None	2022-03-21T19:09:34Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0z-jglk-1yhk	False	None	False	2022-04-12 04:19:35.491	[]
2723	CDC-2022-0024-2729	https://api.regulations.gov/v4/comments/CDC-2022-0024-2729	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from severe chronic back pain. Debilitating pain. And that is when I have opioid pain medicine. Without it the pain is so unbearable I can't live. I can't walk or stand or sit. All I can do is lay in bed thinking of ways to end it by killing myself. <br/><br/>Fortunately, I'm currently being treated by a doctor that empathizes with me and is allowing me to stay on a dose that, even though you consider it high, is the least amount I've been able to be functional on. I've been taking pain meds since an auto accident in 2005. <br/><br/>The dose that we eventually settled on allows me about 3 hours of productivity a day. Without my meds I am basically bedbound. I am not taking any more meds than I absolutely have to. Why would I? To go down to the amounts that you think I should make walking dangerous for me, as I fall often. Falling increases risk for additional injury and even more pain. Why would you do that to me? <br/><br/>Please note that even though your opioid hysteria has been inflicting damage to chronic pain patients, the overdoses have skyrocketed. I know chronic pain patient suicide rates have gone up 470%. Yes, that's right - 470% increase in chronic pain patients committing suicide. What you're doing is not working. You're making it worse. <br/><br/>Please let doctors and patients decide what dose works for people. Everyone is different. Please let doctors do their job. Please stop threatening or blaming them or chronic pain patients for what is going on. <br/><br/>Maybe we should start asking why the hell so many people need to check out and are so miserable that they need to drug themselves. But don't take it out on chronic pain patients. We are suffering enough.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tina	None	None	0900006484fd6105	Sheppard	None	2022-03-21T19:09:49Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Sheppard, Tina	l0z-jv5l-ydp3	False	None	False	2022-04-12 04:19:35.723	[]
2724	CDC-2022-0024-2730	https://api.regulations.gov/v4/comments/CDC-2022-0024-2730	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Despite assertions by the CDC that the MME values are only guidelines that is not the way Pain Management Drs are interpreting them. Because the DEA are using the guidelines as a basis to monitor and in some cases prosecute Drs. the trend as evidenced by my own DR. who just replaced my former Pain Management Dr who retired told me at our first meeting that he was reducing my meds to comply with the MME guidelines. There was no conversation whatsoever about my pain levels . That conversation told me that my new younger pain management Dr was not driven by my pain but driven by fear of prsecution for non compliance with a GUIDELINE. The GUIDELINE isn't being used as such and is causing unnecessary hardship and pain to many many people in the country. I also run a Chronic Pain Support group so I get feedback all the time on this issue. The CDC GUIDELINE has been weaponized by the DEA whether or not that was your intent it is the reality on the ground. Since you are the authors of this GUIDELINE you have to power to correct what become a sea of unintended consequences by removing the MME GUIDELINES from the 2022 CDC Clinical Guideline Practice for Prescribing Opioids. this is not only for Chronic Pain Patients but also Pain Management Drs. who find themselves between a rock and a hard place. The rock being MME values and the DEA who have weaponized the MME values. Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fd6130	Fortier	None	2022-03-21T19:10:23Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Fortier, Robert	l0z-lbqm-exen	False	None	False	2022-04-12 04:19:35.948	[]
2725	CDC-2022-0024-2731	https://api.regulations.gov/v4/comments/CDC-2022-0024-2731	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Congratulations! The CDC and their anti-opioid panel has helped the United States achieve THIRD WORLD STATUS where pain mgmt is concerned! <br/><br/>Palliative care is defined as:<br/> <br/>"Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex illnesses."<br/><br/>How does this concern the United States? Because of the CDCs 2016 opioid guideline, we have:<br/><br/>Achieved inequality of access to palliative care and pain relief for the millions of people suffering with chronic pain.<br/><br/>Because of the CDC guideline, it's ensured that avoidable suffering on a massive scale has been wrought due to lack of access to symptom relief through the use of inexpensive opioid analgesics.<br/><br/>The CDC guideline has ensured that doctors are unable to relieve suffering because primary care physicians and specialists can't or won't prescribe inexpensive opioid medicines <br/><br/>The World Health Organization determined that it's the<br/>ethical responsibility of health care providers to relieve suffering. Unfortunately, in the US, we've lowered our standards to the point where we rival third world countries. That is not complimentary!<br/><br/>Both primary care physicians and specialist health care providers need to implement and manage both palliative care and symptom relief into primary health care. Both primary care physicians and specialist health care providers need to be able to prescribe opioid analgesics based on their clinical judgement, without interference from the CDC, DEA, or DOJ.<br/> <br/>This is both a medical and<br/>moral imperative.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd60c6	Anonymous	None	2022-03-21T19:11:12Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0z-polg-ls4k	False	None	False	2022-04-12 04:19:36.179	[]
2726	CDC-2022-0024-2732	https://api.regulations.gov/v4/comments/CDC-2022-0024-2732	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The current CDC guidelines have affected me and my husband adversely. Because current law is causing licensed physicians, pharmacists and other health care professionals to be fearful of losing their licenses and even being arrested in some States, many patients are left with severe pain unnecessarily. Here are two examples in my family. My husband had three surgeries in four months followed by a severe reactive arthritis which took awhile to be diagnosed as such. As I am a retired RN, any pain medication was used judiciously and for a short time. When the reactive arthritis (mostly in his knee and ankle) occurred, his Orthopedic physician renewed a prescription for an opioid until a proper diagnosis was made. (He was then prescribed Enbrel). The Pharmacist did not want to renew the Opioid due to the previous three post-op prescriptions. I had to explain that my husband's pain was such that he was threatening to jump out of our fifth floor balcony and the Pharmacist had a valid prescription. If I was not adamant, he probably would have been a suicide statistic. The second incident caused me to suffer severe pain & very little sleep due to pain for seventeen months.. I was given a prescription for 20 Tramadol pills & used then only when really needed. I was refused a renewal. When I finally had a proper diagnosis (necrotic femur and hip), the surgery relieved all the serious pain. By the way, through all this, I used a treadmill and bike daily, as well as pilates classes twice per week, so I was doing my part. Why did I have to suffer without reasonable pain relief? I also want to ask why many meds, including post-op opioids have "caution when used in the elderly" with no specifics. I was given Dilaudid post-op hip replacement and had to receive Narcan for a severe reaction. I believe the dosage was probably too high for my size and age. More specific guidelines are needed for our age group. A previous neighbor recently died of a malignancy and he was in excruciating pain his last month of life. Was his physician fearful of prescribing due to your guidelines? Please stop terrorizing licensed medical personnel for doing their work.<br/>[name redacted] [phone number redacted] Las Vegas, NV<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484fd6178	Ashe	None	2022-03-21T19:13:29Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Ashe, Jane	l0z-slre-tzls	False	None	False	2022-04-12 04:19:36.432	[]
2727	CDC-2022-0024-2733	https://api.regulations.gov/v4/comments/CDC-2022-0024-2733	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long time user of opioids due to complications from 56 years as a Type 1 diabetic, I want my voice heard. My doctors and I have tried many other medications to try and get my pain under control. Nothing has worked, some caused stomach issues, some left me feeling like a junkie and some just did not stop the pain. Oxycodone and Oxycontin have helped me keep the pain at levels I can live with. For the most part any side effects are tolerable. Understanding that as time goes by I need more and more to stay at this level, any suggestions that could cap the amount I need scare me greatly. I understand the issues of opioid addiction and overdose. I understand that it is a medication that needs to be kept securely out of anyone else's hands. After over 10 years of use I and my doctors obviously know how to use these medications properly and in a safe manner. Please do not limit the amount my doctor can prescribe, you do not know my medical history and my medical needs. I also am very concerned that when I switch to Medicare insurance on the future the government will try to change my meds. This is something only a qualified doctor(that I chose!) should decide. Thank you, [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484fd7090	Hirst	None	2022-03-21T20:36:14Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Hirst, Daniel	l11-5uho-6fhp	False	None	False	2022-04-12 04:19:36.731	[]
2728	CDC-2022-0024-2734	https://api.regulations.gov/v4/comments/CDC-2022-0024-2734	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I see a common pattern in the “new” guidelines and comments for the updated recommendations. The medical care industry is always telling us what we need and what we should do. They have no semblance of what disabled chronic pain patients go through, especially tenured patients. You don’t live in our bodies. Who are you and especially pharmacist to tell us what our bodies feel like?! Why can a pharmacist override my DOCTORS? They don’t know my full medical records and history. What about the HIPAA LAW? It’s being violated. The pharmacist don’t have my consent. They should just be filling my doctors prescriptions. Isn’t it grand that you can dictate to us the living hell we have to exist in. Its been non stop since you have taken our opioids & benzodiazepines away from us, or making us choose one over the other. I have lost my career, my company, my pension, benefits, social life, friends, family, dating, shot at becoming a Mother (to name a few). Patients like myself should have been “grandfathered” in before your dangerous, deadly, restrictions went into place. We are well documented patients. Why are WE treated like criminals now and NOT the addicts whom caused the illicit opioid, fentanyl deaths rates? They are pacified! I’ve been in bed for 4 YEARS now. Do you have one iota what it’s like to try to exist 24/7-365? We are loosing innocent people to self euthanasia. We don’t want to die we simply can’t exist anymore in this barbaric way. Who are you to tell us that we have to live with your rules in order to take opioids& benzodiazepines? That’s why we go to the Drs! We were never questioned before, asked to submit to random screenings, pill counts. Those should apply ONLY to the actual addicts. We don’t know how we are going to feel. Everyday in this body is different but painful. Even if we get our previous meds back, you expect us to sign contracts with our opiate prescriptions. Including being on call for random pill counts, blood, urinate tests. Why are WE being discriminated against? Patients are expected to just stop their lives? Run down for a pill count or a urine test anytime they say?! Some of us don’t drive, can’t drive, it’s too far, are agoraphobic and have no way to get there. I don’t know of any other patients who have to go through such a controlling, cruel, unusual and disrespectful acts. What country is this? We are disabled adults in agony. I’d love the dignity of showering again. Can you myopic people wake up? If you care like you say you do then 1)Stop terrifying our doctors by threatening their medical licenses and 2)Please have a list by state, of doctors who will take on severely chronic pain patients that will prescribe all of their previous prescriptions. This especially includes patients who have a medical necessity for both opioids and benzodiazepines. Yes, we sadly exist and have been hit the hardest by your archaic guidelines and laws. We didn’t ask to become disabled, ill, injured, have diseases and ailments. Just getting a few hours a day of living with my previous prescriptions would be amazing. If not, their will be more suicides aka self euthanasia. R.I. just passed a law to get my opiates back (see attached). I can’t find a Dr. to do that. My current Dr. & NP are too afraid to loose their licenses. So prove how much you really care! And enough with all the insulting NSAIDS & other “treatments”. We’ve been there and done that to no avail. Why else would we be making a comment here? I even became a vegetarian. Does that sound like an addict?!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	KF	None	None	0900006484fd7076	KF	None	2022-03-21T20:47:22Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from KF, KF	l11-5bna-1x3m	False	None	False	2022-04-12 04:19:36.995	[]
2729	CDC-2022-0024-2735	https://api.regulations.gov/v4/comments/CDC-2022-0024-2735	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from a rare spinal cord disease called adhesive arachnoiditis.<br/>It makes so much pain that I testified before an FDA committee that I believe a healthy human brain cannot comprehend or imagine how much pain a human being can be in.<br/>I was also born with a medically documented CYP450-2C9 defect which makes me an ultra rapid metabolizer of opioids which is fairly common defect among Caucasians. I am currently working full time because my disease is well managed and I am prescribed opioids which are the only thing that controls my pain. What do you think happens to patients like me if they are rapidly tapered or lose pain control? Their pain forces them into suicide. Since the 2016 CDC guideline went into effect there is not a pain patient left that doesn't personally know a fellow pain patient that has killed themselves. I have lost count of the number I knew, there has been so many. Why hasn't the CDC released the numbers on how many of us have died because of the guideline? The doctors working on this guideline are not qualified to treat patients like me so they certainly are not qualified to mess with our treatment options. The CDC needs to get out of the pain business and rescind both guidelines. Leave the treatment of pain to the doctor's who are qualified to treat rare diseases like mime.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd7023	Anonymous	None	2022-03-21T20:48:08Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-4oly-hoh7	False	None	False	2022-04-12 04:19:37.219	[]
2730	CDC-2022-0024-2736	https://api.regulations.gov/v4/comments/CDC-2022-0024-2736	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern people need these drugs to help them live and survive. By limiting a person you are hindering them from living a normal life	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fd75e1	Moreno	None	2022-03-21T20:48:25Z	None	None	1	None	2022-03-21T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Moreno, Elizabeth	l11-4bhn-e2ee	False	None	False	2022-04-12 04:19:37.447	[]
2731	CDC-2022-0024-2737	https://api.regulations.gov/v4/comments/CDC-2022-0024-2737	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>This opioid epidemic is inhumane. I myself have been suffering after injury for 23 years now. The one thing I need desperately is support! II need doctors who will listen and help me to want to live. I have lost income. I have been labeled a “drug seeker” This epidemic is basically telling the world we are terrible people who should be denied helpful medication and viewed as second class citizens. The main problem is understand chronic is so misunderstood. Imagine having pain so severe, it’s hard to breath and you get<br/>sick to your stomach, you panic as you need it to stop. But no one will help. You get bullied instead. Without pain, I am a working, social, kind person with many interests with a healthy disposition on life. Prior to pain,II never took drugs, I rarely drink, and I certainly do not abuse my opioid medication now. You should know that many studies have been done proving that most chronic pain patients DO NOT abuse opioid medication and that it’s the only thing that gives them any quality of life. You think you are taking care of the deaths from overdose by coming down hard & unrealistically on people with chronic pain. In reality, the majority of these deaths are coming from street drugs laced with illegal fentanyl powder that comes from China. This has nothing to do with the pharmaceutical medications that are prescribed and monitored by educated MD’s. You are not accomplishing anything unless you go after the drug trafficker’s. My guess is it’s too difficult. You have now made doctors afraid of us. They are so afraid they will lose their license that they not only deny medications, but treat us with tremendous disrespect.They tag our chart as “drug seekers”, so that we can not get any future help ever! Do doctors really have to act this way? Are they enjoying this power? You did this to them. It’s cruel and unnecessary.<br/>When one becomes disabled by pain, they suffer financial loss and it affects the entire family unit negatively. It disrupts their children’s well-being, marriages, mental health etc. This is the USA and this is the best it can do? As far as compensation for disability goes, we are at the mercy of whoever makes the decision to honor it and how they feel about chronic pain. I was approved in front of a judge, but them subsequently denied with no explanation. If someone like me is unable to get compensated for disability, then this whole system is terribly flawed. Meanwhile people with things like anxiety are granted disability pay Pain alone is a tortuous way to live but there’s much more to it. It affects us mentally, financially, socially etc. We are cast out of society, and left to suffer even more deeply. If Dr’s would treat us in a compassionate and humane way, we could have some quality of life. You are setting the stage for Dr’s to not want to treat us and spreading the idea that we are not legitimate and that we are drug seekers”. We are expected to get over the pain and resume life as a normal person which is impossible! What is most perplexing is people can abuse alcohol on a daily basis and society thinks nothing of it. These people are not labeled anything at all. It’s as if it’s ok. I know this really is not quite this way but these people are not blacklisted and treated like a second class citizen. They do not lose their livelihood, they are not stigmatized in their community. They are not suffering in pain.<br/><br/>For the record, I have a very professional, kind and compassionate Dr. who has been managing my pain for years, and there has been no problems I am able to do more things than I could without it. He is now ready to retire and I know I will never find another Dr. such as him and it has increased my already debilitating anxiety. As far as anxiety and depression go, I despararety need help with that but my Psychiatrist was so against the medication I was prescribed by my Dr that she orchestrated a fictitious scenario to dismiss me from her care and mark my chart a “seeker” so that I could not get future help anywhere. This story is much worse. I told my husband if something happened to me, to go after her, the Psychiatrist. If I had done anything wrong while under her care, I would not be so angry. This was blatant discrimination agaoist someone who is prescribed opiates. The main problem here is this opioid epidemic has made everyone, including Dr’s not want to deal with us. As if we are hard core criminals. Dr’s now play games with us. Before we are denied & dismissed we are basically verbally abused first. Our lives are affected to the point we don’t know how to go on & many no longer want to. I can’t imagine the problems this is causing the government as well. It is all so outrageously wrong and indignant. Please find a way to do better. Help us ASAP! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jill	None	None	0900006484fd44a5	Hansen	None	2022-03-22T13:33:19Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Hansen, Jill	l0w-xt14-c85b	False	None	False	2022-04-12 04:19:37.664	[]
2732	CDC-2022-0024-2738	https://api.regulations.gov/v4/comments/CDC-2022-0024-2738	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I am [name redacted]. I am an American citizen Living in rual southern Illinois. I have suffered from Thoracic compression fractures , herniated discs and thinning of the spinal cord. My condition is very painful somedays , I have been negatively affected by the 2016 CDC guidelines on Opiate medicine, my doctors have pushed painful alternatives such as epidural steroidal injections, Non steroidal anti inflammatory drugs , physical therapy, and others. I just want things to get better for everyone thete are thousands of people like me who are suffering. I beg you to fix this problem . Thank you and God bless , <br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vaughn	None	None	0900006484fd4da0	Eric	None	2022-03-22T13:33:56Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from Eric, Vaughn	l0x-3drf-q1sl	False	None	False	2022-04-12 04:19:37.884	[]
2733	CDC-2022-0024-2739	https://api.regulations.gov/v4/comments/CDC-2022-0024-2739	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was hurt in my 20s as as my 9 month old bb who didn't make it she passed away next to me in our bed I'm 46 now I have seen many surgeons I was told they would never be able to do any types of surgeries or procedures bc of the way the injuries have effected my body I have severe ptsd panic and anxiety I was being treated for both for many years and was able to live a somewhat normal life a very happy life being a mother and going back to school since the csc guidelines changed my life drastically changed especially after moving from Ohio to South Dakota I was told by the only pain management in rapidcity that I would have to choose my physical health over my mental health during the pandemic whilst watching loved ones die and losing our home while in the middle of ine of the most stressful times in my life she cut me off my life saving pain medication [name redacted] was cold and uncaring and I remembered what she said on my very 1st visit were pretty much the only game in town I know you won't cause any trouble. Since she decided I didn't deserve quality of life I have been shoufled from doctor to doctor that have been super rude tried to tell me to go get on suboxin one said he would never write anything for someone on xanax but he would put a morphine pain pump in. This last [name redacted] took the cake telling me even though I have over a decade of medical records with plenty of documentation about my crushed disk herniated disk spinal stenosis and pinched nerves that my only way to prove I'm in constant pain is to allow him to give q spinal blocks those were his words prove and that I failed physical therapy also he brought up how my insurance would cover this painful and risky procedure also talked about ablation therapy were they burn ur nerves . He was gaslighting me throughout the visit trying to minimize my pain and me as a person he saw me as nothing more than thousands of dollars he could make off of doing procedures that were only approved at the time of the 2016 horrific guidelines.we cpp may be hurt but we are intelligent educated ppl who do there home work . Without my medication I can nolonger care for myself ,my home or take care of my daughter who has to live with her father as a result of me not being properly medicated the pain has gotten worse bc I gained over 50 lbs as a result of not being able to do the things I could while being properly medicated. I want to address this warning of not prescribing opioids with xanax. I have been on both for o er a decade and never had any issues ever . Correct use doesn't equal abuse or death .I implore u to change the guidelines change the false narrative your literally torturing me	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chassidy	None	None	0900006484fd4f4d	B	None	2022-03-22T13:37:18Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-18T04:00:00Z	None	None	None	None	None	None	None	Comment from B, Chassidy	l0x-5gl8-q65y	False	None	False	2022-04-12 04:19:38.109	[]
2734	CDC-2022-0024-2740	https://api.regulations.gov/v4/comments/CDC-2022-0024-2740	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been dealing with chronic pain for 10+ years. I have severe nerve pain in both of my legs that makes it difficult to walk on many days. I also have chronic headaches that are secondary to a chronic pain intervention that failed. I have had multiple stomach surgeries as well that make absorption a problem for me. So, I have multiple issues that affect me, and I have tried almost every intervention that is currently available currently along with almost all of the alternative non-opioid medications. All of them failed and many of the medications caused undo side effects. It was my physician that started me on opioids after so many failed interventions. Opioids have been the only thing that makes me a functional human being. <br/><br/>I think that each person should be addressed as an individual and to make a blanket statement on doses across the board is not realistic. Each person has their own individual situation, and one dose fits all does not work. YOU need to take into consideration people's size, sex, age, other medical conditions and other medications they are taking to prescribe the correct dose for THAT patient. That is what your physician is for, to sort all of those things out. <br/><br/>Don't get me wrong, I do agree that the least amount needed should be used but I have many issues with the guideline limits. If a person is on a so-called max dose based on the CDC guidelines there is no room for breakthrough pain or changes in pain control. For example: My headaches are unpredictable and debilitating. Instead of being treated for my headache I was labeled and stereotyped. Labeling people on chronic pain medication is an issue, and it is a growing issue. Many people on chronic pain medication are subject to prejudgment and stereotyping by those treating them and others in the medical field. <br/><br/>I do appreciate the part of your guideline about the physician not abandoning the patient. No one wants to be on chronic pain medication and some doctors are not understanding and/or flexible. They need to be there to help their patients and that is not always the case. I also agree with another person's comments about taking buprenorphine off the "danger" list, or downgrading its opioid class It is a very helpful drug for folks trying to get off of other opioids and the risk is considerably less than most/all other opioids of overdose. My only issue with buprenorphine is many physicians are forcing patients on buprenorphine even if their current regimen is working just fine because they do not want to "do the work." Chronic pain is not a textbook and cannot be treated with textbook guidelines and contracts.<br/><br/>In conclusion I would like you to consider removing the dose caps or at least making them flexible, listen to patients individual pain situation, allow physicians and patients to work together to treat pain, do not allow the physician abandon patients, do not remove the opioid tool from the toolbox. I appreciate the opportunity to make these comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5864	Anonymous	None	2022-03-22T13:38:04Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0x-bypa-poru	False	None	False	2022-04-12 04:19:38.330	[]
2735	CDC-2022-0024-2741	https://api.regulations.gov/v4/comments/CDC-2022-0024-2741	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Suspend and revoke all guidelines given by the CDC in regards to Opioids including the 2016 and possible 2022 guidelines. Prescription drug monitoring and usage is the job of the FDA not the CDC. Stick to viruses and bacteria, which is the CDCs sole purpose. These so called guidelines are harmful and have caused more death and harm. Overdoses are up. People are being denied pain relief via opioids and are left two horrific choices-the street or to unalive themselves. It’s the illegal fentanyl laced stuff that is the problem. Restricting doctors to not prescribe or to under treat pain is causing severe harm to millions. It’s inhumane, it’s unethical. Leg amputed-Tylenol for pain relief. Hysterectomy-Tylenol for pain. Sickle cell patient seeking pain relief via emergency room-denied opioid and marked as a “drug seeker”. It’s cruel. Whomever is reading these comments, please listen to our cries. Don’t do this to our country and our people. Please as one human who feels pain to another human that can feel pain; suspend and revoke this super harmful guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484fd5872	Kiefer	None	2022-03-22T13:38:27Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Kiefer, Marie	l0x-dlwd-7mqa	False	None	False	2022-04-12 04:19:38.541	[]
2736	CDC-2022-0024-2742	https://api.regulations.gov/v4/comments/CDC-2022-0024-2742	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The writers of the CDCs opioid guidelines have major conflict of interests. These guidelines should never exist due to the biased individuals who have pockets of money to discourage use of opioids. [name redacted] admitted he has conflicts of interest but yet his name is still all over the new 2022 guidelines. Please answer me how this is beneficial to Americans? Other than [name redacted] and other prop members who of course have a LOT of benefit and a lot to gain by dismissing the use and benefits of opioids. Please don’t delete my comment just because I mentioned your anti opioid bias doctor by name who has no business being involved. Treating pain with opioids does not create addiction. What is super concerning is that there is no science used to create these guidelines. Lack of quality studies, lack of unbiased studies. Is this how the CDC does business? Makes up own self serving “information”. MME where’s the science there? It’s a made up calculator. Plus different mme calculators don’t agree on the MME conversion. Metabolism of medicine is not taken into account.It’s so obviously flawed. Why is the CDC setting flawed arbitrary mme limits on opioids? Morphine (non synthetic) is nearly impossible to overdose on by itself so again why limit opioids? Insulin is not limited. You give it until it works, same with morphine. Well, that is until the CDC set -without any evidence of benefit or harm- limits on pain relief. Please stop doing this to our country. We lose our civility when we turns blind eye to pain and suffering. We need to keep our compassion which means treating pain with an appropriate opioid dose. This will vary greatly from individual to individual. Our healthcare in the United States is not what it used to be and that is heartbreaking. We can do better. We need to not be afraid to treat pain with opioids. We need to not fear those that suffer with addiction but let’s be clear those are two separate issues that get smashed together which causes both communities to suffer greatly. Let’s also be clear that neither is the job of CDC so these guidelines need to be revoked because they have caused and will cause great harm.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fd4fab	Kiefer	None	2022-03-22T13:40:15Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Kiefer, Kevin	l0x-er1j-a7w8	False	None	False	2022-04-12 04:19:38.782	[]
2737	CDC-2022-0024-2743	https://api.regulations.gov/v4/comments/CDC-2022-0024-2743	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with a spinal defect, mine was a minor form of Spina/Bifida that was causing pain early in life. At sixteen years old surgery was done to remove and repair area's of concern. After a long recovery there was some improvements? This surgery had caused other problems, weakness in my legs and back muscles, plus still very painfull from time to time. Through out my working life at time's my pain was becoming even worse. After another ten years it was clear these back surgery's had failed. I have taken opioid pain medication off and on through out life and never become addicted. At 71 years old it's now clear that I need my pain medication back. Living like this is unacceptable, Tylenol dosen't help. The CDC guideline's have turned life into a night mare. These maximums on dose and other limitation's must be removed. Now retired my doctor's call my condition intractable pain syndrome that cannot be repaired, only managed with opioid pain medication, everything else has been tryed and failed. The FDA has no limitations on dose or duration for these medicine's. Dosesage must be up to my doctor's discretion. Their judgement must prevail. No one else knows my case and health better than them. This is where I am in life and concerns with these guideline's.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4fbc	Anonymous	None	2022-03-22T13:40:45Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0x-g2ia-ew8v	False	None	False	2022-04-12 04:19:38.992	[]
2738	CDC-2022-0024-2744	https://api.regulations.gov/v4/comments/CDC-2022-0024-2744	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines, and treatment of patients by physicians due to them,is inhumane,heartless, and downright barbaric.I suffer terrible chronic pain. I have zero quality of life. None. My son is severely disabled, and depends on me for 24 hour care. I can't make it till lunch without ending up on the floor in tears. I have lupus, spinal stenosis, degenerative disc disease, 3 herniated disc's,severe neuropathy pain, among other things. Pain management have simply become drill mills, and they absolutely refuse to treat pain. I was told all of my conditions were arthritis, and opiate therapy is not an approved treatment anymore. Instead they are trying to load me with anti depressants, after putting in black and white they believe my depression is a dire t result of chronic pain. Better to prescribe mind altering drugs with dangerous side effects, then just treat the pain and allow quality of life. Never been one to believe in suicide. Always viewed it as selfish. I get it now. Have thought about it a couple times. Wondering if My son would be better off with someone who can take him to the park. For walks. Play on the floor with him. If something doesn't drastically change to stop the medical neglect, I may eventually get there. The people writing these guidelines, have no business dictating peoples treatment. The 50 MME mention in the revision must be removed. It's not ok for people suffering loss from addiction to dictate a legitimate patients Healthcare.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd4fbd	Anonymous	None	2022-03-22T13:41:16Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0x-h1df-hycg	False	None	False	2022-04-12 04:19:39.204	[]
2739	CDC-2022-0024-2745	https://api.regulations.gov/v4/comments/CDC-2022-0024-2745	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)<br/>My brother suffered a severe back<br/>injury at work decades ago. He had to have back surgery, a fusion L4 L5 area. Fast forward about a decade later and he was hospitalized for a severe infection in his psoas muscle of his back. He was life flighted to a trauma center in a major metropolitan area for surgery. When he woke up he realized how lucky he was to be alive. He fell out of bed while hospitalized causing chronc hand pain. Fast forward a few more decades and he required a cervical fusion due to numbness and pain of his neck which was curved and causing a great amount of pain. Years later he was having so much difficulty walking and per recommendation of the Drs. he decided to have a third surgery to straighten his spine. He woke up from that surgery unable to walk, became wheelchair confined and started to develop severe hip pain. About a decade later as his mobility was declining and pain increasing and he suffered an upper back fx. Looking at his xrays you can see that his spinal alignment was poor. He became reliant on opoids and was required to submit a C9 monthly thru the Bureau of Workmans compensation and make monthly visits to his pain Dr. for his medication. He would have to handle this repitious monthly protocol to get his pain medication monthly no matter how he felt. It certainly did not make a difference in the outcome of his care but caused him stress to abide by the monthly requirements. Several years later he suffered a spontaneous fx. of the upper back and laid in the local hospital for 3 days in severe pain. This 6 foot 2, 200+ lb man was brought to tears. From his hospital bed after laying there 3 days without psin relief and beong told by the Drs. that nothing was wrong, he called his prior trauma surgeon from his hospital bed and got an immediate transfer to the trauma center and was immediately taken to surgery for a fractured thoracic vertebrae. The antibiotics and pain medication he required played havoc with his stomach. He had an emergency visit due to a fecal impaction. Months later he and his wife became a victims of Covid and were hospitalized for 5 days.<br/>My brother had diabetes and severe hip pain. He was no longer able to walk and the hip pain was 24/7. He started to tell me he was having some really bad days and struggling. Little did I know how severe it was. He had 3 nurses in his family, a monthly pain Dr. and a home care agency in his life at the time he committed suicide 12/3 /2021. He also went to his grave stimatized as a drug addict. The 2016 opiate guidelines caused his death. His Drs. were afraid to treat him and became unsympathetic to his pain. He was in constant pain which no doubt is probable having a steel <br/>cage all the way up his back. (See attachments). Just tell me why he was made to suffer so. The government has to stop interferring in the Dr. Patient relationship. The opiate crisis is not because of people like my brother. Stop trying to regulate patients pain medication. <br/>May my 64 year old brother rest in peace. He was the love of my life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd597d	Anonymous	None	2022-03-22T13:43:31Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0x-t4p4-g6xw	False	None	False	2022-04-12 04:19:39.417	[]
2740	CDC-2022-0024-2746	https://api.regulations.gov/v4/comments/CDC-2022-0024-2746	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a nurse practitioner student who was involved in a serious motor vehicle accident at high speeds 75 miles per hour a kid ran a red light and crashed into me when I was doing 5 miles per hour making a left hand turn. Subsequently, I sustained multiple life threatening physical injuries which necessitated me me to start down the road of needing pain medication; while awaiting multiple surgery. Due to covid 19 A lot of my surgeries got postponed so here I am approximately 18 months past my car accident and I'm just getting more appropriate diagnostics and my neurosurgeons are getting the approval to do the surgeries. Bu, I've been on pain medication. I have been threatened and bullied by my doctors to get off opioids and go down to suboxone. As a healthcare provider. In training, I understand that suboxone is a mixture of meds including the reversal agent naloxone the opioid reversal agent! It is typically prescribed to people with opioid use disorder. That would mean prescribed to addict. I am not an addict and I hate being treated as such. I hate that every single time I have had difficulty filling my prescriptions there has been delays every single month! Some delays are 7 day delay, other months it's 11 days , other months it's 14 days, and one month I didn't get it at all!<br/><br/> I was off for a complete 30 days. Given, that there are black Box warnings that you are not supposed to stop this medication abruptly because it could cause serious things, Adverse Drug Evenrs such as: such as a heart attack, a stroke, coma and death along with many other Lesser terrible symptoms It has felt like torture. No one cared about making sure that it was being filled on time to protect my safety and my health and I was made to suffer From physical withdrawal symptoms from pulling the medication out of my body abruptly such as fever, nausea, vomiting, diarrhea, fatigue, cramps, etc. <br/><br/>I think that we've gone too far and that the opioid crisis and overdose is really coming not from people who DO NOT have legitimate prescriptions but coming from people who get illegal medication off the street. I believe that the government should not be interfering with the doctor patient relationship! If the doctor thinks that the medication is warranted it should be given and there should absolutely be NO DELAY in filling this medication and the medication prescription should be able to be sent a couple days prior to the refill date to make sure that there is continuity in care and that the medication does get filled consistently consistently on the same day so that the level of therapeutic effectiveness within the person's bloodstream is maintained and again all those negative symptoms don't happen and of course we want to avoid the adverse drug effects of Seizures, strokes, heart attack and death! <br/><br/>I also feel that the doctors,nrse practitioners,and physician's assistance that are being bullied into arbitrarily cutting down people's prescriptions because they're afraid of jail time or scrutiny by the DEA this kind of manipulation and bullying needs to stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5082	Anonymous	None	2022-03-22T13:44:29Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-3n86-yrqy	False	None	False	2022-04-12 04:19:39.651	[]
2741	CDC-2022-0024-2747	https://api.regulations.gov/v4/comments/CDC-2022-0024-2747	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sirs & Madams,<br/>I wanted to take a moment to tell you what your regulations did to me. Until 2019 I was being treated by a Dr. that was wonderful, caring & very intelligent. However your regulations became more than she could deal with anymore so she retired. For years she had treated my pain and understood that I was only going to get worse. But when she retired I had to find a new provider and she IMMEDIATELY cut my pain medicine by 34%. I was stunned because I wasn't on a high dose to begin with. In fact I was under your "90MME". Since I've been seeing the new provider I've suffered a broken neck and have had 4 neck surgeries. And what did my provider do? She has cut my pain meds even more!! She says that is because of your regulations and the DEA being so involved in this mess that you've created. You have weaponized the DEA against Dr's that have compassion. <br/>This debacle that you've created has absolutely taken my quality of life away. My question for you is "why don't I have the right to any quality of life"? I've always worked. I raised 2 children by myself. I was a good daughter, sister and mom. But now I'm nearly housebound because of the pain that I suffer every single moment, of every hour, of every day. <br/>The new "guidelines" that you put out should have absolutely NO mention of MME!! You have no business in my health-care. None. I repeat,NO MENTION OF MME!! <br/><br/>A pain patient	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd508e	Anonymous	None	2022-03-22T13:45:15Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-4r0v-vba5	False	None	False	2022-04-12 04:19:39.899	[]
2742	CDC-2022-0024-2748	https://api.regulations.gov/v4/comments/CDC-2022-0024-2748	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	So many of those who suffer from chronic, acute pain have had to suffer. My doctor knows what will make the pain stop and what I need to stop an acute flare up but often has his hands tied by dosing restrictions. I’m not an abuser. I carefully monitor what I take when needed but feel a stigma when O need more or have to go to the ER because he isn’t allowed to give me enough in case of an emergency. In the ER I’m pumped full of stronger drugs when being able to have something else on hand would have avoided the flare getting out of control. Doctors need to be all owed to work with their patients and do what’s right for them on an independent basis. After my last extremely painful surgery I watched his frustration as he wasn’t allowed to prescribe me what he knew I would need. I made it work. Recovering was slower because of the pain, but I made it work. Should I have had to though?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484fd59ff	Hanson	None	2022-03-22T13:45:43Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Hanson, Stephanie	l0y-5a56-9ch7	False	None	False	2022-04-12 04:19:40.115	[]
2743	CDC-2022-0024-2749	https://api.regulations.gov/v4/comments/CDC-2022-0024-2749	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for years 30 to be exact.. we have tried everything throughout the years and I have never found relief by anything other than opiate therapy. I have been able to deal with the pain well enough to stay alive for my family..I suffer greatly from the affects of my chronic pain.. I know for a fact that I will die of suicide if I loose them.. it's well documented . It's not a threat it is a fact. Putting limits on drs.and patients is wrong.. and it shows you care little for the people who suffer everyday and night with such a cruel condition such as severe chronic pain..It's sad you have the control to save ne or let me die because I can't do it anymore. Please let Dr's do the job that they are for!! Stop people from suffering. Mme is wrong!!! If it was you or your mom or kids that sufferd so much knowing the dr could stop it right now. Would you let the dr do what is right?? Compassion love kindness understanding. A true way blessed by god.God.. if you keep doing this more of the truly will die.. when your old who cares right?? Let Dr's be Dr's. Stop right now your killing us with stress and pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anthony	None	None	0900006484fd5ce0	Strong	None	2022-03-22T13:46:57Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Strong, Anthony	l0z-ibkh-mkjw	False	None	False	2022-04-12 04:19:40.339	[]
2744	CDC-2022-0024-2750	https://api.regulations.gov/v4/comments/CDC-2022-0024-2750	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Act now, please!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Philip	None	None	0900006484fd5fe4	Taylor	None	2022-03-22T13:47:48Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Philip	l0z-chba-u7mf	False	None	False	2022-04-12 04:19:40.554	[]
2745	CDC-2022-0024-2751	https://api.regulations.gov/v4/comments/CDC-2022-0024-2751	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your rules are killing pain patients... They are seeking street drugs... Constant pain, all you can do is cry... No Life, no breathe, no activity, yet on pain meds, I can get a job be productive to life... My life has been transformed into nothing.. Fibromyalgia is horrid, there is no reason, and stressed causes episodes... Your policy is causing stress. I want friends, I want life, yet your rules forbid it.. Fentanyl coming in like water.. And you worry about our pain medicine??? Does that make sense?? No.. Your policy destroyed a good friend who was gentle and kind... Yet because of your rules his morphine of 12 years ripped from him immediately.. How can you destroy life's? He was so helpful and kind.. Yet you turned him into a monster.. only 4 Norco..I do pray God deals with your office and the people destroyed by your rules... Wonderful happy, good, helpful people, turned into monsters because of pain... Why. Why	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5fd3	Anonymous	None	2022-03-22T13:48:26Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0z-awo1-mtoe	False	None	False	2022-04-12 04:19:40.770	[]
2746	CDC-2022-0024-2752	https://api.regulations.gov/v4/comments/CDC-2022-0024-2752	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Victim... A 100% Service Connected Veteran VICTIM...<br/> Amazing I started to fall ill around 2015 into 2016... I was totally ignored almost died... My pain went from being manageable to being INTRACTABLE SEVERE PAIN... EVERY DAY, EVERY NIGHT, NEVER STOPS If I could lye down I would be BEDRIDDEN... I won't bore you with ALL My Discrepancies... I have been Suicidal especially while under the influence of the Gabapentenoinds... Been told that I am a drug addict after a failed surgery to install a Intrathecal Pain Pump... Well... My Pain has NOT DISAPPEARED MAGICALLY BY SOME UNKNOWN FREAK OF NATURE BY ELIMINATING PROPER PAIN MANAGEMENT... I have been hanging in there for A LONG TIME NOW I am just too weak... My luck I have a Stroke,A Myocardial Infarction something day before I get help... RIGHT... Who am I kidding... The VA WILL KILL ME THEY ARE TORTURING AND ABUSING ME NOW... I AM STILL ALIVE... THATS ABOUT IT... I HURT SOO MUCH... YOU REALLY SUCK... TERRORISTS GET BETTER TREATMENT THAN PAIN PATIENTS... THIS WHOLE MESS IS JUST BAD... Not treating pain is wrong in so many ways... Obvious Addicts will OD NO MATTER WHAT YOU DO TO GOOD PEOPLE THAT NEED HELP... DO NO HARM... DOH... I [vulgar word redacted] HURT SOO BAD I CAN'T LUE DOWN I CAN'T SIT I CAN'T WALK I CAN'T KEEP BARELY MAKING IT ANOTHER DAY LIKE THIS YOU SELF RIGHTEOUS FOOLS THAT CAN'T UNDERSTAND HOW SOMEONE CAN HURT AND ABANDON YOUR PATIENTS WASTING MONEY ON USELESS PROCEDURES THAT PUTS YOU IN THE ER IN SO MUCH PAIN YOU ARE GOING TO KILL YOURSELF... ONLY TO BE TORTURED EVEN MORE BEING ABUSED by DOCTORS SUCKS... WHAT ARE WE SUPPOSED TO DO... ONLY CHOICE IS DEATH OR CONTINUE TO SUFFER... NOT VERY GOOD CHOICES LEFT... THE VA IS DIRECTLY RESPONSIBLE FOR MY DEATH WHETHER I STROKE OUT OR HAVE A HEART ATTACK OR COMMIT SUICIDE I TOLD THE SHERRIFF WHEN THE VA SENDS HIM OUT TO BE SURE AND DO AN AUTOPSY WHEN HE FINDS ME DEAD... I have notes written placed around IN reference TO this... Also ALL THE documents showing that I have been trying to get HELP... I am listing this MY LIFE SUCKS BAD THIS PAIN IS GETTING TOO MUCH ANYMORE TRYING TOO GET RID OF PEOPLE BECAUSE THEY ARE IN PAIN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fd5c24	Young	None	2022-03-22T13:51:27Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Robert	l0z-1vv7-3fyo	False	None	False	2022-04-12 04:19:40.981	[]
2747	CDC-2022-0024-2753	https://api.regulations.gov/v4/comments/CDC-2022-0024-2753	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a current pain management patient and have been severely negatively impacted by the current guidelines; as a result, I urge you to consider changes to the guidelines in order to improve the quality of life and access to opioids for others suffering and living with chronic pain.<br/><br/>After being hospitalized three times in a six-month period with complications due to systemic lupus erythematosus, bronchiectasis, and antiphospholipid syndrome, leading to MAC infections and inflammation eventually requiring 24-hour supplemental oxygen as well as recurring fractures due to osteoporosis, I was referred to a pain management doctor to help manage my severe chronic pain.<br/><br/>After several months of trial and error, I was finally able to find some relief with the help of my doctor so that I could participate in life without anguish again, albeit limited due to my disabilities. Unfortunately, this delicate balance requires a carefully managed prescription medication schedule which includes one (1) Hysingla 60mg ER and seven (7) Hydrocodone/Acetaminophen 10-325mg per day – the absolute minimum opioid daily dose to keep my pain levels below excruciating while staying within an acceptable daily margin of the current guidelines.<br/><br/>But the process of obtaining my prescribed opioid medications is beyond frustrating. I can only receive a 30-day supply at each refill, and I am required to pick up the prescription in person at my local pharmacy (ie. no mail orders, delivery or 90-day supply allowed.) I cannot pick up a prescription earlier than 2 days prior to the last month’s pick-up date, so I have a narrow window of opportunity to pick up these prescriptions and still stay on track with my dosage.<br/> <br/>To complicate matters, both medications, especially Hysingla, are kept in limited supply at most local pharmacies (apparently due to both cost and liability issues), so often a medication must be ordered and shipped to the pharmacy after the prescription is received, which can take 1 day at best and 5 days or more at worst. If a scheduled pickup day falls on or near a weekend or holiday, I could be without my pain medications for up to 4 days despite my careful medication management. When this happens, I am unable to function, essentially bedridden. Not only is this a painful experience, it is potentially dangerous.<br/><br/>The pain I experience is chronic, severe, but, fortunately, manageable with opioid medications. This situation is fixable with common sense approach to opioid medication management for chronic pain patients.<br/><br/>Surely, this is not the expected outcome of these guidelines. I understand that there is a serious opioid epidemic that needs to be addressed. I am just asking that it not be addressed at the expense of chronic pain patients. We rely on these medications to just get out of bed and be present for our families and ourselves. We are not criminals, we are patients. Please craft guidelines that treat us as such.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allison	None	None	0900006484fd70d7	Busby	None	2022-03-22T15:18:12Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Busby, Allison	l11-68n5-9w7o	False	None	False	2022-04-12 04:19:41.196	[]
2748	CDC-2022-0024-2754	https://api.regulations.gov/v4/comments/CDC-2022-0024-2754	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescriptions are down over 70% since 2016 yet overdoses are higher than ever. This document hasn't made even a dent in the nation's overdose crisis. Drug dealers and street drug users are not affected by these guidelines. All they do is harm pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd7932	Anonymous	None	2022-03-22T15:18:36Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-6xzf-3ndz	False	None	False	2022-04-12 04:19:41.448	[]
2749	CDC-2022-0024-2755	https://api.regulations.gov/v4/comments/CDC-2022-0024-2755	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Thank you for the opportunity to submit my input for the CDC to re-evaluate pain medication dosing recommendations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bryant	None	None	0900006484fd7933	Sebren	None	2022-03-22T15:23:27Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Sebren, Bryant	l11-6mrp-2a2k	False	None	False	2022-04-12 04:19:41.658	[]
2750	CDC-2022-0024-2756	https://api.regulations.gov/v4/comments/CDC-2022-0024-2756	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	WHy do experts who treat the 5% of patients that ultimately get addicted to opioids and only have experience treating addiction get to write these guidelines, instead of pain management experts who treat the 95% of patients who do not? Doesn't that make this guideline useful solely for opioid use disorder and not for pain management?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd7961	Anonymous	None	2022-03-22T15:24:15Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-7jrl-1lac	False	None	False	2022-04-12 04:19:42.470	[]
2751	CDC-2022-0024-2757	https://api.regulations.gov/v4/comments/CDC-2022-0024-2757	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please change these Guidelines back to the way they where , I have have had multiple surgeries on my back and neck that failed after these guide lines went into affect my Dr. cut my meds by almost 3/4 and now I'm basically useless , I don't sleep and be on my feet or walk much at all , my life is basically restricted to a couch now . The Gov. needs to stop the Meth and Fentanyl crisis not punish patients with permanent injuries including Vets. that returned home with permanent injuries . Thank You , you have no idea how many lives have been ruined or lost over these strict guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kenneth	None	None	0900006484fd796c	Prokop	None	2022-03-22T15:24:59Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Prokop, Kenneth	l11-7sn4-9sfz	False	None	False	2022-04-12 04:19:42.698	[]
2752	CDC-2022-0024-2758	https://api.regulations.gov/v4/comments/CDC-2022-0024-2758	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please change these Guidelines back to the way they where , I have have had multiple surgeries on my back and neck that failed after these guide lines went into affect my Dr. cut my meds by almost 3/4 and now I'm basically useless , I don't sleep and be on my feet or walk much at all , my life is basically restricted to a couch now . The Gov. needs to stop the Meth and Fentanyl crisis not punish patients with permanent injuries including Vets. that returned home with permanent injuries . Thank You , you have no idea how many lives have been ruined or lost over these strict guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kenneth	None	None	0900006484fd796d	Prokop	None	2022-03-22T15:26:30Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Prokop, Kenneth	l11-7sn4-n3t8	False	None	False	2022-04-12 04:19:42.910	[]
2753	CDC-2022-0024-2759	https://api.regulations.gov/v4/comments/CDC-2022-0024-2759	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient for 18 years due to failed fusion surgery. Over the 18 years I have tried everything on the market every test every ideas my physicians have tried for years my pain level was under control till the CDC decided for myself and my specialist that my medication had to be tapered to a level they saw fit was ok. I was forced tapered against my will my doctor no longer cared about me he only cared about guidelines and the DEA. I have had so many horrible pain days and nights my guality of life no longer matters. My pain specialist has massive documentation on my spine my blood pressure is thru the roof my endurance is nill. I would like to know how is it legal for the CDC to use anti opiate doctors (phschiatrists) not even pain specialist to write guidelines for patients who are diagnosed with chronic intractable severe pain. The CDC used there crocket antiopiate physicians to write reports to lie about data and to make sure there guidelines were implemented. There is massive data proving that the CDC lied about overdoses caused by legal pain meds when the DEA and CDC knew that fentanyl and cartel illegal fentanyl pills were being sold on the streets for years. The lying must stop the new guidelines you are trying to put out are a horrible remake of the 2016 chronic pain guidelines and to boot you now are making the guidelines for all physicians and lowering the amount of opiate medication to 50 the United States of America is committing genocide on patients. The CDC knew the severe harm being done and did absolutely nothing to stop it. As an American citizen I want to know what legal grounds do sick hurting chronic pain patients have what government agency do we need to notify we have to get pain care back. Will the U S senate overgsight review all this faulty data the CDC hands put out. These guidelines need to be thrown out and the FDA and pain management specialist who treat patients and have medical degrees should be involved not the CDC. At 63 years old I have no respect for the CDC you are lying to the American people for money and grants this whole outright lie must be totally investigated and all who lied to gain money must be imprisoned this is the crime of century. There must be investigation into CDC . I understand your not supposed to use anyone for public policy who has conflict of interest and yet you allowed this remake to be ur out for public knowing the antiopiate psychiatrist who flubbed all the reports is same crazy phychiatrist writing guidelines how evil and unjust is this. There must be full investigation into CDC 2016 and 2022 chronic pain guidelines your killing patients and don’t care	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd765e	Anonymous	None	2022-03-22T15:39:07Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-92t4-amhq	False	None	False	2022-04-12 04:19:43.141	[]
2754	CDC-2022-0024-2760	https://api.regulations.gov/v4/comments/CDC-2022-0024-2760	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient with structural spine and SI joint issues, as well as severe hip pain, I would have zero quality of life without my prescribed pain medication from my pain management physician. We work together on various approaches, including steroid injections and physical therapy. A responsible physician prescribes responsibly but also compassionately. Please do not take away the compassion offered to patients like myself. We’re fighting a 24/7 battle with intense debilitating pain. Don’t give us yet another battle, and one we must fight alone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd766d	Anonymous	None	2022-03-22T15:41:28Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-9au6-61f5	False	None	False	2022-04-12 04:19:43.353	[]
2755	CDC-2022-0024-2761	https://api.regulations.gov/v4/comments/CDC-2022-0024-2761	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My chronic pain story begins with a sports injury to my right lower back. I tore a ligament and began having severe pain, which included drenching my bed with sweat twice a night. Then, I tore another ligament on the left side of my lower back. I was not given enough pain medication, because pain doctors are paranoid about increasing medication and as a result I went into heart block with afib, tachycardia, hypertension and I ruptured my mitral valve. I had to have open heart surgery to repair the heart valve and at that time I was given an increase in pain medication, however it was still not enough to get me out of heart block, afib, tachycardia and hypertension that I have been living with now for 6 years. It is frankly absurd that the heart conditions that I have been going through are preferred to prescribing proper pain medication out of fear of the state. Please revise these guidelines immediately and leave the doctoring to the doctors. The government has no business interfering with how doctors prescribe medication to their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C	None	None	0900006484fd7676	K	None	2022-03-22T15:42:37Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from K, C	l11-a0mq-1cno	False	None	False	2022-04-12 04:19:43.568	[]
2756	CDC-2022-0024-2762	https://api.regulations.gov/v4/comments/CDC-2022-0024-2762	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Crackdown on opioid crisis was as dramatic as crisis itself. Thousands of people who depended on opioid painkiller as they cannot afford for medical procedure, and incensitive and irresponsible regulation imposed on opioid painkilles stigmatized existing patients as drug addict when they desperately need the help of painkiller to go through another day. <br/><br/>Please, take responsible of your action, and please be apolitical and put priorities on human beings who are actually going to be affected. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd767e	Anonymous	None	2022-03-22T15:43:16Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-a8h8-emj9	False	None	False	2022-04-12 04:19:43.779	[]
2757	CDC-2022-0024-2763	https://api.regulations.gov/v4/comments/CDC-2022-0024-2763	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who has endured 3 back surgeries, hip repair and unyielding pain in my legs, I wish that the CDC would understand that a large majority of us are NOT addicted to opioids and use them to maintain quality of life when we have pain. It is terrible that I have been continually denied medication when I am indeed, in PAIN. <br/> Not everyone likes the side effects of these opioids, but sometimes the pain outweighs even the uncomfortable side effects. It is not fair that we can literally SEE that our doctors hands are tied by the RED-TAPE requirements of the CDC. Again, it is NOT acceptable to suffer with conditions because other abuse the system and medications. I hope the new guidelines will allow so many of us to have relief when we need it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Justin	None	None	0900006484fd76a1	Quattlebaum	None	2022-03-22T15:43:46Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Quattlebaum, Justin	l11-b8xf-ikqc	False	None	False	2022-04-12 04:19:43.993	[]
2758	CDC-2022-0024-2764	https://api.regulations.gov/v4/comments/CDC-2022-0024-2764	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife who I have known for 45 years and been with for 30 years has ZERO quality of life since 2016 opioid guidelines were put in place. She has 2 spinal fusions, nerve blocks, nerve scrapes, injections way too numerous to mention. Cindy used to take 120 to 130 mg of opioids and was able to have a few days a week to almost feel human. Since the 90mg restriction she is in constant pain and mostly bed ridden. Talk to her Drs, talk to her, talk to me, this is awful please allow Drs to be Drs.<br/><br/>[Name Redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	0900006484fd76a2	Ethridge	None	2022-03-22T15:44:49Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Ethridge, Mike	l11-bax4-250x	False	None	False	2022-04-12 04:19:44.216	[]
2759	CDC-2022-0024-2765	https://api.regulations.gov/v4/comments/CDC-2022-0024-2765	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain in my left arm caused by spinal surgery in 2002, to remove a tumor within the spinal cord from C3-C7 at [Location Redacted]. After a year, I began to have pain on the upper side of left arm and an electomotor study was done to locate the cause. It was found that the #7 nerve coming from my spinal cord to my arm was the culprit and surgery to repair was too risky, so I have to take 1,7.5 mg hydrocodone 2x daily, sometimes 3, depending on how the weather effects it. I have tried tramadol, but no help. I use a warming salve as often as I need it, but pain medication is the primary tool to lead a normal life. I would prefer to not take opioids, but the pain is too great for any other lesser meds. My doctor knows my problem and I am responsible with my application of these meds. I do not get any joy from taking these as I do not have an addictive personality. I regret many use them for a high, but I do not. I am a law abiding, tax paying, church going man and I do not believe in taking street drugs that are illegal, as I have seen too many go to their graves taking illegal hydrocodone that is laced with fentanyl. <br/><br/>I would plead to let the physician make the reasonable judgement if I need them or not and prescribe them on his/her judgement. This I ask as a reasonable man. <br/><br/>Thank you for letting me comment on my condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jon	None	None	0900006484fd76cc	Eggleston	None	2022-03-22T15:47:48Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Eggleston, Jon	l11-c9lt-y7az	False	None	False	2022-04-12 04:19:44.451	[]
2760	CDC-2022-0024-2766	https://api.regulations.gov/v4/comments/CDC-2022-0024-2766	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I gave my mother a kidney in 1996. After this surgery I was and have been in pain. <br/>When the CDC decided that people like me could live with much lower dose of pain pills. <br/>My life has been a nightmare ever since this policy was enacted. <br/>The lower doses do not control my pain. I was not amusing my pain. Because of this policy I cannot leave my bed. I wish I could explain to you the amount of suffering I endure daily. <br/>It was not my fault I became dependent on pain meds. <br/>I am begging you to change this policy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd76ea	Anonymous	None	2022-03-22T15:48:33Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-da9t-ez87	False	None	False	2022-04-12 04:19:44.711	[]
2761	CDC-2022-0024-2767	https://api.regulations.gov/v4/comments/CDC-2022-0024-2767	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	50MME is ridiculous, before 2016 I was able to have 150MME and get my Xanax at the same time. Chronic pain is stressful. After 2016 no more xanax and only 100MME. With this proposal odds are I will end up going postal in public because uncontrolled pain and anxiety combined makes me far less civil. This idea of 50MME should be tossed unless max pay at the CDC is limited to 50K and maybe then those proposing such silly notions will begin to feel the pain and stress of those of us living with chronic disease that truly disables. We, who are prescribed opioids, do not sell them, give them away or take more than dosage allowed. But kick it down to 50MME and yeah, I am definitely going to re-evaluate what standard I can accept as a quality of life. You are trying to solve complex issues within society on the backs of those of us who are the sickest. Sad. Why not just act like [Name Redacted] and openly kill those of us you do not care about. Truth be told, you who lead the CDC are the addicted. Addicted to the power of controlling the lives and well being of millions of us who are least able to fight back. Again sad and pathetic from a supposed group of educated people. Obvious to me. your parents never raised a one of you correctly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wayne	None	None	0900006484fd76ed	Dunn	None	2022-03-22T15:50:31Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Dunn, Wayne	l11-dgb9-xnu3	False	None	False	2022-04-12 04:19:44.986	[]
2762	CDC-2022-0024-2768	https://api.regulations.gov/v4/comments/CDC-2022-0024-2768	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on opiods for chronic pain for almost 20 years. Since the introduction of the 2016 guidelines, I had a Dr. that dropped my dosage from 180 mg morphine to 120mg in 30 days. The tolling took on my body was unreal. Even now I feel like I'm being held hostage by my Dr. They force constant appointments, while I'm on a strict income being basically disabled. All visits start with him talking about my dosage and how he's going to cut it. Never talk of how to fix the pain. It feels like they're more worried about themselves than the patients. I have never failed a test or abused the medication, but I'm treated like an addict by the hospital. I have to fight to get out of bed daily and they want to make things worse. I saw a study about patients dosages being cut. 84% said they're pain increased and 42% said they contemplated suicide because of it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd76fb	Anonymous	None	2022-03-22T15:54:46Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-dphw-128g	False	None	False	2022-04-12 04:19:45.240	[]
2763	CDC-2022-0024-2769	https://api.regulations.gov/v4/comments/CDC-2022-0024-2769	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a recently retired Family Physician with 45 years of experience in inpatient and outpatient hospice care, chronic pain, mental health and general medicine. I have published in addiction medicine. In my experience chronic narcotic use is an unstable therapy and ineffective in chronic pain management. I have found that the majority of patients with chronic pain are better managed on mood stabilizers (anti-epileptics) and/or lithium. Physical therapy can be equally important in co-treating structural injuries. I tried Suboxone treatment using it with counseling and I lost interest in it as did my patients. Perhaps chronic pain induces emotional dysregulation or perhaps many chronic pain patients have prior bipolar disorder. Patients with bipolar disorder do notably suffer from physical and emotional trauma which resists resolution. Mood stabilizers relieve chronic pain and emotional suffering. The patients became more positive, more attentive, better rested, more energetic, and more social. I did use antidepressants with pain management and sleep problems but generally I found their help was temporary. I worry about the dangerous distribution of narcotics and their availability to young people. Buprenorphine and methadone are being used for chronic pain. They are dangerously high dose medications and I seriously think their distribution is a hazard to public health.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Claudia	None	None	0900006484fd7700	Peters MD	None	2022-03-22T15:59:31Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Peters MD, Claudia	l11-dxer-0pxl	False	None	False	2022-04-12 04:19:45.459	[]
2764	CDC-2022-0024-2770	https://api.regulations.gov/v4/comments/CDC-2022-0024-2770	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 63 year old woman with oateoarthritis/DJD. I believe that going to monthly pain management is expensive and a SCAM. They push procedures every month, either injections or radiofrequency ablation. I am not interested in expensive procedures. have pain that is tolerable with one-two Tramadol 50mg per day and have been on for approx 10 yeard. My primary care prescribed for me in Kansas. However, when I moved to Arizona, my new PCP wouId not prescribe. I was refered to pain management and now pay $85 a month for 15 min office appt or 3 minutes via zoom and every single month they try to get me to do their procedures. <br/>I have never misused my meds. I simply wish to continue to work as a nurse and not have to retire early. I go to chiropractic also. <br/>Doctors need to be allowed to prescribe based on their relationship with their patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lesa	None	None	0900006484fd7e27	Brock	None	2022-03-22T16:14:17Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Brock, Lesa	l11-g592-g2js	False	None	False	2022-04-12 04:19:45.679	[]
2765	CDC-2022-0024-2771	https://api.regulations.gov/v4/comments/CDC-2022-0024-2771	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please let Drs responsibly help pain patients without worry of losing their license. Ever since 2016 the number of overdoses has risen each year. In fact this year it's the highest it's ever been It's still about 50,000 lower than alcohol related deaths per year but this is America and we celebrate alcohol even though it's It's actually considered the most dangerous drug in the world. I understand that if doctors are over prescribing or giving someone narcotics without trying other things first and it's the first time a pain patient goes to a doctor they should try physical therapy, chiropractor, acupuncture, and non-narcotics before getting on pain meds . I just think it's so unfair that for the past 4 to 5 years so many pain patients had the suffer some committed suicide others turned to the streets because it was their only way of getting strong pain relief. Unfortunately these days you can't get real pain pills on the streets, it's hard to even get heroin anymore. If you get something off the streets these days 99% of the time it's going to be fentanyl. We're turning so many people into more hardcore addicts making their tolerance skyrocket because they used to take maybe 20 mg oxycodone a few times a day and now they're doing illicit fentanyl that's way stronger than what the doctors were prescribing them. Also the pill mills have been shut down, and they were a big problem for causing the opioid epidemic back in the day before the CDC went crazy. I'm pretty sure every state now has a virtual database for controlled prescriptions so you can't doctor shop or fill more than one script without the pharmacy seeing it. I know when I was on pain meds I actually had my life back I was able to do work in my yard for my dad play with my niece and nephew and keep a job. Ever since the CDC scared literally every doctor in America and they took away everyone's pain pills I haven't been back to work I get out of bed maybe for total of an hour each day because the only way to not feel the intense pain is to lay down if I stand up longer than 15 or 20 minutes the pain gets unbearable it sucks, I didn't choose to have this pain also opiates / opioids have been used for hundreds or thousands of centuries for pain relief and also depression back in the '50s or '40s until they realized how addicting they can be. I agree with the acute pain rule up to 7 days You're not going to get fully addicted after just 7 days You might want them because they do give off euphoria and pain relief but that person won't physically be addicted after 7 days. However if someone has chronic pain which I don't need to explain the definition of chronic pain and there's nothing the doctors can do to get rid of the pain and they've tried everything else that they can possibly try I think it's cruel and unusual punishment to withhold a medication that would relieve that person's chronic pain. They say oh but then you have to keep upping your dose to get the same effects. I don't necessarily agree with that once you get to a dose that helps your pain it will continue to help your pain unless the pain gets worse which x-rays can show or other things but other than that once you get that dose that gets rid of the pain or at least makes the pain bearable so you can live a normal life you don't need to keep going up. Maybe I'm wrong but for the most part the people that keep asking for the higher doses are possibly looking for that euphoria because that goes away after your body gets used to it. Although if someones pain is so bad, is there anything wrong with them wanting to feel a little euphoria every now and then. I was on the same dose for 3 years and never went up and yeah for the first month or so I got euphoria from it but honestly when you're in pain sometimes you need to feel some euphoria to not feel the pain. When you have chronic daily pain you don't ever really get a chance to feel any type of euphoria because the pain blocks everything else and just makes you depressed and miserable and hate life because you can't live it. So if someone finds a dose that helps their pain but then a month later says it's not helping the pain anymore I need more milligrams the doctor shouldn't keep giving them more without further test and X-rays. Or maybe trying a different pain medication instead of a higher dose. Also for chronic pain patients its not addiction for most It's dependent just like someone that's diabetic needs their insulin they DEPEND on those medications to make them feel better and their lives better. Please don't keep medication away from someone if a doctor prescribes it to them. I'm on my knees crying and praying I and many other won't have to suffer much longer. People that have chronic pain didn't ask for it and we shouldn't have to suffer and feel like criminals All we want to do is live a normal life. If we just wanted to get high all we would have to do is go to a certain neighborhood or corner it's cheaper def stronger. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joshua	None	None	0900006484fd5c26	Tamborini	None	2022-03-22T16:35:05Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Tamborini , Joshua	l0z-28d1-u19d	False	None	False	2022-04-12 04:19:45.918	[]
2766	CDC-2022-0024-2772	https://api.regulations.gov/v4/comments/CDC-2022-0024-2772	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am happy to hear that the CDC recommends the judgment of physicians be used in prescribing opiate painkillers to their chronic pain patients. While there is a well known opioid crisis and high levels of addiction and overdose, chronic pain patients have not been the cause of that epidemic. As an older American who suffers from significant pain in virtually every joint in my body, opiate pain medication has improved my quality of life significantly. With these medicines I can walk, garden, play with my grandson, and be much more active than I was able before the prescription of opiate medication. My quality of life is so much better - (pain was ruining my retirement) and my general health. On pain medications I have dropped 35 pounds, improved my A-1c to pre-diabetic levels and improved my blood fats to better than normal levels. I have had several surgeries. In addition I have had several surgeries to address crumbling joint bones and a lack of cartilage. My pain clinic does more than just prescribe pain medicines, they also have used injections and supplements, and have recommended massage / physiotherapy to improve my health and life. It has been frustrating to see providers so restricted in using opioid medicines for long term chronic pain. At times it has felt like patients are being treated like criminals. I understand that it is easier to find people on prescriptions than those using illegally supplied drugs - but the opioid epidemic will not be curtailed by coming after the people who are not breaking the law, and are well monitored if using opioid pain medications. Regular drug testing, checking state databases to avoid someone getting scripts from multiple doctors or pharmacies and regular in person visits with providers are all steps to use these drugs safely. I am glad to see that “maximum” dosages are being lifted, putting the treatment of patients back in the hands of our doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kate	None	None	0900006484fd5c27	DCamp	None	2022-03-22T16:35:28Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from DCamp, Kate	l0z-2smw-h199	False	None	False	2022-04-12 04:19:46.184	[]
2767	CDC-2022-0024-2773	https://api.regulations.gov/v4/comments/CDC-2022-0024-2773	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My horrific accident was May 10 2014 I suffered greatly by hitting a f150 all metal truck head on with my 650gs bmw 2007 motorcycle that I just bought 2 years before this accident. I was practicing for racing, and exercised greatly everyday and was going to school, also working on my Entertainment lifestyle that's very important as well. In the accident i suffered with a crushed left elbow, and it was replaced with a metal elbow, i only have 30'degree motion. The doctors said five years before I can really use it again and still will have issues, with motion, with grabbing, lifting, and pain will of course be immensely high. The left wrist to the hand has nerve damage, and causes problems but I still push through and exercise everyday little by little. Even if I'm sitting in bed ill still exercise. Now the right wrist has metal in the whole wrist and shows a sharp point on the side so anytime I rubb up against something it will be a shock an then I'll have a burning sensation and have to medicate. Then my pelvis suffered greatly as well, I broke it in 7 places, the doctors gave 5 years before I could walk, and if someone would of been videoing me they would see someone so determined to be healthy and grt back to normal, I pushed everyday, and I was only receiving 15mg Oxycodone and 30mg Morphine. The next injury was my right leg broke in three places, so now there's a metal rod replacing one part of fliba. Metal in the right ankle as well. The new surgeon I seen two years ago before Covid19 happened stated I should of been on way higher dose of Oxycodone an Morphine. When the doctors tried to up my dose the CDC had put a stop to that I suffered immensely. Now that I'm on a strict dose, I take Gabapentin and it makes me very sick mixed with the Morphine, so then the Doctors recommend that I switch the Morphine to Fentnayl. The doctors are very helpful and feel strong in this situation but then the problem of dosage came across again. So, please note that my current situation needs medication, and the doctors that I see need the information and notifications to make it all better, an help me get a higher dose for both medication. I'm a health athlete so I understand these are dangerous drugs, but that's it ... these drugs are only dangerous to those not aware and using them for the wrong reasons. Why should us patients have to suffer??? Because of the other people with no control??? That in itself is ludicrous and I hope someone will stand up an make the changes at the very moment it needs to happen it can't keep going on like this, I feel like a child and I'm a grown woman who knows the world and knows how to survive. So, I appreciate who is bringing up this topic because it needed to be address. Thank you!!!! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Britne	None	None	0900006484fd6010	Wheelon	None	2022-03-22T16:36:19Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Wheelon, Britne	l0z-dyus-haf9	False	None	False	2022-04-12 04:19:46.406	[]
2768	CDC-2022-0024-2774	https://api.regulations.gov/v4/comments/CDC-2022-0024-2774	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After reading the article in the NYT on Sunday March 11 2022 titled The Other Victims of the Opioid Crisis I felt overjoyed. I have been taking Oxycodone for a chronic back condition for years. I have 0 pain when I have my medication. Every Dr. now is terrified of the DEA and that is all I hear about when I have my 15 minute appointment with my new Dr. My old Dr. left his practice due to the strangulation strategies of the DEA. I often don't know who is really in charge of my care. If I tell my Dr. that I have no pain when I take my prescribed dosage (10mg, 5 per day) he continues to talk about the DEA and all of the injections I should try. I have a great solution with the medication I am on now and do not want to feel pressured to have someone stick a needle in my back. I want my Doctor to be in charge of my care, not the DEA or the CDC and I don't want my Dr. to feel threatened like most Dr.s do today . Last time I went to this Pain Management Dr. the patient before me (in her 70's) was crying because he kept telling her he had to lower her dosage of pain medications so that his records would not reflect a high amount of pain medication prescribed. If the Dr.is under such tight scrutiny by the DEA, CDC and many other organizations, they are often not able to fulfill their primary commitment to FIRST DO NO HARM. If Dr's are so concerned with an agency shutting them down, they cannot perform or prescribe in the best interest of the patient. I suffer when I am unable to get the medication I need (I have already been made to cut down the dosage)... I am handling that well, but my Dr. continues to threaten to get rid of my meds and try injections. That scares me b/c I would much rather take my medication than risk a needle in my spine that will certainly not give me the same 100% relief I get now.. Patient care has been taken away from Doctors by Insurance Companies dictating what they will and will not cover and now this young field of Pain Management wants to take more control away from the Doctors. Please stop this madness !	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484fd6177	Joseph	None	2022-03-22T16:36:53Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Joseph, Susan	l0z-scgx-duup	False	None	False	2022-04-12 04:19:46.661	[]
2769	CDC-2022-0024-2775	https://api.regulations.gov/v4/comments/CDC-2022-0024-2775	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a 71 year old male, and have had RLS for as long as I can remember. My mother also had it. About 40 years ago, the condition worsened to the point that medication became necessary to provide relief, and after trying a number of medications, I finally found that relief from a low-total-daily-dose of the dopamine agonist, Mirapex. Over time, I was prescribed higher and higher doses to get the same relief, but the relief was increasingly temporary and my RLS continued to worsen, starting earlier in the day and spreading to my arms. Eventually, I was seen by an RLS specialist at the Quality Care Center for RLS at the [healthcare facility name and city redacted]. I learned that the dopamine agonist I was on was at ten times the maximum dose that it should have been, an unfortunate result of how poorly RLS was, and in many cases, still is understood, even among clinicians. I needed to get off of it entirely as it was making my RLS worse through a process known as augmentation. The withdrawal was 4 days of absolute hell . . . the worst thing I have ever gone through in my life. Since then, I have been on pregabalin and a low-total-daily-dose of methadone (7.5 mg). It has now been about 3 years since I started that regimen, and I can unequivocally say that it has given me my life back when nothing else worked. I have always been an upbeat, "cup half-full" type of person, but my pre-methadone life taught me why chronic conditions such as RLS can drive people to wish for death. RLS is not chronic pain in the traditional sense, but it is chronic pain nonetheless, in the sense that in severe cases such as mine, it destroys restful sleep and makes daily life intolerable. Now, my daily low dose of methadone has me looking forward to my retirement years instead of my former nighttime torture and endless floor-walking.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484fd61a4	M	None	2022-03-22T16:38:05Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from M, Tom	l0z-viu0-e668	False	None	False	2022-04-12 04:19:46.892	[]
2770	CDC-2022-0024-2776	https://api.regulations.gov/v4/comments/CDC-2022-0024-2776	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/> In 2012 I was involved in a serious car accident that left with constant back pain. I have gone through several surgeries to alleviate this pain, but to no avail. I have gone so far as to get a stimulator placed in my back. Also no pain relief. My family physician had me try several neuro meds to relieve this back pain also no relief. Finally we agreed upon a regiment of percocet that seemed to work taking most of my pain away. In 2019 my physician out of the blue sent all of her patients a letter stating that she would no longer treat anyone on opioids due to recent changes in CDC regulations. These meds had become a lifesaver for me allowing me live a somewhat normal life. After this I went to several local drs. All were accepting new patients, but as soon as they saw I was being treated with opioids I was denied by all (due to CDC regulations). I finally found a pain specialist who would treat me., but they were located 300 miles away. I cannot sit, stand, or walk for very long so this was particularly taxing on me having to travel this far every month. Finally I found a new physician that opened in my area and miraculously she treated me as a human being and as an individual, not as a number, nor a drug addict. I have never shown cause to deny me pain meds such as accidental OD, or police involvement. The CDC has ruined many lives with their short sighted rules, giving many physician an excuse to treat us not as medical patients, but as drug addicts. Making many of us have to travel, and jump through so many hoops just to get some pain relief that it is inhumane. We need to be treated as individuals, and if pain meds are a last resort we should not be denied them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	preston	None	None	0900006484fd7e75	babcock	None	2022-03-22T16:46:30Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from babcock, preston	l11-hzgl-l5c2	False	None	False	2022-04-12 04:19:47.190	[]
2771	CDC-2022-0024-2777	https://api.regulations.gov/v4/comments/CDC-2022-0024-2777	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter suffers with CRPS, a pain condition that resulted from a back injury. She had a wonderful caring doctor who gave her encouragement on how to live life in a limited normal, AND medication, For several years Dr H gave her a quality of life that allowed her to pursue her many interests. Her doctor retired Dec 2020, and life has become a struggle since. The new provider cut her meds by 50 percent, and is now abandoning her for no medical reason. My daughter has always been responsible and careful with her pain medications. All throughout the 7 years of care with Dr. H, she improved and flourished. This new doctor has cut her meds to the point where she is mostly bedbound .She has promised to cut her off completely IN A FEW WEEKS!<br/>I can not watch her suffer like she did before Dr H. She suffered so much it just destroyed me watching her deteriorate to the point of constant screaming and crying.<br/>Mme limits are inhumane and immoral. Each patient needs individualized care. No patient should be abandoned by a doctor capable of providing pain relief. <br/>CDC, PLEASE STOP creating fear among doctors who provide quality of life for those who live daily with intractable pain. Pain patients are careful and responsible with their meds, and the level of relief they get should not be dictated by the CDC.<br/>GET RID OF MME LIMITS!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Becky	None	None	0900006484fd7e7b	McMahon	None	2022-03-22T18:09:56Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from McMahon, Becky	l11-io20-8hw3	False	None	False	2022-04-12 04:19:47.400	[]
2772	CDC-2022-0024-2778	https://api.regulations.gov/v4/comments/CDC-2022-0024-2778	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a intractable pain patient that's life has been totally destroyed by the 2016 guidelines. In 2000 I was in a horrific accident that almost killed me. I suffered a catastrophic injury to my spine that left me bed ridden and in a wheel chair. I had spinal fusion that was a complete failure leaving me worse off than I was. for 3 years I searched for help finally finding a dr to redo my fusion. While the surgery was successful the pain was horrific. I developed adhesive arachnites because I couldn't find a dr to help me. The damage is severe and permanent My primary care dr tried everything before putting me on long term opioid therapy which gave me my life back I was able to work again enjoy my family travel the 2016 cdc guidelines came out and I was reduced 90% because my dr feared being shut down by the DEA for doing her work taking care of her patients. Since then I've suffered several heart attacks do to untreated pain. I tried everything my dr asked I never abused my meds never was short I used them responsibly. <br/><br/>Now because the dea has targeted drs I suffer, I have the greatest empathy for families who lost a love one to addiction but I honestly don't understand why I and millions like me have to suffer till we die. I'm 65 I doubt I will live to 70 because of untreated pain. <br/><br/>I hope that the cdc guidelines are completely removed and drs can go back to their jobs and upholding their oath to do no wrong. Thank you for your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd7f1f	Anonymous	None	2022-03-22T18:10:58Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-qdpv-5p61	False	None	False	2022-04-12 04:19:47.616	[]
2773	CDC-2022-0024-2779	https://api.regulations.gov/v4/comments/CDC-2022-0024-2779	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to a life of hard work, disease, and injury, I was treated with what became know as "high dose" opiates.<br/><br/>After working with my Dr. we found a dose that met my needs. I was on the same dose for almost fifteen years, with absolutely no problems. I passed all urine tests, pill counts, no early fills, etc.<br/><br/>Then suddenly, I was cut off, no taper, no nothing. I went from being a productive person, able to work, as well as care for my home, and land, and animals, to being a man stuck on the couch, unable to take a single step without an exclamation of "Ow". Also since my meds were cut off I haven't had one single night of restful sleep due to the pain in different parts of my body, that causes a whole new set of problems <br/><br/>What kind and how much of a prescription a person takes is between a Dr. and their patient. Not the CDC, and certainly not the DEA.<br/><br/>You speak of an opiate problem, that problem is not because of chronic pain patients, it is because of the Fentanyl that is made in China and brought into this country courtesy of the Mexican cartels. However it is the chronic pain patients who are made to suffer.<br/><br/>I recommend that you get rid of all "guidelines" and put patient care back to where it belongs, decisions made between a Dr and his/her patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ben	None	None	0900006484fd7f26	Kelevra	None	2022-03-22T18:15:01Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Kelevra, Ben	l11-tywo-5urd	False	None	False	2022-04-12 04:19:47.852	[]
2774	CDC-2022-0024-2780	https://api.regulations.gov/v4/comments/CDC-2022-0024-2780	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	All mention or use of "MME" from this draft, must be removed, if Legit Doctors will ever be able to use their best judgment, to treat Chronic Pain Patients going forward!Remember you or anyone can easily become inflicted with Chronic Pain so easily, hopefully your all smart enough to, Realize this?! Thank-You!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd7f4d	Anonymous	None	2022-03-22T18:15:25Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l11-vklp-o6si	False	None	False	2022-04-12 04:19:48.069	[]
2775	CDC-2022-0024-2781	https://api.regulations.gov/v4/comments/CDC-2022-0024-2781	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm in NC and the pain clinic comprehensive pain consultant in [Location Redacted] NC just drops patients from practice if your on Medicaid and no medicine for a 30 Day while you are looking for a new clinic comprehensive pain consultant shouldn't any pain clinic shouldn't be allowed to drop a patient especially if their medicine count is right NOT FOR RESCHEDULING a appt....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jo	None	None	0900006484fd77cc	Moore	None	2022-03-22T18:16:09Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Moore , Jo	l12-0wnx-gn9n	False	None	False	2022-04-12 04:19:48.284	[]
2776	CDC-2022-0024-2782	https://api.regulations.gov/v4/comments/CDC-2022-0024-2782	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Clearly the CDC doesn't know what true pain is. Im a chronic pain patient who can't find any relief for my pain due to the guidelines set. I have to do injections that dont work for more than 2-3weeks. I hurt all the time 24-7. Im unable to work because of the pain. This puts me on disability which I cant support my family at all on. Yall have to do better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn	None	None	0900006484fd8e49	Osborne	None	2022-03-22T18:27:58Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Osborne, Dawn	l12-dug1-4tcw	False	None	False	2022-04-12 04:19:48.499	[]
2777	CDC-2022-0024-2783	https://api.regulations.gov/v4/comments/CDC-2022-0024-2783	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s been almost 3 years since being off Norco for pain relief. My life has gone downhill tremendously. I no longer enjoy my life and I struggle with pain and anxiety and insomnia. I have never had a problem with addiction but have family members who do. As I agree something needed to be done with prescription narcotics I don’t believe what the CDC recommendations are fair to the people who need pain medications to have a decent quality of life. I don’t know what the solution is for people like me? I don’t believe in THC as I have worked in law enforcement my entire career. So that leaves people like me to suffer and not enjoy anything about life because I’m to busy dealing with the pain and anxiety and insomnia that not having pain medications leaves me with. I think about ending my life every single day. But could never act on those thoughts as I wouldn’t want to do that to my loved ones. But I have instructed my family if I where to get in a fatal accident not to feel bad for me because I would finally be out of pain. It’s not fair to let people with Chronic pain suffer like this but it’s also not fair for all these innocent people dying from drug overdoses either. Working in Law Enforcement I know first hand that most of these people dying of drug overdoses are not from prescribed narcotics but from street drugs. As I don’t know what the solution is , I do know that my life is pure hell from suffering in pain for so long. My PCP tells me I need to get my pain under control because my blood pressure is anywhere from 180/115 to 220/125 just from pure pain. My pain doctor of over 12 years will not prescribe anything more then tramadol which doesn’t help much with pain. So here I sit still in pain after being able to get pain medications previously. What can I do? What should I do? Does anyone even care anymore ? My only hope is for an early death seeing how my Blood pressure is so high, I hope to not wake up one day soon. May God help us all~	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suecarol	None	None	0900006484fd8e5a	wallace	None	2022-03-22T18:39:37Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from wallace, Suecarol	l12-dwol-k1cx	False	None	False	2022-04-12 04:19:48.711	[]
2778	CDC-2022-0024-2784	https://api.regulations.gov/v4/comments/CDC-2022-0024-2784	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To be fair, I think the Government was attempting to do the correct thing by narrowing the ability for addicts ability to consume narcotics but the end result has been devastating for both addicts and people in need of pain medication. It's forced both those groups to turn towards fentanyl. The outcome of the steps taken ended up being worse than the initial problem. If we give everyone access to make personal choices then those consequences will always land on the person instead of strangers being able to step between someone else's ability to improve their own quality of life. People that are in pain will search out relief. It's up to the medical fields to make sure they have a safe product. It's the same as alcohol during prohibition. No controls so alot of people ended up being hurt by bad liquor. I hope that we can finally get an outcome based in common sense instead of a religious or gov grandstanding type of legislation out of this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Adam	None	None	0900006484fd8e5f	King	None	2022-03-22T18:42:28Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from King, Adam	l12-dy1n-q6q0	False	None	False	2022-04-12 04:19:48.922	[]
2779	CDC-2022-0024-2785	https://api.regulations.gov/v4/comments/CDC-2022-0024-2785	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife, now 69, has been a chronic pain patient since 1995 when she developed severe lower back pain after a hysterectomy. She went through of surgeries to remove scar tissue and elaborate diagnostic procedures to isolate the source of the pain. Her doctors experimented with numerous pain control therapies, including yoga, acupuncture and numerous combinations of pain medications.<br/><br/>Nothing gave her consistent pain control until the duragesic patch. That therapy allowed her to continue her demanding career and to function in society. The pain has never left, but at last it was being managed. <br/><br/>The 2016 restrictions on the use of opioids for chronic pain management have undermined her treatment and threatened her quality of life. Instead of being treated like a patient with chronic and well-understood needs, the guidelines treat her like a borderline criminal drug abuser and constantly threaten to take away her treatment.<br/><br/>She is forced to go to her doctor every month for a prescription refill instead of every three months. This means a full day every month traveling for a 10-minute consultation. We cannot travel at will – every trip out of town requires elaborate coordination with doctors, pharmacies and insurance companies to have the medication for a trip. It’s almost like being a convict on parole who’s every move is subject to oversight.<br/><br/>There is no reason for her to be treated like this. She has been conscientious in using her medication, without a hint of abuse. She has had a 15-year relationship with her pain management doctor. Now he is under threat for continuing to treat her, and she is threatened with losing the only treatment that has worked for her over more than 25 years.<br/><br/>These guidelines must be revised so legacy patients like her and their caregivers like me can at least return to the quality of life we had before 2016. We should not be made to suffer as collateral damage in the war on illegal drug use.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kent	None	None	0900006484fd8e61	Guida	None	2022-03-22T18:46:52Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Guida, Kent	l12-dy7a-6mwl	False	None	False	2022-04-12 04:19:49.133	[]
2780	CDC-2022-0024-2786	https://api.regulations.gov/v4/comments/CDC-2022-0024-2786	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revisiting the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like Restless Leg Syndrome that are different from chronic pain. Restless Leg Syndrome (RLS) is a chronic neurological disease that causes distressing uncontrollable urges to move the legs and in some cases, other parts of the body. It is pure torture and disrupts sleep night after night. RLS is progressive and often gets worse with age/time.<br/><br/>In the U.S. 12 million people suffer from Restless Leg Syndrome. There is no cure. Dopamine Agonist medications (same medications as those used for Parkinson's Disease) may relieve the symptoms for a while, however over time they make the symptoms worse. Alpha 2 Delta medications such as Gabapentin work for only some people. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am woken up 5-8 times per night with these awful feelings in my legs caused by RLS. I must get up out of bed to stretch my legs and walk each time for 10-30 minutes. I currently take Gabapentin however it obviously is not working for me. I have also taken Pramipexole which did not help. This prevents me from getting the sleep I need night after night. For all RLS sufferers lack of sleep effects our emotional, physical and mental health. <br/><br/>The 2016 CDC Opioid Prescribing Guidelines often make physicians afraid to prescribe opioids for any reason, even for patients with severe unrelenting Restless Leg Syndrome. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like Restless Leg Syndrome that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd8f11	Anonymous	None	2022-03-22T18:55:06Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l12-etfw-8k0e	False	None	False	2022-04-12 04:19:49.353	[]
2781	CDC-2022-0024-2787	https://api.regulations.gov/v4/comments/CDC-2022-0024-2787	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ever since the opiate guidelines were issued, the treating physicians considered it to be law. Workers Compensation Board is now requiring that all claimants she be weened from the current dosage without any consideration that every individuals pain is unique to them . I have been on the same dosage for years. Treated by the same Physician. My quality of life has greatly reduced and I am not even half way there to the 90mme they insist. I honestly don't know how I am going to cope with this pain especially when I know if I had my correct medication I would not have to live in daily agony.8 believe many more suicides are in our future. I am struggling everyday and I know I am just one of millions. I beg of you to get this information to prescribing Doctors to inform them these are just quidelines and notify the judges to stop them from automatically side with the insurance carriers. You want to save lives I understand but these quidelines you put out there are causing people to choose not to live with chronic pain or seek street drugs to help ease there pain. I have be stable on my medication for 10 years, never needing an increase nor had run out early. I am being put into the same category as the uses and abuses. Please I beg of you to fix this problem before it is too late.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd8f23	Anonymous	None	2022-03-22T18:57:08Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-ewyd-wwzc	False	None	False	2022-04-12 04:19:49.579	[]
2782	CDC-2022-0024-2788	https://api.regulations.gov/v4/comments/CDC-2022-0024-2788	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [Name Redacted] ..I’ve been a Chef/Restauranteur most of my life..I did my own shopping loaded heavy cases into my car out of my car into my restaurant then put them away for years… I lifted big heavy pots of pasta, sauce, soups and worked 7 days a week for years … at the same time raised 4 kids on my own w/a nanny and had full control of my life.. I was also born with two bones fused together in my neck ..I had a Surgeon for a stepfather growing up… We had boxes of drugs everywhere … I never became a drug addict we had liquor everywhere i never became an alcoholic.. At 50 i got Rheumatoid Arthritis and from years of working an extremely physical job I got osteoporosis… the bones fused together in my neck has become so painful some days where i feel like i’m dying i get blind pain … My doctor prescribed a 5mg opiate for these horribly painful conditions… i never dared to ask for a small amount of stronger ones in fear to lose the small amount i was receiving..He has randomly taken blood tests to confirm i am properly using my medication as prescribed per order of the medical umbrella he worked under… I never failed it .. Now you’ve taken my doctors right to prescribe opiates and because i am not an imbecile and understand this war on chronic pain patients and also understand the new group making all the money off of us on alternative meds are fighting to keep what they are profiting on! It’s a money war and we the patients are suffering! This is a disgrace and we the people should have the right to chose our own methods of relief since everything that i’ve tried has failed me!! Stop playing God! People are going to fentanyl now and dying is that your MO? Disgusting how we are being treated this is all about greed amd profit…	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd837c	Anonymous	None	2022-03-22T18:57:34Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-4wjx-u6ul	False	None	False	2022-04-12 04:19:49.801	[]
2783	CDC-2022-0024-2789	https://api.regulations.gov/v4/comments/CDC-2022-0024-2789	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Do you folks realize how many sick people you hurt with your last guidelines? Do you even care? How do you know what dosage is safe for me when you've never seen me or read my chart?<br/><br/>OD deaths set a new record last year congratulations. You are a major contributor to that travesty.<br/><br/>Remember the days of [Name Redacted] the father of euthanasia? People chose suicide because doctors wouldn't treat their pain. You've led us to return to those dark ages a time when people put their lives at risk because they can no longer live without adequate pain relief.<br/><br/>And here I thought Americans had the right to life, liberty and the pursuit of happiness. What a fairy tale that is turning out to be.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kendal	None	None	0900006484fd84db	Rice	None	2022-03-22T18:59:31Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Rice, Kendal	l12-6j7g-rxdj	False	None	False	2022-04-12 04:19:50.021	[]
2784	CDC-2022-0024-2790	https://api.regulations.gov/v4/comments/CDC-2022-0024-2790	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm sure my opinion is no different than so many others, but I am a living testament to the benefits of carefully monitored opioid use. When I was 23, I had a car accident. My only injury was a case of whiplash; however, I had lingering upper back pain that just never went away. I am 55 now, & doctors can only assume my diagnosis of severe cervical stenosis probably began over 30 years ago with whiplash. I won't bore you with the long list of things my doctors & I have tried just shy of a risky surgery. I am coming to the end of my career as a school counselor. The last five years, I've worked at a school that requires a 2-hour round trip commute. (Jobs in my field are not easy to come by. Many of us commute to work.) Also, school counselor jobs require a lot of sitting as we are responsible for state testing, class scheduling, etc. We definitely do not get to move around all day. My neck & spine pain became gradually worse when I started commuting. Finally, a neurosurgeon referred me to a pain management doctor. I hated the idea at first, but now, I know without a doubt I would never have made it to my retirement year without her help. I have used Hydrocodone daily, under her care, for the last four years. I honestly couldn't tell you if my body has become dependent. All I know is that, taken the way she prescribed, I can function with minimal pain. I can serve children who are growing to be adults in this world. I can be a wife, a grandma, a servant of my church.... so many things, with minimal pain. I am praying a change in my lifestyle after retirement will improve my physical condition, but until then, I can testify that I am one of so very many people who would not have quality of life without the opioid I have been prescribed. When people have a chronic pain condition, but still want to live productive lives with no help from the government such as disability (isn't that what we want for our world?)... those people should not live in fear of losing their pain medicine because it has addictive properties. There are people who get by in life using marijuana. (I never have, not even in younger years.) I know a fantastic attorney whose wife told me, in confidence, that he starts his day with marijuana because he suffers from anxiety. No one around him knows he does this. He's found something that helps and it is not hurting anyone or himself. Likewise, there are millions of us around the nation who are functioning at a productive level on an opioids and no one around them is even remotely aware because it doesn't show. I consider myself to be a smart woman, with or without my degrees, so trust me when I say, I understand there are many ways in which opioids and marijuana are not the same. I am not suggesting they are. However, there are people who are silently and safely using both "drugs", yet the powers-that-be are not only ignoring other addictive drugs, in the case of marijuana, distribution centers are going up on every corner just like liquor stores. (I also do not drink or smoke.) I'm told it is not at all hard to get a medical marijuana card. I'm a former English teacher, so I am not surprised my opinion here became lengthy. If you are still reading, I will close with this. If my pain management doctor told me, "I'm sorry, but new guidelines are now making it difficult, if not impossible, for me to help you in this way, even though we count your pills with every monthly visit and monitor you closely", I would hit rock bottom. I know I would. My neck and spine are full of bone spurs & arthritis. That is not going to magically go away. In fact, it is known to only get worse with age. That's why I am retiring early from a career I love. So I can hopefully stay up and moving to slow the progression of my condition. I will do my part, but I won't be able to do my part without some help with pain relief. Please do not say to yourselves, "Why not just have surgery?" I have a husband, two sons, two daughters-in-law & four grandchildren I adore. My mother and mother-in-law are both still living but aging quickly. The success rate of the surgery, where they enter through the front, near my throat, just to get to the affected areas in order to attempt three separate surgeries.... it has a success rate of less than 70%. No thank you. I have people to love and care for. Surgery is a last resort and it is not the answer to the opioid epidemic. I can't tell you the answer, but I hope I have shown you what is NOT the answer. If I need to come to the nation's capitol and plead the case for myself and others like me, I am happy to do it. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484fd8fbb	Rogers	None	2022-03-22T19:01:30Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Rogers, Denise	l12-fhzr-kjk3	False	None	False	2022-04-12 04:19:50.243	[]
2785	CDC-2022-0024-2791	https://api.regulations.gov/v4/comments/CDC-2022-0024-2791	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain for 20 years and continue to struggle every day. I understand that the opioid epidemic had gotten out of control and something needed to be done. However, I have done everything I possibly can as far as treatment. Not all pain patients are looking to get high or sell their pain meds, some are actually dealing with a daily living hell. I have not only paid a price for this, but I feel my family has as well. I pushed and continue to push myself every day. I am elated that the CDC is changing the guidelines. It is way overdue and I wholeheartedly support it. There needs to be a balance. It shouldn’t be all or nothing. The only relief I get is from Tramadol. Pain patients have already suffered enough needlessly, they should not be shamed for wanting relief. <br/><br/>[Name Redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd89c1	Anonymous	None	2022-03-22T19:03:28Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-7v4e-6447	False	None	False	2022-04-12 04:19:50.469	[]
2786	CDC-2022-0024-2792	https://api.regulations.gov/v4/comments/CDC-2022-0024-2792	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mother in law who is my best friend suffers everyday due to chronic pain. Pain that is cause by illnesses that can only be treated not cured. She has been having her pain medication reduced while MRIs and other tests prove her illnesses are getting worse. She has no quality of life because doctors refuse to help her pain. She lives in spite of health fields "help" not because of it. They stopped helping once the pain became complex. She needs pain medication to get out of bed, why take that from her?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5a3d	Anonymous	None	2022-03-22T19:08:17Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-83tw-5l24	False	None	False	2022-04-12 04:19:50.692	[]
2787	CDC-2022-0024-2793	https://api.regulations.gov/v4/comments/CDC-2022-0024-2793	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am grateful to the CDC for its invitation to the public to comment on the proposed adjustments to the Guidelines for Prescribing Opioids. As a Chronic Pain Patient, it gives me hope.<br/><br/>The 2016 Guidelines were put into place to hopefully reduce the tragic number of opioid overdoses and deaths. This was certainly an admirable goal. Unfortunately, the revised guidelines have had the unintended consequence of harming the ability of physicians to treat Chronic Pain. The 2016 Guidelines reduced the Quality of Life of many Chronic Pain Patients, including myself.<br/>.<br/>Physicians were put in the position of seeing their chronic pain patients as a threat to their medical licenses, should their judgement be questioned. Prescribing opioids that had been helping their chronic pain patients safely maintain a decent quality of life for years, could now endanger the physician's reputation and medical practice, and thus their livelihood. This situation has affected countless patients' treatment plans, adding to the stigma of chronic pain.<br/><br/>Chronic pain patients, such as myself, were put in the position of not wanting to harm a caring physician who was treating them for this difficult medical condition. My medical condition had not changed, but I helplessly watched my quality of life decline. The relief I had been receiving was now being reduced, with the goal of being withdrawn. Everyday tasks that non-chronic pain patients do not give a second thought to became increasingly more difficult. Participating in enjoyable social events became a challenge, with many invitations to join in fun having to be increasingly declined.<br/><br/>If a chronic pain patient has a physician who is still willing to prescribe pain medication, that patient is left fearing that that pain relief could be withdrawn at any time, due to these guidelines. Chronic pain patients no longer feel free to discuss the losses in their life due to increases in pain. It feels useless and ungrateful if the patient has a physician still trying to help the patient.<br/><br/>A patient in this situation is put in the position of declining any type of possibly avoidable medical procedure ( such as dental implants following tooth removal ) that could increase the patient's level of pain, even if temporarily. A Chronic Pain Patient is left to fear the day a new medical condition ( such as one requiring surgery ) should arise. It is a burden a person should not have to carry.<br/><br/>Patients with a complex medical history and their physicians have been forced to fit into rigid guidelines that have reduced the treatment of Chronic Pain to being a type of luxury. It should not be. Chronic Pain is a medical condition ... alleviating pain should not be treated as unnecessary. A rigid MME cap for all patients does not truly address the needs of all individual patients. Physicians need to be able to do that without fear, under compassionate guidelines that address potential abuses.<br/><br/>Please, please create Guidelines with a Safety Net for Chronic Pain Patients and their Physicians. The choice to prescribe opioids should rest in the hands of the physician who has a complete understanding of their patient's full medical history.<br/><br/> Please help Chronic Pain Patients and their Physicians.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5cd1	Anonymous	None	2022-03-22T19:09:58Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0z-h9oj-a5lf	False	None	False	2022-04-12 04:19:50.925	[]
2788	CDC-2022-0024-2794	https://api.regulations.gov/v4/comments/CDC-2022-0024-2794	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Let's be honest here, shall we? The CDC truthfully shouldn't have anything to do with any kind of opioid prescribing. Why? Because the "opioid epidemic" was illicit from the start and never should have happened like it did. If it even qualified as an epidemic in the first place, and I strongly question that point, it should have been called the "Overdose Epidemic" or "counterfeit fentalogue epidemic." To be honest I don't think either one would be legitimate because neither one is an infectious disease, which is listed as a factor that is required by HHS to declare a public health emergency. Bottomline, I believe that the public health emergency declared by HHS is fully illicit and stepped into the realm of social problems. That is not what the public health emergency system was designed to do. It was designed to respond directly to communicable diseases or urgent matters of public health. It was never designed to be used to bypass Congress on social issues. I believe that the CDC combined the massive numbers of counterfeit fentanyl overdoses with overdoses from other opioids. 30% of those were methadone, however, but those numbers are tainted by the use of methadone (does it tabulate separate numbers for people with addiction? What about end of life care?) The CDC has not properly tabulated any of the numbers they have used so far. Is this another "algorhithym error." The CDC has been playing games with our lives...it has been sticking its dirty, corrupt fingers into something they are not equipped to handle. It is up to the FDA to make sure that medications and treatments are safe and effective for everyday Americans. Yet, the CDC launched an attack against pain patients for no legitimate reason and used loopholes within the public health emergency system to bypass the FDA almost completely. That is wrong and you know it. In a nutshell, I perceive this new proposed CDC rule as more of the same corruption we have seen with coronavirus. I believe it will be forced through, then will be used as a way to bypass the and rend useless the CDC Opioid Committee's decisions on the 2022 CDC Opioid Prescribing guidelines. You know very well that most hospitals and clinics will treat these recommendations as law. So this is another attempt to harm more people under an illicit Public Health Emergency. What you are doing is unconstitutional, but you don't give a damn who you hurt. Most of us perceive the CDC as an enemy to the people at this point. We believe that this is just another attempt to make your big pharma/rehab friends financially happy. I'm going to be very raw here and express to you that we are disgusted that the Secretary of HHS and the CDC have conspired more than once to take away the constitutional rights of American citizens for profit. I don't think the CDC should have anything to say at all to prescribers, through these guidelines or any others. I think that all of your guidelines have been illicit and heavy-handed, and your actions attacking opioids has been discriminatory to people with physical pain-based disabilities as well. By doing what you do, and what you have done to date, you have placed a higher value on the life of a person with an addiction diagnosis than the life of a person with a chronic pain diagnosis. Yes, you have. You have also tampered with our licensed practitioners' diagnosis of disease without the benefit of any doctor patient relationship. And the diagnosis you force upon us? You unjustly label us with an addiction diagnosis that most of us absolutely do not have. Yes, we know why this has happened...we know about the DOJ and it's pet law firms, we know about the interconnections between [Names Redacted] connection to [Location Redacted]. We know that [Name Redacted] basically invented the abuse of the term MME which was never designed to implement as a baseline number for all patients. A 90 lb female and a 350 lb male are going to require different amounts of any medication. It's ridiculous to pretend that physical, metabolic and tolerance differences do not exist between different patients. Yet you cling to that MME like it was your long lost friend. Why? Would you prescribe any other medication this way? Of course not. We pay doctors who are trained to make those decisions, not you. It is their license and insurance...not yours. And when these licensed providers get sued because a chronic pain patient committed suicide out of desperation (and yes,it's happened), how much liability will fall on you? Oh that's right, you're not liable for anything. Under this endless illicit "opioid epidemic" you are almost completely immune. How is that not unconstitutional as well? Why should you be immune from all potential litigation resulting from your decisions...but not essential businesses? NOPE! Basically you need to throw all of this opioid mumbo jumbo in the garbage and leave our doctors alone. GET OUT OF OUR LIVES, CDC!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kirsten	None	None	0900006484fd8a29	Klang	None	2022-03-22T19:10:46Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Klang, Kirsten	l12-8azj-j3m3	False	None	False	2022-04-12 04:19:51.158	[]
2789	CDC-2022-0024-2795	https://api.regulations.gov/v4/comments/CDC-2022-0024-2795	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC, please change these guidelines,even better remove them or any reference to MME Equivalents.. Also, Chronic pain patients should always be exempt..<br/><br/>My life has truly been affected by these guidelines and the fear and uncertainty it has placed on good pain management doctor's and primary care physicians..<br/>I've been at my job 15 years, helping disabled clients retain their employment, though I'm permanently disabled. I'was capable of working part-time until these guidelines came out and my pain doctor had felt so much scrutiny that he made it an office policy January 2022 to no longer prescribe pain medicine..<br/>This has placed great threat on my future care, function level and job security..<br/>Please stop hurting the people that did nothing to deserve this..<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd8fd2	Anonymous	None	2022-03-22T19:12:23Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-fmmu-5twz	False	None	False	2022-04-12 04:19:51.588	[]
2790	CDC-2022-0024-2796	https://api.regulations.gov/v4/comments/CDC-2022-0024-2796	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My father has been a victim of prescription opioids for many years. It has completely destroyed his life and has definitely not been necessary to the extent it’s been handed out so freely by these doctors. He is a full blown LEGAL addict because of this system. Not only has he lost all of his teeth and is incredibly unhealthy in every possible way you can be… but it has caused trauma, drama, stress and tremendous pain for all of his family members. He is now homeless do to the fact that he was too high all the time to sign a lease somewhere else to put it much more simply than it actually is. We are now all paying for a hotel for him bc he is completely incapable of taking care of himself bc he is so high from these PRESCRIBED drugs. Lightening the laws in this is horrible and goes to show even more so how much big pharma actually controls the government and don’t care about the people of this country. What a shame it is to watch the morals and values decline more and more. You have ruined so many families. Shame on you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Arielle	None	None	0900006484fd8a7a	Abramovitz	None	2022-03-22T19:13:52Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Abramovitz, Arielle	l12-9axf-635z	False	None	False	2022-04-12 04:19:51.817	[]
2791	CDC-2022-0024-2797	https://api.regulations.gov/v4/comments/CDC-2022-0024-2797	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People should have a right to a shorter life with quality (i.e. low/no pain) versus a forced life of chronic pain and suffering. Not everyone is a drug seeking addict, stop punishing people who are already suffering with chronic pain. Addicts will kill themselves with street drugs (heroin/fentanyl/huffing paint and gas) if all they want is to get high off of drugs. People have pain and should be treated on an individual basis, NOT treated based on some percentage of drug seeking addicts! Everything in this world can be tracked and analyzed, so there is NO reason that pain medication cannot be prescribed based on an individuals needs for a quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484fd8806	Costolnick	None	2022-03-22T19:14:31Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Costolnick, Joseph	l12-b6ld-i5ma	False	None	False	2022-04-12 04:19:52.035	[]
2792	CDC-2022-0024-2798	https://api.regulations.gov/v4/comments/CDC-2022-0024-2798	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Im a Marine veteran with RSDS/CRPS full body and have had 3 spine sugerys, 2 cervical fusions C3-7,a lumbar revision, and prostate removal in last 5 years. Ive been dependent on opioids since 1988. The VA stopped prescribing to me in 2016 leading to a heart attack. Ive had 4 rsds pain related heart attacks. The CDCguidlines have caused undertreatment of my very painful condition. There should be no mention of MMED in the proposed guidlines whatsoever as it is based on junk science and leads to under-treated pain. I will reference [Name Redacted] body of work. See his comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Todd	None	None	0900006484fd8854	Simpson	None	2022-03-22T19:17:04Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Simpson , Todd	l12-bf8s-trag	False	None	False	2022-04-12 04:19:52.274	[]
2793	CDC-2022-0024-2799	https://api.regulations.gov/v4/comments/CDC-2022-0024-2799	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Congratulations! <br/>The CDC and their very openly anti-opioid panel has helped the United States achieve THIRD WORLD STATUS where pain management is concerned! <br/><br/>Palliative care is defined as:<br/> <br/>"Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex illnesses."<br/><br/>How does this concern the United States? Because of the CDCs 2016 anti-opioid guideline, we have:<br/><br/>Achieved inequality of access to <br/>pain relief and palliative care for the millions of people suffering with chronic pain.<br/><br/>Because of the CDC anti-opioid guideline, they've ensured that avoidable suffering on a massive scale has been wrought due to lack of access to pain relief through the use of inexpensive opioid analgesics.<br/><br/>The CDC anti-opioid guideline has ensured that doctors are unable to relieve suffering because primary care physicians and specialists can't or won't prescribe inexpensive opioid medicines because of the interference by the CDC and their anti-opioid panel, as well as the DEA and DOJ.<br/><br/>The World Health Organization determined that it's the<br/>ethical responsibility of health care providers to relieve suffering. Unfortunately, in the US, we've lowered our standards to the point where we rival third world countries. That is not complimentary!<br/><br/>Both primary care physicians and specialist health care providers need to implement and manage both palliative care and pain management. They also need to be able to incorporate this into primary health care. Both primary care physicians and specialist health care providers need to be able to prescribe opioid analgesics based on their clinical judgement, without interference from the CDC, DEA, or DOJ.<br/> <br/>This is both a medical and<br/>moral imperative which the US has completely abandoned because the CDC and their anti-opioid panel has written what was supposed to be guidance for PRIMARY CARE DOCTORS ONLY and has ensured that this "guidance" has been misinterpreted and misapplied as mandates. <br/><br/>As for me... I've followed my pain mgmt contracts, I've had clean urine in every single drug test for the past 20 years, and I've taken my medication exactly as directed by my physician. Unfortunately, my doctors have felt so threatened by the current climate in which they practice that they've cut my medication back to a point where I'm unable to function. My only choice now is to either commit suicide or look for illegal drugs to manage my pain. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd903d	Anonymous	None	2022-03-22T19:19:13Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-g8fg-0cpg	False	None	False	2022-04-12 04:19:52.490	[]
2794	CDC-2022-0024-2800	https://api.regulations.gov/v4/comments/CDC-2022-0024-2800	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As of this year I celebrate 15 years diagnosed with Ehlers Danlos Syndrome hypermobile type. Everyday I am in constant pain from having to relocate multiple joints multiple times a day. Often times my shoulders dislocate and I end up in the ER because I cannot get it in myself. In my 29 years of life I have had thousands and I really truly mean thousands of dislocations. My nerves are fried because of it, my muscles just can’t handle it, and the pain is off the wall. Right now I am on hydrocodone from my PCP, whom of which is scared to change or make changes to my meds because he fears retribution from the government which that’s a real fear for them I’ve tried getting into pain management but when I went I was told I had to give up everything else that helped just to be on one opioid. I’ve been trying for weeks to find a good PM doc but they have waiting lists some of which are years long. This wouldn’t be an issue if my PCP felt as though he was able to sufficiently address my pain without repercussion. I would also feel more comfortable having him do it because I see him regularly and he knows me. A PM doc can’t even give you the time you need because they have so many patients that it’s get in the room, prescribe, and out of the room again. You tend to feel like a number not a patient. I’ve been going through this exact process for 15 years. I’ve met a lot of docs who just shrug and say” I wish I could help but my hands are tied.” I think there should be protocols for prescribing for medical conditions or patients. I cannot tell you the negative impacts the pain has had on my life because there is far too much to say and explain. I’ve lost my daughter because I can’t take care of her, I can’t work, and I literally have to sit here because the pain is so bad. Please hear these people out! A lot of them are the backbone to this country and don’t deserve to be treated like they have!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484fd8857	R	None	2022-03-22T19:21:28Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from R, Nicole	l12-b3tu-9zxa	False	None	False	2022-04-12 04:19:52.718	[]
2795	CDC-2022-0024-2801	https://api.regulations.gov/v4/comments/CDC-2022-0024-2801	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Alternative, non-opioid treatment options for pain cannot be stressed enough. As the draft guideline mentions, laser therapy can be an effective, life-changing option that patients often are not aware of until their pain journey has been long and arduous. Laser therapy should be in the conversation for all stages of pain treatment. It is a game changer in the care of acute and chronic pain. I have been able to get results for my patients that I would never have dreamed of before I starting utilizing this therapy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shona	None	None	0900006484fd886f	Mackenzie	None	2022-03-22T19:21:57Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Mackenzie, Shona	l12-bjvc-eepl	False	None	False	2022-04-12 04:19:52.947	[]
2796	CDC-2022-0024-2802	https://api.regulations.gov/v4/comments/CDC-2022-0024-2802	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>We should all be eternally appreciative the National Pain Council (NPC) finally acted on the behalf of all humanity by publicly proclaiming what countless pain advocates, researchers, and patients have been expressing since the CDC initially overstepped its authoritative boundaries in 2016.<br/>If every existing medically related board/committee/organization, etc., that operates within the United States would have publicly proclaimed the exact same declaration, (or something similar), immediately upon the CDC blatantly overstepping its authoritative boundaries in 2016, it may have potentially minimized some of the needless pain and suffering being unjustifiably endured by millions of innocent Americans. It also potentially could have minimized some of the countless premature deaths, (via suicides) brought about by the hopelessness of having to endure unjustifiable, unrelenting, and agonizing pain.<br/>In consideration thereof, the CDC should be immediately removed from its (self- inserted) role of attempting to create regulations for which it has neither the educational background nor the professional working experience administering to.<br/>Millions of innocent American lives have in many cases been permanently devastated, including those patients who lost their lives. Consequently, in an effort to help ensure nothing this harmful to innocent Americans is ever perpetuated again by any American government agency, the CDC needs to be immediately removed from the guideline recommendation process. Such determinations (if even deemed necessary) need to be made by individuals and/or organizations well versed and educated in the day-to-day administration of chronic and intractable pain patients and the medications and treatments typically available to help them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bradley	None	None	0900006484fd90fd	Percell	None	2022-03-22T19:24:25Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Percell, Bradley	l12-gzzx-8wmj	False	None	False	2022-04-12 04:19:53.165	[]
2797	CDC-2022-0024-2803	https://api.regulations.gov/v4/comments/CDC-2022-0024-2803	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As I sit here in so much pain .i m wondering what I did wrong ?I worked hard for 30 years .i paid taxes .i took care of my family .and now I have to suffer cause I m hurting to bad to do anything .i have deteriorating disk disease .stenouses of the spine my neck has a plate in it that its coming apart hurts from having surgery .also had 2 back surgeries the last one they put plates in my back my disk are popping out above and below the back plates and neck plates .i can't hardley walk at time my legs want to give out I was taken down from my pain meds to a low dose that does nothing for me .i would like to have a life but right now that's not going to happen because of the Mme that was put in place in 2016 now the 2022 is not any better .i also have bone spurs and arthritis in by back and hands .i would like to know when I can start living again with some help from a pill to stop the pain so I can move again .i feel so angry that we all have to be in pain like this because doctors hands are tied and they can't help us .we are treated inhuman .Pharmacy talked to us like dogs oh wait there probably nicer to there dogs .Er doctors assume we are there for pain meds and Mark are little brackets with msn.i was in there for a bad uti I only wanted an antibiotic .also they put a Cath in me and it started hurting and I ask if they could take it out .they took it out alright .still inflated .That means I was bleeding and hurting worse then I went in .all I ask is just get rid of the guidelines period .its not helping us it's killing us .Thanks and have a good day .Because I won't be having one.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd95d7	Anonymous	None	2022-03-22T19:25:57Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-hqr6-yh1w	False	None	False	2022-04-12 04:19:53.418	[]
2798	CDC-2022-0024-2804	https://api.regulations.gov/v4/comments/CDC-2022-0024-2804	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [Name Redacted]. I am a chronic pain sufferer! My doctor prescribed 120 fifteen milligram Oxycodone per month for over 5 year's. Then cut me off saying a dirty UA, then admitted to me her boss told her to exchange my clean UA for a Dirty One!! Telling me she never meant to hurt me. I have been left to Suffer Debilitating Pain for 7 Week's! She also admitted the truth was her boss told her that the dea called telling them to cut off prescribing Oxycodone to any one!! Admitting it was a lie. Now the Oregon [Location Redacted] guaranteed after review of all my medical records that my chronic suffering call for being prescribed opioids for My diagnosed severe pain.! Then did nothing to find me a doctor as promised.Saying [Location Redacted] found me a doctor to help me. Not true! So I'm now filing a violation of my civil rights with the federal and state courts with a attorney. Who told me to contact you for helping me. Can you investigate? I swear the forgoing is true and correct. [Name Redacted]. [Contact Information Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fd88d1	Ready	None	2022-03-22T19:28:42Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Ready, Jeff	l12-bkkv-sa7b	False	None	False	2022-04-12 04:19:53.639	[]
2799	CDC-2022-0024-2805	https://api.regulations.gov/v4/comments/CDC-2022-0024-2805	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain and have been suffering for the past six years. I have severe Crohns of large and small intestines, RA, bilateral sacrolitis in both hips, a spur in front if my spine. Im constantly in severe pain and feel like I've been abandon by doctors and pain management. I've been on numerous psychology meds to try to trick my pain. All those didn't work. Still left suffering. Sometimes, i can't get out of bed and walk. I can't move. When i do sometimes, on a good day, I fall and have broken ankles and butt bone. Pain gets me isolated and i become a prisoner to my bedroom. Who wants to deal with a person who can't eat due to pain. I've been in doctors appointments crying in pain and they only give me lyrica. It still doesn't help. So I'm left and neglected by physicians and the CDC. Leaving me to suffer and despised. I scream in pain which makes my family very uncomfortable and they become so angry that physicians leaving me all alone to suffer. Sometimes i can't move and cry in bed all due to pain. Something needs to be done to help chronic pain sufferers.<br/><br/>You wonder what can be done to help chronic painners? The CDC can not abandon patients and practice continued negligence. Not all patients have addictive personalities. They need help!! Even if it's a 25 supply of pain medication. We need HELP!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kishna	None	None	0900006484fd9274	Nicholas	None	2022-03-22T20:00:29Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Nicholas, Kishna	l12-ixrn-klto	False	None	False	2022-04-12 04:19:53.861	[]
2800	CDC-2022-0024-2806	https://api.regulations.gov/v4/comments/CDC-2022-0024-2806	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been suffering for the last 5 years with on going problems with my spine! I've been on the lowest dose of pain meds and that was ok with me! The rules and lack of any compassion from these doctors is shameful and disgusting when one has lots of documentation to prove the medical condition! Where i live its their way or no way and they label you as a drug addiction no matter who you are there is no help or caring at all! Like the article has stated many just opt to committed suicide or get something on the street! Most have been dropped cold turkey without any help! Im tired of being labeled because of chronic pain! Its to the point for me that I will have to seek legal council just to get help or leave the state of Missouri	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd9267	Anonymous	None	2022-03-22T20:01:26Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-iui6-tf07	False	None	False	2022-04-12 04:19:54.081	[]
2801	CDC-2022-0024-2807	https://api.regulations.gov/v4/comments/CDC-2022-0024-2807	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s) and allow physicians to use the judgement and experience they have just like the FDA allows Physicians to use the experience and judgment to do epidural steroid injections. Why is CDC and FDA recommending epidural steroid injections, an off label experimental drug application that is Contraindicated according to some drug manufacturers. Nowhere does CDC belong in the clinical judgement of physicians who are helping people just like when doing epidural steroid injections and helping people. Why is the CDC waiting until [name redacted]- Vs - United States to do something about best practices anyway? There is no coincidence. The bias study that claims to be better was done by the same people in the working group now as compared to 2016. This will not help patients. This will not change anything. The CDC has no ability at this juncture unfortunately to do damage control. Fortunately, the issue will be decided by the Supreme Court in giving physicians a good faith defense when providing medical treatment. These Guidelines, just like the first ones, are nothing but harmful to clinical practices a d the one-size fits all step therapy is living somehow in a fairytale. It is time to admit CDC has killed thousands of Americans due to these reckless biased actions to destroy the practice of medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd8d9a	Anonymous	None	2022-03-22T20:44:51Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-cmzs-hfng	False	None	False	2022-04-12 04:19:54.303	[]
2802	CDC-2022-0024-2808	https://api.regulations.gov/v4/comments/CDC-2022-0024-2808	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guidlines but the draft does not address chronic conditions like Restless Leg Syndrome that are different from chronic pain. Restless Legs Syndrome (RLS) is a chronic neurological desease (for which there is no permanent cure) that causes, among other things, an urgent need to move the legs and, in my case, arms. The symptoms make it impossible to sleep for any period of time and, in my case, makes it difficult on a daily basis to be a good father to my 4 children and carry on my independent consulting business. <br/><br/>Many people are unaware that in the U.S. nearly 12 million adults and children suffer from this life long disease. As noted, there is no cure. A few prescription medications, of which I have tried most of them over the years, relieve the RLS symptoms at times, but over time those same medications can, and will, make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Now, to my own struggles with this terrible disease. I was diagnosed with Restless Leg Syndrome around 1989. I have suffered with this for over 32 years. I am now 73 years old. I have seen numerous physicians over the years in an attempt to control the symptoms of this unrelenting disease. I was originally prescribed mirapex to help control my symptoms. Mirapex helped at times over a period of 8-9 years at a level that allowed me to at least carry on with my life but did not come close to completely controlling RLS symptoms. I still suffered numerous nights with very little sleep (sometimes 2-3 hours). As an independent consultant I personally know that I lost clients due to my inability to focus on my work. As to being a good father and caregiver to my 4 children, it was difficult. My children are grownups now and have come to understand my battle with RLS and how it affects my daily life. <br/><br/>Around 2007 I found that the mirapex no longer worked and, in fact was causing augmentation. Over that span of time, I tried numerous (if not all) other drugs identified as helping RLS symptoms. None of them worked very often due to the severity of my case. I became desperate. I was unable to function many days. It was at this time that I found Dr. [name redacted] through the RLS Foundation. I have been a member of this very important organization for many years. Dr. [name redacted] was on the advisory board for the RLS Foundation and came highly recommended due to his many years of treating RLS patients. At our first appointment, he again diagnosed me with Restless Leg Syndrome and indicated that my only real option was to take a very small dose of Methadone (10 mgs) at night to control my symptoms. It worked almost immediately! I was so thankful to have finally found a way to lead a normal life. My wife and family were so thankful and so supportive. I am leading a fairly normal life thanks to the relief I found in this small dose of methadone nightly. Remember, the first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, and carefully monitored.<br/><br/>I am obviously very concerned and worried about any changes the CDC may recommend in the prescription of opioids. Please do not forget about people like me and others that take small doses of opioids to control deseases like RLS that have no cure. I beg of you to read my brief story. The small dose of opioids I take nightly allow me to live a normal life, particularly with Family and Friends. I have become a much improved Father and Husband. Please do not take this away from us or limit our ability to have our Doctors prescribe opioids for the treatment of this desease that has taken its toll on myself and others.<br/><br/>I would gladly present my struggles in a more lengthly form if this would help you understand the importance of this issue to me. Please feel free to correspond with me at anytime. Thank you in advance for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. Please know that you can also rely on me for more detailed information related to my lifelong struggles with RLS and its impact on my life. [name redacted]<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fd8fbc	Fullerton	None	2022-03-22T20:47:31Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Fullerton, James	l12-fim8-lz6h	False	None	False	2022-04-12 04:19:54.542	[]
2803	CDC-2022-0024-2809	https://api.regulations.gov/v4/comments/CDC-2022-0024-2809	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please fallow what The lord wants for his people and think about suffering. Our job is to elevate each other's pain...let people's trust in our care again!! We are suffering so much while you sit there able to function.. please stop hurting me innocent.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anthony	None	None	0900006484fd91bd	Strong	None	2022-03-22T20:48:14Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Strong, Anthony	l12-hxoy-nl09	False	None	False	2022-04-12 04:19:54.763	[]
2804	CDC-2022-0024-2810	https://api.regulations.gov/v4/comments/CDC-2022-0024-2810	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted], PhD, and I am Distinguished Endowed Chair in Research and Distinguished Professor at the University of Utah. I am a clinical researcher who studies chronic pain and opioid misuse (www.[name redacted].com). I commend the CDC for recognizing pain as a major public health issue. The new CDC guidelines have remediated many of the issues with the 2016 guidelines. I believe opioid analgesic therapy should be tailored to the needs of the individual patient as part of a person-centered pain treatment approach. Guidelines should not be used as inflexible standards held across patients. Treatment decisions should be individualized for each patient and made in collaboration with patients through discussion and consideration of the patient's concerns. Rapid, involuntary opioid tapering should be avoided, and tapers should be reversed when harm or poor patient outcomes occur. The existing data do not support setting a specific MME threshold; instead, clinicians should use the lowest effective dose of opioids, and assess risks and benefits at every dose increase. Rather than setting strict MME limits, clinicians should monitor for risk of opioid misuse and opioid use disorder using validated screening instruments. If a clinician is concerned about possible opioid-related harms, the clinician could recommend an evidence-based behavioral intervention in combination with opioid medication to reduce opioid-related risks while maintaining adequate pain control. For instance, a new, large-scale randomized clinical trial of patients on long-term opioid therapy (N=250) published in JAMA Internal Medicine found Mindfulness-Oriented Recovery Enhancement to reduce opioid misuse by 45% while simultaneously decreasing chronic pain symptoms and depression (https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2789279). Mindfulness-Oriented Recovery Enhancement might also be useful for helping patients to taper their opioid dose when the physician and patient both agree that tapering is warranted. For additional information, see (https://[name redacted].com/about-m-o-r-e/). Clinicians could recommend interventions like Mindfulness-Oriented Recovery Enhancement to improve quality of life and reduce opioid-related risks for patients who must remain on long-term opioid analgesic therapy to treat intractable pain. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484fd9249	Garland	None	2022-03-22T21:15:39Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Garland, Eric	l12-icxf-gwn4	False	None	False	2022-04-12 04:19:54.986	[]
2805	CDC-2022-0024-2811	https://api.regulations.gov/v4/comments/CDC-2022-0024-2811	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I write to endorse the recommendations of clinicians well-versed in the evidence on opioid prescribing to a) incorporate a risk-benefit assessment on acute care prescribing (Box 1); b) to state explicitly a dosage level (50 MME/day) for Box Recommendation 4; c) to address the situation of existing opioid users in a separate and discrete section, including an emphasis on risks of abrupt tapering; d) in Box Recommendation 12, to incorporate explicitly opioid maintenance drugs with evidence to support their use (methadone; buprenorphine); and e) to state explicitly: "Assessment of benefits and risks for opioid use is complex and difficult due to the development of opioid tolerance and dependence. Available evidence indicates modest benefits of opioids for acute pain relative to placebo, while benefits for chronic pain have not been shown. Opioid risks have been well established, including drug overdose, opioid use disorder and physical and psychological adverse effects, and these harms affect a significant proportion of patients using opioids long-term.”<span style='padding-left: 30px'></span><br/><br/>I would like to comment further on the Box Guideline Recommendations, as this will be the material that prescribers rely upon, either principally or exclusively, when consulting the CDC recommendations. <br/><br/>First, I question how it is that clinicians are supposed to weigh the benefits and risks of prescribing opioids when the benefits have never been clearly established. For this reason, I recommend that the classification scheme designed to convey either the patient population under discussion (A, B) or the strength of the evidence to support the guidance (1-5) be replaced with explicit, descriptive words (for example: "very strong", "suggestive," "weak") and that the application of this scheme be applied to the words "benefits" and "risks" whenever they appear in the Box Guidelines. <br/><br/>I also recommend that the opioid prescribing for sub-acute patients be separated into its own discrete category. I wish to draw attention to the Minnesota opioid prescribing guidelines, which emphasize this phase as a critical point to spot and intercede in opioid dependence: https://mn.gov/dhs/assets/mn-opioid-prescribing-guidelines_tcm1053-337012.pdf (by reference, I would like to incorporate the peer-reviewed literature cited in that report)<br/><br/>Finally, I wish to draw on my own peer-reviewed work on the opioid crisis ([name redacted], “The Pharma Cartel,” in The War on Drugs: A History, ed. [name redacted] (New York: New York University Press, 2021): 303-342) to point out that opioid prescribing in the United States far exceeds elsewhere in the world, and that thousands of Americans overdose fatally on licit opioids each year, a statistic once considered shocking enough to earn the label "crisis," and now sadly normalized by the thousands more who overdose on illicit opioids. The over-prescribing and over-supply of legal opioids is the point of origin for the opioid crisis, and it is still a substantial contributing factor to its magnitude. <br/><br/>I further draw on my research to point out that an essential feature of the history of the opioid crisis is the sophisticated, multi-faceted campaign opioid interests launched in order to influence government agencies and officials. While still do not know the full dimensions of this campaign, we do know that the CDC--including its solicitation of comments in the federal register--has been among its targets (in addition to [name redacted] see: JAMA Internal Medicine, 2017; Center for Public Integrity, 2016; House Minority Investigation, https://www.hsgac.senate.gov/imo/media/doc/REPORT-Fueling%20an%20Epidemic-Exposing%20the%20Financial%20Ties%20Between%20Opioid%20Manufacturers%20and%20Third%20Party%20Advocacy%20Groups.pdf)<br/><br/>As the literature cited above demonstrates, industry influence often comes via ostensibly neutral or independent groups; and that some elements of the proposed revisions (muting or diminishing risk; failing to state explicitly that benefits of prescribing have not been clearly established) comport well with industry-sponsored efforts elsewhere. For these reasons, I recommend that the final publication from the CDC on opioid prescribing describe what efforts the agency undertook to measure and how it decided to assess industry influence, both in terms of comments received as well as in consultation and deliberation.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fd928f	Frydl	None	2022-03-22T21:18:28Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Frydl, Kathleen	l12-j47i-5mv3	False	None	False	2022-04-12 04:19:55.206	[]
2806	CDC-2022-0024-2812	https://api.regulations.gov/v4/comments/CDC-2022-0024-2812	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I did not find "revoke", "rescind", or "replace" in the proposed language... Will the proposed 2022 guidelines replace rescind revoke or replace the earlier guidelines?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bob	None	None	0900006484fd5a22	Coolidge	None	2022-03-22T21:18:41Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Coolidge, Bob	l0y-61qy-cxtj	False	None	False	2022-04-12 04:19:55.426	[]
2807	CDC-2022-0024-2813	https://api.regulations.gov/v4/comments/CDC-2022-0024-2813	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom it May Concern,<br/>Reference : CDC, docket number CDC-2022-0024<br/><br/>I live with a gentlemen who is in chronic pain everyday and every hour of the day. He is NOT a drug addict but needs Hydrocodone (an Opioid) to help cope with the day to day activities of life. He had broken his back several years ago in 4 places AND had vertebroplasty on T10 because it had shattered. He has tried all types of drugs, pain killers, etc. Nothing takes the pain away better than Hydrocodone. He hates to be dependent on them but the pain is TOO excruciating and they really help him.<br/><br/>Last year we moved from CA to New Mexico. When we arrived in New Mexico we had to find a doctor. His general doctor (in the VA system) did not want to prescribe Hydrocodone (unlike CA VA system) and sent him to see a pain management doctor. After waiting to get an appointment at a pain management clinic the doctors and nurses didn’t want to prescribe much Hydrocodone either. It is very hard to get his prescription every month. It is protocol in New Mexico that he see a doctor or nurse once a month in order for him to receive his prescription but sometimes the wait is longer than the month and is very hard to get into see the doctor or nurse. He would have to have an appointment with the nurse and take a drug test. Every month there is a problem with getting his prescription and he would almost fight with the doctors to just get the prescription filled. We could not understand this because in CA, he took the drug test every 3 months or so and he always had his monthly prescription filled when he needed it. In New Mexico he would be on his last day supply and they barely had it filled even though he would call 10-14 days ahead! One nurse told us that he would be fine with out it!!! Unfortunately for us, our VA pharmacy is in Texas and we would have to make the drive there to fill it. This made things very difficult just to live our life. <br/><br/>Some problems we’ve ran into are: the pain management clinic would drop the amount of pills he could get per month. He was already on the most minimal dosage possible. OR they started to increase the dosage so he could possibly get more pills per month by just breaking them apart. That did not work. One day a nurse prescribed the same amount of pills for the month so he would have to break them apart to take them but what she didn’t tell us was that she had lowered the dosage of each pill. So when he was in so much pain and the Hydrocodone was not working he questioned it and saw that on the bottle the dosage amount in each pill was lowered. Long story short, we changed Pain Management clinics. The new Pain Management clinic is a little better in care but still no luck at get the amount of Hydrocodone that he needs to function in daily life. He is in a process for radial frequency ablation (RFA). He had his first shot (Medial Branch Block) in New Mexico in early January and it worked for 10 days. Unfortunately again, you need 2 of these by law BEFORE you can have the RFA. After that first shot, he was a different person. What a relief for him! The pain was so much better! But the pain came back…. This pain management clinic cancelled one of his appointments and unfortunately the next available is in April. We have been begging for his prescriptions the last 2 months because they say we can not get him his medication till we see him. Every month is frustrating. He has no idea if he will get his medication in a timely manner. <br/><br/>He has been told to go to the ER if he runs out of medication. Is this really necessary when our ER’s and hospitals are so overwhelmed with a pandemic??? Several doctors here have told us directly that the doctors hands are tied because of the opioid crisis. Wow! Doctors can no long prescribe opioids to those that truly need them for daily life. Our lives our miserable because we can’t make any plans including travel just because he has to be here 2 weeks before he runs out calling the doctors (who don’t want to talk to him anymore) to when he ACTUALLY receives the medicine. We are retired and still young enough to explore the US. NO long trips in the RV, etc. What kind of a life is that? Bound to just getting what one needs to live. Many people, veterans, etc. have chronic pain.<br/><br/>It is so sad that America has come to this….taking away people’s freedom to live a good life as pain free as possible. I really just don’t know why the doctors hands are tied especially in those with chronic pain. Let them do their job! Let them make the decisions on who needs them and who does not. They are the trained professionals.<br/><br/>Thank you for having a public comment in this manner. We are truly hoping something changes with this problem!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5a3b	Anonymous	None	2022-03-22T21:21:47Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-827k-mas8	False	None	False	2022-04-12 04:19:55.646	[]
2808	CDC-2022-0024-2814	https://api.regulations.gov/v4/comments/CDC-2022-0024-2814	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This comment adds to extensive materials that I earlier submitted to the Federal Register on the proposed CDC clinical practice guideline for prescribing opioids. <br/><br/>The paper linked below has been published by Pain News Network and the American Council on Science and Health in February 2022. If summarizes a case for forcing the CDC totally out of the business of developing or publishing clinical practice standards for any branch of medicine other than communicable disease. Specifically, the article reveals that the underlying agenda of the 2022 updated opioid guidelines is unchanged from that of 2016. The supporting logic and evidentiary process are equally distorted and cherry-picked to support an anti-opioid bias, grounded largely on junk science. The entirely predictable consequences of the proposed update to be even further damage to millions of pain patients and their clinicians and the destruction of pain management as a medical discipline in the United States. <br/><br/>The best advice that peer reviewers of the revised guidelines and comments thereto might deliver to CDC senior management is "cease, halt, and desist!"<br/><br/>see https://www.painnewsnetwork.org/stories/2022/3/9/the-devil-is-in-the-details-of-revised-cdc-opioid-guideline<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fd50ab	Lawhern	None	2022-03-22T21:24:24Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Lawhern, Richard	l0y-9xn0-v4n4	False	None	False	2022-04-12 04:19:55.889	[]
2809	CDC-2022-0024-2815	https://api.regulations.gov/v4/comments/CDC-2022-0024-2815	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i was diagnosed with hep-c, and hemochromatosis, in 2000, by 2002, i was having increased pain levels, (both diseases contribute to connective tissue, and muscular inflamation)i requested opiate pain treatment,fom my doctor, which he denied me , due to my hep-c, and elevated liver enzymes,i love to work, and by 2006, with the increased pain, i could only last 2 hours, i had a new doctor by then , and he agreed to start me on norcos 20mg a day, much to everyones surprise, and it was noted in my charts, my enzymes started dropping significantly, and i was able to work at least 6 hours a day, i now again, have QOL, which i had not known for over 6 years, this is the information people need to know, as after all these years, and 2016 guidelines, a very negative political atmosphere, to somehow garnish votes, we are much worse off, if we suffer from chronic pain. And with all the discussions at hand, i find it strange, that no study has been done, on the benefits of opiate treatment, when in fact, they constantly state, that their is insufficient evidence, due to the lack of such studies, which, leads to a one-sided conversation, in 2016, when the new guideline came out, i was at 50mg a day, working 7 days a week (a body in motion, stays in motion), and now my PCP wanted to discuss tapering, i asked him, what part of my day he wanted to cause me more pain, no answer, he tried to pass me off, i stood my ground, studied, attended opioid workgroups, by then he knew i was serious, in maintaining QOL, and no more conversations to that effect, i have been trying to get a 10mg increase for 4 years now, which he saids he is fearful in giving, because of the DEA monitoring, i can only pray that guideline revisions, will remove the stigma the doctors feel when prescribing or increasing dosages for responsible and hardworking, chronic pain patients.personally my opiate regime, has allowed me to be a very productive member of society, and i can maintain my pride	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	dan	None	None	0900006484fd5a53	stadelman	None	2022-03-22T21:24:58Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from stadelman, dan	l0y-agx8-if1g	False	None	False	2022-04-12 04:19:56.106	[]
2810	CDC-2022-0024-2816	https://api.regulations.gov/v4/comments/CDC-2022-0024-2816	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC has caused such chaos in the lives of millions of Americans. The CDC should be abolished and replaced with DRs and practicing physicians that actually treat these conditions not lobbyist looking to make money on the pharmaceutical companies. I have personally refused medical assistance or even trust the DRs to assist me due to the crazy guidelines they have to follow. The CDC has ruined medicine and DRs are no longer needed since they can’t help. Compassion has been removed from care and voodoo medicines has taken its place. Let DRs do their jobs and remove the CDC from everything medical. Abolish the CDC	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deann	None	None	0900006484fd50b2	Goudy	None	2022-03-22T21:25:26Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Goudy, Deann	l0y-ddfy-3zni	False	None	False	2022-04-12 04:19:56.349	[]
2811	CDC-2022-0024-2817	https://api.regulations.gov/v4/comments/CDC-2022-0024-2817	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I suffer from several forms of chronic pain. I do not take opioids regularly and I actually hate taking ALL pills, but unfortunately, it is necessary for me sometimes. I suffer from Chronic Migraines that I sometimes have to go to the ER to get treatment for. I have Sphincter Of Oddi Disfunction (SOD) which is extremely painful too. I also suffer from Median Arcuate Ligament Syndrome (MALS) which has been likened to end stage pancreatic cancer pain. If you look on the MALS National Foundation Website you can see that if left untreated it can cause a cascade of disease, one of which is SOD. It can effect the pancreas, the liver and gallbladder. The pain attacks that I have from this are more painful than child labor, and believe me, I know! I was in labor with my daughter for 71 hours and I delivered her all natural. I have a high pain tolerance but there are just sometimes that I absolutely have to have Dilaudid. I cannot take just any opioid either, because some can increase my pain due to the SOD. Everyone is different. You cannot make blanket laws that only allows opioid pain management for certain things. You also shouldn't scare the pants off of all the doctors to where they are left unable to help their patients. <br/>All 3 of these illnesses can make a person want to commit suicide...try having all of them at the same time! to deny me treatment during a flare or an attack, or god forbid that the pain becomes less manageable to where I need daily pain meds, well that is just inhumane. <br/>I had surgery for MALS last year and I was sent home with 4 days worth of Tylenol 3s. To explain the surgery, there is a ligament, that is attached to the diaphragm and spine, that is cut back to release the celiac artery that it was compressing. Also, the damaged nerves in the autonomic nervous system are cut back and "cleaned up" as well. Nerve pain is horrible. 2 weeks after my surgery every time that I ate it felt like I was eating shards of glass. The mid back pain and rib pain was absolutely horrible. My surgeon actually apologized that he couldn't give me anything stronger upon leaving the hospital. I couldn't sleep because the pain was so intense, and if you can't sleep, you can't heal. <br/>I am 49 and up until 4 years ago I ate well and exercised regularly. I was fit and healthy in spite of the migraines. It was just part of life. I only took medicine to fight off the migraines because they were pretty severe. Yet in spite of my healthy and "non-addict appearance"... about every other time that I went to the ER in visible pain and vomiting... I have been treated like a drug seeker. Now that I have added SOD and MALS to the reasons for needing pain treatment, it is even worse. So bad that I DREAD going to the hospital. I DREAD asking my doctor for help. It should not be this way! <br/>I am now facing a more invasive MALS surgery because my artery has recompressed. There are people with this illness on feeding tubes because it is too painful to eat and drink. It takes some people 6 months, a year or even 18 months to recover from this surgery and many patients are sent away with a handful of pain medicine that barely even takes the edge off. This has got to change or you will have patients either going to the street to buy the pills or committing suicide. No one should have to live in this kind of pain. <br/>Please reconsider your laws?<br/>Thank you,<br/>[initials redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sonia	None	None	0900006484fd50c8	Bailey	None	2022-03-22T21:26:36Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Bailey, Sonia	l0y-eo64-46bb	False	None	False	2022-04-12 04:19:56.570	[]
2812	CDC-2022-0024-2818	https://api.regulations.gov/v4/comments/CDC-2022-0024-2818	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At least 7 of the 12 revised guidelines are based on low strength evidence that is questionable at best. Exactly who is so broadly agreeing most patients should receive the recommended course of action (non-opioid treatments) based on level 4 evidence, the most questionable low strength evidence with serious limitations?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fd50df	Fimrite	None	2022-03-22T21:26:44Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l0y-g61e-9kba	False	None	False	2022-04-12 04:19:56.788	[]
2813	CDC-2022-0024-2819	https://api.regulations.gov/v4/comments/CDC-2022-0024-2819	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From Living in daily pain! This should definitely be left up to the Dr of the patient! It's ridiculous to have pain that gives you poor quality of life & struggle through a day when 1 or 2 pain pills make you be able to live a somewhat normal life! Those who aren't there yet will get there! If a Dr is over prescribing then address it with that Dr. Why punish all Drs as well as patients? In that case we need no autos as there are wrecks! No guns as there are shootings! No alcohol as there will be people drink it! It's all very illeriate to me!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5dec	Anonymous	None	2022-03-22T21:26:54Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-jvrv-grop	False	None	False	2022-04-12 04:19:57.069	[]
2814	CDC-2022-0024-2820	https://api.regulations.gov/v4/comments/CDC-2022-0024-2820	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic severe refractory Restless Legs Syndrome (RLS) and Periodic Limb Movements in Sleep (PLMS). I am writing to comment on this Notice because I need tramadol to manage these conditions, to make sleep possible, to have a normal life. <br/>I am fortunate to live in a place where there is a physician, a neurologist, with expertise in treating RLS/PLMS. Many people do not, and sadly, many physicians and nurses have little to no knowledge of these disorders, and they are sometimes truly devastating. My sleep studies have shown that untreated, PLMS causes arousal every 42 seconds when I am in certain phases of sleep. My medications make it possible for me to sleep almost 6 hours a night, which is a tremendous blessing. I don't know what I would do without it; life would be intolerable. The only problem with taking it is that as a result, I am discriminated against--assumed to be a drug abuser in some medical settings-- because of my regular use of Tramadol over several years. In my experience, many doctors and nurses think pain is the only indication for opioid medication; it is your responsibility to correct this by including RLS and PLMS in the Practice Guideline for Prescribing Opioids. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jonima	None	None	0900006484fd5e49	Dayviss	None	2022-03-22T21:28:34Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Dayviss, Jonima	l0y-m1re-ugf5	False	None	False	2022-04-12 04:19:57.299	[]
2815	CDC-2022-0024-2821	https://api.regulations.gov/v4/comments/CDC-2022-0024-2821	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In reading these it seems to me that the CDC and people doing studies on pain believe that all chronic pain is mild. The studies used to make the guidelines that destroyed my pain treatment and the new guidelines, that seem to make it worse, are based on mild pain and pain that is “uncomplicated”. That didn’t stop the CDC from using these studies for guidelines on all chronic pain. Chronic pain includes “complicated” pain and pain that is degenerative. Things like autoimmune disorders,DDD,osteoarthritis,MS,CRPS and many more extremely painful conditions not allowed in these studies because they skew the results.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5ea2	Anonymous	None	2022-03-22T21:28:45Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-pbfh-xe13	False	None	False	2022-04-12 04:19:57.514	[]
2816	CDC-2022-0024-2822	https://api.regulations.gov/v4/comments/CDC-2022-0024-2822	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m an intractable pain patient since 1995 injury, had same pain drs. since 2000, suffered through Steven Johnson syndrome, sever blistering & skin breakdown from allergy to meds ordered for me. After years of many QME drs. & finally a settlement for on going pain medication management I thought it was done. Been taking same meds for years & I am able to go about my day limping around doing things that need to be done. I stopped OxyContin myself because of all the fuss about it. Take Norco,Soma & .25 Xanax for sever inter thigh cramps that attack me at rest. I never call meds in early, keep all appointments, urine tests, never any problem. I call meds in, call to see if they are ready to pick up I go down & pharmacies says he can’t fill refill because who ever he calls in to get ok for the pills wants him to call my pain drs and have them put me on a different medication. Is that part of these new guide lines? Plus to spring it on u when u go to pick up refills. So now I have to wait. I understand the abuse of pain meds but I feel this is invasive of my intractable pain care. I hope you do adhere by the intractable pain law that was passed and not make mandatory changes like I’m feeling now!!! Pharmacist called my pain dr. to change my long time pain medications he said who ever he calls to get pill said I should be on long lasting med. is this how ur getting people of opiates?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5f04	Anonymous	None	2022-03-22T21:29:16Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-r3v6-zo7y	False	None	False	2022-04-12 04:19:57.729	[]
2817	CDC-2022-0024-2823	https://api.regulations.gov/v4/comments/CDC-2022-0024-2823	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've submitted my story/journey and wishes to the CDC before; I'm sure it's recorded somewhere to be referenced. There are many human frailties. Disease, injury, pain and suffering to name a few. When the powerful, educated servants of medicine fail to recognize and treat them with comprehension and compassion, the Powers become the problem. The solution is for the meek and suffering to provide education. I attempt that in this text. We attempt it in our lives and share them with you. Please listen to what we say. I have endured unimaginable suffering for nearly 25 years and the CDC guidelines that were provided in an effort to help end the 'opioid crisis' have caused more harm than good to chronic, physical pain patients. Please revoke them pending your further education. Listen to our experience and understand the difference between need and abuse, between addiction and dependence, between tolerance and abuse. Publicly apologize for your ignorance and provide immediate reparations for the damage. I promise you, we aren't stupid. The human will to survive with quality of life is a right that has been stripped and perverted by you - Stop it. You hold the power to suggest and influence, without a full understanding of what you teach you exacerbate suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tiffany	None	None	0900006484fd5b7f	Thomas	None	2022-03-22T21:29:50Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Tiffany	l0y-rfwx-tdcs	False	None	False	2022-04-12 04:19:57.946	[]
2818	CDC-2022-0024-2824	https://api.regulations.gov/v4/comments/CDC-2022-0024-2824	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>"I wish to endorse the separate comments of [name redacted] PhD to the Federal Register. Dr [name redacted]'s views and concerns accurately reflect my own."<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484fd5b83	Draut	None	2022-03-22T21:30:27Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Draut, Sarah	l0y-sfsw-gog2	False	None	False	2022-04-12 04:19:58.172	[]
2819	CDC-2022-0024-2825	https://api.regulations.gov/v4/comments/CDC-2022-0024-2825	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My greatest fear is a set of guidelines which ignore difficult to diagnose condition causing excruciating pain such as neuropathy. In the last 4 years I’ve been subjected to steep reductions in prescriptions of opioid. The uproar over deaths by illicit users has effected the amount of opioid medication to me. This is not a one size fits all problem. I now live with substantial, unnecessary pain. Please do not pressure pain management practices to comply with a single standard. Thank You for taking the time to consider my comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd97f1	Anonymous	None	2022-03-22T21:31:01Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-mw4i-3jn4	False	None	False	2022-04-12 04:19:58.386	[]
2820	CDC-2022-0024-2826	https://api.regulations.gov/v4/comments/CDC-2022-0024-2826	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I know that my limited writing skills will not allow me to express my anger, disbelief and deep sadness at how my country has declared war on people like myself who suffer with daily chronic pain. I have to sit and listen to the people that I must trust for my health care look me in the face and lie. I am a 67-year-old male with no history of drug abuse, yet I am labeled a drug seeking low life. I know beyond any doubt that I would not be alive if I had not access to pain medication in the past. Now after the way I have been treated by the people I have asked for help I am forced to research the best method to end my life. I fell in love for the first time in my life at 59 years of age I do not want to die but when I see how my government has treated those who are in real agony, I know that I must be prepared. I hope one day the people in my position will know why the CDC took control of the medical community and why they allowed a organization like PROP to destroy the lives of so many. Please let the DEA go back to the great job they are doing keeping drugs off the streets and stop terrorizing doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	anonymous	None	None	0900006484fd980e	anonymous	None	2022-03-22T21:31:50Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from anonymous, anonymous	l12-n2gy-xmcn	False	None	False	2022-04-12 04:19:58.605	[]
2821	CDC-2022-0024-2827	https://api.regulations.gov/v4/comments/CDC-2022-0024-2827	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Yes this is [name redacted] I was commenting on the use of which is now been deemed as opiate drugs which I have been taking tramadol for several years my intake of the pills are three per day reasoning for I have extreme lower back pain during the deteriorating disc also was found a bone spur broken towards the spinal cord we recently few years back four years back fell and now it’s creating additional pain at the base of neck, history of work experience started in 1983 when pushing air conditioners around uphill downhill furnaces in attics underfloor one will call extreme manual labor still doing at this time body is worn from understanding tramadol is not A major drugs such as Vicodin etc. at the moment trying to take myself off of tramadol of reducing extremely down to one to one and a half pills per day at this time having to excessively treat also with Tylenol 2 to 3 doses per day alcohol is just a short remedy of numbing does not work very well. Which also my doctor that has been treating me for the past 20 years is about to retire, with the regulations I do not for see any other doctor that would be willing to make a deference. Thanks stay blessed	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fd9848	Cochran	None	2022-03-22T21:32:55Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Cochran , James	l12-ndmb-l74k	False	None	False	2022-04-12 04:19:58.827	[]
2822	CDC-2022-0024-2828	https://api.regulations.gov/v4/comments/CDC-2022-0024-2828	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First off, I would like to thank you for allowing us to contribute in this matter.<br/>I am a Disabled US Navy Veteran. I have been disabled and on Opioid therapy for approx. 30 years. I am lucky enough to have a VA doctor that is compassionate and Knows that Opioid pain medications Do work for long term pain treatment.<br/>However, I must call in twice a month, one for each medication, to request a "Renewal". Since there is no more "Refill" allowed. Leading up to and including the day I call, I have Extreme Anxiety. Just waiting for the day that the admin. at my VA facility make him stop prescribing the Opioid medications that have helped me have some semblance of life. This anxiety can be rather overwhelming. But. Is something I must deal with. All due to the 2016 CDC Guidelines. At least, I have had access to my meds., for now <br/> unlike so many of my fellow veterans. <br/>These are the men and women that have borne the battle, to allow you to have the freedoms you have.<br/>It is my opinion that the 2016 Opioid Guidelines doe NOT need updating. THEY MUST BE RECENDED COMPLETELY! The Guidelines have done NOTHING positive. But, have done Terrible harm to millions of Americans. ESPECIALLY HER VETERANS! AND THIS MUST STOP! <br/>The CDC has no legal obligation to have ever even written the Guidelines! That is the job of the AMA. <br/>If you do nothing else, any and ALL references to MME must be removed. I think that you must admit. Any reference to an MME has been taken as LAW. That has done more harm to patients and providers than can ever be undone.<br/>There is More than enough Proof that these "guidelines" have had NO POSITIVE impact on our society. I have watched Way Too many of my fellow Americans suffer and Die due to under or UNTREATED PAIN. Especially my fellow VETETANS. <br/>As a patient advocate, I am Sick of trying to talk folks out of suicide because they can no longer stand the pain. Or in the case of many veterans, they can't stand the humiliation that they feel. By not being able to do their family responsibilities. The ones they once could do, when their pain was controlled adequately. <br/>To be perfectly honest, I really don't see how the authors of these Guidelines can sleep at night. Much less look themselves in the mirror. Unless they can separate themselves from the reality that they have caused.<br/>They allowed PROP to either intimidate them or just plain [vulgar word redacted] them into believing their LIES. There is plenty of evidence that Proves the members of PROP had and continue to have, ulterior motives for their ideas. FOLLOW THE MONEY! I will leave it at that. <br/>I request these actions with all due respect. Thank you for taking the time to read my comments and suggestions here.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R Michael	None	None	0900006484fd5f65	Maddox	None	2022-03-22T21:33:21Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Maddox, R Michael	l0y-sr1x-e7ub	False	None	False	2022-04-12 04:19:59.044	[]
2823	CDC-2022-0024-2829	https://api.regulations.gov/v4/comments/CDC-2022-0024-2829	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/> To Whom It May Concern,<br/><br/> I was prescribed a low and moderate dose of opioid pain medication for 15 years <br/> following a car accident. Four years ago I was force tapered off this medicine due <br/> to the sudden fear doctors began to have to treat pain. My pain levels have gone up <br/> so much that I can barely clean my house or do things such as cooking, shopping, <br/> walking, standing, sitting, or even resting without experiencing immense levels of <br/> pain. No doctor wants to help me even though I was helped by this medicine for 15 <br/> years and never abused it. I am very confused and frustrated as to why I'm being <br/> made to suffer like this- while even when I was being treated it was not easy for me <br/> to manage my chronic pain. I am sorry to say but I have no better way to describe <br/> what is being done to me amounts to torture. Please help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484fd9849	Merchel	None	2022-03-22T21:33:23Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Merchel, Marie	l12-ndmg-y8nv	False	None	False	2022-04-12 04:19:59.268	[]
2824	CDC-2022-0024-2830	https://api.regulations.gov/v4/comments/CDC-2022-0024-2830	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After the 2016 CDC guidelines came out, my doctor reduced my pain medication by half, for no reason, and against my will. The undertreated pain caused my quality of life to plummet. I had to sell my successful bank consulting company of 20+ years and go on disability. Many chronic pain patients lost 100% of their medications. Numerous doctors have been jailed for doing nothing wrong, and many of their patients have died by suicide.<br/><br/>The 2022 revised guideline is worse than the original guideline. It says that it's not supposed to provide hard limits on prescription medications, but the guideline makes very clear that doctors who prescribe more than 50 MMED to any patient for any reason is at risk for prosecution or sanctions. <br/><br/>I believe that the only viable action is for the CDC to withdraw both the 2016 and 2022 guidelines, and discontinue all efforts to regulate the practice of pain management of any kind. Pain management should be managed between patients and their highly trained pain management specialist doctors.<br/><br/>In addition, I wish to endorse the separate comments of [name redacted] PhD to the Federal Register. Dr [name redactd]'s views and concerns accurately reflect my own.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484fd5f6b	Draut	None	2022-03-22T21:34:07Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Draut, Sarah	l0y-trrp-2mj4	False	None	False	2022-04-12 04:19:59.486	[]
2825	CDC-2022-0024-2831	https://api.regulations.gov/v4/comments/CDC-2022-0024-2831	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on the Buprenorphine for over ten years. Anytime I see a doctor and fill out what medications I’m taking and my history of opiate abuse twenty years prior, I feel extreme stigma and shame, I can feel the room shift. The way the doctor speaks to me is often cold and suspicious and the nurses are all whispering. I abused opiates when I was in my twenties. I went to rehab and a doctor put me on Buprenorphine over ten years ago. CDC NEEDS to review and educate pain management when people maintained on buprenorphine are in acute pain. The CDC has inserted itself into the doctor patient relationship and now has a responsibility to have a comprehensive revisal of these guidelines. I have had 4 C-sections and major dental work while maintained on buprenorphine. These procedures require opiates for pain. They just do. Doctors are so gun shy to prescribe opiates for pain in this special population of people like me on buprenorphine. I was lucky to have some good OB/GYN‘s who, once I provided them with educational materials, were able to understand my pain needs regarding opiates after surgery. I entered rehab for Oxycodone abuse 20 years ago. I don’t really identify as an addictive person anymore. After my C-sections, due to the fact that I am not opiate naive on buprenorphine, I needed to be prescribed extremely high levels of opiates. My take home dose was 30 tablets of 20mg oxycodone and 30 tablets of 10mg oxycodone. That provided adequate pain relief. I never sought additional opiates after. I felt no euphoria, no desire to seek out more medication, I only felt pain relief. These opiates have been taken after all 4 of my C-sections. The CDC and doctors need to understand that Buprenorphine attaches so highly to the mu-receptor in the brain that patients maintained on buprenorphine require high doses and in most cases do not feel euphoria, only pain relief. I felt stigma/shame from most nurses while I was an inpatient after recovering from childbirth. A tender time for a mother and it was always tainted by judgemental nurses and hospitalists. It hurt me considering I have been successfully maintained on buprenorphine and have not sought out opiates. That’s the kicker! They think I wanted drugs for drug seeking purposes but really it is pain relief seeking purposes. I am still a happily married mother of four and I fear that if I do get into another situation of acute pain, it will not be properly relieved. The gold standard of evidence-based care for opiate use disorder is buprenorphine. Most doctors I encounter don’t even know what it is. Every time I pick up my prescription at the pharmacy I feel like a second-class citizen and humiliated. The CDC’s strict guidelines introduced in 2016 were taken as gospel by fearful doctors. My father is a doctor and chief of staff at our local hospital in [city redacted] California. He now refuses to prescribe any patients opiates due to fear of government involvement/repercussions. One of his patients, a quadriplegic he refused to prescribe opiates to, due to fear of losing his livelihood/license, committed suicide. Your guidelines introduced in 2016 swung the pendulum too far in the opposite direction. Anytime government gets involved in medicine it turns out badly. Letting a few bad actors ruin the entire culture of doctor patient relationships has harmed so many. Let doctors do their job without fear of repercussions. Doctors know their patients better than you do. Educate doctors about patients maintained on buprenorphine. Ensure that patients on buprenorphine for opiate use disorder are allowed adequate pain relief, including opiates, when necessary, when they are in pain. That is the reason these medications were created, to relieve pain. Finally, reduce the stigma surrounding opiate use disorder. Ask doctors to do a thorough patient history. Are you currently addicted to opiates? How long have you been on Buprenorphine? Have you needed pain relief including opiates during this time? NO DOCTOR has ever asked me these questions. I am treated like a second-class citizen every time I go to the doctor. God forbid I have a situation where I require opiates. They just won’t provide them for me I’d imagine. There is a difference between someone in active addiction requesting opiates and someone who has been maintained on buprenorphine for years and successfully used opiates at high doses. Those in active addiction also deserve adequate pain relief. Everyone does. Your 2016 CDC guidelines created a culture of fear among doctors and Opiod-phobia. During my brief addiction to opiates, it wasn’t from a prescription to me which is ironic. Please, if anyone is actually reading this, please let doctors do their job and advocate for the patients in recovery, to reduce stigma. That is actually something that would be more helpful than your 2016 guidelines. Although they were certainly well intended, they resulted in my father’s patient killing himself.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006484fd5f6c	Healy	None	2022-03-22T21:36:34Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Healy, Katherine	l0y-ttd6-escx	False	None	False	2022-04-12 04:19:59.703	[]
2826	CDC-2022-0024-2832	https://api.regulations.gov/v4/comments/CDC-2022-0024-2832	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since helping chronic pain patients has been a sub-speciality of mine for about 30 years I would support the guidelines in part. It is a step in the right direction for both responsible MDs and for chronic pain patients. I am concerned about a some issues. ( Please do not censor . I have read that has occurred her but surely those folks are wrong?). <br/>Anyway my first concern is that whoever has been interpreting the research on this does not know how. In that data on chronic pain patients having legal prescriptions for Opioids have been confused with recreational drug users ( illegal nary.). Research stretching back forty years clearly show only 3% of chronic pain patients have misused the Opioids. The results for illegal drug users are very different. Since they are two separate groups research on each group should be interpreted <br/> Also after researching this man ( Chou) his take on this seems biased. I would suggest that before anyone gave recommendations or interpreted research they are both unbiased and use the accepted scientific method to do these things. <br/>Finally research shows chronic or acute pain patients who are denied their prescriptions are in a risky medical situation. For example, it is common for their blood pressures to spike, making a stroke likely. Living in severe chronic pain while one component of their multimodal treatment plan is discontinued can have tragic results, and in reality has during the former guidelines. Other good compassionate providers have expressed worry over these policies and pain patient well being. So providers like these have chosen to be sure their pain patients were affected as little as possible. With former guidelines pain patient quality of life has been reduced and providers placed under inappropriate stress and restrictions . <br/>So please continue to go further in revising these guidelines. Also I hope that t the CDC will find someone who knows how to interpret medical research in a scientific manner.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd5c20	Anonymous	None	2022-03-22T21:37:05Z	None	None	1	None	2022-03-22T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0y-y51y-dkw6	False	None	False	2022-04-12 04:19:59.926	[]
2827	CDC-2022-0024-2833	https://api.regulations.gov/v4/comments/CDC-2022-0024-2833	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These regulations only hurt those of us with chronic pain. It's crazy I'm prescribed three tablets a day for 30 days but they will only give me 60 tablets in total so I end up going a week with no medication for pain and I'm in total agony. How can this be? You need to consider the needs of the patient in pain not all of us are drug addicts or trying to get more pain medication. Those of us that need it really do need it. If you have not had chronic severe pain you don't have a clue of what your rules are doing to us	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Arthur	None	None	0900006484fd98d6	Haugh	None	2022-03-23T15:30:14Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Haugh, Arthur	l12-oiwq-j8kg	False	None	False	2022-04-12 04:20:00.142	[]
2828	CDC-2022-0024-2834	https://api.regulations.gov/v4/comments/CDC-2022-0024-2834	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have CMT,DDD,Fibromyalgia,Kirby’s,RA, and a few more things, all of them cause pain! I have been to pain clinics! One pain clinic I went to seen me for 6yrars yes 6 years and every month gave me my pain meds 180 a month! (I have never failed a drug test) I went to my Appointment and the nest thing I knew is the receptionist told me That I was dismissed, they didn’t not give me a prescription to taper off! When I had my meds I had a little bit of life! I could clean,do things with me Son,go to the store,just have some kind of life! With out my meds now I don’t go no where! It takes me a long time to clean,bath,go to the store is so overwhelming I only go once a month!!! I been to a pain clinic in [city redacted] in ky they wouldn’t help me with my meds but offered me shots in my back! If they didn’t help then they could give me some kind of meds! I did the shot!! Didn’t be put to sleep, and had a bad allergic reaction to it! And the doctor told me I did and then told me there was nothing else he could do! I pray everyday for some kind of relief! My pain level is past the point to where I have no pain scale! I really don’t know how much longer I can take this pain or take not having a doctor that cares! I been treated like I’m a druggie! I have never ever done drugs! (Street drugs) never!! I could write more but I hope you see my pain in this comment (I feel like I just exist! I want to be able to live!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd9983	Anonymous	None	2022-03-23T15:37:56Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-q3go-1lz2	False	None	False	2022-04-12 04:20:00.365	[]
2829	CDC-2022-0024-2835	https://api.regulations.gov/v4/comments/CDC-2022-0024-2835	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m Chronic pain patient for close to 40yrs. I have 2 disabled young adults. In the last 6 yrs I have been tapered down on my opioids. HOW HAS MY LIFE CHANGED?? Can’t work, can’t take care of my household responsibilities, Shop for groceries,need help to care for my autistic kids,can’t vacation,hard to walk. So what quality of life do I have?? NONE. What have I realized due to tapering of my pain meds?? I will spend the rest of my life in agony,I will have to sent my kids to a group home as the day is near where I can’t care for them anymore. This is no quality of life and no one should have to be in pain when we have medication available to help us so we can have a good life. Why should a family members have to watch their loved ones suffer in pain 24/7?? The panel needs to think about if their spouse,parents or even their kids were suffer in pain would they sit back and not medicate their family members because you are afraid they might become an addict! It’s ridiculous. Please have some compassion for your fellow Americans. Please don’t let us suffer in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	shari	None	None	0900006484fd998d	campbell	None	2022-03-23T15:38:41Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from campbell, shari	l12-q7sh-ytii	False	None	False	2022-04-12 04:20:00.582	[]
2830	CDC-2022-0024-2836	https://api.regulations.gov/v4/comments/CDC-2022-0024-2836	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a pain patient since 1997 when I injured and eventually had surgery in 2001 for my back injury. I also had both knees replaced and cancer twice. I am remission right now, thanks to I believe, the fact that with medication I am much more mobile than when I haven’t had medication. I was one of those folks who was told OxyContin was not addictive, then after three years of being pushed to stay on it, was told, here is one more month of meds, wean yourself off of them. Talk about a cruel and unusual punishment when you know how difficult that month was. I need these meds in order to keep moving, keep myself in remission, and live. Please with all the people out there suffering, help them. I wouldn’t want them to go through what I’ve been through those many years ago.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Antoinette	None	None	0900006484fd99d4	DiVackey	None	2022-03-23T15:39:55Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from DiVackey, Antoinette	l12-qupf-pkbo	False	None	False	2022-04-12 04:20:00.837	[]
2831	CDC-2022-0024-2837	https://api.regulations.gov/v4/comments/CDC-2022-0024-2837	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm 44 years old and have been dealing with chronic pain since my first surgery when I broke my right elbow at age 14 years old I had to have emergency surgery I received five screws and a plate in my elbow just to be able to move my elbow and this hardware will be in my elbow for the rest of my life.I received my first knee surgery at age 21 years old and a second one a year later when I stood up and my knee locked up at age 23 years old I got my third knee surgery on the opposite knee and a year later a received a second on the same knee.Ive had a total of four surgeries on my knee two surgeries on both knees I've had three back surgeries started at age 26 and my last one at age 28.On [date redacted] 2020 I had a seizure at work fell and broke my right shoulder same arm as my elbow injury I was sent to the emergency room and had emergency surgery I received nine screws and a plate in shoulder four months later I had no improvements and still HURT the xrays and MRI showed that my body ate bone out of my shoulder.So I had a second surgery to remove the hardware and put new hardware in it I received archors and bolts in my shoulder.Probally two three months later still can't raise my arm no higher then two three inches high plus going thur physical therapy over all this time.My Doctor tells me I need a third surgery so I go thur with the surgery where he removed ligaments from under my armpit and put in the front of my shoulder.Well that's be over a year now and no improvements and I can't use my arm over the years I've been one and off pain medications cause I'm always in PAIN every day since I was 14 years old I've worked over the years and just dealed with the pain.But now since this shoulder injury I haven't been able to work and just received my approval of disability on March [date redacted] 2022 I haven't worked since [date redacted] 2020.I have just been diagnosed with R.A in my hands and knees shoulder and elbows soooooo there are days I can't get out of bed cause I hurt to bad.I get hydrocodone 5/325 twice a day for pain and some days they don't help so I know how is is to have chronic pain for years.By cutting out pain medications isn't going to help cause users will just go to herion cause it's easier to get and cheaper so I don't get where this new CDC guidelines is going to do anything to stop people for abusing medications People abuse alcohol cigarettes food etc......So what's the guidelines for all that?A person will abuse anything that makes them feel good.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd9a48	Anonymous	None	2022-03-23T15:42:03Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-rifv-ogca	False	None	False	2022-04-12 04:20:01.062	[]
2832	CDC-2022-0024-2838	https://api.regulations.gov/v4/comments/CDC-2022-0024-2838	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to accident as a teenager, I had a bone on bone knee for 45 years. It wore down my vertebrae,other knee, ankles, hips. Both knees were replaced as well as right hip. Due to damaged spine & replaced joints I have been taking Hydrocodone since December 2010. I take it up to 4 times a day. I have never abused it and dosage has remained the same. I haven't developed an addiction. In fact, it sometimes upsets my stomach so I prefer not to use it. But I HAVE to use something and this is what WORKS. Please allow this medication to remain available to patients like me who are totally disabled. I have been on SSID since 2013. I can only stand upright for about 15 minutes without pain relief. I ALSO take Meloxicam for mystery arthritis.SEVERE Arthritis is ALWAYS PAINFUL. It's progressive, it doesn't get better. I will NEED to commit to relieve my chronic pain if I have to go thru this life without pain relief. I am a 58 y/o college educated woman. I have ZERO desire to abuse opioid pain relief. Please keep it available. There are not many other pain medications that work. <br/> <br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484fd9a6e	Gordon	None	2022-03-23T15:42:41Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Gordon, Julie	l12-rwe3-evsc	False	None	False	2022-04-12 04:20:01.301	[]
2833	CDC-2022-0024-2839	https://api.regulations.gov/v4/comments/CDC-2022-0024-2839	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There are millions of people in the USA who suffer from chronic pain for various conditions it seems the CDC has put a chock hold on the physicians trying to help these patients with medications because of the government control. I have a son in chronic pain 11 yrs and it has been a fight with the doctors and insurance and pharmacies to get to a dosage to bring relief and better his everyday living activities ADL’s all while trying to raise a son with chronic pain. I realize our Congress, President, and anyone else in the political game can get this type of medication with just a phone call however for the common people it’s a damnable struggle. Your guidelines are ridiculous and NOT serving the very large community of these people suffering daily with chronic pain. If the government can give out crack pipes & get the crack off the streets, I would imagine for the people who want to get pain relief dosage legally through a doctor or pharmacy without a huge fight & anxiety would & should be a better way. Patients will be pushed to get their pain medication off the streets from the cartel drug dealers pouring into this country. Do better and help these people who by the way pay your huge salaries. This country is going to hell and it’s happening quickly. HELP THESE PEOPLE AND STOP THE CHOKE HOLD ON THE DOCTORS AND PHARMACIES. WATCHING OUR LOVED ONES SUFFER FROM CHRONIC PAIN BECAUSE OF LACK OF PROPER DOSAGES IS AN ABOMINATION & INHUMANE. DO SOMETHING AND TAKE THE BOOT OFF THE NECK OF THESE DOCTORS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marqua	None	None	0900006484fd9ab4	Stephenson	None	2022-03-23T15:43:35Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Stephenson, Marqua	l12-skm0-9k9n	False	None	False	2022-04-12 04:20:01.518	[]
2834	CDC-2022-0024-2840	https://api.regulations.gov/v4/comments/CDC-2022-0024-2840	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A surgeon's mistake is going to leave me in pain for life. But the ability to obtain adequate treatment is met by a hurdle at every step. Every doctor has their own views on what is helpful, what is a high dose, and what is appropriate. It is hard enough when family, friends and society make you feel bad about being in pain and less than human for wanting anything that will provide some sort of respite from the pain, yet the person you turn to for help with your wellbeing treats you like a criminal. Every doctor then justifies their actions by referring to the CDC's guidelines which provided a blanket guidelines on what is appropriate and used poorly performed studies such as on morphine equivalency.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd9bad	Anonymous	None	2022-03-23T15:45:40Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l12-vl4m-nkmo	False	None	False	2022-04-12 04:20:01.733	[]
2835	CDC-2022-0024-2841	https://api.regulations.gov/v4/comments/CDC-2022-0024-2841	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been trying to strike a balance between the pain relief I get from hydrocodone and the feeling of tiredness I have when I take too much. What I have found is that if I split the dose in half and take it every 3 hours 48 minutes I can strike the right balance. What seems to be happening in Nebraska is physicians are prescribing only half of what one needs for the month. I feel like my efforts to be perfect are being subverted by medication "half-life" misunderstanding. I wind up in pain half the month, which limits my exercise, daily chores, and other projects. Maybe they think limiting the number of pills prescribed will force people not to share with others. But this type of prescription medication was around when I was a youngun' and there was no opioid overdose epidemic then. Are you sure the link between legal opioids and illegal fentanyl shipped over from China is valid? Or is it just that illegal opioids is a relatively new thing going on?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JoAnn	None	None	0900006484fd9bd2	Curtis	None	2022-03-23T15:46:22Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Curtis, JoAnn	l12-vy5u-wwhf	False	None	False	2022-04-12 04:20:01.954	[]
2836	CDC-2022-0024-2842	https://api.regulations.gov/v4/comments/CDC-2022-0024-2842	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain. I am a mother of three very active children. Pain medication has given me my life back. However, before being prescribed pain medication I was denied and denied even after tests came back stating all my chronic pain issues. After being denied, I couldn’t help to think that this isn’t living. I’m begging you to give doctors their rights back to treat their patients without fear. Every individual is different. Chronic pain patients, with documented painful medical conditions, are unable to find medical care because of this CDC guidelines. People with untreated and undertreated pain are committing suicide. These guidelines and threats to doctors are are killing patients. Please give doctors their rights back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fd9c31	B	None	2022-03-23T15:47:09Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from B, Kathleen	l12-wsmw-9lze	False	None	False	2022-04-12 04:20:02.169	[]
2837	CDC-2022-0024-2843	https://api.regulations.gov/v4/comments/CDC-2022-0024-2843	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who has lived through 28 surgeries and has severe spinal issues from C2-S3, RA and connective tissue disease ask that you look at this situation on a patient by patient basis. I am lucky to have some wonderful surgeons and a great family Dr,, Neuro Surgeons and Rheumatologist, as well as a pain specialist. My providers believe in medical marijuana, spinal cord stims and opioid treatment. I am very responsible and on top of my health care. I am tired of us chronic pain patients being thrown in a bucket with the illicit illegal druggies. It makes zero sense to me that these clinics that were supposed to get people off the street drugs will still give treatment of Suboxone or methadone to people who consistently test dirty. The plan was originally to wean people off, but instead they keep going forever. As a chronic pain patient I sign a contract and submit to urine or pill counts at any time and I have no issue with that. If I were to come in under the amount I would automatically be weaned, which would end my life as a worker. I follow these rules because it’s necessary. To punish all of us chronic pain people because of illegal drug use is an atrocity. Drs took an oath to do no harm, yet I see many people who could actually participate in life and find self worth in doing so. It’s time to separate the medically necessary from those who want a fix. I also don’t appreciate someone telling my Dr what is right for my body when they have never put a finger on me. I urge you to start pushing this concept on the drug clinics and give people who use drugs recreational a cut off. Years ago there may have been a prescription problem, but Drs are scared to death to even prescribe opioids now. While I wish there was an end insite for me to end opioid treatment I have had 5 surgeons tell me this is the rest of my life. Please consider what it’s like to live in excruciating pain, and ask yourself should we make people suffer. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fd9cdc	Bishop	None	2022-03-23T15:48:18Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Bishop, Amy	l12-yseo-dysp	False	None	False	2022-04-12 04:20:02.401	[]
2838	CDC-2022-0024-2844	https://api.regulations.gov/v4/comments/CDC-2022-0024-2844	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include Opioids in the treatment of Restless Leg Syndrome. It is a very difficult disease to manage. I haven't slept well in years which makes life very hard. Thank You.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fdab4c	Itkowitz	None	2022-03-23T15:48:43Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Itkowitz, David	l13-7qra-mfjl	False	None	False	2022-04-12 04:20:02.645	[]
2839	CDC-2022-0024-2845	https://api.regulations.gov/v4/comments/CDC-2022-0024-2845	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain because I have severe arthritis,degenerative disk disease and severe stenosis. I also had a hip replacement and it was not successful. The prosthetic was defective and I have constant severe pain everytime I put weight on that leg. The other hip's cartilage is almost gone and will be bone on bone in a matter of months. I will not have surgery on this one because I was worse off on my left leg after surgery. Since 2009 my degenerating disks have progressevily become more severe and the pain followed it. By 2012 It was almost impossible for me to walk. My sister recommended. When my pain began to rob me of any quality of like my PCP prescribed me morphine. I didn't tolerate it well. All I did was sleep. He then prescribed fentanyl patch which I tolerated much better and I no longer had to stay in my room. I had much improved quality of life.I was able to travel, take care of my home and daughters and, although my pain wasn't gone I was happy with my life. In 2017 my life crumbled before my eyes. My doxtor began to taper me off my fentanel. I went from fentanyl to oxycontin,MS Contin, and finally bupromophine (sp?). I am now bed bound. I hate waking up in the morning because the pain is unbearable. I can no longer do any housework. Cooking is excruiating. Mostly, I just lay in my bed and remember my life before I was tapered off. I never abused my medicine. I never took more than my doctor prescribed. I'm not an addict. I'm a person begging you to revises your 2016 guidelines to allow doctors who have verifiable (xrays. Mri's, CAT scans, ultras I unds, etc.) which shows problems that would cause terrible pain. Let the doctors determine what their patient needs to give some semblance of a quality of life. Do I really need to be dying to get relief? I just want to be able to live not lie in my bed watching my tv. Please give me and thousands like ne, have some quality of the remainder of our lives. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Genie	None	None	0900006484fdae8b	Lamb	None	2022-03-23T15:49:44Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Lamb, Genie	l13-bdlu-gv1l	False	None	False	2022-04-12 04:20:02.861	[]
2840	CDC-2022-0024-2846	https://api.regulations.gov/v4/comments/CDC-2022-0024-2846	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer due to scoliosis and other lower back complications. It has been awful trying to live a normal life since the restrictions were imposed. The stigma of feeling like you have to defend yourself against being seen as a drug addict when you are just trying to live a life as normal as possible is awful. No other drug comes close to the relief given from these medications. I like the fact that I can take them as needed verses going in for treatments that require sedation and in many cases don’t work and are time consuming. In my opinion the illegal drugs have been mixed together with the legal users to create a picture that the problem is bigger than it is. For example I would not count people who die from fentanyl poisoning as an “overdose” is a “poisoning” I’m my opinion. Chronic pain sufferers should not have to be forced to take a urine test unless there’s a suspicion of overuse. If there’s no suspicion why should they have to submit to a urinalysis? I have used opioid medications to live as normal of life as possible as my problem is not one I will ever “recover” from. It will only get worse over time. The CDC states in their own publication for this review that the majority of deaths are caused by heroine and fentanyl as follows . “ Governments tried to restrict the prescriptions, but the overdose epidemic worsened as people hooked on pills switched to heroin and then to fentanyl. Those kinds of illegal injected drugs are now associated with the majority of U.S. overdose deaths.” <br/>Chronic patients and prescription medications should be separated from illegal heroine overdoses and and fentanyl “poisoning” should be added to the poisoning category and removed from the overdose statistics all together. We need more focus on fentanyl at law enforcement level to stop the illegal trafficking if it into our country it is “poison” and shouldn’t be included with actual prescription opioids as an overdose. I have never thought of using heroine as a replacement for my doctor prescribed pain medication. I never would. I really don’t think heroine should be included either. Pain medications for chronic pain and patient living with pain are not drug addicts. Fentanyl is poison and not a drug at all and should be removed from the overdose numbers. Please allow people with pain the relief that actually allows them a better life. Thank You.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelley	None	None	0900006484fdaf21	Brescia	None	2022-03-23T15:52:06Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Brescia , Kelley	l13-flin-ojzt	False	None	False	2022-04-12 04:20:03.082	[]
2841	CDC-2022-0024-2847	https://api.regulations.gov/v4/comments/CDC-2022-0024-2847	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to take out all mention on MME's and any "guidance" on how to manage Chronic Pain People, this should be left to the Dr and the patient to come up with a patient centric approach based on that person's medical back ground, and consensual decisions. We are not one size fits all and medical management should be just that. The CDC's original guidelines have done serious damage to me personally and my family. I am the ONLY breadwinner as I am single and the forced guidelines have taken away my ability to function at a higher level. My kids do not understand why Mommy is now getting worse. My job will only be so understanding, and I can only hope the updated guidelines will focus on NON Chronic pain guidance. I did nothing to ask for Cancer, nor the damage Chemotherapy did to my body. I only ask that I be HUMAINLY treated and not left to suffer based on biases. I can tell you many of us already do NOT trust the medical community and you are only solidifying this opinion by allowing needless suffering. Many of us are able to function as close to normal as we ever will be able to, when our pain is well managed, To create this chaos and inhumane treatment to an already medically exhausted community is not only irresponsible but goes against the Hippocratic oath of do no harm. The amount of harm created with the 2016 guidelines will likely continue if all mention of MME's are not removed. The CDC is siting OLD, incorrect information and the same parties that penned the 2016 guidelines, should be removed from once again forcing their OPIONIONS and ulterior agenda on the America people. You want to know why people do not trust their government? Look no farther than the 2016 CDC's guidelines' .How have the guidelines affected me? I have been forced tapered, with admittance that it has NOTHING to do with my medical information, but is everything to do with Biased opinions and the 2016 "guidelines" this left me in bed for WEEKS unable to clean my house, take care of myself, my home, my pets, my children. I went from a new "normal" for myself to hell, in one failed swoop of the pen. What are my options??????? Am I supposed to meditate myself out of pain? Meditate my clothes clean? A Pain pump is not an option for me due to HIGH risk and history of BAD infections... So what am I supposed to do? File for disability and rot away ? Turn to Street drugs? End it all? When is enough, enough? The Guidelines MUST be repealed. If you maintain you must amend, and ALL mention of MME MUST be removed and any treatment recommendations should be left between the Pain Patient and their Dr's..Healthcare is already a full time job for us, fighting for HUMAINE treatment in this day and age is insulting and WE should NOT be punished for people who abuse these drugs as a recreational escape. These are NOT an escape for me, these allow me to sit at my desk, they allow me to do dishes, they allow me to go to school plays. YOU may view them as HARMFUL, I view them as giving me MY LIFE BACK after Chemo, One that you were SO quick to take away. Shame on you, Shame on the CDC. Do better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fdb3e8	Novak	None	2022-03-23T15:53:42Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Novak, Melissa	l13-l04k-ybgv	False	None	False	2022-04-12 04:20:03.298	[]
2842	CDC-2022-0024-2848	https://api.regulations.gov/v4/comments/CDC-2022-0024-2848	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For Grace, an organization dedicated to promoting care and wellness for women impacted by chronic pain, and its leadership applaud this Opioid Guide revision and the dedicated group behind its making. The revision goes far in mitigating much of the damage wrought from the original 2016 version – and for that we extend our deepest gratitude.<br/><br/>That being said, we feel there are three points that are in need of additional consideration or revision.<br/><br/>1) We generally support that the relationship between doctor and patient is sacrosanct and whatever level of care is determined between them is best with little or no intervention. However, if memory serves us correctly, that autonomy was one of the main drivers of the opioid crisis’ first wave. Doctors were writing prescriptions at historical levels for opioids that just a few years earlier were considered excessive and dangerous. This is not even mentioning the infamous “pill mills” that mushroomed. To go back to a point where doctors and their patients should be trusted to make the right care decision regarding opioids is naïve and turns a blind eye to recent history. <br/><br/>2) We strongly support the guideline’s advocacy for using non-drug, non-invasive therapies as the first line of care for chronic pain. Thank you for seeing the clear benefits of integrative medicine, not only for those adversely impacted by chronic pain, but also as a means of mitigating risk to public health through diversion of and addiction to opioids. In our mind, the integrative approach produces better functional and QoL outcomes long term, and far less dependency on opioids as therapy. However, many of these integrative approaches are not covered by public or private insurance, making them “a bridge too far” for most chronic pain patients, already under the stress of income loss and other financial strain. If opioids are truly a concern to state and federal government, then coverage mandates should be in-acted post-hast for complementary therapies that we believe would prove salvation for the bulk of chronic pain sufferers. <br/><span style='padding-left: 30px'></span><br/>3) We strongly believe that “legacy” opioid patients should be left alone. It is negligent, and, yes, criminal to force taper these individuals. Due to irresponsible policy and a tragic shift in philosophy that opioids were the answer to all instances of chronic pain, these unfortunate folk have been left physically and psychologically dependent on high doses of opioids that were administered over a long period of time. Their systems have now been acclimated to this level of therapy – and to force them through abandonment and/or coercion to taper to a fraction of their former dosage is cruel and unusual punishment. If they chose to lower their intake under caring and attentive supervision, so be it. Otherwise, they should be left to live the rest of their lives without the oppressive fear and anxiety of being cut off due to the terrible mistakes of medical, policy and regulatory leaders.<br/><br/>Prescription opioids are not necessarily bad medicine. They are a critical tool to consider with a small minority of chronic pain patients whose conditions are truly catastrophic. But opioids must be used judiciously, with individual AND societal impact duly considered. <br/><br/>Moving forward, we must find a “sweet spot”, if you will, where opioids can be used safely and effectively short-term in restoring function and well-being. Again, For Grace leaders applaud this proposed revision as a step in the right direction. <br/><br/>Respectfully Signed,<br/>Cynthia Toussaint, Founder & Spokesperson, For Grace<br/>John Garrett, Director, For Grace<br/>forgrace.org <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fd9af9	None	None	2022-03-23T16:17:38Z	For Grace: Women In Pain	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from For Grace: Women In Pain	l12-tc97-9n2w	False	None	False	2022-04-12 04:20:03.525	[]
2843	CDC-2022-0024-2849	https://api.regulations.gov/v4/comments/CDC-2022-0024-2849	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Docket# 2022-0024<br/><br/>The CDC caused tremendous harm to the chronic pain community with it's 2016 guidelines for opioid prescribing. And in turn, the 2016 guidelines were written into laws by state legislators, which weaponized the guidelines against prescribers of opioids for the treatment of pain. Resulting in the DEA to target, raid, and prosecute physicians. Physicians either stopped prescribing opioids all together, stopped taking new chronic pain patients, or forced tapered their patients. Many patients were cut off their opioid pain medication, or cut back to such a low dose of opioids without a taper. Resulting in patients going into withdrawal or undertreated pain. Some may think these actions were purely based on physicians own fears of losing their medical licensure, their assets or fear of the DEA. <br/><br/>The authors of the 2016 CDC guidelines all have had conflicts of interest, and yet the CDC has once again allowed the very same authors to write the new proposed 2022 opioid prescribing guidelines. These very conflicts of interest should make the CDC prescribing guidelines null and void. The 2016 CDC guidelines and the new proposed guidelines were written by anti-opioid biased ideologists. The writers, have never treated pain. Both the writers of the 2016, 2022 guidelines and the CDC fail to follow the science of opioids for the treatment of chronic pain. So much is written about the "risks" of opioids but what about the benefits of opioids for chronic pain and acute pain. Adequate pain relief of acute pain such as in post surgical pain can help prevent chronic pain. Opioids used in chronic pain, can improve function and give people a better quality of life. Prior to the 2016 CDC guidelines, some chronic pain patients were able to maintain employment. And since the 2016 guidelines hundreds of chronic pain patients have committed suicide. Some have had to turn to the streets looking for pain reliefs. While others are now homebound or bedridden. <br/><br/>Many chronic pain patients have tried alternative treatments such as physical therapies, chiropractors, acupunture, massages, other body work or interventional procedures without the pain reliefs that opioids provide. Some chronic pain patients are being forced into elective procedures such as injections in order for a physician to prescribe opioids. Not all patients have the financial means to do many alternative treatments, but if they say no, they are looked upon as noncompliant and are discharged from pain management or at risk of discharge.<br/><br/>Chronic pain patients usually suffer from anxiety or sleep disturbances. Now chronic pain patients are being forced to choose between their opioid medication or their benzodiazepine. All that is necessary is education on how to take these medications safely when both prescribed.<br/><br/>I want to talk about the new proposed 2022 guidelines. We all saw just how the 2016 CDC guidelines had a harmful, chilling affect on chronic pain patients. And how the 2016 guidelines were misinterpreted and misapplied. Yet, these 2022 guidelines will have the same affects. There needs to be no MME dose thresholds. No 50 MME. No mention of MME. The CDC should follow science. MME is unscientific junk science! Using a 50 MME dose, that will be the new 90 MME. chronic pain patients will be forced tapered down to 50 MME causing more pain and suffering than the 2016 CDC guidelines did. Opioids do work for chronic pain and if the dose has to be higher than 50 MME. Patients are all different. Their bodies react to opioids differently so not all patients are at risk of overdose if above 50 MME especially if patients have been forced tapered.<br/><br/>The CDC should honestly abolish the 2016 opioid prescribing guidelines and these new 2022 proposed guidelines and stay out of the business of writing opioid prescribing guidelines. The CDC can't regulate medications or the practice of medicine. The CDC caused inhumane and cruel pain and suffering. And the CDC allowed this pain and suffering to go on for almost 6 years even when chronic pain patients were committing suicides. that is torture!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fdad26	Smith	None	2022-03-23T16:19:38Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Patricia	l12-zoam-lqcv	False	None	False	2022-04-12 04:20:03.742	[]
2844	CDC-2022-0024-2850	https://api.regulations.gov/v4/comments/CDC-2022-0024-2850	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The description of the proposed ".....guideline for prescribing opioids" repeatedly claims it is voluntary. Then why are you doing it? Your past guidelines have been disastrous for both patients and providers. Maybe you should stick to infectious diseases and stay away from health issues you clearly do not understand. <br/>After a long career in forestry, I developed chronic pain. My search for effective treatment took me years and led me to the fringes of medicine. In my desperation, I even fell victim to a quack, a grifter with an MD, who stole from me. <br/>I finally found effective treatment, which involved surgery and opiates. I will not tolerate attempts to taper or to use alternative therapy or any of that nonsense. Opiates allow me to function, to notice and even enjoy the world outside my pain. They allow me peace in my old age. I think it would be darkly comical if I was forced to obtain opiates on the street, a 70-year-old man, standing on the corner, waiting to 'score.' But that is where I was headed after the last batch of CDC Guidelines. Please, leave us in peace, dont force us into the black market.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rich	None	None	0900006484fdba99	f	None	2022-03-23T16:20:39Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from f, Rich	l13-p7ss-xoji	False	None	False	2022-04-12 04:20:03.975	[]
2845	CDC-2022-0024-2851	https://api.regulations.gov/v4/comments/CDC-2022-0024-2851	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC 2022-0024 Due 4-11-22<br/>The CDC is updating 2016 the guidelines for prescribing opioids for chronic pain. The CDC must add in the update to give my pain medication back. The CDC must add this where doctors can find it. There is no way any doctor will have the time to read this mess of 229 pages this is why it needs to be easy to find. Add a link in line numbers 24-27.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdc5c1	Anonymous	None	2022-03-23T16:21:03Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l13-qf6z-unlt	False	None	False	2022-04-12 04:20:04.199	[]
2846	CDC-2022-0024-2852	https://api.regulations.gov/v4/comments/CDC-2022-0024-2852	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 & 2022 CDC Opiate Prescribing Guidelines should be completely withdrawn. The guidelines are based on MME which is known to be junk science. The authors have financial conflicts off in interest. <br/><br/>These prescribing limits have caused an increase in illegal fentanyl overdose deaths and suicides. The guidelines have also caused many functional pain patients to stop working and become bedridden.<br/><br/>Since my medication has been decreased I have had to go on prednisone in order to be able to do the simple things in life like shower! Prednisone is causing dental problems as well as osteopenia. These are causing additional issues not to mention that I have gained 75 pounds while taking the prednisone. That’s causing more wear and tear on my knees in my feet.<br/><br/>The CDC does not the authority to regulate physicians prescribing limits. Stay in your own lane!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fdc5fe	Damico	None	2022-03-23T16:21:36Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Damico, Lisa	l13-qqvf-aiz3	False	None	False	2022-04-12 04:20:04.422	[]
2847	CDC-2022-0024-2853	https://api.regulations.gov/v4/comments/CDC-2022-0024-2853	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2300-0024<br/><br/>IMO (In my opinion)�I don’t think it will matter and we need to realize what the updated guidelines may not do is get our pain medication back. They will not help CPP lives destroyed by the 2016 guidelines. Doctors are still cutting CPP down more than the 90MME. It does not help to tell the CDC over and over what they did to us and I believe it’s time to ask what they are going to do about it. Right now there is nothing unless we all bring this fact up in the comments we leave when the CDC posts the next request for comments on the rewrite on the 2016 guidelines.�If they don’t address this fact somehow in the rewrite what will happen? Even if they do add this in the rewrite how will they change what they have done? Will they bring our doctors out of retirement or release the wrongly accused and in jail doctors? Will they retrain the doctors, surgeons and pharmacists who will not prescribe or fill pain medication that they need to go back to the way it was? Will they change the curriculum for new students starting medical school? They would need to go back at least 10 years or more. I did not read anything that was clear or pointed out that the guidelines are written for primary care doctors and new (opioid naïve) patients. If they added this information it would be huge for CPP community. It would make it so clear who the guidelines are for.�Again IMO�We need to address this fact when we comment for the rewrite. If most of us do this it will be in public comments. We need to get our doctors, caregivers and family to comment. Maybe a short description on what they saw happen to you and how will the CDC correct it. This time we know it will happen.�I know that many, many of us left comments on the previous requests by the CDC and fell like it did nothing to help us. This may be true but don’t let that stop you now. Write a comment now, save it and get it ready to post. Get other CPP to get ready. These request for comments are hard for find so spread the word to get ready. The comments are open for 60 days. The last time we got a chance to comment was about 2 years ago. Out of 50 million we had just over 5,000 comments. There was over 20,000 views. This is why we need to change and get The CPP community off their butts and comment.�I’m not sure how many know this the 2016 guidelines for prescribing opioids for chronic pain patients included how to continue treatment for CPP already on long term over 90MME. The guidelines have 8 sections or recommendations a little more than 1/2 way through them. Section 5 includes treatment for current CPP but it is mixed up with instructions for new patients. I think they make it confusing on purpose. In recommendation section 5 paragraph 4 covers established, legacy, grandfathered patients and transferring ones. In gives instructions that any taper is VOLUNTARY and the CPP patient must agree to it. The doctor can go over or instruct the dangers of long term pain medication over 90MME but the CPP must agree to the taper. There ARE NO MORE CPP TO CUT OFF THEIR PAIN MEDICATION. GiVE US OUR MEDS BACK OR THIS UPDATE IS NOT WORTH THE hours it was written in. In other words it’s worthless.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdc66e	Anonymous	None	2022-03-23T16:22:42Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l13-r8lz-n4c3	False	None	False	2022-04-12 04:20:04.685	[]
2848	CDC-2022-0024-2854	https://api.regulations.gov/v4/comments/CDC-2022-0024-2854	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The pain medicine has helped me tremendously, I have severe back pain , for years . I’m a retired Sheriff Deputy. There’s a lot of good people having trouble. We are appreciative of the relief of pain. I take 5 10’s a day. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdc6dc	Anonymous	None	2022-03-23T16:24:40Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l13-rsqs-u9ec	False	None	False	2022-04-12 04:20:04.927	[]
2849	CDC-2022-0024-2855	https://api.regulations.gov/v4/comments/CDC-2022-0024-2855	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is [name redacted] I’m a wife and mother that became legally disabled due to severe pain before I was 28. I haven't been able to work at all since ‘17. I had the same pain doc for a few years and my pain was managed. After I had our daughter (surprise pregnancy,) in late 2017 my spine started to cause extreme pain in the very middle. It has gotten drastically worse and due to negligence in the medical field I’m just now getting adequate imaging of that area. I was taken off of my pain medication last June, life has been very dark for me and hard on my family sense. Before being taken off meds I had some quality of life I could tend to my flower garden, and most importantly play with my daughter. Now, I’m absolutely miserable 24/7, I don’t sleep until I crash, I’m losing hair, I’m incredibly depressed, I haven’t had more than two periods in 14 months. Us pain patients need a voice, and we need help! The CDC’s guidelines have caused so much suffering and even death. Pain patients are losing their fight, we deserve care! We also deserve to have a say in the treatment of our own bodies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Destiny	None	None	0900006484fdc6f2	Bartley	None	2022-03-23T16:26:13Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Bartley , Destiny	l13-rvxc-oetm	False	None	False	2022-04-12 04:20:05.142	[]
2850	CDC-2022-0024-2856	https://api.regulations.gov/v4/comments/CDC-2022-0024-2856	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If the original guidelines worked as written there should be a very noticeable decrease in opioid use disorder, addiction, overdoses and deaths. It's quite apparent with the data that they failed miserably. The situation now should indicate these guidelines should be rescinded in its entirety. We desperately need to restore the sanctity of the doctor- patient relationship and individualized patient care. Chronic intractable pain patients have suffered needlessly. I have intractable pain and have for over 20 years. Given the right medication and dosage I was able to do most of the activities of daily life. I could play my flute as a gig musician and private teacher. That was stolen from me in 2017. I have 7 grandchildren with whom I thoroughly enjoyed playing with and taking them out on special trips. Now, I see their disappointment and confusion concerning my limitations. <br/>Please, for all pain patients like myself remove the MME. Let our doctors treat us without fear. Spend the resources helping people with substance abuse issues. Don't punish people for whom prescribed opiates have only made their lives better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elinor	None	None	0900006484fdc89e	DeOrsey	None	2022-03-23T17:33:15Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from DeOrsey, Elinor	l13-ub97-5ia3	False	None	False	2022-04-12 04:20:05.434	[]
2851	CDC-2022-0024-2857	https://api.regulations.gov/v4/comments/CDC-2022-0024-2857	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Served my country honorably for 20 years and service connected at 100% disabilities because of said service. The Veterans Administration won't even cover my Civilian Pain Management expenses. They would wean me off of all pain medications which would result in pure misery!!!<br/> Thats the gratitude I get for honorable service! I am made to feel like a criminal.<br/> Due to changes in government regulations on prescribing guidelines my Doctors were forced to change my medicines to adhere to the "new guidelines." These changes have resulted in nothing but increased pain levels, lack of sleep, an overall decline in my quality of life, and my ability to ambulate.<br/> Please stop the persecution of legitimate pain patients. I have to get MRIs regularly to justify my condition(s) and urinate in a cup at each visit to prove I am taking the medications as prescribed.<br/> Please stop the madness and allow the trained professionals qualified to provide treatment and evaluate my overall condition	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdc8c0	Anonymous	None	2022-03-23T18:39:43Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l13-uji9-6ko0	False	None	False	2022-04-12 04:20:05.688	[]
2852	CDC-2022-0024-2858	https://api.regulations.gov/v4/comments/CDC-2022-0024-2858	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel that the CDC has fostered prejudice against pain clinic patients . The rules limiting the amount of pain medications that are available at pharmacies has caused undue hardship for legitimate patients, who have prescriptions needed to manage debilitating chronic pain. I am requesting the limitations on dosing and the amount pharmacies are allowed to have in stock, be loosened and adjusted to meet the needs of patients suffering with chronic pain. I am also advocating for the Dr.’s clinical judgement, regarding the amount and timing of precipitation pain medication dosage to be respected. I believe that efforts should be placed on controlling illegals drugs on the streets , instead of the focus being directed toward those who are legally filling prescriptions needed to manage chronic pain. Thank you for your help with making a difference in this important issue .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdc99b	Anonymous	None	2022-03-23T18:39:58Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l13-vs03-sm6i	False	None	False	2022-04-12 04:20:05.911	[]
2853	CDC-2022-0024-2859	https://api.regulations.gov/v4/comments/CDC-2022-0024-2859	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC’s 2016 Guidelines have literally ruined so many innocent lives! They knew they were fatally flawed from the onset but without the slightest bit of care nor concern they continued on! Their malevolent lies have been now proven! Opiate prescriptions are now at a twenty plus year low yet overdoses are soaring! They are soaring because of the deadly ILLEGAL fentanyl flowing into our country at an alarming rate! If the 2016 and 2022 Guidelines aren’t completely redacted and /or scrapped PERMANENTLY innocents will continue to suffer needlessly and DIE! As a health care provider, I have witnessed the horror first hand! I took an oath to provide help and do no additional harm! I take this oath extremely serious! I ask you with all sincerity to PLEASE remove both guidelines PERMANENTLY Let physicians take care of their patients, not a pretentious group of people with no experience nor a conscious who care only about the money train they have enjoyed long enough!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdc9d6	Anonymous	None	2022-03-23T18:40:36Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l13-wasg-hw4z	False	None	False	2022-04-12 04:20:06.127	[]
2854	CDC-2022-0024-2860	https://api.regulations.gov/v4/comments/CDC-2022-0024-2860	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The pharmacy is refusing to let me have my meds the day I go to pick up refills. The drs. have to answer questions first. One week later still can't get meds. Why didn't they tell me last refill we may have problem filling next refill? I am almost out of any extras I had in case of a fire. No one has called to let me know what is going on. Pharmacy says they can't give them to me. Had settlement from work injury$200,000.00 given to me for medication pain control. What is going on. Intractable pain patients are paying the price for this. Same pain drs. & Pharmacy over 20 years. Help us!!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lettie	None	None	0900006484fdc9d9	Hulet	None	2022-03-23T18:40:57Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Hulet, Lettie	l13-wc06-tn19	False	None	False	2022-04-12 04:20:06.355	[]
2855	CDC-2022-0024-2861	https://api.regulations.gov/v4/comments/CDC-2022-0024-2861	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I moved from one state to another and my medications for CP were immediately stopped. My quality of life has changed completely and I am forced to stop working. I cannot function with the slightest of tasks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdc9f6	Anonymous	None	2022-03-23T18:41:11Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l13-wh2a-xckt	False	None	False	2022-04-12 04:20:06.570	[]
2856	CDC-2022-0024-2862	https://api.regulations.gov/v4/comments/CDC-2022-0024-2862	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why didn’t the CDC make this public in 2016 when they knew doctors were cutting their patients off their pain medication?<br/>Recommendation 5 especially paragraph 4 Fast tapers and cutting patients off their pain medication is voluntary.<br/>Established patients already taking high dosages of opioids, as well as patients transferring from other clinicians, might consider the possibility of opioid dosage reduction to be anxiety-provoking, and tapering opioids can be especially challenging after years on high dosages because of physical and psychological dependence. However, these patients should be offered the opportunity to re-evaluate their continued use of opioids at high dosages in light of recent evidence regarding the association of opioid dosage and overdose risk"<br/><br/>The CDC released the draft of the 2015 became 2016 guidelines asking for Medical and public (chronic pain patients) Comments. The comments came back if the guidelines are released as is it would destroy the CPP community the CDC released them as is.<br/><br/>On 4-24-2019 the CDC released: <br/>CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain. This again talked to doctors not to cut off or rapid taper patients off their pain medication. Because there are NO MORE CPP TO DO THIS TO DOCTORS DID CUT OFF THEIR PATIENTS AGAIN NOW TO 50MME. The 2019 did not help anyone. This is why it is redundant to say all this again with more words in recommendation 5. The 2016 guidelines recommendation 5 is 2 ages. In 2022 draft is 14 1/2 pages 9 are for paragraph 4.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484fdca11	Jolley	None	2022-03-23T18:41:34Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Jolley, Chris	l13-wope-cq6d	False	None	False	2022-04-12 04:20:06.785	[]
2857	CDC-2022-0024-2863	https://api.regulations.gov/v4/comments/CDC-2022-0024-2863	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It appears the revised version of the 2022 CDC Opioid Guidelines has already failed the chronic/intractable pain patients in this country! On March 7th, 2022 I was told by one of my doctors assistants the Pain Clinic I'm going to, is lowering everyone who is over 50MME down to 50MME. My doctor confirmed this is true and it's going to happen sometime in April, 2022. He commented the reason was due to the 2022 revised CDC Opioid Guidelines, the section where the Guidelines states "It is NOT RECOMMENDED to prescribe OVER 50MME". This change appears to be implemented right after the CDC Federal Register Comments closes! This is also happening before the 2022 Revised CDC Opioid Guidelines have been released to the public! Once again CDC has failed the chronic/intractable patients only this time it's worse than the 2016 Opioid Guidelines. Doctors so not have flexibility, the is no volunteer tapering, no discussion regarding my pain management plan. Only cut backs and accept it, or go somewhere else! CDC needs to remove or re-word the 50MME to say it is meant for new patients not patients already on higher doses of opioid pain medication, in the NEW REVISED Opioid Guidelines. This is only one of many inconsistencies, for instance CDC claims they have removed the "one-size-fits all" clause that was in the 2016 Opioid Guidelines and giving doctors more flexibility in prescribing opioid pain medication and adding doctors will be able to "prescribe opioid pain medication using their own discretion" . The "50MME NOT RECOMMENDED" statement nullify those two statements alone. There are several more confusing and contradictory statements and recommendations, in the 2022 Opioid Guidelines. The way the new guidelines are written doctors have no choice but to comply to CDC Opioid Guidelines and in the process harming more and more pain patients. More pain patients will be going to the streets for pain relief, more are going to commit suicide due to pain. This needs to be addressed or the revised guidelines will be a horror story in the making! We all hope and pray CDC fixes these types of errors before they decide to release the Guidelines!<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	anonymous	None	None	0900006484fdcb91	anonymous	None	2022-03-23T19:54:18Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from anonymous, anonymous	l13-zes6-07zb	False	None	False	2022-04-12 04:20:07.007	[]
2858	CDC-2022-0024-2864	https://api.regulations.gov/v4/comments/CDC-2022-0024-2864	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I'm 43 y.o and have been living with chronic pain for about 20 years. of the 20 years the last 12 were managed by opioid pain medication.<br/><br/>The CDC 2016 opioid guidelines are destroying medical care for many fueling the Misinformation, and propaganda pushed and costing the lives of several. I personally have been thrown around, neglected and left to suffer by doctors that claim they are here to help. <br/> <br/>How could you let this happen here, in the state of Idaho. <br/><br/>[name redacted]'s prop, the CDC, the "opioid epidemic" all feeding propaganda.<br/><br/>Something has to change. Some way, some how chronic pain patients need to be excluded from the CDC guidelines. The max MME needs to be removed all together. Pain treatment is different for everyone and has no "one way works for all" method. Doctors here need to know You have their back, trust them and the oath that they have made to cause NO harm, to treat the sick and suffering. <br/>Doctors need to know it's safe, that they have the power to do their job, the safety and security to prescribe what they as medical professionals determine what their patient(s) need.<br/><br/>I understand how the medical industry works, how big pharma plays a role, how doctors get kick backs, I have seen it first hand, and became a victim to it. Big pharma clouds doctors judgment by the dollar sign that comes with falsely diagnosing "opioid use disorder" and pushing suboxone. CDC brainwash doctors with their paid "medical experts" some of which have no or little medical knowledge, especially with Chronic pain.<br/><br/> Unfortunately, over time it's going to destroy many doctor's reputations (has with some already), and as suboxone's long term side effects start to hit and "OUD" is debunked over and over again you will be flooded by law suits, doctors will be flooded with law suits and chaos will unleash. Yes, expensive lawyers will try to help, but the Masses of patients left suffering, the charts with false/illegitimate diagnoses, and the proof unfolding, will all make it unavoidable. The pain community is speaking up, bonding together, suffering together, but their voices are also getting louder together, we will be heard. <br/><br/>Medical professionals need to recalibrate, or all together find their moral compass which should be pointing in the way of compassion and care, and point away from $$.<br/><br/>10 years ago, I was prescribed a pain medication that gave me quality of life, now it's being pulled away from me. How cruel and inhumane. Why allow a doctor to dangle quality of life in front of someone with debilitating pain, just to yank it away. How evil!<br/><br/>YOU HAVE GOT TO MAKE A CHANGE, STOP CUFFING THE DOCTORS, STOP PUNISHING THE PAIN PATIENTS... Start applauding the doctors that actually do their job, that actually improve their patients life by taking some of the pain away. <br/><br/> Thank You for letting my voice be heard,<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	lisa	None	None	0900006484fd61c9	aguilar	None	2022-03-23T20:30:26Z	None	None	1	None	2022-03-23T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from aguilar, lisa	l0z-xcji-08c0	False	None	False	2022-04-12 04:20:07.227	[]
2859	CDC-2022-0024-2865	https://api.regulations.gov/v4/comments/CDC-2022-0024-2865	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I truly hope that comments from people like myself get others to understand we are not drug seekers, we are in pain. I take only what my pain management doctor gives me in order to be able to get out of bed and LIVE my life. When I hurt from migraines, neck and back pain, it is hard to live a normal life without help. Please don't make me suffer. I have blessed by my doctor, who really cares about all of his patients.<br/> God bless you all, I pray you never have pain in your life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sunni	None	None	0900006484fdcc65	Reid	None	2022-03-24T11:48:50Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Reid, Sunni	l14-0fm4-8igg	False	None	False	2022-04-12 04:20:07.477	[]
2860	CDC-2022-0024-2866	https://api.regulations.gov/v4/comments/CDC-2022-0024-2866	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since my accident back in 1989 I have been though back operations and therapy for the past 30 plus years. I have found that following my doctor's advice and working on my life changes. My medicine is important to my health taken responsibly I have had zero issues with any side effects or need taking more pain pills than prescribed. As I enter my later years I am very happy and comfortable with my prescriptions and therapy. Pain medicine is a serious issue and should not be abused.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdcc8a	Anonymous	None	2022-03-24T11:52:13Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-0s9b-v5bn	False	None	False	2022-04-12 04:20:07.697	[]
2861	CDC-2022-0024-2867	https://api.regulations.gov/v4/comments/CDC-2022-0024-2867	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting today largely because I have been harmed by the 2016 opioid prescribing guidelines. I have been pain patient off an on in life from a young age. The CDC guidelines are causing more harm to people with pain than they will ever help. The DEA has misinterpreted these guidelines as a reason to punish doctors. The real danger is largely from drugs Illegally flowing into our country. Most importantly people seeking medical treatment for pain are being turned away . This prohibition of pain medications that has been created is pushing desperate people to more dangerous drugs for relief. This is causing unnecessary problems, suffering and even death. I am thankful for being asked for my opinion and to comment on these guideline's.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdd155	Anonymous	None	2022-03-24T11:53:28Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-2m4f-c5rk	False	None	False	2022-04-12 04:20:07.914	[]
2862	CDC-2022-0024-2868	https://api.regulations.gov/v4/comments/CDC-2022-0024-2868	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What medical evidence is available that supports the recommendation that a long acting buprenorphine product that is FDA approved for pain should not be initiated in an opioid naive patient with chronic pain due to higher risk of adverse effects?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdd197	Anonymous	None	2022-03-24T11:55:11Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-3dev-g8oz	False	None	False	2022-04-12 04:20:08.129	[]
2863	CDC-2022-0024-2869	https://api.regulations.gov/v4/comments/CDC-2022-0024-2869	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was injured after leaving a patients home in 2018. I experienced extreme pain for nearly a year, when I was going down my stairs I experienced a burning sensation that went from my back down to my legs. I lost all feeling and my legs gave way and I fell down 14 of the stair steps. I landed on a concrete pad. I saw my pain management provider and this is when I was prescribed hydrocodone 10/325. I even was set up for a caudal epidural immediately. My provider couldn't even get the needle in between the space in my back because it was completely calcified. This was x-,ray guided. I ended up needing surgery for my Sacro illiac joint as it was detached. During my recovery I was diagnosed with ankylosing spondylitis. Without me being on the hydrocodone I wouldn't be able to ambulate at all and no quality of life. I take as prescribed and there are days I don't take at all. But if I wasn't able to stay on this I would have no quality of life because of the pain. I do think that if a person is needing long term opioid therapy then they need to submit a urine drug screen every few months.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdd1ef	Anonymous	None	2022-03-24T12:15:57Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-4kg5-xa8v	False	None	False	2022-04-12 04:20:08.362	[]
2864	CDC-2022-0024-2870	https://api.regulations.gov/v4/comments/CDC-2022-0024-2870	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I recently moved to the state of Montana. My new MD insists I discontinue use of the Fentanyl patches I have used for 15.2 years. I have taken 100 mcg without incident during this time. My MDs complete and only reason for discontinued use is "I must follow the CDC guidelines as set forth for opiods". I am nearly 71 years old, diagnosed 20+ years ago with disabling cervical and spinal diseases, all of which are progressive. I am currently reduced 25% down to 75 mcg, my anxiety level off the charts, and my pain level is impeding my daily ADLs. I fear further reduction will reduce my quality of life so much, that I will not want to live at all. There would be no benefit to living with such high pain levels.<br/>I understand the risks associated with the Fentanyl patch and 100 mcg dosage, including the risk of overdose. I would much rather live the rest of my short life with some bit of comfort, rather than the hell that is beginning with dosing down. <br/>I should be offered the opportunity to remain on my same medication dosage, to sustain my quality of life. The CDC should enable every doctor/MD to evaluate and treat patients, on an individual basis.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marcie	None	None	0900006484fdd227	Sanz	None	2022-03-24T12:20:59Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Sanz, Marcie	l14-57uw-gcil	False	None	False	2022-04-12 04:20:08.604	[]
2865	CDC-2022-0024-2871	https://api.regulations.gov/v4/comments/CDC-2022-0024-2871	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please bring this debacle to an end especially the 50 MME . Pain is for real. I hurt everyday all the time. I neither wanted or asked for this. Please get the government out of medicL practice. I am 72 and I remember how awesome and great the medical profession once was. Highly respected. Highly revered. The CDC was regarded the same way. No longer though. I am sick of having to be bed bound because of my condition. I've tried almost everything there is in living painful surgery that failed. The only help so far has been the opioid buy I don't receive enough that would allow me to get up and out. Any less and I would leave this world. If something else would work I would leave this stuff behind in a heartbeat. I strongly believe 99.9 percent of my fellow cpps feel and think the same way. The government needs to fo us and go after the ILLEGAL side of this and not the legitimate patients such as myself. I am no expert or learned but I know what I feel and think. I am definitely not addicted nor oud. I and all my fellow cpps take all this very seriously in luding the use òf these legitimate God-given medicines. I think you as an agency really do know all this. Please work on helping us rather than harming us.. Thank you so much for listening to me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Harry	None	None	0900006484fdd25c	George	None	2022-03-24T12:23:47Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from George, Harry	l14-5vdi-7kr4	False	None	False	2022-04-12 04:20:08.820	[]
2866	CDC-2022-0024-2872	https://api.regulations.gov/v4/comments/CDC-2022-0024-2872	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Whenever I am in pain from CRPS, and I am seeing an ER doctor, I know they think I am a drug addict. I can see it in their eyes. Chronic pain patients are not known as "patients" we are known as "pests." It doesn't matter that my disorder is considered the most painful on the planet via McGill University. It doesn't matter that the pain is so bad that I have allodynia (sensitivity to touch, where I can't have anyone touch my right hip and leg). The doctors don't see my pain nor do they understand it. It's like being on fire in front of triage, you're burning, and when they finally bring you back, they inject with you a couple of drops of water and say, "This is all we can do. Sorry." <br/><br/>And as the fire consumes you, turning your affected limb different colors, something THEY CAN SEE, you beg them for more help. You beg them for ANYTHING. Can't they see I am on FIRE? They can't, because that is the problem with invisible illnesses. <br/><br/>I am one of the lucky patients who has been able to receive medical treatment from my current specialist. But I know too many CRPS patients who are treated like a number, and not like a person. That is just too common these days. CRPS has a terrible nickname: "The Suicide Disease." Patients kill themselves because they are in such terrible pain they cannot stand it. I have known at least six patients who have committed suicide from physical pain. <br/><br/>This is the reality for so many patients living in America. They are not getting adequate quality of care, because doctors practice out of FEAR. Fear from the government, fear from the DEA, fear from their boards of directors, and fear from supervisors. Medicine is no longer a practice of saving lives: it's a numbers game. And that is precisely the problem with healthcare today. <br/><br/>My mother called me the other day asking if I could recommend a CBD oil or gummy for her back. She was too scared to ask for medication or even see her doctor about the bulging discs in her back. She DESTROYED her back as a nurse, and now she is afraid of asking for treatment because she believes no one will believe her and they will turn her away. <br/><br/>The fact that she is in so much pain she can barely walk into a grocery store without needing an automated cart, is absolutely unacceptable to me. How can our healthcare system yo-yo from too many prescriptions to none? When will our healthcare system finally come to terms with the fact that pain is a disease and we must treat it as such? When will the CDC recognize that women are constantly put into painful situations and given NOTHING to alleviate their pain? <br/><br/>I had a colposcopy done a few months ago, and not one person told me how painful this procedure was going to be. When I had my hip cartilage surgery done, the surgeon did not adequately prepare me for the pain I was going to experience. When my best friend gave birth, no one told her she might tear pieces of her vagina. What is this curtain of silence and exclusion for women when it comes to pain and procedures? <br/><br/>When I went to my first checkup after my hip surgery (this surgery would trigger my CRPS), even the NURSE said, "Yeah we don't prepare our patients for the pain, we don't want to frighten them." Frighten them? What's frightening is waking up post-op and feeling as if your right side is on fire and broken. When everyone told you it would be a twinge of pain. Being lied to over and over by doctors, or even worse - being told nothing is wrong and you are perfectly healthy? Is just bad medicine.<br/><br/>Because when I go to a hospital with a serious but unique problem, and I am in terrible pain, this isn't like GREY'S ANATOMY. There are not doctors vying for my "case." <br/><br/>We must do better as a society, as a country, and as a people to take care of those in pain. Pain does not go away. Pain shouldn't be accepted as a "part of life", but as something to conquer. <br/><br/>Pain is a disease, pure and simple. It can tear apart the most seasoned athlete, and the most well-trained warriors. If you want to end the opioid epidemic, you have to fight it with the right weapons: with humility and an open-mind. Addicts need more than just less access to medication: they need access to the TREATMENT for their problem. Cutting off medication only leads to more problems, addressing an individual's environment and what influences may occur, is the answer. We can save lives, prevent overdoses, and treat pain all at the same time. If we are willing to differentiate between people, instead of blindly labeling patients and addicts the same thing. <br/><br/>We know that reducing the prescriptions of narcotics only lead to more overdoses. Is this the legacy we want for our children? For the scientific community? For Pharmaceuticals? It's time to fight for the right things.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katelyn	None	None	0900006484fdcee0	O'Leary	None	2022-03-24T15:35:02Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from O'Leary, Katelyn	l14-9yjx-7mc0	False	None	False	2022-04-12 04:20:09.042	[]
2867	CDC-2022-0024-2873	https://api.regulations.gov/v4/comments/CDC-2022-0024-2873	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At the beginning of my legal career, I prosecuted drug cases as a United States Attorney in San Diego, a deputy district attorney in San Diego and again in Contra Costa County in Northern California. After I had my first child, I began to have spinal issues and back pain. Over time, the back pain became severe. For over a decade, I went to dozens of physical therapists, chiropractors, surgeons, acupuncturists, and massage therapists to treat the pain. I eventually had surgery but it was not successful in relieving the pain. I still suffer chronic pain today. Over this period of time, I have taken opioids to be able to fully function as a mother, a lawyer and an educator. During the periods of time I have tried life without opioid pain relief, I am in bed in intense pain using ice and heat alternatively and cannot work nor take care of my husband and children. My pain management doctor has worked with me every month to keep my medications as low as possible and helped me to decrease it when I can. My doctor is often showing great stress about helping me - even expressing fear that the DEA will prosecute him for helping his patients. It has effected his ability to treat me at times. Unfortunately, the laws in the U.S. have made obtaining and taking opioid medications extremely challenging for people with short term and long term pain. My sister in law had a double mastectomy and was sent home with Advil. My 13 year old son had an extremely painful eye surgery and neither his pediatrician nor the surgeon would prescribe opioids for him for the five day recovery process. Both doctors expressed great fear that they could be sued or prosecuted. His pediatrician finally prescribed an opioid after a stressful and exhausting process. We must change the laws to make it easier and less stressful for doctors to help people like my son and sister in law temporarily or like me, on a longer term base. There have been days when I was terrified about handling the intense pain I sometimes experience without the pain relief opioids. While it incredibly distressing to hear about people who are addicted and the lives that have been ruined, we must remember the people who cannot function or live without the lifesaving pain relief opioids are providing them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484fdd028	Allen	None	2022-03-24T15:38:19Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Laura	l14-dlyi-l28q	False	None	False	2022-04-12 04:20:09.259	[]
2868	CDC-2022-0024-2874	https://api.regulations.gov/v4/comments/CDC-2022-0024-2874	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When my grandfather's cancer symptoms and pain suddenly took a violent turn for the worse, his regular doctor happened to be on vacation. He went to the walk-in clinic that weekend and was told to go home and take some ibuprofen.<br/><br/>He took his own life that night.<br/><br/>When I developed a chronic pain condition of my own, I finally understood, and I forgave him.<br/><br/>In the excruciating, humiliating, and hopeless years since, the only reason I have not taken my own life is because I cannot bear the idea of my dad going through that pain twice.<br/><br/>It is so insulting watching policymakers pretend that we are protecting people by restricting or aggressively discouraging compassionate access to narcotics.<br/><br/>The "logic" here is asinine: we have to protect people from narcotics because they might become addicted to heroin and eventually overdose?<br/><br/>I suppose driving someone to suicide is technically protecting them from heroin use, but I would sooner label it cruelty, medical malpractice, or cowardice.<br/><br/>There is a reason the UN classifies denial of pain care as a form of torture.<br/><br/>The only "guidelines" the CDC should be issuing are a mandate to treat patients with compassion and dignity, period.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A.	None	None	0900006484fddd36	Johnson	None	2022-03-24T15:52:46Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, A.	l14-gyxr-ef2o	False	None	False	2022-04-12 04:20:09.487	[]
2869	CDC-2022-0024-2875	https://api.regulations.gov/v4/comments/CDC-2022-0024-2875	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These so-called new guidelines sound so reasonable to those sitting behind a desk, virtue signaling about safety, UNTILL...some of you actually experience a very painful, unrelenting and debilitating condition. Walk half a mile in our shoes!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Veronica	None	None	0900006484fddd6f	Warren	None	2022-03-24T15:53:24Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Warren, Veronica	l14-i2g4-43am	False	None	False	2022-04-12 04:20:09.702	[]
2870	CDC-2022-0024-2876	https://api.regulations.gov/v4/comments/CDC-2022-0024-2876	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings. I am writing you today to let you know we stand together with [name redacted]. on the endorsement of his letter regarding the request for withdrawal of AHRQ Comparative Outcomes Reviews 240 on acute pain. <br/>My name is [name redacted] from NH. I have been a chronic pain patient since 1997 after I broke my neck in two places from a tractor trailer rear-ending me. Up until 2016. <br/>I had very good care with my chronic pain management doctor. When he was forced to cut my dose because of new CDC regulations. my life took a downward spiral. Before this happened, I was able to live as a productive member of society and helping do my part. Now I rarely leave my house and have family members do my shopping and help me out as much as they can. There was no reason for my doctor to do this to me besides him being bullied and threatened with imprisonment for doing his job. Because of this he retired. He felt that if he couldn't give his patients 100%. He couldn't be the outstanding doctor that he once was. Now looking back at the cdc's decision and who they took their recommendations from I'm absolutely mortified that the CDC and other government agencies went along with these ridiculous sanctions and new guidelines. Here we are six years later and things have not changed for the better they have gotten a hundred times worse. The CDC admits to their mistakes and the AMA has also noted that the CDC made horrible judgment calls when it came to the chronic pain patients in the United States. [Name redacted] has been fighting for the undue Justice there was dealt to the chronic pain community. His findings are 100% accurate and true. I employ you not only as a citizen of the United States for 59 years, but a chronic pain patient, that you take the time and and listen to what he has to say. You will be amazed at how much information and knowledge he has for all of us. Thank you for your time and I hope that you'll see it to stop the needless suffering that the chronic pain patients are now forced to endure. <br/>Sincerely [name redacted] Manchester New Hampshire	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fde127	Grady.Jr	None	2022-03-24T16:04:41Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Grady.Jr, Richard	l14-j4r9-0c9w	False	None	False	2022-04-12 04:20:09.927	[]
2871	CDC-2022-0024-2877	https://api.regulations.gov/v4/comments/CDC-2022-0024-2877	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The only ethically acceptable course of action for the US CDC is to outright repudiate both the 2016 and 2022 disasters, and to withdraw them without replacement. CDC must be barred by legislation from publishing any practice guideline on pain medicine. And the US DEA must be told to stand down from its unjustified persecution of doctors who have done nothing wrong.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	April	None	None	0900006484fde1c6	Tucker	None	2022-03-24T16:20:46Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Tucker, April	l14-n7g6-ctib	False	None	False	2022-04-12 04:20:10.149	[]
2872	CDC-2022-0024-2878	https://api.regulations.gov/v4/comments/CDC-2022-0024-2878	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My children’s father and I were originally allowed to attend the methadone clinic in 2010 for only a pain pill addiction, 8 years or so later we switched to suboxone in a different office where we are still battling taking them everyday. In reference to my teeth, I tried to get a full set of dentures and was allowed not too many years ago. I was told I could only get a top partial, my teeth were too good to pull, but now I have one molar left and the partial has deteriorated my top teeth since being on suboxone. I’ve had more teeth crumble since being on suboxone, I could understand but I’ve never even been on a hard drug. I shouldn’t even be on suboxone honestly. The methadone clinic should have turned me around	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tarah	None	None	0900006484fde1e8	Chapman	None	2022-03-24T16:35:30Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Chapman , Tarah	l14-o2jg-vt8b	False	None	False	2022-04-12 04:20:10.364	[]
2873	CDC-2022-0024-2879	https://api.regulations.gov/v4/comments/CDC-2022-0024-2879	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I began suboxone almost a decade ago and my teeth are broken down level with my gums and my teeth have never been weakened so severely. I cannot afford nearly the extensive work needed to fix my teeth since beginning suboxone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fde1f0	Huggins	None	2022-03-24T16:35:51Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Huggins, Kevin	l14-objy-yn4j	False	None	False	2022-04-12 04:20:10.597	[]
2874	CDC-2022-0024-2880	https://api.regulations.gov/v4/comments/CDC-2022-0024-2880	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The fact that I served my country and can't get adequate care beyond me. But that's not what gets me as I didn't sign up for the benefits. I signed up because I believe in freedom and a right to choose. You don't allow the military to torture anyone no matter the case and yet you allow BS guidelines to be enforced as if they were laws. The reason you don't torture is one it's inhumane and whatever information you get may or may not even be true and helpful. The reason is because when you introduce pain to people it causes people to act differently and do things just to get the pain to stop. You have introduced torture to your chronic pain patients by manipulating the population with misinformation to sway your political votes one wadi or another demonize the fact that if you take pain pills is some kinda bad thing. Labeling pain patients as weak or addicted substances abuser. Politics need to stay out of medical care. At the very least you could allow for a patient waiver. Bungee jumping skydiving and many other activities allow people to choose what they want without holding accountable for any injury or death. And I would have a higher risk of something happening doing one of these activities then all of a sudden overdose on a medication that I've taken for over a decade. And at the same time I'm getting under treated and neglected by doctors yall are coming up with more laws a regulation for "Safe Sites" so actual drug abusers can have a safe place to shoot up their illegal drugs. While actual pain patients go untreated and forgotten. We know that this medication will not heal us. As for me it allows me to still be a dad and help tuck the pain away so that I can take care of my family and their needs instead of my 9 yr old son taken care of me because he found me in the floor in so much pain that he has to help me get undressed and out of the floor into a bed or couch. I just want to be treated like a human and be able to be a husband and father of three boys without being made to feel like I'm some criminal or mental case. You should really just remove everything that yall but inplace and stop trying to be doctors with you community organizer background. But if you can't fix that then if drug abusers get their safe zone the chronic pain patients should get their waiver to choose	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Forrest	None	None	0900006484fde1cb	Chambless	None	2022-03-24T16:38:13Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Chambless , Forrest	l14-ncyw-ao83	False	None	False	2022-04-12 04:20:10.815	[]
2875	CDC-2022-0024-2881	https://api.regulations.gov/v4/comments/CDC-2022-0024-2881	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I have been a chronic pain patient for 15 years. I’ve been with a pm dr for that long on a steady amount of pain medication. Never needed any increases. Recently my physician retired. Leaving me to find someone else which isn’t an easy task with Medicaid. <br/><br/>I recently found another provider and he cut my medication down by 65% in one go. To be taken twice daily now instead of 4. I’m miserable. <br/><br/>I’ve never done anything wrong at all. This new dr said that so many practices had been shut down around him. He outright told me he is scared to prescribe opioids. <br/><br/> So what do people like me do? I was able to have some sort of life before but I’m miserable now. <br/><br/>I’ve always been an advocate, but it gives me a new fire to fight for our rights.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde361	Anonymous	None	2022-03-24T16:38:41Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-y33d-yn65	False	None	False	2022-04-12 04:20:11.074	[]
2876	CDC-2022-0024-2882	https://api.regulations.gov/v4/comments/CDC-2022-0024-2882	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I just had surgery for an ectopic. And the obgyn surgeon told me before I had it that I could take two 2mg dilaudid pills (oral) for a total of 4mg which is still low (I’ve been in pain mgmt a total of 6+ years and have a tolerance and need at least like 30MME for this kind of severe pain.) <br/><br/>The ectopic had grown to 10 weeks — it had grown on my Fallopian tube and they took the tube out about 3 hours ago. They said I was lucky to be alive. <br/><br/>First obgyn missed it because she was too busy lecturing me about “narcotics” (which she knew was through legit pain mgmt for multiple chronic pain conditions), and she seemed “relieved” to see a live fetus, which she assumed was in the uterus. I had to come to another obgyn to get the diagnosis (an egg sac on the tube) and then to this hospital in northern VA. They were giving me sufficient IV daudid but now that I’ve gone through surgery they’re being horrible…<br/><br/>I am in serious pain and feel like this was a bait-and-switch. Even the nurses feel bad for me because I’m crying. Can barely walk to bathroom. <br/><br/>The surgeon obgyn doc won’t just give two of rhe 2mg dilaudid (hydromorphine). I’ve asked to talk to the charge nurse and she is “busy.” I’ve spoken to 3 nurses. I got out of surgery like 2 -3 hours ago. They said they could give me more “Tylenol” and toradol every 6 hours. <br/><br/>Guys, what do I do?!! This is ridiculous. This is a major hospital system in northern VA. They KNOW I’m in pain mgmt. And metabolize these meds very quickly too. They know my husband is coming to pick me up in AM (I’m not driving) and won’t do an IV pain pump even tho IV is still in vein in arm (connected)….	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde389	Anonymous	None	2022-03-24T16:40:44Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-yb28-guhj	False	None	False	2022-04-12 04:20:11.294	[]
2877	CDC-2022-0024-2883	https://api.regulations.gov/v4/comments/CDC-2022-0024-2883	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for almost ten years. I've watched my mother live with it for 35, and with opiod addiction for some of those earlier years. I hated opioids and immersed myself in yoga study and practices, TRE, tension and trauma releasing exercising, Somatic psychology, Psychiatric NP that utilized uniques medicines for symptom management alongside my Naturopath who does likewise. I am back on my feet and starting my second business. I still have chronic pain, but it is no longer debilitating. THERE ARE OTHER WAYS!! Our chronic pain bodies already keep us opiod high and these medicines are killing our ability to adapt and heal outside of acute care. And you can't take away the medicines without supporting the other holistic practices that heal!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	j	None	None	0900006484fde38a	engel	None	2022-03-24T16:41:41Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from engel, j	l14-yc17-plml	False	None	False	2022-04-12 04:20:11.510	[]
2878	CDC-2022-0024-2884	https://api.regulations.gov/v4/comments/CDC-2022-0024-2884	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As chronic pain patients (CPP) most of us live in terror, horrific pain, anxious, depression, torture, sick, dark, isolation, anger, sad, cry, worthless, alone, jobless, misunderstood, fear, unable to work, insomnia, helpless, broke, scared, scared of surgery, can’t work, hopeless and at times hopeful.<br/><br/>We have a disability and because of that disability we suffer discrimination just like every group of people. Our doctors abandoned us pharmacist profile us and the public treats us as addicts. No pharmacist wants to fill a prescription fo pain medication even for cancer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde6b5	Anonymous	None	2022-03-24T16:42:24Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-yezc-lqqi	False	None	False	2022-04-12 04:20:11.724	[]
2879	CDC-2022-0024-2885	https://api.regulations.gov/v4/comments/CDC-2022-0024-2885	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to submit some of my story and my sincere concerns. I have been a chronic illness chronic pain patient since 2001 when I had to have back surgery but the surgery failed I also developed a staph infection which required a needle biopsy to confirm the needle injured a nerve that has until this day caused and causes electrical like shooting pains through my body. Procedures by different specialists a multitude of antibiotics while under my orthopedic surgeons care he knew how much pain I was in and managed my pain accordingly then your guidelines came out I was sent to a PM clinic where my medications were lowered to a dose of 60 MME that no longer managed my pain. I was subjected to spinal injections, SI joint injections I now have many other autoimmune diseases Rheumatoid Arthritis, Sjogrens disorder,Interstitial Cystitis Fibromyalgia Osteoarthritis, Neuropathies, Critical Osteoporosis to the point I am now getting compression fractures in my spine , Gastrectomy, bowel resection. I changed PM a couple of years ago where they lowered my MME even further to 45 MME. I no longer have any quality of life. I cannot do much of anything anymore now I’m being told I may have something far worse I have to have a bone marrow and a muscle biopsy. PLEASE CORRECT THIS HARMFUL MESSAGE PRECEDENT THAT HAS SEEMED TO BE SET IN STONE. I truely appreciate the fact that guidelines and messaging to physicians are to be amended, but ALL MME wording needs to be removed as physicians are already using the wording in your revised wording against us. My PM doctor just told me that your revised version coming out does not allow them to RX over 50MME. Please remove all MME language in the guidelines as we are literally dying from chronic pain at an extremely high rate not the pain itself but the consequences of badly managed pain. Please also advice DEA on the fact that our Doctors need the ability to treat patients without fear. Thank you for allowing me a voice in the decisions concerning pain management guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Malinda	None	None	0900006484fde6c3	Shelton	None	2022-03-24T16:52:21Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Shelton , Malinda	l14-ynxi-9qdt	False	None	False	2022-04-12 04:20:11.951	[]
2880	CDC-2022-0024-2886	https://api.regulations.gov/v4/comments/CDC-2022-0024-2886	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Posted by [name redacted]<br/><br/>I hope you are happy with yourselves, MR.CDC, [name redacted], and Insurance companies! I hope like hell your kids never have to succumb to the torture [name redacted] did! This child was 10 years old and innocent. [name redacted] lived most of his life only to dream about what he could accomplish. [name redacted] dreamed of going outside and throwing a ball around, or simply riding his bike thru the neighborhood. Instead, he was forced to live his life inside and was told they would not treat his pain because of some stupid law! Turns out that really wasn't a law at all, it was 2016 CDC guidelines for prescribing that the doctors were referring to. <br/>From the time I knew [name redacted] he loved to talk about fishing, boating, and hunting. His favorite past time was messaging me on Facebook at 5 am to ask me what I was doing for that particular day. He was forced to live his life through others all because a federal law prohibited him any kind of pain relief. American Pain and Disability Foundation and the CPP community were able to came up with the funds and the Advocate to get [name redacted] the relief he needed for the last few months of his life. <br/>[name redacted]'s mother notified us this morning that he had lost his battle to cancer. The Government should be ashamed of themselves for shaming [name redacted]'s parents into painful procedures and threats of addiction. We will continue to fight for these children because we know the governments new population control programs are in full effect. I leave you the note [name redacted]'s mom left for American Pain and Disability Foundation team. Keep fighting, we are in this together!<br/><br/>Sincerely, [name redacted] APDF<br/><br/>Dear Mr [name redacted],<br/> <br/> First of all, thank you for the bottom of our hearts! [name redacted] did pass this morning at 3 am. He seemed most upset with not being able to drive your boat this coming summer! You are a special man Mr. [name redacted]! [name redacted] talked about you often, and thank you so much for responding to him on FB messenger, even though it was pretty regular lol. [name redacted] would come in and tell me what you guys talked about for days and how he wanted to hunt at your house when he was better. You made his last days exciting and I'm so appreciative of that. There is no doubt in my mind he will be on that boat with you now, even though our sweet baby now lives in heaven. Your team and that pharmacist were a gift from the lord himself! Please tell him we are so appreciative to him and all the folks at your foundation for making his last days his most exciting! You will forever be part of our family. <br/><br/>Forever grateful, <br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde6ca	Anonymous	None	2022-03-24T17:00:10Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-ysv8-c9od	False	None	False	2022-04-12 04:20:12.168	[]
2881	CDC-2022-0024-2887	https://api.regulations.gov/v4/comments/CDC-2022-0024-2887	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I applaud the efforts of the CDC tpo develop and introduce workable guidelines for Opioid management. The focus on Shared decision-making between patients and the Doctors and/or providers is long overdue and is a correction to an error that was made.<br/>I do worry that the impact on the care of the revisions in rural and urban settings where patients may not have access to pain specialists or are unable to afford the care will cause undue hardships on the providers in those areas. The default provider for those patients are local primary care providers in private practices who have established pain management programs for patients who are willing to be compliant with their pain management agreement. Sadly, accusatory language such as patient abandonment and needless discontinuation will not help preserve the access to needed therapy and available resources given the current legal environment and may well cause more rural and urban minority and low-income providers to cease providing therapy at all. The language also failed to recognize major violations of pain management agreements as a reason for discontinuation of opioid therapy and in the proposed language could represent patient abandonment and cause drug abuse and diversion to be encouraged.<br/><br/>Happily the guideline provision and discussion correctly characterize the meddling and intrusiveness of outside organizations such as pharmacies into the Doctor-Patient relationship and for stressing that there are voluntary guidelines subject to the discretion of the provider. The appropriate forum for review of prescribing habits of Physicians is with the State Medical Board and not demands by a local pharmacist or refusal to fill prescriptions based on their limited knowledge of the process that went into the prescribing of that medication. <br/>We live in a time of increasing administrative burden. Intrusiveness by organizations extraneous to the process needs to be stopped or more clinicians will exit p[ain management and patients will suffer and yes possibly die at their own hands because of chronic pain. I applaud the Guidelines efforts to focus on the Shared decision-making and application of evidence-based guidelines but emphasize the clinician's clinical judgment as key to the process that should take place. The emphasis on the process led by the Doctor and in conjunction with his patient who he has seen and examined and listened to should not be replaced by a rigid unbending set of guidelines. The unintended consequences of the 2016 guidelines should be viewed and corrected which appreas has been done in large part.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kerry	None	None	0900006484fddf48	Willis	None	2022-03-24T17:48:20Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Willis, Kerry	l15-1alf-6wac	False	None	False	2022-04-12 04:20:12.387	[]
2882	CDC-2022-0024-2888	https://api.regulations.gov/v4/comments/CDC-2022-0024-2888	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 and 2022 CDC guidelines for opiates should be removed. Chronic pain patients are suffering and dying because of these guidelines. It is inhumane. Please allow medical professionals to write a guideline. There is no known science behind the MME. This has to stop. Thank You [initials redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fddfd2	Anonymous	None	2022-03-24T17:48:58Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-1u68-od4s	False	None	False	2022-04-12 04:20:12.605	[]
2883	CDC-2022-0024-2889	https://api.regulations.gov/v4/comments/CDC-2022-0024-2889	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We are a Pain Management Provider in Northern Michigan. Our Physician here is board certified in Anesthesia as well as Pain Medicine. He performs injection therapy, medication management as well as Laser Therapy. We have had our MLS class IV Cutting Edge laser for about 7 years now. This therapy has been extremely beneficial in eliminating and reducing pain. We can't implore you enough to open this up as a billable procedure! We try and keep the cost low but at the same time are cognizant of our costs. This is one of the best alternatives to Opioid medication management. I know many of our patients would prefer this route if insurance would cover it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fde032	None	None	2022-03-24T17:49:43Z	Northern Michigan Pain Specialists	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Northern Michigan Pain Specialists	l15-2d0n-1hfb	False	None	False	2022-04-12 04:20:12.827	[]
2884	CDC-2022-0024-2890	https://api.regulations.gov/v4/comments/CDC-2022-0024-2890	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been clean and sober since [month and date redacted] 1992 and under pain management for over 12 years with a pain management doctor. I have arthritis and bone spurs C6 and 7 t 9 and 10 l4 and 5 injured shoulders and other pain management problems. I understand the opioid pandemic but making elderly people pay is not the answer. A few years ago my pain management medication volume went from 164 15 mg doses a month to 112 for no fault of my own. I am living with that now and fear it may get worse because some lawmakers are making drastic decisions not based on complete data. I understand and agree in fighting drug abuse and there is a serious problem and many people are getting hurt and dying. But, punishing people that are already struggling and have found a healthy balance physically mentally and spiritually is going to do very little to fight the fentanyl problem on the streets. Sometimes you actually push people to the black market with your decisions. Again I've been clean and sober for over 30 years and just want to be able to maintain a healthy pain reduced life without having to live in fear of your overreach. I'll be 68 years old this year I've raised several [city redacted] children and currently [name redacted] widower with one more foster child at home on a IEP. Please allow doctors and pain management doctors to do their job and don't put all of us in one basket. If someone takes advantage of the system then it's time to punish. I'd be more than happy to speak with anybody concerned openly or privately. Please call me or text me I don't use my email [phone number redacted] [city redacted] New Hampshire	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484fdefd5	Boutin	None	2022-03-24T17:53:38Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Boutin, Gary	l15-7v54-8o3m	False	None	False	2022-04-12 04:20:13.077	[]
2885	CDC-2022-0024-2891	https://api.regulations.gov/v4/comments/CDC-2022-0024-2891	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines on opioids was based on and for what? That prescribing opioids lead to addiction that caused overdose deaths. Now we are seeing that the overdose deaths are being caused by illicit forms of fentanyl from insecure borders, ports and mail systems. Supply creates demand and demand creates supply. Therefore, lack of a safe supply leads to an unsafe supply! The director of NIDA uses a theory aka "model", "disorder", "a useful tool" to treat negative habit formation with no biological test for the disease. It's subjective and just a model. The DSM calls it a disorder. However, it is well known that positive habits and negative habits are formed in the same way and same parts of the brain! "The mental “tracks” that get laid down can lead to habits, good or bad. If we develop poor posture, it becomes hard to correct. If we develop good habit, they too become solidified. Is it possible, once “tracks” or neural pathways have been laid down, to get out of those paths and onto different ones? Yes, according to [name redacted], but it is difficult because, once we have created these tracks, they become “really speedy” and very efficient at guiding the sled down the hill. to take a different path becomes increasingly difficult. A roadblock of some kind is necessary to change direction.” Yes, “a roadblock of some kind”. A serious constraint, put on the existing habit; one that forces you to take a different direction, and use a different part of your brain (or sledding hill :-))." http://collaborativejourneys.com/good-metaphor-habits-hard-change/ I have some experience from both sides of treating and having negative habits aka addiction, 45 years of experience. NIDA, NIH, CDC and many others are essentially saying that habits are diseases, disorder models if they don't fit the narrative of how they decide physical pain should be treated. We are being told that unless you form a habit of living in physical pain without opioids you have a negative habit that is causing opioid overdose deaths. Aren't the overdose deaths being caused by illicit forms of fentanyl? Are these deaths only in those with negative habits? No, they are not. One time exposer to illicit unsafe in potency fentanyl can kill. Someone in severe pain with no means to receive care from the doctor dies by going to the street. Is that a disorder? Is it a disorder to experiment with alcohol, drugs for younger adults, NO! No pain or very restricted care from the doctor and if you try to find any, you have a negative habit, disorder, brain disease. If we are to go by the theory, model, disorder of addiction, then unsecured borders, ports and mail systems are the Governments negative habit, disorder, brain disease that is causing overdose deaths. An ideological addiction. Why have I not seen one mention from the CDC, NIH, NIDA on that "addiction"! Oh, that's right, it doesn't fit the narrative of spending $65 billion over the last two years on treating habits as disorders and brain diseases while the overdose deaths are over 100,000 a year now. Why is the brain disease model not being used for treating unsecure ports, borders and mail systems? If NIDA, NIH, CDC, HHS doesn't advocate for more security at the borders from illicit fentanyl, your ideological addiction to treating habit formation as a brain disease, disorder doesn't apply to the you! How can that be? Looks like it will take “A roadblock of some kind” to change the “habits” of the CDC! So called addicts lose their jobs! HUH??????	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484fdf02e	Payne	None	2022-03-24T17:58:14Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Payne, Charles	l15-8diu-831p	False	None	False	2022-04-12 04:20:13.298	[]
2886	CDC-2022-0024-2892	https://api.regulations.gov/v4/comments/CDC-2022-0024-2892	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I speak as both a Registered Nurse with 30 years experience certified in Addiction and Mental Health. I also speak as a patient.<br/>My first experience as a nurse was in oncology and hospice. At that time, it was a battle to medicate patients with opiates even if in Hospice House. Then the pendulum swung and we are all familiar with OxyContin and [name redacted]. Again, the pendulum swung and prescribers are afraid and taught in school not to prescribe opiates at all. <br/>I worked in the past two months with APRNs and PAs with less than 3 years experience. When I questioned them on prescribing opiates, 100% would not prescribe opiates at all. I was told, “pain is good” , “there is rarely a need for opiates and only in the hospital”, “never for chronic pain”. What is being taught in schools? There is definitely a FEAR associated with prescribing an opiate.<br/>As a patient, I had surgery in May 2020 to remove a kidney stone greater than the size of a golf ball through PCNL. My kidney was opened in two places and catherized overnight. My post-op pain was severe and I was medicated with an opiate for 24 hours. I actually requested Toradol and was denied. I was discharged from the hospital after 24 hours with a pain level of “9” by a resident. I was told to use Tylenol and Ibuprofen. This is POOR care in a major hospital.<br/>Please change the guidelines and re-educate new prescribers.<br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484fdd1c8	Bury	None	2022-03-24T18:08:37Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Bury, Debra	l14-429d-f18o	False	None	False	2022-04-12 04:20:13.517	[]
2887	CDC-2022-0024-2893	https://api.regulations.gov/v4/comments/CDC-2022-0024-2893	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My Doctor cut me off cold turkey. I did ok for awhile then one I couldn't get out of bed. Found a new pain management group that has been so helpful and understanding. Now for what's wrong with me my discs are crushed from L1-L5 also have torn my lower root. Stenosis in spinal cord. Servical stenosis. Narrowing of spinal cord fluid in lower cord. Been told and have already used a wheel chair<br/><br/>I have Trimengial Neurology and Occipital Neurolgy. For the time I was off medication suicide was all I thought about, but I know it would hurt my family and friends and to give up is not in my soul. Then pain gets unbearable and staying in bed crying is all I can do. Nothing is worse then suffering and not being able to ease the pain. Am I drug addict, no. I'm a survivor and a bull to fight this battle. I won't let myself worry about what the CDC thinks or strangers don't understand. To get through days is all the energy I have. Continuing my medication helps me enjoy life as much as possible. <br/>Please don't do anything against me that would hurt myself from receiving help. Thank you. Kim	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fdce0e	Quintero	None	2022-03-24T18:13:22Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Quintero, Kim	l14-7zk5-2ygj	False	None	False	2022-04-12 04:20:13.736	[]
2888	CDC-2022-0024-2894	https://api.regulations.gov/v4/comments/CDC-2022-0024-2894	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opiates are safe and effective. I agree they should not be prescribed as first line treatment. When nothing else helps we should not have to suffer. As long as true drug addics have access to drugs. Law abiding citizens should have relief and not be criminalized. Repeal the 2016 guidelines and allow chronic pain patients to set the dose needed. We should not be treated like criminals because we require medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf0ed	Anonymous	None	2022-03-24T18:32:39Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-9cgi-hd1a	False	None	False	2022-04-12 04:20:13.950	[]
2889	CDC-2022-0024-2895	https://api.regulations.gov/v4/comments/CDC-2022-0024-2895	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings to whom it may concern, <br/>I am an undergraduate, legal study major with AMU. I am posting comments to today’s board because it is legislation that interests me as a legal studies student and an American. The opioid crisis that has swept our nation has affected me personally like it has so many other American families. I have several family members who have become addicted to opioids, watched families torn apart, and have had friends that have lost their lives to the disease caused by what I would refer to as the frivolous mishandling of opioids. I believe the goal of this docket and discussion is to find a way to control the crisis mentioned above. After reading the FRN: Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids and the CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016 I have a few questions for the members of the council. Upon conclusion of the readings, I get the impression that much of this policy, if not all, is a mere recommendation instead of law. It appears that one of the biggest contributors to the crisis is the lack of accountability for administering this life-altering drug. According to the National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse, “Opioid-related death rates also were higher among those who had recently been released from prison, those who obtained opioid prescriptions from multiple pharmacies, and those who obtained prescription opioids in combination with other scheduled medications” (July 13, 2017). From personal experience with friends, family, and the authorities as well as this reference it appears the leading cause of opioid addiction is the over-prescribed opioids that allow opioid addicts to get more than their share from doctors and pharmacies and for dealers to pay patients that are over prescribed to obtain prescriptions on their behalf. My questions are: What is the CDC doing to get a handle on this contributor to the opioid crisis? Why isn’t the accountability of opioid prescription being put into law instead of an ambiguous suggestion? <br/>My recommendation for this discussion is a unified technology system that accounts for patients’ information, drugs prescribed to include dosage and timelines, and the doctors who prescribed them. This system would be a government-mandated system that is used by all healthcare providers nationwide. Across the board, unregulated healthcare by way of a non-unified standard in the U.S. is much of the cause for inconsistent healthcare costs and treatment. Although I recognize the need to keep healthcare privatized in order to maintain the competitive edge in the market, I do not feel that a national information system would hinder this edge but only reduce the costs of care. Furthermore, and to the point, it will hold the physicians accountable who are prescribing these opioids without regard to the families they destroy in the process. If such a system were implemented doctors wouldn’t administer opioids as freely because we would have a system that documents it forever and holds the physician and the user accountable. This recommendation would stifle the issue at the source and aid in the recovery of addicts who have been legally prescribed an addiction by America’s healthcare network. Thank you for your time and consideration of my comments and recommendation.<br/>V/R, [name redacted]<br/>References <br/>Addiction Science and Clinical Practice (July 2002) The Neurobiology of Opioid Dependence: Implications for Treatment. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851054/<br/>CDC (2022) Checklist for prescribing opioids for chronic pain. Retrieved from https://stacks.cdc.gov/view/cdc/38025<br/>National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Pain Management and Regulatory Strategies to Address Prescription Opioid Abuse; Phillips JK, Ford MA, Bonnie RJ (July 13, 2017) Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK458661/#sec_000139<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jasen	None	None	0900006484fdcedb	Wrubel	None	2022-03-24T18:33:46Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Wrubel, Jasen	l14-9v3q-lhfx	False	None	False	2022-04-12 04:20:14.353	[]
2890	CDC-2022-0024-2896	https://api.regulations.gov/v4/comments/CDC-2022-0024-2896	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new CDC Guidelines should REMOVE ANY and ALL mention of Morphine Milligram Equivalent. it is NOT based on ANY SCIENTIFIC DATA. The idea of Morphine Milligram Equivalence is based on biased Opinion. <br/> These same Biased Opinions are pushing for Forced or Coerced Tapering of Long-Term Opioid Therapy Patients. There is NOTHING ethical about tapering a patient who is functioning with good Quality Of Life on long Term Opioid Therapy. <br/>These Opinions come from ANTI-OPIOID ZEALOTS with the intention of pushing their snake oil (buprenorphine the Only opioid to ever cause Hyperalgesia) on any and all Chronic Pain Sufferers. These zealots are also pushing a passive aggressive version of the Nazi SS T-4 EUGENICS EXPERIMENT. <br/>Doctors who are willing to COMPASSIONATELY TREAT CHRONIC PAIN PATIENTS are being Arrested by the DEA who have weaponized the CDC Guidelines as LAW. The Forced Tapers and Cold Turkey Cut Offs forced onto LTOT patients has caused preventable deaths and even Suicides. The Nazi SS arrested and even executed doctors who treated their disabled patients with compassion and respect. Here is a history lesson:<br/>https://allthatsinteresting.com/aktion-t4-program#:~:text=The%20ideological%20underpinnings%20of%20Aktion%20T4%20were%20apparent,the%20aim%20of%20improving%20it%20through%20state%20action.<br/>Something the CDC and DEA are currently Pushing to do now with these 2016 Litigation Based Weaponized Guidelines. [name redacted] & [name redacted] should be arrested for the brutalization against all chronic pain patients	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fd1dd9	Ard	None	2022-03-24T18:41:35Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Ard, Melinda	l0v-o5i4-qme1	False	None	False	2022-04-12 04:20:14.633	[]
2891	CDC-2022-0024-2897	https://api.regulations.gov/v4/comments/CDC-2022-0024-2897	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines shouldn't just be revised they should be scrapped/burned and re-written by doctors who are 100% more qualified than those who are currently behind these biased unethical guidelines that have RUINED the lives of Millions of Chronic Pain Patients and their families. The current "doctors" who wrote the guidelines have serious CONFLICT OF INTERESTS and Not One are involved in Compassionate Pain Management of patients with Chronic Cancer or Non-Cancer Pain.<br/><br/>PROP leaders have preached the ideology of banning all opiates except for their Demi-God Buprenorphine and the gospel of "Let them Die Off" eugenics-based theory of ending addiction by Killing off the disabled. As well as promoting experimentation with Buprenorphine on new born babies with the increased probability of becoming addicted to any substance. Calling it Opioid Use Disorder to coral and cull the heard of Chronic Pain Patients who were prescribed any and all kinds of opiate based medications. Encouraging the abuse of patients by doctors with financial kickbacks.<br/><br/>Medications like OxyContin that GASP Gave these people with Chronic Cancer and Non-Cancer Pain quality of life to be a functioning and Productive member of society. Shame on us for wanting to be able to work, raise our kids, volunteer, etc. <br/><br/>You're Guidelines are Killing us Off and you have people who Know that these Guidelines are killing us off. Some even bragging about it like the [name redacted] who even stated she knew her theology 'would hurt chronic pain patients' saying 'they are all just as addicted to heroin like her son' (poor man his family is dishonoring him by killing off pain patients for money in his name.) People she has NEVER LAID EYES ON or know personally. [name redacted] who says that those who have committed suicide after Forced Tapers don't exist. Then there are people like [name redacted] [name redacted] [name redacted] [name redacted] (4 horsemen) and so many more ALL Affiliated with PROP the for-Profit Hate Organization that's targeting the Disabled.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fd2c71	Anonymous	None	2022-03-24T18:42:21Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-17T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l0v-pjd0-r5rn	False	None	False	2022-04-12 04:20:14.845	[]
2892	CDC-2022-0024-2898	https://api.regulations.gov/v4/comments/CDC-2022-0024-2898	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	LONG TERM OPIOID THERAPY IS PROVEN TO BE BENEFICIAL IN TREATING CHRONIC NON-CANCER PAIN!<br/>The argument that it is not beneficial is backed only by a lucrative opioid litigation opinionated agenda put forth by Anti-opioid Zealous groups aka PROP and its greedy narcissistic sociopathic affiliates.<br/>There has been BIASED CLAIMS that opioids don't treat pain. Here is evidence to prove that claim WRONG.<br/>https://journals.lww.com/pain/Fulltext/2022/01000/Evaluating_the_stability_of_opioid_efficacy_over.6.aspx<br/>https://journals.lww.com/pain/Abstract/2022/04000/Efficacy_and_safety_of_strong_opioids_for_chronic.3.aspx	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fd5a06	Allder	None	2022-03-24T18:43:08Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Allder, Melinda	l0y-5qp2-uj4t	False	None	False	2022-04-12 04:20:15.091	[]
2893	CDC-2022-0024-2899	https://api.regulations.gov/v4/comments/CDC-2022-0024-2899	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC is finally realizing that the guidelines they issued for pain meds have hurt many people. Let Drs do their job! Ever since 2016 no Dr would prescribe a pain med to a chronic pain patient. All the drs are too scared of losing their license. CDC SAYS it was never RULES, just guidelines. I know the CDC knew Drs were turning away any pain patients. It took the CDC 7 years to start to fix the problems they helped start. Living with chronic pain is not living at all. You can't do the things you want to. You can't play with your kids, all you can do is lay in bed and cry. With no pain relief we can't do normal things When pain is so bad daily life just isn't fun. I know myself and I know 100's of other people that have all considered suicide because the pain gets so bad and the medicine that helped us can't be given anymore. I don't know anyone that wouldn't consider or commit suicide due to untreated chronic pain. Drs took it away from the patients that were prescribed meds and anyone that had chronic pain after the CDC scared the drs no one got help. I'm one of those people. I tried EVERYTHING I could to for my pain that the CDC recommended. The first time I had a pain pill it lowered my pain from a daily 8-9 to a 3, in my mind it felt like a godsend. Within 30 mins I could actually stand longer than I ever could, the pain was still there but it was bearable. Even though I knew the pain would be back within a few hours cuz I didn't have but maybe 5 pills for a month or so. Even my family noticed something different about me. They noticed something good, they said "wow I haven't seen you smile in 6 years." I was also able to help my father with some yard work and was able to other things I normally can't. My older friend gave me a couple because he saw how much pain I was in. Eventually he got his meds taken away after being on them for 40 plus years. Anyway after the CDC scared all the drs and he got all his meds cut off. After about 2 months he just couldn't live his life with all the pain he had. he knew without medicine he would live the rest of his life in pain and he didn't want that. So he decided to kill himself after his doctor for over 30 years wouldn't help him and neither would any other Dr. He was ran over by a truck when he was in his 30's plus he had a bunch of other painful conditions. He never once was off on a pill count. He never failed a drug test. He never asked for higher dose. He did EXACTLY what he was supposed to under a pain management contract. With all his pain I don't blame him for taking his own life. It was sad and I miss him but I can't say I haven't thought about it. We all know that many of the suicides in the past 6 or so years were from patients that couldn't live with their pain. Also I guarantee that a good amount of the opioid overdoses weren't accidental. These people had lost a medication that helped them for years. When they couldn't get help they took the easiest way out by taking a high dose of illicit fentanyl. Think about it your in so much pain daily and you can't live your life anymore so why not go out the way everyone wants to by falling asleep. Going to Drs for help isn't drug seeking. DR'S TOOK AN OATH TO HELP PEOPLE. Some patients have no choice but to go to the streets it's the only place they could get something to help with pain. I turned to heroin/fentanyl using occasionally. I just got tired of lying in bed crying daily from the pain. Unfortunately everything is FENTANYL now. It was never like this until the CDC turned pain patients into law breakers. I agree there needs to be a system in place for Drs and pain patients they have the script monitoring system so no Dr shopping. The pill mills were a HUGE part of the problem. PLEASE LET DRS HELP PEOPLE WITH CHRONIC PAIN WE JUST WANT TO LIVE OUR LIVES AND ENJOY THE TIME WE HAVE. THATS HARD TO DO WHEN YOU CAN'T GET OUT OF BED.I honestly believe the CDC helped fuel the fentanyl epidemic. I don't ever remember streets flooded with fentanyl before 2016. Drs shouldn't be punished for helping a patient. If a Dr is stupid enough to open a pain clinic and give anyone a script, then ya shut them down and arrest that bad Dr. Why punish the other Drs and us just for having pain? Look how Germany, Canada, and other countries handled the opioid problem. Of course the USA would never do what they do because then the prisons would lose money over arresting people with pain/mental issues. We lock up people instead of helping them. More people are in jail for victimless crimes than other crimes.Yet USA loves and promotes alcohol all the time. Alcohol causes OVER 95,000 death's EACH year. The highest number of opioid deaths as of 2022 is a little over 68,000 deaths. ALCOHOL IS THE MOST DANGEROUS DRUG IN THE WORLD. FACTS! more than 50,000 people die from alcohol per year. Also if someone uses pain meds there not gonna hurt anyone else physically. Alcohol kills WAY more people yet you take away something that HELPS PEOPLE?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joshua	None	None	0900006484fd5c23	Tamborini	None	2022-03-24T18:44:42Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Tamborini , Joshua	l0z-08fg-efkb	False	None	False	2022-04-12 04:20:15.304	[]
2894	CDC-2022-0024-2900	https://api.regulations.gov/v4/comments/CDC-2022-0024-2900	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This war on effective pain medication hits at home. It has completely disrupted our lives, done incredible damage to my marriage, and has affected the mental health of my child. Thanks to the misguided and misinformed guidance of the CDC (much like your idiotic suggestions in people no longer needing to mask) and actions from the DEA, doctors dramatically reduced opioid pain medication prescriptions with no true alternatives to fill the gap. My wife, a woman dealing with a congenital brain condition and multiple spinal conditions has had the last four years of her life wrenched from her control as every possible attempt at receiving pain relief has ended in failure. She has been forced to undergo unnecessary physical therapy, steroidal injections, NSAIDS, anticonvulsants, SNRIs, capsaicin and lidocaine patches, and even a failed lumbar discectomy in an attempt at choosing "conservative treatments" over what is known to be effective, opioids. She was forced onto methadone when she kept experiencing withdrawals from inadequate, short-acting regimen she was on, after being denied long-acting, safe modalities. Now that she's on methadone, pain doctors won't touch her and she is told point-blank that "she must have been on hard stuff to be on methadone". And methadone clinics won't comply with SAMHSA policy that patients receiving MAT CAN be allowed pain medication, if found medically necessary. <br/><br/>Every avenue, a dead end. Every potential visit, a disappointment. Every physician, a condescending God-complex. Another dance. If she appears to pretty or looks too clean, then she surely can't be in that much pain. If she appears disheveled, then she must be drug-seeking. No, she is intervention-seeking! This prostitution of medicine, whereby the patient has to sell themselves for help, disgusts me. And this is the environment and institution your agency strives to protect!<br/><br/>How long must she be made to suffer until she potentially finds respite or decides to end her life because death offers some end to her living nightmare? With suicidal ideation growing daily, THIS is how the CDC and DEA have chosen to engage in their war on opioids, with friendly-fire for those caught in the middle, suffering. I'm not sure if my wife will have the strength to carry on. I pray to God she does, but no one in the world should be treated as in-humanely as she has. My child should not have to hear her mother screaming and moaning in pain. My time should be spent with my family, not researching some other doctor or policy or amelioration for her pain. <br/><br/>You have only paved the way for people to go to the street. Your mindless, one-size-fits-all policies have harmed my family. And I hate you for it. I will never get back these last four years. I will never undo the PTSD this has given me. I wish we were lucky enough to live in British Columbia where the Canadian and provincial government understands that limiting access and stigmatizing the need for medication is not the answer. The war on drugs is one of diminishing returns. You created this mess, but you do not have the backbone to do the right thing and undo your mistake. Our suicide rate will continue to grow, but not because of accidental overdose. No. People will kill themselves to rid them of the pain they experience. Pharmacies are stocked to the brim with medications that can help these people, and even though they may be miles away from the people that need it, they are worlds' away with regard to access.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeremiah	None	None	0900006484fd6029	Rastegar	None	2022-03-24T18:46:20Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-20T04:00:00Z	None	None	None	None	None	None	None	Comment from Rastegar, Jeremiah	l0z-ewqt-u7me	False	None	False	2022-04-12 04:20:15.519	[]
2895	CDC-2022-0024-2901	https://api.regulations.gov/v4/comments/CDC-2022-0024-2901	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments outline (see attached with references) <br/>definition of “prescription” opioids<br/>methadone, when used for pain is classified as a “short acting opioid” by FDA<br/>QTc prolongation including FDA warnings on transdermal buprenorphine <br/>co-prescribed benzodiazepines with co-prescribed opioids vs those for nonmedical use<br/>RIOSORD scale, a validated tool to predict prescribed opioid induced respiratory depression<br/>PDMP data is presumed accurate<br/>EMR warnings of prior overdose may have other explanations<br/>“opioid sparing” procedures have limited coverage <br/>FDA black box warnings for nonopioid pharmaceuticals are not addressed<br/>"Considering only duration of active treatment in efficacy or effectiveness trials, published evidence is no stronger for any major drug category or behavioral therapy than for opioids."	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Howard	None	None	0900006484fdd166	Hoffberg	None	2022-03-24T18:53:53Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Hoffberg, Howard	l14-2fat-si4t	False	None	False	2022-04-12 04:20:15.748	[]
2896	CDC-2022-0024-2902	https://api.regulations.gov/v4/comments/CDC-2022-0024-2902	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has had RLS for over 35 years. It has reached the stage that none of the drugs help .He is up most nights driving me the wife crazy He paces and kicks fidgeting all over the place. He says he can not keep living this way. It's not living is more like torture. I am afraid he may follow up on his talk of killing himself just to make it stop. There has to be a way to fix this for all the people with severe RLS. Itt impacts all family members, I like to sleep too..................	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marge	None	None	0900006484fde150	Craig	None	2022-03-24T19:18:11Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Craig, Marge	l14-kelu-hx8b	False	None	False	2022-04-12 04:20:15.974	[]
2897	CDC-2022-0024-2903	https://api.regulations.gov/v4/comments/CDC-2022-0024-2903	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC has failed chronic pain patients by releasing the pain recommendations from 2016. The DEA, as well as those recommendations, have been weaponized against both pain patients and Doctors. It has created an environment where many Doctors refuse to even write pain medications to people who need them because of <br/>fear. The D.E.A loves masty letters in the mail or embarrassing investigations. If a Doctor writes too many prescriptions one month he gets flagged by a computer program. Pain Specialists mostly do injections now or have tricked themselves into thinking an ablation of nerves is a safer procedure then a patient on mild pain medication. The current fentanyl crisis has it's roots in the war on pills as well. Legitimate pain patients are forced to buy street drugs laced with a drug that is many times stronger then the safe and controlled pills their pain clinic would prescribe before their Doctor was bullied into ablating nerves rather then actually treating pain. The current pain patient war is a tragedy and future Doctors are going to be embarrassed by this period. I'm writing this because I have a an incurable autoimmune disease as well as polyneuropathy and small fiber neuroapthy. I am in so much pain that without narcotic pain medications I can barely keep myself out of the er. I have neurological symptoms that become life threatening when I'm in too much pain. I have dysautonomia and my damaged CNS doesn't care if it would just be easier politically if I didn't need pain medications. People with some pain conditions like mine feel the same pain as people with cancer. Small Fiber Neuroapthy is one of the most painful conditions on earth and I'm sick of paying the price for ignorance. I know the CDC didn't intend for this to be weaponized against us legitimate pain patients but that's what has happened. I have pain recommendations from two of most respected specialists in both Neurology and Rhuematolgy in the United States yet I live in constant fear my Doctor will close his office. I'll have a few days notice to find another Doctor willing to treat me. I live in a major city yet most of the pain clinics have switched to procedures that don't treat small fiber pain. Many pain specialists have decided it's easier to just do expensive procedures then to stand up for pain patients rights or their own. I ask the CDC to release new guidelines and to ask the D.E.A to stop terrorizing pain patients and Doctors. Every time the D.E.A punishes a Doctor they punish over 300 of their patients. These patients have to scramble to find another Doctor who has the gumption to treat their pain. The current environment has made it impossible to find a brave enough Doctor to stand up to this Tyranny. <br/>I write this nameless not from my own fears but because I fear my Doctors and family will be investigated unethically or intimidated because the truth is not always popular with government agencies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde19e	Anonymous	None	2022-03-24T19:23:34Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-mbyk-61gr	False	None	False	2022-04-12 04:20:16.210	[]
2898	CDC-2022-0024-2904	https://api.regulations.gov/v4/comments/CDC-2022-0024-2904	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I have chronic groin pain from work injury and have had 2 surgeries. I also have knee and back pain from service connected injury and was honorably discharged. I can’t find a pain clinic that will treat me and my family dr won’t treat pain. <br/>I work but I don’t think much longer due to uncontrolled pain. The 2016 guidelines harmed me as well as my wife. She is disabled and uses a wheelchair or crutches to walk. She lost her pain care when the pcp dropped her. She was harmed greatly. <br/>The new guidelines do take into consideration of individual treatment plans however, forcing the steps of treatment plans for some pain patients could cause harm before doctors will prescribe. <br/>Please remove all mention of mme’s. The 50mme’s will be applied to all across the board because it’s not clear and may follow the same harm path the 2016 guidelines caused. Doctors and pharmacies will misapply these 50mme’s. They are afraid of being arrested for prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fdf168	Stifle	None	2022-03-24T19:23:40Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Stifle, James	l15-a2iz-2cub	False	None	False	2022-04-12 04:20:16.439	[]
2899	CDC-2022-0024-2905	https://api.regulations.gov/v4/comments/CDC-2022-0024-2905	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)It is a terrible thing to see and have no vision as [Name Redacted] indicated. For over two centuries, modern medicine has not only lacked a vision for people in pain, but lacked any Aristotelian virtues or Kantian virtues and has had identity prejudice and dislike of persons in pain due to their own moral and mental laziness and deficits toward the pathophysiology of pain. Though [Name Redacted] claimed this was due to the medical gaze, he failed to recognize the issue as mental deficit. As [Name Redacted] indicated, from 1800- 1950 there was little conceptual progress in medicine on pain care. And, of course [Name Redacted] overstated the benefit of pain management and continued an unreasoned and unjustified and unevidenced defeatism and fatalism toward chronic pain. The CDC and DHHS has continued a defeatist and visionless lazy orientation toward pain as not a single staff in DHHS or medical professional called for curing pain in the National Pain Strategy- I sallied forth to end the defeatism and fatalism in pain care. I also called for lowering the prevalence of chronic pain but as medicine is a business they wish to continue to exploit persons in pain as cash cows. Instead of moral magnificience we have parlously pertinacious mcdonaldized robopathic Leviathanizing Machiavellian moral midgetry in medical pain care. Conservation of Resources (COR) Theory is adequate to explain much of the motivation in medical pain care.<br/>Less than ten years ago, B.G.- former Assistant Secretary of Health attended a meeting at DHHS we he declared that pain is real. This speaks volumes as to the woeful lack of progress in medicine in pain care to have to declare pain is real. But, of course, just as the CDC repeatedly has stated that there should be individualized patient centered pain care- the moral and mental midgetry continue in medicine toward people in pain. But I am not deceived by the CDC’s rhetoric. For to call for patient centered care and not make a single mention of [Names Redacted],- to name a few ethicists promoting authentic agency- unobscures the intent of the CDC. But to call for avoiding use of opioids for acute and chronic pain whilst simultaneously calling for patient centric care is like telling marathon runners they are free to run marathons as long as they don’t wear nike, Adidas, new balance, Hoka,etc – and use flippies or crocs first and if they sprain their ankles then after much cogitation and hesitation just maybe they can wear some Nikes or Adidas- but only for the shortest time.<br/>[Name Redacted] wrote that the public should feel they are loved by public agencies- undoubtedly people in pain have let the CDC know they are not feeling the love. But the CDC’s administrations aren’t consistent with any theory or public administration- including [Names Redacted] nor any management theory of [Names Redacted]- and it is clear to me they don’t care to know any of the wisdom of the aforementioned nor to make use of it for the public good. THE CDC lacks the intellectual and moral virtues, Kantian, and Aristotelian and Christian virtues, care ethics, and knowledge to serve society well with regard to pain care. It is no wonder dozens of smos have arisen in the past 5 years to advocate for better pain car. One doesn’t have to be [Name Redacted] to know it is in part due to the poor serviceability of the CDC and DHHS in pain care.<br/>The CDC guidelines are motivation by COR as their epistemic communities have profited greatly from court testimony, greedy grant farming on opioids and pain management. Countless boasting and bragging at self congratulatory rubberchickendinner events riddled with hubris and narcissistic self infatuation. But where is the vision, the humanitas, the caritas, the veritas, the humilitas in the CDC guidelines. In a thousand pound of CDC and DHHS documents on opioids there isn’t a pictogram of trust or respect for the agency of persons in pain-and without this trust there can be no care ethics. Instead of humilitas, the CDC gives us hubris, instead of caritas we get callousness, instead veritas we have vice epistemology. The CDC makes no mention of any theory of health justice related to their guidelines, nor any ethic of rights, nor any clearly defined auditable endgoals. Since the NPS had endgoals- so to should the CDC guidelines- failing that we can call it a form of never ending exploitation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fd83d8	Becker	None	2022-03-24T19:23:42Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-22T04:00:00Z	None	None	None	None	None	None	None	Comment from Becker, David	l12-4z6k-br5z	False	None	False	2022-04-12 04:20:16.680	[]
2900	CDC-2022-0024-2906	https://api.regulations.gov/v4/comments/CDC-2022-0024-2906	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Health care professional in a pain clinic here. One of the greatest benefits of the CDC guidelines is that providers have become much more thoughtful about starting chronic opioids on patients. I applaud all efforts to learn and grow and pivot.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf1d7	Anonymous	None	2022-03-24T19:24:16Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-aqsd-yr7n	False	None	False	2022-04-12 04:20:16.909	[]
2901	CDC-2022-0024-2907	https://api.regulations.gov/v4/comments/CDC-2022-0024-2907	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC, please get back to infectious diseases. Opium has been used for thousands of years without any "major issues". Blaming doctors for the "Opioid Crisis" is old news. We know, especially now, that the problem is poly-substance abuse; particularly including the man-made fentanyl that has swamped the country.<br/><br/>Please acknowledge the facts & real science. Drs [name redacted], [name redacted] and [name redacted] are a few who have submitted such evidence and I support their comments.<br/><br/>It's time to let this go. It's not your business in the first place. Let doctors decide what's appropriate for their patients. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashley	None	None	0900006484fdf28b	Rodgers	None	2022-03-24T19:28:24Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers , Ashley	l15-br9u-mi3v	False	None	False	2022-04-12 04:20:17.171	[]
2902	CDC-2022-0024-2908	https://api.regulations.gov/v4/comments/CDC-2022-0024-2908	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescription narcotics work for long term use! I was on it over 10 years & was able to work, raise my family, enjoy life. When the 216 CDC guidelines came out &!the DEA went after Dr's my Dr a pain specialist quit prescribing. Without medication I had to go on disability. It took me a year to find a new Dr & my meds were not at the same level. The Dr was 2 hours away, I have to drug test monthly, never failed and the cost is through the roof. My Prescription barely makes me able to do the simplest tasks. I still can't work, it destroyed my marriage, my quality of living. I'm treated like an addict been labeled as "substance use disorder" there is no disorder. I have a disease that causes immense pain there is no surgery no cure. I constantly think about a "plan B exit plan" as the pain is intolerable. Pain patients are not addicts. We want our medication to live in life. Addicts want to escape life. The government has failed us and have given true legitimate pain patients two choices. Buying drugs on the street or suicide. I have lost many friends in the pain groups I have joined because of untreated pain. Even a simple traffic stop the police check to see if your on a controlled substance & hassle you. Jon's don't want to hire people on controlled substances. We need this medication to function. We have tried everything from acupuncture, chiropractic, heat, ice, yoga, meditation, massage, distraction you name it. Pain medication is a much needed tool for us. These guidelines need to be revoked. We need our lives back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fdd0bd	Lerner	None	2022-03-24T19:30:25Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Lerner, Melissa	l14-faia-gym5	False	None	False	2022-04-12 04:20:17.419	[]
2903	CDC-2022-0024-2909	https://api.regulations.gov/v4/comments/CDC-2022-0024-2909	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Another month another fight to find my pain medication. I talked to the pharmacist at Sam's club and he said they would stock it for me, then they didn't have it and I would be 3 days into withdrawal before it comes in. Transferred to CVS who stocked a maker that was not Rhodes, who makes pills that just barely keep me out of withdrawal. I had those once for a long miserable month. This month Sam's again let me down after covering me last month and all CVS has is Rhodes. So now I wait to see if CVS can get something else by Wednesday when I run totally out or I get stuck with Rhodes. I hate being in pain and I have been taking this dose of this drug for over 9 years. I am getting tired of the runaround and wish Rhodes would either put medication in their pills or raise their prices so it stops being the preferred maker for the pharmacies. Others make better pills. Even Mallencrap who makes worthless hydrocodones makes decent morphine tabs. I have to get both at the same pharmacy to keep my doctor happy and she is not happy with this monthly runaround either.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde6bd	Anonymous	None	2022-03-24T23:38:09Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-ylqm-jcp5	False	None	False	2022-04-12 04:20:17.657	[]
2904	CDC-2022-0024-2910	https://api.regulations.gov/v4/comments/CDC-2022-0024-2910	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2016 the CDC released guidelines for prescribing opioids. The CDC hurt 50 million established, chronic, legacy and grandfathered chronic pain patients. Using false information, propaganda, and down right lies about who the guidelines were for and what they were for.<br/><br/>Because most of prescriptions are written by Family Care Physicians the CDC wrote the guidelines to help new family care physicians know what, when, how, and who to write the prescription for. If the CDC had changed or added a few words what happened to 50 million established patients would of been avoided. The word I am talking about is NEW.<br/><br/>The CDC guidelines are written for NEW family care physicians prescribing to NEW chronic pain patients. First the title <br/>CDC Guideline for Prescribing Opioids for Chronic Pain.<br/>Correction <br/>CDC Guideline for Prescribing Opioids for NEW Chronic Pain patients.<br/><br/>50MME 90MME<br/>As soon as the 2016 guidelines were released doctors started cutting established patients off their opioids or did a rapid taper to 90MME. This destroyed and killed millions of established pain patients. In the guidelines the only time 90 or 50MME is used the guidelines is when starting or increasing opioids for chronic pain patient. If the CDC used increasing opioids for NEW patients everything would of been different for these. Where did doctors get the idea to cut established patients off their opioids?<br/><br/>The CDC knew all this in 2015 and were told through the medical and public comments. The CDC released the guidelines as is anyway.<br/><br/>The CDC must make these changes in the 2022 guidelines. If not there is no reason to do the update.<br/><br/>Under pressure, CDC delays release of opioid prescribing guidelines<br/><br/>https://www.statnews.com/pharmalot/2015/12/15/cdc-opioid-painkiller/<br/><br/>The CDC should have made all of this public immediately and avoided the horrors they caused and continue to do. Unless the CDC remove everything to do with MME nothing will change. Doctors are already cutting patients to 50MME. Where do they get this from	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf316	Anonymous	None	2022-03-24T23:42:36Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-co99-rh8d	False	None	False	2022-04-12 04:20:17.886	[]
2905	CDC-2022-0024-2911	https://api.regulations.gov/v4/comments/CDC-2022-0024-2911	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Counting Overdose Numbers<br/>When the CDC started releasing the number of overdoses for a year a provisional count that was extremely high compared to the correction is released a year later. In 2016 the corrected number of overdoses was released 4-2018. The corrected number is 62,367, out of that number 42,294 included ANY opioid. Out of that number 17,087 had anything to do prescribing opioids. The CDC does this every year and no one hears about the correction. I could go over every year but the CDC knows what they did.<br/>Link to prove how the CDC does this.<br/><br/>https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2017.304265?journalCode=ajph	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf361	Anonymous	None	2022-03-25T00:23:07Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-cujz-qrqx	False	None	False	2022-04-12 04:20:18.133	[]
2906	CDC-2022-0024-2912	https://api.regulations.gov/v4/comments/CDC-2022-0024-2912	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am a wife, a mom, a sister, a daughter, a friend and a chronic illness warrior. I have had a chronic GI illness for over 20 years and stenosis of the spine for the last decade. I have had 4 surgeries to try and alleviate pain with BOTH of those issues. One surgery was 14 hours long and removed FOUR ORGANS and a portion of my intestines. Another was a spinal fusion to try and alleviate nerve pain. I am in pain, every day, all day. I have been on narcotic pain medication for twenty years. I have most definitely built up a tolerance to these medications over two decades. My doctor's hands have been tied for years because of restrictions put on him by a government entity that has ZERO business getting in between a patient and their prescriber. The problem is illicit fentanyl NOT chronic pain patients. Please stop punishing pain patients for the actions of those DEALING DRUGS IN THE STREETS!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484fdf373	Anderson	None	2022-03-25T00:25:43Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anderson, Jeanne	l15-d0ev-tgk6	False	None	False	2022-04-12 04:20:18.355	[]
2907	CDC-2022-0024-2913	https://api.regulations.gov/v4/comments/CDC-2022-0024-2913	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why in 2016 was this ignored and patients had their pain medication cut off. When you knew this why didn’t the CDC do something to fix if? <br/>The 2022 draft does not make this public so what do you expect? Patients are getting cut down to 50MME because they don’t read the guidelines or the draft.<br/>Can you get our meds back to fix this? If not there is no reason why an update needs to be done <br/>You tried to correct it in 2019 and it did not do anything because there are no more patients to cut off except the ones being cut to the 50MM. <br/>There is no ethereal in the draft that tells doctors to do this but they say the same reason and patients do not have a choice. I hate the CDC for pushing so many pain patients to the street and they died or suicide because of their pain.<br/>GD fix this by insisting doctors increase patients back on their previous dose. Slowly becaus you don’t want them to overdose.<br/><br/>Recommendation 5 paragraph 4 of guideline.i<br/>"Established patients already taking high dosages of opioids, as well as patients transferring from other clinicians, might consider the possibility of opioid dosage reduction to be anxiety-provoking, and tapering opioids can be especially challenging after years on high dosages because of physical and psychological dependence. However, these patients should be offered the opportunity to re-evaluate ltheir continued use of opioids at high dosages in light of recent evidence regarding the association of opioid dosage and overdose risk. Clinicians should explain in a nonjudgmental manner to patients already taking high opioid dosages (≥90 MME/day) that there is now an established body of scientific evidence showing that overdose risk is increased at higher opioid dosages. Clinicians should empathically review benefits and risks of continued high-dosage opioid therapy and should offer to work with the patient to taper opioids to safer dosages. For patients who agree to taper opioids to lower dosages, clinicians should collaborate with the patient on a tapering plan (see Recommendation 7). Experts noted that patients tapering opioids after taking them for years might require very slow opioid tapers as well as pauses in the taper to allow gradual accommodation to lower opioid dosages. Clinicians should remain alert to signs of anxiety, depression, and opioid use disorder (see Recommendations 8 and 12) that might be unmasked by an opioid taper and arrange for management of these co-morbidities. For patients agreeing to taper to lower opioid dosages as well as for those remaining on high opioid dosages, clinicians should establish goals with the patient for continued opioid therapy (see Recommendation 2), maximize pain treatment with nonpharmacologic and nonopioid pharmacologic treatments as appropriate (see Recommendation 1), and consider consulting a pain specialist as needed to assist with pain management"	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf39a	Anonymous	None	2022-03-25T00:28:56Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-db8f-ltsj	False	None	False	2022-04-12 04:20:18.588	[]
2908	CDC-2022-0024-2914	https://api.regulations.gov/v4/comments/CDC-2022-0024-2914	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is telling that other comments have had factual information that was not identifying of the author redacted, presumably because it revealed hidden conflicts of interest in authors of the revised and original guidelines & held certain people within agencies accountable for widespread harm to patients. It is considerably difficult to convince TED and YouTube that a video posted on their sites represents hate speech and should be removed. When I requested they remove videos by some key individuals closely involved in the guidelines, they immediately did so, because these individuals, trusted to care for the public, and licensed, openly spout misinformation that is stigmatizing towards disabled patients in pain, calling them, among other things, drug seekers. They see every person in pain as a lying manipulator. Guilty before proven innocent. When this is the mindset of those teaching medical staff, setting guidelines, and becoming wealthy from advising fictional entertainment shows & “expert” testimony, no one will receive appropriate care. Algorithms were conceived in this setting also; they need to go. Guidelines need to go. Addiction and overdose are terrible. Pain patients aren’t responsible, nor are those who care for them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anon	None	None	0900006484fdf3cd	MD	None	2022-03-25T00:30:24Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from MD, Anon	l15-djsx-tmuv	False	None	False	2022-04-12 04:20:18.814	[]
2909	CDC-2022-0024-2915	https://api.regulations.gov/v4/comments/CDC-2022-0024-2915	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The only ethically acceptable course of action for the US CDC is to outright repudiate both the 2016 and 2022 disasters, and to withdraw them without replacement. CDC must be barred by legislation from publishing any practice guideline on pain medicine. And the US DEA must be told to stand down from its unjustified persecution of doctors who have done nothing wrong.<br/>Many of us have been helped by an opioid medicinal regimen. Taking that away or asking for us to jump through more hoops at this time in our lives is just cruel. Your guidelines are based on junk science. Think if all the people these medicines help to have a normal life. Without them I am bedridden. It is not fair to place my value of life in jeopardy. Look at the other countries, especially in the Mediterranean areas, amd parts of Europe that have made all these medicines readily available and not illegal to prescribe or difficult to obtain. Proof in those countries show that we are so far behind as there are not more opioid deaths like you say and there are fewer addicts as well because the medicine is readily prescribed to those who need it and the di tots are telling the patients the amounts to take and when. They are not having to obtain it off the streets, we’re there not given Instructions on how to take it or possible side effects, the doctors have to tell their patients and the pharmacies have to give paperwork on medications so the people know how to take it and they know their risks. Think about your families and what you would want for their future were they to become in a situation where pain was an every day obstacle in their lives. Would you rather there be a medication they could take and live a normal life or would you rather them just suffer and become bedridden and not be able Normal every day things that they used to do. Their health and their mental health fails when this happens and this is due to these guidelines. Please take what I say into respect and look deep inside yourself before you make any more mistakes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kari	None	None	0900006484fdf401	Vaughn	None	2022-03-25T00:33:17Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Vaughn , Kari	l15-duw2-vh2r	False	None	False	2022-04-12 04:20:19.123	[]
2910	CDC-2022-0024-2916	https://api.regulations.gov/v4/comments/CDC-2022-0024-2916	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I work in the hospital taking care of people with acute and chronic pain, and also people with addiction. I also have several serious chronic pain conditions.<br/><br/>It's important to manage pain safely, while providing evidence based treatment. <br/><br/>It's also important to "do no harm", so healthcare practitioners SHOULD have guidelines to follow, and since pain and addiction aren't well taught during their education this is necessary. <br/><br/>Chronic opioid treatment should be a rare exception rather than normalizing prescribing regular monthly scripts. With chronic opioid therapy, this requires close monitoring for adherence and benefit of treatment. How are we helping people who stay at home and take opioids every 4 hours while complaining of pain and inability to work or conduct their daily activities? We're not.<br/><br/>Why can any practitioner with a DEA license easily prescribe opioids, benzodiazepines, and stimulants yet prescribing medications to treat opioid use disorder require obtaining a waiver and restricts the number of patients one can prescribe to? <br/><br/>That makes no sense. <br/><br/>Working in the hospital with pain and addiction patients, I see first hand the devastation that years of opioid prescribing has done to people. Not only dependence, addiction, loss of life and livelihood, but worse pain from opioid induced hyperalgesia. <br/><br/>Managing acute pain for people on chronic opioid therapy is close to impossible. <br/><br/>We are in the midst of the worst overdose crisis in history, mainly attributed to opioids (prescribed and illicit). <br/><br/>Do not permit healthcare practitioners to be "legal drug dealers". <br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	theresa	None	None	0900006484fdf9f0	bee	None	2022-03-25T00:38:44Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from bee, theresa	l15-ha0r-ij4o	False	None	False	2022-04-12 04:20:19.397	[]
2911	CDC-2022-0024-2917	https://api.regulations.gov/v4/comments/CDC-2022-0024-2917	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a quadriplegic (Spinal Cord Injury), 30 years. As the years pass my condition has more obstacles. I know have scoliosis, osteoporosis and a compression fracture. I desperately need pain medication to get through the simplest tasks. Changing what can be prescribed to anything lower would be like a death sentence. The people making these guidelines obviously have never felt a constant pain like the ones that really need it. Yes, there are abusers to pain medication, however us that don't and who do not get a high off them shouldn't be penalized. Please consider something may happen to you and you need the medication, and you can't get it. This is advocating for you also. We just want to live a good life with less pain. I don't think that's asking too much.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marsha	None	None	0900006484fdf67b	Reed	None	2022-03-25T00:40:02Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Reed, Marsha	l15-i0tw-3w23	False	None	False	2022-04-12 04:20:19.635	[]
2912	CDC-2022-0024-2918	https://api.regulations.gov/v4/comments/CDC-2022-0024-2918	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 73 years old and have been a chronic pain patient since 1995 In the past years DUKE PAIN CLINIC has systematically lowered patient's dosage of their meds without regarding how it impacts our lives. These people that sit on committees and arbitrarily send out numbers have no business doing so they do not know the patients. Just who gave them the power to put out these ridiculous so called guidelines. The latest news about overdoses come from the street and illegal fentanyl not prescription drugs. Pain patients are treated like crap and that bunch doesn't give a damn about patients all they are concerned about is some company's reputation. The group on that committee have no idea what's going on on my level. I can only hope that every committee member has a situation where they need pain meds and can't get them and suffer.<br/><br/> WHATEVER HAPPENED TO "DO NO HARM"?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	WALTER	None	None	0900006484fdf71d	RAULERSON	None	2022-03-25T00:41:37Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from RAULERSON, WALTER	l15-jfbm-mojw	False	None	False	2022-04-12 04:20:19.871	[]
2913	CDC-2022-0024-2919	https://api.regulations.gov/v4/comments/CDC-2022-0024-2919	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Do you have any idea what it’s like not to be able to stand up that’s where it starts you can’t get the mail and take out your garbage can’t clean your house because when you stand up the pain if that’s what they wanna call it because it’s far beyond pain pain is something that most people can’t relate to but one a lot of people fail the same thing undescribable I didn’t know that until recently my legs quit working I had A surgery done and it wasn’t long after that my leg started feeling like there’s a Vice I will stand up faster more than maybe three minutes I would fall I’ve got nowhere now I can stand up for a few minutes until the pain if that’s what you wanna call it gets so unbearable that I have to get to a place to sit down or lay down or if not I won’t be able to make it I was given muscle relaxers to help a steroid but they have not touched it I’ve been the doctors and doctors and therapist this morning when I woke up my legs are so sore I could barely move they hurt so and yet there’s nowhere I can get relief because everything is controlled is watched a People you have no idea what this pain is that’s what you wanna call it. I hope they take into consideration not the negative parts of white pain relievers do I hope they take in consideration the quality of life people live when they have to deal with the pain if that’s what you wanna call it because it was a way to describe what people are going through and they are doing certain things. We don’t know what happened to our bodies if we could stop the pain this is what you wanna call it we would in a heartbeat no questions asked we don’t wanna live like this we’re not give her a choice nobody ask us if we wanted this for ourselves it was delt to us. It’s not only physical and social mental because it’s something we live with not just for a couple hours a day couple days a week no Is 20 477 days a week 24 hours a day every day no breaks or like if we could sleep to the night can you imagine that I never thought I could but now I have to I have no choice. They say you have to do other things before you get some Kem medication to stop the pain I don’t think people understand how can you do therapy and try to work your way through getting better when every time you move you have sharp pains if that’s what you wanna call it just about killed you and I just for a second it’s constant try to imagine . There’s no way to explain it there’s no words are used to write and I thought I could put anything down in words but this there is none and that always being able to write what I felt and not being able to say the words I want to say as far as how it feels that is the first.. so I hope you take it into consideration the quality of life and mental health The amount of work we do put in I’m trying to make ourselves better and help us by giving us something so we can help ourselves so we can get rid of that pain if that’s what you wanna call it cause you’re is no other words for it there is none.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006484fdf759	G MmcKay	None	2022-03-25T00:46:33Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from G MmcKay, Robin	l15-k2yd-clgk	False	None	False	2022-04-12 04:20:20.097	[]
2914	CDC-2022-0024-2920	https://api.regulations.gov/v4/comments/CDC-2022-0024-2920	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a friend who has EDS and is in constant pain. Due to a higher tolerance to pain medication, it is necessary for her to take what would be considered narcotic medicine to help her keep her pain under control so that she can be productive. She is not taking meds to get high. The doctors are the ones who should be allowed to limit what pain medications people take, not the government	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf777	Anonymous	None	2022-03-25T00:47:05Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-kiyi-5prz	False	None	False	2022-04-12 04:20:20.333	[]
2915	CDC-2022-0024-2921	https://api.regulations.gov/v4/comments/CDC-2022-0024-2921	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my name is [name redacted]. My late husband [name redacted] passed away on September 12, 2017 due to suicide that brought on by his pain physicians negligence when a nurse practitioner that treated my him cut his rx pain medication dose by more than half in a single visit. I sued my late husband’s pain clinic for malpractice and won. It’s important I share my late husband’s story so the CDC can sympathize and understand what the chronic pain patient community is up against. <br/><br/>The proposed updated CDC Guideline for Prescribing Opioids for Chronic Pain is a long awaited correction to the 2016 CDC Chronic Pain Opioid Guidance that caused widespread suffering and harm to chronic pain patients at the hands of a flawed system that treated chronic pain patients like drug addicted addicts instead of vulnerable patients in significant physical pain. <br/><br/>The misinformation written into the 2016 CDC Chronic Pain Opioid Guidance influenced many physicians, lawmakers, and insurance companies. This caused many chronic pain patients significant harm, and left them at the mercy of their chronic pain physicians. <br/><br/>After reviewing the proposed updates I worry that many chronic pain patients voices will not be heard by their physicians, and they will continue to suffer due to the CDC dosage recommendations and the suggestion that opioid pain medication should be a last resort. <br/><br/>Changes have to be made at a federal level before insurance companies and pharmacies will update their guidelines and practices. I feel it’s time that the FDA steps in and makes the necessary changes considering opioid drug overdoses are at an all time high when opioid pain medication prescribing has been at an all time low for some time. The federal government now has proof that the opioid crisis is not a result of the over prescribing of opioid pain medication, but is mostly due to illegal drug abuse and/or fake fentanyl being sold to addicts and used to lace other street drugs. <br/><br/>Last but not least, my late husband [name redacted] and many cpp’s have, and continue to be taken advantage of by neglectful and cruel chronic pain practices by pain physicians who do not have their best interest at heart, but instead continue to be driven by building their patient count in their practices for revenue. This conflict of interest and lack of regulation has caused many patients to receive lower standards of quality care, and left vulnerable to medical mistakes as in the case of my late husband. <br/><br/>Chronic pain physicians should also be required to see their patients in a realistic timely manner, and on a routine basis instead of contractually obligating patients to see physician assistants and nurse practitioners more often than not.<br/><br/>My late husband and I advocated fiercely for him to receive timely quality and compassionate care, but his pain physicians lack of respect, empathy, and neglect cost [name redacted] his life. The nurse practitioner that mistakenly cut my husband’s pain medication by more than half in a single visit was a new nurse practitioner at the pain clinic that had never seen, or treated my husband before. My husband requested numerous times to see his pain physician, but his requests were often ignored. During the trial his nurse practitioner admitted to not even knowing what a high or low dose of mme pain medication was. Before trial my husband’s physicians testified under oath in their depositions to not knowing why the nurse practitioner cut his pain medication by more than half, and made no mention of purposely cutting his pain medicine in half due to any concerns of his current pain medication dose being too high. Under oath they acknowledged that if a nurse practitioner cut my husband’s pain rx by more than half in a single visit that it would be considered a medical mistake because a nurse practitioner by law can’t write a rx for a schedule 2 narcotic that’s prescribed longer than 72 hours. <br/>By the time we went to trial my husband’s pain physicians stories changed and their trial argument was that one of the physicians in the office purposely cut my husband’s pain medicine because of their concerns his rx pain dose he was currently taking was too high. However, there was no evidence to prove this and their deposition and trial testimonies contradicted themselves. The jury that heard [name redacted]'s story at trial and reviewed all of the prosecution’s evidence turned our family’s tragedy into triumph by making sure his pain physicians and their practice were held accountable on all counts. <br/><br/>Chronic pain patients and their loved ones are trusting in the CDC and the FDA to do their part and make significant changes to the guidelines so cpp’s can have the pain free quality of life they need and deserve. <br/><br/>https://www.nytimes.com/2022/03/07/opinion/opioid-crisis-pain-victims.amp.html<br/><br/>Docket # CDC-2022-0024<br/>Agency: Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS).<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Casonya	None	None	0900006484fdf77c	Richardson-Slone	None	2022-03-25T00:54:48Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Richardson-Slone, Casonya	l15-kk3k-uia5	False	None	False	2022-04-12 04:20:20.563	[]
2916	CDC-2022-0024-2922	https://api.regulations.gov/v4/comments/CDC-2022-0024-2922	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I strongly urge the CDC to give Doctor's the freedom to practice care giving for patients in pain. My wife who suffers from debilitating chronic pain, and opioid medications help her take part in life, tend to our sons, go for a walk and cook a meal. She hates taking these medications and is constantly working on reducing and eliminating them, but this is a lifeline. Her Doctor has frequently expressed the fear of getting into trouble with the law for just providing pain management care, which impacts his decisions on how he manages my wife's pain. This results in her having to endure unnecessary suffering. This is an inhumane and callous approach to pain management of chronic pain sufferers.<br/><br/>For folks in acute episodic pain too, this approach to pain management is bewildering and medieval. Our son went through corneal surgery and we were advised to give him ibuprofen as the Doctor did not want to prescribe opioids to a minor but would strongly advise for an adult. Ibuprofen and acetaminophen was what the Doctors told my sister she could have to manage the pain of a double mastectomy surgery, as was out friend who needed an emergency colostomy. <br/><br/>There is no virtue in making people suffer through pain, and withholding care that allows people to live life instead of be paralyzed with pain is needless and cruel.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf791	Anonymous	None	2022-03-25T00:56:33Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-kwm7-bd1g	False	None	False	2022-04-12 04:20:20.799	[]
2917	CDC-2022-0024-2923	https://api.regulations.gov/v4/comments/CDC-2022-0024-2923	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help chronic pain patients. I had 3 major spine surgeries trying to fix my spine and I am left in agonizing pain. This is crazy with all the people killing themselves. I am shocked this is being allowed to happen to patients. This can happen to anyone at any time. My life has changed after my injury. I dont want to be bed ridden again. Please help those who are not ever going to get better. Please.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf7ca	Anonymous	None	2022-03-25T00:57:02Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-logt-lofh	False	None	False	2022-04-12 04:20:21.038	[]
2918	CDC-2022-0024-2924	https://api.regulations.gov/v4/comments/CDC-2022-0024-2924	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you so much for scaring doctors from prescribing what actually works for us pain patients. YOU HAVE CAUSED SO MUCH MORE HARM THAN GOOD. Whatever happened to the fifth vital sign, "PAIN"? First off, the overdose rates spread through the media appear to be opiate overdoses from illegal fentanyl & heroin, or deliberate suicide attempts. Because of your rules, doctors will not give pain pills. Who gave you the authority to tell a doctor what they can and cannot prescribe? Are you the people taking care of the patient? Now people are turning to the black market for pain relief and getting what they think are legitimate pain pills, but turn out to be pills laced with dangerous substances and end up dying or hospitalized. Suicide rates have also increased because of the lack of doctors that feel safe prescribing appropriate pain relief. Is that what you want? People in pain getting pain relief from laced pain pills instead of a legitimate doctor/pharmacy where they're not laced? You all have gone way too far. You've made doctors too scared to even prescribe them. THANK YOU SO MUCH. Thanks to you, I now have high creatinine levels that could harm my kidneys because all the doctors tell the patients now is to take things like Ibuprofen or Aleve, which can cause life long KIDNEY DISEASE and GASTRIC ISSUES!! People have a RIGHT to have pain control!! I also had a Doctor tell me to go to the next state to get pot because it's not legal here. Then he had the audacity to tell me not to tell anyone that. He said "At least you're not asking for an opioid" which I hadn't even brought up. Opiates have been used safely for hundreds of years!! For the majority of people with pain, they work best. If you’re so scared that someone could take too much then they can always keep naloxone on hand. Over 2.5 million people die from tobacco & alcohol each year. Yet less than 50 thousand die from opiate overdoses each year. I don’t see you taking away liquor licenses or forcing tobacco companies to pay for all medical care because of alcohol/tobacco deaths. You’ve also totally ruined doctor/patient relationships. They look at us who need opiate pain relief as druggies and we look at them with complete disdain because they have caved to your overreach because they’re scared they’ll get their licenses taken away. There is no trust now between doctor and patient. People have a right to decide what they want to use as pain control. NOT YOU! Now you’re saying that if someone takes a benzodiazapine that a doctor cannot prescribe an opiate with it? When is this nonsense going to stop????? I thought we lived in a country with freedom & rights. And make no mistake about it, your “suggested” voluntary clinical practice guidelines are not suggested guidelines. Doctors have lost their licenses because they refused to accept your “suggested” guidelines on how to treat THEIR patients!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf7fe	Anonymous	None	2022-03-25T01:00:00Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-mg7b-f8x1	False	None	False	2022-04-12 04:20:21.262	[]
2919	CDC-2022-0024-2925	https://api.regulations.gov/v4/comments/CDC-2022-0024-2925	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Author: someone who cares<br/>Comment:<br/>I have been living with chronic pain since 2007 , some days the pain is debilitating. I get severely depressed when the pain gets so bad, I hate living with chronic pain. It takes away your quality of life. It makes me feel worthless. The pain medication that I was on lowered my pain levels , I was able to have some Quality of life. They should all be responsible ( including doctors)for what happens to people who have to live with chronic pain with no pain medication ,that gives them some quality of life.<br/>Living with chronic pain is not easy to live with , people take their life because they can't handle the pain.<br/>We wouldn't treat our dogs like this.<br/>I am only 50 and I don't know how long I can take living with this pain.<br/>They will be 100% responsible for the people who live with chronic pain and they take away the one thing that gave some quality of life. people suffering that just can't take it anymore and they take their life ( pain doesn't just affect you physically it affects you mentally)<br/>They should be held responsible for the lives that they will take for making people suffer with chronic pain or other illnesses. They will all be murderers. I myself will not live with this pain forever, I am 50 and because of them taking our pain medication away, "that gave us some quality life" they just cut my life shorter and they will be to blame.<br/>They won't give a ---- about that though.<br/>I bet if their loved ones were suffering in debilitating chronic pain, they wont be denied pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde345	Anonymous	None	2022-03-25T01:06:11Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-y0hl-kwi9	False	None	False	2022-04-12 04:20:21.486	[]
2920	CDC-2022-0024-2926	https://api.regulations.gov/v4/comments/CDC-2022-0024-2926	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I have been on pain meds for over twenty years and now they have decided to take me off them completely i dont no what i am going to do my only choice is to go on the street and buy herion i cannot stand the pain it will turn me into a complete bed bound patient with no quality of life and no one cares i will just be another statistic wen i commit suicide please if there is a doctor who can help me contact me i live in [city redacted] maine PLEASE!!!!!!!!!!’	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fde6b9	Anonymous	None	2022-03-25T01:08:12Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l14-yied-8tt0	False	None	False	2022-04-12 04:20:21.741	[]
2921	CDC-2022-0024-2927	https://api.regulations.gov/v4/comments/CDC-2022-0024-2927	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an intractable pain patient for 20+ year. <br/>My legs are damaged beyond repair due to 9 joint replacements many were done wrong and now I can no longer walk without crutches or wheelchair. I have crps the “suicide disease”. <br/>In 2016 my family dr dropped me from her care due to the guidelines. I was on high dose opioids. It took a year to find new pain management. I suffered so much I felt like dying. <br/>The pain clinic I use treats me as if I’m an addict by doing pill counts and drug ua’s. I have signed a contract with them. I have been a responsible chronic pain patient for 20+ years. I have had pharmacies turn me away while saying so in front of other patients. <br/>My insurance has written me a letter basically saying they are monitoring my medication use. I have had a couple diff providers from the same clinic which makes my Narx score go up. I have used the same pharmacy for 2 yrs. My clinic prescribes within the guidelines. I still have 24/7 pain. I have considered suicide. <br/>The new proposed guidelines are good as in the individual is the point. Not all patients can be a one size fits all. Patients need to be treated for severe pain even while trying different modalities and treatment plans as some plans can take months to accomplish. <br/><br/>Please remove all mention of mme’s. The 50mme’s wil be misapplied and cause paitient harms. This also gives DEA cause to hassle doctors and make pain care even more unaccessible to chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fdf10a	Stifle	None	2022-03-25T01:10:28Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Stifle, Michelle	l15-9k00-78wa	False	None	False	2022-04-12 04:20:21.969	[]
2922	CDC-2022-0024-2928	https://api.regulations.gov/v4/comments/CDC-2022-0024-2928	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ypu cannot prove an innocent person is innocent, only that there is a reasonable doubt. <br/>You cannot prove a negative. <br/><br/>The guidelines ask physicians to prove patients are using just the right amount of medication. This is impossible. This is not democracy or freedom. This is inhumane to all involved. Masses of patients abandoned off pain medication is obscene. Physicians are suffering moral injury, patients are suffering in pain, and those suffering addiction are still overdosing. <br/><br/>Rescind the guidelines and if you have a conscience, retire your licenses as well, as you knew what would happen. Then figure out how to return care to those who need it, release physicians from prison who shouldn’t be there, disband the corrupt DEA, and return the money lining everyone’s pockets over this fiasco. <br/><br/>And undelete the perfectly reasonable comments that keep disappearing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anon	None	None	0900006484fdf879	md	None	2022-03-25T01:12:11Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from md, Anon	l15-olhq-yix5	False	None	False	2022-04-12 04:20:22.213	[]
2923	CDC-2022-0024-2929	https://api.regulations.gov/v4/comments/CDC-2022-0024-2929	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 50yr old woman. I was diagnosed with RA. It is more than just arthritis. It has effected my spleen, lungs eyes along with my joints. I also have IBS and severe degenetive disk disease. While I was taking opiods I worked, I took care of my family and grandkids. I went on walks and exerised 3xs a week. When they were abruptly stopped and was told to take tyneol and motrin I lost my job which made me lose my treatment. I now have ulcers from taking so many. I no longer do anything. I get up my husband help me get dressed and move to the couch. I get to shower 2xs a week because he works 2 jobs. I no longer go anywhere or take care of my grandkids. I cry alot from the extreme pain. I pray for death! I am nothing now. I think about how i could do it. I tried all the injections which are extremly painful and do nothing but they have rotten my teeth. Btw most arent even fda approved but was forced to do it or be dropped by pm. I beg you to stop punishing me for a disease i have no control over. Stop this nonsense and allow drs to do there job. One day you will have a major surgery and ve told to take tyneol or in a serious accident, oh heres some tyneol,i will onky say i told you so.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf804	Anonymous	None	2022-03-25T01:13:28Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-mlrl-kbko	False	None	False	2022-04-12 04:20:22.438	[]
2924	CDC-2022-0024-2930	https://api.regulations.gov/v4/comments/CDC-2022-0024-2930	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have crohns disease and arthritis. I live my life with pain . When my pain is so bad I have thought about taking my own life I have been turned down for pain medicine. There is no caring in healthcare anymore . These restrictions have greatly hurt us .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	tina	None	None	0900006484fdfa44	Suckow	None	2022-03-25T01:15:24Z	None	None	1	None	2022-03-24T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Suckow, tina	l15-hreq-xea6	False	None	False	2022-04-12 04:20:22.671	[]
2925	CDC-2022-0024-2931	https://api.regulations.gov/v4/comments/CDC-2022-0024-2931	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I AM IN CHRONIC PAIN EVERY DAY DUE TO NEUROPATHY IN MY FEET, LEGS, AND HANDS. I HAVE TROUBLE FIXING FOOD TO EAT AND DOING ALL MY DAILY TASKS. I AM IN NEED OF A CHANGE TO HELP ME FUNCTION ON A DAILY BASIS. THERE ARE MANY TYPES OF CHRONIC DEBILLIATING CONDITIONS THAT PEOPLE HAVE BESIDES ONES THAT ARE ONLY FOCUSED ON. PLEASE WITHOUT THE PRESCRITION HELP MYSELF AND MANY OTHERS WILL BE SEEKING PALLITIVE CARE IN THE NEAR FUTURE. THIS IS NOT AN OUTCOME I OR MANY OTHER WANT IN ORDER TO BE ABLE TO STAY ALIVE. MANY OF US WILL NOT MAKE IT THAT FAR BEFORE LIFE IS TOO PAINFUL TO LIVE.<br/><br/>PLEASE CHANGE THE GUILDLINES 2016 TO HELP ALL CHRONIC/TERMINAL PAIN PATIENTS LIKE MYSELF LIVE LONGER AND MORE SELF SUFFICIENT LIVES BY REVISING THE GUILDLINES A.S.A.P.<br/><br/>THANK YOU FOR YOU TIME	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe1a3f	Anonymous	None	2022-03-25T10:21:57Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-uut1-j38g	False	None	False	2022-04-12 04:20:22.903	[]
2926	CDC-2022-0024-2932	https://api.regulations.gov/v4/comments/CDC-2022-0024-2932	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My child has had to suffer due to Drs not being able to properly treat his pain. This child has had surgeries throughout his young life. When he was properly medicated he was able to function, have friends, be in activities & have somewhat of a childhood. When he is unable to have his pain treated he cannot do any of these things. This is inhumane!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe2353	Anonymous	None	2022-03-25T10:25:11Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-57w3-vn17	False	None	False	2022-04-12 04:20:23.145	[]
2927	CDC-2022-0024-2933	https://api.regulations.gov/v4/comments/CDC-2022-0024-2933	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I and my doctor have been harmed by the 2016 CDC opioid guidelines. The 2022 update is not an improvement. It will reliably make my life even worse.<br/><br/>My quality of life has been taken away because of the 2016 "guidelines" <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe2310	Anonymous	None	2022-03-25T10:25:32Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-384s-8cbh	False	None	False	2022-04-12 04:20:23.367	[]
2928	CDC-2022-0024-2934	https://api.regulations.gov/v4/comments/CDC-2022-0024-2934	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include Restless Leg Syndrome as a chronic neurological disorder that frequently requires narcotics in the management of this<br/>disturbing disease. Iron supplementation and oral narcotics are now the preferred treatments over drugs used in the past,<br/>such as pramipexole, which cause augmentation of symptoms with chronic use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fe3356	English	None	2022-03-25T15:10:10Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from English, John	l16-jxkw-fznm	False	None	False	2022-04-12 04:20:23.600	[]
2929	CDC-2022-0024-2935	https://api.regulations.gov/v4/comments/CDC-2022-0024-2935	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sadly, I have been off my opioids since January 1, 2019. I tapered off myself, which I had done several times, just to let my body have a break. I would stay off for a few weeks, until I couldn’t stand it, then go back to the Dr and start again. That hadn’t been a problem before. When I went back this time I was told that they weren’t prescribing opioids any longer because of the opioid epidemic. I’ve been without for a few years now, and the pain in my back is so bad I can’t walk too well and I sure can’t bend. It’s hard just getting in and out of a car. As you can imagine, my quality of life sucks. My Dr still won’t give them back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fe268a	Brindle	None	2022-03-25T15:27:10Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Brindle, James	l16-ftzf-aexk	False	None	False	2022-04-12 04:20:23.851	[]
2930	CDC-2022-0024-2936	https://api.regulations.gov/v4/comments/CDC-2022-0024-2936	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no known cause and (thus) no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse, often permanently. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. Only very recently research has started to elucidate the involvement of the opioids receptors in the brain in the origination of RLS<br/><br/>RLS has been with me since at least my twenties. Over the years it increasingly disrupted my sleep draining me of much needed energy to lead my life as a person, a professional, a partner and a mother. When I finally started medication, the authorized ones quickly made my RLS worse rather than better. It took a journey of more than 5 years and several types of medications to finally arrive at opiods at a very low dose that quelled the RLS symptoms sufficiently to allow me to sit still and sleep almost normally and regain a normal life. The opiod medication has not only given me my life back, but I can also contibute positively to society again. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlotte	None	None	0900006484fe1b30	Deerenberg	None	2022-03-25T15:31:24Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Deerenberg, Charlotte	l16-7twe-vvg1	False	None	False	2022-04-12 04:20:24.074	[]
2931	CDC-2022-0024-2937	https://api.regulations.gov/v4/comments/CDC-2022-0024-2937	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The Visonless CDC revised guidleines fail in every way to call for much needed improvements in the carre of millions of persons in pain . Despite repeated reference to patient centered individualized care, the cdc fails to reference a single reference to ipd or any patient authored text- and so the cdc continues the centuries old identity prejudice toward millions in pain and commits vice epistemology with ever more arrogance, dogmatism, and cxlosedmindedness toward the notion that caring in pain care requires trust of persons in pain. The old secundum quid mcdonaldized robopathic reductionistic datafication of care withpout regard to clear end goals and democratic accoiuntability is clear. That is why our courts and constitution recognize the best lawmakers and rgulators are legislative bodies and not DHHS or unelected officials in executive branch imposing their will on the public. From day one the CDC efforts have been of constitutional dubiety and state no goal to the guidelines to lower the prevalence of pain, to lower the prevalence of opioid deaths byu a certian number, etc. They embody ubi incertum nulla este lege- they are void fo vagueness and lack serviceability, they are ghoulishly gulagish and relegate providers and persons in pain to moral and civil vagabondage- they are exploitaive disaster capitalism as many rubberchickendinnered friedns of the CDC involved in the guidleines have profited handsomely in creating white papers, testifying in court, and greedy grant farming and in a thousand pounds of these papers- there isnt a picogram of respect or reegard for persons in pain- it is mcdonaldized epistocratic Leviathanizing medicocentirc exploitation with no end goal and no auditable goal or democratic accountability. Despite numerous documents evidencing the lack of connection between opioid rx and opioid misuse and overdose- the CDC conmtinue the big lie of asserting that rx opioids caused an opioid epidemic. So the vice epistmology of the CDC has been made clear. Destroying beucahmp and childress ethics and care ethics of [name redacted], [name redacted] [name redacted], [name redacted] [name redacted] [name redacted] [name redacted] [name redacted] etc is not moral magnificience- and once, again not a single reference to any care ethicist has bene made in the CDC revisions- nor any reference to treatment burden adjustment burden or symptom burden. The CDC's efforts continues centuries old lack of serviceabiloity to society, visionless and careless care and moral and mental laziness and identity prejudice toward people in pain that medicine is guilty of.If justice is the right end of society as [name redacted] claimed it would be unjust for the CDC to continue to have any opinion on pain care in America-and anyone of them can debate me in public on the issue- methylate your basomedial amygdalas first- or else yoiur vast darkness on good governance and care ethics and pain will be unobscured as you are encompassed by infrahumanized tribalistic identity politics and simple minded frequentist secundum quid fallacies that follow you areound like flies on ahot summers day.<br/>My documentation makes clear pain care continues to be subject to underpowered underfit efforts and research- the missing data, underpowered trials, poor subgroup analysis, and late reporting and nonreporting of trials continues- as does the self serving never ending esxploitation of pain in America. Shame on medicin- shame on the iron triangle of government, academia and medicine whose visionless moral and mental laziness have subjugated millions of Americans to Kafkaesque nightmare of lousy pain care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fd7373	Becker	None	2022-03-25T17:24:06Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Becker, David	l11-05ww-rfzp	False	None	False	2022-04-12 04:20:24.302	[]
2932	CDC-2022-0024-2938	https://api.regulations.gov/v4/comments/CDC-2022-0024-2938	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The only ethically acceptable course of action for the US CDC is to outright repudiate both the 2016 and 2022 disasters, and to withdraw them without replacement. <br/>CDC must be barred by legislation from publishing any practice guideline on pain medicine. And the US DEA must be told to stand down from its unjustified persecution of doctors who have done nothing wrong.<br/>Regards-<br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristi	None	None	0900006484fe230a	Becker	None	2022-03-25T17:56:44Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Becker , Kristi	l16-3298-yw9c	False	None	False	2022-04-12 04:20:24.537	[]
2933	CDC-2022-0024-2939	https://api.regulations.gov/v4/comments/CDC-2022-0024-2939	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was 39 years old, it was 1998. By the time I was 40 in 1999 I had been to every doctor I could think of or that I could get referred to. I had even had surgery on my neck that I did not need. I finally saw a doctor that stated that if Fibromyalgia was indeed an illness that is what I had. He was kind enough to give me Opioids for treatment. I had a wonderful job, paid very well, in fact I made more money than my husband. We both had new cars, a new boat, had just bought hunting property in Prescott, Arkansas and was planning on building a cabin. I was sick and could not work. Pain was not the only symptom, I had severe anxiety, short term memory problems, depression, just to name a few. I took Oxycontin for nine years but I still had pain. I was in bed for eleven years, I did not leave my house except for MY doctor appointments. I had lost my entire 40's. Finally, I could no longer afford to take Oxycontin because it was too expensive so my doctor recommended Methadone. I finally found the right combination of medications I had a life ten years later. It was as if I had slept eleven years and woke up but everyone else had continued on without me. Now the Government says I cannot have my medication. The doctors have reduced it down so low that most days I do not even get dressed, take a shower, nothing, again. Please I am 64 years old and now you are taking away the medication that I need just to live. I had finally been able to participate in life and now you are taking it away from me. Please let me have my pain medication back. I have lost so much of my life. I have a developmentally disabled daughter that I have to take care of. Fortunately, I have a wonderful husband to help with my daughter but he cannot do it alone. At my age I have taken Opioids for almost 22 years. I do not abuse them, I take them every day at the same time. Now the Government has reduced them so low that I have about 3 hours after every dose that I can do what needs to be done then the pain returns and I have to stop and just sit. There are sick people that need this medication, do not penalize me and others because there are people who abuse drugs. They are going to abuse the drugs if they have to get them off of the street. You cannot keep them from overdosing, they are going to steal or do whatever they have to to get the drugs. I have members in my own family that live on drugs but they do not get them legally, they get them any way they can. Please let the doctors treat their patients without fear of losing their license to practice medicine. Please let me have my medication back to where I can live the years that I have left. Thank you for listening to me and letting me tell my story but most of all let me live a life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carolyn	None	None	0900006484fe33de	Gordon	None	2022-03-25T17:57:56Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Gordon, Carolyn	l16-kvks-6jlw	False	None	False	2022-04-12 04:20:24.769	[]
2934	CDC-2022-0024-2940	https://api.regulations.gov/v4/comments/CDC-2022-0024-2940	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have use several medications forRLS and found that Norco 2-325 works the best. Please allow doctors to prescribe this	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elisabeth	None	None	0900006484fe1988	Mokma	None	2022-03-25T17:59:33Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Mokma, Elisabeth	l15-rtz9-dwm5	False	None	False	2022-04-12 04:20:25.000	[]
2935	CDC-2022-0024-2941	https://api.regulations.gov/v4/comments/CDC-2022-0024-2941	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why are we suffering .does someone get financial gain for this? .THERE ARE so many pain people committing suicide because of the CDC guideline .Now the new one coming out isn't any better if not it's worse it lowering Mme down more when we do not get enough to control are pain now .and also some of us needs leg meds to control are restless leg syndrome but because we take it we have to choose that or a pain medication .This is so so wrong .i wish I didn't have to take anything but I have to because I m in so much pain from my back .my neck my shoulder my legs and fibormiagia .with our pain medicine we have no quality of life what so ever .i m from [location redacted] and it's bad .everyone treats us bad .they talk to us like we are drug addicts but in fact we are not we are cpp.in alot of pain who is just trying to survive .i m tired of getting talk down to .from doctors to pharmacist er doctors and now are insurance company are refusing to release are pain meds until we are complete out .So how are we suppose to live ??	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe19ef	Anonymous	None	2022-03-25T18:00:11Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-tgan-iwaw	False	None	False	2022-04-12 04:20:25.241	[]
2936	CDC-2022-0024-2942	https://api.regulations.gov/v4/comments/CDC-2022-0024-2942	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello so my name is [name redacted] back in 1988 I broke my neck in 3 places while working at a tree company after 6 yrs recovered I started havin horrible sacral and low back pain. Around1996 I was prescribed 2-12hr morphine and 4 10 mg Percocet. I maintained that dose for 27 yrs. I worked my own tree company I built a house and took care of my family. In recent 4 months I have been dropped to 1/4 of the meds I took for 27 yrs with no bad urine rest no misuse & no abuse but still I was drastically cut in meds. In the revision it says that these new rules should not apply to long term chronic pain patients but that wasn’t paid attention to. Now I’m 59 yrs old I’m in horrific pain 24/7 and nobody cares or will help me. The Drs all tell us that it’s because of DEA and they fear prosecution. So they have all forgotten their Drs oath to have compassion and treat people to the best possible situation. We can’t give mme limits not everyone’s pain is the same and we all needs to be individually cared for because we all know that everyone has different pain levels so we can’t be treated with a one size fits all plan. In the past 4 months I have went from a participant to a spectator for all things in life. I can’t even play with or pick up my Gkids. I get about 3-4 hrs of sleep a night because of the pain. I can’t make love to my wife. I can’t do my household maintenance. I can’t go sit in the bleachers and watch my Gkids soccer games. I don’t leave this house anymore except to go to the Dr and that’s barely worth going to now. I don’t know how I’m supposed to keep living with this excruciating pain<br/>The 2016 revision needs to be recalled and done away with because even tho it wasn’t supposed to be law that’s how it turned out. Now the Drs act like I wrote all them prescriptions for the last 27 yrs. I didn’t. They put me here and then yanked it out from under me. I wasn’t discussed any options with as far as cutting my meds it was just done. They even left me to figure out my own withdrawals from such drastic cut I was just left to figure it out alone and for that I was very sick for 30 days cutting pain meds. Then they decided I couldn’t take my anxiety medication that I’d been on for the past 18 yrs for panic attacks and anxiety spells but do u think they helped me get off them. Heck no once more I was on my own sick as a dog trying to stop the anxiety meds by myself. Another month of unnecessary sickness. Since stopping my anxiety meds I’ve had 6 anxiety attacks and totaled out 2 cars. How am I supposed to deal with all this without ending my miserable damn life. Not that I want that but u guys are really making it hard on us chronic pain patients and don’t think this is just my story. This is the story of 50 million chronic pain patients. In my whole life I did nothing to deserve this kind of treatment. This is the kinda stuff u expect to see in Russia<br/>Give us our lives back. Chronic pain can kill a person quicker than a lifetime of pain medication. I really hope that u take the time to read my lengthy rant here it needs to be addressed and not years from now. IMMEDIATELY We have the same rights as a diabetic needing insulin and we deserve to get as close to pain free as we possibly can so that we can go back to having a life ,loving my wife ,loving my kids & Gkids<br/>I hope to God that the people makings rules never need pain medication and have to go through what they’ve put US through. BRING BACK OUR RELIEF!!! Thank u. [name redacted] in [location redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fe19b9	Brawley	None	2022-03-25T18:01:50Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Brawley, Kevin	l15-smac-izzw	False	None	False	2022-04-12 04:20:25.502	[]
2937	CDC-2022-0024-2943	https://api.regulations.gov/v4/comments/CDC-2022-0024-2943	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why does the US Government overcorrect and regulate when an unexpected crisis/issue presents itself? Government entities are responsible to the PEOPLE, not politicians. Guidelines imposed are supposed to help, not harm. I often wonder, what kind of people are handing down these new protocols/guidelines, are they typical Americans or bureaucrats attempting to cast shade and place blame elsewhere? Why not just stand up and take ownership of mistakes and try to help humanity overcome? Why not approach a remedy to the opioid crisis like a common decent man/women would- with practical common sense. Although I have no experience with opiates, from what I’ve read: Opioids have a place in pain management, they work. Greedy and unethical people took advantage of their efficacy resulting in abuses, addiction and so much death. Let’s NOT punish those individuals who rely on opiates to manage untenable pain OR those of us who one day may need them. Why not obtain input from opiate users, let them have a voice on your CDC committee. Despite having no experience with opiates I find myself fearful for the future. I am afraid the CDC is going to impose ridiculous regulations that will result in my inability to obtain adequate pain relief should I require it. Now what does that tell you? My concern is that you will make things even worse. Please, please, think of the common man/woman and base your decisions and regulations on us. Do the right thing for humanity. The majority of Americans do not abuse opiates.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe1a26	Anonymous	None	2022-03-25T18:02:34Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-ud8k-pmbg	False	None	False	2022-04-12 04:20:25.734	[]
2938	CDC-2022-0024-2944	https://api.regulations.gov/v4/comments/CDC-2022-0024-2944	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, first and foremost I am a 40 year old mother of 4, ages 25, 21, 19, and 17, my youngest is pregnant with her first baby and I will have to babysit for her because she works, with that being said I have a really rare kidney disease called LPHS (Loin Pain Hematuria Syndrome), I have had problems with my kidneys since age of 10. I have blood in my urine all the time and severe pain in both kidneys, I struggle with ghost kidney infection and bladder infections all the time, my urine looks like tea all the time. When I was diagnosed with LPHS years ago, I had a time with trying to get a diagnosis, no one wanted to help me, I went from doctor to doctor, then a nephrologist told me what I had and told me I would need to be on pain medicine for the rest of my life and that my pcp would have to prescribe them to me and that’s where the passing me around began for adequate pain relief and in the meantime I had to go to the emergency room to get pain relief and that’s what the doctors told me to do until they figured it out and that’s when I got red flagged as a drug seeker, finally got referred to a pain management clinic and they offered me injections and a spinal cord stimulator and I said that wouldn’t help me so the pain management clinic referred me to another pain clinic that could write me pain pills so I went and they finally was willing to help me and started me on pain medicine to help me. I tried all kinds of pain medicine like Percocet 10/325, Morphine 20mg, Fentanyl patches 25mcg, and then back to Percocet 10/325 3x’s a day and Oxytocin 20mg Extended Release 2x’s a day which worked perfectly for years, but the hoops I had to jump through to get and keep them was bad, I found myself still having to go to the emergency room for pain relief when I had flare ups, but after years of being on the same medication I felt I wasn’t getting the relief I needed to go on day to day, but I also know I will never be pain free which I don’t expect to be but I talked to the doctor and we decided that I needed what they called a pill holiday so my brain could reset and my pain medicine would work again so that’s what I did, well in the meantime they wanted me to go to a pain psychologist, I was hesitant to go but I did because like I said I had to jump through hoops, I was called in numerous times a month for a pill count and drug urine test which I was never off pill count but one urine test they said I failed and told me I was not getting anything else from them but I went straight to my pcp and made him do a blood drug test and it came back negative except for what I was supposed to be taking, anyway I made a big fuss so they gave me my pills back, but ok back to the Pain psychologist, seen him and he asked me questions and I told him the truth like I was molested when I was 10 up to when I was 16 by my moms dad had a baby by my molester at 15 and kept my baby then my brother died of a street drug overdose and now they use it all against me, I went back to the pain management doctor and they said that the pain psychologist said I would be more likely to abuse my pain medication mind you I never did and never will but I am having trouble trying to get pain medicine back and the emergency room won’t help me either anymore so please I am begging you to help me	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fdf922	Anonymous	None	2022-03-25T18:23:34Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l15-g018-5ipt	False	None	False	2022-04-12 04:20:25.960	[]
2939	CDC-2022-0024-2945	https://api.regulations.gov/v4/comments/CDC-2022-0024-2945	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had major reconstructive back surgery done with 48 screws & 2 rods placed in my back after a botched failed fusion. I I've have back surgeries since 1988. I was on pain medication since 1988 up until 2018 when I was cut off cold turkey and given nothing to help with withdrawal. The way us CPP's are being treated is inhumane. <br/>Something needs to change and fast. The suicide rate is climbing because people ate suffering in pain and can't take it anymore. When my medication was taken away, so was my life. I merely lay here existing now. Just waiting to take my last breath. You all need to grow your hearts back and bring back the medical ethics.<br/>Shame on all of you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484fe1a6e	Phillips	None	2022-03-25T18:30:14Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Phillips, Kimberly	l15-vped-qdde	False	None	False	2022-04-12 04:20:26.201	[]
2940	CDC-2022-0024-2946	https://api.regulations.gov/v4/comments/CDC-2022-0024-2946	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am very curious as to why people are encouraged to take antipsycotics for "mental health" and pain without regulation, and also encouraged to try multiple medications at copious amounts to alleviate whatever mental health ailment or pain ailment they feel they have. And opioid therapy is the only drug right now frowned upon. Wouldn't you think that people also become dependant and abuse mental health meds? But not an eye is batted at this. My dear friend took his life in 2017 by Cymbalta, due to untreated pain, so he killed himself with it and I know another which is currently taking 15 different antipsycotics on a daily basis. Of course he's not functional, he stumbles, falls, I even rushed him to an emergency room for overdose on an antipsycotics cocktail. I just happened to stop by to check on him and he was unconscious and couldn't be roused. Once at ER, the blood levels of these drugs were 6 times the dose level a human body should ever consume. And guess what he got for that, a week stay in the mental ward, and wouldn't you know it, MORE ANTIPSYCOTICS AND SENT HOME. There is literally a pill to get him up and a pill to put him down, and half the time his phyciatrist doesn't even know or care what he's actually doing. You want to over regulate and sanction people utilizing opioid medications with an actual purpose, which is to control pain so that one may get up and work, function, not be delirious and a danger to society, and then freely advertise these antipsycotic drugs and push people to take them. You are grossly unaware, or infact blind to the harms and affects of these class drugs when taken by large populations. Just in my area alone, crime and homicide has risen substancially. When asked what is the contributing factor, it's mental health with multiple antipsycotics. These people are literally out of their minds and commit heinous crimes on others such as rape, murder, drive by shootings and then are released at no fault of their own bc they were under the influence of psychotropic drugs. RATHER than attacking the sick, elderly, disabled, and veterans by removing a medication which is MORE CONTROLLED, please look into the stats on this problem, look at crime rates now, and the drugs these folks are taking, these guidelines on pain patients, and newly diagnosed intractable pain patients are just stocking more medicine cabinets with psychotropic drugs, and believe me, PEOPLE ARE TAKING THEM, also, with altered mental states, they can not be held criminally liable for their actions, due to being under the influence of a mind altering substance which was prescribed by a psychiatrist for particular problems. I'm attaching a quote from a local paper from my town.<br/><br/>https://www.goupstate.com/story/news/local/2021/07/27/south-carolina-shootings-homicides-gun-violence-more-frequent-[location redacted]/5377002001/<br/>There is no commonality that allows us to tie a thread between all these instances," Story told council members. "Some are unpredictable and associated with mental illness. It is atypical for the [location redacted] Community to have a period of instances of what we've had."<br/><br/>And no, sitting people in front of any screen to watch or talk about the reasons why they do what they do is NOWHERE COMPARABLE to actual physicians physically laying hands on these people, doing blood draws, having the one on one contact with individuals to asses them. Utilizing telehealth and broadband has repercussions of misdiagnosis, late diagnosis, and isolation by way of not making people tolerate communication outside of their comfort zone. Telecommunications is good for work in distance communities, but is NOT a replacement for a physicians knowledge, and physical workup on a patient. There is no feelings of care, or concern, when you can just text or call in some random med because it sounds like the person might need it. Use your big brain people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe1c35	Anonymous	None	2022-03-25T18:34:47Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-dg7f-su5h	False	None	False	2022-04-12 04:20:26.440	[]
2941	CDC-2022-0024-2947	https://api.regulations.gov/v4/comments/CDC-2022-0024-2947	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	"I have been on suboxone for 5 years. It started out a miracle drug that I can honestly say gave me (most) of my life back. Throughout on and off 10 years of active addiction never had a problem with my teeth now since being on suboxone I need them all pulled and dentures but I can't afford it. Iam in CONSTANT pain from my teeth . No matter how much I take care of them its like they just keep rotting and I couldn't figure out why. I came across your tic toks and finally everything makes sense ! Not only did it ruin my teeth but it also gave me such severe constipation/ IBS sometimes its 5 or 6 weeks before I can go and even then I've got to heavily medicate myself in order to.ive been in the ER twice with a bowel obstruction, once with a paralytic ileus. But it's either that or risk life without suboxone which iam terrified of. At the clinic I go to they do not give u the choice to get subutex only the suboxone strips and there are several clinics in South Georgia/ North flordia that will not give you subutex. But because iam an addict even tho I have 5 years clean no one really wants to hear my story .iam so grateful for you putting this information out there. Iam sure you have no idea how many people have been struggling and now have some answers! Thank you for all you do! "<br/><br/>“Hi. I need help and don’t know what to do. I was put on Suboxone for migraine pain. Bc of that being in my chart I was ignored for months when describing new back pain. I went to my primary, the ER and a neuro. I ended up having a severe spinal cord compression. Had surgery one year ago. Was in a wheelchair for months. The back pain, incontinence and constant falling are persisting. I don’t sleep. I’ve been suicidal since last June, but have a wonderful therapist who trust. I received TMS to help with depression but I need pain relief. My doctor wants me to get injections in my already crumbling spine. I’m terrified to go to the doctor bc they assume I’m drug seeking. My blood pressure is high bc I’m never out of pain. I have 2 small children…no quality of life. Can anyone give me advice? I live on Cape Cod. Thank you for your time and for all the work you do for pain patients.”<br/><br/>“Hi, I have been on suboxone for 6 years, then subutex for 6 ( 12 years on the medication total). I’m in my 30s, a married mom of 2 with a small business, I’m overall successful, and life is good. I’m still currently on subutex because I have no idea how to get off of it. I’m one of those people who never got wisdom teeth, just my regular molars. 4 of my molars have crumbled and had to be extracted. I get really sad thinking about this. Also, my youngest is 6, and she was born with major dental issues. Her two front teeth had to be removed when she was only 3. Her back teeth are riddled with problems and all of her molars had to be capped. I’m worried that her new adult teeth will turn brown eventually. I hate talking about this, it’s very depressing and I feel like it’s all my fault for not being able to get off the medication, or for taking it in the first “<br/><br/>“was put on pain medication by a doctor 14 years ago for my neck and back. I never knew I would be addicted to them because I was never told that. After years of seeing my doctor he got shut down and I was taking off of my medication. I later got put on Suboxone because I was very sick from not having my oxycodone anymore. I have now been on Suboxone for seven years and I do really well but before this medication I had very beautiful teeth. Now my teeth are awful and they are rotting at the gum line and then break off. I need help with this because I was never told that Suboxone can ruin your teeth so it’s embarrassing. I have not dated anyone because of this reason and I am only 41. If you can help please help me. Thank you so much.”	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe22ac	Anonymous	None	2022-03-25T18:35:14Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-0mgz-8zv8	False	None	False	2022-04-12 04:20:26.676	[]
2942	CDC-2022-0024-2948	https://api.regulations.gov/v4/comments/CDC-2022-0024-2948	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s) Please read my attached comments. Also, I am an endorser of the comments made by [name redacted].	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen "Boykin"	None	None	0900006484fe2358	Polizzi	None	2022-03-25T18:36:35Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Polizzi, Karen "Boykin"	l16-50l9-7ic1	False	None	False	2022-04-12 04:20:27.108	[]
2943	CDC-2022-0024-2949	https://api.regulations.gov/v4/comments/CDC-2022-0024-2949	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why is the DEA making cuts to drugs? Doctors were never the cause for the drug epidemic, it was always the drug cartels, why isn't the DEA going after the drug cartels? Proven fact even with the CDC guidelines, and the DEA going after doctors the drug deaths have went way way up, that is because it is coming from the streets not doctors. I don't understand why Chronic Pain patients are being made to suffer, along with post-op patients, and cancer patients? Good doctors are afraid to treat patients because they fear the DEA, and losing their license, they worked so hard for. Things need to change, in America DEA raiding is like we live in a third world country. It should always be the doctors medical choice on how much opioids a person receives, they went to medical school, and they know the patient, and their diagnosis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fe3f88	Tom	None	2022-03-25T18:36:58Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Tom, James	l16-q60z-7id5	False	None	False	2022-04-12 04:20:27.320	[]
2944	CDC-2022-0024-2950	https://api.regulations.gov/v4/comments/CDC-2022-0024-2950	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67 in alot of pain I am afraid every time I go to the doctor because I don't know what I would do if I have to taper more the cdc please stop playing with our life people stop lying to the people	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe3f61	Anonymous	None	2022-03-25T18:37:13Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-pumg-k98n	False	None	False	2022-04-12 04:20:27.534	[]
2945	CDC-2022-0024-2951	https://api.regulations.gov/v4/comments/CDC-2022-0024-2951	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 26-year legacy pain patient, an RN and a member of the National Pain Council (NPC). I have been up and down over that time on opiates without addiction. Since the guideline is only a “recommendation”, and the FDA already has the same guideline, in my opinion, there is no need for it. Remove the 2016 and 2022 guidelines and let the FDA do their Congressionally mandated job. The CDC IS CONTAGION, NOT opiates. Harm reduction is treating with Opiates for patients with rare and painful diseases. Several million have been harmed by the 2016 guideline, that's enough! It’s time to fix the harm done not make it worse. Repeal ALL CDC guidelines for opiates. The FDA has got this!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484fe34b7	TuthillTuthill	None	2022-03-25T18:45:59Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from TuthillTuthill, Karen	l16-mmqy-wmw7	False	None	False	2022-04-12 04:20:27.746	[]
2946	CDC-2022-0024-2952	https://api.regulations.gov/v4/comments/CDC-2022-0024-2952	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why continue to punish pain patients with these corrupt guidelines when the real problem has nothing to do with prescription drugs. I really doubt physicians want CDC telling them how to prescribe medications they are much more trained in the practical use of.<br/><br/>"[name redacted]: It follows the same track as fentanyl, which is also a synthetic opioid, it's manufactured in communist China, sent to the Mexican cartels, and then the porous border makes it easier for the traffickers to flood it into our country. This is a national emergency. DEA has been warning about drugs pouring into our country, especially these deadly fentanyl and ISO now, which look, it will be laced into traditional drugs, illicit drugs. We know that. So people that may not even be suspecting it may inhale fentanyl or ISO may ingest that. We just saw this with the West Point cadets down in Florida during spring break. But it also can kill unsuspecting people that aren't even using it. It can, if inhaled, if it comes in contact with your skin. There has been an increase just in the first 10 months of the Biden administration. 53% increase in the seized fentanyl at the border. We know it's coming through the border, and it is affecting 18 to 45-year-olds. It's the leading cause of death of Americans 18 to 45. So this is a business show. All the businesses out there watching this will devastate our workforce. "<br/>https://www.foxbusiness.com/media/florida-southern-border-biden-drug-cartels-mexico-dea	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe3a19	Anonymous	None	2022-03-25T18:47:49Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-o4jy-guqk	False	None	False	2022-04-12 04:20:27.960	[]
2947	CDC-2022-0024-2953	https://api.regulations.gov/v4/comments/CDC-2022-0024-2953	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The proposed Opioid Prescribing Guideline draft does not address chronic conditions like severe, refractory Restless Leg Syndrome. Although different from chronic pain, for many patients low dose opiods provide the only relief. Restless legs syndrome (RLS) is a chronic neurological disease that makes it impossible to sleep or sometimes even sleep quietly. The suffering is immense.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. The few prescription medications that can relieve the symptoms do not work for long as those same medications can make the symptoms worse over time. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS, including extensive work done by the Mayo Clinic.<br/><br/>From personal experience I can tell you that Buphinorphine and Norco are two drugs that work to relieve these symptoms, notably at much lower doses than are used for chronic pain. For most patients the need to increase dose is rare and is typically driven by a worsening of the condition and not a tolerance to the medications.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. The 2016 CDC Opioid Prescribing Guidelines often make physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. <br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R	None	None	0900006484fe3ce9	Ross	None	2022-03-25T18:48:48Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Ross, R	l16-p5r0-j2xq	False	None	False	2022-04-12 04:20:28.171	[]
2948	CDC-2022-0024-2954	https://api.regulations.gov/v4/comments/CDC-2022-0024-2954	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My interest in this issue is both as a licensed clinical psychologist and as an individual with a longstanding chronic pain problem. (Peripheral neuropathy) The 2016 guidelines have affected me in a negative way. when I moved from one city to another, I found it very difficult to be accepted by a new provider which caused me to experience considerable stress due to fearing that I might not be able to continue to receive my prescription for the opioid that had successfully treated my pain for many years. An abrupt stop would have affected me badly. Another problem occurred when the pain management specialist (explaining that he was following CDC guidelines) decreased the dose that I had been taking for many years with no problems. The lower dose has not been as appropriate in controlling my pain so I suffer unnecessarily.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverly	None	None	0900006484fe3a20	Abraham	None	2022-03-25T18:49:04Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Abraham, Beverly	l16-o5aq-kjry	False	None	False	2022-04-12 04:20:28.416	[]
2949	CDC-2022-0024-2955	https://api.regulations.gov/v4/comments/CDC-2022-0024-2955	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove any and ALL mention of MME. These MME recommendations do not take into account patients that have autoimmune diseases. Many patients with auto immune diseases cannot metabolize medications the same as an Able-bodied person. The ideology of MME limits is discriminatory against these immunocompromised disabled patients simply because we have to take higher than the recommended MME Limits produced by the CDC for Litigation purposes.<br/>here is some information<br/>https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/malabsorption-opioid-medications<br/>https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154?fbclid=IwAR09z0dt-0Ntq_lSQ-g5SU6hO9WiBLrlw2ZcEKLgyo8tbi1ONg0F4PhxvuA<br/>https://www.acsh.org/news/2018/12/12/dear-propcdc-heres-what-happens-when-you-over-restrict-pills-more-deaths-nice-going-13663<br/> Actually, here is 100 plus pages of info you could take into consideration<br/>https://www.acsh.org/news/2021/10/05/analyzing-opioid-crisis-updated-100-articles-published-op-eds-15848	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fe3a1e	Allder	None	2022-03-25T18:51:07Z	None	None	1	None	2022-03-25T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Allder, Melinda	l16-o50g-1bto	False	None	False	2022-04-12 04:20:28.634	[]
2950	CDC-2022-0024-2956	https://api.regulations.gov/v4/comments/CDC-2022-0024-2956	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why does the draft does not address chronic conditions like RLS that are different from chronic pain? Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I first experienced RLS symptoms when I was around 12 years old in the mid 80s, and it has only increased with age. I have to now take medication daily to keep it under control, but eventually this medication will no longer be the best option for me and I will need to look at other options for management, and I would like opioids to remain an option if recommended by my physician. While RLS does not cause me physical pain, it does cause significant discomfort and aggravation and, when not managed, affects my professional life and my overall quality of life.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you allowing the public to comment, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tara	None	None	0900006484fe40f0	Pratt	None	2022-03-26T21:12:22Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Pratt, Tara	l16-tetk-r3x1	False	None	False	2022-04-12 04:20:28.844	[]
2951	CDC-2022-0024-2957	https://api.regulations.gov/v4/comments/CDC-2022-0024-2957	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guideline based on junk science has virtually destroyed lives every side you turn. It has hurt me immensely. Once I was a pain patient, now I am something to be suspect of, treated like a criminal even, although I have never abused anything in my life. You will never connect pain patients and their meds with those dying from a poisoned street drug supply. You should all be ashamed of the damage you have caused. I am 100% on board with Dr [name redacted]'s comments on this new piece of JUNK SCIENCE which needs to be shredded. People who have no experience treating others in pain have NO BUSINESS having input into our lives and our health. SHRED IT NOW.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fe4d75	None	None	2022-03-26T21:13:25Z	Chronic Pain Counselling Services	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Chronic Pain Counselling Services	l16-u023-98gx	False	None	False	2022-04-12 04:20:29.052	[]
2952	CDC-2022-0024-2958	https://api.regulations.gov/v4/comments/CDC-2022-0024-2958	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Withholding pain medication from chronic pain patients is barbaric. Instead of controlling patients being monitored by their Drs try putting more attention on illegal drug importation. It’s illegal drug use that is killing people. You know that. My sister is a chronic pain patient. She shouldn’t have to have the stress and shame that is put upon her for using legal opioids to control her pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fe4dd8	Blanchard	None	2022-03-26T21:13:39Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Blanchard, Kathleen	l16-uncw-zr3m	False	None	False	2022-04-12 04:20:29.275	[]
2953	CDC-2022-0024-2959	https://api.regulations.gov/v4/comments/CDC-2022-0024-2959	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include oxycodone as an approved medication for Restless Legs Syndrome,  RLS. It is the only thing that works for me. Without it I spend sleepless (and I DO mean sleepless) night after sleepless night. I have tried benzodiazapines (does not work well and not recommended anyway), Benzodiazepine Receptor Agonists (ineffective) , Alpha-2 delta Drugs (augmentation) , pramipexole, ropinirole and rotigotine (last three cause Tardive Dyskinesia), Medical Marijuana (works only sometimes) .<br/>Opiates are the only relief from symptoms I have and the only way I can get any sleep. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	LisaAnn	None	None	0900006484fe4dfe	Gover	None	2022-03-26T21:16:43Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Gover, LisaAnn	l16-utir-p7ru	False	None	False	2022-04-12 04:20:29.508	[]
2954	CDC-2022-0024-2960	https://api.regulations.gov/v4/comments/CDC-2022-0024-2960	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 57 year old female who had to give up my dream career due to several debilitating conditions. I have been able to participate in, and have some quality of life thanks to opioid medication. Prior to receiving this medication I was bed bound for eight months in constant excruciating pain, and quite frankly nearly suicidal. If I had not had an infant and three other children at that time, I probably wouldn’t be here today. Luckily I found a wonderful pain management doctor that prescribed my opioid pain medication. I have had many tests, lab work, physical therapies, hydrotherapy, chiropractic care, massage therapy, steroid injections in my spine from my neck to my tailbone, even burned the nerves on spine that transmit pain with radio frequency, and have improved as much as I ever will, yet I am disabled with no hope of improvement. My pain medication doesn’t completely eliminate my pain, but it makes it manageable. <br/>I have been on the same dose for 15 years. I have never felt “high” from taking my medication. I have never felt withdrawals if I skip doses on low pain days. I never take more than prescribed, and only take what is necessary according to my pain level that day. I may need one pill or up to six. <br/>I belong to many online support groups, and I am terrified and appalled by the amount of people who have either been force tapered, or cut off abruptly from their medication as a result if the CDC’s 2016 “guidelines” for prescribing opioid medication. Many doctors are being terrorized by the DEA. Pharmacists are refusing to fill prescriptions. Cancer patients, sickle cell patients, and even amputees are given Tylenol to manage their pain. Nurses are withholding medication after surgeries. We are treated like addicts and criminals. <br/>It’s nearly impossible to abuse a legitimate prescription with the PDMP(prescription drug monitoring program), pill counts at doctor appointments, and random urine drug screens that not only check for drugs that you shouldn’t be taking, but also for drugs that you are supposed to be taking. <br/>Opioid prescriptions are down 42%, and overdoses are at an all time high , the majority of which are ILLICIT fentanyl and poly drug overdoses. Only 1% of overdoses have a prescription, yet chronic pain patients are being abandoned by physicians because their fear of the DEA and losing their license is greater than their desire to help their patients. If everyone that has been prescribed opioid pain medication became addicted, the deaths from overdoses would be much higher. The truth is that addiction runs in families and there is a genetic component that affects whether someone will be an addict. <br/>The pendulum has swung too far in the opposite direction. Chronic pain patients are collateral damage of the war on drugs. We need our medication to participate in life. Addicts abuse drugs to escape life. The addict will move on to their next drug of choice, meanwhile pain patients are committing suicide rather than existing in excruciating pain 24/7. I used the word existing rather than living, because that’s what it feels like. Also, many pain patients are forced to choose between their psychiatric medications and pain medication. Would you force a diabetic who also has high blood pressure to choose which one to treat?<br/>I recently received a letter from my pain management doctor stating that they are closing their outpatient physicians clinic “due to increasingly difficult regulatory conditions“. I now have to find a new pain management doctor. <br/>When I was young and healthy, I never understood how any situation could be so horrible that it would warrant taking your own life. I found out that it could. I don’t remember what a totally pain free day feels like, but I remember the days before opioid medication that nearly killed me. That infant daughter that saved my life is now 20 years old. If my medication is taken away, I’m not sure that I will be able to convince myself to live like that again. <br/>Our healthcare needs to be put back in the hands of our doctors, not people that have never been educated on how to treat pain.<br/>I am now sobbing uncontrollably after reading this out loud to my husband. I implore you to include very clear verbiage that protects chronic pain patients both existing and past who were force tapered or abruptly abandoned. Always remember that EVERYONE is one accident or illness away from becoming a chronic pain patient!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angela	None	None	0900006484fe4e4f	Frise	None	2022-03-26T21:17:52Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Frise , Angela	l16-vekv-9d7t	False	None	False	2022-04-12 04:20:29.719	[]
2955	CDC-2022-0024-2961	https://api.regulations.gov/v4/comments/CDC-2022-0024-2961	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow the doctors to decide how much opioids are given to their patients, it should never be dictated by a government agency, the doctors know their patient's history, diagnosis and they went years to medical school. The DEA are terrorizing doctors and pharmacies who do want to help the chronic pain patient. Prescription drugs are not causing the spike in overdose deaths. Ninety thousand overdoses were recorded in 2020, a huge increase, but 87% of those were caused by illegal street drugs, notably fentanyl and heroin, not a prescription medication. Why are they attacking doctors, pharmacies, post-op patients and the chronic pain patients then if they know this? Studies show less than 1% of them become addicted, not 25% as alleged. Millions of patients who followed the rules and their doctors have been cut off altogether or had their dosages slashed. As we reduced the number of opioids out there, chronic pain patients become medical refugees. People are dying!! Tapering also causes desperate patients unable to get pain control from their physician to “self-medicate” by obtaining heroin or illicit fentanyl, often with tragic results. Another heartbreaking outcome of improper tapering is suicide. Limiting the number of pills [that patients can get] is not going to work. All it’s going to do is screw people.”<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gloria	None	None	0900006484fe4e68	Jackson	None	2022-03-26T21:20:04Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Jackson, Gloria	l16-vjjy-0ibc	False	None	False	2022-04-12 04:20:29.931	[]
2956	CDC-2022-0024-2962	https://api.regulations.gov/v4/comments/CDC-2022-0024-2962	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We are patients. We are not addicts. Screening chronic pain patients for OUD or addiction should be voluntary. Until expensive urin drug sampling, pill counts and contracts are completely voluntary, the relationship between patients and doctors will not be restored. Involuntary addiction screening is a an unnecessary misapplication of the guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fe4e76	Fimrite	None	2022-03-26T21:20:26Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l16-vlch-wtzv	False	None	False	2022-04-12 04:20:30.162	[]
2957	CDC-2022-0024-2963	https://api.regulations.gov/v4/comments/CDC-2022-0024-2963	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to point out when they discuss treating acute pain without opioids that when prescribed and managed by reputable physicians, opioids are not poison. While sometimes opioids really aren’t needed, it is only when acute pain is mild to moderate and comes with an expected short recovery period. In cases of severe acute and high impact chronic pain, opioids are most certainly needed, and not necessarily at the lowest possible dose, for the shortest duration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fe4ef2	Fimrite	None	2022-03-26T21:20:39Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l16-wbem-yjr4	False	None	False	2022-04-12 04:20:30.374	[]
2958	CDC-2022-0024-2964	https://api.regulations.gov/v4/comments/CDC-2022-0024-2964	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescription opioids relieve the most severe pain where other methods often fail. They provide comfort and prevent the absolute agony of severe pain. They give chronic pain patients a break from the everyday pain and agony they have to endure. By lowering the extreme stress of having severe pain, they can reduce the incidence of pain related cardiovascular and adrenal problems, chronic pain, disability and death. This is proven by scientific evidence, but why isn’t it ever mentioned in the guidelines?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fe4f24	Fimrite	None	2022-03-26T21:20:50Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l16-wixg-icag	False	None	False	2022-04-12 04:20:30.590	[]
2959	CDC-2022-0024-2965	https://api.regulations.gov/v4/comments/CDC-2022-0024-2965	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was a healthy mother of 2 teens, working hard when I was injured. My back surgery followed by more surgeries, then migraines, then no vein access, then wheelchairs, canes, walkers, bed. You name it. I took injections, pills, surgerical procedures and more. I now have to use medical marijuana to keep my pain under control. I think we need more leeway with the doctors decisions than this would allow. I am concerned with all the problems that have been caused by trying to get the opiod crisis under control. It is the fakers, the liars, that cause all of us that do suffer daily to go through more emotional garbage and judgement by society and the medical community overall. I have known many who have died in pain, whether it was suicide or overdose, or just the end of life. These actions affect so many lives. Please take all the picture into consideration.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Constance	None	None	0900006484fe4f7d	White	None	2022-03-26T21:21:13Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from White, Constance	l16-wuvg-0lkv	False	None	False	2022-04-12 04:20:30.806	[]
2960	CDC-2022-0024-2966	https://api.regulations.gov/v4/comments/CDC-2022-0024-2966	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have non relenting life altering pain in my mid-back and under my ribs This arrived suddenly fifteen years ago with no provocation.  I have undergone numerous tests to find the root of this problem to no avail.I have tried a multitude of treatments, all to no avail.  I am appalled at the suggestions made by non chronic pain sufferers both in and out of the medical  field - yoga, meditation,acupuncture, swimming,physical therapy,counselling, etc etc etc.  I wish these "experts" could feel my pain for just a day.   I have tried all the treatments available including the above and NOTHING has given me relief.  Adding insult to injury, my insurance company is very restrictive so I have to travel 1-3 hours to attend specialty appointments which only exacerbates my pain.  I must attend a pain specialist appointment every month to get my pills refilled, which is a 1.5 hour drive. I previously saw a doctor in town, but he got scared out by the 2016 guidelines.  I am happy that I seem to be one of the lucky ones that actually has a pain specialist that will give me Hydrocodone. The pills have been reduced to a point where I have to skimp and plan when I want to be able to live my life and when I will have to stay home and suffer.  I have been able to hold down a job with my pain meds although I need to work less hours when my pills don't get me through. I have to undergo random urine drug tests which only make me feel like a common criminal AND I also get to pay for them since my insurance company recently has not been covering them.  Having chronic pain is not only physically painful, it is mentally exhausting, financially difficult and extremely demeaning!  I implore you to change your outlook on the chronic use of opioid drugs to help those of us who truly are suffering with debilitating pain!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	0900006484fe4fe6	Aronson	None	2022-03-26T21:24:59Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Aronson, Kim	l16-xvm9-bvn1	False	None	False	2022-04-12 04:20:31.016	[]
2961	CDC-2022-0024-2967	https://api.regulations.gov/v4/comments/CDC-2022-0024-2967	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The original CDC guideline basically destroyed my life. Forcing Dr.'s to invite the gov into their prescribing, governed by an abstract MME #, instead of prescribing based on managing my subjective pain nearly forced me to suicide. I went from what would've been over 300 MME for ten years, to IMMEDIATELY cut to 100, then under, in six weeks. I didn't sleep a SECOND for over two, (because I should add, they also immediately discontinued my valium (muscle relaxant) cold turkey.) I lost almost 80 prct of my hair, it was falling out from pain and stress. I couldn't work and spent ALL of my savings on my expenses. Losing close to everything, not to mention nearly my life bc life in as much pain as I've been in has not been living. <br/> I tried to find other clinics, but they were ALL just as controlled by this totally meaningless document and "MME". Something I'd never heard of before in having been in pain management for over 17 years. Suddenly, it went from concern over how to best control my pain, to how to best CONTROL their perception to the DEA. They didn't care how patients felt or their pain, they cared about themselves. Forcing all patients to a 1 size fits all prescribing is absolute irrational, madness. It doesn't take into consideration individual metabolisms, reaction to drugs, tolerance, or WEIGHT/HEIGHT. A 400lb man at six eight, has the same ceiling as a woman whose 4'2. Are you serious? How the prescribing in a speciality clinic such as pain management became the business of those w/ no medical background or insight is CRUEL & unusual punishment to the patients who are already suffering to get through each day. Just bc there MAY be some dishonest patients, lying about their conditions across the country & misusing/selling their RX SHOULDNT be used against Physicians OR their honest, suffering patients. <br/>If ANOTHER version of the CDC guideline comes out and DOESNT RECTIFY the original, it may result in my eventual suicuide. I've been praying/hoping for a rectification of this atrocity since it started & was promised this version would be it. Although, its hard to imagine how it could be when the CDC has no business in any doctor's office/prescribing to begin with. Are they MD's? No. Do they understand pain? No. Whether intended or not, their "guideline" has been written to law in states and treated as law in others. Leaving all clinics to prescribe STRICTLY based on this pseudo science MME limit. It's destroying genuine patient quality of life in ways that's INEFFABLE. The DEA should be worrying about policing the proliferation of illegal fentanyl & pill presses that have exploded in response to the POLICING of all pain patients across this country. Yes, leading to those in genuine need to hit the streets and ultimately be sold illicit fentanyl under the guise of oxycodone pills. Had they been able to get their USUAL prescription dose/qty they had been b4 the guideline, theyd never reach desperation so high they'd buy off the streets. This is a reality happening TO EVERYONE suffering across the country as a result of these incompetent guidelines.<br/>So, please: Rectify the original guidelines by STATING IT WAS AN ERROR, that the MME was misapplied, misunderstood and ultimately pseudoscience & prescribers MUST be given their freedom to prescribe WHATEVER MME back.(w/o fear) What 10 MME is 2 one person, ISNT what 10MME is to another. No 2 ppl are the same, hence why Dr.'s are in charge of closely determining these things. If you care about this country, the people with chronic painful conditions who are suffering and the medical professionals who have spent their careers trying to help ppl who they NOW CANT bc of your restrictions, ask: what are you accomplishing? The opiod "crisis" isnt a result of legitimate prescibing, instead illicit street fentanyl OR other drugs "w/ opioiods" that get reported as just opioiod deaths. (despite having alcohol, cocaine, meth, etc as well)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe500d	Anonymous	None	2022-03-26T21:25:27Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-y9f6-bnm5	False	None	False	2022-04-12 04:20:31.245	[]
2962	CDC-2022-0024-2968	https://api.regulations.gov/v4/comments/CDC-2022-0024-2968	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patients are the only group of patients who experience real physical pain and yet have to fight the entire medical establishment, as well as the United States government, in order to get the only class of medications that have been specifically made to relieve physical pain. <br/><br/>"Quality of life is something everyone deserves and has been increasingly recognized as one of the most important parameters to be measured in the evaluation of medical therapies, including those for pain management. Pain, when it is not effectively treated and relieved, has a detrimental effect on all aspects of quality of life."<br/><br/>https://www.sciencedirect.com/science/article/pii/S0885392402004116<br/><br/>While the role of the people hired by the CDC to write their <br/>anti-opioid policies and see that they become mandates by releasing false information regarding drug overdose deaths. They're tasked with reducing the prescribing of opioid analgesics AT ALL COSTS, even at the risk of human life and suffering. The American Medical Association (AMA) issued a report showing a 44.4 percent decrease in opioid prescribing nationwide over the past decade. Smile, at the same time, there's been an increase in overdose deaths from illicit drugs, illicitly obtained drugs, and polypharmacy including alcohol. This proves what the AMA and FDA have been saying all along, the drug overdose epidemic we're experiencing has absolutely nothing to do with chronic pain patients, pain management doctors, or opioid analgesics prescribed to patients suffering with chronic pain. <br/><br/>So why is it that the CDC and their anti-opioid panel want to ensure that people suffering with chronic pain aren't given any real hope of increased quality of life through pain management? Why is it that the CDC and their anti-opioid panel want to ensure that people suffering with chronic pain aren't given any real hope of receiving adequate doses of the only class of medications that were specifically made to treat pain?<br/><br/>We're told to go for psychotherapy, which overall has a "FIFTY PERCENT FAILURE RATE! 35-40% experience no benefit whatsoever!" Patients suffering from physical pain, who are sent for acceptance therapy or talk therapy, have closer to a 90% failure rate. Why? Because physical pain isn't a mental disorder. <br/><br/>Patients suffering with chronic lower back pain are very often forced to undergo injections, which are incredibly dangerous and have long term health consequences. This is what we know about Injections:<br/><br/>"Pfizer in 2013 asked FDA and other regulators to ban the use of Depo-Medrol injections near a patient's spinal cord, noting that the company had received hundreds of complaints about patients experiencing complications and injuries related to the injection's use near the spinal cord. Pfizer wrote Depo-Medrol "must not be used by the intrathecal, epidural, intravenous, or any other unspecified routes." According to the Times, Pfizer's request to ban providers from prescribing Depo-Medrol for a particular off-label use is unusual, but some physicians have said Pfizer in this case had concerns about being held liable for the off-label use. The Times reports that drug manufacturers do not have the same protections for off-label uses as they do for approved uses.<br/><br/>While FDA did not ban the epidural use of Depo-Medrol, the agency in 2014 authorized a stronger warning that steroid injections near the spine could lead to injuries or death. FDA's warning applied to Depo-Medrol and "the entire class of epidural steroid injections," the Times reports. This class of drugs is injected into the epidural space within the spinal cord, but when injection is not administered appropriately and a target is missed, patients can sustain direct injures to their nerves."<br/><br/>https://www.advisory.com/daily-briefing/2018/08/17/injection<br/><br/>The following site talks about the top 5 reasons to avoid epidural steroid Injections. Epidural injections are incredibly dangerous, and yet they're the most used and required treatment used by pain management doctors to treat lower back pain.<br/><br/>https://nervedisc.com/the-5-top-reasons-to-avoid-epidural-steroid-injections/<br/><br/>Even the American Medical Association concluded that the country no longer has a prescription opioid driven epidemic. In fact the American Medical Association also concluded that the CDCs 2016 opioid guideline has cause great harm to patients suffering from chronic pain.<br/><br/>The role of the AMA is to "ameliorate suffering and contribute to human well-being. Both the AMA and FDA believe the CDCs anti-opioid guideline are harmful and should be retracted in their entirety. Let's get back to allowing doctors to do the doctoring and allowing them to be the judges of how to treat chronic pain under the guidance of the AMA and FDA.<br/><br/>https://www.bmj.com/content/372/bmj.n448<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484fe4aec	Spiegel	None	2022-03-26T21:26:02Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Spiegel, Julie	l16-zveh-k96d	False	None	False	2022-04-12 04:20:31.456	[]
2963	CDC-2022-0024-2969	https://api.regulations.gov/v4/comments/CDC-2022-0024-2969	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prior to the original CDC guidelines, I was a pain patient for over 10 years after two failed spinal surgeries (due to the surgeon using non medical grade hardware, ult. butchering me at 24) i was stable in my pain, albeit, still in a good amount of it. My pain dr's still listened and prescribed based on my inevitable tolerance increasing & personal needs. It was managed. My life was tolerable. <br/>Fast forward to 2017 when the guidelines came into effect here and it was like nothing mattered except a "one size fits all" prescribing that was created. ACROSS THE STATE. I was cut from the meds I was stable on for a decade to a quarter of it in less than 2 months. That wasn't enough time to even keep withdrawals from destroying my life, let alone my body to adjust. These changes weren't made bc I was in less pain, requested a decrease or no longer needed them, it was for non patient, non medical reasons due to fear of "license revocation" or being shut down. Despite these guidelines being just that, evryone took them as law. Even though the intended AUDIENCE was made for "family practice", not pain specialists, it didn't matter...everyone changed their prescribing in a DETRIMENTAL manner to patients ALREADY receiving higher doses, not "new to opioiods" but you knew this would be the case. <br/>People on higher doses arent on them bc they didn't try everything else, it's bc everything else failed them to the point of them REQUIRING these doses. No one wants to be on narcotic pain meds, but if your life finds you in such a dark place that you require them not to suffer indescribably, it's no one's place to tell them they don't need a dose that actually brings them relief. It's not like we prefer higher doses for the same relief, it's our physical chemistry that dictates it; something Dr's understand (typically). <br/>Unless and until Dr's in the pain medicine profession are given the freedom to prescribe w/o oversight of "MME" or patients over 90 MME, with fear of reprimand, people will be suffering. People will end their lives. People will hit the streets for meds that r actually illicit fentanyl. It isn't just "addicts" seeking them anymore, as a result of these oversights, bc now they can't get the relief they should from the pharmacy and MUST go elsewhere or risk ending it. When you have a condition that cannot be improved & face a lifetime of pain now knowing it can't even be adequately controlled, why would you bother waking up 2 more suffering? Your tolerance will only grow and the pain will only worsen. <br/><br/>The new guideline states that there is limited, to no data on pain controlf or patients on doses over 90MME. (bc they cant do, or dont do studies of patients on these doses) So, how then, can they make so many conclusions and offer so much instruction for patients receiving these amounts? They don't even have data! Well, here's some data from a patient who's been on it for over 10 years, my functioning level was at next to ZERO until I found a doctor who increased it from fifty MME to (slowly) over 200 where it was required. I HAD been in so much pain I couldn't tolerate being awake. The change in dose allowed me to start my own business, finish school and have a life. Before that, I was bed bound for YEARS!!! So, to suggest/state that increasing patient doses over fifty mme doesn't have a significant improvement in functioning is patently false (its a GUESS 2 begin w/) but they list these assumptions as fact. <br/>Until a new class of drugs comes out to aid in pain of the millions suffering, it's wrong to limit doctor's from helping those who chronically need it. The goal isn't to "taper" everyone, its to control pain. Clearly, the authors of this document's agenda isn't about patient pain, it's about the DEA, reducing drug sales illegally, stopping overprescribing (which i think we all don't approve of; there's a diff between adequate and overprescribing & to claim anything over 90mme is overprescribing is inhertently problematic) & intimidating prescriber's. <br/>As soon as there's a provider's prescribing is influenced by things other than the patient's history, pain, needs, individual XYZ, but instead potential repercussions from the GOV, other prescribing boards etc, individualized care is out the window and these Provider's may as well be replaced by AI, bc their job is just an algorithim determined by the CDC.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484fe4af3	Klimas	None	2022-03-26T21:26:21Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Klimas, K	l16-zx9v-mjgh	False	None	False	2022-04-12 04:20:31.671	[]
2964	CDC-2022-0024-2970	https://api.regulations.gov/v4/comments/CDC-2022-0024-2970	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Many CPP sound like me desperately trying to live some kind of life. Getting cut down to 50MME is like the final cut. I was hanging with the last thought that we might get my pain medication when these new guidelines are released but sadly enough the help you said was coming was a false promise.<br/>I just lost my pain management Dr because apparently he was being a dumbass. So I'm 2 weeks away from absolute misery which will probably end with a bullet. I'm so sick of trying to find adequate care. I'm so tired of being miserable and I've been one of the luckier CPP's for the past few years. I did WANT to be dead but I'm tired of being treated worse than we treat animals!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe4af4	Anonymous	None	2022-03-26T21:26:50Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l16-zzgj-sdk6	False	None	False	2022-04-12 04:20:31.892	[]
2965	CDC-2022-0024-2971	https://api.regulations.gov/v4/comments/CDC-2022-0024-2971	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2005 I was diagnosed with osteomyelitis. I had an infection that ate through 2 of my vertabrae between L1 and L4. I had surgery that rid me of spiderwebbed infection and added 2 titanium rods from L1 to L4. 17 years later I'm still experiencing pain from just under my shoulder blades down to feet. I've had epidural shots, a spine stimulater and even tried physical therapy to no avail. Because of these restrictions I was taken off of opioid pain medication and given a plethora of medications that did nothing for my pain. As of today, I no longer rely on any medical field for help. I have resorted to other possible dangerous resources for help. Because I'm now disabled these other methods are very costly, probably illegal and as mentioned before dangerous. I understand that there was an epidemic where people abused these meds but not all of us on pain meds abused them. We took them AS NEEDED to be able to function and try to retain a quality of life we are all entitled to. These restrictions have done nothing but shame people with chronic pain and basically turned us into social pariahs if not heroin junkies. Another problem is unless you are rich you're not going to get the care you need. Medicaid/Medicare just screams of nothing but poor and therefore probably drug seekers, frequent fliers and all of the other shaming labels that have been fixed upon us. None of this is fair. None of this would be happening if the restrictions the CDC put on these drugs and from what I'm to understand had absolutely no right to. Please lift these restrictions and do us all a favor. Stay to diseases and such because you have no right controlling something that is not in your realm. For God's sake help us. Please...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484fe4b37	Taivalkoski	None	2022-03-26T21:27:02Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Taivalkoski , Charles	l17-1ixj-tosb	False	None	False	2022-04-12 04:20:32.109	[]
2966	CDC-2022-0024-2972	https://api.regulations.gov/v4/comments/CDC-2022-0024-2972	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It's a disgrace to choose the most vulnerable group of people and deny them their right to managed pain. You have taken away every right they have! Subjecting them to a miserable life of suffering! Millions of people are suffering because of what you view as an epidemic? You decide how to treat pain without having seen the patient? Who do you think you are? This is a dark period in America! Sacrificing one population for another!!! Shame on you!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe5066	Anonymous	None	2022-03-26T21:27:17Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-2ajh-aqp3	False	None	False	2022-04-12 04:20:32.325	[]
2967	CDC-2022-0024-2973	https://api.regulations.gov/v4/comments/CDC-2022-0024-2973	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC’s stated mission is: “To promote health and quality of life by preventing and controlling disease, injury, and disability.”<br/><br/>And yet seemingly, your organization is unaware of the harms that the 2016 Guidelines for opioid prescribing have done to chronic pain patients and their doctors. And now your 2022 Guidelines look like they will cause even more harm by tacitly discouraging doctors to treat us with opioid prescriptions. For many of us, our opioid prescription has been the only thing keeping us from being bed-bound. I question if encouraging a decrease in opioid prescribing will improve the “quality of life” that your organization’s mission statement claims to promote. Suffering people have relied upon their opioid prescriptions for many decades to have better quality of life but have become disabled when their pain is uncontrolled. To cause disability in people flies in the face of everything that your mission claims to be about. <br/><br/>As a chronic pain patient, I beg you to please retract all prescribing guidelines and apologize for the harm that you have done to us. We pray that you will leave us and our doctors alone. The harm you have done to the pain community will take decades to correct. You have participated in creating an opiophobic environment, making it nearly impossible for chronic pain patients to now have quality of life. <br/><br/>The 2016 and now the 2022 Guidelines for opioid prescribing exerted undue influence on pain management doctors in a covert way. Doctors are now terrified to prescribe pain medicine, numbers of innocent doctors have been jailed and their lives ruined simply for prescribing opioids to people in pain. This has driven pain patients to the streets for pain relief, numbers of them have committed suicide. Is this what you intended to have happen?<br/><br/>Please retract all Guidelines for Opioid Prescribing, let doctors care for and keep watch over their patients. The Guidelines have caused unneeded complication. Your organization seems to be hurting Chronic Pain Patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daina	None	None	0900006484fe5071	M.	None	2022-03-26T21:27:31Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from M., Daina	l17-2bpu-si4q	False	None	False	2022-04-12 04:20:32.535	[]
2968	CDC-2022-0024-2974	https://api.regulations.gov/v4/comments/CDC-2022-0024-2974	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If the CDC had reported the true overdose numbers starting in 1999 would all of what happened to pain patients? I believe the answer is no. The CDC reported from 1999-2013 the number of overdose was 400,000. I didn’t think about it at first but the number was for the world. If the CDC had been honest with the number of overdoses each year we would not be here.<br/><br/>The CDC allowed millions of pain patients to be cut off their pain medication. The CDC allowed pain patient doctors cut their patients off their pain medication or put them through a fast taper. The CDC allowed them to abandoned their patients, leave their practice, forced retirement, change their practice and loose their license to practice. The CDC allows this to continue. The CDC allowed the government into patients and doctors lives. Allowed the DEA to act like The Gestapo threatening to continue jailing doctors. The DEA does seem to bust more drug dealers but it’s like they spend more time going after our doctors.<br/><br/>After 20 years the news still blame the doctors and their patients to be the cause of this when they know that is not the truth. Why is fentanyl kept out of the news when it was the cause of all of this. <br/>The CDC released a correction or tried to in 2019 but it was too little to late. The damage was already done because the CDC allowed all this to happen so many pain patients were forced into the street for relief they became one of the overdose numbers. <br/><br/>I have told pain patients this time will be different. This time they will fix what they did to cause this. I tell them maybe the CDC will listen for once when it has requested comments they will do something. I realize nothing is going to happen. Every time request are made for comments nothing happens. Nothing happens. Nothing changes. Doctors have started cutting patients down to 50MME just like they did with the 90MME. How do I know the CDC will do nothing? They never have. With all of us tell our heart breaking stories nothing will happen. If the CDC would advertise they are requesting comments more than 5,000+ would be commenting.<br/><br/>As I sit her wondering if I can make it through another sleepless night. This time I don’t think so. How will I do it? Most of have it all planned out for when that second happens. I can’t stand it another second. I’ve tried to end it several times but I mess up. Tonight will be different. My husband or kids won’t know, should I slit my wrist? Shall I sit in the car? Should I take an overdose of Tylenol? No this time I will go in the car it’s really cold out. Drive to the mountains start walking until I can’t do it anymore. I can’t walk too far and I can’t take my wheel chair I must sit in now so I’ll just need to walk out there in the dark and cold until we’ll just in til.<br/><br/>Please tell me I’m wrong that the CDC will fix this. Admit what happened and give the pain medication back to the patients. They will save lives instead of killing pain patients. We can’t do it anymore. We are strong people. Millions were cut off their pain medication, went through a forced withdrawal and most of us came out on the other side. We smile when we are asked hoe we feel when inside we are screaming.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484fe5080	Jolley	None	2022-03-26T21:37:19Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Jolley, Christine	l17-2wxx-fy36	False	None	False	2022-04-12 04:20:32.751	[]
2969	CDC-2022-0024-2975	https://api.regulations.gov/v4/comments/CDC-2022-0024-2975	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The overdose count numbers and how the CDC reports them.<br/><br/>I want to stick with the 2016 reported numbers because most of us are familiar with these numbers. This started the destruction of the CPP community. This is how it works.<br/><br/>The overdose count is from June 2015-June 2016. Once this year ends the CDC issues a provisional count to estimate the number for that year. What is a provisional count?<br/><br/>https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm<br/><br/>This estimate number represents overdoses from 2015-2016 and is based on nothing no data. The CDC admits the provisional count reported was inflated by 54%. This is what they report as correct numbers. The CDC does this same process every year.<br/><br/>Before the correct numbers are released the CDC reviews the death certificates and toxic reports. This takes a year+ to review. While reviewing these the CDC admits what the difference is from coding. The toxic screens show overdoses involving street opioids, prescription opioids are reporting under the same codes and now the CDC needs to separate them. Out of the 42,249 opioid overdose 67% are from IMF (illicit manufactured fentanyl, heroin).<br/><br/>The total number of overdoses deaths is 63,632 (what is not known is not all of the 63,632 overdose deaths included an opioid). Out of that number only 42,249 involved any opioid. Out of that number 17,087 involved prescriptions (I have this same information for every year except 2020. The have not released the true correction yet). On 4-12-2018 the CDC releases the correct numbers for 2015-2016. <br/><br/>What this does to the 400,000 the CDC reports makes me think this is for a few years. The number is for 1999-2018 which is a 20 year period and a involves a world count. Think if we apply the same theory how much lower the number is.<br/><br/>For 2020-2021 the provisional count is 104,000. IMO the estimate is out of that number 70,000-75,000 included any opioid. Out of that number 67%+ are from IMF. Out of that number 20,000-25,000 or less related to prescription opioids.<br/><br/>Read this article closely it supports everything I am posting.<br/><br/>https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2017.304265?journalCode=ajph	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe5086	Anonymous	None	2022-03-26T21:37:39Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-3cln-vzuh	False	None	False	2022-04-12 04:20:33.009	[]
2970	CDC-2022-0024-2976	https://api.regulations.gov/v4/comments/CDC-2022-0024-2976	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi. I am intractable pain patient that was turned away from palliative care because I take pain medicine. <br/>I was discriminated against due to my disability of chronic pain. I may need a full right leg amputation however, I am afraid to have surgery because so many hospitals are treating surgical pain without opioids. <br/>I cannot get pain management to treat me like any other patients needing care. I have to go to ua drug screens and pill counts. No one counts my other life saving meds. My dr dropped me from care in 2016 due the CDC guidelines being applied wrong. The harm was great. I have considered suicide. <br/>Give pain patients their meds back <br/><br/>Please take out any arbitrary morphine milligrams equivalent limits so the doctors will treat each patient as an individual. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fe4b7e	Stifle	None	2022-03-26T21:37:53Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Stifle, Michelle	l17-4hxb-kga3	False	None	False	2022-04-12 04:20:33.227	[]
2971	CDC-2022-0024-2977	https://api.regulations.gov/v4/comments/CDC-2022-0024-2977	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This needs to stop. People in pain are dying because of this guideline. You’re going to make it worse with this second guideline. Enough already.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe4c64	Anonymous	None	2022-03-26T21:38:01Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-4t0a-clr3	False	None	False	2022-04-12 04:20:33.437	[]
2972	CDC-2022-0024-2978	https://api.regulations.gov/v4/comments/CDC-2022-0024-2978	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing on behalf of my wife. She has been forced to taper the medicine that once helped her function. She had a wonderful doctor who managed her pain but, he was forced to retire. Her new doctor will not prescribe what is needed and acts as if he is a godsend allowing her to taper against her will.<br/> Why are we paying to see someone monthly that is supposed to manage pain but, who causes pain. Its undignified, insulting and stupid. Some people need more pain medication than others. It is not rocket science.<br/> Wrong's need to be righted overnight. People need what they need for pain it is subjective. Get rid of the ridiculous MME equation. If you can get millions of people Covid-19 shots overnight you can get people the pain medications they NEED to help them function. I want to see my wife live again. Please do something as fast as you would if it were you in the worst most unrelenting pain you have ever experienced.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Garrett	None	None	0900006484fe4c66	Westover Jr	None	2022-03-26T21:38:14Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Westover Jr, Garrett	l17-52a7-g7ii	False	None	False	2022-04-12 04:20:33.685	[]
2973	CDC-2022-0024-2979	https://api.regulations.gov/v4/comments/CDC-2022-0024-2979	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC 2022 revised and expanded guideline looks worse. Instead of the veiled threat against doctors of a 90 mme limit, there is now an even lower cap of 50 mme implied and this too will likely be interpreted as a hard limit, giving insurance companies excuses not to cover treatment and law enforcement reasons to persecute pain management doctors. <br/><br/>This is not acceptable! The CDC Guidelines of 2016 did not decrease the addiction/overdose rates and now the equally as potentially harmful 2022 Guidelines for opioid prescribing seems to promise more of the same harm. Please step back and allow medical professionals to police themselves. <br/><br/>The CDC seems to have an agenda. In collusion with the DEA and DOJ your group seems to be seeking to eliminate opioids from the face of the earth regardless of the harm it causes to people whose lives are already devastated by having to live in intractable pain! For millions of chronic pain patients, opioid therapy is the last bastion of help for their intractable pain after having tried every other possible avenue.<br/><br/>All of this has been done in a misguided effort to thwart addiction. But this has not happened.<br/><br/>Since 2016, the prescribing of opioids has decreased and yet overdoses and deaths have increased. <br/><br/>Stop writing guidelines! Who asked you to do this in the first place!?<br/><br/>The government has no right to insert itself into a doctor’s treatment of his patient. Every aspect of our lives feels like it is becoming a police state where our every move is monitored, including our medical records and care. Many of us who live in constant pain now believe that the CDC is fully aware of the harm they have caused and feel that your organization is no longer trustworthy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe51d4	Anonymous	None	2022-03-26T21:38:44Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-5y8c-h1f2	False	None	False	2022-04-12 04:20:33.901	[]
2974	CDC-2022-0024-2980	https://api.regulations.gov/v4/comments/CDC-2022-0024-2980	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should not write guidelines for Opioid prescribing - prescribing is between a pain patient and their doctor. By doing so, the CDC has effectively ruined the trust between doctors and patients and limited the very few treatments that are left for chronic pain patients. Using your Guidelines as a blueprint, the DEA has been whittling away at the numbers of physicians left who are willing to help us.<br/><br/>Dosage caps are something that is carefully tailored by a doctor to the individual pain patient based upon their metabolism and the extent of their illness, injury or pain level.<br/><br/>Please leave Chronic Pain Patients and their doctors alone!<br/><br/>Chronic Pain and addiction are two different issues. One cannot be conflated with the other and both issues require different handling. <br/><br/>Pain patients should be treated on an individual basis, by a physician who is familiar with the patient, not a cold government-associated agency or law enforcement who is clueless about the patient’s ailment or disorder.<br/><br/>People with Chronic Pain cannot continuously live in the kind of pain that we do. Uncontrolled, persistent pain elevates the blood pressure, causes strain on the heart among other health issues. Uncontrolled pain decreases quality of life and causing people to have to rely on disability benefits when their pain could easily be treated allowing them to continue working and contributing to society. <br/><br/>There is no need to involve federal agencies such as the DEA and CDC or make blanket guidelines for all patients whose lives and illness are nothing more to these organizations than words on paper. That is both dangerous to the patient and undermines the sacred trust between a doctor and patient. Doctors are capable of watching for and recognizing signs of addictive tendencies in their patients and recommend them for treatment accordingly. <br/><br/>The CDC, DEA and insurance companies should not interfere with treatment of illness or pain nor should they set dosage limits on medications. This should be up to the doctor who can monitor if a patient is using their medicines correctly. <br/><br/> <br/><br/>The CDC has overstepped its bounds by interfering with the treatment of pain and should retract all guidelines and stay out of the business of doctors and their patients. <br/><br/>The risk of addiction in pain patients on opioid therapy is normally less than 1%. The benefits of opioid prescriptions far outweigh the risks when the patient is compliant and cooperative. <br/><br/>In attempts to thwart the addiction problem in our country, people with chronic pain, including end stage cancer patients are being forced to suffer or are abandoned as doctors have become terrified to prescribe for them because the 2016 Guidelines became laws.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe51dd	Anonymous	None	2022-03-26T21:39:01Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-63k1-bf70	False	None	False	2022-04-12 04:20:34.122	[]
2975	CDC-2022-0024-2981	https://api.regulations.gov/v4/comments/CDC-2022-0024-2981	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 Guidelines for Opioid prescribing have adversely affected my medical care.<br/><br/>Surgery and after-care pain treatment for patients has become a pain nightmare, directly due to the 2016 Guidelines. Surgery and the pain of recovery should not be torture. <br/><br/>Between 1993 - 2013, I needed 10 surgeries, of various kinds for various reasons. During this time period, I was not terrified of the surgery beforehand because hospitals and doctors always “stayed on top of” the pain. But since the Opioid Prescribing Guidelines of 2016 were released that all changed. I now fervently pray that I do not end up in a hospital again because if there is an issue of pain I will not be treated as properly as I have been in the past. Hospitals and doctors, because of your 2016 Guidelines, are using Tylenol and Nsaids to treat even the most severe cases of pain in patients. Nsaids cause harm and pain to my stomach, is bad for the kidneys and Tylenol, as well as being dangerous for the liver, is completely ineffective for all but headaches and mild body pain.<span style='padding-left: 30px'></span><br/><br/>I am 67 years old. In February of 2020, I had a total knee replacement. In contrast to previous years and surgeries, my pain was not kept “under control” and was “not manageable” afterwards. I was not only under-medicated in the recovery room and by the nurses during my hospital stay, but days later after being released to go home, Walmart pharmacy refused to fill my at home prescription for the pharmaceutical strength indicated by my doctor. They insisted on filling a lesser strength medicine, which did not come close to addressing my pain and caused the following months of recovery and ensuing physical therapy to be excruciating.<br/><br/>Now, I’m traumatized. I need a shoulder replacement surgery which my doctor strongly recommends. The shoulder is bone on bone, the joint is very unstable, falling in and out of the socket and is constantly painful. But because my knee replacement surgery and recovery was such an incredibly painful ordeal, I will not have the shoulder replacement that I need. I refuse to go through that kind of torture again. The CDC’s Guidelines have ruined the quality of medical care in our country. We are now allowing people, including weak and near-death elderly, veterans and cancer patients, to suffer substantially, something which is shameful for a country which is not a third world one.<br/><br/>When taken as directed, pain management after surgery does not cause addiction. If that were the case then everyone who has ever had a surgery would now be an addict. I have had ten surgeries in my life, each time various opioids were used: for anesthesia and post surgically. If the use of opioids during and after surgery universally caused addiction I would have been an addict ten times over.<br/><br/>Why are people in severe and constant pain being punished for the problems of others? Pain patients who have a good track record of proper behavior with their medicine should have a “legacy card” which allows us to use our pain medicines without being treated like a criminal!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe51de	Anonymous	None	2022-03-26T21:39:25Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-65t3-8o5p	False	None	False	2022-04-12 04:20:34.347	[]
2976	CDC-2022-0024-2982	https://api.regulations.gov/v4/comments/CDC-2022-0024-2982	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient, ( a legacy pain patient for 30 years), and was maintained at a SAFE and therapeutic level, which was determined by my Doctor and myself. Now, we don’t have Doctors who wish to care for the millions of pain patients-who through no fault of their own, are left with debilitating illnesses with NO cure. Conditions like Ehlers-Danlos, MS, degenerative disc diseases, osteo-arthritis,and many other painful conditions; amputees, burn victims, sickle cell disease, auto-immune diseases, as well as birth defects, Cancer, trauma from auto accidents,and end of life care.. The CDC guidelines of 2016 had a catastrophic effect on the pain community. The guidelines became LAW in at least 33 States. I am a Resident of Idaho. Opioid meds serve a life-saving purpose for anyone suffering intolerable pain.They are safe when taken as prescribed, with less than 1% chance of addiction.<br/>Yet, the “opioid crisis” made headlines, and the media went with this false info that opioid meds are addicting! The CDC FAILED to mention that the increase of overdoses were from” ILLICIT DRUG USE.”<br/>Yes, street drugs with enough deadly amounts of fentanyl laced into pill presses on the dark web. These drug dealers were poisoning Americans,mostly use from the drug addicted and sonetimes from an unsuspecting Teen or young adult-wishing to experiment and maybe take one of these deadly ILLICIT drugs at a party. Yes, tragic! We have heard loudly, the voices of parents who unfortunately had their child die from these street drugs. What we haven’t heard,were ALL the law abiding pain patients who had a good life , a productive life, an employable life, have it all taken away from them due to the CDC! <br/>Yes, patients were abandoned by their Doctors as now the DEA would go after any MD who prescribed higher than the amount of 90 MMEs. The MMEs need to be tossed out. Start over! The 2022 draft isn’t much better. They want to force patients down to 50 MMEs. This is NOT acceptable! Will they admit they were wrong? That’s the million dollar question. Why is it, that the public remains ignorant about pain relief along with the CDC? We need our Doctors back! They are being arrested and penalized by the CDC. Whatever happened to personal accountability? Now, we see State Attorney Generals wanting a piece of the pharmaceutical companies$$$$ ( a windfall) ,- because guess what? Well, you will hear that the pharmaceutical companies said that these drugs were not addicting. They were for the drug addicted community! So, if somebody mis-uses a drug, and crushes a pill ( when you KNOW you aren’t supposed to, or snort the drug…see where I am going with this? Where is the accountability?. <br/>I have to believe that some of the CDC members have an interest in drug rehab. They do like this drug called Suboxone. But, Suboxone is supposed to be used for drug addicts. They have a term called: “ opioid use disorder”. Guess who gets treated with Suboxone-yes, those with opioid use disorder. Unfortunately, they want pain patients who were force tapered off their pain meds, to now take Suboxone. Well, this is flat out wrong. What we need is common sense here. We need Doctors to return to pain management. The Medical Boards,DEA, need to leave the good Doctors alone. Get educated about the GOOD in pain meds. Now surgical patients are given plain Tylenol for pain. We have gone back to the Stone Age. State legislators : please pay attention: “ listen to the many pain patients who have tried for 6 years for you to listen to their stories,”See the movie Pain Warriors. Please change the LAWs to give opioid meds back to all who suffer. Please use them for surgery and post-op pain. CDC stick to communicable diseases only. Admit you were wrong! [name redacted], RN ( retired). PS I support all comments by [name redacted], PhD, as he submitted his own comments.As a RN, I never let my patients suffer post-op. It is wrong and cruel!, I too have suffered from this nonsense, and was force tapered off of pain meds through no fault of my own. I am a law abiding patient., as are thousands like me!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fe50d0	Clark	None	2022-03-26T21:41:49Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Clark, Kathleen	l17-7fuo-hj5m	False	None	False	2022-04-12 04:20:34.559	[]
2977	CDC-2022-0024-2983	https://api.regulations.gov/v4/comments/CDC-2022-0024-2983	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC . First the old set and new set of guidelines are very similar and you know this. They need to be stopped now they are whats killing us<br/> I want you to know what these guidelines have done to me personally abd also what the new guidelines are going to mean to me personally.<br/>First im a respectable law abiding citizen I have worked hard all my life Because i worked doubles six days a week which later in life helped to take its toll on me.16 years ago I was hit by a drunk driver.I was in the prime of my life. I have a large family they were my life. I helped to rescue homeless animals i gave back to my community.forward to 2021.<br/>My doctor started to take my meds down i didnt understand no notice no reason.I started suffering severe pain on top inwas suffering severe withdrawls. The pain was so unbareable i started to seek out Assisted Suicide. Why would a mom a grandma want to seek ASSISTED SUICIDE? After begging my pain doctor no one would help. I went to the ER 3 times was treated as a drug seeker. The ER doc says i cant give pain meds. I said my head is gonna explode im not asking you for pain meds. Well after a catscan he diagnosed me with CPS. So why do i have CPS chronic pain syndrome? Because my pain meds were lowered.<br/>I suizered on the way to the hospital <br/>The doc says im gonna give you a non narcotic med Norflex. In 15 mins my pain level went from a 100 on the scale to a 4 on the pain scale.<br/>I suffered so bad that was my first time to have any relief.<br/>He sent me home and shortly it started again. I went to my primary care begging for help she gave me painful injections in my buy that helped 5 days than back to the pain and withdrawls which you say i cant get.<br/>From feb 2021 to july 2021 i was basically bedridden my life was over. I coulndt clean cook i couldnt stand are sit to take a bath every inch of my body hurt. I called my rep my senator i called every number to get help and no one would help me. I was slowly becoming a living vegetable worthless useless to my self my family and even my Rescue Animals. My life was over because my body couldnt function my legs didnt want to work any more. I never slept i tossed and turned all night long begging God for sleep begging for rhe pain to stop.<br/>By july i got severe covid after being bed ridden my body was so weak couldnt fight the covid by day 13 it was almost over i went to the ER they doctored me up sent me home to die. 28 days of horrible pain and suffering. By middle aug i realized i was gona live but still in so mych pain what kind of life am i gonna have? It not only affected me physically it affected me mentally i was in such depression fear horror anger laying here half dead and no one would help get me out of pain. So again my doctor lowers my pain meds no notice no nothing no warning. What did i do to deserve this? Are they trying to kill me?<br/>What is going on? Is this the twilight zone when will i wake up?<br/>Than again more pain more suffeting. It got so bad i can barely open a pop top for the kitty food. I stopped rescuing homeless animals. I stopped seeing my family and my grandchildren i stopped going to the thirft store it was my hobby. Id buycool stuff sell it n buy cat food to feed the homeless animals. I stopped driving more than a few miles the pain is so bad. My kitty had a abcess n needed surgery i couldnt make the drive i was in so much pain.<br/>The list go,s on. Im in the process of divorce a few months ago i was letting my husband free why? Because i could no longer be a wife to him to have marital relations was excruciating to say thr least.<br/>I couldnt be a wife why? Because i was in so much pain.<br/>Even going to Church was out. My whole life revoles around a few pain pills that eased my pain enough i could take a shower cook shop do fun things do normal activities just because a few pills you think is deadly <br/>I been on them 15 yrs ive stayed at low doses. Im not a criminal im not abusing my meds im not a drug addict im being very responsible and i havent overdosed why? I take my meds for real legitimate pain.<br/>But these guidelines have stripped me of my ability to function. These guidelines have made people look at me as a criminal a drug seeker a bad person. Im your average grandma cat Animal rescuer im nothing now but a living vegetable your guidelines took a decent respectful lady in her now golden years and DESTROYED HER YOU STRIPPED ME OF MY QUALITY OF LIFE You have taken away my husbands hugs you have taken away my visits to see grandkids you have takin away anything that meant anything to me you took it away because i can no longer function. Every month i live in FEAR WHEN WILL THEY CUT ME OFF COMPLETELY? IM TERRIFIED! My doctor has belittled me tried to push me to get Surgical procedures i didnt need are i couldnt get my meds. Im terrified please stop these guidelines stop pushing <br/>Surgical procedures stop treating us like criminal.<br/>Im begging please help stop my pain i want to live im begging<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe50d2	Anonymous	None	2022-03-26T21:42:52Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-7mdn-t9aj	False	None	False	2022-04-12 04:20:34.805	[]
2978	CDC-2022-0024-2984	https://api.regulations.gov/v4/comments/CDC-2022-0024-2984	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Firstly, thank you for your continual look at impacts of policy. It is appreciated. I am relieved to hear of some changes which allow practitioner and patient more discretion. I have significantly suffered from taper of medications to treat chronic pain. I am 60-years old. I can barely work since tapering, I won't likely get disability for 2 years. I have 2 different types of arthritis. I have late stage Lyme disease. Since taper on pain management, frankly, I have NO life. I still try to engage with family, but I deteriorate as it hurts to "move". I'm too exhausted fighting pain to do much. I get addiction is bad for individuals, families, society. However, being comfortable would be wonderful! I'm sorry for Fentanyl crisis, but is the cause all those who suffer from chronic pain?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe50e2	Anonymous	None	2022-03-26T21:43:06Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-8fs6-xw9e	False	None	False	2022-04-12 04:20:35.024	[]
2979	CDC-2022-0024-2985	https://api.regulations.gov/v4/comments/CDC-2022-0024-2985	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been harmed by the 2016 CDC Guiglines pertaining to opiate prescribing. From 2010 to 2020 I was on a prescription thar was working for me.In 2020 I guess there had been so much mis-information about the "opioid crises" that my doctor of 20 years stopped prescribing. Which caused me and untold millions of other chronic pain patients to suffer needlessly.When there is medication that eases the suffering.There have been hundreds if not thousands of suicides because the person was suffering horrific pain and had lost access to the only thing that brought relief. Just put yourself in the shoes of a chronic pain patient without access to the only thing that eased their suffering. That is not humane. If anything stop the drug trafficking at the borders and leave people that are trying to have some quality of life out of the ridiculous rules that you are making into law.There is absolutely to much unnecessary suffering among chronic pain patients when there is a drug that can ease their suffering.We jump through hoops to make everyone satisfied that we are not a drug addict and are still treated as though we are criminals. This just isn't right no matter how you spin it.Please get out of the Doctors office and let Doctors treat their patients without fear that that the DEA are going to take everything they have worked their whole life for.And let chronic pain patients have a relationship with their doctors without having to worry every month if they will even have a Doctor. It is not the Doctors that are responsible for the "opioid crisis".	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tina	None	None	0900006484fe5217	Mitchell	None	2022-03-26T21:43:16Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell, Tina	l17-blnh-5gpf	False	None	False	2022-04-12 04:20:35.239	[]
2980	CDC-2022-0024-2986	https://api.regulations.gov/v4/comments/CDC-2022-0024-2986	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,i have been a pain management patient for 10years now. I was diagnosed with cirrhosis from having hepatitis c from a tatoo shop. 2 years ago Iwas feeling extremely worse ,I had to quit my job as a data entry clerk for the state of Alaska, my doctor recieved my blood tests back and I was diagnosed with stage 2 liver cancer. I went through two agonizing chemotherapy treatments. Iwas sick,literally screaming in pain, I couldn't get out of bed ,I had to have family members take me to the restroom, i completely lost my dignity and I didn't want to live anymore, my pain doctors had me down to almost nothing they kept telling me that I was on palliative care but no one called or came to see me about this .I read up on palliative care and tapering cancer patients off or down on their medications. I originally went because my back was getting worse and sometimes I couldn't stand up so yjey did an MRI and a cat scan and found out that I had upper and lower scoliosis,spinal stenosis and spondylosis. I was shocked why was all this happening. I just lost my oldest son at age 23 and my only sister at age 36 . Stress like this makes your pain so much worse. I am only 50 years old and I have no quality of life. I want to be me again and visit my kids and grandkids. And go back to work. I'm not on SSI or ssdi because they turned me down and I am too tired to fight with them. I'm begging all of you to take n bmanagement and receiving facet shots and madication.I only received one opiate medication and the rest were not ,they helped my nerve pain, I am also epileptic. Thank you so much for reading all this of these letters. There should be alot more but there are so many people that are completely ill and almost comatose i SINCERELY hope that you will help us who are not drug addicts we are ordinary people who want their life back. Thank you so much, [name redacted](?u<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angelita	None	None	0900006484fe5218	Torres	None	2022-03-26T21:43:49Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Torres, Angelita	l17-bn9s-6s50	False	None	False	2022-04-12 04:20:35.450	[]
2981	CDC-2022-0024-2987	https://api.regulations.gov/v4/comments/CDC-2022-0024-2987	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a veteran and have several service connected disabilities that cause chronic pain. I was on high doses of opioid meds, benzos, and sleep meds prescribed initially by military provider, then continued by the VA after leaving military. After 2 years of VA care management, they suddenly just stopped prescribing most all narcotics. That left thousands of veterans in serious trouble. The VA then labels veterans as addicts and places blame for withdrawals on vets. Patients are then put on Suboxone or Methadone. <br/>My point is that the opioid problems were created by providers, and then patients were forced to look elsewhere for pain control. Providers over-prescribed then cut patients off just to keep themselves from being scrutinized by feds, pharmacists, and media. If a patient even mentions narcotic meds to a provider, they are immediately flagged in their charts, and patient care basically becomes non-existent. The patients are the ones tossed aside due to scared providers. All they really care about is their license.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RANDALL	None	None	0900006484fe521a	HULSE	None	2022-03-26T21:44:20Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from HULSE, RANDALL	l17-bvm9-1ctg	False	None	False	2022-04-12 04:20:35.668	[]
2982	CDC-2022-0024-2988	https://api.regulations.gov/v4/comments/CDC-2022-0024-2988	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The proposed guidelines will continue to harm chronic pain patients. Just as the 90 MME recommendation in 2016 was interpreted as law, the new recommendations will be also. There should be NO 50 MME guideline stated. The entire policy guidelines should just be revoked, and the CDC should admit their error and acknowledge that the current opioid problem is driven by illicit fentanyl, not prescription medication. Furthermore, data should be presented that acknowledges little abuse in chronic pain patients, and especially seniors, the two groups of people hurt most by these errant policies.<br/><br/>My personal experience with this is a nightmare. I won't bore anyone with the details of my medical history, but forced tapering turned my life upside down and has ruined my retirement I worked so hard for. Please, be honest with the American public and acknowledge that the current crisis is drug poisonings in the form of counterfeit pills laced with fentanyl as well as fentanyl added to other illicit street drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Davina	None	None	0900006484fe52e6	George	None	2022-03-26T21:44:57Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from George, Davina	l17-g2v1-bse9	False	None	False	2022-04-12 04:20:35.900	[]
2983	CDC-2022-0024-2989	https://api.regulations.gov/v4/comments/CDC-2022-0024-2989	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 34 years old and live in Idaho. I have Ehlers Danlos Syndrome and approximately 20 comorbid conditions and I literally don't know what it's like to not be in pain. Some of my earliest memories are of dislocations, pinched nerves and pain, and pain clouds and taints every single memory I have. As is common in people with EDS, I have a gene mutation that halves the absorption efficiency of my liver, meaning that I have an extremely high tolerance to most medications, including opioids. As is also common, I have an extremely high pain tolerance. I have dislocated almost every single joint in my body at least once, and have suffered THOUSANDS, even tens of thousands of dislocations in my life, literally several every single day. I dislocate something in my sleep 5-7 nights per week, so literally just existing is a high risk activity for me and those like me. If I can even get a doctor to believe my injuries and inordinate pain levels because they aren't educated and informed of my condition, it has been next to impossible to get adequate help managing my pain. Most people would be incapacitated by a fraction of the pain I'm in every single day, so if I even mention how much I hurt in passing, let alone seek out medical attention, I am in immense pain. I have reached the point that I rarely bother asking for help because of how rarely I ever receive any help, let alone how rarely I am treated as anything other than a liar and an addict. I take longer than most to recover from injuries, if I ever do, and I am at the point that I have zero quality of life left and I daydream about my life ending so that I can finally be free of pain. With proper pain management, I would finally be able to not only do the bare minimum to take care of and provide for myself again, but possibly even be productive, do things I enjoy and want to do, and be able to play with my kids again. But doctors aren't even currently allowed to do what is required to help me reach that point. What they're currently allowed to do doesn't even take the edge off, and essentially demands that they treat me like an addict instead of treating me for my actual symptoms, pain levels and the reality of my situation, which is bleak and miserable. The current guidelines are cruel and inhumane to those like me, and if those in charge of writing them were cursed with what I feel every day for even a single minute, they would immediately allow my doctor the freedom to treat ME and my situation, symptoms and pain accordingly instead of avoiding to some arbitrary bs and what SHOULD be the case for most people, or they would end their lives to find faster relief. Proper pain management would allow me to work again, to be present with my children, and to reclaim some small semblance of quality of life again. I beg you to do the right thing and allow the doctors that have gone to school to be able to practice medicine to have the ability to provide the care that I desperately need so that I can try to enjoy however much of my life I have left and be able to do things again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	0900006484fe52fd	Vogl	None	2022-03-26T21:45:25Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Vogl, Jeffrey	l17-k8so-7mhw	False	None	False	2022-04-12 04:20:36.125	[]
2984	CDC-2022-0024-2990	https://api.regulations.gov/v4/comments/CDC-2022-0024-2990	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain is a condition that almost every human will suffer at some time in their life and most will seek relief,often by seeing a medical doctor. Many times that doctor will investigate the patient's complaint with questions, a physical assessment, tests of bodily fluids and functions,scans of all sorts to aid in a cause or reason for the pain complaint. That doctor must then use their knowledge and experience to decide the best treatments or actions or referrals to a specialist. Many times,at some point,a doctor will prescribe a relief of the pain by ordering physical therapy, OTC drugs,or pain drugs such as an opioid. I am one of those patients. I've had several surgeries, including 3 major back surgeries, many different scans and tests,much attempted physical therapy, and several different drugs. This included opiods. After a solid decade, I have been led to a pain management clinic and have seen my pain management specialist over several years. I see him several times a year for regular checks,specialized shots, tests,and an opioid. Taken up to 3 times a day and over the course of the past years, one specific drug-an opioid- has proven to offer tremendous relief of my back and leg pain. I must use a cane or walker to cover a short distance and can not stand beyond 3-5 minutes. But to be able to get out of bed,to shower and toilet myself,cook a simple meal,play a game with a child...these are precious times! Enjoyed times because of an opioid prescribed by a board certified,experienced doctor! Qualified doctors and surgeons must be allowed to treat pain to the best of their knowledge and experience and training. Interference from anyone or any agency that does not have any experience in the practice of medicine should not be allowed to interfere or prevent or deny in any way the relief of humans' most common complaint...pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicki	None	None	0900006484fe5551	Honerkamp	None	2022-03-26T21:46:39Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Honerkamp, Vicki	l17-lpvo-jjc5	False	None	False	2022-04-12 04:20:36.388	[]
2985	CDC-2022-0024-2991	https://api.regulations.gov/v4/comments/CDC-2022-0024-2991	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am at the beginning I fear of a well-known story and I am afraid. It started with an injury from when I was pregnant caused by the medical establishment. I was a high-risk pregnancy, carrying twins, on bed rest, in the hospital, and was made to spend hours at a time, on my back, with the full weight of my belly pressing down on my back so that the staff could capture the heartbeats of my sons on graph paper. <br/><br/>The issue, however, was one of my sons kept scooting behind his brother, so what should have been a 15-minute procedure, turned into a 6+ ordeal every time they performed it. And it was performed often. My back was on fire. Did any of the doctors or nurses care? No. The way the medical establishment treats pregnant women is a travesty but that is a complaint for another time.<br/><br/>That is the moment I am sure the issues I am dealing with today started. Over the years my back would flare up, times where long walks would cause issues with my leg buckling up beneath me, pain, numbness, etc. And I tried over these past 18 years to get imaging done on my back to find out what was going on in there. Never could get the insurance company to budge until recently. Prior-authorization is another travesty hoisted upon the American public!<br/><br/>I did finally get that imaging done and I have a vertebra out of alignment, a bulging disc, a root nerve that is being crushed, you know, the usual, and with it, pain. Not crippling pain, not yet. But I am getting older and that pain that was first felt in the dimple of my back has spread and has gotten bigger, and grown deeper.<br/><br/>It wakes me up at night, it limits my activity, and I am afraid. I asked the NP at my doctor’s office what I will do if the pain gets really bad and her suggestions chill me. She tells me she will start me on gabapentin. I already have a script for gabapentin. I received it for the cervical radiculopathy flare-up I had a few years back. That medication helped with sleep, anxiety, but nothing more. What ended up getting me through the flare-up was two courses of steroids and Tylenol 4.<br/><br/>She then suggested Lyrica, which absolutely not! That is a dirty drug, from everyone I know that has taken it, it does absolutely nothing for pain, it makes you put on a ton of weight, and it is near to impossible to get off of.<br/><br/>I asked about PT options, namely, a referral to a good clinic because our insurance coverage limits us to how many PT sessions we can get a year, and the last time I went to PT the particular clinic I went to slapped a heating pad on me, gave me a print out of stretches, and then charged me $450 for that session. It’s a racket at a lot of those places. She did not have any suggestions and told me I would have to shop around. Given that PT is limited, shopping around is not really a stellar choice is it?<br/><br/>Steroids were suggested which are a good call but those are limited, and they are not the magical cure-all you guys seem to think they are. <br/><br/>Lastly, NSAIDs, I have an issue with Ibuprofen and Naproxen. They don’t work. They have never worked. I don’t know if it is how I metabolize them or what, but I have never found any benefit from them for anything I have ever taken them for. I might as well be taking MnMs and I am sure I am not the only one that has this issue. Aspirin is mildly helpful and Meloxicam but they are not the miracle drugs you make them out to be. At best they are useful for mild pain. <br/><br/>What I am dreading is that the pain I have now which is manageable will one day require something stronger than what I have on hand and when it does my doctor out of fear will send me to a pain clinic. I will wait months in agony just to get an appointment and once I finally do get my foot in the door I will be treated like some drug-addled junky looking for a fix and not a patient looking for treatment.<br/><br/>I will be subjected to expensive, dangerous, and unneeded procedures, a hostage if you will in order to receive any medication that would be of actual help. I will be required to pee in a cup every month, will be locked within an x mile radius of said pain clinic, so no vacations, because they could call at random and I would need to bring in my pills for a count. I will live in fear of each appointment of having my dose cut or yanked out from under me. I will be treated like scum by the staff, by the pharmacist that fills the script and live with the constant worry that at any point I could be dismissed for any reason and left with no recourse.<br/><br/>My pain, as of this moment is very manageable, but I am very afraid for the day when it is not.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe5598	Anonymous	None	2022-03-26T21:47:09Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l17-u956-rnu4	False	None	False	2022-04-12 04:20:36.613	[]
2986	CDC-2022-0024-2992	https://api.regulations.gov/v4/comments/CDC-2022-0024-2992	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am simply here to plea for the quality of life for so many of us that are suffering! The CDC is watching us suffer, and keeping the one thing that can help us get our quality of life back. I am talking about the people that are diagnosed with chronic pain disabilities. These are life changing and life altering diseases, and without pain medication to be able to even get out of bed, some can’t. I am 50 years old, I worked with handicapped children and adults for over 25 years, and finally had to file for disability due to my health conditions. I received disability my first try. This is my diagnosis, SLE( Systemic Lupus Eurythemetosis), Spinal stenosis, planters fasciitis, bone spurs in both feet, chronic migraines, I have severe arthritis, I’ve had 11 knee surgeries, 1 shoulder surgery, memory loss, insomnia, restless leg syndrome, fibromyalgia, and etc. Those are just the main things I deal with on the daily basis. I have flares for weeks at a time, sometimes longer. It scares me and I hope this isn’t the one that I’m not going to come out of! If I had pain meds to help me get out of bed to function I truly believe I could get well quicker, I would be able to exercise and move instead of laying around wasting away in a bed or lying on a couch in agony. I used to do this with pain meds. You are not keeping these drugs out of the drug addicts hands by trying to control the doctors from prescribing it to their patients. They are getting them somehow!! Please give us back our life and the doctors back their dignity of being able to do their job of helping their patients. Thank you for your time and listening to what we have to say.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	0900006484fe55a8	Wilkins	None	2022-03-26T21:47:24Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Wilkins, Leslie	l17-v6vx-dt4j	False	None	False	2022-04-12 04:20:36.830	[]
2987	CDC-2022-0024-2993	https://api.regulations.gov/v4/comments/CDC-2022-0024-2993	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a clinician but also a pain suffered. This wod severely limit my ability to work and help others every day. I have had 6 back surgeries and every thing done that can be done I have maybe one hour of no pain a day. I understand needing to supervise but this is going to far	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484fe5391	MANESS	None	2022-03-26T21:52:42Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from MANESS, Debbie	l17-y6z5-mdee	False	None	False	2022-04-12 04:20:37.070	[]
2988	CDC-2022-0024-2994	https://api.regulations.gov/v4/comments/CDC-2022-0024-2994	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have only been to the emergency room twice in my adulthood. Once for a non-pain related issue and the other for excruciating pain in my side. Turns out it was a kidney stone. The ER doc looked at me skeptically, as if I was a drug seeker. I had no history of doctor shopping or bouncing into ERs. They gave me a non opioid shot of something that did nothing for the pain that I was doubled over with. Finally after a couple of hours they gave me a shot of morphine which I never had in my life which helped. Sent me home with nothing. Dental work is also a challenge in getting any kind of relief. One dentist knew her stuff when I had a huge abscess which she had to cut and drain and stitch. She did give me a prescription for a couple days worth but by the time I got to the pharmacy to fill them I was crying like a baby. But thank god she wrote me that prescription because it saved me from horrific pain. Next time I went to dentist a few years later for a similar thing they gave me only Naproxen and it was a terrible few days. These doctors know you’re going to be in terrible pain and brush it off like “oh you’ll be a little sore, take Tylenol”. I also recently had throat surgery and they sent me home with nothing. I would have only needed about 2 days worth but they told me to take Tylenol ugh! I totally understand that these opioids are very addictive but people suffer everyday without them. Quality of life needs to be part of these guidelines. My body is wracked with arthritis. Two bad knees. Bad back. Bad neck. Bad hips. Pinched nerves. I don’t even ask my doctor for anything cause I know I will get a script-written lecture about the dangers. It really does a number on your head to be in contestant pain. This is the USA and people are being treated like everyone is a drug addict. I would ask that compassion and understanding be part of the decision making process. Thanks for the opportunity to speak.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe53bb	Anonymous	None	2022-03-26T21:52:55Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l18-040w-j5mx	False	None	False	2022-04-12 04:20:37.278	[]
2989	CDC-2022-0024-2995	https://api.regulations.gov/v4/comments/CDC-2022-0024-2995	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to be sure that the designers of the revised CDC guidelines are aware that Drs and Pharmacies are so spooked about being disciplined, and both Drs and Pharmacies are so afraid to prescribe and dispense Narcotic pain meds, that patients are being abandoned and cut off meds, and this applies to Injuries, Post-Op, Cancer, intractable pain conditions, and even End of Life.<br/><br/>Pain patients are reporting that Drs will not take them as a patient if he/she are on a pain med therapy. There are complaints from those abandoned or cut off on the Don't Punish Pain Support groups on the Internet. Now before the new guidelines are out, these frightened Drs offices are quoting the 50 MME as a basis for prescribing. Medical training teaches the importance of sufficient dosage amt for effectiveness of any medication. Metabolism and body weight vary from person to person!<br/><br/>As a person with Degenerative Arthritis with Neuropathy, Anxiety Disorder and Insomnia, I was force tapered and now rely on OTC meds. I'm fortunate I get help from these, but am cautioned by my Dr that these will shorten my life. I would accept a shortened life to trying to function with no pain relief. The explanation that is given<br/>of fear of addiction/overdose for not prescribing does not resonate with those of us who took controlled meds with NO danger of harm, many times over many years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006484fe5430	Stitt	None	2022-03-26T21:53:51Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Stitt, Robin	l18-4dax-ybj2	False	None	False	2022-04-12 05:33:49.547	[]
2990	CDC-2022-0024-2996	https://api.regulations.gov/v4/comments/CDC-2022-0024-2996	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Besides having a long medical history of dealing with pain before resorting to opiates after a failed spinal surgery, I had an equally long history in pain management of never failing a test or abusing my meds. Yet, in 2016 I was tapered more than half my doses in accordance to the MME guidelines. It made me reliant on medicaid and foodstamps, something I'd never allowed when I was a single mother with cancer and two small children to raise on my own before the MME guidelines. <br/> The government, in its infinite wisdom,decided I was better off dysfunctional and reliant on government handouts. I was recently thrown out of pain management after 7 years of perfect compliance because I was too old to use methadone (any one after age 60) I was told to register as an addict and go to a meth clinic.<br/> I don't get you people. After killing 1000's through suicide and overdoses from pain patients seeking relief, what do you really want? Do you want us gone? If and when someone in your family is in screaming agony from cancer or some other painfilled diagnosis; will the no opiate laws apply to you and yours? Or is this another "Rules for thee, but not for me" situation?<br/><span style='padding-left: 30px'></span>Stop listening to[name redacted] & friends; study the data. If you then think that the current state of affairs is the way to go, then I have to entertain the idea that you have found a way to spend money in [profanity redacted]. At least clean up your own messes- legalize assisted suicide--our families shouldn't have to do it. Not everyone in pain will choose it, but many have, and many more will.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather	None	None	0900006484fe546e	M Angers	None	2022-03-26T22:10:10Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from M Angers, Heather	l18-653m-5uvp	False	None	False	2022-04-12 05:33:49.755	[]
2991	CDC-2022-0024-2997	https://api.regulations.gov/v4/comments/CDC-2022-0024-2997	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am one of the many pain patients that have been affected by the 2016 opiate guidelines I am sitting here in so much pain I am crying and I can’t get any meds to help with the pain. As many of us can’t get help because of these guidelines have scared our doctors into making us suffer in afraid the dea is going to bust down their doors. This is inhumane to make human beings suffer the way our government has made us pain patients suffer. I am suffering everyday with no relief. The cdc need to remove the MME from the updated guidelines or issue pain patient a chronic pain card that exempt us from the guidelines. It has gotten so bad no doctor will prescribe meds because they don’t want to lose their licenses. I had a doctor tell me I was going to suffer for the rest of my life just deal with the pain but wants me to work a full time job when I can barely walk also he said since I had a workman’s comp claim I will suffer but has sided with them instead of treating me and told me to continue with injections even when I told him they don’t help. So he committed insurance fraud because he got paid by workman’s comp to tell me I was fine even tho I am not but that is ok he told me to just deal with the pain and problems that happened. The guidelines had conflicts of interest and the person writing the new guidelines has conflict of interest and that ok because the cdc says so… we make us pain patients suffer because of the illicit drugs overdoses….thousands of people die from alcohol each year and drunk drivers kill people but guess they can just by more alcohol but us pain patients have to suffer this is not right and it is inhumane to make us suffer. I have thought about going to get illicit drugs from the streets but I don’t know how too it but I am tired of suffering with no relief…I feel right now my only option les are illegal drugs or suicide…I am being you for me and thousands of pain paients to stop the suffering. No one should have to suffer from the hands of doctors who took a oath to protect their paients and stand for what is right and corruption is wicked and I shouldn’t have to suffer….I AM BEGGING FOR HELP REMOVE THE MME FROM THE NEW GUIDELINES AND STOP THE GENOCIDE.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lesley	None	None	0900006484fe548b	Mason	None	2022-03-26T22:10:33Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Mason, Lesley	l18-7xhx-dqv0	False	None	False	2022-04-12 05:33:49.964	[]
2992	CDC-2022-0024-2998	https://api.regulations.gov/v4/comments/CDC-2022-0024-2998	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These & the original 2016 "opioid guidelines" need to be taken down & destroyed! They've done nothing but harm & torture pain patients & doctors! These "updated" guidelines will be no different. They will continue to harm & torture pain patients, possibly even more or worse!<br/>I have several medical problems that require Rx pain medicines that work great & help me get out of bed & move through the days. I also have a higher tolerance to ALL medicines, therefore, requiring a higher dose. I finally got to a higher dose earlier in 2016 & was able to move, cook, clean, work & take care of family, etc. again. But, that was short lived since enforcement of the "guidelines" made all doctors force cut/taper their patients. I'm now back to being bed/couch ridden & cant get up to do much more then go to the bathroom. <br/>You(CDC/Govt) need to quit torturing people in pain! We are NOT robots! We dont function same on the same meds, same amount/dose & expect it to work the same for everyone. We each require individualized treatment/meds. Our pains are different. Each type of medicine works differently for each person. Requiring different doses for each person. <br/>MME's are not based on scientific facts. Its made up! Those(MME's) should be completely taken out. As well as any supporting documents with it in there, too. They'll just be misapplied again.<br/>Forcing people in pain down/off Rx pain meds, you're just pushing more & more right to illegal street drugs(& suicides), which is what the whole "opioid crisis" is from in the 1st place. <br/>The only way you will get a handle on illegal street drug use, is to make it so people dont want to go to the streets. NOT push more & more people right to it. You need to let doctors/patients treat pain as to what works best for each. Rx opioid pain medicines help million every day. Restricting those, you're just pushing more onto more dangerous illegal street drugs, where they'll become addicted, overdose & probably die, or commit suicide. <br/>PAIN is a huge issue! People cannot function correctly when in pain. People are just going to seek out other means & self treat, when you restrict the medicines that are controlled & safe(Rx pain meds) that are VERY effective for pain for millions. <br/>Treat both addiction & pain with what works best for each individual person! Stop making laws/rules that stop/restrict treatment for both addiction & pain. Its making problems we have now, even worse.<br/>Once Rx pain meds where restricted because of the 2016 opioid guidelines, its pushed many right to illegal street drugs. Skyrocketing overdoses & deaths, as well as suicides. And torturing everyone else in pain & their doctors. The "guidelines" have caused WAY more problems than any solutions. They need to be taken down & destroyed!<br/>The CDC(who is supposed to be for infectious diseases) should NOT be writing these supposed "guidelines" that are false, misleading & are used to harm & torture millions. Pain/pain meds are NOT a infectious disease!<br/>Any law/legislation based from the "guidelines" also needs to be destroyed. & the govt/Cdc need to tell doctors to return their patients to their last effective dose of Rx pain meds, they were doing good with, before the 2016 guidelines. & leave US alone!<br/>Stop trying to fix something that isn't broken. Stop torturing & punishing people who are on & do VERY well with Rx pain meds(even higher doses)!<br/>For all the people forced down/off of their once effective Rx pain meds, forced to the streets(illegal street drugs) became addicted, overdose & died, as well as those who committed suicide, you(CDC/GOVT) should be held accountable for murder! You're the one's who caused it! CDC/Govt should also be held accountable for all the torture everyone else who's been forced cut/down from their meds & live in agonizing pain every day now, too. <br/>How can you(CDC/GOVT), when you know nothing of our medical cases/conditions & what we have to live with every day, make guidelines/law on medicine that greatly help us? Its OUR RIGHT to effective medical care! <br/>You cannot restrict medicines that work SO well for millions, not based on scientific facts(where did 90mme come from? Its made up), cannot restrict/take away that which works SO well for millions & expect everyone to be just fine, without there being a replacement that works better or as well for millions & not expect them to seek out other treatment(illegal street drugs).<br/>Pain is a HUGE issue! You cannot put restrictions/blocks from proven & very effective treatment without consequences. & its just pushing more & more right to illegal street drugs, overdosing & dying, as well as suicide! Restricting these meds that work SO well for most, you're also restricting our rights to adequate & very effective treatment.<br/>STOP! Please just STOP NOW! Give us our lives back(at least us who are still alive). Myself & millions of others in pain are begging you! PLEASE, repudiate ALL of the guidelines!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candi	None	None	0900006484fe55fe	P	None	2022-03-26T22:11:19Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from P, Candi	l18-abrc-xcjk	False	None	False	2022-04-12 05:33:50.214	[]
2993	CDC-2022-0024-2999	https://api.regulations.gov/v4/comments/CDC-2022-0024-2999	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live with nonstop, excruciating pain. This all started around the year 1995. I felt a shift in my back one day that left me doubled-over and unable to stand up or sit down without pain becoming unbearable. This day led to many alternative therapies, trying to get the pain to subside. Since that time, my pain has only gotten worse and more extensive. I have major spinal issues from the neck all the way to my lower lumbar areas. I have been to a series of orthopedists, neurosurgeons, physical therapists, cognitive therapists, hypnotherapists, chiropractors, acupuncturists, and others who work in the field of trying to help chronic pain patients. <br/>The first major pain episode did not ever resolve. I had my first MRI and other tests during that time and was told I had a “huge” disc at L2/3 that had herniated and was pressing on my spinal cord. It was also the beginning of a completely different life than I had ever envisioned. I had barely turned 40 and was told I had the spine of a 90-year-old. I was diagnosed with severe Degenerative Disc Disease at many levels already. Today I am 68 years old and have continued to struggle with daily living. My first surgery was a discectomy which caused some temporary relief; however, my original issues with DDD combined with scoliosis and spondylosis among other major back problems have continued to cripple me since those early days. I was still trying to work a full-time job but was struggling more and more with increased problems. I tried anything suggested by the medical professionals. In the early 2000s, I started having horrific pain down my left arm and into my hand and fingers along with feelings of numbness and nerve tingling, especially in my hand and fingers. After numerous screenings/visits with different neurosurgeons throughout the state, the consensus was that I needed major neck surgery, anterior cervical disc fusion. The neurosurgeon went in through the front of my neck and removed all disc material at C4/5, C5/6, and C6/7. This material was replaced with donor bone and the C4 through C7 were fused using titanium plates and screws. Post-surgery, some of the numbness was reduced, but this was when my pain story really became so hard to bear. I have suffered with major pain throughout my neck, shoulders, and severe headaches. My neurosurgeon sent me for help at our local pain clinic. Note that prior to this, I had tried so many methods with no success. On one of my attempts for relief, I found a medical doctor that was famous for his acupuncture. After he examined my MRIs, he explained that my spinal problems were so exhaustive that he could not help me. I had all kinds of injections and manipulations, to no avail. All the while, my spine continued to deteriorate, and post-surgery neck pain was not relenting. The only relief (partial!!) that I have found has been with the use of opioid pain medicines and muscle relaxants as needed for flare-ups. I have relied on the medicines for more than fifteen years and what they allow for me is the ability to have “some” quality of life…perhaps, several hours a day to move around a bit, live independently, and do errands. I have tried almost countless suggested medicines to no avail. Anything requiring sitting or standing for more that a few minutes is extremely difficult for me. My social life is non-existent. I left a career I loved in 2007 as I was no longer able to perform even at a minimal level. Today I have the added anxiety in my life that decisions might be made by others that do not know my personal struggle with intractable pain. Only since I was placed on a regimented use of pain medication have I had even the smallest quality of life. I have consistently passed all tests required with respect to my needed use of prescribed medicines and been extremely responsible in that process. And, now that I am dealing with more degenerative changes in my spine and the ongoing struggles I have with intractable pain, there is an ongoing battle to get even the minimum relief due to constraints resulting from the CDC 2016 "recommendations," which were supposedly retracted. I have been treated differently as a patient at my large chain pharmacy. I have had to go through more and more procedures and phone calls to my health insurance to get the coverage that I deserve. My inability to get prescriptions filled in another state has created travel issues. Please do whatever is needed and right this time! Please, as you read this, think of your parents, your siblings, your children, your friends, and your acquaintances that you care about. Any of them could become a patient like me in a matter of seconds. <br/>With respect to this document, and the horrors resulting from the 2016 document, "I wish to endorse the separate comments of [name redacted], PhD, to the Federal Register. Dr [name redacted]'s views and concerns accurately reflect my own." His reseach and conclusions on this issue should be heeded.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484fe5614	Smith	None	2022-03-26T22:12:15Z	None	None	1	None	2022-03-26T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, K	l18-azvx-d9r4	False	None	False	2022-04-12 05:33:50.422	[]
2994	CDC-2022-0024-3000	https://api.regulations.gov/v4/comments/CDC-2022-0024-3000	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a short story to long agonizing 12yrs of neuropathic pain. The first 9 yrs the pain was controlled with fentanyl patches and opioids. Then came the opioid hysteria and the over zealous CDC's war on drugs. My pain specialist lost her license. My meds were tapered and my pain was not being managed. The practice allows medical marijuana with a medical card so I tried it. I was discharged for noncompliance I didn't discuss this before hand. I was unable to find another practice to take me. Without meds the pain was more than I could bare. My options were street drugs or suicide. Since I didn't know how or where to purchase street drugs. I thought I'd try my family physician. Luckily I was rushed to the ER my blood pressure was extremely high. I bad a recall from a pain specialist. I am underprescribed opiods. On a good day I can take a shower, cook dinner, do laundry, or some other chore. I can't do all of those pick one item and do that one on a good day and in a good night I may even sleep a solid 3hrs.<br/>We do everything that we are supposed to do as pain patients sign contracts stating that we are, subject to random urine tests, random pill counts. We jump through hoops to be medically under treated. All because of Purdue's greed and lies, pill mill's along with heroine and illect fentanyl overdoses all of the honest people who had our lives horribly disrupted by something we never asked for are paying the price of losing everything our jobs, homes,cars,families;friends our sanity. All I am left with is will tomorrow be better or will it be the day pain wins once I figure out what will be least painful for the person who finds me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe56d8	Anonymous	None	2022-03-28T11:33:45Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l18-hj22-4mum	False	None	False	2022-04-12 05:33:50.633	[]
2995	CDC-2022-0024-3001	https://api.regulations.gov/v4/comments/CDC-2022-0024-3001	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	(1) 50 MME should be removed before it replaces 90 MME and causes even more harm for pain patients and gives insurance companies justification of cutting costs on medicine.<br/><br/>(2) This entire guideline seems to be a liberal political document whereby the federal government is attempting to subversively socialize medicine.<br/><br/>(3) Since the vast majority of overdoses are not prescription opioids, why in 2022 does the CDC attempt to not only update but greatly expand the scope of the 2016 guidelines?<br/><br/>(4) Doesn't the FDA not the CDC have statutory authority over drugs?<br/><br/>(5) Since you refer to individualized care and warn against taking this out of scope and being used to enact laws that harm patients and hinder physicians, why does the US taxpayer need to waste money on these guidelines, especially now that states are banning use of CDC guidelines such as Oklahoma?<br/><br/>(6) Didn't you conclude in 2019 that your guidelines caused a lot of harm to patients?<br/><br/>(7) How will you ensure this 2022 update doesn't suffer the same problems as the 2016 guideline, and how will you stop the DEA from trying to prosecute physicians for "overprescribin"?<br/><br/>(8) How many of the authors of this guideline have professional residency training in pain management and anesthesiology, and years of experience treating patients in a pain management practice?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe56e5	Anonymous	None	2022-03-28T11:34:17Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l18-ibe5-dvdk	False	None	False	2022-04-12 05:33:50.845	[]
2996	CDC-2022-0024-3002	https://api.regulations.gov/v4/comments/CDC-2022-0024-3002	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I'm a 58yo woman who sustained a work injury back in 2000. The 2yrs I tried numerous treatments to try to control pain including but not limited to PT, Massage, Chiropractor, Traction, Accupunture, Non Narcotic Medication, INSAIDS, Steroid Injections, Ablation, and a Spinal Cord Stimulator. Non of these have been able to treat my High Impact, Chronic Pain alone. In 2002 I was finally told that I should consider Opioid Therapy. Things changed, although Opioids don't help the nerve damage I have alone that along with other treatments made it tolerable and I was able to continue working another 10yrs. In 2017 I was force Tapered to the suggested mme's and my situation quickly became worse. As my pain levels rose I became more seditary and now spend the majority of my time on the couch or in bed. I can't enjoy time with family outside of my home. I can't even sit or stand for more than 15min at a time. I have no life quality left and have developed heart issues related to constant pain.<br/><br/>I do want to thank you for rewriting these and taking comments, however, there are many similarities to the original <br/>Guidelines. And one in particular is very disturbing. These are my concerns:<br/> <br/> 1. A reference to 50 mme will still cause patients to be under treated or not treated at all. It will likely cause hesitancy by doctors to write anything over 50 mme.<br/><br/>2. Many people w/ different conditions have been able to get their lives back at much higher doses. They are not addicts, nor should they be treated as such. And they need doctors willing to carefully titrate their dosage up-not down to an ineffective dosage.<br/><br/>3. Pain mgmt is not one size fits all and may times takes a mix of different meds. Each person is a unique human, what helps one person may be completely different from another regardless of their condition(s). People are complex individuals.<br/><br/>4. Please remove references to specific conditions not being helped by opioids because whatever studies you referenced do not reflect those who are really being helped by them in real world practice. Perhaps a survey sent to those in the PMP system would better reflect this?<br/><br/>5. Please remove the commentary about those above age 65 needing less than 50 mme as this is also inaccurate.<br/><br/>6. Please allow telemedicine visits for established patients.<br/><br/>7. Please allow early refill of meds. 24hr is unreasonable when many Pharmacies only stock a small supply of Opioid Medication and have to order yours when to bring your prescription in. One may be to sick to go out or at the mercy of a act of God.<br/><br/>8. Please stop insurance companies and pharmacies from meddling with pill count, number of days allowed or dosages under the guise that they are preventing addiction. They are not the treating physician.<br/><br/>9. Please stop the DEA harassment of doctors. They need to be able to write out the correct prescription with the correctly titrated dosage without fear of going to jail or losing their license.<br/><br/>Thank you, <br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fe56f9	Combs	None	2022-03-28T11:36:41Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Combs, Judy	l18-irlr-w414	False	None	False	2022-04-12 05:33:51.071	[]
2997	CDC-2022-0024-3003	https://api.regulations.gov/v4/comments/CDC-2022-0024-3003	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My friend died from being taken off all her opiates abrubtly. She had a heart attack. Opiods used correctly, do help with the quality of life. If there is something that professionals can give to make pain less, then why is it a big deal. I am a chronic pain patient, myself, and I know that I would kill myself, if I had to go without pain relief. The problem with opiods is the illegal drugs on the street, it is not patients that use them as prescribed, and actually have a life to live. It is the illegal opisods coming from other countries, and heroin use. If research and stats were done correctly, I am positive it would be facts, that prescribed opiates, are NOT the problem. Too many people are dying from being taken off something that a Dr. prescribed, to HELP them live a somewhat normal lifestyle. When they are taken off these, they no longer have any reason to live, as most often the quality of life with less pain, is interrupted, and some folks just can't take the pain, anymore. Please please, do some statistics, that include ALL opiates, of those who OD, and separate the numbers, of illegal, and prescribed patients. Most pain patients are NOT dying from their medication, some are dying from lack of life, lack of pain relief, abrubt discontinuing, and when denied LEGAL pain relidf, they HAVE to go to the streets, to control the pain, THAT is why people are dying from opiods.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe570c	Anonymous	None	2022-03-28T11:37:11Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l18-jlel-x1p8	False	None	False	2022-04-12 05:33:51.286	[]
2998	CDC-2022-0024-3004	https://api.regulations.gov/v4/comments/CDC-2022-0024-3004	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since a car accident almost 25 years ago. Over the years I have worked with numerous doctors and tried every modality suggested and never found anything that helped control the pain as well as my prescription for hydrocodone. I’ve had the same prescription over the years, and that has enabled me to live a fairly normal life. I finished raising my children and was able to work at a part time job for over 10 years that I dearly loved. Fortunately, my doctors worked with me and never tried to force me to taper or cut off my medication like a lot of doctors are doing for fear of reprisal from the 2016 “guidelines”. Please try to correct whatever was done years ago that has caused so many pain patients to differ needlessly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fe5720	Herrin	None	2022-03-28T11:37:25Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Herrin, Mary	l18-k87k-nw2n	False	None	False	2022-04-12 05:33:51.538	[]
2999	CDC-2022-0024-3005	https://api.regulations.gov/v4/comments/CDC-2022-0024-3005	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think the guidelines are still too strict. Innocent people who suffer from chronic pain through no fault of their own are being punished for existing by these guidelines. Both opiate deaths and suicide deaths from chronic pain patients have increased astronomically thanks to these useless guidelines. Do something about it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe5725	Anonymous	None	2022-03-28T11:37:39Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l18-kk94-hzbr	False	None	False	2022-04-12 05:33:51.754	[]
3000	CDC-2022-0024-3006	https://api.regulations.gov/v4/comments/CDC-2022-0024-3006	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had several surgery and was denied pain MEDICATIONS but my doctor..I almost died if not for a friend who presented me to The Guardian Pharm w w w . theguardianpharm . c o m . At The Guardian Pharmacy they take goor care of their patients and you do not need to have a prescription before you order. They are the only institution that helps patients reach their medical needs online even without prescription. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Matt	None	None	0900006484fe572b	Houston	None	2022-03-28T11:38:07Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Houston, Matt	l18-kpej-3c8u	False	None	False	2022-04-12 05:33:52.503	[]
3001	CDC-2022-0024-3007	https://api.regulations.gov/v4/comments/CDC-2022-0024-3007	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Rheumatoid arthritis, oesteoarthritis, fibromyalgia, raynauds and other medical issues. Four years ago the doctor that I had ripped my pain medication away from me for no reason. I didn’t abuse them, never failed a drug screen. I went to a few pain management doctor and received no help until recently. I do know there is issues with pain medicine but we can’t all be put in th same basket. I don’t have any quality of life without them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe5737	Anonymous	None	2022-03-28T11:38:23Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l18-l5j7-3ae1	False	None	False	2022-04-12 05:33:52.712	[]
3002	CDC-2022-0024-3008	https://api.regulations.gov/v4/comments/CDC-2022-0024-3008	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a disabled 59 yr old woman who is a chronic pain patient and have been for over 30 years. I started with pain due to a broken vertebra in my lumbar region. I then was diagnosed with cervical cancer at 36 and had a total complete hysterectomy. I started having pain in almost all my joints a couple years after my hysterectomy the Drs. Thought maybe some of my joint pain and deterioration of my joints was due to not having hormone replacement at such a young age. My back continued to get worse and as of today I have degenerative disc disease, spondylitis, scoliosis, lordosis, sciatica, more vertebrae and discs that are bad than good from my cervical to my lumbar! I also SI dysfunction as well as severe osteoporosis, reynaulds phenomena. Because of the osteoporosis I have lost the discs that are in my jaw joints so I have severe TMJ and my teeth are falling out apparently due to the osteoporosis. Without the nerve ablations and pain medication I have pain in my entire back as well as my legs, calves right arm, neck and down my butt cheeks! My titers for Rheumatoid Arthritis come back positive one time and negative the next so they are thinking I’m getting false negative so they say I have Rheumatoid arthritis as well. My fingers and toes lock up daily all day long off and on and at night I get severe leg and foot cramps in both legs and in my rib area that are excruciating and they usually happen in both legs at the same time! I get very little sleep between the cramping and pain. I have had surgery for bi-lateral carpal tunnel, gallbladder, hysterectomy, deviated septum. Most recently after 2 bouts of pneumonia and being hospitalized for it I had a mass in my right middle lobe of my lung. We suspect from COVID pneumonia. They were concerned it was a malignant mass so they removed my right middle lobe in July. So on top of everything else I now have nerve pain in my rib cage from all the incisions they made in my ribs. I have daily pain there to deal with also! I have dealt with all this since I was in my early 30’s. I was declared 100% totally disabled by NYS many years ago. I have had every treatment out there tried every drug out there and I still live in pain everyday. I have been treated like a drug addict by not only Dr’s but pharmacist’s and nurses and some family members. When I had to give up my career due to my health issues I became horribly depressed and started with anxiety! It got to the point I was almost bed ridden because I hurt so bad and it hurt to do anything! I finally found an amazing Dr. 8 years ago who actually cared about his patients and got me on a medication routine which was 100 mcg fentanyl patch and 20mg of oxycodone 5 times a day. He also was doing nerve ablations until most of my entire back from my cervical to lumbar and between the procedures and medication I was able to have back some sort of quality to my life! I was able to function more and sleep better and was not so depressed all the time! I was on the verge of suicide when I first saw him! He changed my entire life! Then Medicare changed their approval of my procedures and all of a sudden last year I wasn’t allowed to have the regular ablation’s that I was getting! So that was a set back and I either had to pay out of pocket or go without them! <br/>I had to move from NY to SC mostly to get out of the winters! I now left my Dr. Just to find out it took me 5 months to just find a pcp! The first question I was asked when I called a Dr. Was are you taking narcotics? When I would say yes they said we don’t prescribe narcotic’s so we don’t see patients that are on them. Or I would say yes and they would say I need approval from the Dr. If he will take you as a patient and call you back! I did not get a call back from 98% of the Dr’s I called and if they did call they would say they couldn’t see me! I did finally find a pcp after 5 months but there is a sign in his office that he does not prescribe narcotics! All he sees me for is if I have a cold, flu or some sort of illness that doesn’t include pain or needing a narcotic. It took me the same amount of time to find a pain management clinic/Dr that would at least give me an appointment! Even pain management will NOT prescribe pain medications! They want to take you totally off them and slap you on suboxone or belbuca. Some of them will do a few procedures but don’t prescribe narcotics even though they are a pain management Dr! The last one I went to a week ago instantly wanted to stop my medication and switch me to belbuca and send me to physical therapy. She then said a chiropractor and then changed her mind saying they probably won’t touch you!<br/>I didn’t have enough room I was over 2000 over so I sent it as a file! Hope you feel great about yourselves. Pain patients are committing suicide because they can’t get help they need! Fix this!<br/>We NEED DR’S THAT ARE NOT SCARED TO PRESCRIBE NARCOTICS!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fe5a08	Delmont	None	2022-03-28T11:40:04Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Delmont, Lisa	l18-mfvf-kwww	False	None	False	2022-04-12 05:33:52.920	[]
3003	CDC-2022-0024-3009	https://api.regulations.gov/v4/comments/CDC-2022-0024-3009	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a 29 year old nurse and mother. Right now my pain is so out of control that I can't work. I also can't bend over or care for my child alone because of my pain. I'm in Ohio and have been unable to get any relief for my pain. My life is falling apart and because I don't have cancer, no one takes me seriously. My GP refered me to pain management and even they don't prescribe pain medicine but have had me try everything else possible. Now I'm going to have to apply for disability all because no one will treat my pain.<br/><br/>I have degenerative scoliosis, disk slippage, and pinched nerves. I can't bend over at all and I can hardly stand for a few minutes. When I sit I'm still in pain but I never get relief. <br/><br/>The new guidelines SHOULD NOT include some specific chronic diseases but not others because you cannot say one person with a condition deserves help but not another. The guidelines should include every single chronic pain condition that there is because if it doesn't you will be causing more people to suffer.<br/><br/>Chronic pain going untreated can make you feel your life isn't worth living. If you don't have it yourself, don't make guidelines about how to treat it. <br/><br/>When the guidelines are updated every doctor in this country needs to be informed IMMEDIATELY so that people can get help. I could be a contributing member of society but I'm reduced to nothing because of this and it needs to be fixed now. <br/><br/>Fix it and let every doctor know they need to give pain relief to people with chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jessica	None	None	0900006484fe5a13	Taylor	None	2022-03-28T11:41:05Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Jessica	l18-negx-bk92	False	None	False	2022-04-12 05:33:53.133	[]
3004	CDC-2022-0024-3010	https://api.regulations.gov/v4/comments/CDC-2022-0024-3010	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Im a CPP I have polyneuropathy and RA.. Think of the pain that never slows down. Can u imagine having that burn 24/7. In my state AR. U can only get 50 mmes a day AND I NEED 75 MMES A DAY..I WOULD HAVE TO TAKE 30 PILLS TO OD.////// So im left with days all i can do is curl up and pray. Imagine waking every day in so much pain u can only wish the cruelty of the CDC would stop...WHY ARE U LETTING ANTI OPIOID ZEALOT PROP MEMBERS ADDICTION PSYCHIATRISTS that know very little about pain OR Intractable pain is a different kind of pain anyway. SO WHY IS DOCTOR C EVEN DOING WRITING GUIDELINES. PLEASE REMVOE 50 MES <br/> Im sorry for people with addictions issues. But MADE ALL THE CDCS' TAKING ALL THE DRUGS AWAY FROM PAIN PATIENTS DOES NOT WORK, I Don't know HOW TO EXPRESS TO U how CRUEL IT IS THE 50 MME LIMITS HAVE TO BE REMOVED . THE 50 MME HAS TO BE REMOVED. ONE MORE THING THE 50 MME IS PRURE CRUELTY, JUST THINK IT COULD BE U AT ANYTIME. PLEASSSSSSSSS I WILL PRAY FOR U....DOCTOR C///// PLEASE END THE CRUELTY/////<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	STEVE	None	None	0900006484fe5a2d	RICHARDS	None	2022-03-28T11:41:37Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from RICHARDS, STEVE	l18-os7e-sziy	False	None	False	2022-04-12 05:33:53.346	[]
3005	CDC-2022-0024-3011	https://api.regulations.gov/v4/comments/CDC-2022-0024-3011	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am 72, hold a Graduate Degree in Health Services from UC Davis, was licensed as a registered nurse in 1973, and nurse practitioner in 1977, trained as a CDC epidemiologist, provided clinical services for over 30 years, worked as a Consultant for the [location redacted] and had oversight responsibilities for all community clinics in California, vetted as an Expert Witness for the California Office of the Attorneys General, conducted criminal investigations with a DHS Fraud Investigator and DOJ Special Agent, created the CDF Medical Services Mobile Clinic and provided clinical services at major fires and disasters and testified in both civil and criminal proceedings. MS and my other diseases forced me to retire at the age of 51.<br/>For decades I have had to live in a sleep deprived state because there were no effective medications I could take to manage my pain. NSAIDs have damaged my kidneys so I can no longer use them to control my pain. There are no other medications and/or palliative treatments that I can use to help me control my pain. It was not until I ran a seemingly endless gauntlet of palliative treatments and took a dozen or more medications that were never meant to be used to treat pain that I was referred to a physiatrist (pain management specialist). Because of my complex medical history, she had a very limited number of medications she could prescribe for me. She eventually gave me samples of a relatively new medication called Nucynta. Nucynta does not stop my pain but it does blunt my pain enough that I am able to fall asleep before 2am or 3am and, with the extended release, I can sleep up to six hours at night. Nucynta has no extrapyramidal effects, is not addictive and has an LD50 of 3000mg/kg. Nucynta is the only medication that I can take to control my pain but I am treated like a street junkie each time I need to refill my prescription. <br/>Something is very wrong with the way the “Guidelines” were envisioned and written. There is no precedence for the CDC to be involved in creating anything that dictates what medications clinicians can prescribe and codify the doses that the clinicians who have far more experience prescribing than the people who wrote the “Guidelines”. In addition, the data that was gathered from the state morbidity and mortality reports on the deaths that were caused by the fentanyl and heroin shipped from China through Mexico and into the US to justify the DEA’s use of tactics that, under other circumstances, would be called terrorist by their nature. They are purely meant to strike fear in the hearts of licensed health care professionals and do nothing to address the failure of our Federal government to stop the tsunami of fentanyl and heroin that is being smuggled across our borders into the US. There are other serious flaws in the reasoning for attacking the professional decisions that our clinicians have been making in good faith but I am loathe to spend any more time on this kind of criticism. The errors and omissions are too obvious to waste anyones’ time in an analysis of them. <br/>But there is one problem I would like to bring to your attention. If the DEA is successful in eliminating the legitimate use of controlled substances using fear as its primary tool, the hacks at the DEA will have caused the deaths of up to a million patients who have a legitimate need for medications they can use to help manage their pain. The DEA will also force those of us who have had to use controlled substances to manage our pain to turn to nephrotoxic substances like NSAIDs. In five maybe ten years our clinicians will begin to report a spike in the rate of kidney disease that has been caused by OTC pain medications like aspirin and ibuprophen. Some will need kidney transplants but many of us will be over 60 and not eligible to receive a kidney transplant. For those of us who cannot obtain a kidney transplant, we will be assigned to a nearby dialysis unit where we will be attached to some very complex machines five to six days a week for the rest of our lives. I haven’t researched the cost for one week of dialysis but I am sure that in 10 years the cost for a week of dialysis will threaten to bankrupt our safety net programs.<span style='padding-left: 30px'></span><br/>One way that the CDC and the DEA can improve the outcomes for people whose quality of life will decline steeply if the legitimate use of controlled substances becomes a criminal act is to create a waiver program for those of us who have a documented need for medications that can effectively control our pain. <br/>In addition, I wish to endorse the separate comments of [name redacted] PhD to the Federal Register. Dr [name redacted]'s views and concerns accurately reflect my own<br/><br/>Sincerely,<br/><br/>[name redacted], RN, NP, MHS<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fe5786	Springer	None	2022-03-28T11:45:21Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Springer, Michael	l18-qhfr-9zlw	False	None	False	2022-04-12 05:33:53.561	[]
3006	CDC-2022-0024-3012	https://api.regulations.gov/v4/comments/CDC-2022-0024-3012	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The first thing we need to keep in mind in that the topic at hand is published guidance for licensed physicians providing prescriptions to patients for legally-manufactured medications. Guidelines for physicians about legal prescriptions for patients do not include addressing any use, manufacture or trade of black market drugs or crimes associated with such activity or persons involved.<br/><br/>In recent years, U.S. government communications to the public about the dangers of different classes of pain medications has been both inconsistent and wildly disproportionate. There’s little public awareness of the clear and growing evidence of the dangers of acetaminophen used at normal over-the-counter doses for less than two weeks, or of the several recent reductions in maximum daily dose. This lack of communication of the serious and deadly risks of acetaminophen has coincided with massive exaggerations of the dangers of legally-prescribed opiates.<br/><br/>The 2016 Pain Guidelines are described as voluntary, but the aftermath of their publication looks exactly like top-down imposition of strict conformity, and not at all like a suggestion for voluntary action. Medical doctors with licenses to prescribe legally-manufactured medication have been prosecuted and portrayed to the public as indistinguishable from low life drug dealers. Patients with chronically painful conditions once treated by their GPs or the specialists in the conditions causing pain, were facing doctors, medical practices and insurance companies continually lowering the amounts they would prescribe. Patients have been funneled into pain management specialty clinics, with added responsibility for bills and time-consuming appointments with a specialist that had not previously been necessary for their care. Pain management clinics are not only few and far between, but some of them proudly take an anti-opiate stance, as if depriving law-abiding patients with chronic and severe pain of reliable, effective and safe treatment was some sort of brave act, instead of being in perfect alignment with the states medical boards that have been threatening licenses and livelihoods of pain management practitioners for writing prescriptions for law-abiding pain patients. <br/><br/>Pain is not an infectious disease. It’s baffling that, with all the infectious diseases that need to be studied, treated and prevented, the CDC are inserting themselves into the pain treatment of private citizens under the care of licensed physicians. The past 5 years have demonstrated that CDC intervention into pain treatment nationwide has been a disaster for pain practitioners and pain patients. The public has been encouraged to have both an excessive fear about the class of drugs known as opiates or opioids, and insufficient warning the public of the newly demonstrated dangers of acetaminophen.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Trish	None	None	0900006484fe5b50	Randall	None	2022-03-28T11:45:49Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Randall, Trish	l19-3oyp-06p0	False	None	False	2022-04-12 05:33:53.773	[]
3007	CDC-2022-0024-3013	https://api.regulations.gov/v4/comments/CDC-2022-0024-3013	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been taking prescription opioids for about 6 years now due to chronic pain from migraines and fibromyalgia. In all the years I have been taking the medication I have never misused or abused my prescription. I receive 30 pills per prescription and try to make them last for at least 2 months just because I am afraid that if I reorder them sooner I will be seen as an opioid abuser. So, there are actually some days that I am in pain but don't take my medication. I am very aware that there are people who do get addicted, but I don't think those of us who are in pain and use the medication responsibly should have to suffer. I think it should be up to a doctor to decide the amount and frequency of medication being prescribed. They have the tools to track how much medication is being prescribed to a patient and can always require the patient to take a drug test if they feel the medication is being abused.<br/>Thank you for allowing me to comment on this important topic.<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawnya	None	None	0900006484fe5817	Kilner	None	2022-03-28T11:46:48Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Kilner, Dawnya	l19-8hth-wmzz	False	None	False	2022-04-12 05:33:54.008	[]
3008	CDC-2022-0024-3014	https://api.regulations.gov/v4/comments/CDC-2022-0024-3014	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting for my aunt who is 73 years old & had a horrible neck surgery go wrong 3 years ago she hasn't been able to even brush her hair; turn her neck; & hasn't been able to drive in 3 years; she was able to walk with a walker & dress her self because she was in pain meds that controlled her pain but 3 months ago her pain Dr told her he had to start tapering her down from 4 pills a day to 2 so now she cries every morning when tried to get out of bed; she sits in a recliner all day & has to use a wheelchair even in the house because it's to painful to walk; how is this ok? We would let a dog suffer or any animal suffer when they try to walk we have pain meds for our animals if they need them but not for a woman or man that needs help! Please explain to me why this is ok? She wasn't able to even go to her sister's funeral because a 2 hour ride is to painful; she has to help even getting dressed & bathing I hate watching her suffer so I wish the CDC had to sit & watch videos of pain patients that are suffering because they are loosing the one thing that helps them!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe5827	Anonymous	None	2022-03-28T11:47:24Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l19-96bu-zmmq	False	None	False	2022-04-12 05:33:54.227	[]
3009	CDC-2022-0024-3015	https://api.regulations.gov/v4/comments/CDC-2022-0024-3015	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I recently had to have outpatient surgery and the doctor prescribed 2 weeks of pain medication. Florida Blue would only pay for one week of the medication and according to the pharmacy the second week of the medication would be void. The only way I could have the prescription filled was to pay for it myself. I am 75 years old and this was an unnecessary hardship.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Constance	None	None	0900006484fe5831	Wisber	None	2022-03-28T11:47:49Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Wisber, Constance	l19-9ov5-s2ap	False	None	False	2022-04-12 05:33:54.432	[]
3010	CDC-2022-0024-3016	https://api.regulations.gov/v4/comments/CDC-2022-0024-3016	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a legacy chronic pain and disease patient. I have intractable pain and damage from an accident. I was steady on my opioid pain medication therapy for 9 years with no problems. In 2020 my medication was force tapered so low it doesn’t help like it did. These guidelines and this mme dosage has got to stop. Any smart doctors know that there’s no one size fits all. Its scientifically impossible. The liver breakdown is different in everyone. Everyone metabolizes different. I’m being cruelly punished as well as 50 million other chronic pain patients. Please remove all mme and guidelines. Leave it to the doctors and individual patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Don	None	None	0900006484fe587d	Marcello	None	2022-03-28T11:48:08Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Marcello , Don	l19-bmzh-0t5g	False	None	False	2022-04-12 05:33:54.638	[]
3011	CDC-2022-0024-3017	https://api.regulations.gov/v4/comments/CDC-2022-0024-3017	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The ones who suffer 24/7 with disabilatating severe uncontrolled pain are victims of today's political system. It's so sad that a human being is forced to decide if taking their own life is the only way to escape uncontrolled pain as a person who suffers with disc in my lower back that no longer exists due to 35 years of very heavy lifting while being a hard working us citizen for the public lifting residential ac and heating equipment. Now that I'm pretty much stuck lying on back unable to have quality of life because guidelines have been designed to prevent me from having any quality of life.Doctors will not prescribe pain medications in fear of being labeled a drug dealer and going to prison just because they want to help me.First do no harm and oaths to heal and provide proper care and medication isn't available anymore and it's not the doctors fault yes there are ones out there that have overdosed due to taking opiods but 0.3% of overdoses from legitimate perscribed medication was unintentional. I haven't seen the true ratio of overdoses due to the ones aguireing fentenal heroin and medications received on street corners. Why Why are the ones who so desperately need opiod meds to have just a little quality of life being treated like drug addicts. I firmly think that this whole behind closed door design of guidelines with paid actors involved with its creation 500 thousand to be exact was intended to curb the cost on the healthcare system medicare medicaid and insurance greed machine .Human suffering has become ok these days so sad for us all thanks to the greedy heartless ones who make the rules .These generic unregulated so called opiod medications made in foreign countries are notifed way prior to inspections when it comes to quality control and we end up with cheap junk for medication all for the sake of greed thanks health insurance company's. When name brand meds don't exist as an option it's pretty evident one size fits all these days even if your doctor perscribed name brand Norco it's not available which actually helps control pain long story short cdc has no need in being involved with guidelines of opiods why the FDA isn't in charge is a mystery to me and this political system of do as I say not as I can do is a joke .Until certain ones who make the rules have to live with the rules they have created because of vehicle accidents falling down the steps or victim of mother nature's wrath then they will realize the torture they have put us all threw for over 10 years now I wish no harm on anyone just a fair and equal system when it comes to uncontrolled unfortunate life changing pain please allow doctors to be doctors again get the dam government and insurance corporations out of our doctors offices please let us have a little Quality of life again soon we are tired of the compassion of greed and no desire for compassion for the sick and in pain .May compassion be instilled into the hearts of the rule makers soon .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe610e	Anonymous	None	2022-03-28T11:49:07Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l19-e33i-pvnf	False	None	False	2022-04-12 05:33:54.897	[]
3012	CDC-2022-0024-3018	https://api.regulations.gov/v4/comments/CDC-2022-0024-3018	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I strongly believe that the use of cold laser therapy as an alternative to opioid medications for pain must be considered a necessity. I have first-hand knowledge and experience as both a client and clinician that this non-invasive approach to alleviate pain works. This modality has helped to manage the pain of hundreds of patients already while minimizing the need for opioid use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fe6200	None	None	2022-03-28T11:49:24Z	OrthoLazer Nashua	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from OrthoLazer Nashua	l19-ekl1-tnv7	False	None	False	2022-04-12 05:33:55.130	[]
3013	CDC-2022-0024-3019	https://api.regulations.gov/v4/comments/CDC-2022-0024-3019	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Laser therapy from OrthoLazer has been an incredible addition to my practice. Many patients who previously may have requires short doses of opioid pain medication or post operative pain medication is no longer needed in most cases and much limited in the remainder thanks to laser treatment. As a anesthesiologist who practices both pain medicine and anesthesiology in the OR finding ways to optimize patient care is integral. Laser therapy is one of these ways.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alex	None	None	0900006484fe6b45	Dressler	None	2022-03-28T11:49:38Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Dressler, Alex	l19-ke1h-bhsd	False	None	False	2022-04-12 05:33:55.359	[]
3014	CDC-2022-0024-3020	https://api.regulations.gov/v4/comments/CDC-2022-0024-3020	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For over 28 years I had pain meds that gave me a quality of life I no longer have because of the C.D.C. guidelines. I have pain everyday,I cannot sleep without having muscle spasms in my legs, feet, hands and along the sides of my body. Anything I try to do has to be done with a great deal of measure. I fall often, I cannot spend a long time in a store because my feet will start having spasms in them. This also happens when I try to cook or clean. <br/>After the pain meds were discontinued, I developed a tremble in my hands that I did not initially have. I seriously do not know how we can have doctors that are not allowed to write pain meds for their patients. We are now treated like street addicts who use drugs for recreation and not true pain. Persons who have conditions and diseases that require opioids, should be able to get them with no mention of MME whatsoever. My pain has effected every single relationship I have. I no longer accept invitations to weddings, showers or cook outs. I no longer attend funerals. I cannot commit myself to anything or anyone because I never know if I will be having a bad day or a horrible day. I never have a good day. Most of the places I go to are doctors offices and they have done nothing for me. One primary care visit can get me 1 to 3 referrals to other specialists. In GA, there is no limit to the amount of medicines that a doctor can order for a patient. The federal government has totally failed in their "war on drugs". While fentanyl pours over our southern border, along with heroin, meth and other things (too numerous to mention), legitimate pain patients are made to suffer day in and day out. Overdoses are at an all time high due to illegitimate drugs. If the C.D.C. guidelines are so great, wouldn't this problem be non existent? the only thing the guidelines have done, have been to take people who had some degree of "quality of life" and destroy it. It is hard to be a nice person when you are in agony most of the time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	BONNIE	None	None	0900006484fe65f5	MCDANIEL	None	2022-03-28T11:50:04Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from MCDANIEL, BONNIE	l19-m295-o3cs	False	None	False	2022-04-12 05:33:55.607	[]
3015	CDC-2022-0024-3021	https://api.regulations.gov/v4/comments/CDC-2022-0024-3021	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My dad has been suffering from ALS and chronic pain for years. His pain management doctor in [city redacted] Kentucky. He continues to suffer greatly. The doctor refuses to give him anything stronger. He said he can’t have anything stronger unless he gets cancer... Complete crap. To watch him struggle every single day when he doesn’t have to is disgusting. These regulations are causing people to suffer unnecessarily. People are turning to streets for pain relief or killing themselves. You should be ashamed of yourself. These rules are bull. There are more overdoses now than ever.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jaime	None	None	0900006484fe6633	Brown	None	2022-03-28T11:51:06Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Jaime	l19-mdxg-k74u	False	None	False	2022-04-12 05:33:55.882	[]
3016	CDC-2022-0024-3022	https://api.regulations.gov/v4/comments/CDC-2022-0024-3022	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I IRGE you to consider opioid treatment for restless leg syndrome. If you have never experienced this condition, you have no idea how miserable it is for night's upon end. You are literally a ZOMBIE as you cannot function as a normal person. Please see any research or speak with the head of Mayo Clinic's RSL Clinic. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rita	None	None	0900006484fe6654	Head	None	2022-03-28T11:51:20Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Head, Rita	l19-mkmr-h46v	False	None	False	2022-04-12 05:33:56.155	[]
3017	CDC-2022-0024-3023	https://api.regulations.gov/v4/comments/CDC-2022-0024-3023	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the reduction in my pain medication I no longer have a job, both outside and inside the home. You are literally causing more problems than solving anything!! Wake up and please consider if YOU we're in MY shoes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484fe66f2	Laxton	None	2022-03-28T11:51:36Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Laxton, Cindy	l19-nem0-5jtk	False	None	False	2022-04-12 05:33:56.408	[]
3018	CDC-2022-0024-3024	https://api.regulations.gov/v4/comments/CDC-2022-0024-3024	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have attached my personal story below in relation to the Opioid Guidelines and why it is VITAL they be updated to ACTUALLY HELP pain patients rather than punish and ultimately kill pain patients. This new draft is a big start, including the elimination of a one size fits all dosage recommendation limit physicians are forced to follow as gospel that ONLY hurts and does NOT help anyone. I hope that physicians no longer feel as though they must run scared and force tapper their patients against their own better judgment as is happening to me right now. My life is hanging in the balance as a result.<br/><br/>The only two things the Opioid Guidelines from 2016 have been successful in doing are further assisting the black market in flourishing, which has resulted in killing both addicts and pain patients alike, as well as creating despair, struggle and often death for patients directly. Legitimate pain patients - those of us suffering daily in severe chronic pain as the result of conditions, chronic illnesses and disabilities we have no control over (and didn’t ask for!) - are DYING because we are not being treated by the physicians’ oath of “first do no harm.” We are dying because we are either forced to the street, forced to commit suicide or experience a catastrophic health events like a heart attack we would have not experienced otherwise had we been provided proper pain management. We are some of those most vulnerable members of society - many of us who if allowed to contribute to this world do AMAZING things - yet we are being disposed of as if we were trash. This has truly felt like - as well as presented like - a genocide on the population of chronic pain patients. <br/><br/>We are your neighbor you never suspected experienced such horrible health struggles and requires pain management to function, we are your coworker you didn’t realize dealt with such struggles, we are your fellow church member that helped you when your kids were sick or brought you food when a family member passed away. We do not look or present like addicts because we are NOT addicts. But yes, we need pain medication to function - to get out of bed each day, to experience regenerate sleep, to exercise to remain as healthy as possible, to take care of and play with our kids, to make a living to keep a roof over our heads and food in our bellies, to avoid horrific mental health struggles that would impact anyone negatively if they were unable to do these things, to reduce the chances of a heart attack because of pain so unrelenting it’s too much for the cardiovascular system to bare. And we DESERVE to be able to function, to survive, to live, to THRIVE just like anyone else. Our ability to do so doesn’t hurt anyone, in fact, it benefits so many - not just ourselves, but our families, our neighbors, our workplaces and society as a whole. <br/><br/>We’ve been treated as the equivalent to criminals and addicts, neither of which we are. Just as our conditions and diseases are not a one sized fits all matter, nor is our chronic pain, and neither is our profile …we are not, by any definition, addicts and we shouldn’t feel like criminals for requiring a medication to function and survive. We have been shamed and tortured for years now by a society, media, government and healthcare system that created and bought into a huge fear and misinformation campaign against us. We have been pushed under the same label and category as the addicts, and it’s NOT okay, and it’s definitely NOT benefited us. It’s hurt us, it’s hurt us in a CATASTROPHIC way. <br/><br/>I am a mom, a daughter, a sister, a wife, an aunt, a friend, a coworker, an advocate, a productive member of society and a human who DESERVES to be treated like a human being and continue having a functioning life for as long as my body allows. I am WORTH saving. My daughter NEEDS a mother. I NEVER once chose this life and these physically struggles. I was dealt a less than great hand and those whom get to judge and decide these guidelines should thank their lucky stars they do not have to experience a body and suffer like mine. <br/><br/>What continues to amaze me is the lack of empathy and complete and total judgment by those whom have NO idea what it’s like and fail to realize that it’s NOT a one sized fits all situation. And that these rules and laws impact other’s lives to great DETRIMENT. By trying to “save” me you destroy my life and ultimately kill me? That doesn’t make sense, does it? By saving the addicts through the means of these insane and false guidelines and propaganda you’re killing me and destroying my 6 year old daughter’s life. And if you haven’t noticed yet, you’re not “saving” the addicts either.<br/><br/>I hope you DEEM me WORTHY to save. Without proper pain management my life is destroyed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenna	None	None	0900006484fe670a	Poole	None	2022-03-28T11:55:05Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Poole, Brenna	l19-n55w-jy4h	False	None	False	2022-04-12 05:33:56.656	[]
3019	CDC-2022-0024-3025	https://api.regulations.gov/v4/comments/CDC-2022-0024-3025	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was functioning great for more than ten years on a stable reliable dosage regimen of tramadol. I've broken my back and my pelvis in five pieces along with other injuries since then. I was ALLOWED up to 6 tramadol per day at first. I did not take the whole six because of my paranoia that it was too good to be true. Having the extra came in handy too because if the roads were too snowy for driving, I had extra so I didn't have to do anything risky to pick up my medications. Also, the times I was without a car, I didn't have to do something expensive to get a ride in time before running out. Then, it was cut down to four a day and I lasted for years with that. I would do what I could to make sure I had as many three tramadol days as possible to keep that extra amount that really does come in handy when I am at my worst. I made the mistake of being honest with my doctor and he cut me down to three. This is the same doctor who a couple of years before that said that I was being silly by saying "I'm supposed to try to NOT take it right." He said "That's like a diabetic saying they should try to stop taking insulin." I felt, THEN, like the doctor was on my side. Lately, it's nothing but a pain in the [profanity redacted] to get the three pills a day. I told him that I sometimes NEED four a day especially in the weeks prior to my period. It seemed like this doctor at one time REALLY understood me and now it feels like someone has his balls to the wall and he's not allowed to make his own decisions. I also developed a great deal of trust with my psychiatrists, which means the world to me, and finally got a doctor to trust me with clonazepam 1 mg, 60 pills per month. Once again, I made the mistake of bragging that sometimes I take only 1.5. Ever since then, my dosage was lessened to 1.5 per night. I have to actually sit down and figure out which nights I should go without sleep so that when I really really need to have a good night sleep because of something important the next day, I'll be ready. This is a complete joke. When regulations amped up, my favorite doctor SUDDENLY retired because he apparently saw the writing on the wall. I knew that doctor since I was 19, that doctor knew my whole family. The medical world seems so against the patient since things have changed. I never ever considered resorting to things like the dark web or street drugs until now and I'm in my [profanity redacted] 50's. I've not resorted to such. Instead I've tried to write letters or turn to support groups. None of that makes me able to function and move any better or sleep any better. Generic medications too don't work NEAR as good as the Brand names. I know because I found very very very Old Ultram and one pill worked as good (even better) than two NEW generics and not only that, it lasted twice as long as the generics. I've already written to the FDA at least once about that issue and I"ve spoken to my doctor about it. He validated my experience by informing me that if there is a difference between generic and brand name it would be in the duration of effectiveness because of binding agents. Please just let our doctors DO THEIR JOB and stay out of it. I'll sign any contract and promise to not hold anybody responsible but myself for any consequences. I want my [profanity redacted] life back. I'm out of work now and am HOPING to be able to work again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fe6cdf	Barbarone	None	2022-03-28T11:57:48Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Barbarone, Jennifer	l19-qtrb-37si	False	None	False	2022-04-12 05:33:56.890	[]
3020	CDC-2022-0024-3026	https://api.regulations.gov/v4/comments/CDC-2022-0024-3026	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a health care worker with a variety of healthcare experience, I am also a Chronic pain patient. Currently I am a Medical Assistant for one of the leading pain management Doctors in the USA. I truly am on the fence about the guidelines. I do believe to some extent there needs to be some kind of guidlines for prescribers but at the sametime I saw how harmful and dangerous the 2016 guidlines were and still are. Chronic pain suffers should have adquate access to opiates with a safe monitored care plan with safe guards and bumpers. I believe that 90 MME Guideline should stay in place but have some flexibility. Also the reccomendation of " gradual tapering of opioids with the consent of patients", has been unilaterally and recklessly implemented by some physicians, with tragic results. Literally. I also believe that "Opiate free" surgeries are inhumane and without patient consent should be illegal. I also believe that THE DEA HAS NO BUSINESS IN HEALTHCARE! Doctors should be allowed to be Doctors with out DEA oversight!<br/><br/>Disclaimer-<br/>These opinons are my own and do not refect the views of my employer	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Danel	None	None	0900006484fe6ce8	Connaughton	None	2022-03-28T11:58:32Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Connaughton, Danel	l19-qvtp-vvey	False	None	False	2022-04-12 05:33:57.131	[]
3021	CDC-2022-0024-3027	https://api.regulations.gov/v4/comments/CDC-2022-0024-3027	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Sirs or Mesdames:<br/><br/>I am a person who has been legally disabled since 2011. My conditions are progressive and I know I will not be walking much longer. I have used all alternative or complementary methods to control pain, including meditation, metaphysics, massage, ten unit, stretching, acupuncture, chiropractic care, yoga relative. I am unable to take nsaids, tylenol, prednisone, gabapentin, or similar components, including codeine for pain, as the side effects outweigh the pain or exacerbate my colitis, gastritis, and esophagus. It's important to understand that I have cervical spinal stenosis, with bulging and degenerative discs from C-4 to S1, and degenerative hip joints. I am also seeing a cancer specialist. (To name the most progressive) I'm trying to not be emotional. I was able to function with one tramadol a.m. and one at night for four years. Now with these proposed guidelines the FDA and DEA is increased their crackdown and threats to physicians, which includes a unilateral contract which literally controls the life of a patient in order to receive two 50mg of tramadol. I have always been a responsible patient, now I must taper from this small dose because I refuse to be treated like an unruly toddler or an incompetent senior. I will not be told when I have to drug test, as we all know the variables involved with inaccurate test results. (false positives, untrained personnel, break in the chain of custody, etc.) and of course the risk assessment scores, that would cripple any chance for passionate medical care in order to get a new prescription. I have never committed a crime, yet I am a criminal in the eyes of the CDC. My relationship with my doctor is fractured, and his code to heal has been robbed from him. I'd like to say my situation is isolated, however my sisters surgery was delayed because of Covid and it became an emergency. She was cut from stem to stern, had organs removed, and was not given pain medication after surgery, she was told she could have tylenol. This was the hospital, and she remembers vividly the screaming and crying on the ward she was on because of untreated pain. She needs further surgery but refuses until she has a guarantee her pain will be managed. It's important to remember that unmanaged pain can kill. My blood pressure runs now from 198/103 to 154/94, all because of the CDC Guidelines and the subsequent laws that mirrored the 2016 guidelines. Unfortunately, the damage is done and these new guidelines will not change anything. The only possible solution is to focus, according to your statistics, on the illegal drugs, and allow doctors to care for their patients. This would include revoking the 2016 guidelines in their entirety and stepping back from further corrective measures or new guidelines. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe6d3f	Anonymous	None	2022-03-28T11:58:58Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l19-rdpb-4g0e	False	None	False	2022-04-12 05:33:57.374	[]
3022	CDC-2022-0024-3028	https://api.regulations.gov/v4/comments/CDC-2022-0024-3028	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A good friend of mine, [name redacted] has chronic pain from an accident. He is in need of pain medicine and unable to get it from the doctors because of the cdc regulations. It’s a shame that some 7 to 9 million people are in this situation. Please consider amending the current regulations. Thank you for your service to the community. Peace. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484fe6e80	Page	None	2022-03-28T12:00:47Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Page , Joseph	l19-ubgp-ln8e	False	None	False	2022-04-12 05:33:57.642	[]
3023	CDC-2022-0024-3029	https://api.regulations.gov/v4/comments/CDC-2022-0024-3029	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired neuropsychiatrist, and I appreciate the opportunity to comment.<br/><br/>The first point I would like to make is that different people metabolize opioids differently, and what may be a high dose for one person, may be a totally inadequate dose for another person.<br/><br/>The second point I would like to make is that pain and depression are coexisting, and pain exacerbates depression, and depression exacerbates pain. When there are external life stressors, pain exacerbates, and this is not necessarily drug abuse, although it can lead to drug abuse. The proper treatment of pain therefore is to reduce external stressors to the extent that this is reasonably possible, and to avoid castigating people when pain exacerbates with stress. <br/><br/>People who have chronic pain can function well and be maintained on chronic medication including opioids. Consideration should be given to maintaining people on opioids as part of a regimen if it allows them to function well. This may well be a better and less intrusive method of patient management then implanted devices.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	michael	None	None	0900006484fe6e9d	Sumner	None	2022-03-28T12:40:41Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Sumner, michael	l19-ujik-svj6	False	None	False	2022-04-12 05:33:57.905	[]
3024	CDC-2022-0024-3030	https://api.regulations.gov/v4/comments/CDC-2022-0024-3030	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Stop the FORCE TAPERS!!!! WE never consent to tapers we are told this is what's going to happen or leave. This KILLS people.<br/>https://twitter.com/i/status/1507705885061230595<br/>BAN FORCE TAPERING!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fe5367	Ard	None	2022-03-28T13:04:44Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Ard, Melinda	l17-whzg-7qju	False	None	False	2022-04-12 05:33:58.134	[]
3025	CDC-2022-0024-3031	https://api.regulations.gov/v4/comments/CDC-2022-0024-3031	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My guess is the CDC staff involved with creating revised recommendations for opioid prescribing spent that friday morning cashing their paychecks texting friends and relatives and sippindg on some lattes before developing recommendations on that friday afternnon. The only plausible explanation for justifying their involvement with developing recommendations besides the COR theory i have mentioned previously is the thinnest of legal positivism- that wouldnt even meet the standard of the most prominent legal positivism proponent. H.L.A.H. But i do not blame the CDC solely for the ever rising deaths to illicit opioids and ever worse pain care- well documented by scores of commenters on the guidelines. For it it is iron triangle of govt, academia, and health industry responsible for failed drug wars The right winged authoritarians in COngress wanted to boast to their constituencies of how much they have done to limit access to opioids and since they regard people in pain as problems and not as persons- no need to justify their theater of cruelty tactics with neutralization theory- for being thingified by the iron triangle- there is no need for them to treat people in pain with any civilitas, dignitas or caritas. And ofc ourse, the CDC and their thick as thieves friends in academia were and are only too willing to via eliminative materialism deem people in pain as othered into less than Gregor Samsa being turned into an insect in the Metamorphosis. Such is the danger of privilege hazard in the iron triangle- privileged irresponsibility. So despite hearing the many reports of suicides due to forced tapering and being refused opioids for pain- the callous unfeeling grandiose manipulative iron triangle continues to oppress dehumanize depersonalize disrespect and dismiss people in pain. Their dried voices remain ever mute and meaningless and distant as fading stars to the iron triangle. Even EDward the V! When he gave commoners property rights via enclosure laws to baronial retinues was kinder because at least they could plead like serfs to recognize a need- but the iron triangle really fails to recognize that people in pain shouldnt be treated as serfs without rights who must plead to the iron triangles like they were feudal masters. So when the CDC decided to disregard principles of good governance and consider acceptability of guidelines to the largest stakeholders- persons in pain- its easy to understand why. After all the CDC is comprises of public health epistocrats who cannot see the trees for the forest and contrary to legal and moral theorists thehy believe every individual in pain must sacrifice their needs to the designs of the CDC(despite being contrary to legal theory of J R and M S- in my documents) and iron triangle so they can boast of what a great job they did to reduce opioid usage And after all, medicine hasn’t evolved beyond believing that pain is some subjective feeling of something-often exaggerated to obtain an addictive drug. . So why take it seriously?<br/><br/>Since the CDC regards PCP’s as clueless in prescribing opioids- wouldn't it be better to make sure they are properly educated by medical schools in the first place. If a sous chef doesn't know about sanitary food practices- is it better to give them quick formulaic practices or would it be better to make sure schools are fully educating them in the first place. The quick and dirty “finish the job, get er done mentality of the cdc coupled with there is no alternative fallacy reflect a CDC whose staff lacks transformative evaluative capacity and fair and full consideration of alternatives. Their vm prefrontal cortexes are deficient theyre frequentist evidentialism doesnt make for responsibilism. Theyre plan is nonadaptive throw it over the wall antipattern and their is no alternative fallacy, They lack wide reflective equilibrium- they dont even know what that means. THeir ethics is less then cartoon thin. They evince no knowledge of Bonferroni correction or Kalman filters and Benfords law- thay are data dredgers and data torturers-they make so much out of so little and too little out of so much. THE CDC and the iron triangle from whence they came are the ones our Framers warned us of- their Myrvold dystopia and theater of absurd/cruelty is upon us.<br/>That the CDC beleives it is greater then Gods and people in pain are less then human. The CDC is beyind good and evil- they are, after all supreme overlords and have no use for morality-they are the 4 wolves and we are the sheep- they have voted on dinner. Ther demand that the public be mindless acolytes and servile to their stupendous narcissism reflects their underestimation of biosocial heterogeneity and the principles upon which our Nation was founded. We will not tolerate their boots forever on our necks and their vast unjustifiable tutelary power will be overcome and just as TJ wrote- their witches spells will dissolve and the public restored to right reason.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fe5383	Becker	None	2022-03-28T14:11:23Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Becker, David	l17-xp91-inqp	False	None	False	2022-04-12 05:33:58.380	[]
3026	CDC-2022-0024-3032	https://api.regulations.gov/v4/comments/CDC-2022-0024-3032	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had an operation on 5/5/05 they put a plate with six strews in my neck. I have severe cervical Spinal stenosis I have been on and off opioid’s since then. I went to Mexico in 2018 and for two an half years a had chronic c. Diff which took a lot out of me and the pain was sometimes so intense and I must have a bad Nexcare score because everyone is scare to treat me. I was on oxycodone for about 10 years and decided I wanted to come off so I went on Suboxone for the pain not because I was addicted they thought it would help for the pain. So after I got a fecal transplant I decided to go back on Suboxone because I was afraid they would go down a path of wanting to use opioids again I’ve been OK without them but when I need them I should be able to use them. Starting in 2021 I fell and hurt my knee and come to find out it is my knee my hip and my back (severe spinal stenosis) so again I find myself hoping to get some pain relief but that has not happened I’m waiting on MRIs for the last month. I guess what I’m saying is things come up and I need to go back on the opioids and no one is willing to do that. I know my threshold in if I run into any problems I will go back on Suboxone which I did and the thing happened in Mexico after everything was fixed. So I need you to know that I have complex problems that need to be treated with opioid’s but am willing to go back on On Suboxone or sublicade which I heard is better for your teeth when needed. There should be a way you can treat people with complex medical problems with both suboxone and opioid’s the best of both worlds in my eyes… thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe8893	Anonymous	None	2022-03-28T15:20:02Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1a-urr5-d2bi	False	None	False	2022-04-12 05:33:58.634	[]
3027	CDC-2022-0024-3033	https://api.regulations.gov/v4/comments/CDC-2022-0024-3033	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In late 2020 my 92 year old mother who had lived a long fruitful life was under care for chronic back pain, caused by arthritis up and down her spine. My 93 year old father was needing emotional and physical support as well to take care of her.<br/>At her primary MD's office for her check up it was found that one of dad's opoid pain medication was found in mom's urine. She told us she was out of her pain pills and dad gave one of his.<br/>Her primary MD was offended that my parents did this "illegal" act and would not prescribe anymore pain meds for my mom. She suffered early into 2021 and was put under Hospice Care at home until her death on February 11, 2021.<br/>Just recently this first of this year, two instances of urine drug testing was done on my father and both times it showed "morphine" in his urine. <br/>His primary MD asked my 93 year old father if he "was on dope". He has not had any pain relief since his primary refused any for him because he gave one to mom in her waning days. We established after a few weeks, we found him eating his spinach with poppyseed dressing. When he returns this week for another urine test I hope to find no morphene in his urine. My father worked two jobs raising 7 children with my mother. If anyone deserves to handle chronic pain, it is him. I hope the new prescribing plan can give hope and reason to his primary to help make his end of life a little more pain free!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fe8781	Robinson	None	2022-03-28T15:20:53Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Robinson, Linda	l1a-u8v4-pbcv	False	None	False	2022-04-12 05:33:58.901	[]
3028	CDC-2022-0024-3034	https://api.regulations.gov/v4/comments/CDC-2022-0024-3034	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2019, I had my 7th surgery for complications due to Ulcerative Colitis. I had the remainder of my intestinal jpouch removed, a rectal stump placed, and some clearing of adhesions. This was one of my biggest surgeries since I had my colon completely removed in 2010. During this particular surgery, I had an incision that started several inches above my belly button and all the way down to the bottom of my pelvis. I also had an incision on top of the rectum area. The incision is about 4 inches long. This one was particularly painful as there are so many nerves in that area. <br/><br/> This time, I came in ready to refuse the epidural pain medication route and go straight for the standard IV. I did this because my 6th surgery in 2015 was extremely painful and I did not want to go through that again. Several doctors and nurses came into my room multiple times to talk me out of getting the regular IV, and told me that I would be much safer and happier with the epidural. I ended up going with the epidural. <br/><br/> When I woke up from this surgery, I had no idea that this surgery lasted several hours more than it should have. I can remember being conscious and trembling to a level I have never experienced. The nurse asked me what was wrong, and I told her that the pain was unbearable. Instead of pushing better pain meds, she placed lidocaine patches NEAR my rectal incision on my bottom. This did not help. <br/><br/> I spent about 5 days in the hospital in excruciating pain. Every 5 hours or so, my nurses would come by to give me TYLENOL and IBUPROFEN They took away my pain button after one single day. I'm usually able to keep it for a few days. <br/>Once they took my epidural out, the pain around my stomach hit like a ton of bricks. I have been through pain before, but never anything like this. We had to beg and plead for IV medication but they would only give it to me after a trial of Tylenol, ibuprofen, then 50mg tramadol, and finally IV pain meds. After the IV pain meds wore off, we had to start over again. <br/><br/> After I was sent home with about 3 days of Dilaudid pills, we found that my pain was even worse and I had contracted a fever. My husband called the doctor on call to beg for more medicine, but they told him I needed to be seen right away. I was admitted back to the hospital where they found two abscesses that had formed which Is why I was in such pain and so sick. <br/> <br/> The level of pain that day was literally unbearable. The infection was not yet controlled, and once again, I was given Tylenol and ibuprofen. Then I was given tramadol, and eventually, they pushed the IV pain medication for "breakthrough pain" management. This only lasted what felt like an hour. I would then wake up again crying and begging for help. I remember waking up asking my husband to let me die because that would feel better. I found later that My husband had begged and begged the nurses to help me but they said there isn't anything they could do due to the process they have to go through before breakthrough pain. <br/><br/>My husband and I have never been the same since that experience. I should have NEVER been penalized for the opioid crisis in this city or around the nation. My records from all 8 surgeries show that I have never stayed on pain medication and have actually never called to request more (until the 2019 incident). This situation gave me and my husband significant PTSD which we are still working through. Please help us, and people all over the nation with chronic pain and chronic diseases and change the guidelines. I completely understand that opioid addiction is tearing apart our society, but I have never contributed to this crisis. Please don't let someone go through what I went through, because I'm concerned that they may not make it out alive.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amanda	None	None	0900006484fe86a2	Botros	None	2022-03-28T15:21:46Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Botros, Amanda	l1a-tfyg-cr2g	False	None	False	2022-04-12 05:33:59.136	[]
3029	CDC-2022-0024-3035	https://api.regulations.gov/v4/comments/CDC-2022-0024-3035	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The original CDC guidelines made a terrible mistake by spelling out specific MME amounts. The health care, legislative, and insurance bureaucracies responded with an onslaught of rules and regulations that substituted arbitrary policy into the patient/doctor relationship. This caused a massive upheaval in the proper care and treatment of long term care that continues to this day. <br/>In my case, I was referred to a pain "specialist" to review my care and set up a forced taper that failed. I was in too much pain and I threatened to take action if reduced further. I was not. In the ensuing years I have tried all sorts of yernatives as I struggle to function on the newer, lower MME schedule. I have been in need of more appointments and care. This is simply not necessary. Yet my physicians are afraid to invoke the possibility of investigation and loss of licensure loss by prescribing the proper care for millions of us that suffer from chronic, long term pain.<br/>Please delete ANY REFERENCE TO SPECIFIC MME in the revised guidelines. This should be left to the prescriber to determine in close examination of patient and circumstances. It is the only way to reverse the damage that has been done to us. <br/>Thank you.<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patrick	None	None	0900006484fe867d	Collins	None	2022-03-28T15:23:37Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Patrick	l1a-tcmp-omwh	False	None	False	2022-04-12 05:33:59.389	[]
3030	CDC-2022-0024-3036	https://api.regulations.gov/v4/comments/CDC-2022-0024-3036	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After reading so many stories of undue pain and suffering to all of the people who have commented on the register my heart is broken. Who would have ever thought that America would treat it's sick and dying like this. We have hundreds of thousands of chronic pain patients out here suffering daily and many want to end their lives because of the 2016 Guideline and what the DEA has done to our Doctors. Now that the state of Arizona has passed a bill trying to protect their pain patients we find out that the DEA should have never had access to the PDMP. Our civil rights were not protected and they ran with it. I always wondered how they had access to my pharmacy records when I never signed anything. Very shady just like your new guidelines. Dropping the MMEs from 90 to 50 has already been made into hard law in all Dr. offices and taking anyone over 90MMEs off pain meds altogether is barbaric. They are obviously the people that need opiates the most. If you are going to go through with this you may as well legalize the medically assisted suicide as Canada has. Seriously CDC just give them a pill to end their suffering. Now that would be humane not this BS you are going to put them through pretending like you are fixing the problems caused by the first guideline. I am glad the media is seeing all of these comments but will it be enough to change the draft or what is already set in stone by the creators who are known to have been paid enormous sums of money to speak out against opiates. The DEA should be prosecuting every one of you who were responsible for writing the Guideline. According to the Americans with Disabilities Act it is illegal to withhold medication from the disabled and that is exactly what the CDC has caused.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fe8661	Donaldson	None	2022-03-28T15:24:06Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Donaldson, Linda	l1a-t9jc-i5lm	False	None	False	2022-04-12 05:33:59.620	[]
3031	CDC-2022-0024-3037	https://api.regulations.gov/v4/comments/CDC-2022-0024-3037	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Laser therapy and other alternative, non-invasive, pain free forms of treatment cannot be stressed enough. In regard to laser therapy, I have had the fortunate opportunity to witness many patients, with both acute and chronic diagnoses experience exceptional relief from their ailments. The relief these patients feel is a quality-of-life improvement that allows them to get back to their ADLs and function independently.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fe8596	None	None	2022-03-28T15:24:21Z	OrthoLazer Flower Mound, PLLC	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from OrthoLazer Flower Mound, PLLC	l1a-sotn-do5x	False	None	False	2022-04-12 05:33:59.850	[]
3032	CDC-2022-0024-3038	https://api.regulations.gov/v4/comments/CDC-2022-0024-3038	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regarding: Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids<br/>Docket No. CDC-2022-0024<br/><br/>First, I have trouble actually finding the proposed guidelines. All the google links and links on CDC.gov seem to talk around the guidelines or point to where to comment, but after spending twenty minutes on my computer, I can't find a copy of the draft guidelines themselves. Maybe I am missing something obvious, but if not, this process should be put on hold until a clear link is available on the splash page of the CDC.gov site that says "Draft Practice Guidelines for Opioid Prescribing 2022" or something similar. <br/><br/>Even without reading the current draft guidelines, several things are worth mentioning: the first is that your guidelines a few years ago have resulted in untold misery for patients in pain because medical boards put the force of administrative law behind them, especially here in Mississippi. It has also resulted in unwanted intrusion into medical practice as Mississippi requires urine drug screens now not only for opioids but all controlled substance prescriptions. This is especially intrusive to the practice of psychiatry, interfering with the doctor-patient relationship. <br/><br/>The second is that people with severe migraines need to be able to have ready access to opiods for when their Imitrex, etc, fails. That is, they need to have a bottle of hydrocodone or oxycodone type medication they can hold onto so they don't need to go the ER every time they have a severe migraine. <br/><br/>Finally, you should take a hard look at the actual data as to whether there is any need for recommendations, implied or otherwise, regarding regulating medical prescribing given there is real evidence that the idea of an opioid crisis caused by prescribers is nothing more than mass hysteria fanned by the media. For instance, in 2016 about 45,000 people died from opioid overdoses (1/10 that of tobacco related causes). Of those 45,000, only about 15,000 were from prescribed opioids. The best estimate for death from NSAIDs such as aspirin for that same time period is also 15,000. In short, there is and has not been a medical opioid crisis. There is a flood of fentanyl and heroin coming from other countries. There have been a few bad docs. There have been teenagers stealing medicines from their parents or grandparents medicine cabinets, which might justify a public education approach to opioid storage and disposal. But, much to the contrary of what the press and juries influenced by the press have said, doctors in general, pharmacies, and even Purdue Pharmaceutical did not cause an opiate crisis. <br/><br/>Substance abuse is a very real problem and falls under my purview as a psychiatrist. Substance abuse is not a problem of alcohol, opiates, methamphetamine, or benzodiazapenes; it is a problem of individual patients with illnesses who need treatment. Your guidelines have only given fuel for the media driven mass hysteria that is hurting patients all across the country and is over-regulating physicians. <br/><br/>Sincerely, <br/>[redacted]<br/>Board Certified General Psychiatry<br/>Board Certified Child and Adolescent Psychiatry<br/>Over 30 years in practice	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jule	None	None	0900006484fe84de	Miller III MD	None	2022-03-28T15:27:06Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Miller III MD, Jule	l1a-s5oj-73s0	False	None	False	2022-04-12 05:34:00.078	[]
3033	CDC-2022-0024-3039	https://api.regulations.gov/v4/comments/CDC-2022-0024-3039	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with chronic regional pain syndrome AKA the suicide disease for over a decade. It is the most painful disease known to man you have restricted my doctors from giving me meaningful life quality life by limiting how they are able to prescribe to me my medication which is the only thing that gives quality to my life it allows me to live without being in a wheelchair and taken care of by other people. I beg of you please allow my doctor to treat me as an individual and not as a criminal because I suffer as so many others do. I'm begging this of you people in pain management with real diseases are not the reason for this opiate crisis, but we are the ones that suffer on a daily basis for it and our doctors, and their patients pay the price. Please allow my doctor to treat me as an individual and not punish him for prescribing me medication to help me live life with meaning.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006484fe89d4	Ritondale	None	2022-03-28T15:44:21Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Ritondale, Pamela	l1a-vjlz-xj2k	False	None	False	2022-04-12 05:34:00.318	[]
3034	CDC-2022-0024-3040	https://api.regulations.gov/v4/comments/CDC-2022-0024-3040	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted], and I have been living with chronic pain for over ten years. I am an author who has written about the chronic experience for many media outlets. I applaud the improvements in the CDC Guideline for Prescribing Opioids, and I find it significant and important that the CDC acknowledges that harm was done with previous guidelines. Throughout the course of seeking medical care, I have experienced many doctors who have unfortunately focused more on their own anxiety about prescribing pain medications than on treatment for my conditions. I believe that doctors want to do the right thing, but being pressed for time, many may focus on rules they must follow. Therefore, I believe that a few edits to these guidelines will make them even stronger. First, I believe that the continued mention of specific doses (50 MME) should be removed, as those non-medical professionals who may use these guidelines to craft anti-addiction legislation may continue to focus on this as a blanket regulation, and medical professionals may continue to focus on this figure as a requirement rather than focusing on their medical judgment. I believe that the "lowest effective dose" should appear instead of this specific figure. Secondly, as someone who has seen outrageous and continued suffering and even suicides within communities of pain patients, the dangers of tapering medications should be much more strongly emphasized, including more medical studies that mention such clear dangers to life and well-being. More language needs to be included to emphasize that tapering can lead to suffering and extreme danger for pain patients. Finally, I believe the CDC should continue to emphasize that pain treatment is always multi-modal rather than "either or." I use a variety of treatments including TENS, NSAIDS, PT, natural supplements, and opioids as needed. Having all of these at my disposal supports my ability to work and function, and I need all of them. Opioids should be seen not as an "either or" but as part of the full range of treatments. As a pain patient, I can tell you that I need all of these strategies to function. In closing, I would like to personally share the traumatic nature of living through the years of these guidelines. Watching the suicides and desperation of those who want to function, want to live, want to enjoy work and life with their families, and watching the agony of people in pain has decreased medical outcomes and quality of life for everyone in pain. I believe it's safe to say that many of us live in fear of the next piece of legislation targeting us, the next change in guidelines, the new doctor, or the next taper. This is an unacceptable burden to place on those who are disabled and seeking to navigate each day with already crushing physical and emotional burdens. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sonya	None	None	0900006484fe8222	Huber	None	2022-03-28T15:45:17Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Huber, Sonya	l1a-pxe9-bwoh	False	None	False	2022-04-12 05:34:00.548	[]
3035	CDC-2022-0024-3041	https://api.regulations.gov/v4/comments/CDC-2022-0024-3041	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines seem like more wordplay giving harmful limitations and suggestions for using a medication that is much more harmful. If the CDC can’t use better science and leave out arbitrary limits that are harming patients then you need to retract them completely. I am also concerned with who is writing these guidelines and their connection with suggested new drugs. I have had two dear friends die from suboxone. I have seen what it does to people. This is nothing more than a war on opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Holly	None	None	0900006484fe7443	S.	None	2022-03-28T15:53:41Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from S., Holly	l1a-atri-he2z	False	None	False	2022-04-12 05:34:00.785	[]
3036	CDC-2022-0024-3042	https://api.regulations.gov/v4/comments/CDC-2022-0024-3042	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As you propose clinical practice guidelines I would like to know why you think you have credibility as you have caused a mental and physical health crisis in this country. Instead of fixing a problem you have made things worse. Maybe a real world fact check might help you! Pushing a narrative that a certain mg dosage will cause an addiction is infantile at best. How do you expect Doctors and patients to respect you when you have harmed stable patients. Creating an atmosphere Of fear for physicians who can not properly prescribe hurts the health and welfare of the citizens of this country. I have never met so many Doctors who have told me they don’t agree with what you have done. This was at a teaching campus. If you want to fix the drug problems in this country go to the streets and learn from them. You did this with Ebola and you found the source, why do you ignore what the facts are telling you with the evidence.?. It is a proven fact that illegal fentanyl is killing people . Stable long term patients do not abuse there medication, learn the facts don’t make them up. Now everybody knows what your medication regime is and this has harmed patients. I never was asked if I wanted to share my medical diagnosis or medications list.Do you think a good public shaming will help a patient or harm them? . Now the country is a mess with no standard of care for prescriptions, every state is different. You created this mess now fix it. Maybe you could get a few doctors that don’t have COI to write guidelines instead of ones that are profiting off of patients distress. You admitted the previous guidelines caused harms , yes major loss of life by suicide and patients abandoned left with no care. We are talking about stable patients. The worst of all is putting the doctors who were great healers in harms way and prison for not prescribing according to your harmful guidelines. If you make things worse shame on you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joe	None	None	0900006484fe7431	Kramer	None	2022-03-28T15:54:14Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Kramer, Joe	l1a-a8yo-9r7s	False	None	False	2022-04-12 05:34:01.014	[]
3037	CDC-2022-0024-3043	https://api.regulations.gov/v4/comments/CDC-2022-0024-3043	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I'm a 58yo woman who sustained a work injury back in 2000. The 2yrs I tried numerous treatments to try to control pain including but not limited to PT, Massage, Chiropractor, Traction, Accupunture, Non Narcotic Medication, INSAIDS, Steroid Injections, Ablation, and a Spinal Cord Stimulator. Non of these have been able to treat my High Impact, Chronic Pain alone. In 2002 I was finally told that I should consider Opioid Therapy. Things changed, although Opioids don't help the nerve damage I have alone that along with other treatments made it tolerable and I was able to continue working another 10yrs. In 2017 I was force Tapered to the suggested mme's and my situation quickly became worse. As my pain levels rose I became more seditary and now spend the majority of my time on the couch or in bed. I can't enjoy time with family outside of my home. I can't even sit or stand for more than 15min at a time. I have no life quality left and have developed heart issues related to constant pain.<br/><br/>I do want to thank you for rewriting these and taking comments, however, there are many similarities to the original <br/>Guidelines. And one in particular is very disturbing. These are my concerns:<br/> <br/> 1. A reference to 50 mme will still cause patients to be under treated or not treated at all. It will likely cause hesitancy by doctors to write anything over 50 mme.<br/><br/>2. Many people w/ different conditions have been able to get their lives back at much higher doses. They are not addicts, nor should they be treated as such. And they need doctors willing to carefully titrate their dosage up-not down to an ineffective dosage.<br/><br/>3. Pain mgmt is not one size fits all and may times takes a mix of different meds. Each person is a unique human, what helps one person may be completely different from another regardless of their condition(s). People are complex individuals.<br/><br/>4. Please remove references to specific conditions not being helped by opioids because whatever studies you referenced do not reflect those who are really being helped by them in real world practice. Perhaps a survey sent to those in the PMP system would better reflect this?<br/><br/>5. Please remove the commentary about those above age 65 needing less than 50 mme as this is also inaccurate.<br/><br/>6. Please allow telemedicine visits for established patients.<br/><br/>7. Please allow early refill of meds. 24hr is unreasonable when many Pharmacies only stock a small supply of Opioid Medication and have to order yours when to bring your prescription in. One may be to sick to go out or at the mercy of a act of God.<br/><br/>8. Please stop insurance companies and pharmacies from meddling with pill count, number of days allowed or dosages under the guise that they are preventing addiction. They are not the treating physician.<br/><br/>9. Please stop the DEA harassment of doctors. They need to be able to write out the correct prescription with the correctly titrated dosage without fear of going to jail or losing their license.<br/><br/>Thank you, <br/>[redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fe771e	Combs	None	2022-03-28T15:55:52Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Combs, Judy	l1a-4nol-j1ti	False	None	False	2022-04-12 05:34:01.248	[]
3038	CDC-2022-0024-3044	https://api.regulations.gov/v4/comments/CDC-2022-0024-3044	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines must take out the 50mme out!!!! I'm afraid that out of fear doctors will lower from 90 to 50 mme. This is very bad for CPP!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gadd	None	None	0900006484fe76e0	Cheryl	None	2022-03-28T15:56:09Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Cheryl, Gadd	l1a-3woc-jadq	False	None	False	2022-04-12 05:34:01.530	[]
3039	CDC-2022-0024-3045	https://api.regulations.gov/v4/comments/CDC-2022-0024-3045	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was going to my last physician for 8 years. He treated my chronic pain condition as well as my other health issues. I had osteoarthritis when I was seeing him. He treated that with hydrocodone and anti-inflamatories. In the 8 years he was treating me for pain I never had a blemish. Not one bad random urine test. I always took them responsibly no issues ever. <br/><br/>My Dr suddenly retired in 2021. Since then I found out that I have Psoriatic arthritis. It's a very painful inflammatory disease that along with the osteoarthritis. It makes life very difficult. I cannot find any Dr that will treat my pain. The one or two Drs that will are not taking any new patients. The rest like 20 Drs refuse to treat pain and will not write for opiates of any kind because of those evil guidelines<br/><br/>The CDC guidelines for opiates prescribing need to be revoked killed and done away with. MME limits need to be cancelled. It should be left up to the Dr and the patient as to how many milligrams and how many times a day and opiate is needed for appropriate pain control. <br/><br/>So I ask for pain patients abolish these opiate guidelines!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rich	None	None	0900006484fe7210	Kurzweil	None	2022-03-28T15:56:56Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Kurzweil, Rich	l1a-05uu-o28l	False	None	False	2022-04-12 05:34:01.757	[]
3040	CDC-2022-0024-3046	https://api.regulations.gov/v4/comments/CDC-2022-0024-3046	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines are too vague when mentioning benefits or harm when mentioning them in the context of opioid use in the context of chronic pain. I would suggest that the harm and/or benefits be described in a more concrete fashion which a physican and a patient can all agree on. Currently, the issue becomes a bone of contention where patient claims benefits from the opioid use and demands opioid to ease the suffering while the physician has no evidence that its truly working for the patient. <br/><br/>Also its a slippery slope and there needs to be a hard stop on daily opioid dose for non cancer chronic pain. Every patient claims developing tolerance after sometimes and wants to go up on the daily opioid dose.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe6fc6	Anonymous	None	2022-03-28T15:57:17Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l19-xh95-tw0n	False	None	False	2022-04-12 05:34:01.997	[]
3041	CDC-2022-0024-3047	https://api.regulations.gov/v4/comments/CDC-2022-0024-3047	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My journey dates back to 2007 when I was seriously injured at my job. I had to fight for 5 years just to receive what I was entitled to have, disability status/payments. The endless surgeries to try to "fix" my injuries, left me with Intractable Pain, and year after year, more painful diseases develop due to my body dealing with the immense pain and the damage it does to your body. <br/>To top it off, being DENIED the appropriate amount of meds, which is my Constitutional right to receive is causing me to "live" in horrific pain, one that I would never wish upon anyone else. I AM NOT AN ADDICT, I JUST WANT THE MEDS THAT I AM LEGALLY ALLOWED TO RECEIVE. Stop clumping all of us (chronic pain patients/drug addicts) into the same bubble, we are polar opposites, and WE deserve to be treated as humans with pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fe6f6c	Newbury	None	2022-03-28T15:57:36Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Newbury , Patricia	l19-wj1a-kovh	False	None	False	2022-04-12 05:34:02.231	[]
3042	CDC-2022-0024-3048	https://api.regulations.gov/v4/comments/CDC-2022-0024-3048	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My friend [name redacted] was in an accident years ago and was on a good pain medication program and was able to tolerate pain. Now due to current regulations he is unable to get the the medication he needs to get through the day. Please reconsider the regulations so that can live a somewhat normal life. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Helen	None	None	0900006484fe6f14	Yee	None	2022-03-28T18:17:14Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Yee, Helen	l19-vi0y-u8lx	False	None	False	2022-04-12 05:34:02.466	[]
3043	CDC-2022-0024-3049	https://api.regulations.gov/v4/comments/CDC-2022-0024-3049	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In the course of medical treatment, the cdc has become over zealous in protecting people who use opiates as a recreational drug. However they are not looking at the situation realistically. Since the crack down on opiates began, the only people with pain pills, and other opiates are the addicts. People with chronic pain are suffering needlessly, because they are not prescribed enough pain medication medication to help them. Thé emphasis of treating chronic pain patients as addicts,is not only wrong, but demeaning. Physicians are becoming callous in the treatment of chronic pain sufferers. The CDC is forcing pain sufferers to find alternate means of controlling pain, because pain causes a decreased interest in life, performing major surgery on a person then prescribing none or too small a dose of medication not only is sadistic, it is keeping people from having needed surgeries. Physicians take an oath not to do harm, to treat their patients with respect, and to INCREASE the quality of life for them, and you can not talk to someone with chronic pain as though they have been abusing pain medication. If a doctor can see his patients joints no longer have cartilage, or are rubbing bone on bone, he has to know his patient is in pain. IF he knows his patient has DJD, DDD, severe spinal stenosis, spondiolysthsis, and has lost 3’’ in height, he has gone to school to treat these things WHY is he sanctioned for treating his patient to the best of his ability. <br/>The one largest group of people affected by these laws are the elderly. I take umbrage at someone 30 to 50 years younger than I telling me because I suffer from chronic pain I have to STOP living. I am almost 77 years old and have watched my friends suffer as I do, to the point they are giving up on living. What is it going to take? The suicides of as many of our chronic pain sufferers as deaths by overdose. What kind of world is this when you are forced to stay in bed or a recliner, instead of riding a bicycle, up until 2 years ago I was running, jumping rope, riding my bicycle 600 to 1200 miles a year, and now, I can’t sleep, due to pain, I can barely walk, due to pain, I want my life back. If I was a risk for overdose it would have happened long before now. Add to that, the fact that other than narcolepsy EVERYTHING I suffer from which causes me pain, was CAUSED by an ADDICTED PHYSICIAN! And I can prove it. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachel	None	None	0900006484fe6eba	Rivera dela Rosa	None	2022-03-28T18:40:35Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Rivera dela Rosa, Rachel	l19-urc8-jta9	False	None	False	2022-04-12 05:34:02.697	[]
3044	CDC-2022-0024-3050	https://api.regulations.gov/v4/comments/CDC-2022-0024-3050	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached letter. At the Healthcare Compliance Packaging Council (HCPC) we focus on improving pharmaceutical use and distribution by promoting better packaging to improve child safety, product integrity, patient adherence and supply chain security. We were involved in the FDA’s development of the SUPPORT Act of 2018 which promotes the use of limited count blister packaging for initial prescriptions to reduce the likelihood of addictions. We are pleased that the CDC continues to review data surrounding the prescribing of opioids and hope that your oversight will consider the broader benefits offered by modern packaging to prescribing, child safety, and product safety. We greatly appreciate the CDC's consideration of our comments on this issue in the attached letter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fe8d22	None	None	2022-03-28T19:42:23Z	Healthcare Compliance Packaging Council	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Healthcare Compliance Packaging Council	l1a-yb7j-o8zs	False	None	False	2022-04-12 05:34:02.938	[]
3045	CDC-2022-0024-3051	https://api.regulations.gov/v4/comments/CDC-2022-0024-3051	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a patient advocate and founder of Don't Punish Pain/The Doctor Patient Forum. I have a membership of over 20k with chapters in all 50 states.<br/><br/>I work with physicians and lawmakers in an effort to bring awareness to the millions of patients who have been left to suffer due to the 2016 CDC pain guideline. <br/><br/>RI Governor [redacted] signed my bill into law in June of 2021 (RI S 384) which exempts people with chronic, intractable pain from the horrific 2016 CDC pain guideline. A version of RI Senate Bill 284 has been brought into several states but doctors are still fearful to prescribe opioid therapy, citing the 2016 CDC pain guideline as a reason NOT to. <br/><br/>As a patient advocate, I receive thousands of emails, messages, voicemails from desperate people who have been without access to opioid therapy. <br/><br/>I hear from patients with end stage cancer, Sickle Cell, rare disease, Hospice who cannot find a physician who's willing to treat their pain.<br/><br/>Millions of pain sufferers, including, the elderly, Veterans have been left homeless in the medical community. <br/><br/>I'm routinely called in to advocate for people who are having painful surgeries, including, limb amputations, and they are being discharged with Tylenol only. Patients desperate for relief, who seek solace at the emergency department are being documented as drug seekers. Patients are being forced to undergo painful, unnecessary procedures or dangerous devices in order to receive a small dose of pain relief. Millions are being forced off their long-term opioid therapy and being offered a highly addictive medication, Suboxone, used to treat opioid disorder. Suboxone is now linked to dental issues as the FDA has issued a warning. <br/><br/>It's not uncommon for people to contact us before they attempt to take their lives due to untreated pain.<br/><br/>Doctors have been vilified for prescribing above the 90mme. I work with physicians who have been incarcerated for treating their patients' pain or for prescribing both a benzodiazepine and an opioid. <br/><br/>Millions have taken both of these medications SAFELY for years. <br/><br/>Opioid prescribing is at the lowest it's been since 1993 while overdoses are up by 400%, all due to illicit fentanyl. <br/><br/>The CDC's own anti-opioid campaign, and those who helped WRITE the guideline, are responsible for the greatest overdosing crisis in history.<br/><br/>The CDC must SUSPEND not amend the 2016 CDC pain guideline.<br/><br/>[redacted]<br/>The Doctor Patient Forum<br/>Don't Punish Pain <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fe8d70	None	None	2022-03-28T19:43:49Z	Don't Punish Pain	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Don't Punish Pain	l1a-yxzu-pns0	False	None	False	2022-04-12 05:34:03.177	[]
3046	CDC-2022-0024-3052	https://api.regulations.gov/v4/comments/CDC-2022-0024-3052	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi I fractured s1 L5 and broke L3 in my back over 20 years ago after about 3 years of at least three to four days a week going to doctors having test having balloons put in my back having an injections in my back being put on soma much and other muscle relaxers and toradol I told the doctor I can't even stay awake to do my job let alone work because I'm constantly at the doctors he gave me Lorcet back then it was one every 3 hours which within two weeks time I was back to work full time functional everyday and providing for my family after a year I told him I didn't think I needed that much maybe whenever 4 to 6 hours which at that point it was my family doctor prescribing them I've led a fulfilling life then because of all the regulations back in December 2021 I was told I can no longer get my prescription for what is now called lortab due to I need to go to pain management or I was offered Suboxone I'm not a drug addict I don't need Suboxone I need pain medication so since January I've only been able to work maybe 20 hours a week if that I don't understand how the government can decide what I'm allowed to take or how my pain is controlled so now I don't know if I can provide to keep a roof over my head or pay my bills unless I spend endless hours getting shots in my back also now I have osteoporosis and rheumatoid arthritis which for pain pills a day I was able to function and now I'm not please correct this so I can get my life back instead of laying on the couch and pain every day	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracy	None	None	0900006484fe91dc	Millard-Hammond	None	2022-03-28T19:44:20Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Millard-Hammond, Tracy	l1b-2dd6-y4lk	False	None	False	2022-04-12 05:34:03.413	[]
3047	CDC-2022-0024-3053	https://api.regulations.gov/v4/comments/CDC-2022-0024-3053	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been living with degenerative lumbar disc disease for more than 20 years. Additionally, Osteoarthritis in knees, ankles and now hands. I was recently hospitalized for the treatment of perforated diverticulosis with abscesses, likely due to more than a decade of taking medications like Diclofenac. After remaining inpatient for the aforementioned diagnosis for just over three weeks, I am no longer permitted to take any type of NSAID medications. I am limited to Tylenol. I have read comments to the HHSD begging the CDC to limit opioids to patients to help prevent overdosing or to prevent them from using opioids as a gateway drug. I have to assume that those writing to ask the CDC to limit the prescribing of opioids are from people who do not experience debilitating chronic pain. They only see the negative side of the so called, "opioid pandemic", possibly due to seeing friends or family members abuse their medications or possibly street drugs. For those of use who suffer from debilitating chronic pain, responsible use of opioid prescription medication is the only thing that allows us some relief. The phrase, "Walk a mile in my shoes", is very much needed when considering how opioid medications should be used. Of course, with the level of pain I am forced to endure each day, hour, minute and second, walking a mile is not something I could come close to accomplishing without the proper pain medication. Please consider those of us in severe pain every minute of every day before deciding to apply strong restrictions and tying the hands of the medical professionals who prescribe such medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fe915a	Hallgath	None	2022-03-28T19:44:39Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Hallgath, Mark	l1b-1yqa-cl4u	False	None	False	2022-04-12 05:34:03.657	[]
3048	CDC-2022-0024-3054	https://api.regulations.gov/v4/comments/CDC-2022-0024-3054	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 opioid guidelines have been adopted and enforced by the Wisconsin State Medical Examining Board. When enforcement began in the fall of 2017, my wife's pain medication was reduced more than 50%. She was soon unable to walk more than a few yards or stand more than 15 minutes. I have spent $50,000 moving to a more handicap friendly house and another $5000 on a power wheelchair,not to mention the wasted $50,000 total ankle replacement surgery earlier in 2017.Spine surgeons say that the osteoarthritis is so extensive that it is inoperable. The last five years have been like watching her being tortured. If it had happened to me, I would have killed myself a long time ago.<br/> <br/>How about following the data that clearly indicates the 2016 guidelines had no effect on the rate of overdose deaths which continued increasing the entire time. <br/><br/>I can only pray that the Wisconsin Medical Examining Board will change their policy if when the CDC officially changes the guidelines. They are ignoring the AMA recommendations and the CDC letter clarifying the 2016 guidelines. <br/><br/>I have written the governor, all the state legislators, the Medical Examining Board and the head of the department that they report to with no result.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fe8fc5	Lyons	None	2022-03-28T19:44:57Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Lyons, Robert	l1b-1kft-ofdf	False	None	False	2022-04-12 05:34:03.886	[]
3049	CDC-2022-0024-3055	https://api.regulations.gov/v4/comments/CDC-2022-0024-3055	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In my local paper was a recent article titled, “They’re just cutting people off” which speaks about a local pain-management clinic that will be closing their doors and shutting down abruptly. Literally hundreds and maybe thousands will be simply cut-off from pain management in one fail swoop. In one month, they will be turned out to the cruel world of pain and the new medical approach to those of us who suffer. <br/>Unfortunately, in this compassionate town of mine are literally zero doctors that will take on these swarms of new pain relief seeking individuals. This is a direct result of the “war on opiates” and with all clarity illustrates the absolute absurdity of this misguided battle. You can’t have a better example and here it is and it’s horribly sad when you think about it. <br/>It’s time for everyone to put on the brakes here and get back to a level of sanity and compassion. It’s time for the plight of the “pain patient” to be fully understood and addressed. What we are seeing now can only be described as cruel and it must stop. <br/>The effort to cure this country of its opiate scourge is looking more and more like a scorched earth policy, where nothing shall stand in the way of curing this nation. When the people who have authority simply stand by and watch this quagmire and do nothing to address it then they are truly failing their constituents. <br/>It’s time for all of us who suffer from painful maladies to rise up and speak out about our stories. Take every opportunity to educate the ill-advised about your experience. Write a compassionate letter to your senator or representative. Write a letter to the editor if you have the ability. It’s time for this hyperbole to return to a more central state of opinion and approach and it’s time for this outrageous treatment of patients to end. Opiates must remain a part of pain management. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484fe8f2e	Cook	None	2022-03-28T19:45:13Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l1b-0uhi-5kvb	False	None	False	2022-04-12 05:34:04.127	[]
3050	CDC-2022-0024-3056	https://api.regulations.gov/v4/comments/CDC-2022-0024-3056	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am so glad you are reconsidering your stance on the treatment of people like myself with chronic intractable pain. Opioid therapy, professionally managed, allows me to be engaged and productive in my life, stay active, and get at least a moderate amount of restorative sleep. I am the most careful, conscientious patient you will ever find, but the unwarranted restrictions of the last few years have left me feeling as if I am either being treated for someone else's problem or punished for someone else's wrongdoing.<br/> <br/>There is pressure that I must submit to invasive procedures to justify or earn in some way the medication, even though I have had probably 30 procedures over the years, and they haven't helped in some time. Please clarify with the providers that procedures are not a prerequisite to medication therapy. The procedures are not without risk and should not be a requirement. My pain is mostly orthopedic, and I suffered a nearly fatal GI bleed from NSAIDS trying to control it before I turned to opioid control. It has been a lifesaver in may ways.<br/><br/>I have been being treated with medication that lasts 4-6 hours, and have been doing very well for years. Suddenly, that same medication is ordered every 8 hours, leaving me with several 2 hour periods in a day with no pain control at all. I was told that was due to pressure from the CDC. Can you imagine treating a diabetic in this way? We will control your blood sugar for 6 hours, then let it rage out of control for 2 hours, then you can attempt to get it under control again, and you can live like that? As ridiculous as that sounds for insulin therapy, it is equally so for opioid therapy.<br/><br/>I am grateful for the specialists who work in this field, and I am aware it is a difficult specialty. There seems to be a "fear of retribution" mindset that determines treatment at times. Please allow these wonderful people to use their good judgment and their direct hands-on knowledge of the patient and their medical record to make these decisions. That would be both smart and merciful.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Private	None	None	0900006484fe8c71	Person	None	2022-03-28T19:45:31Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Person, Private	l1a-xvx3-skwk	False	None	False	2022-04-12 05:34:04.358	[]
3051	CDC-2022-0024-3057	https://api.regulations.gov/v4/comments/CDC-2022-0024-3057	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	National Safety Council - See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fd73ac	None	None	2022-03-28T20:14:29Z	National Safety Council	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from National Safety Council	l11-09p4-mwpz	False	None	False	2022-04-12 05:34:04.591	[]
3052	CDC-2022-0024-3058	https://api.regulations.gov/v4/comments/CDC-2022-0024-3058	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)<br/>CDC-2022-0024-0001	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484fd5a4a	Olson	None	2022-03-28T22:55:17Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-19T04:00:00Z	None	None	None	None	None	None	None	Comment from Olson, Tom	l0y-8c8l-goys	False	None	False	2022-04-12 05:34:04.847	[]
3053	CDC-2022-0024-3059	https://api.regulations.gov/v4/comments/CDC-2022-0024-3059	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John Paul	None	None	0900006484fdceb5	Bernardo	None	2022-03-28T22:56:49Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Bernardo, John Paul	l14-9290-7tk4	False	None	False	2022-04-12 05:34:05.078	[]
3054	CDC-2022-0024-3060	https://api.regulations.gov/v4/comments/CDC-2022-0024-3060	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The proposed 2022 guidelines are not going to make a bit of difference in overdose deaths when the opioid prescription rate is way down but the overdose rate has doubled. You'd have to be blind or ignorant to not see that. Not to mention the countless pain patients who've committed suicide because of your over reach. And the DEA needs to be stopped unless we're all missing the Dr. Before the name DEA! You're in no way stopping the overdose rate. Rather, you've exacerbated it by making the only medicine that works for some practically impossible to obtain. So, due to your gross overreach, rather than curb addiction, you're making actual criminal dealers rich. Way to go! Everything the government touches, turns to crap. The CDC and DEA and prop are directly responsible for the illicit fentanyl crises and hundreds to thousands of murders. It is beyond cruel and beyond your purview to act as nanny for any Americans. If people want to be careless with their medications and die as a result, it is their own fault. Not the doctor or the pharmacy. The individual. There's warnings on the bottle same as alcohol and tobacco. I don't see the CDC offering liquor store guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Darren	None	None	0900006484fdd02a	Taylor	None	2022-03-28T22:58:29Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-23T04:00:00Z	None	None	None	None	None	None	None	Comment from Taylor , Darren	l14-dmce-lmor	False	None	False	2022-04-12 05:34:05.311	[]
3055	CDC-2022-0024-3061	https://api.regulations.gov/v4/comments/CDC-2022-0024-3061	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484fde74c	Nadeau	None	2022-03-28T23:01:07Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Nadeau, Stephen	l14-yzts-jw2y	False	None	False	2022-04-12 05:34:05.542	[]
3056	CDC-2022-0024-3062	https://api.regulations.gov/v4/comments/CDC-2022-0024-3062	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mind keeps going back to the one time I was at a 0 on the pain scale. Is that what "Normal" people feel like. It was nice to experienced it but at the same time I realized I will never be "Normal." I realized I'm ok w/that but my normal was a 3, now its a 7.5 to 10+ I'm not ok.<br/>I was in a hospital setting and getting ready to go home. I was given Medical Grade Low Dose Fentanyl. When it wore off, I was ok too, tired but ok. This was in 2005. I didn't go seeking it on the street nor did I "crave" anything except work and hiking. The misinformation that hospital pain management causes addiction is a complete and total LIE. I'm proof of this. I've been a Chronic Pain Patient since I was 5yrs but I was at a manageable level sometimes then. Now when I need the help I'm labeled, gaslighted, and shamed especially for my painful hereditary genetic mutations. I'm told by Dr.s I'm too young to hurt, my weight causes my pain, my diet is the problem, it's all in my head or flat out yelled at some obscene excuse about pain meds not helping pain (lied to). Then the worst one is "Drug Seeking" when I'm sent to the ER. Which I will not go to even if I'm dying. the abuse is not worth it.<br/>I'm a prisoner of Chronic Pain, my home is now my jail and my Dr.s (PROP worshippers) are the heartless wardens that enjoy my suffering. I'm not alone in this either. None of us deserve to suffer and Die like this but here we are. 40 Million CPP's now considered trash by the CDC, DEA and DOJ.<br/>I kinda feel like the reason there are so many jobs available out there now is because CPP's like me used to work those jobs. Now since this Rx opioid hysteria PROP/CDC/DEA caused to take away our safe meds we can't work. They considered us "Useless Eaters" and disposable. FIN<br/>THIS IS THE REALITY YOUR GUIDELINES HAVE CAUSED. RECIND THE MURDERUOS 2016 AND 2022 BASED GUIDELINES. THIS IS MURDER BY STRICT LIABILITY. The guideline Laws are causing suicides and preventable deaths. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484fe26f0	Allder	None	2022-03-28T23:07:00Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Allder, Melinda	l16-gjb5-54yz	False	None	False	2022-04-12 05:34:05.782	[]
3057	CDC-2022-0024-3063	https://api.regulations.gov/v4/comments/CDC-2022-0024-3063	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing in regards to the prescribing of opiods for pain. I would like to say, that I know of so many people who are forced to suffer, unnecessarily. There is a medication, or numerous medications that work for people in pain. I do not understand the therory of not allowing a HUMAN being to live without pain, when there is a way to make the pain less, or gone. I do understand, the theory of people ABUSING these medications, but for the most part I do not believe it to be the people who actually NEED them. In my studies and investigations, it appears that some physcians, abuse the power to prescribe, and prescribe way too many for the pain they are treating, that is problem number one. The second problem, is that when a physician discontinues someones pain medication, or never prescribes any, it leads the person who is suffering in pain, to look into different options: one of which is seeking illicit drugs, on the street, or anything they can do, to get the pain to subside. This is why we NEED to manage pain. The CDC is making the problem of overdose and SUD worse, by limiting the pain relief, medications that are available. People are turning to Heroin, or pills bought off the street, that could be tainted, but they, may feel as if they have no other choice, than to find something that will help the pain. It is beyond me, to understand why my best friend was discontinued her pain medications, which therefore caused her to commit suicide because she couldn't tolerate the pain. Each individual is different, I feel as if pain can be controlled, as to help someone live a more functionable life, they should be made available legally. The more they are limited, the worse the addiction problem will become. I have watched it happen over and over, where a pt. is denied, and then retort to the streets, to heroin, or mexis. Often ending up dead....when it could all be avoided by not making pain, something you just live with. Let's give the people who NEED it, a way to get it, without doing things that are illegal, and deadly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Collin	None	None	0900006484fe6f45	Johnson	None	2022-03-29T03:17:58Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Collin	l19-w1wm-k365	False	None	False	2022-04-12 05:34:06.016	[]
3058	CDC-2022-0024-3064	https://api.regulations.gov/v4/comments/CDC-2022-0024-3064	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC, in 2016 you imposed an opioid guideline without any pain mgmt doctors being on the panel, matter of fact, you had the people from PROP who had previously been speaking out against opioids. It didn't seem to matter that doctors and the FDA had been publicly against your guidelines knowing it would harm the patients who require pain mgmt. Since then I've had my meds tapered back to the point of me not getting the relief I was previously getting before your guidelines. Now with the CDC knowing how much harm those guidelines have done and with some patients committing suicide because they couldn't handle the pain anymore, you're actually gong to lower those guidelines from 90MME to 50MME?!! You will push even more pain mgmt patients to commit suicide with such a low dose, what are you thinking?! You know the DEA took your guidelines as absolute with no room for patients who have been on pain meds for over 20yrs, or the fact that everyone's tolerance for pain is very different from patient to patient, and with you lowering the guidelines again you're going to cause even more harm to pain mgmt patients. Since you're guidelines, overdoses have more than doubled because pain meds are NOT the problem, it's people gaining access to them illegally and the illegal Fentanyl on the streets. Why don't you and the DEA focus on that instead of causing harm to people who are just trying to get out of bed everyday? With my dosage before the forced tapering, I was able to do small chores around the house, visit with my family and friends, watch my grandsons play baseball, and have some enjoyment in my life, since the forced tapering, I can't sit on the bleachers to watch my grandson play ball, I don't go visit with my family or friends,I can't do a lot of the chores I use to do, and I'm miserable all the time now. I'm treated like a drug addict whose done something wrong when I've never failed a drug test, done everything my doctors asked of me, I've had the ESI infections, I've had physical therapy on and off for 15yrs, I've had numerous radio frequency nerve blocks, I've had 3 major surgeries, etc etc. So why am I treated like a drug addict when I'm taking my meds as they're prescribed, I don't sell them or give them away, and I've done nothing wrong. It's not right to make people suffer in the amount of pain people are in because the people of PROP have partnered with you because THEY'RE against opioids and they saw an opportunity to make millions as expert witnesses, when they're NOT pain mgmt doctors, they're psychiatrist and addiction specialist, they should have to stay in their lane. I'd like to have my meds back so I can get back to having somewhat of a normal life with pain that's tolerable instead of looking forward to nothing but being in severe pain everyday, it's emotionally exhausting.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Penny	None	None	0900006484fe769b	Carrigan	None	2022-03-29T03:22:44Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Carrigan, Penny	l1a-2vg7-e5wq	False	None	False	2022-04-12 05:34:06.257	[]
3059	CDC-2022-0024-3065	https://api.regulations.gov/v4/comments/CDC-2022-0024-3065	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Well folks, there is medication that can control your chronic pain, but YOU CAN'T HAVE IT!<br/>Really? Why not?<br/>Because it has been determined by those not involved in your medical care, who don't know anything about you or your pain, or your loss of quality of life, that you can't have the medication unless you have a terminal illness.<br/>So what am I supposed to do?<br/>Well, you can go see a pain management doctor, who by the way, won't give you the medication that is available to ease your suffering either and who will suggest things which you have already done in an effort to get some relief. This pain management "doctor" will instead want to give you injections that cost thousands of dollars and may only last for as little as a day or two, or try to implant medical devices that will basically do nothing for your pain, but again cost thousands of dollars.<br/>Why can't I have the medication I have been using for decades and which has proven to be effective for me? The medication which costs $25 or $30 a month?<br/>Well because we don't want you to become addicted to it. We don't want you to overdose on it you know. We know that you have been responsibly taking it for years with no problems, but who knows, maybe you will for some reason become irresponsible.<br/>So who will pay my bills when I can't work because of the unbearable pain? I can't get disability because of chronic pain because it's not in the "blue book" as a disability condition. Am I supposed to then live on the street because I lose everything because my pain is no longer under control?<br/>Well, have you tried exercise and stretching? Or have you seen a psychiatrist about your pain? Maybe it's just in your head you know.<br/>What? Haven't you seen my x-rays and MRI's? The evidence is clear, I have real physical damage.<br/>Well, maybe try swimming in a pool?<br/>Who's going to pay for that? <br/>Well, you can become dependent on your state I guess.<br/>But I want to be dependent myself. I can work if I can have the medicine that works. I don't want to live off of the state in some vegetative state. <br/>Well, we would like to have a "perfect society" you know. Maybe we just don't have room in this world for "folks" like you. You know, the addicts and druggies.<br/>I am not an addict! I am not a druggie! I am a human being who wants to contribute to this society!<br/>Well, you can contribute, at least until you go bankrupt. The "pain management" doctors will be glad to accept your money over and over again for failed experiments. Think of the money you are putting into their pockets and they are then in turn buying new homes while you lose your old one.<br/>But if there is a medication that works, and works inexpensively, why can't I have that instead?<br/>Well, you know what, this conversation is over. Please don't come back here and cancel all of your future appointments as I am releasing you from my care.<br/>What? How can you?<br/>Because this is my business. I know that I put up a front that I am in the field to help you, but there's nothing more I can do.<br/>So, what then, am I supposed to get my medication off of the street then?<br/>Oh no, you can't do that. Then you will be adding to the epidemic.<br/>So am I just supposed to end it all?<br/>Well, we are striving for the perfect society, like I said.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe76b5	Anonymous	None	2022-03-29T03:36:37Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1a-37q9-88jy	False	None	False	2022-04-12 05:34:06.549	[]
3060	CDC-2022-0024-3066	https://api.regulations.gov/v4/comments/CDC-2022-0024-3066	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Intractable Legacy pain patient, stable on pain medication 9,10 + years( safe proper use Legacy patient ) for somewhat a quality of life, loving Stable spouse, life of 32 years until moving out of state for better employment opportunity, spouse, selling our home. New employment comes with new insurance and changes of those insurances,exhausted, horrific intensified pains,stress, no medical care in new State acquired, nobody will treat or prescribed. So we reached out to<br/>Medicare and new private insurances to assist us in a new Doctor or practice, even general care,phoning over 80 doctors and practices, 80, list after list via insurances help and with original doctor referrals and all medical files in hand ( medically necessary care needed) added 12 plus inperson consultants within a year-and-a-quater in new state to no avail, denial after denial or to be even treated at all, instead<br/>Deadly allergic reactions to forced medication changes via insurances and Doctors, injection after injection, denial after denial in new state forcing a decision <br/>of an alone seperated from spouse departure, dividing from spouse and a life of 32 years just for treatment to live, Returning to original state ALONE, heartbroken, disbelief, in pain, week, sad and petrified added unnecessary stress only to find more medication forced changes, begging original doctor to treat again, having to rent an apartment now alone,forced, worn down yet not defeated, pushing through the hoops at only 60 years of age (young) until unknowingly verified environmentally certified tested full of black moulds in newely rented apartment, ( Sick building ), deadly ill no laws to protect now forever on top of intractable intensified pain changing life even more and alone.<br/>Now unable to travel one state over to spouse, days and month's go by, seven excatly, hotel after hotel to get away from mould, horrificly ill, exhusted, try to seek proper medical care for black mould to no avail, then, then spouse suddenly passes away alone while heartbroken and in disbelief that (32 years of shared loving world gone) over life saving medication needs, destroying every ounce of us now, homeless and alone. <br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe73ae	Anonymous	None	2022-03-29T03:39:31Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l1a-82c0-hx78	False	None	False	2022-04-12 05:34:06.814	[]
3061	CDC-2022-0024-3067	https://api.regulations.gov/v4/comments/CDC-2022-0024-3067	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed February 14, 2020 with GBS and it led into the chronic form called CIDP. my condition causes extreme pain. while I was hospitalized and going through physical rehab I was getting proper pain medication so I could work I could get up I could move I could work past the pain. Since I have been transitioned into a pain clinic I’ve had no individual care and they tapered my medication which led to breakthrough pain that is so intense I cannot get out of bed. At the pain clinic I saw the medical assistant and he did not even understand fully what GBS North CIDP was. I asked him to do research on my condition so he could better understand how to treat me and he said, “I don’t want to know you. you are a number and I have to look at your drug screen and that is what I base your medication levels at not your pain level.” I need for my specialist and my primary care physician that has been treating me since day one to be allowed to treat me properly. With pain medication I can work I can have a quality of life but without pain medication I have lost my company because I cannot get out of bed because the pain is so excruciating. I need someone to hear me to listen to me. individualized and customized treatment plans for an individual. I don’t want to be a number anymore I need to be seen because I feel like I am not at all . My primary care will not write any narcotics. he does not want to deal with it and I understand that but that does not help me. I try to advocate for myself but instead I was educated on the CDC 2016 guidelines and the laws that they have created . I do not understand how a physician can look at your tests look at your EMG‘s test your pain levels look at your blood pressure look at your life look at your quality of life look at your activities of daily living and not allow you to have what you need because of politics because of laws created because of guidelines . Not every patient is the same and I understand that the 2016 guidelines were initiated because of the pill mills and they had to be shut down! and I but it also unintentionally created an epidemic for the chronic pain patients that have lost their right to have proper care to have a life worth living. I did not ask to be sick I did not ask to have electrodes go through my nerves I did not ask for my nerves to be demyelinating I did not ask for my degenerative disease but I think it is my right not to suffer to be treated properly. not over medicated I don’t want anything over what my pain level requires I want to be able to have individualized and specialized care given by my specialist and not threaten their license for treating my pain . I ask that you please reconsider the recommendations for 2022 and allow chronic pain patients to be treated properly and have a quality of life worth living. I’ve been tested by EMGs CAT scans MRIs bloodwork and spinal taps and it is proven that my body is attacking itself and because of that my nerves are they tore apart and with that they are firing off in the muscles that they don’t belong to causing extreme pain . Your recommendations for the 2022 will determine my quality of life and my ability to have proper treatment by my specialist. I was so strong motivated inspired before my illness but now I feel worthless because I’m not able to do any of the things I used to because my pain. We need your help. In this country we are more compassionate to animals than we already humans and I do not understand that. They are even cutting back pain medication for cancer patients and that is just unimaginable to me. It is been proven that opiates improve the quality of life for chronic pain patients and the treatment of chronic conditions such as CIDP . Why can I not get the proper pain medication to live my life? I don’t want to be one of those people that finally give up because they don’t have a quality of life to live anymore and I am getting close to that because of so many losses that I’ve had since my diagnosis and not getting treated is making an already unimaginable condition even worse. Please hear the hundreds of thousands of chronic pain patients that are reaching out to you and telling either story and how not having proper care is destroying their lives. I am fighting so hard with everything I have but I’m getting tired. Please allow individualized care given by your primary care physician or specialist because they understand our conditions the best and how to treat it. Thank you for allowing me to tell you a little bit of my story and I hope that I have been heard.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amanda	None	None	0900006484fe7889	Evans	None	2022-03-29T03:46:44Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Evans, Amanda	l1a-cadq-gdk6	False	None	False	2022-04-12 05:34:07.049	[]
3062	CDC-2022-0024-3068	https://api.regulations.gov/v4/comments/CDC-2022-0024-3068	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024<br/><br/>I'm not here to start a debate but to let you no how these guidelines affects people like me.<br/>People like me who suffer every day, people who seek to<br/>have more good days than bad, people who want the sharp<br/>edge taken off what we feel every day, from now on. First<br/>and foremost, people who suffer chronic pain and pain<br/>conditions, all we seek right now is some small amount of<br/>relief. If we told an average person that from now on, each<br/>and every day, they would have pain, not just a headache<br/>or some joint pain, but pain, all day, every day, pain.<br/>Pain that will disrupt their life continually, pain that will<br/>make doing "everyday" tasks almost impossible, pain that<br/>makes it difficult to sleep well, pain that makes working<br/>difficult to impossible, pain that throws a wrench in your<br/>social life, your family life, your day to day life, pain that<br/>makes enjoying life, well, impossible! If we told the<br/>average person that this is their life from now on, well, I<br/>don't think the masses would be silent! Please stop the inhumanity you have bestowed on the chronic pain patients. <br/>You never know if it could be you or your loved ones one day. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe7897	Anonymous	None	2022-03-29T03:47:50Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1a-ely3-gy04	False	None	False	2022-04-12 05:34:07.281	[]
3063	CDC-2022-0024-3069	https://api.regulations.gov/v4/comments/CDC-2022-0024-3069	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines are killing me. I am so ready to die because of these guidelines. I'm not depressed I'm in pain. Please please stop this. It is so tragic to not only myself but my family and friends. Why are you doing the wrong thing??	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484fe8334	Laxton	None	2022-03-29T03:48:28Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Laxton, Cindy	l1a-r024-x52r	False	None	False	2022-04-12 05:34:07.567	[]
3064	CDC-2022-0024-3070	https://api.regulations.gov/v4/comments/CDC-2022-0024-3070	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)Thank you for the opportunity to comment on the proposed guidelines. I have attached a letter with our commentary. I have also attached early claims data that I believe shows a trend of benefit and value of pain management. Thank you for your effort and time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelly	None	None	0900006484fe81b3	Martinelli	None	2022-03-29T03:49:59Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Martinelli, Kelly	l1a-p0sz-fs5q	False	None	False	2022-04-12 05:34:07.800	[]
3065	CDC-2022-0024-3071	https://api.regulations.gov/v4/comments/CDC-2022-0024-3071	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 70 year old, gay, white mail who began losing height in 2003. I was first diagnosed HIV + IN 1985 though count my infection back to possibly 1979. In addition I've been diagnosed with GERD, COPD, peripheral neuropathy, sleep apnea (both kinds), double carpal tunnel syndrome cachexia, cervical spondylosis, lumbar spondylosis, thoracic spondylosis, HIV Lipoatrophy, cervical, thoracic, & lumbar stenosis, herpes simplex,recurrent, edema, arms & legs, anal dysplasia, acquired scoliosis, chondrocalcinosis of both wrists, paresthesia, dysphagia, and several others.<br/> I write today because after losing 8 inches in height & 50+ pounds since 2003 about ten surgeries including breaking my back during one, 26 rods & screws in my neck, metal bars in each wrist, a knee replacement, 25+ spinal injections of corticosteroids I had a good history on 200mcg/hr Fentanyl patches every 48 hours for approximately 12 years. A new doctor at [health facility name redacted] took me on about 6 years ago who began removing my high dose. After getting to 100mcg/hr x48 hours I started feeling pain at each of my surgery sites as well as the ever increasing pain in my back which radiates to my front.I now have constant headaches as well as stiff neck & shoulders. The back pain radiates to the front of my thighs. My legs feel (to me) ice cold from my hips down to my numb feet. My circulation is fine, the cold is presumably demyalation or pinched lumbar nerves. All of my spinal diagnoses are of "unknown cause".<br/> Gravity is my demon so standing is almost impossible. I've quit all civic activities in which I engaged due to having a hard time thinking around my pain. I have very little social life & no sex life due to severe constant pain.<br/>My doctor ignores my requests, pleas, and even begging for appropriate management of my pain (in the form of asking to increase my fentanyl patches). I have stopped (on my own) the prescriptions I had since the 2006 surgery of Percodan, cut my use of Oxycontin in half, and filed greivances up the line which were all denied out of hand. <br/>Fentanyl patches are the cleanest, clearest, best painkiller I have experienced. We tried most to little effect before getting to Fentanyl if memory serves.<br/>There is one surgery left to try to deal with my back which two surgeons told me would be negligible in lessening my pain, and would mean a difficult six onth recovery.<br/>I don't care to live even 20 more years but I do care greatly about the quality of my remaining time as well as my ability to contribute to my community, my city, my friends.I urge you to recommend in the plainest language that all health care facilities use a much more generous yardstick when prescribing opiates to people like me. If you announced that tomorrow I expect it would take [health facility name redacted] a full year to begin to change their prescribing rules. I won't live that long in the pain I am in now.<br/>I would like to include the denial letters I received but can only mail them to you. Please let me know if and how this would be possible.<br/>Thank you for your consideration and time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brad	None	None	0900006484fe78e2	Shearer	None	2022-03-29T03:56:49Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Shearer, Brad	l1a-h2fl-juim	False	None	False	2022-04-12 05:34:08.061	[]
3066	CDC-2022-0024-3072	https://api.regulations.gov/v4/comments/CDC-2022-0024-3072	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Life liberty and the pursuit of Happiness. If it was only available in America today. As the director of cdc how do you sleep at night knowing that the physical harm you cause to the ones who are suffering with uncontrolled pain.With the advancement of new medicine why is it such a unacceptable task to apply advancements involving pain management. With the new guidelines coming out late this year which are over 6 years late unfortunately only protect policy makers government oversight commission and dark money shadowed by insurance and pharmaceutical company's who are only concerned about cost on the budget not the humane treatment of us citizens who should have the right to pursue adequate pain relief how do you sleep at night as the one who knowingly is ignoring the fact that so many today are suffering with controlable pain which is uncontrolled and could be with the help of their doctor who is the gate keeper to many obstacles between patients and care givers exist today.Please take your political and barbaric foot off of the necks of the ones in pain we are having to suffer enough and have been for 7 years now enough of the statistics and do gooder round circle meetings that only have the loud voice of insurance company's being the elephant in the room whom have only desire to cutting cost and no compassion for the ones whom deserve compasionate Healthcare needs.what is the reason that the availability of name brand pain meds are not available even if perscribed which are much more dependable for pain management these generic medications are cheap to manufacture one size fits all garbage that have little to no effect on pain .I know that answer the price and cost on insurance company's over rides quality Healthcare today Acupuncture is a joke physical therapy only inflames the pain that's not medically controlled and having to result to smoking Marijuana is a stinking manipulation of the mind that results in a since of comatose. How do you sleep at night knowing that so many are considering taking their own life because they just can't take the pain any longer and are aware of the thousands who have done such awful thing to themselves and destroyed so many families. This is America what in the heck is going on with the guideline makers today stop punishing us and get your dam foot off of our necks please .I will save my comment and will search for it soon on comments page I have not disrespected anyone only calling it what it is commpassionless greed at the top with absolutely no regard towards helping the ones suffering day and night with uncontrolled pain I really don't expect my words to appear because it's the truth to the matter today .How do you sleep at night.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe7cd6	Anonymous	None	2022-03-29T03:58:29Z	None	None	1	None	2022-03-28T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1a-o5b3-3xvy	False	None	False	2022-04-12 05:34:08.292	[]
3067	CDC-2022-0024-3073	https://api.regulations.gov/v4/comments/CDC-2022-0024-3073	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to address multiple problems with the proposed guideline.<br/><br/>How did the board arrive at 50mme or even 90mme to be a high dose? There are multiple painful diseases for an individual patient to suffer a great deal of high impact pain.<br/> <br/>In saying that PAIN MANAGEMENT SPECIALIST are not trained in all diseases that cause pain. We have one doctor pointing at another and are very confused as to who is to treat the pain. <br/>Pain management specialists are trained in SPINAL issues only. This has created a number of issues for patients suffering from internal organ diseases and spinal disease but only receiving the lowest amount of medication for one painful disease.<br/>Another problem is the intractable chronic pain patient whose pain does increase with the disease increasing but the meds are locked at the 90mme. AS we age our conditions worsen there has been NO concern about the number of patients who have been experiencing TORTURE due to other acute pain either from surgery or worsening of conditions. <br/>Patients are sent home after surgical center day surgery. Without the acute pain medications needed to ease the SURGICAL PAIN created by surgery. <br/>For myself, I needed surgery for multiple health issues that now are very serious or inoperable due to 7 yrs of playing with a guideline for the greater good for whom? <br/>WHO PAYS for my life of torture and neglect?<br/>The studies that were completed over the past 7 yrs. do not include studies of women who are middle-aged and at different cycles of life. Menopause. surgical menopause due to a Doctor removing all hormone-producing organs KILLS the women's body and creates chronic intractable pain. This has not been taken into account. WOMANS PAIN and hormonal balance is KEY to health and wellness. There is NO one size fits all.<br/>For myself, I have dealt with the horrors of HIGH IMPACT PAIN the terror I feel every time I go to the doctor's office and the aging process that has sped up due to undertreated pain. I have lost my dignity my livelihood and any chance at having a relationship. I AM IN PAIN ALL DAY every day Since the release of the 2016 guidelines.<br/><br/>The physical pain creates mental pain and frustration. Patients have lost self-respect dignity and a somewhat quality of life. PERIOD! I find it very suspect that assisted suicide has been past so a patient can die with dignity. HOW ABOUT LIVING WITH DIGNITY!<br/> <br/>I want to address steroid injections. Steroid injections were my FIRST LINE OF TREATMENT. I have had 100 plus injections placed in my body and now suffer from scar tissue CUSHINGS and a failed endocrine system that has rapidly aged my body and appearance. These injections have also caused serious dental problems due to the demand on the body with high impact pain. Undertreatment of pain is a slow torturous death. The steroid injections are for minimal use. While I have NOW since 7yr of undertreated pain 3/4 of my spine that including C,T,L,S spine all bilateral have severe degeneration with severe stenosis with inoperable torn discs.at 56. The CDC and everyone sitting on the board are responsible for this.<br/>YOU ARE RESPONSIBLE for throwing a country into a panic. These guidelines have created DEATH SUICIDE and severely deteriorated individuals who were once very active working and happy with a good quality of life.<br/>I can not count the times I have heard a doctor say the MME hard limit is LAW. The DEA has destroyed not only patients' lives but the doctors who treat them. <br/>Inter-agency communication is in play at the FEDERAL LEVEL you can not pass the buck. Again who pays.<br/><br/>The guideline states primary physicians. Not a single primary prescribes pain medication. I have not only been abandoned by pain specialists but primary as well. Doctors do not want to treat a patient who is in intractable chronic high-impact pain.<br/>Why hasn't arthritis and neuralgia been added to exempt diseases? THERE IS NO REMISSION for this type of pain. <br/>The damage that the CDC 2016 guidelines (LAW) has created can not be reversed. Millions have lost 7 yrs while being tortured. Again you are responsible.<br/><br/>The 2022 CDC guideline in its current form will KILL 100,000s patients. YOU MUST DELETE THE MME RECOMMENDATION. Prosecutors and doctors are stating 50mme is the standard and patients are going to die. <br/><br/>Your guidelines not only cost lives but are costing this country's TAXPAYERS 100s of billions of dollars in useless medical treatments and lost productivity. <br/>After exhausting all alternatives with needless step therapy type treatment there are millions of pain patients who respond very well to opiate pain medication. Speaking for myself I never ran to the doctor's office looking for a magic pill. <br/>Lets do not forget it is the lack of concern for the individual human being that has us in a crisis that your agency created. HUMAN RIGHTS ABUSES not to mention GENOCIDE.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe818f	Anonymous	None	2022-03-29T04:00:51Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1a-p5rs-iwts	False	None	False	2022-04-12 05:34:08.529	[]
3068	CDC-2022-0024-3074	https://api.regulations.gov/v4/comments/CDC-2022-0024-3074	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 61 year old chronic pain patient. I have previously had four spinal surgeries. Two of those left me in debilitating pain. As a result of that misfortune I was put on pain medication in order to have some quality of life. I had been on pain meds for twelve years and was able to do small tasks and take care of myself. Due to the 2016 cdc guidelines my Dr decided to cut back everyone’s meds to 90 or below MME. As a result from my medication being tapered which I never agreed to it has left me in excruciating pain. My blood pressure has increased tremendously to the point I’m on two extra blood pressure medications. I urge the cdc to not put any MME documentation in the new guidelines. If it drops to 50 millions of innocent chronic pain patients will be immobilized. It’s unethical and detrimental. I have also suffered from chronic anxiety since I was twenty years old. I was placed of medication for that and it saved my life. Sadly that was taken away a few years back because of the cdc guidelines. I feel like I'm under treated for two chronic conditions all because the CDC thinks they know what’s best for patients over the Drs. I am urging the CDC to stop punishing legitimate pain patients. I have no good quality of life due to the CDC guidelines. Please help chronic pain patients who desperately need their medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gayle	None	None	0900006484feb4b1	Griffin	None	2022-03-29T13:25:39Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Griffin, Gayle	l1c-52ie-vn8h	False	None	False	2022-04-12 05:34:08.769	[]
3069	CDC-2022-0024-3075	https://api.regulations.gov/v4/comments/CDC-2022-0024-3075	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To be honest, I feel that the original 2016 guidelines (and subsequent laws/regulations/implemented policies) should be redacted. The number of problems ranging from lack of credible research to bias from top contributor-- the CDC did not provide guidance that would reduce opiod misuse and allow doctors to practice in the best interest of their patients. I for one was negatively impacted by the original guidelines and see further harm with the latest update.<br/><br/>As should be obvious, overdose (OD) deaths have skyrocketed under this guidance as thousands of pain patients were gaslight by doctors in the name of the CDC, and left in desperation to figure it out on their own. Many went to street drugs and others even took their lives, instead of having FDA approved pain medication perscribed and medical care follows by a licensed physician. There is no reason why this type of treatment should happen in the United States of America. <br/><br/>One of many stories is my own. It seems that I was born in pain. Even at age 3 I would tell my mom that hugs hurt. I was able to function semi-normally for many years. I was diagnosed at age 19 with fibromyalgia. I've had multiple doctors disagree with such an ambiguous diagnosis...but to date they haven't figured out a better explanation for my intractable pain. I was finally beginning to get the pain under control until the original guidelines came out. My medication was significantly decreased one refill. When I finally able to see my doctor months later (at my already scheduled quarter appointment, I was told that the CDC came out with new guidelines that limited what could be prescribed. I'm now considered "stabled" as I can take assisted showers as well as needing help getting dressed. Daily tasks are difficult (sometimes impossible) because some people obtain illegal drugs and OD. Regardless that chronic pain patients have an estimated 0.03% chance of misusing/abusing their prescribed medications. While I strongly disagree with the required drug tests (that are an added expense to my already high medical bills--I can atleast understand it. What I can't understand is the arbitrary use of Morphine Miligram Equivalents (MME). I deserve to have some quality of life. I should be able to attend my children's school functions, participate in family vacation, or even be able to make and eat dinner with my family (these days IF I can prepare the meal, by the time I get food on the table my pain has increased to the point of vomiting) why do you refuse these life experiences to me?<br/><br/>Just as their are no studies showing chronic opiod use lack of effectiveness (recently the contrary has shown long term opiod use has considerable benefits for chronic pain patients) there is no standard for calculating MMEs, nor is their evidence showing how the hard limits these guidelines and supporting documents have any place in medicine. Mention of MME limits need to be removed from any CDC guidelines.<br/><br/>Just as MME needs to be removed, so does the day limit for acute pain. The fact that hospitals are attempting to have amputations, mastectomy, and other serious surgeries without opiod pain relief (Tylenol is not enough in these situations), acute pain often lasts more than "a few" days. This should be between the doctor and patient. <br/><br/>How was [Name Redacted] and PROP able to have so much influence on these guidelines when they are making significant amount of money in non-opiod treatments? Using these FDA approved medication would negatively effect their bottom line. [Name Redacted] was involved in every aspect of these guidelines, despite significant conflicts of interest. Other PROP members were involved despite working for law firms that were involved in opiod litigation. <br/><br/>There is not a one size fits all pain condition nor treatment. There has been no measurable positive impact from these guidelines and the updated guidelines has even more harmful restrictions hidden in the supporting text. These guidelines need to be scraped. If it's possible to provide scientifically supported guidelines, then start again. However, too often CDC guidelines are influenced more by politics and greed than by science and acceptable care practices. Please stop harming pain patients	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe9934	Anonymous	None	2022-03-29T15:13:48Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-5fdb-3ekg	False	None	False	2022-04-12 05:34:09.002	[]
3070	CDC-2022-0024-3076	https://api.regulations.gov/v4/comments/CDC-2022-0024-3076	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines on restricting pain medication hell. I have been turned away from PCP, and 6 other doctors one who was a pain doctor, they refused to prescribe because they flat out told me they had to follow the CDC and rarely prescribe pain medication now. I have had right lower abdominal pain that has gone on for 3 months that is very sharp and have tried alternative (almost everyone you can think of) ways for managing my intense pain without relief. I’m 26 years old and can barely function due to severe pain. This guideline has made it impossible for me to receive short term relieve while continuing exploring medical diagnosis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe9637	Anonymous	None	2022-03-29T15:14:13Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-6704-cp2z	False	None	False	2022-04-12 05:34:09.236	[]
3071	CDC-2022-0024-3077	https://api.regulations.gov/v4/comments/CDC-2022-0024-3077	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Nine years ago when I was diagnosed with Lupus SLE, I went from a young healthy mother to instead a barely functional human being. Since my diagnosis I have had major complications such as Pulmonary Embolisms, CHF, cardiomyopathy, avascular necrosis, chronic pancreatitis, autoimmune hepatitis just to name a few. Prior to 2017 my pain was being appropriately treated and recognized by my doctors, but at zero fault of my own I was eventually just completely cut off with no explanation other than “we can’t prescribe that kind of medication anymore”. I have missed out on countless things with my children because of being in too much pain to participate. I’m no longer helpful within my household which makes me feel like a horrible wife and mother. It’s now a rare occurrence for me to have a low enough pain day to where I am able to interact with my family normally. I have tried every single thing pushed at me by Doctors, such as injections that have caused irreversible damage and nerve blocks. Also I was given things like Gabapentin, lyrica, low dose naltrexone that did absolutely nothing for my pain and honestly made me feel worse. I am just desperate for someone to finally help so I can have the chance to be the mother my children deserve, instead of the bed bound one they currently have.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe96b3	Anonymous	None	2022-03-29T15:15:31Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-6odh-oh24	False	None	False	2022-04-12 05:34:09.480	[]
3072	CDC-2022-0024-3078	https://api.regulations.gov/v4/comments/CDC-2022-0024-3078	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting because it’s so hard for me to get the medications I need due to these laws. I can live almost normally when I have my pain medications. I only asked for 5 a month for my bad days but even those have been taken from me. I have multiple sclerosis and it effects me daily. Without my pain medications I can not live normally. I can no longer go grocery shopping, cook dinner, do my laundry or leave the house on my bad days because of the pain. All I could do is lay there and cry. I was on them for about 5 years and they made my quality of life so much better. Yes, it was only 5 a month but those were the days I knew I could get things done if I needed to. Since being taken off of them, I can not even visit my family very much. Who could have a quality life if they can’t do the most basic things? Please do not take medications from people unless they are showing signs of addiction. 5 a month and never asking for more shows that I was never addicted. People should not suffer with extreme pain constantly. You think the drug pandemic is horrible? If people like us can’t get them from our doctors and they are in pain, I promise you they will find another way to get it and the pandemic will get worse! It will force them to look elsewhere and self medicate. That will lead to more deaths, more dangerous drugs in homes and more people dying because they aren’t taking it under control of their doctor. I just want my life back!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fe97d3	Casias	None	2022-03-29T15:30:36Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Casias, Melissa	l1b-7yr5-eezz	False	None	False	2022-04-12 05:34:09.743	[]
3073	CDC-2022-0024-3079	https://api.regulations.gov/v4/comments/CDC-2022-0024-3079	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please change the CDC guidelines to allow doctors to decide on how much opioids they will give to their patients, it should never have been a government agency. My doctor is so afraid of the DEA he doesn't care about how I am doing anymore, or how much pain I must endure because I have been forced to taper and now can't sleep or have no quality of life. It is long past time to end what has been interpreted as policy, a policy that hurts patients and the community. It’s time for the terrorism to stop. <br/><span style='padding-left: 30px'></span><br/><span style='padding-left: 30px'></span><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachel	None	None	0900006484fe980e	Willis	None	2022-03-29T15:31:05Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Willis, Rachel	l1b-85sm-whee	False	None	False	2022-04-12 05:34:09.976	[]
3074	CDC-2022-0024-3080	https://api.regulations.gov/v4/comments/CDC-2022-0024-3080	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing as a person with intractable pain who has tried numerous non-opioid treatments over decades of pain (yoga, PT, Aqua therapy, injections, surgery, tens units, massage, ketamine, CBD, ointments, CBT, I could go on). I require opioids as part of my treatment plan to address my daily severe pain. The 2016 CDC opioid guidelines have made my life as a disabled person exponentially more difficult. And those guidelines have not only not decreased overdoses, they have lead to additional OD’s. These last two sentences should be enough for the CDC to make the obvious decision - retract and rescind the guidelines. But here we are with a “revision”. <br/>I have congenital central canal lumbar stenosis and failed back surgery syndrome. I was misdiagnosed for 15 years and did not have surgery until it was too late — chronic pain turned intractable in 2015. Due to the disastrous 2016 CDC guidelines and the arbitrary 90 MME “suggestion”, obtaining the medicine that I need to lead any semblance of a life is a constant struggle, a monthly battle with doctors, insurance companies, and pharmacies. Over the matter of six years I have been force- tapered to levels that just barely keep me above water. I have zero social life. My only goal is to keep the full time job even though the pain makes it not only difficult to sit, stand or walk for any amount of time, it makes it difficult to concentrate. I have been outright denied doctors’ appointments based on the medicine I take for my disability. I have experienced losing the only doctor who properly treated my pain by him being forced out of his practice so the hospital could eliminate any outpatient prescriptions. I have been purposely abused by a chain 3 letter pharmacy so that I would no longer get my opioid scripts from them. I have been subject to insane pharmacy policies that make it as hard as possible to obtain the medicine I need for my disability. IE, if one local branch of the 3 letter chain pharmacy did not have the meds in stock, but another one did, they required me to go back to my doctor to obtain another script! They wouldn’t just transfer the script to another one of their stores ! Unlike any other person who needs medicine, I am not allowed refills on the medicine that I will take for the rest of my life. I am required to have a doctors appointment to get a new script every THIRTY days. I can’t refill my medicine until 48 hours before I run out. This means that if I were able to take a trip somewhere, I would have to schedule it around my script schedule to avoid running out. I am subject to random pill counts and drug tests. I have received bills upwards of $3000 for drug tests. <br/>Pain Patients get red flagged by the DEA if they use different pharmacies or go to too many doctors. We are put on a list that can be accessed by docs, pharmacists, law enforcement and even veterinarians. It has been documented that even the pets of pain patients have been forced to suffer after surgery and/or near death, over fear that pet owners will take or sell their pills. (In reality, pain patients will give their own meds in these situations because they are thinking, feeling empathetic human beings who hate seeing an animal suffer, unlike the people who established the CDC guidelines) We are subject to a NarxCare score and private algorithms that determine if we are allowed pain relief or not. <br/>People wonder why pain patients seem “angry”. Imagine living with constant horrific pain and then also being subjected to government policies that make your life as difficult as possible. Policies that have done NO good. Policies that have resulted in an increase in overdoses as proven by the data. <br/>The CDC was warned by actual pain management doctors that the guidelines would lead to extreme harm to patients — and that it wouldn’t even help overdoses. But the CDC allowed anti-opioid zealots with obvious conflicts of interest to take over [Names Redacted]. Psychologists with not one minute of pain management experience now dictate how much medicine my pain management doc is allowed to prescribe to me. Zealots who refer to opioids as “brain gremlins” and “heroin pills” decided how much relief I am permitted. What a world! <br/>The guidelines should be retracted In full. But at the very least, eliminate any reference to the arbitrary MME “suggestions”, and the arbitrary “7 day” max for acute pain. <br/>And for gods sake, make sure actual pain management MD’s are leading any further research and development. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marisa	None	None	0900006484fe988c	Anastasio	None	2022-03-29T15:35:33Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anastasio , Marisa	l1b-8toc-0r8u	False	None	False	2022-04-12 05:34:10.210	[]
3075	CDC-2022-0024-3081	https://api.regulations.gov/v4/comments/CDC-2022-0024-3081	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a healthcare worker, also at times a patient ,and most importantly a human being . I am currently seeing a trend in the healthcare system that involves neglecting patients with both acute and chronic pain. Patients are being treated like addicts and we need to change this. Please stop threatening our doctors and let them do their jobs. It’s a scary time to be a patient. Most recently a family member of mine was hospitalized, painful procedures were performed with no pain meds offered. It’s absolutely barbaric and this will eventually affect all human beings including the people setting these guidelines. Please , please let doctors do their job. Pain management is and has always been an essential part of providing quality and humane healthcare . Let’s also remember severe pain is damaging , causing a variety of other symptoms like high blood pressure and life threatening cardiac issues. <br/>Thankyou for reading this. This will be all of you one day. No one will escape illness or disability before leaving this planet.<br/>Thankyou and please consider putting power back into the hand of our well trained medical professionals!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe9d1d	Anonymous	None	2022-03-29T15:36:37Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-9ty3-xmjx	False	None	False	2022-04-12 05:34:10.493	[]
3076	CDC-2022-0024-3082	https://api.regulations.gov/v4/comments/CDC-2022-0024-3082	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	1. We are seeing patients without adequate pain control d/t 2016 guidelines (most patients have been on opioids for 15-20 plus years). They are either: not functioning, laying around all day, becoming more depressed/suicidal or getting opioids in another manner - friends, street etc. <br/>2. not enough support for non-pharmaceutical pain management. Health insurances don't always cover chiropractic care, acupuncture, gym membership discounts.<br/>3. Challenges getting behavioral health support for patients. Our community was ravaged by fire in 2018 (Camp Fire). Many patients with PTSD, lack of support- neighbors/family all gone. Long wait times for counselors. Patients living in 5th wheels, no room to do a home exercise program. <br/>4. Rural communities - lack of resources: transportation, PT, affordability for medical care. Palliative care programs. <br/>5. Wholesalers holding controlled substance orders for pharmacy, or not filling them d/t volume. Not clinically based, wholesalers looking at tablet count. For example: MS ER 60 mg bid #60 (120 MME) more favorable Rx than Norco 5 mg tid #90 (15 MME) d/t less tablets.<br/>6. Buprenorphine coverage issues: No 1:1 conversion from full agonists to partial agonist - titrating doses needed. Some patients don't tolerate Butrans - not effective, skin irritation. Can't take Belbuca d/t dentures and need bup sl tablets for pain. prescription insurance companies don't like frequencies more than two to three times a day and some will only pay if you state opioid use disorder. <br/>7. Cancer patients/palliative care still getting pushback from pharmacies. <br/>From: Ambulatory care pharmacist assisting with pain management, palliative care and opioid use disorder	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather	None	None	0900006484fe9a55	Barber	None	2022-03-29T15:43:24Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Barber, Heather	l1b-aeby-byni	False	None	False	2022-04-12 05:34:10.733	[]
3077	CDC-2022-0024-3083	https://api.regulations.gov/v4/comments/CDC-2022-0024-3083	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC2200-0024<br/><br/>I’m trying to wrap my head around this. I looked over the 229 draft and I could not find anywhere it states the patient needs to be cut again to 50MME. This happened after the 2016 guidelines were released. I was cut to 90MME and I could find nothing that said in the 2016 guidelines. The only time I found MME is when a new patient is increased. <br/><br/>My doctor finally after 4 years increased me to a dose I could function on 300MME. I was thinking about going to go back to work and now I will be cut down to 50MME. My doctor tells me it’s out of his hands and there is nothing anyone can do.<br/><br/>Will the CDC let this happen again? Why can’t the CDC do an announcement to stop this? I know in 2019 the CDC tried but it was too little to late. Who was going to be cut off or tapered off at that point? Please don’t Let this happen again.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484fe9ad8	Jolley	None	2022-03-29T15:44:05Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Jolley, Chris	l1b-baka-hgpd	False	None	False	2022-04-12 05:34:10.967	[]
3078	CDC-2022-0024-3084	https://api.regulations.gov/v4/comments/CDC-2022-0024-3084	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC 2022-0024<br/><br/>I am helping a friend who can’t comment by herself.<br/><br/>Author: someone who cares<br/>Comment:<br/>I have been living with chronic pain since 2007 , some days the pain is debilitating. I get severely depressed when the pain gets so bad, I hate living with chronic pain. It takes away your quality of life. It makes me feel worthless. The pain medication that I was on lowered my pain levels , I was able to have some Quality of life. They should all be responsible ( including doctors)for what happens to people who have to live with chronic pain with no pain medication ,that gives them some quality of life.<br/>Living with chronic pain is not easy to live with , people take their life because they can't handle the pain.<br/>We wouldn't treat our dogs like this.<br/>I am only 50 and I don't know how long I can take living with this pain.<br/>They will be 100% responsible for the people who live with chronic pain and they take away the one thing that gave some quality of life. people suffering that just can't take it anymore and they take their life ( pain doesn't just affect you physically it affects you mentally)<br/>They should be held responsible for the lives that they will take for making people suffer with chronic pain or other illnesses. They will all be murderers. I myself will not live with this pain forever, I am 50 and because of them taking our pain medication away, "that gave us some quality life" they just cut my life shorter and they will be to blame.<br/>They won't give a ---- about that though.<br/>I bet if their loved ones were suffering in debilitating chronic pain, they wont be denied pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jayson	None	None	0900006484fe9b20	Jackson	None	2022-03-29T15:45:04Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Jackson, Jayson	l1b-bnh6-bobx	False	None	False	2022-04-12 05:34:11.233	[]
3079	CDC-2022-0024-3085	https://api.regulations.gov/v4/comments/CDC-2022-0024-3085	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC-2022-0024<br/><br/>A friend of mine asked me to write her comment. She is nit well enough to write it on her own. Here is what she said.<br/><br/>Posted by [Name Redacted]<br/>I just had surgery for an ectopic. And the obgyn surgeon told me before I had it that I could take two 2mg dilaudid pills (oral) for a total of 4mg which is still low (I’ve been in pain mgmt a total of 6+ years and have a tolerance and need at least like 30MME for this kind of severe pain.) <br/><br/>The ectopic had grown to 10 weeks — it had grown on my Fallopian tube and they took the tube out about 3 hours ago. They said I was lucky to be alive. <br/><br/>First obgyn missed it because she was too busy lecturing me about “narcotics” (which she knew was through legit pain mgmt for multiple chronic pain conditions), and she seemed “relieved” to see a live fetus, which she assumed was in the uterus. I had to come to another obgyn to get the diagnosis (an egg sac on the tube) and then to this hospital in northern VA. They were giving me sufficient IV daudid but now that I’ve gone through surgery they’re being horrible…<br/><br/>I am in serious pain and feel like this was a bait-and-switch. Even the nurses feel bad for me because I’m crying. Can barely walk to bathroom. <br/><br/>The surgeon obgyn doc won’t just give two of rhe 2mg dilaudid (hydromorphine). I’ve asked to talk to the charge nurse and she is “busy.” I’ve spoken to 3 nurses. I got out of surgery like 2 -3 hours ago. They said they could give me more “Tylenol” and toradol every 6 hours. <br/><br/>Guys, what do I do?!! This is ridiculous. This is a major hospital system in [Location Redacted]. They KNOW I’m in pain mgmt. And metabolize these meds very quickly too. They know my husband is coming to pick me up in AM (I’m not driving) and won’t do an IV pain pump even tho IV is still in vein in arm (connected)….	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jayne	None	None	0900006484fe9b34	Ashworth	None	2022-03-29T15:47:49Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Ashworth, Jayne	l1b-btok-5ikc	False	None	False	2022-04-12 05:34:11.469	[]
3080	CDC-2022-0024-3086	https://api.regulations.gov/v4/comments/CDC-2022-0024-3086	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	https://edsinfo.wordpress.com/2015/04/15/why-untreated-chronic-pai-is-a-medical-emergency/<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe9b84	Anonymous	None	2022-03-29T15:50:12Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-ccaw-fa0n	False	None	False	2022-04-12 05:34:11.713	[]
3081	CDC-2022-0024-3087	https://api.regulations.gov/v4/comments/CDC-2022-0024-3087	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I'm a [Name Redacted] that is 54 years old and have been having to get help/relief from my around the clock pain.<br/> I have nerve damage in my spine and legs/feet that feels like a welder is plugged into them. At various times throughout the day my back and legs have muscle spasms that turn painful.<br/>My body was used as a weapon/tool for the time I was blessed to be an active duty Marine and then as an Officer for the [Location Redacted].<br/>I'm not saying that I am any better than anyone else needing help of any kind, but I fought the pain I was in for years before I found any type of relief. I got that relief when I broke my right tibial plateau and after the surgery was prescribed pain medication. This was like a parting of the seas moment for me because for the first time since I had been in the Marine Corps my back did not hurt and I was actually able to get a solid good night of sleep that had been evasive for about a decade!!<br/>I've had 3 surgeries on my right knee and 1 on the left that is overdue for one and no longer has the cartilage to prevent bone on bone. I'm just so tired of having surgery and then the rehabilitation therapy afterwards is so painful.<br/>From everything I have gleaned from the politicians, news and doctors this country is having a problem with a large amount of people who are overdosing on opiods laced with other drugs and the most prominent one being fentanyl.<br/>The situation seems to be fixing itself without any help because of the people who are overdosing on the illegal drugs that are found in their systems you can easily compare the amount of patients like myself who are following the prescribed plan of action with my doctor overseeing any changes.<br/>Legitimate chronic pain management patients such as I are not anything close to the illicit drug users who are buying their drugs and taking them completely illegally. While this is a problem that many hospitals have had to work through you'll never have a legitimate patient having illegal drugs in their systems.<br/>Patients like myself take what we have to to be able to walk to the mailbox with their dog, or be able to function.<br/>I was in an accident in July 2015 and have been forced to retire because of my injuries and no longer being able to manipulate handcuff keys or shoot with the hand that was broken into bits. Walking up or down a single flight of stairs hasn't been any option for me since the accident nor is walking for more than 20-30 yards without a couple of hours to shake off the worst of the pain.<br/>I haven't been able to sleep in our bed since that accident on July 15th 2015. That's almost 7 years of sleeping upright on the couch.<br/>I'm only taking enough medicine to take the pain from a 7-8 down to a 3-4 at best.<br/>As for the others that are much worse off than I am I feel bad for them.<br/>As for the people who are dying to get high on illegal drugs I could care less about them because they are responsible for their own actions - as we all know!<br/>I've been having to live in pain for right about 25 years now and am only able to do the miniscule things I can because I am able to have relief from my pain management team.<br/>No one, and I don't care about what anyone says, has the right to keep people in pain just because they say so.<br/>The only people who have a right to interact with a patient and their doctor them alone. Not a politician or pencil pusher in some office or cubicle. No one!<br/>I'm going to end this with my information.<br/>[Name Redacted], USMC <br/> [Location Redacted] Officer (ret) <br/>[Address Redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Darin	None	None	0900006484fe9ba0	Dyer	None	2022-03-29T15:55:16Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Dyer, Darin	l1b-cpex-bhsy	False	None	False	2022-04-12 05:34:11.963	[]
3082	CDC-2022-0024-3088	https://api.regulations.gov/v4/comments/CDC-2022-0024-3088	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband was in a terrible accident along time ago. And now he is suffering because his Dr. had him on Percocet 10/325 times 3 a day. Then all the sudden he was told I can’t give your meds anymore. He was sent to a Pain clinic in [Location Redacted] Alabama. At this clinic after doing everything they wanted. The clinic gave him a prescription for OxyContin 40 mg and wanted him to take 6 times a day. He refused the prescription due to knowing of people who had ODed on that medication. They told him when he decided to take what they wanted to give him” which was way to much” to come back. So now someone who has several reasons for his pain. He suffers because his Dr. can only give him Tylenol 3 and he can only take 1 a day. <br/>Not my husband. But people are buying meds off of the street or internet and dying of fentanyl poisoning because they can’t get the medication they need from their Drs. <br/>Please Help!!! No one with real pain should be made to suffer. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Glenda	None	None	0900006484fe9c77	Box	None	2022-03-29T15:56:06Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Box, Glenda	l1b-eblt-nksi	False	None	False	2022-04-12 05:34:12.211	[]
3083	CDC-2022-0024-3089	https://api.regulations.gov/v4/comments/CDC-2022-0024-3089	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a neurosurgeon practicing for over 40 years I felt the situation was overplayed by organized medicine. Doctors were under pressure in hospitals to make sure the happy face was the assessment of the patients' pain while in hospital . This was so that patient satisfaction scores were high for the hospital. If you were a doctor that did not buy into everyone getting a PCA pump and did not prescribe Percodan for every postop spine patient, you would get a call from some hospital know it all about your pain management. In spite of this, many of us prevailed. I dont think i had many, I am sure they went elsewhere , that went nuts due to their lack of narcotics. We did not keep refilling either. When Oxycodone came out, lets not forget the TV ads that surrounded this drug. Maybe off air now and erased. All of this with the full blind eye of the CDC and other regulatory agencies. This new policy, maybe by a doctor that looks at the whole patient situation, will be more effective.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484fe9c87	Fletcher	None	2022-03-29T15:56:51Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Fletcher, Stephen	l1b-egcm-e5am	False	None	False	2022-04-12 05:34:12.447	[]
3084	CDC-2022-0024-3090	https://api.regulations.gov/v4/comments/CDC-2022-0024-3090	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines should be revoked. Both my husband and I have suffered from chronic pain for years and were successfully treated and had a high quality of life with the use of opioid therapy. We never abused and always went to same doctor. With the cdc guidelines our doctors now refuse to prescribe for fear of losing their license. Pain doctors only offer painful injections that cause more harm and are very expensive. The. The pain doctor says if you won’t pay for experimental stem cell therapy I can’t treat you. At this point my husband can barely walk he’s in so much pain. My blood pressure is sky high due to pain and over use of nsaids which is now my only option. These guidelines have ruined lives. The overdoses are usually from fake fentanyl. If over prescribing opioids was the culprit then why haven’t the overdose deaths gone down with the dramatic decrease in any physician prescribing opioids. I would be so frightened if any kind of surgery because even surgeons Al aren’t giving pain relief after surgery. These guidelines have ruined so many lives. Please put a stop to the suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe9dbb	Anonymous	None	2022-03-29T15:57:33Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-evmd-ow2v	False	None	False	2022-04-12 05:34:12.692	[]
3085	CDC-2022-0024-3091	https://api.regulations.gov/v4/comments/CDC-2022-0024-3091	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Sirs<br/>I have been a pain management physician for over 20 years. I have been treating primarily chronic pain patients some of them for a very long time. I have seen the transformation of my specialty form just using oral opiates 20 years ago along with some injections to what the specialty is today. Interventional pain management is probably of the many medical specialties one that has undone the most impressive research and development. We have so many treatment options available to us now that there is almost no chronic pain condition that can go untreated. And all of this WITHOUT the use of OPIATES. I feel that IPM has made the most incredible progress at improving patients pain and quality of life while at the same time reducing the need for opiates. Thus I feel that IPM should be an integral part of the decision making on everything related to opiate use and non pharmacological techniques to improve the patients pain. Please hear the voice of the many IPM physicians like me that are at the front lines trying to make a difference in peoples lives. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Luis	None	None	0900006484fe9df8	Fandos, MD	None	2022-03-29T15:58:16Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Fandos, MD, Luis	l1b-fb08-ev72	False	None	False	2022-04-12 05:34:12.919	[]
3086	CDC-2022-0024-3092	https://api.regulations.gov/v4/comments/CDC-2022-0024-3092	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why do we have to be tortore and to be in so much pain .that we pray that God take us in are sleep .Because of the guideline you have provoked on us cpp .and Then you. Keep lowering Mme .and making us choose which me dice we have to give up .This is so inhuman .i have no quality of life what so ever .in pain ?24 7 .I wouldn't wish my pain on my worse enemy ..why must we suffer?doctors need to be Doctors again .without being told what to give us who suffer with acute pain .this is so ridiculous.and now everyone treats us like crap and talk to us like crap why?cause they can .you made that happen to us .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fe9e3d	Anonymous	None	2022-03-29T15:59:05Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-fotk-c280	False	None	False	2022-04-12 05:34:13.162	[]
3087	CDC-2022-0024-3093	https://api.regulations.gov/v4/comments/CDC-2022-0024-3093	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	W	None	None	0900006484fe9e7a	Reit	None	2022-03-29T16:03:10Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Reit, W	l1b-fqxc-fkpb	False	None	False	2022-04-12 05:34:13.398	[]
3088	CDC-2022-0024-3094	https://api.regulations.gov/v4/comments/CDC-2022-0024-3094	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain from Scoliosis, and other illnesses and was denied pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanette	None	None	0900006484fe9f9e	Partlow	None	2022-03-29T16:15:54Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Partlow , Jeanette	l1b-igsq-bd06	False	None	False	2022-04-12 05:34:13.841	[]
3089	CDC-2022-0024-3095	https://api.regulations.gov/v4/comments/CDC-2022-0024-3095	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello I'm 33 years female i have had cancer twice with all the chemotherapy and radiation it killed my bones!! My bones are slowly dying its so painful and I have alot of nerve pain!! It has affected my life so much so that I can't do anything without excruciating pain it affected my day to day life!! The only thing that helps with my pain is my pain medication now with the CDC guidelines the pain doctors want to take them from me! I'm a mom a daughter who take care of my elderly parents my mom has MS and my father has dementia i wouldn't be able to take care of all three of them with the pain I have!! The pain medication have given me my life back helps me enjoy life if not for them I wouldn't even be able to get out of bed. Let alone take care of my family go to my sons football games please don't take away chronic pain patients pains away!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fead78	Anonymous	None	2022-03-29T16:17:18Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-lm70-krds	False	None	False	2022-04-12 05:34:14.079	[]
3090	CDC-2022-0024-3096	https://api.regulations.gov/v4/comments/CDC-2022-0024-3096	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person with rheumatoid arthritis, osteoarthritis, fibromyalgia, and multiple knee replacements, I suffer chronic pain that is poorly managed. Having a cap on optics means I can never get adequate pain management as all other pain management efforts have failed. I am not someone who is over using or looking to get high. I would just like to get out of my chair and participate in life again. Chronic painers, as we refer to ourselves, are not where the gist of the overdoses are coming from. We don't get drugs off the street and od from them. We follow our doctors orders and use appropriately. I'm weary at suffering from the mistakes of others. And suffer I do, since childhood and I'm 63 now. How long must I wait for the medical community to do the right thing and treat my pain?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebekah	None	None	0900006484fead83	Donohue	None	2022-03-29T16:22:15Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Donohue , Rebekah	l1b-lp9f-lwqw	False	None	False	2022-04-12 05:34:14.321	[]
3091	CDC-2022-0024-3097	https://api.regulations.gov/v4/comments/CDC-2022-0024-3097	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in individual who has had several knee and hip replacements. When my first knee was replaced I was in tremendous pain. It never quit hurting and I eventually had to have a knee revision. In the first several months after surgery I took Norco 10 mg every three to four hours with added Tylenol to partially manage my pain. My surgeon did not tell me that a failed replacement was responsible for my pain. The surgeon I saw for the revision three years later told me it was like I had been walking on a broken bone. It was hard to get enough pain medication to even partially control my pain, because my surgeon did not manage my pain recovery and told me to see my primary care doctor, who ordered enough for about ten days, but my insurance company required that I mail order for Norco. So I had to monitor Norco carefully, dividing out how much I could take per day before I could get the next refill, but my pain level remained at about a 5 out of 10 most of the time. [Studies have shown that when opiates are taken for pain, they are not likely to cause addiction. At the peak I was taking 10 Norco per day, but had no trouble getting off of them. After a later surgery I took Norco only when needed for pain and went from 8 one day to 0 the next because the pain subsided. I had no withdrawal symptoms].<br/><br/>All this to say, I do not want the federal government to restrict opiates from people suffering from real pain. and doctors should not have to fear losing a license because they prescribe what a patient needs. Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484feadc8	Anonymous	None	2022-03-29T16:23:17Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-mcvc-84vs	False	None	False	2022-04-12 05:34:14.563	[]
3092	CDC-2022-0024-3098	https://api.regulations.gov/v4/comments/CDC-2022-0024-3098	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please give our doctors the right to give treatment as they see fit . That includes prescribing much needed opioids for Chronic pain patients . We now know all the details about illegal drugs like illicit fentanyl that is killing people . I certainly function better when my pain is managed properly . <br/>The CDC guidelines were taken seriously to overboard for patients . I need my doctor to be able to prescribe what he thinks is best for me . Doctors have been terrified to treat patients so proper treatment has landed them in jail . When did CDC and PROP have the right to make my medical decisions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cathy	None	None	0900006484feb112	Anderton	None	2022-03-29T16:26:04Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anderton, Cathy	l1b-o8yj-oyzp	False	None	False	2022-04-12 05:34:14.830	[]
3093	CDC-2022-0024-3099	https://api.regulations.gov/v4/comments/CDC-2022-0024-3099	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 73 years old & 3 years ago I had neck surgery & ended up with MRSA & had to have 3 different surgeries to keep from dying & spend a total of 158 days in the hospital or rehabilitation center to learn to walk again; before this I never took a opiate I took over the counter pain meds; but since surgery I have been on the same pain meds with isn't much right at 90MME but it keeps me laying in my bed 24/7; & I have never had 1 issue with running out of meds or having to go to the streets like you are trying to make people do if you lower the MME amount? You don't understand the opiate crisis isn't from your chronic pain patients it's from people that are on hard core drugs & people that have been forced to go to the streets because you have made doctors take them off their pain meds because they are scared of loosing their license & your forcing the pharmacy to not fill pain meds! I truly believe if you keeping forcing people off their pain meds you are going to create a opiate crisis that will be even worse than it's even been! My 1 ? To the CDC is if you or your loved one had a surgery that went bad & left you in such severe pain u couldn't function without a pain reliever what would you do? & I don't want to give a long speech here I just wish you would listen to the people like me that has never done an illegal drugs in my life; I have never had any issue with running out of my meds or not following my doctor's orders I need to be able to live not lay in a bed! So please don't change the MME amount! & Listen to the people leaving you comments! Please	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484feaf73	Anonymous	None	2022-03-29T16:27:20Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1b-zdo3-wyji	False	None	False	2022-04-12 05:34:15.068	[]
3094	CDC-2022-0024-3100	https://api.regulations.gov/v4/comments/CDC-2022-0024-3100	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Because of 2 failed spinal reconstructions for disintegrating bone of my spinal column resulting in severe spinal cord and nerve damage, I have insane pain everyday. This is something I will always have. I have no delusions of ever being out of pain. For the first years through my surgeries and after it was crazy hard, but with the pain meds I was on daily that my Pain Management Doctor responsibly prescribed and monitored - I was still able to function and be a wife and Mom. To participate in special family times. Have QUALITY OF LIFE with my family. Then the Lawmakers in Ohio took control and decided with NO medical knowledge that they should be the ones deciding how many mg per day of pain meds patients should get, with no regard to their individual conditions. Since then they have cut the dosage of my meds. (which my Doctor disagreed with, but there's nothing he can do) Over the last couple years I have lost the ability to function. I now only leave my house to go to the doctor, and that is a struggle. I can only be sitting or standing for short amounts of time because of the severe pain and pressure on my neck and body. So I now spend most of my life in bed so I can have support behind my neck. Even just a family dinner that I want to enjoy has a small time limit that I can take the pain to sit at the table. What kind of life is this? I have a daughter who plans to get married someday and have babies, how can I be part of that? Ohio law makers don't care. They feel that it's a great thing for them to sentence chronic pain patients to a life like this. Even though the statistics show that cutting back responsibly prescribed pain meds to chronic pain patients does NOTHING to help the opioid crisis or curb overdose deaths. In fact it adds to them. Patients in serious chronic pain have NO interest in giving their meds to anyone else or taking them in any manner other than what is prescribed. We need our meds and if we don't take them as prescribed then we're not going to have any. We want to have a life. Instead of being prescribed much needed meds safely and responsibly, in order to function in life many of these patients who have had their meds cut by lawmakers are resorting to trying to buy street drugs that could be laced with anything. My daughter is a Respiratory Therapist at our local hospital. She sees it first hand- NO ONE is overdosing on prescribed chronic pain meds. She has seen so many patients in this situation who are chronic pain patients in serious pain, who were doing well in pain management for years, responsibly functioning in life, and then they had their meds cut and now in order to have any kind of life they have resorted to trying to buy something off the street that they thought were their meds. Only it's NOT their meds- they are laced with something else and now my daughter sees them in the hospital after an overdose. But what are they supposed to do? What are the options? Be in unbearable pain and a burden to their family the rest of their life. Buy street drugs that may or may not be what they think they are and could kill them. Or some just can't do it, and they kill themselves because they can't handle either of the first 2 options. People deserve better. How is this helping anyone? It's forcing people who are already struggling to suffer. None of our conditions are our fault, it could be YOUR loved one. Don't you want their Doctors being the only ones making choices for them as to what is the best course of action to be able to live the best life possible? How would you feel if their Doctor decided- this would be the best choice for your loved one to be able to function in life, but then had to tell you -I'm sorry but our lawmakers decided that they will be making the decisions-not me. They feel that this dose -which will probably equal endless pain, being in bed most of the time, and not really being part of life,- that this is the best choice for them. This is the reality of what is happening. YES there should be guidelines -there is a TON of them in place. Things to make patients aware of when they are taking opioids and how they should be used responsibly the way they are prescribed. And of course they shouldn't prescribe un-necessary meds, but that is not what is happening. Law makers have taken things way too far. With NO medical knowledge they are taking health decisions away from doctors and putting themselves in charge of what med doses patients should have. It's time to put focus and resources into stopping the illegal drugs on the street, because they are what is killing people, not going after responsible chronic pain patient's ability to function. Patients and their families are greatly suffering because of this. Some are even paying with their lives. More and more of them are going to die if you don't do something about this. PLEASE make it so that Doctors are the only ones making dosing decisions - NOT Lawmakers. You will save lives and families!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484feafb9	Anonymous	None	2022-03-29T16:31:46Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-06l3-1zxu	False	None	False	2022-04-12 05:34:15.310	[]
3095	CDC-2022-0024-3101	https://api.regulations.gov/v4/comments/CDC-2022-0024-3101	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How can “I/We” have you all to understand “a chronic pain diagnosis”? I’m a disabled/retired nurse myself from a chronic pain situation since age 46 years of age. Ironically, I worked directly in one of the many medical fields, which 80 percent of the time lead to “chronic pain situations” among various patients for many years. I was a compassionate nurse with a high sense of empathy and could easily sympathize with such patients. When ironically I became one of these very patients who I cared for; cried for; felt their sadness, as well as witnessed the many changes that these patients had to go through in life,..it was devastating! My full understanding came as I myself fell into the same medical situation,..and it was even worse than I had imagined! So, to try and explain to all who are responsible for creating these guidelines on chronic pain,..putting restrictions on medications that could be life saving for many, is impossible. Unless you have first hand experience and if only you all could feel the physical pain; feel the emotions; feel the effects that trickle down in the families due to their loved ones chronic pain situations,..it’s truly sad. No human being should be made to suffer in such pain, when we (the science and facts) have the means to properly treat such patients. It’s one thing when physical pain can be cured with specific diagnoses and there’s a light at the end of the tunnel,…however,..can you just imagine when there is no such light; no such hope, and your pain/suffering is for the rest of your lifetime??? Then, when treating physicians are not able to treat you properly, especially when they are taught to “do no harm” and their hands are tied to treat as they have been taught? I have so many devastating medical stories to tell,..so many horrific tragedies that I’ve witnessed while working in the medical field, just like so many other medical workers. I just can’t understand why or how these “pain control guidelines” even came to exist. You cannot put “chronic pain patients” in the same basket (so to speak) as those with drug addiction problems. There’s so much wrong with what’s going on with all of the “human suffering from chronic pain situations”. It’s got to change back to where treating Physicians can properly treat such suffering,..without restrictions to the point that they become paranoid to do so. Please try to understand. I would love to explain more. Please tell me how or what else I can do, for the sake of humanity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JanetJanet	None	None	0900006484feb3c2	Spell	None	2022-03-29T16:34:50Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Spell, JanetJanet	l1c-3oer-w7q5	False	None	False	2022-04-12 05:34:15.554	[]
3096	CDC-2022-0024-3102	https://api.regulations.gov/v4/comments/CDC-2022-0024-3102	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Look at what all of us are doing on this comments page thank goodness for 1st admen rights.With my review of comments here all im seeing is people begging for medication that has become a prohibition of the medications (opiods) that the ones who suffer in uncontrolled severe pain should be provided through their doctors. who should have the right to use such medication by personal choice .Who is to blame the ones who make the guidelines or the ones with no quality of life bed ridden crying in pain who are called drug addicts .What a screw up by cdc they will not admit that their guidelines have caused needless suffering of millions and suicides.Watch the news because of the prohibition there are fake pain pills on street corners now so if granny who has cancer decides that she has to roll down to the street corner in her wheel chair to possibly get a chance of relief of her cancer pain and overdoses on fentynal laced pills who is at fault for her death ??? Not granny she ended her suffering with no ill intentions.You guessed it the quideline creators it is really sad that drug dealers are cashing in on the fact that the ones who should be perscribed pain medication have become refugees because the guidelines restrict them from medications. The perscription drug monitoring programs violates our Hippa rights also God Bless The Ones Suffering In Pain Soon Get IT Right CDC End Your Inhumane treatment of those who Suffer !!!!!!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484feb3c5	Anonymous	None	2022-03-29T16:36:31Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-3qg7-hwti	False	None	False	2022-04-12 05:34:15.794	[]
3097	CDC-2022-0024-3103	https://api.regulations.gov/v4/comments/CDC-2022-0024-3103	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering with arthritis and chronic pain for a very long time. It's no fun suffering! Without my pain meds I went into depression, I see a therapist and a psychiatrist. I'm getting to the point where I can't do this anymore! I have 5 little grandkids and I can't even babysit them due to all the pain iam in. This really breaks my heart even more! Something really needs to be done, I can't live like this anymore! The people that abused the opioids ruined it for us, meaning people who are really suffering. It's not fair! It really isn't. I believe we deserve to get back on our pain meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484febc59	Anonymous	None	2022-03-29T16:37:20Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-7r9k-2trq	False	None	False	2022-04-12 05:34:16.040	[]
3098	CDC-2022-0024-3104	https://api.regulations.gov/v4/comments/CDC-2022-0024-3104	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired family physician and practitioner of addiction medicine. My recommendation is that if it has been decided by a practitioner that use of long term opioids is necessary , buprenorphine be the first opioid of choice. It is a partial agonist that has a ceiling effect for causing respiratory depression , but not for analgesic effect. (1) It also has significantly less abuse and addiction potential since it does not cause the intense euphoria that full mu agonists cause. (2) Finally, it is the only opioid when taken alone that cannot cause sudden death due to its ceiling effect for respiratory depression. (1) It is now available in low dose form and approved by the FDA for the treatment of chronic pain.<br/><br/>1) Dahan A et al. Buprenorphine induces ceiling in respiratory depression but not in analgesia. Br [Name Redacted] . 2006 May; 96(5): 627-32<br/><br/>2)[Name Redacted] DR, et al. Human pharmacology and abuse potential of the analgesic buprenorphine. Arch Gen Psychiatry 1978; 35: 501-16	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484feb81d	Mancini	None	2022-03-29T16:40:26Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Mancini, Joseph	l1c-83fr-1ddu	False	None	False	2022-04-12 05:34:16.282	[]
3099	CDC-2022-0024-3105	https://api.regulations.gov/v4/comments/CDC-2022-0024-3105	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been dealing with pain for quite some time. After being diagnosed, I have been in need of help. I get told to get help, so that's what I'm trying to do. I've been in and out of the hospital, had numerous of surgeries and procedures and as these sectors wanting me to get help, now they will not help me with pain relief that I need. Why do us as patients who suffer from chronic pain get denied as we can't live a normal life?! We are surrounded by normal people who have no idea what it feels like to be in this much pain. As us chronically ill people who battle chronic pain need the guidelines gone, especially for us. I have never battled so many issues in my life. Gallbladder, kidney stones, ovary cyst to Crohn's disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484febeae	Anonymous	None	2022-03-29T16:41:53Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-9frf-na0p	False	None	False	2022-04-12 05:34:16.534	[]
3100	CDC-2022-0024-3106	https://api.regulations.gov/v4/comments/CDC-2022-0024-3106	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 58 years old and you have taken away my rights as a patient to receive care for my pain. My pain Dr. Had dropped my insurance and I've been try 2 months to find another doctor. You have actually taken away pain meds from people who take them just to be able to move. You are affecting my quality bof life and it's just getting ridiculous. Please re write the rules and help people like me who are suffering at the CDC'S hands. ..... [Name Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angela	None	None	0900006484febf44	Christensen	None	2022-03-29T16:43:13Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Christensen, Angela	l1c-a5g0-21xe	False	None	False	2022-04-12 05:34:16.771	[]
3101	CDC-2022-0024-3107	https://api.regulations.gov/v4/comments/CDC-2022-0024-3107	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Eight years ago my son came home to MA to visit from his home and job in NH. He arrived with a severe headache. Having suffered since the age of 10 from headaches after a bout with meningitis, he walked in and went to bed. Little he ,or we, knew that this headache would change his life forever. The headache did not go away, and he never got back to his home and job, he so loved. For three years we tried every known therapy, took every test at the best hospitals in the country, John Hopkins, the Mayo Clinic , and here, where we live in [Location Redacted]. Unfortunately we were informed that we would have to wait till the medical world could find something to help these kinds of headaches.So we started a regiment of well regulated opioid medication.For four years my son never wavered from this medication regiment. He never asked to increase the dose,and never called in early. He was finally able to carve out about a 2-4 hour window of daily relief. He was able to start up a small business to help support himself. He got back to exercising and connecting with the few friends, who had not abandoned him over the years.He was finally able to start reading again, something he dearly loved. THEN, our government in it's infinite wisdom decided to limit the amount of opioids that can be prescribed by highly qualified pain physicians for chronic pain patients.Never taking into account the many variables in patients and what they may need. Making recommendations to lawmakers trying to get a handle on the "Opioid Crisis", that has devastated our country, should never have been lumped together, with no thought, to the vulnerable chronic pain population. They are not one and the same!!!We thought a doctors job was to help their patients live a productive life. This decision has tied their hands and punishes vulnerable human beings for something they never had a hand in making happen. Now, with the "weaning down" of his medications, we no longer have a productive member of society, we have a young man , considered "disabled", who vomits daily from the pain, spends 24/7 in a dark room with an ice pack attached to his head, unable to function at all.A young man who can no longer see a reason to keep living, other than it would break his parents hearts ( that are already broken due to this policy). His choices are seeking "blessed relief" from the streets or ending his life!! To watch someone suffer, when it is absolutely not necessary, is devastating. CHANGE THIS POLICY NOW. Bring back the dignity that these people deserve to have...give them their lives back. We have already lost too many lives because of these policies.<br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484febf49	Corliss	None	2022-03-29T16:45:59Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Corliss, Sharon	l1c-a73r-66lz	False	None	False	2022-04-12 05:34:17.010	[]
3102	CDC-2022-0024-3108	https://api.regulations.gov/v4/comments/CDC-2022-0024-3108	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been on pain medication for over 20 years. Since the CDC guideline in 2016 my doctors have tapered me to less than half of the medication I was on. I’m no longer able to do daily living activities ( housework, laundry, cooking, etc ) without taking breaks. Allow the medical facilities to do their jobs. The CDC and DEA shouldn’t have a say in who gets pain treatment or how much medication is needed per individual. People are committing suicide because of not having their pain treated. This is inhumane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484febf9e	Anonymous	None	2022-03-29T16:46:24Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-alzn-e2im	False	None	False	2022-04-12 05:34:17.599	[]
3103	CDC-2022-0024-3109	https://api.regulations.gov/v4/comments/CDC-2022-0024-3109	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Myositis Support and Understanding (MSU) recently conducted the largest and first-of-its-kind study to show the prevalence of pain and the use of both opioid and non-opioid treatments in myositis. Nearly all the patients surveyed experienced pain attributed to myositis, (idiopathic inflammatory myopathies - IIM). The results underline the importance of treating physicians, to inquire about and address the pain these patients experience. There are currently no analgesic protocols for the treatment of pain in myositis. After reviewing the updated draft version of the Clinical Practice Guideline for Prescribing Opioids – 2022 - we would like to provide the CDC (Centers for Disease Control) with the following statements as they apply to chronic diseases and myositis in particular:<br/><br/>•<span style='padding-left: 30px'></span>In chronic diseases such as myositis, patients often experience pain independent of their lab results or specific clinical symptoms. Often the voices of those patients are not heard by their doctors, some of who tell patients that myositis has no pain. This is detrimental to a patient suffering from pain and results in a patient receiving subpar pain treatment.<br/><br/>•<span style='padding-left: 30px'></span>Patients with myositis may present with both acute and chronic pain, and appropriate management for this condition should be coordinated across specialties. Our patient survey data indicates that Primary Care Physicians (PCPs) often manage pain treatments for patients. Often PCPs are not familiar with myositis and patients’ pain levels are not properly addressed. Untreated pain is one of the main causes of patient depression and isolation. <br/><br/>•<span style='padding-left: 30px'></span>We welcome an open discussion with physicians about the benefits/risks associated with opioids. We believe in creating such a partnership to establish pain management goals for patients with myositis, who may present with or without muscle weakness or skin symptoms.<br/><br/>•<span style='padding-left: 30px'></span>Patients with myositis may experience benefit from different, alternative therapies along with/instead of opioids that should be considered in the risk-benefit analysis and should be included in the wider discussion on pain management (e.g., CBD & THC, in states where they are medically available).<br/><br/>•<span style='padding-left: 30px'></span>Physicians should closely monitor the effect of opioids on the patient’s well-being, as it relates to underlying diseases such as myositis. Medication tapering should be discussed as part of the meaningful improvement in overall physical scores and clinical scores. <br/><br/>In brief, we support the five guiding principles to guide implementation, highlighting that pain needs to be treated based on the individual, whether or not opioids are part of the treatment, flexibility is critical, a multidisciplinary approach is needed in chronic pain conditions and special attention needs to be given to health inequalities and access to appropriate and affordable therapies. <br/><br/>Kind Regards,<br/><br/>[Name Redacted]<br/>Myositis Support and Understanding (MSU)<br/>https://Understandingmyositis.org <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fec0cc	None	None	2022-03-29T16:49:55Z	Myositis Support and Understanding	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Myositis Support and Understanding	l1c-c7uf-i8rh	False	None	False	2022-04-12 05:34:17.819	[]
3104	CDC-2022-0024-3110	https://api.regulations.gov/v4/comments/CDC-2022-0024-3110	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have several bulging discs in my back and neck, bad knee and shoulder, and I have arthritis all over. Every month I struggle to get my pain meds. Why? I don't want to get high. I want pain relief. I'm afraid to take even enough meds to help me function, because I know I could be irrationally dumped from medication at any time. I help raise two children and wonder how they will ever have a future. It's startling how often we are mistreated and openly discriminated against. Doctors and nurses, administrators...they think they can openly abuse us because the the CDC has promoted the false idea that prescription opioids are somehow evil substances. It's an odd idea because most drug abusers freely admit that the problem stems from within themselves and their psychology, yet the CDC has chosen to promote the ridiculous idea that addiction is somehow communicable or contagious. There is no evidence of this whatsoever. Opioids are not a disease, either...they are a class of medication. And "consequences of the opioid epidemic" are not a disease either! Through the 2016 Opioid Prescribing Guidelines, the CDC basically instructed and encouraged medical professionals to believe that pain patients should be scrutinized and tossed out at any opportunity. And that is exactly what happened...the CDC gave clinics and hospitals permission to neglect and abuse us. The CDC implied that discrimination for an incurable pain diagnosis is fine as long as it could be construed to help someone else with a drug abuse problem. Well one has nothing to do with the other and in fact the pain community was more useful at warning the public about the dangers of counterfeit fentanyl than the CDC was. The CDC didn't want anyone to know or to separate prescription opioids from street drugs. The title "opioid epidemic" is inherently unfair to pain patients! And that is why we are here today in the thousands commenting on this. We are doing this because we are putting the CDC on notice that your actions have been wrongful and harmful to innocent American pain patients, and we are now notifying you that we are no longer accepting the CDC unfairly targeting and promoting the violation of our civil and human and civil rights. Prescription opioids were never an emergency. The corruption in the CDC is directly responsible for inserting themselves illicitly into our private medical treatment. We are writing to inform you that we are no longer going to tolerate the CDC petending that pain patients were collateral damage. We are no longer accepting your allegations the medical community was to blame for the so-called opioid epidemic either. It was unfair to persecute us and treat us like we were drug dealers. We are not criminals in any way! We are here protesting the CDC employing corrupt "pet" researchers to write tainted studies to "prove" prescription opioid harms so they can sue doctors, pharmacists and manufacturers. From today on, the CDC is put on notice that we will no longer suffer rude and hurtful bigoted accusations regarding our pain disabilies. We will no longer tolerate being discharged without treatment because we are on opioid therapy. We will no longer accept being deliberately left to wait hours in a doctors office with an empty waiting area to "punish" us for being in pain. We will no longer accept being pushed drugs for addiction treatment that are not approved for pain when we have never abused any drug. Basically we are done with the games and the lies the CDC promoted about us since 2016. The CDC has directly and indirectly harmed and defamed pain patients by hiding the truth -- that the majority of opioid deaths are caused by counterfeit fentanyl deaths. Why did former CCDC Director, [Name Redacted], admit that the opioid problem was caused by counterfeit fentanyl-tainted street drugs and stated that knew about it the whole time (Washington Post article "The Fentanyl Failure" 2019). He also claimed he had no control over the narrative, but went on to plan the writing of the 2016 CDC Opioid Prescribing Guidelines which never should have been written because prescription opioids were never the problem!! Billions of dollars in opioid lawsuits were farmed out of blatantly dishonest and conflicted "opioid experts." And the media promoted the lies, too. You are all culpable for your participation in this ruse. The CDC knew about counterfeit fentanyl since probably 2004! But they didn't test for fentanyl analogues until just a few years ago! It's time the CDC acknowledged the truth about counterfeit fentanyl publicly and start a campaign to teach the public about the dangers. The CDC ignored this for settlement money and control. So many people are damaged by the wrongful actions of the CDC, that at this point it might be best if the agency was dismantled. Bottomline, there was no reason ever to discriminate against chronic pain patients on opioid therapy and we insist that you stop lying and hiding. We see you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484fec06c	Stone	None	2022-03-29T16:54:15Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Stone, William	l1c-bndj-bhc2	False	None	False	2022-04-12 05:34:18.035	[]
3105	CDC-2022-0024-3111	https://api.regulations.gov/v4/comments/CDC-2022-0024-3111	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Being a wheelchair bound full body and internal crps warrior these guidelines are even worse then the 2016 guidelines were.. we caught your attention with the don't punish pain rallys and our best advocates ie [Name Redacted]... Now it's worse. None of us asked for these terrible diseases all we are looking for is the chance to live with controlled pain not even pain free.. it's something I've come to realize after 23 years in battle with Complex regional pain syndrome please don't tighten the restrictions any more your gonna kill us all off and that's not right. Your veterans fought for and became Chronically ill/ mentally ill after they gave their all and you leave them to commit suicide just like many pain paitents have come to this horrible relaxation. Please.listen to your pain paitents.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karey	None	None	0900006484fec51c	Stanziale	None	2022-03-29T16:57:17Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Stanziale, Karey	l1c-cmre-xahr	False	None	False	2022-04-12 05:34:18.357	[]
3106	CDC-2022-0024-3112	https://api.regulations.gov/v4/comments/CDC-2022-0024-3112	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am impressed that the CDC is reconsidering its 2016 guidelines. In my opinion, the 2016 guidelines overcompensated in its attempt to reduce prescription opiate abuse. The new guidelines are not only more humane but more realistic.<br/><br/>In my early thirties, I was working as a successful computer programmer, until one Friday night after pizza and ice tea with a friend, I had a grand-mal seizure at his house. I regained consciousness in agonizing pain from a crushed T7 vertebrae. Over the course of the next three years, I had four more seizures, which resulted in fracturing (and refracturing) two other thoracic vertebrae. The muscles in my back had spasmed so strongly that they fractured my vertebrae. The only way I could continue working was by taking strong opiates. The fractured vertebrae destroyed the intervertebral disks surrounding the vertebrae.<br/><br/>The opiates I took allowed me to work for 15 more years, until I could no longer sit long enough to be an effective programmer. I have been on Federal Disability since then.<br/><br/>I was losing motor control in my left leg, so I had extensive (and extremely traumatic) back surgery. The surgery fixed the motor control problem, but not the pain in my thoracic spine. I tried every option for pain control - including NSAIDs which eventually caused a duodenal ulcer.<br/><br/>For me, the pros far outweigh the cons of using opiates. I have seen opiate addicts who used opiates for recreational purposes, and I just consider them unlucky - not morally flawed. For some reason, my brain chemistry is such that too high a dose of opiates is unpleasant to me. I don’t like being impaired in any way. In my opinion, this isn’t because I am a better person than addicts, it’s just lucky brain chemistry (unlucky in the case of seizures though).<br/><br/>Opiates have obvious downsides for many people, but there is no current effective substitute. I am optimistic that an effective substitute will eventually be found, but for me, and the millions like me, opiates allow us to live reasonably fulfilling and productive lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fec53a	Anonymous	None	2022-03-29T16:59:48Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-crp3-vpcb	False	None	False	2022-04-12 05:34:18.570	[]
3107	CDC-2022-0024-3113	https://api.regulations.gov/v4/comments/CDC-2022-0024-3113	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a NURSE suffering from pain in silence. I was almost killed by negligent Doctor that the laws have prevented me from holding accountable for her negligence. I am now disabled due to the malpractice. I am suffering from pain and being treated less than human. My current situation any diagnosis that I have has a indicator of pain. Recently I was refused a five day of pain medicine for a very painful condition. Yes I said a five day supply of pain medication. I am being treated as a drug seeker and I get less pain medication then a dog will receive receiving surgery from a veterinarian. This has got to stop. I am now disabled in pain and nowhere to turn. How is this ethical how is this legal? I want answers. I’m not gonna stop until things change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fec567	Anonymous	None	2022-03-29T17:00:46Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-d700-zcfg	False	None	False	2022-04-12 05:34:18.785	[]
3108	CDC-2022-0024-3114	https://api.regulations.gov/v4/comments/CDC-2022-0024-3114	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having been a chronic pain patient for many years. Due to the new CDC guidelines my pain medications have been lowered to a point I can't function. This is no way to treat patients that have lived for years in agony.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dawn M	None	None	0900006484fec575	Skinner	None	2022-03-29T17:01:09Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Skinner, Dawn M	l1c-da7v-r1fl	False	None	False	2022-04-12 05:34:19.007	[]
3109	CDC-2022-0024-3115	https://api.regulations.gov/v4/comments/CDC-2022-0024-3115	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and have suffered great harm with the 2016 guidelines. <br/>The new proposed guidelines need to have no mention of mme’s. Please take the limits out as they will be misapplied as they were previously. <br/> I need pain medication to just sit up as well as insulin and blood pressure meds. Please let my doctor decide my plan of treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fec5be	Stifle	None	2022-03-29T17:43:35Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Stifle, Michelle	l1c-dxbj-dzfh	False	None	False	2022-04-12 05:34:19.231	[]
3110	CDC-2022-0024-3116	https://api.regulations.gov/v4/comments/CDC-2022-0024-3116	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Who has the right to decide how much human pain and suffering is acceptable? The patient and their physician period not the CDC, which never had the authority to regulate medicines in the first place. The harms and lives lost due to the guidelines and lack of action from the CDC is unforgivable! The guidelines cleary have not decreased overdose deaths since prescribing is at an all time low while overdoses from illicit drug abuse rises. The only correct thing to do now is to REVOKE the guidelines entirely.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacqueline	None	None	0900006484fec6a2	Schneider	None	2022-03-29T18:02:03Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Schneider, Jacqueline	l1c-f1j5-fwfn	False	None	False	2022-04-12 05:34:19.473	[]
3111	CDC-2022-0024-3117	https://api.regulations.gov/v4/comments/CDC-2022-0024-3117	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Our patient care has been reduced to barbarism when it comes to pain control . It’s not even reasonable in this country. People that get biopsies , major surgeries are denied adequate pain control. My husband had a detached retina that went horribly wrong . He was in so much pain that he could not sleep for 4 days. His blood pressure was 190/100. Stroke level . It was finally determined his eye pressure was 86. The uncaring surgeons did NOTHING for pain control . It’s shocking they let him suffer like this without 1 pain pill . This is what our government has caused with their unreasonable rules! Shame on all of them ! It’s time to turn this ship and punish doctors that are this barbaric!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammie	None	None	0900006484fec6d2	Vuletich	None	2022-03-29T18:02:20Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Vuletich , Tammie	l1c-f428-pr82	False	None	False	2022-04-12 05:34:19.687	[]
3112	CDC-2022-0024-3118	https://api.regulations.gov/v4/comments/CDC-2022-0024-3118	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have periphial neuropathy, degenerative disc disease, spondylosis, rhuematoid arthritis and osteoarthritis and am 64 years old. I had been in pain management for 15 years and was able to function well. After ten years, I needed to increase the pain medication I was on, so my pcp referred me to a pain management doctor who managed me for the next five years. I was on a benzodiazaphine and oxycodone at the time and had been for 7 years. Pain management forced me to choose one. Since I had needed the pain management longer than the anxiety medication, I chose the pain medication. I was immediately taken off the anxiety medication and went through a horrible withdrawl. After five years of being treated, the doctor decided to wean me down to half the dose I was on (60MME to 30MME) and out of the blue dropped me completely citing she didn't have the resources to treat me anymore. I have spent the last year and a half barely functioning and utterly exhausted just trying to get out of bed and make it to my job. I rarely speak to anyone, including family, because I am too busy trying to convince my brain that I can carry on, but my brain keeps telling me back that I can't do it anymore. I tried medical marajuana after I was dropped, but that made my anxiety return with a vengance. My blood pressure is constantly way too high, even being on medication for it, due to the constant pain. I am unable to take anti-inflammatories due to having IBS and can't take acetominifen due to liver issues. I am unable to find any doctors willing to treat my chronic ongoing pain and have no where to turn. I long to return to the functioning member of society I once was. What these guidelines and the DEA have done to previously functioning and law abiding citizens is deplorable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fec6fb	Forster	None	2022-03-29T18:03:11Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Forster, Donna	l1c-fjjj-iphl	False	None	False	2022-04-12 05:34:19.904	[]
3113	CDC-2022-0024-3119	https://api.regulations.gov/v4/comments/CDC-2022-0024-3119	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired police officer in Central Florida. I was involved in a motor vehicle accident is a result of my employment as a police officer and suffered a traumatic injury during the accident. I lost my entire left leg including my hip and as a result I have been struggling with phantom limb pain ever since. <br/>It has been approximately 12 years since losing my leg and my phantom limb pain has gotten worse and has not gone away at all. I have been treated by two different pain management specialist and the thing that has worked for me in the past was opiates. Specifically Dilaudid helps with my pain but due to governmental regulations I cannot get an appropriate amount of pain medicine so I experience extreme phantom limb pain a daily basis. I have never been a person to use narcotics but due to this injury I have been forced to if I want to be free of pain. But as a result of the government coming down on opiates for people that abuse them I have been thrown into that mix and as a result I am being punished for the people that have abused the narcotics. My quality of life has diminished due to this governmental overreach and I am asking for help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacob	None	None	0900006484fec775	Bratten	None	2022-03-29T18:03:52Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Bratten, Jacob	l1c-g4t4-brgq	False	None	False	2022-04-12 05:34:20.121	[]
3114	CDC-2022-0024-3120	https://api.regulations.gov/v4/comments/CDC-2022-0024-3120	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am just an ordinary citizen, but an ordinary citizen that lives in chronic pain. Reading the proposed updated guidelines, I am shaking my head and baffled. I thought the updated guidelines were supposed to be an improvement of the 2016 guidelines, but they are far from that. An improvement to the guidelines would be something similar to what the state of Arizona just did with their new laws. They leave opioids to the discretion of doctors and patients, understand that a "one size fits all" approach to opioids cannot occur, and that there are so many reasons why a patient can have chronic pain and there is no time frame for this.<br/><br/>Right now, the best thing would be to remove the guidelines completely. I understand that this will not happen, so get doctors with clinical experience treating chronic pain to help write the guidelines. Remove any mention of specific conditions and a max MME equivalent.<br/><br/>As far as my experience, I was living a functional life with high dose opioids. I never failed a random drug test, and yet my dosage with cut down. I felt like I had no option but to get an intrathecal pain pump, so I did. This has exacerbated some of my pain locations and does not provide the same relief as oral or transdermal opioids provide. I have been in chronic pain since 2008. My dose was effective. Right now, I have days where I don't want to live. If I did not have children, I would have probably taken my life. The suicide rate of chronic pain patients is ridiculous, and the CDC is to blame. <br/><br/>Lastly, the new guidelines must restrict the DEA and other law enforcement from being able to prosecute good, compassionate doctors that are writing legitimate prescriptions for patients that need opioids. Yes, bad doctors need to be prosecuted, but they are prosecuted the good doctors as well and have scarred so many doctors into not helping patients. This has to end!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fec74b	Anonymous	None	2022-03-29T18:05:01Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-fwve-7gyq	False	None	False	2022-04-12 05:34:20.342	[]
3115	CDC-2022-0024-3121	https://api.regulations.gov/v4/comments/CDC-2022-0024-3121	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 cdc guideline have destroyed my life. I suffer in pain daily and have been on a forced taper even though I am no where near 90mme dose daily. You have scared the medical professionals away from caring for their own patients. Please consider people who suffer every single minute of every single day without pain relief. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fec7f0	Gottobed	None	2022-03-29T18:33:39Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Gottobed, Deborah	l1c-ghax-i6hl	False	None	False	2022-04-12 05:34:20.597	[]
3116	CDC-2022-0024-3122	https://api.regulations.gov/v4/comments/CDC-2022-0024-3122	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for accepting comments regarding changes to guidelines for prescribing opioids. I feel the 3-day limits are exposing people to unnecessary suffering and need to be changed. If you have ever had any kind of surgery, this limit would be adequate in very few instances. The entire policy seems to be affecting those who are responsible and dealing with on-going, life-long, chronic pain extremely negatively. The problem happening with opioids is with abusers, street users and not people who actually have chronic health problems. Yet, the 'good' people are the ones you are punishing. <br/>Prices have increased, availability has decreased and there are fewer and fewer pain management physicians available. This is very bad causing much suffering to those in need. We are not abusers! Prescribing guidelines that have us refilling scripts on the day or day after we run out is dangerous and you are putting people at great risk. What if a pill drops in the trash, down the drain, under a cabinet....which has happened to me multiple times? Vilifying those who need opioids is shameful and that is the position you have put us in at our pharmacies and in the general public. Not all meds uniformly require constantly increasing dosages and yet I feel that is how you are looking at this class of meds. Going after the abusers is fine but please bring your policies for responsible patients back in line. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patti	None	None	0900006484fec800	Mehaffie	None	2022-03-29T18:34:04Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Mehaffie, Patti	l1c-gnt9-dm2p	False	None	False	2022-04-12 05:34:20.832	[]
3117	CDC-2022-0024-3123	https://api.regulations.gov/v4/comments/CDC-2022-0024-3123	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a young 42 year old woman that has been diagnosed with a rare condition called Ehlers Danlos syndrome. In 2016 my Doctor Who was prescribing my pain meds suddenly stop my medication and was told I had to go to Pain management. I was able to get in to a pain management center but only to feel like I was a drug addict. I was forced to do urine test and pill counts on demand. I am limited in the care that I can receive and the medication that I can receive. I am not eligible for surgery as my doctor feels that it could hinder my symptoms even more. I do have a doctor now but he is limited on what he can prescribe me. I find myself in the winter needing more adequate care but can find no doctor that is willing to take me on as they consider me a complex case. I was even home by one pain management center that They will only prescribe Suboxone for pain management and that is not even FDA approved. I have three children oldest being 21 and a husband and I am on disability. I try to work when I can but again because I cannot get my paint managed correctly I’m only four to work less than part time. Before 2016 I was a US customs broker who worked full-time and beyond because I was able to get my pain control. We need to get rid of the MME and get rid of an all for one care. Doctors are more concerned now with being investigated than caring for their patients. The patient doctor care has been distrusted and many are now afraid to even speak to their doctors about proper pain management in fear of either being looked down on or get what ever little pain meds, taken away. We need individual care for each patient we all do not fit in the same box and should not be forced to be on the same level of care for each of are different.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrea	None	None	0900006484fec814	Ortiz	None	2022-03-29T18:34:24Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Ortiz, Andrea	l1c-gvng-sa52	False	None	False	2022-04-12 05:34:21.048	[]
3118	CDC-2022-0024-3124	https://api.regulations.gov/v4/comments/CDC-2022-0024-3124	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC:<br/><br/>The CDC appears to have been complicit in pain patients suffering needlessly, and often dying, over the past six years. The guidelines created in 2016 have made life nearly impossible for those of us living with chronic intractable pain. Some have taken to the streets, and died doing so, due to counterfeit drugs laced with fentanyl and other substances. Why were the guidelines changed, making doctors afraid to prescribe needed pain medication for their patients for fear of losing their medical licenses? Seems to me that it was somehow supposed to cut down on deaths but in truth it has actually increased them.<br/><br/>My diagnoses, limited to the main ones, are degenerative disk disease, along with four failed spine surgeries with instrumentation and five more surgeries due to infections I acquired in the hospital (never determined what, how or when), and fibromyalgia, though there are many others such as arthritis, osteoporosis, ankylosing spondylitis, stenosis, neuropathy, and more.<br/><br/>I have been in chronic pain for much of my life but it worsened exponentially after 1998 when I had my first spine surgery. Eventually it would become nine spine surgeries and other issues along the way. You don’t want me to go into all of my pain issues but I will include a letter below which I wrote to my insurance company in early 2018 when they refused to continue covering the prescription medications I had been using, and they had been paying for since 2001 or so. There is also a long list of rejected drugs that either made me ill or didn’t help with pain, many of them antidepressants prescribed off-label.<br/><br/>Unless they’ve experienced it no one can know how difficult it can be to live with pain every second of every day when you can’t handle or acquire any of the medications used to control it. So many opiates made me vomit violently so I refused to use them for many years, through every one of the many surgeries I’ve had in my lifetime, though I was accidentally given them several times and re-hospitalized due to severe vomiting. I only used Ibuprofen for all my surgeries because of my past experiences with pain medications. I feared trying any of them but a pain specialist finally told me about OxyContin in the early 2000s.<br/><br/>That pain management doctor eventually prescribed OxyContin, maximum at 280 mg daily, 80 mg 2x & 120mg 1x every 8 hours, concurrently with Diazepam to control any vomiting or nausea, maximum at 60 mg daily, 20 mg every 8 hours. I had been slowly tapering both with my PCP's assistance prior to the CDC's new guidelines but was forced to taper more quickly than recommended beginning in 2018, eventually to 10 mg OxyContin 2x daily and 2 mg Diazepam 2x daily. The forced taper of benzodiazepines sent me into withdrawal syndrome and the low dosage of OxyContin only twice a day barely touches my chronic pain. I continue to have difficulty getting a doctor to prescribe these much lower doses because my insurance company, and most doctors (my long time PCP retired in May, 2020), don’t want patients taking OxyContin and Diazepam together, or anyone taking an opiate that may help them. I’m now required to keep Narcan in my home in case I overdose on my small amount of medication, which would never happen unless it was intentional.<br/><br/>My doctor recommended six months time to taper from where I was to where my insurance company, and the CDC, wanted me to be. The insurance company denied his recommendation. No longer would I be allowed to take the dosages that actually helped with my pain. Now they didn’t want me taking an opiate and a benzodiazepine together, as I had been for over seventeen years. It somehow became a problem. There is much more detail in the attached letter, but this is patient abuse or neglect and has to stop.<br/><br/>My insurance carrier is Medicare as primary and [insurance company name redacted] as my supplemental.<br/><br/>Add to all this the fact that I live in a rural extremely medically underserved area and have had seven temporary primary care doctors in less than two years. It becomes nearly impossible to get my current prescriptions, as low as the doses are now, due to having no chance to gain the trust of doctors I only see for a few months at maximum, maybe only once ever. The stress of having to go monthly to our walk-in Clinic and ask for my prescriptions from a new doctor who doesn’t know me from a hole in the ground makes all of this much worse. I never know month to month whether I’ll be able to continue taking the small amount of medication I’ve been allowed over the past four years.<br/><br/>Thank you for your attention to this matter and please do the right thing. Make life livable for chronic pain patients.<br/><br/>Sincerely,<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484fe76b2	Lyford	None	2022-03-29T18:52:57Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-27T04:00:00Z	None	None	None	None	None	None	None	Comment from Lyford, Nancy	l1a-2sxy-1zrg	False	None	False	2022-04-12 05:34:21.263	[]
3119	CDC-2022-0024-3125	https://api.regulations.gov/v4/comments/CDC-2022-0024-3125	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am in pain every day, and have been for most of my adult life. Diagnoses include Post-Viral Syndrome (since 1995), Ehlers Danlos-Hypermobile type (lifelong), scoliosis, kyphosis, early-onset osteoarthritis, hip dysplasia, TMJ syndrome, collapsed arches, cervical instability.<br/><br/>For eight years I was able to function and have a little bit of a social life, thanks to 5 mg oxycodone, 3 times a day. I was on the same dose with no issues for eight years. It improved my functioning, allowed me to exercise, and gave me dignity and quality of life. <br/><br/>In 2019, the doctor stopped the oxycodone 3x/day, with NO TAPER, and switched me to 20 pills a month of hydrocodone 7.5, which is far less effective and a little bit sedating. The best I can say is they are better than nothing. But going from three pills a day to 20 pills a month is a huge change.<br/><br/>After the med change, my blood pressure began to rise, and became dangerously high after about six months of gradually getting worse. A cardiologist concluded (after 48 hours of monitoring) that my hypertension was due to "untreated pain." But no changes were made. Even on blood pressure medication, my blood pressure averages 180 over 100, every day. But the cardiologist's recommendation has fallen on deaf ears. I have to wonder how long my kidneys will last. (Is this not a violation of the Hippocratic Oath?)<br/><br/>Since 2019, I have had memory problems I'd never had before. I can no longer do simple arithmetic in my head, I have frequent issues with word recall, and struggle with dates and times. I am angry all the time, and have symptoms consistent with complex PTSD. I have flashbacks of the cruel doctor who destroyed so much of my life and peace of mind. I wake up at night, punching at the air (I have never punched anyone in my life!). I have stopped responding to friends and family (online and off) because I can't control my temper and can't carry on a simple conversation anymore. I gave up my driver's license because I no longer feel safe to drive. My home has become so cluttered. My autistic son dropped out of high school due to lack of support. My husband was so distressed at the loss of my formerly happy, more energetic self, that he stopped taking his diabetes and heart meds, effectively committing suicide.<br/><br/>The pain meds gave me some quality of life, in spite of my serious health issues, and enabled me to be a homemaker, an involved mother, and a loving wife. Losing the pain meds didn't just hurt me, it destroyed my family. <br/><br/>Opioid hysteria has made a cruel joke of the Hippocratic Oath.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484fec3d5	C	None	2022-03-29T19:30:17Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from C, Amy	l1c-hw3t-joo7	False	None	False	2022-04-12 05:34:21.484	[]
3120	CDC-2022-0024-3126	https://api.regulations.gov/v4/comments/CDC-2022-0024-3126	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The Guidelines should be taken away and destroyed. These guidelines have destroyed millions of lives. I am one of them who was functioning pretty good with some quality of life for 15 years while taking what the guidelines would consider a large amount of opioids. I was dependent on them but not addicted to them. I have one of the most painful genetic diseases you can have. The opioids allowed me to not go out of my mind in pain that never ends 24/7 365 days a year. Now my life is a living [profanity redacted] and because the government has gotten in between me and my doctor. I was left with no medication and had to find a clinic to get put on Suboxone, the worst medicine I have ever taken. The side effects were terrible. I now I've house bound in pain all the time. I moved to Florida in 2017 when Medicare cut me off my opioids. I thought my retirement was going to be nice, but in realityi am living in hell. Every doctor will not prescribe. You have them all so afraid of losing their neural liscences that none will prescribe. People going in for surgery are coming out screaming in pain because doctors will not control pain anymore. They are afraid of the DEA. When your guideline went out state laws were changed. It is barbaric the stories I am hearing. Even children have tonsils taken out with nothing but Tylenol. Mothers trying to stop their screaming so they do not split their stitches. What the hell happened to DO NO HARM ? I will not have any surgery unless I am dying. The boarders are letting Fentyl pour through. I thought the guidelines were meant to stop the overdoses not increase them. So now people are committing suicide, dying from overdoses when they go to the streets to get pain relief and opioids have been cut by 50% and people are avoiding needed surgeries because doctors are afraid to prescribe opioids. Now you get your medical files which were private being tracked. The lharmacist can refuse to fill a doctors prescription. When did pharmacists get their medical liscences? This whole guidelines and MMEs should be done away with. All it did was make the pharmaceutical company that makes Suboxone rich. The rehab centers are getting rich while our young and elderly are going around in horrible pain. Leave it to the government to royally screw it up. Looking for a fast fix, never taking into consideration the people who the opioids benefit greatly and allow them to work, have a family life and a quality of life instead of going on the disability rolls and having to have family members helping them when if they had their medicine they could fend for <br/>Themselves . I never asked to up my dose in 10 years when I was at the right dose. I did not loose pills or family steal them. I never sold them. Why should I be punished because other people just want to get high!! It's wrong!! Erase the quidelines and put the laws back to where they were. There was never a prescription opioid crisis!! Just PROP trying to run other peoples lives. I'm sorry for people who lost family to overdoses, but there is personal responsibility. No one forced their family members to take drugs illegally. Get rid if the guidelines and give us back our lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484fec3e6	Thomas	None	2022-03-29T19:42:05Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Lori	l1c-hz4b-6of1	False	None	False	2022-04-12 05:34:21.705	[]
3121	CDC-2022-0024-3127	https://api.regulations.gov/v4/comments/CDC-2022-0024-3127	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The words that replay over and over again in my head when I see anything related to the CDC are UNINTENTIONAL CONSEQUENCES, along with the faces of hundreds of Chronic pain patients family members faces after they announce the hastened death of their wives and husbands. I think they stand out the most because they were often still raising children at home with their spouses, the impact of losing a parent is a difficult one under the most benign of situations. Knowing that your Mother or Father had been actively vibrant, functioning and that most importantly they were there, apart of these children's lives. So what happened? Well Mommy or Daddy couldn't get their regular prescription pain medications either at all or the dose was cut or tappered to the point that life changed in big ways not for just one person but for many. But nobody is counting the numbers on the hastened deaths occurring from undertreated sever pain or lack of, because of a funny little trick in how death certificates list these deaths. You can find them most often under, Sudden Natural Death. Though I doubt that any of the family member would agree with that. Because their loved ones deaths were directly related to the published Guidlines written into laws. Countless numbers also committed suicide, and that when the announcement came of the unintentional consequences of the CDC guidelines. But, can we really call it unintentional anylonger? Surely not, and mabe the thinking is that the greatest wave of suicides due to sudden doctor abandonment and unwillingness to prescribe is over. However you have a whole lot of other issues of culpability to be conserned over. Such as being completely aware of the fact laws have been written based off these guidelines. The revision of them solidifies the fact that these are not simply misinterpreted guidelines made for primary care physicians only, and holds the CDC accountable for all foul harms of false imprisonment and wrongful death, and ofcourse will be accountable for the tourcher of possibility of millions rather than hundreds or thousands. In my minds eye the only way the CDC could save their reputation now is by Publicly rescinding the guidelines and admitting to its failure to properly ensure that and advisory panel was fair and equally represented by failing to ensure no conflicts of interest were at play. In particular because it's well known now by almost all that the CDC failed to provide documentations on numerous requests for transparency. So how should the American public feel about their own personal safty, all at the hands of their own country. Because reducing MME only causes greater harms than goods, and I question when positive patient outcomes failed to be Priority. And we as humanity cannot accept any cap on the MME threshold period because as even the CDC is aware no two people are similar in their healthcare needs. It's simply impossible to attempt to place a cap on the MME and I do not support the rational of this decision because it only looks at the one sided veiw without any attempt to truly document of discover how many people actually died prematurely due to untreated or undertreated severe intractable pain. This issue and all CDC guidlines need tossed out. Statistics show that where we need all DEA focus at this point is on the deadly fentanyl poisoning deaths that are killing record numbers and is only continuing to skyrocket while doctor related prescribing accounts for decades low. Again how to you measure risk vs benefits and with patients being informed of such dangers how do you justify the imprisonment of physicians. If you ask me everyone wants to pass the buck and it's easier to tear our country apart at its heart if YOU, the CDC, go forward and proceed with these guidelines. Guidlines that will continue to terrorize our physicians and chase them away from the feild of medicine and ultimately cause the collapse of our medical care infrastructure. Today's young people have access to information and technology, let's give them a chance to use it before our country becomes as some dystopian world where human life is no longer something considered to be precious and preserved. If the CDC will not rescind guidlines and make public apology to save their own reputation then at the minimum removed all wording suggestive of regulatory action, remove tappers or forced tappers and remove limits on MME. allow doctors to treat patients according to patient by patient basis because I have faith in their medical expertise. No MME THRESHOLDS! THANK YOU FOR READING MY COMMENT IN ENTIRETY AS I have the right to be heard in this democracy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Danielle	None	None	0900006484fec406	Mroz	None	2022-03-29T19:47:24Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Mroz, Danielle	l1c-if9z-hh83	False	None	False	2022-04-12 05:34:21.919	[]
3122	CDC-2022-0024-3128	https://api.regulations.gov/v4/comments/CDC-2022-0024-3128	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Will Doctors who were threatened by DEA with taking their medical licenses away ever be able to prescribe opiates again?<br/>As we all know it is difficult, if not impossible to secure another Primary Care Physician. Especially one to prescribe all previous prescriptions that worked for patients. For example patients successfully on both opiates with benzodiazepines. The patient had no severe interaction with the combination or of course addiction. That would have been documented in their medical records. One is a muscle relaxant and one is for pain. In my state Physician Assistants and Nurse Practitioners don’t practice as a single entity but with a Doctor. My family member faces this problem and a solution would be appreciated. Why aren’t tenured chronic pain patients who have been waiting for nearly half a decade to get their previous prescriptions back. Clearly they are not addicts. You don’t know their medical history. Too just assume every patient is an addict is ridiculous. This judgement is as preposterous as assuming that they can’t be on life saving benzodiazepines at the same time as opiates. Every person is unique with tolerance, metabolic rate and so forth. Just as a person who consumes anything else whether it’s food, alcohol, coffee, street drugs (the real opioid problem), prescriptions, OTC for example. You can’t make a blanket statement for a group of people. It’s archaic and cruel to punish non addicts. My family member has missed out on so much of life. Especially after what your guidelines have put her through since the hellacious 2016 opiates guidelines. Why should she be sentenced to bed. Why should I have to watch her suffer day in and out. Stuck in bed not of her own volition but from bureaucracy and control. Give chronic pain patients doctors the green light to go back to their previous treatment before the 2016 guidelines came into affect. I can’t bare to see my daughter fade away because she can’t be treated with her own previous prescriptions. You must stop playing God. I know my daughter has had it and I don’t blame her. You have no idea the loss and damage you have done to her and others like her. The suicide rates are scary for these patients. They don’t want to die. They simply can’t exist another painful, exhausting, stressful, non productive, lonely, never ending ground hog day. Her and others are in cruel pain, panic, no activities, no socializing, lost friendships, loss of careers, partners, no holidays/birthdays, not being able to physical take care of themselves because they are in not in control of their bodies anymore you are, so fix it now. You can reverse the myopic 2016 guidelines. They are loosing all hope with one option left. Do you just not care about “self euthanasia” by not treating documented, disabled patients with the respect and help that you give the actual addicts under your watch? How would you like to see your child or grandchild go through this?<br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gloria	None	None	0900006484fec885	Kennedy	None	2022-03-29T19:48:48Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Kennedy, Gloria	l1c-irxj-ds1x	False	None	False	2022-04-12 05:34:22.162	[]
3123	CDC-2022-0024-3129	https://api.regulations.gov/v4/comments/CDC-2022-0024-3129	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was taking three of the 5 mg opiods for many issues I was having. Being very athletic for years back in the 70s when we still ran on dirt most places, bb, gymnastics, softball, cross country etc. Plus fibromyalgia. I was doing okay, still had a nice life. Since I’ve been weaned off my pain pills, I spend 80% of my time in bed. I can’t travel, I order everything online to be delivered. I do nothing. No quality of life! My life had to be destroyed due to the illegal drugs running rampant in our streets. Do what’s right and weed them out of the statistics and get a real number! I hope someday you all in a position to be lied to about the pain being in your head, it doesn’t really hurt! Bull! <br/><br/>M	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484fec8a0	Knox	None	2022-03-29T19:49:52Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Knox, Stephanie	l1c-j447-rlnp	False	None	False	2022-04-12 05:34:22.379	[]
3124	CDC-2022-0024-3130	https://api.regulations.gov/v4/comments/CDC-2022-0024-3130	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop over-regulating people's medications. While I understand there's a crisis of opiate overdose & dependency, that's not a reason to create barriers between physicians and patient care. I have a degenerative disease (hEDS) that, ultimately, will require pain management. There is (presently) no other way to manage the agony of connective tissues shredding within our bodies. I watch my mother, who has the same degenerative disease, struggle to function in daily life (she's on permanent disability) due to a constant, agonizing level of pain. Her Fentanyl patch is what provides her a relative quality of life. It's already difficult enough for patients to manage highly regulated prescriptions, with the hurdles of insurance and payment and individual pharmacies. Many, my mother included, experience long gaps in their care due to these hurdles. Limiting what doctors can prescribe their individual patients creates an undue burden upon those who are already suffering enough for one lifetime. And, as addiction studies have repeatedly shown, restricting prescriptions is ultimately not a solve for addiction issues. What DOES work is providing social support systems and spaces for safe use – no one OD's when their drugs have to go through quality control, and folks don't become addicted in the first place unless they're trying to escape suffering. Please provide guidance reflecting these nuanced realities, criminalization only hurts everyone involved and is ultimately more expensive of a system to maintain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fec8c3	Anonymous	None	2022-03-29T19:50:07Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-j6zm-5vy6	False	None	False	2022-04-12 05:34:22.597	[]
3125	CDC-2022-0024-3131	https://api.regulations.gov/v4/comments/CDC-2022-0024-3131	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Chronic Pain Patient that lives in northeast ohio. I was on disability for almost ten years and now retired. All my health care needs have been by one of the two largest health care providers in northeast ohio. After years of being under there care , being monitored, drug tested and following all the rules a lost my pain medication without warning. The CDC started this misdirection in my opinion. They know street drugs are the real problem and at this point getting worse. Legit Patients with chronic pain trust there doctor and follow the rules. I am not addicted and never was. Along with taking pain medication as written did everything my doctors said I should do. Which I did! If a giant health care system says I need pain medication that should be enough. Even now the health care systems in northeast Ohio will not trust the CDC. The CDC has a major problem now. No matter what the new guidelines are going to be, Health Care no longer trusts the CDC or the FDA. Health Care Systems have turned there back on legit Patients that really need pain medication. They have decided the stop writing scripts for pain. PERIOD. Legit Chronic Pain Patients lose and suffer 24/7. And health care could care less at this point. The CDC needs to convince Health Care Systems to again help patients. The CDC started this MESS and they need to fix this major problem. I suffer from low back pain, L4,L5 and S1 damage. I suffer from a collapse wrist, I suffer from Hip Pain and my knees are bone on bone. I suffer 24/7 and now because of the CDC I go day by day with no pain medication. Its insane to be treated in this way. I call this medical care as if I'm living in the 1800's. Before losing my pain medication I was not 100% but I could do chores, wash my car, go shopping. Not any more! There are two giant health care systems in northeast Ohio and there afraid the write a prescription for pain medication. That includes Pain Management Doctors. They will see the patients, charge the patients and or the insurance companies but then send the Legit Patients back home with no pan medication. They only offer experimental treatment that cost hundreds of dollars which may help or not help the patients. Just like me, years ago my doctors agreed with me I should be taking pain medication. Im a baby boomer and at 67 years of age I want to be able to enjoy what's left of my life. The pain medication was working for me and it should be continued. The CDC has a problem on there hands, Convincing health care will be tuff. If the CDC really wants something to do, fix the Street Drug Problem in this country. The CDC's problem never needed to happen in the first place. There are millions of patients just like me that need there doctors help. But now there hands are tied. This is not health care its, insanity. I keep saying Legit Patients because if there not legit the Patients will not have MRI's and CAT SCANS to back up the reason there on pain medication in the first place. That's what makes a patient Legit. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bob	None	None	0900006484fec8cb	Schneider	None	2022-03-29T19:51:26Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Schneider, Bob	l1c-jank-r8cc	False	None	False	2022-04-12 05:34:22.834	[]
3126	CDC-2022-0024-3132	https://api.regulations.gov/v4/comments/CDC-2022-0024-3132	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to submit my comments for the disillusion of the CDC 2016 opioid guidelines and subsequent versions. I am the spouse of a chronic pain patient who was injured by a doctor with epidurals for pain, which are come to find out not a approved use on from the FDA or the manufacture. My wife has been injured for over 12 years now, and since the 2016 guidelines she went from able to hold a job,do house work,and work her horses to bed ridden. <br/>Your paper says for approx 30 pages that you recognize that your guidelines were misapplied and that it has caused severe issues. You then use cherry picked studies from anti opioid zealot doctors who state that their is no long term data for use of opioids. I assume that they are not fans of history because the use of opioids goes back to Sumerian times and used in a modern medical history since the 1790's. See this for a brief reference: https://www.yalescientific.org/2017/01/ancient-analgesics-a-brief-history-of-opioids/<br/>Your guidelines are criticized by the American medical Associations See attached but your agency and the members of PROP were quick to discredit this opinion. <br/>I have worked in public safety as a police officer,paramedic,and firefighter for over 20 years, I have been exposed to illicit fentanyl by skin contact but since it has a long absorption time and needs a catalyst I was able to wash off, on the flip side I've used in the back of an ambulance via an IV and had a drop hit my lip and worst thing that happened was I had a bit of anxiety, naloxone was not needed like the propaganda videos put out by police departments happened, these stories have been debunked by many doctors and and professors of law and medical sciences.<br/>These guidelines have been the cause of more then six(6) friends who served this country in the wars in the middle east who were injured by IED to commit suicide due to the uncontrolled pain and your policies becoming laws and the VA adapting them as such, another example I can give is my friends mother who had survived Hiroshima and at 88 years old developed numerous health issues and various forms of cancer and was denied pain care in hospice because she may get addicted, she died in bloodcurdling agony screaming, crying and eventually had a heart attack from the pain. How is this exceptionable? the answer is it's not. My wife is 42 years old we lost the ability to have children,have a life outside of her cave (aka her bedroom) we have to sleep in different rooms so my night movements don't cause her pain or if she is in sever pain in crying in a ball saying over and over this will go away only to pass out, she has gained over 125lbs since the start of this due to pain, she has drop foot, spondilitus, failed back surgery syndrome. She had a spinal cord sitmulator implanted since 2013 and it does little to help it also messes with her heart if she uses it on a setting that gives some minor relief. <br/>The CDC should not have purview over this issue that FDA should and their is only 2 drugs they don't set hard limits on insulin and opioids. The CDC's involvement under the guise of public health crisis is very shady especially since when PROP approached the FDA about this agenda in 2012 they were told no. The CDC charter is "Description of Duties are as follows below<br/><br/>The committee activities may include providing advice and guidance to the Secretary, HHS; the Director, CDC; Deputy Director, DDID, CDC; the Director, NCEZID, CDC; and the Director, DHQP, NCEZID, CDC, on the development and evaluation of healthcare infection prevention and control guidelines and guidance; the development of policy statements regarding the prevention and surveillance of healthcare-associated infections and healthcare- related conditions; and new and updated surveillance methodologies related to healthcare- associated infections" per their web sight. When an actual issue under their charter came to fruition ie the Covid-19 pandemic they passed the buck to the National Allergy Foundation who's charter is as follows <br/>"The National Institute of Allergy and Infectious Diseases (NIAID) conducts and supports basic and applied research to better understand, treat, and ultimately prevent infectious, immunologic, and allergic diseases" https://www.nih.gov/about-nih/what-we-do/nih-almanac/national-institute-allergy-infectious-diseases-niaid <br/>The CDC needs to remove it's self from this subject matter period. <br/>The war on illicit fentanyl and drugs is a job for the US Customs and border protection, my wife's prescription is not the cause of people getting laced or counterfeit drugs. I will end with this DARE was created by former first lady [name redacted] to combat the war on drugs and to teach kids about the danger of them, what it actually was teach them about what the drugs would make them feel like, the program now as changed from drugs to bullying and is not affiliated with law enforcement. <br/>Don't punish pain patients with made up system of "MME"	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fd7217	Hull	None	2022-03-29T19:52:07Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-21T04:00:00Z	None	None	None	None	None	None	None	Comment from Hull, John	l10-wlqi-tw4c	False	None	False	2022-04-12 05:34:23.050	[]
3127	CDC-2022-0024-3133	https://api.regulations.gov/v4/comments/CDC-2022-0024-3133	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We at National Spine & Pain Centers are the largest group of affiliated interventional pain management physicians in the world. First, we want to thank you for the opportunity to review the proposed guidelines. Attached is a letter with our commentary. Second, we have attached early claims data that we believe shows a trend of benefit and value of interventional pain management. We remain available to discuss further if it would be of benefit. Thank you for your efforts and time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ketan	None	None	0900006484fe17d4	Patel	None	2022-03-29T19:54:00Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-24T04:00:00Z	None	None	None	None	None	None	None	Comment from Patel, Ketan	l15-pj7y-6zla	False	None	False	2022-04-12 05:34:23.292	[]
3128	CDC-2022-0024-3134	https://api.regulations.gov/v4/comments/CDC-2022-0024-3134	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fe3476	None	None	2022-03-29T19:55:38Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Montgomery County [Ohio] Community Overdose Action Team, Prescription Branch	l16-lk9z-3ljs	False	None	False	2022-04-12 05:34:23.512	[]
3129	CDC-2022-0024-3135	https://api.regulations.gov/v4/comments/CDC-2022-0024-3135	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	wow, what a poor guideline. fails to address interventional options available. also, takes no responsibility for putting out the first, poorly written guideline that has caused significant problems for people with legitimate pain issues. <br/>you should be more forward thinking this time around. <br/>Pain management physicians are a resource that you have completely ignored. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	gene	None	None	0900006484fe9793	mahaney	None	2022-03-29T19:59:29Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from mahaney, gene	l1b-77k6-y4y1	False	None	False	2022-04-12 05:34:23.727	[]
3130	CDC-2022-0024-3136	https://api.regulations.gov/v4/comments/CDC-2022-0024-3136	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your new regulations regarding opioid prescription are appreciated, but fall far short of where they could/should be. As a practicing Pain Management physician of over 35 years, I have a great deal of experience treating patients with pain. The biggest tools we have are Interventional Pain treatments. They have the power to rapidly find and treat the acual source of pain, getting the patient back to their lives BEFORE they need opioids to treat escalating and chronic pain. With pain, we need to act fast, not slow with good treatments! Not just pain pills! This keeps people off opiods and it is unfortuanately not put forward in your new guidelines. This is not right. It's bad medicne. <br/><br/>I have attached a more formal letter wich goes over these issues more cogently. Thank you for your attention.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mayo	None	None	0900006484fe9e7c	Friedlis, MD	None	2022-03-29T20:13:02Z	None	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from Friedlis, MD, Mayo	l1b-frbe-7o2w	False	None	False	2022-04-12 05:34:23.942	[]
3131	CDC-2022-0024-3137	https://api.regulations.gov/v4/comments/CDC-2022-0024-3137	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have attached our comments regarding the proposed CDC guidelines. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fe9f49	None	None	2022-03-29T20:15:26Z	National Spine and Pain Centers	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-28T04:00:00Z	None	None	None	None	None	None	None	Comment from National Spine and Pain Centers	l1b-hd25-roo5	False	None	False	2022-04-12 05:34:24.157	[]
3132	CDC-2022-0024-3138	https://api.regulations.gov/v4/comments/CDC-2022-0024-3138	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484feb8b5	None	None	2022-03-29T20:18:57Z	Restless Legs Syndrome Foundation	None	1	None	2022-03-29T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Restless Legs Syndrome Foundation	l1c-85f1-ccoy	False	None	False	2022-04-12 05:34:24.400	[]
3133	CDC-2022-0024-3139	https://api.regulations.gov/v4/comments/CDC-2022-0024-3139	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 51 year old female. I was thrown from a vehicle in 1995. In 2012 I went through 7 back and neck surgeries. My neurosurgeon who did my surgeries retired in [month redacted] of 2021. I broke my foot a spiral fracture after not having my medication. I have severe degenerative disc disease, spinal stenosis, narrowing of my spinal cord, and also menieres disease. I broke my foot bc I didn’t have the right medication for my Ménière’s disease. I’ve been to 3 drs since my neurosurgeon who was prescribing my medication for all of my diseases. I recorded the last conversation I had with the dr so that people could see how we are treated. Dr. [name redacted] in the [city redacted], Texas I have him recorded he refused to give me the medications I need unless I try a non fda approved injections. I said no he said there’s nothing he can do for me. I broke my foot and received no pain medication I had surgery on my foot the dr who did the surgery did not give me any pain medication. I have not left my house since Christmas because I have no quality of life. My pain is being untreated and drs are abandoning their parks because of the stringent opioid guidelines set by the cdc. I can’t do things with my family I can’t live a normal life bc of the cdc guidelines and drs not treating patients. The government has taken my life away!! I HAVE NO LIFE!! TAKE AWAY THESE BARBARIC GUIDELINES! I want my life back. There are so many of us suffering because of the government’s over reach. By the way this is my second time commenting because you guys are wiping comments. I have copied my comments and if I do not see it. I’m going to find an attorney. This has got to change you are killing people and do not care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suzanne	None	None	0900006484fec628	Mitchell	None	2022-03-30T14:45:24Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell , Suzanne	l1c-eako-wo35	False	None	False	2022-04-12 05:34:24.615	[]
3134	CDC-2022-0024-3140	https://api.regulations.gov/v4/comments/CDC-2022-0024-3140	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 Opioid Guidelines have destroyed my life, lead to my current excruciating quality of life today, lead to my current incapacitation, and risked my death numerous times. The updated guidelines don't do nearly enough to rectify the countless errors in the original document, but additionally do absolutely nothing to undo the State laws and mandates based on the 2016 document. This makes changes to the original document, positive or not, completely moot because States have no incentive to implement them.<br/><br/>I suffered an adverse reaction to a medication in 2011 at the age of 21 which lead to excruciating and constant facial pain. Despite numerous doctor and neurology appointments, nothing could be found at the time as a source of my pain. I was given the diagnosis of "atypical facial pain." My pain was so constant and severe that I barely slept, couldn't function, and within weeks became suicidal. I was referred to pain management where after trialing dozens of non-opioid medications to zero effect, was given a short acting opiate equivalent to 45 MME's/day. This saved my life. I was able to pursue my career again. I was back to being a normal, functioning life. I got married to my soul-mate. I never once abused my medication. I don't drink, have never done street drugs or marijuauna. I cleared every urine test, and never required an early refill. I was stable for nearly 10 years. Never needed a dose increase. All was well, that was, until I had a manic/psychotic episode at the age of [redacted] and received the diagnosis of bi-polar disorder. <br/><br/>At this point, I had been completely off of my pain medication for nearly a year. My facial pain had died down to a manageable level that I could deal with on a day to day basis. During the course of my treatment for bi-polar however, I was prescribed an anti-depressant. This anti-depressant triggered my facial pain reaction the exact same way as in 2011. I was in excruciating pain again, at an 8-9, and within days became suicidal. I went to the ER. After 3 hours of being curled up in a ball on the floor, the doctor gave me one 5mg dose of hydrocodone. This did absolutely nothing. Because I was suicidal, they decided to hold me over night. But the reason I was suicidal was because I was in so much pain: and I was being refused pain medication. I was held for nearly 36 hours, forced to sleep on a wooden bench in a hallway with 50+ other people in the middle of a COVID outbreak. The next day, I was just as suicidal, but because I knew I wasn't going to be treated for my pain, I lied to the doctors and said I was feeling much better so I could be discharged.<br/><br/>It is a miracle that I didn't leave the hospital that very moment and kill myself. My situation was particularly severe because the stress from the pain triggered a manic-depressive episode. The next day I traveled back to my childhood home in California and was able to get an apt with my old pain doctor who prescribed my exact same dose and meds from 10 years ago - 45MME of a short acting opiate. Again, this saved my life. My pain was controlled. My manic-depressive symptoms passed because I wasn't dealing with the stress of constant pain, and the addition of a new mood stabilizer did wonders. But a couple months later the NP I had worked with for years told me that because of "the complexity of my situation" I needed to see the attending doctor who was new and had just taken over the practice. He said he was uncomfortable prescribing me opiates, and gave me a time-limit that I would need to find a new doctor to take over. The one in my network had a policy of not prescribing opiates to new patients. No other facilities in my area even had openings to see me. <br/><br/>After the doctor told me this I had 3 more severe psychotic/manic episodes because of the stress of having my medication taken away and the prospect that my pain would go uncontrolled. I was constantly suicidal and close to killing myself. I eventually ended up with a doctor who doesn't even practice pain management and am now being treated for "opiate use disorder," despite never once abusing or misusing my medication and being a perfect patient. I am now labeled an addict in the medical system, and this diagnosis will follow me for the rest of my life. In the course of this my wife of 10 years left me. The side effects from the buprenephrine for me is severe depression, which is layered on top of my bipolar disorder. <br/><br/>My wife of 10 years left me 6 months ago. I was forced off my medication without consent because no etiology could be found for my pain and I'm bi-polar. This is the definition of discrimination. Yesterday at a neurology-specialist apt I learned that due to a childhood fall where I hit the back of my head, I have been living with post-concussive syndrome my whole life. My vestibular system does not function, and I have brain damage to systems which explain my psychiatric and pain disorder.<br/><br/>I have one word for everyone involved with this: SHAME	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Spencer	None	None	0900006484fec97e	Andrews	None	2022-03-30T14:57:44Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Andrews, Spencer	l1c-k7th-yt04	False	None	False	2022-04-12 05:34:24.859	[]
3135	CDC-2022-0024-3141	https://api.regulations.gov/v4/comments/CDC-2022-0024-3141	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2015, the CDC proposed guidelines for pain management. They were written in secret. We were given 48 hours to comment on them. No pain patients or pain specialists were included in the panel of “experts”<br/>PROP attempted to<br/>Limit opiate dosages through the FDA and were rejected because of lack of evidence for their proposal.<br/>The cdc never ever managed opiate doses or prescribing in the past. Sadly, and unscientifically,<br/>The guidelines came out despite considerable protest from those of us in the field.<br/>We predicted exactly what happened: severe restrictions on treatment of Legacy pain patients. Since these ill-advised departures from CDC‘s usual lane of infectious disease management and epidemics, catastrophic results have occurred.<br/>The CDC has no business, and no expertise, in the management of chronic pain, neurology, addiction. CDC has damaged its integrity and reputation by branching into this area, and doing so with out competence or expertise.<br/>It is now proven that the CDC guidelines have benefited no one, and created great harm.<br/><br/>Doctors have been driven out of practice, incarcerated, and quit prescribing all together. This has led to a wasteland in pain management in my state of Montana as well as the rest of the country.<br/><br/>When I was forced to stop prescribing for opiate refugees, six of them died. <br/>There’s no evidence that anyone has been saved from addiction by these draconian actions. I no longer even believe that these mistakes were well-meaning.<br/>Follow the money. The end result of these guidelines has been increased overdoses and overdose deaths. There’s been an increase in harmful invasive procedures for desperate patients who could no longer get their pain relieving medication‘s. There’s been an increase in suicides. And of course there’s been an increase in enrollment in unproven rehabilitation programs for people who are in chronic pain.<br/><br/>Revoke these harmful guidelines. <br/>Initiate congressional hearings as to how this criminal travesty of harm occurred for millions of legacy pain patients. <br/><br/>As a reference please consult the Institute of medicine report on pain in America from 2011. In that report it was determined that over 100 million patients are in pain in America at a cost of $625 billion.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484fec9bb	IbsenMD	None	2022-03-30T15:21:41Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from IbsenMD, Mark	l1c-kt7i-a4xs	False	None	False	2022-04-12 05:34:25.077	[]
3136	CDC-2022-0024-3142	https://api.regulations.gov/v4/comments/CDC-2022-0024-3142	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient with anxiety from PTSD for many years. I now have been taken off of opioids and benzodiazepines. I suffer with pain and panic attacks daily. I have been offered only depression medication after years of successful use of opioids and benzodiazepines. I have been suicidal for over a year and not one depression medication has worked. Stop punishing pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doreu	None	None	0900006484fec9c4	Marshall	None	2022-03-30T15:22:02Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Marshall , Doreu	l1c-l4id-n8te	False	None	False	2022-04-12 05:34:25.303	[]
3137	CDC-2022-0024-3143	https://api.regulations.gov/v4/comments/CDC-2022-0024-3143	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain in my neck, back, and knees.<br/>My neck was broken in a car accident 51 years ago. I have a cervical spine fusion in levels 1-4. The adjacent disks and vertebrae are degraded and arthritic.<br/>My back has ruptured disks and has bone to bone contact.<br/>Both knees have full prosthetic replacements that are degraded and painful.<br/>I take Norco which contains hydrocodone. I am currently allowed only two pills per day. Some years ago, I was allowed three pills per day and felt much better. The level of pain prevents me from sleeping. I get only four to five hours of sleep each day.<br/>I have tried many other types of pain medication and therapy without success and some with unacceptable side effects. Norco works best for me. Between doses the pain can become unbearable.<br/>I suffer from pain off & on every day. I walk carefully with a walker and wear a neck brace. I use heat and cold packs to try and cope with the pain. My muscles get tight from the pain and make it worse.<br/>If the opioid prescribing guidelines were relaxed, allowing my Norco prescription to be increased from two to three pills per day, it would greatly help to reduce my pain to a tolerable level. As is, I suffer every day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Audrey	None	None	0900006484feca0e	Litz	None	2022-03-30T15:23:02Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Litz, Audrey	l1c-m42p-fqv8	False	None	False	2022-04-12 05:34:25.543	[]
3138	CDC-2022-0024-3144	https://api.regulations.gov/v4/comments/CDC-2022-0024-3144	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ll start with, I personally researched Suboxone and asked my doctor what he thought about trying it. He agreed we could and FALSLY labeled me an addict. I could not take the medication. So, there I was. I’m almost completely bed bound. I’m honestly tired of having no quality of life. I haven’t had for about 4/5 years now. <br/>I watched my husband actively dying of small cell cancer in withdrawals because “they didn’t want to suppress his breathing”. BS… <br/>I watched my daughter scream in pain, begging God to take her out of her misery after palliative care dropped her from pain meds because her ex called to tell them she was selling her meds… he was mad because she caught him trying to get into her meds and she kicked him out. My daughter was never asked for a pill count or anything else. <br/>I probably won’t survive this pain myself. My grandchildren have got me this far. But, with that said. I’m no grandma. I’m in too much pain to be anything to anyone. <br/>This crap “war on drugs” has not hurt ONE addict. It’s killing those of us who need it because when the pain becomes too much. We are ending our lives. There’s a lot of blood on your hands people. <br/>Stop punishing those of us who have NEVER failed a drug test. Never failed a pill count. Those of us who actually NEED pain meds to function as a half normal human DO NOT ABUSE our medication. It helps us LIVE. <br/>I honestly pray non of you people ever live through what we are forced to try to live through. Keep protecting addicts, do some REAL research on addiction and please stop killing the rest of us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484feca5e	Hamilton	None	2022-03-30T15:29:52Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Hamilton, Denise	l1c-mwvo-dcm7	False	None	False	2022-04-12 05:34:25.762	[]
3139	CDC-2022-0024-3145	https://api.regulations.gov/v4/comments/CDC-2022-0024-3145	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would just like to say that I was receiving a higher dose of opioids for chronic severe pain for many years for multiple severe orthopedic injuries and conditions, and got a very good theraputic treatment from the opioid medications. I took them just as prescribed by the doctor, I never had any problems or overdoses, I did have some mild constipation that was easily controlled by laxatives and stool softeners. I am still being treated by opioids for chronic severe pain syndrome, however due to the guidelines being changed some years ago my dosage was reduced by one third very abruptly and the control over my chronic severe pain was greatly reduced causing my quality of life and ability to function to be greatly reduced. I have to lay down more often in the daytime and my stress level stays on a higher level daily. I feel that it was very unfair to have my dosage reduced because I had no problems tolerating the higher dosage and had a much better quality of life! I do not believe a one size fits all is appropriate, and as long as a patient is working closely with the doctor and taking them as prescribed and is cooperative they should be able to receive the correct dosage that is right for their pain level! Sincerely [initials redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R	None	None	0900006484fecdaf	C	None	2022-03-30T15:31:42Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from C, R	l1c-n903-u4re	False	None	False	2022-04-12 05:34:25.981	[]
3140	CDC-2022-0024-3146	https://api.regulations.gov/v4/comments/CDC-2022-0024-3146	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, however:<br/><br/>This draft fails to address chronic conditions like RLS that differ from chronic pain. <br/><br/>Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I suffer from RLS, and it is tortuous. This is not hyperbole. Imagine you are tired, even dead tired, and ready to go to sleep. Just as you start to drift off, you feel an electric-like tingling in your knees. You try to ignore it, but it quickly grows in intensity and spreads to your thighs. You fight the sensation but you cannot win. You are compelled to move, and your legs jerk hard, bringing you fully awake. The movement ends the tingling and brings immediate relief. Just as you drift off again, the tingling starts again, building until it compels the leg jerks, relieving the urge just long enough to drift off again. The cycle repeats, ad nauseam.<br/><br/>Thank God, I am currently able to control my symptoms with a medication (Pramipexole, not an opioid) that helps immensely. The catch-22 is that it simultaneously worsens the symptoms through a process called augmentation. Augmentation requires higher doses, which in turn further worsen the symptoms. At some point my medicine will stop working altogether at any dose. I live in fear of that eventuality.<br/><br/>To be clear: I am not talking about a few nights' of poor sleep. The suffering is torturous and prolonged. RLS deprives me of the sleep I need to function effectively. It impairs my judgement and motor control. It has hindered my job performance and career advancement. It has affected my parenting adversely, as well as my physical and mental health. <br/><br/>I dread the day when my medication loses its effectiveness. I am especially frightened because alternative meds that incorporate low-dose opioids will be denied by the guideline you are now considering. If that day comes and I have no legal options, you will leave me no choice but to buy illegal drugs. I will lose the safety of the legal pharmaceutical system, and it will put my health and life at risk. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Malcolm	None	None	0900006484fecef6	Montgomery	None	2022-03-30T15:41:21Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Montgomery, Malcolm	l1c-qhe3-bd3z	False	None	False	2022-04-12 05:34:26.198	[]
3141	CDC-2022-0024-3147	https://api.regulations.gov/v4/comments/CDC-2022-0024-3147	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please lift this so we can have lives again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carrie	None	None	0900006484fecefd	Worrell	None	2022-03-30T15:41:30Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Worrell , Carrie	l1c-qm7u-l4fl	False	None	False	2022-04-12 05:34:26.449	[]
3142	CDC-2022-0024-3148	https://api.regulations.gov/v4/comments/CDC-2022-0024-3148	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE suspend any rules or guidelines regarding chronic pain treatment.<br/>I'm 59 years old and I've been managed successfully for over 20 years with opioids. I had a significant traumatic injury to my spine with multiple surgeries and would not be able to work and have a life without pain medicine. I've tried so many other things. Injections epidurals two spinal cord stimulators nothing has worked as well as medication management. The right medication opioids help relieve some of the brain pain that's affected by chronic pain..<br/>. I can't say enough since these guidelines came out and the havoc it is played.. I've lost pain doctors that just no longer will prescribe opioids, I've had difficulty in finding and still having difficulty finding in a new PM doctor..I beg you for the chronic pain community. We are feeling so desperate having to manage this pain on our own, feeling so lost and desperate there's no access to help <br/>I've Been working at the same job for 15 years. Even though I'm permanently disabled. I work part-time with special needs adults. My function level has done well with opioids and there is never been a problem until these last few years. Please suspend these guidelines The problem is that people are taking their lives trying to Manage pain on their own is is just too much to bear.. I attached a copy of my neck from the surgery in 2020. That's just a portion of my spine. The other is fused at another level. I've done so, so well with opioids treatment, my life has gone down hill since the CDC, DEA and other groups tried a one size fits all with medication management, which doesn't work!! <br/>PLEASE, please remove this!! Thank you kindly for hearing me out	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fecf17	Anonymous	None	2022-03-30T15:43:08Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-qfuj-wxyv	False	None	False	2022-04-12 05:34:26.665	[]
3143	CDC-2022-0024-3149	https://api.regulations.gov/v4/comments/CDC-2022-0024-3149	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please please help with this . It is so detrimental for patients who are living with chronic debilitating pain. I personally not be here if they lower the MME. It is so important for us .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fed0dd	Anonymous	None	2022-03-30T15:45:47Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-v5m2-14yc	False	None	False	2022-04-12 05:34:26.886	[]
3144	CDC-2022-0024-3150	https://api.regulations.gov/v4/comments/CDC-2022-0024-3150	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for reviewing. <br/><br/>The 2016 guidelines have been grossly misapplied. Just the other night, the news stated, "the opioid crisis was caused by the over prescribing of opioids". If overprescribing caused deaths, look what UNDER PRESCRIBING has caused, even higher number of opioid deaths and suicides so far. <br/><br/>I've been a patient in the same pain management clinic since 2014 and have seen first-hand the damage the crackdown has caused the pain community, my friends, and myself. Those of us in pain management have been blamed for the opioid crisis, humiliated, and treated like drug seekers at every point in the process. Many of us have been made to feel shamed for needing medication in order to be able to carry out basic physical day to day activities needed to survive. <br/><br/>Pain Management Clinics have become drill mills and push shots and injections. Since 2014 I've had a minimum 4 injections EACH year (epidurals and/or nerve blocks). I've also done the spinal cord stimulator trial which did not work. (Because my back curves and twists, the doctor was unable to put both leads for the stimulator in my back and it would not stay in place for the trial.) These procedures are VERY expensive, and I have a huge outstanding balance with the pain clinic. However, because I do not want to be cut off my opioid therapy, I continue to get the shots even though the pain relief from them is short lived and minimal at best. (I ended up having back surgery which corrected some of the issue but not all.) These doctors are making a lot of money off our suffering pushing these EXPENSIVE procedures under the guise of "opiate free therapy" and "Interventional pain management." If these procedures help some people, great, but to push these on people because they are in pain is wrong. Doctors do not make money writing scripts, so they push these expensive procedures and hide behind the CDC guidelines. <br/><br/>In addition to the pain clinics expensive injections, and due to the strict guidelines, there are also the mandatory monthly office visits and degrading drug tests, I spend more time, and money treating my pain than my overall health. The current system is really pushing low-income people to the streets. <br/><br/>The damage from the guidelines have already been done and it will take years to undo. The guidelines need to be rescinded especially the MME equivalent. The MME has become the gold standard and doctors use this to deny, lower or not increase the amount in fear of getting in trouble with the DEA. For those in long term pain management, once they are at the top end of the MME, they will stay on the same medication level for years, this could to 5, 10, 20, 25 etc. years or even more. This is unacceptable and should be based on the patient, their unique individual medical condition and tolerance level. What works for some people, may not work for others. When you have cookie cutter guidelines, set a limit (MME) or try to advise how many pills or what should be tried first, the people who fall outside the norm will suffer. <br/><br/>Since the 2016 guidelines, primary care doctors, clinics, hospitals and even rehabilitation centers have drastically cut back or discontinued prescribing opioids all together. This practice is harmful to the community because people still experience pain for multiple issues and want, need and deserve relief so people are forced to look elsewhere. There are patients INSIDE hospitals, nursing/rehab looking for people outside to bring them something for pain while they are in the hospitals. This should alarm everyone. Until things improve and my pain will be treated adequately, I will not have a surgery unless it's truly life or death. <br/><br/>Pharmacies misapplied the guidelines and have added to the crisis by refusing to fill prescription. They are some of the worst at making you feel like a drug seeker. I have seen them deny filling a script because someone went to the emergency room several times in a year and the pharmacist said it looked like the person was just trying to get drugs, which was not true, the person had kidney stones and was on Medicare and did not have a primary care doctor. Other excuses I've heard from pharmacies, we don't fill that doctor's script, we don't fill within so many feet of a pain center, we only fill opioids during certain hours, we can only fill so many per day and we are out. Pharmacies really need to be held more accountable when they do not fill a valid opioid prescription because if someone cannot get the medication, what options are left for that person? <br/><br/>The 30 day only script writing needs to be reviewed as this can causes gaps, and needless suffering. Life happens; what if you can get the script filled on day 30th. Any other medication, you can fill a day or two early so you do not run out. It should be the same for opioids. Just one day early can help ensure there are no gaps and prevent people from running out and going to the streets. <br/><br/>Thank you<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484fed0f0	Starling	None	2022-03-30T15:49:57Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Starling, K	l1c-uyw7-l9u9	False	None	False	2022-04-12 05:34:27.099	[]
3145	CDC-2022-0024-3151	https://api.regulations.gov/v4/comments/CDC-2022-0024-3151	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 63 year old female who has suffered sever chronic pain since 2003, from conditions and injuries prior to and following an automobile accident. I will spare readers a list of conditions and the vast number of treatments I have undergone since treatment began in 2003, however opioid pain medication has been and has remained the only consistent form of treatment that has enabled me to live somewhat comfortably. Prior to the CDC Opioid Prescribing Guidelines was published in 2016, my Primary Care Physician referred me to a Pain Specialist who in the beginning continued my pain medication as it had been prescribed for 15 years. Once the CDC Guidelines were published, like so many pain patients, my medication began to be tapered drastically. Since my medication has been tapered, I’m bedridden 90% of the time. My days are tearful and I am overcome with debilitating pain. I’ve felt isolated and abandoned by the medical community and my government, namely the CDC. If you have never experienced long term chronic pain that is resistant to conventional treatment, you have NO IDEA what it is like to live in pain that renders you unable to function. We’ve already given up every aspect of our lives that has meaning and brings joy and self esteem to life. To give up my only form of relief is unbearable. You and others who comment about limiting opioid pain medication to 50 and 90 MME as a form of treatment for people like myself, have no idea the despair you are inflicting on citizens of this country. Without knowing me or review of my medical history you have rendered me unworthy of a satisfactory existence. I, along with the vast majority of chronic pain patients have NEVER abused opioid pain medication. But you know that. I’m all for treating people who become addicted and abuse opioid medication. We need to spend more time and attention making it easier and affordable for those individuals to get the help they need. We need more rehabilitation facilities, treatment centers. We need special programs for young people who take pain medication for the first time after injuries and surgeries, to educate and assist stopping opioid medication when necessary. But to use chronic pain patients like myself and so many as a way to end the so called opioid epidemic is not the answer. It’s time to give doctors back the privilege of prescribing opioid medication in adequate doses, to responsible patients! Please listen to the millions of pain patients who desperately seek your consideration in this request. I beg you to give us our quality of life back!<br/><br/>You state in the 2016 CDC Opioid Prescribing Guidelines that the MME restrictions were “recommendations” and were intended for Primary Care Physicians yet your restrictions were enforced across the board, to ALL doctors! This went outside the intended influence of the guidelines. It’s taken the CDC 6 years to make a statement suggesting that doctors went to far to cut patients off cold, or rapidly reduce opioid medications, causing great harm and unnecessary distress to opioid patients, this is UNACCEPTABLE! It caused suicide, untold harm and devastating withdrawal that should NEVER have been allowed to happen! <br/>Please eliminate the MME restriction language in the 2022 revised guidelines. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annette	None	None	0900006484fed506	Badger	None	2022-03-30T15:51:26Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Badger, Annette	l1c-vkfy-rtq9	False	None	False	2022-04-12 05:34:27.337	[]
3146	CDC-2022-0024-3152	https://api.regulations.gov/v4/comments/CDC-2022-0024-3152	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi My name is [redacted] a Certified Peer Recovery Specialist. I work with individuals that have been directly affected by the opioid addiction. I to suffered for over 22 years in active addiction and I am now 6 years free from all substances. I feel like it should be up to the doctors to prescribe how the feel necessary because all the restrictions in the world is not going to stop someone who is addicted to opioids from finding them on the street. Our streets are over run with fentanyl which is way more dangerous than a pill ever thought about being. When if I ever need pain pills again I hope I have gained enough tools in my recovery to take them for the time I have to and ask for guidance while doing so. If anything should be done is to give more money in grants to help with the epidemic for the workers who are here with there boots on the ground fighting this disease everyday. So the state boards can give us more money to stay in the field. When we are working short staffed. Please allow the doctors to do what they need to do to help people and do more for people who work in substance abuse. Those are the real problems at hand coming from both sides of this problem. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Crystal	None	None	0900006484fed54d	Songer	None	2022-03-30T15:52:33Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Songer, Crystal	l1c-wd63-2c32	False	None	False	2022-04-12 05:34:27.573	[]
3147	CDC-2022-0024-3153	https://api.regulations.gov/v4/comments/CDC-2022-0024-3153	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024<br/><br/>I never seem to have the right words to say when I come into my doctor's office so I decided to put them to paper. <br/><br/>I feel like a prisoner in my own body. Pain is my constant companion. I try to convince myself that my current meds are fine until I end up in tears with excruciating pain throughout the day. It's not fair. I didn't ask for this chronic pain nor did I do anything to purposely cause it. Up until four years ago I led a pretty normal life being able to go on long walks and camping- two of my favorite things- with the aid of low level opiods 3x/day. Now I barely start to walk and my back/neck spasms so hard that I can't catch my breath and have an almost instant panic attack. <br/><br/>I realize that there will be addics no matter what the medical climate and I have never been addicted to anything in my life- except the relief from this staggering pain. The stigma I received as a chronic pain patient after the 2016 CDC guidelines was humiliating and devastating because all I did was take my prescription as directed, filled at one pharmacy and enjoyed a much better life.<br/><br/>When I've checked on ways to return to a more pain free existence with a pain doctor, I'm told that I'm over weight and it's just something I need to get used to. I feel like I'm being punished and doing hard time for the crime of having this unbearable pain. They always tell me the steroid injections and RF ablation will give me back my quality of life and when I get those procedures done, it only exacerbates the problem. By the way, I did lose 20 pounds and my pain didn't change at all.<br/><br/>I feel like our doctors have gone through a tremendous amount of specialized training and should be able to decipher between abuse of meds and legitimate pain patients without having to do drug tests, pill counts or worse yet, forced to sign agreements that they will no longer prescribe life saving opiods to patients who desperately need them. I know you're probably rolling your eyes when I say life saving, but I truly don't want to be subjected to another 20-30 years of this excruciating painful existence. Most people I know tell me just use marijuana as it's medicinally legal in almost half the states but I don't want to be high, I just want the pain to subside. It's fine if you use Mary Jane for your pain, but I want my choice back to use what allows me to function best which is low dosage opioids. <br/><br/>How is it that the many pain patients are paying for the crimes of the addicts? It's a well know fact that overdoses after 2016 are primarily related to fentanyl and people who have been abruptly cut off are forced to use unsafe street versions of opiods which may or may not contain fentanyl, or go to heroine or worse yet their doctors load them up on antidepressants. We are not depressed! We are in pain! What if it was you or someone you love? There has to be a balance and that's understood but this pendulum is swinging too far to the extreme of no opiod hospitals. Many have been told to start methadone however they've never used heroine and with methadone being low dosage heroine it's way more dangerous than opioid. <br/>Plus I see these methadone clinics where these poor addicts pay $15/day to stand in a long line like a dog and wait to get their juice. <br/><br/>What are we coming to as a society that we're okay with mass suffering due to this opiod hysteria? From what I've heard and read there not only hasn't been a decline in overdoses on pain killers, there has been a rise! Simultaneously the real pain patients are committing suicide due to their pain! Where are those numbers? <br/><br/>Desperation is a scary thing! Please be part of the voice to restore a chronic pain patient's basic right to as much of a pain free life as possible. I want to be able to enjoy my grandchildren one day and get back to biking/hiking and camping. <br/><br/>I've tried every remedy under the sun (CBD/KRATOM, etc.) to no avail as a consistent solution. I've never been addicted, only dependent on opiods to give me a quality of life with much less pain. I don't know how much longer I can go in this existence of seriously under treated pain. And no I'm not depressed or suicidal. It's just common sense that our body and mind will eventually demand a solution, even if it's not safe or logical.<br/><br/>I work full time, have two kids (26/15), a husband and house and cars and many friends and family to live for. I also have my faith in the Lord. I am a helper to others and am naturally fun loving. This pain has changed the core of who I am. <br/><br/>All I ask is that you share this plea for giving legitimate pain patiens back the relief they deserve. Dogs and cats are currently receiving more pain relief than humans. Talk to your peers, administrators and groups and help us regain our quality of life. I hope I'm always a productive member of society but am not sure how many more years I can work with this seriously undertreated pain.<br/><br/>God bless you and your family!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristina	None	None	0900006484fed55c	Stamper	None	2022-03-30T15:55:32Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Stamper , Kristina	l1c-wiw0-gs01	False	None	False	2022-04-12 05:34:27.789	[]
3148	CDC-2022-0024-3154	https://api.regulations.gov/v4/comments/CDC-2022-0024-3154	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines put in place in 2016 needs to be investigated. My primary care doctor stopped prescribing opioids because of this guideline. I was sent to pain management where it’s mandatory that I get injections and physical therapy when they have caused severe allergies and created undue burdens. I have a 10 year old with cerebral palsy and with my health conditions I can’t lift her. Since the guidelines I have had multiple surgeries, and have been denied appropriate pain management. The cdc has vilified pain patients and we can’t find anyone to help us. Doctors use those guidelines as the rule - no exceptions. Unfortunately, most doctors are afraid to prescribe at all, they call you drug seeking (even when you have just had surgery, are taking your meds as prescribed, and have done nothing wrong). My friends are committing suicide because living in constant pain is unbearable. What this government has done to the chronic pain community is unforgivable and needs to be investigated ASAP. The saddest part of all of this is that doctors and nurses don’t care about pain anymore. This is what the CDC has done.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fed5db	Anonymous	None	2022-03-30T15:58:27Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-xxcx-klkn	False	None	False	2022-04-12 05:34:28.017	[]
3149	CDC-2022-0024-3155	https://api.regulations.gov/v4/comments/CDC-2022-0024-3155	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Fibromyalgia pts. suffering is at an ALL time high! Drs don't prescribe the pain medication they need and suicides of the people with fibromyalgia are getting higher each DAY! Whether you like it or NOT it's a life long pain DISEASE! Nerve drugs and antidepressants are NOT enough! HELP people! HELP pts. With fibromyalgia!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484fed5e5	Brown	None	2022-03-30T15:59:10Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Nicole	l1c-xyoj-rlhu	False	None	False	2022-04-12 05:34:28.236	[]
3150	CDC-2022-0024-3156	https://api.regulations.gov/v4/comments/CDC-2022-0024-3156	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have no files my name is [redacted]. When this whole opiod problem blew up my Dr. never gave me a choice I was drop at first 4 milligrams of hydromorphone - A week later I found out I had lung cancer. Called pain dr to let him know &ask to please let me have the 4mg pill back. It was to stressful right know to be dropped. At the time I was on 4 4mg hydromorphone & 3 30mg of morphine time release. I was told you have to be cut back to egual 100 mg morphine a day. What happened at the hospital a month or so later was worst then this.I had lyng surgery took 3 days get get a pump put in. Then a month after surgery maybe 2<br/> I was dropped 30mg time release morphine because they had to get me down too 100mg morphine. I had a little bit of a problem with first drop. This 1 was much harder and I finally couldnt make scpeit last. I. Went to dr they put me on subxone. I dont have withdrawel but no pain reluef. I try tell8ng them but its to a deaf ear. The pain in my neck& other paets of my bosy are brutal. Im starting to feel victimzed by the pain center Im going too. I cantbelieve everyone is on 100mg... My pain is as bad even worse at times. Ive also had surgery for it.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fed61a	Angelica	None	2022-03-30T16:00:14Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Angelica, Robert	l1c-ypbc-0f5c	False	None	False	2022-04-12 05:34:28.450	[]
3151	CDC-2022-0024-3157	https://api.regulations.gov/v4/comments/CDC-2022-0024-3157	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 65 yr. old female with chronic pain due to lower back & neck injuries, Rheumatoid Arthritis and Fibromyalgia. I've undergone multiple surgeries (including a total knee replacement) and ALL of the aforementioned required/still require pain medication. <br/><br/>I'm going to start by saying I am LIVID at the way the "Opioid Crisis" has affected those of us in LEGIT pain! When the crisis first began my PCP told me she had patient's who had become bedridden after being cut off from their pain medication. She also stated the suicide rate had already increased. When I asked her point blank what she & her colleagues were doing to help this situation her answer was dead silence. There are a limited number of Pain Management physicians still willing to write prescriptions... and those that are have case loads so high they aren't able to take on new patient's (straight from the mouth of my pain doctor)! In addition, the CDC guidelines aren't being followed correctly. Doctors, hospitals & pharmacies have made up their OWN rules. I belong to an on-line spinal support group and have read horror stories from people suffering in pain. A few individuals told of being in the hospital and nurses ignoring written orders to give pain medication because THEY decided the patient was "drug seeking"! I know of a pharmacist who denied filling a prescription with the excuse "the address of the doctor who wrote it isn't close enough to us" (important to note it had been filled there MULTIPLE times prior). I myself had the experience of having to find another Pain Management doctor after my health insurance changed. First appoint. with the new doctor she stated "your pain doesn't meet the protocol for pain medication." She refused to request medical records and wanted ANOTHER round of x-rays, an MRI etc. WHY?!? I went back to my previous doctor and became a cash paying patient (the extra cost was difficult but worth not being treated as an addict)!<br/><br/>Finally, there is a MAJOR difference between being dependent on a medication to manage your pain vs. actual ADDICTION. Studies have proven the majority (key word!) of individuals taking Opioids for legit purposes do NOT abuse them. Pain is REAL and should be treated as such. It's time to STOP these insane practices!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fed6ba	Anonymous	None	2022-03-30T16:01:19Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1d-275j-e5os	False	None	False	2022-04-12 05:34:28.671	[]
3152	CDC-2022-0024-3158	https://api.regulations.gov/v4/comments/CDC-2022-0024-3158	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I know that my comment may not be read but if by chance it does I want to share just a short story of my life with opiates; I am able to dress my self; take a shower; & walk with a walker; & on very good days I am able to cook my own meals; I am 56 years old & have been in chronic pain since I was in my 20's due to a rare type of bone disease & a rare arthritis I have had 5 back surgeries; 2 knee replacements; both hips replaced; my ankles both have screwed & pins; both wrist have played & pins; my neck has a rod & screws; my last back surgery in 2018 left me paralyzed in both legs from my waist down I was in hospital for 3 1/2 months it took 2 years before I was able to get back feeling in my left leg I use a walker now & still drag my right leg but hey I can walk & not live 24/7 in a wheelchair; I am on Palitive care & have been for 3 years; I know I will be dependent on pain meds for the rest of my life but it's up to you somebody that doesn't know me; somebody that has no idea what I go through to tell me how much pain medication I need & can take!? That's wrong your not my Dr your not able to see what not taking the correct amount of pain medicine works for me? So why are you able to force my Dr & pharmacy to prescribe oy a very small amount of pain meds to me? I have parents in their 80's that have only had to take pain meds maybe 4 or times in their lifes because they had to have major surgeries but they both worked till they were in their 70's they both walk & even exercise daily they have watch me with in severe pain & having to live in a bed 24/7 many times in my life & they both understand that with out the right amount of pain meds I will not be able to even get out of my bed the pain is so severe; in 27 years of being on opiates daily I have never ran out of my meds early; I have never abused my meds; I have never had a Dr refuse to keep me on my pain meds! But the CDC is wanting to control what my Dr & pharmacy now can give me? Why? I just want to know why? You wouldn't let an animal suffer; you wouldn't watch a child suffer but you don't care if you make a person like me suffer? I just want to know why? I didn't ask to be born with a disease that destroies my bones & I didn't ask to have my life be so painful but I am begging not asking begging you to please think about what you be doing to people like me! I have never done anything illegal in my life be a good person all my life but I feel by you taking this away from me u are punishing me & millions others like me! & Please truly read all these comments; & if you can just for a min think long & hard about what if I was your mother; daughter or sister would you want me to suffer? This is the hardest thing I have had to do in a long time sharing my fears with someone I don't know & someone that I feel doesn't actually care about what will happen to me so I do want to thank you if you take the time to read my comment & I do pray that you will really listen to do many others just like me we feel so desperate right now!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bridget	None	None	0900006484fed6cc	Byrd	None	2022-03-30T16:03:46Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Byrd, Bridget	l1d-2q0b-lmj7	False	None	False	2022-04-12 05:34:28.889	[]
3153	CDC-2022-0024-3159	https://api.regulations.gov/v4/comments/CDC-2022-0024-3159	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Rheumatoid arthritis Osteoarthritis Spinal stenosis done a one major back surgery and I have holes already in my hips I have no choice but to work a full time job and I don't get near enough pain medicine I have no quality of life I go to work crying I come home from work crying because of my pain. as a pain patient we should not have to suffer any longer please let our Pain Doctors do their jobs and treat us like Doctors should be able too there is so many us suffering and there is no reason for it	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484fedc5f	Lilly	None	2022-03-30T16:04:00Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Lilly, Melissa	l1d-6au7-4csw	False	None	False	2022-04-12 05:34:29.107	[]
3154	CDC-2022-0024-3160	https://api.regulations.gov/v4/comments/CDC-2022-0024-3160	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC said that the reason it created the Guideline was to help doctors control opioid prescriptions, because of the overdose rate or crisis. Since the Guideline came out in 2016, absolutely nothing has changed. Opioid prescriptions are way down, but overdoses continue to rise because of illicit fentanyl and heroin coming across our open borders. In fact, since the Guideline came out in 2016 with its false narrative and pure propaganda, CPP have been either abandoned or forced tapered, some CPP have resorted to buying illegal pain medication off the streets, and some, because they can no longer endure the daily suffering from chronic pain, have committed suicide. Great job CDC! Please tell the American people once again how you are going to stop the overdose rate? Doctors have been targeted by the DEA for writing prescriptions for suffering CPP, and some have even been put in prison. The CDC should have stayed in its own lane, which is infectious diseases. The CDC, had no business dictating to doctors how to treat legitimate CPP and regulate what dosage of pain medication each patient should receive. All the CDC has managed to accomplish in the last six years is this: it has caused thousands of CPP to needlessly suffer and frightened doctors into submission. Just like every other federal and state agency, the CDC is out of control and really doesn’t care about the American people or people who suffer from chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Larry	None	None	0900006484fed702	Collins	None	2022-03-30T16:05:23Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Larry	l1d-8oxg-velr	False	None	False	2022-04-12 05:34:29.322	[]
3155	CDC-2022-0024-3161	https://api.regulations.gov/v4/comments/CDC-2022-0024-3161	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC Guidelines were supposed to have been a tool for PCPs to know when to refer a patient to a pain specialist. They were taken as law by many states and medical systems. I’ve lived with pain all my life due to birth defects, only after trying every over option for over 40 was I sent to a pain specialist. <br/><br/>I read the 2016 guidelines and thought they made sense. I was aware that there was abuse, and I hoped they would help stem the abuse without causing harm to patients and doctors who are not outside the boundaries of FDA regulations. Overdoses from abuse and illegal opioids should be separate from deaths of patients taking meds as prescribed. To this day when reports of opioid deaths are in the news, it shows a prescription pill bottle. <br/>That is very misleading. <br/><br/>I’d like to see the CDC actively reducing the known harm caused to pain patients and doctors. There is very real need for prescription opioid meds for many very painful conditions. Listing certain conditions as exempt from the guidelines wasn’t effective in 2016. I don’t see how it’ll help now. <br/><br/>Doctors with a license to practice medicine should be allowed to practice medicine. If you want PCP’s to stop prescribing opioids, you must state who CAN. Holding pain specialists to a 50-90 mme threshold doesn’t make sense. They see the people with the most severe pain. Of course they are going to have higher opioid prescribing rates! Ortho surgeons have higher joint replacement rates, oncologists have higher rates of prescribing cancer drugs. It’s what they DO. There must be allowances for specialists treating pain. Prison for specialists treating pain is insanity. <br/><br/>Pain exists. It’s impossible to ignore. There must be a place for patients who follow the rules to seek relief. To trust again. Too many are suffering in silence, ashamed to even admit they’re in horrible pain. Nowadays if you complain you are still in too much pain (despite the reduced meds you may be allowed) you risk being labeled a DRUG SEEKER. Pain control and some quality of life should be a human right. There are science backed tests that can show who has real pain. There are DNA tests that show which medication will be effective, and what won’t. We should use them. It costs $250.<br/><br/>Many addicts say they started with pills, but how many people took pain pills as prescribed and DIDN’T become addicted? Where’s that study? <br/><br/>I was happy to see that the OWG included doctors who actually treat pain. I felt they raised many fair points, such as there is no one proven method for MME calculation, and the concern of 50 & 90 MME thresholds repeated in the update. They also noticed more warnings of risks with opioid therapy, but very little emphasis on benefits. Taper, reduce, or stopping opioids were strongly favored to the point that it appears biased. These meds were in use long before the “opioid epidemic”. It doesn’t seem the concerns of the OWG were taken very seriously. I too worry 50 mme will be the new cut off point, in fact, some patients are already being weaned further. <br/><br/>Opioid medication can have fewer side effects than many impractical, unaffordable, even dangerous alternatives. Patients doing well on a stable dose should be allowed to continue. To further reduce harm, patients that were tapered for no reason other than the 90 mme cap should be given the chance to regain the dose that was safe and effective. Sure, take it slow, but lower isn’t best for everyone. <br/>A patient that doesn’t abuse meds after years on a steady dose is not at increased risk. In fact, the stress and trauma of untreated/under-treated pain is a much greater risk. Too many innocent people have suffered or died from misapplication of the guidelines. <br/><br/>Prescribing rates dropped, but overdoses continue to skyrocket. Responsible patients and doctors are not fueling this fire. Illicit fentanyl in drugs sold on the street and ABUSE is where the epidemic is spreading. This should be the focus of the CDC & DEA. Harm reduction looks different for addiction. Drug assisted treatment and naloxone are great tools. Illegal drugs are everywhere! I realize fighting this plague is daunting. Steps have been made in the right direction. That’s important. Everyone should have a chance at their best life. We just can’t keep doing the same thing and expecting different results. Thank you for this opportunity to comment. I’m sorry it’s so long. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fedc81	Anonymous	None	2022-03-30T16:08:26Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1d-aqae-o397	False	None	False	2022-04-12 05:34:29.609	[]
3156	CDC-2022-0024-3162	https://api.regulations.gov/v4/comments/CDC-2022-0024-3162	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please! Please! Please! <br/><br/>Stop this inhumane madness, one day you or your loved one could be in the same shoes as us!<br/><br/>Let me start by telling you how your guidelines with the MME’s have destroyed my life..<br/>I am unable to work, cook, clean, socialize, shower, deal with stress , sleep, drive, plus more things you as normal people can do without thinking about, take for granite!<br/>When I was given a higher does or higher MME per day I could do these things and I also had more frequent doses of medication to keep me comfortably functional. I was stable on a high dose of MME’s with no issues, no Narcan, for accidental OD. Never happened! <br/>Let me tell you the latest thing it’s prevented me from doing. This last weekend my son was involved in a severe rollover car accident. I thought we lost him and that I had to push through the horrible pain just to be there for him. Of course I was at the end of my month for meds so there were not any extra to take for the in between pain. I actually had to tell him I couldn’t be there for him and I’d have to go home to lye down. I’m his mother and he needed me that night after a rollover car accident that ejected him out of the window and yes he wears seatbelts always! He could of died! Anyways point is I was making it about how horrible I felt and here he’s lying in the icu with cuts all over and internal bleeding but nope his mom couldn’t manage her pain long enough to be there to support him. Now his dad has to take time off from work to rehabilitate him back to normal and I can’t even do that. I think the worse part was telling him and seeing the disappointment in his face and eyes like you really have to go, that please dont leave me look was the hardest thing a mother could feel it broke my heart…please remove these guidelines for the intractable chronic pain patients before we end our pain by seeking meds from the streets out of desperation or suicide, you don’t want that blood on your hands!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fed7d5	Anonymous	None	2022-03-30T16:09:24Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1d-iesm-6or9	False	None	False	2022-04-12 05:34:29.832	[]
3157	CDC-2022-0024-3163	https://api.regulations.gov/v4/comments/CDC-2022-0024-3163	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi My name is [redacted] I suffer with severe pain from DDD and many other unfixable back issues I had my pain treated from 2008-2016 also do Yearly mri etc so GOVERNMENT can physically SEE my pain just recently did a new mri was referred to pain management INJECTIONS only With this said I had a Epidural injection in 2008 and suffered dearly I AM ALLERGIC and its not FDA approved anyways ! So now I suffer because all doctors are scared to death to treat pain here in [city redacted] MS because of u guys Many people in my shoes are committing suicide! Its definitely a option on my mind as I suffer now ! FIX WHAT YOU HAVE DESTROYED …These ridiculous guidelines hurt So many more people than you could ever know . God help us	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brandy	None	None	0900006484fed7f2	Fletcher	None	2022-03-30T16:10:23Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Fletcher, Brandy	l1d-ih2j-tl7x	False	None	False	2022-04-12 05:34:30.047	[]
3158	CDC-2022-0024-3164	https://api.regulations.gov/v4/comments/CDC-2022-0024-3164	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Hello, <br/><br/>[name redacted] here; I live in [city redacted], TX. I have Lupus, Sjogren's, Fibromyalgia, Pelvic Floor Dysfunction, Spinal Stenosis, osteoarthritis, and I am in remission of . I am on biologics every week. I hurt, my pain is real. Before the guidelines came out, I was living life working, going to games, I could go dance a couple slow songs with the hubby. Now, if I get the urge go dance we sway side to side in the living room. Please I am begging you to do away with the guidelines. I am in pain management there is not management. He gives the 90 pills a month of 5/350 not only. I cry I hurt so bad when I go to bed. I am begging for help. Thank you, [name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lacey	None	None	0900006484fed8b6	p	None	2022-03-30T16:13:51Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from p, Lacey	l1d-klio-v9wc	False	None	False	2022-04-12 05:34:30.295	[]
3159	CDC-2022-0024-3165	https://api.regulations.gov/v4/comments/CDC-2022-0024-3165	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please change the opiod prescribing guidelines to make it easier for chronic pain patients to get treatment. Chronic pain patients are being denied treatment and being treated like addicts by some doctors. <br/>I was cut off and put on buprenorphine last year which made me sick and did not control my pain. The doctor said he was scared to lose his license. I ended up weaning myself off the buprenorphine which is a lot harder to come off than any other pain medication I have been on.<br/>I found another doctor but he does not give me enough medication to control my pain due to the guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Salmon	None	None	0900006484fee1a1	Luis	None	2022-03-30T18:00:26Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Luis, Salmon	l1d-mre8-9jnz	False	None	False	2022-04-12 05:34:30.511	[]
3160	CDC-2022-0024-3166	https://api.regulations.gov/v4/comments/CDC-2022-0024-3166	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	----SAMPLE COMMENT-----<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had Rls since I was in my teens and am now 70 years old. After being on dopamine agonists for 20 years I experienced severe augmentation and rebounding. With the help of a wonderful neurologist I was able to gradually transition from pramipexole to a combination of Gabapentin and a very low dose of Codeine (15 - 30 mg per day). My symptoms are now mostly under control. Please approve this use of Opioids.<br/> <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006484fee34a	Anastasi	None	2022-03-30T18:06:15Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anastasi , Donna	l1d-op5d-cwih	False	None	False	2022-04-12 05:34:30.742	[]
3161	CDC-2022-0024-3167	https://api.regulations.gov/v4/comments/CDC-2022-0024-3167	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to have my voice heard regarding opioid use to manage pain from a chronic condition.<br/><br/>I was diagnosed with multiple myeloma in the summer of 2012 following a number of procedures to determine the high level of pain I was experiencing throughout my body. During the course of the next months, I received chemotherapy treatment, underwent radiation treatment and had exploratory surgery. In January of 2013 I underwent a complete Stemcell transplant followed by added chemo treatments. The good news is my cancer has been in remission since the transplant. The not so good news is some of these procedures caused nerve damage, muscle fatigue and other conditions that had a negative impact on my quality of life. My doctors recommended a variety o possible treatments to relieve pain, discomfort and symptoms all with little or no results. The only relief I experienced came from using OxyContin. I was prescribed a dose of 10mg every 4 hours to manage the pain. We of course discussed all the potential side effects and realized the danger that could come with use of this medication. Fortunately for me, the only effect I realized was relief from my chronic pain!<br/><br/>Several year passed when I was advised that my primary oncologist could no longer prescribe this medication for me. He said I would need to find another clinic to care for my need. Fortunately for me, I was able to receive assistance from my local VA Clinic. However, they immediately reduced my prescription from 10mg every 4 hours o 5mg every 6 hours. This caused a great deal of anxiety, limited pain relief and reduced my quality of life. My pain management team suggested a variety of procedures all of which I agreed to but once again without success.<br/><br/>After several years, my team did increase my prescription from 5mg every 6 hours to 5mg every 5 hours. A minor change but one that made a positive impact by giving me 4 additional hours of reduced pain each day.<br/><br/>Medications such as opioids can be lifesavers for those of us fighting our battles with chronic pain caused by in my case cancer, and in others through a variety of conditions out of our control. <br/><br/>Please add my voice to the list of people who rely on these medications to manage chronic pain and enjoy a better quality of life!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fee753	Froelich	None	2022-03-30T18:43:27Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Froelich , John	l1d-qr5w-hq4f	False	None	False	2022-04-12 05:34:30.961	[]
3162	CDC-2022-0024-3168	https://api.regulations.gov/v4/comments/CDC-2022-0024-3168	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have struggled for years, beginning at the age of nine. I took a very low dose opioid for an injury once and realized how much it helped me. I went to my PCP of about ten years and described the pain, did some tests, and was prescribed titrated upwards to a maximum that the doctor would prescribe (not much 120 10 mg 'norco' a month)<br/><br/>This was before the CDC etc, there have been very strict limits in place for at least a decade. Its wholly appropriate to RX patients a few days worth without a second though, but it is not appropriate to give 30 pills of whatever for something unproven.<br/><br/>which brings me to unproven pain - this was my struggle for the longest, but it turns out as I mentioned that I had a valid reason which sucks.<br/><br/>I'm otherwise healthy, never smoke, rarely drink, and just want to live an average normal life where I can function. <br/><br/>Currently my dose has been reduced 70% from its high. Its crazy to me that psych drugs are all the rage (you know the SSRI & SNRIs etc) but those are completely and wholly manufactured chemicals. The opium poppy in a way is similar to the marijuana all the doctors are pushing. <br/><br/>I want to move with my partner to a different state and because of my Doctor situation and the "war on drugs" I feel like I can't because I wont have access to care or medications. It is already extremely difficult and the pharmacists practically make you go pharmacy shopping by telling you they can't get the prescribed meds, etc. My pharmacist suggested a fentanyl patch. I'm 32, not 60. I don't need something that strong. I also do not ever purchase those fake pillls with fentanyl that are killing people WHICH IS WHERE THE DEA AND THE GOVERNMENT NEED TO FOCUS..<br/><br/>DEA, CDC, FBI.. whoever can't you guys call eachother and reiterate that doctors ARE DOCTORS... Ive often seen that the testosterone pumped folks love these type of police officer, DEA, etc, positions because they get to kick down doors and shoot at folks (including George Floyd) but the reality is that we need access to medicines. <br/><br/>I never imagined in a million years when I was mad at my grandma for being on 'drugs' aka painkillers that I would need them 1. early in life 2. ever 3. on an ongoing basis requiring dr visits.<br/><br/>I should be able to focus on my career, partner, and other self care and see my dr once every few months not every 3 weeks. <br/><br/>Please retract the guidelines or do something coordinative with DEA so they will stop going after our doctors. <br/><br/>You know its hitting hard when someone like me in a very affluent area is having a difficult time accessing care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fee849	Anonymous	None	2022-03-30T18:44:33Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1d-t06u-0gkl	False	None	False	2022-04-12 05:34:31.201	[]
3163	CDC-2022-0024-3169	https://api.regulations.gov/v4/comments/CDC-2022-0024-3169	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PCMs should be allowed to do what they went to medical school for. Treat patients. They are the ones that see the patient most often and have a better understanding of the patient’s medical history. Because of that relationship the PCM knows if the patient is a drug seeker or misusing their medication.<br/>It has been my experience that pain management clinics do little to manage pain. They are more concerned with treating you like a drug addict by having you fill out a multipage pain contract, requiring you to pee on demand, have your pills counted or other demeaning requirements.<br/>A PCM has your entire medical history. A pain management clinic is only interested in the “source” of the pain, such as a bulging disk. A PCM knows that different medical conditions can contribute to the increase of chronic pain, such as menopause. <br/>A PCM knows whether the patient is just asking for pills or doing everything within their power to mitigate the pain. Things such as chiropractic, acupuncture, massage or moderate exercise. A pain management clinic is not interested in these things and their only concern is giving you a steroid shot, burning your nerves or getting you surgery. <br/>Some patients have already had surgery which has contributed to the continued chronic pain. Some patients are trying to prolong getting surgery as long as possible and trying as many non invasive therapies as possible.<br/>Many medications prescribed for pain don’t work, don’t address the problem or are for off market use. Many medications for pain require other medications to counter act the side effects of the medication being used for pain. <br/>I now suffer from chronic pain due to service in the military. I am now a 100% disabled veteran. I have been dealing with my conditions for over 20 years. I have a fused neck, degenerative disk disease, peripheral neuropathy, spondylosis. Not to mention chronic migraines. I utilize as many non invasive treatments as I can to treat my pain. Things such as chiropractic, acupuncture, massage, physical therapy, and moderate low impact exercise. When my pain gets too bad I seek out steroid injections which help calm the nerves. However during the interim something is needed to treat the pain flair ups. This is where the PCM comes in. It takes time and referrals to get into a pain clinic. Does the CDC really expect a person to suffer? That should be unacceptable on the CDC’s part and for any medical professional. It is certainly unacceptable for the person experiencing the pain.<br/>My PCM just informed me that they can no longer prescribe opioids because I have been diagnosed with chronic pain. It does not matter that I have been with this current PCM for over two years and have only had one prescription over a year ago. It does not matter that they can see my medication prescription history over ten years with the same insurance to see that I do not receive numerous opioid prescriptions. <br/>The CDC’s last opioid recommendation have caused countless people to experience extended pain, stress, frustration and demeaning treatment.<br/>The CDC could not get a handle on mask or no mask. Lock down or no lock down. The CDC concerns itself with which pronoun to use. It is time the CDC to stop interfering with the doctor patient relationship and let PCMs do the job they went to medical school for, taking care of patients.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484feed41	Anonymous	None	2022-03-30T18:45:06Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1d-v2up-tw9v	False	None	False	2022-04-12 05:34:31.420	[]
3164	CDC-2022-0024-3170	https://api.regulations.gov/v4/comments/CDC-2022-0024-3170	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic and acute pain patient for a few years and have a serious diagnosed condition , Psoriatic arthritis and Ankylosing Spondylitis. I do see pain management and rightfully so, I do take low level meds, but they really aren't adequate as my condition has changed. I tried to get a stronger "PRN" drug but basically told to go do a $10,000 epidural and see if that helps first. Not my first rodeo, as it would be 6th shot, all had little impact so I suppose this one will be the charm. Financially devastating to people when you could go fill a 4.00RX that would help better and be far less invasive and dangerous, but doctors have had their hands tied and they are afraid of their own shadows. This is ridiculous. I've had major spinal surgery and take high tech biologic drugs, so to deny someone like me proper pain management is POOR. Documented pain sufferers don't turn to some insane elicit drug like heroin, they use their drugs for a purpose. Reducing pain allows people to be more functional, without the disgusting stereotype of drug addict and doctor is "drug dealer'. This is a great country and these treatments need to be readdressed. People who suffer aren't going to be productive, they can't, but the Government doesn't address this and puts opioid users into some bizarre elicit category. This nonsense needs to stop and reliable, documented pain patients actually need meds instead of being angry and suffering which so many do thanks to the over reach of government. The system needs to change and effective drugs should be given to patients who need them . So many suffer at this time, thanks to these condescending bureaucratic rules. Let's change it and start helping people again<br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006484feed82	Landiak	None	2022-03-30T18:46:17Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Landiak, Maria	l1d-vmze-k40f	False	None	False	2022-04-12 05:34:31.653	[]
3165	CDC-2022-0024-3171	https://api.regulations.gov/v4/comments/CDC-2022-0024-3171	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We hurt .we cry .we ask God why ? But it's not his fault it your all fault we are being torture every single day every single min .i have stenosis of the spine .deterorating disk disease.bone spurs ..arthritis .also had to back surgery with plates and screws in my back .and in my neck .which is coming apart so it hurts to turn my head .net head starts shaking for no reason and really bad headaches .lower back is constant pain never lets up it feels like someone is kicking me with a steel toe boot .right shoulder is a mess had 4 surgery on it last time they opened it up they had to pull my muscle up and sew it back in place .i worked hard for over 30 some years I m 58 and I don't know if I ll make it to 60 .i pray god takes me in my sleep some nights cause I'm hurting so bad .i was told I will end up in wheel chair .No quality of life what so ever because of ypur guideline you ve put in place and now the new one is worse you need to take the Mme out one size pill doesn't fit all .also we should have to choose are clonazepam or pain meds I have restless leg syndrome and fibormiagia .i m in pain .Just stop please .i m begging you .i not a drug addict I m a pain patient .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484feef1e	Anonymous	None	2022-03-30T19:42:36Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1d-y8v0-xkmk	False	None	False	2022-04-12 05:34:31.876	[]
3166	CDC-2022-0024-3172	https://api.regulations.gov/v4/comments/CDC-2022-0024-3172	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include opioids for treatment of RLS. I have this extremely awful case. It has spread to my arms now. The only relief I get is from 10 mg oxycodone. This is an awful disease that drives you to wanting to take your life. It’s hard to explain the feeling you get with this. It’s a maddening pain achy crawling feeling. You just want to not live anymore. Please all of us that have this disease we need this medication. I do not abuse any medication. I only take it when my episodes are extremely painful. Please support us. Than you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484feca59	Anonymous	None	2022-03-30T20:14:46Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-mtmd-2gor	False	None	False	2022-04-12 05:34:32.095	[]
3167	CDC-2022-0024-3173	https://api.regulations.gov/v4/comments/CDC-2022-0024-3173	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good afternoon, Thank you for allowing the opportunity to share my story about how the CDC’s current guidelines have impacted my life. I have a disease called Adhesive Arachnoiditis. Three years ago, I was healthy, active and what anyone would consider fit. I was one of those annoying people who actually enjoyed running, needed it even, and loved time spent at the gym. Both of these things helped me blow off steam, feel and look my best. <br/>Then, I was in an accident that caused multiple herniated discs in my lower back and the compression of the nerves going to my left leg. I tried everything to avoid surgery. Multiple epidural injections, many rounds of steroids, every type of physical therapy and more. Finally, I was exhausted of all options and could not live with the pain. I had to have the surgery to be able to function. My pain for the couple months after this accident was constant and severe. I couldn’t care for myself or my children. The surgery ultimately failed, but initially there were complications causing Cauda Eqina Syndrome. I had to have a second emergency surgery to relieve the hematoma compressing my Cauda Equina nerves. The doctor likened the damage done to an elephant stepping on a hand. There was only so much they could do to fix it. The damage was not all reversible. I had already realized the difficulty that can be faced when trying to get help with pain, before my surgery. During my recovery, this would become a much greater issue. I was in constant, severe and overwhelming pain. Again, the CDC’s guidelines and the opioid crisis were given as reasons for not prescribing pain relief. Over the next year I continued to see the physiatrist every month. Again I tried physical therapy, tens machines, eastern medicine techniques, and all forms of non-opioid pain relief. I cried from pain every day. I never slept more than a couple of hours at a time and became suicidal. I couldn’t imagine living this way any longer. I had thoughts that even animals are treated better. We would not allow an animal to ever suffer the way that I was suffering. I started trying to find second opinions as to why I was still in so much pain. I felt as though something more must be wrong. That’s when I was accused of doctor shopping. The act of me trying to find an answer to my debilitating pain, led to this accusation. Doctors have become so afraid and convinced that every patient who has pain is drug seeking. Everyone is an addict or will be and no one is willing to risk their license or practice to help someone in pain. That’s the place I was in when I was “t-boned” by a semi truck. The neurosurgeon on call that day after looking at my M.R.I. found that not only had the surgery been a failure, not only had the Cauda Eqina done extensive damage, I also had Adhesive Arachnoiditis (AA) and now new herniated disks. He explained to me that the AA was within the top most painful conditions someone could have. There is no treatment or surgery that he or any other doctor could offer. I could never have surgery or even injections into my spine, it would all do more harm than good. He arranged for a second opinion. They explained that as bad as my condition was, looking at the previous MRI’s and the new one, this progressive disease was getting worse quickly and that most people in this condition would eventually be in a wheel chair. It was agreed than managing the pain was the only option. He referred me to a pain specialist. I was finally able to get a tiny bit of help. Now, a couple of years later, I am in fact far worse. Yet again, I’m told that the CDC’s guidelines won’t allow for me to have the pain relief I need. I’m told that 120 MME is all that a patient in my state can have regardless of the condition. I’m in so much pain that I cry every single day. I lay in bed at night and count the weeks until my daughter graduates high school so that maybe then I can kill myself knowing that I hung on until she could maybe go on without me. If you have ever had a toothache and know that horrible exposed nerve pain, it feels like that… but, everywhere and so much worse. It’s everyday, all the time, always. But, because it has been decided by the government, I can’t have enough pain medicine to even exist, much less function. I have never abused my medication. I have never not passed the constant drug screens. Yet, I’m constantly treated like a criminal. I was recently hospitalized with covid and though I had an O2 level of 79 without oxygen, he felt I could be drug seeking and tested my urine to be sure I wasn’t just out of medicine. Then told me that he couldn’t give me the amount of medicine that I was prescribed. After 2 days, I couldn’t take it. The covid and the hospital bed made my pain so severe that I couldn’t take it. They sent me home on oxygen rather than give me pain medicine. I cannot go on like this and I truly believe that no one could.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dana	None	None	0900006484fece33	Lindsay	None	2022-03-30T20:21:17Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Lindsay, Dana	l1c-oeik-ixi5	False	None	False	2022-04-12 05:34:32.321	[]
3168	CDC-2022-0024-3174	https://api.regulations.gov/v4/comments/CDC-2022-0024-3174	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span><br/>I am adopting these comments by [name redacted] and [name redacted] as my own,<span style='padding-left: 30px'></span>( https://washingtonmonthly.com/2022/03/24/how-[name redacted]-can-improve-the-cdcs-pain-guidelines/ ) even though I didn't write them. I am EXTREMEMLY infirm from non-stop chronic pain and I have a very hard time keeping the brian fog I experience from helping me makes sense in a way that will move the CDC off their inpossible position of denying pain meds to those who suffer non-stop chronic pain, like I do. I have a laundry list of ailments, starting with Cancer, RA and Fibro. I also have several completely compromised joints that need to be replaced, but I will not have surgery without pain control, altho my right shoulder and my left knee are shredded from the scoliosis in my back, and I have been told to get surgery, I won't do it. I had a complete hysterectomy, including 7 lymph glands, my cervix, ovaries, tubes, etc. removed for endometrial Cancer, without pain control and I so badly wanted to to die from that pain. The police were to be called to calm me down, I was in so much overwhelmed by that pain. I still plan on taking my own life soon, as I connot function anymore. The extra dose of Humira my retired doc insisted on giving me to control my pain, ( instead of giving me more hydrocodone, she gave me more immunosuppression ) which resulted in my contracting a very rare fungal infection ( Aspergillosis ) in my eyes and I am now BLIND. The pandemic keept me out of my eye doctor's office for an extra month,, while the infection simmered away. My regular doctor quit practice because of a compbination of fear of the DEA and fear of the patients she hurt, in trying different methods of pain control that harmed instead of helping. She left town for fear of many Summons coming her way.<span style='padding-left: 30px'></span><br/> (She did not ask me if this Humira for hydrocodone was an OK trade off )I am bedridden, and life is nothing but misery, an not worth living anymore. I was abruptly terminated from my 37.5 MME"s hydrocodone after being on it for 20 years, in 2020. ( since 2000, although I receiving at leas 67 MME's/day ) I was a complaint patient, or I never would have been able to extend my prescription for that length of time. This is horrible practice of medicine. The CDC's policy has been a complete failure. Overdoses have skyrocketed, in spite of the agencies' ( I'm looking at you DEA and CDC ) manic reduction in prescripting controlled subtances. ) In particular I want to mention that the 50 MME limit on opiates is especially egregious, in that such a limit will be taken by the DEA as law and enforced as a crime when it is exceeded. 50 MME'S is NOTHING compared to lifelong chronic pain. It's the equivalient of two tylenol, as far as pain control is concerned. There should be no limit but what the doctor and his/her patient determine to be the most pain relieveing and the safest. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fecfc8	Anonymous	None	2022-03-30T20:27:58Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1c-soco-l6af	False	None	False	2022-04-12 05:34:32.543	[]
3169	CDC-2022-0024-3175	https://api.regulations.gov/v4/comments/CDC-2022-0024-3175	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been using opioids safely and properly since 2006. Before I started Pain Management I had contemplated suicide due to such extreme chronic pain that left me writhing inconsolably out of work and in bed constantly. I could not function and had zero Quality of Life. Thanks to being on low dose continuous relief opioids, I am able to walk, to work, and to care for my elderly mother. None of that would be possible without my pain medication. I shudder to think what my life will be like if the laws are changed and there’s an interruption in my pain management. How will I work? How can I take care of my 90-yr-old mom from my bed? Please don’t do this to me and the many others like me whose bodies betray them and leave us crippled in pain. Please don’t. This is very scary, hence in addition to my 24-hr pain, I’m no anxious from this and couldn’t sleep last night. <br/><br/>I understand opioids are dangerous, but I strictly follow directions from Pain Mgmt, am 100% compliant, and the meds enable me to rejoin life and be a functioning member of my community. If that gets taken away and I’m back in total back pain all day, I really don’t know if I can mentally handle it. I’d have to institutionalize my mother, go on disability, and my husband will leave me if I’m, “Ever flat out in bed” again. The thought of it has me shaking and crying.<br/><br/>Please allow those of us compliant with opioids under the care of Pain Management to continue with our life saving meds (when you’re suicidal from intense pain.) Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Regina	None	None	0900006484fed866	Skorge	None	2022-03-30T20:31:21Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Skorge, Regina	l1d-jxqy-geik	False	None	False	2022-04-12 05:34:32.776	[]
3170	CDC-2022-0024-3176	https://api.regulations.gov/v4/comments/CDC-2022-0024-3176	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I passed the definition of chronic pain over 25 years ago. Yes I still work I am the one who helped my mother the last ten years of her life when her income was a small SSI check that didn’t cover all of her medications. My youngest sister is also disabled and depends on me for her health insurance. I work because there is no choice. I come home crying because the pain just breaks me some days. I am tough, I’ve worked with a broken ankle at a stand up job the day after I broke it, I’ve worked with necrotizing pneumonia till I was hospitalized. I don’t talk about pain with my doctor anymore cause there is nothing they can do. They won’t give anything for pain other than Tramadol. It helps some. The pain makes it hard for my brain to think clearly at times. I know brain stuttering isn’t a thing but when you reach a pain level of 7or 8 your thinking capacity changes. I think your guidelines from 2016 are partly to blame for this. I have been told by Drs there is literally nothing they can do without risking there license. You have backed me into a corner now and on several times turned me into a criminal all because I neede to go to work to provide for my family. I don’t expect to ever be out of pain, nothing in life is pain free but the 2016 guidelines won’t let my Dr even help me manage it on days that I work.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484feeaea	Elza	None	2022-03-30T20:33:33Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Elza, Barbara	l1d-z6yq-n12x	False	None	False	2022-04-12 05:34:32.992	[]
3171	CDC-2022-0024-3177	https://api.regulations.gov/v4/comments/CDC-2022-0024-3177	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am posting a comment for a dear friend who is on hospice he is 65 and has terminal cancer. They limit the amount of pain relief they can prescribe him due to these guidelines. This medication is the only thing that gives him any quality of life. His next step is morphine which makes him extremely ill. Hospice cannot prescribe him what he needs due to the restrictions. He should not have to live in pain and not be able to be as active as possible at the close of his life due to others abuse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Molly	None	None	0900006484feeb4d	Cook	None	2022-03-30T20:33:43Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Molly	l1d-ztfm-lvb2	False	None	False	2022-04-12 05:34:33.261	[]
3172	CDC-2022-0024-3178	https://api.regulations.gov/v4/comments/CDC-2022-0024-3178	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors need to be able to practice without fear of losing their license because they prescribed too many pain meds if it has nothing to do with what their patients need. My mother in law has MS among other things and was going to a pain clinic for over 10 years where she was prescribed one pain med for constant pain and another for breakthrough pain both of which were opioids. When the last guidelines were passed she was taken off both without warning and put on a low dose of tramadol. The first 4 months were horrible as she went through terrible withdrawals the doctors did nothing about and they started treating her like a junkie and criminal because she was constantly combining about her pain. They did nothing. She now has no energy and lays in bed all day. When she had her meds she would take her grandkids to the park, cook dinner and have people over and was pleasant to be around. It's several years later and her condition has worsened because she's now inactive because it hurts too much for her to move around. Her quality of life is terrible. My children lost the person their grandma was. Instead of punishing pill mills doctors and addicts (which to be honest punishing addicts is kind of stupid) you also punished people who need those drugs, are not addicted to but we're/are dependent on these drugs. A good friend of mine's mother has lyme disease and she was on pain meds for years and they cut her off completely putting her into withdrawal with no offer of help or support. In her middle 50's she went to the streets to get pills that were fentanyl and became a strung out addict. She lost everything including her house and cars trying to keep her pain at bay and when she had nothing left she took her own life is. I could go on with dozens of similar stories of pain and suffering. People who followed the advice of their doctors and then we're abandoned by them. Who had normal lives and were turned into criminals by the people who take an oath to do no harm and a government that legislates without knowing what they are doing and cares less about the cost in lives. Why is the USA the only country that can't get it right with real patients, that have real pain. They took their medicine ad prescribed and had manageable lives and then they are tossed in the trash by their doctors and governments? Treated like criminals now by pharmacists, doctors insurance companies and eventually law enforcement. The amount of resources wasted in punishing people is staggering. It's awful that you are punishing people with diseAses and injuries this way but punishing addicts is just as bad. Addiction is a disease not a crime. Making it a crime turns addicts into criminals and gives power to drug cartels and drug dealers. The war on drugs is over and America lost. Lost in the most obvious and horrible way. Every other civilized country has figured this out and America needs to play catch up and now. Like 20 years ago now. Do better. Show some humanity for gods sake. You would think congress us full of sadists the way they treat hurting and vulnerable people.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484feebc6	Dunlap	None	2022-03-30T20:41:07Z	None	None	1	None	2022-03-30T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Dunlap, James	l1e-0zni-833r	False	None	False	2022-04-12 05:34:33.489	[]
3173	CDC-2022-0024-3179	https://api.regulations.gov/v4/comments/CDC-2022-0024-3179	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC must advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. This is consistent with the AMA and the 2019 HHS Best Practices report that embrace a multidisciplinary model that includes IPM. <br/><br/>IPM procedures, including epidural and facet joint interventions, spinal cord stimulation, infusion systems, minimally invasive endoscopic surgery, interspinous prosthesis, and other nerve block, in conjunction with opioids, are both safe and effective. The proposed 2022 CDC guidelines are suggesting that IPM procedures have limited evidence and are unsafe. the language that suggests that IPM has limited evidence and is not safe should be removed. <br/><br/>Thank you<br/><br/>[name redacted]<br/>Board certified Anesthesiology and Pain Management	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484feebe5	mehlberg	None	2022-03-31T12:10:38Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from mehlberg, Eric	l1e-1b68-07t8	False	None	False	2022-04-12 05:34:33.718	[]
3174	CDC-2022-0024-3180	https://api.regulations.gov/v4/comments/CDC-2022-0024-3180	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. This is consistent with the AMA and the 2019 HHS Best Practices report that embrace a multidisciplinary model that includes IPM. <br/>The proposed guidelines need to recommend early Pain referral after 3 months of conservative care. The referral to pain is for both diagnosis and treatment Treatments such as Neuromodulation, Radiofrequency, and Vertiflex, improve pain and function, and decrease the need for opioids<br/>IPM procedures are both safe and effective. The proposed 2022 CDC guidelines are suggesting that IPM procedures have limited evidence and are unsafe. Please remove language that suggests that IPM has limited evidence and is not safe. Further, the CDC should adopt the 2019 HHS Best Practices report, specifically Section 2.4 dealing with IPM. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Moises	None	None	0900006484feebe9	Lustgarten	None	2022-03-31T12:11:38Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Lustgarten, Moises	l1e-1csv-xwwx	False	None	False	2022-04-12 05:34:33.937	[]
3175	CDC-2022-0024-3181	https://api.regulations.gov/v4/comments/CDC-2022-0024-3181	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic leg pain for 31 years, as time has went on, my condition has evolved into back, hip, leg and foot pain. For 27 years I took ibuprofen. My pain finally reached the level to which only opioid would give relief. In 31 years I have tried all other methods to relieve pain to no avail. Since being on pain meds I have been treated unfairly by the medical profession and pharmacists. The current laws have made it unreasonably hard to get the only thing that is left for me. Chronic pain is a horrible condition that we should be able to get relief. Thank you for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484feec00	Cosgrove	None	2022-03-31T12:12:26Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Cosgrove , James	l1e-1keg-hds2	False	None	False	2022-04-12 05:34:34.155	[]
3176	CDC-2022-0024-3182	https://api.regulations.gov/v4/comments/CDC-2022-0024-3182	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines have really hurt the chronic pain community, since they have put the mme in place most Dr are terrified to treat their patients, I can longer enjoy the simple things in life, I just wish the they would let our Dr decide what's best for us<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Randy	None	None	0900006484feec06	Coleman	None	2022-03-31T12:12:49Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Coleman, Randy	l1e-1nky-1ikp	False	None	False	2022-04-12 05:34:34.375	[]
3177	CDC-2022-0024-3183	https://api.regulations.gov/v4/comments/CDC-2022-0024-3183	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>The doctors inform me that they are afraid of losing their licenses if they prescribe opiods. It seems that this is an irrational fear. The few that do prescribe opioids were using the 2016 guidelines as a way to document their file in case the DEA or some other imagined entity looked at them.<br/><br/> There is not one primary care provider in the town where I live that prescribes opiates anymore. If a patient says they have pain, they are sent to a pain clinic, an hour away. <br/><br/> The reactions of the doctors are not based on a patients needs. When it comes to pain, policy determines treatment, medical need be damned.<br/> While the guidelines are not meant to be gospel, I believe the doctors will continue to use them this way.They are looking for some kind of certainty in an area fraught with individuaLIzed complications.<br/> Your idea of using alternatives to opioids for pain sounds good unless you live here, in eastern Oregon. Providers tell me they sometimes have to refer people to Portland which is 3.5 hours away. There are simply no resources here.<br/><span style='padding-left: 30px'></span>The other problem is that sometimes the alternatives don't work. Then what will the doctors do? I fear they will simply blame the patient and red flag the file. Perhaps the guidelines could be clearer on when opioid prescribing might be appropriate for chronic pain.<br/> I also wish the guidelines would speak to the use of suboxone. The doctors tell me that suboxone is an opiate but you won't get addicted. WHAT? Where have I heard that before??? There is a NP in town who is prescribing suboxone for chronic pain, not for OUD.I hope you can address this issue because this is becoming common although suboxone has not been approved to treat chronic pain<br/><br/>BTW, I am a retired attorney with multiple sclerosis. I will probably have some kind of chronic pain for the rest of my life but I have learned to keep my mouth shut about pain when speaking to my doctors. They will just refer me to some God forsaken place if I'm lucky and if my luck runs out, I will be seen as a drug seeking addict.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Renee	None	None	0900006484feec2f	Caubisens	None	2022-03-31T12:16:47Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Caubisens, Renee	l1e-21wj-euqs	False	None	False	2022-04-12 05:34:34.590	[]
3178	CDC-2022-0024-3184	https://api.regulations.gov/v4/comments/CDC-2022-0024-3184	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I spent a good portion of my life dealing with RLS without any type of treatment. It caused numerous issues in my life. Not getting enough sleep because of this disease has led to other issues that arise with lack of quality REM sleep. When I was finally diagnosed my doctors ran me though all of the current (at that time) medications to help treat me. Like so many others none of those provided much if any relief. When I was finally prescribed an opiate it was given with the warnings of dependence and side effects. But starting that night I got my first well rested sleep in 20 years. My life instantly turned around and I had my life back. No other medication was able to do that.<br/> <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christopher	None	None	0900006484feec55	Nixon	None	2022-03-31T12:26:32Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Nixon, Christopher	l1e-2gkt-pvqi	False	None	False	2022-04-12 05:34:34.810	[]
3179	CDC-2022-0024-3185	https://api.regulations.gov/v4/comments/CDC-2022-0024-3185	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a healthcare provider and surgeon, my practice has evolved over the years away from using oral medications whenever possible when it comes to controlling pain. The opioid crisis in our country and the sheer numbers of opioid prescriptions written in our country as compared to the world is astonishing and somewhat shameful. Ortholazer therapy has become a game changing addition to my practice and for my patients. It is a remarkably safe and effective means of controlling pain of all sorts and should continue to be endorsed and encouraged.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484feec74	Bouvier	None	2022-03-31T12:27:27Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Bouvier, Daniel	l1e-2ojb-4fen	False	None	False	2022-04-12 05:34:35.050	[]
3180	CDC-2022-0024-3186	https://api.regulations.gov/v4/comments/CDC-2022-0024-3186	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted], and I take care of my wife who suffers from Lupus, and several other auto-immune diseases. She is prescribed the maximum recommended dosage of pain meds because of there being no treatment plan available at this time to relieve her pain. After her rheumatologist quit his practice my wife’s PCP prescribed her pain meds until she could find another rheumatologist, which took quite long. My wife’s PCP sent her to a pain management clinic where they proceeded to cut her pain meds more than in half. Now instead of interacting with my wife, mostly what I do is watch her suffer f from these painful disabling diseases. My wife has never used illegal drugs, she exercised and ran regularly, and took care of herself. When she got sick, the Drs. eased her pain with these pain meds and now the very same Drs. are treating her like a drug addict who is drug seeking. This is simply Un-American. Please tell the Drs. To treat patients with the dignity they deserve and quit treating them like problem patients. <br/><span style='padding-left: 30px'></span>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484feecc6	Black	None	2022-03-31T12:30:32Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Black, Mark	l1e-3nz3-inky	False	None	False	2022-04-12 05:34:35.289	[]
3181	CDC-2022-0024-3187	https://api.regulations.gov/v4/comments/CDC-2022-0024-3187	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>Prior to low dose opioids, I would sleep on average 3 hours per night. Depression and suicidal thoughts were a regular part of my life. Now with low dosage opioid therapy I am able to sleep 6+ hours per night. My life is happy and meaningful. I am so grateful for the treatment. Please give this consideration. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Verlil	None	None	0900006484feecea	Hawthorne	None	2022-03-31T14:00:18Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Hawthorne , Verlil	l1e-3zyz-k31w	False	None	False	2022-04-12 05:34:35.515	[]
3182	CDC-2022-0024-3188	https://api.regulations.gov/v4/comments/CDC-2022-0024-3188	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an ACGME Board Certified Pain Medicine , I request the following to be considered and<br/>incorporated into the upcoming guidelines:<br/>1. Interventional techniques as defined by MedPAC including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, minimally invasive endoscopic surgery, interspinous prosthesis, posterior lateral fusion with arthrodesis, vertebral augmentation procedures, sacroiliac joint interventions, and other techniques, are safe with extensive evidence of clinical and cost effectiveness with improvement in quality of life, thus reducing dependence on opioids, leading to attenuation of fourth wave of illicit drug epidemic.<br/>2. The CDC guidelines must eliminate mission creep of providing standard of care with only restricted opioid use without multiple interventional techniques as recommended by HHS Best Practice Report.<br/>3. As evidenced by extensive literature, excluding the literature by [name redacted] et al, interventional pain management strategies, in conjunction with other modalities, have shown to be effective as evidenced by HHS Best Practices Report.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484fef130	Lascarides	None	2022-03-31T14:05:47Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Lascarides, Peter	l1e-4mfu-nsgn	False	None	False	2022-04-12 05:34:35.754	[]
3183	CDC-2022-0024-3189	https://api.regulations.gov/v4/comments/CDC-2022-0024-3189	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have two knee replacements, a third degree separation of my left shoulder, a torn tendon and had a broken clavicle that required surgery as it was not healing. These were in my right shoulder. My left knee replacement became infected and required further surgery and still can be quite painful. I also have Chronic Kidney Disease and cannot take NSAIDS. I have run into the problem of doctors telling me to use NSAIDS, even though I tell them I can't. I was on medicinal marijuana program, but this can be very expensive as it is not covered by Medicare, or any other insurance. Consequently, I am in pain a good deal of the time and try to live with it as best I can. There are days when I find it hard to walk. Having more options in regard to medications I can take would be helpful. This is actually one of the reasons I stopped seeing my Pain Management physician, as their answers are NSAIDS and/or marijuana and I do not see the point of going. It seems doctors are skittish about prescribing opioids; whereas I can see this to a point, I think it has gone too far. People in chronic pain need more options.<br/>.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ann	None	None	0900006484fef13f	Crownover	None	2022-03-31T14:13:42Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Crownover, Ann	l1e-4nbr-bpbc	False	None	False	2022-04-12 05:34:35.978	[]
3184	CDC-2022-0024-3190	https://api.regulations.gov/v4/comments/CDC-2022-0024-3190	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a palliative care physician, I have seen far too many patients suffer from the first set of CBC "guidelines" which have been hijacked by pharmacists and insurance companies to deny patients opioids DESPITE their licensed, competent physician's prescription. This has gone too far. BIG pharma had a role in the overdose debacle and the FDA sold out at a time when they should have hit them harder. So don't blame deserving patients for needing appropriately prescribed opiates. Stay out of it, CDC! Reform the FDA and let them do the policing job!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef182	Anonymous	None	2022-03-31T14:31:05Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-5f0w-671t	False	None	False	2022-04-12 05:34:36.201	[]
3185	CDC-2022-0024-3191	https://api.regulations.gov/v4/comments/CDC-2022-0024-3191	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had opioids prescribed after many of my more than 30 surgeries. Only once have I had problems. My orthopedist prescribed fentanyl. When I went to stop, I recognized the withdrawal symptoms. I got my regular, long-term internist to prescribe lower doses so that I could taper off & ended the dependency. Now, under the pharmacy's interpretation of your current guidelines, I can't get squat. A previous prescription for 60-10 mg. codeine sulfate tablets which I cut into halves or quarters & only used when absolutely necessary so that a single prescription lasted 3 or more years cannot be filled. That's total crap. I have a law degree & the equivalent of PhDs in 2 other fields. I am 78 & I know my painful old body very well. CDC & whoever else wrote the guidelines should have cracked down on the pill mills in Florida & the pharmacies in W. Virginia who created the biggest part of the drug problem.& left the rest of us alone. We didn't need your interference.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Randall	None	None	0900006484fef1ad	Douglas	None	2022-03-31T14:36:55Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Douglas, Randall	l1e-654v-oown	False	None	False	2022-04-12 05:34:36.419	[]
3186	CDC-2022-0024-3192	https://api.regulations.gov/v4/comments/CDC-2022-0024-3192	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In March 2005, after taking the antibiotic Bactrim for approximately 10 days, I suffered a severe allergic reaction. My immune system attacked my central nervous system at the brachial plexus in both shoulders. The result was paralysis in both arms and hands and extreme pain. The paralysis has mostly, though not completely, resolved over the last seventeen years. However, permanent nerve damage remains and manifests as weakness, numbness and severe pain.<br/><br/>My doctor prescribes continuous release morphine, immediate release morphine and gabapentin to help me tolerate the pain. I also receive cervical injections every 90 days to try to block some of the pain. I know from direct experience that without the opioids my life is a nightmare. The drugs don't "kill" the pain and they don't get me high or induce a feeling of euphoria, but they do dull the pain to a level that is manageable.<br/><br/>I wish that I didn't know from experience how important opioids are to someone who has chronic pain. But, I do. Without medication my pain is debilitating. When every moment of every hour of every day is filled with pain and there is nothing that you can do to stop it, you feel grateful for a drug that helps you to manage it. Because of the medication therapy I am able to remain a productive member of society, a loving husband and a good father. Without it I would be none of those things.<br/><br/>Please consider my case and all the others who, like me, depend on the small relief that opioid pain medication provides. Thank you for your time. Sincerely, [name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fef1af	LeValley	None	2022-03-31T15:31:42Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from LeValley, Paul	l1e-65ty-ca35	False	None	False	2022-04-12 05:34:36.640	[]
3187	CDC-2022-0024-3193	https://api.regulations.gov/v4/comments/CDC-2022-0024-3193	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Amazing that public policy and legal decision determines medical judgment. Focus on prescription opioids is outdated. There has been a 44% reduction of opioid prescriptions over the decade. https://end-overdose-epidemic.... Opioid prescribing for terminal cancer fell 40% between 2007 and 2017. https://ascopubs.org/doi/10.... Both are coupled with a 30.4% increase in opioid overdose deaths from Illicit drugs that the Supreme Court cannot influence.<br/><br/>WE MUST TREAT PAIN<br/><br/>One study of millions of medical records, which compared the timing of state opioid regulations and reductions and could therefore suggest causality, found that opioid reductions actually led directly to increased disability, decreased productivity, rising medical costs and more pain. https://dspace.mit.edu/hand.... Another study found that among veterans who had their opioids stopped involuntarily, 9 percent became suicidal and 2 percent actually tried to take their own lives. Even worse, other research shows that rather than minimizing overdose risk, cutting access to medical opioids nearly triples the odds of overdose death among people in pain. https://link.springer.com/a...<br/><br/>Opioids are triple locked in the hospital and dispensed under supervision by nurses. Yet the same opioids are sent home with patients without any type of security or dispensing controls. One in four opioid overdoses today involves children and teens. https://jamanetwork.com/jou.... For those who say that prescription opioid are not the problem, 86% of Heroin and illegal fentanyl users report first abusing prescription opioids as teens. https://www.doh.wa.gov/Port.... Prescription opioid abundance then restricted access has lead to a 7-fold increase in Heroin overdose deaths. https://www.cdc.gov/drugove...<br/><br/>OUD doesn't start in hospitals: OUD starts at home.<br/><br/>At home, we need secure storage medication adherence monitoring, active control dispensing, & destruction of unused pills upon tampering and prescription end.<br/><br/>WE MUST TREAT PAIN and as physicians we need to do something to change policy. WE MUST TREAT PAIN and as physicians we need to do something to change policy so we can without liability.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelly	None	None	0900006484fef1b3	Kraft	None	2022-03-31T15:35:35Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Kraft, Kelly	l1e-68qj-r22a	False	None	False	2022-04-12 05:34:36.895	[]
3188	CDC-2022-0024-3194	https://api.regulations.gov/v4/comments/CDC-2022-0024-3194	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The use of opioids should not be withheld from truly appropriate patients, while at the same time keeping in mind the potential of dangerous and devastating effects of over prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lance	None	None	0900006484fef1d4	Ofenloch	None	2022-03-31T15:38:09Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Ofenloch, Lance	l1e-6o4r-2gms	False	None	False	2022-04-12 05:34:37.298	[]
3189	CDC-2022-0024-3195	https://api.regulations.gov/v4/comments/CDC-2022-0024-3195	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for rewriting these and taking comments, however, a reference to 50 mme will still cause patients to be under treated or not treated at all. It will likely cause hesitancy by doctors to write anything over 50 mme.<br/><br/>Many people w/ different conditions have been able to get their lives back at much higher doses. They are not addicts, nor should they be treated as such. And they need doctors willing to carefully titrate their dosage up-not down to an ineffective dosage.<br/><br/>Pain mgmt is not one size fits all and may times takes a mix of different meds. While people are human, what helps one person may be completely different from another regardless of their condition(s). People are complex individuals.<br/><br/>Please remove references to specific conditions not being helped by opioids because whatever studies you referenced do not reflect those who are really being helped by them in real world practice. Perhaps a survey sent to those in the PMP system would better reflect this?<br/><br/>Please remove the commentary about those above age 65 needing less than 50 mme as this is also inaccurate.<br/><br/>Please allow telemedicine visits for established patients.<br/><br/>Please allow early refill of meds (sometimes you are too sick to go out or are snowed in or at the mercy of a hurricane).<br/><br/>Please stop insurance companies and pharmacies from meddling with pill count, number of days allowed, or dosage, under the guise that they are preventing addiction. They are not the treating physician.<br/><br/>Please stop the DEA harassment of doctors. They need to be able to write out the correct prescription with the correctly titrated dosage without fear of going to jail or losing their license.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fef533	Combs	None	2022-03-31T16:04:32Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Combs, Judy	l1e-86jo-uttm	False	None	False	2022-04-12 05:34:37.503	[]
3190	CDC-2022-0024-3196	https://api.regulations.gov/v4/comments/CDC-2022-0024-3196	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been on pain meds for 12 years without ONCE taking more than what I’m prescribed. Now I can’t get my prescriptions filled because of the restrictions. What am I supposed to do? My doctor and I both agree on pain meds so I can have a decent life but these insane restrictions make it so that responsible people can’t get prescriptions filled! Would you do that to your mother? Father? If they were suffering? Tell them, “OH WELL! Some drug addict is abusing drugs, so people taking your prescription can’t get prescriptions filled anymore.” It makes absolutely zero sense. <br/>I have a spinal tumor, firstly, then something called Arachnoiditis (look it up). On TOP of that, I have Ehlers Danlos Syndrome with is a connective tissue disease and every single joint is falling apart little by little. Now that I’m old, it’s pure hell. I am furious and I’m serious pain and can’t my prescriptions. <br/>Why don’t you help the addicts instead of punishing pain patients?? We have nothing to do with their addiction!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristie	None	None	0900006484fef592	Snively	None	2022-03-31T16:09:13Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Snively, Kristie	l1e-9m5o-yemv	False	None	False	2022-04-12 05:34:37.743	[]
3191	CDC-2022-0024-3197	https://api.regulations.gov/v4/comments/CDC-2022-0024-3197	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please revise guide lines for low dose opioid to help RLS sufferers. <br/>I am a 73 year old wife, mother and grandmother who no longer can sit with my special needs grandson and read him a book! I can’t watch a Disney movie with him or take him out to dinner. RLS prevents all these joyous times! I have to hide from him when I cry every night, because I am in pain and cannot relax because my legs are twitching, jumping and burning. Low dose opioids with give me back some quality of life during my remaining years! Low dose opioids have been proven to help! Please, we are begging you to add RLS to the qualifying list of illnesses for which they can be prescribed! <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joanne	None	None	0900006484fef5d8	JoanneTornambe	None	2022-03-31T16:15:33Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from JoanneTornambe, Joanne	l1e-9yki-mv7u	False	None	False	2022-04-12 05:34:37.948	[]
3192	CDC-2022-0024-3198	https://api.regulations.gov/v4/comments/CDC-2022-0024-3198	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please revise the draft to INCLUDE chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. I know this because I have suffered with the condition for over 20 years and tried every treatment, both prescribed and anecdotal. I have found 2 treatments that work, low dose opioids (Tramadol) OR THC/CBD.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef5a6	Anonymous	None	2022-03-31T17:24:26Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-9sqk-sl95	False	None	False	2022-04-12 05:34:38.154	[]
3193	CDC-2022-0024-3199	https://api.regulations.gov/v4/comments/CDC-2022-0024-3199	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[I have severe refractory restless legs that keep me up most of the night. I cannot sit in a movie theatre, on an airplane, enjoy dinner with my family. If I get 1.5-3 hours of sleep at night, I’m lucky. These hours of sleep are not uninterrupted. Low dose opioids are the only thing proven to help sufferers from this debilitating disease. I can not work due to no sleep. It affects my family life and causes extreme anxiety and depression. The very medications so took to stop my rls have caused them to be significantly worse all day and night and spread to my arms and face. Please help us to live some semblance of a normal life as many sufferers are taking their own lives from this terrible disease.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fef5d7	Leifer	None	2022-03-31T17:30:07Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Leifer, Lisa	l1e-9yk6-tuec	False	None	False	2022-04-12 05:34:38.370	[]
3194	CDC-2022-0024-3200	https://api.regulations.gov/v4/comments/CDC-2022-0024-3200	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please find attached my Comments on Docket CDC-2022-0024 new Opioid Prescribing Recommendations	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fe4df1	Eliot	None	2022-03-31T17:58:16Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Eliot, Richard	l16-ud0v-guw5	False	None	False	2022-04-12 05:34:38.589	[]
3195	CDC-2022-0024-3201	https://api.regulations.gov/v4/comments/CDC-2022-0024-3201	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached file (Word doc):	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fe4fb6	Gustafson	None	2022-03-31T18:00:52Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-25T04:00:00Z	None	None	None	None	None	None	None	Comment from Gustafson, David	l16-x1n4-i74d	False	None	False	2022-04-12 05:34:38.801	[]
3196	CDC-2022-0024-3202	https://api.regulations.gov/v4/comments/CDC-2022-0024-3202	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fe5637	Sullivan	None	2022-03-31T18:01:41Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-26T04:00:00Z	None	None	None	None	None	None	None	Comment from Sullivan, Deborah	l18-br9g-p1mg	False	None	False	2022-04-12 05:34:39.016	[]
3197	CDC-2022-0024-3203	https://api.regulations.gov/v4/comments/CDC-2022-0024-3203	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Here is my story and how the CDC guidelines have hinder my life. At the age of 25 on March 1, 2013 my life was changed in the most unimaginable way. I was the passenger in a pickup truck traveling 72 mph in the slow lane on highway 90 when an improperly, fully loaded lumber truck pulled out taking over both lanes and ending in the slow lane at 1/4 mile ahead causing us to rear end the trailer. Most of the damage was on the passenger side (my side) of the truck causing me to fracture my C2, fracturing all of my right ribs, damaging T3-6, splitting my liver & spleen, damaging L3-S1, shattering my right wrist, torn my ACL and fracturing the head of my right tibia. I had to be life flighted to University Hospital in [location redacted], TX where i spent 2 weeks in a medically induced coma with chest tubes that failed requiring me to have a tracheotomy after 1 week and I got discharged from the hospital after 1 month’s time. Anyone and everyone who has seen my news debut tells me I am a miracle for surviving the unsurvivable; however, due to the CDC guidelines I am forced to fight for the opioid medications that allow me to continue to work full time and be the good housewife and mother I strive to be. I believe these guidelines need to be completely removed not amended! I believe the MME should be taken out! We chronic pain patients are not all the same and we should not be treated as such!! Thank you for taking the time to read my comment and I truly hope you will consider what these guidelines have done to me. I am 34 years old and since being tapered down to half my dose, I have missed lots of work and am unable to do all the things I used to do. Since having my opioid medications cut in half I struggle to clean our home and am often left to lay in bed in unimaginable, excruciating pain that no one should ever have to endure! Attached is a screenshot of the red pickup I was a passenger in. Please have mercy on all the pain patients in this country! Opioid prescribing is at an all time low yet overdoses are sky rocketing, which leads any sensible person to believe that prescription medications are not the issue so please stop punishing chronic pain patients for not doing anything other than not wanting to live in constant, nonstop pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lauren	None	None	0900006484fecdac	Nava	None	2022-03-31T18:02:25Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Nava, Lauren	l1c-mvwb-wbvi	False	None	False	2022-04-12 05:34:39.227	[]
3198	CDC-2022-0024-3204	https://api.regulations.gov/v4/comments/CDC-2022-0024-3204	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Penny	None	None	0900006484fece91	Johansen	None	2022-03-31T18:03:16Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-29T04:00:00Z	None	None	None	None	None	None	None	Comment from Johansen, Penny	l1c-p0l6-snwf	False	None	False	2022-04-12 05:34:39.466	[]
3199	CDC-2022-0024-3205	https://api.regulations.gov/v4/comments/CDC-2022-0024-3205	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	On behalf of American Society of Interventional Pain Physicians (ASIPP), Society of Interventional Pain Management Surgery Centers (SIPMS), and 49 state societies of interventional pain physicians, we thank you for updating 2016 Centers for Disease Control and Prevention (CDC) guidelines. <br/><br/>Please find our comment letter attached.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fed8d8	None	None	2022-03-31T18:04:16Z	American Society of Interventional Pain Physicians-Society of Interventional Pain Management Surgery Centers	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from American Society of Interventional Pain Physicians-Society of Interventional Pain Management Surgery Centers	l1d-knku-mbd9	False	None	False	2022-04-12 05:34:39.674	[]
3200	CDC-2022-0024-3206	https://api.regulations.gov/v4/comments/CDC-2022-0024-3206	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	On behalf of Henry Ford Health, we are pleased to submit comments on the CDC's Proposed Guideline for Prescribing Opioids [Docket No. CDC-2022-0024]. Sincerely, Cathrine Frank, MD and Nabil Sibai, MD	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fee74c	None	None	2022-03-31T18:05:32Z	Henry Ford Health	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Henry Ford Health	l1d-qcfg-omog	False	None	False	2022-04-12 05:34:39.882	[]
3201	CDC-2022-0024-3207	https://api.regulations.gov/v4/comments/CDC-2022-0024-3207	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s).	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484feeb54	None	None	2022-03-31T18:06:39Z	Physicians for Responsible Opioid Prescribing	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Physicians for Responsible Opioid Prescribing	l1d-zhz1-vp1k	False	None	False	2022-04-12 05:34:40.102	[]
3202	CDC-2022-0024-3208	https://api.regulations.gov/v4/comments/CDC-2022-0024-3208	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	OK. This is an addendum for my previous statement/comment.<br/> I have trouble finding the right words to describe how much this pain haunts me.<br/>I was doing really well. I have gotten myself into good shape. THEN. (For me the they or them are the VA). They started to mess around with my simple prescriptions. I started falling. While I was falling trying to get HELP the whole time. EVEN NOW I AM PLEADING FOR HELP. STILL. I ONLY GET. I'm sorry I don't know anything about chronic pain. Or. Something like that.After all that People who are in Pain have had to go through.<br/> First we were "TOLD" You have to STOP USING YOUR ANXIETY MEDICATION. NOW!!! Then started a Barrage of Negativity, Labeling, Talking Down Too, Gaslighting, False Statements in Records, Misleading Information, Misdiagnosed, Missed Diagnoses After all of this We Still Have To Face our PROVIDERS KNOWING THAT THEY ARE LIEING,<br/> So Yeah. NOW WHAT ARE WE SUPPOSED TO DO. I MEAN REALLY.WHAT ARE WE TOO DO.<br/> I try to Not fall asleep sitting in a chair. Every Day It Is the same. I have a chair that I can sit in out front at front porch/door. I go from sitting out on front porch to sitting at/on a counter height stool at kitchen counter then to Lazy Boy Recliner with 5 pillows that help me from falling forwards when I Do Fall Asleep in that chair only to be awakened in severe pain from falling asleep in the chair. Doing this ALL Night and Day After Day and EVERY NIGHT OVER AND OVER AGAIN AND AGAIN OVER, AGAIN, ANOTHER DAY, ANOTHER NIGHT, ANOTHER WEEK, ANOTHER MONTH, ANOTHER YEAR. FOR THE REST OF MY LIFE!!! SUFFERING EVERY MINUTE OF EVERY DAY.<br/> I get NO Peace No Comfort No REST<br/> Ironically I have Insomnia along with the MANY Complications that Follow. Which by itself is a Serious Medical Condition that requires immediate treatment to prevent possible complications that can arise from Improper Underteated Untreated Treatment. I have a eating Disorder ALSO From my Sleeping disorder ALSO Caused by my Intractable Chronic Pain Conditions that have Been Left UNTREATED AND OUT OF CONTROL Causing many unnecessary Conditions that are EZY to treat with Proper Pain Management. Instead of creating EVEN MORE PHYSICAL/PSYCHOLOGICAL Detrimental Conditions.<br/> Pain left uncontrolled is Obviously Not healthy to ones health. Take it from me. Abusing using patients by not Treating and Torturing them to the point of the pain patients wanting to KILL ONESELF.<br/> I am 100% Service Connected Veteran. I am being Tourtured/Abused by my local VA Hospital. In [location redacted].<br/>I am a single Veteran which makes it TOO EASY FOR "PROVIDERS" to just NOT CARE. VA NO LONGER REQUIRES THAT DOCTORS ARE ACTUALLY DOCTORS That have a commitment to the Patients in there Care.It is the opposite.DEFLECTING, Not Worrying too much about what they Can't do for you than to actually just treat you with some respect and as a patient.<br/> I am a Chronic pain patient of 30 plus Years.I left my home in Florida IN 1996. I was being treated for my conditions ALL OF THEM. Then, When the NEW VA [location redacted] HOSPITAL Opened it's doors. This is when Darvon & Darvecet was taken off the market. Around that time is when I was told by the First couple of Providers "Well, I was just in a meeting. We were told to cut back or lose your job". Well. They did not lose their job.<br/> I have noticed this type of treatment is concurrent with the OPENING OF NEW FACILITIES.<br/> I was then Told that I have "Osteoarthritis. You need to Move to a Dryer More Arid Climate at a Higher Elevation".<br/> Well. I have been running from this pain for far too long now. To HAVE TO SUFFER AND START OVER AGAIN WITH EVERY NEW PROVIDER THAT I SEE. WHICH IS NOT THE PROVIDER THAT I NEED. IT IS A GAME THAT THE SUPERIORS OF THE HOSPITAL TRY TO HIDE BY GIVING VETERANS AN APPOINTMENT ANY APPOINTMENT WITH ANY PROVIDER JUST TOO BE ABLE TO SAY "HE HAD APPOINTMENTS" When in fact we just get brushed off, And told "YOUR FINE" After looking at the Blood Pressure machine stating "196/110 pulse at 106". YEA I'M FINE ALRIGHT.<br/><br/> So yes. I am just trying to make it through another day. In hopes that I will Finally get some help I NEED. Not sure how much more of this pain that I will be able to handle. It gets Harder Every Day then a Front will come through and FLARE-UP EVERYTHING.<br/><br/> FYI. Intractable Chronic Pain Patients ALREADY Feel like shit ALL DAY. Then a provider wants to give you something that WILL CAUSE/DO MORE HARM and NOTHING to help the pain AND CAUSE MORE PAIN.<br/><br/> After Reading MANY Comments on here.<br/> I see that I am NOT ALONE with ALL THIS PAIN THRUST at me.<br/> IT is a shame knowing how much pain I am in is. OK. WITH THE MEDICAL Community.<br/><br/> I AM A VICTIM...<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef568	Anonymous	None	2022-03-31T18:09:22Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-8wlc-0iex	False	None	False	2022-04-12 05:34:40.315	[]
3203	CDC-2022-0024-3209	https://api.regulations.gov/v4/comments/CDC-2022-0024-3209	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in pain since a bad crash in August of 2020 broke many of my body parts. Even while in the hospital and nursing home I had to fight to get some relief. Now I am home and can't do anything because of constant pain. It hurts to take a shower and for it I am taking 450mcg Belbuca which does absolutely nothing for my pain. I know it doesn't help because CVS screwed up my prescription and I had to go 2 days without anything. When then changed everything in 2016 it really hurt a lot of people. I know! I cry on deaf ears while trying to have any kind of life. This is truly making me suicidal. What would you do?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484fef1dc	Peterson	None	2022-03-31T18:32:13Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Steven	l1e-6srt-1dhg	False	None	False	2022-04-12 05:34:40.528	[]
3204	CDC-2022-0024-3210	https://api.regulations.gov/v4/comments/CDC-2022-0024-3210	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to review and respond to guidelines attached to the letter with our commentary. Second we have attached [name redacted] claim dated that they believe shows the trend of benefit and value of interventional pain management. We remain available to discuss further thank you for your effort and time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ramatia	None	None	0900006484fee724	Mahboobi	None	2022-03-31T18:45:34Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Mahboobi, Ramatia	l1d-q1z6-4yrv	False	None	False	2022-04-12 05:34:40.736	[]
3205	CDC-2022-0024-3211	https://api.regulations.gov/v4/comments/CDC-2022-0024-3211	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Tears are running down my face as I write this. It’s a bad day for my shoulder and I know there will be no relief. I want to give you 2 examples of how the 2016 CDC guidelines have changed doctor’s attitudes and treatment of patients. <br/>1. I’ve been to the ER 3 times (all to our local rural hospital) in the past 19 years. All 3 visits were for kidney stones. The first 2 visits I was injected with pain meds and sent home. The 3rd visit was approximately 1 year ago. The ER doctor was very condescending and treated me like an addict trolling hospitals for pain meds, even though he could see in my records that was NOT the case. He eventually administered an injection he said was for pain and sent me home. It did not alleviate my pain and I spent the next several hours at home in excruciating pain until passing the stones. Several months later during a regular check up, my family doctor asked if I was still taking a medication listed on my file. I do not take any medication, did not recognize the name, or the name of the doctor who “prescribed” it. We finally concluded it was the doctor from the ER visit and the “pain medication” I was given was a mild nausea med for babies. The ER doctor had outright lied to me and done nothing to help me. And this has become a common theme at every hospital.<br/>2. I’ve had chronic pain in my neck and shoulder since high school due to horseback riding injuries. I’ve had one surgery to correct it but it only worsened the pain and made it flare up more frequently. I’m 51 yrs old now and the pain flare ups have reached an unbearable level. I finally reached out to my family doctor a few months ago seeking relief. Her response was to sneer and inform me, they “don’t prescribe those kinds of medications.” And here I thought all patients were worthy of treatment. The very few people I know who are fortunate to have a doctor who still prescribes pain medication are treated like a street addict by their doctors and randomly blocked by pharmacists refusing to fill their prescription. Their doctors threaten to cut off their prescriptions if they do not submit to on demand random drug tests and random calls to their doctors office for pill counts of their prescription. If the count is off by a single pill, the prescription is canceled and their pills confiscated by their doctor. Forcing daily use on someone in lieu of losing their prescription sounds like a sure road to creating an addict. Use as needed would be the obvious less harmful instruction.<br/><br/>The current CDC guidelines have left people like me with 3 options to manage pain and/or a tolerable quality of life.<br/> • Suicide.<br/> • Relocating to Mexico for those who can afford it. I can’t.<br/> • Sourcing a street dealer and pray the pills aren’t produced by the cartel and made with fentanyl.<br/>I’m currently searching for a somewhat reliable street dealer. If I die from a bad pill, however many pain free days I have until that happens is a fair enough trade off. <br/><br/>An expansion of the guidelines is desperately needed. Unfortunately, the guidelines created a very real and deep taboo against prescription pain medication and that has turned into a social signal of medical righteousness among physicians and will therefore take a very long time to correct/uproot. If it even can be.<br/><br/>One reason often given against long term use of pain medication is that it damages certain organs. The patient alone should always have the right to choose between quality and quantity of their own life. No one should ever have the right to make that choice for another human being. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catonya	None	None	0900006484fef16a	Owens	None	2022-03-31T18:46:46Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Owens, Catonya	l1e-4xem-7z0q	False	None	False	2022-04-12 05:34:40.944	[]
3206	CDC-2022-0024-3212	https://api.regulations.gov/v4/comments/CDC-2022-0024-3212	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to express out concern with the opioid epidemic. Please see the attachment	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bahia	None	None	0900006484fee74e	Chacal	None	2022-03-31T18:46:51Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Chacal, Bahia	l1d-qcvz-pdgk	False	None	False	2022-04-12 05:34:41.177	[]
3207	CDC-2022-0024-3213	https://api.regulations.gov/v4/comments/CDC-2022-0024-3213	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for your time in reviewing the attached document regarding the CDCs response to opioid prescribing. I appreciate your concern in this matter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nadia	None	None	0900006484fee755	Bangura	None	2022-03-31T18:48:07Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Bangura, Nadia	l1d-qeyo-vxrw	False	None	False	2022-04-12 05:34:41.384	[]
3208	CDC-2022-0024-3214	https://api.regulations.gov/v4/comments/CDC-2022-0024-3214	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for allowing individuals with pain and chronic pain voice their concerns with regards to the new guidelines in 2022.<br/><br/>I have been a chronic pain patient for over 20 years due to a myriad of autoimmune diseases, neurological disorders, and spinal conditions, which have completely turned my life upside down. First off, I want to explain how fearful doctors are to actually test and discover reasons for pain. Not only is insurance one of the most awful roadblocks for a physician, but also I have found doctors to be terrified to attempt to provide anything for pain relief. This, in turn, results in patients being directed to pain management physicians who are extremely overworked and overbooked, yet are doing the very best they can to assist patients in dire need.<br/><br/>The opioid crisis in our world is a frightening issue and a sad reality that countless individuals have experienced and fallen victim to. It is understandable that physicians are apprehensive to prescribe pain medications. However, the patients who are not addicted to medications are being denied more than a certain amount of meds within an extended period of time. With that said, people who are in severe pain are finding it beyond challenging to maintain a sense of normalcy as pain medications can’t be prescribed until the doctor sees the patient. Individuals who finally found relief for pain were beginning to gain back function, decreasing the depression and anxiety that accompanies chronic pain, and going back to work. Leaving the house and waiting in a doctor’s office can be one difficult task for someone who is already in pain, exhausted from not being able to sleep and suffering from brain fog. <br/><br/>It is crucial I share with you the challenge patients face when in the emergency room or in a surgical facility with excruciating pain. Prior to finding a medication that would actually provide some relief, I visited a physician who noticed that my vitals were dangerously high and sent me, immediately, to the emergency room. The doctor said my excruciating pain was most likely the cause of the dangerous vitals and that she wanted me to receive something for pain via intravenous in order to decrease the severity of my blood pressure and heart rate. Upon entering the emergency room, I handed to the doctor a piece of paper from the physician who sent me. The paper had on it the following: the doctor’s name, doctor’s cell phone, reason for sending me to the emergency room, and asked that the doctor seeing me would call my sending physician to discuss my dilemma with pain. Prior to the ER doctor calling my physician, she abruptly and rudely accused me of “fitting the profile of a drug addict.” I asked how that could be since I cannot tolerate oral pain medication besides Tylenol. There was no response from the doctor, but I can assure you I filed a complaint. This comment has completely scarred me for life. Fifteen years into the chronic pain, I still had no option for oral pain meds as the side effects were often dizziness, vomiting and blacking out. However, in an IV this was never the case for me, which I discovered after my first spine surgery. I felt safe in a hospital setting with a doctor and nurse monitoring me, yet I was told about a profile I fit into. You have doctors so angry towards patients who are in pain because they do not want to be responsible for another patient becoming addicted to pain medicine. I was not in there asking for a prescription, just following my doctor’s orders, and yet this is how I was treated. It happened a few other times after procedures and surgery. Often following a procedure, there is increased pain to what already hurts like hell. Unfortunately, the nurses in recovery are conditioned to refrain from treating pain. Again, an IV dose of a pain medication while in a hospital setting with medical professionals around to monitor for reactions, yet the denial is there. “Just take Tylenol when you get home.” I have been told. How is that acceptable after surgery? <br/><br/>A test I would highly recommend doctors use, is Genesight Testing, which is a simple cheek swab to collect a patient’s DNA. The results are used to determine which medications will moderately and significantly affect a person’s body based off of genetic information the test provides. This has been extremely helpful to rule out which medications I have tried in previous years and did not find beneficial or gave me an adverse reaction(s). My doctor can look at the results page for opioids and determine what may work best for me. This has been instrumental in finding the proper medication to assist with pain. <br/><br/>Overall, my hopes for the new guidelines are the following: an individualized approach to meds for each person’s situation, to include genetic testing, provide an appropriate amount of medications to allow the patient to continue functioning, and please end the stigma.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christine	None	None	0900006484fef147	H	None	2022-03-31T18:59:13Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from H, Christine	l1e-4q6c-nkjg	False	None	False	2022-04-12 05:34:41.592	[]
3209	CDC-2022-0024-3215	https://api.regulations.gov/v4/comments/CDC-2022-0024-3215	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from RLS last seven years. I was prescribed Ropinirole at 1mg but since then due to RLS augmentation I am at 6 mg a day which is supposed to be the max dosage. I am at a point I cannot sleep at night and I am in indescribable discomfort. It not fair to live under such agony and it is not fair for people who do not know this horrible situation to make decisions that will impact many lives. Please have some pity and take into account RLS patients before you finalize the new guidelines.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erdal	None	None	0900006484fef5d9	Unver	None	2022-03-31T22:13:03Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Unver, Erdal	l1e-9z70-b24n	False	None	False	2022-04-12 05:34:41.809	[]
3210	CDC-2022-0024-3216	https://api.regulations.gov/v4/comments/CDC-2022-0024-3216	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an RLS sufferer at age 81, I am certain that I will need an opiate in the future sooner or later. My genetic relatives with RLS have lived into their 90s. Please expand the legislation to include RLS patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bernyce	None	None	0900006484fef5de	Moran	None	2022-03-31T22:13:22Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Moran, Bernyce	l1e-a0vg-bf91	False	None	False	2022-04-12 05:34:42.020	[]
3211	CDC-2022-0024-3217	https://api.regulations.gov/v4/comments/CDC-2022-0024-3217	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I was prescribed with RLS when I returned from Iraq in 2006. Bethesda Naval Medical doctors put me on Horzant, Ropinirole, and Codeine. Later as the pain became more severe, I was taken off Codeine and put on 15mg of Morphine 2 tabs/night and 5mg of Oxycodone HCI 4 tabs/night. Without the meds I am unable to sleep, restless, and in pain. The low dose of medications does not fully relieve me of pain but make the nights bearable and I can sleep. I enjoy the low dose and have asked not to raise when offered. I feel safe taking the medications on a regular basis. I do not feel that I will become addicted, but I know without the medications I would not be able to function. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484fef5e0	Gardner	None	2022-03-31T22:14:23Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Gardner, William	l1e-a17h-sd3j	False	None	False	2022-04-12 05:34:42.227	[]
3212	CDC-2022-0024-3218	https://api.regulations.gov/v4/comments/CDC-2022-0024-3218	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The RLS community is crying for more opioids while refusing to look at non-drug alternatives seriously. <br/>If non-drug alternatives are recommended as first line and there was even a 10% positive response there would be a tremendous benefit to the healthcare system. <br/>I’m being self serving her because I developed a non-drug alternative over a decade ago which proved over 50% effective, is simple and very inexpensive. Something big pharma does not want to hear nor acknowledge. <br/>Beyond my company’s potential gain, the quality of life for suffering folks on MORE opiods is anything but good and breaks my heart. <br/>I suffered with RLS many years without relief, I took their drugs and suffered from them as well. I been 13 years free of the drugs with complete control of my symptoms and hundred share my solution and relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fef5e1	None	None	2022-03-31T22:15:25Z	Restful Legz	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Restful Legz	l1e-a18s-mjo6	False	None	False	2022-04-12 05:34:42.437	[]
3213	CDC-2022-0024-3219	https://api.regulations.gov/v4/comments/CDC-2022-0024-3219	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I have had Chronic Restless Leg Syndrome for over 25 years. The ONLY relief I have been able to find is a low dose opiod prescription.<br/><br/>This disease is awful. Please allow this to kerp happening!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Don	None	None	0900006484fef5e2	Lovell	None	2022-03-31T22:16:05Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Lovell, Don	l1e-a25o-5dw4	False	None	False	2022-04-12 05:34:42.667	[]
3214	CDC-2022-0024-3220	https://api.regulations.gov/v4/comments/CDC-2022-0024-3220	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I've suffered from Restless Leg Syndrome for over 30 years. I've tried Tramadol, Mirapex, Gabapentin, various over the counter pain killers, and all kind of home remedies. The side effects of these various drugs has sent me to the ER with a broken foot, head injuries, and breathing problems but has not helped long term qwith the RLS symptoms. Only a low dose, 10 mgs, of Methadone has helped ease my suffering with not serious side effects. I need this medicine to sleep at night and lead a productive next day.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fef5e4	Marcinkowski	None	2022-03-31T22:17:01Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Marcinkowski, James	l1e-a3ay-6l1z	False	None	False	2022-04-12 05:34:42.890	[]
3215	CDC-2022-0024-3221	https://api.regulations.gov/v4/comments/CDC-2022-0024-3221	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid prescribing guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. RLS is a neurological condition that causes one to feel the need to move their legs whenever they try to be still or relax. I have had RLS for 40 years and it has progressively gotten worse over the years. I have rarely been able to sit comfortably and watch my children/grandchildren in school events, I have a job that requires a lot of sitting at a computer and some days are torture trying to concentrate while fighting the unpleasant, aggravating urge to move my legs. I kick so much at night, I’ve worn out sheets. This is a real condition that is hard to explain. There are many treatments out there, but they work only temporarily and the side effects are miserable. I took Requip for a few years and it stopped my legs, but caused me to sleep constantly. I couldn’t drive because i was constantly tired. Low dose opioids have been the only drug that continuously help. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Becky	None	None	0900006484fef5e7	Stahl	None	2022-03-31T22:17:53Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Stahl, Becky	l1e-a45i-qwnn	False	None	False	2022-04-12 05:34:43.098	[]
3216	CDC-2022-0024-3222	https://api.regulations.gov/v4/comments/CDC-2022-0024-3222	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I take low dose methadone for restless leg syndrome. It allows me to sleep. I have no urges or cravings to increase my dosage, or to commit illegal or unhealthy acts to support my medically necessary treatment. Please do not make it more difficult for me or others like me to find relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484fef5e8	Kelley	None	2022-03-31T22:18:13Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Kelley, David	l1e-a4cu-oskp	False	None	False	2022-04-12 05:34:43.312	[]
3217	CDC-2022-0024-3223	https://api.regulations.gov/v4/comments/CDC-2022-0024-3223	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with Restless Leg Syndrome (RLS) for 5 years. I did not get sleep and many nights I went from warm bath to pacing. I was teaching and could barely function. I was treated with Lyrica and antidepressants, then neurontin. None of this worked for me. I went to a sleep specialist and began Ropinerole. It was a Godsend! But my dose kept getting higher to stop the awful symptoms. I was started on 5 mg oxycodone at bedtime. It helped the rogaine work longer. I still. had other episodes, so my dosage of oxycodone was raised, but the Ropinerole dose stabled. That's important because ropinerole can cause the symptoms to worsen, needing more ropinerole. I am stable on 5 mg oxycodone three times a day and 3 mg of ropinerole. I feel normal and do not suffer anymore. I'm 67 years old and thankful to have found what works to give me a good, productive life. Opioids are a crucial treatment modality for people like me. They have place in medical therapy...an important one.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Valerie	None	None	0900006484fef5f2	Leek	None	2022-03-31T22:19:22Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Leek, Valerie	l1e-a6aa-cghr	False	None	False	2022-04-12 05:34:43.519	[]
3218	CDC-2022-0024-3224	https://api.regulations.gov/v4/comments/CDC-2022-0024-3224	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering from restless leg syndrome for over 10 years. I've tried other medications but low dosage methadone works best for me. I've been taking it for about 5 years and I can't imagine not having it. I have no side effects except being able to sleep at night. Please include it in you guidelines for prescribing opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484fef5f3	Wilkes	None	2022-03-31T22:19:57Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Wilkes, Marilyn	l1e-a6lp-lcxw	False	None	False	2022-04-12 05:34:43.735	[]
3219	CDC-2022-0024-3225	https://api.regulations.gov/v4/comments/CDC-2022-0024-3225	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like Restless Legs Syndrome(RLS) that are different from chronic pain. Restless legs syndrome is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. <br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse and cause the symptoms to spread into the arms (augmentation). When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from RLS for over 30 years. I have used almost every prescription drug, prescription medical devices, and nonprescription supplements and devices to treat my RLS, which worsened over time. At least in part, the worsening of my symptoms was due to some of the medications that I received in treatment. The symptoms made it impossible to sleep at all on some nights and, impossible to sleep more than an hour or two without being wakened by RLS symptoms. Opiods are the only medication that provide relief for me now. Because of public pressure against doctors prescribing opiods, it became more more and more difficult to find a doctor that will prescribe the medication that I need to be able to sleep. For example, my primary care physician and all of the other doctors in his practice have surrendered their licenses to prescribe narcotics. For those of us with RLS, it is vital to have access to opiods to treat our RLS so that we can sleep normally and therefore be able to live a normal life. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bonnor	None	None	0900006484fef5f4	Hudson	None	2022-03-31T22:21:16Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Hudson, Bonnor	l1e-a6w3-banu	False	None	False	2022-04-12 05:34:43.948	[]
3220	CDC-2022-0024-3226	https://api.regulations.gov/v4/comments/CDC-2022-0024-3226	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with restless legs all of my adult life. Imagine not being able to rest when you want/need to. After taking a dopamine agonist for 15 or 20 years, I now need to discontinue that drug because of augmentation. Due to the nature of dopamine agonists, one cannot discontinue taking them without a good deal of suffering. In my case, an M.D. has advised me that I would surely fail in discontinuing this medication without the help of a low dose opioid. My personal doctor will be reluctant, leaving me between a rock and a hard place. If the use of low dose opioids is approved by the CDC in the treatment of restless leg syndrome, doctors will be comfortable prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fef5fd	Nichols	None	2022-03-31T22:21:55Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Nichols , Patricia	l1e-a9ls-j93p	False	None	False	2022-04-12 05:34:44.209	[]
3221	CDC-2022-0024-3227	https://api.regulations.gov/v4/comments/CDC-2022-0024-3227	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484fef5ff	Bullock	None	2022-03-31T22:22:23Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Bullock, Diane	l1e-aabx-2tsz	False	None	False	2022-04-12 05:34:44.441	[]
3222	CDC-2022-0024-3228	https://api.regulations.gov/v4/comments/CDC-2022-0024-3228	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing today to try and explain why small dose opioid treatment for RLS should be added to the CDC Guidelines. Unfortunately, I am trying to make my appeal to peofolks who don't have personal experience with RLS. I'm talking the extreme exhaustion that comes from not sleeping because your muscles are twitching and the spasms are so bad you just want to die. Can you imagine night after night after night of this torture! I truly wouldn't wish this disease on anyone. It is sheer torture every night. I have to sleep in our guest bedroom to allow my wife to get some rest. I've tried walking on our treadmill but fell off once when the exhaustion overcame my sense of balance. RLS has contributed to a very diminished lifestyle due to my constant exhaustion! All I can ask is that the CDC decision makers stop vilifying thee poor souls who suffer from RLS and the multitude of other conditions that cause chronic pain! What happened to the hypocratic oath? Relieving suffering should be the main goal of our medical industry. When traditional measures don't work, then for God's sake, please think of me up all night literally being tortured by Restless Leg Syndrome. It's real and we need your help in loving real solutions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ray	None	None	0900006484fef603	Ward	None	2022-03-31T22:24:18Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Ward, Ray	l1e-ac7x-ydvp	False	None	False	2022-04-12 05:34:44.648	[]
3223	CDC-2022-0024-3229	https://api.regulations.gov/v4/comments/CDC-2022-0024-3229	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids for RLS are the ONLY drug that works for some people! I belong to a group of RLS sufferers and it gets so bad for some that they consider ending their lives. The other medications that help have horrific side effects etc. addictions such as gambling, shopping etc. Until there is a cure, this is our only hope.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef605	Anonymous	None	2022-03-31T22:24:42Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-acsa-mupf	False	None	False	2022-04-12 05:34:44.857	[]
3224	CDC-2022-0024-3230	https://api.regulations.gov/v4/comments/CDC-2022-0024-3230	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] and I have suffered with Restless Leg Syndrome since my early twenties (I am now 69 years old). Through my life I was able to manage RLS with taking Folic Acid. Unfortunately, I experienced a period of severe anxiety and was given Clonazepam to deal with the anxiety. After a lengthy period of therapy, I decided it was time to stop taking Clonazepam by going through a long withdrawal schedule. However, this set off the RLS and I could no longer control it with Folic Acid. Fortunately, my physician knew that Ropinirole would help control the symptoms of RLS. 99% of the time, the Ropinirole would keep it under control but there were nights where it would not stop the sensations. My doctor also prescribed Hydrocodone as a “as needed” prescription. On those nights that the Ropinirole does not work, the Hydrocodone saves me from sleepless nights. Prior to the Ropinirole and Hydrocodone, it would not be unusual for me to go without sleep for days. This is not a healthy way to live. I ask that you please give consideration to the use of opiates for the treatment of RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	0900006484fef606	Lansing	None	2022-03-31T22:26:05Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Lansing, Leslie	l1e-acww-6reu	False	None	False	2022-04-12 05:34:45.100	[]
3225	CDC-2022-0024-3231	https://api.regulations.gov/v4/comments/CDC-2022-0024-3231	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i THINK CONGRESS WHICH IS MOSTLY COMPRISED OF ATTORNEYS LET THE PAIN SPECIALIST WHO HAVE PHDs<br/>in pain management do there jobs. Since congress started interfering with the opiod epidemic it has gone up not down???<br/>I have had restless legs syndrome for over 7 years...it is a god awful disease. I have been on the same dose of opiods 50mg<br/>per day for the last 7 years. I also do alternative therapies like NIR light..40 hz music. All scientifically based. <br/>I have a few assoicates that are in severe chronic pain like myself...none of them abuse the drugs. <br/>Also every medical doctor I know of do not...let me repeat do not hand out opiods indiscriminately.<br/>Every states have there own laws on it...I know of folks that cannot move to another state because the<br/>states requirment are to low. It is a piss poor situations when all congress can do is talk about the deep<br/>state...give corporations 3.5 trillion dollars to piss away as they please and basically [vulgar language redacted] over the working<br/>class. I know one thing if a congressman or woman wanted to get opiods they can get all they want.<br/>Congress did the same thing with the Truck Drivers and hours of service...they did not interview one truck<br/>driver nope...A bunch of sleep specialist that know nothing about the biological clock of truck driving. <br/>Every truck driver knows about it...all you had to do was extend downtime from 8 to 10 hours leave<br/>everything else the way it was. Nope your all just came up with some [vulgar language redacted] law that<br/>increased the death rate involved with semi trucks increased by 6%. Yeah good job folks.<br/>Why dont you pass laws that mean something to the majority instead of sucking up to the big<br/>boys.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Don	None	None	0900006484fef608	Adams	None	2022-03-31T22:29:13Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Don	l1e-adhg-z1fq	False	None	False	2022-04-12 05:34:45.311	[]
3226	CDC-2022-0024-3232	https://api.regulations.gov/v4/comments/CDC-2022-0024-3232	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am currently using buprenorphine to control my RLS. Before using buprenorphine, every other medicine (of which there were many) that I was prescribed by my doctor augmented on me which means it only worked for a certain period of time until it stopped being beneficial and then started working against me by making the symptoms of this intolerable condition/disease worse. Opioids seem to be the only meds that control RLS symptoms without augmenting. If this medicine was taken away from me, I don't know what I would do. Please don't take away the only category of medicine that for most helps calm the miserable symptoms of RLS. That would be cruel. These meds are prescribed at a low enough dosage to not be addictive but to still provide much needed relief of our symptoms. You cannot compare our use of opioids to those who abuse these meds for their own pleasure. Unless you have RLS, you cannot imagine the suffering that we go through and most of which cannot be relieved without a low-dose opioid. Thank you for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lana	None	None	0900006484fef60a	Edmonds	None	2022-03-31T22:30:20Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Edmonds , Lana	l1e-adla-chn6	False	None	False	2022-04-12 05:34:45.516	[]
3227	CDC-2022-0024-3233	https://api.regulations.gov/v4/comments/CDC-2022-0024-3233	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Clinical Practice Opioid Prescribing Guideline draft does not address Restless Legs Syndrome (RLS) - a chronic neurological disease that causes a diabolical / maddening need to move my legs. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of my daily life. Nearly 12 million U.S. adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. Gabapentin is working for now, but opioids may be in my future. The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Please make informed decisions, and utilize the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. Thank you for your empathy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484fef60e	Rumora	None	2022-03-31T22:31:06Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Rumora, Tom	l1e-aeo9-qrs1	False	None	False	2022-04-12 05:34:45.737	[]
3228	CDC-2022-0024-3234	https://api.regulations.gov/v4/comments/CDC-2022-0024-3234	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I request that the CDC include chronic diseases like Restless Leg Syndrome in the treatment guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alison	None	None	0900006484fef61b	Heath	None	2022-03-31T22:35:34Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Heath, Alison	l1e-aj0p-68fa	False	None	False	2022-04-12 05:34:46.006	[]
3229	CDC-2022-0024-3235	https://api.regulations.gov/v4/comments/CDC-2022-0024-3235	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include Low Dose Opioids as a treatment for RLS I have suffered with RLS my entire life, even as a small child and now I am 68 years old. I may not need daily opioids but at certain times, low dose opioids are the only thing that gives me a good night sleep.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484fef626	Wright	None	2022-03-31T22:35:55Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Wright, Brenda	l1e-akux-glfv	False	None	False	2022-04-12 05:34:46.217	[]
3230	CDC-2022-0024-3236	https://api.regulations.gov/v4/comments/CDC-2022-0024-3236	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 73 year old registered nurse who was diagnosed with RLS when I was 45 years old. I have been taking dopamine agnostics for nearly forty years. The medication has caused impulse control disorder that resulted in a sixty pound weight gain. Alpha2-delta ligands could not control the leg movements and caused side effects such as leg swelling. Please allow the use of low dose opioids as an alternative treatment for this painful and intractable condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Virginia	None	None	0900006484fef627	Moriarty	None	2022-03-31T22:36:24Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Moriarty , Virginia	l1e-amfr-53td	False	None	False	2022-04-12 05:34:46.428	[]
3231	CDC-2022-0024-3237	https://api.regulations.gov/v4/comments/CDC-2022-0024-3237	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am 75 years old and have struggled with RLS most of my life. I have been treated by multiple doctors and specialists over that time and no doctor or medication was able to help me. Drugs like Primapexole will work for a while and then augmentation developed that made my condition much worse. I couldn't sleep, I could sit for any period of time, I was absolutely miserable. Finally, my doctor prescribed a low dose of Methodone 10 mg BID. It was like magic. The dose is so low that I feel nothing except relief. I have been on the same dose for 25 years. I have never once taken more than prescribed. There has never been any need to increase my prescription. I don't know where I would be today with the opiod. Please recognize that opiods have a useful purpose to inprove the life of RLS patients. Thank you for your consideration.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484fef628	Russell	None	2022-03-31T22:37:59Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Russell, Gary	l1e-aotf-8iue	False	None	False	2022-04-12 05:34:46.726	[]
3232	CDC-2022-0024-3238	https://api.regulations.gov/v4/comments/CDC-2022-0024-3238	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The current medication available only works for a short amount of time and have extremely bad side affects. Since I have been on low dose of opioids I have been doing 98% symptom free for 7 years. The opioids and Dr who prescribe them saved my life.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484fef629	Thomas	None	2022-03-31T22:38:42Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Steve	l1e-aov5-cwen	False	None	False	2022-04-12 05:34:46.935	[]
3233	CDC-2022-0024-3239	https://api.regulations.gov/v4/comments/CDC-2022-0024-3239	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand the CDC is revising the Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that I suffer from and that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life, and indeed if not addressed could lead to a drastically shorter life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. This is what happened to me when I took Ropinorole and Pramipexole. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>After a few months using the typical RLS medications of Ropinorole and Pramipexole, I was unable to sleep more than a few hours every 3 or 4 days. This was a total disaster as far as my life was concerned, and I feared that I wouldn't live much longer (and was advised of that by several doctors). With a very low dose of Oxycodone, I was given enough relief from the symptoms to sleep more normally, and have enjoyed a prosperous life for the last ten years.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. People's lives including mine are at risk if you do not do this!<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nelson	None	None	0900006484fef62a	Caldwell	None	2022-03-31T22:40:32Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Caldwell, Nelson	l1e-apgj-9fp9	False	None	False	2022-04-12 05:34:47.163	[]
3234	CDC-2022-0024-3240	https://api.regulations.gov/v4/comments/CDC-2022-0024-3240	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I. have had RLS for many years, but only recently has it reached a point where it significantly disturbs my sleep. Though not "painful", it can turn a night into a "hellish" experience. Some nights I dread going to bed!!<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Faith	None	None	0900006484fef638	Allen	None	2022-03-31T23:07:41Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Faith	l1e-auh8-uri1	False	None	False	2022-04-12 05:34:47.376	[]
3235	CDC-2022-0024-3241	https://api.regulations.gov/v4/comments/CDC-2022-0024-3241	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 66 year old retired pastor and college professor with degrees from Harvard and Yale and a PhD from Scotland's Univ of St. Andrews. I have suffered from RLS/Wills Ekbohm disease all my life. It has become much worse as I have aged. It is triggered by physical weariness, being in a confined space, drinking alcohol (even moderately), and often occurs for no apparent reason. For the last 25 years it has profoundly interfered with my ability to sleep. At first, my doctors treated it with Requip, Ropinarole, and other dopamine agonists. Drugs such as these almost ruined my life. I experienced compulsive behavior, ADD, difficulty controlling my impulses, and other symptoms. Finally, I found a brilliant neurologist who prescribed a small dose of controlled release morphine, and this changed my life for the better. Later, I met the renowned RLS expert Dr. [name redacted], and he prescribed a small dose of methadone. If I were not treated with a small dose of either morphine or methadone, the terrible pain of RLS would make life unlivable. Please allow opioids to be prescribed for treatment of RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barry	None	None	0900006484fef63d	Vaughn	None	2022-03-31T23:09:23Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Vaughn, Barry	l1e-awmn-f1um	False	None	False	2022-04-12 05:34:47.600	[]
3236	CDC-2022-0024-3242	https://api.regulations.gov/v4/comments/CDC-2022-0024-3242	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In regards to the CDC Prescribing Opioid Guidelines revision, there has been a great oversight by not addressing chronic conditions such as Restless Legs Syndrome that are different from chronic pain. Neurological diseases such as RLS respond to low dose Opioid therapy in a way like no other. As someone who has lived with this malady since early childhood as well as watching my Father suffer from RLS, I had reached the point of no return without any quality of life after exhausting all prescriptions available and experiencing side effects and the expansion of uncontrolled movement throughout my upper body. My life changed after being prescribed Opioids by a well known Neurologist, Dr. [name redacted], who had had been treating RLS patients with great success and relief from this unrelenting condition which causes it's own form of "pain"! Please include RLS in your guidelines for Opioid Therapy so that patients like myself can continue to live life without constant agony!<br/>Thank you in advance for doing the right thing...<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lenise	None	None	0900006484fef642	Chaffe	None	2022-03-31T23:10:45Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Chaffe, Lenise	l1e-aynn-1f5e	False	None	False	2022-04-12 05:34:47.825	[]
3237	CDC-2022-0024-3243	https://api.regulations.gov/v4/comments/CDC-2022-0024-3243	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Todd	None	None	0900006484fef645	Burkhardt	None	2022-03-31T23:11:28Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Burkhardt, Todd	l1e-azwo-mipj	False	None	False	2022-04-12 05:34:48.056	[]
3238	CDC-2022-0024-3244	https://api.regulations.gov/v4/comments/CDC-2022-0024-3244	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from extreme RLS all my adult life. At times I thought I would lose my mind from being unable to sleep from the effects of RLS. Initially I was prescribed Requip to control the RLS symptoms. At first it worked great, but with time I found I needed more and more to have an effect. Other drugs were tried but none provided relief. Finally, Dr. [name redacted] at Cleveland Clinic prescribed a low dose Buprenorphine/Nalox treatment which has resolved the RLS effects completely. I have taken it for almost 1 year and the dosage has remained the same and my relief is 100 percent. I was also taking Tramadol for severe back pain and that is no longer required. I review my situation with Cleveland Clinic staff regularly to ensure I remain in control without the need for additional drugs.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Walter	None	None	0900006484fef648	Masnyk	None	2022-03-31T23:12:53Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Masnyk, Walter	l1e-b275-ajq8	False	None	False	2022-04-12 05:34:48.274	[]
3239	CDC-2022-0024-3245	https://api.regulations.gov/v4/comments/CDC-2022-0024-3245	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I had been on the standard treatment for RLS for about ten years but the medication made my RLS worse. I was switched over to a low dose opioid regimen that has been very effective in controlling the disease. I have been on the same dose about five years now and I have no side effects. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bjorn	None	None	0900006484fef64a	Fredrickson	None	2022-03-31T23:13:55Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Fredrickson, Bjorn	l1e-b2jf-zbsn	False	None	False	2022-04-12 05:34:48.485	[]
3240	CDC-2022-0024-3246	https://api.regulations.gov/v4/comments/CDC-2022-0024-3246	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been diagnosed with a severe case of RLS since 1996, and have been prescribed all the usual RLS drugs. Unfortunately, a few of them caused me more problems because they augmented, making my symptoms worse, and caused compulsive behaviors. I have been taking a low dose of Methadone without any problems, and I finally got my life back. I can sit through a movie, without having to stand up in the back of the theater. I can go on long car rides without having to make frequent stops so I can walk around to obtain relief. Low dose opiates have really been a game changer for those of us who suffer with moderate to severe RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robyn	None	None	0900006484fef64d	Mellor	None	2022-03-31T23:20:16Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Mellor, Robyn	l1e-b2ox-zdjv	False	None	False	2022-04-12 05:34:48.695	[]
3241	CDC-2022-0024-3247	https://api.regulations.gov/v4/comments/CDC-2022-0024-3247	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am almost 67. I have suffered with Restless Legs Syndrome since my late twenties. Didn't realize it had a name until my mid-forties, when I saw a specialist, who prescribed Ropinirole, a typical prescription for RLS. It was a love-hate relationship; sometimes it worked well; often it didn't work at all, even making the symptoms worse (augmentation). Doctors offered a variety of other medications, none of which worked any better. I was basically an insomniac for 35 years. In 2011 I had a bad accident (including eight broken ribs), with a long hospitalization and rehabilitation. Morphine was prescribed, and I realized I was not "twitching," sleeping like a baby. Doing my own research, I discovered opioids were a top-tier treatment for severe RLS. I began talking with my doctors, even getting more expensive insurance so I could see a specialist. No one would prescribe it. Finally one neurologist said he would prescribe methadone if I retired as a school bus driver. I don't really understand this: It was fine if I drove the bus without sleep but not fine if I drove the bus with proper treatment to give me a restful night's sleep. Anyway, I turned 62 and retired. That was July 2017. The methadone has been a lifesaver. And, fyi, it is very well monitored -- overkill, in my opinion. But I'm thankful to have it. The prescription is 10 mg at bedtime. I try to take only 5 mg, half the time taking 10. I think it's sad that not one doctor ever told me about opioids. They were all content to let me live as an insomniac and suffer for decades with medications that didn't work. Opioids are helping a lot of people with RLS. Well, I'm making an assumption. Maybe RLS sufferers don't even know this treatment exists!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monica	None	None	0900006484fef64e	Mestas	None	2022-03-31T23:21:44Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Mestas, Monica	l1e-b2st-l30i	False	None	False	2022-04-12 05:34:48.905	[]
3242	CDC-2022-0024-3248	https://api.regulations.gov/v4/comments/CDC-2022-0024-3248	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello CDC Representatives,<br/>I've been living with Restless Legs Syndrome (RLS) for most of my life, now in my mid-50s. Even before age 10, I had significant RLS symptoms that caused meaningful sleep deprivation. Early on in my relationship with my RLS doctor, it was found that low dosage opioids - specifically Tramadol and Hydrocodone (like Vicodin) - were an essential part of my daily prescription requirement in order to obtain enough relief just to get a simple night's sleep. I've been taking low dosage opioids successfully for more than 40 years. I have tried dozens of different RLS medications but none have provided the essential RLS relief as low dosage opioids that allows me to obtain a decent night's sleep. I beg of you to keep allowing low dosage opioids for RLS as not being able to get a reasonable night's sleep is devastating. Without low dosage opioids, I would be in a state of constant RLS pain and discomfort such that I would honestly not be able to function in society. It's the honest truth. Picture [name redacted] shaking like he does and that is with high dosage medications. Without his medications, he would be unable to function at all and would need 24 hour care and likely sedation for the severe limb movements. That is similar to what happens to me with my very severe RLS situation. The only mediation has that consistently worked for my for decades is low dosage opioids. I beg of you to please continue to allow low dosage opioids as a RLS treatment. Thank you, [name redacted] ([city redacted], Michigan)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fef652	Grand	None	2022-03-31T23:23:41Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Grand, Robert	l1e-b56v-aww8	False	None	False	2022-04-12 05:34:49.118	[]
3243	CDC-2022-0024-3249	https://api.regulations.gov/v4/comments/CDC-2022-0024-3249	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of LOW-TOTAL-DAILY-DOSE opioids to treat severe RLS.<br/>I have had RLS since childhood. I was diagnosed with it at age 42. Now, at age 57, I have tried over 25 medicines plus other therapies. Requip and Mirapex do not give life-long coverage. At first, they helped my RLS, but after a few years these drugs made RLS worse. This is called "augmentation". Now, I have permanent severe RLS which requires the use of opioids to have any quality of daily life, and nightly sleep. I am under the care of a sleep neurologist, and together we found an opioid dose that works, and I am able to maintain that dose without increasing it. This makes RLS different from chronic pain. Opioids are necessary for many of us who suffer from RLS and should not be regulated or reduced for those of us who are not abusing them. <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily-doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484fef65c	Wilson	None	2022-03-31T23:25:14Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Wilson, Jeanne	l1e-b96l-l3r1	False	None	False	2022-04-12 05:34:49.353	[]
3244	CDC-2022-0024-3250	https://api.regulations.gov/v4/comments/CDC-2022-0024-3250	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from Restless Leg Syndrome (RLS), in my case, genetically passed from my mother and grandmother. I have identified genes for RLS.<br/><br/>My case is extreme, meaning the most common drugs for RLS are not effective in holding off the extreme pain. The pain is such that it impacts sleep as well as heart rate and blood pressure. Experts believe that extreme RLS shortens life-span.<br/><br/>I have taken buprenorphine-naloxone sublingual for years, prescribed by one of the acknowledged experts at Johns Hopkins. It is a controlled substance.<br/><br/>If you make it more difficult or impossible for those with extreme RLS to gain low dose controlled substances, you will condemn us to a hell-on-earth and a shorter life-span.<br/><br/>Thank you for your service.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fef661	White	None	2022-03-31T23:25:48Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from White, John	l1e-bamm-tq1z	False	None	False	2022-04-12 05:34:49.566	[]
3245	CDC-2022-0024-3251	https://api.regulations.gov/v4/comments/CDC-2022-0024-3251	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>In the last 11 years of clinical practice, I have personally seen several refractory patients with restless leg syndrome who failed all traditional therapies and are now on opioids for control of restless legs syndrome. This medication is the only help they have to achieve symptomatic relief and sound sleep at night.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fouzia	None	None	0900006484fef663	Siddiqui	None	2022-03-31T23:26:38Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Siddiqui , Fouzia	l1e-bbl0-d7ry	False	None	False	2022-04-12 05:34:49.773	[]
3246	CDC-2022-0024-3252	https://api.regulations.gov/v4/comments/CDC-2022-0024-3252	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless Legs interferes with sleep and daily life. Please make it possible for doctors to make responsible decisions for RLS treatments that include low dow opiods.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Don	None	None	0900006484fef666	Morgan	None	2022-03-31T23:26:52Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Morgan, Don	l1e-bfck-9pnl	False	None	False	2022-04-12 05:34:49.998	[]
3247	CDC-2022-0024-3253	https://api.regulations.gov/v4/comments/CDC-2022-0024-3253	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been struggling with RLS for 40 years. Mirapex ultimately stopped working and made things much worse. I know take a very low dose of Buprenorphine and Naloxone 1/8 of a normal dose. It has changed my life! I am 66 years old and finally can sleep at night without the every night 2 hour thrashing. I have no symptoms anymore at all! Truly remarkable!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fef669	Amateis	None	2022-03-31T23:27:12Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Amateis, Judy	l1e-bgli-5byf	False	None	False	2022-04-12 05:34:50.204	[]
3248	CDC-2022-0024-3254	https://api.regulations.gov/v4/comments/CDC-2022-0024-3254	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I’m a 71year old female. I have had restless legs since the late 1990s. I went to a neurologist about the movement in my legs that was preventing me from sleeping in 1997 and he named it Restless Leg Syndrome. He said there are medication‘s that work for some people but the most effective medication they had found was an opioid. He prescribed me 30 tablets of 5 mg Percocet. I started using half a tablet (2.5 mg) on the evenings when my legs would bother me and found that I got relief within 15 minutes. At this time my restless legs were not as extreme as they are now. I only used a half a tablet because if I used a whole tablet my system seem to speed up and I was not able to go to sleep which defeats the purpose of going to bed. About 2 to 3 times a year for probably 10 years, I would get a prescription of 30 tablets to use for my restless legs. I never over used or abused any of the drugs. As I’ve grown older, my restless legs have gotten worse to the point where now I am currently using 7.5 mg a day to control my legs so I can sit in the afternoon when I need to rest, travel on an airplane, go to a concert or a movie, and go to bed at night. My daughter, two brothers, and two nephews also have restless legs which confirms the genetic connection that I’ve read about in the research. I have taken part in a RLS ongoing study about the effects of opioids for the last three years. I report twice a year, if my legs have gotten worse, if I’ve had to increase or decrease my use of an opiate and this is been a very enlightening study for me because I found that I’m actually a very lucky person being able to maintain and having only to increased my usage from 2.5 mg to 7.5mg over nearly 30 years. I went through a very bad time when the “powers to be” decided that they had to restrict opioids and require doctors to cut back on prescribing opioids for people like me. I was made to use substitute prescription such Mirapex,Requip, Neupro patch as alternate medication‘s which only accentuated my restless legs to the point that I would lay for hours almost in a state of having convulsions every few minutes from the restless leg syndrome. It was extremely painful, very uncomfortable and finally got very mad with my doctor and she gave me my opiate back, of which now I am comfortable again when I go to sleep. I think Congress needs to take a very good look at some of the ways they pass laws because there is no blanket solution to the opiate crisis. I’m very aware of people that have addictive nature‘s and have alcohol and drug problems, some of which have been in my own family. I am not one of those people, I need the help of this medication in order to get sleep because without sleep a person cannot function as they’re meant to . I would hope that you would listen to the people that actually suffer from this syndrome with an open mind and some compassion. I personally think there’s a whole lot of changes that need to be made in our Congress and House of Representatives and the process of how legislation gets made into laws. But here, I am only referring to the laws on opioids and how they are prescribed and the conditions under which they are prescribed and how bad these laws tie the hands of too many good doctors that are trying to help people but end up doing more harm than good because of the laws passed at midnight on the last day of Congress where things haven’t been researched thoroughly . Please please please, take into consideration that not everybody wears the same hat nor does everybody look good in the same style hat so there are individualist traits that need to be addressed and there is no blanket solution to any of it.<br/><br/>Sincerely and Respectively, <br/><br/>[name redacted]<br/>[address redacted] <br/>[email redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susie	None	None	0900006484fef66b	Fagen-Wirges	None	2022-03-31T23:31:09Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Fagen-Wirges, Susie	l1e-bhgg-rs5b	False	None	False	2022-04-12 05:34:50.426	[]
3249	CDC-2022-0024-3255	https://api.regulations.gov/v4/comments/CDC-2022-0024-3255	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Methadone is the only medication that consistently works for my RLS. However, the government makes me jump through so many hoops to get my medication that it creates a constant stress. Trying to find a doctor that will prescribe methadone, going to get drug test, finding a pharmacy to fill the prescription, and answering all the questions about why I need this medication is a constant battle. Just the stress from worrying about getting my medication takes makes my quality of life worse. Without this medication I would end up in severely mentally ill due to lack of sleep. I was out work for months trying to recover from lack of sleep due to RLS the last time I didn’t take medication and my quality of life was terrible. Please allow me to be treated with methadone without the suffocating government overreach.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Travis	None	None	0900006484fef66d	Boudreaux	None	2022-03-31T23:32:21Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Boudreaux, Travis	l1e-bhsh-rhez	False	None	False	2022-04-12 05:34:50.637	[]
3250	CDC-2022-0024-3256	https://api.regulations.gov/v4/comments/CDC-2022-0024-3256	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low dose opioids have become an essential medication for the control of Restless Legs Syndrome. I can personally testify to the debilitating effects of this disease in my life. I encourage you to strongly consider the use of these drugs as a legitimate use for us with this diease.<br/>[name redacted]<br/>[city redacted], GA	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dwain	None	None	0900006484fef677	Smith	None	2022-03-31T23:33:16Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Dwain	l1e-bk2f-9qjc	False	None	False	2022-04-12 05:34:51.389	[]
3251	CDC-2022-0024-3257	https://api.regulations.gov/v4/comments/CDC-2022-0024-3257	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've had RLS for 50 years. Until a doctor prescribed an opioid, nights were pure torture. The thought of going through that again makes death sound like a relief. Nothing else works and I've tried everything there is.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	June	None	None	0900006484fef67b	Cathleen	None	2022-03-31T23:33:34Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Cathleen, June	l1e-bmio-gdb0	False	None	False	2022-04-12 05:34:51.595	[]
3252	CDC-2022-0024-3258	https://api.regulations.gov/v4/comments/CDC-2022-0024-3258	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include prescribing low dose opioids for restless leg syndrome (RLS) in your updated guidelines. I was in total agony and near suicidal after other medications did not relieve my symptoms. I have been on a low dose of Methadone for the last several years which has allowed me to lead a normal life. I don’t know how I could survive if this option was not available to me. Please do not forget RLS in your new prescribing guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fef67c	Foley	None	2022-03-31T23:34:04Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Foley, John	l1e-bmiw-xyr4	False	None	False	2022-04-12 05:34:51.801	[]
3253	CDC-2022-0024-3259	https://api.regulations.gov/v4/comments/CDC-2022-0024-3259	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with RLS at Stanford about 12 years ago. After going through a pretty long list of drugs -- and I would add that this was a rough time with adverse reactions to the medications being tried: such as suddenly spasming in the car to the point I could not put hold a foot on the brakeI was -- I was prescribed methadone. Methadone has been working now for about ten years without difficulty at 25mg. Originally, the dosage was higher (I think it started at 35mg) but I found 25mg worked most of the time. While not a perfect solution, methadone allows me to run a business employing 8 people, participate in my family's activities -- for example, I would not be able to attend my daughter's plays because I could not sit still in a theatre seat -- and, in general, get out and about. <br/> Then the opioid crisis hit. <br/> I was told the limit on the methadone was 20mg a day BY LAW. This was not exactly true: however the law-of-survival for one's medical career was the law being followed. The multi-year relationship I had with my pain management doctor ended when he decided to leave practice due to the risk. Even though he had me see another doctor to confirm his prescriptive practices: because he was a sole practitioner, he felt the risk too high to continue in practice. He was afraid, and I would say that fear was the common thread connecting almost all the doctors I saw in my effort to get back to 25mg a day. At the office visits the discussion did not center around what my medical needs were, but what could happen to a doctor if DEA or some other entity walked through the door. Not a single doctor even suggested the amount of the methadone prescribed was inappropriate. <br/> I tried tracking down the a government entity to talk about the situation, but no one accepted responsibility and everyone I spoke to said there were exceptions to the 20mg daily limit, but the reality is everyone points to someone else and there is no one who says the buck stops here when it comes to opioid policy. In your legislation there should be a clearly defined agency and office within the agency that complaints can be brought before immediately.<br/>I want to know who made this decision. I repeat -- I WANT TO KNOW WHO MADE THIS DECISION. Who is it that is prescribing for me when they have not even met me. There absolutely need to be a visible chain of responsibility.<br/> A 5mg difference does not sound like a lot but my life changed significantly when I was put on 20mg a day -- I went from 150 5mg pills to 120 5mg pills a month. RLS is often thought of as something that just effects legs, but I feel it in the hands and upper shoulders as well. The reduction resulted in times I could neither write or type, meetings where my legs would just be bouncing catching other people's attention, waking in the middle of the night -- and so on.<br/>Everything deteriorated, our income suffered -- I ended up picking and choosing days I could function.<br/> There is an opioid problem, people are dying, but ham-handed legislation which takes medicine out of the hands of the immediate providers makes no sense. Driving experienced sole practitioners out of business makes no sense. You need a mix of medical community members, patients, and law enforment at the local level to make a plan that does not terroize practitioners and deny people the medications that makes lives livable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fef684	Austin	None	2022-03-31T23:38:43Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Austin, Michael	l1e-bp60-lr58	False	None	False	2022-04-12 05:34:52.014	[]
3254	CDC-2022-0024-3260	https://api.regulations.gov/v4/comments/CDC-2022-0024-3260	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have endured living with this disease for over 20-years. I implore you to follow the science on this matter.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef686	Anonymous	None	2022-03-31T23:39:20Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-bqo8-mhz4	False	None	False	2022-04-12 05:34:52.233	[]
3255	CDC-2022-0024-3261	https://api.regulations.gov/v4/comments/CDC-2022-0024-3261	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I ask the CD to include chronic diseases like RLS in the treatment guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006484fef689	Foster	None	2022-03-31T23:39:35Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Foster, Deborah	l1e-bs4d-a67l	False	None	False	2022-04-12 05:34:52.452	[]
3256	CDC-2022-0024-3262	https://api.regulations.gov/v4/comments/CDC-2022-0024-3262	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS for at least five years. I suffered several sleepless nights thinking I was suffering from muscle pain. The only way I found relief was by walking around for an hour to squelch the desire to walk to ward off the strange sensations in my legs. It was only when I read an article about RLS that I realized I must have this condition. After being diagnosed with RLS by my doctor, we decided on a low dose regimen of hydrocodone-acetaminophen. I have stabilized at a dosage of 15/325 once each night before going to bed. I now have very few episodes of RLS. <br/>I urge the CDC to include in its 2022 Opioid Prescribing guidelines to address conditions like RLS that require opioid therapy in a low total daily dosage.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fef68f	Mains	None	2022-03-31T23:40:28Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Mains, Robert	l1e-btq9-zec2	False	None	False	2022-04-12 05:34:52.665	[]
3257	CDC-2022-0024-3263	https://api.regulations.gov/v4/comments/CDC-2022-0024-3263	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I long to have Opioids as an option for the treatment of my restless legs syndrome….if you don’t suffer with this ailment, then you have no idea how dreadful the suffering is. I have many other miserable major health issues, but RLS is the WORST! Without the right medication choices (optimal word CHOICES) the suffering is never ending. The worst pain and uncontrolled movements you can ever imagine. Please, please finalize and approve Opiods for the treatment of RLS. We need all the help we can get. Please. Help. Us. <br/>Kind Regards,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anita	None	None	0900006484fef691	Warren	None	2022-03-31T23:41:17Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Warren, Anita	l1e-by1g-6p2u	False	None	False	2022-04-12 05:34:52.874	[]
3258	CDC-2022-0024-3264	https://api.regulations.gov/v4/comments/CDC-2022-0024-3264	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support the RLS proposal for low dose opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marjorie	None	None	0900006484fef69d	Meredith	None	2022-03-31T23:41:33Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Meredith, Marjorie	l1e-c2c2-fvs6	False	None	False	2022-04-12 05:34:53.084	[]
3259	CDC-2022-0024-3265	https://api.regulations.gov/v4/comments/CDC-2022-0024-3265	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve had 3 big surgeries within 2 years. Prom meds are the only thing that take away most of the pain. I’ve tried Gabapentin, lyrica, antidepressants and they didn’t do anything. I’ve had si injections and trigger injections and ended up in the er to be treated horrible even though my bp was 224/114. They had me take my own meds as they don’t give pain meds even at the ER. i was rocking back n forth in agony. I will never go to an ER again. I pray this gets bet with time and Pt but in meantime chronic pain patients are being treated horrible. Please help us. I’m a mom and a nana and would like to have my life back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef6a1	Anonymous	None	2022-03-31T23:42:58Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-bs5f-aqp0	False	None	False	2022-04-12 05:34:53.296	[]
3260	CDC-2022-0024-3266	https://api.regulations.gov/v4/comments/CDC-2022-0024-3266	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering RLS for over 10 years now and can find almost no relief for the disease that has taken control of my life....some of the medications that are available actually change who you are and do things that you have no control over until you realize the medications that was to calm you was destroying your credit and your marriage. I can't afford a vibration mat for $300.00 dollars and I can't wait for RLS to be noticed and taken seriously. This disease can be passed on in your DNA and I wouldn't wish this on No one. I can't even hold a job and I'm still young I think but this condition has aged me 20 years or more. On top of RLS I have asthma,chronic bronchitis, sleep apena, muscle spasms, allergies and exposed to chemicals in [city redacted] ohio (90s),and anemic .. I'm afraid to go out as my legs and arms go crazy , can't go to movie theaters any more can't even shop for long. Can't even sit to rest for longer than 20 minutes because that's when it acts up when you need to rest.. so please have consideration for those of us who are suffering suffering with no cure.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fef6b0	Hunkley	None	2022-03-31T23:44:17Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Hunkley, Michelle	l1e-cdg6-5sy4	False	None	False	2022-04-12 05:34:53.523	[]
3261	CDC-2022-0024-3267	https://api.regulations.gov/v4/comments/CDC-2022-0024-3267	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm 59 and have struggled with RLS for about 15 years. I can't sleep a full night and it affects my work during the day. I can't sit and relax to watch a movie at night with my husband. I pray for the day when I may be able to do this! Please consider low dose opioids to help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barb	None	None	0900006484fef6bd	Belcher	None	2022-03-31T23:44:36Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Belcher, Barb	l1e-cins-xguf	False	None	False	2022-04-12 05:34:53.734	[]
3262	CDC-2022-0024-3268	https://api.regulations.gov/v4/comments/CDC-2022-0024-3268	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been suffering from RLS for nearly 30 years. It prevents me from sitting still during business meetings, at movie theaters, at theater events, at dinner, and even when playing with my children and grandchildren. I've been taking medication for RLS all of these years, switching from one to the other as the current medication becomes ineffective. I expect to need the low dose opioids very soon, as the symptoms have just increased as I've aged. I'm now 74. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fef6c4	Bednarek	None	2022-03-31T23:45:23Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Bednarek, Mary	l1e-cm1g-ln28	False	None	False	2022-04-12 05:34:53.946	[]
3263	CDC-2022-0024-3269	https://api.regulations.gov/v4/comments/CDC-2022-0024-3269	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline. However, the draft does not address chronic conditions such as restless leg syndrome (RLS) that are different than chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes a very uncomfortable and urgent need to move the legs and in my case, the arms as well. The symptoms make it impossible to get a complete night's sleep. It is difficult to sit comfortably and keeps the patient from being at peace and comfortable. I am one of almost 12 million RLS patients. To date there is no cure. There are a few prescription medications that can relieve symptoms for a while, but over time those same medications can actually increase symptoms. Scientific research supports the use of low total daily dose opioids to treat severe RLS.<br/><br/>I spent 2 years with such bad symptoms that I was unable to sleep until 5:00 AM and then due to severe fatigue I fell into fitful sleep for several hours. I was unable to get more than 4 hours sleep each night. I tried several medications that often help a RLS patient before I found one that has been working relatively well for me. One of the medications I tried has the side effect of the possibility of a patient falling asleep suddenly and without warning, whether the patient is walking, driving or doing another activity. If the medication I am currently taking fails to help me in the future, low dose opioids would be my only choice.<br/><br/>I urge the CDC to include a section in the 2022 Opioid Prescribing Guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low total daily doses and with the patient carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Evelyn	None	None	0900006484fef6c5	Hart	None	2022-03-31T23:46:42Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Hart, Evelyn	l1e-cm76-77ss	False	None	False	2022-04-12 05:34:54.161	[]
3264	CDC-2022-0024-3270	https://api.regulations.gov/v4/comments/CDC-2022-0024-3270	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from severe RLS. As a result of low dosage methadone treatment, I am now able to live a normal life and enjoy my husband and family beyond 7:00pm. Previously, I was taking the upper limit dose of Gralise (1800 mg per day) and Neuro Patch (4 mg). My breakthrough symptoms occurred frequently, so I’d have to supplement with 10 mg of Tramadol. When they occurred, they prevented me from doing anything but dealing with the symptoms. I stopped making plans or going out in the evenings. I couldn’t even sit and watch an hour or two of television! When I learned that Ropinirole (Neuro Patch) was a dopamine drug, and likely to be responsible for my ever worsening symptoms, I decided I needed to get off the Ropinirole and try a<br/>Methadone treatment. After a very difficult few months of weaning from my medications, I am now free of the Gralise and Ropinirole. I continue to take Methadone, 10 mg, daily. My symptoms are finally, after years of restless, uncomfortable and sleepless nights, completely under control. I’m a different person. I get enough sleep. I can make plans to do things beyond 7:00pm, without fear of being caught somewhere (in a restaurant, play, movie, car, airplane) with breakthrough symptoms that I can’t control. I am now living my best life, symptom free, thanks to low dose opioid treatment, specifically Methadone, for my Augmentative RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marcy	None	None	0900006484fef6c7	Dicker	None	2022-03-31T23:47:46Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Dicker, Marcy	l1e-cmld-e188	False	None	False	2022-04-12 05:34:54.368	[]
3265	CDC-2022-0024-3271	https://api.regulations.gov/v4/comments/CDC-2022-0024-3271	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand these proposed guidelines address using opioids for chronic pain. Many of us, myself included, suffer from RLS, Restless Leg Syndrome. For some of us, the only relief we can get is from the use of a low dose opioid on a daily basis. Without this help, we suffer in a way that is difficult to describe and understand. I will use myself as an example. If my RLS is not controlled I am unable to do very much. Most important of all, I am unable to sleep. If I don't have my needed opioid medication I experience the need to constantly move my legs. Often walking reduces my discomfort but only while I'm walking. If I have a really bad RLS attack, even walking doesn't help a lot. When that happens not only am I unable to sleep, I am also unable to find any level of comfort except in a hot bath. Once I'm in the bath, I feel relief and sometimes fall asleep. Falling asleep in a tub isn't the safest thing to do. Once I get out of the tub, my RLS returns full force. Eventually, I will get a few hours of sleep. When this happens on a regular basis I have no life. I'm too tired to do anything. If I try to do something, there is a 95% chance I'll have an RLS attack and will need to spend my time walking. Anything that requires a car ride is out of the question as having RLS as a driver or passenger is a miserable experience. Opioids have given me back my life. I can sleep and engage in normal activities. At the age of 82 I have a short horizon for enjoying my life. It would be very sad if I needed to spend this stage of my life dealing with RLS on a daily basis. I beg you for my sake and for the sake of others with chronic RLS, please address this condition. Do not, I beg you, leave us wondering if our medication will not be available to us at some time in the future. Thank you for your attention to this serious condition. As I've experienced, uncontrolled RLS is not only miserable, it can lead to thoughts of suicide. It is my understanding that some RLS suffers have taken this step because their lives became so unbearable with this condition.<br/>Thank you again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484fef6c8	Weiden	None	2022-03-31T23:49:33Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Weiden, Janet	l1e-cn00-r8tr	False	None	False	2022-04-12 05:34:54.606	[]
3266	CDC-2022-0024-3272	https://api.regulations.gov/v4/comments/CDC-2022-0024-3272	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing this comment to encourage support for low dose opioid therapy as a recommended treatment for restless leg syndrome. Restless leg syndrome is a terrible disease impacting 2-5% of the US population. This sensorimotor disease causes chronic and significant sleep deprivation, destroying the quality of life for most sufferers. Up until recently, there have been no long-term treatments for this life long affliction; however, low dose opioids have shown to be incredibly effective over long periods of time. The RLS opioid registry has tracked the medical history of hundreds of RLS patients on low dose opioids showing the safety and efficacy of this therapy. Unfortunately, many doctors are not familiar with RLS care and are hesitant to prescribe low dose opioids. With the support of the CDC, physicians will feel more confident in treating their RLS patients with this life changing therapy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ali	None	None	0900006484fef6d9	Hashmi	None	2022-03-31T23:52:40Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Hashmi, Ali	l1e-cfkd-s2dz	False	None	False	2022-04-12 05:34:54.814	[]
3267	CDC-2022-0024-3273	https://api.regulations.gov/v4/comments/CDC-2022-0024-3273	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS has affected my life since I was 12 years old. At night, I would rock back and forth for hours, trying to calm my back muscles so that my legs would stay still. By age 29, dating my future husband, he would have to pull over if we drove more than a few miles so I could stretch my legs. <br/>I am now 67 years old. On Christmas Eve, 2015, the rls had flared horribly. For 5 days and night, I wandered the house unable to sleep or rest. My husband took me to a local hospital that was clueless as to what to do. By Christmas Day, my entire body was writhing. All four limbs moved incessantly. I was hallucinating and conversing with our deceased son. My husband took me back to the hospital where it became evident when I finally was able to get my medical records that the hospital had labeled me a psychotic person, rather than realizing that I was in a full blown dopamine agonist crisis due to 20+ years of taking mirapex to control my rls. I read their notes in horror; “unkempt female with psychosis”. Further reading, it was clear they had decided I must be on some illicit drugs. There were pages of “negative” lab results for every conceivable prescription and street drug. No one ever bothered to read the papers my husband brought to the hospital that might have helped the clinicians diagnose me properly. When I think back, it makes me shudder to think of what would happen now if they found the low dose methadone in my system. It would have confirmed in their minds that I was a dirty unkempt druggie and they may have treated me even worse. <br/>After that horrifying event, every single drug prescribed by a local neurologist was denied by our insurance. Worse, none of them worked to control my rls. Sleep, rest, sitting, was impossible. The insurance denied payment for gabapentin, Horizant, Lryica, Neupro patches, mirapex extended release and requip. We had to pay for all of these drugs out of pocket. The Horizont alone was over $350 for 10 pills. <br/>We went to Mayo Clinic in March 2017 where I was trialed on tramadol, morphine sulfate extended release and finally methadone, my savior drug. Finally, I could sleep. Finally, I could visit friends without squirming all over, I could work and travel on an airplane. I could LIVE. <br/>This has been wonderful with the exception of trying to pick up my monthly methadone. Our local pharmacy decided to make it almost impossible for me to get 5mg three times a day methadone. This is less than a third of a therapeutic dose! The pharmacist would come up with one excuse after another and actually had my physicians nurse in tears. The pharmacist yelled at her and hung up. The pharmacy refused to give reasons for their denials. When I would finally pick up the medication, the pharmacist would yell my name and address and then even louder would yell “Do you have questions about your METHADONE!” I lived in terror that a drug seeker might hear her and break into our home for my medication. We finally found a pharmacist who understands the necessity of this medication. We are grateful to this new pharmacy. Being unfairly profiled by a pharmacist, ignorant of the use of opioids for rls, was horrifying. <br/>My latest issue with rls occurred on August 8, 2018 when I had my first of two scheduled knee replacements. The years of standing to eat a meal, walking incessantly and constant movement wore down my joints. I was so very disappointed to find the surgery has reactivated my rls, even on methadone. Once again, our insurance has denied trial of morphine and other drugs since my situation does not fit their “algorithm “. I had an infection post op that caused my rls to be completely out of control. Finding that methadone did not stop that episode of post op rls was terrifying. <br/>I barely made it through the night one night. Ninety nine percent of my energy went to dealing with trying to calm the rls. I was so exhausted that physical therapy was almost impossible due to my surgical leg flailing. I can say this without reservation. Those of us with primary refractory restless legs syndrome understand what waterboard torture is. We live it every night that our rls goes uncontrolled. There are nights I have to fight a mighty battle to stay alive. I am not a depressed person. I am a tortured person. There is a huge difference between depression and someone who fights a daily battle to stay alive. I think we are brave. We deserve our opioids without being treated or judged. I have been on low dose methadone ever since. I only required one dose change in all this time. My life is finally full! I can sleep for the first time in my life! I can sit for as long as I want in a restaurant! I can stay seated on an aeroplane! Life is so good! If I had to give up my mere 15mg of methadone, I would seriously consider suicide. I could not imagine having to go back to a life of torture, like I had to live, prior to using methadone for my rls.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ruth Ann	None	None	0900006484fef6df	Artz	None	2022-03-31T23:57:42Z	None	None	1	None	2022-03-31T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Artz, Ruth Ann	l1e-cv9t-iatd	False	None	False	2022-04-12 05:34:55.019	[]
3268	CDC-2022-0024-3274	https://api.regulations.gov/v4/comments/CDC-2022-0024-3274	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate that you're revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like Restless Leg Syndrome (RLS) that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms can make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse, a process called "augmentation". When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Personally, I was initially diagnosed with RLS about 15 years ago. My general practioner prescribed Requip (ropinirole, a dopamine agonist), a medication developed for treating seizures that had gained popularity for treating RLS and was approved by the FDA for that purpose. Unfortunately, my doctor was not aware of the augmentation issue associated in the majority of RLS patients treated with Requip. Over the first 2-3 years of treatment, my symptoms began to plateau and the doctor would prescribe higher dosages. My symptoms then started getting worse, to the point where I would sometimes not fall asleep until 4 or 5 a.m. Finally I saw a specialist in RLS and got off Requip (cold turkey), then tried new medications. While pregabalin and similar drugs work for some, the damage done to me by Requip meant these medications were ineffective. I tried every conceivable non-medication approach as well. The only thing that worked was low-dosage opiods. I had difficulty tolerating some opiods (they would help with my legs but cause insomnia and itching), but finally found that 5 mg of methadone was effective. Given my experience with Requip, I wanted minimal dosing, so I actually cut my 5 mg pills in half and take 2.5 mg most nights. If I didn't have methadone available to me, I would be getting 2-3 hours of sleep per night and would have to quick my high-level executive work. While I still have nights with 4-5 hours of sleep occassionally, I am able to function, work and enjoy life. I understand the difficult issue of opiod addiction and the toll it's taking on many people. Still, opiods are vital for RLS treatment and making it too difficult to access them would dramatically reduce the quality of life for many people like myself. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. I have never taken more than 5 mg in a 24 hour period and expect I never will. <br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allen	None	None	0900006484fef6e3	Bucknam	None	2022-04-01T04:13:46Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Bucknam, Allen	l1e-cwzo-f7t9	False	None	False	2022-04-12 05:34:55.231	[]
3269	CDC-2022-0024-3275	https://api.regulations.gov/v4/comments/CDC-2022-0024-3275	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been alerted by the Restless Leg Syndrome Foundation that RLS is not to be included on the list of conditions that can and are being treated by low dose opiates. As one who has had this condition since childhood (am now 66), low dose opiates have helped me cope with the chronic pain that is RLS. I have been using 50 mg a day of Tramadol for the past 11 years and it has made a huge difference in my daily life and sleep habits. I'm not quite sure what my life would have been like without this help. I used to take a high dosage regimen of aspirin every night, usually about 2,450 mg per night but am concerned about long term repercussions to my stomach lining as I have read that this can become a problem. It has been a challenge to continue my prescription due to the negativity surrounding opiate use but have been fortunate in working with doctors who understand the necessity of this prescription in treating RLS. I understand that our society has taken opiate use to the extreme, abusing it and becoming dependent on debilitating amounts. I check in regularly with my MD to confirm that I am using this low dose responsibly and out of necessity, rather than for recreational purposes. This low dose simply makes the symptoms go away without an attendant high.<br/>Please amend the articles of your new proposal to include low dose opiates for RLS...<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef6e5	Anonymous	None	2022-04-01T04:14:59Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-cygg-hkmt	False	None	False	2022-04-12 05:34:55.453	[]
3270	CDC-2022-0024-3276	https://api.regulations.gov/v4/comments/CDC-2022-0024-3276	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new guidelines do not include chronic conditions such as restless leg syndrome (RLS). Conditions such as RLS are very different than chronic pain. Other medications have been used for restless leg syndrome but have a rather large incidence of augmentation, essentially providing no relief. <br/>I no longer can take these other medications and must take opioids so that I can sleep and function during the day. <br/>Not including the use of opioids for chronic conditions needing such drugs does a disservice to many people. <br/> For me personally, opioids are my only answer. Having to beg for relief is reprehensible. I am well aware of the issues with opioids. I am also well aware that persons needing these meds for chronic conditions tend not to encounter issues with dependence or tolerance. <br/>The Restless Leg Foundation would be a great place to contact for information regarding this awful condition. <br/>I would be most grateful if use for chronic conditions would be added to your guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sue	None	None	0900006484fef6e9	Plancon	None	2022-04-01T04:15:50Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Plancon, Sue	l1e-d3ci-1tcw	False	None	False	2022-04-12 05:34:55.664	[]
3271	CDC-2022-0024-3277	https://api.regulations.gov/v4/comments/CDC-2022-0024-3277	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been suffering from RLS for most of my adult life. I am now 68 years old. About 10 years ago my RLS became intolerable. I was unable to sit in the evening to watch TV, I could not go out to eat with my family without bouncing my legs and kicking endlessly under the table, I have had to leave in the middle of live performances and concerts because of the relentless and tortuous need to move my legs constantly. Long flights, particularly at night were indescribably horrible. I have also suffered from RLS in my arms and torso. The pain often left me writhing and screaming as I tried furtively to sleep. The interruption of my daily life and exhaustion severely reduced my quality of life. I started taking one of the dopamine agonist drugs, ropinirole, about 5 years ago which helped, but as time has gone on, I've needed to increase my dosage of ropinirole. This is a dangerous thing to do because of the risk of augmentation, so about 3 years ago I was able to start taking low dose hydrocodone with my ropinirole in the evening and it has been a life saver. I do not say that as an exaggeration because there was a time when I felt I could no longer live with this disease and I began to have thoughts of suicide. I have been taking 5 mg of hydrocodone once daily for 3 years. I take it every night and it makes my RLS go away within 30 minutes of taking it with the ropinirole. I have no desire to increase my dosage, I do not get any high from this medication, and I do not have any side effects such as itching or constipation. I know that RLS is a chronic condition and it is my feeling, from my own experience, that low dose opioids are extremely beneficial in the treatment of this disease. I am so thankful to have an understanding physician willing to treat me appropriately for the torture caused by RLS. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jorjann	None	None	0900006484fef6f2	Kuypers	None	2022-04-01T04:17:49Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Kuypers, Jorjann	l1e-d75m-rcjz	False	None	False	2022-04-12 05:34:55.878	[]
3272	CDC-2022-0024-3278	https://api.regulations.gov/v4/comments/CDC-2022-0024-3278	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with intractable Restless Legs Syndrome (RLS) for decades. After all other treatments failed, I was prescribed opioids to relieve the unbearable nerve irritation that accompanies RLS in its most severe form. For some RLS sufferers, opioids are the only medication that is effective in giving any relief at all. I have been taking small daily doses for 20 years without any problems with the medication. My condition is monitored regularly by a neurologist. Please allow the decision to prescribe opioids for RLS to be between a patient and their physician. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dianne	None	None	0900006484fef6f3	Jackson	None	2022-04-01T04:18:16Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Jackson, Dianne	l1e-d8s3-grat	False	None	False	2022-04-12 05:34:56.092	[]
3273	CDC-2022-0024-3279	https://api.regulations.gov/v4/comments/CDC-2022-0024-3279	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing regarding the updated Clinical Practice for Prescribing Opiods. I have a movement disorder called Restless Legs Syndrome (RLS) with augmentation, meaning severe. I was in very desperate condition when I saw Dr [name redacted]'s name on the RLS Foundations website. He is a leading specialist in the world with regard to RLS. I contacted him and I am eternally grateful he accepted me as a patient. He recommended that I go off of the usual and damaging dopamine agonist therapy I had previously been prescribed and that I start on a daily, very low dose opiod routine, in my case 5mg methadone. Just the stigma of the word methadone terrified me but I can't say enough about how much it has changed my life for the better. It's been almost 7 years now and I have never increased my dose. It is not a cure but it has most certainly made a huge improvement in my quality of life. I am able to function now, where before methadone my condition was getting progressively worse. I don't know where I'd be without it. It literally gave me my life back. I urge you to read the paper he wrote for Mayo Clinic titled "The Appropriate Use of Opiods in the Treatment of Refractory Restless Legs Syndrome". It will also familiarize you with RLS. Opiods have their place in medicine and it is for RLS patients like me. Please keep patients like me in mind when you consider guidelines for physicians prescribing opiods. I appreciate your thoughtful consideration of my comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fef6fe	Abraham	None	2022-04-01T04:19:37Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Abraham, Elizabeth	l1e-deje-7qh4	False	None	False	2022-04-12 05:34:56.300	[]
3274	CDC-2022-0024-3280	https://api.regulations.gov/v4/comments/CDC-2022-0024-3280	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE consider and let our doctors prescribe opioids for those of us that are SUFFERING from RLS. We have tried many other options and if small doses help us to sit on a plane, or thru a movie or appointment or even function in our daily lives than know how much we need you to consider our plea!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary Jo	None	None	0900006484fef70f	Enyeart	None	2022-04-01T04:20:19Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Enyeart, Mary Jo	l1e-djzm-0hjm	False	None	False	2022-04-12 05:34:56.508	[]
3275	CDC-2022-0024-3281	https://api.regulations.gov/v4/comments/CDC-2022-0024-3281	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have many, many RLS patients that require opioids once they've reached no other options. This could be for various reasons, such as augmentation with any dopaminergic medications, side effects with gabapentin/Pregabalin etc., and iron stores are normal. I can't tell you how many patients have said low dose opioids change their entire lives and they are once again able to sleep, mood and outlook improve, and their entire quality of life is dramatically improved. I have many patients that would freely attest their journey with you to show you the dramatic difference opioids made in their lives when using it to treat RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M. Suzanne	None	None	0900006484fef712	Stevens	None	2022-04-01T04:21:35Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Stevens, M. Suzanne	l1e-dliq-1h7d	False	None	False	2022-04-12 05:34:56.732	[]
3276	CDC-2022-0024-3282	https://api.regulations.gov/v4/comments/CDC-2022-0024-3282	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been hurt by the cdc guide lines that were implemented in 2016. My Doctor was prescribing me opiate pain medication for pain. My original doctor had retired and I was at a new office when my entire prescription was taken away from me because i called in a few days early for a refill request following a painful reaction to the second Covid shot AND because the doctor used this excuse to discontinue my medication and kick me out her practice because she was feeling pressure to conform to the new guidelines. I had never purchased opiates from the street because my pain was being controlled by the medication that i was receiving. I had never demanded more medication because i knew that she had restrictions put on her by the new guidelines and i did not want to loose the small amount of medications that i was receiving. I have had to find a Suboxone clinic to help manage my pain because no doctor would help me because i had been kicked out of my previous office and because so many doctors now refuse to prescribe opiate medications because of the intense scrutiny doctors have been put under since the new guidelines were implemented. Opiate medications are the only medication that works for my headaches and intense pain that is a hold over from an operation that had gone wrong several years earlier. Doctors do not need to have their licenses threatened just because they are compassionate enough to treat people in pain. My quality of life has been adversely affected because of the recent restrictions. And although I believe that companies like Purdue lied and were the main cause of huge problems in the past...a one size fits all and a punitive posture towards patients in need of opiate medications is almost as bad. Please point the finger at the real reason for the opiate crisis and not a made up one to make politicians look like they are tough on crime.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef71d	Anonymous	None	2022-04-01T04:23:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-dsxf-l9un	False	None	False	2022-04-12 05:34:56.943	[]
3277	CDC-2022-0024-3283	https://api.regulations.gov/v4/comments/CDC-2022-0024-3283	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it difficult to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I first was diagnosed with RLS about 10 years ago. I am now 74 years old. I have gone through many different prescriptions for my ailments and until this past year, all of the prescriptions failed to relieve my problem. In 2021, my neurologist prescribed Methadone. I was unable to get any help from my medical insurance for this prescription and due to the high price and difficulty in obtaining these pills, my doctor switched me to Oxycodone. Later, we switched to Oxycontin, which have a longer lasting effect. I am on 20 mg of Oxycontin per day and they work better than anything else I have used. I am trying to eliminate Ropinirole from my prescription because of the augmentation effect is has on me. I have even found it difficult to obtain these Oxycontin medications. My insurance pays for a portion, but they will only allow me 30 days of supply. I realize this medication is addictive, but with my RLS problem, it is a situation I must accept. At my age, you do whatever you can to get a restful night of sleep. Please don't affect my ability to acquire this medication. The state I live in does not allow medical marijauna for this disease. Hopefully, someday i can try that as a potential additive to my medication.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy in low-total-daily doses.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fef71f	Koppy	None	2022-04-01T04:24:54Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Koppy, Richard	l1e-dxmx-rxek	False	None	False	2022-04-12 05:34:57.151	[]
3278	CDC-2022-0024-3284	https://api.regulations.gov/v4/comments/CDC-2022-0024-3284	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from refractory RLS since my first pregnancy back in 1997. I am unable to tolerate the dopamine antagonist drugs that are recommended for RLS treatment. The opioid class of drug therapy is what has worked for me but I am no longer able to obtain a prescription for them from my neurologist because of the new drug regulations. Without this medication I do not sleep AT ALL. Due to the constant movement of my legs I can not fall asleep. It is a miserable way to live. It only takes a very low dose of an opioid drug to calm my legs so that I am able to fall asleep. . I always follow the recommendations for their usage as well as dosage only taking them at night before bedtime.Not having access to opioids for the treatment of my RLS would severely diminish my quality of life. The RLS community of patients really needs your help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tonja	None	None	0900006484fef725	Cross	None	2022-04-01T04:25:30Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Cross, Tonja	l1e-dze9-2rmq	False	None	False	2022-04-12 05:34:57.401	[]
3279	CDC-2022-0024-3285	https://api.regulations.gov/v4/comments/CDC-2022-0024-3285	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75 year old male and have suffered from RLS (Restless Leg Syndrome) for most of my adult life and after taking the recommended non opioid drugs for many years I started to suffer augmentation which caused all of the non opioid drugs to stop being effective at reducing my daily RLS symptoms. After a spinal surgery I was prescribed 20mg hydrocodone tablets for the pain. While taking this opioid I had no RLS issues, however after stopping the hydrocodone my RLS returned. After speaking with my doctor about this he decided to prescribe a low daily dosage (20-25mg daily) prior to bedtime. My RLS symptoms were reduced to near zero and have been that way for one year now.<br/>Please allow a low dosage (25-50mg) of such opioids to be prescribed for the treatment of RLS.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	douglas	None	None	0900006484fef726	rea	None	2022-04-01T04:26:15Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from rea, douglas	l1e-e0ba-4w1i	False	None	False	2022-04-12 05:34:57.617	[]
3280	CDC-2022-0024-3286	https://api.regulations.gov/v4/comments/CDC-2022-0024-3286	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low total daily dose opioids need to be included for RLS(Restless Leg Syndrome). This is a horrible condition that ruins peoples lives. Low dose daily opioids are often the only treatment that can give relief to people like me who suffer with this condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jackie	None	None	0900006484fef72a	Duvall	None	2022-04-01T04:26:37Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Duvall, Jackie	l1e-e2q8-hi47	False	None	False	2022-04-12 05:34:57.829	[]
3281	CDC-2022-0024-3287	https://api.regulations.gov/v4/comments/CDC-2022-0024-3287	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mother and I both suffer from severe cases of RLS (Restless Leg Syndrome). I am married to a physician who sees opioid abuse all the time and was extremely skeptical when he found out my mother was prescribed low dose opioids to manage her symptoms. In the 12 years she's been on them she has never gone up in dose and my husband now understands how the treatment of RLS with opioids is completely different than pain management. As insignificant as this disorder may seem, it can be completely debilitating both physically and mentally to those that suffer from severe cases. Please take into account there are many scenarios in which opioids are a necessary treatment. No one can argue that they've been overprescribed by some physicians and abused by patients. There must be a way to limit opioid use without denying those that truly benefit from them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kris	None	None	0900006484fef72e	Muntan	None	2022-04-01T04:27:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Muntan, Kris	l1e-e5ws-3g8c	False	None	False	2022-04-12 05:34:58.038	[]
3282	CDC-2022-0024-3288	https://api.regulations.gov/v4/comments/CDC-2022-0024-3288	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My journey with RLS began as a child. I had no idea what was wrong with me and always believed it was just a “me” thing. As I got older and my symptoms worsened, I began to lose sleep and eventually became less productive while at work. For years my evening routine consisted of several steaming hot baths and very little sleep. There were lots of tears and even fights with my wife as my constant moving or pacing woke others. My RLS wasn’t the same as many others I had heard stories from. Yes there were many similarities. But mine included a deep throbbing and aching pain. The pain was constant.<br/><br/>Once I began to research RLS and understand more about it, I began seeking advice and finally went to my PCP. I learned a lot through the internet and different forums, even to the point where I was able to educate my PCP. Unfortunately, all the medications (non opioids) that were prescribed had very little positive effect, if any. My symptoms continued to worsen over the years to where I dealt with various symptoms throughout the entire day, not just while at rest in the evenings. Again, the urges to move greatly intensified. But also the pain associated with my severe RLS intensified. We tried more medications and even upping doses of existing meds. All to no avail. Very little people know that the symptoms became so bad that it negatively effected my work life and productivity.<br/><br/>It wasn’t until I was in my mid 30’s before I found my current specialist, who was extremely knowledgeable when it came to RLS. Where other RLS medications failed, a treatment plan of lose dose opioids worked wonders. To this day I am able to avoid most severe symptoms of RLS. The program my specialist has in place to closely monitor everything is exceptional and works for us. To think that I could of had this relief so much sooner, but because of our crazy regulations and the stigma associated with opioids, my PCP and other doctors were too afraid to try low dose opioids. Instead I was often prescribed way too high doses of Neupro and Mirapex than I should have been on. During that time I also had to be on various medications to help sleep. Even though I have relief now I still have to jump through so many additional uncalled for hoops. I still fear that one day my relief will be pulled away from me. I also feel for my specialist and other doctors, as the regulations make it near impossible to take care of their patients properly. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kevin	None	None	0900006484fef739	Porter	None	2022-04-01T04:29:39Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Porter, Kevin	l1e-edyv-mg6h	False	None	False	2022-04-12 05:34:58.250	[]
3283	CDC-2022-0024-3289	https://api.regulations.gov/v4/comments/CDC-2022-0024-3289	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>I'm 44 years old, I have had RLS since I was a young kid. My life had been destroyed from restless legs syndrome, when ever I'm relaxed, over tired. Bored, with a full bladder, not only do my legs start twitching but my arms go wild as well. I can't sleep, I don't sleep. Every night I dread, dead knowing it will start again, and then the only thing i an given to help is clonazepam, I have to take (3) .5mg to finally fall asleep, by time this happens I only get a few hrs of sleep and I have up wake up to begin my day, so I'm left tired and exhausted from not getting enough asleep but then the drowsiness from the clonazepam just toss tops the cake. No doubt I will have an early heart attack from all the stress my body is under. A low dose opioid would greatly improve my quality of life. <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristina	None	None	0900006484fef740	Kleinschmidt	None	2022-04-01T04:31:05Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Kleinschmidt , Kristina	l1e-efq3-vmox	False	None	False	2022-04-12 05:34:58.492	[]
3284	CDC-2022-0024-3290	https://api.regulations.gov/v4/comments/CDC-2022-0024-3290	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I use to be able to receive a 90 day supply of the Lorazepam (Ativan) 1MG that I took daily before bedtime. I am 77 years old and I have had RLS since child hood. My parents called the sensations I told them about "growing pains". I am aware that RLS is hereditary and my mother and her sister had RLS. In November 2021 my doctor informed me that she wouldn't approve a prescription for Lorazepam (Ativan) 1MG I took at bedtime. I also take Ropinirole HCL 5MG at bedtime. Over the years the MG has increased, but I have been stable with 5MG. A warm bath helps me sleep when my RLS is extremely painful. RLS makes traveling unbelievable the only relief I get is to keep bouncing my legs while in a car, and is irritating to my husband. I do take 1MG Ropinerole when traveling over 50 miles while on a trip. I began going to a neurologist for RLS in 1987. He started me with Ativan and Ropinerole. I also had a sleep study in 2000 and I was informed the number of times my legs moved. Currently I am using a CPAP machine, and I don't mind using it, but it doesn't help my RLS, I also know of a few things that I do or drink that triggers my RLS. Thank you RLS organization for joining all of the RLS victims around the world.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paulette	None	None	0900006484fef745	Balda	None	2022-04-01T04:32:03Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Balda, Paulette	l1e-ejqo-oyq3	False	None	False	2022-04-12 05:34:58.707	[]
3285	CDC-2022-0024-3291	https://api.regulations.gov/v4/comments/CDC-2022-0024-3291	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The use of low dose opioids works like a charm for my RLS and I’ve had no addiction problems after a year with this medication. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Simon	None	None	0900006484fef747	Turner	None	2022-04-01T04:32:29Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Turner, Simon	l1e-ek9b-tmbv	False	None	False	2022-04-12 05:34:58.923	[]
3286	CDC-2022-0024-3292	https://api.regulations.gov/v4/comments/CDC-2022-0024-3292	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I'm 75 years young with childhood-onset RLS which has manifested into Primary Limb Movement Disorder, PLMD, as RLS often doses as one ages. My PLMD causes severe repetitive limb movements and muscle spasms throughout my body. I very rarely experience uninterrupted sleep as the PLMD wakes me up every couple of hours. Getting back to sleep is a huge challenge. I also have bouts of PLMD during the day making daily life extremely difficult. I hope the CDC will consider the plight of people like me who have PLMD and RLS combined. I wish I could attach a video of myself, taken by my husband, of me during an attack of PLMD. You would truly understand why this is so important to people afflicted with PLMD. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mari	None	None	0900006484fef74b	Wilbur	None	2022-04-01T04:33:30Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Wilbur, Mari	l1e-ekmk-ev7r	False	None	False	2022-04-12 05:34:59.134	[]
3287	CDC-2022-0024-3293	https://api.regulations.gov/v4/comments/CDC-2022-0024-3293	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><span style='padding-left: 30px'></span>The opioid (Tramadol) that I take during the day keeps me sane. It keeps me able to sit at the computer and function, able to read, able to drive a car. It's a medication that actually keeps me awake. Please make it easier for people with RLS to obtain opioids for relieving the horrible sensations that accompany the disease. My days were horrible without the Tramadol. I take Pramipexol at night, and not Tramadol.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MARTHA	None	None	0900006484fef759	LENTZ	None	2022-04-01T04:34:06Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from LENTZ, MARTHA	l1e-esfp-bmo6	False	None	False	2022-04-12 05:34:59.587	[]
3288	CDC-2022-0024-3294	https://api.regulations.gov/v4/comments/CDC-2022-0024-3294	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thanks for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a neurological disease that causes an urgent need to move the legs and can severely impact with sleep and overall quality of life. I have had very bad RLS for over 30 years. <br/>In the U.S. over 11 million people suffer from RLS. There is no cure. Some prescription medications may relieve the symptoms initially, but over time make the symptoms worse. When first line medications fail, research supports the use of low dose opioids to treat severe RLS.<br/>The 2016 CDC Opioid Prescribing Guidelines made some physicians afraid to prescribe opioids ever, even for patients with severe RLS who had been on the same low dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy. <br/>Thank you for your time, [name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erik	None	None	0900006484fef760	Sween	None	2022-04-01T04:34:59Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Sween, Erik	l1e-etzo-rcww	False	None	False	2022-04-12 05:34:59.807	[]
3289	CDC-2022-0024-3295	https://api.regulations.gov/v4/comments/CDC-2022-0024-3295	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a sufferer of PLMD, Periodic Leg Motion Disorder, a subset, as i understand it, of RLS.<br/><br/>I have tried every remedy that i can think of, including leg wraps and vibrating pads, in order not to take medication. Those help, but the only real relief I have found is a nightly staggered dose of gabapentin up to 3200mg, combined with an opiod. Right now, the opiod is Tramadol 150mg daily at bedtime.<br/><br/>I hope to try another opiod, such as methadone, because I hear tramadol can cause long term augmentation. That may be happening to me. However, for now, I can cope with the combination of the gabpentin and the tramadol.<br/><br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fef764	Martindale	None	2022-04-01T04:35:41Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Martindale, Robert	l1e-eyu0-seep	False	None	False	2022-04-12 05:35:00.029	[]
3290	CDC-2022-0024-3296	https://api.regulations.gov/v4/comments/CDC-2022-0024-3296	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Veteran, I have had RLS since I retired in 2000, my RLS has become worse and worse. I urge CDC to approve other types of meds or treatment for this. The VA does not recognize RLS as a disability but I'm living proof that my quality of life has diminished tremendously that my wife cannot deal with me when my legs, arms and body start this craziness. Been dealing with.this disease for 20 plus years and there is not a cure for it. Please pass this guideline for us that suffer day, and night.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ferdinand	None	None	0900006484fef767	Ramos	None	2022-04-01T04:36:13Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Ramos, Ferdinand	l1e-f11w-zqin	False	None	False	2022-04-12 05:35:00.259	[]
3291	CDC-2022-0024-3297	https://api.regulations.gov/v4/comments/CDC-2022-0024-3297	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>While I do not personally have RLS, my husband does. With us having been high school sweethearts and still being married to this day, I’ve experienced his journey with RLS every step of the way. From him feeling alone and depressed because conventional RLS medications weren’t working, to finally finding someone specialized in RLS and who was willing to take care of him properly as any doctor should be able to do. <br/><br/>Throughout his journey we came across so many different doctors who understood what he was going through but were either too scared to try opioids or were too fearful of regulations. No patient should ever go through what he has had to experience. Doctors need to be able to properly assess their patients symptoms and conditions, and be able to treat them as needed, without fear of crossing any lines. <br/><br/>My husband and I completely understand the need for regulations as we’ve all seen people impacted by opioids. But unfortunately we overreact as a country (or agency) and tighten things up so far to where patients cannot receive the care needed. Yea, more research is needed in terms of what regulations should be in existence. But the priority should always be patient care above all else. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angel	None	None	0900006484fef76b	Porter	None	2022-04-01T04:37:30Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Porter, Angel	l1e-f1sg-uy8p	False	None	False	2022-04-12 05:35:00.480	[]
3292	CDC-2022-0024-3298	https://api.regulations.gov/v4/comments/CDC-2022-0024-3298	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand you are revising the CDC Clinical Practice Opioid Prescribing Guidelines. I think it is very important that the guidelines take into consideration the use of opioids in the treatment of chronic conditions<br/><br/>I am a 71 year old woman who has had Restless Leg Syndrome for more than 30 years. I recently had a conversation with the head of the [name redacted] Sleep Disorder Center as I wanted a second opinion about the use of opioids in my treatment. After an extremely thorough diagnostic discussion, he affirmed that given my condition and my symptoms, that it is absolutely appropriate that the opiates I am on are completely in line with best practices for patients with my degree of severity. I have tried other drugs to treat my condition and they have either not been effective or have created an augmentation effect where my symptoms got worse but increasing these non opiates did not help my condition. <br/><br/>Taking a “cocktail” of drugs that include 45 to 60 mg of hydrocodone has literally saved my life. And, without these opiates my life would be a living hell<br/><br/>It frightens me that government agencies would take away this life affirming and life saving drug from me, or go after the doctors who have prescribed these medicines as they watch over me. When I read about efforts to limit access to opiates for people who have chronic medical conditions, I fear for myself and others who have no other treatment options<br/><br/>I am not a drug addict —but rather a responsible citizen who has led an exemplary life in the service of my community. I have thoughtful and respected doctors who understand that these opiates are my only hope. <br/><br/>Please please take my story and the story of thousands of others in my situation as you consider options for treatment of diseases where low level doses of opiates — carefully monitored — are the only viable option. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484fef779	Kaye	None	2022-04-01T04:39:09Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Kaye, Judith	l1e-fbrt-98pw	False	None	False	2022-04-12 05:35:00.746	[]
3293	CDC-2022-0024-3299	https://api.regulations.gov/v4/comments/CDC-2022-0024-3299	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 77 year old male and have suffered from RLS (restless leg syndrome) for over four decades. It started in my thirties in my lower legs. The symptoms are hard to describe. They feel like ants are crawling under my skin. The only way to relieve the sensations is to get up and walk about. I would get RLS about twice a week at first. <br/><br/>As I got older, the RLS attacks became more frequent. They were most severe when I was sitting and I couldn't get up to pace about (such as on a bus, plane, or seated in a theater.) I was a special ed teacher. I accommodated the RLS by seldom sitting during my work day. I remained afoot, walking about in the classroom.<br/><br/>Over the last 15 years, the RLS has spread up my legs and become much more severe. It occurs every night when I attempt to sleep. I have tried all kinds of therapies-- yoga, massage, acupuncture, acupressure, hot and cold pads, supplements, etc. Nothing helped. I sought medical support. My doctor prescribed Mirapex, a dopamine agonist. This initially was effective at suppressing the RLS attacks. I was so grateful I could sit through a movie and sleep through the night. But over time, I needed more and more Mirapex to keep the RLS under control. In time, the Mirapex ceased working altogether. It actually augmented my RLS, making my symptoms worse. I was up every night pacing about. I would crawl back in bed and within minutes the RLS became unbearable. Over time I felt more and more exhausted. I felt sleepy all the time, but even during the morning hours when the RLS symptoms lessened, I could only nap for short periods. The quality of my life was slipping away. <br/><br/>My doctor prescribed a different drug, Gabapentin, a ligand commonly used to treat seizures and neuropathic pain, as well as RLS. But I had serious side effects and could not tolerate the medication. <br/><br/>This left just one other possibility, opiates. I really didn't want to go this route. I was concerned that I might become addicted. But there were no other pharmaceutical options for treating RLS. My doctor assured me that the dosage was much less than given patients with severe pain. <br/><br/>So I decided to try the opiates. My doctor initially prescribed Methadone. But I had difficulty handling side effects of this drug and it wasn't much help with the RLS symptoms. He then prescribed Oxycodone. This drug provided a lot of relief from the RLS symptoms and had negligible side effects. I felt no euphoria or spaciness with my small dosage of Oxycodone. I no longer was concerned about addiction. <br/><br/>Using Oxycodone I was able to sleep much better than before. But it didn't suppress my RLS for the entire night. I had to take additional (small doses) of the medication every few hours, so my sleep continued to be interrupted. My doctor suggested a time release version of Oxycodone. I combined a small dose of Oxycodone followed by one tab of Oxycontin, the time release version. This worked very well. I now could sleep through the entire night most of the time. I began to feel well rested when I awoke. With the Oxycodone/Oxycontin combination, I actually took less medication than I did with Oxycodone alone, and it worked much better. <br/><br/>But late last year, Oxycontin was withdrawn from availability. My doctor recommended M.S. Contin, a low dose, extended release form of Morphine. Again I was resistant because of concern over addiction. But my RLS again was uncontrollable, so I gave it a try. Fortunately, it was able to suppress my RLS symptoms and I was able to sleep at night. I am grateful for the medication. <br/><br/>The opiates are not a panacea for my condition. RLS usually becomes more severe as people age. For me, RLS episodes still occur, especially in the late afternoons/early evenings. I'm vulnerable to RLS attacks in situations where I need to sit for long periods. But usually I can walk about and minimize the discomfort. The MAJOR benefit of opiates is that I can sleep again and no longer feel constantly exhausted. <br/><br/>I am a member of Kaiser Permanente. I have their Senior Advantage insurance. The opiates are carefully controlled, and I must get my doctor's prescription renewed every month. I need to pick the drugs up in person with ID every month. (I understand why and support regulations that prevent excess drugs from getting into circulation.) I'm more than willing to accept this inconvenience, because the medications have restored my life. <br/><br/>Opiates are not “evil” drugs. They are an important part of our nation's medical arsenal. They can provide short term relief in high dosage for people with severe pain. They can also provide great relief in low dosage for people suffering from chronic RLS. They can literally be life savers when no other medication or treatment is available.<br/><br/>Please keep these medications available to people suffering from Restless Leg Syndrome. We are not addicts. We are responsible, hard working citizens. We need your understanding and support.<br/><br/>Thank you,<br/><br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alfred	None	None	0900006484fef784	Weiler	None	2022-04-01T04:42:57Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Weiler, Alfred	l1e-fipv-7prs	False	None	False	2022-04-12 05:35:00.978	[]
3294	CDC-2022-0024-3300	https://api.regulations.gov/v4/comments/CDC-2022-0024-3300	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Takings single small dose of Tamoxifen at night makes it so I can sleep through the night without my leg movement waking me up several times. I take it in conjunction with gabapentine. It doesn’t create a dependence on the drug, only keeps my legs from waking me up.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef78a	Anonymous	None	2022-04-01T04:43:13Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-fkj1-ypad	False	None	False	2022-04-12 05:35:01.197	[]
3295	CDC-2022-0024-3301	https://api.regulations.gov/v4/comments/CDC-2022-0024-3301	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from RLS since I was a teenager, with it progressing as I became older. For many years there was no recommended treatment available so I would try things like exercising before bed to fatigue my muscles, warm milk, alcohol, even sleeping on the floor. Finally, while suffering with bronchitis, I was prescribed codeine cough medicine for my cough. I realized how much the cough medicine was helping my RLS because of the wonderful sleep I was experiencing. I had to educated my physician about RLS and what I was having to experience. Luckily my physician listened and understood my symptoms, therefore agreeing to prescribe Codeine cough medicine for me on an “as needed” basis.<br/><span style='padding-left: 30px'></span>Today I have been using Mirapex since the drug came on the market taking 0.125mg tablets 2-3 tablets 2-3 times a day. This low dosing allows me to titration the dosing I feel is needed. However, there nights that, for whatever reason, my symptoms are “off the charts” with multi-limb movements that prohibited any chance of sleep. After taking my Mirapex dosing, adding 3 Advil 200mg, and exercising to fatigue my muscles, I find the only thing that will relieve my RLS symptoms is my Codeine cough medicine. Within 30 minutes of taking a 5-10 mg dosing, my muscles begin to settle down, allowing a peaceful night of sleep.<br/>I am now 71 years old and am still looking for the “magic formula” that will totally control my RLS symptoms but having some form of a narcotic available to me has been extremely helpful. My need for an increasing dose of the codeine cough medicine has not been a problem since I am still, after many years, taking only 5-10 mg. It is completely unpredictable when my symptoms will become more intense, but the availability of this small amount of codeine is invaluable to me in getting a restorative night of sleep. This allows me to function safely the next day in my duties and driving. Please take into consideration those of us with chronic conditions that benefit from various forms of narcotics when establishing your practice guidelines for prescribing opioids. Thank you for allowing me to share my years of RLS experience with you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suzan	None	None	0900006484fef79d	Griffin	None	2022-04-01T04:44:50Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Griffin, Suzan	l1e-fxyp-f86k	False	None	False	2022-04-12 05:35:01.416	[]
3296	CDC-2022-0024-3302	https://api.regulations.gov/v4/comments/CDC-2022-0024-3302	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider those who suffer Restless Leg Syndrome as you update the guidelines for prescribing opioids. I have had this condition for over 40 years. Each year it gets worse. The medications I have had prescribed would make a long list and I am still seeking one that truly works. Although not a cute, I have experienced some relief from a low dose of hydrocodone over a period of 25 years or so. My dosage has not changed during that time. I recognize the dangers from drug abuse but that should not deprive those of us who need help. Thanks for hearing me out.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef7aa	Anonymous	None	2022-04-01T04:45:24Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-g86d-fst8	False	None	False	2022-04-12 05:35:01.684	[]
3297	CDC-2022-0024-3303	https://api.regulations.gov/v4/comments/CDC-2022-0024-3303	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent, extremely uncomfortable and often debilitating need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>RLS has caused me severe emotional and physical distress. I cannot sit nor sleep for any length of time due to the sensations caused by RLS. Medication only helps for so long before the body adapts and there is a need to take more and more medication. At some point the medication stops working and there is no higher dose for someone suffering from RLS to take. The lack of sleep and inability to rest are debilitating. I have felt at times that suicide may be the only answer to relieve the symptoms. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef377	Anonymous	None	2022-04-01T04:46:10Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l1e-gfcl-0709	False	None	False	2022-04-12 05:35:01.901	[]
3298	CDC-2022-0024-3304	https://api.regulations.gov/v4/comments/CDC-2022-0024-3304	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain is not a choice. It is our existence of despair. This is not addiction. This is our survival. Forget about making it though the day in pain, you are just trying to make it to the next hour. With our limited pain medications, car accident victims are broken souls putting their lives in the hands of the caring professional pain management doctors. This is what they specialize in. They know our history. You need to step aside and let them lead the pathway to our destiny of hope and a better life. A day in pain is not a day, its hell. You are scared and lonely, waiting for the agony to stop but it doesn't because you are limited to your paid medications. What the CDC has done does not match the correct outcome. Why? Because our doctors cant do their jobs. We are suffering because of you. Free us and let the professionals do their jobs. Our doctors are our last hope. Free us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef37a	Anonymous	None	2022-04-01T04:47:06Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-ghbl-umcq	False	None	False	2022-04-12 05:35:02.124	[]
3299	CDC-2022-0024-3305	https://api.regulations.gov/v4/comments/CDC-2022-0024-3305	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low dose opioid therapy (i.e. 2.5-10mg methadone or equivalent) is a critically important treatment for patients with severe restless legs syndrome. Previous first-line treatment of restless legs syndrome (RLS) with dopaminergic agents (pramipexole, ropinirole, rotigotine) is no longer a good option due to long-term side effects of augmentation and impulse control disorder. Current first-line treatment of RLS with gabapentin & pregabalin works for many patients, but for some patients nothing controls severe symptoms except opioids. Low doses are required compared with patients with chronic pain. Mayo Clinic guidelines for treatment of severe restless legs syndrome with low-dose opioids provides accurate guidance for physicians treating severe RLS patients with opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484fef37d	Kanak	None	2022-04-01T04:48:54Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Kanak, Richard	l1e-g642-xqfg	False	None	False	2022-04-12 05:35:02.350	[]
3300	CDC-2022-0024-3306	https://api.regulations.gov/v4/comments/CDC-2022-0024-3306	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67 year old female with severe Restless Leg Syndrome. My condition robs me of the ability to sit still & quietly starting around 4-5pm every afternoon. I am not able to sew, read, or study. I am not able to sleep at night because my legs are constantly moving & jerking. Low dose opioid treatment allows my legs to be still & I now sleep 6-7 hours each night. Please consider RLS Foundation at www.rls.org as a resource for scientifically based information about Restless Leg Syndrome.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	0900006484fef381	Hunt	None	2022-04-01T04:49:29Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Hunt, Shirley	l1e-glb5-fa5k	False	None	False	2022-04-12 05:35:02.566	[]
3301	CDC-2022-0024-3307	https://api.regulations.gov/v4/comments/CDC-2022-0024-3307	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS since 1985. I was on dopamine agonists until 2020 when the side effect of the medication worsening my RLS became intolerable. Fifteen miserable months of trying GABA, pregabalin and gabapentin enacarbil in combination with other drugs with no success led to starting 3 mg hydrocodone twice daily. While that brought some relief, it has took another seven moths of trying other medications in addition to the hydrocodone to finally achieve relief 60 - 65% of the time. I cannot fathom the misery I would be forced to endure should low dose opiods not remain available for treating my RLS. As a 66 year old, I'm potentially looking at many more years of living with RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fef397	Harner	None	2022-04-01T04:50:39Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Harner, James	l1e-gz8q-kmi6	False	None	False	2022-04-12 05:35:02.783	[]
3302	CDC-2022-0024-3308	https://api.regulations.gov/v4/comments/CDC-2022-0024-3308	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m 54. I’ve lived with RLS all my life. My doctor at [name redacted] Bayview said it is an extremely bad case. I definitely agreed! We tried all different medications over time. Nothing but a small dose helps me and makes me a more involved person in all aspects of my life! It is goes away I wouldn’t be the same person.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef39b	Anonymous	None	2022-04-01T04:52:00Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-h2tc-9qn3	False	None	False	2022-04-12 05:35:03.024	[]
3303	CDC-2022-0024-3309	https://api.regulations.gov/v4/comments/CDC-2022-0024-3309	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient suffering from restless leg syndrome, I implore you to include opioids for RLS in your new guidelines for pain management. My 25 year battle with RLS affects every aspect of my life and I am unable to lead a normal life because of it. I have tried every medication that’s out there, including Mirapex, Requip, Clonazepam, Trazodone, Ambien, Amitriptyline, Gabapentin, Lyrica, Methadone, and Tramadol, and cannot get relief. The lack of sleep is slowly killing me. It would absolutely change my life and dramatically improve my health if I could find a medication that would allow me to sleep normally. Millions of others also suffer from RLS and many have it worse than me. Thank you for your consideration, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candace M	None	None	0900006484fef3a4	Allen	None	2022-04-01T04:52:50Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Candace M	l1e-h9yp-v6qe	False	None	False	2022-04-12 05:35:03.275	[]
3304	CDC-2022-0024-3310	https://api.regulations.gov/v4/comments/CDC-2022-0024-3310	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>I am writing to you on behalf of myself and millions of other people who are unfortunate to have have the debilitating disease of Restless Leg Syndrome. RLS sounds like a “silly” medical condition, a“just suck it up” problem to people who have never experienced it. I have had a mild case of RLS since my youth, but it has become exponentially worse with age. Dopominergic medicine is an approved treatment which rarely works well and when it does relieve the symptoms augmentation occurs which negates any helpfulness that dopamine may originally have had. Dopamine never alleviated my severe symptoms. Nor was I iron deficient. After not sleeping for about 3 months (other than short interval sleep until my RLS set in to awaken me and I would walk around the house, ride a stationary bike or walk outside in the dark until the sensation disappeared, only to awaken in about 30 minutes due to RLS symptoms again) I fell asleep at the wheel coming home from my veterinary practice, drove into the woods hitting a tree and having to be pulled from a burning fire with a broken sternum. I was lucky. Others are not. <br/>The only medication that gives me a solid nights sleep is low dose opioids. I have slep like a baby since the Doctor put me on it. Thank goodness he was not frightened out of his mind by the threat of DEA intervention or a CDC that just states this is not appropriate treatment for RLS. <br/>Yes, opioids are being abused but that in itself should not make the use of MEDICAL opiates illegal. Opiates are a life saving medicine when nothing else ameliorates the pain. It can save lives. I am asking you to consider RLS a relatively common disease to be included in your guidelines as to when low dose/potency opiates may be used. This philosophy applies to many other painful diseases the do not respond well to alternative medicines<br/>I thank you for the work that you do and strongly request that you include RLS in your decision as to what diseases opiates may be recommended and used to give people a life back. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Timothy	None	None	0900006484fef3a5	Bingaman, V. M. D.	None	2022-04-01T04:54:54Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Bingaman, V. M. D. , Timothy	l1e-ha0j-ecbw	False	None	False	2022-04-12 05:35:03.514	[]
3305	CDC-2022-0024-3311	https://api.regulations.gov/v4/comments/CDC-2022-0024-3311	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I suffer from refractory RLS. This disease has robbed me of sleep, family life, productive work and health. After many years of being mis-diagnosed I finally found relief with a low dosage of methadone. This changed my life in I can now sleep, my health has improved, and I hold a creative full-time job. I have tried almost all other therapies with no luck. Please include low dose opiate therapy in the CDC guidelines.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	0900006484fef3a6	Wendt	None	2022-04-01T04:55:48Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wendt, Bill	l1e-ha0l-9xxz	False	None	False	2022-04-12 05:35:03.746	[]
3306	CDC-2022-0024-3312	https://api.regulations.gov/v4/comments/CDC-2022-0024-3312	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a retired substance abuse counselor and recovering person, and as a writer and activist with a concern for the opioid epidemic, I understand the necessity of strict, comprehensive guidelines for prescription of opiates. However, as a person who also suffers from Restless Leg Syndrome, I am deeply concerned that current proposals risk excluding RLS from among the conditions for which opioid treatment will be considered appropriate. I have suffered for years from RLS. Poorly informed physicians prescribed a number of medications which only made my condition worse. Finally, after I fell asleep at the wheel and wrecked my car, I found a physician who could really help. He prescribed a low dose of Methadone which finally brought me some relief. It has not been easy. The side effects of opioid treatment can be uncomfortable. But I can now live a normal life. I can sit through a movie; I can read a book; I can safely drive my car. None of this would be possible without opioid treatment. I strongly encourage the CDC to include low-dose opioid treatment for conditions like RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fef3a9	Henson	None	2022-04-01T04:56:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Henson, Michael	l1e-hd2z-ezhx	False	None	False	2022-04-12 05:35:03.968	[]
3307	CDC-2022-0024-3313	https://api.regulations.gov/v4/comments/CDC-2022-0024-3313	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm grateful for your thoughtful, careful work in revising the 'CDC Clinical Practice Opioid Prescribing Guideline'. I also have a deep concern. I have Wilkes Ekbom Disorder (colloquially called RLS), and it is not mentioned in the draft. Indeed, in many medical school curricula, the disorder is inadequately addressed, so your draft's exclusion of the need for low-dose opioids to treat the disorder is not surprising. Research on the disorder is growing and impactful. Still, a thorough knowledge of WED/RLS hasn't yet fully arrived in the general medical world, with the exception of some of the top research hospitals in the world and in the United States. Top-notch medical institutions like Johns Hopkins, the Mayo Clinic, Scripps, Massachusetts General and more. Yet not enough to help the hundreds of thousands of children, adults and senior citizens afflicted with this debilitating and incurable disorder.<br/><br/>When this disorder is in full play, as it is in my life and far too many to tell of here, you have an indescribably uncomfortable sensation in your legs. Some call it 'worms crawling', 'hundreds of tiny siezures', 'creepy crawly nerves' and children often call it 'tickling', while they cry and scream from it. It sounds so mild, and yet it is inescapable. You cannot sleep. You cannot sit. You cannot attend to life's responsibilities. When it is highly developed, as it is in many, especially over 45, it is a form of torture. It eats away at your life until you only have a few hours in the day—usually late morning—when you have a few hours of relief. It is a kind of pain, but not a traditional pain. It doesn't require more and more opioids to be managed. It requires a low dose; sometimes only 20-30 mg a day, and the dose stays stable. But it does require opioids.<br/><br/>I have WED/RLS. What began as a mild case became a desperately painful and difficult experience, as I had to go through withdrawal of pramipexole, an approved medicine. There are many stories like mine. Even though I was under the treatment of a neurologist in a sleep disorder clinic on the outskirts of [city redacted], IL, he was unable to understand the gravity of the progression of the disorder. My life became a desperate search for answers. I could not continue my business and lost it in all but name. I could not go out with friends in the evening, even during the few times a hiatus of Covid allowed it. I was so tired and debilitated from the lack of sleep I longed to die. I couldn't sleep in the same bed as my husband.None of the medications my well-meaning neurologist prescribed did anything other than sedate me. I was no longer able to drive safely. The isolation on top of the Covid isolation was like being buried in a cave. I was faced with unbearable loneliness, when I was least able to cope. Sleeplessness takes away your initiative. It takes away your buoyancy and in the end, your hope. You can't think straight any more. The only medication that helped a little was a very, very low dose medication called Tylenol #3, which has codeine. But I had to take 4-5 pills on top of other medications, risking taking an overload of Tylenol. And because of the opiate crisis, my doctor was not happy about prescribing it at all. Thank God he did. But it was far from enough. <br/><br/>I finally spoke with a doctor from the Mayo Clinic, who, while he could not prescribe over state lines, sent my neurologist a recommendation to take 20-30mg oxyContin, a long lasting opiate. It's the first time in 18 months I've been able to lay in bed without writhing in agony. The current draft does not address chronic conditions like RLS which is different from chronic pain. Restless legs syndrome (WED/RLS) is a chronic neurological disease that causes an urgent need to move not only the legs, but in some cases, other parts of the body as well. <br/><br/>Knowing that people laugh at WED/RLS, as if it's just in someone's head, reminds me of the coming-of-age of ADHD. It was also mocked, for years. But what a wealth of information, hope and health there is now for people with ADHD! Apparently in the U.S., nearly 12 million adults and children suffer from incurable WED/RLS. Yes, a few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Please, please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information. It's been a Godsend for members like me, and should really be the first stop for neurologists and researchers. You will find a wealth of data. <br/><br/>With all my heart, I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Valerie	None	None	0900006484fef3ac	Osakada	None	2022-04-01T05:00:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Osakada, Valerie	l1e-hj27-oezr	False	None	False	2022-04-12 05:35:04.203	[]
3308	CDC-2022-0024-3314	https://api.regulations.gov/v4/comments/CDC-2022-0024-3314	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I’ve suffered from RLS (Restless Leg Syndrome - an admittedly wimpy name for THE most serious disease I’ve ever SUFFERED from). I’m 63 years old and I began having symptoms about 10 plus years ago. The only non-opioid medicine gives relief for a little while and then stops working. Period. If low dose opioids are not allowed for this chronic neurological condition for which there is no cure, I sincerely do not know what I will do. I do know that I CAN NOT tolerate the symptoms of RLS. I’m being honest when I tell you that I may have to join the league of others who were unable to tolerate the UNBEARABLE sensations of RLS, and end my life. I’ve never said that about anything. But the horrific sensations along with the chronic sleep deprivation are nothing short of torture. Please please please allow low strength opioids to be used to treat RLS. I want to live. Thank you. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	0900006484fef3ae	Glowacky	None	2022-04-01T05:03:28Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Glowacky, Catherine	l1e-hkht-hjs2	False	None	False	2022-04-12 05:35:04.435	[]
3309	CDC-2022-0024-3315	https://api.regulations.gov/v4/comments/CDC-2022-0024-3315	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate your revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, such as mine, my whole<br/>body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life, including car, bus and air travel, seeing a movie, a play or concert or just watching tv.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The restrictions on my medications are so severe that every month I struggle getting the prescriptions renewed. And I will do so for the rest of my life. It is intolerable. <br/>But these medications are the only ones that make my daily life tolerable.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	0900006484fef3b2	Canade	None	2022-04-01T05:04:17Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Canade, Catherine	l1e-hr1x-1ubf	False	None	False	2022-04-12 05:35:04.651	[]
3310	CDC-2022-0024-3316	https://api.regulations.gov/v4/comments/CDC-2022-0024-3316	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Restless Leg Syndrome. I am taking a medication (Ropinirole) that gives me almost total relief. However, my doctor says that this medication will likely become less effective over time, even if I take a larger dose. If that should happen I hope opioids will be available for use with RLS. I am told that they are very effective, and that a small dose is all that is needed.<br/>RLS may sound like a very minor problem, but in fact it is terribly difficult to live with. I hope that opioids will be available should I need them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484fef3b6	Thomas	None	2022-04-01T05:04:46Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Judy	l1e-hwbh-xmkx	False	None	False	2022-04-12 05:35:04.871	[]
3311	CDC-2022-0024-3317	https://api.regulations.gov/v4/comments/CDC-2022-0024-3317	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I exhausted all other medication possibilities before starting on methadone several years ago. I began with a 10-mg dose and am now taking only 7.5 mg per day. My RLS symptoms are well controlled with this regimen. I hate to think what my life would be like if my access to the methadone were cut off.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patty	None	None	0900006484fef3bd	Hodgins	None	2022-04-01T05:05:20Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Hodgins, Patty	l1e-i0jd-yj41	False	None	False	2022-04-12 05:35:05.093	[]
3312	CDC-2022-0024-3318	https://api.regulations.gov/v4/comments/CDC-2022-0024-3318	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please list RLS as a valid disease to treat with opoids. It is a disease little understood but someone who has a severe case and has tried all the non-opioid meds, the only that allows me not to suffer has been opiods. I am not otherwise affected or addicted. I have easily gone off an opiod or two.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484fef3c1	Steiner	None	2022-04-01T05:05:46Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Steiner, Judith	l1e-i32f-pijd	False	None	False	2022-04-12 05:35:05.312	[]
3313	CDC-2022-0024-3319	https://api.regulations.gov/v4/comments/CDC-2022-0024-3319	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have suffered from RLS most of my life. It is highly prevalent on my father’s side of the family with most of his siblings and their children suffering from it as well, in varying degrees of severity. My father is the most severe and I have followed in his footsteps. Primary RLS, can be extremely debilitating and cause a low quality of life. I was 38 when it became intolerable and required treatment, as it worsens with age. My Dr tried the "first line" treatments, which either were ineffective at controlling my RLS or the side effects were not tolerable. I have what is known as "refractory" RLS, not easily treated, same as my father. I suffered greatly with severe sleep deprivation which eventually caused depression. I had two young children and was unable to properly care for them. I was a night RN and my RLS began to affect me while working. I found myself having to march in place while caring for my patients to relieve the symptoms. Severe depression set in and I began having suicidal thoughts. I saw no end in sight and felt hopeless.<br/>My family doctor was not familiar enough about the condition to treat me properly, but open to suggestions. I began doing my own research and getting educated. I found the RLS.org website and reached out to one of the nationally recognized RLS specialists. Gave him my story and treatments tried and failed. He was the first to suggest I try opioids. I began with Percocet. It has a short half-life and it’s affects wear off quickly. This would cause my legs to kick in and wake me from sleeping, making it impossible to fall back to sleep without taking another dose. I reached out again, and he suggested a long acting once nightly dose. This was highly affective and I only needed to take one, once at night. I also needed something else to take during daytime hours and while working, so we added in Tramadol. THIS REGIMEN SAVED MY LIFE!!! I have been on it now for approximately 7 years with no need to increase the amount monthly nor increasing the dosage. THESE MEDICATIONS HAVE LITTLE TO NO SIDE EFFECTS. To this day it is still working wonders for me. Honestly, If I was no longer able to get my medication, I don’t know that I would survive. I don’t know that life would be worth living as it would be a life of suffering. <br/>This treatment has proven to be SAFE AND AFFECTIVE WITH LITTLE TO NO RISK OF ADDICTION for the RLS population. If most doctors do not understand the condition enough to properly treat it, then I can imagine most of the law makers don’t have a either. Just like one needs to listen to their doctor, because they are the educated ones, we ask that the law makers do the same!! Please take the time to learn about this condition and the effects it has on one’s quality of life. Please listen to the doctors and the experts about this condition and the safe and effective treatments for it and include it!!<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484fef3c5	Stone	None	2022-04-01T05:08:19Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Stone, Julie	l1e-i4lf-9q57	False	None	False	2022-04-12 05:35:05.536	[]
3314	CDC-2022-0024-3320	https://api.regulations.gov/v4/comments/CDC-2022-0024-3320	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have restless leg syndrome and it now affects me 24 hours per day as a result of the FDA appproving Dopamine Agonists as the only approved drug to treat RLS several years ago. After taking the FDA approved dopamine agonists for 5 years, it made my condition “augment”, which is not reversible. This made my condition so bad that I ended up flying to the Mayo Clinic to try to find relief thru any other way possible. This led me to my current doctor in [city redacted] approximately ten years ago and low-total-daily-dose methadone has literally saved my life. I have taken it every single day for the last ten years and i work closely with my physician and also Johns Hopkins Medical Center, regularly. This is much more than just a quality of life issue. It is simply, “an ability to live and be a productive person and father@ issue. Iam a father of 4 children, I am a grandfather and I am a business owner. Without the medication, I likely would either be living in another country that allows the prescribing of this medication in low-total-daily-doses or I would literally be dead. It is through this medication that I can manage my symptoms and lead a productive and loving life. Please add RLS to the list of approved conditions for the prescribing of low-total-daily-dose opioids. If this does not occur, you will be jeopardizing the quality of life for thousands of RLS sufferers for whom other medications don’t work. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. Thank you for reading my comments and for making sure that RLS is added to this legislation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tim	None	None	0900006484fef3ca	Thornton	None	2022-04-01T05:10:09Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Thornton , Tim	l1e-ickw-58hc	False	None	False	2022-04-12 05:35:05.758	[]
3315	CDC-2022-0024-3321	https://api.regulations.gov/v4/comments/CDC-2022-0024-3321	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I suffer from severe RLS and opioids are the only thing that gives me any relief. Please approve this as a treatment. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef3cb	Anonymous	None	2022-04-01T05:10:36Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-ideb-3o5x	False	None	False	2022-04-12 05:35:05.977	[]
3316	CDC-2022-0024-3322	https://api.regulations.gov/v4/comments/CDC-2022-0024-3322	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for reading my comment. Please include chronic diseases such as restless legs syndrome in the treatment guidelines for prescribing opioids for chronic pain and neurologic conditions. My name is [name redacted] and after being diagnosed with sarcoidosis in 1987 I immediately started suffering from RLS. After trying numerous medications and holistic treatments for the next 10 years with absolutely no benefit, my Doctor started me on oxycodone. I had been sleeping 0-2 hours per night for these 10 years which resulted in a very poor quality of life for my family and myself. For the first time in 10 years my RLS symptoms greatly improved, allowing me to sleep 5-6 hours per night. I have been taking oxycodone since 1997, presently taking 20 mg at bedtime. I am 69 years old with numerous other health issues. Without oxycodone my sleep time would be reduced to the 0-2 hours of sleep again and most likely would not survive. People with health issues that need and require opioids should not have to suffer because some people have made poor choices. I wish I did not need to take any medication at all. Thank You<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484fef3cd	Abdow	None	2022-04-01T05:11:52Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Abdow, Michael	l1e-iijn-q87k	False	None	False	2022-04-12 05:35:06.207	[]
3317	CDC-2022-0024-3323	https://api.regulations.gov/v4/comments/CDC-2022-0024-3323	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thad	None	None	0900006484fef3d0	Wolosinski	None	2022-04-01T13:02:19Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wolosinski, Thad	l1e-ilpi-k27t	False	None	False	2022-04-12 05:35:06.457	[]
3318	CDC-2022-0024-3324	https://api.regulations.gov/v4/comments/CDC-2022-0024-3324	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Restless Leg Syndrome and as much as I hate opioids, they are -in low doses- effective in relieving the pain and enabling sleep. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elsa	None	None	0900006484fef3d1	Waller	None	2022-04-01T13:08:16Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Waller, Elsa	l1e-imwi-1t9x	False	None	False	2022-04-12 05:35:06.676	[]
3319	CDC-2022-0024-3325	https://api.regulations.gov/v4/comments/CDC-2022-0024-3325	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an 84 year old male who has suffered from Restless Leg Syndrome for many years. Medicines that were prescribed to relieve this chronic and debilitating condition caused augmentation that made the condition worse. About three years ago my doctor at the *** prescribed a low dose of methadone to control the condition. That has restored my ability to sleep and has changed my life for the better. I believe that the guideline for prescribing opioids should recognize the safety and utility of low dosages to treat chronic conditions such as Restless Leg.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484fef881	Landsberg	None	2022-04-01T13:16:13Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Landsberg, Brian	l1e-kegd-f1f6	False	None	False	2022-04-12 05:35:06.905	[]
3320	CDC-2022-0024-3326	https://api.regulations.gov/v4/comments/CDC-2022-0024-3326	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The implementation of these guidelines, as written, is going to lead to more violence, more street crime and more deaths. A humane government should not endorse any form of torture, much less one against such a vulnerable population. <br/><br/>There is nothing to be gained by the government in turning the doctor/patient relationship into an adversarial one. But there's much to be lost.<br/><br/>The government should be very concerned that healthcare providers are requiring patients to complete applications to determine whether they are worthy of treatment or not -- especially when advocating for universal healthcare. The ACA promised people that they would not be denied care because of pre-existing condition. <br/><br/>These guidelines prevent that promise from being implemented for people with chronic pain conditions or for people with acute pain that is likely to be chronic in nature.<br/><br/>Today, an oncologist refused to review my son's chest x-ray to determine whether he needs a lung cancer workup or not because he is taking cough syrup with codeine in it. It doesn't matter what the intent of the guidelines were: their very existence is hurting people, hurting our healthcare system, and hurting our democracy.<br/><br/>The CDC has very little credibility remaining after the COVID debacle. It shouldn't squander what little goodwill Americans have left for administrative agencies by destroying the doctor/patient relationship.<br/><br/>It is in the best interest of the patients, doctors, government agencies and the government as a whole to revoke the 2016 guidelines and to refuse to issue new ones. Instead, the CDC should reiterate one of the fundamental tenets of healthcare -- the doctor/patient relationship is sacrosanct.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef886	Anonymous	None	2022-04-01T13:29:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-kion-sate	False	None	False	2022-04-12 05:35:07.121	[]
3321	CDC-2022-0024-3327	https://api.regulations.gov/v4/comments/CDC-2022-0024-3327	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE include low dose opioids (for example, TRAMADOL) for the chronic disease of WILLIS EKBOM DISEASE aka, RESTLESS LEG SYNDROME. Low dose opioids very effectively stop the horrible limb jumping and creepy sensations of RLS. I would “go mad” every night if I didn’t have TRAMADOL to help calm my awful RLS symptoms. Thank you for your consideration!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fef88c	Conley	None	2022-04-01T13:30:29Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Conley, Kathleen	l1e-kp44-yg9u	False	None	False	2022-04-12 05:35:07.347	[]
3322	CDC-2022-0024-3328	https://api.regulations.gov/v4/comments/CDC-2022-0024-3328	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My dad suffers from RLS. PLEASE help. It is severely hurting our family. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Philip	None	None	0900006484fef3fa	Wendt	None	2022-04-01T13:34:16Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wendt, Philip	l1e-kz77-kzes	False	None	False	2022-04-12 05:35:07.569	[]
3323	CDC-2022-0024-3329	https://api.regulations.gov/v4/comments/CDC-2022-0024-3329	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was just 21 when I got hurt at work, my foot was crushed; multiple open compound fractures so bad that a cast couldn't be put on and my foot was black. Since 11-20-1985 I've had 50 nerve blocks, numerous reconstructive surgeries, physical therapy, antidepressant therapy, I've had 2 strokes, and diagnosed with Reflex Sympathetic Dystrophy. I went through 14 years of being poked and prodded and experimented on. I even had a Lumbar Sympathectomy which left me with a scar 14 inches long across my right side around my back. I have been in the hospital so many times the people know me by my 1st name. I finally was told that there was nothing more that could be done and my only option was opioids. It took the doctor a week to get me to try and he made me a deal and said if after 72 hours I get no relief then he would never bring it up again. That was over 20 years ago and before the 2016 guidelines I was doing exceptionally good and I could walk up stairs and go grocery shopping and clean and cook and shower alone! Things that people don't think about normally who don't have chronic pain but the day they cut my meds 70% I started getting worse and I even watched my baby brother have massive spinal surgery which failed and saw him go for help only to be told no; even when he crawled into the ER on his elbows until the guards helped him to a wheelchair, he was told NO and told to take a Tylenol. He died 16 days before he would have been 50 because he asked what he thought was a friend for a few opioids and 15 minutes after he took 2 pills he was dead. I blame the CDC for his death because of their idiotic guidelines that made it impossible for him to get help and he was someone who didn't drink, smoke or do drugs and yet he is dead. He saved me from committing suicide so many times when my meds were taken and I have no one anymore. These revised guidelines are a joke. The CDC should be ashamed because they are in not just my opinion but many peoples opinions murderers of every life lost. I can no longer go up stairs, shop, shower alone or have any human dignity because of the guidelines so I ask you are you going to make it right for those of us who take prescription pain medication for chronic pain or are you cowards and do care because you are politicians who only care about your bank account?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fef3fb	Kearney	None	2022-04-01T14:03:52Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kearney , Kathleen	l1e-l65c-stbs	False	None	False	2022-04-12 05:35:07.789	[]
3324	CDC-2022-0024-3330	https://api.regulations.gov/v4/comments/CDC-2022-0024-3330	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is very important that you PLEASE include chronic disease RLS in updating opioid prescribing guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fef401	A LaFayette	None	2022-04-01T14:04:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from A LaFayette, Elizabeth	l1e-le5v-xy2y	False	None	False	2022-04-12 05:35:08.012	[]
3325	CDC-2022-0024-3331	https://api.regulations.gov/v4/comments/CDC-2022-0024-3331	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doria	None	None	0900006484fef893	Chege	None	2022-04-01T14:05:49Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Chege, Doria	l1e-lkdf-anim	False	None	False	2022-04-12 05:35:08.229	[]
3326	CDC-2022-0024-3332	https://api.regulations.gov/v4/comments/CDC-2022-0024-3332	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider opioids as a treatment for restless leg syndrome. I have had RLS for 25 years and have tried exercising, relaxation techniques, meditation snd massage with no relief. I have taken 900 milligrams per day of gabapentin 2 hours before bedtime which resolved RLS somewhat but unfortunately the side effects are not tolerated and prevent me from this treatment. Before I was prescribed gabapentin.<br/> The “only” thing that has worked to totally relieve my RLS symptoms I stumbled upon when I was taking one 50mg tablet of tramadol a day for a hip injury. It was a miracle! I experienced total and complete relief from my RLS symptoms. After seeing two different doctors to ask if they would prescribe tramadol for my RLS symptoms, they both said no.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DeAnne	None	None	0900006484fef895	Jones	None	2022-04-01T14:07:04Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, DeAnne	l1e-lnng-hv94	False	None	False	2022-04-12 05:35:08.465	[]
3327	CDC-2022-0024-3333	https://api.regulations.gov/v4/comments/CDC-2022-0024-3333	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a 57 year old female. I have had an active career in Social Work, I have been married for 28 years and have to wonderful grown son's. (One of which is an officer in the U.S. Army.) I have suffered from RLS for as long as I can remember. I have tried all of the medications to treat RLS and have tried all homeopathic remedies. I was on Mirapex from the time it was introduced until 2017 when I was determined to stop this medication as it was ruining my life! I had developed augmentation which creates a worsening of the symptoms while causing a dependency on the drug. If you read the possible side effects of Mirapex it indicates that it can cause a person to gamble. This seems absurd!! But it happened to me! My medication was increased in 2009 and within 2 months I began to gamble at a local casino. I had never gambled more than 2 or 3 times prior to this! It became an obsession and I gambled away my income in 2010 and 2011. I stole from my husband to get money and nearly ended my marriage! I lost friends because of the need to gamble. It was ruining my life!<br/>I began seeking treatment for gambling addiction but knew that the root cause was the medication. In 2016 I was desperate so I began to research RLS on my own. By this point I was on Family Medical Leave from my job because I could not sleep at night and had difficulty functioning. I sought help from my physicians but they were not knowledgeable enough to provide appropriate treatment. They incorrectly took me off Mirapex without weaning me off. They also prescribed a medication that I was allergic to. I suffered injuries as a result of this medication as it caused me to function in a trance like state. I fell off our front porch at one point and busted my head open because I simply walked into our fireplace mantle! I learned that * in * was the leading researcher of RLS. I traveled to * to seek treatment. I live in * so this was no small step or expense. The physician there had me wean off of Mirapex over a 6 week period and then begin a low dose regime of Oxycodone. I could not believe it worked!! However, I had difficulty finding a local physician willing to prescribe an opioid. I live close to * and after working with several unsuccessful physicians, I began working with my current physician group that is extremely knowledgeable in RLS. I have been on the same low dose of 10 mg opioid since my visit to * with no need to increase the dose. There are medications specifically made to treat RLS, unfortunately for some of us, they simply do not work or create additional problems as it did in my case. I do not feel 'addicted' to the opioid but I do know that it is the only treatment that is successful in treating my RLS. I urge you to see the seriousness of severe RLS and how debilitating the condition can be. Please do not eliminate the only viable treatment option for those of us with this condition in its severe form! <br/> <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. I would gladly communicate further in regards to my RLS journey and my opioid regime. Feel free to contact me via the following methods. <br/>Sincerely,<br/>***<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fef89e	Worden	None	2022-04-01T14:11:05Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Worden, Lisa	l1e-m057-6fez	False	None	False	2022-04-12 05:35:08.681	[]
3328	CDC-2022-0024-3334	https://api.regulations.gov/v4/comments/CDC-2022-0024-3334	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is * and I live in *. I am 72 and have had restless legs syndrome since age 26. I am writing to ask you to include low dose opiates for treatment of RLS in the 2022 clinical practice guidelines for prescribing opioids. I am under the care of a neurologist for my condition and take mirapex and gabapentin. I currently take one or the other 5 times a day. I still have problems with recurring symptoms two or three times a week. My Doctor was unable to prescribe tramadol for my condition under Healthpartners insurance. I am now prescribed clonazepam daily to prevent recurrence instead. It makes me very sleepy in conjunction with the gabapentin. I would like the option to try something other than a tranquilizer. The Mayo Clinic in January 2018 consensus recommendations found opioids useful in the treatment of rls. I hope I attached a pdf file of the Mayo Clinic document.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janet	None	None	0900006484fef8a6	Rahm	None	2022-04-01T14:35:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Rahm, Janet	l1e-m03l-6klp	False	None	False	2022-04-12 05:35:08.903	[]
3329	CDC-2022-0024-3335	https://api.regulations.gov/v4/comments/CDC-2022-0024-3335	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include low-dose opioids on the approved list as a prescription for relief from Restless Legs Syndrome. I can tell you from personal experience that they do work to eliminate the awful effects of RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484fef8af	Maggi	None	2022-04-01T14:36:15Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Maggi, Thomas	l1e-mwsm-qmsy	False	None	False	2022-04-12 05:35:09.121	[]
3330	CDC-2022-0024-3336	https://api.regulations.gov/v4/comments/CDC-2022-0024-3336	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern at CDC:<br/><br/>The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/><br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/><br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe, and have extensive clinical and cost-effectiveness data.<br/><br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/><br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of Dr. Chou’s own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/><br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. <br/><br/>Please reconsider to the CDC to adopt the 2019 HHS Best Practices report, specifically Section 2.4 dealing with IPM. <br/><br/>Sincerely,<br/><br/>***<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elmer Pinzon	None	None	0900006484fef8b0	Pinzon	None	2022-04-01T14:37:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Pinzon, Elmer Pinzon	l1e-mxpp-glk2	False	None	False	2022-04-12 05:35:09.353	[]
3331	CDC-2022-0024-3337	https://api.regulations.gov/v4/comments/CDC-2022-0024-3337	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My experiences with RLS have been horrible and lasting at least 50 years of my life. It gets so bad that I wish I could “ cut my legs off”. Other than the pain which I have to take pain meds for, I also have to take sleep meds daily, otherwise I would never get any sleep.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484fef8b1	Schmidt	None	2022-04-01T14:42:03Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schmidt , Debra	l1e-mz7o-yrxi	False	None	False	2022-04-12 05:35:09.572	[]
3332	CDC-2022-0024-3338	https://api.regulations.gov/v4/comments/CDC-2022-0024-3338	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I urge the CDC to include conditions such as Restless Leg Syndrome as a part of opioid treatment guidelines for pain. I have suffered from RLS for over 25 years. During that time it has evolved from a nuisance to a condition that controls most aspects of my daily life. For example, I must have an aisle seat for any theater, movie or lecture events so that I can stand up if necessary. I now need to fly first class, (aisle) because my legs cause so much pain and discomfort. My husband and I cannot share a bedroom because of the constant movement of my legs. I retired a few years early because my RLS did not permit me to have sufficient sleep to carry out my duties as CEO of a large community organization. I should mention that all of this happens even though I have been on low dose opioid for the past 5 years! I hope that one day, a permanent cure will be found but until then, a low dose opioid regime makes my symptoms livable. I am not alone in suffering from RLS as it can happen in up to 10% of the population. The vast majority do not require opioids but for those of us who do, it is the difference that allows a somewhat normal life. <br/>Thank you for your attention to this critical issue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	andrea	None	None	0900006484fef8b6	L.	None	2022-04-01T14:43:43Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from L., andrea	l1e-n1yk-d8g3	False	None	False	2022-04-12 05:35:09.796	[]
3333	CDC-2022-0024-3339	https://api.regulations.gov/v4/comments/CDC-2022-0024-3339	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from severe RLS in app. 35 years and have tried all recommended and approved treatments. Five years ago the only low-dose opioid treatment was left to try. After a couple of years on Methadone I switched to Buprenorphine to enjoy a slightly better pattern of side effects. However, both Methadone and Buprenorphine have proved to be very effective for me at low doses without any need for dose increases at all. Actually, my situation without access to this treatment would be intolerable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nico	None	None	0900006484fef8b9	Schou	None	2022-04-01T14:44:17Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schou, Nico	l1e-n2ia-b7is	False	None	False	2022-04-12 05:35:10.011	[]
3334	CDC-2022-0024-3340	https://api.regulations.gov/v4/comments/CDC-2022-0024-3340	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from Restless Leg Syndrome, RLS. I remember, as far back as a young child, having to get out of bed in the middle of the night to do deep knee bends until my legs were so tired I couldn’t do another one. There were nights I fell asleep on the floor because my legs were too tired to make it back to bed. At that time, the mid-1950’s, all I knew was that I would not be able to go back to sleep until the feeling in my legs, that made them continuously move, went away. This was the only thing this child could think to do. And, something I continued to do for about the next 40 years until I was diagnosed and prescribed medication. <br/><br/>I am so thankful that this syndrome is now widely acknowledged and that there are drugs to alleviate the symptoms. I am fortunate that it is only my legs that are affected. Even so, I cannot imagine the severe discomfort and lack of sleep I would suffer if the drug I am now taking was taken away. <br/><br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	0900006484fef8bd	Adams	None	2022-04-01T14:47:10Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Rebecca	l1e-njfq-db2d	False	None	False	2022-04-12 05:35:10.227	[]
3335	CDC-2022-0024-3341	https://api.regulations.gov/v4/comments/CDC-2022-0024-3341	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I was diagnosed with RLS about 15 years ago and have symptoms in my legs as well as my arms. Over the first 10 years or so, I was treated with about 6 medications. They would work for a while, and then the symptoms would reappear and sometimes get worse. About the time I ran out of medications for RLS we learned about treatment with opioids. I was being treated for severe pain because of fibromyalgia, and soon we were able to manage both the pain and the RLS with opioids.<br/><br/>While being treated for chronic Lyme disease, I noticed my pain lessening. Now I no longer need opioids for pain and can control my RLS with low-total-daily-dose opioids. At no time during the over 8 years I’ve been treated with opioids have I had a problem with addiction.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I was diagnosed with RLS about 15 years ago and have symptoms in my legs as well as my arms. Over the first 10 years or so, I was treated with about 6 medications. They would work for a while, and then the symptoms would reappear and sometimes get worse. About the time I ran out of medications for RLS we learned about treatment with opioids. I was being treated for severe pain because of fibromyalgia, and soon we were able to manage both the pain and the RLS with opioids.<br/>While being treated for chronic Lyme disease, I noticed my pain lessening. Now I no longer need opioids for pain and can control my RLS with low-total-daily-dose opioids. At no time during the over 8 years I’ve been treated with opioids have I had a problem with addiction.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chaz	None	None	0900006484fef8be	Shields	None	2022-04-01T14:48:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Shields, Chaz	l1e-nlu2-e24g	False	None	False	2022-04-12 05:35:10.470	[]
3336	CDC-2022-0024-3342	https://api.regulations.gov/v4/comments/CDC-2022-0024-3342	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Manon	None	None	0900006484fef8bf	Vincelette	None	2022-04-01T14:50:07Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Vincelette, Manon	l1e-nm66-h6yp	False	None	False	2022-04-12 05:35:10.686	[]
3337	CDC-2022-0024-3343	https://api.regulations.gov/v4/comments/CDC-2022-0024-3343	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I take two Tramadol 50gm capsules each night and J am able to enjoy a minimum of 7 hours sleep	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Malcolm	None	None	0900006484fef41c	Thornton	None	2022-04-01T14:54:37Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Thornton, Malcolm	l1e-o95g-9jet	False	None	False	2022-04-12 05:35:10.916	[]
3338	CDC-2022-0024-3344	https://api.regulations.gov/v4/comments/CDC-2022-0024-3344	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are not the answer d/t opioids will need to be increased in time cause your system gets immune to the doses ! I was on morphine and it caused me to not feel myself to urinate. Plus now it has affected my kidneys. Drugs are not safe I titrated off morphine	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef41d	Anonymous	None	2022-04-01T14:55:00Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-oamm-4z22	False	None	False	2022-04-12 05:35:11.134	[]
3339	CDC-2022-0024-3345	https://api.regulations.gov/v4/comments/CDC-2022-0024-3345	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I ask that Restless Leg Syndrome, a chronic neurological disorder that seriously affects one’s ability not only to sleep, but to simply rest while sitting or lying down, to the medical condition for which low dose opiods are approved for treatment. There is a good deal of sound research evidence (double blind clinical trials) that low dose opiods are an effective way to manage RLS symptoms. The other medications, specifically dopamine agonists such as Mirapex and others, cause serious augmentation and the risk of impulse control disorders. Opiods are effective and safe when patients are properly screened (not substance abuse history and proper physician monitoring) and they have no significant side effects. Please consult leading RLS experts at Yale and John’s Hopkins on this subject. Thank you from a life long RLS patient who was quite hopeless and distressed by severe refractory RLS until my physician convinced me to try low dose Oxycodone. That was 10 years ago. My symptoms are controlled, but not perfectly and I’ve had no dosage increase. Intermittently, I’ve tried other medications, most notably Horizant, Lyrica, and gabapentin (all same class of medication) with no success. I then went back to Oxycodone. I entertained a change because of the palpable stigma at the pharmacy. Please help remove the stigma and approve low dose opiods for the treatment of this torturous disorder.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roseanne	None	None	0900006484fef41e	Gotterbarn	None	2022-04-01T14:56:37Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Gotterbarn, Roseanne	l1e-oh11-d2of	False	None	False	2022-04-12 05:35:11.384	[]
3340	CDC-2022-0024-3346	https://api.regulations.gov/v4/comments/CDC-2022-0024-3346	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Proposed 2022 CDC Clinical Practice Guidelines for Prescribing Opioids she go ahead and opioids should be allowed given the proven benefit this is shown to have and unless you suffer from RLS you have absolutely no idea, how debilitating, frustrating and exhausting this disease can be. Clinical practice should also be brought inline worldwide, ie. UK so that sufferers in any Country can get the benefits. As I said, and I can't stress it enough, unless you suffer from this disease, which can ruin poeple's livlihoods, relationships and overall health through not being able to function from lack of sleep and side effects of other prescribed drugs which don't work. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef420	Anonymous	None	2022-04-01T14:57:14Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-ovvi-t1w5	False	None	False	2022-04-12 05:35:11.616	[]
3341	CDC-2022-0024-3347	https://api.regulations.gov/v4/comments/CDC-2022-0024-3347	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Clearly, my doctors at my HMO have no clue as to the tormenting pain that a person with a neurological disability goes through and clearly, they have very little, if any, compassion for such a person. Trust me. You are sorely mistaken to think that I actually enjoy going under the reproach of a doctor every three months and subjecting myself to the stigma attached to getting pain medication, not to mention all the urine tests. I’m all ears if there is a better alternative. I would gladly give up the pain medication if it were possible. In the interim, it is my last stop-gap remedy to subdue break through RLS symptoms so that I can stop moving and get some rest. My HMO regulations require me to see a general practitioner ever three months and I have complied. I’ve yet to see or be referral to a doctor who was actually interested, knowledgeable, and educated in familial Willis-Ekbom Disease, save one who confirmed my condition. Once a person is diagnosed with an incurable neurological disease, they should not subject to seeing a doctor every 3-months for a drug test in order to get low-dose pain medication. Instead, there should be guidance for uneducated, disinterested physicians to treat low-dose pain medication in the same manner as you would for high cholesterol or high blood pressure, for an example.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484fef429	Smith	None	2022-04-01T14:57:58Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Linda	l1e-pmc5-o4yv	False	None	False	2022-04-12 05:35:11.832	[]
3342	CDC-2022-0024-3348	https://api.regulations.gov/v4/comments/CDC-2022-0024-3348	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low-total-daily dose opioids must be included as a viable treatment option for RLS. We who suffer from this progressive neurological condition MUST have alternatives to dopamine agonist drugs and others such as gabapentin and pregabalin. After augmentation has caused us to reach the max dosage of these drugs, we are left with no other viable alternatives. Life would be absolute agony without the relief from this condition that opioids would offer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fef42b	Tanchevski	None	2022-04-01T14:58:27Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Tanchevski, Elizabeth	l1e-q41w-gt9g	False	None	False	2022-04-12 05:35:12.052	[]
3343	CDC-2022-0024-3349	https://api.regulations.gov/v4/comments/CDC-2022-0024-3349	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered with severe RLS for 35 years. I augmented on dopamine agonists, which is where the medication end up making the condition worse over time. I began taking low dose opioids a couple of years ago and they have helped me a lot. I have never increased my dose. Living with RLS is pure, daily torture. In addition to the discomfort of the symptoms, I suffer from severe sleep deprivation. It affects every aspect of my life from my health, to my job to social interactions. I have been unable to maintain a regular job for years. It's simply impossible when you go days without sleeping. The extreme fatigue interferes with my ability to concentrate. I simply can't sit at a desk for more than an hour or two, on a good day. Some days I feel unsafe to drive. I rarely leave my home. Life without opioids is absolutely miserable. Please make sure that people like me have access to these drugs. Very small doses make a huge difference in our quality of life.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Act NOW!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484fef42e	Decker Stewart	None	2022-04-01T15:05:06Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Decker Stewart, Kathleen	l1e-qkah-enpx	False	None	False	2022-04-12 05:35:12.270	[]
3344	CDC-2022-0024-3350	https://api.regulations.gov/v4/comments/CDC-2022-0024-3350	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I did not take the time to read the ENTIRE 211 pages, but my thoughts are rather simple. The problem with the "opioid crisis" is not most doctors, but all doctors have been tared with it. I have one pain doctor in my area, which means the only one doing chronic pain and prescribing opioids for long term, within 80 miles of my home. Everyone is concerned about the quantity of my life, but not the quality, and opioids are the ONLY thing that has even dented my multiple pain issues. There MAY have been too many opioid prescriptions being written, but there is most definitely an over reaction now. Rheumatologists and Dentists no longer prescribe opioids, centuries of prescribing opioids for both are now no longer an option due to guidelines provided by the CDC (So I am told by these doctors). Opioids are here because they work, and now it is so difficult to find pain relief it has become a burden and the statistics show that overdoses are UP! These rules may snare a doctor or two, but at the cost of burdening EVERY person with chronic pain. Pharmacies no longer want to prescribe it, many months they don't have medication, and if you get it every 30 days and it takes an additional 2 days to order, you are out of luck till they get it in stock. You have a problem, your insurance has a problem, your doctor has a problem, the pharmacy has a problem....the patient has to deal with it, and everyone says too bad, so sad, bye bye. Wish I could help, but the government will have a problem if I do or I can't or I would loose my license. Their license is more important than patient treatment. You can't move the Rx, getting the doctor to move it is a burden on them, often one they won't do. And overdoes are UP! Its street drugs that have been the overdose problem, and you have tared anyone with chronic pain! It's stigmatizing, its horrible. Arbitrary numbers, when the effectiveness of opioids depends on the person directions to not go over 50 or 90 mg has become an unofficial law that doesn't take into account the patient. 160 milligrams for me may have he same effect as 5 milligrams for someone else, but you have set a limit regardless of how effective, that is not great patient care. The Opioid Crisis is not a drug problem, but a societal problem. Cocaine is NOT readily available, but the US uses more than any other country. Why do we think severe restrictions will curb opioid use if the same doesn't stop cocaine use and abuse. We lost the drug war, and we need to not make this a hill to die on, and if you must, at least figure out a way to make individuals with chronic pain to get assistance from the CDC or Federal Government. I need help finding a doctor closer to me, there are NONE. I travel for work, which means if I can't get back to see my doctor and go to my pharmacy, I am out of luck. Coordinating between my doctor and pharmacy is always an issue, mainly because the pharmacy is never one pharmacist. So you have a situation resolved with one pharmacist, but you have to make sure that is the one there when you go to pick up your Rx! And when its not, they won't due it because "I don't want to loose my license". I have all these issues because someone(s) overdosed, most likely fentanyl mixed with another illicit drug. But rather than deal with illicit use, which you will never resolve (cocaine is an example), you go after all prescribers and dispensers, creating problems for Patients, ALL Patients...licit and illicit . If you want to do severe restrictions, first find a way to help those with legitimate pain issues, do something with that. Then put in severe restrictions that won't affect those with legitimate issues. So please, think first of those with legitimate issues, those who don't get relief from other options, and have tried most if not all the other possibilities. Make sure you don't stigmatize legitimate use with illicit use, I can tell you that is not what I see, I feel stigmatized multiple times by different people in this dance (Nurse Practitioner, Pharmacist, Insurance provider). Care about my quality of life AT LEAST as much as you seem to care about the quantity of my life. I promise you, these policies hurt. If all I have to look forward to is pain, why do you want me to be on this earth? What do I have to look forward to if pain is my one unending experience. So please, make the guidance take this into account and please work on the next version that lowers them more or addresses chronic pain users. Because right now, it just seems you are lumping everyone together and I have NO one to get assistance from when I have issues, and EVERYONE (Doctors, Pharmacists, Insurance) blames the government as the reason I have an issue and there is nothing they can do and no one they can point me to for assistance. The CDC created this issue that affects me, this is not a good first step, but better than nothing. Anonymous because I talk about my RX, please work on this!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef42f	Anonymous	None	2022-04-01T15:49:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-qq7p-hfom	False	None	False	2022-04-12 05:35:12.500	[]
3345	CDC-2022-0024-3351	https://api.regulations.gov/v4/comments/CDC-2022-0024-3351	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider allowing the prescribing of low dose opioids, in treatment of RLS.<br/>The agony of years and years of trying to lay still long enough to get a few hours of sleep, while your nerve endings are being told to move is nothing short of torture. <br/>Try it!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Todd	None	None	0900006484fef8e2	Silfies	None	2022-04-01T15:49:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Silfies, Todd	l1e-redu-ckc1	False	None	False	2022-04-12 05:35:12.746	[]
3346	CDC-2022-0024-3352	https://api.regulations.gov/v4/comments/CDC-2022-0024-3352	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<span style='padding-left: 30px'></span><br/>I have suffered for years with RLS being unable to sit while flying on a plane, watch a movie with my family, eat dinner at a table sitting down or have my hair done, etc without the use of a low total daily dose opioid. Please understand that this is not a chronic pain issue but a neuromuscular disease much like Parkinson's where you have no control over movement without blocking the receptors that are firing with a low dose opioid. I have taken other medications and developed augmentation which made the condition worse. When uncontrolled this disease can cause severe depression from the restrictions of daily living to sleep deprivation. PLEASE include chronic conditions like RLS in your draft.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beth	None	None	0900006484fef8e5	Essman	None	2022-04-01T15:52:14Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Essman, Beth	l1e-rnsg-pa2i	False	None	False	2022-04-12 05:35:12.969	[]
3347	CDC-2022-0024-3353	https://api.regulations.gov/v4/comments/CDC-2022-0024-3353	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>RLS affects me personally in many ways. I am awakened nearly every night and have to do stretch exercises, sit in a warm bath, or take additional medicine to calm down my RLS. The medicine I take makes me sleepy and nauseaus. It affects my relationships because I cannot stay away in the evenings due to my RLS. When in business meetings, I sometimes have to excuse myself to take medicine or stand up during the meeting, which is awkward. I feel pins and needles in my legs and other parts of my bodies that trigger the RLS. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484fef8e6	Schafer	None	2022-04-01T15:53:24Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schafer, Lisa	l1e-rzfz-o1it	False	None	False	2022-04-12 05:35:13.185	[]
3348	CDC-2022-0024-3354	https://api.regulations.gov/v4/comments/CDC-2022-0024-3354	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revisiting the CDC Clinical Practice Opiod Practicing Guidelines but the draft does not address chronic conditions like RLS that are different from chronic pain. Resless Leg Syndrome is a chronic nurological disease that causes a painful urgent interrmittant movement of the legs and sometimes other parts of the body as well.This symptom makes it impossible to sleep, sit quietly which seriously affects every aspect of life.<br/><br/>In the U.S. nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for awhile, but over time these medications can make the condition even worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opiod to treat severe RLS.<br/><br/>I would deeply appreciate it if the CDC include a section in the 2022 Opiod Prescribing Guidelines which addresses chronic medical conditions like RLS that require opiod therapy as a last resort , in low total daily doses carefully monitored.<br/><br/>Please consider the RLS Foundation a resource for scientifically based information about this condition as it is for members like me.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fef8e7	Daly	None	2022-04-01T15:57:21Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Daly, John	l1e-s5xr-0ptu	False	None	False	2022-04-12 05:35:13.410	[]
3349	CDC-2022-0024-3355	https://api.regulations.gov/v4/comments/CDC-2022-0024-3355	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS - Restless Leg Syndrome: This Syndrome is why we need the Medical Proffession comfortable and able to prescribe Opiods to their patients. In most cases, Opiods are the only relief people with RLS have and under a Doctor's care, will not get out of hand and addictive because these patients are very knowlegeable regarding this Syndrome.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Twylla	None	None	0900006484fef8e8	Fettis	None	2022-04-01T15:57:38Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Fettis, Twylla	l1e-sc3m-ybfq	False	None	False	2022-04-12 05:35:13.630	[]
3350	CDC-2022-0024-3356	https://api.regulations.gov/v4/comments/CDC-2022-0024-3356	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines needs revoked immediately. The harm this agency has created is immeasurable and it's well aware of how many lives were ruined bc of it. At the very least, any mention of mmes should be removed. How are there so many conflicts of interest in creating the guidelines to begin with?<br/> The illicit fentanyl supply is pouring into the country, the absolute distrust and disgust at the medical community and government agencies is growing rapidly. The suicides among people in pain is terrifying, preventative and has risen drastically because of these guidelines. The CDC is aware that Drs are too scared to treat pain yet they insist on doubling down. Why? Why take away our lives when we know and have seen the data that less prescribing= more death. <br/>Do not pretend to care about the pain and addxs community when the CDC is singlehandedly responsible for the demise of both. <br/>Do the right thing!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shannon	None	None	0900006484fef43e	Michelle	None	2022-04-01T15:58:09Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Michelle, Shannon	l1e-t9pp-xekm	False	None	False	2022-04-12 05:35:13.844	[]
3351	CDC-2022-0024-3357	https://api.regulations.gov/v4/comments/CDC-2022-0024-3357	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have restless leg syndrome. Currently I am taking a non opioid medication but I understand that at some point this medication will no longer be effective. RLS is relentless. It prevents any rest and is exhausting, causing other health problems from sleep deprivation. Many RLS patients ultimately take a low daily dose of an opioid which is effective in treating this debilitating disease. Please don’t prevent physicians from prescribing low daily doses of opioids to RLS patients who require it to function well in their daily lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Juliet	None	None	0900006484fef441	Bergner	None	2022-04-01T15:58:28Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Bergner, Juliet	l1e-toil-z5jg	False	None	False	2022-04-12 05:35:14.059	[]
3352	CDC-2022-0024-3358	https://api.regulations.gov/v4/comments/CDC-2022-0024-3358	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My life began again...<br/>14 months ago when I received a surgically implanted pain pump with fentanyl in it. <br/>I suffer from severe chronic pancreatitis. Daily life was excruciating. <br/>I naturally still have symptoms, but thanks to my doctors; creon and zofran keeps me from nausea and vomiting. Fentanyl, curbs severe pain. <br/>Many pain patients are still suffering. Opioids have a place. Please let the doctors decide!<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bram J.	None	None	0900006484fef442	Cast	None	2022-04-01T15:58:46Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Cast, Bram J.	l1e-tt9n-d4hb	False	None	False	2022-04-12 05:35:14.289	[]
3353	CDC-2022-0024-3359	https://api.regulations.gov/v4/comments/CDC-2022-0024-3359	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids May be needed to control rls when other drug fail to work. I have augmented out of two drugs already I need sleep and Opioids maybe needed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bruce	None	None	0900006484fef443	Bredland	None	2022-04-01T15:59:01Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Bredland , Bruce	l1e-tv03-09gj	False	None	False	2022-04-12 05:35:14.555	[]
3354	CDC-2022-0024-3360	https://api.regulations.gov/v4/comments/CDC-2022-0024-3360	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low-dose opioids have completely changed my treatment Outlook .my symptoms don't come back on a daily basis. And I'm not suffering the depression and just general brain fog that taking Carbidopa and levodopa gives you. Not to mention that with the previous prescribed medications I was having breakthrough symptoms constantly several times a day. The use of logos or Peoria that says completely change things I'm more productive and just enjoying a much better life!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484fef444	Troutman	None	2022-04-01T15:59:22Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Troutman, Michelle	l1e-u4ax-biyt	False	None	False	2022-04-12 05:35:14.788	[]
3355	CDC-2022-0024-3361	https://api.regulations.gov/v4/comments/CDC-2022-0024-3361	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 70-something male living in [location redacted], WA. I formerly lived in [location redacted], VA. I have a severe case of Restless Leg Syndrome, as diagnosed by [name redacted] of [name redacted], probably the leading expert on RLS in the U.S. [name redacted] prescribed methadone for my condition in approximately 2011, and I have been using methadone successfully ever since; and my local neurologist has classified my current situation as “stable”. I have almost zero side-effects, and I am leading a very comfortable and productive life. I am commenting here today to STRONGLY advocate that you do nothing that would preclude the use of opioids in the treatment of RLS. I can tell you honestly that absent methadone I would possibly be thinking seriously about suicide. RLS is absolutely a miserable affliction. Please take my comment seriously. I don’t know what I would do if not for methadone. Feel free to contact me with questions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484fef445	Killen	None	2022-04-01T17:06:01Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Killen, James	l1e-uesf-978r	False	None	False	2022-04-12 05:35:15.005	[]
3356	CDC-2022-0024-3362	https://api.regulations.gov/v4/comments/CDC-2022-0024-3362	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from RLS since I was 20 I am now 76. It has disrupted my life for 56 years. It has made every day a living he'll. Being able to get some few hours of relief is heaven only because of prescriptions that are opiates.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerry	None	None	0900006484fef8fd	Abell	None	2022-04-01T17:06:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Abell, Gerry	l1e-uvg2-xhn2	False	None	False	2022-04-12 05:35:15.221	[]
3357	CDC-2022-0024-3363	https://api.regulations.gov/v4/comments/CDC-2022-0024-3363	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern,<br/><br/><span style='padding-left: 30px'></span>I have had RLS for about 20 years now and have been on various medications that only work for a short amount of time and then you need something else.<br/>The pain associated with this disease is not tolerable and has caused poor sleep, fatigue and never feeling rested in the morning. Year after Year everything gets worse.<br/>I have had to leave friends houses in the early pm because of the pain affecting my socializing. Not to mention what effect it has at night on your significant other.<br/>You do not punish good people because of people abusing anything. Why should people in pain suffer for them when there is relief available. It is cruel and unusable punishment for 12 million people who suffer with this disease and you have the ability to help us all.<br/>So do the right thing and give us relief and a good enjoyable life like you yourself would want for your friends and loved ones!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rod	None	None	0900006484fef8fe	Snyder	None	2022-04-01T17:06:50Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Snyder, Rod	l1e-uvm7-z95m	False	None	False	2022-04-12 05:35:15.440	[]
3358	CDC-2022-0024-3364	https://api.regulations.gov/v4/comments/CDC-2022-0024-3364	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered intermittently with RLS for all of my adult life. My symptoms progressed about 10 years ago to the point where it was impossible to get a normal night sleep. Naturally, this spilled over into my daily life and effected my relationships, my personality and my employment. I finally had no choice but to ask for medical assistance. The medications manage my symptoms pretty well. I and, 22 million people like, me need drugs to lead any sort of normal, productive life.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484fef8ff	`Hughes	None	2022-04-01T17:10:53Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from `Hughes, Peter	l1e-v6ly-cpn4	False	None	False	2022-04-12 05:35:15.677	[]
3359	CDC-2022-0024-3365	https://api.regulations.gov/v4/comments/CDC-2022-0024-3365	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	So let me get this straight…<br/>A person is shot with a gun and killed. But…<br/>Guns don’t kill people, people kill people, therefore everyone gets to keep guns.<br/>An addict ODs on an opioid and dies. But…<br/>It’s the opioid’s fault, not the addict who took the opioid, therefore all chronic pain sufferers get their pain meds taken away.<br/><br/>How is it guns are innocent but pain meds are guilty?<br/>Why the double standard?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fef901	Anonymous	None	2022-04-01T17:11:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1e-vell-q85r	False	None	False	2022-04-12 05:35:15.897	[]
3360	CDC-2022-0024-3366	https://api.regulations.gov/v4/comments/CDC-2022-0024-3366	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My RLS became severe about 15 years ago when a back injury herniated two disks causing nerves to be hit. Since then, I have been unable to sleep peacefully and obtain a restful and restorative nights sleep. I may “sleep” for five, six, or seven but I wake tired every single day. Every single day. I move so much in my sleep, and that us even with taking Mirapex twice a day, a medication I am augmenting to and will one day have to take a “vacation” from. And then I will have nothing to help me sleep, nothing to quiet my legs. Imagine not being able to enjoy an evening out, even with meds, because your legs won’t stop and let you relax. Or being sick but you can’t nap because your leg movements won’t allow it. Please, please don’t ignore those who suffer from RLS. It is very real and very debilitating. I am so afraid of what lack of sleep is doing to my brain. Please, consider our disease when making your decision. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484fef903	Rask-Huntington	None	2022-04-01T17:12:31Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Rask-Huntington , Sharon	l1e-vqol-he2a	False	None	False	2022-04-12 05:35:16.126	[]
3361	CDC-2022-0024-3367	https://api.regulations.gov/v4/comments/CDC-2022-0024-3367	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a physician and also have had Restless Legs Syndrome (RLS) for over a decade. Although I personally haven’t required opioids to manage my condition, I can speak to the disabling effects, which quite simply make sleep impossible. The physiologic effects of sleep deprivation are well documented in the medical literature. There are individuals who require opioids to treat RLS and they should have access to them. I ask that RLS be included in your recommendations for long term opioid use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marc	None	None	0900006484fef460	Heller	None	2022-04-01T17:12:54Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Heller, Marc	l1e-vwwc-r1n5	False	None	False	2022-04-12 05:35:16.346	[]
3362	CDC-2022-0024-3368	https://api.regulations.gov/v4/comments/CDC-2022-0024-3368	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>One week ago I began the withdrawal process from Ropinole. I cannot imagine the utter madness physically and emotionally I would be enduring if I did not have the very low dose of Suboxone to get me through this. I am beyond thankful and appreciative for all the opioid research.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barb	None	None	0900006484fef461	Henderson	None	2022-04-01T17:13:52Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Henderson, Barb	l1e-w0ch-j7o1	False	None	False	2022-04-12 05:35:16.605	[]
3363	CDC-2022-0024-3369	https://api.regulations.gov/v4/comments/CDC-2022-0024-3369	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have rls. It is nearly intolerable. Without my low dose opioids I would not see a minute’s peace. Please add RLS in your guidelines for prescribing opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006484fef465	Fitzjohn	None	2022-04-01T17:14:04Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Fitzjohn , Wendy	l1e-w5t4-csvl	False	None	False	2022-04-12 05:35:16.821	[]
3364	CDC-2022-0024-3370	https://api.regulations.gov/v4/comments/CDC-2022-0024-3370	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 60 year old female that has had RLS for about 30 years. Through time my symptoms have increased exponentially. I have been diagnosed with intractable RLS by my Internist, Neurologist, and Pulmonologist. I have had all the testing done for RLS a number of times and have been sent to different specialist to see if there were any other options for me. I have taken the normal treatment for RLS such as Requip, Mirapex, etc. About 3 years ago I was no longer able to control my RLS on these medications. I had significant augmentation of my symptoms on these medications. Each one at different times in the last 30 years. The symptoms are disabiling to those of us who struggle with RLS.<br/> This is when my physician suggested trying Methodine. The Methodone has worked at controlling my symptoms with no increase in dose. I am on the same dose that I was when I started it. Without having some of these drugs available to people like me, there would be no treatment available that would work. As you are aware, RLS causes sleep problems. Sometimes because of augmentation of symptoms some of us have worsening symptoms and even have symptoms during the day. Please do not take these drugs (opioids) from us. Some of us have nothing else that works!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fef46d	Taylor	None	2022-04-01T17:14:38Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Patricia	l1e-wfyr-nr8l	False	None	False	2022-04-12 05:35:17.051	[]
3365	CDC-2022-0024-3371	https://api.regulations.gov/v4/comments/CDC-2022-0024-3371	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with RLS for 45 years, the last 10-15 being the worst. I ran the gamut with Ropinerle until I was addicted and endured augmentation.I have been on Methadone for two years and it has changed my life! It is difficult to describe the euphoria I felt when all of a sudden my life was my own-from car rides to movies and meetings and plane rides and of course sleeping. <br/>Every person suffering from this dreaded disease should have the opportunity to experience relief with opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alice	None	None	0900006484fef475	Winters	None	2022-04-01T17:15:01Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Winters, Alice	l1e-wuuz-meq3	False	None	False	2022-04-12 05:35:17.266	[]
3366	CDC-2022-0024-3372	https://api.regulations.gov/v4/comments/CDC-2022-0024-3372	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please , please add Restless Leg Syndrome to the list of diseases that can use opioids as treatment. I am 72 years old and have suffered from RLS since childhood. The prescription drugs used to treat RLS no longer help me and the quality of my life is very much diminished. Many people see RLS as a nuisance and don’t realize how serious it can be and the misery it causes. Please allow me and so many others to use opioid therapy to relieve the symptoms of the miserable disease. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candace	None	None	0900006484fef4a5	Broman	None	2022-04-01T17:17:39Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Broman, Candace	l1e-xhwa-0gi5	False	None	False	2022-04-12 05:35:17.481	[]
3367	CDC-2022-0024-3373	https://api.regulations.gov/v4/comments/CDC-2022-0024-3373	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a retired federal magistrate judge. I have suffered from Restless Legs Syndrome for more than 20 years. This affliction is not a myth or a joke. When untreated, it has made my life unbearable. My symptoms are not confined to my legs - they crawl through nearly every muscle in my body. I am unable to sit, drive in a car, or sleep. I’m in nearly constant agony. But I understand these symptoms do not count as pain for purposes of this regulation. <br/>Over the years, my doctors have prescribed every known treatment and medication, but one by one, they either stopped working or in some cases actually made my condition much worse. About four years ago, at a point where nothing was helping to alleviate my symptoms and my life was almost not worth living, my doctor prescribed opioids. For me, this was a miracle. My RLS symptoms were finally under control. <br/>Please understand. For me and many others, opioids are the only option. For about three years, I have taken four hydrocodone tablets a day, one tablet every 4-6 hours. Somehow it has made my RLS symptoms manageable. I do not get “high” or abuse the medication. I simply rely on it to be able to be able to function. Please, please understand - opioids have saved my life. I beg you to include in this regulation a provision authorizing the use of Opioids to treat Restless Legs Syndrome. If you don’t, you will be putting my life and the lives of many others RLS sufferers in jeopardy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484fef4d3	Zoss	None	2022-04-01T17:18:29Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Zoss, Paul	l1e-y4ls-3e2t	False	None	False	2022-04-12 05:35:17.705	[]
3368	CDC-2022-0024-3374	https://api.regulations.gov/v4/comments/CDC-2022-0024-3374	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I find 25mg of Tramadol works better than Gabapentin. I feel better on Tramadol. I sleep much better. And I have no reason to increase the dose. Please do not make it more difficult for me to obtain relief from RLS.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Connie	None	None	0900006484fef4d6	Bellamy	None	2022-04-01T17:19:16Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Bellamy, Connie	l1e-y7bx-6doo	False	None	False	2022-04-12 05:35:17.920	[]
3369	CDC-2022-0024-3375	https://api.regulations.gov/v4/comments/CDC-2022-0024-3375	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS for over 30 years. I was treated with Requip effectively until it stopped working, and increased doses made it worse. It has been unbearable. My quality of life was diminishing as my team of doctors prescribed various other medications to try to treat my RLS. I researched treatment options on RLS.ORG and had discussions with my neurologist about trying Methadone. It has been successful in treating my RLS. I am able to sleep and function again.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484fefd02	Feigleson	None	2022-04-01T17:19:59Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Feigleson, Julie	l1e-ydyi-2jwd	False	None	False	2022-04-12 05:35:18.152	[]
3370	CDC-2022-0024-3376	https://api.regulations.gov/v4/comments/CDC-2022-0024-3376	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Personally I have been on several different types of RLS Prescriptions and had to change them several times, because of my body either getting use to them and not working anymore or they had made me very fatigue and I could not get my work done.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484fefd03	Demallie	None	2022-04-01T17:22:35Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Demallie, Kathy	l1e-yg7i-21ku	False	None	False	2022-04-12 05:35:18.418	[]
3371	CDC-2022-0024-3377	https://api.regulations.gov/v4/comments/CDC-2022-0024-3377	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Got an email from the RLS foundation that you were taking comments regarding low dose opiods as a treatment option and had to share my brief but albeit effective experience with opiods and RLS. First of all, I've had RLS (or at least figured out what I had as I thought it was insomnia at first) since my late 20's to early 30's. I'm now 52 and have tried everything under the sun to get it under control. Like most people it flares at night when I lay down. I rarely ever have it during the day although I've had to leave movies at times because I could not sit still (try squeezing legs as hard as I can, pinching my skin, etc. first before I gave up). I've been on mirapex/pramipexole for at least a decade....probably more like 15 yrs. Does it help? Definately. Does it solve the problem? Not even close. I would say it calms it enough where I can get to sleep after an hour or 2 whereas without it it's a battle all night. My nightly routine is that I start in bed with my wife and if I can't fall asleep within a couple hours I go off to a big chair as it tends to help if I'm upright....for whatever reason. Regardless, I move to the chair every night as I'll wake up and get the sensation again. Anyways, I also take gabapentin at night.....probably for the last 5 or so years with mixed results. Now that I've established my 'night' life is horrible I want to share the one time in the last 20+ years I had calm legs and could sleep. It was when I had my hip replaced 10 yrs ago and was on opiods. Despite the pain, I can still recall how good it felt to just sleep. And the reason I feel it was the opiods and not something else related to the surgery is that the RLS came back immediately once the prescription ran out. So do I have any experience with low dose opiods? No. Does it give my hope for a better life? Definately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jason	None	None	0900006484fefd09	John	None	2022-04-01T17:24:02Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from John, Jason	l1e-yyzv-rvpc	False	None	False	2022-04-12 05:35:18.659	[]
3372	CDC-2022-0024-3378	https://api.regulations.gov/v4/comments/CDC-2022-0024-3378	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with rls for over 45 years and it has gotten progressively worse. Two years ago I was in terrible shape barely sleeping and being confined to a car was excruciating. Turns out I was augmenting on Requip. Thank heaven for [name redacted]. He started me on gabapentin and a low dose of oxicodone at bedtime. That was February 2020. Just prior to the onset of Covid 19. Thank goodness for the timing, I would have never survived the shelter in place orders. I take 5 mg of the opioid at 9 pm nightly. My dosage has been the same for the last 2+ years and it is sufficient to not make me want to cut off my legs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484fefd6d	Vimislik	None	2022-04-01T17:24:55Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Vimislik , Patricia	l1e-z281-th89	False	None	False	2022-04-12 05:35:18.903	[]
3373	CDC-2022-0024-3379	https://api.regulations.gov/v4/comments/CDC-2022-0024-3379	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I know for a fact this helps, I have rls! Have for a number of years now, it started in on right leg back in 2010 and now here in 2022 I Now even in my chest the feeling is trouble, I wouldn't wish this on anyone. I have it in both legs my right arm and r shoulder and chest it'd impossible to get it to stop once it's sit in.Without medication it would be impossible to live this is a horrible medical issue, I take pramipexole, and also gabapentin that is every hard to get in itself the people that have chronic issues are SUFFERING! OVER WHAT HAS HAPPENED! We are lucky to get a doctor to listen must less get actually help for this issue, I have other heath issues that have caused chronic pain as well and I can't get help for it either I struggle everyday, I'm not going to include my personal medical info at this time but if it is necessary I would to get help I'd do whatever it takes desperate, but please the people that go thur this have a very hard life and it's not easy to go on without sleep if I take something for sleep it makes it so much worse. THIS IS A SERIOUS MEDICAL CONDITION Plz HELP!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484fefde2	Conley	None	2022-04-01T17:25:50Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Conley , Jennifer	l1e-zeif-xglt	False	None	False	2022-04-12 05:35:19.151	[]
3374	CDC-2022-0024-3380	https://api.regulations.gov/v4/comments/CDC-2022-0024-3380	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>As a concerned, chronic Restless Legs Syndrome (RLS) sufferer, I would like my voice to be heard. Although there are medications on the market specified for the treatment of RLS, these dopamines are only effective for a limited amount of time before they stop working and in fact make the condition worse. In my case, and countless others, the only relief from this hideous disease is a low daily dose of opioid treatment.<br/><br/>I suffered for years before I discovered through research, and discovery of the RLS Foundation, that my condition was made worse by the longtime use of dopamines, and that a low daily dose of opioid treatment could manage my unrelenting, 24/7, symptoms. But my PCP was intimidated by the crackdown on doctors to prescribe opioids and would not prescribe them for me. I finally found relief when I visited an RLS Specialist at [name redacted] in [location redacted], and he made it possible for me to receive a low daily dose of Methadone at a pain clinic near me. This changed my life -- actually gave my life back to me.<br/><br/>While suffering with RLS without the help of opioids, I had to leave my job. I could no longer sit at my desk, could not sit or lay down except for a few hours a day. I could not drive or even ride in a car. I had to stand on my feet, often pacing the floor, for most of the day and night for several years. I was suicidal as there seemed to be no hope. I was anxious, depressed, lonely. I was a prisoner in my home.<br/><br/>I am concerned about the abuse of opioids, as well as other prescription drugs. I am not unaware of the use of these drugs for recreational use. But I am asking you to please not punish those of us who legitimately depend on them in order to live a normal life while managing debilitating illnesses like RLS.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Loa	None	None	0900006484fefe06	Dunn	None	2022-04-01T17:28:33Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Dunn, Loa	l1e-zh9n-1i4y	False	None	False	2022-04-12 05:35:19.395	[]
3375	CDC-2022-0024-3381	https://api.regulations.gov/v4/comments/CDC-2022-0024-3381	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The struggle for me began early in life and continued with speed from my 30’s until now. There are other medicines that help. However, those for me carry a heavy burden of side effects. If those medicines are not taken at exactly the right time, pain, the creepy crawly urge to move my legs and body not only keep me up all night but condemn to a night<br/>Of agony. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484fefe13	Peterson	None	2022-04-01T17:29:14Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Diane	l1e-zi16-a6br	False	None	False	2022-04-12 05:35:19.639	[]
3376	CDC-2022-0024-3382	https://api.regulations.gov/v4/comments/CDC-2022-0024-3382	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	HELLO, I'm a 78 year old woman from Michigan, and I have suffered withe RLS for most of my life . RLS started when I was 34,I have been to [name redacted] twice for them the first time they put me on Mirapex and it helped for about 6-8 years and then it would not hold so I went back to [name redacted] a second time as my RL were lasting day and night and they told me I had about the worst case they had seen and put me on oxycodone pills, 3 times a day. and sent me home, Well it did not help and I called them back and asked if I could take a Mirapex with the opioid and I finally got relief and I have been on this for rover 20 years now, I have tried to discontinue the opioid several times to see if I still need it and the RL come back. Don't know why it helps me BUT this is the only thing that helps my RLS, SSO I PLEASE ASK YOU TO APPROVE , OPIOIDS FOR RLS AS IT IS A LIFE SAVER FOR ME AND I AM SURE IT IS FOR MANY , MANY, OTHERS. WE NEED YOUR HELP TO APPROVE OPIOIDS FOR RLS SO WE CAN HAVE A LIFE AND NOT WANT TO KILL OURSELFS. I THANK YOU FOR YOUR KINDNESS AND UNDERSTANDING IN ADVANCE FOR APPROVING OPIOIDS FOR US TO USE. BLESS YOU. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacquelyn	None	None	0900006484fefe4d	Cline	None	2022-04-01T17:30:44Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Cline, Jacquelyn	l1e-zobm-klc7	False	None	False	2022-04-12 05:35:19.877	[]
3377	CDC-2022-0024-3383	https://api.regulations.gov/v4/comments/CDC-2022-0024-3383	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include allowance of low dose Opioid treatment for Restless Leg Syndrome (RLS).. I have a severe case of RLS and none of the currently approved meds for RLS work to ease my symptoms. With the current meds I only average about 2 hrs sleep per night. A few years age I had knee replacement surgery and was prescribed 5mg Oxycodone for pain. I did not use them for the pain however I saved them for my RLS. Every 5th day I would take one at night for my RLS and would sleep all night. This gave me a least one night per week of sleep. Low dose opioids work for RLS. It is the only thing that seems to work to ease the agony of RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484fefe6b	Schaffran	None	2022-04-01T17:31:15Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schaffran, Robert	l1e-zr9z-jko4	False	None	False	2022-04-12 05:35:20.122	[]
3378	CDC-2022-0024-3384	https://api.regulations.gov/v4/comments/CDC-2022-0024-3384	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This would be absolutely helpful to RLS sufferers! I would know.....I have it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erin	None	None	0900006484fefe85	Allen	None	2022-04-01T17:31:38Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Allen, Erin	l1e-zrza-y9pc	False	None	False	2022-04-12 05:35:20.376	[]
3379	CDC-2022-0024-3385	https://api.regulations.gov/v4/comments/CDC-2022-0024-3385	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have RLS and have had it for many years now. 15+ years . It is hereditary and runs in my immediate family. RLS is sometimes hard to treat with just nerve drugs. Very annoying when you can't stop them from moving, twitching. Especially during sleep. I have worn holes in our bedsheets from the constant feet movements. A few times a week, Hydrocodone, and a lessor Opioid drug, Tramadol, help dramatically in relaxing the RLS symptoms, especially during sleep. When under a Dr's care these Opioids are definitely helpful and needed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	NICK	None	None	0900006484fefef1	Mavros	None	2022-04-01T17:32:04Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Mavros, NICK	l1e-zzll-d1yv	False	None	False	2022-04-12 05:35:20.612	[]
3380	CDC-2022-0024-3386	https://api.regulations.gov/v4/comments/CDC-2022-0024-3386	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline. However, alarmingly and distressingly, the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. The toll on society because of workers who can't work and family members who cannot function is incalculable.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a 52-year-old woman, and I have suffered from (and "suffer" is indeed the right word, although "been tormented by" is perhaps more accurate) early-onset RLS for 22 years. In the absence of knowledge about low-dose opioids, my PCPs prescribed ropinirole for all of those years...a medication which is known to horrifically augment RLS. As a result, I spent countless sleepless nights stumbling around my house in agony and hopelessness and sleep deprivation. The first time I took a very low dose of oxycodone, I could actually feel my legs and arms relaxing and resting. It was the most enormous gift. Chronic sleep deprivation is a maddening condition which adversely affects EVERY OTHER area of a person's mental, physical, and emotional health. It takes a toll on families and society. And yet when I asked my PCP about prescribing low-dose opioids (a PROVEN solution to RLS for hundreds of years), she looked at me in horror. This is a problems which could be dramatically reversed with your action and guidelines.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge--BEG, in fact--the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484fefc9c	Spencer	None	2022-04-01T17:33:08Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Spencer, Elizabeth	l1f-0096-ialc	False	None	False	2022-04-12 05:35:20.851	[]
3381	CDC-2022-0024-3387	https://api.regulations.gov/v4/comments/CDC-2022-0024-3387	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am glad that you are <br/>revising the CDC Clinical Practice Opioid Prescribing Guideline. However, the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>Sleep deprivation has been used to torture people. RLS creates ongoing sleep deprivation. I have had members of my family commit suicide from untreated RLS. It is truly torture. <br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>Low dose opiods can be extremely effective in treating RLS. I took tramadol 50mg at bedtime for 12 years without needing to increase my dose. When my RLS got worse (it tends to be a progressive disease) I couldn’t take a higher dose of tramadol because of itching. I switched to low dose methadone (5mg) plus pregabalin. Together they control my restless legs so that I can sleep. They are truly a lifesaver. I have been on it for over a year and have not had to increase my dosage. This is typical of RLS patients. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I had this happen to me. I had a new PCP (when my old one moved away) and she refused to fill my tramadol. I had to scramble to find someone who would prescribe it for me. I was so panicked. Imagine if you suddenly faced the prospect of having to walk around alll night long. With RLS you not only can’t sleep. You can’t even lie quietly in bed. You have to keep moving. It’s horrible. You want to rest and sleep but your body won’t let you. You are exhausted but your body has to keep moving. <br/>I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fefca1	Anonymous	None	2022-04-01T17:33:42Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-00z3-hvbv	False	None	False	2022-04-12 05:35:21.100	[]
3382	CDC-2022-0024-3388	https://api.regulations.gov/v4/comments/CDC-2022-0024-3388	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>I suffer from RLS. Often at night I am up because I cannot sleep due to the RLS. I don't have it nearly as bad as many others. Doctors need to have access to meds that can bring relief.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	0900006484fefca2	Conley	None	2022-04-01T17:34:17Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Conley, Mike	l1f-0160-d6zo	False	None	False	2022-04-12 05:35:21.349	[]
3383	CDC-2022-0024-3389	https://api.regulations.gov/v4/comments/CDC-2022-0024-3389	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thanks for your revision of CDC Clinical Practice Opioid Prescribing Guideline. However, RLS, which is not chronic pain, is not considered.<br/>RLS, restless legs syndrome, is a chronic and debiliating disease that can make it extremely difficult to skleep or even rest quietly.<br/><br/>I suffer from RLS. I have had this condition since I wss 12 years old. I am now 72 and the RLS has gotten worse with age. I have tried multiple medications without getting any relief until I was prescribed low-dose OxyContin. I am now able to get some sleep. Activities such as going to a movie and riding on an airplane are now possible for me. Before taking opioids, this was not the case. And the constant urge to move that came with RLS was torturous. Medical research and my experience indicates that opioids are a solution to the difficult diagnosis of RLS.<br/><br/>Please address chronic conditions such as RLS in the Opoid Prescribing Guidelines. There are conditions in addition to chronic pain that need to be considered in these guidelines to allow patients such as myself to be prescribed low-dose opioids in order to live a productive life. OxyContin has made an enormous difference for me and others and can be prescribed and monitored successfully.<br/>Please think of the RKLS Foundation as a resource for evidence and information.<br/>Thank you.<br/>Thank you for your attention.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Therese	None	None	0900006484fefce6	Russell	None	2022-04-01T17:35:29Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Russell, Therese	l1f-07bv-pa9c	False	None	False	2022-04-12 05:35:21.594	[]
3384	CDC-2022-0024-3390	https://api.regulations.gov/v4/comments/CDC-2022-0024-3390	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for for reviewing the opioid problem but the draft doesn’t address conditions like mine. I am 65 yrs old and have severe Restless Leg Syndrome and only after trying 13 different medications to help me I tried a very low dose of opioid with a lot of fear. I have been on that same very low dose for at least 6 yrs with no side effects and am now able to sleep through the night without getting up to walk half the night like I use to.<br/>There is no cure for RLS and so many people who suffer with it. My grandmother, mother, sister and daughter all have it. Almost 12 million people in the US have it and Drs have been using opioids for RLS for over 300 yrs.<br/>I truly can’t go back to walking 1/2 the night and sometimes in the day also, please don’t that the only thing that ha helped me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JoAnn	None	None	0900006484ff010e	Peacock	None	2022-04-01T17:35:52Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Peacock , JoAnn	l1f-0b4q-jdtj	False	None	False	2022-04-12 05:35:21.833	[]
3385	CDC-2022-0024-3391	https://api.regulations.gov/v4/comments/CDC-2022-0024-3391	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had Restless Leg Syndrome for over 50 years. It is a neurological disease that cause a person to "have to' move the legs, often depriving me of sleep at night. There is no treatment, just some mediations that help to relieve it, but not eliminate the condition. And it seems to get worse with age. Sometimes, when prescribe drugs no longer work, opioids in low dose are the only treatment. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. Please don't ignore the help and relief low dose opioids can people with RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484ff012d	Adams	None	2022-04-01T17:36:48Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Nancy	l1f-0dlw-bzkl	False	None	False	2022-04-12 05:35:22.071	[]
3386	CDC-2022-0024-3392	https://api.regulations.gov/v4/comments/CDC-2022-0024-3392	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE! Please review and change the current guidelines for low dose opioid use to include the management of Restless Leg Symptoms. I am a Registered Pharmacist. I developed RLS at the age of 49. The only long standing successful treatment for me was 5mg/325mg of hydroxycodone/apap. I used multiple dopamine related drugs and other agents. Side effects and contraindications became intolerable for me. Due to the OVER-vigilance of doctors in their use of opioids, doctors have NO-opioid policies. They won’t prescribe them at all!! I don’t and will not go to a pain clinic just to obtain a once a day dose of a bedtime medicine used appropriately for the management of RLS. PLEASE EDUCATE YOURSELVES IN REGARD TO RLS AND WHAT THE CURRENT GUIDELINES ARE FOR TREATMENT OF RLS SYMPTOMS. It is a chronic condition that can be devastating to one’s lifestyle and overall health if not properly managed. www.RLS.org/understanding	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484ff0158	Christy	None	2022-04-01T17:37:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Christy, Karen	l1f-0hqe-k4bh	False	None	False	2022-04-12 05:35:22.310	[]
3387	CDC-2022-0024-3393	https://api.regulations.gov/v4/comments/CDC-2022-0024-3393	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Include RLS as chronic condition for opioid prescription	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ff015a	Paver	None	2022-04-01T17:37:36Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Paver, James	l1f-0i33-74gl	False	None	False	2022-04-12 05:35:23.830	[]
3388	CDC-2022-0024-3394	https://api.regulations.gov/v4/comments/CDC-2022-0024-3394	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to severely reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/><br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/><br/>1. Interventional pain management techniques are safe and effective, and have extensive clinical and cost-effectiveness data.<br/><br/>2. With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies and do not have the best interest of the patient at the forefront.<br/><br/>3. A transparent assessment without inclusion of [name redacted] own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/><br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and ready access to physician prescribed Interventional Pain Management (IPM) strategies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fred	None	None	0900006484ff0168	Dery	None	2022-04-01T17:38:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Dery, Fred	l1f-0k53-ph92	False	None	False	2022-04-12 05:35:24.078	[]
3389	CDC-2022-0024-3395	https://api.regulations.gov/v4/comments/CDC-2022-0024-3395	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS for about 20 years. I searched far and wide for relief. I finally found a doctor who concluded opioid is the answer and prescribed Methadone at 7.5 mg distributed at 2.5 mg 3 times a day. What a life changer. I have very few breakthroughs. Managing the program to schedule the prescriptions and refills is difficult for both the doctor and me, but the results are well worth the problems.<br/><br/>RLS can worsen with age. This 82 year old is glad I found the right doctor and the right solution.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gordon	None	None	0900006484ff0190	Hartshorn	None	2022-04-01T17:39:35Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Hartshorn, Gordon	l1f-0nud-4gjg	False	None	False	2022-04-12 05:35:24.296	[]
3390	CDC-2022-0024-3396	https://api.regulations.gov/v4/comments/CDC-2022-0024-3396	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have struggled with RLS since my early teens. In my 40’s it got so bad I needed medication to sleep. I was prescribed Ropinerole and eventually I was being prescribed 4x the maximum dose by my neurologist. This medication not only becomes ineffective over time but it also makes the symptoms worse. I finally found a neurologist that specializes in RLS and I was prescribed a very low dose of opioids. I take this prescription daily and I finally have some relief from my RLS symptoms.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terese	None	None	0900006484ff019e	Plumb	None	2022-04-01T17:40:04Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Plumb, Terese	l1f-0p0r-le0a	False	None	False	2022-04-12 05:35:24.506	[]
3391	CDC-2022-0024-3397	https://api.regulations.gov/v4/comments/CDC-2022-0024-3397	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 77 years old and have been suffering from restless legs syndrome for over 10 years. I can't sleep at night,usually not able to get to sleep until 2am at the earliest, usually 3am or 4am when I finally get exhausted enough to fall asleep despite the restless legs. Only two treatments have worked to help me. One is the use of low doses of marijuana, which is illegal in Minnesota. The other is a 5mg dose of oxycodone, which works great and so far shows no indication of addictive aspects or other bad side effects. I fall asleep quickly when I go to bed and I awaken refreshed each morning. It is very difficult to get these prescriptions filled since doctors are being urged ( due to the opioid crisis ) not to prescribe opioids like oxycodone. But my doctor was persuaded by the evidence I showed him from the Restless Legs Syndrome Foundation and has complied with my request for monthly prescriptions of 5mg of oxycodone, of course with regular blood draw checks to be sure I am not using any other drugs or overusing oxycodone. I also have to meet with my pharmacist almost every month to discuss my use of an opioid. I have to educate him or her about the research by the RLS Foundation that shows oxycodone, in very low doses, is an acceptable, and often preferred, treatment for restless legs.<br/><br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Thanks for taking my experience and comments into consideration.<br/><br/>[name redacted], [location redacted], MN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff01c8	Gagne	None	2022-04-01T17:41:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Gagne, David	l1f-0uhi-aaqt	False	None	False	2022-04-12 05:35:24.719	[]
3392	CDC-2022-0024-3398	https://api.regulations.gov/v4/comments/CDC-2022-0024-3398	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop making it so hard for people with documented pain. It took me over a year to find a doctor that wii it his even help me. I Alma st gave up. The first pain management I went to with clean urine 3x tried to put me on a addicts medication with more side effects than a opioid that actually helps take away my pain so I’m able to function. Please stop letting these drug companies pay these doctors to use thes medications like belbuca. Please stop making it hard on the doctors that follow their oath helping the pain patients with a real med. I have had several surgeries and I need two more has of now. I am not going into a surgery knowing you only will allow advil and tylonal and the god aweful gabapentin that does nothing for my pain but make me foggy and off balance This was on the legal patient needs to stop. Stop hurting us with your works and stop allowing drug manufacturers paying doctors It’s not about the oath they took. It’s inhumane	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff01cc	Anonymous	None	2022-04-01T17:42:16Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-0urf-49r6	False	None	False	2022-04-12 05:35:24.935	[]
3393	CDC-2022-0024-3399	https://api.regulations.gov/v4/comments/CDC-2022-0024-3399	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered with RLS for over 40 years. I am about to have to transition from one drug for RLS to another, because the first one has stopped being effective. And occasionally, I do need an opioid in addition because of severe aching that comes with constant movement. It is a comfort to know that if one medication fails, there are alternatives.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484ff01f2	Malkovich	None	2022-04-01T17:42:48Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Malkovich, Kathleen	l1f-0zx0-6k1i	False	None	False	2022-04-12 05:35:25.153	[]
3394	CDC-2022-0024-3400	https://api.regulations.gov/v4/comments/CDC-2022-0024-3400	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider lifelong painful disease of RLS for prescribing opioids. I have had RLS for 35yrs and it only gets worse but right now it is(Opioids) the only pain medicine that allows me to get some sleep. I have tried everything twice including Parkinson meds and they cause augmentation which make matters worse. Please consider helping this horrible sleep disorder thank you, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JOHN	None	None	0900006484ff0221	HARPER	None	2022-04-01T17:43:30Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from HARPER, JOHN	l1f-13k1-3cvz	False	None	False	2022-04-12 05:35:25.367	[]
3395	CDC-2022-0024-3401	https://api.regulations.gov/v4/comments/CDC-2022-0024-3401	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I am a physician myself suffering from RLS and many of the centers treating RLS have seen improvements in the treatment with low daily doses of opioids. Opioids are part of the treatment of many medical condition when are properly used and carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff0250	Anonymous	None	2022-04-01T17:43:51Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-1b6v-44xh	False	None	False	2022-04-12 05:35:25.624	[]
3396	CDC-2022-0024-3402	https://api.regulations.gov/v4/comments/CDC-2022-0024-3402	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Anyone who has suffered from RLS knows the importance of opiate medication to control it. I have had the condition since a child and I am now76 years old. The intense reactions of electrical shoots and creepy, crawling feelings in the feet and legs keeps me awake every night and whenever I sit for periods longer than 10 minutes. I started taking Mirapexx 25 years ago to make the disease tolerable. I sleep 3-4 hours a night and it has caused me many problems with my social life. <br/>Please continue to keep RLS on the list for opiates treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Edna	None	None	0900006484ff02bf	Mortenson	None	2022-04-01T17:44:40Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Mortenson, Edna	l1f-1kj1-6hnk	False	None	False	2022-04-12 05:35:25.838	[]
3397	CDC-2022-0024-3403	https://api.regulations.gov/v4/comments/CDC-2022-0024-3403	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I have had severe RA with organ involvement for 35+ years. I also have ankylosing spondylitis, sever damaged nerve in my thighs, fibromyalgia, vasculitis & gout. I have been in pain mang for bout 20 years. I have never failed a drug test or pill count. But they have cut my pain meds in half 3 times in a few months time. I own a Ins. agency and I work everyday. I have gotten worse every time they cut them and I’m not able to stand longer than 5 min until I’m in awful pain in my back. I’m in severe pain every day of my life. Now the pain dr.’s are not treating us anymore. They don’t care how bad we are suffering. They originally started opening up to help and treat us innocent chronic pain patients. But now they don’t want to help us anymore so why are they even open. What happen to the oath they take to Do No Harm. That’s exactly what they are doing and they use the laws and cdc to explain why they keep taking our pain meds from us. You have got to do something to help us innocent patients. You are NOT thinking of us when you make these rules and tell the Dr they have to obey or get in trouble or loose there license. This has got to STOP. I run a Christian RA support group and just since the first of the year we have lost 27 people to suicide because they couldn’t take the nonstop never ending pain. No one is thinking of us and I have tried to contact our law makers in my state and they never get back to me. So im begging you please stop n think of us innocent chronic suffering patients when u sit down to make these laws. Tell the dr it’s ok to treat us when they have loads of medical records to prove the sever pain were in. Also I’m allergic to morphine and cuts out a lot of pain meds I can even take so I’m just about not able to function. I understand how people get to a point they no longer want to be here and suffer. I just pray that none of you ever get a debilitating painful condition and none of the dr will help you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484ff02c3	Potts	None	2022-04-01T17:46:41Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Potts, Patricia	l1f-1kxn-ruhb	False	None	False	2022-04-12 05:35:26.053	[]
3398	CDC-2022-0024-3404	https://api.regulations.gov/v4/comments/CDC-2022-0024-3404	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>As a person who has had chronic RLS and has augmented, symptoms get worse from medication, from all medication that is at my disposal, opioids are my last chance for a normal life that doesn't include excessive tiredness, chromic pain and restlessness in my legs and sometimes in my arms, constant sleepless nights, annoying my husband due to my constant movement and getting up at all hours to try and relieve my symptoms with little to no effect and not being able to function at my job due to this disease. I am at the point in my life that if I don't get relief I don't know what will happen as this is not a recognized disease for Social Security benefits if I cannot work and have to go out on disability from my current position. You have to understand that there has to be a drug at our disposal once all the current recommend drugs no longer work! Please for the health of all RLS patients pass this law to include Opiods as another medication at our defense to beat this terrible illness. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484ff02d5	Cadwell	None	2022-04-01T17:47:55Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Cadwell, Melissa	l1f-1n3j-un7f	False	None	False	2022-04-12 05:35:26.275	[]
3399	CDC-2022-0024-3405	https://api.regulations.gov/v4/comments/CDC-2022-0024-3405	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Current guidelines do not include Restless Leg Syndrome which I have experienced for the past 5 years. Current meds only work sometimes and then stop working and make it worse. There are studies that low dose opioid can treat the symptoms without the need to increase the dosage. It is a debilitating disease. Please review and consider adding RLS within the guidelines. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacqueline	None	None	0900006484ff030e	Peterson	None	2022-04-01T17:48:12Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Jacqueline	l1f-1tb6-n647	False	None	False	2022-04-12 05:35:26.492	[]
3400	CDC-2022-0024-3406	https://api.regulations.gov/v4/comments/CDC-2022-0024-3406	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please, please, please include possibilities for proper use of opioids for conditions other than pain! Restless legs deprive people of sleep which is torture, though perhaps not "pain" as such. For me, personally, ropinerol is working but I dread the possible future loss of sleep because I have experienced it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K. Ann	None	None	0900006484ff032f	Busch	None	2022-04-01T17:48:42Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Busch, K. Ann	l1f-1xtp-m3pm	False	None	False	2022-04-12 05:35:26.708	[]
3401	CDC-2022-0024-3407	https://api.regulations.gov/v4/comments/CDC-2022-0024-3407	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am alive because of long term low dose opiates. Restless leg syndrome is a poor name for a large group of poorly understood neurological symptoms. In my case without treatment I have feelings of electrocution in my lower and upper body every 10 seconds throughout the night or while sleeping. Having been treated for over 35 years with all of the dopenergic meds they failed. The only thing that has kept me from suicide due to the intolerable pain is a one time daily dose of 7.5 mg of Methadone and prn doses of 2.5 mg Oxycodone. Without this I can go for days without sleep because the pain is unbearable.<br/>Please, please allow chronic low dose opiates for Restless Legs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff0362	Anonymous	None	2022-04-01T17:49:15Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-28o0-38yo	False	None	False	2022-04-12 05:35:26.919	[]
3402	CDC-2022-0024-3408	https://api.regulations.gov/v4/comments/CDC-2022-0024-3408	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include Restless Leg Syndrome in your proposed clinical practice guidelines for prescribing opioids. I take 5 mg of hydrocodone every night and it helps me sleep for 2 or 3 hours before I wake up and have to get out of bed and walk around. Without hydrocodone I am up every HOUR or so. It is an awful disease and I implore you to include it on your list of approved uses of low dose opioids. Thank you.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484ff0371	Theiss	None	2022-04-01T17:49:37Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Theiss, Susan	l1f-2aqm-mo5w	False	None	False	2022-04-12 05:35:27.134	[]
3403	CDC-2022-0024-3409	https://api.regulations.gov/v4/comments/CDC-2022-0024-3409	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>After suffering the effects of severe restless legs I have found a solution with a night low - 50 mg dose of tramadol the only opioid I can tolerate. Without this dose I literally have to walk the floors of my home most of the night. If and when I can finally sleep it is broken by the overwhelming urge to move my legs and I have to get up again. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronnie	None	None	0900006484ff0372	Roche	None	2022-04-01T17:51:06Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Roche, Ronnie	l1f-2au5-kkbt	False	None	False	2022-04-12 05:35:27.346	[]
3404	CDC-2022-0024-3410	https://api.regulations.gov/v4/comments/CDC-2022-0024-3410	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had severe Restless Leg Syndrome for many years and was finally put on a low dose Methadone. I’ve finally gotten relief from symptoms and am eternally grateful! Please put RLS on the list for opioids so that we can be adequately treated for our symptoms. It makes life worth living again to not have to be up walking for 6-7 hours a night. I beg you to add RLS on your list.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484ff0385	Maril	None	2022-04-01T17:51:47Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Maril, Linda	l1f-2ee6-mtp3	False	None	False	2022-04-12 05:35:27.567	[]
3405	CDC-2022-0024-3411	https://api.regulations.gov/v4/comments/CDC-2022-0024-3411	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I take the opioid Suboxone on a daily basis under the guidance of a physician and would not be able to sleep or go about my daily activities without it.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006484ff039c	Riethmiller	None	2022-04-01T17:52:22Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Riethmiller , Wendy	l1f-2gk1-fbdy	False	None	False	2022-04-12 05:35:27.796	[]
3406	CDC-2022-0024-3412	https://api.regulations.gov/v4/comments/CDC-2022-0024-3412	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My own experience is as follows. Since 2006, I have had an increasingly severe case of RLS, making it impossible to sleep through the night: only short periods of sleep, abut 20 minutes each. Then it jolts me awake, and I have to get up and walk around until it calms down. The standard RLS drugs helped for several years, but they no longer work for me. My neurologist recognized that low-dose opioids were the only class of medications left for me, so he prescribed low-dose methadone. This has given me my life back, and I am so grateful for it. I've been taking it for over 3 years, and have not increased the dose at all. Please make sure that opioids remain available as a well-monitored treatment option for those of us with intractable pain or RLS. Without that option, our lives often become sheer hell.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Peter	None	None	0900006484ff03d6	Warren	None	2022-04-01T17:52:52Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Warren, Peter	l1f-2qwp-j1s5	False	None	False	2022-04-12 05:35:28.028	[]
3407	CDC-2022-0024-3413	https://api.regulations.gov/v4/comments/CDC-2022-0024-3413	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe restless leg syndrome. I have used all of the drugs available for RLS and have augmented on each. Mirapex gave me extreme compulsive behavior. As a result, my doctor put me on a low dose of methadone. It has worked wonders and I have been using it for 6 or 7 years. I take 15mg. And it allows me to function. Without it, life would be unbearable. What I haven’t appreciated is the stigma associated with using a life changing drug. Any new Pharmacist or uninformed doctor gives me great grief because it’s not acknowledged as a drug for RLS. Please stop making this treatment so difficult for those that really need it. I am a Professional woman who has been running a nonprofit for the last 18 years. Without medication, I couldn’t work.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff03e3	Stompe	None	2022-04-01T17:53:36Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Stompe, Mary	l1f-2sq7-8ubf	False	None	False	2022-04-12 05:35:28.243	[]
3408	CDC-2022-0024-3414	https://api.regulations.gov/v4/comments/CDC-2022-0024-3414	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We are not addicts, but we need help (mainly sleeping) , do not keep door closed for a real need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jesse	None	None	0900006484ff03f0	Adams	None	2022-04-01T17:53:57Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Jesse	l1f-2tuo-5yi5	False	None	False	2022-04-12 05:35:28.457	[]
3409	CDC-2022-0024-3415	https://api.regulations.gov/v4/comments/CDC-2022-0024-3415	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider opiods for rls sufferers. I use requip but painkillers have also helped. It's a debilitating disease where I don't drive at night or go out late. It starts every night at 7pm. I'd be dead without my meds. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melanie	None	None	0900006484ff03f3	Baker	None	2022-04-01T17:54:10Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Baker, Melanie	l1f-2umg-bs40	False	None	False	2022-04-12 05:35:28.667	[]
3410	CDC-2022-0024-3416	https://api.regulations.gov/v4/comments/CDC-2022-0024-3416	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The men and women who find themselves in positions of power to create new laws and ratify or deny proposed laws have gotten there as a result of a passionate pursuit of excellence that has required years of hard work built on the foundation of innate giftedness and realized through responsible choices in the face of opportunity. Your intelligence and diligence speak for themselves. What hangs in the balance is your integrity. Our government made the elementary mistake of assuming that radically limiting the supply of opioids to citizens who have to have them because they are inescapably dependent, unintentionally addicted, or both, would then result in a decrease in demand and prevent many tragic overdoses. The rapid increase in overdoses from illegal, and, unlike prescription opioids, unregulated fentanyl is a tragic case-study demonstrating the failed and counterintuitive logic of our law-makers with regard to the basic principles of supply and demand. We all know that, on a practical level, eliminating what a person needs doesn't eliminate the need for what was eliminated. We also know that, on a moral level, we tend to want what we can't have. Furthermore, and perhaps most important, science has shown that an addicted brain is one that tells addicts that we have to have that to which they are addicted in order to survive, and, if 'surviving' can be allowed to include the ability to live a meaningful life unhindered by pain, then what the brain is telling us is fundamentally true. All this has created a crisis on top of the crisis. At this heart-breaking moment in history, it is within your power to make the needed adjustments to save lives. One life is enough. Now is the time! Do whatever it takes! If necessary, use the power you have to limit the power you exert and deregulate. Conversely, use the power you have destigmatize and de-criminalize addiction. If the measures put it place beginning in 2016 were driven from a desire to save lives, then please, out of that same desire, make the changes necessary to end the cruelty of withholding what many need and putting them in a position to do whatever it takes to survive. We can sort illusion and reality as we go. At least we'll be alive to do it. With Grace and Compassion.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Johnny	None	None	0900006484ff0421	Zeboskey	None	2022-04-01T18:20:00Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Zeboskey, Johnny	l1f-30gc-zg99	False	None	False	2022-04-12 05:35:28.878	[]
3411	CDC-2022-0024-3417	https://api.regulations.gov/v4/comments/CDC-2022-0024-3417	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regarding opioid low dose treatment for RLS. It is very helpful in some cases of RLS which allows one enough relief to sleep.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484ff0434	Raus	None	2022-04-01T18:20:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Raus, Michael	l1f-32z9-5r82	False	None	False	2022-04-12 05:35:29.091	[]
3412	CDC-2022-0024-3418	https://api.regulations.gov/v4/comments/CDC-2022-0024-3418	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RE: revising the CDC Clinical Practice Opioid Prescribing Guideline<br/><br/>Request: including low-total-daily dose opioids as a viable treatment option for RLS patients<br/><br/>I am a 59-year-old male suffering from severe Restless Legs Syndrome (RLS) for more than 15 years. At best my daytime symptoms can be mild - having to stand more than I’d like and only getting a few hours of sleep a night. On my worst days symptoms make it nearly impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>Several months ago, I began to resist treatment from the prescribed dopamine agonist Mirapex (Gen: Pramipexole). Slowly increasing my dosage as the symptoms became worse had moved me into a state of augmentation reversing any medicinal benefits. As my symptoms became extreme and inhibited normal activity and sleep functions my team of doctors attempted to find solutions through complimentary medications. I was in an untenable state – at the end of my rope.<br/><br/>On guidance from doctors at [name redacted] we began to introduce opioids. While we had some success with Oxy, true progress was only achieved when we introduced Methadone into the plan. Once we were able to find the appropriate low daily dosage (first 2.5MG, then 5, 7.5, and finally 10MG), my symptoms became very manageable and returned my quality of life. <br/><br/>Throughout this entire journey my health insurance has been obstructive at best – challenging each solution. They have, in fact, refused to cover Methadone as an appropriate treatment. The medication protocol they offer instead demands that we evaluate several other meds first – meds intended to treat addictions, not RLS. As living with severe RLS is not an option, I’m paying out of pocket for the only medication proven to manage my RLS - Methadone. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require monitored low-dose opioid therapy as a last resort. Formal recognition and inclusion of opioids as part of the possible RLS solution set would provide tremendous lift to treating people who suffer as I have. Please consider. Thank you.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Edward	None	None	0900006484ff0458	Fitchett	None	2022-04-01T18:21:03Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Fitchett, Edward	l1f-35zm-hvtc	False	None	False	2022-04-12 05:35:29.305	[]
3413	CDC-2022-0024-3419	https://api.regulations.gov/v4/comments/CDC-2022-0024-3419	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. <br/><span style='padding-left: 30px'></span>I’ve had Restless Leg Syndrome most of my adult life. I’m 67 years old and have never been able to sleep well or sit through long meetings without having to get up and walk around. Several years ago a doctor put me on a medication that worked well for a year but began to cause the symptoms to get worse. This is called augmentation. The RLS got worse and worse and became so extreme that I could only sleep for an hour or less at a time without getting up. Many times it was so bad all I could do was get on a treadmill. My life was reduced to a constant cycle of sleep an hour and walk 2 hours. I couldn’t work or have a social life. I couldn’t drive without falling asleep. I couldn’t be a passenger for long trips because not being able to move my legs was torture. I began to consider suicide. And then I found a new doctor who prescribed Methadone. I take only 1.5 ml every evening. Immediately after starting it I slept through the night. When I woke up that first morning I sobbed like a baby because I knew I was saved. That was 6 months ago and I’ve slept well ever since with no side-effects. Now I can drive and do things with friends. I’m not tired during the day and have lost weight (this is a good thing!). I’m exercising because I want to - not because I have to. I would have ended my life by now without this miracle drug. I felt I had to send comments to help represent people like me who depend on this miracle medication to have normal lives. Thank you for giving me a chance to do that. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484ff0469	Buling	None	2022-04-01T18:21:58Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Buling, Susan	l1f-37wp-1le1	False	None	False	2022-04-12 05:35:29.524	[]
3414	CDC-2022-0024-3420	https://api.regulations.gov/v4/comments/CDC-2022-0024-3420	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife has severe restless leg syndrome. She requires low dose Tramadol to have a manageable quality of life. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Doren	None	None	0900006484ff046c	Goldstone	None	2022-04-01T18:22:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Goldstone , Doren	l1f-38em-mhl2	False	None	False	2022-04-12 05:35:29.739	[]
3415	CDC-2022-0024-3421	https://api.regulations.gov/v4/comments/CDC-2022-0024-3421	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My RLS Story<br/><br/>To whom this concerns, <br/><br/>I am writing you to illustrate how low dose opioid treatment has dramatically helped me manage my highly disruptive refractory RLS. My name is [name redacted] and I have RLS, PLMD, Sleep Apnea, & Narcolepsy. I have had RLS/PLMD for as long as I can remember. Even as a child, I struggled with this chronic condition to the point I (without knowing and over time) kicked a hole in the wall my bed was positioned next to. It was difficult for me to stay focused in a lot of my middle school and high school classes as a result. I only started treating it in 2009 when I realized there were options to do so. When it got to the point I couldn't successfully sit and hold my newborn baby to feed or rock him to sleep, I new I had to do more to try and get this problem under control. <br/><br/>2009 was the first time I had seen a doctor who told me what I have and how it could be managed. <br/><br/>Enter a dopamine agonist. <br/>My experience was pretty textbook. It worked great for a few years, then I had to bump up the medication. Over time, I had to bump it up again, and again. Until the symptoms were worse and still not being controlled. <br/><br/>Enter Augmentation.<br/>The medication wore off sooner, the feeling started moving to my hands, I would get extremely tired early in the evening and then not so much when I needed to go to bed. I was irritable most days. At different times, I was prescribed ropinirole with no success, Xyrem for narcolepsy (and the possibility it would block my PLMD as it knocked me out for the night), Gabapentin, and I am sure there were other things which I am not remembering as I write this. I tried to taper the dose to get off of the DA multiple times which was unsuccessful. The only way I was able to get off of the dopamine agonist was to stop “cold turkey” and experience the two most difficult weeks of my life. <br/><br/>Enter methadone. <br/>I only go into this level of detail to show that if anyone could rationalize NOT taking daily medication to manage chronic conditions, it would be me. I never really liked the option way back in 2009 but I felt I needed to do what I could to live a better life and get back what RLS was taking away from me. I had HUGE reservations on taking a daily dose of opioids to manage RLS/PLMD. So much so that I talked with multiple doctors and one gentleman who was had already been using methadone at a low dose for a few years per his doctor’s guidance. I was afraid it wouldn’t work, I was afraid it would be too expensive, and I was afraid it would be easy to abuse and become addicted to. <br/><br/>Enter a better quality of life (finally). <br/>It has been a little over 6 months since I started using methadone to treat my RLS/PLMD and I could not be more pleased with finally feeling like I am more in control of these conditions. None of my fears have come true and I need the CDC to understand the importance of how this medication helps me manage what was otherwise a torturous daily feeling and disruption. <br/><br/>I understand everyone is different and people react differently to medications so I can only speak to my experience but I am very grateful for this treatment option and can not imagine trying to successfully manage my refractory RLS/PLMD without it. I am able to live a more enjoyable and fulfilled life without the interference of RLS/PLMD and I am a better person, husband, and father because of it. <br/><br/>Thank you for allowing me to share my story and I am available to answer any questions the CDC may have after reading my comment.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeremy	None	None	0900006484ff0478	Stebler	None	2022-04-01T18:23:55Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Stebler, Jeremy	l1f-39rr-3s93	False	None	False	2022-04-12 05:35:29.953	[]
3416	CDC-2022-0024-3422	https://api.regulations.gov/v4/comments/CDC-2022-0024-3422	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have sever Restless Leg Syndrome ("RLS"). I have tried every recommended treatment available over the past 20 years. The only relief I get is from low dose opioids. I have been taking them since 2011 averaging about 33 mg peer day of a combination of oxycontin and oxycodone. I am 74 years old. Without opioids the amount of sleep i would get a night would be in the 4 hour range and it would be low quality rest. My days would be punctuated with drowsiness and an inability to have any quality of life. I lived in that regime for 10 years before i started being treated with opioids. Without opioids I expect this lack of sleep would eventually manifest itself in a shortening of my life span. Seniors need their rest. The severity of my RLS causes extreme pain and discomfort. The only pain I have suffered which was worse was kidney stones. Thank you to taking the time to read this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484ff0483	Schwager	None	2022-04-01T18:24:26Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schwager, John	l1f-3ajb-ck0f	False	None	False	2022-04-12 05:35:30.207	[]
3417	CDC-2022-0024-3423	https://api.regulations.gov/v4/comments/CDC-2022-0024-3423	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low dose opioids for restless leg syndrome It's important. I have severe RLS and without opioid therapy my life would be over.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484ff0509	Pike	None	2022-04-01T18:24:38Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Pike , Daniel	l1f-3ltx-lbwv	False	None	False	2022-04-12 05:35:30.423	[]
3418	CDC-2022-0024-3424	https://api.regulations.gov/v4/comments/CDC-2022-0024-3424	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After over 25 years with RLS, I have not found a med that works. I don’t like taking opioids (nausea reaction) but I would like to try a low dose. I may be one of those it could help!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484ff0519	Brown	None	2022-04-01T18:25:08Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Carol	l1f-3omx-7pli	False	None	False	2022-04-12 05:35:30.637	[]
3419	CDC-2022-0024-3425	https://api.regulations.gov/v4/comments/CDC-2022-0024-3425	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have lived with RLS for over 20 years, and it has progressively ruined my quality of life. I have used every approved medication for my RLS in that time, to varying degrees of success. Some simply did not handle my symptoms and left me suffering. Others worked for a period of months or years, but all ultimately lead to augmentation, which is a paradoxical effect whereby the medication ends up causing a worsening of RLS symptoms. Each time I augmented, I went through months and months of suffering while coming off of one medication and trying to find a new one that could control my symptoms. During these periods, it was nearly impossible to sleep or even lie down at night. Like many others with this disease, I contemplated ending my life to relieve myself of the misery. It’s not an overstatement to say that RLS took over, and ruined, my life. After cycling through all possible medications and treatments, including some experimental treatments, I found myself at a place where it seemed like there was no possible further treatment for me, and I thought my life was over. Luckily, I have a neurologist who is an expert in the treatment of RLS. He suggested low dose methadone treatment, which he said is a last resort for severe RLS patients like myself. I hesitated in taking him up on his suggestion, due to the stigma of opioids. However, after several more months of agony and hopelessness, my wife convinced me that it was worth trying. It was either that or just give up on life. Since starting low dose methadone treatment, I have my life back. I am able to lie down again at night and sleep. I can once again function like a normal human being. I am able to be a good husband and father again. There is still a stigma associated with methadone, but I owe my life to it and my doctor. I wouldn’t still be here without it. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	0900006484ff052c	Gillies	None	2022-04-01T18:26:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Gillies , Bill	l1f-3s2o-ve7j	False	None	False	2022-04-12 05:35:30.846	[]
3420	CDC-2022-0024-3426	https://api.regulations.gov/v4/comments/CDC-2022-0024-3426	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Restless Leg Syndrome. My medications include Gabepentin and Neupro patch. My doctor has also prescribed a low dosage of Hydrocodone. I cut each oill into quarters so that on nights that I require a low dosage of Hydrocodone in order to lessen my RLS symptoms enough so that I can asleep. I urge the CDC to recommend low dosages of Opiods such as hydrocodone in the treatment of Restless Leg Syndrome.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wayne	None	None	0900006484ff0542	Davis	None	2022-04-01T18:26:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Davis , Wayne	l1f-3vac-eoga	False	None	False	2022-04-12 05:35:31.063	[]
3421	CDC-2022-0024-3427	https://api.regulations.gov/v4/comments/CDC-2022-0024-3427	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have had Restless Leg Syndrome for over 3 years now and have tried numerous medications that did not work for me. Low dose opioids has helped me tremendously with this awful diseased. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484ff0549	Mahnken	None	2022-04-01T18:27:13Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Mahnken, Linda	l1f-3wpk-l882	False	None	False	2022-04-12 05:35:31.323	[]
3422	CDC-2022-0024-3428	https://api.regulations.gov/v4/comments/CDC-2022-0024-3428	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from RLS for 7 years now and the only effective relief, without side effects has been a 5mg dose of Methadone. I've been on this treatment for 2 years now with absolutely no adverse effects, no withdrawal and no desire or inclination to tamper with my dosage. Opioids have been used to treat this disease effectively since the mid 1400s. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jorge	None	None	0900006484ff054d	Garcia	None	2022-04-01T18:27:43Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Garcia, Jorge	l1f-3y7y-rq5e	False	None	False	2022-04-12 05:35:31.544	[]
3423	CDC-2022-0024-3429	https://api.regulations.gov/v4/comments/CDC-2022-0024-3429	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was taking 7 pills per day for RLS. 3 Tramadol, 3 Requip, and 1 Clozapine throughout the day. My RLS was getting worse and worse every day. Dr. called it "augmentation" My new doctor weaned me off all previous RLS meds and that was not an easy or pleasant experience. After the months of withdrawal, I started taking 5 milligrams of Oxycodone...one pill per day, cut in half I take half the pill at dinner and half at bedtime. For the first time in years, I can read a book without walking around while I read. I can attend church and the theater without having to get up and walk during the program. I can take an afternoon nap if I choose. The low dose, 5 milligrams of Oxycodone, literally has given me my life back. Please understand that a small dose of this drug is working miracles for RLS patients like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert K	None	None	0900006484ff0574	Campbell	None	2022-04-01T18:28:34Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Robert K	l1f-42ht-fxkg	False	None	False	2022-04-12 05:35:31.784	[]
3424	CDC-2022-0024-3430	https://api.regulations.gov/v4/comments/CDC-2022-0024-3430	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand you are reviewing the CDC Clinical Practice Opioid Prescribing Guideline. I am concerned that it does not include RLS or similar conditions that are not really chronic pain. I have had RLS since I was a child. It went undiagnosed until it got extremely difficult to live with. After being diagnosed as an RLS patient and not just someone who thought she was going crazy as no one she knew had the same symptoms, the doctors began prescribing all of the usual anti-Parkinson drugs like sinemet, gabapentin among many others. Those medications caused what I called rebound...the conditions worsened and I wanted the drug more often and a stronger dose. MY LAST RESORT was taking methadone to help control this very debilitating disease. This was the only drug that was left to try. Can you imagine not being able to sit and rock your child while reading a book? Can you imaging going to see your son or daughter in a concert or play and have to stand and walk in the back of the auditorium? I had learned to read while walking and actually sew while standing. I watched a lot of television because I could walk and watch. A car ride to see my children was virtually impossible. I could get only 2 - 3 hours of sleep at a time without having to get up and walk. Once offered methadone I refused at first as I know what a dangerous drug it is. I know it is habit forming and getting off of it would be almost impossible. After two weeks I finally gave in and offered to at least try it. The change was IMMEDIATE. I could sit and read, I could sleep through the night. I have been on that medication for almost 10 years with NO INCREASE IN DOSE. I did agree to try a new drug called Horizant that was a mixture of gabapentin and another medication. Unfortunately I got rebound again from the gabapentin! Methadone is my ONLY choice. Please do not fail to address people like me with chronic conditions like RLS in your revision of the prescribing guideline. It is a life issue for me.<br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484ff058a	Richter	None	2022-04-01T18:29:27Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Richter, Linda	l1f-452n-ttuh	False	None	False	2022-04-12 05:35:31.998	[]
3425	CDC-2022-0024-3431	https://api.regulations.gov/v4/comments/CDC-2022-0024-3431	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep, sit or even stand quietly	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denice	None	None	0900006484ff059d	Leon	None	2022-04-01T18:29:41Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Leon, Denice	l1f-49au-8f14	False	None	False	2022-04-12 05:35:32.210	[]
3426	CDC-2022-0024-3432	https://api.regulations.gov/v4/comments/CDC-2022-0024-3432	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic RLS and it destroys every night and every day for me. I cannot sleep normally because of it. Lack of sleep makes me dysfunctional and unable to do certain tasks thru out the day due to lack of rest causing poor judgement . Please instead of allowing children to receive xanax for anxiety why not distribute to adults that would benefit from a drug greatly for a true cause without becoming an addict. You know something like RLS that needs attention as much as any other disease you know like AUTISM. Let the doctors prescribe medicine that help people. I'm not a addict. They are the ones that don't need this prescribed. Why should I be punished for what addicts do. Don't take my helpful meds from me because someone else can't control their urge to overdose. To HELL with this dumb ass logic. Give me my meds to help me and others feel better. I truly hope this bill will pass. Common sense will help pass this . Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff05ab	Anonymous	None	2022-04-01T18:32:38Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-4c3v-hzna	False	None	False	2022-04-12 05:35:32.434	[]
3427	CDC-2022-0024-3433	https://api.regulations.gov/v4/comments/CDC-2022-0024-3433	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff05af	Stebnitz	None	2022-04-01T18:34:14Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Stebnitz, David	l1f-4cpy-dmpb	False	None	False	2022-04-12 05:35:32.653	[]
3428	CDC-2022-0024-3434	https://api.regulations.gov/v4/comments/CDC-2022-0024-3434	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My RLS began at a young age (31) and it progressively got more painful each night until at age 50 I was sleeping 3 hours a night. I finally sought professional medical care and after trying various non-opioid drugs that did not work, Methadone was prescribed and it saved my life. There is no high feeling with Methadone, only the complete quelling of the pain. I now sleep 7-8 hours a night and I have no feelings of addiction. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	0900006484ff05b1	Kloc	None	2022-04-01T18:35:00Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kloc, Jeffrey	l1f-4day-eoff	False	None	False	2022-04-12 05:35:32.874	[]
3429	CDC-2022-0024-3435	https://api.regulations.gov/v4/comments/CDC-2022-0024-3435	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is very welcome to read that these are suggestive and not regulatory in nature.<br/><br/>Too many health care providers have read the prior versions as law or regulation and therefore denied pain medication to too many.<br/><br/>Many dental, post surgical/ procedural patients have been made to suffer, only being given analgesic pain medicine when something stronger would have relieved the pain, and there was absolutely no threat of this becoming an addiction.<br/><br/>Incredible that prescriptions can't be properly tracked to know the difference between what could be grounds for addiction (and therefore targeted for consultation/ treatment options), and standard merciful pain relief.<br/><br/>Thank you for taking this matter seriously and not heavy handed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff05b9	Anonymous	None	2022-04-01T18:35:28Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-4dgg-5l8z	False	None	False	2022-04-12 05:35:33.087	[]
3430	CDC-2022-0024-3436	https://api.regulations.gov/v4/comments/CDC-2022-0024-3436	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In or around 1969 I survived an automobile accident in which the car was totaled. in or around 1982 I fell on concrete stairs, cracking a vertebrae in my lower back, and later that year broke my left ankle. Over the years since I have acquired a number of other injuries and age related problems, both knees and hips have been replaced, arthritis in my hands, narrowing of the nerve pathways to my arms, grains of calcification in joints, and a bone spur in my left foot are the highlights. In spite of all these insults, my quality of life has been quite satisfactory, with minimal usage of Acetaminophen #3--one tablet before bedtime provides a good night's sleep, wearing a back brace helps, and only occasionally half a tablet more during the day is required. <br/><br/>I have a new, very competent primary care physician, but alarmed by the 'Schedule II' criteria, she is attempting to treat my chronic pain (managed well by minimal doses of codeine) with gabapentin. It isn't working for me. <br/><br/>I applaud the restatement of the 2016 CDC guidelines to indicate that patients who have long-term successful moderate use of Schedule II drugs should be allowed to continue this pallative treatment, and I will share that information with my PCP.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006484ff05ea	Thornberry	None	2022-04-01T18:36:38Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Thornberry, Margaret	l1f-4mpg-5nle	False	None	False	2022-04-12 05:35:33.303	[]
3431	CDC-2022-0024-3437	https://api.regulations.gov/v4/comments/CDC-2022-0024-3437	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a 68 year old male. I have had RLS for as long as I can remember. I am fortunate that 7 years ago my doctors identified my RLS disease and prescibed a medicine that works for me. I could not survive at night without my RLS treatment. I NEED to take 15 mg of methadone and 400 mg of pregabalin nightly to get to sleep and to stay asleep. I have tried many times to minimize the medicine that I take but it does no good.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Henry	None	None	0900006484ff062e	Kelly	None	2022-04-01T18:37:02Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kelly, Henry	l1f-4ntt-8cux	False	None	False	2022-04-12 05:35:33.514	[]
3432	CDC-2022-0024-3438	https://api.regulations.gov/v4/comments/CDC-2022-0024-3438	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i have tried for years to take anything that would allow me sleep, Requip, Gabapentin, etc but nothing helped. the only relief i get and it is total relief is from Tramadol. have been taking it for approx 20 years without having to increase dosage or strength. RLS began after 2 back surgeries.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	james	None	None	0900006484ff06e2	bourne	None	2022-04-01T18:37:21Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from bourne, james	l1f-4vay-beie	False	None	False	2022-04-12 05:35:33.724	[]
3433	CDC-2022-0024-3439	https://api.regulations.gov/v4/comments/CDC-2022-0024-3439	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low dose opioids are critical treatment for moderate to serve Restless Leg Syndrome(RLS) RLS is a debilitating disease. It is not fatal or life threating and thus gets very little serious attention or funding. Low dose opioid treatment, under the guidance of a physician, is a safe and effective treatment that must not be curtailed under new opioid use regulations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dexter	None	None	0900006484ff06e6	Wang	None	2022-04-01T18:37:39Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wang, Dexter	l1f-4vxn-tb3e	False	None	False	2022-04-12 05:35:33.949	[]
3434	CDC-2022-0024-3440	https://api.regulations.gov/v4/comments/CDC-2022-0024-3440	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline. However the draft does not address chronic conditions like RLS that are different from Chronic pain. Restless Leg Syndrome is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the US, nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am an 80 years old woman in otherwise good health who had been suffering from increasingly worsening RLS for a number of years to a point where my sleep averaged 2 to 3 hours per night. With the help of the RLS Foundation I was able over the past year to consult with a neurologist -[name redacted], MD, PhD at [name redacted]. After a careful trial of prescriptions medications (Horizant, Lyrica) which offered little relief and were discontinued, [name redacted] prescribed a daily 5 mg dose of Methadone. My RLS symptoms have decreased steadily to the point where I now have nights with no symptoms and 7 hours sleep. It has been simply life saving.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily dose opiod therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing Guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation as a resource for scientifically based information about RLS, as it is for members like me.<br/><br/>Respectfully,<br/><br/>[name redacted]<br/>[location redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Guillemette	None	None	0900006484ff06e9	Simmers	None	2022-04-01T18:39:23Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Simmers, Guillemette	l1f-4wdi-xjp9	False	None	False	2022-04-12 05:35:34.162	[]
3435	CDC-2022-0024-3441	https://api.regulations.gov/v4/comments/CDC-2022-0024-3441	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please read my statement in the Word Document file attachment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484fef614	Olsen	None	2022-04-01T18:40:30Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Olsen, Sharon	l1e-a3jx-wd69	False	None	False	2022-04-12 05:35:34.380	[]
3436	CDC-2022-0024-3442	https://api.regulations.gov/v4/comments/CDC-2022-0024-3442	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who has suffered with Restless Leg Syndrome I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. When I first noticed in the 1980's that I would wake up at night with a condition that I could only describe as ants running through my legs I had no idea what was going on. I tried to find out what the condition was and then stumbled upon a book which listed the condition called Restless leg syndrome. I was to find out that Restless legs syndrome (RLS), which I initially thought was a condition relating to my leg, is actually a chronic neurological disease that causes a sensation in my legs that requires me to constantly move them. This means that almost every day there is a period of time (usually the evening but sometimes starting in the early afternoon) that I cannot sit down with my family and enjoy dinner or other evening activities. I rarely go out to dinner knowing that I may have to leave the restaurant or walk around the neighborhood until my party is done. My continual walking just makes RLS barely tolerable, it does not stop it. The medicines I take are no longer effective against the condition. <br/><br/>I am approximately one of 12 million adults and children who suffer from RLS in the United States. There is no known cure. As I well know there have been a few new prescriptions that have relieved my symptoms for a short time but in a while those same medications have make the symptoms worse. I have spoken with my doctor about the use of low-total-daily dose opioids. Scientific research supports the use of these opioids to treat severe RLS symptoms when other medical options fail. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy, in carefully monitored low-total-daily doses,. As an older American I do not want to have to live out my remaining years walking around the living room while my family relaxes and enjoys the evening. The only one who really wants my company in the evening is our dog, because she knows that I am need a good long walk for the whole evening. I would like to be able to spend my evenings with my family rather that suffering from a condition that could be treated better to give me some relief.. Thank you.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484ff071f	Leffingwell	None	2022-04-01T18:40:34Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Leffingwell, Richard	l1f-4zfn-8n5p	False	None	False	2022-04-12 05:35:34.601	[]
3437	CDC-2022-0024-3443	https://api.regulations.gov/v4/comments/CDC-2022-0024-3443	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 77 year old male who suffers from Restless Legs Syndrome (RLS). RLS is a chronic neurological disorder that results in spasms, jerks, and paroxysms in the legs and other parts of the body as well. It occurs classically when one lies down to sleep and makes sleep impossible. It also can occur during the day. Without medication, it is reduced only by walking around, thus our RLS nickname, “night stalkers.” Medications like Mirapex work well in the short term, but their effectiveness ends after about 10 years. The only medication that works in the longer term is low doses of certain opiods.<br/><span style='padding-left: 30px'></span>My doctor is a specialist in RLS at [name redacted], who I went to in 2017 after Mirapex ceased to function, and I was in acute “pain” being unable to sleep. First we tried Methadone, but its side effects were unacceptable. Since 2019, I have been prescribed a small dose (3 mg/day) of Buprenorphine-Naloxone, which has worked well. <br/> The use of opiods to treat RLS has been known for 300 years. I and other RLS suffers need opiods at low doses and are not part of the opiod crisis. The CDC Guidelines need to permit doctors to offer low dose opiod therapy to those of us plagued by this disease. It is not “pain” in the common use of the word. But it is a debilitating condition that disrupts daily life just as much as “pain.” Imagine being unable to stop hiccuping or sneezing - not “painful” but impossible to live with. This is life with RLS. <br/><span style='padding-left: 30px'></span>Please ensure the CDC guidelines do not place impediments in front of doctors needing to prescribe low dose opiods to help those of us with RLS live normal lives. We are not opiod abusers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Don	None	None	0900006484ff0760	Arbuckle	None	2022-04-01T18:41:58Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Arbuckle, Don	l1f-58mq-1k90	False	None	False	2022-04-12 05:35:34.826	[]
3438	CDC-2022-0024-3444	https://api.regulations.gov/v4/comments/CDC-2022-0024-3444	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It would seem logical and protective to include all diseases which are benefitted by some form of opioid treatment to be inclined<br/>In the list of those woth <br/><br/>With guidelines<br/><br/>It would seem logical and se [name redacted]<br/><br/>It would seem logical to include in the list of opioid guidelines for all diseases which benefit from opioid treatment. A case in point is for Restless Legs Syndrome. I was prescribed Lyrica for my RLS and have been helped significantly, and on a small dose. I would feel protected if I knew my treatment was guided by the CDC.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diana	None	None	0900006484fef683	Hahn	None	2022-04-01T18:42:15Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-30T04:00:00Z	None	None	None	None	None	None	None	Comment from Hahn, Diana	l1e-bo7f-8g9y	False	None	False	2022-04-12 05:35:35.070	[]
3439	CDC-2022-0024-3445	https://api.regulations.gov/v4/comments/CDC-2022-0024-3445	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been treating many patients with RLS over the years. I found that many patients , I have been treating many patients with RLS over the years. I found that some patients, particularly the intractable or refractory cases and those and those with intolerable Augmentation to dopaminergic medications needed treatment with opioids for adequate relief. In some patients after some time I had to switch from one opioid to another opioid for effective relief ( based on the principle of drug holiday). Therefore, I will strongly suggest including RLS patients in the practice guidelimes for opioid treatment of chronic painful conditions.<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sudhansu	None	None	0900006484ff077b	Chokroverty	None	2022-04-01T18:42:36Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Chokroverty, Sudhansu	l1f-5bha-oq25	False	None	False	2022-04-12 05:35:35.298	[]
3440	CDC-2022-0024-3446	https://api.regulations.gov/v4/comments/CDC-2022-0024-3446	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had RLS for over 40 years. I've been close to suicide three times during that time. Approved drugs that had been approved and been working ceased to work or began causing the very symptoms they were meant to prevent. I tried increasingly strong opioids. In the end, only Dilaudid kept the RLS symptoms enough in control that I was not driven to take my life. <br/><br/>Anyone who has not experienced severe and chronic RLS symptoms, day and night, cannot possibly imagine what it feels like to live with RLS. It is debilitating. Before Dilaudid, there were times when I slept barely an hour or two for three to five days in a row.<br/><br/>My Master's Degree is in Public Health and Epidemiology. I have searched for and found numerous food and other RLS triggers. I avoid them with a passion. I no longer eat out and my diet is rather restricted and home-made. There is nothing else I can do to prevent RLS attacks. <br/><br/>I wish that a drug other than an opioid could work on RLS over the long term. I do not like taking it. I do not get high from it and, like I tell everyone who asks, I do not take it for pain management. <br/><br/>At the risk of appearing dramatic, please do not condemn me to end my life because despair sets in and I see no other way to be still. I have too much yet to contribute.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Armando	None	None	0900006484ff079c	Rancano	None	2022-04-01T18:43:19Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Rancano, Armando	l1f-5i5r-swm7	False	None	False	2022-04-12 05:35:35.511	[]
3441	CDC-2022-0024-3447	https://api.regulations.gov/v4/comments/CDC-2022-0024-3447	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my name is [name redacted] I am 62 years old I’ve been a hairdresser for 40 years and I work full-time. I have four herniated disc in my low back , Stenosis in my low back and scoliosis in my low back. I’ve been going to pain management for over 10 years. I’ve had four different types of injections. A side entry injection between the facet joints and then two basic injections. None have worked. As a hairdresser being self-employed I have no form of retirement. I have no choice but to continue to work. I’ve made all the appropriate changes needed. I now have a chair that I sit in when I shampoo my clients hair. I also have made adjustments to the type of shoes I wear and to the placement of my client in the chair when I am working on their hair. Thank goodness they understand and are willing to work with me. I’ve gone to other forms of treatment that the pain management practice has recommended. One was a type of trigger meditation. Honestly I thought it was a joke. I do try to get massages when I can. I do belong to a gym and try the best I can. Several several years ago I was on 100 mg patches of fentanyl with my daily allotment of my OxyContin as well as a muscle relaxer. I did not like the fentanyl patches so I went down slowly off of them completely. Then I was put on Opana long lasting twice a day at 30 mg a tablet. Over the last 2 1/2 years they have been reducing me. I went from 30 mg twice a day to 20 mg twice a day, also reducing my soma daily. They also added reducing my OxyContin 15 mg x8 per day. Then we went down to 10 mg Opana while continuing to reduce my soma every month and reduce my OxyContin every month. I am now completely off Opana and completely off so much. There is no way I am going to be able to work on 3 OxyContin 15 mg tablets a day. There are days when I need to take four tablets possibly five. This is my livelihood. I have never had a complaint from a family member or a coworker or a client that I was under the influence. I have tried other forms of medication this is what I can control for my body and what works best for my body and my career and my home life. Being reduced to three tablets daily will cost me at the end of the month to be completely out. If I am too take three tablets once in a while and four tablets once in a while. Then at the end of the month I’ll be lucky if I have one tablet a day. I cannot clear my schedule and tell my clients I cannot return to work until my new prescription is filled. I had no side effects no problems. Each month when I go to my doctors appointment I pass my urine test I show up on time. But I also cry my eyes out. Because I am very upset with the CDC. My doctors have known me for so long they could see whether it was causing me a problem. I have followed all the rules all their suggestions and done everything possible to alleviate my chronic back pain. As I get older I am working at a slower pace I now have to schedule brakes in. And I’m not complaining about that. I’m just letting you know that there is a drug problem out there I understand about reducing those of us who have been safe and sane with our medication in order to have a quality of life like the majority of the population pain free would be nice. I’m getting more and more depressed as my medication is being ripped out from underneath me. And I’m really concerned about my job my home and my future. Thank you for listening, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Belinda	None	None	0900006484ff07c9	Heller	None	2022-04-01T18:47:00Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Heller, Belinda	l1f-5n6f-i9kl	False	None	False	2022-04-12 05:35:35.725	[]
3442	CDC-2022-0024-3448	https://api.regulations.gov/v4/comments/CDC-2022-0024-3448	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is to support the inclusion of severe Restless leg Syndrome in the guidelines for prescribing opioids. I have been using them for 20+ years ; increases in dosage have been minor. Prior to using them I tried using a number of other medications which either were not effective or had serious side effects. Although the name of this disorder implies something inconsequential, in its refractory form , it turns people lives upset down causing sensations which can be almost intolerable, making sleep difficult, often impossible and seriously limiting people's ability to do anything that requires sitting for any length of time- attending meetings or performances ,socializing, traveling etc. Opioids at low dosages provide a pathway to a tolerable life. I appreciate the havoc that opioids have wreaked on many lives. However making this tested treatment unavailable to people with refractory RLS is not an answer. Given the social stigma associated with opioids, I am signing my name anonymous.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff07cb	Anonymous	None	2022-04-01T18:51:39Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-5n9b-ubyi	False	None	False	2022-04-12 05:35:35.944	[]
3443	CDC-2022-0024-3449	https://api.regulations.gov/v4/comments/CDC-2022-0024-3449	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. <br/><br/>RLS is not a joke. Since the 1990's I have tried every medication possible for the alleviation of Restless Leg Syndrome. I have tried dopamine agonists, gabapentin, iron supplements - you name it. Only two medications worked for me. One is pramipexole, from which I have unpleasant side affects. In addition, over time pramipexole augments symptoms and RLS becomes worse. The other is hydrocodone/acetamenophen, which I take nightly. This is the ONLY medication that has worked really well for me. I honestly believe that if I had not been prescribed this opioid I would not be alive today. My symptoms began about 25 years ago and were mild at first. Eventually they exacerbated to the point where I could no longer sit still in an afternoon meeting. I could not sit to watch a movie or go the theater. I could not even sit still to watch television at night. <br/><br/>People who do not experience this disease have no idea what it's like. It consumes you. You cannot concentrate, relax, work or enjoy any activity because of the constant need to move. Moving to alleviate symptoms is all you think about. It is a horrible disease. As I mentioned above, had I not been prescribed this opioid by a sleep specialist, I would not be alive. I would have killed myself years ago. This is not an exaggeration, it is the truth. I simply cannot tolerate the constant need to move. On the rare occasions I have had to go without the medication for even a short period of time, I must constantly be in motion. It can be intolerable. I am 71 years old and in no way do I abuse this medication. <br/><br/>I certainly understand the conditions that impacted the 2016 CDC Opioid Prescribing Guidelines. The abuse of oxycontin and other opioids was tragic, and it justifiably made physicians afraid to prescribe these drugs for any reason. However, I strongly feel that while physicians need to be monitored for all types of Rx abuse, patient cases must be assessed on an individual basis. For chronic sufferers such as myself, I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses.<br/><br/>Thank you for your consideration. Your decision is critically important to all RLS sufferers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jo	None	None	0900006484ff07e7	Griffith	None	2022-04-01T19:25:32Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Griffith, Jo	l1f-5pvm-y6ia	False	None	False	2022-04-12 05:35:36.167	[]
3444	CDC-2022-0024-3450	https://api.regulations.gov/v4/comments/CDC-2022-0024-3450	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS is a chronic pain condition that can be effectively managed with low dose opioids. Consider the torment of being in a situation where standing is not permitted -- like a long flight with air turbulence --with nothing to relieve the pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006484ff07fb	Rainford	None	2022-04-01T19:25:44Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Rainford, Robin	l1f-5tqk-ny67	False	None	False	2022-04-12 05:35:36.383	[]
3445	CDC-2022-0024-3451	https://api.regulations.gov/v4/comments/CDC-2022-0024-3451	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS since I was in my 20’s. I am now 61. At the time I didn’t know there was a diagnoses and called it creepy legs. About 10 years ago I was seeing a neurologist for a possible TIA when I told him about my legs. He started me on Mirapex which didn’t work well as I recall. Since that time I have been on at least 5 other medications and have had iron infusions. I tried the patch and was so allergic I was covered in hives. The last med I took was Ropinerole. It worked initially but after a few months I had to increase the dose until I ended up augmenting. At the point I could not take a nap, sit and watch a show or lay down in bed for the night without my legs becoming so agitated and painful that I couldn’t hold still for even a minute. I dreaded bedtime because I knew I wouldn’t be able to sleep until 3-4 hours later when exhaustion would take over and around 3am I might fall asleep if I was lucky. RLS has been so debilitating and has affected every facet of my life. I can’t go on an airplane because the sitting causes extreme twitching, jerking and pain in my legs. I can’t go to a meeting, church, a plane ride or long car ride without having RLS set in immediate. I started reading about opioid therapy and took the article to my neurologist. Thankfully he was aware of and had prescribed low dose opioids to other RLS patients with success. He started me on 5mg Methadone and within one day I was feeling relief. I was able to wean off Ropinerole within a few weeks. I have no side effects accept craving sweets. It has literally taken away ALL my RLS except occasional small episodes at night. Methadone has been a miracle for me!! The same dosage has been working for almost a year now and I have my life back. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484ff0810	Junk	None	2022-04-01T19:26:27Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Junk, Kathy	l1f-5wgp-mu7b	False	None	False	2022-04-12 05:35:36.602	[]
3446	CDC-2022-0024-3452	https://api.regulations.gov/v4/comments/CDC-2022-0024-3452	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having RLS for 10 years, I have found that opioids offer the best relief and minimal side effects. I think that patients who take opioids for help with RLS can benefit from a lose dose that is capped in order not to result in addiction and abuse of the drug.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverly	None	None	0900006484ff0844	Muskopf	None	2022-04-01T19:26:40Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Muskopf, Beverly	l1f-61bo-38sx	False	None	False	2022-04-12 05:35:36.835	[]
3447	CDC-2022-0024-3453	https://api.regulations.gov/v4/comments/CDC-2022-0024-3453	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 51. I’ve had RLS since I was pregnant at 29. I have mostly been able to manage it through avoiding triggering foods but around once a month I have trouble. The last time was on a 8 hour airplane ride. The horrible feeling of insects crawling inside the bones of my legs started and wouldn’t not quit. It was so awful. I walked up and down the airplane isle, did squats in the aisle and wiggle my legs non-stop. I took my usual low dose of clonazepam but this time it didn’t work so I took another one. Finally I had relief after suffering for three hours. If I hadn’t had the clonazopam I don’t know what I would’ve done. I have the rest of my life to deal with this disease and while I only use opioids occasionally I can’t imagine not having something to help stop the symptoms. It would affect the quality and happiness of my life. Please do not take away low daily dose opioids from people with RLS. It is a maddening disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L	None	None	0900006484ff0852	Leo	None	2022-04-01T19:27:20Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Leo, L	l1f-635w-kn7t	False	None	False	2022-04-12 05:35:37.045	[]
3448	CDC-2022-0024-3454	https://api.regulations.gov/v4/comments/CDC-2022-0024-3454	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 90 year old male suffering from Restless Leg Syndrome for the past 15+ years with increasing severity. At the time of onset my physician prescribed a number of the non narcotic medications including Mirapex, Requip, Gabapentin, etc. without benefit. He titrated the various medications and tried different combinations to no avail. Finally he prescribed hydrocodone 10/325 mg. with the explanation that in resistant cases it is a "third level" appropiate medication. I experienced relief at the first dose.<br/><br/>Subsequently, for the past 9 years I have been prescribed this medicine to take 1 pill nightly with the admonition to to never take more than. prescribed. I was initially apprehensive that I might become addicted and suffer from a number known side effects such as constipation, cravings, augmentation, etc. I have been pleasantly surprised to find no changes in the effectiveness over these 9 yrs.and have not experienced any side effects which apparently commonly occur. Also I have had no addiction symptoms such as cravings, need for increasing dosage or difficulty stopping which I have periodically done to check whether it was necessary to control my RLS.<br/><br/>It is understandable that stricter controls of opiates has been necessary to try to curtail the crisis of opiate abuse. However, it appears that the crisis has only worsened with increasingly stricter regulations. The restrictions were not particularly onerous at the onset of my RLS but as more and more regulations were imposed it has become increasingly problematic to obtain my medication. Doctors retire or dropout and new doctors especially young ones, have been loath to prescribe long term opiate use. I moved from California to Arizona where the laws are even stricter. The PCPs do not prescribe my medication so I have to obtain the services of a specialized pain doctor although the prescription is not for pain. Thus I am required to obtain the services of yet another doctor. As a 90 year old I already have several speciality doctors with many overlapping services. I have enough office visits already but now have the expense for myself and medicare to have more office visits and unnecessary lab tests for my RLS. Having doctors who barely know me results in a constant air of suspicion that I may be a drug abuser. I feel that medicine has become a realm of regulations and polices with little to no patient to doctor bond of mutual trust and caring. The situation seems similar to the days of Prohibition when we should have learned that strict laws are not always the solution to all human indiscretions.<br/><br/>I urge the law makers to refrain from passing even stricter laws relative to medication abuse, under the naive presumption that you can pass laws strict enough to end a human frailty. Young people in particular, thrive on the challenge of a prohibition which appears to have little merit.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Harold	None	None	0900006484ff0857	Underwood	None	2022-04-01T19:28:44Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Underwood, Harold	l1f-63mg-nabs	False	None	False	2022-04-12 05:35:37.262	[]
3449	CDC-2022-0024-3455	https://api.regulations.gov/v4/comments/CDC-2022-0024-3455	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from the effects of Restless Legs Syndrome (RLS) for well over 25 years and it has impacted every facet of my life, to include my marriage. Over the years, I have been prescribed every treatment, to include low-dose opioids. Though not a cure, it certainly mitigates the painful effects of RLS. Please include RLS as an aliment to which opioids would be listed as a practice guideline.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	PHILIP	None	None	0900006484ff0877	DAVIS	None	2022-04-01T19:29:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from DAVIS, PHILIP	l1f-6c89-mldh	False	None	False	2022-04-12 05:35:37.502	[]
3450	CDC-2022-0024-3456	https://api.regulations.gov/v4/comments/CDC-2022-0024-3456	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a child of 2 Chronic pain patients, watching the endless battles with physicians, pharmacies, various therapies that do I good. This guideline needs to be ELIMINATED. It is atrocious that people are made to feel like they are doing something wrong or illegal, all because they want to live their lives normally again! Shame on you CDC!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tamara	None	None	0900006484ff0879	Fairman	None	2022-04-01T19:29:27Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Fairman, Tamara	l1f-6cmv-mpqe	False	None	False	2022-04-12 05:35:37.715	[]
3451	CDC-2022-0024-3457	https://api.regulations.gov/v4/comments/CDC-2022-0024-3457	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have struggled with RLS for 25 years and it is only when I started on a low dose opioid that I could finally live again. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sherry	None	None	0900006484ff089b	Eldridge	None	2022-04-01T19:29:54Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Eldridge, Sherry	l1f-6i9o-5bot	False	None	False	2022-04-12 05:35:37.932	[]
3452	CDC-2022-0024-3458	https://api.regulations.gov/v4/comments/CDC-2022-0024-3458	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. <br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michele	None	None	0900006484ff08b7	Sutton	None	2022-04-01T19:30:17Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Sutton, Michele	l1f-6o5e-4dbx	False	None	False	2022-04-12 05:35:38.164	[]
3453	CDC-2022-0024-3459	https://api.regulations.gov/v4/comments/CDC-2022-0024-3459	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer with a disease called Restless Legs Syndrome. It is a debilitating disease that robs me of my ability to sleep at night. Without treatment I spend every night walking the floor and every day exhausted. A low-dose of an opioid alleviates most of these symptoms and helps me sleep. I do not know what I would do without the opioid's help. I am very careful about what drugs I take and would prefer to not take ANY drugs. Unfortunately, for me because of RLS, that is not possible. Please keep these comments in mind as you re-write your opioid guidelines. Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Edward	None	None	0900006484ff08ba	Schumacher	None	2022-04-01T19:31:29Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schumacher, Edward	l1f-6p3v-jc4k	False	None	False	2022-04-12 05:35:38.390	[]
3454	CDC-2022-0024-3460	https://api.regulations.gov/v4/comments/CDC-2022-0024-3460	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I am a long time sufferer of severe RLS (over 40 years) and for many years have been on the prescription medication Pramipexole (Mirapex) in steadily increasing doses as it's effectiveness slowly decreases. Now, after many years of research, dopamine agonists like Mirapex are no longer recommended for long term treatment due to augmentation and side effects. I am a good candidate for a low dose opioid but the restrictions, regulations and stigma associated with prescribing drugs like methadone make it extremely hard to get this medication, especially in rural areas with doctors that are not familiar with treatment of RLS and the use of opioids for treatment of RLS. We need to remove the stigma, the restrictions and allow doctors and patients to use these very effective low dose drugs in severe cases of RLS in cases where dopamine agonists no longer work and tend to cause more problems the longer they're used. Multiple studies have shown low doses of some opioids are extremely effective at controlling symptoms of RLS but many doctors are reluctant to prescribe these drugs due to the stigma attached to their use. We need to change the perception associated with prescribing these type of drugs and allow their use in specific applications where they're shown to be effective.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wayne T	None	None	0900006484ff08d6	Sibilia	None	2022-04-01T19:32:10Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Sibilia, Wayne T	l1f-6uqk-6cyg	False	None	False	2022-04-12 05:35:38.604	[]
3455	CDC-2022-0024-3461	https://api.regulations.gov/v4/comments/CDC-2022-0024-3461	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484ff1118	Gordon	None	2022-04-01T19:32:37Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Gordon, Robert	l1f-78zf-z6sj	False	None	False	2022-04-12 05:35:38.815	[]
3456	CDC-2022-0024-3462	https://api.regulations.gov/v4/comments/CDC-2022-0024-3462	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have restless legs syndrome which wakes me up every night about every two hours. When I wake up I am up for an hour walking and taking a hot shower. Some nights I take up to 3 showers. I am not a fan of medication but I am willing to take a low dose opioid if I could find relief. RLS is impacting my quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nina	None	None	0900006484ff1132	Griffith	None	2022-04-01T19:33:09Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Griffith , Nina	l1f-7e46-9pda	False	None	False	2022-04-12 05:35:39.049	[]
3457	CDC-2022-0024-3463	https://api.regulations.gov/v4/comments/CDC-2022-0024-3463	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	jerry	None	None	0900006484ff1134	avila	None	2022-04-01T19:33:59Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from avila, jerry	l1f-7fz1-gggg	False	None	False	2022-04-12 05:35:39.267	[]
3458	CDC-2022-0024-3464	https://api.regulations.gov/v4/comments/CDC-2022-0024-3464	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have been severely affected for many years and worked through and past all of the first drugs typically prescribed. My symptoms are now managed (barely) by low dose Methadone. Absence of this drug would make my quality of life much worse. I had to switch away from the Neurology department of a major care giver because of their blanket policy of not prescribing opioids. I am glad I did. <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Randall	None	None	0900006484ff114b	Vermillion	None	2022-04-01T19:34:25Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Vermillion, Randall	l1f-7iq2-v1wl	False	None	False	2022-04-12 05:35:39.483	[]
3459	CDC-2022-0024-3465	https://api.regulations.gov/v4/comments/CDC-2022-0024-3465	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My life was miserable, unable to sleep or sit down for a meal with my family until I found a Sleep Medicine Center that had RLS experts. They put my on gabapentin and that controls about 70% of the symptoms. I have a prescription for tramadol for night time break through symptoms and receive about 60 Oxycodone a year to use when I have to stay still, i.e. plane or theatre. etc.. I have used the same low doses (50 mg tramadol and 5 mg oxycodone) for over 10 years and have never needed to increase dosage. It simply improves the quality of my life dramatically. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Caroline	None	None	0900006484ff114c	Garber	None	2022-04-01T19:35:34Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Garber, Caroline	l1f-7j04-ub2n	False	None	False	2022-04-12 05:35:39.701	[]
3460	CDC-2022-0024-3466	https://api.regulations.gov/v4/comments/CDC-2022-0024-3466	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have tried so many medications to treat my RLS which has caused major depression and anxiety, and affected my quality of life tremendously. The only thing that has helped is low dose opioids. I have taken the same dose for over 3 years with no need for increase. It has been a life saver, although all who suffer from RLS hope for better treatements. Opioids are often the ONLY option for many. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	m	None	None	0900006484ff115a	Rasure	None	2022-04-01T19:36:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Rasure, m	l1f-7ja9-3jpr	False	None	False	2022-04-12 05:35:39.934	[]
3461	CDC-2022-0024-3467	https://api.regulations.gov/v4/comments/CDC-2022-0024-3467	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand you are revising the CDC Guideline for prescribing opioids, but the draft does NOT address chronic conditions like RLS that are different from chronic pain. Restless Leg Syndrome is a chronic neurological disease that causes an urgent need to move the legs as well as other parts of the body. <br/>These symptoms make it impossible to sleep or even to sit quietly, which seriously affects quality of everyday life.<br/>I am a 78 year old woman that has suffered with RLS for many, many years. I have tried to many different drugs to battle my RLS all to no avail and it was pure hell to come off some of those meds.<br/>The ONLY sustainable relief I have found is with low dose opioids. They literally have saved my life and my sanity. <br/>Please, please be sure to include RLS in your program!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mimi	None	None	0900006484ff1176	Coco	None	2022-04-01T19:36:47Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Coco, Mimi	l1f-7s7j-180r	False	None	False	2022-04-12 05:35:40.183	[]
3462	CDC-2022-0024-3468	https://api.regulations.gov/v4/comments/CDC-2022-0024-3468	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a RLS patient for approximately 50 years. In those years I have taken many medications prescribed by doctors. Some work temporarily then cease to work. The last two were ropinerole, then pramopixol. After a few months I began to get worse rapidly. In November and December of 2021 I got so bad with jerking legs and total body jerks I stayed awake for 5 nights and 5 days without any sleep. At this point I stopped taking any prescribed drugs and resorted to CBD'S. They help some but I still stay awake to 2:00am or 3:00am.<br/>Everyone suffering from RLS deserves to have some method of rest. So please include RLS as a disease to be approved for this treatment. Thank you for this opportunity to bring to the CDC's attention how debilitating RLS can get.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlaine	None	None	0900006484ff118c	Adams	None	2022-04-01T19:37:32Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Charlaine	l1f-7z1u-1nt9	False	None	False	2022-04-12 05:35:40.400	[]
3463	CDC-2022-0024-3469	https://api.regulations.gov/v4/comments/CDC-2022-0024-3469	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My wife has RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff11b1	Sutton	None	2022-04-01T19:38:04Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Sutton, David	l1f-80wa-skq7	False	None	False	2022-04-12 05:35:40.611	[]
3464	CDC-2022-0024-3470	https://api.regulations.gov/v4/comments/CDC-2022-0024-3470	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a pain sufferer for over 20 years. I cannot get over the fact that we have people, me in serious pain and we have to deal with having our medications taken away. And all those years being on pain medicine I never abused what I took. Over the past several years they have taken me off my medicine to the lowest point and I have tried all the other things that they have asked me to do to take away the pain. I had a stimulator, I had SI joint Fusion oh, Many backshots too many to count. Most of the people that I see that are dying from overdoses are people who are buying their medicine abscess Street.<br/><br/>Look at all the drugs coming over the border. This must stop. I believe most doctors want to help their patients with all this pain. I suggest that the CDC do an all out study on the people taken medicine for pain, and stop looking at the people that need this for extreme pain<br/><br/>How many lives has the 2016 guideline cost due to suicides and adverse health affects such as strokes, heart attacks, and other poor outcomes? How many people had to file for disability due to loss of pain care?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Regina	None	None	0900006484ff4215	Mello-Laughman	None	2022-04-01T19:38:19Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Mello-Laughman, Regina	l1g-tujt-f9r3	False	None	False	2022-04-12 05:35:40.824	[]
3465	CDC-2022-0024-3471	https://api.regulations.gov/v4/comments/CDC-2022-0024-3471	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After being placed on a low dose opioid for a fracture in my back, I immediately noticed that my RLS, of 35+ years, was much better. I had to meet with a pain management clinic once per month and also have a counseling session with their personnel. This "hoop" that I had to jump through was because my regular physicians were unable to prescribe the opioids. I left the pain management clinic and and the nights are very long and uncomfortable. If my internist or neurologist could prescribe the the low dose opioids, life would be much more comfortable. So I recommend that opioids be part of the treatment plan for RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484ff11d5	Morton	None	2022-04-01T19:38:58Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Morton, Nancy	l1f-85dl-nz2m	False	None	False	2022-04-12 05:35:41.040	[]
3466	CDC-2022-0024-3472	https://api.regulations.gov/v4/comments/CDC-2022-0024-3472	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does Not address chronic conditions such as RLS that are different from chronic pain. Restless Legs Syndrome (RLS) is a chronic neurological disease that causes an URGENT need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspects of daily life. <br/>Most of my life I have experienced RLS in my legs, chest and arms. At age 38 my symptoms became so bad I started going to Johns Hopkins [location redacted] Hospital and it is there I started taking multiple medications to help my RLS. In 2011 my Doctor suggested I try (other medications did not help) taking methadone (5mg) daily. Methadone has been so successful!! I am now 62 and take 10mg of Methadone daily - My quality of life is so much better and I am able to rest without very little RLS symptoms. <br/>Thank you for your consideration and please consider the RLS Foundation at rls.org as a resource for scientifically-based information about RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484ff41c2	Reaser	None	2022-04-01T19:39:15Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Reaser, Kimberly	l1g-t3qa-t8v6	False	None	False	2022-04-12 05:35:41.257	[]
3467	CDC-2022-0024-3473	https://api.regulations.gov/v4/comments/CDC-2022-0024-3473	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines are killing innocent people. It’s taken me the last 10 years to find pain relief, I have not wanted to live at times because the cdc has made it nearly impossible to get any relief. My 30 year old nephew turned to steer because he didn’t get relief. He and many many many have died because of fentanyl. I just found out that I have CRPS. I belong to many organizations that have people not treated with what they need. Over 5000 Pennsylvania residents died in 2021 from fentanyl. There were 260 from prescriptions but didn’t care enough to see if they were prescribed or stolen or sold these medications. This continues as in my area kids want to have fun but there is no longer any things for them to do. No ywca or ymca skate rinks or public pools. So what do they do? Drink or do drugs.<span style='padding-left: 30px'></span>You must remove these guidelines as now the main man running for Governor [name redacted], fights opioid use. Sad as many many more will die or be harmed. Please hear my cry for the humanity!!!! I see many people in my state that can not find relief. Can’t find a doctor as you have them so scared of being sued or losing their license and home. The studies done for 2016 guidelines were very flawed and continue today. The MME is a joke and I hope you don’t have to deal with chronic pain 24/7.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katie	None	None	0900006484ff4196	Hilderbrand	None	2022-04-01T19:41:16Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Hilderbrand , Katie	l1g-t08h-6371	False	None	False	2022-04-12 05:35:41.473	[]
3468	CDC-2022-0024-3474	https://api.regulations.gov/v4/comments/CDC-2022-0024-3474	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please address standardized ordersets that specify opioid doses based on specific pain ratings. Many healthcare organizations are developing such ordersets. Pain is a subjective sensation and such ordersets assume that all individual's pain ratings are identical and all individuals need and will respond to the same opioid dose. Such ordering is a risk to patient safety.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484ff4195	Dempsey	None	2022-04-01T19:41:46Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Dempsey, Susan	l1g-szad-kce7	False	None	False	2022-04-12 05:35:41.684	[]
3469	CDC-2022-0024-3475	https://api.regulations.gov/v4/comments/CDC-2022-0024-3475	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines have both taken the lives and destroyed any quality of life the pain patient may have had. We have become collateral damage in this war. It has become impossible to receive individual care, instead becoming a “one size fits all” tx plan. Not all pain is the same, nor are the diseases that cause the pain. Not all patients respond the same to different tx. I was declared disabled due to pain/nerve diseases 22 years ago. I have been on LTOT for all those years and have never had an issue. Never an issue with bad UDT, never an issue with med counts, and no negative physical or mental results of LTOT. Regardless, when forced to change pain mgt doctor due to retirement of previous pm doctor, I have been treated like a drug addict and have been tapered so far by 75% and the doctor will continue to cut those in half even though he said he wasn’t going to because he claims he has no choice. My QOL has become no life. I spend every day in extreme pain, at home, either in bed or my wheelchair just trying to get through each day. Since these cuts have been made, I have not been able to leave the house other than being taken to doctor appts. I’m not the only one who has lost QOL, but my loved ones have as well, Opioid pain meds have never made me feel “high”, unlike medical cannabis that is being pushed now. It doesn’t work nearly as well for pain in my circumstances. I’m being told that a pain pump is the answer, but I don’t consider the risks acceptable. Why is using the same medication through a foreign object inserted in your body supposed to be the answer? As I said, I’ve had no negative health results from LTOT orally, but the risks from the pain pump include infection, cerebral spinal fluid headaches, machine malfunction to name only a few. You all know that prescribing has gone way down and yet overdose deaths have gone way up. You know that these deaths are not a result of legally prescribed pain medication, but of illicit fentanyl and yet you continue to “encourage” doctors to taper or remove LTOT. You say it wasn’t intended for long term chronic pain patients, yet doctors are afraid to prescribe beyond what your guidelines indicate for fear of punishment. States are changing laws regarding MME because of your “guidelines”. These guidelines weren’t even started by pain mgt doctors, but by addiction specialists. What is happening due to your “guidelines” is nothing short of crimes against humanity and human rights violations. History will not look kindly on this period of abuse, neglect, and mistreatment of tens of millions of chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484ff11db	H	None	2022-04-01T19:42:07Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from H, K	l1f-88kn-9nfb	False	None	False	2022-04-12 05:35:41.895	[]
3470	CDC-2022-0024-3476	https://api.regulations.gov/v4/comments/CDC-2022-0024-3476	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006484ff4170	Siciliano	None	2022-04-01T19:42:20Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Siciliano, Patricia	l1g-stug-ovjb	False	None	False	2022-04-12 05:35:42.113	[]
3471	CDC-2022-0024-3477	https://api.regulations.gov/v4/comments/CDC-2022-0024-3477	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The draft for the CDC Clinical Practice Opioid Prescribing Guidelines does NOT address chronic conditions like RLS that are very different from chronic pain. Restless Leg Syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs or other parts of the body. This condition makes it impossible to sleep or even sit still which greatly affects the quality of life. Without medication, I cannot fly on a plane, ride any distance in a car, go to a movie, or even watch TV in my own home, just to name a few aspects of my life effected by this condition. There are approximately 12 million adults and children in the US who suffer from this condition. There is no cure. It is now known that there is a genetic component to this condition. My Mother had it, my sister has it, and now my adult children are experiencing symptoms. There are very few prescription medications that relieve the symptoms of RLS. Over time, one of the groups of medications that initially provides relief - the dopamine agonists - actually make the symptoms worse and have to be gradually stopped. Many doctors are no longer prescribing the dopamine agonists for this reason.There is ample scientific research to support the use of low-total-daily-dose opioids to treat severe RLS, when all other medical therapies have failed. For 10 years I was misdiagnosed with insomnia and treated by numerous physicians with sedating medications intended to induce sleep. None of them worked. I not only did not sleep at night due to my RLS symptoms, I was left groggy and cognitively impaired during the day making it difficult for me to drive and do my job as an RN. I felt desperate. I finally received a diagnosis and successful treatment after 10 years of suffering. Through exhaustive research, I found an RLS specialist through the RLS foundation @www.rls.org. After reviewing all the medications that I had taken with unsuccessful results, this physician started me on a low dose (2.5mg) of hydrocodone. With an eventual 2.5 mg at 6pm and another 2.5mg at bedtime, I experienced relief from my symptoms and was finally able to sleep!! That was in 2017. I now take a total of 12.5mg of oxycodone in divided doses between 5pm and bedtime. (The switch from hydrocodone to oxycodone was physician preference. I moved from CA to NJ in 2019 and changed specialists.) The thought that this medication could no longer be available to me, frightens and angers me. The suffering and the cost of all the other medical problems that result from lack of sleep due to RLS far outweigh the time and cost of a low-total-daily-dose of an opioid. RLS was first diagnosed more than 300 years ago by a physician who treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, refractory RLS who had been on the same low-total-daily-dose opioid therapy for decades. This was certainly true in my case when I moved to NJ. My PCP/PA spent the majority of my short visit reciting to me the NJ protocols for opioid prescribing and how he feared for his license. I brought him copies of research and a copy of the Provider's Guidelines put out by the [name redacted]. Since I continued to receive the same "lecture" on each monthly visit, I am assuming the material was never read. I now drive 3 hours to CT to the [name redacted] to see an RLS specialist who understands the role of opioids in the treatment of RLS. I urge the CDC to include in the 2022 Opioid Prescribing Guidelines a section that addresses medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily-doses, carefully monitored by a qualified physician. Thank you for your consideration of this vital issue that greatly affects the quality of life for millions of people like me. Please consider the RLS Foundation at www.rls.org as a resource for scientifically based information about RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lindy	None	None	0900006484ff11f8	Munoz	None	2022-04-01T19:44:02Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Munoz, Lindy	l1f-8azc-swf7	False	None	False	2022-04-12 05:35:42.330	[]
3472	CDC-2022-0024-3478	https://api.regulations.gov/v4/comments/CDC-2022-0024-3478	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had RLS for the past 15 years. I am now 80 years old. And been through all to medicines usually prescribed for treatment of RLS. None of which provided any noteworthy treatment. Last resort was hydrocodone, 5mg as needed during the day, not to exceed 4 doses. IT WORKS. MY GOD IT WORKS!<br/>I am dead in the water if an opioid is not available for treatment. No other treatment has proven effective including not medical interventions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484ff11fb	Byrd	None	2022-04-01T19:44:21Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Byrd, William	l1f-8bf7-hx2p	False	None	False	2022-04-12 05:35:42.551	[]
3473	CDC-2022-0024-3479	https://api.regulations.gov/v4/comments/CDC-2022-0024-3479	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had Restless Leg Syndrome, which worsens with age, for almost 40 years.<br/>Symptoms render sleep impossible and often interfere with sitting or any kind of rest. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Thank you again,<br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	0900006484ff11fc	Townsend	None	2022-04-01T19:45:10Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Townsend, Leslie	l1f-8byx-bz5y	False	None	False	2022-04-12 05:35:42.769	[]
3474	CDC-2022-0024-3480	https://api.regulations.gov/v4/comments/CDC-2022-0024-3480	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>After years of RLS suffering and becoming deeply depressed from the notion that no medication can reduce my symptoms (we tried all of them), my doctor informed me about an Opioid study with low doses of Methadone that we could try. It worked immediately and has been fantastic for more than a year. I take 5mg once a day. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barry	None	None	0900006484ff1212	Brenner	None	2022-04-01T19:45:41Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Brenner, Barry	l1f-8hfa-6tde	False	None	False	2022-04-12 05:35:43.014	[]
3475	CDC-2022-0024-3481	https://api.regulations.gov/v4/comments/CDC-2022-0024-3481	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please understand because of a few who misused pain pills you have treated everyone who take pain pills the same & that not right. It's just like a police officer when they pull you over they can't treat everyone like they are criminals & have done something wrong cuz that's not always the case. what you did you are treating everyone like we are drug addicts going to overdose instead of seeing there are chronic patients who do everything correct. I started hurting years ago. No doctor understood when I said my bones hurt I used to think I had bone cancer I did everything they said pool & land therapy, a TENS machine, massage, over the counter pain meds & still years later of having no life I met a doctor who said what I had. a biopsy & some blood work along with CT & MRI i know what all is wrong. I have not had a normal pain free life far back as i remember but now i knew where to go. I went to a rheumatologist a neurologist & pain management doctor. those 3 put together a medication program that gave me my life back! I had pill counts & random drug test & did everything i was told by all 3 docs. then my doctor retired & his replacement quit. the practice he was at said with the cdc recommendations they are doing other type therapy like Cymbalta thats an antidepressant that has worked with nerve pain in some patients I already take something for nerve pain & Im not depressed would you take an antidepressant if you hurt youre back? They also will provide acupuncture, massage,chiropractic, <br/>and meditation! I cant even get cortisone shots i have degenerative disc disease & spinal stenosis. The disc is pushing IN on my spinal cord cutting off my spinal fluid at the top of my neck ( 4 discs pushing out & 1 disc pushing in) I have Sjogren's syndrome, rheumatoid & osteoarthritis, De Quervain's disease & fibromyalgia. He wants to teach me to MEDITATE my pain away!?! he took my nighttime pain pill away ( ive now replaced it with sleeping pills) & has now tapered me down to 1 pain pill a day & Im back to having no life. Instead of a few pills that I took I now take 2 aleave,12 ibuprofen 6 Tylenol Biofreeze patches, im back on prednisone a steroid & methotrexate (chemotherapy in pill form) & a sleeping pill at night I have no life I have woke up crying from the pain in my elbows I understand people misuse or whatever they are doing but that should not mean everyone has to suffer if Im doing my pill count & am doing my urine test doing everything my 3 doctors told me to do why do I have to suffer?? You put us all in the same basket drug addicts people that misuse & chronic pain patients in the same basket how do you think that's fair?? I don't drink don't smoke don't do drugs im a vegetarian I do everything correct after years of no work I was able to go back to work but not now. It's not as simple as a surgery on my back or neck Sjogren's syndrome affects everything every joint & muscles 5 pain pills over a 24 hour period Gave me a real life. I understand you tried to do the right thing your heart was in the right place you thought you were going to help people but you didn't think it through and all you ended up doing is hurting more people than you helped . you overstepped & made pain management doctors afraid to help their patients.if the doctors are doing it correct & the patients are doing their part correct especially with pill count how do you think you are correct?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Althea	None	None	0900006484ff416d	Dorsey	None	2022-04-01T19:45:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Dorsey, Althea	l1g-spt5-iflr	False	None	False	2022-04-12 05:35:43.236	[]
3476	CDC-2022-0024-3482	https://api.regulations.gov/v4/comments/CDC-2022-0024-3482	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 70 years old and have suffered from RLS since my elementary school days. For years, even decades, I was told all sorts of "stories" why my legs always bothered me in the evenings and why it took so long to get to sleep. As I got older, in my 30's with a job that kept me at work mostly at night, I thought it was getting worse just because of my shift work so my sleep took a huge hit even more. I finally, somewhere in my 40's began to hear about RLS and by this time had reached RLS Poster Boy status. I was lucky to sleep and average of 3 hours a day and could never just sit a relax even during the daylight hours. I learned of medicines that could help with the pain and anguish of what had morphed from R Leg to Restless BODY Syndrome. I started and often changed medicines and doses because after a while the body adjusts to the meds and augments and RLS increases. So after several years of working with different meds and higher doses, my Doctor suggested adding a supplemental drug instead of continuing higher doses. Most of these supplemental meds are low dose Opiods such as my current Tylenol/Codeine. I take 1 of these at night with my Mirapex and I have kept my Mirapex from having to be increased every year or so. The difference between a night with just Mirapex and Mirapex with one 30G Tylenol/Codeine is about 6 hours of sleep compared to 3 hours of sleep. The Tylenol/Codeine for me is the difference between functional life or nearly 100% misery! PLEASE!! Continue to allow low dose Opiods to be used for RLS and any other diseases such as this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484ff0f5e	Tindall	None	2022-04-01T19:46:21Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Tindall, Tom	l1f-8qwi-0gwu	False	None	False	2022-04-12 05:35:43.462	[]
3477	CDC-2022-0024-3483	https://api.regulations.gov/v4/comments/CDC-2022-0024-3483	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have the worst form of Restless Leg Syndrome. My symptoms augmented dramatically after 10 years of taking Mirapex. I learned during the difficult time of not being sit still or sleep normally for months, that this has been known for a long time. The ONLY treatment available to reduce RLS symptoms are opioids. The only good thing is that it appears tolerance does not happen. I take 8mgs of hydromorphone in the evening. It's all I got. Please be aware!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484ff0f78	Schultz	None	2022-04-01T19:46:54Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schultz, Jennifer	l1f-8x5s-1xks	False	None	False	2022-04-12 05:35:43.677	[]
3478	CDC-2022-0024-3484	https://api.regulations.gov/v4/comments/CDC-2022-0024-3484	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I started having serious trouble with RLS over three years ago. Over time several drugs have been prescribed, with varying degrees of success and for limited times. Recently, my neurologist prescribed tramadol, a low-strength opioid. That in combination with two other drugs gave me much-needed relief. RLS needs to be included in your prescribing guidelines. Please let this drug continue to help us control this horrible, life-ruining condition, and let doctors know that it is CDC-approved for RLS treatment. Please.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ben	None	None	0900006484ff0f8b	McClinton	None	2022-04-01T19:49:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from McClinton , Ben	l1f-92lu-az5q	False	None	False	2022-04-12 05:35:43.892	[]
3479	CDC-2022-0024-3485	https://api.regulations.gov/v4/comments/CDC-2022-0024-3485	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for considering the opioid prescribing guidelines. I suffer from severe RLS and I AM ONE OF MANY. I was seriously considering ending my life because I could not sleep any duration beyond 30 minutes without getting up to walk. I was too sleep deprived to drive a car safely. I could no longer work. A single low dose of an opioid at bedtime changed my life. I have taken this medication for 18 months without increasing the dosage or dose frequency. This disease was identified in the middle ages and THE ONLY effective treatment has been opioids in all this time. We all hope there will be new effective therapies. Nobody likes the constipation and itchiness opioids cause! But never being able to rest is a special circle of hell. Don’t send us back there. Please don’t throw the baby out with the water; opioids appropriately prescribed are true lifesavers for those of us with RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sara	None	None	0900006484ff0f8c	Aglietti	None	2022-04-01T19:49:46Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Aglietti, Sara	l1f-92m0-3pkz	False	None	False	2022-04-12 05:35:44.126	[]
3480	CDC-2022-0024-3486	https://api.regulations.gov/v4/comments/CDC-2022-0024-3486	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been taking opioids for about 3 years now for Restless Leg Syndrome. I have the worst kind. After 10 years of taking Mirapex my symptoms increased dramatically. This is called Augmentation when the medication you are taking makes the symptoms worse. The ONLY thing that enables me to have a normal type of sleep are taking 8mgs of hydromorphone in the evening. It's all we got!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484ff0f98	Schultz	None	2022-04-01T19:50:43Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schultz, Jennifer	l1f-93vl-3pee	False	None	False	2022-04-12 05:35:44.356	[]
3481	CDC-2022-0024-3487	https://api.regulations.gov/v4/comments/CDC-2022-0024-3487	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new guide lines won't help most of us who were abandoned by our Dr's and falsely labeled as OUD patients.We only have 1 p<br/>M Dr here in my area and after 10 yrs on my meds stable and living life being a foster parent volunteer and wife mother and grandmother and adopting a baby born addicted I had my whole life taken away by the new p.m Dr I went to after my Dr of 20 yrs retired.1st day he told me how he hated the new CDC guidelines which I thought he meant because it effected his ability to care for his patients properly but he quickly corrected me to let me know that it was because now he has to start seeing all the drug addicts liars and crimials..I'm 65 and because of my work with the city and community I'm used to a degree of respect.but after that 1st visit being treated like a criminal I sat in my car crying for 30 mins.before I could drive home.after that he kept telling me how he was going to taper me off my meds.when I asked him what he was going to replace them with he said nothing.then he proceeded to tell me about a cramp he had in his leg in his 20s and how he walked it off.I am 65 I had a tumor in my spine that destroyed my disc's so they had to put a metal cage around my spine and screw a metal plate into my back to keep it in place and keep it from collapsing.i can see how his cramp in his leg compares to my collapsing spine.a couple more appts and he cut off my meds completely after only 4 visits no tapering and he just cut me off cold.he also took away my sleep meds for my extreme insomnia which 3 Dr's have told me I have the most extreme case they have ever seen.i can't get help from sleep clinics cuz I can't sleep when there so my Dr of 20 yrs. Prescribed me the only thing that helped after a long time of trial and error which was larazapam.I had no issues with either for over 10 yrs.but he cut me off cold turkey after 19 days of the most excruciating hell a person can go through with 24/7 pain and no sleep for 19 days my heart wore out and stopped.its happened 3 times now because I can't sleep at all.afyer the 1st time it happened I came home from hospital and 2 days later after killing me I got a letter dismissing me as a patient.the hospital sent him referrals to a cardiologist and a neurosis cuz I had a stroke also that night he refused to send my referrals.as bad a shape I was still in I was calling everyday and begging for him to send the referrals.he refused.i got upset and told him I was going to sue him for killing me.then all the false lies started showing up on my charts.A nurse told me he was covering his butt for a lawsuit and was going to make me look as bad as he could.I still don't have a Dr.I still can't sleep.Still live in excruciating pain and can't take care of myself anymore.its embarrassing but I seldom bathe because I cant.i went from being a vibrant involved woman to a cripple who can't leave my house can't work and had to give up my foster license which broke my heart.Im an invalid now.I lost my babies my grandbabies my friends and my social life my volunteering and the ability to be a wife or mother or anything.all I am is a blob of pulsating pain.i wanted to kill myself and sat here with a pistol on my lap alot trying to get up the nerve to do to my kids what my mother did to me.but because I said something in my support group an admin contacted my son and he gathered my other kids and they came over and made me promise not to kill myself.now I'm stuck in hell.im already dead but in excruciating pain.if you dot have a life and all you do is exist in pain it's not living.My hubby at the time of 40 yrs and I had plans for when we retired and we had a wonderful future ahead of us.but our future we worked all our life for was stolen from us and replaced with agonizing torture.im tortured by my own Country everyday of my life.so much for the golden oldies.and because Primary Dr's can't or won't prescribe I have no options for getting any relief for the rest of my life.So now I'm working on a way to have an accident and kill myself thst my babies won't be suspicious of and think I broke my promise.So change the damn guide lines and remove any wording that the Dr's will read like opioids should not be a first choice or the words you have put in to discourage Dr's to help other patients.its too late for me cuz the only choice for a Dr here is the one who killed then abandoned me and I can't travel 4 hrs to find a new Dr so I'm a statistic already.but for God's sake I beg you to get the damn d.e.a out of the patients rooms deciding their treatment.until the dea is removed.no Dr's will prescribe and the suicides will continue to rise.I never caused my tumor.i played softball for 30 yrs with my ex and never even took an aspirin<br/>I didn't go looking for drugs in fact I tried to endure without them for 3 months after surgery till I couldn't walk.now I'm a statistic cuz trust me no one can endure this.im gone.you have killed my babies mother and grandmother	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Betty	None	None	0900006484ff4167	Acosta	None	2022-04-01T19:51:14Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Acosta, Betty	l1g-sili-q9ra	False	None	False	2022-04-12 05:35:44.578	[]
3482	CDC-2022-0024-3488	https://api.regulations.gov/v4/comments/CDC-2022-0024-3488	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a psychologist who has worked in substance use treatment for many years, and consult on opioid prevention across the state of California. Consequently I am highly concerned about opioid misuse, but at the same time I have severe Restless Leg Syndrome (RLS) and have developed tolerance to its usual medications and am often up pacing the floor most of the night and am chronically exhausted and worn out. The only effective treatment for someone like me (who is fully aware of the harms of opioids on individuals, families, and society), is very low dose opioids (for example, 5-10 mg Methadone for RLS vs 100 or more mg for a heroin user), Doctors are reluctant to prescribe opioids due to the regulations and I have suffered needlessly for many months when the RLS medications stopped working. I started buprenorphine (an opioid treatment medication) and I can actually sit through a movie now or sit in the evening and visit and not pace the floor multiple times each night, or all night. RLS patients have higher than average depression and suicide rates, and dementia and heart disease rates, and I understand why- we are chronically severely exhausted. RLS users do not need increasing dosages of opioids to continue to be effective. Please provide relief for those of use who don't misuse any drug, and help us get the help we so badly need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dr. SUE	None	None	0900006484ff0fa1	NELSON	None	2022-04-01T19:51:49Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from NELSON, Dr. SUE	l1f-98pg-afhi	False	None	False	2022-04-12 05:35:44.801	[]
3483	CDC-2022-0024-3489	https://api.regulations.gov/v4/comments/CDC-2022-0024-3489	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a lot of problems, but RLS is by far the worst. It’s a disease that I wouldn’t wish on anyone. There’s been times when I haven’t slept for 48 hours! There’s been many times I just rather die then suffer through long episodes of RLS! The drugs now work to various degrees, but anything that can help, I’m all for! Thanks for your consideration on this issue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff0fbc	Rubino	None	2022-04-01T19:52:09Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Rubino, David	l1f-9dax-r9ur	False	None	False	2022-04-12 05:35:45.023	[]
3484	CDC-2022-0024-3490	https://api.regulations.gov/v4/comments/CDC-2022-0024-3490	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am commenting on the 50MME that clearly shows in more than one place. There were to be no hard limits in the update of the 2016 opioid prescribing guidelines. The damage caused by the mention of 90 MME in the 2016 opioid prescribing guidelines has caused major damage to pain management in our Healthcare System. This has caused people with pain more than six years of suffering. The 50MME shown clearly in the 2022 update will cause pain patients and Millions of Americans in the general population with pain even more harm and suffering. This 50MME must be removed with no limits on days or quantities. This must be left up to the judgment of our physicians. The mention of 50MME fuels aggression from DEA to harass doctors and pharmacist. Also this is misinterpreted by city's, state's, Insurer's and lawmaker's to set policy. I implore you to remove any mention of 50MME. This is already being misinterpreted even now in these early stages of the comment period. "Thank you for hearing my thoughts on the 2022 Opioid Prescribing Guideline's draft"	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff4140	Anonymous	None	2022-04-01T19:52:55Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-s7wm-isr9	False	None	False	2022-04-12 05:35:45.245	[]
3485	CDC-2022-0024-3491	https://api.regulations.gov/v4/comments/CDC-2022-0024-3491	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I'm a retired Registered Nurse, surfer, kiteboarder, long-distance paddle boarder, 64 y.o. with Restless Leg Syndrome. I've only been on the RLS medication for a few years so fortunately, it's still effective in controlling the typical symptoms. But I also experience unusual symptoms of the disease which are occasional sustained muscle contractions causing severe contortion of my feet and ankles and the only medication that will stop or prevent and episode is Hydrocodone- an opioid. Opioids are effective on the same neural pathways that cause my dystonia/cramps according to my neurologist/RLS specialist. It's difficult to describe how severe the pain is from these cramps- a kidney stone and multiple abdominal surgeries for cancer were a piece of cake compared to the extremity dystonia and muscle cramps I get. If Hydrocodone wasn't effective, I'm not sure what I what do because I could not live with them. Currently, a 30 tablet prescription every 6 months is sufficient for my prn usage. <br/><br/>As you work on revising the Opioid Prescribing Guidelines please consider that there are other conditions for which opioids are highly effective and the only option for some of us. So far the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. <br/><br/>Currently I don't require a daily low dose opioid and for my problem I probably never will. But I empathize with those that do, and I would hate for prescribing guidelines to become so rigid that those with unusual conditions like myself are prevented from receiving the only known medication that is effective.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006484ff0fcf	Wood	None	2022-04-01T19:53:10Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wood, Cynthia	l1f-9h91-bi45	False	None	False	2022-04-12 05:35:45.461	[]
3486	CDC-2022-0024-3492	https://api.regulations.gov/v4/comments/CDC-2022-0024-3492	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If you do not have chronic pain you first of all are very lucky, and do not understand what medication ( opiods) do for us. Quality of life has become very important to me. Without relief from pain through opiods I have no quality of life ! Please do not take them away from us. Compassion used to mean something in this country.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff100a	Anonymous	None	2022-04-01T19:53:22Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-9we7-z5t5	False	None	False	2022-04-12 05:35:45.673	[]
3487	CDC-2022-0024-3493	https://api.regulations.gov/v4/comments/CDC-2022-0024-3493	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include Restless Leg Syndrome in the list of chronic diseases for which low-dose opiods are allowed. RLS is a terrible neurological condition that causes one to have urges to move legs that are uncontrollable. Sounds silly, but try to sleep with this tortuous sensation that makes you get out of bed and walk,walk, walk. My RLS is severe, and the only medication that has worked for me has been low doses of methadone and Belbucca. I had surgery last July and stayed overnight in the hospital, where I was not given my prescribed medication due to lack of trained nurses, and an anethesiologist who ignored my pre-op explanations about the severity. I had to walk the halls all night; I could not sit down; my heart rate hit 120, and I'd just had surgery! The worse night I've ever had. No sleep. RLS is not like chronic pain. When I am on the medication, I am fine, with no pain. When off, I have tortuous sensations in my legs that are relieved only by moving my legs. Thank you for your consideration. This is vitally important to all of us sufferers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sally	None	None	0900006484ff4128	Forest	None	2022-04-01T19:53:41Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Forest, Sally	l1g-s3tb-ik4i	False	None	False	2022-04-12 05:35:46.075	[]
3488	CDC-2022-0024-3494	https://api.regulations.gov/v4/comments/CDC-2022-0024-3494	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient that is currently not on any medication because it is just to hard to get help in that area. I fully support the new guidelines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tanya	None	None	0900006484ff3ce7	Irvine	None	2022-04-01T19:53:55Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Irvine, Tanya	l1g-ro8d-8bq3	False	None	False	2022-04-12 05:35:46.282	[]
3489	CDC-2022-0024-3495	https://api.regulations.gov/v4/comments/CDC-2022-0024-3495	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was pleased to hear that the CDC was revising the Clinical Practice Guideline for Prescribing Opioids. As someone afflicted with Restless Leg Syndrome (RLS), I was hoping that this revised guideline would include treatment for RLS. Unfortunately, the proposed draft does not. Prior to taking an opioid, 50mg Tramadol daily, I was taking the recommended 0.5 mg pramipexole for my RLS. After taking pramipexole for over 5 years my RLS symptoms began getting worse. My sleep doctor at the time prescribed doubling the dose of pramipexole as a solution to relieving my symptoms. As I member of the [name redacted], I knew that this was not the way to go in relieving my symptoms. Coincidentially, I recently had minor surgery with 50 mg Tramadol being prescribed should I need it for pain. I had filled the prescription but had not taken any as the discomfort was not that bad and I did not want to start taking an opioid. Well, one day, several weeks after the surgery, the surgical site, along with some other physical issues made me decide to take one of the Tramadol pills. The next day it occurred to me that I had no RLS symptoms that evening after taking the Tramadol. I tried taking just one 50 mg Tramadol pill for 3 days and the same phenomenon occurred, no RLS symptoms. Shortly thereafter, I had my first appointment with my new sleep disorders physician. He agreed that I should continue taking 50 mg Tramadol daily to help with my RLS symptoms. This has changed my life. I can now sit down in the evening and relax instead of jumping around in my chair and getting up frequently to walk around. I can sleep uninterrupted at night. My spouse no longer has to sleep in another bedroom. I was afraid to take an opioid but now one small dose daily and I can live a more normal life after suffering from RLS for 35 years. I have no side adverse effects from taking Tramadol, just a new lease on life free of RLS.<br/><br/>I hope you consider my story and include RLS in the 2022 Opioid Prescribing Guidelines that you will soon be publishing.<br/><br/>Thank you for considering my story on the use of a small daily dose opioid for the relief of RLS. Should you require more information on RLS, please visit the RLS Foundation website at www.rls.org.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerald	None	None	0900006484ff102c	Migely	None	2022-04-01T19:54:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Migely, Gerald	l1f-a2m2-ji6l	False	None	False	2022-04-12 05:35:46.493	[]
3490	CDC-2022-0024-3496	https://api.regulations.gov/v4/comments/CDC-2022-0024-3496	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from Restless Legs over 30 years. I have tried all FDA approved medications for Restless Legs but sadly suffered from Augmentation. For 13 yrs I have been taking low dose Hydrocodone. Have had no addiction problems or need to increase the dosage. Low dose opioids is the only way for me not having to be in pain and suffering every single day!<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ron	None	None	0900006484ff106d	Draxler	None	2022-04-01T19:55:37Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Draxler, Ron	l1f-afnf-cq1e	False	None	False	2022-04-12 05:35:46.700	[]
3491	CDC-2022-0024-3497	https://api.regulations.gov/v4/comments/CDC-2022-0024-3497	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My dad suffers from RLS and has caused so much stress in our families lives. I have hated seeing him constantly bothered with no way to cope. We need to continue low dosage opiate therapy for people with RLS because I don't think the common person understands how much it can impact quality of life. I was one of those people when my Dad would say "his legs are bothering him", I would often tell him to just sleep it off or walk it off. He best described RLS to me when he said it feels like pins and needles throughout his legs. An itch that you cannot scratch. A burning sensation throughout the entire day and night. There are days he gets zero hours of sleep and days where he feels "lucky" to get 3 hours. He frequently doesn't travel because the airplane is a nightmare for him. I know this has caused relationship issues within my family. How can we expect him to be himself when he gets 15 hours of sleep a week? He has tried everything. He does nightly walks, he has experimented with every kind of drug, and even done acupuncture. There is no cure and it is maddening for him and our family. <br/><br/>My heart goes out to anyone with RLS and this community needs all the resources available.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484ff1088	Wendt	None	2022-04-01T19:56:28Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wendt, Stephen	l1f-alyx-kse5	False	None	False	2022-04-12 05:35:46.908	[]
3492	CDC-2022-0024-3498	https://api.regulations.gov/v4/comments/CDC-2022-0024-3498	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t have any peer-reviewed material or published articles. I have only my own experience with pain issues. I never expected to be pain-free. What I needed was enough relief to do my life. When even that was taken away I larentaed Tylenol and ibuprofen every two hours, plus alcohol. It wasn’t nearly as good but it was what was available. I never had noticeable symptoms of withdrawal. My life has constricted ever since, to a point where I am nearly home bound. If I must go out, I need to plan ahead for the misery. You were not forceful enough in your info to physicians about the "grandfathering" thing or their ability to adequately aprize them of their obligations not to let people suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484ff10aa	Nahra	None	2022-04-01T19:57:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Nahra, J	l1f-atjg-r869	False	None	False	2022-04-12 05:35:47.115	[]
3493	CDC-2022-0024-3499	https://api.regulations.gov/v4/comments/CDC-2022-0024-3499	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a life time sufferer of Restless Legs Syndrome and have successfully treated some of the symptoms of this condition with opioid therapy; in my case Hydrocodone-Acetaminophen.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Walter	None	None	0900006484ff10d5	Goodson	None	2022-04-01T19:57:28Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Goodson, Walter	l1f-azdz-qrn1	False	None	False	2022-04-12 05:35:47.322	[]
3494	CDC-2022-0024-3500	https://api.regulations.gov/v4/comments/CDC-2022-0024-3500	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2013 I was hit by a semi truck at freeway speeds. I have seen my Family Physician, 4 Physical Therapists, Massage Therapists, Chiropractic, 3 Physiatrists, 2 Pain Psychologist, 3 Pain Management Dr.'s after the first one I saw left, Acupuncture, and a neurosurgeon to look into SI Joint Fusion. I take an opioid only at the point I can no longer function. It helps me manage my pain enough to sleep at night which allows me to take care of my family, work, and not show up at the emergency room when my heart goes 120-150 bpm when my pain is uncontrolled. I've had my nerves ablated in my back twice at over $5,000 a session which helps lessen my pain for about 6 months and was very painful to have done which allowed me to lessen opioids further but not completely because I still had pain in my sacroiliac joint. I spent well over a year fighting with health insurance to cover a Sacroiliac Fusion after my Neurosurgeon, Family Physician, Physiatrist, Physical Therapist who teaches at the University of Washington all agreed my joint was unstable, and fusion could improve my pain in my Sacroiliac Joint. What Middle Class family can afford over $10,000 a year to have procedures after paying $800 a month for health insurance through their employer and still have pain? Insurance doesn't cover massage or other things that temporarily help with pain and last year they removed coverage for all out of network providers who are some of the best in the area including my Physical Therapist and Physiatrist, so I now have to pay out of pocket to receive decent care. When my nerves grew back I had to eventually go back to my Physician and ask him for a few more pills so I could function better. I was a few days short of the 28 day cycle but he wrote ok to fill a few days early given the change in my pain from the nerves growing back. The pharmacist told me she wouldn't fill my pain prescription even though he had said it was ok. I was treated like I had done something wrong for being in pain and left not to sleep that night and debate having to go to the emergency room from the pain flare I was in. I am well under the daily MME dose. The pharmacist didn't even say let me call him in the morning or I can give you 1-2 pills for tonight and contact them tomorrow. Didn't even ask why he said it was ok to fill early. Luckily I called back the next day and was able to talk to a different pharmacist who was willing to look at the prescription and fill it as prescribed. Pharmacist currently have too much control based on their opinion of opioids and don't spend the 30-40 minutes in the room treating you and discussing options. Pharmacists spend a few minutes and insurance never sees the patient at all. Insurance and Pharmacists should not be involved in limiting a pain patients ability to receive treatment especially when the patient is well below the CDC's recommended prescribing instructions. More recently Aetna has seemed to take interest in trying to be involved with my pain management by micromanaging prescriptions I am sure to help their profits. Everything the insurance companies do seem to come down to profits and not what is in the patients best interest or they would put more weight to Dr.'s recommendations. My Dr. is ultimately the one who has a pain contract, and asks randomly for a urine analysis to confirm I am following his rules. He's the one who's spent 30-40 minutes in the room with me. In the 9 years of being a pain patient I have never encountered a Dr. just willing to fill a prescription or giving advice to take anything more than what was absolutely needed. The only person who even suggested I might benefit from more pain medicine without asking was a pain psychologist. This micromanaging of responsible pain patients adds excessive stress on top of the daily stress that comes with constant pain. I never know what barrier I am going to encounter just so I can sleep at night, improve my function, and quality of life. I never asked to be this way and the stigma is sicking. Those who choose to abuse opioids will do it regardless just like those who abuse alcohol will abuse it. I've never once wanted to take my medication other then as prescribed. I've never thought of buying street drugs or asking to take someone else's prescription. I've only wanted to access my own and take it as prescribed so I can have some kind of quality of life. Having pain management controlled by a Dr. who follows the rules and monitors treatment for abuse I believe is the best deterrent for abuse. There are already rules in place like you always have to use the same pharmacy and now prescriptions are faxed directly to that pharmacy. A pharmacist shouldn't be allowed to control treatment unless there are red flags. The micromanaging and stigma only hurts responsible patients who need the help and reduces quality of life. When you've tried other options and they don't work people shouldn't be punished for needing help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff3c83	Anonymous	None	2022-04-01T19:57:52Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-qvok-a233	False	None	False	2022-04-12 05:35:47.531	[]
3495	CDC-2022-0024-3501	https://api.regulations.gov/v4/comments/CDC-2022-0024-3501	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I inherited restless legs even when I was a teen I was sleeping very little. It took time but I found a doctor that knew RLS was real and I tried several medications. I found one that works for me unfortunately the side effects force me to sleep with a bucket by my bed for when the nausea sets in. In my 40's a back injury caused me to get some opioids and blessed quiet sleep was finally mine. I slept at night I didn't get up and walk around with my bucket. Don't make people with RLS suffer! Sleep is everything and you learn that very quickly when you can't get it. I beg you to allow opioids for the treatment of RLS! Don't deny me another bad night. Lack of sleep leads to other heath problems. Also I used to be able to get Requip XL then the insurance company said it was "off label" for the use of RLS and I was denied the time release medicine that once it started helping it kept helping. Have mercy and add it to the treatment list. Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cathy	None	None	0900006484ff425d	Carver	None	2022-04-01T20:01:07Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Carver, Cathy	l1g-udg5-z16q	False	None	False	2022-04-12 05:35:47.743	[]
3496	CDC-2022-0024-3502	https://api.regulations.gov/v4/comments/CDC-2022-0024-3502	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for investigating this issue. I have worked out at a club since I was 18years old, 3 to 4 times a week. In my early days I worked at clubs as a instructor, sales rep. And made exercising programs for members. I had 2 work accidents at a school district I worked for 21 years. They hired people that shouldn't have been at that job. After my 2 major accidents, I worked very hard to try to continue to workout and get myself better.It took me years to figure out what exercise helped me and what ones made me worse and what ones did nothing at all. If it wasn't for my doctor prescribing me pain medication, I wouldn't have been able to get myself BETTER it would have never happen. I didn't get back to where I was but I did get a exercising program for the pool and the fitness center also one at home. I couldn't do the things I did before but at least I could do something and still have a life. It's not as my doctor started me with oxycodone and oxycontin. She started slow with over the counter and went up until could have somewhat of a life. I went to [name redacted] for many years. Yes there would be times I need physical therapy appointments but it always helped. I found a dose that helped me get my life back and never went up in dosage for over 20 years. Until doctor's told me I needed to get off of the oxy's. The doctors I seen just kept taking away my meds with out giving me something else for pain.<br/>I found a clinic that had stimulators and pain pumps. What other choice did I have? I would have cut my hand off if they told me it would stop the pain. They put a spine and cervical stimulator in. Yes they worked wonderful for a while. I haven't worked out for almost 3 years. They then said to get a pain pump. But a pain pump targets a certain spot and I have more going on then headaches and lumbar chronic pain. I have scoliosis, stenosis, a sack of fluid hanging out of my spine from a fusion surgery. I have deformed feet that cause pain, degenerative disks, chronic neuropathy in my right hand that goes up my arm. My sinuses now sit on the top of my teeth.Even if I got my meds back, I would feel less pain but could I ever do the things I did before they took my oxy's away.if I wasn't a Christian and know that killing yourself was a sin...I'd be dead. It isn't the people who get prescriptions form their doctors who are abusing it, It's the junkies that are looking for a high.<br/>What I was on you didn't get high. That's why I'm still here. At [name redacted] I seen people dieing because they couldn't stand the pain.<br/>Please help<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484ff150b	Christenson	None	2022-04-01T20:01:40Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Christenson, Diane	l1f-bdz3-5x36	False	None	False	2022-04-12 05:35:47.963	[]
3497	CDC-2022-0024-3503	https://api.regulations.gov/v4/comments/CDC-2022-0024-3503	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am sharing how important the use of low dose opioids are for patients with RLS. This disorder can be devastating for people with high levels of RLS. They have tried every other medication available with no help. They can't relax their bodies or sleep. I understand how opioids use can be a killer if used in high doses, but we are asking for approval of low dose opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Meade	None	None	0900006484ff10ea	DeKlotz	None	2022-04-01T21:55:09Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from DeKlotz, Meade	l1f-b463-dnoo	False	None	False	2022-04-12 05:35:48.207	[]
3498	CDC-2022-0024-3504	https://api.regulations.gov/v4/comments/CDC-2022-0024-3504	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alex	None	None	0900006484ff1554	Vuksanovic	None	2022-04-01T21:59:42Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Vuksanovic, Alex	l1f-boql-65rg	False	None	False	2022-04-12 05:35:48.414	[]
3499	CDC-2022-0024-3505	https://api.regulations.gov/v4/comments/CDC-2022-0024-3505	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hydrocodone is an absolute NECESSITY for me to get any sleep at night. I have tried multiple prescriptions, combinations, natural products like Melatonin and none work as well as the Hydrcodone does. Please don't make it any harder for LEGAL, LAW ABIDING citizens to get this product. You've already micromanaged enough medications - please help!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wayne	None	None	0900006484ff159b	Johnson	None	2022-04-01T21:59:58Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Wayne	l1f-cdvs-qiiu	False	None	False	2022-04-12 05:35:48.622	[]
3500	CDC-2022-0024-3506	https://api.regulations.gov/v4/comments/CDC-2022-0024-3506	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from Restless Leg Syndrome since I was a young child. I have times when I have to pace for hours at a time and cannot sleep. The current medications for RLS only work, for me, for a short time and then I have the augmentation effect happen. They are a bear to get off of and you must or your RLS keeps getting worse. There are patients out there that are having success using opioids for relief. Try sitting on a plane for 17 hours and have the airline insist you not stand. It's very cruel and unethical for you to allow patients to suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff15b9	Alexon	None	2022-04-01T22:00:18Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Alexon, Mary	l1f-cku0-xhp0	False	None	False	2022-04-12 05:35:49.370	[]
3501	CDC-2022-0024-3507	https://api.regulations.gov/v4/comments/CDC-2022-0024-3507	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. RLS is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. the symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the US, nearly 12 million adults and children suffer from RLS. There is no cure. a few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. this is called parodoxical augmentation syndrome. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLs<br/>I myself have lived with RLS for over 20 years and was successfully treated with pramipexole and gabapentin until last year when I developed augmentation syndrome. This caused such severe symptoms that the only place I could get any sleep was in a bath tub filled with warm water. While this provided 2 hours of sleep, it was also dangerous and resulted in a flooded bathroom on several occasions. I was referred to a neurologist who specializes in sleep medicine who immediately diagnosed me with augmentation syndrome and prescribed 5mg of methodone every evening. I was reluctant because of the stigma of using opioids on a daily , chronic basis. I cannot express the joy and relief obtained from this small daily methodone dose. I have been on this dose for 13 months now and sleep very well. While it may be possible to return to a dopamine agonist like pramipexole again, there is a real danger that I will again develop the augmentation syndrome.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guideline to address chronic conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-bases information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484ff15d5	wiborg	None	2022-04-01T22:00:45Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from wiborg, Elizabeth	l1f-cm7f-f7yf	False	None	False	2022-04-12 05:35:49.583	[]
3502	CDC-2022-0024-3508	https://api.regulations.gov/v4/comments/CDC-2022-0024-3508	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your opinions are biased, and based on conspiracy theories and deep monetary pockets. Public animosity against opioid Pharma is palpable. News article after blog, after speechifying lawmaker spouts out: Lock um up, take the money, they got our children addicted and dead. The hatred is everywhere. People who are opposed to incarceration perse want to put Pharma executives in prison. At the same time, the thesis that the availability of drugs causes addiction, at best, questionable. This fury has more to do with finding someone, somewhere to blame and punish than it does with a nuanced consideration of how best to help vulnerable people. And we need to end the stigma of addiction. Two court rulings have emphasized that opioids have legitimate medical uses and concluded that drug companies could not be held responsible for abuse of their product. Both decisions recognized that under treatment of pain is a real problem and that boba fide patients rarely become addicted to prescription opioids, let alone die as a result.The justices noted that opioids are currently a vital treatment option for chronic pain, a persistent and costly health condition, “ that affects millions of Americans.” The FDA “has endorsed properly managed medical use of opioids (taken as prescribed) as safe, and effective pain management, and rarely addicted” Addiction rate is less than 5%. Everyone wants a piece of the I’ll gotten proceeds, from suing pharmaceuticals. Public animosity against opoid Pharma is palpable. No One reporting has any knowledge of chronic pain, or that even patients should exist. The hatred is everywhere. At the same time, the thesis that the availability of drugs causes addiction is, at best questionable. Does all this fury have more to do with finding someone, somewhere to blame and punish than it does with nuanced consideration of how best to help vulnerable people? But opioid pharma has become so demonized that people working in addiction are endlessly criticized. The public and political obsession with opioids is misguided, when many other drugs are involved in deaths, and majority of opoid related deaths involve opioids combined with other substances considered relatively benign. “We are so closed and focused on opioids that we are missing the big picture, we are ignoring the elephant in the room which is ALCOHOL.” Pharma profiteering is harmful- and increasing assess to necessary medications is vital. When millions of pain patients-subject to invasive and onerous requirements, and frequently cut off from their meds they rely on being able to receive and afford opioids, what kind of impact are the lawsuits, settlements and bankruptcies likely to have on them? And why are so few people willing to make the case. Plaintiffs attorneys are digging in do deep that defense council is saying lock it down, don’t defend yourself in the media, don’t go out and try to work with patient advocacy organizations. “Their isn’t a voice in the media” Neither is their any counterbalance to the media stories quoting only attorneys generals, recovery organizations and anti-opioid zealots like [name redacted]. We also have to fault the workers compensation industry. “They have been a leader in the movement to reduce or end prescribing of opioid analgesics.” who overdosed on prescribed opioids. The [name redacted] has been trying to make the public aware of certain facts, including how the ing overdose crisis as it relates to the “poor execution” of regulatory authorities aimed at reducing controlled-substance diversion-as recently exposed in a review by the Department of Justice Often the Inspectior General, the news media- even liberal outlets like [name redacted] has universally vilified the [name redacted]. This is overblown. None of these drug companies said, “Let’s Kill people.”, adding the same is true of Pharma CEO’s. That doesn’t rule out gree, recklessness, or dishonesty. The prosecutions and public outcry lack all sense of proportions. This is one instance of a money grab by trial lawyers and politicians, and on other a failure on the part of reporters, and the public to think rationally about an emotional topic. “ The bloodlust after the [name redacted] is disturbing.” And lastly any reference to conversion tables and MME will be interpreted as validation of them. We saw what happened after the 2016 guidelines. The CDC needs to explicitly state the lack of scientific basis for both, and that their use could be dangerous in some cases. They should not site 50 MME threshold anywhere, as it is meaningless, misleading and will further misapplication of the recommendation. You would have thought the CDC would have learned that after the 2016 guidelines. Patients are not dying from prescription opioids. On the contrary they are dying from your incompetence thereof. They are dying from street drugs. How many patients have to commit suicide because of your grievances.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff15f5	Trawick	None	2022-04-01T22:03:49Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Trawick, Mary	l1f-csw8-vb42	False	None	False	2022-04-12 05:35:49.804	[]
3503	CDC-2022-0024-3509	https://api.regulations.gov/v4/comments/CDC-2022-0024-3509	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been a chronic pain patient since 2014. In 2016 when these arbitrary guidelines were imposed, I was bound to a very small amount of pain medication to treat multiple conditions for which there is no cure. I have lived in excruciating pain and for 6 years have been treated like an addict by many in the medical community. The overdose rate in this country has actually increased since these guidelines were enacted due to large amounts of illegal illicit street drugs like fentanyl being smuggled into this country, not because of painful lifelong conditions that afflict many Americans. These outdated random guidelines have only hurt the pain community. Please reconsider your guidelines. They are doing no good.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1610	Anonymous	None	2022-04-01T22:04:10Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-d0zp-3ka5	False	None	False	2022-04-12 05:35:50.017	[]
3504	CDC-2022-0024-3510	https://api.regulations.gov/v4/comments/CDC-2022-0024-3510	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been a RLS sufferer for more than 30 years. On those nights when the condition worsens I am helpless to get any rest and must pace and fidget constantly even when I am extremely sleeply. If I lay down I will be awoken again in a matter of moments. Therrapies including the low dose opiods make a real difference in being able to function cognitively at my job the next day.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	chris	None	None	0900006484ff1629	powell	None	2022-04-01T22:04:42Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from powell, chris	l1f-d6i9-0h5l	False	None	False	2022-04-12 05:35:50.222	[]
3505	CDC-2022-0024-3511	https://api.regulations.gov/v4/comments/CDC-2022-0024-3511	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to do more to undo the damage caused by the old 2016 CDC guidelines. Many drs are still refusing to treat their chronic pain patients as individuals with individual needs as the new guideline purpose. Instead we are look at as a 90mg morphine equivalent. Drs are still being forced either by fear or other drs in the practice to adhere to the old guidelines & will not adjust to the new guidelines even if there is evidence to the contrary. There still is much to be done to undo the harm being inflicted on the chronic pain person. Unfortunately some chronic pain sufferers are no longer with us unable to contiune to find purpose in thier fight to receive proper pain relief care. The individual states are still enforcing the old guidelines & requiring thier prescribing to be monitored. Please stop the carnage	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Clara	None	None	0900006484ff1634	King	None	2022-04-01T22:04:59Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from King, Clara	l1f-d7nk-xspx	False	None	False	2022-04-12 05:35:50.429	[]
3506	CDC-2022-0024-3512	https://api.regulations.gov/v4/comments/CDC-2022-0024-3512	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am begging you to please allow opioids for people who suffer with RLS. My mom suffered terribly for the last year and half of her life as she could not get any relief from her Restless Leg Syndrome. After going to the RLS organization and learning that a little bit of opiod helped people we started giving her hydrocodone that she had used for pain in the past and this did give her relief. Please help people get relief from this horrible disease. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	E.	None	None	0900006484ff1638	zu Hone	None	2022-04-01T22:05:15Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from zu Hone, E.	l1f-d826-uv18	False	None	False	2022-04-12 05:35:50.645	[]
3507	CDC-2022-0024-3513	https://api.regulations.gov/v4/comments/CDC-2022-0024-3513	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>For 4-5 years RLS has nightly disrupted my sleep and sometimes my days. There have been long periods with 4-5 hours of low quality sleep, living each day exhausted and struggling just to do anything. Better days I'm always tired. I have taken the dopamine agonists (ropinirole, pramipexole, etc.) and experienced augmentation, making symptoms worse. A very low dose opioid provides the most real relief.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nelson	None	None	0900006484ff165f	Pardee	None	2022-04-01T22:05:35Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Pardee, Nelson	l1f-depm-zy23	False	None	False	2022-04-12 05:35:50.859	[]
3508	CDC-2022-0024-3514	https://api.regulations.gov/v4/comments/CDC-2022-0024-3514	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been taking low dose Methadone (opioid) for 17 years for Restless Legs Syndrome. Before that I was getting about 3-4 hours of sleep a night. Now I get 7-8 hours of sleep. In all those years I have not increased my dose. I have never had a drug problem from this or any other drugs. I am 83 years old.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484ff1661	Jenkins	None	2022-04-01T22:05:55Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Jenkins, Barbara	l1f-dfgg-9ab0	False	None	False	2022-04-12 05:35:51.068	[]
3509	CDC-2022-0024-3515	https://api.regulations.gov/v4/comments/CDC-2022-0024-3515	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe Restless Leg Syndrome. I take 3 5mg Oxycodone pills a day. This low dose takes care of my symptoms for 24 hours.<br/>Please consider this in your guidelines for prescribing opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1671	Anonymous	None	2022-04-01T22:06:05Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-dj8i-miuo	False	None	False	2022-04-12 05:35:51.273	[]
3510	CDC-2022-0024-3516	https://api.regulations.gov/v4/comments/CDC-2022-0024-3516	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had symptoms since preteen age. Many members of my family are afflicted. I have a very severe case, at age 70, with symptoms affecting my legs, arms, head, spine. It is so severe, I can understand one committing suicide. There are studies indicating that RLS is associated with heart disease and stroke. I have been through every recommended drug and non medicinal treatment recommended by my doctor at [name redacted]. Opioids are the only thing to provide relief at this time. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the [name redacted] at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484ff1696	S	None	2022-04-01T22:07:19Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from S, K	l1f-dno2-1r34	False	None	False	2022-04-12 05:35:51.518	[]
3511	CDC-2022-0024-3517	https://api.regulations.gov/v4/comments/CDC-2022-0024-3517	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I started medical therapy with Ropinerole, but it soon evolved into augmentation and made my RLS worse. My neurologist prescribed gabapentin and low-dose morphine which has been working beautifully for years, allowing me to sleep, instead of waking for hours at a time in the middle of the night.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the [name redacted] at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ff16c9	Emswiler	None	2022-04-01T22:08:06Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Emswiler, James	l1f-dvvm-87al	False	None	False	2022-04-12 05:35:51.739	[]
3512	CDC-2022-0024-3518	https://api.regulations.gov/v4/comments/CDC-2022-0024-3518	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the [name redacted] at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484ff16e4	Cain	None	2022-04-01T22:08:46Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Cain, John	l1f-dy4e-xmdm	False	None	False	2022-04-12 05:35:51.964	[]
3513	CDC-2022-0024-3519	https://api.regulations.gov/v4/comments/CDC-2022-0024-3519	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	15 years ago while playing on [location redacted] with my children when I was struck from behind by an Quad ATV.I have been working hard to put my life back together and pain management has been a huge part of that in order he beginning I had nothing else.Over the years I have continually reduced my doses and have many tools in my belt to address the pain, yoga, swimming, deep breathing, and injections. Every day is different and the pain ebbs and flows. I have never taken my medications incorrectly yet I feel you have criminalize pain and the Doctors don't want to treat me fairly or even care that I have come so far even attending community college, before the pandemic and wish to return to complete my double AA in Psychology, and Sociology. I came off all my pain medication to reassess my pain levels which I was glad to do although the pain is ever present and I will still need pain management. Instead of criminalizing patients who did the right things and take meds correctly, maybe you should make pharmaceutical companies who flood communities with easy access to meds without verified conditions they are the criminals not people who have worked so hard to get better and have a good life with their families and in there communities. Thank you.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Desiree	None	None	0900006484ff1769	Walker	None	2022-04-01T22:09:42Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Walker, Desiree	l1f-ea7t-iq6a	False	None	False	2022-04-12 05:35:52.174	[]
3514	CDC-2022-0024-3520	https://api.regulations.gov/v4/comments/CDC-2022-0024-3520	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] and I suffer from restless leg syndrome. This disease is very difficult to treat and if not for opioids I would not be here. Before access to methadone I had to be on a dopamine agonist which the side effects destroyed my life. As soon as you start to fall asleep restless leg kicks in.. it will not allow you to sleep. Until we find a cure we have to manage it. Im seeing the top restless leg doctor at [name redacted]. Hes researched restless leg for 30 years. Ive tried all the other drugs.. whats left is opioids. Please allow me to have a decent life with having access to these drugs. Not everyone is wanting to get high. Please don't penalize the sick for the few criminals . Im begging you as a human allow us to have access to drugs that allow us to live productive lives. <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicki	None	None	0900006484ff176a	Dehne	None	2022-04-01T22:10:39Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Dehne, Vicki	l1f-eadr-xwq0	False	None	False	2022-04-12 05:35:52.380	[]
3515	CDC-2022-0024-3521	https://api.regulations.gov/v4/comments/CDC-2022-0024-3521	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	“I’m writing to you to comment on the CDC guidelines.<br/><br/>My involvement in this is that I have a relative that has had their medical license under suspension.<br/><br/>He is a doctor in Illinois and through close contact with him I know of his dedication to his patients. He had a small practice of not more than 130 patients. 70 or 80% of these patients were getting the drug buprenorphine. The average time people were with him was five years. They saw him for an hour every month. Besides being an excellent family practice doctor he is a skilled psychotherapist.<br/><br/>So, to be clear 70 or 80 patients trying to recover from addiction on buprenorphine were put out on the street overnight.<br/><br/>His goal was to treat everybody that came in his door. He stuck with patients over the years, some very difficult patients and for this he’s being punished.<br/><br/>From what I understand without the CDC guidelines of 2016 his situation probably would not of happened despite the fact that the DEA has been doing similar things long before the 2016. However as you know, and as you now realize, your guidelines were used to prosecute doctors. You are now trying to fix that and I applaud that.<br/><br/>Bottom line is:<br/><br/>1-if I would have my way I would prefer that you just simply go moot on the subject and not publish new guidelines.<br/><br/>2-given that that’s not going to happen I would want that no mention of MME’s be made. No matter how you state it or how many disclaimers you make I am certain that law-enforcement will take it to heart and just establish a new benchmark that is even lower, that it’s going from 90 to 50. If you don’t understand that then things are just hopeless.<br/><br/>It is my understanding that the whole idea of MMES is dubious. I’ve learned there’s little in the literature that supports the idea.<br/><br/>There should be no mention of the limit of days you can prescribe opiates. Stay out of the doctors office. Stay out of the physician patient relationship. Bureaucracies love numbers and rules. Guidelines are fine, goals are fine but anything that hints of some thing that can be turned into a rigid limit is anathema.<br/><br/>All of the above is to say nothing of the people I know that are being denied pain care. This is inhumane and a disgrace on the nation.<br/><br/>Thank you and sincerely<br/><br/>A concerned Citizen<br/>www.federalregister.gov	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	EILEEN M.	None	None	0900006484ff17ba	LYNCH	None	2022-04-01T22:12:18Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from LYNCH, EILEEN M.	l1f-ei3a-pvkm	False	None	False	2022-04-12 05:35:52.585	[]
3516	CDC-2022-0024-3522	https://api.regulations.gov/v4/comments/CDC-2022-0024-3522	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to you today as a 69 year old woman who suffers from severe Restless Legs Syndrome (rls). I have suffered with this difficult syndrome for more than 35 years. When I was first diagnosed I was treated with a very low dose of Klonopin. <br/><br/>As the years went by I was started on Mirapex. My neurologist, although certified in sleep medicine was only using Mirapex. All he knew to do was increase the dose, so as my rls increased so did my medicine. When I became aware of the [name redacted], I began to learn more than my doctor knew about treatments. I tried all of the therapies medical and homeopathic with no relief. In 2018 I was able to get a referral to the [name redacted] in [location redacted], MN. (I was living in the suburbs of [location redacted] at the time). It was there that I learned that my Mirapex was dosed at extreme levels and I needed to get off of it ASAP. Unknowingly I had experienced the worst side effects of the Mirapex, I was binge eating and compulsive shopping. <br/><br/>It took me 1 year to get off the Mirapex with many sleepless nights, walking around my house, shaking my arms and legs because I couldn't get the need-to-move out of my system. Later in 2018, I met a new doctor at the [name redacted] who was using low dose opiates to treat restless legs. What a difference it made for me. It took a few months to get the dose right but I now take one 2mg/.05mg of Buprenorphine/Naloxone. As long as I was in Michigan I was fine. <br/><br/>My husband and I moved to Illinois in late 2020. That's when the battle began again. The very medicine that was allowing me to sleep at night was one that most doctors would not prescribe. I had physicians literally yell at me because they would not write for a narcotic, even a low dose, because they were afraid of being sited for misuse of their narcotics license. The [name redacted] offers a physician education program and I have not found anyone willing to take it. They don't want to be educated in this area because they are afraid to write prescriptions for narcotics. We have scared the heck out of the doctors to the point they don't want to even be helpful to longtime patients. Your rules for prescribing narcotics have put patients like myself at risk of not being treated the way modern medicine safely permits. The scientific evidence is out there. <br/><br/>Please, please help those of us that require opiates to get the help we need. Research suggests addiction is rarely a side effect at the low levels required for rls patients. I strongly urge the CDC to consider patients like myself when rewriting the Clinical Practice Guidelines for prescribing opioids. Low total daily dose opioids are an appropriate and important treatment for Restless Legs Syndrome.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marcia	None	None	0900006484ff17c1	Ball	None	2022-04-01T22:14:41Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Ball, Marcia	l1f-ek2u-iore	False	None	False	2022-04-12 05:35:52.808	[]
3517	CDC-2022-0024-3523	https://api.regulations.gov/v4/comments/CDC-2022-0024-3523	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to thank the CDC Clinical Practice Opioid Prescribing Guideline, but the draft<span style='padding-left: 30px'></span>does not address chronic conditions like RLS. My condition developed about 10 years ago and my [name redacted] for the first 9 months tried all types of meds before turning to opioid which did provide some relief. It was rear that I got a full night of sleep, offer up for 1 or 2 hours during the night because of the pain of restless legs and the need to move, it was like HELL. within about 3 years I was trying to live a normal live but I was taking 25 or 30 mg of Oxycodineper day just to maintain somewhat of a normal life, then contending with the side effects of the meds.<br/><span style='padding-left: 30px'></span>About 5 years ago I learned of [name redacted] at [name redacted], it took 2 months to get an appointment and after describing my condition to him, since there is no test he did say I indeed had RSL and said your condition I give my patients Methadone and I would start you at 5 mg per day. To make the story short within a week of taking just 5 mg per day I was a new person, my RLS was under control about 90% of the time and I have no side effects except for constipation which is easy to control. Today I still see [name redacted] and I am using only 10 mg per day and it controls the RLS most of the time.<br/><br/><span style='padding-left: 30px'></span>I really do not know how I would live a normal life without my Methadone, its a life line to a living. For me it works, no side effects and it is cheap. [name redacted] told me when I first met him that he has been using it for more than 30 years.<br/><br/>please do not cut me off from my only med that works for me<br/><br/>Very truly yours<br/><br/>[name redacted]<br/>[contact information redacted]<br/>[location redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	STEPHEN	None	None	0900006484ff17c7	ISER	None	2022-04-01T22:17:11Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from ISER, STEPHEN	l1f-elo5-oevk	False	None	False	2022-04-12 05:35:53.021	[]
3518	CDC-2022-0024-3524	https://api.regulations.gov/v4/comments/CDC-2022-0024-3524	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish to add my thoughts on the use of opioids to treat Rest Leg Syndrome. I have been using 1. 5mg. tablet of hydrocodone each night for over 15 years, after having tried some of the other dopaminergic drugs, which brought on severe augmentation of the symptoms. My sleep doctor prescribes the Vicodin and I don't know what I would do without it. I have never increased the dosage and it has made a world of difference for me as far as allowing me to get a good night of sleep. Please make sure that physicians will be allowed to continue prescribing opioids for RLS. As it is now, it is very tightly regulated and makes me feel like a drug addict when I go in for monthly refill - can never get more than a month supply of pills at a time. Please realize how important this is to those of us who have suffered with the RLS problem over the years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484ff184a	Ritger	None	2022-04-01T22:17:41Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Ritger, Judy	l1f-f87v-nkyl	False	None	False	2022-04-12 05:35:53.227	[]
3519	CDC-2022-0024-3525	https://api.regulations.gov/v4/comments/CDC-2022-0024-3525	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My comment relates to the CDC Clinical Practice Opioids Prescribing Guideline: My problem with it is that the draft does not address chronic conditions like RLS that are different from chronic pain. Please do not leave out the usage of opioids for Restless Legs Syndrome. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, even in other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. Just imagine how your life would be if you could not sleep! I am 67 years old and my degree of RLS is called “intractable” which means standard medications have been tried (for me, 25 years) and are not effective in controlling the intense, chronic RLS symptoms. I have now been prescribed oxycodone 5 mg only once per night. This med manages my symptoms very well and it has restored my ability to sleep and, thereby, the ability to function during the day. Please make the guidelines so that it will not adversely affect my and my doctor’s ability to get and use this drug for a clear, CHRONIC, NON-PAIN neurological health issue. – Please make a very thorough review, and include patients with non-pain, long term use of opioids for RLS. Also please consider the [name redacted] at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006484ff1850	Langevin	None	2022-04-01T22:18:44Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Langevin, Brian	l1f-f9yz-zspt	False	None	False	2022-04-12 05:35:53.469	[]
3520	CDC-2022-0024-3526	https://api.regulations.gov/v4/comments/CDC-2022-0024-3526	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was originally diagnosed with RLS in 1997. I was prescribed Ropinarole a dopamine agonist as the first line of defense. This form of treatment worked perfectly for 15 years. However, I begun noticing that I was being awakened 2 hrs earlier than usual with RLS symptoms in my legs about 2010. I just dealt with it as usually all I needed to do was get up and walk for a while go back to bed and the symptoms had abated. I took 2, two mg tablets per day at bedtime. In 2006 I begun taking Vicodin to ease the pain of a back injury. Ie 2 compression fractures and a burst fracture. My injury happened in 2006. I took the Vicodin for approx 3 months to help with the pain. As I was taking the opioid Vicodin I noticed I could now sleep as long as I needed to get proper rest. Usually 8 hrs nightly. When no longer taking the Vicodin the RLS symptoms interrupted my sleep again awakening me earlier than previously mentioned. Now I was getting only 4 to 6 hrs sleep when the RLS symptoms begun. In 2018 after urging my docs to take a look at the positive affects of the opioid Vicodin all agreed this was a great additive to the Ropinarole helping me get much needed sleep and much improved QOL. I stayed on the Ropinarole and 3 low dose Vicodin for several years. In 2018 I went to Africa for 30 days and Madagascar for eight days. After returning home I begun getting RLS symptoms in my arms. For 4 years the new symptoms in my arms went undiagnosed at Kaiser permanente. I finally got a referral to see a World renowned neurologist and sleep specialist [name redacted] at [name redacted] Ca. My symptoms got so bad they had encompassed my entire torso including legs arms and chest! I WAS going to take my life as the symptoms had gotten unbearable. Before seeing [name redacted] I had been prescribed (eight) 8 250mg Percaset daily!! There seemed no end in sight.. I was doomed. And I was told we will NOT prescribe more than 8 per day. Often I was awakened twice each sleep cycle every night having to take 2 more Percasets. This dose was the only thing that stopped this Horrific, torturous disease giving me at least four hours of uninterrupted sleep. I was going to take my life July 5 2022 and I was okay with this as I could no longer take the torture that this disease was causing. <br/>I finally got through to the [name redacted] after [name redacted] searching my symptoms in only 30 min. Yet 2 neurologist at [name redacted] couldn’t do so in four years. I explained everything I have written here and was told there is a possibility I might be augmenting with my RLS. They gave me [name redacted] name and phone number. I made a appt and he confirmed that I WAS in RLS augmentation. He prescribed the slow acting long lasting script for Methadone. I was shocked that he would prescribe this as I’m NOT a drug addict looking for a fix!! I’m a 74 year old Christian man. <br/>The bottom line is now I can sleep for as long as I want and have reduced my overall mg of opioids unbelievably to accomplish my ultimate goal. And that goal is to no longer experience this Horrific, torturous disease that when not intervene medically, I literally looked like I had cerebral palsy!! But, that only happened when I took the Percaset to late or I went over my daily allowance of eight per day. The opioid based Methadone and [name redacted] have been a God send saving me from taking my life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484ff1883	Jones	None	2022-04-01T22:21:44Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Michael	l1f-ff11-fvm2	False	None	False	2022-04-12 05:35:53.677	[]
3521	CDC-2022-0024-3527	https://api.regulations.gov/v4/comments/CDC-2022-0024-3527	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been suffering from this dreaded condition for over two decades. I had augmentation with Requip after about 5 or 6 years of use. At that point my neurologist prescribed opiates. I took pill form hydrocodone for over a decade before being switched to a different type of opioid called Belbuca. The relief I've felt with the opioids gave me my life back. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the [name redacted] at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484ff1885	Grosse	None	2022-04-01T22:22:22Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Grosse, Michelle	l1f-ffr7-lbfc	False	None	False	2022-04-12 05:35:53.887	[]
3522	CDC-2022-0024-3528	https://api.regulations.gov/v4/comments/CDC-2022-0024-3528	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from a neurological disease called Restless legs syndrome (RLS). It causes an on-going urge to move the legs when at rest or while trying to sleep. It also causes my body to repetitively jerk. Restless legs syndrome makes it impossible to sleep or even rest. I have been seen by many doctors and specialist throughout the years. There is no cure. I have tried every imaginable lotion, potion, pill, therapy, and prescription. Some prescriptions only made the condition worse. The only prescription that has worked is a small dose opioids. <br/>Thank you for your consideration of these vital issues, and please consider the [name redacted] at www.rls.org as a resource for scientifically-based information about RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff1888	Reed	None	2022-04-01T22:22:55Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Reed, Mary	l1f-fft1-d1dm	False	None	False	2022-04-12 05:35:54.125	[]
3523	CDC-2022-0024-3529	https://api.regulations.gov/v4/comments/CDC-2022-0024-3529	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer. This is not something I asked for nor do I want. I want to enjoy my life, family, and friends. I want to see my grandchildren grow and be in their lives. I no longer work and limit my activities due to pain. I have to plan when I can do a simple task like taking a shower, the time to recover from it, and then decide if I will be able to venture out to complete an errand. Majority of the time I can not and my husband will be responsible for my task. All of his wears on me physically, mentally, and emotionally. I am a responsible adult who has never abused anything in my life. I have been responsible for myself since I was 17. My life is important and matters! However, I have lived in constant pain for over the past twenty years at what point does it become too much. Why do I have to suffer from someone else’s mistakes and decisions? Why do others get to dictate that my pain does not matter or exist? This needs to stop. How many more lives will be lost because the pain never ends and their is no way to get help? Please listen to the cries of many across our country.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff18b2	Anonymous	None	2022-04-01T22:23:28Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-fo1j-bvdy	False	None	False	2022-04-12 05:35:54.330	[]
3524	CDC-2022-0024-3530	https://api.regulations.gov/v4/comments/CDC-2022-0024-3530	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Studies don’t allow people with severe pain in because it skews their results. I’ve tried, they say my pain is “too complicated”. The guidelines should not disregard all of us with complicated or severe pain because you only looked at studies on people with mild pain. The total disregard of patients actual experiences, calling them just anecdotal, is infuriating. The actual experience tells you more than a study that picks and chooses the patients, manipulates the data and doesn’t consider those that dropped out as important. Many patients have done well on what is now called high doses of opiates for many years without problems of addiction or OD. Just studying addicts and their MME doesn’t mean that everyone with the same MME will become an addict. You have many addiction people involved in this but seem to have no idea what causes or contributes to addiction. Your use of illicit drug deaths against legitimate patients have led to suffering and deaths among both groups. I happen to metabolize many meds faster than some people. Thank goodness you haven’t tried to make a standard dose of everything else or I would stroke from the high blood pressure I developed after 4 years of poorly controlled pain. If you had actually talked to pain patients and pain management doctors you would have included ways to deal with tolerance like opiate rotation. Or ways to cope with side effects like magnesium or fiber for constipation. But you use this claim in your PR. I had a life for 20 years with opiates and adjunct therapies. I only started them after all other treatments failed and I was injured by steroids, NSAIDs,antidepressants and electric stimulation therapies started causing muscle spasms. Your mention of any MME is a problem. I will not live much longer if they lower to 50MME.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jackie	None	None	0900006484ff18c4	Melcher	None	2022-04-01T22:24:32Z	None	None	1	None	2022-04-01T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Melcher , Jackie	l1f-frdi-q58z	False	None	False	2022-04-12 05:35:54.541	[]
3525	CDC-2022-0024-3531	https://api.regulations.gov/v4/comments/CDC-2022-0024-3531	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>I suffer from chronic RLS and have for 20 years. My mother also has the disease, as well as other family members. I have struggled with treating the pain and discomfort from RLS and have taken every drug that is recommended without any long-term relief. My RLS has gotten worse on the "typical" treatments of pramipexoel and requip. I have also tried many of the non-medication treatments often recommended - meditation, good sleep hygiene, acupuncture, and exercise. I am a healthy 57 year old woman who is fit and not obese. In 2019, after another failed attempt by my doctor to find an effective treatment, I sought out an RLS expert, not just a sleep specialist. <br/><br/>I arrived in her office with my bag full of medications that didn't work in the long term. I was in tears describing how this disease had impacted my life. If I hadn't been fortunate to retire early, I would not have beem able to continue my work as an Vice President for a multi-national energy company. That is how the disease has effected my life! She prescribed buprenorphrine. I take an extremely low dose - less than .5 mg per day with clearly remarkable results! I rarely suffer from symptoms and when I do, the drug is effective at stopping the painful sensations in my legs. I have had to work through some side effects, like constipation and nausea, but that has been worth the relief.<br/><br/>Unfortunately, my doctor with the expertise in RLS retired. I felt fortunate that she was willing to call my General Practitioner and talk with her about prescribing the buprenorphine. If my GP had not been willing to take on the responsibility, I would have had to start all over again trying to find a doctor to work with me in treating this disease. Since I moved often for my job, I had many doctors treat my RLS. Only one, very early on had even mentioned the use of opioids and he wasn't encouraging the use. I believe that most of the other doctors who recognized my disease was not well controlled did not even consider raising the possibility of an opioid prescription, is because the CDC Clinical Practice Guideline for Prescribing Opioids does not mention RLS.<br/><br/>Please take my experience into account. I am happy to answer any questions and will provide my phone and email below. <br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maureen	None	None	0900006484ff8346	Ciemian	None	2022-04-04T16:06:13Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Ciemian, Maureen	l1k-w8pv-x6x3	False	None	False	2022-04-12 05:35:54.747	[]
3526	CDC-2022-0024-3532	https://api.regulations.gov/v4/comments/CDC-2022-0024-3532	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the cdc guidelines i have been a prisoner in my own body, unable to function and live a quality of life!This is America!This is not a 3rd world country! This is discrimination and against our human rights to take away appropriate pain medication to ease our pain from an unfortunate injury /illness!This is not civil times!Are we going backwards?? Seems so with what is happening in health care!Give Doctors back their right to help their patients!You are not Doctors!We are being punished because of illicit carafentynal flooding through our borders.This was not caused by Doctors easing patients pain!You governmental agencies already made enough money through this false narrative!You have caused a massive epidemic by taking patients pain medications!They are desperately seeking help because of their pain!Not being these awful criminals like you are portraying!We are not addicts or junkies!We are intelligent human being that were given a awful situation!Please help us have our life back!Its not one size fit all!Please stop mme limits!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff82f9	Anonymous	None	2022-04-04T16:08:57Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-voui-2eim	False	None	False	2022-04-12 05:35:54.955	[]
3527	CDC-2022-0024-3533	https://api.regulations.gov/v4/comments/CDC-2022-0024-3533	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Morning,<br/><br/>I’ll give you a very brief overview of what is going on with myself and that of people in the chronic pain community. I’ve had CRPS since 2014. As you know it is the most painful medical condition known to modern medicine. It’s nearly impossible to find a doctor or PM center that even knows anything about it. I don’t have tried everything known to stop the pain. I’ve paid for Ketamine infusions, I’ve had a SCS implanted and then removed because it only provided relief positionally due to my stenosis. I had to get two laminectomies and Diskectomies to get it installed and removed. I have over 12,000 pages of medical records to support this. I was on opioids for over three years. They helped me. They got my pain level to 5/10. I have never had a bad urine screening. I’ve never had a bad pill count. My records will validate all above. When my PM Dr count me down to 90 MME it destroyed my life. I am now bedridden and 100% disabled. Why? Chronic intractable pain patients are not the majority of the problem with the opioid problem. We NEED this medicine. We don’t, as a rule, abuse them. We rely on them to have some semblance of life. We want to spend time with our families too. We want to work. We miss the dignity that being able to provide for our families. We are being punished because some people with addiction aren’t getting the help they need and deserve. Our Dr’s treat us all like drug seekers. They treat us horribly. There is no sympathy for our condition. We aren’t treated as sick people who need help. We’re automatically thrown into one group of a population that we aren’t a part of. I know 4 people with CRPS that have committed suicide because they could no longer deal with the pain. There are many more. I completely understand monitoring, I see a pain psychologist, I’m not going to overdose. I just want some of my life back. I’ll never be pain free. I get that. I just want to be able to be as productive as I can and enjoy my life with my family as much as possible. You have to end this nonsense for people like me. You have to tell Dr’s it’s alright to prescribe the medication that the condition requires. They’re all afraid of losing their licenses or the DEA raiding their office. I don’t blame them. I would too. This was a horrible idea that has killed people and turned others to heroine or other unsafe medications bought in the street. I don’t believe it was intentional. I believe it was an overreaction targeting the wrong people. It’s unfortunate for all of us. It’s unfortunate for the healthcare providers. It’s bad all around.<br/><br/>If you need validation you can reach out. I have all records on a thumb drive that will walk you down this slow path to hell. Please change this policy and be supportive of the pain Dr’s. They are victims of this too.<br/><br/>I thank you for listening<br/>[redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Greg	None	None	0900006484ff7cd5	White	None	2022-04-04T16:09:55Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from White, Greg	l1k-u7i1-05ga	False	None	False	2022-04-12 05:35:55.172	[]
3528	CDC-2022-0024-3534	https://api.regulations.gov/v4/comments/CDC-2022-0024-3534	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to submit a comment. I have a close friend that I have known for over 40 years. Unfortunately she contracted juvenile onset diabetes. She has spent her entire adult life facing a series of health hurdles. In addition to the blood sugar and insulin issues, she has required multiple kidney transplants. The accompanying immunosuppressant drug therapies have also been a burden. She has shown great courage in facing these many health challenges. She is not a person who quits.<br/><br/>About a decade ago she had to face a new debility, spinal stenosis. This progressive lower back disorder has resulted in high levels of chronic pain, and has become a malady from which she has struggled to find relief.<br/><br/>After consultations with her medical professionals a treatment plan using very low dose opioids was prescribed. This therapy was maintained for the next 4 years. During this period she was under careful medical management. No indication of opioid use disorder was present and her doses remained constant at the lowest level.<br/><br/>This therapy proved successful in controlling chronic pain and allowed for a return of greater mobility, flexibility, and stamina. Simply put this was a life-changing improvement. Physically as well as mentally.<br/><br/>After the 2016 revisions to the CDC's policies on the use of opioids therapy, her medical professionals became unwilling to prescribe these medications. The fact that these medications had been well managed, well tolerated and very effective seemed to have no bearing on their decision. She was told opioid therapy was no longer an option for patients like her. The opioid therapy was to be systematically reduced, then eliminated. <br/><br/>Unsurprisingly, soon after cessation of the opioids the the chronic pain returned. This was followed by increasing debilitation and a marked decline in her quality of life.<br/><br/>In an effort to ease her discomfort her medical professionals prescribed non-opioid drug therapies for pain management. These included at least 10 different prescription pain management drug therapies. Unfortunately none were helpful in reducing the pain to acceptable levels and/or they had intolerable side effects which her diabetes made more acute.<br/><br/>Alternative non drug therapies were then tried. These included Physical therapy, Chiropractic care, Acupuncture and Yoga. Although giving some temporary relief none of these therapies were sufficient in restoring her to the quality of life she had maintained prior to the 2016 CDC's change in usage policy.<br/><br/>She currently suffers from a near complete loss of mobility with constant high pain levels in the 8 to 9 range. She suffers from sleep deprivation, inability to concentrate, and the burden of a terrible sense of utter helplessness without any prospect of improvement. Once again I state she is not a person who quits.<br/><br/>I am fully aware of the dangers and suffering the mis-use of opioid medications have unleashed upon our nation. I would submit however that the current near complete ban on their use ignores many suffering people that could be helped by these powerful medications. When medical professionals are afraid of making the right decisions for their patients because of the threat of legal retaliation, changes need to be enacted to restore the doctors ability to do what's in the best interest of their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stuart	None	None	0900006484ff791c	Zastrow	None	2022-04-04T16:10:27Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Zastrow, Stuart	l1k-tgo6-c27v	False	None	False	2022-04-12 05:35:55.391	[]
3529	CDC-2022-0024-3535	https://api.regulations.gov/v4/comments/CDC-2022-0024-3535	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regarding CDC-2022-0024, I convey to you the paramount need for guarding against injustice against a significant percentage of people suffering with chronic pain including but not limited to cancer. I write as a widower (my wife died of cancer with mers to the bones, intense pain), ER medical social worker, mental health counselor/psychotherapist, LCSW, and resident of a geographical area with large racial minority population. I was a member of the Oak Park-River Forest Opioid Task Force.<br/>I am a Caucasian male in my 50's. African Americans who are cancer patients and chronic pain patients seem at risk to be written off as drug-seeking. This would be, at lea nst in my locale and experience, often inadvertent by providers, not an overt effort at racism but subconscious skew in providers' perceptions of patients. These perceptions are significantly influenced by the statements of nurses and others working with the providers. One mention of the words "drug seeking" put a patient's pain into the suspect category.<br/>Here is my request: Please, please implement safeguards into your guidelines against the PERMANENCY of a patient's medical record. One mention, one time, by a medical technician in earshot of a prescriber that a patient might be drug seeking, and that patient becomes condemned for the rest of her life, without a court's due process, to inadequate pain relief, no opioids allowed anywhere, and this unduly influenced by mere guessing by medical professionals with little consequence to them. Things like race and gender unduly influence this unjust scourge on our record as decent humans.<br/>Please guard against injustice and suffering. Thanks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ff72dc	Quandt	None	2022-04-04T16:11:03Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Quandt, James	l1k-t1v4-bebi	False	None	False	2022-04-12 05:35:55.598	[]
3530	CDC-2022-0024-3536	https://api.regulations.gov/v4/comments/CDC-2022-0024-3536	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The arrogance of many pharmacists and medical professionals regarding the so-called abuse of opioids is out of control. Anyone who actually spends any time researching the facts into this "crisis" will easily find that the majority of deaths associated with opioids are primarily due to a percentage of people seeking out drugs on the "street". <br/><br/>This "crisis" began and remains the fault of overly strict laws that artificially restrict the supply of safe pharmaceutical medications. Street dealers have filled this "need" which has turned into a for-profit and unregulated creation of very dangerous opioid pills/powders that now frequently contain the addition of Fentanyl. There is never a safe amount of Fentanyl in these non-pharmaceutical created drugs.<br/><br/>While there were many cases of doctors over-prescribing opioid medications for patients who likely needed lower doses, or none at all, this percentage was quite small in comparison to the many who actually need, are properly prescribed and ethically consume these prescriptions. The sudden removal and over-regulation of opioids created a very dangerous situation with thousands of patients who were immediately left with the choice of severe and dangerous withdrawal. This situation was extremely medically unethical and never provided a pathway for patients to safely reduce opioids or receive any kind of counseling during this sudden change. Between suicides, domestic abuse, depression and loss of work, many patients and families had their lives drastically upended due to the false reporting of and creation of, again, an opioid "crisis" that was far different than reality. <br/><br/>Millions of patients are dependent on medications every day. There is a difference between dependency and addiction and this is where the government and medical industry has failed to address needs vs abuse. The current assumption that every adult that uses opioids is doing so as a means to get high is a prime example of what lies and disinformation has caused. May patients face monthly abuse and disdain from Pharmacists and some doctors who continue to believe false propaganda that was feed to them regarding this crisis.<br/><br/>This continued spreading of false information will not only reduce the quality of life of many patients but will continue to grow a dangerous business of black market purchases and manufacturing. These are the pills that are reaching our youth and some pain patients. Again, this country has to stop associating need with addiction. We have to stop putting fear into our medical professionals who know when a patient will properly benefit from opioids. We have to stop putting fear into pharmacists whom many have turned into arrogant and verbally abusive fronts to patients due to the false belief that they will lose their license for following the laws. Yes, we have a problem. No, it's not every patient. Yes, we need to regulate. No, we don't need to abuse and condemn and humiliate. <br/><br/>Between statistical facts and more education, there is much more information to be shared. Use common sense and listen to the patients. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff72d7	Anonymous	None	2022-04-04T16:11:43Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-szia-8nr8	False	None	False	2022-04-12 05:35:55.813	[]
3531	CDC-2022-0024-3537	https://api.regulations.gov/v4/comments/CDC-2022-0024-3537	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	United States Court of Appeals FOR THE DISTRICT OF COLUMBIA CIRCUIT<br/>Norman Clement,<br/>Petitioner<br/>v.<br/>Drug Enforcement Administration,<br/>Case: No. 21-1262<br/>Respondent ___________________________________________________<br/>PETITIONER’S DISPOSITIVE MOTION TO VACATE ADMINISTRATIVE JUDGES FINDINGS AND DEA ADMINISTER’S ORDERS, RESTORE CSA REGISTRATION of PRONTO PHARMACY LLC AN AWARD DAMAGES, AMEND INDEX OF RECORD<br/>Pursuant to the Court’s Order of December 20, 2021 and D.C. Circuit Rule 30 (c), Petitioners [redacted] pro-se in Case No. 21-1262 files this Dispositive Motion and Amend Petitioner’s Certified Index Record to include blog [redacted], hereby states,<br/><span style='padding-left: 30px'></span><br/> STATEMENT<br/>The decision in this case will have far-reaching deleterious effects on the professions of Medicine, Nursing and other Mid-Level Practitioners and Pharmacists.<br/>After reading the TRIAL TRANSCRIPT and ALJ DECISION many glaring errors became apparent. This document is intended to enlighten the court as to the true nature of the STANDARD of CARE as it pertains to the practice of PHARMACY.<br/>The practice of Pharmacy has many traditional and emerging roles and a one size fits all standard cannot apply. The proof of this is that certain facets are known as retail establishments, institutional establishments, healthcare organizations and others. Within these broad categories there are subdivisions.<br/>ARGUMENT<br/>The Controlled Substances Act (CSA) and its implementing regulations established a closed system of distribution to ensure appropriate medical care and to maintain the integrity of the system through an accountability process.<br/>One of the most important principles underlying the CSA and its implementing regulations is that to be valid, every prescription for a controlled substance must be based on a determination by an individual practitioner, that the dispensing of the controlled substance is for a<br/><br/> legitimate medical purpose in the usual course of professional practice. United States v. Moore, 423 U.S.C. 122 (1975) and 21 CFR 1306.04(a).<br/>Federal regulations do not define the term legitimate medical purpose nor do they set forth the standards of medical practice. It is up to each DEA-registered practitioner authorized by DEA to do so, to treat patients according to his or her professional medical judgement in accordance with a standard of medical practice that is generally recognized and accepted in the United States.<br/>DEA has not promulgated any new regulations regarding the treatment of pain. Federal law and DEA regulations do not impose a specific quantitative minimum or maximum limit on the amount of medication that a practitioner may prescribe on a single prescription, or the duration of treatment intended for a particular patient.<br/>What is clear here is that Pronto Pharmacy is acting as a specialty pharmacy which specializes in pain management as well as non-sterile compounding.<br/>Since DEA expert, [redacted] seems not to have any experience in pain management nor non-sterile compounding it is understandable that he does not grasp of the fine nuances in these fields. Since THE PETITIONER has experience in the fields listed above the following is submitted to enlighten the court.<br/>REFLECTING THE DISTINCT ROLES OF PRESCRIBERS AND PHARMACIST, § 1306.04 IMPOSES LIABILITY ONLY ON PHARMACIST WHO “knowingly” fill an illegitimate prescription.<br/>Although § 1306.04(a) regulates both prescribers and pharmacists, the two roles are far from inter- changeable, including for purposes of determining potential liability. With different licenses, education, skill sets, responsibilities, and workplaces from physicians, pharmacists play a vital but distinct role in a patient’s care. (see [redacted] Brief<br/><br/> National Association Chain Drug Stores, US Supreme Court Case No. 20-1410, Ruan vs. United States of America)<br/>Specifically, when dispensing a controlled substance to a patient, as prescribed by a physician, a pharmacist relies on the physician’s assessment of the patient’s needs. The pharmacist has neither examined nor diagnosed the patient, and lacks the information the physician has collected on the patient’s medical situation, records, and history, including such things as x-rays, ultrasounds, lab results, and treatment plans.<br/>The CSA recognizes pharmacists’ circumscribed role in dispensing controlled substances. It provides that pharmacists may not dispense Schedule II con- trolled substances “without the written prescription of a practitioner,” 21 U.S.C. § 829(a), and that they risk criminal and civil liability if they do, see id. §§ 841(a), (c), 842.<br/>The CSA’s implementing regulations further explain that a prescription for a controlled substance “must be issued for a legitimate medical purpose by an individual practitioner acting in the usual course of his professional practice.” 21 C.F.R. § 1306.04(a).<br/>.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff755c	None	None	2022-04-04T16:14:29Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from youarewithinthenorms.com	l1k-skmu-5aa3	False	None	False	2022-04-12 05:35:56.047	[]
3532	CDC-2022-0024-3538	https://api.regulations.gov/v4/comments/CDC-2022-0024-3538	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi,<br/><br/>I am an interventional pain physician and have attached a document in response to the proposed 2022 CDC Opioid guideline.<br/><br/>Thanks,<br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bimal	None	None	0900006484ff751d	Patel	None	2022-04-04T16:21:32Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Patel, Bimal	l1k-rtj4-c56r	False	None	False	2022-04-12 05:35:56.263	[]
3533	CDC-2022-0024-3539	https://api.regulations.gov/v4/comments/CDC-2022-0024-3539	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When the Opioid prescribing laws were tightened the ppl hurt the most were the ones who Medically Needed the medicine. Most "Addicts" just changed to Fentynal and Heroin. Which caused more deaths than prescribed Opioids ever has. Basically the intention of Lawmakers "Backfired" on All of us. Pain management clinics became the New way to get legal drugs for the addict, if they have insurance or can afford to pay. These Pain Management Clinics make boo Coo's of money bc Dr's are afraid of prosecution if they "Treat" their patients correctly. The Lawmakers, insurance companies, and others that benifit from tight regulation of Opioids have taken the decision out of the physicians hands. Making laws that essentially tell the world that Our Physicians are idiots and don't know what they are doing. Insurance companies, and law makers are "Better Doctors" than the Physicians that have gone to Medical School and have a License to Practice in the United States. Insurance companies and Lawmakers do Not need to be Overriding Dr's decions or regulating patient care. Unless they have a medical license and experience treating patients. I do not want you in my medical business. That is a violation of my privacy rights. You will Never wipe out or cure addiction. It has been here forever and will be here until the end. My Dr knows my health history and if he is afraid of going to prison for treating me then I'm finding another Doc. I want my Doc to have the Courage to stand up for my medical needs and refuse to allow Lawmakers and insurance companies to make decisions about my medical care. Pain Management Clinics may be the perfect place for addicts. Many addicts are using them already. When the laws tightened down on Opioids ppl started dying by overdose at 2.5 X the previous rate. The town beside us would have 8 to 10 overdose calls every day. And it wasn't just the low socioeconomic population. Some were Dr's kids, lawyers kids, and kids (and adults) from very prominent families. Please Stop trying to "Play God", you are Not God and you cannot "fix" anything by being Bullies. There are hundreds of thousands of people who are Dead now because of the attempts to control Opioids. Let the Doctors be Doctors Please. Please Don't Allow Insurance Companies that care Nothing about me to make decisions about my personal medical care. Please know that your (the ppl who pushed to change in Prescribing laws) Decision put into practice literally Killed ppl. There were also chronic terminal patients who couldn't longer get the necessary pain relief they needed. Many of these ppl committed Suicide bc they could not stand the 24 hours a day pain without relief. These are the consequences of the decision to take patient care Out of the Doctors hands. Please fix this horrible mess you have put us in. Ppl are Still dying today bc of your decision to "Play" Doctor! Fix this before there is more blood on your hands that won't wash off.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484ff751a	Wright	None	2022-04-04T16:22:26Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Wright, Debbie	l1k-s4rq-31p3	False	None	False	2022-04-12 05:35:56.485	[]
3534	CDC-2022-0024-3540	https://api.regulations.gov/v4/comments/CDC-2022-0024-3540	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After 30 years of restless legs (and arms), and after 10 years of trying (unsuccessfully) a variety of prescribed drugs, I had come to a stage ot total breakdown.<br/>I could no longer sit at my office desk because my condition had spread to daytime, it had before only affected me during the night.<br/>I presented at A&E at 5 in the morning after another sleepness night before going to work. I was given a Diazepan tablet and told to call my GP.<br/>My GP issued me a prescription of Oxycodone, (30mls a day is my current dose). It hasnt changed in 3 years. <br/>Without a shadow of a doubt this saved my life. 10 years of trying the suggested RLS drugs didnt help, they caused my condition to worsen. <br/>I feel strongly that RLS should be highlighted to all medics and taught at medical school.<br/>Suicide is overrepresented in the RLS community. All of the RLS charities can back that up and offer statistics.<br/>Low dose opiod medication is the only drug that works for many sufferers.<br/>I suggest compassion and the reality of what works are discussed positively for this cruel disease going forward. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	jane	None	None	0900006484ff18e6	birch	None	2022-04-04T17:40:12Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from birch, jane	l1f-g1ip-qkza	False	None	False	2022-04-12 05:35:56.727	[]
3535	CDC-2022-0024-3541	https://api.regulations.gov/v4/comments/CDC-2022-0024-3541	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, But the draft does not address chronic conditions like RLS that are different from chronic pain. Restless leg syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those medications can make the symptoms worse. When all other medical therapies fail, ample scientific proof supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had to deal with RLS for the past 20 some years. I cannot sit still in the late afternoon and evening and cannot sleep without medication. We who have RLS are known as night walkers because that is what at times we have to do to calm our legs down enough to get some, though less than required sleep. I have been taking a drug usually prescribed for Parkinson disease for a significant length of time and have reached a point where it is no longer completely effective and I need to been weened off this drug and use something which is more effective. Low-total-daily-dose opioids appears to be the only option I have. I can't take an afternoon nap, or sit still in the late afternoon because the urge to move my legs is unrelenting. I am 80 years old, I served my country well during difficult times, my life is on a down hill roll and my time to leave this cranky body approaches closer each day. I just would really appreciate it if my country would enable me to finish my time in a restful manner rather than night walking.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing Guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily-doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terrence	None	None	0900006484ff18fe	Musick	None	2022-04-04T17:43:01Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Musick, Terrence	l1f-ga9b-oh82	False	None	False	2022-04-12 05:35:56.967	[]
3536	CDC-2022-0024-3542	https://api.regulations.gov/v4/comments/CDC-2022-0024-3542	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	After exhausting numerouse options (surgery, therapy, acupuncture, massage, injections and non-opiate medications) I was ultimately prescribed opiates in 1998 and remain on opiates. I have never abused my medication and am regularly drug screened. I hold a full time job, drive myself where I need to go and maintain my home all by myself. My chronic pain condition has ruined my marriage and several other relationships as I am often not able to participate in many activities that others enjoy. The opiates make it possible for me to work and function as well as can be expected. Prior to opiate therapy, I was using a wheel chair at my job and while in college. In March 2022, my insurance company sent me a letter stating that they will not cover opiates greater than 200 MME (morphine milligram equivalent) per day. This means that I have to reduce the strength of opiates that I have been successfully functioning on for several years (no dosage changes during that time). I am scared about the withdrawal symptoms I know I will endure and the unrelenting pain that will return. It is so cruel to take away the one thing that helps me to function as much as I can.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jody	None	None	0900006484ff7850	Carr	None	2022-04-04T17:45:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Carr, Jody	l1k-zd30-dv7m	False	None	False	2022-04-12 05:35:57.207	[]
3537	CDC-2022-0024-3543	https://api.regulations.gov/v4/comments/CDC-2022-0024-3543	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think the guidelines offer a very nice summary of disparities and I think it is really important to address this- I would like more specifics on this and like this to be high lighted. <br/><br/>I would really like to see some guidance on psychosocial screening (food insecurity, housing insecurity), history of depression/anxiety, history of trauma and ACES as part of the foundations of screening for problematic opioid use and in the management of chronic pain as these things make pain and suffering worse and if we do not appropriately identify/screen for them, then we cannot address them and therefore, cannot address pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melanie	None	None	0900006484ff784e	Ripley	None	2022-04-04T17:45:38Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Ripley, Melanie	l1k-zbbz-pznw	False	None	False	2022-04-12 05:35:57.501	[]
3538	CDC-2022-0024-3544	https://api.regulations.gov/v4/comments/CDC-2022-0024-3544	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted]. I have chronic back pain for the past 15 years. I have 5 herniated discs along with several lacerated discs. Without the help of medication I am not able to function properly. The current guidelines are affecting me because my Doctor has been cutting me back on the necessary medication that I need. My quality of life has suffered immensely, which affects everyone in my family. It is wrong and negligent to set one standard for people who actually NEED this medication because of the few who ABUSE the medication. Without this medication I would not have been able to finish my career as a union carpenter. I am asking that you withdraw the 2016 guidelines on the grounds that these documents are flawed by weak medical evidence and are a misrepresentation of the efficacy and safety of non-opioid alternative therapies. Each case should be considered individually based on the NEED of the patient. I am constantly tested to be sure I am not abusing my medication, which I never have. If there is proof of abuse then by all means that individual patient should have restrictions. This is not a one solution applies to ALL situation. AS my medication is being decreased from what I have taken for 15 years to a fraction of that my life has changed dramatically. I implore you to change these guidelines and treat each situation individually; continue to test for evidence of abuse and apply sanctions to that patient. It does not make sense to punish the innocent patients who actually need this medication.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484ff7841	Barry	None	2022-04-04T17:46:11Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Barry, William	l1k-z494-ktz3	False	None	False	2022-04-12 05:35:57.739	[]
3539	CDC-2022-0024-3545	https://api.regulations.gov/v4/comments/CDC-2022-0024-3545	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guideline and 2020 addendum have failed to address the needs of chronic pain sufferers in terms of offering a 'suggested' prescribing limit that morphed into a hard number. I had my medical regimen reduced 25% after the introduction of the guideline despite it allowing me to function, be whole, and have a limited social life. The guideline should NOT include any 'suggested numbers' for a dr. to prescribe to. Let our drs. feel confident in treating cpp to the best of their abilities without fear of repurcussions. We are not all the same thus our prescribing regimens will be different. To conclude, my community has suffered enough, let us be treated according to our circumstances, this has gone on far to long.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484ff780a	Morton	None	2022-04-04T17:46:24Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Morton, Richard	l1k-yl94-izs0	False	None	False	2022-04-12 05:35:57.987	[]
3540	CDC-2022-0024-3546	https://api.regulations.gov/v4/comments/CDC-2022-0024-3546	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My brother's suffering has increased a millionfold ever since the FDA clamped down on the prescribing of opioids for pain management. He is not a drug addict and if his fractured spine could be magically repaired he would never take a pain pill again.<br/><br/>His injury started when he was serving in the Army during the Viet Nam War. He was hit in the back by a projectile during a practice accident. As he has aged the damaged to his back has become more pronounced. He has tried all the usual prescribed treatments which include over the counter medications, chiropractic treatments, spinal injections, operations etc. Nonetheless, the pain is unbearable 24 hours a day and 7 days a week.<br/><br/>His wife has suffered with him because at least twice a year he has mentioned suicide. His pain was being managed by a pain specialist for many years, until the FDA put strict guidelines on number of pills allowed to be given in a month. His specialist has very strict guideline including monthly drug testing but even that has not been enough with the rigid FDA rules.<br/><br/>Our family is very angry that all opioid users are painted with the same brush as drug addicts. Nothing could be further from the truth. Finally, when a good friend of mine who has stage 4 breast cancer that has migrated to her bones has to beg to get opioids for relief, the regulations have gone too far. Fix this mess for sufferers and their families.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484ff77d8	Hardin	None	2022-04-04T17:46:43Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Hardin, Jane	l1k-yd8x-mzg7	False	None	False	2022-04-12 05:35:58.256	[]
3541	CDC-2022-0024-3547	https://api.regulations.gov/v4/comments/CDC-2022-0024-3547	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Due to my insurance company guidelines, I am being forced to taper long term opiates. Actually, they didn't even give me the opportunity to taper. When I tried to refill 100 mcg Fentanyl pages, I received a letter stating I could not exceed 200 MME/day. The pain condition I have came about in 1996 and has been chronic since. I have tried surgery, nerve blocks, infusions, injections, topicals, biofeedback, Physical Therapy and ultimately and successfully opiate therapy. Of course, I did not begin at 100 mcg of Fentanyl, but after many years that is the dose I am at and remain functional at. I work full time (at a desk job), I drive 50 miles round trip for my work and I live alone so I am responsible for getting groceries and maintaining the household. As a result of the "200 MME/day" rule, I will have to switch to 75mcg Fentanyl patches. This, of course, will result in withdrawal symptoms and breakthrough pain. I am scared to death of this taper process and fear I could lose my job and my home. I am drug tested on a regular basis and have always been careful and compliant with my medications. Please let it be up to the prescriber and patient as to if long term, higher dose opiate therapy is appropriate.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jody	None	None	0900006484ff7775	Carr	None	2022-04-04T17:47:03Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Carr, Jody	l1k-xvv8-aook	False	None	False	2022-04-12 05:35:58.498	[]
3542	CDC-2022-0024-3548	https://api.regulations.gov/v4/comments/CDC-2022-0024-3548	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted]. At the age of 26 I was thrown from as horse, collapsed a lung, and broke many ribs on my left side. In 2004, I fell approximately 20 ft and broke my neck, ruptured several disks in my spine. Since then I have problems breathing and it's not due to anything other than a collapsed lung and COPD. I'm in constant pain. Up until a few years ago I was unable to get any kind of pain medicine because doctors will not give it to me. I would do all the drug tests, urine, blood, follow all their instructions and they still would not prescribe pain medication. I recently found a neurologist that has helped me more than any other doctor in Oklahoma. Why is it so difficult for people like me with chronic pain? Thank you for your time.<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chad	None	None	0900006484ff839d	Black	None	2022-04-04T17:47:45Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Black, Chad	l1k-wtkl-anrw	False	None	False	2022-04-12 05:35:58.768	[]
3543	CDC-2022-0024-3549	https://api.regulations.gov/v4/comments/CDC-2022-0024-3549	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain since I was in 8th grade and I am now 40 years old. I had 6 knee surgeries, and only had one where something was repaired. I had surgery b/c they had no clue what was wrong. These surgeries led to more on other body parts b/c my gait hurt other areas. Then in 2002 I had my first migraine while trying to study at College, ended up in the ER because the pain was so bad. That was the first time I got treated like a drug seeker. I had never been to that ER ever and had never gone to an ER for a migraine, yet, they treated me like a heroin addict seeking drugs. I was scared and in a ton of pain, had visual disturbance, and was throwing up, and given Tylenol. That started my run of chronic migraines. By the time I was 22 I was having migraine 4--7 times a month, and at 32 (after having my child) I was graced with having 3-5 every week' some were so bad I was screaming in bed for days. Sometimes I had no choice but to go to the ER for dehydration from throwing up. I would beg my husband not to take me because I hated being treated like a drug seeker. I never asked for pain meds and never even mentioned them. But as always, they treated me like I was a drug addict. I was passed from doctor to doctor trying to find the cause of all these and why my migraines did not respond to triptans. I tried yoga, acupuncture, acupressure, PT, and even went to a Mind Body medicine specialist. I finally found a Neurologist that was willing to try off label things to treat me. They continued to get worse and worse. The CGRP inhibitors came out, and I thought, finally something is going to resolve these migraines; mine did not respond to them. I tried every single one that came out to prevent and treat migraines. I was finally passed to a neurologist that specializes in hard to treat migraines; he got use to treating these as he worked with military, active duty and veterans, that had migraines do to head injuries from bombings and also PTSD. He got me off all my migraine meds and we tried again with the common migraines and some other that were off label. He saw how much pain I was having. I became depressed and I was SURVIVING NOT LIVING; I was missing my daughter grow up. Then I began to have joint pain all over, GI issues, severe dry eye, severe dry mouth, and horrible fatigue. I finally had the correct blood work run by my new neurologist, and it showed I had autoimmune disease. I was then diagnosed by Ulcerative Colitis and Sjogren's disease. My rheumatologist said there was a very good chance that the knee pain I was having way back in 8th grade that no one could figure out why was probably the start of the autoimmune effects on joints. I was also suffering from migraines still at this time, and I was getting more depressed. I was loosing jobs because I would call out so much. I had a master's degree and could not use it because I was so sick. I was slipping more and more into depression because of that pain, GI issues, migraines, and not being able to participate in MY life. Finally the neurologist started me on opioids to help with the pain, since my new rheumatology medications were not helping with the pain (they were helping with other issues). I was finally able to get out of bed and move around without crying. I was still having 3-4 migraines a week and sometimes the migraines were back to back and I was in bed for Weeks. It finally has ended with me on a Fentanyl Patch with oxycodone as a rescue pain med. I am finally able to hold down a great job that uses my degrees, I can participate at my child's school, and watch her play sports. I can play with her and actually BE present in my marriage. I am by no means perfect on opioids (I still have 4-5 migraines a month lasting 1 or 2 days each) but I am finally able to LIVE. My depression has gotten much better now that I am happy and being in my family's life. People may look down on my for taking opioids and some doctor's think I need to come off them. My I am very responsible with my medications. I change my fentanyl patch as prescribed and take my rescue meds as prescribe. I never ask for medications early or try and get other ones from other doctor's. I work in healthcare and hold down a very good job. I lock my medications up in a safe so no one, especially my daughter, can get to them. She is taught not take medications prescribed to her. Opioids have saved my life, and I am not sure that is they were not and option that i would be here on this earth; I believe the pain would have become too much to manage. Opioid restrictions need to be loosened, as some people need them to live and function. My husband works in law enforcement and says that those that are addicts are going to find the drugs no matter what. The opioid restrictions have not helped that.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484ff70d4	Garbarino	None	2022-04-04T17:48:30Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Garbarino, Jennifer	l1k-rzwi-ugpg	False	None	False	2022-04-12 05:35:59.010	[]
3544	CDC-2022-0024-3550	https://api.regulations.gov/v4/comments/CDC-2022-0024-3550	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm sorry, but I have more to say. What is so frustrating and angers me, is that people who do not knkw what pain is, do not understand. When I say my feet are burning, or are so cold they hurt, so, they re burning,,what does that mean? Imagine having g the top layer of skin peeled off of the tops and bottoms of your feet, the having some one poring lemon juice on them, contstantly,,now,,THATS what burning in my feet is to me! And as for being g cold, bone hurti g cold, take a foot soaking container, put 4,5 dz ice cubes in it with half a gallon of water, now, out your feet in, and keep them there for 20 minutes!, Now, THAT'S the bone hurting cold I feel,,,now,,tell me to bear this pain without an opiod! People, drs included, have NO idea!,,,try treating g this pain with acupuncture, talk therapy, inserting devices into one's spine,,,it s ludicrous, that we have a drug that controls pain, and,,no one will Rx it,,,its like drs everywhere have the sword of Damocles hanging over them,,,THE DEA! Please, please please, get the DEA to ease up on drs who Rx for these drugs, and,,please please, please hurry.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484ff6f0f	Nawrot	None	2022-04-04T17:48:43Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Nawrot, Mark	l1k-pkc1-h56a	False	None	False	2022-04-12 05:35:59.259	[]
3545	CDC-2022-0024-3551	https://api.regulations.gov/v4/comments/CDC-2022-0024-3551	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is my second posting. I want to update my search for pain control. As you might remember, my dr of 24 yrs retired. She was Rxing 15 mg qd for my neuropathy, which is not enough at this point , I need 30 mg to cover pain for the whole month. But she would not go any higher. The new prescriber who took over her patients, will not ANY Rx s for any opiod...I have enough pills left for another 3 weeks, after thatI don t knkw how I will deal with the pain. My foot Dr recommended I go to the pain clinic in Ruch Oak Park hosp,he said,, they re prescribing,,,well, they re not. They wanted to do. Pain block, inserting a gadget into my spine. I am totally against that, on principle alone. Being diabetic it s not a good, safe idea to go doing an invasive procedure that could cause infection, and what they don t tell you, is that it only covers 50% of the pain, 60, if you re lucky. I asked my chiropractor if he had any thoughts on the matter, he said, well I ve known 7 people who have had it done, a d it only worked for 1 of then, and them, not well enough, she still had to be on pain killers. So,,,I went to another pain clinic, that , on their website said, they do do prescribing, as an adjunct. I made an appt, and they wanted to do implants too, and would not do just writing scripts. I reminded her of the 2016 "Guidelines" that said, any dr can write an Rx for an opiod upto 50mg,,,her reply,,,,Tell that to the DEA,,,,,drs are scared shitless of the DEA, feari g loosing their license, their livlyhoods! AND CHRONIC PAIN PATIENTS SUFFER! So e thing HAS to be done to get the dea off of drs backs! I CAN take more gabapentin to help with the pain when my norco ru s out, but then I'll be in bed 20 hrs a day. My dad is 94 and needs looking after, my sister, ad epstien bar virus, which morphed into chronic fatigue syndrome suffers from severe depression, we all live together, ,,,who is going to take care of them, the household, if I'm either in severe pain, or doped up from more that 1,200mg of gabapentin a day, getting g up only to eat, use the bathroom? I m already at the point of not taking care of myself, washing g up only every three days, brushing my teeth only every other day, and find it hard to do MY household chores, let alone do food shopping, cleani g, laundry for my dad,,and sister,,,I pray to God that I can find a dr who is not afraid of the DEA,,,a d help me with my pain, so that I can function,and have a so ewhat happy life,,,what's left of it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484ff68ec	Nawrot	None	2022-04-04T17:49:45Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Nawrot, Mark	l1k-oqv0-j7yt	False	None	False	2022-04-12 05:35:59.555	[]
3546	CDC-2022-0024-3552	https://api.regulations.gov/v4/comments/CDC-2022-0024-3552	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PKD, Degenerative Disc Disease, Chronic Kidney stones. Just the beginning. Refused any kind of pain medication. Told no ibuprofen or acetaminophen. Had to go to the street for pain relief after being send home with 2 stents in both ureters and 0 pain relief. Have been offered Haldol/ Benedryl for pain?!? This is barbaric and biderline malpractice.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leah	None	None	0900006484ff69c8	Cronk	None	2022-04-04T17:50:18Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Cronk, Leah	l1k-nab7-25my	False	None	False	2022-04-12 05:35:59.803	[]
3547	CDC-2022-0024-3553	https://api.regulations.gov/v4/comments/CDC-2022-0024-3553	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an attorney and I practice law in the State of Alaska. My dad was a physician and so was my grandfather but both have since passed on. My mom and my sister both taught clinical nursing and my mom is retired.<br/><br/>After the enactment of the 2016 Guidelines, I received several complaints from clients that suffer from serious chronic pain that their pain was not being adequately addressed in the community. Those that were being treated in the past were being told by their physicians that they would have to cut their use or be terminated from treatment. <br/><br/>I represented some of these people in guardianship proceedings, wills, estate planning and/or misc. civil proceedings. I listened to many complaints from my clients who were scared and frightened after being told by their physicians that they had to greatly reduce their pain treatment for long-term chronic pain problems. Many of the doctors that treated these patients were afraid they would be chastised by the DEA if they didn't bring their patients into compliance with CDC Guidelines of 2016. One physician with 45 years experience of in treating patients in [redacted], AK was shut down in 2018 by DEA.<br/><br/>I have observed since 2016, that many of these people who were once good patients of local doctors have either chosen to find doctors 150 to 450 miles away in [redacted] or [redacted] or have turned to buy drugs on the street that are illegal and very dangerous but offer them relief from their pain. Patients should not be put in a position to make such choices. Very few people would consider living life in severe pain preferable so their pain treatment falls under some CDC guidelines. Getting pain relief to be able to sleep or have dinner with your family should not be restricted to "one guideline fits all".<br/><br/>I ask the CDC to re-evaluate its restrictive guidelines of 2016. Persons with chronic pain should not be forced to seek street drugs to get a moderate amount of relief from their pain. Thank you for listening to my concern. Sincerely, [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph Raymond	None	None	0900006484ff683d	Skrha	None	2022-04-04T17:52:05Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Skrha, Joseph Raymond	l1k-eo5g-us7m	False	None	False	2022-04-12 05:36:00.042	[]
3548	CDC-2022-0024-3554	https://api.regulations.gov/v4/comments/CDC-2022-0024-3554	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC lacks statutory authority to write drug guidelines. FDA regulates drugs. CDC formed an illegal panel comprised of anti-addiction psychiatrists who had a goal of destroying the Sackler family, and their head advocate Andrew Kolodny is paid $500,000 a court case to testify. CDC lacks the medical expertise to write such guidelines and has harmed millions of pain patients while failing to make a dent in the nations overdose crisis. If anything CDC guidelines made overdoses WORSE. THe correlation between prescriptions and overdoses is negative. The fewer the prescriptions as you pursued and achieved, the more deaths caused by overdoses.<br/><br/>You have no understanding of basic human psychology.<br/><br/>It is sheer stupidity to attempt to control supply as history has shown with prohibition of alcohol. All this money wasted should have gone toward reducing demand, which actually works as seen with tobacco.<br/><br/>This has been purely a liberal drive to socialize medicine from the start.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6834	Anonymous	None	2022-04-04T17:53:10Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-dmz0-rx9i	False	None	False	2022-04-12 05:36:00.285	[]
3549	CDC-2022-0024-3555	https://api.regulations.gov/v4/comments/CDC-2022-0024-3555	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Help me, please. Help all of us in pain. The travesty to our health and well being, basic quality of life has been cruelly taken by our government. Government had NO PLACE IN MY DOCTOR'S OFFICE! I have suffered from terrible back and joint pain with muscle issues and nerve issues for over 20 years. I've been in pain management for 20 years and I am employed, work from home andI follow my pain management agreement consciously. I've had two major back surgeries so far and have had to beg for pain relief. I've been more fortunate than some. But I've been tapered from a dose of morphine that worked well for me down to a dose that is less than half and barely touches the pain (85mg) and now I have to take all the OTC pain meds and other additional prescription meds to try to make up for it because my doctor doesn't want the DEA to take away his license! He's a pain specialist for heaven's sake! The current dosage doesn't work, the OTC and other meds cost me much more and gives me stomach/liver problems. The doctors are scared to treat pain because some committee decides they should all go to jail rather than be compassionate and work with their patients to give them a shot at a normal life. Prices have gone up, there are almost no doctors willing to treat pain and how many of our law makers have any type of medical license? Why are they able to say what works for every patient? I was on a stable dose and it was ripped away from me. Leaving me in more pain. I'm no longer able to do many of the things I could do before when my pain was managed well. Let our doctors decide our medication tolerance and safety. Let us have a say in our treatment. Please stay out of my relationship with my doctor. Even my insurance company wants to have a say now...I was told I needed to DECREASE my medication even more before surgery so that 90mg equivalent would work for me post surgery. I was in hell. My loved ones had to argue with my doctors to give me more medication while in the hospital. When the doctor added just 5mg of Valium, it made a big difference but to my pain level but because the CDC recommends no Valium with pain meds, I had to give that up when I got back to my pain doctor. One of only 2 pain management doctors in the city of OKC after 2017. Please remove the mg equivalency and the recommended maximum dosage for chronic pain patients. Or lives depend on this medication. Many of us are able to work, take care of our families and pay our taxes so as not to be a burden on society. As my partner says, it is much safer to get my pain management from a pharmacy rather than the streets. Please don't make us go to the streets? Please stop listening to people who are only out to line there pockets. THERE IS NO OPIOID CRISIS! There is a mismanagement and misinterpretation of data. Please help us get the pain relief we need and stop the states from writing bogus laws which affect us so badly. Listen to the doctors who work with pain patients. HELP US HELP OURSELVES LIVE AS NORMAL A LIFE AS WE CAN! PLEASE?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M.	None	None	0900006484ff6918	Dvorak	None	2022-04-04T17:53:57Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Dvorak, M.	l1k-dj8o-t1be	False	None	False	2022-04-12 05:36:00.524	[]
3550	CDC-2022-0024-3556	https://api.regulations.gov/v4/comments/CDC-2022-0024-3556	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am happy that you are revising the CDC Clinical Practice Opioid Prescribing Guideline, BUT I have severe Restless legs syndrome (RLS) and buprenorphine is the only drug that has been able to help me - the Guideline draft does not address chronic conditions like RLS that are different from chronic pain. RLS is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, and these symptoms have ruined my career. I have recently been awarded Social Security Disability due to RLS.<br/><br/>There are approximately 12 million people in the US who suffer from RLS, and there is NO CURE. I took various dopamine-related drugs for 10 years, and they helped to relieve the symptoms for a while, but after 7-8 years, these same drugs started to work against me - they made my symptoms worse. About this time (2018), I found an RLS specialist at the Yale University Sleep Center, and he saved my sanity and perhaps my life by prescribing a low-total-daily-dose opioid to treat my severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. BUT in an ironic twist of fate, the 2016 CDC Opioid Prescribing Guidelines made physicians afraid to prescribe opioids for ANY reason, even for patients like me who suffer from severe, unrelenting RLS. Before I found my RLS specialist at Yale, my doctors in Boise Idaho made me feel like "opioid" was a dirty word. They made me feel like a street using junky if I even suggested help from an "opioid". And here is the REAL IRONY. The "strong" opioids like methadone and buprenorphine that actually help RLS require a special license to prescribe, but these drugs don't even give the user a euphoric high like the supposed "lesser" opioids. People that want to abuse opioids for a euphoric high are actually interested in the "weaker" opioids like norco or OxyContin - any any doctor can prescribe these. Ha! It is laughable, really. It is all backwards.<br/><br/>I hope you will amend the Opioid Prescribing Guideline so that it addresses chronic conditions like RLS that are different from chronic pain. Also, you should consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cornelius	None	None	0900006484ff681a	Hofman	None	2022-04-04T17:54:27Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Hofman, Cornelius	l1k-9nex-t91f	False	None	False	2022-04-12 05:36:00.801	[]
3551	CDC-2022-0024-3557	https://api.regulations.gov/v4/comments/CDC-2022-0024-3557	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a severe back injury. The insurance company refused permission for surgery for 3 years. Finally, I was approved but my spine was in such bad shape, I was almost paralyzed. My spinal cord was being ground between 2 vertebrae because my disc was gone. I had another spine surgery 5 years later. In 2012 during my pregnancy, I was diagnosed with stage 3 breast cancer, not able to take chemo until my son's birth. I've had masectomy after 2 years of chemo. I'm in pain every day from back injury & cancer. I was prescribed fentanyl since I couldn't swallow pills. This past year, I lost 3 pain management drs due to insurance changes and war on opioids. I spent weeks in ER detoxing because I couldn't find a Dr to treat my pain. Even tho I'm a VFW VET, the VA won't treat me....I need to be off pain meds for 2 years before being a patient with their clinic. I'm 50 yrs old with 7 kids & grandkids. Im used to a very active lifestyle gardening, camping, fishing, arts& crafts, home remodeling, traveling....none of that possible today because my pain keeps me in bed. My lack of movement & quality of life is the fault of politicians who say my life is not important because I'm in pain. Shame on you. When I served my country willingly as a [redacted] in Desert Storm, I fought for you...not asking for anything in return. Now I'm begging, please don't do this. I have alot of living left.<br/><br/>[redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Veronica	None	None	0900006484ff6819	Gay	None	2022-04-04T17:56:24Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Gay, Veronica	l1k-9j1i-y78h	False	None	False	2022-04-12 05:36:01.043	[]
3552	CDC-2022-0024-3558	https://api.regulations.gov/v4/comments/CDC-2022-0024-3558	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow Opioids for Restless Leg Syndrome!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484ff6810	Hash	None	2022-04-04T17:56:36Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Hash, Richard	l1k-8vk1-35g1	False	None	False	2022-04-12 05:36:01.298	[]
3553	CDC-2022-0024-3559	https://api.regulations.gov/v4/comments/CDC-2022-0024-3559	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve had moderate to severe chronic pain for more than six month. I understand the concern of the real opiod crisis, but I’m of the opinion that the pendulum has swung 180 degrees. Many death related to overdoses are related to black marked purchases, many of them contain fentanyl, resulting in many patients having live day in day out with moderate with severe pain <br/><br/>My pain at times is severe, it’s debilitating. I’ve never abused opiods , Tradol is about as effective as Tylenol-which has never even giving me any relief. I had a stroke 2 years ago and I’m on Placid. According to my neurologist I can not take even 1mg of NSAIDS. But because I need some relief, I resort to NSAIDS. I see no way out—it’s so debilitating, I don’t want to go on with my life if I’m in that much pain the rest of my life-currently there is no hope for me and millions of others. It’s absurd that only patients with cancer can get opiods, but no patients with moderate or severe chronic pain can not under your current guidelines. <br/><br/>Under a pain doctors care, patients with chronic to better opiods than just Tramadol. In addition, the doctor can monitor opiod use, after all the government keeps a data base of every opiod prescribed, so it’s easier for doctors and pharmacist to monitor usage as well as doctor shopping. <br/><br/>I would like the rest of my life being able to lead a full life. I highly recommend the CDC to make smart changes. <br/><br/>I thank you very much	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484ff680e	Roth	None	2022-04-04T17:56:53Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Roth , Marie	l1k-8rn3-9ggu	False	None	False	2022-04-12 05:36:01.538	[]
3554	CDC-2022-0024-3560	https://api.regulations.gov/v4/comments/CDC-2022-0024-3560	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mother had breast tissue removed yesterday as a preventative for another future mastectomy in outpatient surgery. She was told to take Tylenol and/or ibuprofen for the pain. She is 75. She is extremely uncomfortable and the way I see it, she was left to suffer unnecessarily. Why? This is barbaric. How many more people is the CDC comfortable with hurting? What reasonable explanation can there be for this suffering. It’s unjustified. Please rescind your harmful and deadly guidelines. Too many lives are being harmed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amparo	None	None	0900006484ff680a	Chavez	None	2022-04-04T17:57:10Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Chavez, Amparo	l1k-8p5g-no04	False	None	False	2022-04-12 05:36:01.796	[]
3555	CDC-2022-0024-3561	https://api.regulations.gov/v4/comments/CDC-2022-0024-3561	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I’m writing to you to comment on the CDC guidelines.<br/><br/>First thing that I would like to speak on is something that makes me upset is how my brother is dying of cancer and in so much pain but the only pain medication the doctor will give him is Tylenol with codeine 2 mg that is not helping him at all. I just don’t understand how that is right or fair. <br/><br/>My involvement in this is that I have a relative that has had their medical license under suspension.<br/><br/>He is a doctor in Illinois and through close contact with him I know of his dedication to his patients. He had a small practice of not more than 130 patients. 70 or 80% of these patients were getting the drug buprenorphine. The average time people were with him was five years. They saw him for an hour every month. Besides being an excellent family practice doctor he is a skilled psychotherapist.<br/><br/>So, to be clear 70 or 80 patients trying to recover from addiction on buprenorphine were put out on the street overnight.<br/><br/>His goal was to treat everybody that came in his door. He stuck with patients over the years, some very difficult patients and for this he’s being punished.<br/><br/>From what I understand without the CDC guidelines of 2016 his situation probably would not of happened despite the fact that the DEA has been doing similar things long before the 2016. However as you know, and as you now realize, your guidelines were used to prosecute doctors. You are now trying to fix that and I applaud that.<br/><br/>Bottom line is:<br/><br/>1-if I would have my way I would prefer that you just simply go moot on the subject and not publish new guidelines.<br/><br/>2-given that that’s not going to happen I would want that no mention of MME’s be made. No matter how you state it or how many disclaimers you make I am certain that law-enforcement will take it to heart and just establish a new benchmark that is even lower, that it’s going from 90 to 50. If you don’t understand that then things are just hopeless.<br/><br/>It is my understanding that the whole idea of MMES is dubious. I’ve learned there’s little in the literature that supports the idea.<br/><br/>There should be no mention of the limit of days you can prescribe opiates. Stay out of the doctors office. Stay out of the physician patient relationship. Bureaucracies love numbers and rules. Guidelines are fine, goals are fine but anything that hints of some thing that can be turned into a rigid limit is anathema.<br/><br/>All of the above is to say nothing of the people I know that are being denied pain care. This is inhumane and a disgrace on the nation.<br/><br/>Thank you and sincerely<br/><br/>A concerned Citizen	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelly	None	None	0900006484ff6805	Lupo	None	2022-04-04T17:57:42Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Lupo, Kelly	l1k-8c7h-f5n9	False	None	False	2022-04-12 05:36:02.047	[]
3556	CDC-2022-0024-3562	https://api.regulations.gov/v4/comments/CDC-2022-0024-3562	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	From 2015 to 2021, I took opioid without upping dose to relieve spinal stenosis by a physiatrist to remain functional. I had surgery and could discontinue opioid. Unfortunately, the pain returned and intensified after 6 months. I consulted a neurosurgeon and waited for 6 months before he told me that opioids were NOT effective for chronic pain! Another 6 months passed before another neurosurgeon told me they were effective, but he could not prescribe them. This was to postpone an inevitable spinal fusion. Additional expense was needed to get another doctor to prescribe opioids and I remained in pain for over 1 year with uncontrolled pain simply because I could not find anyone who would prescribe a proven opioid drug regimen that worked for me! My primary care doctor can only prescribe 1 month of opioid per guidelines, but other drugs I need I can get a 90 day supply. I was asked to sign a drug contract and provide urine to prove I would not abuse drug even though doctor knew I was not likely to abuse it. I must submit to a drug monitoring program and provide identification. The assumption is I will abuse the drug and I must prove I will not - which is impossible. My doctor states I must see him every month to monitor my usage - an additional expense and barrier since I have mobility issues. Strangely, I can buy alcohol - a known additive substance - anytime, anywhere, for any reason, and for unlimited amounts. I ask that I have the same option to obtain an opioid that has been proven to work to control pain and keep me functional. The hassle factor is very expensive, unwarranted, and counterproductive for chronic pain patients!<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006484ff67fd	Cleveland	None	2022-04-04T17:58:12Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Cleveland, Carol	l1k-7n9b-wdeu	False	None	False	2022-04-12 05:36:02.305	[]
3557	CDC-2022-0024-3563	https://api.regulations.gov/v4/comments/CDC-2022-0024-3563	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Two years ago, I was struck down with debilitating lower back pain. I could barely walk or sleep. After 3 weeks of hellish pain, I felt I needed to go to the ER. I was diagnosed with spinal stenosis. I was sent home with no medications and I had to 2 weeks to make an appointment with physical therapy. I was also referred to a "pain management" specialist. I was prescribed many anti depressants and other drugs that were not only ineffective for the severe pain but had horrific side effects. Physical therapy did not help and in some cases made the pain worse. I tried accupuncture which did not provide any relief either. 4 or 5 months later, after not getting any better, I called the doctor at KP and got transferred to the attending nurse. By this point I was desperate and on the verge of a mental breakdown. I couldn't walk, take care of my basic needs and I couldnt sleep because of the pain. I was sobbing when I was on the phone asking her to please help. I will never forget her cold indifference when she said, " We can't help you". One year into my ordeal I considered suicide as a way out. I'm only 45. I wanted a gun very badly. Instead, my survival instinct kicked in and I took risks going out of the country to get humane medical care. I am much better now I can work and provide for my family. I curse your guidelines for taking away humane health care in this country and leaving the sick, vulnerable and elderly in such despair. Do the right thing and abolish these nightmarish policies. Attached is a letter I received from the medical organization I am insured through explaining that the CDC Guidelines are the reason for denial of pain care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M	None	None	0900006484ff67f7	Basurto	None	2022-04-04T17:59:33Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Basurto, M	l1k-6umf-b88i	False	None	False	2022-04-12 05:36:02.559	[]
3558	CDC-2022-0024-3564	https://api.regulations.gov/v4/comments/CDC-2022-0024-3564	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As someone with a family member suffering from under-treated chronic pain, the effects of new guidelines further restricting access to pain relief would be absolutely devastating to me and my family as well as the families of so many others living with painful diseases. Under-prescribing for acute and chronic pain causes those affected to live in a constant state of fear and agony, unable to have the quality of life they deserve and could be having with proper pain control. Pain patients deserve more compassion and less villainization within our healthcare system. I truly hope you will find it in your hearts to recognize that there are so many people who need your help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff67e3	Anonymous	None	2022-04-04T17:59:43Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-6dcf-s6w5	False	None	False	2022-04-12 05:36:02.800	[]
3559	CDC-2022-0024-3565	https://api.regulations.gov/v4/comments/CDC-2022-0024-3565	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC:<br/>The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe and have extensive clinical and cost-effectiveness data.<br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of [redacted]s own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. <br/>Sincerely,<br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484ff67be	Cabaret	None	2022-04-04T18:00:31Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Cabaret, Joseph	l1k-4vl4-r847	False	None	False	2022-04-12 05:36:03.051	[]
3560	CDC-2022-0024-3566	https://api.regulations.gov/v4/comments/CDC-2022-0024-3566	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am [redacted]’s mother and I have watched him suffer for 18 years. He has not been able to work for at least 18 years nor has he been able to do much around the house or participate in his daughter’s life. It is very hard for me to listen to him cry or talk about suicide. I always do what I can to help him. He has never abused opioids. He lies down probably 90% of the day. Travel is out of the question. I understand trying to control the opioids but please don’t take them away and punish the ones who really need them. Thank you for what you can do. To see my son have a better life is everything to me. [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff679a	Jelinek	None	2022-04-04T18:01:11Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Jelinek, Mary	l1k-3eqq-bzny	False	None	False	2022-04-12 05:36:03.299	[]
3561	CDC-2022-0024-3567	https://api.regulations.gov/v4/comments/CDC-2022-0024-3567	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My grandpa passed away a few years ago at 87 yrs old. You need to understand how hard he worked his entire life to fully appreciate the inhumane treatment he endured during the last few months as a result of the restrictive guidelines imposed on opioid prescriptions. <br/><br/>He was a veteran of the Korean war. He was a farmer and rancher on 300 acres. When the cattle market was booming in the late 60’s he borrowed the money to lease a couple thousand acres and buy the cattle for the lease. He was in debt to the bank for almost $1 million when the market busted in the early 70’s. Believing bankruptcy was dishonorable, he went to work as a long haul truck driver and over the next few years paid back the entire debt. He drove the truck Mon-Fri. On Friday evening he returned to his small farm to tend cattle and farm wheat. During planting or harvest season I witnessed him drive an open top tractor the entire weekend only coming down long enough to eat, then back on the truck Mon morning. He didn’t retire until 70. Beat colon cancer in his 70’s. Survived a quadruple bypass in his 70’s. Alzheimers struck at 83, nursing home at 86. <br/><br/>How much general body pain do you think he had after working his ass off for 70+ years? I guarantee you it was more than a Tylenol 4 or OTC ibuprofen could ease. The last couple years if he was awake he was hurting. Nothing specific, just the pain of a worn out body. I begged his doctors to prescribe something for his pain that was stronger than ibuprofen. They always refused and followed up with a lecture about the addictive nature of prescription pain relievers while treating me as though I made the request so that I may suck the opioids from his veins. Pardon my language, but are you f---ing kidding me? 87 yrs old, less than a year to live because of a failing heart and the doctors were using addiction as an excuse to refuse easing his aches and pains? He suffered til the very END. <br/><br/>Let’s be honest and real for a moment – what if he had become addicted during the last 1 or 2 years of his life?! The ONLY concern should have been for his QUALITY of life because quantity was a non-issue by that time. Never mind that pain medication is one of the cheapest prescription drugs on the market. And if he spent the last couple years of his life feeling a little buzz from opioids while they relieved his physical pain – that is the very least of the respect and empathy he was due. <br/><br/>Perhaps the sickest part of those guidelines is that they were put in place because of your supposed concern for the overdose deaths caused by the “opioid epidemic”. I can’t help but wonder, if you were so very concerned about overdose deaths – why the hell did you set up ridiculous criteria for doctors to meet before they can prescribe suboxen?! <br/><br/>It is impossible for those seeking help to find a doctor to treat opioid addiction thanks to the limits you’ve placed on the number of prescriptions a doctor can issue. You people could not have set up a more counter intuitive, oxymoronic system for those who NEED help, if you had 50 experts working around the clock to do exactly that.<br/><br/>Since putting the guidelines in place, the NIH is learning that many if not the majority of the overdose deaths resulted not from prescription opioids but were instead the result of pills sourced on the street which were laced with fentanyl by the cartels. While I’m saddened for the families of those who died of overdose, it does not justify the outcome. Legitimate chronic pain patients are now forced to suffer every day so that you may pat each other’s backs for attempting to save the lives of criminals who were illegally buying, selling, and using street drugs. It is inhumane. And it is not government’s job to protect people from themselves. <br/><br/>One day in the future, doctors will look back at this time in history and they will be shocked by the barbaric treatment of people who suffered daily in pain. Everyday I pray for a future where bureaucrats and politicians actually do more to help people than they do to hurt them. Or at the very least, just stay the hell out of the way and allow people to help themselves.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	CJ	None	None	0900006484ff678f	Stewart	None	2022-04-04T18:01:59Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Stewart, CJ	l1k-2ym3-s68m	False	None	False	2022-04-12 05:36:03.539	[]
3562	CDC-2022-0024-3568	https://api.regulations.gov/v4/comments/CDC-2022-0024-3568	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a multiple time cancer survivor, plus multiple surgeries in the past 25 years, I suffer chronic pain. To add insult to injury, I suffer from back pain. I found out that I have scoliosis which was never diagnosed as a child. In order to function and live the life I battled so hard to have, I need pain medications (opioids)to be able function and enjoy life. I am unable to take NSAID’s because they cause my colitis to flare. If I were unable to have these medications prescribed I’d be lying on the couch because I wouldn’t be able to function.<br/>If I wanted to move to another state to be near one of my children, I might not be able to since I might not be able to have my medications prescribed. Each state has different rules and regulations for the use of pain medications. <br/>These regulations are unfair. Each person is different and these regulations don’t take that into account.<br/>It isn’t right that a person who needs pain medications in order to function, be penalized because others have abused these drugs. <br/>My husband recently retired. We always planned to take a car trip to see the states. But even that can’t happen the way we planned because I need to be seen every 28 days. So, not only am I being penalized but so is he.<br/>It seems ridiculous that there are medications that can alleviate pain, but it is so difficult to have them prescribed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rita	None	None	0900006484ff6783	Burfitt	None	2022-04-04T18:03:45Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Burfitt, Rita	l1k-2cnn-4dcc	False	None	False	2022-04-12 05:36:03.786	[]
3563	CDC-2022-0024-3569	https://api.regulations.gov/v4/comments/CDC-2022-0024-3569	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started RLS symptoms five years ago. My PCP prescribed Pramipexole to help relieve my symptoms. It worked for awhile, but my symptoms returned, in turn, my PCP increased my dose which again helped for awhile. I then started having symptoms during the day and night. Doing research, I found out I went into augmentation. My PCP thought that increasing my doseage would improve my RLS, but it made it worse resulting in augmentation. I am now doing well on a low dosage of methadone which is now the most used medication for individuals with refractory RLS. We need all the support we can get in support of using low doses of opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joanne	None	None	0900006484ff78f5	Correll	None	2022-04-04T18:05:14Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Correll, Joanne	l1l-0nv8-8r0q	False	None	False	2022-04-12 05:36:04.029	[]
3564	CDC-2022-0024-3570	https://api.regulations.gov/v4/comments/CDC-2022-0024-3570	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Individual care has been tarnished. Doctors are hesitant to prescribe anything for pain that qualifies as an opioid. Despite the thousands of years of safe treatment and no better options for some patients. Please let doctors do their job and what’s right for chronic pain patients. Our fate is in your hands, have compassion please!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6761	Anonymous	None	2022-04-04T18:06:05Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-1ejo-bdbt	False	None	False	2022-04-12 05:36:04.276	[]
3565	CDC-2022-0024-3571	https://api.regulations.gov/v4/comments/CDC-2022-0024-3571	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Registered Nurse, I find it frustrating that patients who have chronic pain disorders are unable to find a MD to pain medication, as MDs are afraid of the repercussions since the change of law in 2016. I can understand MDs not prescribing opiates to drug-seeking people at the ER or treating those with temporary painful injuries to prevent addiction to opiates. But what about those people who actually need pain medication due to cancer symptoms, fibromyalgia (FM), RSD, etc? <br/>My girlfriend [redacted], is a good example of a patient with chronic pain who needs pain medication but cannot find a doctor to prescribe it and her physical health and mental health has gone down rapidly since 2016 CDC opiate revisions. She has fibromyalgia and RSD - a little understood nerve pain disorder that causes her excruciating constant pain that apparently feels like electrical shock running throughout her body. In addition, she has two broken ribs from a male ER nurse assaulting her in 10/21. She had an appointment with a physiatrist (a doctor specializing in tissue and bones) close to a year ago and then last month/ after attack and he said she'd never be the same as the two ribs broken have small shards of bone that won't heal properly. <br/>I have witnessed the symptoms of pain on the many visits to her house, seen her tensing her body, clenching her teeth, uncomfortable and needing to change position and lie down after sitting up in her power chair, crying out in pain and close to tears (her aides have seen her cry - she tries not to), at times not being able to speak, and short of breath after her rib injury. The painful conditions mentioned above have greatly contributed to her disabled condition, now reliant on a power chair since 2018, and pretty much bedridden. I knew her before this and have seen her gone from walking around to barely able to stand. <br/>A professor who teaches nursing at [redacted], [redacted], says from her prior experience being a hospice nurse that many of her patients, such as those dying with cancer, exhibited signs of intense pain such as "white-knuckling it". She tried to advocate for a patient in that exact state, but all the doctor did with that information was order a CT scan and did nothing to try and alleviate his pain. <br/>The CDC aren't a group of doctors. Should doctors be afraid to use their best judgement and after seeing the undeniable signs of intense and chronic pain diagnoses prescribe opiates cautiously to those who truly need it? I think not. Please allow doctors to make considerations for patients who truly need better pain management/ those chronic pain disorders in which lesser pain medications just aren't cutting it - after trialing less addictive/ non-schedule 4 drugs, of course.<br/>Thank you,<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katrina	None	None	0900006484ff6758	Krech	None	2022-04-04T18:07:15Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Krech, Katrina	l1k-0vtf-pfx8	False	None	False	2022-04-12 05:36:04.561	[]
3566	CDC-2022-0024-3572	https://api.regulations.gov/v4/comments/CDC-2022-0024-3572	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I have been suffering from chronic pain caused by 4 herniated disc’s that are pressing on nerves in my back. I have severe low back and leg pain along with numbness and burning. These conditions have caused me to lose work, spend less time doing things with my family and difficulty performing every day life duties. I have put off surgery because of fear that the surgeon won’t offer pain control following the surgery. I can’t be put in that position as I suffer enough with the little pain control that my doctor is allowed to prescribe now. The cdc guidelines make it difficult for pain patients across America with the strict guidelines they put in place and the fear that they put into pain doctor’s who prescribe medications that are helpful to us. This is complete nonsense. Without pain medicine, I honestly would not be able to function at a rate that my employer requires me to. This in turn would cause me not to be able to work and provide for my daughter. Please reconsider your guidelines!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6750	Anonymous	None	2022-04-04T18:07:30Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-0ofh-a5cb	False	None	False	2022-04-12 05:36:04.806	[]
3567	CDC-2022-0024-3573	https://api.regulations.gov/v4/comments/CDC-2022-0024-3573	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Help US, Please!!<br/>These horrible so called guidelines are killing Chronic Pain Patients. <br/>I don't care where the pain comes from, a car accident,, work injury disease process or all of the above,by not treating, our pain,, you are literally taking our lives.<br/>We cannot function to perform daily tasks, such as cooking cleaning and personal hygiene. Let alone work for wages.<br/>I was a very good surgical nurse when, for doing nothing other than my job, I was hurt moving a patient .<br/>Tried to shrug it off and carry on, but no!! Blew 3 disc in my back and separated my SI joint. Tried all other modalities since 2007. PT, nerve ablation surgery, so many injections, I Cannot have any more. Acupuncture, Acupressure, hypnosis, EVERYTHING!<br/>Finally found a PM Dr who helped me with opiods. Wow. Why was I so hesitant. To try them. I was back at work, not in surgery/patient care, but still an RN and helping patients.<br/>2016 guidelines came, Poof, there went my career! No more medication, just go home to sit in misery on a daily basis.<br/>I have no social life, I don't go anywhere but 1 x a month I see my grandma it's, that live less than 20 miles from me, but I can't ride in the car that long many times.<br/>Thus has stolen everything from me!!<br/>Had a wonderful life, now it has turned to absolute crap!<br/>I truly understand these people who contemplate suicide or who have done it.<br/>I too, have thought about it on days I haven't slept for almost a week. Sobbing on the floor in the bathroom so my sweet Husband doesn't hear me.<br/>This is what you forced a good person, great Nirse, wonderful mom and grandma to.<br/>Hope you are F$@^#_<> happy and are able to sleep at night.<br/>Stop the madness!!<br/>No MME. It is junk science put forth by the slimey PROP conflict of interest Maniacs!!<br/>Just stop.<br/>Get out of medicine. You don't have a medical degree and are NOT a pain management Dr.<br/>CDC just needs to stay in their lane of infection diseases, although you guys did such a GREAT job messing up Covid, maybe we should abolish you! <br/>Cancel CDC like they canceled pain patients!<br/>Now that's something I could get behind, if I could get off the bathroom floor!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6468	Anonymous	None	2022-04-04T18:08:00Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-09cl-yg5h	False	None	False	2022-04-12 05:36:05.056	[]
3568	CDC-2022-0024-3574	https://api.regulations.gov/v4/comments/CDC-2022-0024-3574	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Almost all my family members and some relatives suffer from RLS with no medication that can help us sleep and have a normal and stress-free life. I am taking Advil and nerve pain medication daily but am sure opioid therapy can help the quality of my life and sleep significantly. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lale	None	None	0900006484ff6456	Moradpour	None	2022-04-04T18:08:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Moradpour, Lale	l1j-zg11-hyfg	False	None	False	2022-04-12 05:36:05.299	[]
3569	CDC-2022-0024-3575	https://api.regulations.gov/v4/comments/CDC-2022-0024-3575	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just want to say that trying to reduce the amount of pain medication that’s been prescribed to people that have been on the medication for numerous months or years is not a good idea. We know that some doctors profiting greatly have made this into this problem we’ve all been seeing and hearing about. That’s where it has to be resolved at. If you cut off medication that has been going on like I said ,then you and most people know what kinda dark and deadly world they will go to. We’ve already seen the effects caused from tighter restrictions that have been requested. You can’t punish people that are trying to make themselves comfortable or get some relief for their pain issues that they were told by a doctor to take. These actions that have been put in ,have resulted in regular people thinking that they are druggies and have them worried crazy what is going to happen to them and there’re life the next doctor appointment and deterring others to go to the street. Sorry , But THATS not a solution, it’s a far more bigger problem and even a death sentence to some unlucky people. The rules put in place have helped a lot , let’s not just push it anymore and have a huge problem with illegal opioids because it will never end to who you’re trying to control with this idea ,as stated before it needs to start at the head of the problem because these seekers,dr shopping, addicts, they will move to the next couple options for themselves and then we’ll all have to govern whatever they are doing to overdose,steal, or just makes them be a menace to society. And doin so , put another wall up for the American people that are the ones who get punished.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6381	Anonymous	None	2022-04-04T18:08:39Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-yd56-85bj	False	None	False	2022-04-12 05:36:05.539	[]
3570	CDC-2022-0024-3576	https://api.regulations.gov/v4/comments/CDC-2022-0024-3576	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Line 2110 states, " Evidence is limited for many of these procedures". It is misleading to use a blanket statement to comment on the efficacy of a myriad of interventional pain medicine techniques. While steroid injections are archaic, newer methods including radiofrequency ablation, peripheral nerve stimulation, spinal cord stimulation with the newest waveforms (HF10, DTM, and burst), as well as minimally invasive surgeries all have good to robust evidence for their use. <br/><br/>If the goal is to use a "multimodal" approach to the rationale treatment of pain in the U.S., interventional care needs a prominent role.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrew	None	None	0900006484ff637e	Porter	None	2022-04-04T18:08:57Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Porter, Andrew	l1j-y68e-98vj	False	None	False	2022-04-12 05:36:05.784	[]
3571	CDC-2022-0024-3577	https://api.regulations.gov/v4/comments/CDC-2022-0024-3577	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider low opioid medications for Restless Leg Syndrome. It's a miserable condition and can be very disabuilitating. People that suffer with this deserve some kind of relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6361	Anonymous	None	2022-04-04T18:09:04Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-xaf5-bkby	False	None	False	2022-04-12 05:36:06.031	[]
3572	CDC-2022-0024-3578	https://api.regulations.gov/v4/comments/CDC-2022-0024-3578	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 35 year old woman, who has been suffering for nearly 20 years with endometriosis and interstitial cystitis. I have spent thousands of dollars (with insurance) on specialists, physical therapists, surgeries with the most skilled surgeons in the US, numerous diets, etc. I have been or nortriptyline, muscle relaxers, NSAIDs, 10 different birth control pills, medicinal marijuana, massages, TENS machines, and instilled medications directly into my bladder with only mild success. <br/><br/>The only thing that has helped me has been legally prescribed and monitored opiates. I have taken these as needed for over 10 years responsibly and without issue. I have no history of addiction, no criminal record, and otherwise am an upstanding and contributing member of society. Taking opiates, responsibly, has given me my only real relief from the pain and the ability to participate in activities with friends, family, and for work, and allow me to live my life. It is hard to convey what chronic pain is like to those who have not experienced it, because their perception of pain is based only on their own experience. I have lay awake at night, screaming out of my lungs, curled up into a ball from the pain. Pain that is like someone shouting in your ears at all times of the day, pain that makes you desperate to make it stop-even if that may be ending things. <br/><br/>I wish we had cures for some of these chronic illnesses and diseases, but unfortunately we do not. To resign individuals with legitimate conditions to suffer a life in pain is not reasonable. Legally prescribed and responsibly used opiates for diagnosed conditions should not make a patient feel like a criminal. I urge you to please keep this in mind when making your decisions. The voices of those who have loved ones impacted by drug abuse and overdose is loud, but our voices as patients have been drowned out. As access gets tighter and tighter, more desperate patients in pain have started going to unregulated options like kratom that have more risk of being contaminated and abused. Please remember us	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484ff6352	Gates	None	2022-04-04T18:09:18Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Gates, Sarah	l1j-x2hc-sqpn	False	None	False	2022-04-12 05:36:06.272	[]
3573	CDC-2022-0024-3579	https://api.regulations.gov/v4/comments/CDC-2022-0024-3579	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello I am asking the CDC to please throw out the whole guidelines .and my reason for this is because opioids should be between the patient and the Dr not no guide lines .since the 2016 guidelines my health has went down hill .I'm 43 years old and I have ra graves dieases 7 server heart dieases.i have COPD asthma and interstitial lung dieases .I have 1 disc left in my back .I can't have surgery because I carry a blood clot disorder and Drs are scared plus I'm not doing if they did ..I took steroids injections for two years than one week after I stopped I was took to the hospital I had blood clots in both lungs ..4 different times I have had a heart attack because of pain and my meds being lowered .I both on both long acting and short acting for 25 years never had a issue .never failed a pill count or pee test .I have serve dibeates ..I have been through alot .it's not fair to me that I'm dieing in horribly pain ..I can't even get out my bed when I was on high dose I could do household chores I could go shopping I could work I could be with my kids now I feel bad and I feel like a burden on my family and yes sometimes I can't take the pain and just like every one else I wonder what it would be like if I end it all .but I hang on hopeing that this would all change .my dad took his own life because he couldn't live with the pain no more and I know what he put me through I couldn't do that to my kids . please I'm begging u ..the people are begging u either fix these guidelines or get rid of them ..this has been a horrible effect on everyone primary care Drs are there to help but now they won't because of the guidelines .we have veraterns and chronic pain people killing them self every day because they are suffering .I know people who have cancer that are now on heroin for pain and taking a risk every day because Drs through them to the st..this is not fare ...I have one question how come if u are on addict u can get your meds every day no questions asked but someone who is really sick has guidelines and rules does that make since no it don't I see plenty of people abusing their meth or sub s selling them but there is no rules on them they even keep u in the clinic for years to get that money ..it's sad very sad ..please take all mme the 50 mme and 90 mme out of the guidelines or just throw the whole thing out .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484ff634e	Guthrie	None	2022-04-04T18:09:33Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Guthrie, Melissa	l1j-wz9l-vdo3	False	None	False	2022-04-12 05:36:06.516	[]
3574	CDC-2022-0024-3580	https://api.regulations.gov/v4/comments/CDC-2022-0024-3580	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Fibromylgia,stenosis,bone spurs in my back,buldging disks,RA, amongst many other things wrong with me. I'm a shell of a person,extremely Exhausted all the time all what I've gotten prescribed were medications that messed with my mind, absolutely no pain relief, I'm talked to and treated awful from specialists that are supposed to relieve my pain and they blame each other so I'm running from specialist to specialist to my primary, and the ER is just as bad. I'm tired,I'm a shell of a person, I can't work 90% of my life is in my bed or the couch. Honestly my life isn't worth living anymore, opioids aren't even prescribed where I'm a patient! And if I ask I've had Dr's drop me as a patient! Inhumane treatment. I don't even leave my house anymore and I have zero trust with Dr's here. At this point I'd try dog poop on a spoon if it were to relieve any of my pai . I'm only writing this because maybe it will help someone else,because I'm not gonna be around much longer!<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Connie	None	None	0900006484ff6341	Curry	None	2022-04-04T18:10:05Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Curry , Connie	l1j-w7uc-22nj	False	None	False	2022-04-12 05:36:06.768	[]
3575	CDC-2022-0024-3581	https://api.regulations.gov/v4/comments/CDC-2022-0024-3581	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is [redacted]. I have been a chronic pain patient since 2006 when I left my career to start the long journey of finding out what was wrong. I have a long list of rare conditions, such as Ehlers danlos syndrome, achalasia, .multiple autoimmune disorders, degenerative discs, stenosis, spondylitis, afib, optic neuritis, bleeding disorder, thoracic outlet, just to name a few. I just had my 67th major surgery!! That doesnt include hundreds of minor procedures. During my last 2 surgeries, which were back to back spinal fusions because the hardware was coming out at 8 wks, the hospital offered me tylenol for my SEVERE PAIN. I'm on percocet at home, just so I can get out of bed and function, try to take care of my family and home. But I'm still in severe pain. And every time I have surgery, the surgeon doesnt give pain meds and then I'm left suffering In ACUTE PAIN for weeks. People that abuse drugs, or abuse their medicine that the Dr prescribed, have made it very difficult for us chronic pain patients. I take my medication exactly as prescribed and i need it to handle the severe pain. It doesnt stop it, but it helps me be able to get up and complete some tasks. When you have pain and take medication as ordered, you dont get high or addicted. It goes to treating the pain. There are millions of people suffering and now drs are not giving medicine for pain, not even for surgery! This has got to change. We are praying for help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lori	None	None	0900006484ff6323	A	None	2022-04-04T18:10:46Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from A, Lori	l1j-vd81-ajze	False	None	False	2022-04-12 05:36:07.019	[]
3576	CDC-2022-0024-3582	https://api.regulations.gov/v4/comments/CDC-2022-0024-3582	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had restless legs for 15 years, and the only thing that helps is suboxone/opioids.<br/>Without this off-label treatment, there is a serious quality of life issue. Unable to sleep nights are hell. Think of someone driving needles into your feet/toes as soon as you start to drift off. Repeat. Sleep comes only after extreme exhaustion and much suffering.<br/>With it, the symptoms are completely negated. The fact that one must be designated opioid dependent in order to obtain this treatment is a travesty. It's beyond ridiculous and plain wrong. <br/>The lack of understanding of the needs of RLS sufferers and broad strokes under which everyone that has a need for opiates, or even an opiate agonist, leads to mistreatment, suffering and poor outcomes for many.<br/>I hope that the CDC can see the benefit in this course of action to relieve not only the suffering, but also the stigma associated with this treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bruce	None	None	0900006484ff631a	Edge	None	2022-04-04T18:14:07Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Edge, Bruce	l1j-v7hp-d91o	False	None	False	2022-04-12 05:36:07.280	[]
3577	CDC-2022-0024-3583	https://api.regulations.gov/v4/comments/CDC-2022-0024-3583	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient for almost 30 years the current CDC guidelines have impacted me in ways that I am sure we’re not intended and resulted in my new Dr. ending a effective pain regimen that had worked for me for over 25 years. While opiate free I have become obese due to longer engage in most physical activity now being too painful, this obesity has then caused more pain due to the additional weight on my joints, knees,hips and back. It has also affected my mental health as being in chronic pain with no relief as well as a negative self image from being obese is depressing. This long term depression and lack of mobility also contributed to the end of my marriage also adding to my depression that includes suicidal ideation…. Yes opioids are a problem but the answer is not cutting chronic pain patients off of the meds they need to function and have any quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6313	Anonymous	None	2022-04-04T18:14:22Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-ut8w-ej3s	False	None	False	2022-04-12 05:36:07.533	[]
3578	CDC-2022-0024-3584	https://api.regulations.gov/v4/comments/CDC-2022-0024-3584	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with spina bifida occulta and was diagnosed with scoliosis at age 9. I was fused T1-T12 by age 12 with bone graft on left hip. At 18 I was diagnosed with spondylolisis, spondylolthesis and pars defect, which means my spine is broken at L5-S1. I was an athlete still with all this and had a full ride scholarship to play college basketball. The pain was severe and I didn’t want to go through anymore YET so hydrocodone was prescribed. As I’ve tried everything else possible since age 12. Hydrocodone allowed me to play 2 years of college basketball and then I was faced with another spine fusion at 23. But now I needed the Harrington rods removed due to them bending due to my spine continuing to curve. I then went on to move to Las Vegas to work on the strip as a bartender and cocktail server and model. If it wasn’t for the opioids there is no way I would be able to live such a high active life. At 36 my spine was deteriorating even worse and I was losing feeling in both legs. Now by this age I’m a mother of a small child and couldn’t afford to not work..so without my pain medicine this wouldn’t be possible. I’m in shape, work out and do every exercise to better my spine problems but I’m here to tell you it doesn’t matter cause the pain is still there! At 37 I was facing more rods at L5-S1 and one disk to be replaced. So now here I am at 40…literally my whole life living with spinal pain and if it wasn’t for my opioid pain medicine my life wouldn’t of been so GREAT! I’m thankful for my meds but the last few years I moved to Michigan and it’s been constant drama getting my meds. One disaster after another. I’ve never been rated at risk I have never ran out of meds early…I have ALWAYS been responsible! Then in recent years this MME has become an issue in my care. All these CDC guidelines have caused me more mental trauma than I already had! Enough already! These meds help me and other like me live a active and better quality of life. I would appreciate not having to fight so hard over legal meds that were made for people like myself!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brandy	None	None	0900006484ff62f0	Novicka	None	2022-04-04T18:15:07Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Novicka, Brandy	l1j-tyvw-jzsn	False	None	False	2022-04-12 05:36:07.775	[]
3579	CDC-2022-0024-3585	https://api.regulations.gov/v4/comments/CDC-2022-0024-3585	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think when a person has documentation that proves their pain is not faked they should be able to get the medicine they need	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff62eb	Anonymous	None	2022-04-04T18:15:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-tv47-c7bf	False	None	False	2022-04-12 05:36:08.021	[]
3580	CDC-2022-0024-3586	https://api.regulations.gov/v4/comments/CDC-2022-0024-3586	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient, I have had PPMS since 2007(meaning many spinal lesions, uncontrollable amounts of pain most days, with opiates i am able to sustain a pain level of 4/5, which allows me to function).<br/><br/>Fortunately, I am one of the few that is still able to walk, however without opiate medications this would not be the case. I am one of the "lucky ones," I have now been declared palliative by my pain management physician. Yet due to many moves across the country(my husband is a defense contracting expert engineer that is moved around like a chess piece by our government), I too have been subjected to the opiate "limits" seen in the 2016 guidelines and subsequent DEA witch-hunt. I have known many folks from my support groups that have killed themselves. I know it was something I, myself, thought of, however I had 5 children that needed me, so the option was not something I could contemplate for too long for fear of being too comfortable with that option, but I know the feeling well!! With these updated guidelines will the DEA and insurers be on board? Will their systems update as well? What will be done for the families of those that we harmed so egregiously in the previous 6yrs?<br/><br/>While I appreciate the update, until medical schools stop teaching that ES Tylenol is enough for post surgical patients and opiates quit being vilified, we will not be able to make any true progress and patients will continue to suffer!! As I have stated, I am lucky, I have an amazing team of doctors who recognized my hundreds of spinal lesions as a source of debilitating pain, who understood that my ability to walk and function in life was at stake, so they ensured that I was deemed a palliative patient to get around guidelines(as of 2yrs ago, prior to that I was in Appalachia & in the same 90mme boat as everyone else, while being trapped in my own body, in my own home, with my world falling apart around me, unable to take care of my own hygiene needs, let alone do laundry or make a meal). Will the DEAs pill counts be adjusted to ensure pharmacies have the medications available for patients? This is a problem that was created by the CDC in 2016, now that we see prescriptions are down and overdoses are up, pain patients and their doctors were not the issue....how does the CDC propose to fix the rest of the broken system they have created?<br/><br/>I appreciate the updated guidelines, I truly hope that there is follow through within other agencies and organizations as without that we remain in the same, tortuous boat.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammie	None	None	0900006484ff62e9	Hinkle	None	2022-04-04T18:15:40Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Hinkle, Tammie	l1j-ts4y-zeja	False	None	False	2022-04-12 05:36:08.284	[]
3581	CDC-2022-0024-3587	https://api.regulations.gov/v4/comments/CDC-2022-0024-3587	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm not going to waste your and my time. You know you are killing people with your war on pain patients. At least Hitler killed them quickly instead causing more pain and suffering. Your organization is just another corrupt arm of the government trying to do harm to its people that need help. My comment: REPUDIATE THE 2016 GUIDELINES AND ADMIT IT DID NOT WORK.<br/>Have a nice day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Johm	None	None	0900006484ff62d7	Macak	None	2022-04-04T18:15:49Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Macak, Johm	l1j-t9og-zjnm	False	None	False	2022-04-12 05:36:08.546	[]
3582	CDC-2022-0024-3588	https://api.regulations.gov/v4/comments/CDC-2022-0024-3588	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My fentynal patches were taken from me for no medical reasons....I have bilateral encroaching sciatic nerves that are constantly being squeezing the pain is excruciating I cannot function like this I'm a 60 çp patient I was doing well and functional when all of a sudden they were taken from me? Why? I'm being tortured and I cannot take the pain...please stop this madness.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bonnie	None	None	0900006484ff62a9	STONEHOUSE	None	2022-04-04T18:16:14Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from STONEHOUSE, Bonnie	l1j-s26j-wh9s	False	None	False	2022-04-12 05:36:08.800	[]
3583	CDC-2022-0024-3589	https://api.regulations.gov/v4/comments/CDC-2022-0024-3589	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern:<br/><br/>I have known [redacted], and have been her caregiver, for 3.5 years and during the time I have watched her moan in agongy from untreated pain.<br/><br/>There is no reason or common sense for her to be in this much pain 24/7. This poor lady is suffering around the clock.<br/><br/>The pain gets to a point where she has no appetite for anything, and she is losing weight.<br/><br/>I don't think it should be difficult to prescribe pain medication to help her with her daily life because for now - she has no life at all. All she does is lay down on the couch, crying her eyeballs out with pain.<br/><br/>Thank you for your consideration in this matter, and I truly hope you will finally do the right thing for chronic pain patients.<br/><br/>Sincerely,<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ndey	None	None	0900006484ff6299	Faal	None	2022-04-04T18:17:38Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Faal, Ndey	l1j-rj14-b4l2	False	None	False	2022-04-12 05:36:09.051	[]
3584	CDC-2022-0024-3590	https://api.regulations.gov/v4/comments/CDC-2022-0024-3590	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I speak as a patient who suffers from chronic pain. I also speak as a critical care RN with over 40 years experience.<br/><br/>>Obtaining a prescription needs to be simplified<br/>Patients are often forced to go through a series of steps before pain medication is prescribed, this often means delays of weeks to months in order to do all of these steps. Most non-pharmacologic options that are recommended by regulatory bodies and providers are not covered by insurance and the out-of-pocket cost can be quite expensive and yet many of the drug approval processes require you to try them.<br/><br/>>Limiting the number of doses of a narcotic<br/>Often you are told preop that you will only get X number of doses of pain medication and that should be enough to take care of things. This can lead to anxiety as if to say I have to be pain-free by a certain date or I’ll be left to suffer in pain or I'll be labeled a drug seeker. For ongoing routine opioid prescriptions there should be an option of not having a default amount of a 30 day supply. This is a decision that should be made between the patient and the provider. I should also not be required to submit to and have to pay for drug screening tests unless there is some indication. I was told this was a federal requirement yet my insurance is not required to pay the cost which can be as high as $300.<br/><br/>>Providers need education on drug options<br/>Most providers have no idea how to prescribe effective pain management, they learned one way and when that doesn’t work it’s not their fault, it’s your fault that you failed, not that you got the wrong drug or wrong dose. If you have a known intolerance/allergy to a drug, you may not be able to get a different pain med. I have a known drug allergy to the drug my provider usually gives his patients post-op. When I pointed this out he said that I would just have to use an NSAID. There was no option of using another narcotic. If an NSAID was not what he typically felt was needed for adequate for pain control then why did he think an NSAID would be OK for me?<br/><br/>>Providers need education on types of pain<br/>Providers need more education on pain and pain syndromes. Acute pain is not the same as subacute pain which is not the same as chronic pain - there isn’t a one size fits all answer for pain management and providers need to learn this. Chronic pain overlaid with acute pain is an even more complex subject for providers to try and understand. When pain management is ineffective providers are quick to assign mental health diagnoses, especially to those with chronic pain. Once again, it’s easier to say the patient is the reason for failed management, not the provider’s lack of skill/knowledge. No matter how much is said that people are more open minded about mental health diagnoses those labels immediately put up a barrier to getting effective pain relief. These are labels that follow you for the rest of your life and become a lens through which you are judged. It adversely taints the prospect of receiving objective, effective care from future providers.<br/><br/>>Providers need to be objective<br/>Providers need to be more objective and quit evaluating peoples pain based on their own personal experience. If a provider has never experienced pain from an injury, from surgery, or chronic pain like migraines or arthritis it’s really easy for them to sit there and judge you and decide how bad your pain really is. Providers also need to know that pain is a complex process and two people can have the same source of pain and yet have a completely different response to it. Individual physiology comorbidities, etc. are all going to influence how well somebody does or doesn’t handle pain. It doesn’t make one person a stronger person versus somebody else being a weaker person in terms of how they’re handling their pain. Providers need to get their personal judgment out of the picture and look at things in a more objective, comprehensive perspective.<br/><br/>Thank you for your time,<br/>[redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484ff6296	Ryan	None	2022-04-04T18:18:12Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Ryan, Debra	l1j-rf8x-eekx	False	None	False	2022-04-12 05:36:09.294	[]
3585	CDC-2022-0024-3591	https://api.regulations.gov/v4/comments/CDC-2022-0024-3591	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have lived with a chronic pain suffer for the last 10 years. In that amount of time I have seen the requirements and stipulations that your agency has placed on doctors that has made it harder and harder for chronic pain patients to get the medication they need. And I have also noticed you tend to lump people who do everything correctly and go to the pain clinics and take their medicine as they should with illicit drug users. You cannot put the two together. Doctor should be allowed to decide what a pain patient needs that will make them to where their life can be manageable I know that a lot of the pain patients like the one I live with is never free of pain but the pain medicine they take allows him to live a halfway normal life .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484ff627f	Stansberry	None	2022-04-04T18:18:20Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Stansberry, Charles	l1j-qu3h-oxp4	False	None	False	2022-04-12 05:36:09.568	[]
3586	CDC-2022-0024-3592	https://api.regulations.gov/v4/comments/CDC-2022-0024-3592	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I began experiencing RLS symptoms throughout my early twenties and thirties but the severity of the episodes increased dramatically a few years ago. I was put on the standard medications including gabapentin and mirapex which helped for a while but the symptoms always came back. My sleep specialist's response (as is likely the standard of care) was to up the dosage on these meds. Again, it helped for short periods of time but starting last fall the symptoms came back with a vengeance. The episodes began to last longer and were more severe in nature. I actually became afraid to try and go to sleep at night for fear of having an RLS episode. Between chronic insomnia and the RLS episodes that were keeping me up for hours at a time, I'd become a walking zombie. I was afraid to drive my car because I was nodding off at the wheel. I didn't have the energy to do anything and every time I asked for help, the response was to change the dosage on my meds and tell me to come back in a couple of months if it didn't help. The episodes became so severe that I was literally unable to sit or lay still for more than a few seconds at a time and this would last all night and well into the morning. It was like being tortured. I was physically exhausted and yet I couldn't be still. I had no control over my own body. All I wanted to do was sleep. I remember one early morning where I was so tired but I couldn't stop my legs from moving that I got up and went outside with my dogs and actually laid down in one of their dog beds on my driveway in near freezing temperatures in the hopes the change in environment would help me settle. Other methods of coping have included sitting under my shower spray for twenty minutes at a time, often six or seven times a night. Even that doesn't always stop the need to move my legs. I've tried every device on the market to no avail. I've tried meditation, CBT, etc. No improvement. At one point I had severe episodes for three nights in a row so I drove myself to the hospital to beg them to knock me out. The only thing that has ever helped has been taking tramadol after an episode starts. Within an hour, the episode is over. However, the tramadol happened to be something I had left over from a previous medical procedure. When I begged, in tears, for my doctors to prescribe tramadol to help me get through the episodes, they refused because it wasn't part of their standard of care and they didn't used opioids. I am not lying when I say that I reached a point where I wondered if my life was even worth living. I ended up spending thousands of dollars out of pocket to talk to a specialist at Mayo where they DO prescribe opioids at low doses to help manage this disease. My Mayo physician had a whole new way of attacking my RLS including changing one of my meds and using a different kind of iron infusion (something none of my local medical facilities even carried so I had to drive to Rochester, MN to get the treatment!) Since then, my episodes are fewer and less severe, but more importantly I have hope that I didn't have before. I have someone who I know can and will continue to help me fight this thing instead of responding with, "we don't do that here or we don't prescribe that medication." I understand the need to fight the opiod crisis but don't forget that there are many, many people out here like me who need help; who need physicians who aren't stymied by standards of care that by nature MUST evolve as the understanding of this disease changes. I'm not someone who just can't sleep sometimes. This isn't something I can walk or shake off. I am terrified of the day where EVERY night becomes a 12+ hour session of living hell. Please make it so that I can believe someone out there can and will help me in any way they can instead of casting me aside because they've supposedly done everything they can. I shouldn't have to go through this alone. I CAN'T go through this alone. Thank you. ~[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandy	None	None	0900006484ff5a1a	Preusser	None	2022-04-04T18:59:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Preusser, Sandy	l1i-7yu9-9vto	False	None	False	2022-04-12 05:36:10.005	[]
3587	CDC-2022-0024-3593	https://api.regulations.gov/v4/comments/CDC-2022-0024-3593	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a disabled vet! I have steal plates in my head and a prosthetic shoulder. I'm now 49 and need a hip replacement and back surgery. But I can't have the surgery until I can lose some weight. I can't lose the weight due to the pain. <br/> Due to the pain I've been very inactive. The inactivity has led to heart issues. I just had 2 stents put in on my birthday [redacted]. Your pain meds restrictions are killing people. Either threw inactivity or the pain gets so bad suicide becomes to only way out. I don't have much time left in this world so let me leave u with this. <br/><br/><span style='padding-left: 30px'></span>Screw your restrictions! One day your going to get old! No one is going to treat your pain. You'll have 2 choices! Live with it or suicide. Remember these are the decisions you've brought up on yourselves. <br/>Sincerely [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Howard	None	None	0900006484ff5a1c	Lacy	None	2022-04-04T19:00:16Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Lacy, Howard	l1i-7zse-ad3w	False	None	False	2022-04-12 05:36:10.226	[]
3588	CDC-2022-0024-3594	https://api.regulations.gov/v4/comments/CDC-2022-0024-3594	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing on behalf of my mother who suffers from chronic pain. Her opioid pain medications allow her to function more normally, like being able to drive, do some housework, go for walks, spend time with family, etc. <br/><br/>I am very concerned about the new 2022 proposed CDC Opioid Prescribing Guidelines. There should be no mention of MME's or number of days for a patient to be on opioid pain medications. The guidelines are over 200 pages, no doctor is going to read that but insurance companies will make their decisions based anything said in them. State laws and medical boards will follow suit. No specific diagnoses should be mentioned; severe pain can be caused by many conditions and it should be left to the doctor to determine if opioid pain medications are appropriate.<br/><br/>The 2022 proposed guidelines don't mention a plan to undo the significant damage done to chronic pain patients. Unless this is included they shouldn't be published.<br/><br/>Why have opioid overdoses and overdose deaths increased instead of decreased since the 2016 guidelines were published? Until this question is answered the CDC guidelines should just be completely withdrawn.<br/><br/>What has happened to all of the patients who have been abruptly cut off opioid pain medications, force tapered, or completely abandoned? This should be a top priority to figure out.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff5a32	Anonymous	None	2022-04-04T19:00:32Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-85n5-ubc4	False	None	False	2022-04-12 05:36:10.438	[]
3589	CDC-2022-0024-3595	https://api.regulations.gov/v4/comments/CDC-2022-0024-3595	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If you don't experience RLS, you cannot appreciate how disabling it is. The effects of relatively low does of opiate are inconsequential compared to the devastating effects of RLS on ones daily life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Harry	None	None	0900006484ff5a40	Carpenter	None	2022-04-04T19:00:41Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Carpenter, Harry	l1i-8hrq-qnkx	False	None	False	2022-04-12 05:36:10.645	[]
3590	CDC-2022-0024-3596	https://api.regulations.gov/v4/comments/CDC-2022-0024-3596	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have RLS and for the last few years I have been taking a low dose of methadone. It has worked wonders on controlling my RLS. About 5 yr. ago I went in for an ablation on my heart. I almost bled to death because my leg jumped while under sedation. Last week I was able to have an ablation and lie still for 6 hrs. I have never had the urge to increase my dose. I've never showed any symptoms of addiction. Please include RLS in prescribing opioids as a chronic disease. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484ff5a5d	Osborne	None	2022-04-04T19:00:49Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Osborne, Debra	l1i-8u8e-4v88	False	None	False	2022-04-12 05:36:10.894	[]
3591	CDC-2022-0024-3597	https://api.regulations.gov/v4/comments/CDC-2022-0024-3597	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE remove all mentions of MME dosages.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff5a93	Anonymous	None	2022-04-04T19:00:55Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-9kpf-0qam	False	None	False	2022-04-12 05:36:11.100	[]
3592	CDC-2022-0024-3598	https://api.regulations.gov/v4/comments/CDC-2022-0024-3598	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to you today as a concerned caretaker of an intractable pain patient. I am writing to express my extreme concern about the unintended consequences of our country’s continuing war on opioid drugs. My wife suffers from a long-term condition that at this time has no cure, that can and often does causes severe intractable pain. She has received tremendous benefit from opioid pain medications that were prescribed, as a last resort, to manage her constant severe pain after all standard pain treatments had been tried and failed to help. By taking these medications, she has been able to get back some semblance of a normal life that she doesn’t have without them. As a result of actions taken by the Centers for Disease Control and Prevention (CDC), the Drug Enforcement Administration (DEA), and other regulatory agencies, my wife may soon lose access to the medications that she relies on to manage the pain and have a decent quality of life.<br/><br/>During the past several years, the media has trumpeted that deaths have continued to rise from illicit drug use, even as prescriptions for opioid medications have declined.<br/>There are two very separate problems going on that involve the same substances:<br/>•<span style='padding-left: 30px'></span>The use of medically prescribed opioids to treat painful conditions, and<br/>•<span style='padding-left: 30px'></span>The misuse and abuse of illegally obtained opioids often resulting in overdose or death (whether prescription medication obtained via misdirection of legal prescriptions or plain illegal substances like illicit fentanyl or heroin).<br/>Please know that a person who suffers from severe pain who has also dealt with discrimination and demeaning treatment from medical professionals, the general public, and sometimes from their own friends and associates. Severe intractable pain conditions are very real and, if untreated or undertreated, can result in physiological deterioration and even death due to cardiac arrest, stroke, or adrenal failure. My wife is a responsible, law-abiding citizen who has done nothing wrong. Despite the fact that she used opioid medications responsibly, never misused or diverted medications, and been stable on her opioid dose for many years, my wife will soon experience the same constant excruciating pain she endured for years prior to finding appropriate medical care. This is the other side of the declared opioid public health emergency…the return to horrific suffering of innocent citizens who happen to be seriously ill. As far as I am concerned, deliberate action by our government that results in the withdrawal of readily available and effective pain treatment from a person suffering intractable pain is equivalent to the commission of torture. This is a violation of human rights, an injustice of the highest order that must stop now!<br/><br/>•<span style='padding-left: 30px'></span>“A statistic often quoted in popular media is that over 70% of all people with addiction report that their first exposure to opioids was from prescription drugs. So how are these young men and women exposed to prescriptions? The answer is almost entirely through theft and diversion of unused medications left over after legitimate patients no longer need them. 75% of people with addiction who begin this way never saw a doctor for pain. Few are able to sustain a developing addiction from home supplies. They soon begin purchasing street drugs – either illegal drugs like heroin (often laced with illicitly-manufactured fentanyl), or safer, but diverted, prescription drugs that cost much more.”<br/><br/>The facts about the risks of opioid medications when properly used by severe chronic pain patients do not support the actions that have been taken by Congress, Federal agencies, and state agencies. The CDC needs to take action to address this situation on behalf of all these vulnerable Americans. It is clear that the “war” on drugs has become a war on pain patients.<br/><br/>I ask that the 2016 CDC Prescribing Guidelines be completely withdrawn as the prescribing of medications is not in the purview of the Charter for the CDC. The proposed revision of these guidelines does nothing to correct the errors and biases found therein. Again, field-experienced medical practitioners and patients were not included in the revision process. If the CDC insists on putting forth a revision to the flawed 2016 Prescribing Guidelines, then all references to MME levels must be removed.<br/><br/>There are people with severe pain all across the country who are suffering at the hands of their physician because of the actions taken by the Congress, CDC and DEA. There are people dying because they were not given warning and were not allowed to properly wean off their medication. We have people with chronic pain who are committing suicide because they simply cannot deal with the pain on a daily basis without the treatment they had been on for a long period of time. I ask that you please act now before my wife becomes the next casualty in the ongoing war on opioid pain medication.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lawrence	None	None	0900006484ff5b3a	Favero	None	2022-04-04T19:01:17Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Favero, Lawrence	l1i-c1b6-pcf6	False	None	False	2022-04-12 05:36:11.311	[]
3593	CDC-2022-0024-3599	https://api.regulations.gov/v4/comments/CDC-2022-0024-3599	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75-year-old male who has suffered from severe Restless Legs Syndrome ("RLS") since 1985. I have been treated for this terrible condition by many doctors. I have been prescribed every drug approved and off-label for treating RLS. In each case, the drug dose had to be increased. Even worse, the drugs always caused my condition to become worse. It wasn't until I had to take opioids for pain that I discovered that they had virtually cured my RLS. I have been taking low dose opioids since about 2005, and I am praising God for the relief I have had from RLS. Furthermore, the opioids do not cause the RLS to get worse like the other meds did.<br/><br/>I realize that some people have a problem with drug and alcohol addiction, but I have never even had a single craving for these drugs since I began taking them many years ago. I see my doctor every 3 months, and he checks to make sure that I am still taking my medicines as prescribed.<br/><br/>I am asking that you please consider people like me who use opioids to treat Restless Legs Syndrome. It is a terrible disease to live with, and it has led so many to do the unthinkable to escape from its torment.<br/><br/>Thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chuck	None	None	0900006484ff5b43	Decker	None	2022-04-04T19:01:31Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Decker, Chuck	l1i-c6hu-e8hh	False	None	False	2022-04-12 05:36:11.544	[]
3594	CDC-2022-0024-3600	https://api.regulations.gov/v4/comments/CDC-2022-0024-3600	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was prescribed Anaprox DS at age 14 for severe menstrual cramps. I was on it continuously for seven years, until I developed a stomach bleed at age 21. That same year, I was diagnosed with Endometriosis via laproscopic surgery. This was in the mid 90's, before the dangers of long term use of non steroidal anti Inflammatory class medication became fully known. A few years later, I was dealing with chronic kidney stones, which developed during my first pregnancy and continued after the birth of our child. This coincided with the release of a medication called Oxycontin ER, and I do not recall a single physician who did NOT try to prescribe it to me. (I learned pretty quickly it was not for me, the nausea it caused could not be controlled.) Nevertheless, I did require medication as the pain from my two (soon to be three) conditions was not compatible with life. The journey I've been on ever since can only be called farcical, and the abuse I've been subjected to has created an extreme aversion to doctors, hospitals, etc. that continues to this day. I did, however, get stabilized on a medication regime through my family practice physician until my insurance stopped covering them in direct response to the CDC opioid prescribing guidelines published in 2016. In the three years after, I only had OTC NSAIDs to rely on for pain control until last summer, 2021, when I started to get sharp stomach pains along with dizziness and cold sweats after taking them. I went to my family doctor, and as a result of those three years of NSAID use, my kidneys were damaged, which led to severe hypertension, enough to have to go on medication at age 43. She said I could NOT take NSAIDS anymore, ever...and got me back on medication that my insurance still won't cover, because the amount exceeds 7 days. Again, as a direct result of the 2016 CDC guidelines. I applaud that the CDC has amended its previous position(s), but I fear the damage has already been done that is either permanent, or will take a long time to be remedied. Particularly, with insurance companies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff5bfb	Anonymous	None	2022-04-04T19:01:47Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-eno6-nqv8	False	None	False	2022-04-12 05:36:11.757	[]
3595	CDC-2022-0024-3601	https://api.regulations.gov/v4/comments/CDC-2022-0024-3601	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since 1994 and due to CDC guidelines have been tapered to 90mme. I can barely work and do my day to day chores due to extreme pain and sleepless nights due to pain. Recently I moved to Florida to start a new career and cannot find a doctor to prescribe my pain medications because their fear of the DEA due to CDC guidelines. I'm begging you to change these guidelines so millions of us chronic pain patients can live our lives!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff4beb	Anonymous	None	2022-04-04T19:01:55Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-fkmt-rc7o	False	None	False	2022-04-12 05:36:11.964	[]
3596	CDC-2022-0024-3602	https://api.regulations.gov/v4/comments/CDC-2022-0024-3602	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC:<br/><br/>I have been suffering from relentless pain for over 17 years. After trying many different pain medication combinations and other pain relief methods, my doctor concluded that a dosage of 90 mg of Oxycodone per day (9 pills of 10 mg Oxycodone and 325 mg acetaminophen per day) was beneficial. I was on this dosage for over ten years, with no ill effects. Although I was still in a great deal of pain with this prescription, I did have some quality of life. <br/><br/>Due to the current guidelines imposed by the CDC, my doctor has been forced to reduce my Oxycodone dosage to 60 mg per day. This dosage is not working…at all. My life is a living hell. I am in constant pain, I’m a nervous wreck, I can’t sleep, and my life is frankly not worth living. <br/><br/>I implore you to please ease up on these Draconian measures, so that I may get some relief and some form of quality of life back.<br/><br/>Thank you,<br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	0900006484ff4c0d	Dunlap	None	2022-04-04T19:02:28Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Dunlap, William	l1i-g47k-ecsd	False	None	False	2022-04-12 05:36:12.173	[]
3597	CDC-2022-0024-3603	https://api.regulations.gov/v4/comments/CDC-2022-0024-3603	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a chronic pain patient that suffers with a chronic rare nerve diease to which there is no cure and very little to no help other than pain control. It's called CRPS/ complex regional pain syndrome. This happened to me as a result of a work injury to which I was at my job for 23 years when I got hurt. A botched simple small hand surgery turned my life up side down. I had a very active life not only at work but in the community. It all changed when I woke up from surgery in the most horrifying pain you could ever imagine. This is a progressive nerve diease and most doctors have zero clue what to do for me. So I've went through all the shots nerve blocks physical therapy. You name it ive done it. Nothing was slowing this down and the ONLY relief I get is when I take my pain medication. Now fast forward 6 years. I'm still on the same amount of pain medications. I went off the nerve medications and depression medications I was put on because they were causing so many more side effects than I was willing to deal with. I wasnt depressed they were giving me them for oain control. I had brain fog I couldn't even do my own bills or take care of family. I had way more side effects from the gabapentin and Cymbalta then I ever had my pain meds. The only thing my pain meds do for me is give me a better quality of life. All those other drugs decreased my quality of life and didn't give me any pain relief. My pain doctors put OUD opioid use disorder on my medical charts without my knowledge and I DO NOT HAVE OUD!!! When I asked why this was on my charts I was told he couldn't take it off or he could no longer prescribe my pain medication due to me being monitored closely and he wasn't loosing his license for me. So I'm only 46 and I had to change pharmacies due to being treated horrible by the employes at the pharmacy because they are monitoring my medical records against my own right as a patient and so they think im an addict and treated me horrible becauseof the OUD diagnosis. I have to drive an hour out of the way to a pharmacy that understands my diease and doesn't treat me as if I'm a drug addict. I've never ever abused my medication and I need more than what I'm taking but my doctors are afraid to prescribe what I actually need due to the new laws because the CDC guidelines but the state that I goto the pain clinic in passed laws that doctors and pharmacies have to follow to keep Dea from showing up. Now just so you know im driving 2 hours to another state because the state I live in has one of the highest drug overdoses in the US so when I called 20 plus pain clinics to find a doctor everyone that I called refused to take me on as a patient except for 4 of them and all 4 of those would only AGREED to see me if I would agree to a spinal cord stimulator and Morphine pain pump. They required me to SEND them all <br/>of my medical records before I ever made my 1st appointment so when they would see that I was already on pain meds and at the maximum MME I was considered high risk and didn't want the problem. So that's my story and it's not my fault i got hurt and I'm now permanently disabled and the pain medication only gives me a little better quality of life. I'm NOT AN ADDICT but a law abiding chronic pain patient that needs pain meds to function in this world!! Please please separate pain patients and addicts and stop putting all our private health issues out for all to see. It's like I'm being punished because I was dealt a bad hand and now suffer from pain amd have to take pain medication. It's so humiliating that i now have PTSD over worrying whether or not my pain meds will be taken away. All pain patients ate required to take urine tests which I have no problem doing but... there is also faults in that system too and it happened to me 2 times aince I've been a pain patient. I was dropped by my 1st pain doctor for a negative urine sample. I took my meds like I always do. I couldn't nor was I given a chance to prove I wasn't not taking my medication. I was immediately dropped and left to find my own doctor. I took another test the same day with my family doctor and it was normal so something had to be wrong with thar test and I felt like a piece of scum under my doctors shoe and was treated accordingly. I had been seeing him for 4 and half years with zero problems before this happened. This should not be happening here in 2022 bit it happens all the time to chronic pain patients because of addicts abusing their drugs I was treated as an addict. I'll never forget that day... Up until I got hurt I never even took a Tylenol. I excersized worked 2 jobs taught excersize classes ran in 5k. Now I live a very quiet life . My excersize now is my 2 times a week trip to the grocery store but I couldn't even do that if I didn't have what little pain medication I do get. Please stop this. So many are suffering for no reason!!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tonya	None	None	0900006484ff4c10	Shuler	None	2022-04-04T19:09:18Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Shuler, Tonya	l1i-g64s-qqqe	False	None	False	2022-04-12 05:36:12.396	[]
3598	CDC-2022-0024-3604	https://api.regulations.gov/v4/comments/CDC-2022-0024-3604	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Clinical Practice Opioid Prescribing Guideline draft does not address the condition RLS (Restless Leg Syndrome),which is a chronic neurological disease that causes an urgent, unrelenting need to move your legs making it impossible to sleep or sit quietly. It really affects one's life and there is no known cure.Research has shown that low-total-daily-dose opioids can successfully treat RLS. When RLS strikes, I have to constantly walk around the house at night in order to get some relief; sleep is out of the question. I depend on the availability of low-total-daily-dose opioids to treat this condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484ff4c5d	Carty	None	2022-04-04T19:09:34Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Carty, Stephanie	l1i-hhvz-caco	False	None	False	2022-04-12 05:36:12.608	[]
3599	CDC-2022-0024-3605	https://api.regulations.gov/v4/comments/CDC-2022-0024-3605	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel it is very important to include low dose opiods for RLS. Many of the medicines prescribed aren't effectived or barely. Exhaustion from this disease is under-rated, and all options need to be available as not 1 or 2 medications work for everyone. It has been showen that once the correct dose of opiate is found an increase is not needed. The doses are not high enough to produce a high. Please consider adding RLS and supporting those ofnus woth this horrible disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susam	None	None	0900006484ff4c7e	Jennings	None	2022-04-04T19:09:44Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Jennings, Susam	l1i-hxur-47ub	False	None	False	2022-04-12 05:36:12.844	[]
3600	CDC-2022-0024-3606	https://api.regulations.gov/v4/comments/CDC-2022-0024-3606	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the opiate hysteria , & harmful cdc guidelines caused me to no longer have access to pain management. I have been living with untreated pain since 2017. I no longer have quality of life and it not only affects me but my family as well. They wanted to shove me into a pain clinic to get injections. The injections are worse for the body in the long term, there is research on it. But also to ask someone with fibromyalgia to willing put needles into their joints would only cause me more pain, you can’t cause medical trauma to fix pain in fibro as it only leads to more pain. Some days it is hard to hug my kid , that’s how sore my body is from pain. I wasn’t even on a daily regimen just as needed for my bad flares. Without it I am now in bed 95% of the time. As being in chronic pain wears down the body keeps me exhausted l. To be honest there is no word that describes how exhausting it really is. You just don’t know until you are experiencing it yourself. I was taking an anti inflammatory for a couple years and it also helped keep me more mobile however I had to stop taking them because nsaids are not kind to the kidneys. That left me with muscle relaxers and opiates to manage my pain. Then when I lost opiates, I only have muscle relaxers, and my use of them is questioned often. If I lose those, I told my husband to take me out back and shoot me. That’s how bad it is. When you are in high pain, you don’t get high from opiates, and I think that is something people fail to understand. When you are in high pain, an opiate is like taking a Tylenol and although it never relieved all the pain, it kept it more manageable and me more active. Simple things like cooking dinner or taking my daughter to our backyard to play. Now my husband cooks almost all the meals, as well as working to support us. He has to basically do everything. It is well documented that pain is detrimental to overall health. I don’t know why we are going backwards. The war on drugs has been a failed war and chronic pain patients shouldn’t be left out in the cold so to speak. This narrative to control opiates to save those addicted is simply put is asinine.OD’s haven’t slowed down and now we have more suicide in the pain community cause it’s inhumane to let people suffer. This is all about greed, like most things in this world. If they wanted to solve the OD deaths they need to stop slapping a bandaid on everything. Addiction is not about the drug in and of itself so to demonize it stigmatizes those that need it. Addiction is a mental health issue, as if affects all types of people from all walks of life rich & poor, etc. if they want to solve deaths related to addiction then they need mental health & mindfulness. Mindfulness & critical thinking should be taught in schools from k-college. I’m not the smartest person, but I see a lot of people in this world that without tools on how to deal with anger,stress and anxiety that drug problems will not stop. The deaths will not stop. Most people go through life and don’t know how to manage it, and coming from ignorance those people really never had a chance to begin with. Recently a study was published about a school system that started teaching mindfulness how to deal with emotions, after years and year of work they were able to decrease the amount of addiction,joblessness, even divorce by something around 80 percent decline. I mean sure there are some doctors that over prescribe , and they should be dealt with. Someone with temp pain doesn’t need months and months of opiates. But that should all be on an individual basis not a blanket assumption that if a doctor is writing the scripts they must be doing something wrong. As some doctors like rheumatologists would have the patient quota vs the use, etc. I would like the government out of my doctors office when it comes to pain management. My doctor and I were managing just fine. The attack on opiates needs to stop, as it is known that it’s illicit fentanyl that is cause OD’s but when media runs with it its all opiates, and that is simply not the case. The science & studies are there. The greed of Prop that rolled out these opiate guidelines is all about money and nothing to do with saving lives, the like of [redacted] and others that put these guidelines into place are just lining their pockets and now it has spread to doctors being paid not to prescribe opiates. All the info is out there, only have to look k follow the money. Just search Twitter for personal accounts , #NEISvoid #CPP are just a few.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachel	None	None	0900006484ff4ca3	Reynolds	None	2022-04-04T19:10:34Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Reynolds, Rachel	l1i-imgw-a5f4	False	None	False	2022-04-12 05:36:13.055	[]
3601	CDC-2022-0024-3607	https://api.regulations.gov/v4/comments/CDC-2022-0024-3607	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Tylenol 1,2,3 with Ropinirole 0.25 is a game changer. I have been doing this for years and it helps immensely. Little chance of harm with such a low dose. Please consider this a valid protocol.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerry	None	None	0900006484ff4cef	Davis	None	2022-04-04T19:10:41Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Davis, Gerry	l1i-jjin-bqm0	False	None	False	2022-04-12 05:36:13.265	[]
3602	CDC-2022-0024-3608	https://api.regulations.gov/v4/comments/CDC-2022-0024-3608	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate your work in reviewing the CDC's Clinical Practice Guideline for Prescribing Opioids. I understand that the current draft does not include guidelines on chronic conditions. As so many people residing in the US suffer from chronic conditions that include pain, this seems a grave oversight that could be detrimental to the medical care for these patients. I have two chronic conditions, both of which frequently include recommendations for opioid therapy for management by medical researchers. I have Restless Leg Syndrome (Willis-Ekbom Disease) and hypermobile-type Ehlers Danlos Syndrome. I am currently so incapacitated by pain for both that I am unable to work for a living, cannot take care of my children by myself, am unable to get a full night's sleep, and sometimes cannot imagine living in this much pain much longer. Protecting patients from addiction is important. Addiction can destroy lives. But pain also destroys lives, and when patients' pain is resistant to other types of treatment (I derive no benefit from over-the-counter anti-inflammatories, Gabapentin kept me awake for three days, SSRIs increase other symptoms without positively impacting my pain, etc, etc) opioids may not only be appropriate but necessary. You can't keep robbing Peter to pay Paul. It's important to prevent addiction. But it is important to provide humane care to patients living with chronic pain conditions. Additionally, I have a mutation of the rs1799971 AG phenotype of the OPRM1 gene indicating that I metabolize opiods at a faster rate than the general population. I hope that you account for the range of opioid metabolism that patients may experience when coming up with your guidelines. If I am given a dose that is large enough for someone with a slower opioid metabolism, that is an inappropriate dose for me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathryn	None	None	0900006484ff5dea	Liljeholm	None	2022-04-04T19:10:52Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Liljeholm, Kathryn	l1i-ks9o-z4sa	False	None	False	2022-04-12 05:36:13.482	[]
3603	CDC-2022-0024-3609	https://api.regulations.gov/v4/comments/CDC-2022-0024-3609	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Indivual	None	None	0900006484ff5df0	Three	None	2022-04-04T19:11:02Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Three, Indivual	l1i-kzj8-yjd1	False	None	False	2022-04-12 05:36:13.704	[]
3604	CDC-2022-0024-3610	https://api.regulations.gov/v4/comments/CDC-2022-0024-3610	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC,<br/><br/>THOSE WHO HAVE NOTHING TO HIDE, HIDE NOTHING. <br/><br/>Please stop deleting comments from this site that you don't agree with or that don't fit your narrative. <br/><br/>Quit hiding. <br/><br/>Thanks, <br/>CPP	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff5df4	Anonymous	None	2022-04-04T19:11:13Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-l47c-6ij2	False	None	False	2022-04-12 05:36:13.961	[]
3605	CDC-2022-0024-3611	https://api.regulations.gov/v4/comments/CDC-2022-0024-3611	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am happy to see the CDC returning to review guidelines for prescribing opioids, since so much has changed since 2016 (the last noted change). The opioid crisis in the country has hurt so many families. I hope that more consideration is given to other pain-relief methods or that further guidance is offered to physicians on how to prescribe opioids only when it is absolutely necessary. My father is a chiropractor and my mother is a nurse, and both have inevitably seen the results of those who have become addicted to opioids in their work. The danger of the drug was not adequately described when guidance was first released, and the consequences were terrible. I sincerely hope the CDC takes this new evaluation very seriously and looks into the research and impacts of the opioid crisis in America.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vanessa	None	None	0900006484ff5dfa	Carey	None	2022-04-04T19:11:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Carey, Vanessa	l1i-l4sf-qi56	False	None	False	2022-04-12 05:36:14.172	[]
3606	CDC-2022-0024-3612	https://api.regulations.gov/v4/comments/CDC-2022-0024-3612	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment on the proposed guidelines for prescribing opioids. I am concerned that the current draft does not include the use of opioids to treat chronic diseases like Restless Leg Syndrome (RLS) that are different than chronic pain. There is ample scientific studies showing the effectiveness of low dose opioid treatment of severe RLS especially where other available medications are no longer effective, or have actually made the condition worse. I’ve had RLS since I was a child, and the condition appears to worsen as I age. At 65, I find the severity of the condition and inability to get any quality of sleep on a long term basis has a very negative impact on my daily life. Currently only carbodopa-levodopa has helped somewhat but it often makes the RLS worse and also makes it appear during the day as well. I’m been prescribed low dose hydrocodone in the past and found it very effective not only with reducing the restless legs but also with improving sleep quality, something which none of the other available medications has provided me. I would like to make sure that this low dose opioid treatment remains a viable treatment option for those of us with chronic diseases like RLS. Studies have shown that patients on long term treatment rarely need increased dosage over time and it does not lead to addictive use, as is the case for normal dosages used to treat pain, especially chronic pain. Please consider the use of low dose opioids for chronic diseases in the new guidelines. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dee	None	None	0900006484ff1903	Carlson	None	2022-04-04T19:29:04Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Carlson , Dee	l1f-gb8p-0irt	False	None	False	2022-04-12 05:36:14.394	[]
3607	CDC-2022-0024-3613	https://api.regulations.gov/v4/comments/CDC-2022-0024-3613	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 33 years of age I have had sickle cell for 33 years. my first 18 years being treated was good, I had a lot of support from my doctors and they cared. Once i turned 21 getting treatment became a nightmare...from the way im spoken to, the way im judged, and the way I am constantly NOT treated. I have a degree in Accounting and graduated from Cass Tech so Im not slow but when I am requesting any pain medicine that is how I am treated. I am constantly told what I do and do not need as if I have not been in this journey for 33 years. <br/><br/>getting treatment is so hard that i would rather lay on the floor in pain at home rather than go to the emergency and be judged or mistreated	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	charity	None	None	0900006484ff1917	kemp	None	2022-04-04T19:31:07Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from kemp, charity	l1f-gm8c-m41e	False	None	False	2022-04-12 05:36:14.601	[]
3608	CDC-2022-0024-3614	https://api.regulations.gov/v4/comments/CDC-2022-0024-3614	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I, along with more than ten million other Americans, suffer from Restless Leg Syndrome. Despite its often mocked name, RLS is a chronic neurological disease with serious consequences. For six years I have been taking a low dose of methadone to control the symptoms. Every day I take 7.5 mg of Methadone at precise time. If I am even a few hours late, the symptoms become unbearable. <br/><br/>The only available pharmaceutical alternative are dopamine antagonists. Unfortunately, these are not appropriate for extended use for the chronic condition; prolonged use results in worsened symptoms. Patients end up in a cycle of worsened symptoms, increased dosages, which provides temporary relief, followed by another increase of symptoms. <br/><br/>While I appreciate any effort to control opioid abuse, I hope you do not increase the difficulty in getting this essential (I would say life-saving) drug for RLS sufferers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carl	None	None	0900006484ff1930	Hagenmaier	None	2022-04-04T19:35:28Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Hagenmaier , Carl	l1f-gs84-21yy	False	None	False	2022-04-12 05:36:14.812	[]
3609	CDC-2022-0024-3615	https://api.regulations.gov/v4/comments/CDC-2022-0024-3615	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had restless legs syndrome for 70 years and can find no way to sleep without a low-dose opioid. Please add this to prescribing policy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484ff1983	Mccurdy	None	2022-04-04T19:43:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Mccurdy, Pam	l1f-h4zr-dzwi	False	None	False	2022-04-12 05:36:15.019	[]
3610	CDC-2022-0024-3616	https://api.regulations.gov/v4/comments/CDC-2022-0024-3616	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from Restless Legs, specifically periodic leg movements. Without medication, I am unable to sleep at night or even relax during the day reading a book. Whenever I start to relax, my legs start jerking approximately every 20 seconds. I have been suffering from this condition for over 30 years. I was taking Mirapex for several years, and it did give some relief. However, I needed to take ever increasing dosages of the Mirapex, as it loses it effectiveness over time. Fortunately in July of 2017, I found a doctor who prescribed methadone for my restless legs. I have been taking it for almost 7 years now, and the results have been fantastic. I am almost 100% symptom free on my low 10 mg.daily dose of methadone.. And the best part of all is that I have been on the same dosage for this time period. Please do not make it more difficult or impossible to obtain the drug that allows me to live a normal life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allen	None	None	0900006484ff1480	Silver	None	2022-04-04T19:44:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Silver, Allen	l1f-hgxf-q4t8	False	None	False	2022-04-12 05:36:15.232	[]
3611	CDC-2022-0024-3617	https://api.regulations.gov/v4/comments/CDC-2022-0024-3617	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from Restless Legs, specifically periodic leg movements. Without medication, I am unable to sleep at night or even relax during the day reading a book. Whenever I start to relax, my legs start jerking approximately every 20 seconds. I have been suffering from this condition for over 30 years. I was taking Mirapex for several years, and it did give some relief. However, I needed to take ever increasing dosages of the Mirapex, as it loses it effectiveness over time. Fortunately in July of 2017, I found a doctor who prescribed methadone for my restless legs. I have been taking it for almost 7 years now, and the results have been fantastic. I am almost 100% symptom free on my low 10 mg.daily dose of methadone.. And the best part of all is that I have been on the same dosage for this time period. Please do not make it more difficult or impossible to obtain the drug that allows me to live a normal life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allen	None	None	0900006484ff1481	Silver	None	2022-04-04T19:55:43Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Silver, Allen	l1f-hgxg-q91k	False	None	False	2022-04-12 05:36:15.452	[]
3612	CDC-2022-0024-3618	https://api.regulations.gov/v4/comments/CDC-2022-0024-3618	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been taking methadone for 7 years now for restless legs. Please do not take away my ability to get the drug that allows me to relax during the day and sleep at night without my legs jerking about!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1490	Anonymous	None	2022-04-04T20:01:44Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-hp7c-ro41	False	None	False	2022-04-12 05:36:15.658	[]
3613	CDC-2022-0024-3619	https://api.regulations.gov/v4/comments/CDC-2022-0024-3619	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC conversion table, MME, is junk science. The over 60 year old studies never even compared the doses of the various opioids that cause respiratory depression and death. The types of trials that went into the table would never be conducted today. This same deeply flawed science has become policy in many hospitals, health plans and pharmacies. In the state of Oregon, these are used currently as limits. The constant DEA investigations as caused moat doctors in our state to stop taking pain patients. People are dying of suicide and illicit pain medication overdose at outrageous numbers. People in pain should be able to make an educated decision on how to treat their pain so that they can have their pain properly managed, just as people make an educated choice to use alcohol even though it has high consequences such as death, injury, and addiction. Chronic pain patients are suffering, how much more torture does this agency think we can take. There are thousands of incurable, painful medical conditions where the only available medical option is to treat the pain associated with it. The world health organization say this is wrong. Doctors say this is wrong. If you would like to help the opioid epidemic bust drug dealers and drug users, the police can tell u where they live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484ff14b8	Cornilsen	None	2022-04-04T20:06:00Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Cornilsen, Kimberly	l1f-hyfz-9dzd	False	None	False	2022-04-12 05:36:15.895	[]
3614	CDC-2022-0024-3620	https://api.regulations.gov/v4/comments/CDC-2022-0024-3620	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from Restless Leg Syndrome for almost two decades now. The name does not begin to describe the destructive and disabling nature of this disease. Every medication I have tried stopped working and eventually made the RLS worse. The only thing that works now is a small dose of opioid. Please make sure you include RLS in your considerations for practice guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff14c9	Ivers	None	2022-04-04T20:06:42Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Ivers, David	l1f-i1hk-v9q6	False	None	False	2022-04-12 05:36:16.105	[]
3615	CDC-2022-0024-3621	https://api.regulations.gov/v4/comments/CDC-2022-0024-3621	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please I beg you, this is the only help for someone like me with RLS. I have tried everything else and once my body gets used to it my legs then become worse. I am a 56yr old educated women who runs 2 businesses without any trouble. I am not an addict! For some this is the only way to have any relief from this horrific disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	l.	None	None	0900006484ff1d06	l.	None	2022-04-04T20:07:32Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from l., l.	l1f-ikf5-9vjk	False	None	False	2022-04-12 05:36:16.318	[]
3616	CDC-2022-0024-3622	https://api.regulations.gov/v4/comments/CDC-2022-0024-3622	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on the opiate Tramadol for over ten years. I suffer from Restless Leg Syndrome, Tramadol is not a cure but it is the only medication (I have tried many different medications) that gives me relief. I have actually reduced my dose to the minimum amount. Without Tramadol the quality of my life is severely reduced. I believe that patients who need it should have access. Please consider those of us who need certain opiates to live a productive life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	0900006484ff1d62	Murphy	None	2022-04-04T20:24:04Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Murphy, S	l1f-jkse-rm6k	False	None	False	2022-04-12 05:36:16.535	[]
3617	CDC-2022-0024-3623	https://api.regulations.gov/v4/comments/CDC-2022-0024-3623	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe Restless leg syndrome. <br/>I am augmenting on Mirapex. <br/>I am in the process of weaning off the Mirapex when I was given a low dose opioid due to rotator cuff surgery. <br/>My Restless legs haven't been this good in years. I am certain that low dose opioid is is a viable option for patients like me. I was terrified of the surgery only because I had no idea how I would endure being so sore with my rls. I take one dose of opioid per 24 hours and I am at peace.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rachael	None	None	0900006484ff1d73	Vanlaar	None	2022-04-04T20:26:07Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Vanlaar, Rachael	l1f-jqoj-eo3b	False	None	False	2022-04-12 05:36:16.766	[]
3618	CDC-2022-0024-3624	https://api.regulations.gov/v4/comments/CDC-2022-0024-3624	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain from RSD CRPS, osteoporosis arthritis damaging my cartilage in my joints, fail lumbar surgery, and the list continues. I was asked recently by a therapist what gives you Joy? My response nothing. I was taking off my pain medication and was told ibuprofen works well. I can no longer take it due to intestinal bleeding. I’ve been disabled since 2006. I’m not asking for much just get my pain level in half would be helpful. If people could walk in my shoes they would understand.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1d7e	Anonymous	None	2022-04-04T20:37:26Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-juwo-ytc6	False	None	False	2022-04-12 05:36:16.979	[]
3619	CDC-2022-0024-3625	https://api.regulations.gov/v4/comments/CDC-2022-0024-3625	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain management patient, I am appalled at the current treatment of actual patients at this time. Your policies have ruined my career, put me on disability and I have been subjected to severely painful procedures to try and help my pain. None of these painful procedures have helped and now my quality of life is nothing….AND what are you doing for the people that are allergic or have severe side effects to the “alternative” medications you are pushing down the pipeline now? I can tell you it’s ABSOLUTELY NOTHING…You are hurting millions of people who were apart of society, leading normal lives and thriving. It’s disgusting!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Penny	None	None	0900006484ff1db4	Volosin	None	2022-04-04T20:38:40Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Volosin, Penny	l1f-kcuq-diee	False	None	False	2022-04-12 05:36:17.188	[]
3620	CDC-2022-0024-3626	https://api.regulations.gov/v4/comments/CDC-2022-0024-3626	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering in pain for over 10 years. I have neuropathy from nerves damaged in surgery. I am allergic to most drugs Dr's have tried. I'm not a candidate for shots but have been given them several types but no help. The only drug I can take is percocet. No Dr in my area will prescribe it. So I live my life in excruciating pain. These opioid have a purpose. To help those in pain. It's not right that pain patients who are medical compliant be taken off their only saving grace. Suffering socks. My life is me either in a recliner or bed. I am 55. Change the laws.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tracyjo	None	None	0900006484ff1df9	Herlihy	None	2022-04-04T21:02:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Herlihy, Tracyjo	l1f-l71o-g6kz	False	None	False	2022-04-12 05:36:17.403	[]
3621	CDC-2022-0024-3627	https://api.regulations.gov/v4/comments/CDC-2022-0024-3627	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have tried several different treatments and I have found that opioids are the only thing that helps for me. A low dose of course. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dorothy	None	None	0900006484ff1e15	Lucas	None	2022-04-04T21:03:26Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Lucas, Dorothy	l1f-lkzo-x3i8	False	None	False	2022-04-12 05:36:17.630	[]
3622	CDC-2022-0024-3628	https://api.regulations.gov/v4/comments/CDC-2022-0024-3628	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had RLS for over 15 years and have had sever symptoms not alleviated by standard protocols. Low dose opioids can be a life changing treatment for many of us. Not being able to sleep night after night impairs my ability to work, drive, have meaningful conversations and special times with my family and friends. It is isolating and caused depression and anxiety. My symptoms and treatment are closely monitored by a at least two physicians. And they keep checking on side affects. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lois	None	None	0900006484ff1936	Martin	None	2022-04-04T21:55:30Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Lois	l1f-gx3k-fg3a	False	None	False	2022-04-12 05:36:17.854	[]
3623	CDC-2022-0024-3629	https://api.regulations.gov/v4/comments/CDC-2022-0024-3629	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. <br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I personally have been treated for RLS for the past 22 years with symptoms worsening over time. Initial dopamine agonists prescribed prior to eventual FDA approval for RLS gradually became ineffective with negative side effects outweighing any benefit. Newer gabaminergic treatments also proved to be ineffective leaving me with both RLS and brain fog. I ultimately found treatment success with low dose opioid based drugs 10 years ago through my closely monitoring neurologist. Without opioid treatment, I would surely be unable to function, work or live a productive life. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. <br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1d22	Anonymous	None	2022-04-04T21:56:37Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-iv3v-xwj5	False	None	False	2022-04-12 05:36:18.065	[]
3624	CDC-2022-0024-3630	https://api.regulations.gov/v4/comments/CDC-2022-0024-3630	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have severe restless leg. So far, I have managed to stay off opioids and plan to continue that as long as possible, but without my current meds, I go into utter agony. Knowing there could be an alternative if my current meds no longer work, gives me hope.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MJ	None	None	0900006484ff1d5f	Welchner	None	2022-04-04T21:57:13Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Welchner, MJ	l1f-jjty-7mwo	False	None	False	2022-04-12 05:36:18.277	[]
3625	CDC-2022-0024-3631	https://api.regulations.gov/v4/comments/CDC-2022-0024-3631	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>I was diagnosed with RLS {Restless Leg Syndrome) 15 years ago. As time went on medication prescribed became less effective. Dosage was increased but once again became less effective. Eventually no medication was effective. I went to Lahey Sleep clinic where numerous other medications were tried with no relief. 2 Months ago I was prescribed a low dosage Opioid nightly. The improvement was dramatic. It has changed my life<br/><br/> There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/> I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484ff1d88	Hearn	None	2022-04-04T21:58:12Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Hearn, Michael	l1f-jyj4-9p74	False	None	False	2022-04-12 05:36:18.485	[]
3626	CDC-2022-0024-3632	https://api.regulations.gov/v4/comments/CDC-2022-0024-3632	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines seem to be non scientific. It seems that the FDA, not the CDC should be in charge of something this important. I have been on a pain regimen for over 20 years without a problem. It has made my life worth living. Without medication I can barely climb out of bed in the morning and then I’m in so much pain that my daily life is non existent because I feel so bad I don’t want to do anything. I’m sure there are many many more people just like me out there that will have their life negatively impacted with this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brad	None	None	0900006484ff1dc6	Beyer	None	2022-04-04T21:58:41Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Beyer, Brad	l1f-kiwa-z3br	False	None	False	2022-04-12 05:36:18.694	[]
3627	CDC-2022-0024-3633	https://api.regulations.gov/v4/comments/CDC-2022-0024-3633	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had to point out the hell I have been through due to the lack of recognition RLS patients and opioid therapy receive. Even seasoned neurologists often have no idea about the latest RLS opioid research done by the top institutions.. If they do, they usually will not prescribe even a low-dose opioid due to the intense fear placed on them by the DEA...the fear of losing their practices.<br/>These doctors continue to prescribe Dopamine Agonist drugs, which cause augmentation and an intense worsening of symptoms. Ultimately this puts the RLS patient in the position of needing an opioid to get through the agonizing withdrawal and drop them for good. They are evil and old school drugs that are no longer considered first-line treatment.<br/>I have been cut off from an opioid (used to get me off the DA drugs) quite suddenly by TWO doctors, with no further help or direction. I went through a night of withdrawal that was totally unnecessary. All due to fear and/or a complete lack of knowledge as to the benefits for RLS patients.<br/>All of the top US doctors and institutions have proven research detailing the success of low dose opioids, without the need to up the dose over many years' time.<br/>Furthermore, I was told that mere lay people are reviewing the prescribing doctors' records; they are not even medical professionals! And yet they are controlling my life and the lives of many RLS patients. Their fear-mongering and ignorance have made my life hell these last months.<br/>I live in a giant city and yet cannot get the help I need. I must travel across the country at great expense. Again, due to widespread ignorance and refusals to acknowledge the latest research. I have held the research under many doctors noses and they refuse to even read it.<br/>Thank you and best of luck to all who are suffering...and to those trying to change these outdated practices/assumptions!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1dde	Anonymous	None	2022-04-04T21:59:58Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-kvac-np26	False	None	False	2022-04-12 05:36:18.904	[]
3628	CDC-2022-0024-3634	https://api.regulations.gov/v4/comments/CDC-2022-0024-3634	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Everyday I am reminded that RLS is never going away. It will last til the day I am no longer alive am praying for a more effective prescription that works 24 hrs a day. The current meds out there have a window of about 12 hrs and forget going to the movies forget about socializing where sitting is the norm. Wouldn’t it be nice to be able to workout as doing so taking the current meds really ascerbates the symptoms of. RLS, which is uncontrolled limb movement affecting the legs major and the arms on a less intensive shaking . If opioids are more effective then lets go the opioid route. It will be dosed by my Neurologist, and it will be safe as I understand its a very powerful drug	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	WILLIAM	None	None	0900006484ff1e31	SMITH	None	2022-04-04T22:01:00Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from SMITH, WILLIAM	l1f-ltgh-191l	False	None	False	2022-04-12 05:36:19.112	[]
3629	CDC-2022-0024-3635	https://api.regulations.gov/v4/comments/CDC-2022-0024-3635	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have bilateral TOS, a condition which is notoriously, extremely painful. Opioids allowed me to continue working and gave me a quality of life. I have since had surgery for my TOS (first rib resection, scalenectomy, and pec minor release) and when I needed pain relief most it was taken from me because a pharmacist chose to misinterpret my prescription history through the states PMP. I had my surgery in another state, it should not have been unusual that I was receiving post operative medications for an incredibly brutal surgery from my surgeon. The nosy pharmacist spooked my surgeon and he has since refused to treat my post op pain. I’m now disabled and I cannot work. I’ve seen two new pain management specialists since surgery and I have been told my kind of pain should not be treated with medications but with injections. In good faith I tried the $800 injections but they made my pain significantly worse. Despite this they are still trying to push more on me, along with extremely sedative muscle relaxers and Belbuca…Belbuca has been causing severe tooth decay!! How on earth is that a solution when there are perfectly good medications in existence that I already know help me without any bad side effects? Is someone getting paid off? My PCP refuses to do anything about my pain, he has told me repeatedly to “go get a MMJ card”. How am I supposed to get a job if I test positive for marijuana?!?!! Nobody is thinking anything through, I’m just not their problem and that’s all that matters to them.<br/><br/>I’ve been desperate to get back into work, I can’t continue supporting myself with no income. What’s the point in going on living if I’m homeless and can’t feed myself?<br/><br/>The fact that the CDC has been including illegally manufactured fentanyl ODs in the number of prescription opioid ODs is disturbingly dishonest. The installment of these opioid guidelines has harmed countless chronic pain patients, many of them choosing to take their own lives rather than suffer. Someone needs to make this right.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6585	Anonymous	None	2022-04-04T22:40:43Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-f2yw-a8vf	False	None	False	2022-04-12 05:36:19.328	[]
3630	CDC-2022-0024-3636	https://api.regulations.gov/v4/comments/CDC-2022-0024-3636	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person with multiple chronic invisible illness it has become terrifying. Either suffer unbelievably or try and not die while supplementing with street pills. So far I am not turning to that danger but I can see all to clearly why people do. My dr wants to help but is hand tied after the DEA came in and told them in clear and unforgiving terms that they are only to prescribe a certain amount per person period. I can't imagine people with stage 4 liver cancer being told 3 hydrocodone 5/325 a day or a beuphenophine patch. Forget having an acute injury on top of it. If the pills you get are not sufficient on the daily then an injury and you still have to get up and go to work so you can hope to save your home etc? Some conditions like [redacted] include frequent injury on top of daily pain. It is appalling that so many are forced to try and find potentially fatal solutions that are outside of a medical care monitor or face loosing everything they have worked so hard for. Or the pain is so frequent and bad that everything else no longer matters. Heart breaking and wrong. Although I agree there should be awareness of the dangers of opiates, the pendulum has swung so far in the opposite direction, it has devastated pain patients who legitimately have a need for better pain management. It not only affects pain patients but the medical professionals who treat pain patients. They have become cold robots because how can a human who studied that hard for that long to help people be ok watching those people suffer. Patient after patient day after day same story and no way to relieve the suffering. The current guidelines and ability of DEA to come in and bully doctors into letting the suffering continue need to change. It is killing people, both patients and doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484ff65d6	Potteiger	None	2022-04-04T22:41:24Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Potteiger, Judith	l1j-g4bx-akrb	False	None	False	2022-04-12 05:36:19.541	[]
3631	CDC-2022-0024-3637	https://api.regulations.gov/v4/comments/CDC-2022-0024-3637	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a cpp for over 30 years. In that time I have, for the most part, been able to function and live a productive life because I had adequate opiate pain meds, which, along with other tools brought my pain to an acceptable level. That is, up until the cdc and dea decided that they knew better than my doctors how much medication I should have, in a misguided and failed attempt to fight the opioid crisis by taking away effective pain medication from the people who need it the most and going after the doctors who prescribe this medication. All because people like Andrew Kolodny and prop decided they are the "experts", when in fact their only motivation is monetary gain and the 100's of thousands of dollars they are making as so called expert witnesses against big pharma.<br/>The CDC needs to completely remove the mme recommendations from the guidelines. They are doing great harm to chronic pain patients. One size does NOT fit all. My doctor cut my pain medication in half because of these guidelines. He is terrified that the dea will come knocking on his door, and take away his license. So now his patients, who were once well managed on an effective dose of opiate medication are left without the quality of life they once had because they are unable to function. Is this how the US government treats their most vulnerable citizens now? Torturing them?<br/>I understand that there is a drug problem. Sadly there always will be. But even sadder is the way the cdc and dea and people like andrew kolodny have chosen to fight this fight. Because since the cdc guidelines were enacted this problem has gotten worse, not better. Overdoses are way up, because you refuse to go after the real culprits, drug lords, and the street drugs they provide. And now CPP have become your collateral damage. Many have have had to go to the streets since you have taken away their access to legal meds. Many are choosing to end their lives because they can no longer live with the excruciating pain that they have to endure because of your guidelines. Many have had to fake being addicts so they can get access to methadone, which is an effective pain medication. Something is very wrong with your approach when it causes 100's of thousands of legitimate patients to suffer. Patients who were NOT abusing their medication. YOU NEED TO FIX THIS. And not by putting a band aid over it. YOU NEED TO FIX IT. Stop allowing people to suffer.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Helene	None	None	0900006484ff65e1	Diponzio	None	2022-04-04T22:41:39Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Diponzio, Helene	l1j-gbjh-49uq	False	None	False	2022-04-12 05:36:19.753	[]
3632	CDC-2022-0024-3638	https://api.regulations.gov/v4/comments/CDC-2022-0024-3638	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern at the CDC, <br/> I am writing today on the behalf of the updated draft on the opioid guidelines. I have read both versions of the guidelines and not much has changed except how it is worded. It looks as if they were copied and pasted and changed only a few words! I do not have chronic pain, but my family members do! I can not begin to tell you how heart breaking it is to see your loved ones in so much pain they can’t think, can’t barely move, and to where they can not even hide it any more and they are violently shaking! Imagine being a prisoner in your own body, and then imagine there is only one thing that lightens the pain, doesn’t take it away, but makes it so you can move your body just to get out of bed! Now imagine being looked at like a criminal, an addict when you go to the doctor, some where you should go for help and to feel safe, and your scoffed at and treated like garbage, all for something you have no control over. You have tried all the therapies and all recommendations given in your 20 plus years of pain. Nothing works, except a safely regulated drug that’s produced in a factory. I am an ex-drug addict! I say ex because I no longer will hold that title. I have been clean for over 15 years. I will tell you, I never once blamed anyone else for my actions! They were my choices and mine alone! Addiction is everywhere! Sugar, caffeine you name it. Are we as humans now going to start regulating how much sugar and coffee we can put in are body in a day! Addicts will find any way to get what they want and will substitute anything in its place! The only ones affected by these so called guidelines are the doctors, (who are now so fearful to help ANYONE) and the actual patients needing opioid pain medication! Doctors have been threatened to lose their license, raided and held by gunpoint because the DEA and state legislators have weaponized the 2016 CDC guidelines! Pharmacies are being threatened! Patients are being abandoned and disregarded! Patients are in so much pain they would rather DIE! I never understood suicide! I couldn’t imagine anything being so bad that you want to take your own precious life before your time is up (and trust me I have been through a lot). Until I have seen my loved ones go through so much pain and agony, while being treated like garbage! What kind of life is that? That is no quality of life, and not one person on this earth should have to go through it! I urge you, let these people live what life they have left! not in agony! Let the doctors be doctors and actually do their job without the fear of losing their lively hood and even their freedom! These guidelines have hurt and even killed so many! I truly believe the CDC guidelines should be retracted! <br/><br/> Sincerely,<br/><span style='padding-left: 30px'></span>A very concerned and worried loved one, EX-drug addict <br/><span style='padding-left: 30px'></span>[redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	brent	None	None	0900006484ff661f	wennerlind	None	2022-04-04T22:42:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from wennerlind, brent	l1j-hc1j-nmll	False	None	False	2022-04-12 05:36:19.960	[]
3633	CDC-2022-0024-3639	https://api.regulations.gov/v4/comments/CDC-2022-0024-3639	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been using kratom to manage the syptoms of severe restless leg syndrome for the last ten years. Because of all of the mis-information put out by the CDC, my PCP keeps trying me on more standardized Rx drugs. The DA drugs made me nauseaus and unless I have a doctor willing to prescribe opioids to help me get off of a DA if (or more likely, when) I start to augment on the DA drugs, but my current neurologist doesn't believe in prescribing opioids, and just<br/> doesn't prescribe them at all. So I would have to go through the torture of getting off of the DA when I augment without the help of an opioid. I have read many postings from people who have augmented on a DA but then were not given an opioid to help them get off it. From what these people say, going off of a DA without the benefit of an opioid, is the definition of torture. The kratom has been wonderful for me--no side effects, and good control of the restless leg symptoms. Also, I have never gotten high from kratom; My experience is that you have to take way more kratom to get high than you need for pain relief. I know if I try to take more kratom than I need for symptom relief, I usually just vomit it up. It is very difficult to get high on kratom: it tastes simply horrible, and you have to take a lot to get high at all. I taught high school for almost 40 years, and I have a very hard time seeing teenagers fall in love with kratom. It tastes awful and doesn't easily make you high.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff6626	Leonhardt	None	2022-04-04T22:42:39Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Leonhardt, Mary	l1j-hgfl-catz	False	None	False	2022-04-12 05:36:20.169	[]
3634	CDC-2022-0024-3640	https://api.regulations.gov/v4/comments/CDC-2022-0024-3640	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in pain management for over 20 years due to chronic pain. The doctors here are diffently using the hardliner for Opioid patients. I've been having issues with them keeping my meds the same. Everything a new report comes out I'm the one left hurting. They insist on a 50 mme hardline for me and they just keep cutting my meds. I don't ask for anymore then I'm on and had been on the same amount for over ten years, the exact prescription for 10 years and now they keep cutting them. Now the pain management I'm with is not excepting my insurance and no other pain management want to take me as a new patient. So what am I to do. The doctors around here are dropping pain management practices like flies. Chronic pain is the only med issue that is so demonized that everything I let doctors know what I'm on the instantly assume I'm a junkie. And that stereotype is so demoralizing. Is their anywhere We can do or anything we can do to stop this terrible treatment of people with "real" problems	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dena	None	None	0900006484ff662b	Walters	None	2022-04-04T22:42:51Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Walters, Dena	l1j-hkxs-z7ta	False	None	False	2022-04-12 05:36:20.416	[]
3635	CDC-2022-0024-3641	https://api.regulations.gov/v4/comments/CDC-2022-0024-3641	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a longterm pain patient I first started opioids in 2009 after trying all other options. From 2009 to 2017 my pain was under control and my primary care doctor who know my health well was prescribing my opioid needs. Due to the cdc guideline I was moved to pain management. The first thing was they felt the need to lower the amount that been working to control my pain. Thats when my health started to go downhill once they got me down to below the cdc guidelines things really changed in my life.Before this I was a active person who enjoyed life who now due to increased pain had to leave my job and was almost bed bound due the pain.<br/>My primary care doctor was surprised to see my health worsen to this degree but her hands where tied. I spoke with pain management about this but they said due to cdc rules that couldn't increase medication. Going to pain management was the stressful and was scared they lower pain medication. The monthly visit felt more like a interrogation than medical care. After a year of being on the lower dose they said since I was still in pain the needed to remove the pain medication since it wasn't helping. At this point it was causing depression as the continued to lower dosage the pain levels increased to the point i wasn't able to get out bed. I ended up switching to another pain management and they at least returned to cdc guidelines. Still thou everyday was I barely able to do anything. Then when pandemic came my pain management doctor decide to retire. I was unable to find another and went thru withdraws. The last 2 years have been worse of my life. I went from 161 to 130 in weight I spent hours crying out in pain daily and it has damaged relationship with most of my family and friends.<br/><br/>I don't see how destroying people life's has helped the overdose problems. Since these guidelines been installed overdose has increased. Last year there was over 100,000 but only around 10,000 happened to people that had a doctor prescription for a opioid. Sadly some people become so desperate living with pain and turned instead to street drugs. Drug dealing filled the void for many instead of doctors. For others it was even worse and suicide was the there only option. <br/>Please let doctors decide how best to treat patients a one size for all approach doesn't work. I want my life back instead of being a burden on family and friend please allow me to again enjoying my life with them.<br/> Honestly I'm not even sure why the cdc should be writing recommendation. Pain does not fall under a disease control. They have destroyed enough people lifes in the last 6 years with there bad policies. How many more life must be lost are needed before they correct there mistake?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	0900006484ff61e3	Havis	None	2022-04-04T22:43:17Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Havis, Mike	l1j-jcb9-xb8j	False	None	False	2022-04-12 05:36:20.623	[]
3636	CDC-2022-0024-3642	https://api.regulations.gov/v4/comments/CDC-2022-0024-3642	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 64 years old I’ve been to two different pain management doctors. I’ve been on OxyContin and I needed it at the time. I no longer need that strong of a pain medication but now I am fighting to try to simply get the pain relieved that I have come to realize that I need after all that I’ve been through. My current pain management doctor constantly tells me that they will lose their license if they prescribe certain medication‘s for me. I know what I need and I know what I don’t need. I feel that my general practitioner knows me well enough that she could help me with my pain meds if she was allowed to. My ability to function in my daily life is being altered because my pain management doctor refuses to prescribe medication that will help me. This doctor wanted to put needles in my back the minute I walked into his office and I refused. I’ve used every alternative method medication or therapy that I can and I’ve come to the conclusion that pain medication is needed. Unfortunately because of the CDC regulations doctors are afraid to listen to their patients and prescribe what they need. I’m in adult, I am merely trying to function at the end of my life after working on jobs that were hard labor all my life. I feel like even if the CDC change their guidelines it’s going to be years before any of us get relief from the meddling of government in our pain. It’s time to allow doctors to treat their patients again. Everyone knows that street the drugs are now the problem with overdosing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff61f9	Anonymous	None	2022-04-04T22:43:26Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-jtun-ek4m	False	None	False	2022-04-12 05:36:20.840	[]
3637	CDC-2022-0024-3643	https://api.regulations.gov/v4/comments/CDC-2022-0024-3643	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As I read thru the comments posted the only ones who feel opioids are not needed to control pain are people not in pain. Sadly they do not understand how living in pain daily affects ones life. It easy to say no when it doesn't effect you. Before these guideline fentanyl wasn't a issue now its become a huge problem. Anyone looking at stats can see its not people with a prescription for opioids overdosing but it's due to a cause and effect of these horrible guidelines. <br/>When you remove millions of people from a drug thats controlling pain some will instead turn to street drugs. Others will commit suicide rather than face a lifetime of pain. Please listen to the voices of people suffering from pain over those who aren't. I know they mean well but facts show these guidelines vastly worsened the problem. Show some compassion you have no ideal what a life in pain is like. Why should we suffer when there medication that allows us to live a productive live and enjoyable life instead of pain. How much longer and how many more need to die before common sense is restored?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484ff6219	Jones	None	2022-04-04T22:43:46Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Pam	l1j-kc3j-ui94	False	None	False	2022-04-12 05:36:21.056	[]
3638	CDC-2022-0024-3644	https://api.regulations.gov/v4/comments/CDC-2022-0024-3644	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment on the proposed 2022 CDC clinical practice guidelines for opiate prescribing. I am a physician who has recently retired from a busy clinical and academic practice at Harvard Medical School. As a clinician I am well aware of the double edged sword that opiates represent. They are an important part of doctors' armamentarium in treating cancer, post operative pain, and other conditions, but have the ability to be abused in their prescribing and in their use. I write today, not only as a physician, but as a decades-long sufferer of Restless Legs Syndrome (RLS). In my case the RLS symptoms are both genetic (my father had RLS) and severe. Millions suffer from RLS, which is one of the diseases least appreciated and most overlooked by busy clinicians today. The treatment for RLS is problematic. Dopaminergic medications work at first, but then become less and less effective and even augment symptoms (augmentation syndrome). Other medications such as gabapentin help some but make patients very drowsy and prone to loss of balance and falling. Research has shown and I can attest from my own personal experience that small doses of opiate work wonders for RLS. For over 5 years I have been part of the national registry study of opioids in RLS, conducted out of Mass General Hospital, by Dr John Winkelman. The results of the registry study were recently published, and show a significant effect of opioids in controlling RLS symptoms. Moreover, the side effect profile of opioids in treating RLS is very good, and there was only a very mild increases in dose per patient over the several year follow up of the registry. I don't know what I would do if I did not have my low dose of oxycodone to help me every night before bedtime. If, for any reason, I forget to take it I am up walking the floors of my home with RLS symptoms, much like my now deceased father did decades ago, when RLS was barely understood. In your 2022 updated opioid prescribing guidelines, I implore you to include RLS as one of the disorders for which opioid treatment is indicated to control moderate to severe symptoms. Thank you!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronald	None	None	0900006484ff6226	Silvestri	None	2022-04-04T22:44:33Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Silvestri, Ronald	l1j-kpzz-jt0l	False	None	False	2022-04-12 05:36:21.265	[]
3639	CDC-2022-0024-3645	https://api.regulations.gov/v4/comments/CDC-2022-0024-3645	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eric	None	None	0900006484fef48a	Kozfkay	None	2022-04-05T01:07:28Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kozfkay, Eric	l1e-wx12-0lcs	False	None	False	2022-04-12 05:36:21.472	[]
3640	CDC-2022-0024-3646	https://api.regulations.gov/v4/comments/CDC-2022-0024-3646	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am on SSDI for chronic neuropathy pain. In Wisconsin I was receiving Lidocaine Infusions at [location redacted] Hospital. This worked well for me but the cold in Wisconsin made my pain so much worse that I could barely get out of bed during winter. So I decided to move to a warmer climate. I bought a house in [location redacted], Arkansas through the USDA’s Low Income home purchasing program. While preparing for this move my roommate in Wisconsin decided she could sabotage my plans and keep me there by not paying her half of the rent and utilities. To cover all of the bills in that home, and save the money that I needed to move, I got a job delivering pizza. In order to work and pack for my move, my doctor gave me a prescription for hydrocodone. Then my car died. So I had to finance the cost of a used car so I could get to my new house. This is an extra monthly expense that I hadn’t counted on when budgeting for the house. When I got to [location redacted] my doctor continued to prescribe the hydrocodone until I could get into a new pain doctor. This took about three months. I saw Dr. [name redacted] at [clinic redacted] in [location redacted]. He accused me of being an opioid addict and said the only thing he would do was put me in their rehab program to get me off of pain meds and then if I just did an hour of aerobics six days a week I wouldn’t have any pain! I was very upset by this. He wrote me a two week prescription for hydrocodone and said I had two weeks to decide. He also signed the form for me to get a Medical Marijuana card. I left and never went back. Didn’t fill the hydrocodone prescription. Stopped cold turkey, that’s how “addicted” I was! But I did get the Medical Marijuana. I tried to work but couldn’t without pain relief. Then the pandemic started. This allowed me to defer my mortgage payments until last January. Throughout the pandemic I tried to get into many other pain doctors in [location redacted] and [location redacted]. No pain doctor will even see me!! Being bedridden in pain most days, the stress of not being able to work and the way I was being treated by the doctors caused me to become very depressed and suicidal.<br/>As I am now facing being homeless because of this cruel pain medication policy, I posted on [clinic redacted]’s Facebook page that I was going to get a gun and blow my brains out in front of the [clinic redacted], with a note pinned to my chest revealing how they treated me and how it lead to my being homeless and suicidal. THIS got the hospital’s attention FINALLY! I was contacted by the hospital’s Patient Experience Specialist and I told him everything. He spoke to the pain clinic and they called me. I was told that I would ONLY be able to see Dr [name redacted] and that I would be put in their rehab program. So I asked her “How are you going to justify charging Medicare for a rehab program to get off of a drug that I HAVE NOT HAD FOR TWO YEARS?” She replied “We do it all the time and they pay it.” So not only would I have to agree to being labeled an OPIOID ADDICT, a lie that would follow me in my medical record for the rest of my life, but I would also have to cooperate with what sure feels to me like insurance fraud!! And then she told me I had to seek care elsewhere! So I contacted the Patient Experience specialist at the hospital again. I forwarded him copies of my medical record from Wisconsin where they show I have neuropathy, diagnosed by a punch biopsy, was having Lidocaine Infusions, and that my doctor prescribed the hydrocodone so I could work and pack for my move. Additionally I sent him an email from my doctor in Wisconsin where she stated that she does not consider me “addicted” and nowhere in my medical record does it suggest that I am. The hospital patient experience specialist contacted the pain clinic again and got them to schedule me an appointment. He also told me that he was a patient at the pain clinic and he was having success with a Suboxone patch. I told him Suboxone doesn’t come in a patch, that just the Buprenorphine comes in a patch. I told him I would not take the Suboxone because that in itself labels me an ADDICT, and per the CDC website it doesn’t do much to treat nerve pain, or any REAL pain for that matter. So now I’m waiting to see Dr [name redacted] on April 19th. In the meantime I can’t work without pain meds and I’m close to becoming homeless. I don’t hold out much hope that Dr [name redacted] will actually treat my pain and my back up plan is suicide. <br/><br/>Withholding pain treatment from someone with a proven physical cause is causing harm to the patient and violates their Hippocratic Oath!!<br/>How many people have to choose suicide to end their pain before you stop this?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484fefda5	Troestler	None	2022-04-05T01:14:28Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Troestler, Mary	l1e-yyon-hqvu	False	None	False	2022-04-12 05:36:21.689	[]
3641	CDC-2022-0024-3647	https://api.regulations.gov/v4/comments/CDC-2022-0024-3647	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from RLS for over 20 years. I took prescription drugs for it but it caused augmentation and I soon became worse, unable to sit through breakfast or long enough to read a newspaper any time of the day. Can you imagine what it's like to not sleep and have to walk and walk all night long because of RLS? You can't even sit or watch TV because your legs only give you peace when you are moving. It's torture to be so exhausted your body is falling over but you have to keep moving or twitch and move involuntarily. Taking a low dose opioid is the only thing that has given me enough peace to sleep. Without sleep not only do you hallucinate after days but you can't work or function at all. It makes you not care if you live or not, you just need to get some peace for yourself. I am attaching a photo of my expensive sheets that were shredded by my constant movement of my legs from RLS. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roslynd	None	None	0900006484fefe4e	Wenrich	None	2022-04-05T01:16:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wenrich, Roslynd	l1e-zbhx-o85d	False	None	False	2022-04-12 05:36:21.925	[]
3642	CDC-2022-0024-3648	https://api.regulations.gov/v4/comments/CDC-2022-0024-3648	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The revised 2022 CDC Clinical Practice Guidelines for Prescribing Opioids were reviewed by a subgroup of the ACPM Science and Translation Committee. Consensus was that these updated guidelines are an improvement on the 2016 guidelines, and are useful for informing clinicians involved in treating those with opioid use disorder. Over the past few years, some stakeholders have misapplied the 2016 guidelines by interpreting the recommendations as inflexible prescribing and treatment restrictions in policy and medical therapy (https://www.cdc.gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html). In their 2022 updated guidelines, the CDC emphasizes that their guidelines are solely recommendations, and should be considered as an aid to a person-centered treatment plan. However, in their updated guidelines the CDC removed references to specific MME, which were helpful guideposts. <br/>The United States makes up less than 5% of the world's population, but consumes over 80% of the world's opioids, 99% of the hydrocodone supply, and 2/3 of the world’s illegal drugs ([names redacted]. Therapeutic opioids: a ten-year perspective on the complexities and complications of the escalating use, abuse, and nonmedical use of opioids. Pain Physician 2008 Mar;11(2 Suppl):S63-88). Despite this prevalence, it can be difficult to uncover patients who are on multiple narcotics prescriptions from different clinicians, and/or may be diverting narcotic medications to others. It can also be difficult to wean patients from high-dose opioids. The CDC’s 2022 guidelines provide recommendations for use of PDMPs, and leveraging counseling and other specialties in an integrated way to lessen opioid use. Applied in a consistent manner across the spectrum of clinicians, these guidelines may have a measurable impact. However these recommendations alone are not sufficient to stem the opioid epidemic, without effective and comprehensive public policy and community-level interventions. The National Institutes of Health has released the National Pain Strategy as the Federal Government’s first coordinated plan to address pain management on a national level. <br/>Medical school curricula do not adequately prepare physicians for opioid prescribing ([names redacted]. A focus on the future of opioid prescribing: implementation of a virtual opioid and pain management module for medical students. BMC Med Educ 22, 18 (2022)). The recommendations in the 2022 CDC guidelines can be used to help craft targeted training for future doctors. Importantly, they should not be applied in a directive manner that prevents clinically-indicated and individualized treatment, and removes physician autonomy.<br/>Our suggested edits include:<br/>-<span style='padding-left: 30px'></span>Recommend changing “person-centered” to “patient-centered” throughout the document.<br/>-<span style='padding-left: 30px'></span>Recommend adding to discussion about opioid overprescribing and diversion, since over half of persons abusing prescription opioids obtained them from someone else (Lipari RN, Hughes A. How People Obtain the Prescription Pain Relievers they Misuse; 2017).<br/>-<span style='padding-left: 30px'></span>Recommend expanding discussion of naloxone options including: prescribing by physicians, dispensed per protocol at pharmacies, or available over-the-counter.<br/>-<span style='padding-left: 30px'></span>The CDC 2022 guidelines state that a majority of surveyed physicians feel uncomfortable appropriately prescribing opioids. What recommendations does the CDC have to address this? Increased/improved opioid prescribing education in medical school? Improved CMEs on opioid prescribing? More education and familiarization by opioid manufacturers? Also, there should be some discussion that PAs and NPs are more likely to prescribe high frequency, high dose opioids in comparison to physicians ([name redacted] Differences in Opioid Prescribing Among Generalist Physicians, Nurse Practitioners, and Physician Assistants. Pain Medicine, 2020;21(1)).<br/>-<span style='padding-left: 30px'></span>In discussion about cost effectiveness of various interventions, the criteria defining cost-effectiveness are not described. A summary of the cost-effectiveness criteria may be useful.<br/>-<span style='padding-left: 30px'></span>Recommend adding OUD management recommendations for hospitalized patients who may be discharged on pain medication.<br/>-<span style='padding-left: 30px'></span>Additional suggested areas of research should include: enhancing access to naloxone, and recommending new ways to decrease payer and regulatory barriers to OUD therapy.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff051d	None	None	2022-04-05T01:23:04Z	American College of Preventive Medicine	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from American College of Preventive Medicine	l1f-3pvj-rwq8	False	None	False	2022-04-12 05:36:22.138	[]
3643	CDC-2022-0024-3649	https://api.regulations.gov/v4/comments/CDC-2022-0024-3649	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I personally have suffered with RLS for over 20 years. I have tried every medication and treatment available, only to have my symptoms worsen. The lack of quality sleep has greatly reduced my quality of life. Since being prescribed a low daily dose of opioid approximately 1 year ago, my symptoms are greatly reduced and I am able to achieve quality sleep. Unfortunately, my insurance will not cover the expense of the medication because it has not been approved for use in the treatment of RLS. Please consider adding RLS as one of the conditions approved for treatment with low dose opioids. I have attached a copy of a study supporting the use of carefully monitored low dose opioids for the treatment of severe cases of RLS’<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	0900006484ff0823	Mergener	None	2022-04-05T01:23:31Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Mergener, Tammy	l1f-5mia-78fd	False	None	False	2022-04-12 05:36:22.346	[]
3644	CDC-2022-0024-3650	https://api.regulations.gov/v4/comments/CDC-2022-0024-3650	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bindu	None	None	0900006484ff106a	Popat-Lewis	None	2022-04-05T01:25:51Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Popat-Lewis, Bindu	l1f-a1xy-pxd1	False	None	False	2022-04-12 05:36:22.554	[]
3645	CDC-2022-0024-3651	https://api.regulations.gov/v4/comments/CDC-2022-0024-3651	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Walter	None	None	0900006484ff153d	Goodson	None	2022-04-05T01:29:52Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Goodson, Walter	l1f-b4os-zgqm	False	None	False	2022-04-12 05:36:22.771	[]
3646	CDC-2022-0024-3652	https://api.regulations.gov/v4/comments/CDC-2022-0024-3652	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have had severe refractory restless leg syndrome for over 20 years. I was treated with various dopamine agonists, which worked at first but then made my RLS much worse. I went from doctor to doctor trying to find help. I prayed I would not wake up for over 6 months and finally found a neurologist willing to treat my RLS. I was put on daily, low dose (7.5 mg) Methadone and it was life-changing. I now have a normal life. My RLS is 95% under control. It is extremely important to know that I NEVER feel high or drugged. My dosage has not changed in over 5 years. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. <br/>RLS is horrific. If I lost access to this drug without an option that worked, I would not be here. Imagine being as tired as you have ever been in your life and you cannot sleep because your legs are jumping around due to extremely uncomfortable feelings. You have to get up and walk around to get it to stop. However, you are so tired it is hard to walk. Until we have a cure or a better solution, I beg the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rosemary	None	None	0900006484ff1551	Stader	None	2022-04-05T01:30:29Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Stader, Rosemary	l1f-bae7-9hws	False	None	False	2022-04-12 05:36:23.003	[]
3647	CDC-2022-0024-3653	https://api.regulations.gov/v4/comments/CDC-2022-0024-3653	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	An aaddendum.<br/><br/> I have trouble finding the right words to describe how much this pain haunts me as well as what the "Opioid Crisis" had turned me into.<br/> Doing really well. Gotten myself into great shape. THEN. (For me the they or them are the VA). They started to mess around with my simple prescriptions. Started falling. While falling trying to get HELP the whole time. EVEN NOW PLEADING FOR HELP. STILL. I GET. Sorry don't know anything about chronic pain. Or. Something like that.<br/><br/> After all People in Pain have had to go through.<br/><br/> First "TOLD" You have to STOP USING YOUR ANXIETY MEDICATION,NOW! Then started Barrage of Negativity, Labeling, Talking Down Too, Gaslighting, False Statements in Records, Misleading Information, Misdiagnosed, Missed Diagnoses After all of this We Still Have To Face our PROVIDERS KNOWING THAT THEY ARE LIEING, UNWILLING TO HELP Hypocritical, Unethical, Providers.<br/> NOW WHAT ARE WE SUPPOSED TO DO, REALLY, WHAT ARE WE TOO DO.<br/> I try to Not fall asleep sitting in a chair. Every Day It Is the same. I have a chair that I can sit in out front at front porch/door. I go from sitting out on front porch to sitting at/on a counter height stool at kitchen counter then to Lazy Boy Recliner with 5 pillows that help me from falling forwards when I Do Fall Asleep in that chair only to be awakened in severe pain from falling asleep in the chair. Doing this ALL Night and Day After Day and EVERY NIGHT OVER AND OVER AGAIN ANOTHER DAY, ANOTHER NIGHT, ANOTHER WEEK, ANOTHER MONTH, ANOTHER YEAR.AND <br/> FOR THE REST OF MY LIFE!!! SUFFERING EVERY MINUTE OF EVERY DAY.<br/> I get NO Peace No Comfort No Rest.<br/><br/> When I Finally do decide to lay down, I have to set the alarm for three hours. If I stay lying in bed for longer than that the pain gets soo bad I will be Nauseous for most of the rest of that day... Vomiting after drinking ICE COLD WATER when rising from my couple of hours of interrupted unrestful sleep?<br/> ONLY TOO DO IT AGAIN.<br/> Ironically I have Insomnia along with the MANY Complications that Follow. Which by itself is a Serious Medical Condition that requires immediate treatment to prevent possible complications that can arise from Improper Underteated Untreated Treatment. I have a eating Disorder ALSO From my Sleeping disorder ALSO Caused by my Intractable Chronic Pain Conditions that have Been Left UNTREATED AND OUT OF CONTROL Causing many unnecessary Conditions that are EZY to treat with Proper Pain Management. Instead of creating EVEN MORE PHYSICAL/PSYCHOLOGICAL Detrimental Conditions.<br/> Pain left uncontrolled is Obviously Not healthy to ones health. Take it from me. Abusing patients by not Treating and Torturing them to the point of the pain patients wanting to KILL ONESELF.<br/><br/> I am 100% Service Connected Veteran. I am being Tourtured/Abused by my local VA Hospital. In Southern Arizona.<br/><br/> I single Veteran makes it TOO EASY FOR "PROVIDERS" Too DEFLECT responsibility to just NOT CARE.<br/><br/> I am a Chronic pain patient of 30 plus Years. I left my home in Florida IN 1996. I was being treated for my conditions ALL OF THEM. Then, The NEW VA PALM BEACH HOSPITAL Opened. This is when Darvon & Darvecet was taken off the market. Around that time is when I was told by the First couple of Providers "Well, I was just in a meeting. We were told to cut back or lose your job". They did not lose their job.<br/> I have noticed this type of treatment is concurrent with the OPENING OF NEW FACILITIES.<br/> I was told I have "Osteoarthritis. You need to Move to a Dryer More Arid Climate at a Higher Elevation".<br/> have been running from this pain for far too long now. To HAVE TO SUFFER AND START OVER AGAIN WITH EVERY NEW PROVIDER THAT I SEE. WHICH IS NOT THE PROVIDER THAT I NEED. It IS A GAME THAT THE SUPERIORS OF THE HOSPITAL TRY TO HIDE BY GIVING VETERANS AN APPOINTMENT ANY APPOINTMENT WITH ANY PROVIDER JUST TOO BE ABLE TO SAY "HE HAD APPOINTMENTS" When in fact we just get brushed off, And told "YOUR FINE" After looking at the Blood Pressure Monitor while in the ER stating "196/110 pulse at 106" YEA I'M FINE.<br/><br/> So yes. Just trying to make it through another day. In hopes that I will Finally get some help I NEED. Not sure how much more of this pain that I will be able to handle. It gets Harder Every Day then a Front will come through and FLARE-UP EVERYTHING.<br/><br/> FYI.Intractable Chronic Pain Patients ALREADY Feel like [profanity redacted] ALL DAY. Then provider wants to give you something that WILL CAUSE/DO MORE HARM, NOTHING to help the pain AND CAUSE MORE PAIN.<br/><br/> After Reading MANY Comments on here.<br/> I see that I am NOT ALONE with ALL THIS PAIN THRUST at me.<br/> IT is a shame knowing how much pain I am in is. OK. With THE MEDICAL COMMUNITY.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1483	Anonymous	None	2022-04-05T01:36:13Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-hhks-p1ci	False	None	False	2022-04-12 05:36:23.212	[]
3648	CDC-2022-0024-3654	https://api.regulations.gov/v4/comments/CDC-2022-0024-3654	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are a credible treatment for RLS and for some, the only treatment. Physician's cannot count on DAs (Parkinson's drugs) as an appropriate first line medication for RLS any longer. The side effects of augmentation are predictable and serious. Other off-label drugs and iron infusions may or may not work. Low-dose opioids nearly always provide relief, yet can be difficult to obtain since there are few physicians willing to monitor this treatment. As an individual with 35 years of experience with RLS, I can attest to the lack of options for effective treatment of this disabling disease which can interfere with work and home life significantly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Glenna	None	None	0900006484ff1d66	Blomquist	None	2022-04-05T01:37:08Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Blomquist, Glenna	l1f-j92y-om2x	False	None	False	2022-04-12 05:36:23.446	[]
3649	CDC-2022-0024-3655	https://api.regulations.gov/v4/comments/CDC-2022-0024-3655	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient and a Registered Nurse that spent her career in emergency nursing. I destryoed my spine helping others. I have had 19 surgeries with my 20th scheduled for the second week of May 2022. I have had one pain management doctor completely shut down by the DEA for “over prescribing opioids” he was a neurologist the specialized and trained in pain management. He had a large successful practice that left close to an estimated 50,000 patients left without a doctor. He had several PAs & NPs working with him as he over seen their care. However, there were several reported suicides in the media from patients left without hope. I had to move to an entire new state to continue my care because being his patient carried a stigma and no one local would treat me. Then when I moved I was rapidly withdrawn from many of my medications due to the new CDC recommendations. I am very physically debilitated and utilize a walker just to ambulate. My pain is not controlled. I can not function at this level of care. The CDC guidelines need to be revised to make stable chronic pain patients exempt.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jessica	None	None	0900006484ff1dc0	Hopson	None	2022-04-05T01:38:06Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Hopson, Jessica	l1f-kfi8-2xvt	False	None	False	2022-04-12 05:36:23.655	[]
3650	CDC-2022-0024-3656	https://api.regulations.gov/v4/comments/CDC-2022-0024-3656	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484ff1e2e	Walford	None	2022-04-05T01:42:39Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Walford, Chris	l1f-lstd-cq2i	False	None	False	2022-04-12 05:36:23.893	[]
3651	CDC-2022-0024-3657	https://api.regulations.gov/v4/comments/CDC-2022-0024-3657	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in Florida. I am a stroke survivor that has back pain and neck pain that I survived in a car crash separate to the stroke. I have to drive 45 minutes to see a pain specialist because no one in my area will prescribe any opioids or any pain relief for me and my condition. Furthermore, I have been labeled a pain pill seeker and an addict. I can guarantee you that both of those things are not true. I wish I had answers for you as to how I can make this thing better but I don't and right now the only thing that helps me keep going are the pain pills. I am a mother, I'm a wife, a daughter, a sister, a cousin and a friend. Please stop punishing pain patience. If you'd like to see suicide skyrocket then I suggest you stay on this path if you want to change your environment change the way you prescribe pain medication for people that are suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Claudia	None	None	0900006484ff1e70	Tejada	None	2022-04-05T01:43:05Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Tejada, Claudia	l1f-mm9v-th95	False	None	False	2022-04-12 05:36:24.101	[]
3652	CDC-2022-0024-3658	https://api.regulations.gov/v4/comments/CDC-2022-0024-3658	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand the Opioid crisis here in America, and understand the need to control them. What I don't understand is not being able to get them when suffering from chronic pain, unless you have suffered from chronic pain you don't understand the need. Please think long and hard about this, my friend suffers from chronic pain and her Dr's are afraid to prescribe the pain medication she needs, out of fear. If a person is abusing them, then by all means the Dr should not prescribe them. A person who uses them correctly will be able to get up and be a successful part of society. Punish the abuser, and not those who are using them correctly. <br/>Thank you for your time<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006484ff1e71	Garcia	None	2022-04-05T01:43:18Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Garcia , Debbie	l1f-mn22-eegi	False	None	False	2022-04-12 05:36:24.317	[]
3653	CDC-2022-0024-3659	https://api.regulations.gov/v4/comments/CDC-2022-0024-3659	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was glad to hear that the CDC is revising the Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My husband has struggled with RLS for many years and the non-opioid treatments no longer work for him at all. He has worked with a sleep specialist for several years to try to get some relief from this devastating condition. While not a perfect solution, he is doing better now that he is taking low-total-daily-dose opioids. It is a constant fear that something will negatively affect the availability of this treatment. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like my husband.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tina	None	None	0900006484ff1e8b	Kurys	None	2022-04-05T01:43:46Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kurys, Tina	l1f-mxmj-vxwh	False	None	False	2022-04-12 05:36:24.528	[]
3654	CDC-2022-0024-3660	https://api.regulations.gov/v4/comments/CDC-2022-0024-3660	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am concerned that the draft update of the CDC Clinical Practice Opioid Prescribing Guideline does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. As I too well know, the symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications often make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am 60 years old and have suffered from RLS for over 20 years. Until 3 years ago I was able to successfully treat the condition with a non-opiod medication. Then, my body began to react differently and the medication that once helped began to hurt. Over a period of a couple of years I tried multiple alternatives at two different hospitals in Boston with highly respected clinics for sleep disorders. I suffered the daily torture of RLS symptoms, sleep deprivation and medication side effects. I was unable to work or experience a normal life with friends and family. As a last resort, I agreed to try low-dose opioids. Finally, my RLS symptoms are well managed again and my life is returning to normal.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues. In addition to my personal experience as related above, please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS and the role opioids can play in mitigating the devastating effects of this serious condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484ff1e7d	Kurys	None	2022-04-05T01:43:51Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kurys, Daniel	l1f-muly-6i4e	False	None	False	2022-04-12 05:36:24.742	[]
3655	CDC-2022-0024-3661	https://api.regulations.gov/v4/comments/CDC-2022-0024-3661	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for all your work on the Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids - however those of us who struggle with a chronic condition Restless Leg Syndrome have been left out in your considerations. There is a large group of individuals who can not get relief with the with traditional medicine approved for RLS. However we do get relief from a low daily dose of opioids. Without the help of this daily dose It is impossible for me to get comfortable enough to relax in the evenings - without this dosage it becomes impossible to sleep. Please reconsider and make an allowance for those of us who are trying to exist with this condition! Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484ff1eb7	Mattocks	None	2022-04-05T01:44:31Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Mattocks, Laura	l1f-n7kj-qbo2	False	None	False	2022-04-12 05:36:24.961	[]
3656	CDC-2022-0024-3662	https://api.regulations.gov/v4/comments/CDC-2022-0024-3662	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic Pain Patients have never been the source of the Opioid epidemic. As a Chronic Pain Patient well before 2016 my pain at one time was properly treated, I followed all instructions from my doctor, and never took more medication than was prescribed. After the guidelines were enacted, I was abruptly taken off of my medication, forced to undergo procedures that provided no relief. (In fact, steroid injections made my pain worse) and put on 7 additional medications that do NOTHING to treat my pain. My quality of life has decreased, my memory is foggy, and I suffer side effects from the additional medications that were given to replace the opioids that helped me live a normal life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tiffany	None	None	0900006484ff1ec9	Kozak	None	2022-04-05T01:44:44Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kozak, Tiffany	l1f-nc4c-7ptz	False	None	False	2022-04-12 05:36:25.170	[]
3657	CDC-2022-0024-3663	https://api.regulations.gov/v4/comments/CDC-2022-0024-3663	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guidelines, but the draft doesn’t address chronic conditions like RLS that are different from chronic pain. The symptoms make it impossible to sleep or even sit quietly, which seriously affects every aspect of daily life. A few prescription medications may relieve symptoms for awhile, but over time those same medication make the symptoms worse. When all other medical fail, ample scientific research supports the use of low-total- daily dose opioids to treat severe RLS. Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.RLS.org as a resource for scientifically-based information about RLS as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary Lee	None	None	0900006484ff1f0c	Morgan	None	2022-04-05T01:44:51Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Morgan, Mary Lee	l1f-nusk-ucnz	False	None	False	2022-04-12 05:36:25.380	[]
3658	CDC-2022-0024-3664	https://api.regulations.gov/v4/comments/CDC-2022-0024-3664	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started suffering from Restless Leg Syndrome After passing out because of ventricular tachycardia. Current medications will be temporary and eventually will stop working and even make symptoms worse. I have no desire to use controlled substances but eventually may be the only treatment that can help me to control a disease which has no cure.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484ff1f42	Soroken	None	2022-04-05T01:44:58Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Soroken, Mark	l1f-o7zj-b8v0	False	None	False	2022-04-12 05:36:25.592	[]
3659	CDC-2022-0024-3665	https://api.regulations.gov/v4/comments/CDC-2022-0024-3665	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate and thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, however the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a 31 year old woman who first developed RLS at 8 years old. I was misdiagnosed and suffered into my twenties before trying RLS medication. The first-line RLS medications are typically dopamine agonists. They caused severe side effects as well as augmentation, a common phenomenon in which RLS gets worse and requires more and more dopamine agonists to manage symptoms. I finally saw a RLS specialist who prescribed me a daily low dose methadone. I am not exaggerating when I say low dose opioids gave me my life back. With 10mg of methandone a day my symptoms are managed and I can sleep. Before proper treatment I would toss and turn in agony until 5am every night and wouldn't be able to sit down during the day for more than 20 minutes at a time. Please consider what it would be like to not be able to sit down on the couch after a long day of physical labor (I work in the trades). Low dose opioids are the only medication I have tried that have successfully treated my RLS and given me the opportunity to sit still without agonizing symptoms. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ally	None	None	0900006484ff1f46	Bortolazzo	None	2022-04-05T01:46:07Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Bortolazzo, Ally	l1f-o9qq-rsaz	False	None	False	2022-04-12 05:36:25.802	[]
3660	CDC-2022-0024-3666	https://api.regulations.gov/v4/comments/CDC-2022-0024-3666	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please,Please consider the use of low dose opioids for restless leg syndrome- this could help eliminate the use of every night dopamine medicines. Restless leg syndrome is worse than having a pain issue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484ff1f50	Itkowitz	None	2022-04-05T01:46:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Itkowitz , Joseph	l1f-od2v-t7zx	False	None	False	2022-04-12 05:36:26.020	[]
3661	CDC-2022-0024-3667	https://api.regulations.gov/v4/comments/CDC-2022-0024-3667	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC has no business authoring guidelines to treat pain. They are not doctors who have ever treated patients with pain. The CDC guidelines for opioid prescribing have wreaked unimaginable havoc in the pain community, leading to the deaths of countless people. The CDC needs to be held accountable for the damage they have done and be forced to retract their guidelines and give patient care back to our doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1f66	Anonymous	None	2022-04-05T01:47:50Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-oiuy-zvea	False	None	False	2022-04-12 05:36:26.228	[]
3662	CDC-2022-0024-3668	https://api.regulations.gov/v4/comments/CDC-2022-0024-3668	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You people are criminals! You have blood on your hands. People are suffering and you know what the right thing to do is. People are making money while pain patients suffer, and people are dcommiting suicide. This is a joke and the epidimic is from street fentynal so those lifes are on your hands to. My mom has been denied a quility of life and wont even have neccecary surgerys. Time is ticking and you know what the right things to do is.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1f76	Anonymous	None	2022-04-05T01:48:21Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-on5v-8asp	False	None	False	2022-04-12 05:36:26.439	[]
3663	CDC-2022-0024-3669	https://api.regulations.gov/v4/comments/CDC-2022-0024-3669	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a life before the CDC guidelines on opioid prescribing took everything away from me. Not only can I not get effective treatment for my painful conditions, but I've been abandoned by the medical profession and can't get any of the care I desperately need. The CDC has no business writing guidelines for treating pain! Redact the guidelines NOW.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff2194	Anonymous	None	2022-04-05T01:55:17Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-phdr-n9hl	False	None	False	2022-04-12 05:36:26.652	[]
3664	CDC-2022-0024-3670	https://api.regulations.gov/v4/comments/CDC-2022-0024-3670	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good afternoon my name is [name redacted] and I am a chronic pain patient. I am here to give you my testimony. The Centers for Disease Control overstepped their bounds when they came out with the opioid guidelines in 2016. They have destroyed lives without conscience, they have torn families apart with absolutely no regard for the damage they have incurred. All I have to say about this is ask yourself if you were going to go in to have your gallbladder removed or your appendix taken out, would you be okay with the doctor not giving you any kind of sedative or anything for pain while you were under? This is one of the horrifying side effects of your horrifying guidelines. Not once did you stop and take time to ask the public what their opinion would be in this matter. The chronic pain Community has lost so many friends, mothers, Brothers, fathers, sisters, grandmothers, grandfathers to your worthless and useless guidelines. I understand that you want to make certain types of medications safer for the people but this specific guideline has had horrible effects. Millions have died and millions more will die because of these guidelines and even though you tell the doctors that they are just guidelines, the doctors are being paid do not prescribe these medications, to come up with ways to do surgery without any type of use of these medications. I underwent a hysterectomy a year after my daughter was born and if I had not had Oxycodone after I had that surgery, I would very well have had a heart attack from the pain. Surgery is not something that should be taken lightly or be performed with little to no sedation. A person is being literally cut open, tissue and body parts are removed, and this is all being done with no regard to the patient's pain level. This is barbaric. This is what happened in the 17-18 and early nineteen-hundreds when there were no medications 2 do surgery without just biting down on a stick. We are in the year 2022 and there is no reason for this. These guidelines should be completely scrapped and the CDC needs to get out of this area of Medicine. Stop thinking that the Centers for Disease Control as anyplace telling a doctor how to treat their patients pain. It's insulting to the population of the United States and for every patient who had their medication yanked from their hands, the remaining family should come forward should be able to come forward and Sue the CDC and put you out of business. I would not go to a law firm until the lawyer had it run his business. This is what you're doing it needs to be stopped. And as far as [name redacted] goes, he has absolutely no business in this business. He doesn't care how many people died. Put yourself in our position. Go through an amputation without any pain medication. Good day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484ff21a2	Wike	None	2022-04-05T01:56:36Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Wike, Amy	l1f-pl5e-icbp	False	None	False	2022-04-12 05:36:26.873	[]
3665	CDC-2022-0024-3671	https://api.regulations.gov/v4/comments/CDC-2022-0024-3671	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have RLS and nothing really works to stop it that I have tried except hydrocodone. My life is miserable. I can't sit through church, movies, drives, airplane rides. Please help me. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicki	None	None	0900006484ff1a71	Fischer	None	2022-04-05T01:59:05Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Fischer, Vicki	l1f-q4du-vszu	False	None	False	2022-04-12 05:36:27.081	[]
3666	CDC-2022-0024-3672	https://api.regulations.gov/v4/comments/CDC-2022-0024-3672	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have RLS and without opiods I would never sleep, ever. My life would be beyond unbearable. Low dose opioids allow me to sleep most nights like a normal person.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynn	None	None	0900006484ff1aec	Kucharas	None	2022-04-05T01:59:10Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Kucharas , Lynn	l1f-qmjn-j1dv	False	None	False	2022-04-12 05:36:27.292	[]
3667	CDC-2022-0024-3673	https://api.regulations.gov/v4/comments/CDC-2022-0024-3673	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi I m a acute chronic pain patient .i have stenosis of the spine .DDD.bone spurs .plates and screws in back and neck .which are coming apart .i ve had 4 surgeries on my right should which last time I had x ray it has gone spurs and a bag of flood on it .Shoulder on left side is coming apart .i can't stand and walk or sit for only 15 min at a time cause I m in so much pain .i ve had 2 surgeries on my back and no one want to touch my back now because of my deteriorating disk .i have bulging disk all the way down my spine .i m in pain all the time I can't go any where do to pain .i have no life because of the guideline you people have it in place . And the Mme .one pill does not fit all .i get very little pain meds to try and help .but it doesn't .some days I just want to just throw in the towel and say you won .But I don't want to hurt my family .So why do I need to suffer like this. The guide line you all put our needs to go .Let doctors be doctors and do there jobs .also I m so tired of getting talked to like a dog from pharmacies and insurance companies cause I m a pain person not a addict .why do they talk to us this way because they can and because of the propaganda that was put in place 2016 .Now 2022 is even worse lower the Mme down more .So we are going to get treated worse .why ????	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1af1	Anonymous	None	2022-04-05T01:59:45Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-qr8z-fsze	False	None	False	2022-04-12 05:36:27.500	[]
3668	CDC-2022-0024-3674	https://api.regulations.gov/v4/comments/CDC-2022-0024-3674	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been on Ropinirole 1mg, 4mg/day, for over 3 years. It finally began to decrease its effectiveness, immensely. I was able to be put on 30mg Codeine at bedtime, and am finally able to sleep through the night 4 to 5 nights per week. I had been getting up 4,5,6 times per night to walk for 20 to 30 minutes each event because of my RLS. Now, if I do have to get up due to my restless legs, I only need to walk for 5 to 10 minutes to get back to bed and sleep. I continue to have RLS symptoms during the day, mostly evenings. I cannot sit for greater than 30 minutes, many times less, to read, watch TV, meditate, or perform devotionals anytime during the day. If you will, please try to imagine yourself unable to sit for any significant length of time during the day or evenings or getting any uninterrupted sleep at night...ie: 4, 5, 6 maybe 7 hours of sleep total. My sincere hope is that you will allow LOW DOSE opioid medications to control RLS symptoms. Thank you for hearing my story.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484ff1b62	Cox	None	2022-04-05T02:01:16Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Cox, John	l1f-qybe-atd9	False	None	False	2022-04-12 05:36:27.711	[]
3669	CDC-2022-0024-3675	https://api.regulations.gov/v4/comments/CDC-2022-0024-3675	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There are alot of us with chronic pain and some of us turn to suicide because it is so hard to get any kind of opioid. It is not right. Do what is right for the people in chronic pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carrie	None	None	0900006484ff1b73	Mawhinney	None	2022-04-05T02:01:24Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Mawhinney, Carrie	l1f-r1ha-jh6l	False	None	False	2022-04-12 05:36:27.956	[]
3670	CDC-2022-0024-3676	https://api.regulations.gov/v4/comments/CDC-2022-0024-3676	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been prescribed opiates for almost 7 years due to chronic and severe pain issues in my body. The doctor that I have been seeing for the past 4 years or so is tremendous. He has tried numerous other treatment plans where opiates were not used but unfortunately those treatments did not give me any relief at all. I take my pain medications "by the book" meaning that I never run out early, I never abuse these drugs in any way at all and without these opiate prescribed treatments I would suffer every day from when I wake up until I go to sleep (sleep is all but impossible without the opiate drugs.<br/>I totally understand the nationwide (and worldwide) concern for people who overdose or use these medications in the wrong way and I am in 100% agreement that something needs to be done to stop the "recreational" use of opiates.<br/>At the same time however, there are many people who suffer 24 hours a day from different pain ailments so taking away from us a medication that is proven to work	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff1c68	Anonymous	None	2022-04-05T02:01:46Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-sf6s-ncmw	False	None	False	2022-04-12 05:36:28.166	[]
3671	CDC-2022-0024-3677	https://api.regulations.gov/v4/comments/CDC-2022-0024-3677	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on low dose opioids for almost three years now. This medication is my “last resort” medication dealing with my Restless Legs Syndrome. I don’t like the side effects, but nothing is worse than dealing with the extreme discomfort and inability to sleep. I’ve tried everything, including gabapentin, dopamine agonists, therapists, chiropractors, magnesium, iron infusions, etc. to no avail. Please do not do anything to block my access or anyone else with this condition to opioids. Thank you, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teressa	None	None	0900006484ff1cab	Nelson	None	2022-04-05T02:02:05Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Nelson, Teressa	l1f-skwx-uk23	False	None	False	2022-04-12 05:36:28.382	[]
3672	CDC-2022-0024-3678	https://api.regulations.gov/v4/comments/CDC-2022-0024-3678	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have a genetic form of RLS-My dad had it. My son was diagnosed at age 5 in the 1990s; he was one of the first known pediatric cases. I’ve never, nor has my son, known what it’s like to feel rested after sleeping. I’m unable to fall asleep without medication. My symptoms are relentless, but are worst when I’m trying to fall asleep at night. My sleep test in 1993 showed that I kicked 300-400 times, and awakened every 7-8 minutes in an 8-hour period. I have unbearable discomfort if my legs aren’t able to move, either during the day or at night. I have pain and exhaustion from RLS. I’m now over 65, and pray that before I leave this earth, I’ll have a good night’s sleep. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484ff1cd9	Schwager	None	2022-04-05T02:02:21Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Schwager, Karen	l1f-t312-7l0k	False	None	False	2022-04-12 05:36:28.596	[]
3673	CDC-2022-0024-3679	https://api.regulations.gov/v4/comments/CDC-2022-0024-3679	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been suffering with RLS for at least 15 years. This chronic medical condition takes it toll on me, even now, at age 71. My physician had finally started me on a very low dose Opioid because nothing else worked for me and I am much improved. I still have breakthrough nights where I must walk instead of sleep, but without the low dose of Tramadol that I am taking in the evening, the restlessness would begin very shortly after sitting down to watch a TV program in the evening and I would be up every night walking instead of sleeping! Please allow Opioid therapy for RLS as an option and help alleviate the suffering of this terrible malady.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in monitored low-total-daily doses.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff2543	Campbell	None	2022-04-05T02:02:33Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Mary	l1f-tmvg-cw60	False	None	False	2022-04-12 05:36:28.826	[]
3674	CDC-2022-0024-3680	https://api.regulations.gov/v4/comments/CDC-2022-0024-3680	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a recently retired college professor who suffers from Restless Leg Syndrome (RLS). Although I found relief from a prescription of ropinirole, after several years I suffered from augmentation, a significant worsening of my symptoms. The other main alternative drug category available for RLS sufferers, without associated augmentation, is gabapentin-type drugs. I've tried a number of these (gabapentin, pregabalin, and Horizant) and have not found them effective for me. Currently I am not using any prescription drug to treat RLS and, consequently, suffer most nights. Please consider adding a low dose of prescription opiods to the pharmaceutical arsenal available to doctors for individuals who suffer from RLS and have no other pharmaceutical option.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	0900006484ff2547	Ogletree	None	2022-04-05T02:02:48Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Ogletree, Shirley	l1f-tn6o-0knt	False	None	False	2022-04-12 05:36:29.036	[]
3675	CDC-2022-0024-3681	https://api.regulations.gov/v4/comments/CDC-2022-0024-3681	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am writing to ask you, as an entity that exists for the public good, to PLEASE STOP having doctors, FDA, DEA, etc. mandatorily refer to these CDC Guidelines (even your re-write) for treating chronic pain in America. I am a living example of one for whom the PROPER use of opioids have verifiably saved my life after a plane accident left me with severe, intractable pain syndromes and a spinal cord injury. In fact, my treatment – one that has been a stable dose, though higher than “normal” for 16 years -- allows me now to have a more normal life than I ever thought possible again!<br/>Mine is a story that, at its center, features someone who had never used an illicit drug IN HER LIFE, nor did she want a lifetime spent taking them. In 2000, I was in an aircraft accident on the job as an Airborne News & Traffic reporter. In the mild treatments & PT for the back injury, I then got what became a spinal cord injury when a Discogram procedure punctured a hole in my spinal cord lining. I still wanted to be the "good patient,” diligently doing all the doctors told me to do in order to physically heal the best. Surgeries could restore my skeleton but not address the ravaging pain. Before this point I hadn't known of "chronic pain" as a real problem - after all, don't you just get used to it after a while? (THAT is one of the biggest misconceptions about chronic pain EVER and yet it is still the most prevalent idea in the public not directly touched by the problem; see the Institute of Medicine Report "Relieving Pain in America: ...). <br/>To control the pain, I tried physical therapies, electrical box units (aka T.E.N.S. unit) that sent my nerves through the roof; I did epidural steroid injections, nerve blocks, facet blocks and more that led to 79 punctures to my back. I then tried acupuncture, biofeedback, more/different physical therapies, internal pumps and much more. (ALL TO AVOID “ADDICTIVE” PILLS!!!) My body degraded each time until by August of 2004, I was mostly bed bound with a resting heart rate of 102 and a body that was near going into SHOCK more than once a month. Cardiology reports that this kind of cardiac stress is typical for a person with severe undertreated pain.<br/> What was the result of this life in ever-increasing pain without the use of opioids? 18 newly diagnosed issues with 5 separate diseases/conditions that - for the rest of my life - will cause pain signals to overwhelm my body every moment of every day. I then got my first pain syndrome called injury Adhesive Arachnoiditis - Stage 3 because my spinal cord was now shredded and caked in hardened scar tissue from all the NON-OPIOID epidural steroid injections so that now, each individual nerve in my spinal cord from L3 (mid waist) to my coccyx (tailbone) gets torn -- TORN- with each move I make (my innate sarcasm begs me to scream "but wow folks, screw those evil pain pills, huh?” because this spinal cord injury route is so much better!” SIGH*). Central Pain Syndrome is next: it causes my whole spinal cord to churn out pain as if it were a pulse, feeling it from head to toe. Experts have called this syndrome "the pain ABOVE pain." Another one of the so-called “suicide diseases” hit me next: CRPS-type 2, aka Complex Regional Pain Syndrome – Type 2. That syndrome took over my entire sympathetic nervous system and causes it to malfunction in anyway it finds feasible. <br/>So, what finally gave me a life out of bed and with more of a restored life than I'd ever hoped to have? A closely watched regimen of not just OPIOIDS, but higher-than-average dose opioids that I have been on now for 16 years with each subsequent year restoring one more piece of my damaged health picture (hypothalamus, thyroid, etc.) Any disease-managing medication will have side effects and mine are managed with some extra supplements. I am living proof that if the tool of opioids is known to its specialist, than important things can come from individualized dosing. As you may observe by my writing here, though I am on opioids at this moment I am not mentally or physically altered. I communicate with lucidity; my overall health picture has improved, not deteriorated with long time use. Each person and case MUST be taken individually. For each case of the diversion and "bad apple" patients, there are hundreds of real, honest, law-abiding but suffering patients who look to each of you for help. <br/>"Education' - NOT - "Prohibition" is what is going to turn around the tide of unintended victims that come from both sides of the Opioids for chronic non-malignant pain. Addicts will always get their fix – but real patients only have one place to go, their doctor. The IOM report's estimated 100 MILLION patients in America who SUFFER with some form of CHRONIC PAIN. I beg YOU, do not LEAVE THEM with no tool of relief just because opioids are not yet perfect. Thank you. <br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Radene	None	None	0900006484ff261a	Cook	None	2022-04-05T02:07:48Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Radene	l1f-ukfw-cvzz	False	None	False	2022-04-12 05:36:29.244	[]
3676	CDC-2022-0024-3682	https://api.regulations.gov/v4/comments/CDC-2022-0024-3682	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I applaud CDCs involvement in addressing the ravages of substance abuse as a major public health concern, I urge them before submitting further guidelines to do due diligence regarding the benefits and risks of current regulatory efforts and guidelines not only as they pertain to prescription related outcomes but overall public health outcomes related to pain management and opioid/substance abuse. Pain being the 5th vital sign was not based on Big Pharma profits but solid evidence re overall health outcomes. The pain rules in Washington State appear to have aggravated overall opioid related overdoses. Coincidence?Common sense says otherwise but the CDC is purportedly the expert re population based evidence pertinent to Public Health. I suggest they focus on what they are best preprared to do and getting pulled into the opioid regulatory clinical arena through "guideline" production was/is a fiasco and another example of their meaningful work being "politicized".	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JAMES K.	None	None	0900006484ff2736	ROTCHFORD, MD MPH FACPM	None	2022-04-05T02:11:40Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from ROTCHFORD, MD MPH FACPM , JAMES K.	l1f-w22u-1wyc	False	None	False	2022-04-12 05:36:29.461	[]
3677	CDC-2022-0024-3683	https://api.regulations.gov/v4/comments/CDC-2022-0024-3683	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2016, the Guidelines for opioid prescribing came out.<br/>What a complete disaster that has been! <br/>Those so called guidelines quickly became laws, according to most Dr's in the US. Patients were cut off or completely abandoned by the same people who took an oath to help. The CDC teamed up with DEA to terrorize Dr's who prescribed opiods. Many quit practicing. Many were threatened with prison. Chronic pain patients were totally screwed by your so called guidelines. The CDC was warned by many in Healthcare that this was not the way to stop the overdose problem in America. But the CDC got PROP and all their little anti opioid people on the committee and NO pain specialist or pain patients to have UNBIASED and a balanced committee.<br/>After 3 years, in 2019, the CDC came out and stated the Guidelines were being " mis applied " 3 years? Why not 3 months after the witch hunt started? Why not hold a televised press conference about the HUGE mistake it made?<br/>Now, 6 years of HORROR layer, the overdoses in America have hit over 100,000!! Just let that sink on for a minute. This in spite of legally written prescriptions being at a 20 year low.<br/>Not to mention the thousands who could not take the constant pain and took their own lives.<br/>Rescind All of the ridiculous so called Guidelines. Let MY pain management specialist practice medicine!! <br/>This is NOT the CDC jurisdiction. This is FDA.<br/>Get rid of the ridiculous MME!! It is junk science and isn't helping. One size doesn't fit all.<br/>Admit you screwed up and trash the whole thing. Also , you need to get [name redacted] and [name redacted] and all the others on your committee with HUGE CONFLICT OF INTERESTS. You are going against your own by laws.<br/>No MME, cause all that will happen is that is what Dr's see and legislature will see that. Get out of my Dr appointments. This is between me and him. When you get a degree to practice medicine, then you can have your own practice, until then, get out of my medical business.<br/>Please rescind the Guidelines and the MME.<br/>You are literally killing us CCP.<br/>I know we are not important to you in government, but we are all important to our families and friends.<br/>Stop torturing us!!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kay	None	None	0900006484ff279e	Emery	None	2022-04-05T02:20:13Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Emery, Kay	l1f-wpva-476f	False	None	False	2022-04-12 05:36:29.672	[]
3678	CDC-2022-0024-3684	https://api.regulations.gov/v4/comments/CDC-2022-0024-3684	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please , Please, Please listen! I am the mother of 2 grown sons who has Sickle Cell, ages 30 and 32. I have watched them suffer from pain episodes their whole life, however, it wasnt until they became adults that we begin to experience institutional racism, when it comes to pain medication. Please note, both of my sons try their best to manage their pain at home until it becomes unbarable and then they have to go to the ER for stronger medication. Almost everytime they have gone, they are either told, "your blood work, looks fine", which is not and indicator they are having PAIN, or they are treated as if they were their to score drugs or to get high. It's a shame, that in order for them to get treated with dignity and respect and when I, their accompany them to the ER. I litterally have to go to the ER and sit with my grown sons for the doctors and hospital to know they are not just their to score drugs, but there because they have no choice. My son's would rather be at work , then the hospital!!!<br/>Now the ER has access to my sons Medical Records because they have been going there for years, so they see that both my sons, may only come in once or twice a year for PAIN episodes, so they are not there for drugs but because they are in pain. They are refused strong medication and want to discharge them. I have to contact the Patient advocate or the doctor 90% of the time to get fair treatment. Do the doctors not understand that the hallmark of Sickel Cells is PAIN-my sons describe it as if someone was crushing their bones, and even sometime the strongest medication doenst kill the pain, but it does give them some relief.<br/>Refusing them pain medication is like refusing a Cancer Patient Kemo!!!!!<br/>or refusing a Diabetic patient insulin!!!!<br/>Will someone please educate the doctors on Sickle Cell at [location redacted] Michigan. PLease start with staff.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patrice	None	None	0900006484ff27f7	Jones	None	2022-04-05T02:21:48Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Patrice	l1f-x7li-wxmk	False	None	False	2022-04-12 05:36:29.886	[]
3679	CDC-2022-0024-3685	https://api.regulations.gov/v4/comments/CDC-2022-0024-3685	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was a clinical social worker and CPS investigator for almost 20 years when I was attacked.by a client. I was injured and required emergency surgery to repair both my neck and my back. I also suffer from autoimmune disease. I had permanent damage from both. After my injury with the help of my Dr, my pain was managed with opioid medications that allowed me to continue working and raising my daughter. I had a good quality of life despite the constant pain. I used any and all possible alternative treatments to avoid taking opioid medications. I tried physical therapy, tens unit, meditation, yoga,massage,acupuncture, medical marijuana, psychotherapy, creams,heating pads, behavioral therapy, decompression therapy, chiropractic, trial for CSC stimulator, spinal infections, ratio frequency ablation, all with very little relief. Opioid medications were a last resort. They worked, I was able to continue with career and raise my family. In 2017, my doctor said that the CDC said opioid pain medications don't work for chronic pain long term. He said he had no choice and abruptly stopped my medication without warning or refill. He told me the CDC said it makes pain worse. He said he was sorry, he didn't believe the CDC but was just too fearful of being jailed. I was sick for months, i lost my job 6 months later because I couldn't sleep due to the pain, nor complete my work in an acceptable manner. I had to apply for permanent disability and was approved for permanent disability. Prior to my Dr suddenly stopping my medications I was on allowed 120 mme dose that didn't change for 8 years. I was also forced on Gabapentin at high doses, which has left me with severe memory issues and other horribleside effects. After 3 years of agony I was at the end of my rope, stopping the pain medications didn't make me better it left my in agony. I contemplated suicide as there's is no other avenues of relief. I refuse to obtain medications illegally. I tried multiple doctors and Pain management drs only to be told they understand my pain and wanted to help but were no longer prescribing opioid medications for anyone. It never got better, only worse. The pain is unbearable. I'm not depressed or suicidal, I'm mad and in agony. I lost my quality of life, my career that I loved,and most importantly, my ability to parent my only child. It took almost 3 years to find a new Dr and now I have to fight to get a small dose, a fraction of my previous dose. It doesn't provide adequate relief. But it's all I'm allowed. The new guidelines are going to extend and worsen my suffering. The current guidelines have a 90mme limit. The new ones lowered that yet again to 50mme. Despite the statements that this isn't a hard rule, all drs will follow this out of fear of prosecution and insurance companieswill use this to refuse to pay just like 2016. The reference to ANY MME LIMIT MUST BE REMOVED. It repeatedly says that opioids aren't effective for chronic pain. That's untrue, I know it. I live it. Please give me my life back. People are dying everyday due to lack of pain relief. These medications have been used as effective treatment of pain for thousands of years. Until there are safe, effective,available and affordable treatments for pain, don't deny me the ability to live my life….at the current time, I don't live, I only exist. Thank you for your consideration. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paula	None	None	0900006484ff2845	Perry	None	2022-04-05T02:22:26Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Perry, Paula	l1f-xpeo-d5uy	False	None	False	2022-04-12 05:36:30.098	[]
3680	CDC-2022-0024-3686	https://api.regulations.gov/v4/comments/CDC-2022-0024-3686	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please suspend this and allow Doctors to treat patients as they see fit to the quality of life. Not all pain feels the same to people. Some people need a lot, some none, some a little. My husband has had 2 back surgeries, so many failed injections that I've lost count. He needs a 3rd and a 4th surgery and his pain keeps getting worse. He once could manage the pain with pain pills, well the Dr. quit giving them and sent him to a pain clinic where they changed all of his medications completely and he's been in horrific pain ever since. They refuse to give him his fast acting pain medication that was working. They keep trying to push suboxone on him. We know the side effects of that are far worse than the pain pills that once helped him. Because of these guidelines doctors are afraid to help people and the people who the CDC is supposed to look after are left to suffer. Many so bad that they would rather take their own life than live another day in the pain that they suffer with. Doctors are there to help, not make patients worse. My husband has recently started talking about taking his own life rather than living like this. Taking away his pain pills has taken his quality and possibly quantity of life away from him. Not only from him, but us as his family as well. The one person I thought could do anything has been reduced to a bed not able to move in pain because he is refused the pain pills he so desperately needs. There are so many good people who just want a quality life, but because they're in pain they've been denied that or reduced to go to the streets desperate for something to help. You have the power to stop this. I beg you to do the right thing and protect the patients and allow them the meds they need to live. Allow Dr's the freedom to help patients. The more restrictions put on this the more lives will be lost because people just can't live in excruciating pain day in and day out. It's exhausting both mentally, emotionally, and physically. Families are being destroyed by suicide, street drugs, and any way they can find relief. Again, we beg you to suspend this people need the correct medication and helpful doses to live a life worth living. Help give that to the people who need it and their families.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shelly	None	None	0900006484ff2851	Hartman	None	2022-04-05T02:25:21Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Hartman, Shelly	l1f-y48s-wx72	False	None	False	2022-04-12 05:36:30.317	[]
3681	CDC-2022-0024-3687	https://api.regulations.gov/v4/comments/CDC-2022-0024-3687	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Although I have had RLS since I was a child, like many other people I have been more seriously impacted as I've gotten older. It has caused me often to be unable to sleep until after 4 a.m., seriously depriving me of sleep and disrupting my health and ability to participate in daily life. Although I have tried several medications recommended by my doctor, nothing worked until I began taking a very low dose of Codeine and acetaminophen. This medication has permitted me to fall asleep at a normal time, and has reduced the number of times that I am awakened by RLS in the middle of the night. It has changed my life and kept me from the depression that I was suffering due to the torture of sleep deprivation. I am aware of no alternatives that would work for me, because the other drugs and therapies that I have tried were not effective.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rob	None	None	0900006484ff2893	Thomas	None	2022-04-05T02:26:29Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Rob	l1f-yene-2l61	False	None	False	2022-04-12 05:36:30.528	[]
3682	CDC-2022-0024-3688	https://api.regulations.gov/v4/comments/CDC-2022-0024-3688	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with chronic refractory eye pain prior to the CDC's Guidelines and after years of trying less invasive methods I sought out and was able to find a sympathetic doctor who provided me a small daily dose of hydrocodone (Norco), equivalent to what a dentist would give to someone who just had a root canal. It gave me enough relief to be able to function a few hours a day as we tried desperately to find experimental treatments. After the CDC guidelines, the tone changed significantly, doctors would arbitrarily reduce my dosage to meet administrative goals, force me to attend physical therapy and group sessions, force me to try and retry alternatives even when they had already been tried shown to be ineffective, subject me to random drug screenings, and even take away my medications and force me into withdrawals despite responsibly using the medications for years following doctor's orders amd showing no signs of abuse. <br/><br/>My condition is genetic and incredibly painful. The epithelial (upper layer) of my cornea grows in such a way that my eye basically tears itself apart, causing painful erosions and a constant state of burning pain. Anyone who has ever been injured with a corneal abrasion or similar injury it is a pain that cannot be ignored and OTC options like Advil do not come anywhere close to providing relief, imagine the impact that living with that level of eye pain daily and the subsequent burning neuropathic eye pain would have on someone's life with no relief.<br/><br/>I have always asked for the minimum dose, my hospital kept me at the same level for years, eventually my condition progressed and I needed more medications adding a long acting morphine (MS Contin) because the prior level I could not even sleep through the night from the pain. I was bounced from specialist to specialist, some of which were open about their intention to switch me off even though all 1st 2nd and 3rd line medications had been tried. I would then fight and show once again my proof of my condition and fight with administrators until eventually they agreed to put me back on opioids. I was lucky to have a good understanding of my condition and the Healthcare system and be able to win these battles, I could have and still might lose that battle at any time as countless others have. <br/><br/>I have a professional background working with Healthcare and Public Health, I understand the risks very well and abusing these medications has always been furthest from my mind, years of experience has shown these medications have not only helped me when no other drugs could, it also shows I have been a responsible user and will remain so until a better option comes (if that should happen in my lifetime) . Even when the pain caused me to not be able to work, I still kept the dose low enough that I can just get through the day. <br/><br/>I am now forced to be on disability because there is no job I can support myself on while coping with this pain and the damage to my eyes. My whole life has been changed by my eye pain, all I want is a chance. I want a chance to keep surviving and looking for experimental treatments, but I live in constant fear that the hospital will target me once again to be forcefully "transitioned" to a lesser medication that doesn't work, or a new doctor who has never learned about painful conditions like mine despite the imaging from corneal specialists that shows the cysts and epitheliopathy and dysfunctional subbasal nerves. Unfortunately corneal specialists don't train in pain management, I am forced to deal with primary care and pain doctors with no understanding of the impact this pain has, their supervisors want results on the "opioid epidemic", and I am well aware that I could be made a victim. <br/><br/>I shouldn't have to live with this fear, and being marginalized by the doctors who are supposed to be helping me. I witnessed first hand the before and after as the CDC Guidelines were published and my hospital began forcing chronic pain patients to less effective medications and bragging about their "successes" on social media. The statistics now show that opioid overdoses from legally prescribed meds are not only low to begin with, but falling. If the goal is to save lives, keep in mind the lives of chronic pain patients. We don't want to die, we want to keep fighting and looking for a cure, but there are few good options. Some patients will commit suicide rather than live with the pain. Some patients will undoubtedly turn to the streets if their doctor denies their medications, that's where dangerous illegal fentanyl and heroin are plentiful.<br/><br/>The doctors and hospitals now are better educated on the dangers of opioids, they understand the risks and have made changes. The doctors who prescribe may not be perfect but they understand their patients' needs better than a committee at the CDC ever could. Please act sensibly and compassionately and let chronic pain patients get the help they need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Noah	None	None	0900006484ff28da	H	None	2022-04-05T02:27:10Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from H, Noah	l1f-yvqk-o8x0	False	None	False	2022-04-12 05:36:30.736	[]
3683	CDC-2022-0024-3689	https://api.regulations.gov/v4/comments/CDC-2022-0024-3689	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want on record that in the last 6 years I have watched so much torture <br/>and suffering come since these guidelines. I have watched a 6 year old <br/>cancer patient unable to get liquid morphine, my own niece have my great <br/>nephew had to be yanked out of her ribs to save both of them - he sustained <br/>a torn lung and she got 2 days! of pain meds!, my mil has been narcanned TWICE <br/>when she had conscious issues from utis BECAUSE now young doctors have become <br/>trained that everything is an opioid crisis! <br/>My fil was cut off of his opioids from the VA - no tapering- he first got heart damage, <br/>then kidney damage- watching him suffer was unforgivable. Mercifully he died last year. <br/>I have now lost track of the wonderful- talented- productive persons I met on Twitter who <br/>committed suicide because they could no longer take the pain or the ones their bodies <br/>just gave out. <br/>I was personally reduced in 2016 even though I have multiple chronic painful conditions <br/>documented by multiple doctors. In 2017 I was abandoned when I would not put a <br/>pain pump in my spine where I have arachnoiditis- cfs leaks - iih- chiari- scoliosis- <br/>osteoporosis- osteoarthritis- slipped disks etc - my nsg said absolutely NOT! <br/>Guidelines that were supposedly meant for pcps have been weaponized against chronic <br/>pain patients- disabled- elderly and veterans. We are dying and being tortured. <br/>50mme an arbitrary standard- nsaids that cause kidney damage- ignoring pharmogenic <br/>testing - ignoring the PRACTICE of medicine! will be forever known as what those <br/>at the CDC did <br/>Rescind these guidelines— reeducate mds- DEA and stop the torture <br/>opioids are safe and effective <br/>fund research into pain and the brain - into chronic conditions <br/>History will NOT be kind to all those complicit!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff28de	Anonymous	None	2022-04-05T02:27:37Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-yxqq-yu8l	False	None	False	2022-04-12 05:36:30.946	[]
3684	CDC-2022-0024-3690	https://api.regulations.gov/v4/comments/CDC-2022-0024-3690	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had severe and chronic Restless Legs Syndrome for over thirty years. My Mom had it, my three brothers have it and my son has it. It has been absolutely brutal and akin to torture at times. I took a medication called Pramipexole for the past twenty years. It worked real well for some time and then stopped working. The RLS attacks became even worse after this medication no longer helped. Hundreds of sleepless nights, the inability to sit still at meetings and use a keyboard. It effected my whole body. Then due to serious rotator cuff injuries I was prescribed Oxycodone, (10mg). It knocked out the RLS symptoms. Please, Please, Please put in guidelines addressing chronic RLS that for the worst cases opioid therapy in daily low doses monitored by your doctor. Thank you, [PII redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006484ff2906	Howland	None	2022-04-05T02:28:12Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Howland, Thomas	l1f-zkyu-8pn6	False	None	False	2022-04-12 05:36:31.160	[]
3685	CDC-2022-0024-3691	https://api.regulations.gov/v4/comments/CDC-2022-0024-3691	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 76-year old woman suffering from Restless Legs Syndrome since I was a teenager. Over time, it has gradually gotten worse. I suffer from a genetic form of anemia--thalassemia trait--which keeps my hemoglobin level low and thus exacerbates the RLS. I have seen doctors for decades to try to find some relief from my problem, which severely impacts my life and my ability to carry out normal activities. For instance, I cannot sit through a regular 2-hour movie without having to get up and walk around. Also, I only get five or six hours of uninterrupted sleep at night. At present, I am taking Ropinirole and pregabalin, which keeps the symptoms mostly at bay, although each day is a struggle to see whether the medications or the RLS will be the victor. Following knee replacement surgery, I was temporarily given a low dose of an opioid for pain management. It worked so well that I was able to suppress some of the other meds. I feel that if I could continue to take a low dose of the opioid, it would mean a significant improvement in my quality of life, however, physicians will not prescribe it for me. I assure you, at my age, I am not going to run amok and become addicted and want more and more of the medication. I am simply looking for some relief from my problem. I urge you to consider prescribing a low dose of opioid medications for the relief of RLS, to be administered, of course, under carefully controlled conditions. Please!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484ff24b2	Ponce	None	2022-04-05T02:28:26Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Ponce, Jane	l1g-12vw-g9fw	False	None	False	2022-04-12 05:36:31.372	[]
3686	CDC-2022-0024-3692	https://api.regulations.gov/v4/comments/CDC-2022-0024-3692	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My dad has nerve problems in his back. I don’t want to even think about what would happen if his doctor didn’t have the ability to give him opioids to help him with that pain. They save his life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jada	None	None	0900006484ff2d18	Mayne	None	2022-04-05T02:28:34Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Mayne , Jada	l1g-5gpf-s6mg	False	None	False	2022-04-12 05:36:31.781	[]
3687	CDC-2022-0024-3693	https://api.regulations.gov/v4/comments/CDC-2022-0024-3693	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is extremely important that low dose opioids be included in the treatment of severe RLS! I personally know that life becomes so painful and difficult that one no longer wishes to go on and only through their belief in God does one continue to struggle and pray for relief. Please allow the use of opiates and continue research for cause of RLS. Thank you, we will be so grateful for your consideration!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katharine	None	None	0900006484ff2d1d	Barry	None	2022-04-05T02:28:41Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Barry, Katharine	l1g-639n-57rs	False	None	False	2022-04-12 05:36:32.002	[]
3688	CDC-2022-0024-3694	https://api.regulations.gov/v4/comments/CDC-2022-0024-3694	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not continue entering the doctor’s office with every patient. Please discontinue this absurd obsession with removing the most inexpensive and effective relief available for people with chronic pain. My journey began as a child of neglectful parents. The pain I suffered as a child was brutal and increased through my teens. By the time I had 3 operations to clear infection from my bones, when I turned 18 and took a job with benefits to fix myself, it seems to have been too late. Then the county hospital, during an RN strike, botched my first childbirth. I suffered a spinal injury, fractured coccyx, bladder and nerve damage. When my husband nearly died in his early 30s, he was rushed to a hospital and while still in his hospital bed, he was laid off. In the 90s, pre-existing conditions were not covered. I worked full time for benefits for the rest of us, and to pay his COBRA. His first application for disability was denied because he was ‘able to attend church’. I worked a second job and my health went downhill from stress and lack of sleep. Fibromyalgia, Hashimotos, constant and unrelenting back pain, piriformis syndrome. digestion issues, surgery after surgery. I was prescribed a prescription pain reliever 27 yrs ago. Coupled with an anti-inflammatory and gabapentin, I can still get by on that original dose. It doesn’t change that I wake each day with searing pain. It’s the kind of pain you know you should escape. The brain scrambles to find the source. Then I remember…who I am, and that this is my life. I get up, take my thyroid med and the rest of the medication. Thirty minutes later, I can finish doing my hair and on a good day, apply makeup. I make my way downstairs to run our business. Every 4-6 hours I take medication. Thus, I make dinner, keep the house up, sometimes go on vacation, and walk an hour on most days. I participate at some level. I remember the first time a pharmacy refused to fill my prescription. After nearly 10 years of taking the only thing that truly helps, I was being treated like a criminal. When my insurance changed, and I had ONE pain reliever left, the new medical group pronounced they don’t prescribe ANY of the medications I was on for any reason. I was forced to go to an uncovered physician who knew me. $400 a visit. I have to get steroid injections to satisfy my dr. Thousands of dollars and risk factors make this an undesirable option. I am forced to take urine tests where I have to hand my urine to the lab tech…in front of other patients. It is humiliating! Easing people’s suffering shouldn’t be a punitive thing. Imagine limiting people to the equivalent of one glass of wine per week. Alcoholism is very prevalent. Why isn’t the CDC putting alcohol into a computer system? Tracking drinkers? As a responsible adult, I have studied options, discussed this with my dr. and chosen the best path for my health and quality of life. The new guidelines are not good enough. Opioids provide relief from an otherwise agonizing existence. Not complete relief and not all the time. I’m now under -medicated. I’m suffering needlessly! We are readying to move. With so many things to do: packing our home of 36 yrs, saying good bye, selling our business…I have this constant concern that when I move, I will not be able to have relief from my endless, constant partner…pain. The only compassionate pathway for this country is to end the obsession with prescription drugs and deal with illegal substances instead. I don’t hurt anyone by alleviating my pain. Why am I being punished at this stage of life?!?! There ought not to be a set of guidelines by the CDC that deals with prescription opioids. They are not a disease. They are a help to so many of us. They work. They are affordable. Abolish the guidelines and punish the people who started this cruel crusade for their personal gain. Please!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff295f	Anonymous	None	2022-04-05T02:29:06Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-90cg-he6r	False	None	False	2022-04-12 05:36:32.220	[]
3689	CDC-2022-0024-3695	https://api.regulations.gov/v4/comments/CDC-2022-0024-3695	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Daily Chronic Pain. I’ve had 4 surgeries to my Cervical Spine. I have arthritis in my Facet Joints. I have 3 blown Discs Lumbar Spine, that after 6 six years of injections my former pain management Doctor dropped me saying she could no longer help me as it wasn’t cost effective. For who? Not me. One of her Nurses Practitioners called me a “ Drug Addict “ . I didn’t want anymore injections as they only helped for a month maybe two. They’re supposed to last at least 6 months which originally they did. I was on a Norco Prescription, which she took away and I had 1 one month to wean off, which I did on my own. I pee tested monthly at her office. My life has changed dramatically. I also have Fibromyalgia and joint pain in my shoulders, elbows, knees, and hands. I have Chronic Daily Migraine. I’m in severe pain every day. To go food shopping? I have to rest up. I know I can order online and pick up. I use coupons to save money. I’m on SSA Disability and live alone. My ex husband called me a burden. Good riddance. Most days I’m either on my couch or in bed. The constant throbbing, aching pain is too great. I missed my Granddaughter’s Birthday Party this year. She turned 3 years. She is beautiful. I’ve missed other events due to pain. Ibuprofen is not doing it to help. I’m allergic to Lyrica and those sort of medications. I don’t wish this on anyone. You must understand there is a real person behind the pain who needs medication in order to have a better quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484ff2d50	Kreimes	None	2022-04-05T02:30:22Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Kreimes , Lisa	l1g-9ifm-w94f	False	None	False	2022-04-12 05:36:32.446	[]
3690	CDC-2022-0024-3696	https://api.regulations.gov/v4/comments/CDC-2022-0024-3696	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have serious case of RLS and take 50 mg. of tramadol at bedtime. It has been a lifesaver. I urge the gov. to permit physicians to be able to prescribe options for their RLS patients.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484ff2da4	Stoll	None	2022-04-05T02:30:31Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Stoll, Marilyn	l1g-bgnu-rjfb	False	None	False	2022-04-12 05:36:32.661	[]
3691	CDC-2022-0024-3697	https://api.regulations.gov/v4/comments/CDC-2022-0024-3697	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've suffered with lower back pain for about 12 years. I've had a hip replacement when I only went in because I had knee pain. Maybe for the last 2 years, I've had a few episodes of "freezing up" - usually after I've done major housework with lifting, bending, carrying and squatting. I just had no use of my knees and at the same time my back. The double whammy of back and knee pain has left me unable to stand and I just pushed myself inch by inch with my feet until I get to a stool or sofa. Then, it takes a few days to feel normal again. I believe that as a single, retired woman without any family, these last two years of staying inside, living a sedentary life, simply caused my muscles to lose strength and opportunistic degenerative disc disease had a party down my spine. I suddenly had strange "episodes" where my entire body had tremors so bad, I had to hold onto furniture, walls, broom or mop to move around my apartment. It felt like I'd lost control of my whole body. After a week, stretches, good sleep position, it just disappeared. Then, two months later it happened again, which caused a fall. I woke up on my kitchen floor. I felt again, that I couldn't get up and scooted to a room with a rug and laid down. This time I got Uber to the ER. They did an MRI on my head, though the pain was in my back. I was asked "do you want to think about moving into a care center?" Hey, I might have bad bones but not prepared or packed for a nursing home. My ears were ringing, and I was referred to an ENT who also wanted to do an MRI of my head. I told him my GP had me see a nephrologist and in April, I'm scheduled for a head, cervical and lumbar MRI. The one of the head in the ER cost $6000. He said I had some minor hearing loss but he felt it was nothing serious. Everyone wants to do an MRI. Previous back/knee episode was 2017 and that was $17,000 worth of MRIs and x-rays. So, I continue to see the different providers. Next, Physical Therapy! ( I honestly think Youtube has better and more detailed instruction. ) throughout all these visits with MRIs, I have continuously asked to "see" my images. I want to see what multi-level bulging discs look like, what bone spurs look like, what degenerative disc disease really looks like. I have not once been given an image to look at. I'm old enough where I remember x-rays w a light box. Your doctor would point to the problem and discuss what needed to happen. Today, I don't see doctors, I see a PA. I am realizing that someone with back or joint pain is just as common as they come. There's nothing special about me, I'm just getting old and need to do less strenuous activities. Started PT last Wednesday - I arrived home in pain. Next day, worse pain and sent my GP a message about how my back feels worse, that PT shouldn't hurt you and I worried my back had somehow been injured by the exercises they put me through. She replied "you can do PT in a chair". That's all. One week, 2 days later, I can barely walk. The pain now burns from my lower back, through my buttock and down my leg to my foot. It's probably the worst pain I've ever experienced. I can barely get up and down off the sofa. Can't lay on my sides. My leg feels like it's not mine - it's uncooperative and wonky. Every part of my back, my flank - but mostly the L5/S1 area. I looked and read for days about back issues and treatment. She had previously called in some Lidocaine patches for my bank. My insurance company denied those. Appeal resulted in the same. She called in Voltaren gel 3% for my knees, my insurance company denied that too! It's crazy how they can bill Medicare $20,000 for MRIs and nothing towards helping with pain. I haven't slept for 2 nights. I had sewage backup into the toilet and bathtub. I can't bend to scrub it so I could soak in Epsom salts. I am beginning to feel frantic. I feel like ordering tests of all kinds is the extent of my care. I've never asked for or been given opiates except at the dentist and my hip replacement in 2015. I can't walk my dog. I feel nauseous with the pain and can't stand long enough to microwave anything. Ii think "maybe I have a herniated disc" or "maybe I have a nerve impingement" but why is it ME doing anything? That's why I see a physician. This 9 days of pain, just a blob on a sofa trying to find one spot that doesn't shoot flames down my legs. Do I feel like I could call my doctor and tell her about how terrible this pain is? Not at all. I'm afraid to. I know before it happens I'll be treated like a drug seeker, labeled a drug seeker, noted "she wants drugs" and that would upset me just one more time. I am afraid to ask my own doctor for pain medicine. The stigma and shame of being a "pain patient" is awful. I'd rather sit in the same clothes I had on a week ago. Unbathed. Nasty bathroom I can't clean. Can't bend into brush my teeth or wash my face. I even feel like a bad person. This is wrong. It's broken. $ wins - dr. saves self not me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff2e8a	Anonymous	None	2022-04-05T02:31:26Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-dvge-orxu	False	None	False	2022-04-12 05:36:32.888	[]
3692	CDC-2022-0024-3698	https://api.regulations.gov/v4/comments/CDC-2022-0024-3698	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a long time sufferer of Restless Legs Syndrome (RLS). Low dose opiod treatment has been shown to improve the quality of life for those of us who suffer from RLS. Please consider regulations that permit Physicians to prescribe low dose opiods for RLS patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484ff2f2e	Yates	None	2022-04-05T02:31:34Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Yates, Steve	l1g-exrm-x1fw	False	None	False	2022-04-12 05:36:33.106	[]
3693	CDC-2022-0024-3699	https://api.regulations.gov/v4/comments/CDC-2022-0024-3699	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2022 Guidelines should be reduced to declaration that the 2016 Guidelines are rescinde. The CDC should then clear the field for other regulators not bound by the commitment to the 2016 framework.<br/><br/>The 2016 Guidelines in practiced established a limit of 90 MME of opioid pain medication. This was a catastrophe for pain patients, leading to suicides, overdoses (as patient pursued pain relief in illicit markets), and other early deaths from pain. It did so despite a research consensus that chronic pain patients rarely become addicted to their meds.<br/><br/>The 2022 Guidelines as they now are will lead effectively to a new limit of 50 MME, which will exacerbate the crisis along every dimension.<br/><br/>This is aside from the fact that the MME concept was created on the fly by a small group of doctors who never validated the concept scientifically.<br/><br/>At the very least, then, the CDC should remove all references to MME thresholds or limits. <br/><br/>But in truth, the CDC has failed in this area, should rescind the 2016 Guidelines, and move on to areas in which they are competent, whatever those may be.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	0900006484ff2f49	Albertson	None	2022-04-05T02:31:59Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Albertson, Jeffrey	l1g-fbb0-oqqz	False	None	False	2022-04-12 05:36:33.340	[]
3694	CDC-2022-0024-3700	https://api.regulations.gov/v4/comments/CDC-2022-0024-3700	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>I am a pain patient, and lived with family who suffered cancer, vets injured, spine issues,surgeries. Many of these conditions classically treated with opioids, and yes the nature of the drug, consensual dependence ensues but this is different than addiction.<br/> Things like "OIH", MME set to a magical number, I saw the benefits of Purdue's life saving drugs, the bottle never said lick coating and inhale...These antiquated, draconian, and prohibitionist actions have led to the biggest OD crisis ever, suicide, mental health, and QOL decline.<br/> I lost many including a fiance, friends, etc right when everything turned to H after controlled pharma got scrutinized to the point of suing (J+J) and other opioid manufacturers sued while they create a life saving vaccine for Covid simultaneously. This is an atrocity and also a burden many cannot take.<br/> God made the plant that gives us this medicine as man needs it for analgesic action. Like alcohol, there are very bad consequences, the paradox being that people with access to legal opioids, MAT, etc generally never have the associated detrimental effects of alcohol and its potential for destruction. Yet its accepted.<br/> I implore Dr's to hear stories on Cmerandi #Dontpunishpain to gain perspective. Narxscore and ORT are considering things like mental health and trauma as an algorithm to my knowledge to rule out providing analgesic meds. Prevents Dr's from upholding the Hippocratic Oath. And many turning to fent etc. for variety of reasons listed causing a OD crisis. Harm reduction, safe supply, more MAT options. Humans are not meant to live in pain, esp during these times when anxieties etc are bad enough.<br/><br/>Thank you for allowing us to comment! <br/> <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff2f63	Anonymous	None	2022-04-05T02:33:56Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-fddb-18ig	False	None	False	2022-04-12 05:36:33.560	[]
3695	CDC-2022-0024-3701	https://api.regulations.gov/v4/comments/CDC-2022-0024-3701	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>Comments on 2022 CDC Draft Opioid Prescribing Guidelines<br/>1. CDC 2022 update removes 90 MME but replaces it with an even lower limit of 50 MME, while admitting the harm caused by the 90 MME limit in the 2016 guidelines, which became state laws, Medicaid hard edits, and is in the SUPPORT act. How does the CDC ensure 50 MME does not become the new limit?<br/>2. CDC states that 65% “misuse” opioids now for pain vs. 11% to get high and 2% due to being hooked. Doesn’t this suggest that the government’s regulations are causing more problems than they solving?<br/>3. CDC warns insurers, governments, and others to not use 50 MME or this guideline go set hard limits such as the Medicaid hard edits that were based on 90 MME, but how will this be accomplished?<br/>4. Sickle cell anemia and palliative should be rewritten as “severe chronic pain” or “intractable pain.” Others have equally painful diseases and should also be excluded. Why not be fair to all?<br/>5. CDC claims it found only one long term study while hundreds exist but were not used in creating this document. Why did CDC not consider all available studies dating back 100 years plus?<br/>6. You advise use of NSAIDs then advise against its use. Tylenol has become preferred to opioids due to prior CDC guidelines. Why recommend more harmful medicines? Addiction paranoia?<br/>7. CDC advises against using opioids and sedatives or anti-anxiety drug. Isn’t this concern stemming from polydrug illicit drug use, and this policy will harm patients with multiple condition. How can CDC avoid injuring patients who have pain and other conditions?<br/>8. CDC suggests opioids are not useful in fibromyalgia and osteoarthritis based on very limited data. Many patients have tried other modalities and only function thanks to opioid therapy. Why artificially limit clinician decision making based on limited studies, and against your advice to individualize care? Why attempt to subterfuge use of opioids in any medical case?<br/>9. The CDC editors are not trained or experienced in pain management and/or have conflicts of interest and are instead biased by their roles in treating addiction. Why are pain management experts not writing this guideline, rather than addiction specialists? This entire document seems a defense of poor CDC advise that continues.<br/>10. CDC suggests unproven alternative therapies & drugs which patients often lack access to. How do you plan to make alternative therapies available when you lack authority to grant access?<br/>11. You do not have statutory authority to regulate drugs, which belongs to the FDA. Why should the CDC be writing these guidelines rather than the FDA who has the authority?<br/>12. You constantly refer to tapering and imply the default position should be to taper people off their pain medicines as a default position. Why keep harping on tapering? Is it due to your pre-occupation about addiction, which effects only a minority of patients (0.5% to 5%)?<br/>13. Your guidelines appear to discourage use of opioids and impose restrictions not only on opioids, but you exceed your charter to cover every facet of pain management and every possible opioid prescriber. Since most overdoses are due to illicit drugs, what is the benefit of this guideline?<br/>14. How have overdoses declined since the release of the 2016 guideline, and if they haven’t, how is an even more comprehensive and burdensome document going to solve this problem?<br/>15. Why is this guideline now 229 pages and has expanded from an opioid prescribing guideline into a comprehensive pain management manual, and who authorized you to expand the scope?<br/>16. Does the CDC honestly expect a 229 page guideline to be useful to busy clinicians? This document is more an anti-opioid political document than a useful clinical decision making guide.<br/>17. Why do you emphasize individual care best left to clinicians and their patients, and yet this entire document attempts to standardize and limit care, resulting in needless suffering?<br/>18. How many lives has the 2016 guideline cost due to suicides and adverse health affects such as strokes, heart attacks, and other poor outcomes? How many people had to file for disability due to loss of pain care?<br/>19. CDC constantly emphasizes decisions including choice of opioids, dosages, durations of treatment, etc. should be made by the clinician, and warns against misuse of this document as occurred in 2016, which became a weapon. Why not just delete the 2016 guideline and not replace it, especially since overdose deaths have risen while prescriptions have declined, showing you are only causing pain and suffering and not saving lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff2f87	Anonymous	None	2022-04-05T02:35:10Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-fp42-ntmc	False	None	False	2022-04-12 05:36:33.779	[]
3696	CDC-2022-0024-3702	https://api.regulations.gov/v4/comments/CDC-2022-0024-3702	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 60-year-old female living in a rural Idaho town. I suffer from osteoporosis (-5.0 dexa scan), osteoarthritis, hypothyroidism, viruses: west nile/singles/herpes, PTSD, and chronic fatigue syndrome. Over the last 10 years, my skeletal and fibromyalgia type of muscle pain has increased to the point that I can only work part-time. I use the remainder of my day to actively participate in my physical and mental health by taking frequent rest periods, moderately exercising, cooking all my meals using whole food, doing household chores, and engaging in limited social activities. Last year, I even drove 2 hours, round trip, once a week, to the big city to do Osteostrong therapy. The year before that it was the same drive to do acupuncture. Additional things I have tried to reduce my pain and maintain functionality are OTC pain relievers, physical therapy, yoga, low impact aerobics, walking, chiropractors, meditation, vitamin & mineral supplements, and restricting gluten & dairy. None of these things have helped reduce and restrict my pain, as much as I wished they would. Every morning I wake up with my body feeling like I’m 90 years old. After waking, I need 3 hours to loosen up and move through the pain to start my day. I also own and use a hot tub, massage chair, sauna, and adjustable bed. The next modality I’m going to try is a red/infrared light strip. I’m glad I had $600 to purchase it. What has kept me productive and active in my physical and mental well-being is prescription opioid medication, as much as I wish they didn’t. Even with the assistance of opioid medication, I still have high pain days when I question continuing this quality of life. When I read stories of other people who have less functionality, I feel fortunate. CDC suggests opioids are not useful in fibromyalgia and osteoarthritis based on very limited data. Beside myself, many patients have tried these and other modalities, only to function thanks to opioid therapy. Each patient comes with their own medical history so why artificially limit clinician decision making based on limited studies, and against your advice to individualize care? Each Person’s medical case needs to be assessed on its own merits. Don’t hand-tie our medical providers due to a few bad players with a more restrictive and punishing policy. Don't further limit prescribing opioid medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff32cd	Anonymous	None	2022-04-05T02:36:01Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-gkbo-rx83	False	None	False	2022-04-12 05:36:33.999	[]
3697	CDC-2022-0024-3703	https://api.regulations.gov/v4/comments/CDC-2022-0024-3703	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve had 4 surgeries on my lower back and two fusions on my neck. I’ve also had knee surgery and I have a two cm tear in my right shoulder. I’ve lost count of the number of injections I’ve had in my spine over the last 20 years. Almost two years ago something happened from a procedure that was supposed to help the pain in my neck, right shoulder, upper arm area. And I had a seizure two days later. Still don’t know what happened. I had another seizure a couple weeks later so I had to see a neurologist, get put on seizure medication and was told I couldn’t drive until I was seizure free for a year. I’m almost there, I’ll be one year seizure free in about six weeks. My pain Doctor I’ve had for the last couple years is moving and I’ve been warned that I’ll have to choose between my pain meds, which I have zero life without, and my Diazepam which is part of my treatment for seizures. With the pain meds I live with a 4-6 on the pain chart. Without the diazepam I’m afraid I’ll have seizures again. I don’t want to choose between horrible pain or tonic colonic seizures. My meds are always locked up, I’ve never been off on my count or failed a drug test. I was already planning on tapering off the diazepam after I’m two years seizure free, but that’s a little over a year away. I’m scared of the injections. They help for a little while but not for long. When I tell the doctor i don’t know if I want to have the injections they start talking about cutting my meds. I just want to have a reasonable life back. What life I can have with screws, rods, a replacement disk and narrowing of the spinal canal. Please, please fix the guidelines so that good Doctors can treat real patients so we can have some quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donald	None	None	0900006484ff32ce	Cockman	None	2022-04-05T02:36:13Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Cockman , Donald	l1g-glsw-3k4k	False	None	False	2022-04-12 05:36:34.217	[]
3698	CDC-2022-0024-3704	https://api.regulations.gov/v4/comments/CDC-2022-0024-3704	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Until you experience years and years (20) of ruined sleep because of RLS you have no idea how your quality of life is diminished . Please allow opioids to be prescribed for such severe cases.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terri	None	None	0900006484ff33a0	Hanichak	None	2022-04-05T02:36:41Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Hanichak, Terri	l1g-hsvf-utk5	False	None	False	2022-04-12 05:36:34.429	[]
3699	CDC-2022-0024-3705	https://api.regulations.gov/v4/comments/CDC-2022-0024-3705	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from severe chronic pain for 25 years. My pain has been very effectively managed with opioids for 17 of those years by my primary physician, who had been my primary for 30 years. Over those 30 years we had developed a level of trust in one another that was unmatched by any other relationship in my life, including my marriage. He had to stop practicing in 2020 and passed away in early 2021 from a rare form of stomach cancer. Since that time I have found it impossible to find a doctor who is willing to help me manage my pain with opioids. I should mention that I have multiple sources of chronic pain with over 17 years of documented tests and diagnoses. They include two failed back surgeries, brachial plexus nerve injuries, complex regional pain syndrome, peripheral neuropathy, diabetic neuropathy, MS and Parkinsonism due to brain lesions from carbon monoxide poisoning. I have been through physical therapy, pain psycologists, etc and have exhausted all other options. The opioids work very well to manage my pain while nothing else does. I have no quality of life whatsoever and I am racked with excruciating pain 24/7. With all of this, I still cannot find a doctor willing to manage my pain. In my search for help I have had many doctors sympathize and tell me they believe I should be prescribed opioids but they are terrified to prescribe them for fear of losing their license to practice medicine and their only option is a referral to a pain clinic..... until you quickly come to realize that contrary to popular belief, pain clinics do not operate to help people manage their pain, they operate purely for profit. THERE IS NO PROFIT IN PRESCRIBING OPIOIDS. However there is massive profit in nerve blocks, epidurals and cortizone injections, as well as radio frequency ablation and implants to block nerve signals to the brain. While some of these may be helpful for persons with mild pain or a single source of pain, it is ineffective for persons such as myself. Then take into account that because I'm totally and permanently disabled and medicare is my only source of medical coverage and I'm responsible for 20% of every visit, procedure etc, the cost alone is prohibitive and that"s not even taking into account the donut hole in coverage. And please explain to me how a pain clinic is better positioned to serve a patient than a primary physician with whom you've had a long relationship who knows your history inside and out, who has earned a patients trust and the patient has earned the physicians trust. Your primary provides care and compassion and is sympathetic and understanding to your needs. Who knows you better than your primary physician? <br/>Do I have compassion for addicts? Of course. But what makes the life of an addict more important than mine and why should their actions effect my life or the quality thereof? I have done nothing to deserve the cards this life has dealt me, it is through no fault of my own. While trying to control the actions of people who cannot control themselves, you are needlessly punishing those who desperately deserve to have their pain managed. You cannot legislate morality. While an addict is capable of changing their life, they have to want it and take action No law can ever force them to change. Meanwhile the addict stays an addict and good people suffer.<br/>There are two types of prosecutors. One believes that the conviction of some who are innocent is acceptable in order to prevent even one who is guilty from escaping justice. The other believes it is acceptable that some who are guilty should go free in order to prevent a single innocent person from being convicted. My morality sides with the latter. This is a perfect description of the current situation, but the prosecutor in this case believes in the former idea, not the latter.<br/>The CDC is responsible for the current state of affairs, that is the absolute fact of the matter. This is their weak attempt at saving face. Do they really think that any doctors are going to start prescribing opioids now, after every state in the country has enacted oppressive opioid legislation based on their 2016 recommendations? Due they believe the DEA is going to relinquish the power that the legislation has given them? All the while saying the recommendations are not mandatory, it's just guidance, use it at your discretion. In order to have any effect, each state would have to repeal the legislation that is currently in effect and THAT IS NEVER GOING TO HAPPEN unless the CDC makes the changes mandatory. We have been told the CDC is the ultimate authority, that we should accept their recommendations as if they are scripture when it comes to masks, social distancing, vaccinations, etc. This weak attempt will change absolutely nothing, it is designed to placate chronic pain sufferers so they can say "look, we tried". I would ask that the CDC would show some courage and compassion. They have the ability to effect real change if they so desire.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Russell	None	None	0900006484ff344f	Collard	None	2022-04-05T02:38:33Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Collard, Russell	l1g-iihl-p3zh	False	None	False	2022-04-12 05:36:34.656	[]
3700	CDC-2022-0024-3706	https://api.regulations.gov/v4/comments/CDC-2022-0024-3706	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No doctor I have seen in the past 2 years will give pain medications! I e gone from having 85% quality of life to 5%! Most days I cannot even make a because I cannot stand long enough.Because of the CDC and DEA threats to Doctors this is how it is for thousands of us.I used to enjoy life make a summer list of where to camp and hike,now on antidepressants and anxiety meds because suicidal thoughts,tears,extreme pain take over my day,every day.My diagnosis severe scoliosis,osteoporosis, broken tailbone,spinal stenosis,brittle bone disease,bulging discs,anemia,vitamin D deficiency. So why does no Doctor care to help me?I'm 56,have a "Will"and writing goodbye letters to my 5 children.THIS IS WHAT THE CDC AND DEA HAS DONE THEY ARE TO BLAME,AND THE SUICIDE RATE IS HIGHER NOW THAN IN 2016 WHEN ALL THIS STARTED!!THEY HAVE BLOOD ON THEIR HANDS ARE THEY PROUD?WHAT DID THEY PROVE?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dianne	None	None	0900006484ff347a	Henderson	None	2022-04-05T02:39:34Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Henderson , Dianne	l1g-itm8-2piv	False	None	False	2022-04-12 05:36:34.896	[]
3701	CDC-2022-0024-3707	https://api.regulations.gov/v4/comments/CDC-2022-0024-3707	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/><br/>I'm a 61 year old man that was diagnosed with Restless Leg Syndrome twenty years ago. The medications I've taken (Pramipexole and Neupro) are no longer effective due to augmentation. My quality of life has dramatically plummeted to the point I dread the evenings when the symptoms are the worst.<br/><br/>I beg the CDC to allow the prescribing of low dose opioids for the treatment of Restless Leg Syndrome as I and numerous others are feeling hopeless facing the rest of our lives with this hellishly bad disease. <br/><br/>As you my already know, recent research strongly demonstrates the efficacy of low dose opioids for people like me who no longer respond to traditionally prescribed medication. Rest assured, growing up in the 70's and 80's I had ample opportunity to abuse drugs and alcohol and never did so. I've taken opioids a few times after surgeries and have ended up throwing away most of them as I didn't need them after the first couple days.<br/><br/>Thank you very much for your consideration of this issue.<br/><br/>Sincerely,<br/><br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	0900006484ff34ba	Weygint	None	2022-04-05T02:41:18Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Weygint, Mike	l1g-j64b-ykk7	False	None	False	2022-04-12 05:36:35.114	[]
3702	CDC-2022-0024-3708	https://api.regulations.gov/v4/comments/CDC-2022-0024-3708	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain due to neurofibromas (Neurofibromatosis 1) on my spine. I currently have an intrathecal morphine pain pump. On rare occasions I take oral morphine for break through pain. It is imperative that for us who have chronic pain not to take away our only source that allows us to live a life worth living. Please, let up on the severe restrictions that have our doctors terrified to give us our life saving medications. And they ARE life saving. If a person is in such severe pain they cannot even get out of bed without medicinal help, many will decide to die rather than live a life like in agony.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Casundra	None	None	0900006484ff2bb4	Venable	None	2022-04-05T02:41:49Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Venable, Casundra	l1g-jotw-6cjk	False	None	False	2022-04-12 05:36:35.328	[]
3703	CDC-2022-0024-3709	https://api.regulations.gov/v4/comments/CDC-2022-0024-3709	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why does the CDC keep sticking it's nose where it doesn't belong? The doctors who work with pain patients have a much better idea of what their client is going through than the CDC. Is any concern given to those who suffer all day, every day with relentless pain? How come we don't hear anything about the outcome of the last guidelines? How many people desperately turned to street drugs, only to overdose from laced drugs, to get a moment of pain relief? How many people took their own life because they could not stand being in that kind of pain with no end in sight? How many people lost the miniscule quality of life that they held on to every day because they could not get pain medication? <br/>Pain patients did not ask to be in pain. We did not choose this and we don't want it. Regardless, we are stuck suffering from it. As for abusing the opioids, I am not sure if you are aware, but those of us on a pain management program do not get high from opioids. The best result we can get is relief for a period of time. Often, it is a small amount of relief at best! We do not have fun taking it. Again, for the CDC and it's partners, we do not get high or have fun with opioids.<br/>If there is such a big concern about opioids, why isn't there anything being done about the ILLEGAL drugs coming into our country? All the illegal fentanyl that is being put in the heroin, you know, the fentanyl deaths that the CDC misled the public to believe were deaths from prescription pills? That must be acceptable since no one is concerned or doing anything about it.<br/>I feel that the only people allowed to make recommendations about pain medications are the people in pain and the doctors treating them. Until you have been in so much pain that you dread every moment you wake up or contemplate committing suicide, you have no right to tell pain patients what medication they can or can not take.<br/>Since the CDC feels the need to make more guidelines, I will say in advance thank you. Thank you for making the last remaining pharmacies that stock opioids, reconsider that. That you for making me feel like a criminal every time I ask if a store carries my medication. Thank you for having me jump through even more hoops at my doctor's office, just so I can stay on the same medication. Thank you for having my son be embarrassed to say his mom has a pain syndrome. Thank you for letting the thoughts float to my mind that someday soon, there may be no more opioids allowed at all. Most of all, thank you for making any of us who legitimately take prescription opioids, feel awful.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff2c0b	Prince-Sico	None	2022-04-05T02:43:08Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Prince-Sico, Mary	l1g-k3pf-m737	False	None	False	2022-04-12 05:36:35.557	[]
3704	CDC-2022-0024-3710	https://api.regulations.gov/v4/comments/CDC-2022-0024-3710	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If it were not for Tramadol I could not function. In fact RLS has gotten so bad that I will have to ask for something stronger.<br/>I am 85 and do not want to spend the remainder of my life in such agony.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Emily	None	None	0900006484ff2c0e	Bernhardt	None	2022-04-05T02:43:16Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Bernhardt, Emily	l1g-k6bn-k8lh	False	None	False	2022-04-12 05:36:35.772	[]
3705	CDC-2022-0024-3711	https://api.regulations.gov/v4/comments/CDC-2022-0024-3711	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As A Legacy patient of 24 years, my concerns regarding the 2016 and 2021 CDC update revolve around the concern that long term patients are not properly represented .<br/>We as a whole have been limited in ability to receive proper care and are seen as a burden to the nation's quest to lower opioid statistics with regards towards proper dosing, forced tapering and overall refusal by doctors that chose to use the 2016 guidelines as hard level statutes to deny care through MME constraints .<br/>I urge the FDA and CDC to realize that punishing long term pain sufferers to limited care and forced tapering is a HARM. It is not conducive to restrict law abiding patients the medicines needed for basic life activity.<br/>I have personally experienced the negative effects of hastily and politically driven discriminations against people just trying to have some level of normalcy after being stricken by accident or disease. It Is an atrocity to condemn long term patients to suffer while refusing us the appropriate accommodation to medical relief. The guideline glosses over the adversity and life long suffering that chronic pain sufferers live with every day. The doctors who know how poorly this guideline protects the interests of long term pain patients are cancelled and rebuked for their need to provide realistic and meaningful options including opioid therapy.<br/>For the people in all forms of institution and medicine, just beware, disease and accident may not have touched you in your life, but if and when it does you will know the extent of harm and suffering that is needlessly realized by patients who have been forced to endure through the confounded notions that the current guideline and its modified perspectives are taking into account the growing numbers of sick and injured who have lost quality of life and function . to explain and defend these guidelines as a solution and provision of effective care for thousands of lives is a short sighted and self satisfying illusion.<br/>Incorporate unambiguous language to fully describe the totality of the plight of the chronic pain sufferer devoid of realistic remedy or continue to denigrate countless lives who have no alternative but to realize the inequity of unjust medicine.<br/><br/>With Sincerity,<br/><br/>[name redacted] Legacy Patient<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joe	None	None	0900006484ff2c1c	Tellez	None	2022-04-05T02:45:12Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Tellez, Joe	l1g-k8hm-m3ec	False	None	False	2022-04-12 05:36:35.990	[]
3706	CDC-2022-0024-3712	https://api.regulations.gov/v4/comments/CDC-2022-0024-3712	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have ghost pain due to losing my leg above the knee. The use of norco 7.5 mg seems the only medication that works without affecting my stomach. The doctors have no idea how to deal with my pain because it is all in my head. That may be so but how do I deal with a pain that is real to me! The new rules make it almost impossible to get medication that works!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	robert	None	None	0900006484ff2c55	taylor	None	2022-04-05T02:45:22Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from taylor, robert	l1g-kke1-0fhz	False	None	False	2022-04-12 05:36:36.205	[]
3707	CDC-2022-0024-3713	https://api.regulations.gov/v4/comments/CDC-2022-0024-3713	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I spent many years maintained on opioids for chronic pain. Somewhat in advance of the last set of guidelines, my pain specialist's nurses began telling me a lie: opioids "did not work" for my pain. <br/><br/>The reality is, opioids were the ONLY thing that worked for my pain. <br/><br/>Eventually, I was moved off opioids as pain relief and that caused me to spend several years with severely reduced mobility. Intolerable pain circumscribed my life, interfered with parenting my children, caused me to be less active and gain more weight, caused depression, and was one primary motivator in the failure of my marriage of 25+ years. Even now, my children think I was neglectful (and the ex tells them lies about opioids), causing them to sever contact. The ex thinks I was a bad wife because I was in too much pain to move around, keep the house up, shop for groceries, or care for our teenagers. But the CAUSE was PAIN. Being on opioids was bad enough with the side effects, the sleepiness, how they made my brains "stupid" and the overwhelming stigma from medical professionals, but being taken off opiods RUINED MY LIFE. Being put on anti-inflammatories instead of opioids damaged my stomach and GI tract to the point where I lost over 100 lbs. I developed auto-immune reactions to foods due to anti-inflammatories causing changes in the permeability of my intestines. To this day, I cannot eat dairy, wheat, eggs, coconut/palm, or strawberries. Those things are in EVERYTHING, plus every soap, lotion, deodorant, and many, MANY medications. Last time I had had strawberries, I went to the ER with a plunging heart rate and BP so low, they thought I was going to die. Strawberries have been a personal favorite since I was a child. <br/><br/>The worst part is, even though I have been off opioids for years, and NEVER had even a hint of misuse while I was maintained on them, was withdrawn appropriately from the pain meds, and never had any addiction problems afterwards, the stigma PERSISTS. Doctors STILL treat me like an addict or a drug seeker. When I have acute pain (root canal, tooth removal, kidney stones), they give me enough codeine (a weaker opiate, but one I am not allergic to) for about 36 hours, even though they KNOW the pain is expected to last a solid 2 weeks. Once, I went six weeks with bad enough kidney stone pain to keep me in bed (later had surgery), because I could not get appropriate pain relief. The doctors are CLEARLY afraid of being prosecuted by the federal government if they appropriately medicate pain. They are SCARED.<br/><br/>This is INSANE. I should not be TORTURED because some people--a minority--are addicts. No one knows why people get addicted. No one can predict WHO will get addicted. But who does get addicted has a far higher correlation to recreational use than it does to chronic or acute pain. Even pain patients don't get addicted while they are properly maintained on opioid meds, but often after they are improperly withdrawn from opioids, they remain physically dependent. It's not the opioid medication, it's the LACK of meds, coupled with no resolution of their pain. Something like 90% of pain patients DO NOT GET ADDICTED while they are on meds. They just have pain, and need medication, which makes them physically dependent on opioid pain meds. They should't lose everything in their life because they hurt. they should not be removed from meds that work and placed on meds that destroy their bodies. They should not be gaslighted that something which they know works really doesn't. It's cruel and morally wrong and causes people with chronic pain to kill themselves. America is better than this. Please, some sanity. Stop treating pain patients like addicts. We are not.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary E	None	None	0900006484ff2c56	Tyler	None	2022-04-05T02:45:44Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Tyler, Mary E	l1g-kl4r-bbtk	False	None	False	2022-04-12 05:36:36.416	[]
3708	CDC-2022-0024-3714	https://api.regulations.gov/v4/comments/CDC-2022-0024-3714	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Unless you've personally experienced RLS or have a loved one that deals with this everyday issue, you would have no idea how life changing for the worse this disease can be. Please allow the use of low level opioids for those who have this disease and where no other remedies seem to work. Our leading research physicians believe that it is helpful and when managed, does not create a dependency or the need to increase dosages. Thank you for your consideration to allow the prescription of opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tony	None	None	0900006484ff3917	Schlegel	None	2022-04-05T02:45:53Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Schlegel, Tony	l1g-lrt0-yarl	False	None	False	2022-04-12 05:36:36.632	[]
3709	CDC-2022-0024-3715	https://api.regulations.gov/v4/comments/CDC-2022-0024-3715	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have taken a Benzodiazepine for years for anxiety and panic attacks. I was diagnosed with Ankylosing Spondylitis a few years ago. I have a lot of pain with this. My family physician prescribed me a pain medication for this. I have good days and bad days with the severity of pain. I only took the pain medication on an as needed basis. I don't want to take the pain medication on a regular schedule, I just want to take it when I absolutely need it. My family physician knew that I was on a Benzodiazepine when he prescribed me the pain medication and showed no concern, because he knew that I would not abuse the pain medication. My Psychiatrist that prescribes the Benzodiazepine knew that my family physician had prescribed me a pain medication and she showed no concern. I got both prescriptions filled at the same pharmacy and was never told to not take the medications together. My family physician was diagnosed with Pancreatic cancer and died only a few months after his diagnosis. I have found a new family physician and he refuses to prescribe me the pain medication, because I take the Benzodiazepine and he uses the CDC guidelines as the reason why. I tried to explain to him that I only take the pain medication as needed and have had no problems. He still refuses to prescribe the pain medication due to the CDC guidelines. Now there are days that I am in misery due to pain. I didn't ask for either of these conditions and don't feel like I should have to suffer since I have both of the conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	April	None	None	0900006484ff392d	Amburgey	None	2022-04-05T02:46:04Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Amburgey, April	l1g-m053-9op6	False	None	False	2022-04-12 05:36:36.870	[]
3710	CDC-2022-0024-3716	https://api.regulations.gov/v4/comments/CDC-2022-0024-3716	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with Restless Legs Syndrome since my early 20s. I am just turning 72 now. I have taken so many different medications, tried all manner of Eastern medicine including 4 months of thrice weekly acupuncture. Nothing helped. One of the medications worked fairly well but it knocked me out about 4 minutes after taking it. The only medication that has consistently worked for me is low dose oxycontin. I've heard so many frightening things about that drug that it took a couple of years for my doctor to convince me to try it. I'm so glad I did. I have been taking it for about 4 years now. I have never had to increase the dose, I have no desire to take more than I've been prescribed. Once a year I take a drug vacation from it just to make sure I'm not having a problem. I have absolutely NO craving for it. Understandably, just the word OxyContin frightens people. But you never hear about the hundreds of thousands of people like me who rely on it for relief. Please add Restless Legs Syndrome to the list of chronic disorders that benefit from opioids. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484ff3945	Smolik	None	2022-04-05T02:48:21Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Smolik, Jane	l1g-m5bm-d85t	False	None	False	2022-04-12 05:36:37.082	[]
3711	CDC-2022-0024-3717	https://api.regulations.gov/v4/comments/CDC-2022-0024-3717	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow opioid to be included as an option for treatment for RLS. We need every tool possible to find relief from this perplexing condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	0900006484ff3948	Smiley	None	2022-04-05T02:49:02Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Smiley , Chris	l1g-m8xw-m8mx	False	None	False	2022-04-12 05:36:37.315	[]
3712	CDC-2022-0024-3718	https://api.regulations.gov/v4/comments/CDC-2022-0024-3718	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have taken a Benzodiazepine for years for anxiety and panic attacks. I was diagnosed with Ankylosing Spondylitis a few years ago. I have a lot of pain with this. My family physician prescribed me a pain medication for this. I have good days and bad days with the severity of pain. I only took the pain medication on an as needed basis. I don't want to take the pain medication on a regular schedule, I just want to take it when I absolutely need it. My family physician knew that I was on a Benzodiazepine when he prescribed me the pain medication and showed no concern, because he knew that I would not abuse the pain medication. My Psychiatrist that prescribes the Benzodiazepine knew that my family physician had prescribed me a pain medication and she showed no concern. I got both prescriptions filled at the same pharmacy and was never told to not take the medications together. My family physician was diagnosed with Pancreatic cancer and died only a few months after his diagnosis. I have found a new family physician and he refuses to prescribe me the pain medication, because I take the Benzodiazepine and he uses the CDC guidelines as the reason why. I tried to explain to him that I only take the pain medication as needed and have had no problems. He still refuses to prescribe the pain medication due to the CDC guidelines. Now there are days that I am in misery due to pain. I didn't ask for either of these conditions and don't feel like I should have to suffer since I have both of the conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	April	None	None	0900006484ff3973	Amburgey	None	2022-04-05T02:49:17Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Amburgey, April	l1g-meg4-15h9	False	None	False	2022-04-12 05:36:37.530	[]
3713	CDC-2022-0024-3719	https://api.regulations.gov/v4/comments/CDC-2022-0024-3719	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to start by saying that I think it's a shame that people who have actual lived experience with chronic pain have not been included in policymaking when it comes to treatment thereof. There is value in experiential data that cannot be discerned through observation. Study group subjects only represent a small, limited portion of the population that lives with a wide variety of and combinations of sources for chronic pain. We are not ignorant to that fact. I would also address the idea that there could or should be limits assigned to dosing when it comes to treating pain with opioid pain medication. This is a particular point of contention for a reason and it isn't the reason it's been speculated to be. Many patients have not one but many painful diagnoses, making adequate pain relief a very complex issue and limiting what can be prescribed does nothing more than restrict relief when it comes to patients that have multiple sources of pain or that have severely painful conditions. I should know, I belong in both groups. I was very close to being able to get my first ever job before I got cut the first time. After that, I spent 2 years trying to readjust as I had a massive flare in my conditions that caused me to barely be able to eat even, during that time. Again, not for the reasons you might think. I have severe internal pain and pain medication is the only thing that would make it tolerable to be able to eat many foods that are a little more difficult to digest. Such as lean meats and vegetables. I got stuck eating junk because it doesn't hurt me to digest for some reason. Anyhow, I was subsequently cut down again due to Medicaid's policies, which are based upon the "recommendations" put forth by the CDC. Tell me, if long term opioid use is not helpful to chronic pain sufferers, how it is that I was at a point where I was ready to go to work and after having the yanked the rug out from under me since adequate relief went along with the cut, how does that support the relief that I was getting as being unnecessary? Why even apply if I'm going to be fired because I know that I will end up in more physical pain than I have the medication to be able to control, which would trigger termination when I simply can't physically do the job any longer? This policy has effectively crippled me and my ability to ever get a job. You may wonder why I don't just do X, Y or Z to treat pain. There is a valid reason for that as well. I would have to have the ability to get out of my house on a regular basis. An ability that I did have, before being cut down to next to nothing. That ability has not returned. I have literally overcome as much as I can humanly overcome without the assistance of opioid pain medication. I can't do certain of your suggestions due to the nature of some of my conditions. I have tried the vast majority of them prior to being treated with opioid pain medication. If they hadn't failed to provide adequate relief, I'd have never had to go on opioid pain medication. But they did fail. They failed miserably. Pain medication at proper dosage for ME, afforded me the ability to have some semblance of a normal life. Do you know what that means? It means I was able to do many of the things that I used to do, comparable to my peers that do not suffer from severe chronic pain and as I could before pain set in as a constant companion. I know what my experience has been. Opioid pain medication, at a dosage adequate for ME, afforded me ABILITY period. Isn't that what it's supposed to do? Provide relief and through that relief, ease limitations on physical ability that have been hindered by life altering pain? The fight for access to opioid pain medications in the dosage specifically needed as per individual chronic pain sufferer is not about the fact that the medication is an opioid. It's about the fact that it works. It does what it was designed to do, contrary to the fact that all we hear about are the drawbacks. Having been on them for nearly 10 years, I am here to attest to the fact that they do indeed work for chronic pain in the long term. Regardless of what some prefer to believe, there is much more to the issue than it's been reduced to and there are positive attributes to opioid pain medication. Ask any chronic pain sufferer or the doctors that treat us. The bottom line for me is that instead of my being able to contribute to payment on the home my family was buying after being able to get the job that I was looking forward to getting, we ended up homeless for 2 years and through the beginning of the pandemic because I was left in a terrible state after having the one thing that afforded me physical comfort and ability cruelly yanked away from me. From that point onward, I have required a caregiver to assist me with daily life. Coming from a place of hope to a place of despair over not having personal ability is soul crushing. All these policies do is affirm I'll likely never have ability again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006484ff39ca	Jusselin	None	2022-04-05T02:55:08Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Jusselin, Sarah	l1g-n7vt-omkd	False	None	False	2022-04-12 05:36:37.763	[]
3714	CDC-2022-0024-3720	https://api.regulations.gov/v4/comments/CDC-2022-0024-3720	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I will just never understand why the CDC wants people like me and millions of others to suffer in horrible pain every day of their lives. I understand not to just give them to anyone who asks or says they’re in pain but if you have proof through an MRI that you are definitely in a lot of pain what is the problem the CDC should not be in the doctor patient relationship thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ann M	None	None	0900006484ff39cd	Perrone Vesper	None	2022-04-05T02:55:23Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Perrone Vesper, Ann M	l1g-n9zk-175b	False	None	False	2022-04-12 05:36:38.015	[]
3715	CDC-2022-0024-3721	https://api.regulations.gov/v4/comments/CDC-2022-0024-3721	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your intention to review the policy (Docket no. CDC-2022-0024) can mean a truly life changing action for my wife and me. Let me explain. My wife, 66 years old, type 1 diabetic since age 10, and one who has been diligent since that early diagnosis to control her blood sugars the best ways that medicine offered at the time. However, complications arose like diabetic retinopathy requiring multiple laser interventions, kidney failure followed by 2 transplants, and peripheral neuropathy. As a consequence of taking anti-rejection meds for the kidney transplants, which includes steroids, spinal degenerative changes occurred with spinal stenosis. Pain from the stenosis manifested in the lower spine and legs progressed over time to consistently be in the 8 to 9 range. This is pretty devastating. Different modalities have been used to try and deal with the pain including chiropractic with some limited but temporary success, yoga, stretching and strengthening exercises, acupuncture, and even spinal steroid injections. Only one other therapy helped enough to ameliorate the pain to the point that a somewhat more normal lifestyle could be lived. Oxycodone was prescribed for a few years until the doctors were scared off. It worked with a low dose and strict compliance of doctor’s oversight. She was weaned off 2 years ago and now only questions why she remains alive to suffer this constant 8 to 9 pain. This certainly cannot be your intent to make doctors unwilling to use a tool that when monitored properly can be a quality of life boon. Thank you for listening. Our lives depend on a change in direction here.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484ff3a20	Etzweiler	None	2022-04-05T02:55:58Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Etzweiler , John	l1g-no88-avgy	False	None	False	2022-04-12 05:36:38.232	[]
3716	CDC-2022-0024-3722	https://api.regulations.gov/v4/comments/CDC-2022-0024-3722	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 79 years old and I would not be here if not for my medication which is Hydorocodone. I have been on this for at least 13 years and I have never had a problem. I originally took a dopamine agonist which eventually caused me to augment. I can get symptoms in the afternoon, always at night and in the morning when it wakes me up. Without the medication I would not be able to sleep. Without sleep I cannot safely drive a car, not to mention the agony I suffer from the symptoms., This is no joke. I will not be able to live if you take my medication away. This seems cruel beyond belief. I have never misused this medicine and my doctor can tell you that. Why not consider why people get hooked on opioids instead of taking them away from people like me who have never had a problem with drugs. For me, this is a death sentence.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006484ff3a59	Lafferty	None	2022-04-05T02:56:17Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Lafferty, Jeanne	l1g-o081-fy9t	False	None	False	2022-04-12 05:36:38.445	[]
3717	CDC-2022-0024-3723	https://api.regulations.gov/v4/comments/CDC-2022-0024-3723	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hey CDC, how about getting out of the opiate prescribing and leave that to our doctors. You are unqualified to make ANY opiate pain guidelines, esp based on ADDICTION SPECIALISTS anti opiate bs. See attached file	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynn	None	None	0900006484ff3abb	S.	None	2022-04-05T02:56:51Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from S., Lynn	l1g-oepe-bt35	False	None	False	2022-04-12 05:36:38.696	[]
3718	CDC-2022-0024-3724	https://api.regulations.gov/v4/comments/CDC-2022-0024-3724	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 45 year old woman that has been battling severe crohn's disease since 1987. I have chronic pain from 12 surgeries and ongoing crohn's disease flares for close to 35 years. The law must change. With not being able to get adequate pain meds I spend most of my life in bed, with no quality of life. Each day I wake up to see if I will be able to take shower or get dressed. I will tell you most days the answer is no. Some days I'm lucky if I can make it from bed to couch. This is no way for anyone to live. Constant pain and sickness has ruined my life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shannon	None	None	0900006484ff3abc	Rouse	None	2022-04-05T02:57:39Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Rouse, Shannon	l1g-ohhh-ikux	False	None	False	2022-04-12 05:36:38.920	[]
3719	CDC-2022-0024-3725	https://api.regulations.gov/v4/comments/CDC-2022-0024-3725	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The HHS and CDC and All other entities involved in this highly publicized atrocity on the American citizens should be brought before senate oversight committee and bring all data regarding not only the highly currupt anti opiate group PROP 2016 chronic pain guidelines and there highly bias revision and explain in front of 1000s of physicians how they came to bias conclusions to implement the genocide of millions of American severe pain patients. For six years you have heard from millions of patients who have been severely harmed by your guidelines you should have to answer for this in front of the media let us understand this The CDD and full government have been aware for 6 years the atrocities you have placed upon chronic pain patients and acute patients and you are being allowed to implement even more damaging guidelines not only were the 2016 cdc chronic pain guidelines only for primary care doctors with your distructive 90 mm now you want to make your cdc guidelines for all physicians at 50mm this was done to the American Citizens to kill off millions there is no other answer. You have seen all the reports about [name redacted] PROP [name redacted] reports from patients meetings with HHS yet you are trying to destroy American Health more STOP THIS MUST BE FULLY INVESTIGATED BEFORE YOU THE CDC ARE ALLOWED TO WRITE ANYMORE DAMAGING DEADLY GUIDELINES STOP THESE GUIDELINES NEED TO BE BURNED AND A FULL INVESTIGATION NEEDS TO HAPEN	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff3bd6	Anonymous	None	2022-04-05T03:04:02Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-pni8-o2wc	False	None	False	2022-04-12 05:36:39.130	[]
3720	CDC-2022-0024-3726	https://api.regulations.gov/v4/comments/CDC-2022-0024-3726	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ff3bf9	Shanley	None	2022-04-05T03:04:45Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Shanley, James	l1g-prf8-l8yf	False	None	False	2022-04-12 05:36:39.354	[]
3721	CDC-2022-0024-3727	https://api.regulations.gov/v4/comments/CDC-2022-0024-3727	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	im a CCP. That said uve heard my story from so many others. Why DOES THE CDC BREAK ITS OWN RULES. FIRST DOCTOR C SHOULD NOT HAVE ANYTHING TO DO WITH THE G LINES. THE MMES SHOULD BE REMOVED.SO MANY PEOPLE ARE LIVING WITH UNTREATED PAIN OR UNDERTREADED WHICH I AM. AS I WRITE THIS IM IN SO MUCH PAIN I CANT WORK, ITS HARD TO DRIVE AND ITS HARD TO THINK. SO PLEASE REMOVE THE MMES FROM THE G L.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff3c0f	Anonymous	None	2022-04-05T03:06:05Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-q2zy-81vn	False	None	False	2022-04-12 05:36:39.577	[]
3722	CDC-2022-0024-3728	https://api.regulations.gov/v4/comments/CDC-2022-0024-3728	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 and 2022 opioid guidelines issued by the CDC must be publicly repudiated and revoked without replacement. Any and every law citing or based on said guidelines is defunct. The DEA, DOJ, state agencies, et al should stop targeting physicians or patients and go after illicit fentanyl, which according to CDC data, is the cause of most fatalities.<br/>-Define how the CDC obtained authority over the FDA as to how medication can be prescribed. The FDA has limits per medication. <br/>-Revoke 2016 guidelines and urge states to reverse all laws based on them immediately. Prescriptions were not and are not causing overdoses. <br/>-Request investigation into PROP, Kolodny, Chou, and other conflicts of interest using tax payer dollars and harming patients. <br/>-Clearly state the actual cause of overdose; differentiate between “taken as prescribed”, “mixed with other medications or alcohol”, “in conjunction with illegally purchased drugs”, etc. CDC’s own data suggests it is currently, and always has been, illicit fentanyl causing overdoses; NOT prescription medication. <br/>-I’d like to see a study on suicide rates since 2016 guidelines versus addiction and overdose rates from prescribed medications only. <br/>-Patient care should be between the patient and the physician! My personal physician that knows me and my ailments. The CDC, DEA, and DOJ have physicians so scared that they cannot even treat their patients effectively. <br/>-Projects should be measured by their impact, not their intention. While the 2016 guidelines had good intentions, they created a severely negative impact. Patients and physicians alike suffered grave damages. Veterans and civilians alike are committing suicide. The addiction rate is marginal versus the quality of life given to patients in chronic pain. NO laws should ever be based off something like this. The guidelines also created a stigma through the media that anyone in pain and on opioid therapy is an addict. <br/>-2022 guidelines comments: <br/>-Remove ALL references to MME<br/>-Do not recommend addiction medications for pain when they do not treat pain. <br/>-Engage failure to treat/prescribe punishments for emergency room physicians or surgeons.<br/>-Clearly define palliative care, it is NOT a transition to hospice. <br/>-Pain is pain; whether cancerous or non cancerous.<br/>-MME is NOT proven science <br/>-Hyperalgesia is NOT proven science. <br/>-Less than 3% of all pain patients become addicted to pain medication. <br/>-Opioids HAVE been proven effective for long term, chronic care. <br/>-I endorse and echo all of the comments made by Dr. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tory	None	None	0900006484ff3c48	B	None	2022-04-05T03:06:57Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from B, Tory	l1g-qi1l-h2k6	False	None	False	2022-04-12 05:36:39.792	[]
3723	CDC-2022-0024-3729	https://api.regulations.gov/v4/comments/CDC-2022-0024-3729	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Hi, I've had Restless Leg Syndrome for about 30 years. There is currently no cure, only some form of relief via medications. Very recently, I became aware of studies from Johns Hopkins, Mayo Clinic, and RLS.org on the effectiveness of low dose opioids as an effective treatment for RLS. I'm currently on a low dose 5 -10mg of Hydrocodiene for about a year now. I'd have to say, the 5 to 10 mg dose has been the most effective relief for RLS so far. I haven't had to increase my dose to get relief. I'm aware of the opioid crisis in America, but an infliction like RLS makes you look at other alternatives. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484ff3c5c	Harness	None	2022-04-05T03:13:18Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Harness, Paul	l1g-qmpj-tybt	False	None	False	2022-04-12 05:36:40.005	[]
3724	CDC-2022-0024-3730	https://api.regulations.gov/v4/comments/CDC-2022-0024-3730	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Full comments in attached document. <br/>The 2016 and 2022 opioid guidelines issued by the CDC must be publicly repudiated and revoked without replacement. Any and every law citing or based on said guidelines is defunct. The DEA, DOJ, state agencies, et al should stop targeting physicians or patients and go after illicit fentanyl, which according to CDC data, is the cause of most fatalities.<br/>-Define how the CDC obtained authority over the FDA as to how medication can be prescribed. The FDA has limits per medication. <br/>-Revoke 2016 guidelines and urge states to reverse all laws based on them immediately. Prescriptions were not and are not causing overdoses. <br/>-Request investigation into PROP, [name redacted], [name redacted], and other conflicts of interest using tax payer dollars and harming patients. <br/>-Clearly state the actual cause of overdose; differentiate between “taken as prescribed”, “mixed with other medications or alcohol”, “in conjunction with illegally purchased drugs”, etc. CDC’s own data suggests it is currently, and always has been, illicit fentanyl causing overdoses; NOT prescription medication. <br/>-I’d like to see a study on suicide rates since 2016 guidelines versus addiction and overdose rates from prescribed medications only. <br/>-Patient care should be between the patient and the physician! My personal physician that knows me and my ailments. The CDC, DEA, and DOJ have physicians so scared that they cannot even treat their patients effectively. <br/>-Projects should be measured by their impact, not their intention. While the 2016 guidelines had good intentions, they created a severely negative impact. Patients and physicians alike suffered grave damages. Veterans and civilians alike are committing suicide. The addiction rate is marginal versus the quality of life given to patients in chronic pain. NO laws should ever be based off something like this. The guidelines also created a stigma through the media that anyone in pain and on opioid therapy is an addict. <br/>-2022 guidelines comments: <br/>-Remove ALL references to MME<br/>-Do not recommend addiction medications for pain when they do not treat pain. <br/>-Engage failure to treat/prescribe punishments for emergency room physicians or surgeons.<br/>-Clearly define palliative care, it is NOT a transition to hospice. <br/>-Pain is pain; whether cancerous or non cancerous.<br/>-MME is NOT proven science <br/>-Hyperalgesia is NOT proven science. <br/>-Less than 3% of all pain patients become addicted to pain medication. <br/>-Opioids HAVE been proven effective for long term, chronic care. <br/>-I endorse and echo all of the comments made by Dr. [name redacted]. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484ff3c5e	B	None	2022-04-05T03:16:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from B, Daniel	l1g-qbwh-8dky	False	None	False	2022-04-12 05:36:40.219	[]
3725	CDC-2022-0024-3731	https://api.regulations.gov/v4/comments/CDC-2022-0024-3731	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I was diagnosed with RLS over 15 years ago and experienced symptoms for many years before that. My doctor at the time prescribed a fist line treatment that later made my disease much, much worse. It caused an increase in the negative symptoms associated with my RLS. Eventually the medication, Ropinirole, stopped working completely and I was left in a physical and mental state that I don't think anyone would want to endure. The uncomfortable nerve pain from my RLS was off the charts, I could not sleep for more than two hours at a time, that is if I could get to sleep, sleeping pills didn't work and the dr's I was seeing in [location redacted], TX did not seem to know what to do excepet continye to throw various drugs at it that only seemed to make me and my disease more uncomfortable. My wife and I then started doing our own research online and found out about the RLS foundation and an amazing doctor in California named [name redacted]. Dr [name redacted] had been treating patients like me with severe Refractory RLS for years and I had some hope again. I scheduled an appointment with him in [location redacted], CA and flew out to see him when the day arrived. In his office he took one look at me, read through my chart, looked at the numerous medications they had me on, and he apologized to me on behalf of the medical community. Specifically for all the misinformation out there and the pain I'd gone through getting to him. But he assured me we were going to take care of this. Dr. [name redacted] started me on low dose methadone that day and my RLS symptoms have been dramatically better since that time. It isn't perfect but it is drastically improved from the nerve symptoms that used to plague me on a daily basis. Without this medication my life would be much, much worse.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff4217	Anonymous	None	2022-04-05T03:18:37Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-tvrd-6qyn	False	None	False	2022-04-12 05:36:40.441	[]
3726	CDC-2022-0024-3732	https://api.regulations.gov/v4/comments/CDC-2022-0024-3732	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in a bad car accident in 1996. I have four rods, 14 screws, 6 cages and 8 brackets in my lower back at 3 levels. One screw is broke and is poking out of my back and bleeds regular.My pain meds do not bring the pain level lower than a 5 out of 10 scale. I was cut or tapered by about 80% in 2016 and can barely do my own self care. I have lost pretty much everything except my life. Without an increase in my meds I do not think suicide will just be a thought for to much longer. I am a legacy patient, since 1998. I can barely walk do to a blood clot that led to amputation all my toes on my left foot. I seldom leave the house and can not even remember the last time I went out and did anything fun. The pain is all I have left. The 50mme if or when it becomes law I believe many more suicides from chronic pain will be happening. Why not grandfather legacy patients to be treated according to there problems and level of pain. I am sure none of you at the CDC could handle just one day of what me and so many more deal with 24/7. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff4234	Anonymous	None	2022-04-05T03:19:51Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1g-u6os-ui45	False	None	False	2022-04-12 05:36:40.657	[]
3727	CDC-2022-0024-3733	https://api.regulations.gov/v4/comments/CDC-2022-0024-3733	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a person who has suffered with RLS for many years. I have tried at least 9 different medications and now have found relief with using methadone. Because of the restrictions on this medication, I have had to travel over 1000 miles to get access to this life saving medication. My RLS gives me symptoms between 12 and 20 hours a day. It affects everything I do. Without the methadone, I would be absolutely miserable and unable to sleep. I have had RLS for over 20 years. I have been on either hydrocodone or oxycodone since 2011 and successfully treated. I was able to switch to methadone in the last 6 months which is a much better medication but it was very difficult to find a doctor willing to prescribe it. I live in Oregon and had to travel to LA to get a prescription for methadone. If the restrictions on opiates included RLS as a condition appropriate for long term opiate treatment, more physicians would be willing to offer this life saving treatment.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484ff4282	Moorhead	None	2022-04-05T03:20:41Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Moorhead, Karen	l1g-upt3-6i2u	False	None	False	2022-04-12 05:36:40.870	[]
3728	CDC-2022-0024-3734	https://api.regulations.gov/v4/comments/CDC-2022-0024-3734	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. <br/><br/>When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barry	None	None	0900006484ff42c6	Bogart	None	2022-04-05T03:20:52Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Bogart, Barry	l1g-v5cs-k7qk	False	None	False	2022-04-12 05:36:41.084	[]
3729	CDC-2022-0024-3735	https://api.regulations.gov/v4/comments/CDC-2022-0024-3735	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for updating the CDC Clinical Practice Opioid Prescribing Guideline. Unfortunately, the proposed draft does not address chronic conditions such as Restless Legs Syndrome (RLS) that are different from chronic pain. RLS is a chronic neurological disease that causes an urgent need to move the legs and, in my case, the arms and abdominal muscles as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. Airline flights, movies, concerts and children's plays can be torture sessions and are therefore avoided by most who suffer from RLS.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse and some of these can cause impulse control disorders that can ruin family finances via gambling or shopping or other impulsive actions that can destroy marriages and families. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I went through the stages of these medications, but they only helped for two years. The only medication that was left that I had not tried and failed were the low dose opioids. I had to wait for almost a year before I found a doctor that was willing to treat me using an opioid. She prescribed the smallest dose of methadone that is made and it turned my life around and is approximately 10% of what is used to treat chronic pain or those recovering from opioid addiction. I have been taking that same dose of methadone now for over six years. I have never felt any euphoria from my medication other than the relief that comes of being free of the need to continually move around. To give you an idea of what this means, on the few occasions when I ran out of pills, I was forced to spend over 48 hrs on my feet, continually walking around. I would walk the neighborhood around my home throughout the night, even though this carried a sizeable risk of being accosted by the homeless or local gang members. Why did I run out of pills, the current 30 day limits on prescribing pills and filling prescriptions left me without enough pills to cover my needs over an extended holiday weekend. Many of us also suffer from sleep deprivation due to our need to move around at night. When this happens for several days in a row, we start to suffer from severe depression, which cannot be treated because anti-depressants are all very potent RLS triggers. This leaves those of us with RLS with a feeling that the federal government is trying to kill us off via suicide or with the impression that you care more about the drug addicts than you do about law abiding citizens who simply want to live our lives out in peace.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses that are carefully monitored by our physicians.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006484ff42e4	Smith	None	2022-04-05T03:21:51Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Stephen	l1g-v6bg-4ys3	False	None	False	2022-04-12 05:36:41.299	[]
3730	CDC-2022-0024-3736	https://api.regulations.gov/v4/comments/CDC-2022-0024-3736	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The biggest problem with these guidelines are just that. They are only guidelibes. They are not being used as a whole report/ finding. They are being cherry picked by insurance companies, medical Boards, pharmacy managers, hospital systems and doctors. <br/>A doctor may want to treat you but a pharmacy may not. A doctor and pharmacy may be able to help but an insurance company may not. A doctor may tell you the guidelines are state law and the medical board says they are not. Its a situation today where no one really knows what is going on at this point except for the patients. <br/>Even the CDC has been soft on its messaging that these guidelines have been misapplied. The CDC has had messaging on Covid-19 2 to 4 times per week. But with prescribing guidelines, only on 3 occasions has the CDC said that dangerous tapering, or being completely cut off of medications was not the intentions of the guidelines. That's it! You know what? This is still happening daily 6 years later even as you whisper " it is not our intention". We have heard enough. Please fix this.<br/>I pray everyday that those responsible for this miscalculation have a serious injury, serious accident or disease that they to get to navigate this mess. It's been nothing short of a bad joke on a vulnerable population that quite frankly has limited resources because of their situation. Shane on you!.<br/>I'm writing this, along with many others, to shed light on the harm these guidelines have caused.... Intended or not. I'm telling you these guidelines have given the healthcare industry a greenlight to verbally abuse and wrongfully accuse people of being drug runners, distributors, dealers and nothing more than Tuesdays take out trash. I mean read these testimonials. It's Real!!<br/>Please fix this for God's sake. No one is getting younger. No one is going to escape the pain associated with growing old and your next.<br/>Please, it's impararive that guidelines remain in tack and not be used to cherry pick a number here, a sentence there. This is what has been done to the point no knows what's coming next.<br/>Lastly, the chronic pain community should never be lumped in for street drug addicts. We don't fight the same fight. We are not the same, ever.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484ff42ea	Sanderson	None	2022-04-05T03:22:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Sanderson, Michael	l1g-vkh7-zwm6	False	None	False	2022-04-12 05:36:41.515	[]
3731	CDC-2022-0024-3737	https://api.regulations.gov/v4/comments/CDC-2022-0024-3737	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been on low dose opioids for almost 20 years with no need to increase my dosage for my restless leg syndrome. All the new meds and methods have not worked and in some cases made it worse. You can’t imagine what it’s like to not be able to sleep or even be able to sit and read a book or watch tv. Pleas allow us to have some peace.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Geraldine	None	None	0900006484ff42f0	Weber	None	2022-04-05T03:22:29Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Weber, Geraldine	l1g-vnun-2vno	False	None	False	2022-04-12 05:36:41.766	[]
3732	CDC-2022-0024-3738	https://api.regulations.gov/v4/comments/CDC-2022-0024-3738	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person with RLS, I strongly encourage CDCandPrevention to support and adopt the Clinical Practice Guidelines for Prescribing Opioids. I stumbled upon the amazing benefits of opioids helpfulness with RLS after a surgery post op Rx. After 5 days of both pain relieve for my surgical areas and NO RLS, I asked my sleep specialist to try an experiment with me by adding this to my current RLS tx plan. I was and still am amazed at how few break thru nights I experience. This has now been the case for over 10 years and I'm so glad that the greater RLS now also knows the success that can happen from opiate treatment plans that are well supervised and monitored. These folks are not a population that will abuse the opiates since all they need is a small amount and no benefit is gained from upping does. Some of us do a combo tx plan for our RLS, as do I, because the opiate helps the other medication reduce our RLS symptoms, lets us sleep with less interruption and waking. Others do fine on just opiates, w/o a pairing of secondary Rx. PLEASE give us all a chance to have the best in treatment options by keeping the door open. It is with great frustration that I have to already endure the financial, time, and energy consequences of getting my opiate Rx done one month at time. This makes me insure a 12x the doc office visits/co-pays, appts that take me away from my other responsibilities to get renewals/refills processed, and pick up time. Not to mention the missed savings of getting a 3-6 mo renews/higher quantity per renewal. The scheduled urine sample tests makes me feel like a criminal. And I hate it. BUT I am willing to do all of these things because it has finally created a QUALITY OF LIFE I never expected to get back to once RLS entered my reality. Please be supportive and proactive in approving this major step for RLS. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	0900006484ff4327	White	None	2022-04-05T03:22:53Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from White, Tammy	l1g-wa5d-y1lb	False	None	False	2022-04-12 05:36:41.984	[]
3733	CDC-2022-0024-3739	https://api.regulations.gov/v4/comments/CDC-2022-0024-3739	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is disgusting that the CDC allows people with gigantic conflicts of interest, including those who head the [clinic redacted] at [location redacted], to participate in writing opioid guidelines for pain patients when the goal of that institution is to steer ALL treatment to non-opioid methodologies supported by their quack alternative medicine funders/lobbyists.<br/><br/>Over the last five years, the university has received nearly $2 billion in contracts from the CDC and other federal agencies, much of it going to the EPC to support research and propaganda which generally discourages the use of opioids, and is shamelessly cited over 100 times in the revised CDC guideline. Gee, I wonder how that would happen since the same people are writing both papers??? Isn't there a term for the ethically-retarded practice of reviewing your own work to pass it off as scientifically pristine??? If not, I can supply you with some!<br/><br/>The new guidelines should be stripped of all influence and reference to anyone, or any group, that has such conflicts of interest. That is how the first batch of disatrous guidelines got passed, and look how much damage was done! Don't make the same mistake twice!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006484ff437f	Olson	None	2022-04-05T03:24:50Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Olson, Kimberly	l1g-xc94-gkxn	False	None	False	2022-04-12 05:36:42.197	[]
3734	CDC-2022-0024-3740	https://api.regulations.gov/v4/comments/CDC-2022-0024-3740	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a CPP for over 17 years and the last 4 year has been the most miserable I have had to deal with in my life.My doctor retired at the end of 2017 I needed another surgery 10th over all on lower back , so I asked my nerusurgeon to see if he could set me up with someone else knowing I would be without pain medication if not and he did . Well this new doctor I saw was the same month I had my last surgery and 1 month post op he was weening me down 10mgs of both my breakthru and long acting meds each month until I was down to 10 mgs each and he told me I was going back to work , I asked him how was that I was deemed disabled by 2 IME doctor's that I could not stand by sit,walk for more than a 5 minute period and would be unable to do any kind of job,and would need to be on medication for the rest of my life . It was just as bad as being cut off cold turkey... I am now on my 6th doctor from that period (only had 2 prior to this) and at that time I was on 3 30mgs oxymorphone ER and oxycodone 30 mgs 4 a day with 2 kilotpin 1.0 and 2 Xanax 1.0 for restless leg and lack of sleep. I am now on 2 15 mgs of oxymorphone 1st off these pills has only ever worked as a 8 hr pill and 2nd I have lost 100 lbs am skin and bone( and this happened within the last year)I lost the best years of my kids lives, teenage years and I'm frustrated is not the word for it ,I can barely walk do not drive anymore suffer 8 to 10 hours a day do not sleep I am a diabetic and now it's affecting my eating habits. It is bad enough I can't be comfy but now I am always tired never want to eat and sugar is sky high . When does it end , where or what has to happen for a human to be treated like he is human ???? You have taken my life from me so much and this Dr not only did all these fusions I had (and he fused me flat which is causing all of my problems), now I need another 1 and my new nerusurgeon wants a myleogram because it looks like my hardware is backing out again(L5/S1 4th time) he wants to break my back and this is a 50/50 chance of survival because it puts so much stress on your heart. In all honesty all I want is to be comfortable but I am being told I am maxed out on my opoid dosage so what am I supposed to do? Look to the streets or end my life . I have and keep saying it going to get better but honestly it's getting worse not better so what does someone in my position do? Is there anyone out there that can answer me this please?????? I will not lie there is times because I am so miserable I would love to end it all , but I keep fighting for my kids and wife all would like is relief and to have a full quality of life back again to feel as normal as I can at this time nothing more just to be comfy enough to go places to eat, sleep, and do things with other is all I would like to have back not much to ask for is it?????	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shawn	None	None	0900006484ff4029	Thompson	None	2022-04-05T03:25:32Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Thompson, Shawn	l1g-ytzd-lb2h	False	None	False	2022-04-12 05:36:42.410	[]
3735	CDC-2022-0024-3741	https://api.regulations.gov/v4/comments/CDC-2022-0024-3741	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Restless Leg Syndrome which is a very difficult disease to live with and to treat. The only current treatment that is effective for me, (Carbidopa-Levidopa) will eventually augment, meaning that it will make the symptoms worse. The clock ticks with this medicine. Very low dose opiods have proven to be effective when nothing else works. So until researchers come up with something new, it would be could if the CDC can allow certain certain special low formula opiods to treat RLS. [name redacted] in Massachusetts	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judith	None	None	0900006484ff4081	Lipsky	None	2022-04-05T03:26:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Lipsky, Judith	l1h-01u6-hn58	False	None	False	2022-04-12 05:36:42.624	[]
3736	CDC-2022-0024-3742	https://api.regulations.gov/v4/comments/CDC-2022-0024-3742	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is always the citizen who pays for the missteps of Government, none greater than those whose quality of life is diminished with chronic pain, when a one size fits all approach is applied in a medical treatment. Doctors struggled to conform to this one size fits all approach only to come under fire by those who held them to the one size fits all approach or because they didn’t walk on water and made zero mistakes as imperfect human beings. While this much needed change is welcomed, the problem unaddressed are those doctors who would still be in practice if it existed sooner than later. The patients suffer two fold. They had their medications reduced to meet the one size fits all approach, which diminished their quality of life, only to have their doctor replaced by those fearful of the previous CDC guidelines and suffer the same fate as those doctors who lost prescribing privileges, leaving patients unable to receive the benefit of these new changes. These changes vindicates many Doctors who are essential to these new changes, and should be offered a one time opportunity to practice under these new regulations, as chronic pain patients like myself have lost more than a quality of life in reduced medication, we lost relationships decades long in many instances of those who knew our medical history best, and how to treat it. The art of medicine is unable to provide the depth of color to ones life when limited to few colors and a single brush.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Guy	None	None	0900006484ff408b	L	None	2022-04-05T03:27:34Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from L, Guy	l1h-05wz-3t5h	False	None	False	2022-04-12 05:36:42.836	[]
3737	CDC-2022-0024-3743	https://api.regulations.gov/v4/comments/CDC-2022-0024-3743	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>I am a person who is living with chronic pain and have been for many years. I had suffered with such immense pain that my quality of life almost came to a complete halt due to not only the severe pain, but also the intense depression that over came me.<br/><span style='padding-left: 30px'></span>I sought help for many years for pain management and because of the ridiculous CDC {guidelines} what little help I received for short term did absolutely nothing to aid in my pain relief and my quality of life. My severe depression only intensified. <br/><span style='padding-left: 30px'></span>I finally found a pain management specialist that was willing to accept me as a patient after reviewing my medical history.<br/><span style='padding-left: 30px'></span>The pain management specialist see's and knows through my medical history and understands why I am in need of the pain medication through our pain management contract. The pain management specialist see's me as and individual who has been suffering for many years unnecessarily due to {the fear that the CDC has put into General Practitioners that they are unwilling due to the fear of the CDC guidelines and their lack of knowledge and willingness to help their patience to the best of their ability to obtain and sustain a healthy pain free quality of life.} Those in the medical field especially Dr's and general practitioners take an oath to help their patients to the best of their ability and are NOW unable to do so because of the CDC and their guidelines. <br/><span style='padding-left: 30px'></span>I was a patient that unfortunately was released from my Dr's care because my Dr was unable to aid any longer in my pain relief and specifically said it was due to the CDC GUIDELINES. <br/><span style='padding-left: 30px'></span>It is in my opinion that the CDC needs to do studies on this matter and in the studies it is of upmost importance that they truly hear each and every chronic pain patient to know what their needs are for their pain relief. The CDC also needs to dig deep into studies of addiction and overdose to know that they are caused NOT from chronic pain suffer's that are being managed by pain management specialists, but by being turned away from Dr's who are unwilling to aid in their pain management , they are those who are turning to street drugs that they are forced to seek out to get relief from their intense chronic pain due to the ridiculous bare minimum guide lines that they the CDC have no true and honest case studies to back up.<br/><span style='padding-left: 30px'></span>Chronic pain suffer's are able to sustain a good quality of life and are able to live with less pain only with the help of pain management specialists. <br/><span style='padding-left: 30px'></span>The Center for Disease Control needs to stop it's war on us the chronic pain suffer's and let the Dr's and the Practitioner's due their job they swore an oath to do.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff40b1	Anonymous	None	2022-04-05T03:30:27Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-0tgw-a7vl	False	None	False	2022-04-12 05:36:43.052	[]
3738	CDC-2022-0024-3744	https://api.regulations.gov/v4/comments/CDC-2022-0024-3744	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have dealt with severe RLS for fifteen years and is a very debilitating illness. Prior to medication I could not sleep effectively. When first administered medication for RLS it was a dopamine agonist medication and worked well at first. And I've been prescribed three different dopamine agonist medications. Over time all of these medications stopped working at the prescribed dosage and had to be increased on a fairly regular basis. What occurs with these dopamine agonist medications over time is called augmentation, where the same meds that helped earlier now cause severe RLS symptoms to return, not only at night but during the day and it is pure torture. I had to deal with this for several years until I found a doctor who was very well versed on RLS and prescribed me low dose methadone. The dosage I have been on for over two years is 3.5ml and I have not had to have it increased at any time. Being prescribed methadone for RLS is a life saver although it does come with an attached stigma that it's only use is for drug addicts. I've even had a Urologist question me on this and stated that methadone is not for RLS until he looked it up on the Mayo Clinic website. So, I'll deal with the stigma as there is no better treatment for RLS than low dose methadone!<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Len	None	None	0900006484ff40b3	Pinelli	None	2022-04-05T03:30:46Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Pinelli, Len	l1h-0v4a-qhh0	False	None	False	2022-04-12 05:36:43.267	[]
3739	CDC-2022-0024-3745	https://api.regulations.gov/v4/comments/CDC-2022-0024-3745	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Remove MMEs.<br/>When I saw initial media reports about MME’s being removed from these draft guidelines, I was ecstatic. That feeling of relief evaporated as I read this gargantuan 211-page document. Although referrals to 50 and 90 MMEs have been removed from the 12 top tier level guidelines, references to 50 MME are imbedded throughout the subordinate “Implementation Considerations” and “Supporting Rationale” sections of the related numbered “guideline”. It is clear the drafters of this revision intend to further push their anti-opioid agenda but are now employing a tactic of subterfuge. A tactic called out by our 28th US President, Woodrow Wilson with these words: “No one who has read official documents needs to be told how easy it is to conceal the essential truth under the apparently candid and all-disclosing phrases of a voluminous and particularizing report…”<br/>Just as the 2016 CDC Guidelines caused grave harm to severe chronic pain patients and their physicians, this revision will continue to do so. But now, “50 MME”, not “90 MME”, will become the new de facto upper prescribing limit. NO AMOUNT of disclaimers or clarifications such as those stated in the dialogue box at line 26 of this draft document, will alter this truth. Here is proof: <br/> In 2019, the FDA, the CDC, and my home state issued such clarifying guidance: <br/>April 9, 2019, FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering \| FDA.<br/>April 24, 2019, CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain \| CDC Online Newsroom \| CDC,<br/>August 27, 2019, Don't Drop Your Patient (ca.gov)<br/>On September 7, 2021, my state doubled down, again to no avail, with this physicians alert: CDPH SOS Workgroup Action Notice - Best Practices for Providers Who Inherit Patients on Opioids (ca.gov) . <br/>All of this “clarifying guidance” failed to reverse the harm inflicted upon severe chronic pain patients by the alleged “misapplication” of the CDC’s 2016 Guidelines. <br/>This just occurred to a pain patient who I know for a fact has been prescribed and safely used, with no adverse event, opioid medications for over 20 years. Medications by the way, until they were involuntarily tapered subsequent to the CDC’s 2016 Guidelines, actually provided her a very reasonable quality of life. On March 2, 2022, after her pain management physician of the last 20 years, sold his practice to a pain management clinic, the physician at the clinic she was “transitioned” to, at her first appointment cut her off from her long term, already previously tapered opioid medications. He walked into the room and without even introducing himself announced, “I will not write your prescriptions. They are not safe. I can offer you Suboxone or referral to a detox facility.” I have attached a PDF of the last page of this “Doctor’s” arithmetic challenged appointment report dated six days later. As evidenced thereon, he cited 90 MME and CDC criteria as his sole justification for his decision. For convenience, here is an excerpt from his signed report: “… advised patient and her husband that 240 MME (should have been 220) was way above the safe dose of 90 MME … explain per CDC criteria the dose that she is on very high and there is risk of overdose … “<br/>Additionally, since 2016, the annual lowering of health insurance company prior approval MME thresholds, and then the subsequent denial of “prior approval” requests dosages exceeding these lower MME thresholds, all cite CDC criteria as the justification for these patient harming actions. Even the US Office of Personnel Management (OPM), who contracts with many different health insurance companies on behalf of federal employees and retirees, in an August 25, 2020, appeal denial letter wrote, “The CDC recommendations indicate that the dosing combined should not exceed 90 mg morphine milligram equivalents (MME)/day …” This is the same OPM whose “Laboratory” facilitated the “one on one” CDC conversations, in which I participated in September 2020. You will recall, these conversations were held with approximately 100/physicians, patients, and advocates at the beginning of this ongoing revision of the 2016 CDC guideline.<br/>Bottom line: Only removal of the MME thresholds from this draft document will remedy these and similar ongoing harms. PLEASE DO SO!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monty	None	None	0900006484ff40b4	Goddard	None	2022-04-05T03:32:52Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Goddard, Monty	l1h-0lcg-iik4	False	None	False	2022-04-12 05:36:43.482	[]
3740	CDC-2022-0024-3746	https://api.regulations.gov/v4/comments/CDC-2022-0024-3746	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I can't believe these bureaucrats are doing this AGAIN! You never had the right to mess with the medical treatment of private citizens...but you did. You stole our lives to chase a dream that you could make drug abusers want to live. You are despicable with your reckless games you play with our lives for your profits.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff43dd	Anonymous	None	2022-04-05T03:33:02Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-29db-wu2z	False	None	False	2022-04-12 05:36:43.710	[]
3741	CDC-2022-0024-3747	https://api.regulations.gov/v4/comments/CDC-2022-0024-3747	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I am writing to you the CDC to tell my story on how these opioid guidelines have severely hindered my lifestyle and ability to have a normal functioning everyday life. I was born with a chronic illness as as I get older my illness continues to worsen. The ONLY thing that allows and HELPS me to have somewhat of a functional lifestyle is my opioid medication! However over the years these CDC guidelines have hindered that and have made it very very difficult for me to get my medication! I have been very fortunate to get a great pain management medical team but then you go to the pharmacy and because of the CDC rules they try to change your prescription and tell you your dose is too high and you will become addicted to your medication! They make is difficult to receive my medication. They do not understand that I am NOT addicted to my medication, I am DEPENDENT on my opioid medication and there is a difference! I need this medication to function and live a daily life. So please I ask you the CDC to take a close look at the guidelines again and change them for us chronic and severe patients that need these medications to live a functioning life or have a surgery to live! If you were in our shoes you would want the same. I have never abused my medication I only take it to functions Remove ALL mention of MME (Milligrams of Morphine Equivalent)including in the supporting text and Please remove ALL mention of limit of days for prescription for acute pain including in the supporting text. These restrictions hinder our medical professionals from doing their jobs and helping us patients that truly need the help! My life with my medication is functional, when I can’t get my medication I am UNABLE to get out of BED, I am crippling with pain and just don’t want to carry on! This is not fair to us! I had a great job and because of this I can no longer work due to my disability and I have surgeries every 2-4 months for the last 12 years continuously and NEVER allowed additional pain medication than what I am already prescribed. Please I am pleading with you to take another look at the guidelines and make a change for the better! Please	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Filomena	None	None	0900006484ff43e9	DiZenzo	None	2022-04-05T03:34:29Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from DiZenzo, Filomena	l1h-2o0g-jaxt	False	None	False	2022-04-12 05:36:43.924	[]
3742	CDC-2022-0024-3748	https://api.regulations.gov/v4/comments/CDC-2022-0024-3748	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been struggling with back pain/herniated disc in several locations. I've been through 3 fusions and 1 discectomy. I will need another one, but have been using other methods to hold it off. I was originally on pain pills for years. They worked very well and knowing I could take another one when needed or to make it through the day was a good feeling. My back Dr suggested a pain management clinic. However, they changed all my medications and took me off my fast acting meds. They put me on morphine at the lowest possible dose. It didn't touch the pain. They then put me on the lowest dose of xtampza not touching the pain. They refuse to increase the dose. They are trying to push the spinal cord stimulater and suboxone on me. It doesn't matter to them that I'm extremely uncomfortable with those options, and because of that they don't want to help me. I've considered suicide several times, because what kind of a life is this? I can't walk, I have trouble working, and doing day to day tasks. I could do all of this on my fast acting pain pills. Taking them away is a mistake. They really help more than the alternatives that are offered. I've had my nerves burned, several failed injections. Every day the pain is worse. This is not quality of life. I can't even go to the ER for help with the pain because of the contract. This life of pain is miserable. It's a torcher that I wouldn't wish on anyone. I wish we as the patient could tell the Dr what they are forcing on us doesn't help and they could prescribe a pain pull to increase quality of life without fear of prescribing options. Pain is different for each individual and the medications that work for some don't work for all. Doses that work for some don't work for all. I know its hard for someone who doesn't feel excruciating pain to understand our cry for help, but im begging you to find the compassion to help those of us who really suffer and allow us options of being able to take what helps us. Since restrictions have been placed on these opioid more people have taken their life, turned to street drugs, or overdosed on drugs just for some relief. Pain not only affects the individual in pain, but everyone close to them who watches it and cannot do anything to help. That's no life, that's torture. I know there will be some who abuse the help, but that's going to happen with or without restrictions and those of us who don't abuse it shouldn't be punished or made to feel like our quality of life doesn't matter because of the bad ones. My wish is that you or whoever makes these decisions decide to help those who need it. It's really frustrating knowing there is something that can help, but you can't take it because dr's are afraid or told not to prescribe it. We should be allowed to live our life rather than feel like prisoners in our own body. Please help those of us that really need the pain pills. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Corey	None	None	0900006484ff4439	Hartman	None	2022-04-05T03:35:09Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Hartman , Corey	l1h-46gu-szpt	False	None	False	2022-04-12 05:36:44.136	[]
3743	CDC-2022-0024-3749	https://api.regulations.gov/v4/comments/CDC-2022-0024-3749	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)<br/>I am a chronic pain patient with multiple rare degenerative spine and spinal cord diseases. I also have an autoimmune diseases called Ankylosing Spondylitis which destroys bone, tissues, muscle and organs. I am in constant pain and it will only get worse, I also have small fiber neuropathy from multiple osteophytes pressing on my spinal cord and they are inoperable due to doctors ignoring my pleas for tests for forty years!. My current pain doctor tells me that I need more pain medications but due to missing a kidney I cannot take NSAIDS and Gabapentin type medications caused way too many side effects. My doctor says the DEA is threatening them daily if they prescribe over 50mme! I fall under palliative care with my diseases, but in Florida, they will no longer provide palliative care, only hospice care because of DEA interference. <br/>The guideline’s need to be dissolved due to the harm they are causing millions of Americans like me.<br/>I am in agreement with the attached file. Do not delete my comments! I have seen numerous comments being deleted because they mention certain names of people who wrote the guideline’s that have conflicts of interest and broke the CDCs own rules. Just because of this they should be redacted!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff445a	Anonymous	None	2022-04-05T03:38:07Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-4d7w-g9bd	False	None	False	2022-04-12 05:36:44.351	[]
3744	CDC-2022-0024-3750	https://api.regulations.gov/v4/comments/CDC-2022-0024-3750	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am a 61 year old female living with CRPS for 10 years now.<br/>Since you put your guidelines in place, I have had to live with this horrific, terrible pain without any pain medication of any kind. I feel this has ruined any quality kind of life I once had. I often contemplate not wanting to live anymore. the only thing that gave me any quality of life was opiods. I was never on a high dose, but it allowed me to participate in daily living. I now waste away, not being able to do the things I once loved, such as gardening, crafting, being social and loving life instead of dreading waking up. <br/>Your guidelines have ruined me and my life. I can't say it enough how inhumane it is to be treated like this,<br/>PLEASE leave it between the doctor and patient as to what they can give us.<br/>People wonder why so many deaths from street drugs, I feel strongly you are to blame for this happening.Those of us who suffer with medical documentation, are suffering.<br/>I have no more to say.<br/>Sincerley<br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484ff47aa	Miller	None	2022-04-05T03:38:52Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Miller, Sandra	l1h-6sdk-5ln1	False	None	False	2022-04-12 05:36:44.593	[]
3745	CDC-2022-0024-3751	https://api.regulations.gov/v4/comments/CDC-2022-0024-3751	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	All Americans have a right to live. But when you live with chronic pain, and levels of pain at an 8 or 9 (on a scale of 1 to 10) on a daily basis (24/7/365), you cannot function, eat or sleep. The minimum pain relief found in otc pain relievers will not begin to touch that high level of pain. They help as much as a couple of cookies will to take away major pain. Pain from cancer, arthritis etc is not your average minor headache type of pain. Plus you cannot take a couple of otc pain relievers once in a while, like with a headache and expect no pain for days, weeks, months, etc. Industrial strength pain relief is required. Those with chronic pain take their meds as directed. We shouldn't be required to jump through a bunch of hoops as required by pain management. Chronic pain patients have the same rights as o5her people. But we have our privacy invaded. We can have people come into our hometown count our pills. But if you are on other types of medications that doesn't happen. We loose our doctors because they are scared of loosing their license to practice medicine. The government is tracking pain meds prescriptions. What about other prescription medications? How are chronic pain patients different from those on blood pressure medicine, cholesterol medication, etc. Those prescriptions are between the patient and their doctor, and not tracked by the government by each doctor. We are no different. Chronic pain patients deserve the same freedoms etc as other patients. So our pain meds should be treated the same. Any caring doctor can tell the difference between addicts and pain patients. So give them credit to know the difference. Also treat chronic pain patients with the dignity and respect they deserve. If your parents, spouse, children have chronic pain, don't they deserve the same respect, or would you want their privacy rights invaded by people who don't experience chronic pain on a daily basis and no medical degree to have control of their medicines, or your medications?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484ff47d1	Marks	None	2022-04-05T03:40:32Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Marks, Sharon	l1h-7giy-jmu0	False	None	False	2022-04-12 05:36:44.805	[]
3746	CDC-2022-0024-3752	https://api.regulations.gov/v4/comments/CDC-2022-0024-3752	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The draft of the 2022 CDC Clinical Practice Guideline for Prescribing Opioids does not address chronic conditions like restless legs syndrome (RLS) that are different from chronic pain. Although RLS can be painful at times due to muscle spasms, it is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly which seriously affects common aspects of everyday life. A lack of sleep worsens and magnifies those symptoms.<br/><br/>There is no cure for RLS. A few prescription medications may relieve the symptoms but over time those same medications can make the symptoms worse. When all other medical therapies fail, scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My wife is one of the nearly 12 million people in the U.S. who suffer from RLS. She has suffered with the condition since childhood. I have observed her years of trial and error with various doctor-prescribed medications that seem to help for a while then lose their effectiveness. The severity level ebbs and flows over the days, weeks, months, and years. At the worst of times she can go for multiple days without sleep due to the condition. Lack of sleep worsens the condition and she ends up in a vicious cycle and desperate for relief. We discovered by accident after a dental procedure that taking an occasional opioid (such as hydrocodone) at the time of a severe multi-day RLS event will give her just enough calming relief to allow her to fall asleep and begin the improvement cycle as she catches up on sleep. Just a simple, occasional hydrocodone can reverse that desperate cycle and give her the relief and hope that comes with sleep. A single dose at only the worst of an episode (as in two to three tablets total per month) would give her much needed relief.<br/><br/>I have learned from the RLS Foundation that the 2016 CDC Opioid Prescribing Guidelines often made physicians reluctant to prescribe opioids for any reason, even for patients with severe and unrelenting RLS. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS as it is for members like me.<br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R	None	None	0900006484ff47d2	Wallace	None	2022-04-05T03:42:09Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Wallace, R	l1h-7h9z-jtgw	False	None	False	2022-04-12 05:36:45.018	[]
3747	CDC-2022-0024-3753	https://api.regulations.gov/v4/comments/CDC-2022-0024-3753	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC is incredibly unethical and deceptive. How dare they lead chronic pain patients to believe their concerns would be taken into consideration while not even waiting for their comments to be read. Instead, the CDC and their very anti-opioid panel have already begun sending out the new guidelines to doctors. Guidelines that will further harm patients suffering with chronic pain. <br/><br/>I've had it with not being able to get adequate treatment for severe intractable high impact chronic pain that was caused by being hit by an 18 wheeler twice in the same accident, fracturing several vertebrae, and a broken tailbone. I also have severe spinal stenosis, degenerative disc disease, and sciatica. I also have severe osteoarthritis in my spine knees and hips. As well as numerous other very painful problems. <br/><br/>Because of the deceptive practices of the CDC, I can't get the pain relief I need. I've followed my pain mgmt contract for nearly 20 years. I've had clean urine drug tests for the entire time I've been in pain mgmt. I'm not an addict, I only want adequate doses of opioid analgesics for the pain that's prevented my from living my life and participating in the lives of my family members.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff47e6	Anonymous	None	2022-04-05T03:43:19Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-7uj3-af12	False	None	False	2022-04-12 05:36:45.237	[]
3748	CDC-2022-0024-3754	https://api.regulations.gov/v4/comments/CDC-2022-0024-3754	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	What about the damage already done? What does this revision do to reverse harm caused by it? What’s stopping misinterpretation of the latest MME “suggestion?” What about the wrongful codification and adoption of the “voluntary” guideline into law/practice and surrounding areas like insurance? It appears that this behavior is being encouraged by your publication in the Federal Register (more coloring this with false legal legitimacy) and your presenting your guideline written in a manner/format that physicians will associate with actual standards of care that are enforced by law. What about prescribing fear and behavior change (patient avoidance/abandonment) already in place from this war on pain? Why are drug addicts given more compassion and mercy than medically Ill people? Those who chose to abuse are now rewarded with lifetime medication maintenance? That’s what we disabled people are actually fighting for, to be treated for our condition with dignity and respect. Currently, it’s the addicts who are allowed much easier and compassionate access to opioids to indefinitely “manage their addiction, I mean condition“ and their “condition” allows for phone scripts and refills etc. Yet, compliant patients with a track record of safe benefit are treated like a recent parolee (in stigma and practice). Why on earth is the addict treated with more respect and easily provided opioids when “organic” medical patients (not psych patients with malleable conditions within their control) are denied, tapered, and forced to suffer? Others have opined based on the all mighty dollar and how there are multiple people who authored the guideline who have admitted conflicts of interest and have benefited from their participation in the guideline. The many failures and unintended consequences are enough to scrap the guideline entirely. Then there’s the question as to why this guideline is allowed to exist when the CDC is the wrong agency and doesn’t have proper legal authority. There are glaring issues of credibility and conflict of interest publicly known about the authors. This guideline MUST BE ABOLISHED. That’s it. It causes harm and was based many on a false premise. It is obvious now that all of these efforts had no effect on the real problem- illicit drug overdose (heroin,fentanyl). Are addicts and abusers more important than patients in dire need of easing the torture caused by 24/7 pain? The money and structure for treating addicts is huge and exponential growth is here via Biden’s Spending. Pain patients are left out, as always. Now, that this house of cards is crumbling, why are you choosing to prop it up? I’d say all one has to do to answer that question is to look at the guideline authors and their actions, associations, and finances for the answer. The research proof is catching up with common sense observation of the harm this guideline caused.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff481a	Anonymous	None	2022-04-05T03:46:00Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-9sy4-pa5j	False	None	False	2022-04-12 05:36:45.451	[]
3749	CDC-2022-0024-3755	https://api.regulations.gov/v4/comments/CDC-2022-0024-3755	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi I’m [name redacted] I first fell and broke by tailbone in 1996. On top of all of that the discs in my neck started degenerating. The doctors said nothing could be done and did cortisone shots and my neurologist gave me Caffeine pain medication for my migraines along with sumatriptan. For a while that worked until i broke my tailbone again then 2 more times. In 2 places when I was just about 50 by then. I was being treated well in every state I live having to move quite a bit for my husbands work. We ended up in Ohio. Not one doctor was able to help me get back to work at all! I was on a great schedule of Botox, cortisone and 5mg oxy, 8 per day and was able to walk and work. My biggest issue is living like this. Whenever the government takes away something necessary to people in grave pain the inevitable happens! The drug dealers come out of the woodwork. It’s always been proven. The only problem I see is that people weren’t getting proper check ups and urine screenings. That’s the only issue needing change everything else should go back to normal. We should have a right to choose how we feel, know our pain and limits. What we have now are more overdoses from product sold on the street. How is it a government can take away what we really need to love and give out a gun to anyone on the street. Seams totally backward to me. You also say how many billions of dollars in revenue we’re losing in the USA. I’m guessing if you give the pain medication back those billions would follow since they do cost quite a bit. I’m afraid for America and the choices the government has made for us. This is a free country! We know what we need and we are the only ones who know how much pain we are in. I’m in Wisconsin now which is just as strict as Ohio. I have only one month to find a new doctor before I’ll be bed ridden. In my opinion you need people in<br/>Pain or have been in pain to be on your judgement panel, which completely take away our right to medical care and treatment of pain that works and has worked forever! Stop choosing for us check in on us but don’t decide how much pain we’re in. I’m starting to believe in large class action lawsuits are really a good idea I never did before but now would be the time I hope you chose in favor of letting us walk, sit move, and work if we want to thank you,[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Abby	None	None	0900006484ff4820	Zeiler	None	2022-04-05T03:50:59Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Zeiler , Abby	l1h-a4sd-mhgh	False	None	False	2022-04-12 05:36:45.671	[]
3750	CDC-2022-0024-3756	https://api.regulations.gov/v4/comments/CDC-2022-0024-3756	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 1998 I was involved in a car accident that was caused by a drunk driver. Such irony since I quit drinking at age 22 (I am correctly 60) after losing five friends to alcohol related deaths. Three is my lumbar disks tore in half upon impact. Subsequently, I have had a 3-level lumbar fusion and a single fusion at C5-C6. Both fusions are failing and I have several more damaged disks in the Thoracic region. All of my physicians have told me that my back will never get better and continue to deteriorate. I am not one to accept defeat so I started swimming. The pain prevented me from doing much more than water walking. I was making no progress so I requested fentanyl patches just long enough to get my body used to the physical exertion related to swimming. At the time I was on 120 mme. it worked. I was able to start swimming and get up to a quarter mile. So I asked to get off the fentanyl and back to oxycodone. We did this and I slowly increased my swimming to a mile a day. It effectively replaced one of my 5 pills a day with the endorphins from swimming. After five years of this regiment I was told I had to taper. I am down to 30 mme and it has had an extremely negative impact on my swimming regiment. They plan to take me to zero to try other alternatives. I have already tried: pain pump (since removed), spinal stimulator, physical therapy, dry needling, acupuncture, Rolfing, massage and chiropractics. None of these have provided sustained pain relief sufficient for any quality of life. The CDC’s opioid analysis needs to provide detailed breakdown of exact causes of death, form of drug and whether it was prescribed or not. My pain levels have increased from consistent 3’s under my old swimming regiment with 50 mme to consistent 5’s with limited swimming and 30 mme. I am unable to swim when I have tried to self-taper to 20 mme. Please consider making changes that allow for better analysis. Include Chronic Pain Patients on the panel. There are plenty of physicians and professionals in the industry that are chronic pain patients. Each partient has his or her own experience with pain that requires a responsive, personal doctor-patient relationship. Please encourage physicians to rely on the primary data they get from their relationship and history with the patient. There is no reason for so many pain patients to suffer from an improper analysis and response to such a critical issue for people to have health and quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	0900006484ff44bc	Hill	None	2022-04-05T03:51:14Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Hill, Daniel	l1h-avug-kynm	False	None	False	2022-04-12 05:36:46.437	[]
3751	CDC-2022-0024-3757	https://api.regulations.gov/v4/comments/CDC-2022-0024-3757	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic intractable pain for the past 15 years due to scar tissue on one of my cervical nerves in my neck. I've had 34 surgeries or procedures to try to help and this cannot be fixed. I am in pain all the time. The only thing that helps are opioids. My doctors are afraid of prescribing it not because they don't think it will help. They 100% think it's the only correct treatment for me. But, they are afraid of losing their license because the medical board and doctors in general have misinterpreted the original guidelines to mean that these drugs should not be prescribed and if you do, you will cease to practice medicine because we will take your license away. I have been told this by many doctors. They are afraid. This medicine is life saving. It would be impossible to live a normal life without it. The war on drugs is being fought at the price of law abiding citizens while criminals still get drugs without a prescription. The opioid crisis has increased since these guidelines were implemented and only innocent patients pay the price. <br/><br/>I would like to see:<br/>1. De-implement 2016 guidelines and fund the de-implementation.<br/>2. Guidelines need to be redacted and redone.<br/>3. Remove all mention of Milligram Morphine Equivalents (MME)<br/>4. Remove ALL mention of limit of days for prescription for acute pain including in the supporting text.<br/>5. There should be no mention of conditions or exclusions. There are many diseases other than cancer, such as my condition, that can cause chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff44c6	Anonymous	None	2022-04-05T03:51:24Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-az6l-6618	False	None	False	2022-04-12 05:36:46.676	[]
3752	CDC-2022-0024-3758	https://api.regulations.gov/v4/comments/CDC-2022-0024-3758	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>I am a chronic RLS sufferer and unfortunately was prescribed a "routine" medication (no longer recommended by the experts in RLS) called Ropinirol - I had a severe reaction to the drug (an acute case of augmentation) which caused my symptoms to accelerate and intensify. I had to suffer through an incredibly long and difficult withdrawal period that lasted for over 6 months (with lessening severity) from this drug. After years of trying different treatments, from the recommended available drug treatments (i.e, Gabapentin, etc.) to every homeopathic suggestion, I finally found relief after traveling to Southern CA to an RLS specialist (Dr. [name redacted]) who finally convinced me that a very low-dose of Methadone would likely help. I can finally sleep! I take a lower-than-recommended dose, so I still have minor tremors which can impact my sleep quality, but without this medication, I cannot sleep at all! My legs go crazy! Suffering from restless legs is akin to torture, and can only be understood by those who suffer from this! <br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. I am one of those people for whom the symptoms became radically worse!!!!!!<br/><br/>[<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M	None	None	0900006484ff44cc	H	None	2022-04-05T03:52:17Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from H, M	l1h-b5jh-ox6o	False	None	False	2022-04-12 05:36:46.892	[]
3753	CDC-2022-0024-3759	https://api.regulations.gov/v4/comments/CDC-2022-0024-3759	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines are a disaster. The streets are flooded with illegal fentanyl while chronic pain patients are subjected to heavy handed medical surveillance, or are driven to suicide by inadequately treated pain. The CDC must confine their attentions to infectious disease, and leave doctors alone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	0900006484ff44db	Stack	None	2022-04-05T03:52:27Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Stack, Elizabeth	l1h-bjap-suad	False	None	False	2022-04-12 05:36:47.106	[]
3754	CDC-2022-0024-3760	https://api.regulations.gov/v4/comments/CDC-2022-0024-3760	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a clinical psychologist and a widowed parent who has been raising my children after losing my husband. I have had severe RLS my entire adult life. My neurologists have tried hard to control my severe symptoms; however, as my symptoms worsened they needed to add a low dose opiate to amplify the effects of my dopamine agonist. I have remained at exactly the same low dose of opiate for over a decade years - never increasing the amount. By far the greatest difficulty I have is getting the prescribed medication. Even though I live in a large East Coast city I must travel 50 minutes each way to get a pharmacy who will fill the prescription - and even then they have more than once suggested that I might want to get my script filled elsewhere. I have been questioned repeatedly by pharmacy technicians (Do I really hold a job? Where am I going and what am I going to do with my medication after I get it filled? etc. ) Endured questioning and rude comments that one would never ask other patients picking up a prescription. -- All because I following my doctor's orders and taking necessary medication he is prescribing so I can remain functional enough to support and take care of my family after my husband died. <br/><br/>Please do not make things even more difficult for people like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff44ef	Anonymous	None	2022-04-05T03:53:12Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-cebu-5ypt	False	None	False	2022-04-12 05:36:47.323	[]
3755	CDC-2022-0024-3761	https://api.regulations.gov/v4/comments/CDC-2022-0024-3761	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is[name redacted], I am a real human being, I am also a chronic pain patient. My life has been turned upside-down by the 2016 CDC guidelines. The MME wording has scared all medical subscribers to the point that they no longer want to treat chronic pain patients and it should be done away with. Please take the MME WORDING out of the equation. I am not a criminal, I'm in pain. I've had 8 failed back surgeries. I have Fibromyalgia,Osteoarthritis,osteoporosis DDD and my last cervical spine X-rays were just frightening, I'm told my spine is crumbling so I'll probably need another failed surgery just to mention a few. All of these things have led to depression,anxiety and insomnia which creates a vicious cycle that makes the horrible pain that I'm already in, much worse. Now after a CPP has to go (for me) an hours ride, pee in the cup, do a drawing of where their pain is, answer 20 questions and make the next month's appointment, ride another hour back home... THEN the ordeal of having to go to the pharmacy. There you are intimidated, embarrassed and humiliated by someone who couldn't care less about the 3 or 4 hours you've already been through hell. So they do the same by questioning the ability of the doctor to decide the amount of medicine you should get. And if said pharmacy doesn't want to fill your Doctors Rx they can choose not to. And if they don't have enough of your Rx you must go without your medication or forfeit the rest of your medication that the pharmacy doesn't have. When will enough be enough? Is it not enough that we are losing 22 America's Veterans on a daily basis to untreated pain and PTSD? Will it be enough when CPP'S can no longer get out of bed and enjoy family gatherings? (I'm very close to there now). I can no longer clean my own house. I can't enjoy my great grandchildren anymore because no one is willing to treat my pain adequately. It's causing problems in my marriage. I'm 65 I can no longer travel. I have to be here for my PM appt. Or I have to be here to pick my medication up. If I do get to go somewhere I have to rent a van so I can lie down, then I have to lie down at least 2 days after I get where I'm going if I've had to travel more than an hour or two. So a 7 day vacation actually drops to 5 days. Please at least try to understand the plight of Real Chronic Pain Patients. I'm praying that you will actually read my comment and take to heart what I've said. I need your help. Let out Doctors be out Doctors. Allow them to treat us with some sort of dignity <br/>They went to school for a long time to do just that. Government has no place in a Doctor Patient relationship. It is a private matter. Thank you for reading my comment. I'm not an eloquent writer, I just said what I felt needed said. I wrote the truth, that's all I knew to write.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484ff44f6	Wagner	None	2022-04-05T03:54:16Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Wagner, Brenda	l1h-cyxm-hzuz	False	None	False	2022-04-12 05:36:47.539	[]
3756	CDC-2022-0024-3762	https://api.regulations.gov/v4/comments/CDC-2022-0024-3762	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, my name is[name redacted] and opioid pain medications have saved my life. I had ulcerative colitis. When I was 19 (back in 1978), I had a total colectomy (removal of large intestine). The pain of both the disease and the surgery was overwhelming. If I just got Tylenol I would have died. Only opioids saved me. But my pain is still nothing compared to those with chronic pain. They need prescription opioid medicine more than I ever did. These people are not addicts. They spent years of meticulous trial and error to find out how to take the least pain medicine and live their lives successfully, much as I have spent the last 40+ years teaching myself how to deal with an ileostomy. I have heard too many stories from these people who have told me that after years of relative peace and stability, their doctor told them they had to cut their pain medicine by half or worse. Thinking these people can survive with Tylenol and meditation and breathing exercises means you have never been in true pain ever. I am a religious person and as such, I can only say God help you if you let these people down, for He sees everything. Do let these suffering souls down. They have overcome so much just to exist. I attest that in the most extreme pain, it's opioids or death. I have had other episodes requiring this level of pain management, gallstones and gall bladder surgery, gout, kidney stones, but I am still an amateur compared to those who have this level of pain 24/7. We have treatment for addicts. Those in chronic pain have nowhere else to go, except when they commit suicide. I beg you not to make living unbearable for these people. If we allow these people to suffer, who are we?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	0900006484ff44fe	Tucker	None	2022-04-05T03:55:10Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Tucker, Jeff	l1h-dg2y-46vk	False	None	False	2022-04-12 05:36:47.754	[]
3757	CDC-2022-0024-3763	https://api.regulations.gov/v4/comments/CDC-2022-0024-3763	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with chronic pain since 2002. A work related injury resulted in three failed lumbar spine surgeries. In 2004 I was diagnosed with a severe spinal cord disease called Arachnoiditis. The around the clock pain caused by this condition has no cure. I was placed on opioid therapy treatment after all other treatment options failed. In 2017 the CDC placed recommended guidelines on prescribing opioids. The decision scared pain management doctors away from prescribing opioids. I was forced to wean off opioids since 2017 and have suffered needlessly ever since. My life has deteriorated to simply sitting in a recliner or laying in bed. I struggle with the activities of daily living and fell abandoned and neglected by the medical community. Pain patients are left to suffer and some are committing suicide as a last resort. The recreational drug user can acquire illegal drugs anywhere in America at any time. Fentanyl and other illegal drugs continue to pour into this country and can be purchased online in some places. It makes no sense to hold chronic pain patients responsible for the opioid crisis. My life is a tremendous burden and one of great suffering. How this has been allowed to happen is unacceptable and unethical. To sit back and allow people to suffer is inexcusable. I hope at some point a true leader with courage will step forward and end this nonsense. Chronic pain patients deserve to have their pain adequately treated…society is out of control due to bad decisions and greed , it must stop or we will cease to have a society. I am as miserable as a person could be and am in much pain. Please help me get the care I need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ff4904	Chumbley	None	2022-04-05T03:55:42Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Chumbley, James	l1h-eqbi-a61g	False	None	False	2022-04-12 05:36:47.969	[]
3758	CDC-2022-0024-3764	https://api.regulations.gov/v4/comments/CDC-2022-0024-3764	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help with this. Way to many Doctors have taken the 2016 guidelines as restricting opioid medication no matter what. They seem afraid they will go to jail or possibly lose their license to practice. The war on opioids should be against the illegal use and criminal activity not the sick and disabled. I spent 9 years complaining about pain before I ever received any opioid medication and 9 years later 60% of my medicine was taken away by doctors that said it was because of the CDC guideline. Was told the med's I was on equal 120% of what is allowed so 50% of my patch was taken away and I left there office crying. 3 months later my pills were changed from 30 mg 3 times a day to 10 mg 4 time's a day. 3 months later pills changed to 3 times a day. Now 13 months has gone by of witch I have asked if I could go back to fentanyl 50 micro gram patch told no it would violate CDC guideline. If true why would pharmacy still have it. Before the pain management clinic used the CDC guideline to take my medicine away I had a much better quality of life. I could help my 66 year old wife with some house work and even go to the store with her. I could walk down the street a couple blocks away and back. Now I lay in bed all day in pain every day. I thought that was the Ideal of pain management to provide a better quality of life. Now sometimes I wish I would die to end the pain. Again please do something about this problem for all your US citizens who just want to live out there lives with out physical pain and the depression that comes with it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484ff54b5	Thomas	None	2022-04-05T03:55:59Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Thomas, Steve	l1h-hpxm-59yi	False	None	False	2022-04-12 05:36:48.181	[]
3759	CDC-2022-0024-3765	https://api.regulations.gov/v4/comments/CDC-2022-0024-3765	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Attn: CDC/FDA Please note I am, unfortunately, a middle aged Nana who has done Everything I humanly could to improve my very serious health conditions caused by 1st a very unusual diagnosis of Spinal Stenosis prior age 30 having then had a extensive Surgery that left me 'segmental unstable' I then required 2 more EXTRAORDINARILY Complex lumber surgeries requiring Rods, screws hardware a Spinal Fusion was to have Solved the issue Doctors CAUSED by taking out layers of actual bone leaving my spine collapsing on itself, well then my body was rejecting the Foreign Metals I kept blowing up with fluid had to be rushed 3 hrs South to U of Penn to have it drained this continued for 1 year while fully casted to SAVE my Spine from collapse then 1 yr to date essentially I had to have the hardware taken out as the fusion now took & ALL throughput this VERY Painful time I barely took pain medication except right after Surgeries & could tolerate with minimum of Mild Pain medication of course I would not have survived ANY of the initial diagnosis surgery etc Withoyt the PROPER Pain Medicines First I Never took even recreational drugs Never drank always had Extremely low tolerance for any type of mind alteratering drugs drink etc hated that type of feeling Nir have I ever been 'High' from a prescription pain medication nor would I ever choose to be. I'm completely against those types of activities I choose to be control of my faculties at All times so the story doesn't end there having gone through 3 years physical therapy etc recovery was best I would be THEN I was in a bad Not at fault Motor Vehicle Accident hit from behind by driver going nearly 60mph I was at a complete stop 4 vehicles in front of me nowhere to go So then am finally diagnosed correctly having thoracic Outlet NEUROGENIC at that time I had homes investment properties businesses etc I lost my entire wonderful life as I progressively worsened the pain was extreme ripping BOTH Trapezious muscles a neck injury I refuse to have any more surgeries after a R Rib Resection because I couldn't even pick up my R arm anymore arm hand shook uncontrollably I developed RSD in that R arm having been misdiagnosed for nearly 3 yrs by the time I had the needed surgery the RSD went throughout my entire body my body feels like I'm being electrocuted burned stabbed while ice cold water is being poured on entire body I suffer horrible migraines from day 1 of accident never having had a headache prior my life is a disaster I barely function & that is Wirh Strong Pain medication which took Years to finally find the right medication & dosages then since 2016 has been cut nearly in half Again I was Never one to ever take ANY medication if I didn't need to it took my physician s years to even get me to take the proper amount to help Manage the unbelievable unrelenting Pain I'm in on a daily basis the injuries I have is considered the Suicide type as the pain is Everywhere apparently the brain gets overwhelmed with pain signals & sends messages to areas not injured I have done every surgery every block tried every therapy one could do I simply want to be able to live a somewhat decent life unfortunately I have NOT had ANY quality of life in many many years the pain medication I do take barely takes the edge off so I don't blow my brains Our but due to the outrageous pressure on very knowledgeable Professional Actual Pain SPECIALISTS because of Mostly the illicit Drug Seekers & More Specifically MORE people are dying from the ILLEGAL Drugs now flowing over the Border the Goid physicians got rid of the bad patients, drug seekers for kicks long ago now the pressures are enormous and REAL Pain Patients are Suffering & dying or going out to illegal drugs I believe there should be ZERO Conflicts of interest with those Trusted to do these Studies & being paid by CDC this is Outrageous there should be NO outside influence except testimony from Actual Physicians & their Very Real Suffering patients I did everything I could to qualify for what my Last hope was, which is Ketomine Therapy I contacted a facility in NJ by myself sought them out went thru all they required Heart scans, clearance, Psych evals which was difficult to find qualified Psycolgist who was covered by my insurance, Medicare finally had received all ok to try the Ketamine which is working Miricles with RSD etc found out I need be there over 3 wks have a driver daily etc its NJ Medicare covers treatment there NOT in PA could not do that Im 3+ hrs away So the Only hope I had left is NOT an option I've NO choice but be on Maintenance Pain Regime Which, unless someone is going through what I & unfortunately many very real patients I've met throughout years are going through then perhaps they should NOT interfere with what Our Own physicians are trying to do, which is help us survive manage pain to some degree please consider the Lives of actual patients	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DeAnn	None	None	0900006484ff54c8	Eisenhauer	None	2022-04-05T03:57:11Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Eisenhauer , DeAnn	l1h-khhr-72sn	False	None	False	2022-04-12 05:36:48.394	[]
3760	CDC-2022-0024-3766	https://api.regulations.gov/v4/comments/CDC-2022-0024-3766	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a nurse. I see everyday how these ridiculous guidelines have effected my patients negatively. Open heart surgery with Tylenol, colon resections and hip replacements. People<br/>Going back to the ER with symptoms of emergencies when it’s just uncontrolled pain. Little old ladies riddled with arthritis, older gentleman with back injuries that were once well controlled with FDA approved opiates now do not have a quality of life. Let’s face it. Tylenol and Motrin are good for minor aches and pains like headaches or fevers. But chronically ill Individuals DESERVE A QUALITY OF LIFE! I have recently seen patients with cancer. Getting a ONE DAY SUPPLY of pain meds. If they haven’t been brain washed to the point they’re scared to take them in fear of becoming an addict. But riddle me this, why are overdoses at a record high when these guidelines were supposed to help? I’ll tell you it’s because these guidelines are bull. THERE IS A PLACE IN MEDICINE FOR FDA APPROVED OPIOIDS. Please reconsider just completely stopping these guidelines and let our docs prescribe without fear of going to prison.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006484ff54ef	K	None	2022-04-05T03:57:24Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from K, J	l1h-o9c0-uxyo	False	None	False	2022-04-12 05:36:48.615	[]
3761	CDC-2022-0024-3767	https://api.regulations.gov/v4/comments/CDC-2022-0024-3767	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I am one of the unfortunate people that has restless legs syndrome. Unfortunate because at this time there is no cure for it under control was appropriate when it was prescribed but it is has been found that it may stop working (augmentation). This is the third medicine that I have used as the others also didn't work for ever. When this happens it appears that low dose opiods can fill the void without creating addiction. I will continue with my current plan but I worry about what comes next. It is hard to find a doctor that is knowledgeable about this situation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Neil	None	None	0900006484ff4933	Greenwood	None	2022-04-05T03:57:36Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Greenwood, Neil	l1h-qetd-4glt	False	None	False	2022-04-12 05:36:48.839	[]
3762	CDC-2022-0024-3768	https://api.regulations.gov/v4/comments/CDC-2022-0024-3768	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The chronic pain patient is the one paying for those that don’t follow true pain management rules and many times obtain the drugs illegally and take them irresponsibly. A person who is in a pain management program, who follows the rules, has the urine monitored on a routine basis, and functions throughout their daily life deserves better treatment and pain relief. The cuts or complete withdrawal of opioid medications has been detrimental to lives. I’ve followed the rules, and after trying all types of treatment, the opioid medication was the one that allowed me to function and have a somewhat normal life. By normal, I mean despite constant pain, the medication made my life tolerable. It was never used to get high, but to have the ability to move and function. I’ve been in pain management a while and watched my meds get reduced at a rapid pace. Within months, the mg was cut back and every 4-6 hrs was changed to every 6 hrs. My doctor stated they’re limited and despite a worsening condition, there’s nothing she can do. The cut back has hurt me. By the time I wait 6 hrs, the pain is worse and therefore harder to treat. I lost a total of over 25 mgs a day if not more and went from full functioning to more limited functioning. The stress of it all has resulted in depression and anxiety as I battle an MS type illness, spinal issues, endometriosis, and neuropathies. It’s also put a strain on my role as wife and mother. Do you know how many times I’ve heard from a doctor, “I’ll lose my license” or I know your needs, but my hands are tied. How can the govt interfere in the doctor/patient relationship? We’re being punished for the actions of others not abiding by the rules. Chronic pain patients with true documented conditions deserve relief and we need to give the power back to the doctors. They monitor us as we check in monthly and they shouldn’t have their hands tied. The guidelines that came out suggesting cutbacks were devastating to my life. I did what was required of me. Played by the rules and I functioned and in the end, I’m paying the price for others who chose to do the opposite. Stop punishing people in pain and allow doctors to be humane again. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff4934	Anonymous	None	2022-04-05T03:57:49Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-r0wn-9uvh	False	None	False	2022-04-12 05:36:49.052	[]
3763	CDC-2022-0024-3769	https://api.regulations.gov/v4/comments/CDC-2022-0024-3769	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had Fibromyalgia most of my life. I am currently 41. I went almost all of that time 100% unmedicated for the widespread pain I feel on a daily basis. The days I had flare ups even wearing my clothes would feel like pure torture. Showering if at all possible would be avoided because the water hitting my skin would feel like broken glass. From 2015-2021 I was able to not even get near a doctor's office. I still felt the extreme pain but I did what I always do and grinned and beared it. In August of 2021 I sustained a bad back injury at work and was prescribed Tramadol for the pain. During the 6 months following I underwent physical therapy, injections, tens unit, supportive belts, Meloxicam, Gabapentin and about once a week 1/2 of a Tramadol for the worse days. Finally at the end of 6 months I finished the bottle the ER had prescribed! My pain management doctor prescribed me more because 6 months was plenty of time between prescriptions. Now here is where the CDC guidelines come into effect. All of that should clearly say I am not an addict and have been more than willing to try other things. But when I went to fill that prescription the pharmacy at first Refused to fill it based on the fact it was for chronic pain and I clearly had to be an addict! It took an embarrassingly long time standing at the counter explaining it had been 6 months since last refill and the pain is chronic from an injury. Finally they filled it but informed me that they would be keeping an eye on my frequency. Now, if my experience as a very mild user of an opioid pain medication can spark this kind of treatment because of guidelines and whatever else is going on I can't even imagine what it's like for those who have to get it filled monthly! The system is horrible. Something needs to change because I'm not getting any younger and I know there's going to be a time when I'm going to need that extra boost on a more regular basis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lelania	None	None	0900006484ff4938	Barton	None	2022-04-05T03:58:11Z	None	None	1	None	2022-04-04T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Barton , Lelania	l1h-ri8i-6qw1	False	None	False	2022-04-12 05:36:49.264	[]
3764	CDC-2022-0024-3770	https://api.regulations.gov/v4/comments/CDC-2022-0024-3770	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am alarmed at the lack of studies, claiming that opioid meds are harmful. You see, I am a legacy pain patient of more than 30 years! I am also a health care Professional. I became a Registered Nurse, and took care of many. Surgical patients. So, I learned a lot about pain relief with much needed opioid meds. They are life-saving meds. When taken as prescribed-they relieve suffering!<br/>Yet, the CDC wants to punish those patients who rely on these much needed pain meds. Why?? MD’s are the EXPERTS, NOT the CDC!! I am quite angry at the CDC for RUINING my life as a chronic pain patient, when I retired from my Nursing job-due to unrelieved pain. I was born without a hip socket, and have had at least 7 hip surgeries-and suffer SEVERE bone pain. The relief from pain is from my opioid pain meds. There are so many pain patients like myself who benefit from these life saving meds. The CDC is wrong! You are picking on the wrong group of people! How dare you state that LEGITIMATE law abiding pain patients should be force tapered off of their pain meds which they took safely for years. The CDC is trying to ELIMINATE these vital meds. Why? Because they want you to believe that legitimate pain meds are EVIL.and highly addicting! And, they are flat out LYING!! <br/>It’s been 6 tortuous years of [profanity redacted]. There is NOT one study published stating that pain meds are dangerous, and will shorten one’s life span. I have never overdosed on my pain meds! They are confusing poly drug abuse and ILLICiT drug use and making it out to be-that taking any opioid med is BAD. My quality of life was excellent,when I took my pain meds. I got wonderful pain relief. Now; the CDC wants to eliminate these meds-claiming they are EVIL without ANY scientific evidence what so ever! How is this EVEN LEGAL? THE CDC members must be heartless!Yes, I live in the free USA. What is happening is very wrong. Get rid of the 2016 & 2022 GL. Get the FDA and MDs to be in charge! The CDC isn’t fit to determine pain relief and they are stalling already it’s been 6 years, too many pain patients are dying by suicide!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathy	None	None	0900006484ff5523	Clark	None	2022-04-05T04:01:49Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Clark, Kathy	l1h-tcpu-htun	False	None	False	2022-04-12 05:36:49.485	[]
3765	CDC-2022-0024-3771	https://api.regulations.gov/v4/comments/CDC-2022-0024-3771	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My rls effects not just my legs but my arms and torso. None of the none drug techniques work. I running of drugs that will work for my rls. We need more options for treatment.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484ff5527	North	None	2022-04-05T04:02:03Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from North, Teresa	l1h-tn3z-1gcr	False	None	False	2022-04-12 05:36:49.701	[]
3766	CDC-2022-0024-3772	https://api.regulations.gov/v4/comments/CDC-2022-0024-3772	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Who: 20 year veteran of Marine Corps, female. 58 years old<br/>Diagnosis: Hereditary Spastic Paraplegia, Hemorrhaging Spinal cord, Severe Disk Degeneration, no disks in spine, Syringomelia, esteo & erosive arthritis in hands and feet TMJ<br/><br/>1. On adequate pain meds, I was able to work full time, volunteer for Special Olympics, Hospice, Animal Rescue. I exercised & led a fairly normal life. It lasted 20 years<br/><br/>2. WITHOUT Adequate pain meds, I was fired from 2 jobs, could not volunteer, developed high blood pressure, severe depression, have to pay people to help me do daily living skills, sleep much less bc of pain. I lived a meaningful & productive life with adequate pain meds, now I am receiving 100% disability from VA, receive social security disability, & I lay in bed on a heating pad most of the day at only 58 years of age.<br/><br/>I have gone into debt by $10,000 trying ingredients alternative methods of pain relief. Acupuncture, deep tissue massage, energy healing, several rounds of physical therapy, new mattress, rolfing, u name it, I tried it before asking a Dr for help. I pray to die daily. You have turned the last years of my life into a living hell.<br/><br/>[name redacted]<br/>[location redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	0900006484ff5537	Kotuba	None	2022-04-05T04:02:53Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Kotuba, Mary	l1h-uleg-wica	False	None	False	2022-04-12 05:36:49.941	[]
3767	CDC-2022-0024-3773	https://api.regulations.gov/v4/comments/CDC-2022-0024-3773	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern,<br/><br/>I am a practicing pain management physician in a part of the country ravaged by the opioid epidemic. The 2016 CDC opioid guidelines have dramatically interfered with the ability and willingness of primary care physicians to provide opioid therapy for those patients where such medications are appropriate. They have also interfered with the ability of patients to get evidence-based care from interventional pain management specialists. The newly proposed guidelines will continue or worsen this trend.<br/><br/>Effective guidelines must advocate for interventional pain management techniques as safe, efficacious, and cost-effect, as the evidence base shows. Otherwise our patients and fellow citizens will continue to suffer needlessly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicholas	None	None	0900006484ff554e	Clark	None	2022-04-05T04:04:11Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Clark, Nicholas	l1h-wg14-avli	False	None	False	2022-04-12 05:36:50.153	[]
3768	CDC-2022-0024-3774	https://api.regulations.gov/v4/comments/CDC-2022-0024-3774	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an 85 year old women with a 50 year history of RLS I have found low dose opioids to be my only solution to a few<br/>hours of sleep at night. Remember the RLS person on opioids is not "The Ophioid Crisis" merely a patient with an<br/>incurable disease trying to live as normal a life as possible. Do not throw out the baby with the bathwater.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484ff5556	Olson	None	2022-04-05T04:04:24Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Olson, Nancy	l1h-wu3u-hina	False	None	False	2022-04-12 05:36:50.362	[]
3769	CDC-2022-0024-3775	https://api.regulations.gov/v4/comments/CDC-2022-0024-3775	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a sister who has Interstasial cystitis and is in constant pain at a lever of 10+++++. Due to your stringent new regulations she is no longer able to get the pain medications she needs to control her pain levels enough that she can have a little relief so she can function and be able to do every day tasks like cooking, cleaning, seeing her family ie grandchildren etc. You, the government have taken that away from her. Even when she was able to get the medication she desperately needs her pain level never goes below a 6. Imagine yourself or those you love being in constant pain 24/7 with no relief. What kind of life would you have. Imagine having your career that you love taken from you because you are in so much daily pain you can’t function. This happened to her. She was an elementary school teacher who went a into teaching because she loves children and wanted to help them anyway she could. She was a fantastic teacher. Doctors have said her pain levels are higher than someone with stage 4 bladder cancer without the cancer. Her pain is incredible and you won’t let her doctors give her the relief she needs. When she goes to the bathroom she says it’s like peeing glass shards that are red hot. It hurts her so much and is so not fair to her or others in her same situation to not be able to get the medication she/they need. So many people with her disease have chosen to end their life instead of living with the constant pain. Please if you have any heart at all let her be able to get the medication she desperately needs. There are ways to control the things she needs by linking all pharmaceutical outlets to the same computer programs. Please help her. There have been way too many times when I talk to her or see her she tells me she’s going to end her life that she can’t live this way anymore. She was diagnosed in 2008. That’s a long time to be in constant pain. She is NOT a drug addict asking for more and more medication. She’s a genuine human being who deserves to have what little relief these medications will give here. Pease I beg you don’t take these medications away from those in genuine need of them. They need to be able to have somewhat of a life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff555c	Anonymous	None	2022-04-05T04:04:42Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-wy4q-kjr8	False	None	False	2022-04-12 05:36:50.575	[]
3770	CDC-2022-0024-3776	https://api.regulations.gov/v4/comments/CDC-2022-0024-3776	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The old CDC practical guidelines and the revised ones have done nothing but hurt the chronic pain community. Obviously shown by the statistics, ie: overdose numbers it has done nothing to help the illicit drug situation either.<br/>I know personally, after the guidelines were published my pain treatment was destroyed. I was rapid detoxed to a very low dose of medication. I suffer from multiple chronic and fatal diseases including, MS, CKD, Gastroparesis,EDS, and DDD. I am in serious pain 24/7 365 days a year. Now my Dr's cannot treat my pain appropriately because they are afraid of the DEA. <br/>The "updated" guidelines are just more of the same hand tying upon Dr's. It is not helping patients to gain assistance in living lives with value. It's continuing to torture post surgical patients and any and all chronic pain patients. <br/>These guidelines are also effecting patients in the VA system. My husband is a veteran who was a combat medical in the Army. He is a chronic pain patient and has recently been rapid detoxed from most of his pain meds. It has been torture to watch him in so much pai for no reason. Please consider repeal the guidelines all together. They are truly completely unnecessary. Patients need to be treated case by case. Have some empathy. You never know when YOU may be in OUR shoes.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff555e	Anonymous	None	2022-04-05T04:04:53Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-x06d-jmwo	False	None	False	2022-04-12 05:36:50.790	[]
3771	CDC-2022-0024-3777	https://api.regulations.gov/v4/comments/CDC-2022-0024-3777	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My doctor tried to prescribe me a medication that would help with a chronic bowel infection, but the insurance company refused to cover it. My doctor got tired of trying to fight the insurance guidelines and abandoned me. I ended up with a chronic infection and had to find emergency care as well as another doctor. When a doctor states we need a certain medication it should not be the insurance company that makes the decision if we can have it or not. The doctor should be able to prescribe whatever it needed without restrictions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tee	None	None	0900006484ff562a	Lewis	None	2022-04-05T04:05:02Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Lewis, Tee	l1h-ytzg-rvod	False	None	False	2022-04-12 05:36:51.025	[]
3772	CDC-2022-0024-3778	https://api.regulations.gov/v4/comments/CDC-2022-0024-3778	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a severe case of restless legs syndrome and it has been lessened greatly by 2 mg of hydrocodone ad day for the past 10 years. No addiction and no side effects. The dosage is 5/325 and my usage has not increased in those10 years. This pill should be on the approved list fpr RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff56dc	Anonymous	None	2022-04-05T04:05:10Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-zc57-qf1v	False	None	False	2022-04-12 05:36:51.237	[]
3773	CDC-2022-0024-3779	https://api.regulations.gov/v4/comments/CDC-2022-0024-3779	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You know for a fact that the overdose deaths are due to illicit drugs! I would like to know how you sleep at night. My quality of life have been affected by the 2016 guidelines that were based on "low quality data" but you already knew that would happen. All reference of any MME limits need dropped since they will be made as hard limits by states and doctors. Treatment of pain needs to be between patients and doctors, as the CDC and DEA really has no business even being a player in all of this! Imagine watching the one life you have been given, slip away as you are bedridden, suffering. Opioids allowed be to be a productive citizen with a fairly normal life until you put out these guidelines that have destroyed millions of lives and literally have cause thousands of suicides. These guidelines need dropped all together since they have done nothing but punish people with chronic irretractable pain and add to the increase in overdose deaths.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff573d	Anonymous	None	2022-04-05T04:05:23Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-zlwa-2tu8	False	None	False	2022-04-12 05:36:51.453	[]
3774	CDC-2022-0024-3780	https://api.regulations.gov/v4/comments/CDC-2022-0024-3780	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have RA, DDD,and diabetic neuropathy. I was on tramadol for 10+ yrs. I lived a fairly normal life. But those fays are over since my meds were dropped 3yrs ago. I did the shots and they hurt me worse! I wont do them NO more! They dont work! My days are now consumed on the couch or in bed. I cannot do anything for myself. I think about suicide or going to the streets for drugs. Which by the way started all this crap. No i dont want to die but i have no quality of life. Herion and illegal fentanyl is to blame why my meds were taken away. I never took more than orescribed and always passed my drug test. Why should i be punished for doing the right thing!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shelley	None	None	0900006484ff5742	Koedinger	None	2022-04-05T04:05:30Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Koedinger, Shelley	l1h-zm65-6ixh	False	None	False	2022-04-12 05:36:51.667	[]
3775	CDC-2022-0024-3781	https://api.regulations.gov/v4/comments/CDC-2022-0024-3781	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please don't stop prescribing opioids for RLS, they are the only thing that brings me some relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484ff5755	LeMieux	None	2022-04-05T04:05:38Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from LeMieux, Teresa	l1h-zowb-88xf	False	None	False	2022-04-12 05:36:51.880	[]
3776	CDC-2022-0024-3782	https://api.regulations.gov/v4/comments/CDC-2022-0024-3782	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I just wanted to let the powers that be that 2016 CDC guidelines on opioid prescribing has caused so much harm to me.I was taking these medications for severe arthritis in my back and other spine issues. They allowed me to function and have some quality of life. I was abruptly taped down to non therapeutic dose because of these MME dose guidelines. I’ve done much research on who and why this happened and it’s shocking the 2016 guidelines were allowed to be implemented? Please allow Dr.s to practice medicine and take a hard look at the 2022 guidelines. Many people need more medication then others and the mention of dose caps is not science. Now that we know who was responsible for this draconian debacle please fix it. Lives depend on this. I’ve been in bed since I was dropped from long term effective opioid therapy for chronic pain. I’ve thought and still do of ending things or trying to find medication from other sources which is not ok. Please allow these life saving medications to be used as intended and without the input from people that have conflicts of interest. You now know your statistics on addiction and overdosing has little to do with prescribed pain medication and everything to do with illegal fentanyl and heroin. You’ve caused much harm and can fix this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff5762	Hunt	None	2022-04-05T04:05:49Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Hunt, David	l1h-zqvh-edoj	False	None	False	2022-04-12 05:36:52.091	[]
3777	CDC-2022-0024-3783	https://api.regulations.gov/v4/comments/CDC-2022-0024-3783	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a neurologist at the [clinic redacted] specializing in sleep disorders. Restless legs syndrome (RLS) affects 5-10% of the US population, and it is a neurological condition that can be debilitating. It affects quality of life and can be very disruptive to sleep. There are some effective treatments, which are not always accessible or have side effects. The previous first line FDA approved medications-dopamine agonists- have been shown to worsen the condition over time and lead to very severe cases. For severe cases, opioid medications are often required and work slightly differently in the brain than typical for classic pain conditions. Opium was the original treatment for RLS in the 17th century and methadone has been used for at least 3 decades with significant success along with other opioids. There is increasing movement toward buprenorphine as the safest and very effective opioid for this condition. Please consider this significantly large, but underrepresented population of patients to preserve and facilitate access to opioids for these patients. <br/>Moreover, due to the dearth of providers for this condition, access to opioid prescribing through telehealth care is essential and in-person visits should not be required. There is no role for physical examination or need for in-person visits in the diagnosis and treatment of this condition. In my own practice for example, less than 20% of patients on opioids for RLS live within one hour of the main clinic. Placing barriers to access treatment through telemedicine will disadvantage those in rural or underserved communities and those with transportation/work/time limitations. Attached is one of the most recent clinical guidelines for RLS from 2021 explaining the role of opioids for this condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484ff5771	Berkowski	None	2022-04-05T04:06:41Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Berkowski, Joseph	l1h-zhbm-0ktt	False	None	False	2022-04-12 05:36:52.378	[]
3778	CDC-2022-0024-3784	https://api.regulations.gov/v4/comments/CDC-2022-0024-3784	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC & DEA have no business here! Let doctors do their jobs. People with legitimate chronic pain are not addicts. They are just people trying to have some quality of life. These guidelines need retracted! Don't continue to torture innocent people and add to the number of deaths from people being driven to the street or committing suicide due to untreated/ undertreated pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff5773	Anonymous	None	2022-04-05T04:06:50Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1h-zud3-5cbd	False	None	False	2022-04-12 05:36:52.593	[]
3779	CDC-2022-0024-3785	https://api.regulations.gov/v4/comments/CDC-2022-0024-3785	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Chronic Pain Patient who cannot get help from anyone. The pain specialists look at me and all say they have no other options. I am my own advocate who is running out of places to be heard. I am an educated woman with one masters degree and in the process of getting another. This time around has been more difficult due to the times studying feels impossible because of the constant pain I have. I have goals and ambitions for life and fear that if this continues how it is now where I’m shoved away or looked at as a pill seeker then I won’t be able to live life. I can’t continue like this forever, and that thought brings tears to my ears. As a Christian who relies on her faith I know I can push through but honestly even for me it feels impossible most days. <br/>No one asks me as the patient what I want, what my ultimate goal is and what I honestly NEED. How crappy is that?! I have no say anymore in my own health because of policies that honestly shouldn’t be so generic for the masses. As I write this, I feel heartbroken. I am laying in bed in pain not wanting to move but to just lay here and cry. I am hungry but so nauseous from hurting that if I eat I’ll probably get sick. I would love to go on a walk or even for a ride but I think of moving or hitting a pot hole and the thought stops. This isn’t life and this certainly isn’t living and thriving. <br/>I’m not asking to have pills thrown at me or as a cure, they aren’t. But the option of having them on days like this when I want to quit (but won’t and can’t) would be nice. Right now my bad days and more than my good days, but I pray these policies/laws can change and give us the chance to have more freedom and a chance for more ‘good days’.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jessica	None	None	0900006484ff5795	Rowell	None	2022-04-05T04:07:14Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Rowell, Jessica	l1h-zz02-7lpa	False	None	False	2022-04-12 05:36:52.810	[]
3780	CDC-2022-0024-3786	https://api.regulations.gov/v4/comments/CDC-2022-0024-3786	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are essential for an individual who suffers from Restless Leg Syndrome. Opioids relax the legs for the person and allows them to sleep which as we all know is absolutely essential.<br/>Not everyone who needs opioids becomes a drug addict and for anyone to assume that shows that they are also suffering from ignorance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candace	None	None	0900006484ff579e	Wylie	None	2022-04-05T04:07:21Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Wylie, Candace	l1i-00kx-2yqq	False	None	False	2022-04-12 05:36:53.032	[]
3781	CDC-2022-0024-3787	https://api.regulations.gov/v4/comments/CDC-2022-0024-3787	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. Both myself and my husband (a stroke patient with RSD, CRPS) have been effected detrimentally by the CDC's opioid "guidelines". I had a toe amputation with had great amounts of pain both before and after the procedure. My doctor didn't prescribe anything at all before the procedure and afterwards, he informed me that he most definitely would take care of the pain. When I was discharged, the "hospitalist" who signed the papers was supposed to follow his directions. She did not. I had to refuse to leave the hospital as she told me "you shouldn't need anything for pain after a day". Ok wow. I had to call my surgeon who was quite angry with her and obtain a prescription. Fast forward to hand surgery last year. I was told oh it's an easy surgery-no pain afterwards. It was quite painful and I suffered, in tears, for 3 days before the nurse at the office finally gave the surgeon my message. Had a fall back in October 2021. I could not turn, cough, move yet it seems that everyone is scared to write anything for fear their license will be in jeopardy (that's what I was told). <br/><br/>My husband had a major stroke at age 47. He was left with horrible, burning pain down the left side of his body that is constant. His neurologist describes it as his brain firing off pain signals even when there's not a reason. He was on a regimen of MS Contin 30 mgs twice daily and Percocet 7.5 for breakthrough pain. He was forced to go to pain management where all that doctor did was take him totally off MS Contin, cold turkey mind you, and decrease his Percocet to 60 pills per month. Some days he feels like giving up. He has depression caused by all this pain. Says he feels like an addict just asking for meds and forget about asking for an increase. His neurologist, because the copays were so high for my hubby, said he would write for the 60 Percocet every month but the nurses there grab the message and refuse to give it to the doctor. I have to jump through hoops every month and fight just to get the refill through to his doctor. Every single time the nurses tell me that my hubby needs to find a pain management doctor. Every. Single. Month. I have to go through the whole process and explain no, his neurologist said he would write the medication for him and to please just give the message to his doctor. I sometimes have to send a message 6 times just to get it through to his doctor and by that time, he's totally out of pain medication. His pain gets so bad and they just do not care was long as it's out of their hands. I've even spoken to the doctor. He says he's going to fix it but every month, it's the same thing. Insanity. I'm going to have a stroke just attempting to get help for him. He can't do it so I have to be the one to fight for his medication. <br/><br/>It is ridiculous that a man in this much pain chronically has to live this way, let alone everyone else. Surgical patients do better when they have pain relief. I do better after surgery with pain relief. With just a prescription, I was able to get up and walk after painful tarsal tunnel surgery in less than 30 days whereas I would probably still be in the bed had I not gotten effective treatment. I can see why there are still overdoses. People are in pain. Pain is subjective, not objective. You can't make a one size fits all for human beings and I feel that's what the governmental is attempting to do. Addicts will always find a way to get high. Addiction is a mental illness. You cannot lump together prescription painkillers with heroin, cocaine or illicit drugs. I understand that there are increasing overdoses. Maybe more mental health clinics for illicit drug users would help without stigma. What you have to understand is I've heard many CPP saying they will go to the streets in search of anything to relieve their pain. It's a shame we treat our animals better than some doctors treat their patients. . People who are in actual pain whether it be from surgery, falls, strokes, etc deserve to be treated with respect and decency not threats and accusations. These were meant to be guidelines, not rules yet they have become the absolute way pain is ineffectively managed.<br/>Thank you for listening and I sincerely hope there are changes! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gia	None	None	0900006484ff57e4	Mitchell	None	2022-04-05T04:07:38Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell, Gia	l1i-0dcy-d2p3	False	None	False	2022-04-12 05:36:53.251	[]
3782	CDC-2022-0024-3788	https://api.regulations.gov/v4/comments/CDC-2022-0024-3788	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The opioid guild lines have made my life so much worse. I have a ruptured disc in the L4-L5 area ,spinal stenosis, and chronic gout. Doctors here in NC are so scared for themselves now that they disregard the patients quality of life. I’m a 48 yo male that has a family to provide for and some days it’s impossible to do because of the pain. I don’t need/want daily meds. I just need them when my back goes out or when the gout comes on. When I go to my Family doctor I feel like a criminal for even asking for pain medicine. The local pain clinic here will not even consider me as a patient now. They say it’s because of the opioid guidelines! <br/>Please relax these guidelines on doctors so us regular working people can work and provide for our loved ones. <br/>Why do legitimate patients like myself have to suffer and be punished?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ff5914	Patterson	None	2022-04-05T04:07:48Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Patterson , James	l1i-1uac-vcil	False	None	False	2022-04-12 05:36:53.468	[]
3783	CDC-2022-0024-3789	https://api.regulations.gov/v4/comments/CDC-2022-0024-3789	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>My disc herniated at L4-5, I tried everything, finally had a Microdiscectomy, was fine for about a year, then it herniated again, had a laminectomy and after the surgery my disc collapsed, causing excruciating pain that never stopped, I now had nerve damage, I then had a fusion had no choice, although it stabilized my spine the pain never stopped, I had steroid injections, spinal stimulator, everything you can think of I have had. The only thing that gives me a quality of life is opioids, I was on them since 2004,nevver once had an increase of medication, never abused them, never wanted to get high, always had negative urine tests, they even have counted them and I always had the right amount, and I always did what I was suppose to. Then in 2019 my PC doctor decided I needed to be reduced even though technically I was never on a high dose, he blamed it all on me, saying I was old, there were new procedures out there to help me, but never would elaborate what they were, he even screamed at me, and several times I left crying. I am on a dose now that is lower than the CDC recommends, I now can't sleep, enjoy my family, I am in pain constantly all because the CDC is not educated enough about Pain Care Patients and their complex needs. And very few people like less than 1% of pain patients actually get addicted. Pain Care patients, post op patients and cancer patients are not the same as people who are addicted and want to get high. You must let doctors be doctors, and prescribe the right amount of medication for each patient, some patients are bigger and some are smaller and patients have all different kinds of diagnosis's, not one size fits all for patients. The doctors went many years to medical school, they know the patients, they know their diagnosis, their weight, their height, and it is up to them, not a government agency to diagnosis everyone without even seeing them, knowing them, etc. The DEA and pharmacies need to stop harassing doctors and patients who have chronic pain, nobody knows when they might start experiencing pain that never stops, and I pray they won't get treated like the Chronic Pain Patients are being treated today. Why, Why is the CDC, DEA making CP patients suffer? I don't understand why the DEA is harassing doctors instead of going after drug cartels? Almost all drugs deaths are caused by street drugs not from legal prescriptions. Will the DEA continue to raid and terrorize the doctors so they will be afraid to prescribe and help the CP Patient, this all must be stopped, as well as pharmacies profiling and treating CP patients cruelly just because they are unfortunate enough to experience chronic pain? Nobody would think of taking away insulin from a diabetic patient, why then are you taking opioids from CP patients who desperately need them?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	0900006484ff49ca	Lee	None	2022-04-05T04:08:03Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Lee, Amy	l1i-30pq-kk56	False	None	False	2022-04-12 05:36:53.707	[]
3784	CDC-2022-0024-3790	https://api.regulations.gov/v4/comments/CDC-2022-0024-3790	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Proposed 2022 CDC guidelines<br/><br/>I have intractable chronic pain and have been harmed due to the 2016 guidelines. I was just dropped from pain care by my GP. It took me a year to find pain management care. <br/><br/>I gave had 9 total joint replacements of which they are both failing. I am in wheelchair most of the day and sitting the rest. I can no longer do foster care. My husband also has chronic pain plus he takes care of me. <br/><br/>I was stable on my meds previously to 2016. Now my prescrber is afraid to go over 90mme’s due to fear of arrest and jail time. <br/> <br/>The studies you cite should not be included in new guidelines for certain diseases. Osteoarthritis and fibromyalgia are painful diseases and need treatments to accommodate each individual. Listening certain diseases as exempt should not be done. All diseases and ages should be exempt when dealing with opioids for chronic pain. <br/><br/>No mention of mme’s in the guidelines. Take out limits totally. Let the drs and patients decide on a safe dose and various treatments. Requiring certain non opioid treatments should not always be forced upon a patient before any pain medications can hinder recovery from chronic diseases.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484ff49e4	Stifle	None	2022-04-05T04:08:13Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Stifle, Michelle	l1i-39an-4zv2	False	None	False	2022-04-12 05:36:53.938	[]
3785	CDC-2022-0024-3791	https://api.regulations.gov/v4/comments/CDC-2022-0024-3791	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft doesn't address chronic conditions like RLS that are different from other chronic pain conditions. Restless Legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move ones legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or sit quietly which impacts every aspect of daily life. There is no cure.<br/><br/>While there are medications and remedies available that may alleviate the symptoms they are often short-lived, have devastating side effects, or over time actually make symptoms worse. There is ample scientific research that supports the use of low-total-daily opioid to treat severe RLS.<br/><br/>I have suffered severe RLS for decades in both my legs and arms. Imagine having to pace for hours because your body won't be still. Imagine going through periods where you only sleep 10 minutes at a time for days. There have been years when I have been unable to work or leave the house because the lack of sleep has left me unable to function. I have had many doctors (both PCP & specialists) and been on different medications that come with a host of side effects such as tremors, weight gain, blurry vision, & headaches. I'm grateful for the 3 or 4 hours of sleep I can get, until the medication stops working or worse augments. The medication that has helped the most is Tramadol, but PCP's can't prescribe it for long and seeing a specialist every 90 days can get costly. It is humiliating to beg for a medication that allows me to sleep enough to work and live.<br/><br/>I urge the CDC to to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require low-total-daily doses.<br/><br/>Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484ff4a27	Harshbarger	None	2022-04-05T04:08:24Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Harshbarger, Linda	l1i-3k85-6fd1	False	None	False	2022-04-12 05:36:54.347	[]
3786	CDC-2022-0024-3792	https://api.regulations.gov/v4/comments/CDC-2022-0024-3792	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted],[phone number redacted]. I am a 75 year old with extensive injuries and I am treated as a drug dealer. For record, I have never taken a drake off anything and have used an illegal drug. The word is NEVER.<br/>In the 1970's at 22,ran a 450 sear restaurant with 175 car parking lot. My problem it was too small.<br/>Today, there is a 8 million dollar, 2 1/2 acre park over looking the Atlantic, named after my restaurant.<br/><br/>Enough of history and onto pain <br/><br/>In the past 7 years, you have spend millions on my care and it has been completely worthless. Why the pain from this body does not stop 24 hours a day.<br/>I took pain killers for 17 years and it was quality of life and no problems.<br/><br/>Now, when you changed the law 8 million people's pain did not stop,It was an ill thought out move.<br/>Oh, go to the pain clinic and miracles will occur.Not True and, I have been to at least t a dozen and what a complete joke.<br/>I am familiar with the overdosing problem and served 3 million drinks with no proble.<br/>I have a great memory and loads of in the process of sett up a web site for pain victims, to help you see the big picture.<br/><br/>Am, not trying to sell anything, just trying to get the truth out and help 8 million people.<br/><br/>Please be in touch.<br/><br/>[name redacted]<br/>[email redacted]<br/>[phone number redacted]<br/>Thank You<br/><br/>o<span style='padding-left: 30px'></span>i	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cary	None	None	0900006484ff4aaa	Sabanty	None	2022-04-05T04:17:27Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Sabanty, Cary	l1i-4lgc-wek1	False	None	False	2022-04-12 05:36:54.558	[]
3787	CDC-2022-0024-3793	https://api.regulations.gov/v4/comments/CDC-2022-0024-3793	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate that you are revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a 71 year old female in very good health. My only debilitating condition is RLS. I have tried every drug approved by the FDA for my RLS, which is most active at night and results in sleep deprivation and depression. While my current drug is okay for now, my neurologist says the ONLY effective option I will have if this drug (a dopamine--known to 'turn on the patient' in a horrible experience called augmentation, which I have had and nearly drove me to suicide) begins to fail me, is a low-dose of an opiod. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. <br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	0900006484ff4ac4	Wuichet	None	2022-04-05T04:17:56Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Wuichet, Pam	l1i-4rty-etno	False	None	False	2022-04-12 05:36:54.766	[]
3788	CDC-2022-0024-3794	https://api.regulations.gov/v4/comments/CDC-2022-0024-3794	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been without proper pain medication for a little over a year now, and I fear that if I don’t find something that works I won’t be able to survive it. I’ve tried everything besides opiates and it doesn’t help. My old doctor back home managed my pain properly, usually 10 5mg Norcos every 3-6 months. No doctors where I live now will prescribe anything for any reason. It’s absurd. No wonder so many people are moving to the street. It’s incredibly dangerous. Please help us who are suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eden	None	None	0900006484ff4b02	Med	None	2022-04-05T04:18:04Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Med, Eden	l1i-5esf-8hq9	False	None	False	2022-04-12 05:36:54.979	[]
3789	CDC-2022-0024-3795	https://api.regulations.gov/v4/comments/CDC-2022-0024-3795	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom it May Concern:<br/>I have been using opiates responsibly for over 30 years. I do not take more than prescribed, sell them, or give them away. My scripts last for the entire 30 days and I do not pill seek or use illegal drugs. I do understand why chronic pain patients do use illegal drugs. Our pain docs have been under the gun since the 2016 opiate guidelines were released. Many docs have been threatened with having their license revoked and other punitive actions. This is why many of them have treated the "guidelines" as law or strict rules. They are terrified of the DEA! I am in constant pain as due to these "guidelines." My doc set a rule in their clinic that they will not go over 50 MME's per day for anyone. I have been on the same dose for over 4 years in spite of the fact that my pain has gotten significantly worse. I am terrified to change pain clinics as there is a possibility that no one will take me, or my dosage could be cut even farther and it will negatively affect my narx report score. At my first visit with my current doc I was greeted with my narx report score of about 570 and told that I was an overdose risk. I was flabbergasted to say the least. I have never done anything that would make my score that high. I researched the algorithms that are used to compute this score and realized that they were poorly developed. My score was falsely inflated by these errors and I explained to my doc why. After that he did not bring it up again but of course its always in the back of my mind as a weapon that could be used against me. My score was incorrect due to multiple providers in the same practice were classified as completely separate prescribers. I had also moved to a new state so changing my provider was a red flag as well. In addition I had surgery during that time and my surgeon's post op pain meds counted against me as well. I have a condition that requires surgery every few years but in 2018 my post op pain was not treated aggressively enough this time. When I went to my pharmacy to get my post op pain meds filled my pharmacist questioned why I needed them since I am already on 10 mg Oxycodone three times a day. He called my pain management doc to question whether he should fill it or not. I finally laid it out for him that this rx was for 10mg every four hours and my chronic pain dose was 10mg three times a day. Even with that dosage I literally was in the fetal position sobbing the pain was so bad. I asked my surgeon why and he stated that he gets a monthly report questioning his opiate rx's by the DEA. He also said they do not check into the patient's chart to see if there is justification for more pain meds, they just call him out for prescribing them at all! I decided that when my next surgery is scheduled I will ask that a pain control agreement is agreed upon prior to having the procedure. I will not suffer like that ever again! Due to the guidelines too many people have committed suicide, turned to illegal drugs, or overdosed just trying to get some quality of life back! Since my doc has set the mme rule I have been unable to continue working anymore. If the treatment of people's chronic pain is left to the judgement of the pain management doc who is trained to make these decisions, many more people would lead more productive and happier lives! The overdose statistics are not accurate as illegal drugs are lumped in with legal ones. The "opiate crisis" as it is erroneously called has been caused by the government sticking their nose into people's healthcare where it does not belong! If they had made sure to emphasize that these were guidelines, and they had not used scare tactics to enforce them, so many people's lives would not have been lost and many many more people would not have to rely on SSD instead of being able to work and lead productive lives! Thank u for taking the time to read my story. Please please make sure that the docs no longer live in fear and can adequately treat people's pain as it should be done. I am concerned that some docs will still be afraid of possible consequences in spite of the new guidelines and will still not treat people's pain adequately. The damage that the 2016 guidelines has caused will not be easy to reverse in some cases.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jill	None	None	0900006484ff4b39	Hammer	None	2022-04-05T04:18:17Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Hammer, Jill	l1i-5rjl-ny0f	False	None	False	2022-04-12 05:36:55.192	[]
3790	CDC-2022-0024-3796	https://api.regulations.gov/v4/comments/CDC-2022-0024-3796	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffered a minor injury from a workout in 2006. After suffering in silence for about a year, I finally found a pain management doctor who began treating me for my spinal pain. Multiple X-rays, cat-scans, and other radio procedures notated that I had a few discs in my lower back which were either displaced or deformed and worn. My pain management doctor suggested multiple forms of treatment to avoid surgery. I had everything from acupuncture to steroid injections in an attempt to manage the pain. Finally, with his help, I was able to get a proper amount of medication to relieve my pain and allow for an almost normal function of my daily life. My pain management doctor, however, would not stop at just medication and insisted on me seeing a surgeon for my disc issues. The surgeon promised me a pain-free life if I just had a fusion of my L5-S1. I subjected myself to this procedure and went through more than a year of pain and misery and was never the same after his fusion surgery. This constant pain caused by the failed fusion procedure, along with Crohn’s disease, Chronic Fatigue, Fibromyalgia, and Arthritis had my pain level raised to an excruciating level. Before the CDC’s guideline changed in 2016, I could still live a fairly productive life. I was able to raise and care for my family. My life was not pain-free, but it was manageable. When the CDC guidelines took effect, my world came to a crashing halt. I was cut by my pain management doctor that I had seen for 12 years. His reason: my level of treatment would get him prosecuted and he would lose his license and practice! He would no longer treat me, and I was in a panic to find any pain management doctor who would help me. Almost two months of searching and out of pain medication, I was blessed to find another doctor that agreed to treat me. Part of his agreement to treat me was that he would immediately begin cutting my dosage and as he called it: He would ween me down to an acceptable CDC level for management. I would also have to have routine procedures in an attempt to circumvent the need for medication. I agreed so I could at the very least get some relief. Now, as part of that treatment, I am subjected to routine (about every 6 months) Steroid Injections, Rhizotomies, and Nerve Ablations that do little to nothing to help my pain and as a general rule, only add to my misery for a few weeks post procedure with no additional medication benefits. I ask you, “how does this make sense”? My current doctor forces these procedures so he can document his files to protect him from being arrested or having his practice shut down by the state or CDC (“Feds” as he calls them). When I’m lucky enough to get a prescription for medication, I must fight a whole new battle with the pharmacies and now the insurance companies. I have been turned away or told there is a shortage of medications, or I must deal with Pharmacists playing doctor and God from behind the cash register. I have had to go as far as calling my doctor to have him contact the pharmacist to tell them to give me the dosage he prescribed. WHAT? Everything is a BATTLE.<br/>Please - remove the harmful guidelines inflicted on pain patients and their doctors. We are not drug addicts out wandering the streets trying to find drugs. It is a different group causing the crisis. It is street Fentanyl pouring into our country freely and being distributed by dealers and doctors with absolutely no qualifications that is harming us real pain patients who do everything by the CDC book. We test every month to ensure we are taking our assigned doses and are not taking anything more than that. We have been warned away from other (even though legal in some states) options like CBD, Kratom and Marijuana. If caught in our system, we will lose our medications. We need your help to keep us functional and manageable. We are not asking for increases, but let the doctors who know us and know our pain levels prescribe a necessary amount without governmental interference. We pray for a quick change.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff4b43	Anonymous	None	2022-04-05T04:18:31Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-5vft-mnqj	False	None	False	2022-04-12 05:36:55.434	[]
3791	CDC-2022-0024-3797	https://api.regulations.gov/v4/comments/CDC-2022-0024-3797	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am disabled and am a chronic pain patient. My disabling conditions are failed back syndrome, severe nerve compressions down my left leg (double crush syndrome), hamstring sciatic nerve entrapment, endometriosis attached to my ilioinguinal nerve, and osteoarthritis which have caused very large bone spurs and damage to my left ankle and left shoulder. I have had 17 surgeries since 2008 to deal with these medical problems and have another two scheduled for 2022. I am no stranger to severe pain.<br/><br/>In December 2017, I received a letter from my pharmacy insurance company, CVS Caremark, that I was being force-tapered and it just happened to bring me below the 90 MME threshold mentioned in the 2016 CDC Opioid Prescribing Guidelines. This was no coincidence. At the lower dose I haven’t been able to do as much and my pain isn’t managed as well. I can no longer tolerate daily walks and am unable to do as much housework. I often can’t attend family get togethers to spend time with them. I have difficulties sleeping which I didn’t have prior to being tapered. The CDC Pocket guide to opioid tapering mentions that dosages shouldn’t be lowered more than 10% per month, but CVS Caremark lowered me abruptly and much faster than that. <br/><br/>Over 30 states, including my state of Minnesota, took the recommendations in these guidelines and turned them into law which was predicted by many and should have been foreseen. The DEA, DOJ, and state medical boards are terrorizing clinicians and pharmacists to the point where many won’t prescribe any controlled substances at all. Hundreds of thousands of patients nationwide have been abruptly cut off of or force tapered from their opioid pain medications which can cause suffering from uncontrolled pain, suicidal thoughts and actual suicides.<br/><br/>I have many concerns about the 2022 proposed CDC Opioid Prescribing Guidelines:<br/><br/>1. Why is my pain considered any less than that of the palliative, cancer, or sickle cell disease pain? The cause of the pain or diagnosis shouldn’t be considered as part of whether or not a patient is eligible for opioid pain medications, and this decision should be left in the hands of the clinician. Pain is pain and has many causes.<br/><br/>2. There has been no effort to follow up with patients who have been tapered or cut off. How are they doing now? Did they commit suicide? Has their quality of life changed for the worse? Has their level of function deteriorated? Are they now using street drugs or alcohol to manage their pain? The guidelines should be completely withdrawn until there is a system in place to determine the effects these guidelines are having on Americans.<br/><br/>3. The 2016 guidelines were over 50 pages and the 2022 proposed guidelines are over 200 pages. This is basically an attempt to create a thorough pain management manual in relation to opioid pain medications. However, this isn’t in the wheelhouse of the CDC, it should be the FDA doing this. The CDC should stick to managing communicable diseases.<br/><br/>4. 50 MME is mentioned twice in the proposed guidelines, and a number of clinicians are already tapering patients to under that amount even though the guidelines aren’t approved yet. There should be no mention of any number associated with MME’s, and this should be left to the clinician.<br/><br/>5. There should be no mention of how long a patient should be put on opioid pain medications. This should be left to the doctor treating the patient.<br/><br/>6. Overdoses and overdose deaths since 2016 have risen, not fallen. This is a very important point. If you were keeping people safe by issuing the guidelines, would a reasonable person expect that overdoses and overdose deaths to decline? To me, this shows a complete failure of the 2016 guidelines and indicates they should be withdrawn, the problem should be comprehensively studied by a balanced group of experts including several who have actually treated chronic pain patients for pain management, and the FDA should issue new guidelines if they determine that’s even the right step to take.<br/><br/>7. Both the 2016 and now 2022 proposed guidelines heavily focus on the addiction risk of opioid pain medications, but this only affects a small percentage of patients who take them (.5% - 5%). There is no focus in the proposed guidelines on the benefits of opioid pain medications or the risks associated with untreated or undertreated pain. Chronic pain patients can experience benefits of quality of life and gain or maintenance of function while on opioid pain medications which in many cases justify their use.<br/><br/>8. Insurance companies, states, medical boards, the DEA, the DOJ, and many others wrote hard laws and rules based on the 2016 CDC Opioid Prescribing Guidelines which have been very harmful to chronic pain patients. What does the CDC plan to do to unravel the damage already done? <br/><br/>9. The quality of evidence used for the proposed guidelines is weak at best.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484ff4b60	S	None	2022-04-05T04:18:45Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from S, Brenda	l1i-65ab-af7n	False	None	False	2022-04-12 05:36:55.654	[]
3792	CDC-2022-0024-3798	https://api.regulations.gov/v4/comments/CDC-2022-0024-3798	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I empathize with those that have dealt with chronic pain or have dealt with this in the eyes of someone they love. Being a nurse myself and now in nurse anesthetist school, my medical background has allowed me to gain insight into the real issues our system has caused. I have also watched my boyfriend’s mom struggle with chronic back pain and due to strict regulations and guidelines for prescribing opioids, she had turned to illegal street drugs (luckily a recovering addict now). Not only does she deal with chronic pain, but those that love her have been affected negatively as well. The issues with these strict regulations not only leave patients in pain, but make insurance coverage expensive and restrictive, and leaves physicians less apt to take on patients for fear of “seeking” behaviors and the many hurdles it takes to even prescribe opioids. Failure of a prescribing physician to comply with opioid-prescribing laws and policies may put a prescriber at risk for legal or regulatory sanctions ([name redacted], 2015). Thus, making prescribers hesitant on prescribing opioids due to all hurdles the federal and state governments impose ([name redacted] 2015). Not only is finding a doctor to treat chronic pain difficult, but there are endless insurance hassles, preferred drug lists, prior authorizations, and out-of-pocket costs that complicate easy access to medication, especially long-acting injectable formulations that can exceed $1,000–$2,000 per dose ([name redacted], 2021). The CDC’s new proposed guideline should be a positive move toward helping those in pain and give physicians more confidence in the ability to treat their patients. This also could take away power and money from drug dealers on the streets and thus lead to less crime. Pain is subjective to the patient, and it is real, instead of creating ways for patients to seek other ways to relieve pain, we should be helping them. This could include treating patients with pain medications in conjunction with holistic treatments but keeping patient advocacy at the forefront of treatment plans. One size does not fit all.<br/>[name redacted]. (2015). Current regulations related to opioid prescribing. <br/><span style='padding-left: 30px'></span>PM&R, 7: S236-S247. https://doi.org/10.1016/j.pmrj.2015.08.011<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff4b6d	Anonymous	None	2022-04-05T04:19:47Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-696q-z37v	False	None	False	2022-04-12 05:36:55.867	[]
3793	CDC-2022-0024-3799	https://api.regulations.gov/v4/comments/CDC-2022-0024-3799	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has had RLS (Restless Leg Syndrome) for many years and it has become progressively worse. He doesn't sleep well at night, is exhausted during the day, and I know his overall health is being affected. He was on the usual prescriptions in the beginning, then went onto dopomine, which helped in the beginning and then got progressively worse and he has restless leg, arms and torso! They put him next on tramadol which helped in the beginning but after two months got worse. Now he ha been on methodone for several months and THANK GOD he can sleep and he is doing much better. Please allow doctors to prescribe methodone for patients with very bad and dangerous restless! Thank you[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynda	None	None	0900006484ff4b72	Taylor	None	2022-04-05T04:20:10Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Taylor, Lynda	l1i-6b27-aygy	False	None	False	2022-04-12 05:36:56.103	[]
3794	CDC-2022-0024-3800	https://api.regulations.gov/v4/comments/CDC-2022-0024-3800	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids shouldn’t be restricted the way the are being restricted. Doctors should not be afraid to prescribe opioids for patients if they have medical evidence of on going pain. Opioids help people do things and have a normal life. It is so wrong to not prevent and get rid of pain. People should not have to be in pain if they don’t want to be. So sad the way this has gone for people who truely have a need for any opioids, be it short or long term.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	George	None	None	0900006484ff5999	Hopkins	None	2022-04-05T04:20:17Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Hopkins, George	l1i-6upb-psw5	False	None	False	2022-04-12 05:36:56.319	[]
3795	CDC-2022-0024-3801	https://api.regulations.gov/v4/comments/CDC-2022-0024-3801	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	By my mid-forties, my Restless Leg Syndrome (RLS) was so severe, I spent most of my nights on the bedroom floor, kicking and thrashing. I began taking a combination of small doses of Mirapex (0.25mg) and Oxycodone (5mg). After some 18 years, the dopamine-agonist caused augmentation of symptoms, so I had to stop. Replacing with gabapentinoids was nearly ineffective (which is typical when switching from dopamine-agonist to alpha-2-delta ligands). So I have been left with no options except opioids. I could get by on 12.5 to 15mg of Oxycodone, re-dosed through the night. But I have since found better relief from Buprenorphine (Subutex 0.285mg), a Schedule III Opioid.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484ff59a3	Sager	None	2022-04-05T04:20:46Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Sager, Paul	l1i-6z4v-ui3u	False	None	False	2022-04-12 05:36:56.534	[]
3796	CDC-2022-0024-3802	https://api.regulations.gov/v4/comments/CDC-2022-0024-3802	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had surgery on my shoulder June of 2021 and was given no pain medications post op. It was the worst pain I've ever felt in my life. I talked to my doctor about it 2 days post op and he still wouldn't give me any pain meds other than telling me to take Tylenol and ibuprofen which didn't help my pain at all. I didn't sleep for 5 days straight.<br/><br/>I'm in my mid-70's and will never have surgery again of any kind. <br/><br/>Please withdraw the CDC guidelines as they are causing far more harm than good!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff59a4	Anonymous	None	2022-04-05T04:20:54Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-6zyd-cw7f	False	None	False	2022-04-12 05:36:56.743	[]
3797	CDC-2022-0024-3803	https://api.regulations.gov/v4/comments/CDC-2022-0024-3803	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife had surgery and was given no pain meds afterwards. She was in horrible pain, couldn't sleep for days, and the doctor wouldn't give her anything. She is completely unwilling to have any future surgeries now. <br/><br/>The doctors won't prescribe due to fear of losing their licenses due to laws put in place based on the CDC guidelines.<br/><br/>What is the CDC doing to fix this? The guidelines should be withdrawn until this is addressed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff59c2	Anonymous	None	2022-04-05T04:21:08Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-76i8-1z6x	False	None	False	2022-04-12 05:36:56.957	[]
3798	CDC-2022-0024-3804	https://api.regulations.gov/v4/comments/CDC-2022-0024-3804	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was employed in a job I LOVED and was very good at. Unfortunately I was injured on the job. That put paid to my medical career. I was taking opiates for pain control. Went back to school and found a new job that I was able to do while taking my meds. In 2016, when your new guidelines came out, POOF!! There went my stable for 15 years medication! I am no longer able to work, someday I cannot even get out of bed. These guidelines robbed me of my life. I no longer go out with friends or family because of the pain. I am severely depressed and HATE what my life has become. Your so called guidelines became hard limits and Dr's ran for the hills.<br/>Please drop all of your MMEs from the revised addition. It will again be seen as laws.<br/>My doctor is a wonderful man but he feels his hands are tied. I need pain medication to be a functioning human being. <br/>Why is it every addict on the street gets safe places to use illegal drugs. Free syringes, everything to kill themselves, some even provided by the government? And I cannot get legally prescribes pain medicine to survive and be human? <br/>Please Please help chronic pain patients. We need help and that is what you are supposed to do! <br/>I won't go into the Fact that you have the Same people revising these guidelines as in 2016. These individuals have Huge conflicts of interest, but I digress.<br/>This is about me and about 30 million Americans who need their pain medication. Make no mistake. We use it as medication not getting high. <br/>Just because our medical issues aren't visible, doesn't mean it is any different than diabetes, cancer etc. It is very painful Medical conditions that have put us in this bind.<br/>If I could go back in time and Not move the very large patient, thus hurting myself I would! I don't want this life, but it is mine. All I am asking for a medication that will and DID help me lead a normal life.<br/>Please make sure this time that you think and act on our behalf. We are the invisible the unseen.<br/>Please SEE US and HELP US. <br/>Let the Dr's give us the medication we need!<br/>Thank you<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff59e2	Anonymous	None	2022-04-05T04:21:50Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-7fsy-q10u	False	None	False	2022-04-12 05:36:57.164	[]
3799	CDC-2022-0024-3805	https://api.regulations.gov/v4/comments/CDC-2022-0024-3805	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife is a chronic pain patient and has been force tapered from an opioid pain medication dosage to one that doesn't work as well. She used to go for daily walks but now can't, and she is upset that she can't do as much housework or spend as much time with our grandkids.<br/><br/>Almost no doctors in our area are willing to prescribe opioid pain medications anymore because they fear for their licenses due to laws based on the 2016 CDC Opioid Prescribing Guidelines and state medical boards.<br/><br/>There should be no mention of specific MME's in the new guidelines, and there should be no mention of length of time for prescriptions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff59ee	Anonymous	None	2022-04-05T04:22:05Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-7jsm-8lrc	False	None	False	2022-04-12 05:36:57.381	[]
3800	CDC-2022-0024-3806	https://api.regulations.gov/v4/comments/CDC-2022-0024-3806	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC must recognize the Chronic Pain Patients live in daily horrific pain and are unable to live normal lives. The 2016 Guidelines harmed us greatly, and cost most of us our careers, loved ones, daily lives, limited our travel, and forced us onto SS Disability. I'm lucky it didn't cost me my life, but it almost did. It's necessary the CDC recognize there are no cures for most of us. Not even valid treatments for many. We can only treat the symptoms. It's the last treatment we have available.<br/><br/>To limit Opioids for these Chronic Pain Patients is cruel and inhumane. I knew the prior Guidelines of 2016 were wrong and harmful. Yet, the CDC refused to hear us for YEARS! You allowed corrupt people to set the direction for ALL of us, knowing they had an agenda. That should have never been allowed. How is this right or fair? We have the right to have this question answered - openly and honestly. And see exactly who is making these decisions for ALL of us. Open and Honest communication goes a long way.<br/><br/>I participated in one of the working groups - yet find no reference to any of my input. I know the majority of us had the same input I did, and their commentary doesn't exist either. What did you do with our input? Why wasn't it included? We DO appreciate the update, language change, and the reference to decisions between patients and physicians. That is an improvement.<br/><br/>Everyone wants to limit Opioid usage but it is necessary to also understand that some of us have honest medical needs for treating symptoms when no other options exist/have failed. Modern Medicine simply doesn't have all the answers or cures - yet. Severe Nerve Root Damage is one such item. So are inoperable, but benign, brain tumors! When it's not cancer, you're stuck without treatment. Lucky me to have both, plus RA, multiple damaged nerve roots and crazy asthma along with aging.<br/><br/>A special paragraph calling out the fact that the Chronic Pain Patients, regardless of age, may have needs that are legitimately higher/lower than other patients is required. It should state factors are to be determined between Physicians and Patients ONLY. There should be no firm MME Requirements placed on this category of patients, and this would be clearly documented. Knowledge discussion, help in decision making, perhaps, but not an MME requirement. Most of us have utilized every single previous suggestion the CDC provided, and they have failed. It's difficult to treat us. It's even more difficult to live with this level of intense pain and expensive to keep searching (and painful!).<br/><br/>Please don't repeat the same mistakes as last time. We require, and deserve, our own section. There should not be MME limitation for Chronic Pain Patients, as needs do increase/change over time, and usually a combination of meds/treatments are most successful. Those are determined ONLY by Physicians and Patients within current status, not some Guideline with no knowledge of our Medical History, Failed therapies, prognosis, limitations, etc. I think this is fair and right. <br/><br/>I'm in Pain Management 20+ yrs, taking as little as possible, but I do require some help for my pain. I have a failed Lumbar Fusion, Stenosis, Multiple Failed Back Surgeries, Benign but inoperable brain tumor, RA, Multiple Damaged Nerve Roots, 2 SCS's, etc. and tried every available option! Yet still have intense burning and tingling in both feet & legs...standing in a fire 24/7, with no break. It just never stops and is uncontrollable. I am suicidal without Pain Management and have proper medical records to back it up. With these records, I should be allowed proper Pain Management or Family Dr if no PM is available.<br/><br/>We, the Pain Patients, are NOT the cause of Opioid Crisis. We are under strict guidelines, limits, testing...every single month! It's EXTREMELY expensive and time consuming. 2016 harmed us in innumerable ways. It's time to right that wrong, even if unintentionally done.<br/><br/>Get the people with Agendas OFF the Guidelines! Their input should be equal to or less than mine, considering they don't even treat patients. We understand the dangers of Opioids, and it is up me, my health, and physician as to treatments. After all, we are the only ones who know about me.<br/><br/>Also, to limit my own Family Physician when Specialists are not accessible, is cruel. Current rules and limitations do keep us housebound, but I'm praying for a change now. <br/>With proper PM, I can travel for a couple of years yet. Going to Dr every 30 days is a lot, with monthly UA's, and appts, and it costs $1000.00 mo. Then it takes days for Pharmacy to order and receive meds & fill it. If they will at all. This delay means about 5-7 days while I go through withdrawals! It's inhumane. THIS is ALL caused by the 2016 Guidelines. Before was $25.00 plus meds for 3 mo. Allowing our own section eliminates a lot of this.<br/><br/>It's time. Let's correct this and get it moving forward.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debra	None	None	0900006484ff5a18	Moby	None	2022-04-05T04:22:43Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Moby, Debra	l1i-7wtt-6pba	False	None	False	2022-04-12 05:36:57.591	[]
3801	CDC-2022-0024-3807	https://api.regulations.gov/v4/comments/CDC-2022-0024-3807	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a disabled veteran, I have chronic pain because of injuries sustained while on active duty. I was being prescribed pain medication (Norco 10/325) to help ease the pain when I WALK, SIT, or attempt any normal day to day function, INCLUDING SLEEP. I have severe anxiety and ptsd because of my time in service. During the time when I was prescribed pain medication AND anxiety medication, I had a great life. I was able to be an active parent in my child’s life, I was able to hold down a job and go to school. When new laws were introduced and pressure put on the VA Healthcare System, I was cut off. Cold turkey, withdrawals and all (9 years of being on this medication, btw) I was told my provider had changed and would not be given a taper schedule for EITHER of my medications. So….I suffered. I couldn’t walk, I could barely bathe. I regret the day I reached out to the street, it was dangerous and I was scared every single time that I was using this to help me live and walk and be present in my daughter’s life, scared that there was a chance I’d have been scammed and would die. BUT I took that chance so that I could do simple things like walk my daughter down the street to school, or take her outside to walk by the river and enjoy nature, heck, just to sleep soundly for one night! However, once deaths started to rise due to “bad drugs” I realized the luck I’d had in not getting a “bad batch” could be running out. So….I turned to the VA once again for help. The only option I had. I was put on Suboxone, that medication made me feel crazy, like I wanted to die and burn the world down with me, it made me someone other than who I knew I was. So I complained again and again until the day came when the VA responded…but not to help, they turned their back on me. Here I was, broken and in severe pain, begging for help from the very organization I broke my body for….and I was labeled an addict, treated like a black sheep, transferred to a civilian methadone clinic, and I haven’t received any help since. So now I’m on methadone, which does not help my pain at all, I’m unable to work now because some days I can’t even get out of bed, my daughter hates me because I’m never able to do anything with her, she’s probably embarrassed. And when I go to the VA for my regular check up appointments, I’m treated like an addict, as if I’m making everything up, even though there are diagnostic images and tests validating the source of my pain. It’s a struggle. Constant anxiety and panic attacks, never a nights rest, never a beautiful morning for me, just constant pain, forever shame from being labeled an addict, no decent doctor will give me the time of day, and unable to hold down a decent job because of the pain im constantly fighting. Here I am, a veteran, signed up right after 9/11, served my time AND even extended it to help more….believing my country would have my back, like how I had theirs….busted my butt to transfer my college courses to online ones, ACHIEVED my bachelors degree WITH an HR Management certification….One that im unable to use because no one wants to hire a disabled vet that calls off work because of her pain and her inability to walk or stand. All my hopes, all the “payoff” I thought I’d get by doing what’s right, serving my country and sacrificing my time, getting my degree, never giving up….not knowing that “they” had already given up on me, left me to be a statistic, because of the pain I have every single day, due to the injuries I encountered serving THEM and my country, they won’t ever see me as anything more than an addict. Disregarding my experiences, my medical record, all of it. Just because I need a little help with my pain. The pain I got by serving my country. I just don’t get it. It’s a hard “pill to swallow”. But that’s where I am now. No help, left at the steps of the methadone clinic to help my pain…..which it does not. Doctors are scared. Patients are suffering. What will it take for them to open their eyes and stop the “one label for all” [profanity redacted]?!? :( I’m sorry. I went off. I just….I’m at my wits end. I’m lost. I’m hurting. I need an advocate. Please, if you know anyone in [location redacted], Ca, or even northern Ca. Please have them reach out to me. [phone number redacted]. Thank you. -[name redacted]-	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Adriana	None	None	0900006484ff4c17	Torres	None	2022-04-05T04:24:56Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Torres , Adriana	l1i-g7dg-ohrh	False	None	False	2022-04-12 05:36:57.803	[]
3802	CDC-2022-0024-3808	https://api.regulations.gov/v4/comments/CDC-2022-0024-3808	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC, <br/>Your ‘New Revised Guidelines’ aren’t any better than the 2016 version. Yes there are some changes that on the outside look like it’s a start in the right direction from all the horrendous misapplication outcomes. When you really read through it you start to see through them and see how badly these ones will go wrong as well. The 50 mme has got to GO!!! There can not be any form of an mme cap in the guidelines what so ever! So many stable patients that were doing fine were destabilized. They became completely disabled. Suffer horrifically every second of every day. They’ve become bed-bound. Lost their significant others, friends , famiky. They are a shell of who they once were ! All because their doctors listened to what were supposed to be voluntary guidelines but were applied like law. The mme was one of the biggest factors of pain patients being cut off or cut down on their much needed pain medications. Even though it stated for opioid naive patients!! There are already people being tapered down to 50 mme just from this draft guideline being released. The comments on limited effectiveness when myself and thousands of others can attest that for decades these medications kept us functioning human beings when nothing else worked is asinine! There needs to be long term studies done following people on LTOT to prove that it works . You need to openly admit the effect your 2016 guidelines did to the chronic pain community. People when to street drugs to get help with their pain and the overdoses sky rocketed or they committed suicide! This ‘ revision’ will not make it any better! You all need to take a step back and take a real hard look at what you’re doing to some of the most vulnerable people there are. People that suffer unimaginable pain! Again , you need to pull the entire thing but I know you won’t because you all don’t care what harms you’ve Wrought. The lives you’ve destroyed. The lives you will continue to destroy. You’re not just destroying the pain patients life but their loved ones, their children. Their mothers and fathers. So , You need to make sure that pbm’s. Policymakers etc stop using the guidelines as a standard of care against patients and allow patients to return to normal !!!! <br/><br/>You need to get rid of the mme but if you keep the mme make damn sure you state it is NOT for chronic pain patients. It is NOT for people already above that threshold and functioning on the amount they’re on. You need to stop the dea from scaring our Drs , arresting Drs for prescribing over the mme threshold!!! <br/><br/>You Still discuss tapering . After all the horrific outcomes , after all the so called ‘unintended consequences’ you give step by step instructions on how to taper like you expect tapering to be done and needed consistently for everyone! <br/>There shouldn’t be wording in the guidelines for specific disease and not others. Pain is pain. Pain is subjective. Many pain patients have more than one painful condition and their pain is severe. I have a condition where I grow non cancerous tumors all over my body. They hurt the same as cancer . I also have a destroyed spine, gastroperisis, endometriosis, inflammatory bowel disease, migraines. I can tell you with 100% honesty that my pain level on any given day is a 7. On my bad days it’s a 10. I was a functioning happy woman prior to your 2016 guidelines. Now I’m a shell of a human being. I had so much hope for the new guidelines and now I’m scared. I’m scared that my doctors will taper me again to 50 mme. I will NOT survive that. I hardly survive the pain now. So PLEASE I am begging you From the bottom of my being and the depths of my soul. Please do not make the same mistakes . Please do not put an mme threshold. Please rethink what you are doing. I know you think you’re helping but it didn’t help anything. It made things worse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jamie	None	None	0900006484ff5e1b	Bey-hewes	None	2022-04-05T04:25:19Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Bey-hewes, Jamie	l1i-lw18-o685	False	None	False	2022-04-12 05:36:58.015	[]
3803	CDC-2022-0024-3809	https://api.regulations.gov/v4/comments/CDC-2022-0024-3809	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wanted to share how the 2016 CDC guidelines did to my Chronic pain how it interrupted my life, making it challenging to get through daily tasks and activities. The chronic pain I felt would affect my ability to sleep, produced anxiety and depression, It cause mood changes, made me feel weak, and interfered with my ability to work and interact with friends and family. When I was forced tapered by my pain management doctor without no warning. Because of the cdc 2016 recommendations my quality of life was affected severely. Especially the fact I was still in chronic pain from my motorcycle accident I was evolved in January of 2020. I sent some pictures to share what I looked like after my accident so you would imagine what pain I went through Thank You.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julio	None	None	0900006484ff5e1c	Maisonave	None	2022-04-05T04:27:05Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Maisonave, Julio	l1i-ljd4-l3bz	False	None	False	2022-04-12 05:36:58.255	[]
3804	CDC-2022-0024-3810	https://api.regulations.gov/v4/comments/CDC-2022-0024-3810	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from long-term chronic pain from arthritis and neuropathy in my lower to mid-back, hips, groin, and knees. My age is now 66 however, I was 18 years old when I was thrown off a horse resulted in a traumatic injury to my tailbone area. I learned to live with chronic pain using acetaminophen and aspirin up to my 50s but I couldn’t tolerate the pain with over-the-counter medication anymore and got prescribed hydrocodone which I took daily since 2003. Then in 2015-2016, I was not able to get the Hydrocodone because of regulations. I don't know why but I didn't have any withdrawals from stopping the Hydrocodone. I was so afraid to go through that after about 20 years, but I think because I am not a candidate for needing to get high from opioids, I recognize that I'm looking for relief from pain and somehow I think those points play a role. I don't drink alcohol at all and never have. Immediately after I was not taking hydrocodone I began to feel the pain coming back as the nerves in my tailbone and spine area felt like they woke up from a deep sleep and the pain was unbearable. This was when I realized that the opioid medication was working to maintain quality in my entire being, not only for keeping me active but also including my mental health. Depression was out of control as I felt dread facing each day. I struggled to walk, bend, sleep, sit and stand. The quality of my life went down and each year it gets worse. My self-image has taken on a negative note because I can’t push myself through the debilitating effects the pain is causing me. Eventually, I ended up going to a neurologist for about four years getting spinal injections and prescriptions for tramadol and gabapentin which I have also taken since 2003. I continued gabapentin until recently as a doctor wouldn’t prescribe them to me because he felt that there were effects from the medication that could interfere with the health of the brain. The gabapentin did not help me enough for the pain anyway. It didn’t allow the pain to subside enough to push me into getting on my feet and staying active as the Hydrocodone did for me. Tramadol was like taking acetaminophen, so I stopped asking for it. The struggle is more difficult than I can express. The spinal injections I received did finally help me but after several years of work and going two to three times daily a week and then the relief only lasted about a few weeks. I am not living life. I am struggling to survive through every moment and that's it. I feel like I don't have any natural endorphins left to feel good on any level. I do take Cymbalta for depression and I can imagine it must help but no anti-depression medication is going to take away the actual struggle, the intensity of pain, with also knowing that the quality of my life is dwindling down each day from the inability to be active. I do try. I try to cook, and tidy and I will get out once a month to grocery shop. But those are only done when they can't be ignored anymore. I suffer and struggle greatly to do those things and usually, I pay the price with even more increased pain afterward. If I can only get some relief from the effects of chronic pain, maybe then I can start to live again. I have no hope without the way opioids help to block the pain to give relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Treva	None	None	0900006484ff5e7a	Strom	None	2022-04-05T04:27:30Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Strom , Treva	l1i-n0bn-w7j9	False	None	False	2022-04-12 05:36:58.469	[]
3805	CDC-2022-0024-3811	https://api.regulations.gov/v4/comments/CDC-2022-0024-3811	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on Pregabalin and Pramipaxol and from last 2 years nothing is helping me. My only hope is opioids now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hitesh	None	None	0900006484ff5ed4	Lade	None	2022-04-05T04:27:38Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Lade, Hitesh	l1i-oyu5-tk7v	False	None	False	2022-04-12 05:36:58.687	[]
3806	CDC-2022-0024-3812	https://api.regulations.gov/v4/comments/CDC-2022-0024-3812	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 82 years old and have had RLS for 15 years. When first diagnosed, my primary care doc prescribed Mirapex, which didn't work, and then on through a list of dopamine agonists which made things worse. Over a period of 3 or so months I was sleeping more and more badly, the RLS was agonizing, and I felt that I was going crazy. Finally I found a MD who prescribed methadone 5 mg which worked great but made me constipated...Long story short, I am now taking gabapentin 300 mg and methadone 2.5 mg, in addition to a low-carb diet and lots of exercise, which keeps the RLS at a manageable level. I am convinced that low-dose methadone literally saved my life.<br/><br/>MDs often fear prescribing opioids for RLS, and CDC would be doing an important service to them and to patients like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	leroy	None	None	0900006484ff5edd	jackson	None	2022-04-05T04:27:50Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from jackson, leroy	l1i-p6h8-l94y	False	None	False	2022-04-12 05:36:58.904	[]
3807	CDC-2022-0024-3813	https://api.regulations.gov/v4/comments/CDC-2022-0024-3813	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had a severe case of RLS for many years. I used to take Mirapex for my RLS only to learn over the years that my condition became much worse on that drug because of the Augmentation problem. I found a great doctor active in the RLS Foundation that got me off Mirapex and started Gabapentin and a very low dose of Methadone for the nights when my RLS symptoms flair up far beyond what the Gabapentin can do for me. Even though I am used to taking only 5 mg rarely to occasionally, I never have been tempted to take anymore than that dose. Methadone does work at a very low dose and the dose never needs to be increased because the drug for this disease works on different receptor sites. This is unlike taking opioids for pain where a person is needing more and more of the drug to get the same effect or relief from pain. My RLS is much better controlled now and do not suffer nearly as much. With the supervision of a good doctor who is knowledgeable in this disease (I wish there were more of them), there can be good relief without increasing doses. I finally can get better sleep and feel normal.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Colleen	None	None	0900006484ff5f14	Burroughs	None	2022-04-05T04:27:57Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Burroughs, Colleen	l1i-qknt-2tfh	False	None	False	2022-04-12 05:36:59.123	[]
3808	CDC-2022-0024-3814	https://api.regulations.gov/v4/comments/CDC-2022-0024-3814	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We need help to live normal lives. I'm lucky to sleep 20 in a weeks time. Please allow low level opioids as prescribed by a medical professional.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Todd	None	None	0900006484ff5f24	Thompson	None	2022-04-05T04:28:05Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Thompson, Todd	l1i-qzji-eohm	False	None	False	2022-04-12 05:36:59.337	[]
3809	CDC-2022-0024-3815	https://api.regulations.gov/v4/comments/CDC-2022-0024-3815	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thousands of chronic pain patients have gone to the streets looking for relief or committed suicide due to the 2016 CDC guidelines. This new guideline drop the MMEs from 90 to 50. It does not matter if you say that is a suggestion it will be taken as a hard limit by doctors and states. This document is probably one of the most important documents that is pending. If the MME limit is not removed or the guideline is not rescinded you are going to see a major increase in suicide. Many chronic pain patients have been holding on to the hope that things will get better and that humane medical treatment will be restored. If you release this ,as is, many of those suffering 24/7, will give up. The data repeatedly shows that overdose deaths are not being caused by prescription medication but yet we continue to promote this and torture people with legitimate chronic pain. I guess it remains to be seen the outcome that you are hoping to secure with this. Nobody should have to suffer when there are safe, effective medications that could improve their quality of life significantly!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6109	Anonymous	None	2022-04-05T04:30:21Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1i-wl2u-6c59	False	None	False	2022-04-12 05:36:59.547	[]
3810	CDC-2022-0024-3816	https://api.regulations.gov/v4/comments/CDC-2022-0024-3816	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People are suffering! You can't keep opioids from chronically ill people for fear of addiction. We need these to function. Do you know what it's like to live in 24 hour pain? I'm submitting this anonymously because I get opioids, but I live with the fear they'll be reduced or taken away EVERY SINGLE MONTH. I'm a multiple cancer survivor who needs these meds. It's not at all fair that so many truly sick and hurting people must suffer because the government is afraid they'll become addicts. I'm just one sick person who suffers brain fog so I'm not sure this will do one bit of good or even if someone will read this but please, please, PLEASE DO NOT REDUCE THE AMOUNT OF OPIOIDS WE CAN GET AND DO NOT DENY CHRONICALLY ILL PEOPLE THE HELP THEY NEED!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff5f9a	Anonymous	None	2022-04-05T04:30:33Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-18gn-g4xt	False	None	False	2022-04-12 05:36:59.761	[]
3811	CDC-2022-0024-3817	https://api.regulations.gov/v4/comments/CDC-2022-0024-3817	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have trigemenal neuralgia & now newly diagnosed with lupus SJOGREN lucky ME. Today Iam a non functioning adult where my granddaughter is on her 4th yr of college wants to become a dr finds herself taking care of me. Neurologist says go to pain mngmnt, pain mngmnt says ooooh no there is NOTHING WE CAN DO FOR YOU GO SEE OUR NEUROSURGEON, NEUROSURGEON SAYS IM GOING TO FLAG IT SO THAT THEY CAN HELP YOU. Pain mngmnt TOLD ME I HAVE THE RIGHT TO GO TO ANOTHER HOSPITAL & start the process all over. MY QUESTION IS WHY, WHY ??? I’ve done nothing wrong. Today instead of me trying to find work even though I know with pain medication I can live a good quality of life I sit here & wait maybe to wither away & wait for the cdc to say ok WE KNOW YOU WILL NOT ABUSE YOUR PAIN MEDS. PLEASE STOP THIS MADNESS PEOPLE WHO Legitimately need pain management can’t receive it. Can’t work want to work about to lose my home where to go my family can only help me NO MORE. Please HELP	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Migdalia	None	None	0900006484ff5fcf	Reyes	None	2022-04-05T04:30:48Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Reyes, Migdalia	l1j-6t5d-rcwp	False	None	False	2022-04-12 05:36:59.972	[]
3812	CDC-2022-0024-3818	https://api.regulations.gov/v4/comments/CDC-2022-0024-3818	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People are in pain. Tapering, refusals, lead to unreasonable, immeasurable pain and suffering. I have chronic back pain from blue collar work over the last 25 years. Bulged C4/c5. Operation on L4L5. When I contracted mrsa in 2016 my infection was attacking my c4c5 and was in unexplainable unimaginable 10 out of 10 pain. I explained to them why and how, because I was told the mrsa shouldn't cause pain. For 4 day I laid in the hospital unable to move unable to sleep because of the sheer pain in my neck and spine. They wouldn't give me anything for my pain. Now you'd make that worse? For people in worse conditions? The cdc has mucked up everything they've put their hands on from pain management to covid to health and safety. Eventually they gave me 2 MRIs and a CTscan to prove that I was in pain. And on day 5 they gave me enough to manage to sleep. You'd take that away? I haven't had a pain medication since. However I'd expect to be able to get a rx if needed, you'd take away a person's will to live? That's what you want to do? The ods and suicides have increased since the last restrictions. They clearly don't work. People would rather risk illicit drugs than live in their restricted pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jason	None	None	0900006484ff5fec	Bird	None	2022-04-05T04:31:06Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Bird, Jason	l1j-9g6j-ga3f	False	None	False	2022-04-12 05:37:00.211	[]
3813	CDC-2022-0024-3819	https://api.regulations.gov/v4/comments/CDC-2022-0024-3819	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please change guidelines. In 2017 I had head surgery to fix cranial csf after which I was left in pain that felt like my head was pounded with hammer with every heartbeat. This pain was present in every second of every day. I was near suicide to prevent pain and no one would help. My doctors answers were "it's impossible that you're in pain" and "are you trying to get pain meds". Finally I left him after eighteen months of pure torture. <br/>Turnes out I have IIH. Condition that gives me symptoms of a brain tumor, caused by EDS, genetic condition. I finally have doctor who helped me. I'm on three different medications to manage range of symptoms. One of them is opioid. I'm also in therapy to deal with ptsd I was left with after living what I describe as torture chamber for two years. Only reason I survived suicidal ideas was my family. Please change your guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Milica	None	None	0900006484ff5fee	Obradovic	None	2022-04-05T04:31:26Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Obradovic, Milica	l1j-9lo9-izf2	False	None	False	2022-04-12 05:37:00.421	[]
3814	CDC-2022-0024-3820	https://api.regulations.gov/v4/comments/CDC-2022-0024-3820	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have left many comments over my too many years of torture. As you now see more people are dying of overdoses not less, they are not and never were chronic pain patients. Time to admit you were wrong and turn course. The data was always there, your agency decided promoting a political agenda was the important issue, not pain care.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6004	Anonymous	None	2022-04-05T04:31:39Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-abo7-upz9	False	None	False	2022-04-12 05:37:00.643	[]
3815	CDC-2022-0024-3821	https://api.regulations.gov/v4/comments/CDC-2022-0024-3821	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	"What many people don't know is that the CDC was warned that the Guidelines would hurt patients. Did they care? No. So, when they say, "we didn't know this would happen," just know they're lying."<br/>-Anonymous but important-<br/>All this talk about the [name redacted] yet none of you are talking about the $$$ incentives given to doctors to not treat pain with narcotics. This is a war on the disabled community put forth by the Hate Group PROP.<br/> Your weaponized guidelines are used to arrest doctors by the DEA for prescribing pain medication to patients that are in pain. You knew the last set of guidelines would Kill thousands. You also know these new guidelines at 50 MME are already being weaponized against patients and doctors.<br/>If you want to be part of the solution of fixing the Mess YOU Made. Then either RECIND THE GUIDELINES ALTOGETHER or Remove any and ALL mention of Morphine Milligram Equivalents. <br/><br/>Less than 4% of drug abusers started in Prescription drugs.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484ff60c1	Ard	None	2022-04-05T04:32:57Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Ard, Melinda	l1j-cg5m-y4xy	False	None	False	2022-04-12 05:37:00.912	[]
3816	CDC-2022-0024-3822	https://api.regulations.gov/v4/comments/CDC-2022-0024-3822	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I lost my doctor of nine years when the clinic suddenly stopped prescribing opioids for my chronic pain. I’ve been nearly bedridden for 10 years now (the first 5yrs I was 100% laying in bed and crying waiting for my next dose), and can’t work after a successful 22 year career in accounting. I have endometriosis, inoperable degenerative disc disease, fibromyalgia, migraines, and more. My first back spasm was when I was 16 and I’m now 55. I had been on and off (possibly once or twice in 3-4 years?) opioids for spasms, etc. since that young age and show no signs whatsoever of addiction, yet my chronic pain isn’t treated humanely due to the guidelines that made me lose my longtime doctor. I’m hurting. There are sufficient medications and dosages that would give me at least a bit of quality of life but that would mean going over the suggested chronic pain prescribing limits currently in place. There is only one pain management facility even remotely close to me, over an hour’s drive, that I went to for a couple years and was spoken down to, constantly given steroid injections and under-treated for pain. The steroids didn’t help, but I had to have whatever procedures the doctor wanted to do in order to get any pain relief opioid prescriptions. I’m disabled and on Medicare, and I firmly believe that he required the procedures because they pay better than writing a scrip! This is mental and physical abuse by the government, which has no place getting between doctors and their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ruthie	None	None	0900006484ff60ed	Windsong	None	2022-04-05T04:33:09Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Windsong, Ruthie	l1j-cxxh-oin3	False	None	False	2022-04-12 05:37:01.157	[]
3817	CDC-2022-0024-3823	https://api.regulations.gov/v4/comments/CDC-2022-0024-3823	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient the cdc/dea are torturing more lives than you think your are saving! You are not the solution, you are the problem I am angry and downright appalled by your inability to analyze your own opioid data! Opioid prescriptions have been reduced drastically yet opioid overdose deaths have risen exponentially. It’s the street drugs not the Pain Management Doctors & patients! We are not the problem, yet we suffer. Our pain management doctors are scared to death for their license that many are leaving practices and thereby refusing to compassionately care patients who are unnecessarily suffering with pain, living in agony. We knowingly and responsibly rely on our medications for pain relief and required to have any quality of life. Am I not entitled to have an acceptable and better quality of life, too be functional?? I wish all you “experts” could live one week in my shoes, you would quickly change your tune! My doctor has said on multiple occasions that she can no longer properly care for patients because of the overreaching and overreacting policies and programs you put in place. Stop PUNISHING PAIN PATIENTS! We are not the problem! You don’t know what we go through day in day out.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff60f7	Anonymous	None	2022-04-05T04:33:39Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-d3r2-62v6	False	None	False	2022-04-12 05:37:01.418	[]
3818	CDC-2022-0024-3824	https://api.regulations.gov/v4/comments/CDC-2022-0024-3824	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 change in opiate prescribing policy was tragically misdirected at patients being successfully treated with opiate pain medication, for chronic / long term pain. I had been successfully treated with hydrocodone (the same strength and dose) for 20 years, judiciously and without incident.<br/>Primarily, opiate overdose deaths are the result of recreational use… use of illicit or illicitly obtained (think heroin, fentanyl, deep web, unregulated) substances.<br/>Chronic pain patients, taking opiate pain medication judiciously and successfully are being treated like drug seeking addicts. We can’t go into a hospital emergency room, or to a new physician / specialist without being expressly told, “I won’t prescribe you any pain medication!”… even before assessing the condition we are being seen for.<br/>The 2016 policy that was implemented, in the absence of any credible studies, has caused irreparable harm to a very large population of people.<br/>Withdrawal of appropriate pain control in my case has taken away my ability to garden, to drive or walk any distance, to perform activities of daily living. It has interfered significantly with my ability to sleep, as well.<br/>I find it very disconcerting that primary care physicians who once treated their patients for pain, are now advertising Suboxone and other treatments for drug addiction, and are financially rewarded by charging big bucks to see drug addicts‘s, ordering expensive drug/urine testing, and prescribing expensive medication‘s. Unfortunately, chronic pain patients can no longer be treated in their primary care physicians office, they must go to pain management specialists, at greater cost, invasive urine screens given in the absence of any probable cause to think that their pain medication is being used in properly. Our medical records begin to look like drug addict, drug seeker medical records rather than the records of a patient being appropriately treated for pain.<br/>Clearly there’s something wrong with this picture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484ff6519	Foster	None	2022-04-05T04:35:27Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Foster, Jennifer	l1j-dobz-ot2y	False	None	False	2022-04-12 05:37:01.668	[]
3819	CDC-2022-0024-3825	https://api.regulations.gov/v4/comments/CDC-2022-0024-3825	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While the CDC write these guidelines are flexible, intended to help clinicians rather than restrict them, the guidelines are, in practice, effectively limiting. When a government regulating body puts out guidelines, physicians who depend on their licenses, are of course going to treat those guidelines as mandatory. The CDC writes it’s not intended to box physicians in, but it does just that. Opioids, like any drug with abuse potential, are not in themselves the problem. Patients all over the country, I’d guess in the millions, take their opioids and other potentially addictive medications as prescribed. Chronic pain patients are not looking for a high, we are looking for a moments relief from intense pain so we can participate in rehab or leisure or the workforce. Acute pain and chronic pain, as the CDC well knows, are entirely different and the response to relief will be different. When you’ve been living with pain for years, you’re grateful for even a 10% reduction in pain, so being able to take an opioid which increases that percentage, means even more gratitude and respect for the medication that is giving a life back. Acute pain, well in my experience, you want immediate total relief and you want it now. Abuse might happen easier there. Chronic pain is different. Most physicians, let alone the CDC, do not understand chronic pain patients needs. I come from a background of heavy addiction in my family. I had problems of my own in my earlier years, but I’m an adult now and capable of making my own decisions. I want to function, not be high. I think Because I take a low dose and it’s a different form, physicians aren’t as scared. But this low dose has been life saving. My pain was unbearable and still is most of the time, but at least I get some relief. I’m not asking for much, I actually didn’t ask for this prescription. I told my doctor I could not live with the pain any longer and she said wow, let’s look into this, I had no idea it was so bad. And that’s because I have a rare spinal cord condition every doctor I go to has never heard of. If I had had a doctor scared off by the CDC “guidelines” (read: effective, guised mandate) , I might not still be here. I was given more opioids after an oral surgery than for anything that actually interferes with my life. My low dose dose opioid plus some ibuprofen was more than enough. I did not need anything else. There may be other places to put in strict “guidelines” but for chronic pain patients, each with a vastly different chart and story and disorder, it doesn’t make sense. The CDC writes these guidelines are to help educate physicians on dosing and help improve communication. Then I ask why not employ continuing education credits? Or offer any sort of education rather than rules. Rules do not educate, they force and give parameters without educating on why they are that way. These “guidelines” have only served to hinder “communication” between the physician and patient, both scared to discuss or act on life saving medications. The CDC is an archaic body, slow moving, behind the ball on so much, Especially womens health. Now chronic pain patients health. Please get young blood on your panel of “experts in prescribing opioids. “	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brianna	None	None	0900006484ff6540	OBrien	None	2022-04-05T04:36:10Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from OBrien , Brianna	l1j-e563-qp5w	False	None	False	2022-04-12 05:37:01.915	[]
3820	CDC-2022-0024-3826	https://api.regulations.gov/v4/comments/CDC-2022-0024-3826	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi,I had 3 failed surgeries from a workplace accident.I have 6inch titanium rods and 6 screws in my lower back,severe nerve damage,chronic pain syndrome,DDD,etc.Back in 2001 my neurosurgeon told me I will have severe pain the rest of my life due to scar tissue and severe nerve damage.I tried different alternatives,PT,epidural steroid injections which made my pain worse.I had my pain managed well by my PCP.My PCP Dr.[name redacted] managed my pain with extended release OxyContin 80mg 2X a day with no issues whatsoever.That all changed in March of 2016 when a NP at my PCP,s office basically abandoned me.I received my regular prescriptions of BP meds,and cholesterol meds and I asked the NP about my pain medications,she told me this office doesn’t prescribe pain medications any longer.I told her I could get sick Iam 59 and could be hospitalized from complications of being abruptly cut off pain medications.So the NP gave me 2 weeks of extended release OxyContin 80mg and no referrals for a Pain Specialist doctor.I searched and found a pain specialist who immediately started to force taper me.The second month he switched me to oxycodone 15 mg pain pills.I was force tapered from 160mg a day to 60mg a day in 3 months.This was done because of the Opiod Guidelines in 2016.So now my pain medications are 4 oxycodone 15mg pills or 60mg per day.At this dosage since 2016 Iam in severe pain and basically lay on my temperpedic memory foam mattress and watch TV and read my IPAD.I asked the NP who I see on ZOOM every month if they could increase my dosage because 60mg a day doesn’t even take the edge off my pain.I see the new guidelines still have MME and 50MME as the new limit which is disgusting.Two 15mg oxycodone pain pills equal 45MME which wouldn’t relieve pain in a small animal.I do not like the updated guidelines which will cause millions of disabled intractable pain patients and wounded veterans to look for pain relief on the streets.This has to stop and let our doctors decide what dosage and what pain medications we are prescribed not the government or agencies.The guidelines should be rewritten by pain specialists,pain patients,and advocates.Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff656f	None	None	2022-04-05T04:36:55Z	Don’t Punish Pain Patients Rally	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Don’t Punish Pain Patients Rally	l1j-ewno-i4c8	False	None	False	2022-04-12 05:37:02.163	[]
3821	CDC-2022-0024-3827	https://api.regulations.gov/v4/comments/CDC-2022-0024-3827	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was a young mother of one and unfortunately my life took a horrific turn as I fell thru a ceiling and landed on a toilet. When I woke up my foot was up by my head the only thing that was keeping my leg together was skin. Fast forward 30 plus years and 8 knee surgeries. The last surgery performed at Special Surgery in NYC by The head of orthopedics Dr. [name redacted](the [personally identifiable information redacted].). This surgery was the only one done in the states the apparatus that was placed in my knee was shipped from France. The Dr. received FDA approval prior to my surgery. This surgery allowed me to walk again after many failed attempts prior. Unfortunately from all of the trauma that was placed on the knee I acquired a disease called CRPS. Because of the pain driving my Blood Pressure too high I had no choice but to take the pain medication. I still would have breakthrough pain that would leave me debilitated. My pain Doctor then introduced me to a pain medication that gave me a chance at some normalcy of life. It was the Fentanyl Lollipop and for approximately 10 years I had the same prescription 1 lollipop for each day and 3 morphine 30mg. I would still have many hours of pain. But at least when I had the worst pain I could control it with the lollipop. I didn’t have to use it all in one moment either I could take enough to get me out of pain and then save it for later. My life was not perfect but I could do everyday chores, make dinner, even golf once in a great while. The biggest relief was my Blood Pressure when it would go up to 210/157 or higher the lollipop could bring it down 95% of the time. The day the doctor came in and explained the new CDC requirements and that he could no longer prescribe the Fentanyl I was upset for I knew it was keeping me from having a stroke or worse. The next month I was in an FDA trial for a new pain relief procedure with the product neodrinate, and I ended up having a massive heart attack. I barely made it to a hospital and my widow maker was 100% clogged. Even though my life was somewhat sedentary I still was in good shape (nor over weight) I did not drink nor smoke. At the age of 51 this was a shock to my family and myself. The CRPS has increased and my Blood Pressure is off the charts. I take a healthy amount of Blood Pressure Medication and yet when the pain is bad my Blood Pressure still hits highs of 200/147 or higher. I have been on the same drug regiment minus the Fentanyl lollipop since day one. And unfortunately the medications are not enough as 4 doses does not equate to 24 hours in a day when you have chronic pain. I now spend most of my time in bed. Not by my choice but by my bodies choice. I do not understand how someone can have this cruel disease that is unbearable and there are solutions but because of bad choices from others I must be punished. Please let the dr.s do their jobs and the politicians stay out of it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff657e	Anonymous	None	2022-04-05T04:38:14Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-eyzf-0wg8	False	None	False	2022-04-12 05:37:02.406	[]
3822	CDC-2022-0024-3828	https://api.regulations.gov/v4/comments/CDC-2022-0024-3828	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My experience with opioids started back in 2004. I was involved in a car accident on 09/01/2004, while on my way to work that morning. A car pulled out in front of me and I couldn't avoid hitting it. I was doing the speed limit (55mph), and was ejected from my vehicle. I stayed in the ICU for 9 days, followed by 2-3 weeks of rehab before I got to come home. I had a cervical spinal fusion (2 pins, 6 screws) due to breaking my neck, I had 2 fractured vertebrae in my thoracic spine, and my spleen was removed due to being ruptured when I was ejected from my vehicle. And they also took a piece of bone off my right hip and ground it up to be used in the procedure on my neck. So I have scars and considerable "weak spots" all over my body. <br/><br/>Fast forward to 2022. My pain levels currently are between a 4-7 daily. Since 2004, I have not been prescribed opioids on a long term basis. For years now I've taken 800mg of Ibuprofen twice a day, which helped for a while, but at this point it doesn't do much for my pain. A year or so ago I noticed that my pain had increased dramatically. <br/><span style='padding-left: 30px'></span>Keep in mind: I'm a physically active person, I walk/jog, lift weights (safely and within my limits), and try to take care of myself. I see a chiropractor, I get massages when I can, etc. And I'm not obese.<br/><br/>I went to my Dr and told her about the increase in pain. We tried a few different things to ease the pain (meloxicam, lidocaine patches), but that didn't work. I was prescribed 5mg hydrocodone, still didn't ease the pain. Finally she prescribed 10mg hydrocodone and I started to get some relief. After I got an MRI, we found that I had ruptured two discs (L4,L5). At this point my primary care doctor had told me that I needed to go to a pain management clinic. On my first visit to the pain clinic, they lowered my dose of hydrocodone from 10mg twice a day, to 5mg broken in half and taken when needed ONCE A DAY! Needless to say, the 2.5mg dose didn't do anything to relieve my pain. I couldn't even tell I'd taken anything. And the entire time all the pain clinic tried to do was push for surgery, after I told them I didn't want to have any other surgeries. They did finally get some epidural steroid injections approved through insurance. I had one injection and the relief from it only lasted 3-4 days and my pain was right back. <br/><br/>So as of April 2022, I quit going to the pain clinic because they couldn't help me. It was just a routine of "we want you to jump through all these hoops and maybe we'll find something that works. If not, you'll have to have surgery." Not to mention I felt like an absolute junkie every time I had to ask for a refill of the 5mg hydrocodone. <br/><br/>This coming week I'm going to see my primary care doctor for the first time in almost a year. I pretty much gave up on the entire medical field being able to relieve my pain. In the meantime though, every day is a struggle. My back pain is constant. I also found out that I have spinal stenosis now, so that helps. Depression and anxiety are constant companions now, just from dealing with the pain on a daily basis and not having any relief. I've had to turn to using cannabis as a pain killer, which is not legal in my state. And I can only use it at night, because I can't be stoned at work. I'm going to see my Dr this coming week in a last ditch effort to see if she will start the 10mg hydrocodone again, because it was the only thing that has helped with the pain. I've never been an addict, I've never missed work because of painkillers, nothing. I'm responsible with prescribed meds. <br/><br/>It is absolutely ridiculous that it's so hard to get what I need for my pain though. Please change something and let the people that actually need relief, get that relief. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erik	None	None	0900006484ff660d	Gunter	None	2022-04-05T04:38:40Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Gunter, Erik	l1j-gz1y-v5fp	False	None	False	2022-04-12 05:37:02.655	[]
3823	CDC-2022-0024-3829	https://api.regulations.gov/v4/comments/CDC-2022-0024-3829	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My migraines started when I was a toddler. Yup, toddler. My mom would find me sobbing with my head pressed against anything cold in the house - bathroom tiles, kitchen tiles or especially the corner of the fridge. It was cold and sharp. I could press my head into it and make the pain dull enough to play with my toys while I leaned against it for hours. By the time I was a kid in the double digits the pain was chronic, daily, fully intractable. I’m not sure if the people reading this have ever had a migraine - it’s not just a headache. It’s a full body neurological storm. It feels like physical deaths, over and over. You lose your vision. You vomit. You shit. You sweat. Then your body tingles like you’re falling asleep. You forget words and faces. All while your nerves are on fire. Every day now. For decades as I’m in my 30s now. There are no answers no cures. And usually a doctor starts enthused, but once they realize they can’t cure you, they blame you or get bored or rude or appointments become a minute or two. And when something becomes chronic- everyone expects there to just be a day where you act “normal” again because you have to be faking. No one could actually survive all that right? Doctors don’t believe you. Family doesn’t believe you. Friends don’t believe you. Work especially doesn’t believe you. You have to do it all anyways though because you have to produce still for others and for yourself. So what does all this have to do with the CDC guidelines? It has to do with the alleviation that pain medication provided me from that massive amount of pain. When I was young, like 13, I was prescribed Vicodin for the first time. It was the first time ever pain was quieter than my wants and needs. The pain wasn’t gone but I felt I was actually a person maybe for the first time. I could think and breathe and want to exist. There is no cure for the pain that I have yet, but for some time there was an ability for doctors to give my life quality. I got a degree finally. I felt like I could contribute in my relationships because I was managing my pain, not lost to it. But the disaster that was the change to the original guidelines by Involving the DEA and their KPIs (and as many have pointed out blatantly erroneous data) on MOUD and addiction to inform decisions on the further treatment of chronic pain patients (CPP) was nothing short of necro-politic. It has been shown over and over again that there is a difference between medical opioid & synthetic opioid; and synthetic opioid is the main driver of the overdose crisis (this body itself walked back data that showed a 53% overstated stat on overuse among CPP!). A crisis pushed into overdrive by these very guidelines - by pushing this large number of CPP out of the medical complex and out of care networks giving them legal pain prescriptions to manage YEARS of pain, where were these people supposed to go? Sorry but telling us to consume cannabis is not an equivalent (if we even live in a state where it’s legal)! YOU pushed us into this crisis. Our pain doesn’t just go away because the CDC tells us that the guidelines changed. You harmed people that had nowhere to go. Who were trapped in their own bodies. These guidelines need to be updated to fix the harm perpetuated so that chronic pain patients can be brought back to their doctors and care networks, if that’s even possible at this point. Doctors are so afraid to prescribe at this point. Patients have been pushed out of legal means of care. All because of DEA and other lobbying. Those with chronic pain deserve real treatment. Chronic pain needs opioid treatment, it just does. Not much really scratches the surface of unrelenting pain. Does it need guidelines for patient safety - yes! But those guidelines should be crafted by CPP to ensure that those most effected by them are thought of in their creation. <br/><br/>But a large piece of this that also needs to be addressed is how the CDC and the DEA treat addiction. And why? Because apparently we also don’t medically treat those with addiction in this country! All I’ve now encountered by what was put in place by these guidelines is simple - “pain contracts” from “pain management clinics”: we will treat you for your horrendous condition, but only if your urine is clean”. Otherwise, you are on the street! Right? Addicts don’t deserve care per the CDC! It’s been a stark look at how we actually medically care for people - how will you craft these guidelines so that those with addiction are not left behind? <br/>Change these guidelines to actually line up with medical truth, harm reduction reality and save some lives. There are people in agony. <br/>Those in chronic pain that need your help and those in addiction that are also suffering bc of previous policy changes that also need your help. Don’t leave them behind either.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hannah	None	None	0900006484ff6633	Morand	None	2022-04-05T04:39:11Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Morand, Hannah	l1j-hosr-se9z	False	None	False	2022-04-12 05:37:02.931	[]
3824	CDC-2022-0024-3830	https://api.regulations.gov/v4/comments/CDC-2022-0024-3830	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>The Federal govt. should not be involved in the matters between a doctor and his/her patient.<br/><br/>They are trying to impose a "one size fits all" scenario, and this does not work.<br/>At the Federal level, they are trying to say that millions of patients are exactly the same.<br/><br/>My partner was diagnosed with advanced Trigeminal Neuralgia and chronic migraines about 8 years ago.<br/>Her illness has progressed and worsened since this time.<br/><br/>She quickly went from being an extremely physically active woman who loved outdoor activities to a person wracked with constant, debilitating pain.<br/><br/>In the early stages of this disease I have seen her fall to the floor crying when something as simple as a light breeze or the cold air from the food freezer hit her in the face or head.<br/><br/>The disease quickly progressed to where the pain was constant, 24/7.<br/>She has described it to me as feeling as though a red-hot fireplace poker has been pushed into her head through her ear.<br/>Her doctor went through many medications with her, some of which created horrendous side effects.<br/>He eventually prescribed her morphine sulfate in 30 milligram tablets at 3 per day as needed for the pain.<br/><br/>On many days she felt that she did not need 3 a day and would only take 1 or 2.<br/>Other days she needed all 3. And this was just to keep the pain somewhat manageable.<br/><br/>For several years she has slept downstairs on the couch because the almost constant pain prevents her from sleeping more than 2 or 3 hours hours at a time.<br/><br/>On countless mornings I have come downstairs to find her on the couch, rocking back and forth, with her fists clenched while holding the sides of her head. She is unaware that I have even entered the room.<br/><br/>In the past 5 years she has asked me about a half dozen times, in crying seriousness, to take her out to the backyard and shoot her. Later she tells me that she realizes that I would spend the rest of my life in prison if I did this for her.<br/><br/>She has mentioned suicide on another dozen occasions. It hurts me so much to see someone in so much constant pain that they would contemplate this.<br/>But seeing the pain she is experiencing all the time, I can understand why she would think this way.<br/><br/>Oh I forgot to mention this. About 6 months ago, her doctor left our town and state with about 2 months notice to his patients. He gave her the name of another doctor whom he knew from back when they were in residency together.<br/><br/>The new doctor made it plain that he would not prescribe opiates for her pain because of govt. interference and threats that he would be targeted by the DEA and other agencies, and would be at risk of losing his medical licence.<br/><br/>This meddling in doctor/patient relationship by the CDC, DEA, DoJ, top political senators and representatives of our country is beyond reprehensible.<br/><br/>Far too many respected doctors and others in the medical field have come forth and risked their own licences by disputing the guidelines being set forth by the govt. and many others; many of whom seem to have personal financial reasons for wanting to see opiates being outlawed.<br/><br/>This is a complete and utter disgrace.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rick	None	None	0900006484ff61c3	Stevens	None	2022-04-05T04:39:30Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Stevens, Rick	l1j-ipik-rw0c	False	None	False	2022-04-12 05:37:03.186	[]
3825	CDC-2022-0024-3831	https://api.regulations.gov/v4/comments/CDC-2022-0024-3831	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop the torture and war against people in pain!We are not criminals!We are humans with unfortunate injuries/illness that have caused us to need pain medication and are functional with our pain medication.Please don’t set one size fits all guidelines for pain medication.Everyone is not the same..pain differs and just because we don’t have cancer does not mean we are not in as much pain as cancer pain.Please us have back our quality of life…we only have one let us live!We don’t want to suffer in pain or die due to pain.Please drop the m.m.e guidelines and allow doctors to do their job!Please stop the discrimination against CCP’s!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6221	Anonymous	None	2022-04-05T04:39:41Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-kkc3-4qjv	False	None	False	2022-04-12 05:37:03.437	[]
3826	CDC-2022-0024-3832	https://api.regulations.gov/v4/comments/CDC-2022-0024-3832	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider this. I thought I knew what RLS was like, having watched my mother SUFFER for years. It will [profanity redacted] drive you crazy. But you cannot know it until you are in it. I have it, and it will get worse. Where is the hope of having a semi-normal life?<br/>I use weed now because I will not use the dopamine agonist again. Please give me some hope that when it gets worse, there will be something that works.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484ff6247	Young	None	2022-04-05T04:45:20Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Linda	l1j-lq5i-v8e9	False	None	False	2022-04-12 05:37:03.682	[]
3827	CDC-2022-0024-3833	https://api.regulations.gov/v4/comments/CDC-2022-0024-3833	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. I have been dealing with RLS for more than 20 years. The disease has increased in severity over that period of time. I am allergic to the Gabapentin family of drugs, normally used to treat RLS. Without my current medications; a combination of Lyrica, Belbuca (an opioid in film form) and ClonazePam. I would not be able to sleep. Literally, I would not sleep at all. My current medication of Belbuca is a substitute from 10mg. of Methadone, as that protocol lost its effectiveness, causing 4-6 hours of loss of sleep nightly. Bottom line: Without my current opioid medication I would not be able to sleep. It is important to note I do not feel any drowsiness the following day after a good nights sleep. Additionally, while dependent, I am not addicted and experience no craving for the drugs. Please understand RLS is a serious neurological disease and should be treated as such. Thank you<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Myron	None	None	0900006484ff624d	Blackman	None	2022-04-05T04:45:35Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Blackman, Myron	l1j-lxxc-6ygp	False	None	False	2022-04-12 05:37:03.930	[]
3828	CDC-2022-0024-3834	https://api.regulations.gov/v4/comments/CDC-2022-0024-3834	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I'm a 58 years old female. I am a mother of 2 grown sons, I've been married for 36 years and I'm a licensed nail technician. I have suffered from RLS for over half my life. It most definitely has worsened over the years. My RLS not only attacks my legs, it will crawl up my arms into my neck also. Untreated my RLS would be a daily event, usually lasting from 3-8 hours. Treated I have 1-2 breakthroughs weekly, lasting 1-3 hours. I've been under a doctors care for RLS for more than ten years. I have been on countless medications including Opioid medications, anti-seizure medications, herbal products and even hocus-pocus treatments all in a desperate search of relief, rest and sleep. Unfortunately the Opioid Crisis and new regulations are now preventing doctors from prescribing Opioid medications for those who truly NEED it for RLS treatment! I am now forced to take a drug that was originally approved for Parkinson's Disease. I DO NOT HAVE PARKINSON'S! It causes me involuntary hand movements, the feeling of be confused, the feeling of my head being in a cloud. It causes me muscles pain, weakness, water retention. It's also known to cause addiction to gambling, food, sex and overspending. WHY? Why do I have to be on this drug when a property managed Opioid treatment is as an affective treatment for me? Because it's the only thing that works and my doctor feels comfortable prescribing after all the new regulations went into affect. This medication is toxic to me! My life is in shambles, and it wasn't before taking this medication!!!! But I can't live without it! My RLS would literally drive me insane. If you have Never experienced it, you simply can't understand it. I honestly wish there were words that could give you an actual physical event of RLS, but there isn't. There are NO words that can describe how debilitating this syndrome is without physically experiencing RLS on a daily basis. Please consider the use of Opioid medications for treatment of RLS. So those that truly benefit from Opioid drugs can be on a properly managed treatment plan that is worked out between the patient and their doctor. Please give our doctors the tools they need to successfully treat their patients with severe RLS. Thank you for your time in reading my story.<br/><br/>Best Regards,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006484ff6254	Fitzgerald	None	2022-04-05T04:45:53Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Fitzgerald, Sandra	l1j-m91m-6qkh	False	None	False	2022-04-12 05:37:04.218	[]
3829	CDC-2022-0024-3835	https://api.regulations.gov/v4/comments/CDC-2022-0024-3835	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has a back injury from work occuring about 17 years ago. He has been unable to work since that time. He has been on Oxycodone 10 mg 3x/day for approx. 10 years. He has never taken any more than he was prescribed of this drug. There is a great problem in obtaining this prescription from our local pharmacy. <br/><br/>You must physically see the doctor every 4 weeks to pick up the prescription and physically take it to the pharmacy. (Only just in the last few months is the doctor able to submit the prescription electronically.)<br/><br/>The pharmacy can only refill this prescription every 28 days. You have to plan any time away from home around your doctor visit and prescription availability. Also, recently, several of the pharmacies in our county have not had the drug, nor in another county where we have a friend who takes the meds, too. It is very scary to be without your pain pills for even a day or two.<br/><br/>It would be ideal to be able to get a 90-day prescription for this med. Having said that, I realize that there are many people overdosing on this medication. However, it seems that there have been many doctors found out to be prescribing this drug illegally and the authorities are aware of them. <br/><br/>Thanks for your concern and for taking comments on this issue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joyce	None	None	0900006484ff6670	Buhler	None	2022-04-05T04:46:07Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Buhler, Joyce	l1j-mtyb-3men	False	None	False	2022-04-12 05:37:04.472	[]
3830	CDC-2022-0024-3836	https://api.regulations.gov/v4/comments/CDC-2022-0024-3836	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include low-total-daily dose opioids must be included as a viable treatment option for RLS patients. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Harold	None	None	0900006484ff6673	Faulkner	None	2022-04-05T04:46:15Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Faulkner, Harold	l1j-mw3q-vbc5	False	None	False	2022-04-12 05:37:04.721	[]
3831	CDC-2022-0024-3837	https://api.regulations.gov/v4/comments/CDC-2022-0024-3837	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 70-year-old married woman, mother of five, grandmother of four, living in central Pennsylvania. I am retired after 40 years as a secretary.<br/><br/>With no apparent “cause,” I began suffering with severe pain in my neck and shoulders about 25 years ago. My doctor at the time put me through a rigorous series of tests before compassionately prescribing Hydrocodone. I was on this drug for about 20 years, at a dose of 7.5mg twice daily. It allowed me to resume a normal life, one in which I didn’t lose full days to incapacitating pain. During those nearly-two decades I never sought an increase in dosage. The plain fact was that it worked, with no obvious ill effect.<br/><br/>Time passed, my doctor retired. His replacement continued to work with me, and even prescribed a very limited supply of lower-dose hydrocodone pills for the inevitable “breakthrough pain” which occurred randomly and, thankfully, rarely. Then this provider moved on, and my care fell to other, newer practitioners who apparently took the new opioid guidelines as a threat to their livelihood. At one time a provider literally put her hand up in the face of my request and told me in no uncertain terms that she could not help me with that beyond referral to the local pain clinic.<br/><br/>At this time, Pennsylvania authorized the use of medical marijuana. Although I was a child of the 60s, I had never experimented with any drugs, but was intrigued by the notion of a more “natural” medicine. I’m sure it amused the worldly dispensary employees when I requested, at my initial interview, no psychoactive results from the drugs. They directed me to an appropriate product, which helped initially. But I could never achieve the pain relief I needed. At one time a dispensary employee told me that I would probably have to get a bit high to realize that pain relief; I did not increase my dosage. Although I continue to use these products, they are indeed not as effective for me.<br/><br/>Soon I contacted the pain clinic and fell into their typical routine of trying different treatments until you find one that works. Trigger point injections brought some short-lived relief. We moved onto RFA (radiofrequency ablation), a process in which the sheath of various nerves is systematically burned away, thereby interrupting the pain messages my body sent out. That was painful, and had a medieval aspect to it that just didn’t seem wise to continue. And so we have moved on to Botox injections. My first experience with this brought me an initial few days of quasi-relief, followed by a 12-hour siege of the worst pain I have ever known in my life. If you are familiar with the “pain faces” chart that is used to gauge the level of one’s pain on a scale of 1-to-10, this was a full-blown 12, and it was relentless for 12 hours. I was reduced to tears, and could not perform any everyday mental or physical tasks well. Although not quite as intense, the following weeks have been filled with enough pain to prevent me doing everyday chores such as folding laundry, running the vacuum sweeper, or emptying the dishwasher. This is a terrible decline in my quality of life.<br/><br/>Along the way over these years, I have tried virtually every suggested form of pain relief: acupuncture, massage, surgical fusion of two vertebrae in my cervical spine, reiki, physical therapy, yoga, muscle relaxers, OTC pain relievers, chiropractic, deep breathing, CBD, medical cannabis, heat therapy, ice therapy, and distraction. I use a TENS unit (transcutaneous electrical nerve stimulation) and a TheraCane. One major obstacle to some of these therapies is the cost, which is denied by insurance. <br/><br/>As a diagnostic tool, I have even endured two nerve conduction tests. This is a truly archaic procedure in which multiple needles are inserted into many areas of your skin surface; these are then mildly electrified to judge how well your nerves are conducting messages. In short, I have been an agreeable patient and have abided by all of the rules.<br/><br/>What threat to society is a 70-year-old woman who is on a constant low-dose of opioids for decades? The answer is: None. None whatsoever. What I have been subjected to in my later years, in terms of the general refusal to treat my chronic and well-documented pain, except invasively (and incompletely), is plainly a failure of the medical establishment – pushed by government strictures – to offer the type of pain relief to which I am entitled.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anna Marie	None	None	0900006484ff6675	Harshman	None	2022-04-05T04:46:54Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Harshman, Anna Marie	l1j-mwan-plg6	False	None	False	2022-04-12 05:37:04.963	[]
3832	CDC-2022-0024-3838	https://api.regulations.gov/v4/comments/CDC-2022-0024-3838	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless Leg Syndrome (RLS) is a chronic condition that can suck the joy out of life. I know. I have suffered from it for 30 years. My legs throb at night and sleep is often hours in coming. And sometimes it doesn't. <br/><br/>There are a number of medications on the market but most, like Ropinirole, to treat the symptoms, but they can cause augmentation that requires increasing dosage until the medication has to be stopped, which is its own kind of horror. <br/><br/>Low total daily dose opioids appear to be a long term treatment. The dosage is low enough not to cause problems with every day activities yet the dosagedoes not appear to have to be increased in time. I would ask that you allow doctors to have opioids in their arsenal of medications to combat RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martin	None	None	0900006484ff6686	Johnson	None	2022-04-05T04:47:02Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Martin	l1j-n6ek-929x	False	None	False	2022-04-12 05:37:05.250	[]
3833	CDC-2022-0024-3839	https://api.regulations.gov/v4/comments/CDC-2022-0024-3839	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[name redacted] 65 yrs old<br/>I have been taking hydrocodone since 2007 for back pain, at the time the doctors said it was degenerative disc disease. Then in 2008 I was diagnosed with Crohn`s disease, in 2015 diagnosed with axial spondyloarthropathy. I also have carpal tunnel disease and an abdominal aortic aneurysm (no pain from this). My back, shoulders, neck, ankles, feet, wrists, hands and knees are in constant or frequent pain. The doctors increased my dosage to 6 hydrocone a day over the years, which was working pretty good for me. I also had many injections and ablations in my back that didn't work for more than a few days, and didn't offer any relief to my other pain points. Then they cut me back to 4 a day and my life has been miserable since. The doctors added 2 subutex also but that increased my anxiety so now I take at least 2 klonopin a day instead of 1. And I have to go to the pain care doctor every month to get my pills, give a urine test, and get set up for another injection if they think I need it. Also, I have tried many of the biologics, Humira, Enbrel, Remicade... and am currently trying Cimzia. I also tried CBD, physical therapy, and acupuncture. So far no relief except from the hydrocodone. Since they cut me back I lay down a lot during the day where before I used to be active. I take the hydrocodone and subutex as directed, and I don't do illicit drugs. I would like to get my quality of life back, I have never had a problem with the hydrocodone and look forward to going back to 6 a day. My whole life seems to revolve around the pain care doctors while I am still in horrible pain every day. I can't even make a salad without having to take a break to stretch my back out. I gave up gardening for the most part because of the pain ( I have a couple pepper and tomato plants in pots). Anyway, I would love to see the CDC let the doctors decide who gets what and how many. <br/>Thank you,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484ff6695	McLeod	None	2022-04-05T04:47:41Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from McLeod, John	l1j-noke-bnq1	False	None	False	2022-04-12 05:37:05.533	[]
3834	CDC-2022-0024-3840	https://api.regulations.gov/v4/comments/CDC-2022-0024-3840	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	"TIME BECOMES A LOOP:<br/>This hole mess of "Pain Management" OR shall I say "LACK OF PAIN MANAGEMENT" FORCING PROCEDURES ON PATIENTS. Because they can MAKE YOU AND NOT EVEN CARE WHAT DAMAGE IT CAN CAUSE, Thinking how much MORE MONEY THEY CAN MAKE BY FORCING PROCEDURES ON PATIENTS All the while making EVEN MORE MONEY FROM FORCING PROCEDURES ON PATIENTS THAT ALREADY BEEN THERE.By the way these procedures are not FDA Approved FOR BACK PAIN, Yet We are forced too Have this Done. THE LAST ONE I HAD, PUT ME IN THE ER AND THEN ADMITTED INPATIENT FOR 5 DAYS, The PAIN IS UNREAL.<br/> In the 1950s and 1960s a wonder drug called Cortisone Was Widely Used, Doctors felt like heroes because patients were so grateful Corticosteroids worked like magic. It Took quite awhile before they realized they were playing with FIRE, as side effects of long-term,high dose corticosteroid use include weight gain, cataracts, glaucoma increased susceptibility to infections, elevated blood pressure, fluid retention potassium loss, stomach ulcers, blood clots, irregular heart rhythms, osteoporosis, headaches thin skin, impaired wound healing, menstrual disturbances, moon face,Diabetes, muscle weakness and loss, bone deterioration spontaneous fractures, insomnia, irritability, fatigue, and "Steroid Psychosis"<br/> THEN CAME NSAIDS...<br/> Doctors hailed each new NSAID as it became available. <br/> As many as Half the patients taking NSAIDS regularly experience heartburn nausea, abdominal pain or ulceration. Many end up with Sores in their digestive tracts without warning symptoms. Lesions can become bleeding or perforated ulcers, which can be life threatening. More than 100,000 People are hospitalized each year because of such complications, and more than 16,000 PEOPLE DIED, These also can raise blood pressure, alter heart rhythm, cause fluid retention, dizziness, tinnitus, visual problems, headaches depression, trigger skin reactions or put a strain on the KIDNEYS NSAIDS Also interact with many other medications <br/> Then we have COX-2 INHIBITORS. Of course the Commercials for these DRUGS, giving people false Hope, of being able to LIVE AGAIN, VIOXX was taken off the market, estimated as many as 139,000 Americans may have suffered a HEART ATTACK or STROKE a Side Effect of VIOXX.<br/> Gabapentin OFF LABEL USE should be ILLEGAL as it IS Unethical to FORCE PATIENTS TO TAKE THIS RISKY DRUG. FDA APPROVED for Partial Seizures, Posterpetic Neuralgia.<br/><br/> ONE SIZE FITS ALL DOES NOT COMPUTE.<br/> There has to be something that will HELP PAIN PATIENTS FEEL BETTER, NOT WORSE...LIKE... I DON'T KNOW... MAYBE AN ANALGESIC<br/>MEDICATION... DOH!!!<br/><br/> SEEMS LIKE THE OPIOID GUIDELINES FROM 2016 HAD DONE ITS JOB SO MANY PATIENTS WITH SEVERE PAIN HAD KILLED THEMSELVES ALREADY. THE NUMBER IS STAGGERING.YET. STILL CONTINUES, As many of US ARE STILL HANGING IN THERE, WHICH SEEMS FUTILE. WE NEED HELP PAIN IS REAL <br/><br/> NOT TO MENTION WE IN PAIN CAN NOT REALLY "Have a Rally/Protest/March on the steps of JUSTICE... WE CANNOT MAKE IT TO THE GROCERY STORE To get necessary staples and supplies WITHOUT CAUSING FLARE-UPS. HOW CAN WE PROTEST WHEN IT'S HARD TO MAKE THROUGH A DAY...AT HOME.<br/><br/> MORTALITY RATES ARE INCREASING THIS MODERN WAY OF DEPOPULATION,FORCING INTRACTABLE PAIN PATIENTS TO KILL ONESELF IS A SAD STATE OF WORLD WE LIVE IN. MONEY MONEY MONEY F U PEOPLE WHO ARE SUFFERING...<br/><br/> SHOWS THE WRONG MESSAGE... WE CARE MORE ABOUT JUNKIES THAN WE DO PEOPLE THAT ARE TRYING TOO BETTER WITH THEIR LIVES <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484ff66ad	Young	None	2022-04-05T04:48:18Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Robert	l1j-o1dk-d88y	False	None	False	2022-04-12 05:37:05.817	[]
3835	CDC-2022-0024-3841	https://api.regulations.gov/v4/comments/CDC-2022-0024-3841	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fred	None	None	0900006484ff66ca	Brown	None	2022-04-05T04:50:29Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Fred	l1j-ojlo-54pk	False	None	False	2022-04-12 05:37:06.195	[]
3836	CDC-2022-0024-3842	https://api.regulations.gov/v4/comments/CDC-2022-0024-3842	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings. I have been disabled for 24 years from a rear end collision by a tractor trailer. This left me with a broken neck. Nerve damage. Herniated disk in my low back . Migraine headaches and vertigo. I know live with 7 pieces of titanium in my neck from the surgery I went through after I got hit. I have to been to many doctors and was a patient at mass general hospital. After finally figuring out what was wrong. Yhey sent me back to my pain doctor with new ways to treat me. After trying many different typse of meds. My doctor found 2 meds that worked pretty good for me. I was able to go back to work and try to live a halfway decent life again. I was doing fine until the CDC set out new guidelines cor doctors to follow. My meds were cut by more than half. Ever since then. I've had a hard time finding a steady job. I can't go out like I use to. And Im missing a lot of family functions. I slowly adjusted and tried to get out and stay involved with my family. Then all of a sudden out of nowhere. My doctor tells me. I have to taper down and start taking suboxone. I didn't understand why after 23 years with this doctor. He changed his ways of treating his patients. When I asked why are you doing this. Did I do something wrong? I have never failed a test. Im a good patient that has suffered trauma and went through surgery because of it. Changing my meds is going to be the wrong thing for me. After asking a few people I found out the place I at is protecting themselves. I thought they were suppose to help me. Not steer me down the wrong road. Then as I read some more. I see these reports from the AMA and the CDC saying the guidelines are wrong and they didn't do what they thought it would do. The doctors are being bullied by the DEA and are now in fear of the DEA. When I looked to see who wrote the new guidelines for Doctors to follow on how to treat their patients with pain meds was a Chiropractor.... A CHIROPRACTOR ??? Is this cor real ?? A person who isn't even a MD gave you these new guidelines ??? They aren't even qualified to write out meds cor people. And they made this the new guidelines?? Well I wouldn't go to the dentist if my arm hurts. How could let some back Cracker make you think they knew what they were talking about. Now because of this. So many chronic pain patients have either died. Taken their own lives because they can no longer get the medications that kept them alive and going. Or have become stuck in their homes because they can hardly move. I know I have so many bad days where I have to wear this big hard plastic looking shell for my back. I also have a special type of neck brace that inflates so my neck stays stable. These bad days are becoming more prevalent sin e my dose my got cut. What happen to taking care of our people Our Citizens who worked so hard to make this Country the great place that it is. Now our government turns its back on us and just us to try and live with this awful pain. We need some real help and we need it right now. There is no reason why these guidelines can't be revised. And not another ex use that it takes time. No it doesn't. The proof is right there. The numbers are all right there. Why are the government politicians looming out cor us. Why are we being thrown to the wolves and called awful names. We don't like living like this. We just want to live a halfway decent life and maybe get some relief from our pain. We would love to have a nice comfortable day too.. Please help us. We all put.in the hours. Paid our taxes. Paid our bills. When do we get a good day again ?<br/>We matter too !!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff66d4	Anonymous	None	2022-04-05T04:51:00Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-p8kp-9bxx	False	None	False	2022-04-12 05:37:06.495	[]
3837	CDC-2022-0024-3843	https://api.regulations.gov/v4/comments/CDC-2022-0024-3843	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom this may regard:<br/><br/>The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe, and have extensive clinical and cost-effectiveness data.<br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of Dr. [name redacted]’s own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. <br/>Sincerely, <br/><br/>[name redacted] MD<br/>Board Certified Anesthesiologist and Pain Medicine Specialist	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Taufiq	None	None	0900006484ff66d9	Ahmed	None	2022-04-05T04:55:17Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Ahmed, Taufiq	l1j-pc36-0764	False	None	False	2022-04-12 05:37:06.765	[]
3838	CDC-2022-0024-3844	https://api.regulations.gov/v4/comments/CDC-2022-0024-3844	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	April 3 2022,<br/><br/>I am not using my name because of the potential of unfavorable actions to me, my family and doctors. I will be 77 years old in July and I have had three personal doctors. My first doctor I was from the age of five or six to my mid to late 20s. That doctor prescribed pain pills for me for lower back and leg area pain. My next doctor would have been from my late 20s to about 3 years ago. I remember having an MRI way back then and I remember being told that I had spondylitis at L5 S1. I don’t really know what that meant but I do know that I had terrible pain from it. The pain was in my back and down my legs and butt area. The pain down my legs is called sciatica. The pain was always there but it would get worse at times and throughout that period I took pain pills. I would get relief from them and so I was able to function. In my late 20s I opened my own business and did that for just about 30 years. My business was very successful and a huge part of my success was being able to function because of the medicine I took. During that period of time of my first business I employed around 20 employees.<br/><br/>I closed that business in the year of 2000 and after a brief time I opened my second business. I operated that business for 20 years. I was the sole owner of that business and it’s only employee. I worked that business totally on my own and when I needed help I would contract a person to give me a hand or a company to give me a hand. That also was a successful business and in order to function I took pain pills. I took a time out when I closed that business in 2020 but I decided retirement wasn’t for me. I am now working again now with my son. I am working an average of three days a week and my medicine allows me to work.<br/><br/>Reflecting 50 or so years I have been able to have a good life. I was able to do that with the aid of medicine. The pain is always there and at times it’s not too bad and other times it is terrible. I have discussed getting an operation or operations with my second and third doctors and we have agreed if I can still function in a way that I am productive and can live a normal life that’s what I will do. I will not get an operation. I know there are lots of people much worse than I am in their physical situation but I also know there is no guarantee that an operation will fix me. <br/><br/>Two things I forgot to mention are number one, I have had quite a few spine shots that were done over a 40 year period with results ranging from fair to good. Secondly the doctor I had from 30 something years old to 50 something years old prescribed oxyContin and I took it for two or three years with good results but I decided I did not need a medicine that was as powerful as it was. I decided on my own without outside influence including doctor or family to quit taking Oxycontin and switched back to Tylenol 4. After a while the doctor and I decided I had a tolerance to that drug and I switched to oxycodone.<br/>Taking that medicine allows me to have a good physical life.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff66e2	Anonymous	None	2022-04-05T04:55:31Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-phqb-pa48	False	None	False	2022-04-12 05:37:07.046	[]
3839	CDC-2022-0024-3845	https://api.regulations.gov/v4/comments/CDC-2022-0024-3845	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in constant pain. As if that isn't hard enough, I also need to live with the constant threat of losing the small amount of relief I am afforded. I am one of the lucky ones. I still have a physician willing to treat me. The treatment I receive is nowhere near adequate. Because of cdc guidelines and rampant anti-opioid hysteria, my access to any medications is limited, forcing me to pick and choose when I get bits of respite from the grinding agony. I am never able to get any level of control over the symptoms because I am unable to treat them aggressively enough. My treatment has been repeatedly disrupted at every level. If my doctor retires, I am at risk of losing treatment. My pharmacy is often unable to get my meds because of government regulatory enforced shortages, but rules also make it impossible for me to take my scripts to alternative pharmacies. Patients like me are constantly losing treatment because we're getting caught in these fault lines in the system, and it's costing us our lives. Literally. And these fault lines aren't systemic flaws, but rather purposeful features that are meant to make it harder for patients to access pain control. And when you live with intractable pain, loss of pain control is life threatening. The problems of addiction are not more important than the lives of people in chronic pain. Allow doctors to treat patients without interference.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Naomi	None	None	0900006484ff66f3	Rogosin	None	2022-04-05T04:57:03Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Rogosin, Naomi	l1j-py0x-9e6g	False	None	False	2022-04-12 05:37:07.316	[]
3840	CDC-2022-0024-3846	https://api.regulations.gov/v4/comments/CDC-2022-0024-3846	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am a 36 year old mother to an amazing 11 year old boy. Im married to a wonderful man. I was born and raised in the suburbs of Chicago. Although I never graduated college I took courses in CNA and phlebotomy and was an orthodontist assistant which I loved. On the outside people would think I have a picture perfect life. I live in a nice home, I have good friends and a mother who will go to hell and back for me. On the inside I feel like I am slowly dying a miserable suffering death. I was first diagnosed with scoliosis at the age of 12. I refused to get braced for my scoliosis because I already got bullied for being overweight. I couldn’t even imagine wearing a brace. At 17 I was diagnosed with a condition called linear morphea which lead me to see my first rheumatologist. They diagnosed me with antiphosphid lipid antibody but not the syndrome. I need to have a stroke, blood clot, heart attack or miss carriage in order to have the syndrome. At 25 I had my son. Slowly my body started falling apart after. In 2013 I had bilateral torn labrum’s in my hips. I had to get repaired with surgery. Following my hip “repair” I had my spine fusion for my scoliosis because my spine had shifted from 30 to 58 in only a few years. I was fused from t-12 to l4 and nightmare really started. Surgery after surgery. I was cut open 6 times in my spine in less than 2 years. I had to get a revision because I did not fuse. Then 3 back to back infections of osteomyelitis. Followed with removal of my hardware in 2015 because of the infections. After all my surgeries I was told by multiple rheumatologist that I looked to healthy to be sick with anything. Until my labs came back. I was diagnosed with lupus rheumatoid arthritis. I suffer with lupus flares but nothing compares to the fact that after 2 years of back surgeries my spine has shifted and is right where i started. The pain is unexplainable. Herniated the whole way down and impinging on nerves. My body rejects metal because I had a ring called the linx put on my esophagus to prevent acid and I had to get it removed. Now I have eosinophilic esophagitis with no motility in my throat. I see multiple doctors every other day. My quality of life is horrible. I was with a pain doctor for 10 years. Things where good. I was getting injections every month. And although the steroid injections didn’t help I felt the doctor would not want to continue to see me it I wasn’t getting them, as he made that perfectly clear to me. 10 years of steroid injections in my spine now I have osteoporosis and osteoarthritis. One day I went in to see my pain doctor and was told they would be cutting my meds by more than 50 percent. No mention prior. It was brutal. The things I was once able to do with my family I can’t do anymore. Living a “normal” life. Even though my life is anything but normal the medication atleast helps me live a semi decent normal life. All of that ripped out from under you as if someone is saying “you don’t matter” the dea CDC and whoever else seems more concerned about controlling peoples life than they do helping people. Nobody is helping us. I feel like I’m drowning. But it’s either take the 50 percent cut in meds or be ready to kill your self. So I decided to take the 50%+ cut. Knowing at any given visit he will cut it again without warning. He cut me again. That’s when I told my pain therapist I needed a new doctor And thankfully I did because Because he certainly didn’t care about my quality of life or anyone else at his practice because everyone was being cut more than half. It’s no longer treating the patient. It’s fear of losing your license for practicing. Do you care that I can’t cook dinner for my family. Or do laundry. Or wash my floors or go on a walk. Or do yard work or really anything physical. Of course not because it’s not your life. They say try this. This will help your pain .Lose weight. They say do physical therapy, get injections, try massages, heat, ice, anti inflammatories, working out,other medications (non narcotics) patches. When you do it all and you still are suffering. I need more surgery but nothing is promised. Wether it will help or not. I feel like I get tossed around. All judgmental doctors for being on pain meds. What chronic pain patients go through.. I would never wish this on a worse enemy and I’m not even talking about the pain. And until you have dealt with chronic unrelenting pain 24/7 365 you really won’t know, understand or have any empathy what so ever. So if the CDC DEA or whoever else wants to keep cutting a life line for us who suffer I pray you will never be in pain that is so deep, so severe so constant, that It stops you from living any sort of life or what life we have left. I shouldn’t have to be dying to get pain relief or to enjoy a nice day with my son without going to lay down. I know life isn’t fair. But it shouldn’t be this miserable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff66fa	Anonymous	None	2022-04-05T04:58:01Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-q3r2-xwsu	False	None	False	2022-04-12 05:37:07.600	[]
3841	CDC-2022-0024-3847	https://api.regulations.gov/v4/comments/CDC-2022-0024-3847	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Multiple ruptured discs in my neck and back from work related injuries. Chronic migraines, CDifficile, severe bacterial infection from incompetent forced tapering. <br/><br/>In 2017 my pain management practice of 25yrs closed suddenly and without warning so I had to find a new pain management doctor. In the next few years every pain management practice that I started care with closed, one after the other. In the few months that I spent with each practice they would forcibly taper me against my will. Not one of these Pain Management doctors appeared to have any experience or knowledge about the method and risks of force tapering chronic pain patients. The result was severe withdrawal symptoms, one of which was severe diarrhea. This went on until 2020 when I was diagnosed with Cdifficile, a very unrelenting, deadly bacteria that I am now unable to recover from. Not only was I suffering from severe chronic pain as they continued to force taper me, but now as a result my body had to also fight a very dangerous and lethal bacteria. <br/>Not one of those pain management doctors cared that the force tapering was causing my severe chronic pain to now be uncontrolled and merciless. They said “this is THE LAW now, we have NO choice, these are the CDC Guidelines and we MUST follow them.” They also didn’t bat an eye about the fact that as a result of the force tapering my health was circling the drain. <br/>I’ve had a transplant (FMT) at Mass General for the Cdiff, and STILL my current pain management doctor is telling me they will begin force tapering again until I get down to 50MME. He is saying that “50MME is now the law”and he has no choice but to comply. He also says that even if the state did not require the 50MME he would still have to comply or the DEA will take his license!!!<br/>So due to the “CDC Guidelines” that are being followed as though they are the law now he says that “all of the chronic pain patients must be forcibly tapered down to ZERO opioids! It’s the new law directly from the CDC.” <br/>PLEASE REMOVE THE MME LIMIT AS I’M SURE YOU KNOW THAT THE SUDDEN RISE IN SUICIDES AMONG CHRONIC PAIN PATIENTS IS ON YOUR HANDS. <br/>It’s time to actually treat patients pain rather than torture them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6706	Anonymous	None	2022-04-05T04:58:19Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-qe4g-lv7p	False	None	False	2022-04-12 05:37:07.881	[]
3842	CDC-2022-0024-3848	https://api.regulations.gov/v4/comments/CDC-2022-0024-3848	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was force tapered to nothing for pain. I no longer feel like anyone cares or has my back. Any trust in doctors or psychiatrists has been irrevocably damaged. Not only did these decisions hurt chronic pain patients by taking away their ability to function, it has also hurt in terms of getting mental health help. I have anxiety disorder and they took away my small dose benzodiazepine when they took my pain medication. Quit punishing me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6707	Anonymous	None	2022-04-05T04:58:34Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-qeex-qdnz	False	None	False	2022-04-12 05:37:08.145	[]
3843	CDC-2022-0024-3849	https://api.regulations.gov/v4/comments/CDC-2022-0024-3849	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The authors of the CDC 2016 Guidelines acknowledge that the evidence used to create their recommendations on opioid tapering was limited to 1 trial. This begs the question, why would the committee limit the data-set to a singular study? The committee also fails to identify which study was used for the basis of their recommendations. Despite the severe limitations of the data regarding the tapering of patients off opioid based <br/>medications, the authors dedicate the majority of the 2022 Opioid Prescribing <br/>Guidelines to this topic. Additionally, the authors continuous use of their own research <br/>throughout the report lends concerns to whether or not the "one study" used is also <br/>their own work. The CDC needs to provide the pubic a citation for the study used to <br/>create these recommendations given their serious impact on the public's health and <br/>well-being.<br/>The authors attempt to create individualized guidance for a variety of painful <br/>conditions. Yet, upon review of the recommendations made, the authors take the <br/>same generalist approach towards all conditions with a focus on the use of non-opioid <br/>and non-pharmacological treatments instead of opioid-based medications. Oftentimes <br/>making unproven and/or contradictory statements about their efficacy. The authors acknowledge there is a lack of data on the harms of non-pharmacological <br/>therapies. Yet, despite this admittance, they repeatedly made ascertains that "there is <br/>no evidence of harms." Once again we see the authors contradicting themselves and <br/>inserting their personal opinions (bias) instead. The authors have no right to make <br/>claims of "no evidence of harms" when there have not been any studies on the <br/>outcomes. As a patient and an advocate, we come across people every day who have <br/>experienced great harms from a number of non-opioid and/or non-pharmacological <br/>modalities. While the authors claims not to support or encourage the use of a step-therapy <br/>approach to pain management, it is clear that the application the recommendations <br/>being made do effectively put patients through a step-therapy process in managing <br/>their pain and accessing certain modalities. When we use the step-therapy approach <br/>to managing illness/injury/pain we risk leaving patients in limbo with woefully <br/>inadequate pain care while enduring severe, inhumane suffering as they try and fail <br/>different steps.<br/>Most if not ALL of the 140+ MILLION Chronic Pain Patients have "Run-the-Gauntlet" of step therapy to no avail of pain relief. <br/>Myself as an example: I have done everything my doctors have asked of me. Physical Therapy, Aroma therapy, Mental therapy, Better Nutrition, and I was already doing the Herbal remedies. What has been PROVEN TO WORK: Long Tern Opioid Therapy + Physical Therapy + Good Nutrition. <br/>Since the 2016 opioid prescribing guidelines I've been denied the Opioid Therapy that Allows me to participate in Physical Therapy. Due to not having 2 out of the 3 of what works for me individually. My health and life have gone to [profanity redacted]. I'm existing in constant suffering. I have level 10 days that cause Atrial Fabulation, High Stroke Level Blood Pressure, Migraines, Vomiting, system widespread "Only the dead know peace" level of Pain.<br/>Please know that while you enjoy the profits you receive from the suffering you knowingly caused there are people out here in the "real world" committing suicide from being forced to live in constant agony. There Blood is on your hands.<br/>The options of a Chronic Pain Patient are 1) turn to street drugs 2) Suffer in Constant Agony 3) Suicide. Many have committed suicide since what's on the street is either Buprenorphine which does NOTHING FOR PAIN or Illicit fentanyl Laced anything that would lead to death.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff62d2	Anonymous	None	2022-04-05T05:02:59Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-t336-p1nu	False	None	False	2022-04-12 05:37:08.426	[]
3844	CDC-2022-0024-3850	https://api.regulations.gov/v4/comments/CDC-2022-0024-3850	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	DONT MEAN TO OFFEND BUT WTF IS WRONG WITH THIS. JUST ABOUT EVERYTHING. HAS ANYONE OF U EVER BROKEN A BONE. JUST THINK OF THAT MUCH PAIN EVERY MORNING WHEN U WAKE. THE FIRST THOUGHT EVERY [profanity redacted] DAY. SO WHEN I WAKE UP, I HAVE TO TAKE ONE TEN MG OXY ONE NORTRIPLINE AND ONE LYRICA. THEN I CURL UP IN A BALL OF PAIN FOR ONE HOUR. SINCE IM IN TO MUCH PAIN TO GET OUT OF BED. SO AT 7 AM. I TAKE ONE MORE 10 MG OXY ONE MORE NORTRIPTLINE AND ONE MORE LYRICA. WAIT ANOTHER HOUR THEN GET UP AND SHOWER. SO BY THEN ITS NINE OCLOCK AM. SINCE IM STILL AT A SIX ON A PAIN CHART. THEN I HAVE TO TRY AND DO WHAT EVER I HAVE TO DO LIKE GO TO A DOCTORS APP. OR GO TO WALMART AND LET THEM PUT MY FOOD IN MY CAR, SINCE I HURT TO BAD TO GO SHOPPING. IM STILL HAVE TO WAIT TILL 5 PM. TO TAKE MY LAST DOSE. BY EIGHT PM. WHICH IS RIGHT AS IM WRITING THIS IM HAVING SOME KIND OF ELECTRIC SHOCK STATING AT MY TALE BONE THROUGH MY GROIN AND [profanity redacted] DOWN THE BACK OF MY LEGS DOWN TO MY FEET. NOW MY FEET BURN ON THE BOTTOM. THEY HURT 24/7 I HAVE A HARD TIME WALKING FOR THE PAIN. THATS WHERE UR 50 MMES GETS ME. IM NEVER EVEN CLOSE TO BEING PAIN FREE. IM NOT EVEN ASKING TO BE WITHOUT PAIN. I WOULD JUST LIKE TO FORGET ABOUT FOR AN HOUR OR 2. IS THAT ASKING TO MUCH. WITH UR 50 MMES ANYWHERE IN UR G.L. THE PEOPLE TAKING 90 MMES WILL BE CUT BACK TO 50. TAKE THE 50 MMES OFF THE G.L. IF U DONT TAKE OFF THE 50 MMES DO U KNOW HOW MANY PEOPLE THAT WILL DIE BY THERE OWN HANDS. UR NOT STOPING DRUG ADDICTS. I REPEAT THIS IS A FACT DRUG ADDICTS WILL BECOME DRUG ADDICTS NO MATTER WHAT U OR I DO.. PLEASE REMOVE THE MMES. PLEASE REMOVE THE 50 MMES. I HAVE HAD MY NERVES INBLAZED. THATS WHAT GAVE ME THE ELECTRIC SHOCKS. NEVER LET ANYBODY POKE UR SPINE.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6778	Anonymous	None	2022-04-05T05:04:23Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1k-24l8-1574	False	None	False	2022-04-12 05:37:08.710	[]
3845	CDC-2022-0024-3851	https://api.regulations.gov/v4/comments/CDC-2022-0024-3851	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 68 year old male former high school athlete and formerly active adult. my life change late in 2008 when I was involved in a rear end collision in front of Arrowhead stadium (go Chiefs) resulting in a 360' back surgery, followed by two additional back surgeries, and two neck surgeries. My body continued to betray me as I have also had three shoulder, two stomach , two hip, three knee including both knees replaced, an ankle, and an arm among my 17 surgeries. Needles to say, I have pain somewhere on my body daily. Imagine waking up, not knowing what exactly will cause me pain today, but I will know as soon as my feet hit the ground, also realizing I will not feel any better today, my current dosing regimen not totally relieving my pain issues. My regimen was disrupted due to the 2016 CDC prescribing guideline, not because it was medically necessary or better for me, as my pain specialist informed me the prescribing 'suggestion' was now law and ALL patients prescribed in excess of 90 mme would be reduced accordingly. The 25% reduction in my regimen caused a month long detox and a great deal of pain. These problems were only the beginning as I have had two different pharmacies refuse to fill my prescriptions, even after a surgery! I have missed countless school and athletic functions of my grandchildren, left numerous family holiday gathering early due to the pain I experience. My suggestions for a new guideline are : move oversight to the agency this issue belongs, the AMA. Make no reference to numerical suggestions in a revised guideline as it morphs into hard prescribing limits and does not encourage drs to treat patients to their best of their ability and education. Doctors must be made to feel safe when making dosage decisions, as humans are not all the same, we have unique issues and different height and weight. I would suggest all pain specialists have an open phone line and be available for weekend calls due to prescriptions that cannot, by law, be transferred to another pharmacy. Telehealth should be utilized for most appointments, the Dr. to decide when it is necessary to see you in person. Stop needless urine drug test unless my dr feels it is necessary. I have taken ua's since 2008 and never failed one, yet I am treated like a criminal every time I visit my dr and pharmacy. I have always taken my meds as prescribed, I should not be treated like this. Medical marijuana should be available to all chronic pain sufferers. Prescribing limits should be totally removed from any new guideline. I have had my life interrupted to the point I spend most of my time in a recliner, can go out to eat and a movie on occasion. I live my life in pain every day and feel very cheated out of the time I have left. I need stronger medication than I am currently being prescribed, make the needed changes and let us enjoy life again. I think to those concerned, cpp do not get high on their medication as I have taken opioids since 2008 and have never gotten high on my meds. Please, make the suggested changes, implement our suggestions. WE HAVE SUFFERED LONG ENOUGH. P.S. - if it matters, I have lost a son to an opioid overdose. He made a choice, I have not. Thank you for your consideration and a chance for our community to offer suggestions, and I hope you take them seriously and implement the suggested changes swiftly, their are people dying while you ponder.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484ff78d1	Morton	None	2022-04-05T05:18:16Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Morton, Richard	l1l-0am0-t1st	False	None	False	2022-04-12 05:37:08.989	[]
3846	CDC-2022-0024-3852	https://api.regulations.gov/v4/comments/CDC-2022-0024-3852	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Drugs have ruined my brother's life and he is now serving 20 years in prison.<br/><br/>My brother got hooked on Meth in 2018 and ended up doing some horrible things that have landed him in prison for 20 years in 2019. I tried to get him help, but there are no programs that would assist me because it had to be voluntary. <br/><br/>Since the 2016 everyone, CDC, doctors, and news, have been talking about the opioid pandemic, opioid this, opioid that. His addiction did not start with going to the doctor or pain management. He got completely got hooked on Meth from the streets and I absolutely hate Meth. <br/><br/>No one has talked about the different types of drugs, or any addiction assistance; only opioids mainly prescription pills. Then they make it out like the "opioid crisis was brought on my prescription pills". <br/><br/>Looking over all the comments from people in pain is very disheartening. The crack down on giving people opioids for pain, did not reduce the opioid deaths. You can try to say well there is less deaths from prescription pain pills, not true... prescription pain pill deaths have been replaced with other street drugs. It has only shifted from one to the other. You say there is less prescription pain pills on the street.... well they have been replaced with even more deadly stuff. <br/><br/>The big increase in deaths from drugs is directly related to not treating people from pain. ALMOST ALL DOCTORS, HOSPTIAL, AND CLINICS ARE NOT TREATING PAIN AND PEOPLE ARE GOING TO THE STREETS. I know this to be fact, because his ex girlfriend who used to be in pain management and got kicked out for failing a drug test (cannabis) with no plan, no referral to drug treatment....nothing. NOW had the doctor referred her to a drug treatment center for failing the drug test, she would not have resorted to using street drugs to treat her pain. (She was in an accident that crushed her hip, she has real pain on top of being an addict). She now "self medicates" her pain with illegal cannabis but I know she has used other stuff depending on what's available. <br/><br/>Now because of all stigma with prescription pain pills, my grown son who is not a drug addict, never did illegal drugs, could not get anything strong enough to treat his dental pain other than what's over the counter ibuprofen which he was already taking. No mom wants to see their child suffer but yet, it's happening. No mom wants to see their child die from a drug overdose but forcing people to go to the streets to treat pain, it is going to happen. <br/><br/>It's not a coincidence due to the lack of treating people's pain, more and more states are legalizing cannabis for medical and recreational use. <br/><br/>You can't relay on what the medical community says about opioids, because medical community is split on opioid for pain use, there are some for it and some against so the numbers will always be scaled to their favor. I know this to be fact, no one wants to suffer, it's 2022 no should suffer or beg for pain relief and be made to feel like a drug seeker. If doctors don't start prescribe pain medicine, provide pain medicine before and after surgeries, PEOPLE WILL GO TO THE STREETS MORE AND MORE. This is creating a huge black market for drug dealers, and those drugs are far more additive and deadly than what they would get from doctors. <br/><br/>In order for doctors to prescribe opioids the guidelines need to be updated, they need to be encouraged to prescribe and without fear of being arrested and the message regarding prescribing opioids needs to change. It's much safer for someone to get their pain meds from a doctor who can monitor the person, and if someone fails a drug test, they should be referred to an addiction counseling, not kicked out to the streets. <br/><br/>As it stands now, people are going to the streets to treat their pain. The 2016 guidelines did not stop any overdose because anyone who wanted to take drugs were going to the streets, but now, more people are going to the streets. It's sad when drug dealers treat people better than doctors. If you want to stop overdoes, how we treat people with addiction needs to change. <br/><br/>As far as the proposed updated guidelines, when it comes to pain management patients, and people who have chronic conditions, stop treating them like dogs and criminals they are people who need our help, not our judgement. They do not need to be blamed or made to suffer because of street drugs overdoses. <br/><br/>If there are drug deaths directly related to prescription pain pills, investigate why. There may be a solution there that no one has investigated that could reduce opioid deaths from prescribed opioids. (Is it because they combined it with something else, could be how the medicine interacted with the person's condition etc). I do know with 100% certainly, the current process is causing more deaths and harm. <br/><br/>CDC, DEA, Doctors and Pharmacies - The current process is an epic fail. Let's all work together to do better for everyone. Thank you. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Please	None	None	0900006484ff78d3	Read	None	2022-04-05T13:50:30Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Read, Please	l1l-0c50-8v9q	False	None	False	2022-04-12 05:37:09.522	[]
3847	CDC-2022-0024-3853	https://api.regulations.gov/v4/comments/CDC-2022-0024-3853	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern:<br/><br/><span style='padding-left: 30px'></span>I have severe Willis-Ekbom Disease (formerly called the Restless Legs Syndrome) and have been under the care of [Name Redacted], at [Location Redacted], for over 2 decades. I suffered for many years before finding [Name Redacted]. My initial treatment for this neurologically based sleep disorder was at a local sleep disorder clinic. However, after a year their treatments were no longer working, I experienced such severe sleep deprivation that I was declared Totally Disabled. I could not drive, and had to retire at the age of 58. I was then referred to [Location Redacted] in [Location Redacted]. When they could not find a successful treatment, I was referred to the [Location Redacted], also in [Location Redacted]. After they could not find a successful treatment, I was recommended by the Director of a Sleep Disorder Center in [Location Redacted]. to see [Name Redacted] at [Location Redacted] . Before seeing [Name Redacted], I was prescribed dozens of different medications without success. [Name Redacted] present medication cocktail includes: (1) 50/0.5 mg, Pentazocine/Naloxone (AN OPIOID) tablet at 3 PM; At 6 PM, a 1 mg. Rotigotine (Neupro) patch must be put on; at 8 PM, 900 mg. of Gabapentin is taken; and finally at 8:30 PM (2) 50/0.5 mg. Pentazocine/Naloxone (OPIOID) tablets must be taken. This regimen has enabled me to resume living a normal life!<br/><br/><span style='padding-left: 30px'></span>After over two decades of taking opioids to control my Willis-Ekbom Disease, I have NEVER had to have the dosage level or frequency of administration increased. IT IS ESSENTIAL THAT LOW DOSE OPIOID MEDICATION, SUCH AS I USE, CONTINUE TO BE AVAILABLE TO TREAT DISORDERS SUCH AS MINE.<br/>[Name Redacted], M.A., NCSP<br/>Licensed Psychologist - [Location Redacted]. (Retired)<br/>[Email Address Redacted	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dennis	None	None	0900006484ff854e	Moore, M.A., NCSP	None	2022-04-05T13:55:00Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Moore, M.A., NCSP, Dennis	l1l-1g9k-l4ke	False	None	False	2022-04-12 05:37:09.770	[]
3848	CDC-2022-0024-3854	https://api.regulations.gov/v4/comments/CDC-2022-0024-3854	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	adelia	None	None	0900006484ff855a	stout	None	2022-04-05T14:27:13Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from stout, adelia	l1l-19li-1osa	False	None	False	2022-04-12 05:37:10.006	[]
3849	CDC-2022-0024-3855	https://api.regulations.gov/v4/comments/CDC-2022-0024-3855	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom It May Concern:<br/>The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. Patients have died due to these restrictive and ill-informed "guidelines". These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe, and have extensive clinical and cost-effectiveness data.<br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of [Name Redacted] own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eugene	None	None	0900006484ff85a0	Mahaney	None	2022-04-05T14:29:30Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Mahaney, Eugene	l1l-29ee-rir5	False	None	False	2022-04-12 05:37:10.252	[]
3850	CDC-2022-0024-3856	https://api.regulations.gov/v4/comments/CDC-2022-0024-3856	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 51 years old and have suffered with rheumatoid arthritis, fibromyalgia, and degenerative disc disease for decades. As a chronic pain patient, I have tried many pain treatments (in addition to disease treatments), including physical therapy, acupuncture, chiropractic, steroid injections, prescription and OTC NSAIDS, and even oral opioids (hydrocodone/acetaminophen). None of them sufficiently treated my pain (and in some cases risked harming my liver and/or kidneys) and so I started on prescription fentanyl patches which have been a lifesaver. I have remained on a low dose for years and have followed all my doctor's instructions. I am fortunate that they are still willing to prescribe them as so many have been pushed off their medications due to the Opioid Guidelines.<br/><br/>While these Opioid Guidelines may be an improvement over the previous version, they still go too far in restricting opioid use for pain patients, particularly chronic pain patients. Doctors take these guidelines as mandatory and pain patients suffer from lack of access to needed treatments. I know we have a crisis of opioid overdoses, but the research shows that it is largely made up of illicit drug users, not pain patients. Please do not punish responsible pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff85a8	Anonymous	None	2022-04-05T14:30:42Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-2ay8-x1zs	False	None	False	2022-04-12 05:37:10.487	[]
3851	CDC-2022-0024-3857	https://api.regulations.gov/v4/comments/CDC-2022-0024-3857	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The federal law did not change drug addiction in my county meth overdoses higher then ever my family members whom were on combined pain meds to keep them living life were taken my brother in law is now fully crippled with pain and spends most days in bed before the law he had a somewhat descent day he has had to much damage to his entire full back to complete replacement surgeries which failed with severe wide spread nerve damage I am devastated for what smile he had is now replaced with I am just surviving the doctors tried to force him to get another surgery for a stimulator to replace all the meds he lost why are we making people with verified chronic pain suffer and lose what good life they can lead no federal government no state government should make humans suffer	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484ff85af	Smith	None	2022-04-05T14:32:11Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Melissa	l1l-2dkg-lrfp	False	None	False	2022-04-12 05:37:10.756	[]
3852	CDC-2022-0024-3858	https://api.regulations.gov/v4/comments/CDC-2022-0024-3858	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	"The clinical practice guideline includes recommendations for primary care clinicians (including physicians, nurse practitioners, and physician assistants) as well as for outpatient clinicians in other specialties (including those managing dental and postsurgical pain in outpatient settings and emergency clinicians providing pain management for patients being discharged from emergency departments). This voluntary clinical practice guideline provides recommendations and does not require mandatory compliance; and the clinical practice guideline is intended to be flexible so as to support, not supplant, clinical judgment and individualized, patient-centered decision-making." It is critical that guidelines are used to support patient-centered decision making and the use of clinical judgment is emphasized. too often these guidelines become legal weapons used against providers. Patients pay the price when they are used as a "bible" for prescribing without consideration for the individuals unique circumstances. <br/>We must be very careful that the document does not become a bludgeon to deny patients quality of life nor rob them of life through a preventable opioid overdose. <br/>Judgement, sound clinical judgment and collaboration across specialties is required for patients to achieve their best quality of life while keeping our communities safe. Educating the public, providers and support services on how to make informed decisions is critical.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	0900006484ff85fc	Wagner	None	2022-04-05T14:33:40Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Wagner, Laura	l1l-2wc4-jddg	False	None	False	2022-04-12 05:37:11.003	[]
3853	CDC-2022-0024-3859	https://api.regulations.gov/v4/comments/CDC-2022-0024-3859	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To CDC<br/>my name is [Name Redacted] and have been on hydrocodone since 1989 when a patient fell on top of me and I felt and heard my lumbar region snap. I spent many years chasing for a cure. I unfortunately have grown tired and do not want to fight anymore. In 2017 I was in the Intensive care unit for over 4 months. At that time I was also given Fentanyl patch form. I am off Fentanyl because I done it. My sister warned me of the effects. Now I am labeled a drug addict with the red mark in the state of Pennsylvania. No more fentanyl. I feel enough is enough. I live with pain so bad I can’t walk very much. My life has been robbed from me. I don’t want no sympathy I just want to live the best I can. I walked 2 miles a day and was excited. Now to laying and standing I sit but in short duration. Please reconsider taking us off more pain medicine. I have seen and heard of many people I have met getting the street drugs only to die. My heart aches for those PAIN people. Not drug addicts but real people in severe pain. <br/>They started medical marijuana and honestly it don’t help. Yes marijuana good for the street people but it is not helping us in severe pain.<br/>Please put yourself in our shoes. Imagine waking every morning to feeling like you have the flu and as the day progresses you hurt so bad in your muscles and bones. This is my life. I hurt so bad by noon that I pray to be dead. When does our doctors get to act like doctors again. They are being stripped of their rights to treat us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margo	None	None	0900006484ff86b2	Bowen	None	2022-04-05T15:05:31Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Bowen, Margo	l1l-4hqh-12u2	False	None	False	2022-04-12 05:37:11.238	[]
3854	CDC-2022-0024-3860	https://api.regulations.gov/v4/comments/CDC-2022-0024-3860	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids. <br/>The CDC Clinical Guidelines for Prescribing Opioids are not as specific as I would have liked. They also make them somewhat challenging to access. I think that the recommendations about whether or not to initiate opioid use for chronic pain is a no-brainer, I think that developing a tapering plan that is agreed to ahead of time would also be a good addition. I think that it is important to stress an item that appears later in the guidance document which is that we have limited evidence of the effectiveness of opioids for long term chronic pain management (yet we have lots of evidence of the harm).<br/>I have a challenging time putting a specific feel to the 50MME and 90MME doses that are mentioned. I see a lot of comments which are frustrated with these. Is there evidence that 130MME provides better long term pain management or is it only valuable while the dose is increasing?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacob	None	None	0900006484ff87c4	Kositzke	None	2022-04-05T15:32:45Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Kositzke, Jacob	l1l-6x0y-hi3x	False	None	False	2022-04-12 05:37:11.490	[]
3855	CDC-2022-0024-3861	https://api.regulations.gov/v4/comments/CDC-2022-0024-3861	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see the attached file for comments from the American Headache Society Board of Directors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff883d	None	None	2022-04-05T15:35:51Z	American Headache Society	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from American Headache Society	l1l-7n4i-68e1	False	None	False	2022-04-12 05:37:11.734	[]
3856	CDC-2022-0024-3862	https://api.regulations.gov/v4/comments/CDC-2022-0024-3862	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fred	None	None	0900006484ff861e	Brown	None	2022-04-05T15:49:58Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Fred	l1l-2tel-nycm	False	None	False	2022-04-12 05:37:11.993	[]
3857	CDC-2022-0024-3863	https://api.regulations.gov/v4/comments/CDC-2022-0024-3863	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	these guidelines have created a life of misery for a lot of people including myself. nothing good has came out of these guidelines for compassionate care. what have we become when suicides have occurred due to others' recommendations, there is money made off the chronic pain patients that use shots that are not FDA approved,we go through drug screens like we are criminals to society ..they are biased and conflict of interest involved with these guidelines and false statistics .they needs to be funding and a goal to de implement 2016 guidelines for they are adopted into laws and regulations .the mme is also false due to being 4 ways of calculating a daily dosage .my pain medication is giving me a somewhat quality of life and that is not scaled in numbers its a way of life to be able to do basic things around the household..i been cut on metal put in and now they want to put wires in my spine ,well i have a right as a human being in my medical care to be between a doctor and myself not my govt.we are at the point of no return life in pain is not fun its horrible these days due theses guidelines cause i fear they are creating more harm than good .thank you for letting me have a voice perhaps ,i hope theses comments gets considered highly recommended into the updated guidelines cause pain patients deserve and need a adequate amount of pain medication to help with there pain for everyone is so different in there DNA make up .please i beg of you to just get rid of these harmful guidelines and let doctors be doctors and not have to look over there shoulder cause of writing a much needed medication .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff8841	Anonymous	None	2022-04-05T15:50:39Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-835o-68qd	False	None	False	2022-04-12 05:37:12.273	[]
3858	CDC-2022-0024-3864	https://api.regulations.gov/v4/comments/CDC-2022-0024-3864	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe that the CDC's goals and mission are to be the nation's health protection agency. The CDC is supposed to help save lives and protect people from health threats. Using blanket guidelines in this manner hurts the overall health of the individual seeking care and their ability to get proper and timely care. The only way to provide appropriate and timely care is to stay within your mission and goals. Leave healthcare laws and regulations to the states and the people. Protect the sanctity of the provider-patient relationship. Please help promote individualized care instead of blanket guidelines for the masses on areas better served by other agencies and state regulatory boards. The CDC should be conducting critical science overviews and provide health information that protects our nation against expensive and dangerous health threats and responds when these arise, such as the pandemic, and access to proper care, such as promoting telehealth options. The CDC is responsible for controlling the introduction and spread of infectious diseases and providing consultation and assistance to other nations and international agencies to improve their disease prevention and control, environmental health, and health promotion activities. Please let our practicing medical professionals and systems handle diagnosis, treatment, and care for those already living with chronic illness.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barby	None	None	0900006484ff8d11	Ingle	None	2022-04-05T15:52:17Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Ingle, Barby	l1l-agh6-cfjw	False	None	False	2022-04-12 05:37:12.522	[]
3859	CDC-2022-0024-3865	https://api.regulations.gov/v4/comments/CDC-2022-0024-3865	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am providing comments (attached) as an American College of Physicians member on behalf of the ACP.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff8d22	None	None	2022-04-05T16:04:06Z	American College of Physicians	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from American College of Physicians	l1l-ad2c-o8wc	False	None	False	2022-04-12 05:37:12.773	[]
3860	CDC-2022-0024-3866	https://api.regulations.gov/v4/comments/CDC-2022-0024-3866	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Welcome to the American Inquisition!!<br/>2016!<br/>If you use pain medication you are an addict and should not be seen as a human, according to the CDC and their masters PROP!<br/>Dr's are allowed to terrorize you with not filling your prescriptions for ANY reason! Line up for the pill counts and pee tests, at tour own expense of course.<br/>Pharmacist, your turn to terrorize and exfoliate the pain patient. Sorry don't have enough meds til xx day. No we won't transfer to a different location. Suck it up!!<br/>ER visit cause ya cannot take it anymore, just stick her at the end of the hall, maybe she will get sick of waiting and leave, if not we will refer her to a detox ( detox from what?) Or a rehab center, drug seeker!<br/>Friends and family, step right up to tell them to just get up, you will feel better if ya just start doing something. Why can't you take an advil like everyone else? Oh, YOU take pain meds??!! Addict.<br/>Insurance carriers turn. Dear Ms XX, we will no longer be covering any pain medication or trips to pain clinic. We will still expect your payment monthly, and also we are upping your premiums cause, we'll We Can!!<br/>The 2016 so called guidelines were a mess from the very get go!<br/>Why was it written in secret? Why were NO pain management Dr's on the panel? Why were Dr's given 48 hours to comment? Why didn't you listen to them when they said it was a BAD idea? Why did you use junk science of MME ? You know it's BS!<br/>What are you going to do to fix this mess? Are you going to shout it from the roof tops that you were so very wrong and tell All Dr's they are once again practicing medicine in America and take Back all the tossed aside patients?<br/>Are you going to stop taking advice from PROP and all the others that have Conflicts of interest? You all know who they are, but of I write the names, they will be redacted!<br/>Meet the new Boss, same as the old Boss!!<br/>Different director of CDC, but she will just go along to get along. Hope she will prove me wrong. No faith whatsoever. Covid was such a rousing success, can't imagine how screwed up the revised guidelines will be.<br/>CPPs should never have been included in the guidelines and when you saw the devastation, you should have put a Stop to it then and there. Why did it take you to whisper about it in 2019? Cowards.<br/>Real adults take responsibility for their mistakes and try to fix them. But I forgot we were dealing with people trying to make it retirement on the government sugar!<br/>Do the RIGHT THING finally! Get rid of these awful guidelines. This isn't even the purview of the CDC . This is the jurisdiction of the FDA.<br/>Stop the Witch Hunt for we'll meaning compassionate Dr's and Nurse's. <br/>I truly hope these guidelines are thrown out and you TRY to rectify ALL the damage you have wrought on all the lives of truly CCPs.<br/>You can start by coming clean about your made up figures of ODs, that you inflated 54 percent!! <br/>The next step is to recuse all of the original writers of these lies. We All know who they are.<br/>Then each one of you should get in your Lexus and BMW and visit every American CPP and Dr you have harmed and beg their forgiveness!!<br/>Hope you all SACK up and admit this was as big or bigger mistake as Alcohol Prohibition!<br/>NOT HOLDING MY BREATH !!<br/>Do the Right thing!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff8d47	Anonymous	None	2022-04-05T16:06:12Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-ax3w-za6k	False	None	False	2022-04-12 05:37:13.007	[]
3861	CDC-2022-0024-3867	https://api.regulations.gov/v4/comments/CDC-2022-0024-3867	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 48yr old female. I survived a stage 4 cancer.I now live everyday with the side effects of chemotherapy and radiation. I also suffered a stroke during that time. I now live with permanent disability. Chronic pain has been and always will be a part of my life. This isn't going to get better.Of all the pain relieving treatments I have been through never helped me as much as the opioid treatment has.I'm a legacy pain patient. I have been followed by Pain Management now for almost 15yrs. I had a good doctor/patient relationship. My pain had been well managed. I had good symptom control, I was productive, I had good quality of life. That all changed in 2016 when the current guidelines were introduced. I was forced tapered off my pain meds and had to go through a bunch of injections,physical therapy for the umpteenth time, nerve ablation. I had a SCS implanted. None of these procedures were effective and actually ended up causing me more pain, not less. I am but a shell of my old self now. I suffer from intractable pain now,I am now bed or wheelchair bound. I can no longer do the things I enjoy and my activities of daily living are extremely limited. I need help with everything. I need help with cooking, cleaning, laundry, groceries.getting the kids to school. Everything is a struggle now. I have NO QUALITY OF LIFE!! I didn't fight like hell to survive cancer only to end up in this kind of condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Annette	None	None	0900006484ff8d51	Camlin	None	2022-04-05T16:11:36Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Camlin, Annette	l1l-b35k-gdqo	False	None	False	2022-04-12 05:37:13.233	[]
3862	CDC-2022-0024-3868	https://api.regulations.gov/v4/comments/CDC-2022-0024-3868	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids perpetuate chronic pain. My wife suffered head pain for over 15 years. We went to many different neurologists in search of an answer to the cause of the pain. During that time, there was one who told her that she couldn't even begin to answer that question unless she was off the opioids. Unfortunately, that wasn't an acceptable option to her. Many years and neurologists later, we found a senior neurologist and psychiatrist. After several visits he determined that the opioids were triggering the "original" pain (whatever it's source, but now had healed). I was relieved, but my wife didn't accept this explanation, so she continued to suffer for several more years. The pain management clinic just kept providing scripts of one version or another including fentanyl. She was completely debilitated. Prior to that she was superwoman. After I intervened with a letter to the pain management clinic, it was a very long rocky road to recovery. Eventually, she was free of the drugs and the pain. I can't begin to count the costs of what we lost. In my study of this subject, it's my understanding that there are not any long term studies that support the use of opioids long term. Opioids are very powerful and useful drugs for short term use. Has this changed? I suggest that you contact [Name Redacted] (psychiatrist in charge of the dual diagnostic addiction clinic at [Location Redacted]) for a technically informed dialogue on this subject. Don't reopen Pandora's box, please!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Craig	None	None	0900006484ff8d57	Perkins	None	2022-04-05T16:13:29Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Perkins, Craig	l1l-b747-coti	False	None	False	2022-04-12 05:37:13.472	[]
3863	CDC-2022-0024-3869	https://api.regulations.gov/v4/comments/CDC-2022-0024-3869	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been left in agony due to the 2016 guidelines. I was a working professional and parent all my life. I suffered from diabetic neuropathy and psoriatic arthritis. I also have degenerative disc disease. I've had 6 spinal surgeries to address the pain which have not helped. I also have a spinal stimulator that stopped working after 6 months after installed that I can't find a dr willing to remove it. For 10 years I was able to work and care for my kids with the help of my Dr. I tried many types of therapy before I agreed to try opioids. They were both effective and inexpensive. Many of the alternative treatments weren't covered by insurance. In 2017, my dr said his practice had been threatened. He stopped my medication without warning. He stated his practice no longer prescribed opioids to anyone for any reason. There are no other pain management drs within a 3 hour drive. I have seen 2 pain management drs who both stated all they offer patients is injections and scs units, when told I already have one that broke at 6 months, and stated I want it removed. They both stated they'd only remove it if I let them put another one in. I advised that injections made my pain worse not better, they both said I either agree to the costly injections or they wouldn't treat me. I am no longer able to work and I'm bedridden 90% of time. I am on permanent disability now. . Along with poor treatment by drs, pharmacies have refused to fill medications stating they don't fill opioids. I never had a UA I didn't pass, never ran out of my meds, my dose staying the same for over 7 years and 1 day my pharmacy said nope, can't fill it anymore. He said it was store policy. He openly discussed my medications with 6 people staring and listening to our conversation. It's bad enough that I now suffer daily with out help but I have been treated like a drug addict and criminal all due to the CDC Guidelines. I had to undergo full hysterectomy, when I woke up after surgery, I was allowed Tylenol. I was in agony for weeks, and the dr refused anything stronger than Tylenol. He told me anything stronger is dangerous due to addiction, he stated 50% of peoplewho use pain medicationbecome addicted. That's not true. I have never been a drug addict nor had any issues with drug use or alcohol. I don't drink or smoke. You must remove the 50mme reference. It will be used to refuse medications to those in need. Insurancecompanieswill use these guidelinesto deny paying g for care. Stop saying opioids don't work. Millions of us know they do. Until there are effective alternatives stop denying our pain relief. You are literally killing people with your actions. Thanks for your time <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paula	None	None	0900006484ff8d99	Eames	None	2022-04-05T16:28:00Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Eames, Paula	l1l-cmu2-acyg	False	None	False	2022-04-12 05:37:13.714	[]
3864	CDC-2022-0024-3870	https://api.regulations.gov/v4/comments/CDC-2022-0024-3870	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with something called Junior rheumatoid arthritis. If you don't know about this disease it's debilitating and my body is basically been eating itself since I was born. My pain level on it every day normal basis is an eight and when it really acts up it's a 10 or more where I can't move and I have to lay down all day. I've had the steroid shots I've had the physical therapy basically done anything and everything my doctor has asked me to do and nothing helps. I was able to manage it up until I turn 30 and I had my first back fusion. I've since had three more and looks like I need another one. I had to go into the building since I'm not allowed to have pain medicine right now I can't find a doctor to prescribe it because they are too scared to. Basically my day is laying in bed taking a bath laying in bed if it wasn't for social media I probably would not have a social life at all. Before these guidelines I was actually able to have friends hold down a part-time job play with my kids it wasn't the best life ever but it was an okay life. I had a wonderful Doctor who understood my pain he really try to help me we used to work on what worked and what didn't somebody said that he was giving too much pain medicine out even though he only gave it to people who really needed it. These godlines have destroyed people's lives including mine especially these where you can only have pain medicine for 3 Days and 7 days and it's crazy and I know you all taking it out of the main document but you still have it in the comments are still scared to death of you. I know people have abused pain medicine but has taken it off the market really helped anything? There are still people dying every day but now it's for heroin. I've known pain patients who have actually killed himself because the pain got too bad and they couldn't live with it anymore I've known pain patients who actually went to street drugs because they can't take the pain anymore. I agree that not everyone needs pain medicine but there are those of us out there who really do need it to live day by day in order to even just get up. It has really taken hold of my state, Kentucky. I don't know exactly why all this is started I know that there were people taking it who didn't need it but I really do believe most people on pain medicine didn't need it. Doctors were just trying to do the best they could buy some of us and he won't have totally destroyed that. Please take into consideration mind all these other stories I know we don't represent a big chunk of the population but there are several of us out there who live day by day in God forsaken pain that I wouldn't wish on my worst enemy. As mean as it is to say I really wish some of you I would be in a chronic pain situation so maybe you can understand where we was coming from as much as I don't want anyone else to go through this I really wish really really wish you all could see what we go through day in and day out. I've had to be kept in a critical stabilization unit before because I didn't want to live this way anymore. I'm just a blob and a train on my family and my kids. When you took away my pain medicine you took away my life. I've never been addicted to pain meds I took three pain pills a day for break through pain and one pain pill a day for all day pain never took any more sometimes took less but it was enough for me so I could get up and clean the house, visit with my kids, maybe go out to dinner with my husband. Most of us don't ask for a normal life we know better but we do ask we treated like people and not addicts. Please give the power back to the doctors. Start treating pain again quit making it take a Tylenol Tylenol does not work ibuprofen does not work and if you actually look it up they harm the body worse than most opiates. Please start helping us we're a population that does vote but more than that were population who needs a voice	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006484ff8daf	Jones	None	2022-04-05T16:29:52Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Jennifer	l1l-cycv-lz8u	False	None	False	2022-04-12 05:37:13.959	[]
3865	CDC-2022-0024-3871	https://api.regulations.gov/v4/comments/CDC-2022-0024-3871	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for this opportunity.<br/>When 12 a horse fell on me paralyzing me from the waist down. Eventually I 'recovered' - perhaps with osteopathic manipulation. I was unconscious a lot, so unsure. Pneumonia followed and I didn't receive the hospitalization the M.D. recommended because of parental objections. At 16 my shoulder dislocated and without medical help, I put it back in myself & never did have medical treatment.<br/>Upon starting to drive, I was rear-ended by a person whose brakes failed in a nearby city. <br/>5 years later, as a passenger, my seat belt failed on a 3 time collision with a bridge over a river as icing had just began on an interstate. I broke the windshield with my head, but the car spun, keeping me from going through that windshield. My entire body was bruised. <br/>A few months later that same year a driver crossed the center line and hit me head on. Unconscious immediately, I awoke down and embankment where the car landed, with much glass in the side of my head. <br/>Many years later my left humerus was broken in 2 in a fall. <br/>Finally I found a doctor that believed me, and my pains, and received my 1st MRI. <br/>Since, I have had a 1990 lumbar fusion, another in 2019, a hip replaced in 2003 and another in 2020. I was prescribed arthritic medicines and Oxycontin, with Vicodin for breakthrough pain. I am allergic to ibuprofen, codeine, Tylenol gives me additional headaches, aspirin bursts my finger blood vessels due to the years of vioxx. Once I received Oxycontin, I was able to resume my life. When I couldn't tell I took it, instead of asking for more, I would stop taking it until so miserable, the regular dose was a great help. So I didn't increase the dose. Then I found a Teeter inversion table. It helped so much and about the same time, I was often submitted to drug tests when picking up my script. I asked why, as I had to pay for them, and knew I only took prescribed medicine. I was told they were monitoring my doctor for the amount of scripts he prescribed his patients. He had told me that he believed in the patient's bill of rights which meant that we shouldn't have to live in chronic debilitating pain. So, I agreed to the drug testing for his sake. I am nearly 70, and he was the first doctor that listened and believed me. I felt something was wrong because of the testing and decided to gradually wean myself off pain meds on my own terms in case there was a drastic change in availability. There soon was. I'm not sure why my doctor was removed from practicing medicine, but wonder if that was why. <br/>As I sit here my head hurts, my neck glows out to my shoulders with the right one constantly burning. The pain goes down my entire spine and down through my left toes. Even my replaced hips often hurt. A nerve was hit in my last lumbar fusion, causing my left thigh to feel pins and needles as if just waking up, and sometimes just straight pain, as well as being weak without constant attention to stretches and exercise. Facing each day is so difficult, so I must stretch and exercise just to get out of bed and dress. Chiropractic and CBD oil is a lifesaver. Medical marijuana is not legal here, but I am told it helps. I agree that we do not need more impaired drivers. If I would have had to live without pain meds when younger I couldn't have made it with work and raising children. It's not depression as it has tangible source. It is exhaustion from the continual challenge to stay on top of it. You cannot live continually on an ice machine. I eat as much of an anti-inflammatory diet as possible, which does help, as do supplements. I live on a farm with a beautiful view and have people who care about me. Without that, I completely understand why people give up and take their lives. Chronic pain is relentless and reminds you every day of every injury you ever suffered. I recently had a thumb surgery to remove a bloody mass growing out of it and found that apparently I am now allergic to hydrocodone as well. They put so much acetaminophen with it that it is not surprising I cannot tolerate it without a full body itch. Even the Moderna Covid vaccine caused my arm to have an 8-10" long red oval each time. Telling people like me that we are some kind of addict or criminal if we need pain relief is inhumane. Please reconsider your guidelines. Not everyone becomes an addict. I haven't had Oxycontin since 2012 or 2013, when I purchased the inversion table. But now, scans show many twists of much of my back. You cannot fuse the entire thing. You cannot have a surgery for every old injury. Assisted suicide is illegal, but you really must give people options to enjoy as long a life as possible.<br/>I had Covid in 2020 without a positive test as they were unavailable, so my test wasn't until 6 weeks in. THAT resurfaced the intensity of every pain. Without liquid zinc, Vit C, NAC, and my supplements I wouldn't have made it. <br/>Please & thanks.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dee	None	None	0900006484ff8dba	Moore	None	2022-04-05T16:33:45Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Moore, Dee	l1l-d4m3-xvge	False	None	False	2022-04-12 05:37:14.210	[]
3866	CDC-2022-0024-3872	https://api.regulations.gov/v4/comments/CDC-2022-0024-3872	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have uncontrolled chronic pain. My chronic pain stems from Rheumatoid Arthritis. I am 40, female, and 6’3. I am clinically obese. I have bone on bone/loss of cartilage in too many joints to list here. <br/>I am in joint pain daily and take daily DMARDS and use steroids to try to take care of disease flares. <br/>I am well educated and read. I am a shell of who I was due to uncontrolled chronic pain. I was a vibrant person who, before pain, kept busy with work, outside interests and friends from 5am to 10pm every day. I am home now, 24/7. Therefore, when I can, I read voraciously about pain. I have a weekly therapy session with someone who specializes in chronic conditions. I understand fully the risks of opiate use. After much research I decided to use state legal pot to try to manage break through and daily pain. Unfortunately, Federally illegal pot means I am unemployable in my career due to drug testing and it also means am denied opiates for pain by my doctors due to my pot use. I am in a catch 22 due to pain that, I have been told by doctors, would be managed easily with opiates but it’s use for me is restricted due to the current guidelines. I have never been prescribed opiates and this rule change will give my doctors and Nurse Practitioners more flexibility and help to address my pain more completely. Essentially it would be an added resource for me to try to help me get back to the person I was without making me a federal criminal. It will also help to make the stigma for use of pain management opiates lessened. The total restriction for people like me is proving to be more detrimental than the help it gives to the people who get addicted. The resources for the addicted should also be addressed in hand with this. Fully legalizing all drugs and treating drug abuse as the illness it is looks to be the most likely thing to balance the scales, not further prohibition. This guidance would help push the balance to where it needs to be. Pro person, not anti drug. The war on drugs did not work. How much more evidence do we need?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff8dd5	Anonymous	None	2022-04-05T16:58:16Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-dgs7-5ghb	False	None	False	2022-04-12 05:37:14.449	[]
3867	CDC-2022-0024-3873	https://api.regulations.gov/v4/comments/CDC-2022-0024-3873	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am concerned about an issue with in the CDC guideline's against the use of anxiety medicine with opioid pain medicine. Benzodiazepines have been prescribed concurrently with opioid pain medicine for decades. I can find no scientific evidence of there being a danger while under a doctors care. I was taken off benzodiazepines after years of treatment and while under going radiation treatment for prostate cancer, at one point I was in fear for my life till I received emergency treatment. " The National Council" when asked responded with " Quote" Opiate or opioid pain medication when prescribed concurrently with benzodiazepines. There is no scientific evidence there is a danger when under the care of a doctor or especially when you have been on them in the past. Thank You..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff8def	Anonymous	None	2022-04-05T16:58:42Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-dxz4-m7df	False	None	False	2022-04-12 05:37:14.700	[]
3868	CDC-2022-0024-3874	https://api.regulations.gov/v4/comments/CDC-2022-0024-3874	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)<br/><br/>Stop this version 2.0 of Tiergarten Strauss 4 Euthanasia of Chronic Pain Patients. <br/>Aktion T4 (German, pronounced [akˈtsi̯oːn teː fiːɐ]) was a campaign of mass murder by involuntary euthanasia in Nazi Germany. The term was first used in post-war trials against doctors who had been involved in the killings. The name T4 is an abbreviation of Tiergartenstraße 4, a street address of the Chancellery department set up in early 1940, in the Berlin borough of Tiergarten, which recruited and paid personnel associated with T4.[5][c] Certain German physicians were authorized to select patients "deemed incurably sick, after most critical medical examination" and then administer to them a "mercy death" (Gnadentod).[7] In October 1939, Adolf Hitler signed a "euthanasia note", backdated to 1 September 1939, which authorized his physician Karl Brandt and Reichsleiter Philipp Bouhler to begin the killing.<br/>Funny how History is repeating itself with the current agenda of the CDC/DEA against chronic Pain Patients. Just like in Germany if doctors help their patients, then they too get arrested and killed off by the enforcing government branch bent on this version of GENOCIDE.<br/>THIS IS HOW THE CDC AND DEA WILL BE REMEMBERED IF YOU DON'T RECIND THE 2016 AND 2022 PRESCRIBING GUIDELINES!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff8d5e	Anonymous	None	2022-04-05T17:03:53Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-aygs-0oj2	False	None	False	2022-04-12 05:37:14.932	[]
3869	CDC-2022-0024-3875	https://api.regulations.gov/v4/comments/CDC-2022-0024-3875	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Todays a hard day but I don’t want to forget my comment. I’m crying because I’m barely alive during these past few years. I was rejected by so many doctors when I asked for opioids that work. I am bedridden from pain without them. I frequented ERs begging for the medicine that works and they told me because I knew the drug I needed that I like that one and I want a high. NO! Some opiods don’t work and I don’t want opiods that don’t. I don’t want opiods unless it gets me healthy. I hate them. I never felt high because I need a low dose. Twice they gave me migraine medicine and I went inpatient. ERs treated me so badly 5 hours each time then sent me to the street with nothing. I begged them to take my urine sample that I’m not a drug addict. I begged them to look at my back spinal surgery and the cyst that’s pinching my spinal cord. They said no. They wouldn’t even look at my body! I was asking for opiods so they discharged me with NOTHING at all like I’m trash. I’m only alive today because after months I found a primary care who prescribed me Opiods. He saved my life. I had told myself in 12 months I’d let myself commit suicide. I was already dead from the pain. Not just bedridden but can’t sleep can’t think can’t even watch tv can’t remember anything from pain. I’m begging you to please use a guideline like NOT 3 months Opiod prescription for a dental surgery, just a week. Not over prescribing but not under prescribing either. Thank you for making these changes!!! You’re saving lives. I support suing big pharma and education, but the right people NEED them for health care. Again thank you!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006484ff8e02	Bolanos-Ivory	None	2022-04-05T17:07:00Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Bolanos-Ivory, Brenda	l1l-e5fd-tchb	False	None	False	2022-04-12 05:37:15.185	[]
3870	CDC-2022-0024-3876	https://api.regulations.gov/v4/comments/CDC-2022-0024-3876	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife and I have been victims of the opioid witch hunt for several years. My wife has "atypical migraines," which means that without an effective pain relief, she hides in a dark room, in pain. For about 20 years she was on high doses of hydrocodone /acetaminophen With that, she could function pretty normally. Accompany me to the store, even go out for lunch. Then it all changed. Her primary physician asked if she was willing to try something different. she said yes. The put her on buprenorphine. It provided very little pain relief and caused violent itching, which led to scratching, which let to a bed with lots of blood stains and open sores. We said, lets stop this and go back to hydrocodone. Pain specialist said she had never been our pain specialist, she was only there to get my wife off hydrocodone. We had been misled from day one. We thought my wife was trying something out. We did not know taht there would never be a return to hydrocodone. Primary care physician says my wife cannot go back on hydrocodone. So that is where we have been for the past coupe of years - no effective pain relief, when we know hydrocodone worked for 18 years or so.<br/>I could use stronger language, but that probably won't help. It has not been pleasant dealing with my wife's untreated pain. I see no reason her pain has gone untreated. It is pretty clear that your guidelines have been at the root of this.<br/>Please make it clear that doctors won't be disciplined for prescribing hydrocodone in cases where there is a lot of pain and nothing else works.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Francis	None	None	0900006484ff8e13	Coats	None	2022-04-05T17:07:46Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Coats, Francis	l1l-ebml-vods	False	None	False	2022-04-12 05:37:15.429	[]
3871	CDC-2022-0024-3877	https://api.regulations.gov/v4/comments/CDC-2022-0024-3877	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. <br/>As a person who has had 5 major spine surgeries, countless other spinal procedures 2 with titanium/carbon fiber implants, numerous bulging thoracic discs, and in daily excruciating pain, I really think that patients in legitimate pain are not being heard. Prior to developing intractable thoracic pain about a year ago, my chronic lumbar pain (2 laminectomies and third spinal cage fusion ) was well managed for 11 years with the same dosage of oxycodone/acetaminophen 10/325. Never once did I misuse my medication or have to ask my physician(s) for more. Unfortunately my current thoracic pain is not well managed with the same amount of medication. It’s extremely frustrating and totally uncalled for to not be able to receive appropriate treatment because other people use and abuse medications for the intent to get high. It’s also inappropriate for a medical person or politician who has never experienced intractable pain to decide what is appropriate for someone living daily with it. <br/><br/>Also, someone needs to seriously look into the pharmaceutical companies (Camber) as their medication is sickening. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff8b83	Anonymous	None	2022-04-05T17:09:34Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-eejj-qnza	False	None	False	2022-04-12 05:37:15.675	[]
3872	CDC-2022-0024-3878	https://api.regulations.gov/v4/comments/CDC-2022-0024-3878	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The pain never goes away. As prescribed, and as I've taken Rx opioids for the last 50 years (I'm 74), the pain is always there. What the Rx does is keep my pain at a "tolerable" level. It's allowed me to have, within limits, a productive life and a quality of life almost free of intolerable pain.<br/><br/>I've never overdosed. My doctor trusts me, and I trust him. I have to make the pills last the whole month. The meds have kept me out of a wheelchair. In 2019, my doctor was under pressure to cut me back. I asked him what would happen. He said, "Well, you'd experience more pain."<br/><br/>To persuade my doctor not to cut me back, I wrote a column for my local newspaper called "The Myth of the Accidental Overdose" (attached). In it, I argued that legitimate pain patients were getting cruelly deprived of quality of life because some people were intentionally overdosing to get high or totally kill the pain. We legitimate chronic pain patients are the collateral damage in the misguided CDC guidelines. Some of us turned to street drugs ... and some just killed themselves.<br/><br/>I sincerely urge the CDC to restore the ability of responsible physicians (like mine) to compassionately manage their patients' pain without arbitrary guidelines. I'm deeply sorry for the addicts and truly accidental fentanyl victims, but you shouldn't be hurting us to save them.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006484ff91e3	Durkin	None	2022-04-05T17:10:49Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Durkin, Tom	l1l-fl87-onj8	False	None	False	2022-04-12 05:37:15.908	[]
3873	CDC-2022-0024-3879	https://api.regulations.gov/v4/comments/CDC-2022-0024-3879	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have ankylosing spondylitis and opiates are the difference between me being able to go to work, cook for my family, and generally enjoy life, and being bed-ridden (I wish as I actually sleep on the floor) and giving up. Because of drug addicts, patients with chronic pain are being made out to be drug seekers. I have taken a prescription opiate at the same dose for almost four years. I am surrounded by misinformation all around me. I will get addicted. I am getting high. It doesn't really work for pain anyway. It will make your pain worse. It is extremely frustrating and harmful. I have to go to a pain clinic every thirty days to get my prescription. The pharmacy is always out of stock, requiring extra visits. <br/><span style='padding-left: 30px'></span>We need a way to identify valid patients under the care of a doctor and stop treating patients like children. I take a pain pill an hour before I get up in the morning. By two pm, I start having thoughts that I can't go on like this. The pain is too much. Thanks to having a good doctor I know that is pain talking and I take my second pain pill. But I always wait until I am in pain to take the medication because I am afraid the medication will be taken away. I also know that if I have a bad flare up and need an extra pill that day I cant ask for more. It is always a measurement of how bad my pain is versus how much medication I have left. I know another chronic pain patient and he deals with his pain the same way. Coping as long as you can and the the agony of the hour it takes for the pill to start working. I know I will give up if I lose complete access to pain medication. <br/><span style='padding-left: 30px'></span>I don't understand why our government is putting the needs of drug abusers over the needs of good men and women who are trying to get to their jobs and provide for their families. Drug abusers will always find a way to get high. Pain medicine is for people in pain. As long as a pain patient is working with a doctor and following their guidelines, they should be able to access the medication they need at the dosage level their doctor feels is adequate. As a person in a lot of pain all the time I am telling you opiates work. They are the difference in being able to walk or having to sit. They are the difference between being able to work and constantly calling in sick. And for me, if I am lucky, the difference between having to lay flat on the floor to sleep and occasionally getting to sleep in bed next to my husband.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D	None	None	0900006484ff924d	Anderson	None	2022-04-05T17:12:07Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anderson, D	l1l-h00u-e7g9	False	None	False	2022-04-12 05:37:16.196	[]
3874	CDC-2022-0024-3880	https://api.regulations.gov/v4/comments/CDC-2022-0024-3880	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don't know really where to start with my comment with out just crying; I have been in chronic pain since I was 18 years old I had severe arthritis & my family were farmers we never had medical insurance; never went to a Dr unless it was absolutely an emergency but at the age of 19 I fell just walking in my house & broke both my knees; my right ankle & left wrist all in one fall; was told I had RA & a rare bone disease they then called brittle bone syndrome; I am 56 & I now am in wheelchair & I can't even take a bath or get dressed by my self; before 2020 I was on 6 oxycodone 30 mlg a day & 60 MLG of Morphine ER & then boom my Dr retired I start with a new pain management Dr & since then he took me down to just 2 oxycodone 30mlg a day & 2 30MLG of ER morphine I absolutely have to stay in my bed with heating pad 24/7; I haven't driven in 2 years; haven't been able to go shopping at all & was even able to go to my granddaughter's graduation because I can't ride in a car longer than 30 mins without crying & even throwing up because the pain is so bad!<br/>So please just answer me this? <br/>What have I done to deserve this why are u letting me suffer like this??<br/>I don't understand why?? So plz just please re think this re think changing this unless u are going to raise the MME	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff9251	Anonymous	None	2022-04-05T17:12:51Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-h1rx-cfg3	False	None	False	2022-04-12 05:37:16.423	[]
3875	CDC-2022-0024-3881	https://api.regulations.gov/v4/comments/CDC-2022-0024-3881	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings. I urge the CDC to address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an uncontrollable need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>There is no cure for RLS. There are many medications that are used for RLS. However, none are specific to the disease thousands of us live with every day. Some of these medications make our symptoms worse, and many have little or no effect at all. Others will help somewhat for a period of time, and then they are no longer useful. <br/><br/>I have been treated for RLS for twenty years. I have tried many medications and have suffered when I had to discontinue some of them because of terrible withdrawal symptoms. When my neurologist prescribed opioids I began to experience more consistent sleep at night and was free of symptoms during the daytime. I have had no adverse side effects from the opioids and have not had to increase my dosage. <br/><br/>I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006484ff9288	Brown	None	2022-04-05T17:16:04Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Barbara	l1l-hhxr-ep88	False	None	False	2022-04-12 05:37:16.672	[]
3876	CDC-2022-0024-3882	https://api.regulations.gov/v4/comments/CDC-2022-0024-3882	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to urge the CDC to liberalize the rules for prescribing opioids as much as possible and to eliminate dosage guidelines. Even though the guidelines are voluntary, some state governments have passed legislation making them binding. Insurance companies use them to determine how much medicine they will pay for. Law enforcement agencies use the guidelines to prosecute physicians, making them reluctant to prescribe the medicines to people who need them. In extreme cases this has led to suicides among people in excruciating pain. There are many more cases of people suffering needless, unable to get enough medicine to control their pain.<br/><br/>Eliminating these guidelines would be a tough call if we had to weigh treating pain against preventing addiction and deaths, but it is not clear that guidelines prevent addiction or death. Some patients in severe pain turn to street drugs or alcohol to relieve their pain, which is obviously worse than medicines prescribed by a physician.<br/><br/>Please eliminate all guidelines and leave this matter to physicians and patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484ff9298	Gervasi	None	2022-04-05T17:16:35Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Gervasi, Charles	l1l-hky6-pblf	False	None	False	2022-04-12 05:37:16.903	[]
3877	CDC-2022-0024-3883	https://api.regulations.gov/v4/comments/CDC-2022-0024-3883	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish to comment on the 50MME. My system has a hard time with absorbing the medication. I've read all 229 page's of the guideline update several times, what I see over and over is this 50MME. This must be removed, it will lead to misinterpretation of what is intended the way this happened in 2016. When this happens it will be a disastrous for heath care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff92a8	Anonymous	None	2022-04-05T17:17:17Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-hsdu-mscl	False	None	False	2022-04-12 05:37:17.166	[]
3878	CDC-2022-0024-3884	https://api.regulations.gov/v4/comments/CDC-2022-0024-3884	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The only ethically acceptable course of action for the US CDC is to outright repudiate both the 2016 and 2022 disasters, and to withdraw them without replacement. CDC must be barred by legislation from publishing any practice guideline on pain medicine. And the US DEA must be told to stand down from its unjustified persecution of doctors who have done nothing wrong.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	April	None	None	0900006484ff92c4	Tucker	None	2022-04-05T17:17:39Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Tucker, April	l1l-i0q5-msvw	False	None	False	2022-04-12 05:37:17.400	[]
3879	CDC-2022-0024-3885	https://api.regulations.gov/v4/comments/CDC-2022-0024-3885	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The deaths at the border are telling the way that the Prohibition of Necessary Narcotic Analgesics has been going, pushed on by the U.S. Government and the MSMedia! The percentage of addicts is down to 1 percent! Patients taking Narcotic Analgesic meds are even less likely to be addicts below 1 quarter of 1 percent! This must end and MDs must be able to be MDs, along with pharmacists to be pharmacists and be able to treat patients for their diseases or conditions with a full chest of medications and not to be forced to treat patients like criminals, either! Millions are suffering, including me! I have a very rare disease with no known cure and I am now in year 45 with it, which I will go into further below. Change the rules back or get rid of them, all together, so that patients can be given their necessary medications and doctors and pharmacists can do their jobs without the persecution of the DEA and other entities! Until then, it is cruel, unusual and inhumane for those of us who are needlessly suffering and for those trying to treat us!<br/><br/>This is my 45th year with a very rare disease, with no known cure (NKC), it is Childhood Onset Cervical and Generalized Dystonias of my head, neck, both arms, shoulders, upper body, etc. and I'm only 53 years old! On top of that, I was T-boned in a MVA and suffered a damaged spinal cord, along with a broken lower back, was partially paralyzed (having to learn to walk and use my left arm again) and was then diagnosed with Reflex Sympathetic Dystrophy-Chronic Regional Pain Syndrome! All was diagnosed at NIH-NINDS both pre- and post-accident and most “standard treatments” to treat Childhood Onset Cervical and Generalized Dystonia I've been successful with, including all types of Botox, no longer work, I am now immune to or they don't work any longer! I am not a “good candidate” for any surgeries, being far beyond the 20ish year mark. NIH/NINDS stated, along with several doctors, that I would be on Narcotic Analgesics for the rest of his life and were very successful until 2016, when the 2016 CDC Guidelines came out. I fought to stop all of the new laws along with good doctors, nurses and other patients and I am not an addict, but require these medications, along with sedatives and muscle relaxants, to keep my body from going into spasms, shaking, pulling, pain, etc.<br/><br/>The Cervical and General Dystonias with tremor, I suffer from, are from both sides of my families and are different types of dystonia! To make my matters worse, I was slammed into by another driver (none of this is my fault)! I'm not blaming, I'm a fighter, as I've had to be the majority of my life! I used to exercise every day, now maybe I'm able twice a week, because I'm being dropped on my Narcotic Analgesics, because my neurologist is, literally, too scared to prescribe the “correct amount,” now! Why? DEA and Insurance threats, when I should be on a dosage of 100-125mgs (Ht-Wt-Metabolism-Amt of blood in my body+-10) of Methadone and Oxycodone, occasionally Hydrocodone, for better control of my body and to be in less pain! To make all even worse, though, NSAIDS are off the table for me, for the most part. Why? I had been prescribed, by multiple doctors 1,800mgs-3,600mgs of Gabapentin for about 20 yrs!<br/><br/>I had actually begun to have a life, again, in the 2010s, when taking around 125mgs of Narcotic Analgesics, had gone back to college, began working out (seeing a physiatrist, as well), almost daily, until 2016! I also did Tai Chi and more! Having been told by NIH-NINDS I'd be on these medications for the rest of my life, I realized how well they controlled my Dystonias and RSD-CRPS and thought of the Narcotic Analgesics just as a “part of life!” Obviously, I treated them more seriously, also telling only doctors, family and few friends. Also, they worked well as a “control!” There's No Known Cure for my conditions, but those medications with sedatives and muscle relaxants allow me more control of my body and pain relief! I've never had any major issues, my heart is good, per my cardiologists and my liver and kidneys are fine for a 53-year-old male, per my endocrinologist, and my toxicology was fine on my check up in 2021 at 90mgs/day, also when between 100-125mgs-day of Narcotic Analgesics with sedatives and muscle relaxants!<br/><br/>My life now? I am pretty much home bound and life is hard, I'm lucky to get 4 to 6 hours of broken sleep most nights and the twitching, pulling, spasms, shaking and pain are more apparent and my QOL is low! The pain is hard and I'm a “fighter” but this is wrong, because it is controllable! This is “cruel and unusual” punishment to inflict on a human, for?<br/><br/>Every federal and private agency or org I've spoken with has said I should be seen by an MD who can prescribe me Narcotic Analgesics! Allow MDs to do their jobs without persecution! I want my life back and access to the meds and the amount that works for me! Stop the suffering of us by the Draconian rules!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484ff92c5	Wiesman	None	2022-04-05T17:20:33Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Wiesman, Gary	l1l-i137-xl0k	False	None	False	2022-04-12 05:37:17.639	[]
3880	CDC-2022-0024-3886	https://api.regulations.gov/v4/comments/CDC-2022-0024-3886	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Ehlers Danlos. I have had to have 15 surgeries since the time I was 12 . I have never been on opioids for longer than 2 months in a row for pain. Because of this "crack down on opiates" , I cannot even go to a doctor for anything without getting a finger pushed in my chest. Telling me opiates won't help me. I'm in for a sinus infection or a urinary tract infection, not even for pain. I'm labeled a drug seeker and humiliated because of my rare genetic condition. Not for what I'm in the doctor office for. This has just started happening since your guidelines. I will never get a cancer or heart screening. I rather die young then have even more pain and get nothing when it gets really bad. What for? So I can suffer and be used as a lab rat on how well a person can handle pain? My 78 year old Aunt has the same condition. Doctors cut off her pain meds now she just wants to die. Congratulations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff92d1	Anonymous	None	2022-04-05T17:21:28Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-i3d0-6o7z	False	None	False	2022-04-12 05:37:17.877	[]
3881	CDC-2022-0024-3887	https://api.regulations.gov/v4/comments/CDC-2022-0024-3887	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The only ethically acceptable course of action for the US CDC is to outright repudiate both the 2016 and 2022 disasters, and to withdraw them without replacement. CDC must be barred by legislation from publishing any practice guideline on pain medicine. And the US DEA must be told to stand down from its unjustified persecution of doctors who have done nothing wrong.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	April	None	None	0900006484ff92ea	Tucker	None	2022-04-05T17:21:56Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Tucker , April	l1l-ifu9-zdqw	False	None	False	2022-04-12 05:37:18.133	[]
3882	CDC-2022-0024-3888	https://api.regulations.gov/v4/comments/CDC-2022-0024-3888	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. I have malformed disks and degenerating disks, this has been going on for 12+ years. Before the 2016 guidelines I didn't have any trouble getting my pain killers or pain treatment from my doctor. At the time I didn't know the 2016 guidelines went into effect but around that period I started noticing that my doctors were "suggesting" I lower my pain killers or stop taking them at all.<br/>My first pain doctor ended up retiring his practice around the time the new guidelines came into effect, the last time I spoke to him before he left he was fed up with how he felt he couldn't help his patients. <br/><br/>My current doctor who prescribes me pain meds tells me I need to get down to the point where I only take 2 a day even though these are the same pain meds, same strength that I have taken for 8- 9 years and they aren't nearly as effective as they use to be, and my pain hasn't gotten any better with age, it has just gotten worse. Yet, he offers zero alternative to pain relief. <br/><br/>I have stressed to my doctor multiple times I need to see a specialist, or I need something stronger because the pills I am currently given are heavily losing their effectiveness due to the amount of years I've been taking them. All he tells me is "There is nothing I can do for you" which leaves me in a spot where I cant go seek a specialist on my own because it would be insane to go talk to someone without a referral without instantly being labeled a drug addict instead of a pain patient.<br/><br/>I have done everything my doctor has asked of me in terms of drug testing. I have asked him for things such as stem cell injections, MRI requests, etc, to try and figure out exactly what's causing the pain and if anything can be done about it. <br/>While, the doctor approves of sending these costly MRI Requests, he argues the effectiveness of MRIs despite I want him to rule out the possibilities of pain coming from other areas of my back. Also, the doctor has no issues giving out these expensive experimental stem cell treatments.<br/><br/>Right now I am on a mixture of muscle relaxers, anti-inflammatory, and pain killers to try and manage my pain but I've been repeatedly told by my doctor to reduce my dosing and get me completely off of them. Even when I try and say "What am I suppose to do about my pain if you want me to not be on pain killers? Am I suppose to just quit my job and suffer? Why cant I be given something that would work better so I wouldn't have to take them as frequently? and How can you tell me to lower my pain meds when your not offering any solution?" He simply tells me "I can't help you then" and refuses to refer me to a specialist or a doctor who can potentially find the cause of my chronic pain as my current doctor cannot seem to do so. All I am seeing is my quality of life dwindle before my eyes and I see no real solution to it.<br/><br/>If these new guidelines makes it easier for me to get my meds or get meds that would help me more than what I'm currently on. I'm all for it. Opioid overdoses in the US seem to be mostly linked to uses with Fentanyl. I don't know why people would want to make it harder for chronic pain patients to get the help they need, and its not like we're asking for Fentanyl to be prescribed and circulated more. I would never touch Fentanyl, but the meds that I need, the meds that make it so I can live a somewhat normal life, shouldn't be so incredibly difficult to get or to make sure I'm going to be able to get any when my prescription is running out. I feel like I have done the requirements, tried physical therapy, multiple types of different injections, essentially everything except surgery. I have been in pain for 2/3rds of my life now and there doesn't seem to be anything in sight to completely rid me of pain. So, please don't make it so hard for me to have some semblance of a life, because how I have been living these past few years is no way for a person to live, and its not something that's maintainable for the rest of my life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff92f6	Anonymous	None	2022-04-05T17:23:36Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-invl-f2fy	False	None	False	2022-04-12 05:37:18.376	[]
3883	CDC-2022-0024-3889	https://api.regulations.gov/v4/comments/CDC-2022-0024-3889	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern,<br/> I am a 69 year old disabled man with degenerative spinal stenosis. it started when I was 19 years old. <br/>I have had 6 major surgeries over the span of 50 years. PLEASE HELP ME. Pain is ruining my life.<br/> Every surgery has been a "must" surgery as my spine gets worse over time I wind up losing my<br/>ability to walk or control of my legs. My pain level has never been worse.<br/> Every time I have surgery my pain level gets worse and worse. My last surgery took 2 days to complete, I was in such a bad way. They had to go in from the back and the front to work on my spine.<br/> I now am in pain 24 hours a day, 7 days a week. I am used to taking 120 milligrams of oxycodone<br/>to help me deal with every day life as I live alone and have trouble getting help. I am poor and have no friends to help and my few living relative are not close to where I live. I need medication to help me sleep and live as normally as possible throughout the day. I also do as much physical therapy as I can and walk 2 miles a day to stay as strong as I can. <br/> My Dr. has cut my oxycodone down to 100 milligrams a day and plans to cut my medication down<br/>even further. I am already feeling the pain of my reduced dose. It has taken a few months to cut down but my pain center is NOT adapting and my pain is the worst it has ever been. I am suffering terribly by the decisions of others who do not have any idea what 50 years of phonic pain can do to a person.<br/> I am aware on the opioid crisis but that is mainly due to users who have no need for pain medication per se. Thes are mostly people of all ages using to get high and mixing with other drugs, or even mixing oxycodone with needle using street heroin.<br/>PLEASE, RELAX YOUR LAWS FOR LEGACY PATIENTS LIKE MYSELF. I have never had an issue, claimed loss of medication or broken my pain contract with my doctor ever!<br/>Please take me an millions of others seriously. We are law abiding citizens suffering for the sins of <br/>others.<br/>Thanks You,<br/>[Name Redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484ff8ea6	Buffington	None	2022-04-05T17:25:09Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Buffington, Steven	l1l-jmhb-6jzh	False	None	False	2022-04-12 05:37:18.628	[]
3884	CDC-2022-0024-3890	https://api.regulations.gov/v4/comments/CDC-2022-0024-3890	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am now 75 y.o. After two full hip replacements, two knee surgeries, a dental procedure, and a hand surgery over two decades, opioid meds were prescribed. During the years when prescriptions were large (50-100), and I was inexperienced in their use, I encountered reduction in effectiveness and reduced intake, improving effect. More recently, with prescription counts lower (15-20), I have stretched out supplies to once in a while, when Acetaminophen and/or NSAIDs were not much help. Oddly, after pain and discomfort retreat during the few hours when the drug is active, days or weeks might pass before another single dose, taken in the same circumstances. The effect is reliable and helpful.<br/>If opioids in low doses and modest quantities could be readily prescribed by my family doctor without pressure from policies, then filled without undue procedure and reporting by pharmacists, older patients with bodies cranky from osteoarthritis and whatever goes along could be helped substantially.<br/>Thanks for taking comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff8ebf	Reynolds	None	2022-04-05T17:25:55Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Reynolds, David	l1l-k0b9-uzw6	False	None	False	2022-04-12 05:37:18.884	[]
3885	CDC-2022-0024-3891	https://api.regulations.gov/v4/comments/CDC-2022-0024-3891	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 73 yrs old. I have a history of deep vein thrombophlebitis dating back to 1969. As life went on I suffered multiple episodes of DVT. I am now on warfarin therapy and compression stockings for life. My doctor set my therapeutic INR range at 3.5 to 4.0, which is unusually high. As I have aged I have developed chronic pain issues, primarily with my lower back, that SEVERELY limit my ability to remain active. Because of my warfarin therapy, I can't take nsaids for pain because nsaids interact with warfarin to create a dangerous and even fatal condition. The only pain relievers I can take are acetaminophine and oxycodone(percocet). I have used percocet for several years without incident, but have found it increasingly hard to get the drug. I know there is a problem with percocet, but I'm not part of it. I have learned that some people are not susceptible to addiction. I am one of them. I have NEVER taken the drug because of some feeling of addiction(since I have never been addicted to anything I have a hard time even relating to the concept). I take it only to blunt my pain so I can be active. I implore you to please craft policy that allows people like me to continue having long term access to percocet. It has been a lifesaver for me. I close by stating that at my age I never thought I would have to fight so hard to simply continue taking pain medication that I have been taking for years and that I know I need so that I can remain active.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Howard	None	None	0900006484ff8efc	Carter	None	2022-04-05T17:27:27Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Carter, Howard	l1l-l5fn-ne2j	False	None	False	2022-04-12 05:37:19.364	[]
3886	CDC-2022-0024-3892	https://api.regulations.gov/v4/comments/CDC-2022-0024-3892	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I injured my back in 1994 playing Volleyball and have been in pain ever since.<br/>Over the course of many years I have tried Physical Therapy (4 different times), Pilates, Stretch Classes, Acupuncure, Massage, Tylenol,but nothing ever relieved the pain. I wore a back brace for 5 years to work at a book store, I had a desk that I could sit or stand and work at bookkeeping for 22 years. Around 2012 I did something that made the pain much worse. I have been an active hiker for over 30 years, but could not even walk 100 yards. My Doctor finally recommended pain medication and we started with Tramadol and a few others but they had no effect, until finally putting me on Hydrocodone. My prescription is for 210 tablets of 10-325 (7 per day for 30 days) and have had this for many years. I have a very high tolerance and do just fine. I am able to lead an active life outdoors, hiking and camping and working in greater comfort. Does it take the pain away...NO. I drive over 17,000 miles per year (with a 2 miler per day commute) and have never had a ticket or accident (other than unfortunately hitting a deer). I am able to hike hard 15 mile hikes in my beloved Sierra Nevada Mountains and lead an active lifestyle. It just helps keep the pain manageable, it NEVER goes away. I learned bookkeeping, payroll and accounting while taking them. I live in a Spiritual Community and don't drink alcohol, smoke marijuana or take drugs but I take the drug test regularly. I have had 2 MRI's 10 years apart and all they show is a bulging disk, but it must just hit the nerve just right. Before my injury I never even took aspirin. My choice would be to have a healthy back and not take any drugs. It IS important to have guidelines, but allow that there are many different types of people that have different tolerances and needs. Thank you for this opportunity to share that it does do some good.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Greg	None	None	0900006484ff8f01	Dewey	None	2022-04-05T17:28:52Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Dewey, Greg	l1l-lbl5-w393	False	None	False	2022-04-12 05:37:19.635	[]
3887	CDC-2022-0024-3893	https://api.regulations.gov/v4/comments/CDC-2022-0024-3893	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>Please do not overlook what has been happening to the target of the CDC guidelines. The Patients! Not Addicts! Sick Patients like me. I suffer from an incurable spinal cord disease (adhesive arachnoiditis) that makes pain so bad it will force me into suicide when I lose pain control. How could it get any worse? The CDC guideline has been a death sentence for patients like me! Add to that a genetic defect called CYP450-2C9 that makes me a ultra-rapid metabolizer of opioids so I need a high dose to manage my pain. Any limit on opioids once again is a death sentence for patients like me I feel like a Jew hiding in the attic. I'm just holding my breath waiting for my doctor to be raided! Again! Do you realize how hard it is for someone like me to find stable care and pain control? I am 68 years old, opioids along with the Tennant Protocol allow me to work full time and I have never been in trouble with the law but the DEA empowered by the CDC has a manhunt nationwide searching for patients like me and the doctors that treat us. Why is it that patients like me are being sentenced to death by a denial of care without a trial? No jury? No charges? No Miranda rights? There have been so many of us committing suicide soon we will all be gone. Who will speak up for us? The CDC guideline needs to be rescinded before they kill us all	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484ff8f24	Snook	None	2022-04-05T17:29:48Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Snook, Gary	l1l-lxjz-hz9o	False	None	False	2022-04-12 05:37:19.891	[]
3888	CDC-2022-0024-3894	https://api.regulations.gov/v4/comments/CDC-2022-0024-3894	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a female, 69 years old, have never smoked, drunk alcohol or used drugs. I am in chronic pain from severe arthritis and nerve damage. I am unable to find a medical person who will prescribe me even the lowest disagree of Percocet. I am not a druggie, I am in pain and I think it is a travesty that people like me are unable too get the relief we need because the medical community is paranoid about being sued.I am due for hip surgery in May and I do not believe Celebrex and Tylenol are going to be much help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484ff8f33	Collins-Knick	None	2022-04-05T17:30:12Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Collins-Knick, Melinda	l1l-mbhz-egig	False	None	False	2022-04-12 05:37:20.137	[]
3889	CDC-2022-0024-3895	https://api.regulations.gov/v4/comments/CDC-2022-0024-3895	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments on These are the following observations made to the 2022 CDC Guideline revision.<br/><br/>1. CDC 2022 update removes 90 MME but replaces it with an even lower limit of 50 MME, while admitting the harm caused by the 90 MME limit in the 2016 guidelines, which became state laws, Medicaid hard edits, and is in the SUPPORT act. How does the CDC ensure 50 MME does not become the new limit?<br/>2. CDC states that 65% “misuse” opioids now for pain vs. 11% to get high and 2% due to being hooked. Doesn’t this suggest that the government’s regulations are causing more problems than they solving?<br/>3. CDC warns insurers, governments, and others to not use 50 MME or this guideline go set hard limits such as the Medicaid hard edits that were based on 90 MME, but how will this be accomplished?<br/>4. Sickle cell anemia and palliative should be rewritten as “severe chronic pain” or “intractable pain.” Others have equally painful diseases and should also be excluded. Why not be fair to all?<br/>5. CDC claims it found only one long term study while hundreds exist but were not used in creating this document. Why did CDC not consider all available studies dating back 100 years plus?<br/>6. You advise use of NSAIDs then advise against its use. Tylenol has become preferred to opioids due to prior CDC guidelines. Why recommend more harmful medicines? Addiction paranoia?<br/>7. CDC advises against using opioids and sedatives or anti-anxiety drug. Isn’t this concern stemming from polydrug illicit drug use, and this policy will harm patients with multiple condition. How can CDC avoid injuring patients who have pain and other conditions?<br/>8. CDC suggests opioids are not useful in fibromyalgia and osteoarthritis based on very limited data. Many patients have tried other modalities and only function thanks to opioid therapy. Why artificially limit clinician decision making based on limited studies, and against your advice to individualize care? Why attempt to subterfuge use of opioids in any medical case?<br/>9. The CDC editors are not trained or experienced in pain management and/or have conflicts of interest and are instead biased by their roles in treating addiction. Why are pain management experts not writing this guideline, rather than addiction specialists? This entire document seems a defense of poor CDC advise that continues.<br/>10. CDC suggests unproven alternative therapies & drugs which patients often lack access to. How do you plan to make alternative therapies available when you lack authority to grant access?<br/>11. You do not have statutory authority to regulate drugs, which belongs to the FDA. Why should the CDC be writing these guidelines rather than the FDA who has the authority?<br/>12. You constantly refer to tapering and imply the default position should be to taper people off their pain medicines as a default position. Why keep harping on tapering? Is it due to your pre-occupation about addiction, which effects only a minority of patients (0.5% to 5%)?<br/>13. Your guidelines appear to discourage use of opioids and impose restrictions not only on opioids, but you exceed your charter to cover every facet of pain management and every possible opioid prescriber. Since most overdoses are due to illicit drugs, what is the benefit of this guideline?<br/>14. How have overdoses declined since the release of the 2016 guideline, and if they haven’t, how is an even more comprehensive and burdensome document going to solve this problem?<br/>15. Why is this guideline now 229 pages and has expanded from an opioid prescribing guideline into a comprehensive pain management manual, and who authorized you to expand the scope?<br/>16. Does the CDC honestly expect a 229 page guideline to be useful to busy clinicians? This document is more an anti-opioid political document than a useful clinical decision making guide.<br/>17. Why do you emphasize individual care best left to clinicians and their patients, and yet this entire document attempts to standardize and limit care, resulting in needless suffering?<br/>18. How many lives has the 2016 guideline cost due to suicides and adverse health affects such as strokes, heart attacks, and other poor outcomes? How many people had to file for disability due to loss of pain care?<br/>19. CDC constantly emphasizes decisions including choice of opioids, dosages, durations of treatment, etc. should be made by the clinician, and warns against misuse of this document as occurred in 2016, which became a weapon. Why not just delete the 2016 guideline and not replace it, especially since overdose deaths have risen while prescriptions have declined, showing you are only causing pain and suffering and not saving lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	0900006484ff8f15	Combs	None	2022-04-05T17:32:34Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Combs, Judy	l1l-lmej-bnkj	False	None	False	2022-04-12 05:37:20.405	[]
3890	CDC-2022-0024-3896	https://api.regulations.gov/v4/comments/CDC-2022-0024-3896	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The fact that the CDC is even involved in the regulation of narcotics is laughable at best. The agency doesn't report the statistics correctly. Prescription opioids are not the same as street drugs and shouldn't be lumped together for statistical analysis. I am a chronic pain patient and take my prescription as needed and responsibly. What I object to is your charactization of responsible doctors that do their due diligence before prescribing as unable to do their jobs. Taking a prescription opioid does not make me a drug addict nor do I even want to be one. The CDC has no business setting the agenda or the limits of the prescription. Also the 50 MME limits need to be deleted from the new guidelines. If it were me the CDC wouldn't have anything to do with it at all. Until there is a legitimate replacement for opioids the patients who need them need to be left alone. Use the money that has been extorted from the drug companies to help the addicts with an alternative and easier access to mental help to keep them clean.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff93ca	Anonymous	None	2022-04-05T18:09:03Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-o04d-nr1g	False	None	False	2022-04-12 05:37:20.643	[]
3891	CDC-2022-0024-3897	https://api.regulations.gov/v4/comments/CDC-2022-0024-3897	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why have you removed the 90 MME and put 50 MME in its place. Also why are you advertising this as though it was final. I have severe spinal stenosis and osteoarthritis, you are killing me!! It’s time for the IG!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janine	None	None	0900006484ff8f76	Murphy	None	2022-04-05T18:09:32Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Murphy, Janine	l1l-oxt9-o3a8	False	None	False	2022-04-12 05:37:20.921	[]
3892	CDC-2022-0024-3898	https://api.regulations.gov/v4/comments/CDC-2022-0024-3898	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments on 2022 CDC Draft Opioid Prescribing Guidelines<br/>1. CDC 2022 update removes 90 MME but replaces it with an even lower limit of 50 MME, while admitting the harm caused by the 90 MME limit in the 2016 guidelines, which became state laws, Medicaid hard edits, and is in the SUPPORT act. How does the CDC ensure 50 MME does not become the new limit?<br/>2. CDC states that 65% “misuse” opioids now for pain vs. 11% to get high and 2% due to being hooked. Doesn’t this suggest that the government’s regulations are causing more problems than they solving?<br/>3. CDC warns insurers, governments, and others to not use 50 MME or this guideline go set hard limits such as the Medicaid hard edits that were based on 90 MME, but how will this be accomplished?<br/>4. Sickle cell anemia and palliative should be rewritten as “severe chronic pain” or “intractable pain.” Others have equally painful diseases and should also be excluded. Why not be fair to all?<br/>5. CDC claims it found only one long term study while hundreds exist but were not used in creating this document. Why did CDC not consider all available studies dating back 100 years plus?<br/>6. You advise use of NSAIDs then advise against its use. Tylenol has become preferred to opioids due to prior CDC guidelines. Why recommend more harmful medicines? Addiction paranoia?<br/>7. CDC advises against using opioids and sedatives or anti-anxiety drug. Isn’t this concern stemming from polydrug illicit drug use, and this policy will harm patients with multiple condition. How can CDC avoid injuring patients who have pain and other conditions?<br/>8. CDC suggests opioids are not useful in fibromyalgia and osteoarthritis based on very limited data. Many patients have tried other modalities and only function thanks to opioid therapy. Why artificially limit clinician decision making based on limited studies, and against your advice to individualize care? Why attempt to subterfuge use of opioids in any medical case?<br/>9. The CDC editors are not trained or experienced in pain management and/or have conflicts of interest and are instead biased by their roles in treating addiction. Why are pain management experts not writing this guideline, rather than addiction specialists? This entire document seems a defense of poor CDC advise that continues.<br/>10. CDC suggests unproven alternative therapies & drugs which patients often lack access to. How do you plan to make alternative therapies available when you lack authority to grant access?<br/>11. You do not have statutory authority to regulate drugs, which belongs to the FDA. Why should the CDC be writing these guidelines rather than the FDA who has the authority?<br/>12. You constantly refer to tapering and imply the default position should be to taper people off their pain medicines as a default position. Why keep harping on tapering? Is it due to your pre-occupation about addiction, which effects only a minority of patients (0.5% to 5%)?<br/>13. Your guidelines appear to discourage use of opioids and impose restrictions not only on opioids, but you exceed your charter to cover every facet of pain management and every possible opioid prescriber. Since most overdoses are due to illicit drugs, what is the benefit of this guideline?<br/>14. How have overdoses declined since the release of the 2016 guideline, and if they haven’t, how is an even more comprehensive and burdensome document going to solve this problem?<br/>15. Why is this guideline now 229 pages and has expanded from an opioid prescribing guideline into a comprehensive pain management manual, and who authorized you to expand the scope?<br/>16. Does the CDC honestly expect a 229 page guideline to be useful to busy clinicians? This document is more an anti-opioid political document than a useful clinical decision making guide.<br/>17. Why do you emphasize individual care best left to clinicians and their patients, and yet this entire document attempts to standardize and limit care, resulting in needless suffering?<br/>18. How many lives has the 2016 guideline cost due to suicides and adverse health affects such as strokes, heart attacks, and other poor outcomes? How many people had to file for disability due to loss of pain care?<br/>19. CDC constantly emphasizes decisions including choice of opioids, dosages, durations of treatment, etc. should be made by the clinician, and warns against misuse of this document as occurred in 2016, which became a weapon. Why not just delete the 2016 guideline and not replace it, especially since overdose deaths have risen while prescriptions have declined, showing you are only causing pain and suffering and not saving lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janine	None	None	0900006484ff8f9b	Murphy	None	2022-04-05T18:14:42Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Murphy, Janine	l1l-ps55-6bd7	False	None	False	2022-04-12 05:37:21.189	[]
3893	CDC-2022-0024-3899	https://api.regulations.gov/v4/comments/CDC-2022-0024-3899	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In this policy it is focusing on creating a practice guideline for prescribing Opioids. As opioids have been used for suppression and pain for hedonic effects for thousands of years. It is used when people are going through chronic pain. Throughout time in the 21st century chronic pain has been a leading cause of disability globally. Opioids have been prescribed throughout the years. My position in this policy is that there should be practice guidelines for prescribing opioids. The reason I agree there should be more guidelines when doctors prescribe opioids is because of the side effects it has and the addiction it gives people. Being with opioids helps people deal with the pain they are going through and have to live with. However it does come with side effects depending on the type of dose, lower dose will make a person feel sleepy and higher doses can slow breathing and heart rate which can lead to death. People can all experience different side effects including confusion, nausea and constipation. The reason why addictions can happen is that people will begin to feel pleasure out of opioid as it is a feeling they are enjoying and will want more. Sometimes people will begin to lie about their pain in order to receive opioids due to their additions that were caused because of their true pain and prescription. Another point on why there should be practice guidelines for prescribing opioids is because it is a drug that has been said to have similar side effects to heroin. Heroin has also had its history of being an overused drug and addition through the years. At the end we can all come to an agreement that opioids is a drug prescribed by doctors that should be considered and thought thoroughly for the patients as they are explained carefully of the side effects and the causes it can occur. In this policy they create a study to those who volunteer to be part of this but not mandatory. At the end it is to improve communication between clinicians and patients about the risk and benefits of pain treatment. In the policy it states “opioid use disorder, overdose and death”, more of a reason that there should be practice guidelines when prescribing opioids in future.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff8fe6	Anonymous	None	2022-04-05T18:15:43Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-ujql-5hzt	False	None	False	2022-04-12 05:37:21.477	[]
3894	CDC-2022-0024-3900	https://api.regulations.gov/v4/comments/CDC-2022-0024-3900	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'd like to comment on what I have seen happen since the 2016 guidelines and the difficulty they have caused people in pain, but the CDC seems to be aware of the major problems with their misapplication. However there are still some issues that will need to be addressed. <br/><br/>The biggest problem combines the belief and stigma that the 2016 Guidelines have created. We all know these were not meant to be engraved in stone rules and primarily intended for the guidance of Primary Care doctors and dentists. However most physicians misapplied the Guidelines because they failed to read them, assuming they would be in compliance by being as restrictive as possible treating pain with pharmaceuticals. This 2022 revision will be no different, you will still have doctors who believe not treating pain is the only way to protect their license. Saying its now ok to Rx opioids if they are indicated will not get them prescribed if they are indicated. There needs to be a mechanism to reverse the chilling effect caused in 2016. I wish I knew what mechanism to suggest, but you have a majority of physicians, including pain specialists, who even when they are needed, and lots of medical evidence to support opioid therapy, will not use them under any circumstances. This MUST be addressed.<br/><br/>One suggestion I would make is immediate abandonment of MME as a useful measurement. Why equivalence only considers a patients tolerance when prescribing methadone is absurd. Any experienced doctor or patient will tell you MME doesnt work, not only for any kind of hard limit, but for eqianalgesic values of any kind, without considering tolerance. There must be a range as is used when changing a patients medication. You just cant say 90MME and leave it as that. Perhaps that brings out the biggest failing of theses guidelines, not treating each patient as an individual. One size does not fit all and is a dangerous idea in medicine.<br/><br/>Without writing a novel of all the failing of these guidelines, there is one area which has not been addressed, even in the 2016 version. That is the pharmacy. If you asked most patients the biggest roadblock to pain treatment more would point to their local pharmacy than their doctor or CDC guidelines. This has never been addressed. Many patients are forced to wait until they begin active medication withdrawal before the pharmacy will fill an opioid Rx. MANY MANY pharmacists will refuse to fill an opioid prescription outright.Several large drug store chains were recently named in class action law suits, but the size of the pharmacy doesnt matter. Living in the DC suburbs, I have encountered this myself a dozen times in the last 2 months and have to drive far from home to get an opioid Rx filled. The excuses are terrible, obvious lies, but whats the alternative? Drive across town. But what about small towns in big states where its a 3 hours drive each way (non rush hour) to find a pharmacy willing to fill pain medication? Its absurd. And its not the DEA, their rules are relatively simple. Whenever a provider, be it a doctor or a pharmacy has to resort to lies to avoid imagined discipline there is a big problem. People in pain are lied to from first urine test to last pill.<br/><br/>One last critical observation. When the CDC releases death statistics for overdoses, the dividing line is synthetic vs non synthetic. This is a meaningless distinction if you want to stop the dying. For 20 years it has been a distraction from the real cause of overdose deaths, drug abuse and addiction. All this time the DEA and CDC has been after physicians while the real problem has been illicit fentanyl and related products on the streets in numbers hard to imagine. Hundreds of billions of fatal doses. Instead of spreading the word among addicts, the CDC/DEA have done little but provide an excuse to normalize addiction. That may be admirable to reduce addiction stigma, but its terrible if you want to stop the dying. It would be so easy to divide statistics by legitimate and illicit use. Medical examiners only need check with the electronic prescribing database and contact the physician of record to see if there was any legitimate reason for use of an opioid. When you do this, youll find that only 2% of overdoses had any legitimate reason as a recent study showed. Reason is all important if you want to stop a problem, forgetting all the unintended damage, as the 2016 Guidelines have done. The public may still believe a sector of the medical community is responsible for overdoses and increased addiction, but a large part of the public is going to find it difficult to swallow that hundreds of billions of fatal doses of illicit fentanyl suddenly appeared in their communities and they will start asking some uncomfortable questions about why this wasnt noticed and addressed sooner.I would not like to have to answer that question. <br/><br/>I could go on but this is enough for now. I thank you for your time and the opportunity to comment...<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff9492	Anonymous	None	2022-04-05T18:17:42Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1l-xus8-8f5n	False	None	False	2022-04-12 05:37:21.736	[]
3895	CDC-2022-0024-3901	https://api.regulations.gov/v4/comments/CDC-2022-0024-3901	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Clearly the vaccine doesn’t care how many pain patients died by suicide, or having to take to the streets to get relief from their chronic pain when they lowered to 90mme imagine all the deaths dropping to 50mme will cause an they clearly don’t care. Physicians that agree to this should lose their license as they took an oath to treat patients and part of treatment is managing pain. You can see the lies from the cdc when they claim this wasn’t their intention yet their already sending flyers to physicians asking them to drop to the 50mme. This is why you can’t trust the cdc or anything they claim.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JEANNE	None	None	0900006484ff9494	PETERSON	None	2022-04-05T18:18:20Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from PETERSON, JEANNE	l1l-xwcr-pqhq	False	None	False	2022-04-12 05:37:22.008	[]
3896	CDC-2022-0024-3902	https://api.regulations.gov/v4/comments/CDC-2022-0024-3902	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a family physician at an FQHC in Michigan, who has practiced for 12 years now. The 2016 guidelines were overall very reasonable and helpful in making decisions with patients regarding their pain. I feel the issues with the guidelines were not the guidelines themselves, but rather the system-wide application of those. Hard rules were set by payers on how much and what type of pain medication could be prescribed, regardless of the patient's needs and conditions. I even had trouble with some of my cancer patients transitioning to Hospice to receive opioids. <br/><br/>I have continued to have a small population of chronic pain patients on opioid pain medications. I would like to see updated guidelines still have recommended levels of opioids/day, and continue with recommendations of length of time for opioid prescriptions for acute pain. However, an emphasis that these are just guidelines and should not be applied as set rules is imperative. Also, a statement that it is many times not appropriate for providers to have a strict rule to never prescribe any opioids to any patient would be helpful, because then all those patients end up going to the select few of us who are willing to care for them. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484ff94f1	McConnon	None	2022-04-05T18:19:25Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from McConnon, Michael	l1m-1oqf-nppu	False	None	False	2022-04-12 05:37:22.265	[]
3897	CDC-2022-0024-3903	https://api.regulations.gov/v4/comments/CDC-2022-0024-3903	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Everyone needs to quit begging for medically needeed medications because we are all falling on deaf ears.With the insurance companys in control and senators getting their pockets stuffed to pass laws like opiod guidelines with no compassion towards fellow man we are all doomed to untreated quality of life zapping guidelines.until the government gets out of our doctor visits we will continue to suffer.unfortunately the ones in power dont care about you only getting reelected and waisting our tax dollars daily. America is on a path that we will never return to quality health care again .More people die from alcoholism and cancer related to smoking by six fold compared to legidiment opiod perscriptions you dont see any alcohol guidelines nor cigarette guidelines the reason is senators have billions invested in alcohol and tabaaco industry so put the blame where it belongs government and insurance companies just trimming the budget by implmentation of guidelines.They only smile with greed while we are suffering opiods are a gift from god for relief of pain not a gift from a senator.I am not anti anything just tired of the dictatorship system where there are two legal systems the public and the political its evident politicans can get away with anything just watch the the news hang in there ones in untreated pain maybe there will be compassion instilled into the hearts of the ones pushing cruel guidelines very soon .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff9516	Anonymous	None	2022-04-05T18:22:35Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-2rq5-fs5c	False	None	False	2022-04-12 05:37:22.515	[]
3898	CDC-2022-0024-3904	https://api.regulations.gov/v4/comments/CDC-2022-0024-3904	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The proposed amount of 50 MME needs to be removed because of the harm this will cause to chronic pain patients. While it may be ideal for opiate naive patients post op it doesn’t work for chronic pain patients with horrific, non cancer pain like myself. I have complex regional pain syndrome and without my dose of oxycodone, which is 60 MME apparently, I would not be able to work and would be on disability. With it I can work, be an active parent, volunteer and give back to my community. Please, please leave the dosing up to qualified pain management providers who go through extensive training for this specialty. Opioids are the last resort for most of us but it’s what works when nothing else has.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anna	None	None	0900006484ff9537	Stauff	None	2022-04-05T18:23:01Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Stauff, Anna	l1m-34um-5h9h	False	None	False	2022-04-12 05:37:22.765	[]
3899	CDC-2022-0024-3905	https://api.regulations.gov/v4/comments/CDC-2022-0024-3905	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	ELIMINATE THE 50 MME LIMIT GUIDELINE! <br/>MME was never designed to determine a dosage limit! It was designed to compare different drugs...they are for CONVERSION from one drug to another. It's as if the CDC core group never seen a MME conversion chart before, and that they don't notice that these charts ordinarily list a warning that MME is not a concrete thing and subject to variables. These variables cou8ld be height, weight, age, genetics, tolerance, etc... The CDC's attempts to use a casual sample of veterans to try to establish that a limit to 50 MME is appropriate for everyone. WRONG. Not only do these numbers come from a group of people with far more issues than just chronic pain (veterans have sky high rates of suicide, which can never be truly reflected in the death numbers for many reasons). <br/>Also, the CDC does not take into account that some MME charts warn that there can be no fully safe MME conversion for fentanyl and methadone. Why? Because the metabolism of these drugs is widely variable and the two drugs are more likely to cause serious side effects like respiratory depression.. in fact it is the counterfeit version of fentanyl that is found in street drugs coming over the border that kills 2/3 of all overdose fatalities. And of the rest? Methadone claims The lion's share of the rest. <br/>Perhaps it would be more prudent to apply additional cautions to fentanyl and methadone ONLY instead of applying random 50 MME limits to more innocuous opioid drugs? Maybe just focus on things that have been a problem instead of generalizing this idea to everyone? We know why this is being done, of course, and it's time for the DEA to go back to busting street drug dealers and get our of our doc offices and pharmacies. Millions of Americana are pissed at you for what the CDC and DEA have done to pain patients are we are calling you out <br/>it's time to stop abusing people for profit pretending we don't see it, and the whole 2022 OPG should really be scrapped along with the ridiculously ambiguous "opioid epidemic" too.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff9539	Anonymous	None	2022-04-05T18:25:41Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-3bx4-g5yk	False	None	False	2022-04-12 05:37:23.018	[]
3900	CDC-2022-0024-3906	https://api.regulations.gov/v4/comments/CDC-2022-0024-3906	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient who has lifelong conditions, excruciating pain daily, continual medical care for these conditions & had brain surgery to try to help one of them, I still am not able to be prescribed any form of pain relief from my doctors. I understand the negative affect that addiction has on many people, but some of us truly need pain relief to function or even survive daily. We wish to get out of bed & be able to have even just the most basic quality of life at this point, yet it is impossible without pain relief. I truly do not understand why relief from pain is impossible. There are days we no longer want to live due to the debilitating pain, yet we still cannot get proper care from our medical teams. None of them will help because the CDC has made it almost a crime to prescribe opioids. I hope someday this is fixed & we are able to have quality of life again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ivory	None	None	0900006484ff9743	Lybrand	None	2022-04-05T18:26:43Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Lybrand , Ivory	l1m-4p6k-fv0m	False	None	False	2022-04-12 05:37:23.261	[]
3901	CDC-2022-0024-3907	https://api.regulations.gov/v4/comments/CDC-2022-0024-3907	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. I would like to know why the CDC has decided that doctors can no longer prescribe medications for their individual patients but must follow a one size fits all formula devised by a board engaged in central planning. Central planning always leads to under supply and poorly served needs. In some areas we are told by our government that treatment should be between a doctor and their patient, but when it comes to treating chronic pain we are told that the people in Washington, D. C. know what is best for us. Yes, their is an opioid problem in the USA but it is largely with illegal street drugs. Don't punish the many chronic pain patients because of the actions of the illegal drug dealers. Don't count votes, treat patients!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484ff97ae	Soyack	None	2022-04-05T18:27:41Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Soyack, Richard	l1m-5g7p-i4q3	False	None	False	2022-04-12 05:37:23.559	[]
3902	CDC-2022-0024-3908	https://api.regulations.gov/v4/comments/CDC-2022-0024-3908	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a caregiver for a long-time chronic pain patient. Her condition is due to VITEK IPI failures from TMJ disc replacement in the mid 1980s.<br/>For 13 years my wife tried every alternative to opioids, including many forms of PT, Steroid injections, NSAIDS,etc.<br/><br/>Side effects and additional damage caused by these treatments worsened her pain.<br/>Finally, after total joint replacements bilaterally, she regained function, but the pain was not relieved.<br/><br/>As a last resort, she was prescribed opioids and for 25 years was well-managed and functional.<br/>Pain management was based on patient needs and managed by [name redacted], in [location redacted], and then [name redacted] in [location redacted].<br/>Both have ended their careers due to DEA and CDC interference in their practices.<br/><br/>After reviewing the proposed guidelines, and noting the repeated referral to OUD and chronic pain treatment, it is apparent the CDC has adopted a position consistent with defensive posturing against claims of over-prescribing. This is consistent with the use of these gudelines in lawsuits, by the very doctors who contributed their input into their formation.<br/><br/>My recommendation is to return the responsibility for identifying and warning/cautions to the purview of the FDA<br/>The CDC guidelines should be a one-paragraph statement advising physicians to pay attention to the packaging notices and take special care to note the risks associated with long-term use, but that ultimately, the use of opioid medications is a decision best left to physicians and their patients.<br/><br/>The CDC has assumed an exclusively-risk management position, as evidenced by the specialties of the contributors.<br/>Like any other medication, the FDA should have responsibility for approval and efficacy of opioids.<br/>The CDC should ONLY advise Doctors and Patients to pay attention to the risks, because patients have enough issues getting proper health care without unsolicited obstruction by self-appointed PROP fanatics.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484ff9813	Melcher	None	2022-04-05T18:30:54Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Melcher, Robert	l1m-6hl0-ssva	False	None	False	2022-04-12 05:37:23.797	[]
3903	CDC-2022-0024-3909	https://api.regulations.gov/v4/comments/CDC-2022-0024-3909	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I believe in a comprehensive approach to pain management and the use of opioids. Opioids should never be a stand alone therapy but rather included in a comprehensive treatment plan that includes Interventional therapies and physical modalities. The notion of a prescribing limit may be ok for primary care but that ceiling should not exist for pain management specialists who see the most challenging pain sufferers. If we include Interventional therapies in the treatment paradigm then primary care physicians would be required to include Interventional pain management physicians in the treatment of their patients and these patients would not simply be prescribed opioids for treatable conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Matthias	None	None	0900006484ff9883	Wiederholz	None	2022-04-05T18:32:58Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Wiederholz, Matthias	l1m-76pk-azwy	False	None	False	2022-04-12 05:37:24.033	[]
3904	CDC-2022-0024-3910	https://api.regulations.gov/v4/comments/CDC-2022-0024-3910	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines have caused so much harm that I want them completely eliminated. I personally have had my medications taken after 23 years of stable use. I was able to live a normal life and contribute to society in meaningful ways. Now I am unable to leave my home. I have been out of the house 3 times in the last year as untreated pain now leaves me in daily agony. I know I don't have much time left, my body has worn down and my physician is too afraid of DEA to prescribe to me. What I have to live with every day is inhuman. The new guidelines will do nothing to erase the fear in physicians and they will continue to abandon patients. I want the guidelines completely thrown out and give the power back to physicians completely.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006484ff9895	Armand	None	2022-04-05T18:33:32Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Armand, Nicole	l1m-7d6h-ukaq	False	None	False	2022-04-12 05:37:24.284	[]
3905	CDC-2022-0024-3911	https://api.regulations.gov/v4/comments/CDC-2022-0024-3911	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good day, my name is [name redacted] an I am a 62 year old women, that has been in several car accidents, dating back to 2006, then another in 2010. Both required injections in lower back and physical therapy, along with some pain medication. Over the years my pain has increased and medications have changed. I had managed to remain employed until 2019.My reason for writing this comment is because the Government has decided that they should have a say in patient care. In other words, since they deem it a opioid epidemic, they have a say in an individuals general care. This should not be allowed. If a patient has never had any problems with drug screening,doctor shopping or pharmacy harassing, they should not be treated liken the average addict and if you see a person has a problem, get them the help they need on an individual basis, not treated as one.<br/><br/>I am aware of the problems we face as a nation in regards to the opioid epidemic,but we should not be treated as if we are less then, because we have pain and are trying to find relief so we can participate in everyday functions with a little relief.<br/><br/>Sincerely,<br/><br/>Worried Patient	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gina	None	None	0900006484ff98df	Sanders	None	2022-04-05T18:45:42Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Sanders, Gina	l1m-808k-nkob	False	None	False	2022-04-12 05:37:24.533	[]
3906	CDC-2022-0024-3912	https://api.regulations.gov/v4/comments/CDC-2022-0024-3912	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>FOR ME PERSONALLY, A DAILY DOSE OF METHADONE (5 MG) HAS CHANGED MY LIFE! FOR THE FIRST TIME IN OVER 40 YEARS I AM SYMPTOM FREE FROM THIS TRULY DIBILITATING ILLNESS. I'VE TRIED ALL THE TREATMENTS FROM KLONAPIN TO ROPINAROLE. THE SIDE EFFECTS WERE NASTY (SOMNULENCE, IRRITABILITY, MEMORY LOSS, AND MORE). THE PHENOMENON KNOWN AS "AUGMENTATION" PLAGUES ALL THESE DRUGS (DOPAMINE AGONISTS) SUCH THAT OVER TIME, THE DOSAGE HAS TO BE INCREASED TO ACHIEVE A BENEFICIAL EFFECT, CAUSING MORE SIDE EFFECTS AND A TRUE DEPENDENCY THAT IS NEARLY IMPOSSIBLE TO OVERCOME. METHADONE, ON THE OTHER HAND, HAS NONE OF THE SIDE EFFECTS, NO AUGUMENTATION, NO DEPENDENCY, AND MOST IMPORTANTLY, IT IS MORE EFFICACIOUS THAN ANY OF THE PREVIOUSLY APPROVED DRUGS FOR RLS. PLEASE, PLEASE, APPROVE THIS TREATMENT PROTOCOL FOR THIS CHRONIC, DEBILITATING DISESEASE. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ff9d22	Bucholtz	None	2022-04-05T18:55:48Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Bucholtz, David	l1m-8kbq-7jg9	False	None	False	2022-04-12 05:37:24.764	[]
3907	CDC-2022-0024-3913	https://api.regulations.gov/v4/comments/CDC-2022-0024-3913	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This year I am 60 and the situation has caused a huge rift in my marriage and personal life with family and friends - my ability to travel has been severely effected because I have be present to receive my meds and each state and country differ on regulations. As a start, Recall the 2016 CDC guidelines and you will return respect to the CDC!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff99f8	Anonymous	None	2022-04-05T18:56:06Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-95mo-3x4r	False	None	False	2022-04-12 05:37:25.022	[]
3908	CDC-2022-0024-3914	https://api.regulations.gov/v4/comments/CDC-2022-0024-3914	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Where in you data does it Sat death's have lowered? Finding pain medication for people is an individual doctor patient relationship. They are the only ones who can judge a person's pain tolerance and medical conditions. Most are multi faceted. I don't know many CPP that only have one thing wrong. All documented medical conditions. This has to be considered!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Loretta	None	None	0900006484ff9a3c	Ranieri	None	2022-04-05T18:56:43Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Ranieri, Loretta	l1m-9qdb-sqcr	False	None	False	2022-04-12 05:37:25.255	[]
3909	CDC-2022-0024-3915	https://api.regulations.gov/v4/comments/CDC-2022-0024-3915	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband is 60 years old. He broke his leg in multiple places and had rods inserted when he was 19 due to a motorcycle wreck. In 2004, he fell off a roof and was facing amputation of his foot due to the trauma sustained by his ankle during the fall.<br/><br/>In 2005, he sought treatment with a Pain Management Specialist. My husband was able to continue working thanks to the relief he received from opioid medications. The medications did not totally relief ALL of his pain but made his life bearable. <br/><br/>When researching Pain Management Specialists we paid specific attention to whether or not a doctor was a "pill mill" doctor. We sought advice from our insurance company as well so as to avoid the charlatans.<br/><br/>In fact, he did see several of these "doctors". It was obvious that patient care was NOT as important as profit.... Watching patients arrive to their appointments limping or exhibiting pain until they received their prescriptions, when they literally RAN from the office to go fill their prescriptions.<br/><br/>With the help of our insurance company we found a reliable, reputable doctor. My husband did not "doctor shop" and stayed with his Pain Management doctor for 15+ years.<br/><br/>In 2012, he was diagnosed with osteoarthritis in multiple places throughout his body, compounding the pain he suffered.<br/><br/>During his time under the care of a Pain Management Specialist, he had a difficult time obtaining his medications from pharmacies due to the tightened regulations concerning opioid medications. In many cases, the pharmacists REFUSED to fill his medications REGARDLESS of his doctors orders. <br/><br/>We literally spent many hours attempting to get his prescriptions filled. There were times when he would have to endure a week or more without his medicines. <br/><br/>My husband NEVER abused his medications. He took them exactly as prescribed.<br/><br/>During times he was unable to fill his prescription, I saw him contemplate suicide as the pain was so great. <br/><br/>This scenario should NEVER happen in a country as great as the USA. <br/><br/>LEGITIMATE doctors should be able to care for their patients and patients should be able to fill prescribed medications without having to feel like criminals in the process. <br/><br/>I would be happy to supply you with ALL of my husbands medical records, prescriptions receipts, emails between pharmacies refusing to fill medications and any other pertinent documentation needed to verify my husband's journey. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alison	None	None	0900006484ff9a49	VanderMolen	None	2022-04-05T19:00:44Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from VanderMolen, Alison	l1m-9w9v-5hbl	False	None	False	2022-04-12 05:37:25.507	[]
3910	CDC-2022-0024-3916	https://api.regulations.gov/v4/comments/CDC-2022-0024-3916	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good morning,<br/><br/>I’m a 71 year old female and currently in a battle to retain the use of hydrocodone/acetaminophen 10/325 for my chronic pain related to OA and RA. I was prescribed a dose of 60mg/day ten years ago. It was subsequently reduced to 40mg/day and I’ve been on that dose continually for the last 8 years or so. It works for me and I’ve had no issues with it whatsoever. I’m now fighting for my life, literally, for continuity of care. With hydrocodone I’ve been able to continue doing the things I love that also make my life worth living. I work 21\hrs/wk at a physically demanding post-retirement job that I love. Attending raucous rock concerts at which I stand and scream with the crowd is something that feeds my soul. Hiking, biking and snowshoeing are important activities I enjoy.<br/><br/>I’m now on my final month’s supply of hydrocodone. In searching for a doctor who will continue my prescription I’ve been told I will overdose, that my osteoporosis will worsen and my bones will break, that I’ll be involved in an MVA, among other risks designed to invoke fear. I’ve been accused of being a dealer, I’m considered a “seeker”, I’ve been preached to, condescended to, yelled at and lied to. I’ve been “fired” by one of my providers for “non-compliance” only because I disagreed with his one-size-fits-all stance regarding narcotics. There was no “non-compliance” he just wanted to take the easy way out rather than dealing with a patient trying to make a reasoned argument. His ego demanded a sheep that mumbled “yes sir” to everything. <br/><br/>All I want right now is a continuation of the life I’ve led for 10 years. No more, no less. Most of the doctors I see on a regular basis are in agreement with me but their hands are tied due to management dictates. For management it’s one size fits all when it comes to prescribing narcotics and the easy way out for them is to prescribe none at all - no risk involved (except to me). A doctor’s opinion based on years of treating me means nothing. <br/><br/>Knowing my ability to obtain this drug safely and legally is being cut off I’ve attempted to go a period of time without it. There is no joy working bent in half from pain, there is no joy in hobbling to a rock concert and being forced to sit through it because I can no longer stand, there is no joy in feeling the need for a cane to steady my balance because my leg hurts so much. There’s no joy in life. Period.<br/><br/>Is hydrocodone a wonder drug that heals my body from every type of pain? No, of course not. But it mitigates the pain, makes it manageable and gives me a quality of life I can live with…CAN LIVE WITH.<br/><br/>So now what? When I take the final tablet that I have, do I quit my job, stay home and sit in a recliner all day until I die? Sorry, that’s not living and it’s a recipe for disaster in terms of my psyche. It’s well past time to give doctors the autonomy to prescribe for their patients without fear of reprisals, to take away loopholes in wording that allow management to continue taking the risk-free easy way out, to give patients the respect they deserve in knowing their own bodies and how certain drugs may or may not affect them.<br/><br/>I ask you to seriously consider revising your guidance. For people like me. <br/><br/>As a way of background, I worked for 20 years in pharmaceutical research and development managing clinical trials and contributing to the submission of NDAs. I’m not some stereotypical “seeker” looking to score a hit.<br/><br/>Regards, <br/><br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006484ff9a73	Collicott	None	2022-04-05T19:08:05Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Collicott, Marilyn	l1m-ae9l-zcun	False	None	False	2022-04-12 05:37:25.769	[]
3911	CDC-2022-0024-3917	https://api.regulations.gov/v4/comments/CDC-2022-0024-3917	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include RLS as chronic pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ramey	None	None	0900006484ff9ac3	James	None	2022-04-05T19:11:32Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from James, Ramey	l1m-b0el-ofoq	False	None	False	2022-04-12 05:37:26.015	[]
3912	CDC-2022-0024-3918	https://api.regulations.gov/v4/comments/CDC-2022-0024-3918	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Regarding document number CDC-2022-0024, as someone who has suffered from chronic pain for 35 years, I was encouraged to see that the CDC acknowledges in the opening paragraphs of the 2022 guidelines that unintended harm was done to the pain patient community. The CDC acknowledges that states have used the 2016 guidelines as the basis for enacting new opioid prescribing regulations and laws which have led to the abrupt stopping and/or forced tapering of opioids, as well as patient abandonment by physicians. Therefore I find the lowering to 50 mme disingenuous at best. If the CDC wants to correct the harm done to the pain community, any mention of mme needs to be struck from the guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff9ac4	Anonymous	None	2022-04-05T19:12:09Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-b0wt-78vo	False	None	False	2022-04-12 05:37:26.262	[]
3913	CDC-2022-0024-3919	https://api.regulations.gov/v4/comments/CDC-2022-0024-3919	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been experiencing chronic pain for the past four years. This began with whiplash from a car accident and continues with arthritis--which results in inflammation up and down my spine. I have no history of either opioid or alcohol abuse but have reached a dead end in trying to get some kind of ongoing prescription for pain relief from my provider: [name redacted]. My quality of life it much lower than it used to be. Over-the-counter painkillers are not effective. I have vigorously pursued other options including PT and related stretching exercises which have helped in a limited way but I still have multiple days a week where the pain distracts me, reduces my energy and stops me from doing many activities.<br/><br/>From what I understand about your guideline revisions, I don't think they will have any effect on most primary care physicians' or nurse practitioners' willingness to address my chronic pain via opioids. Please make them clearer! I just can't wait another several years for some relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joe	None	None	0900006484ff9b1e	LePla	None	2022-04-05T19:13:15Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from LePla, Joe	l1m-c032-qluu	False	None	False	2022-04-12 05:37:26.506	[]
3914	CDC-2022-0024-3920	https://api.regulations.gov/v4/comments/CDC-2022-0024-3920	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff98c7	None	None	2022-04-05T20:11:56Z	Maine Primary Care Association	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Maine Primary Care Association	l1m-7jog-dkht	False	None	False	2022-04-12 05:37:26.763	[]
3915	CDC-2022-0024-3921	https://api.regulations.gov/v4/comments/CDC-2022-0024-3921	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When providers try to hold long time opioid patients to the 80-90 mg equivalent and insurance companies become companions to this same "regulation", the pharmacies and their staffs also are party to it. This becomes a hassle for the patient and the system becomes the drug pusher to illegal drugs--the patient becomes tired of being harrassed and being treated like a criminal and figures what do they have to lose and that it would probably be cheaper just to start using street drugs like heroin or pills they could get not knowing that they may be laced with fentanyl. The state of NM makes every provider prescribe narcan annual with every opioid prescription not realizing that most long time opioid patients are not really the people who need narcan, and are intelligent enough not to escalate their dosing to get into that kind of trouble. The state of NM in general has a very poor pain care provider network as well as most of them are more interested in making money with injections and procedures rather than treating patients. NM requires pain continuing education every year, but it seems to be more rote learning than applied learning. The prescription monitoring program (PMP) is a tool that the state requires that the provider looks at if they prescribe controlled substances, but it only shows the date of the prescription and a date that the pharmacy enters that may not coincide with the actual date the patient picks the rx up, which can be a problem for the patient. Maybe if continuing education about hyperesthesia and overdosing went along with the "pain contract" every patient signed and was reviewed at every drug test interval so there is an understanding between patient and provider that would help both patient and provider. There needs to be a trust and respect relationship with the patient, not a suspect and accuse relationship with the patient along with education and other forms of pain treatment besides the pills such as: lidcocaine patches, NSAID creams, tens units, accupuncture, physical therapy techniques, chiropractic, ice and heat packs, plus activity etc.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006484ff9b4b	Coomber	None	2022-04-05T20:16:43Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Coomber, Susan	l1m-chbj-q1ik	False	None	False	2022-04-12 05:37:27.018	[]
3916	CDC-2022-0024-3922	https://api.regulations.gov/v4/comments/CDC-2022-0024-3922	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Otho Lazer therapy seemed to have a positive effect in reducing pain for the first two or three treatments. It is very easy to take, and the people who administered the test were pleasant and upbeat, which did promote a positive feeling.<br/>Unfortunately, I have not noticed any long-term benefit from treatment series. My condition is no better or worse that it was before treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ff9ba3	Maurer	None	2022-04-05T20:17:09Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Maurer, James	l1m-d15a-4p32	False	None	False	2022-04-12 05:37:27.264	[]
3917	CDC-2022-0024-3923	https://api.regulations.gov/v4/comments/CDC-2022-0024-3923	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a decorated Vietnam combat veteran wounded in both legs during that period. I have, from repeated nerve conduction studies, neuropathy in all extremities rated "severe". Initially this was deemed to be a result of exposure to dioxin(s) through the spraying of Agent Orange and I was given a 40% disability rating for that. Later upon diagnosis of type II diabetes the cause mysteriously changed to a result of that disease. I don't know why or really care.<br/>Since 1998 I was treated by use of opioid drugs, specifically Hydromorphone (4mgx4 daily) and a slow release morphine (15mgx2 daily). At first those were adequate to allow me good use of my legs. The condition is, I've been told, progressive, and I can attest to that now at age 73.<br/>Throughout my time using those drugs I have been increasingly restricted. One primary care physician told me that I was taking enough to "drop an elephant" as I stood before him, not an elephant. Others (I've had repeated changes of primary care physicians - about one a year since 2005 or so) have been variously accusatory, demeaning, and clearly pressured to reduce and eliminate my use of the only drugs which have helped me. I've willingly tried in good faith several alternative compounds either as 'off label' or specifically meant to help with neuropathic pain. I suppose they may help some with a less advanced or severe condition but none of them helped me at all. Some made me sick or ill feeling in one way or another.<br/>Now with yet another change of primary care physician his clerk (or nurse, helper, whatever) was so abusive of my sense of dignity along with insisting upon yet another reduction of treatment to some level well below effective use of the drugs, seemingly out of fear of an agency or administrative censure, that I decided not to take any more abuse to obtain relief and unless there is a shift in the focus of the restriction of the drugs which actually do relief chronic pain, and soon, well... I won't try to obtain help thru illegal means, the risks are too high. So I'll take it if I can or I guess I've lived enough. There hasn't been anything medical about the use of effective pain relief since doctors began reporting to the Federal Drug Enforcement Agencies, now have there been?<br/><br/>ps: I tried to attach copies of the nerve conduction studies but seem not to have sufficient bandwidth up here in the hills of thin populace. Sorry.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kenneth	None	None	0900006484ff9bd1	Shine	None	2022-04-05T20:18:28Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Shine, Kenneth	l1m-d90c-se8e	False	None	False	2022-04-12 05:37:27.503	[]
3918	CDC-2022-0024-3924	https://api.regulations.gov/v4/comments/CDC-2022-0024-3924	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the daughter of a now deceased mother who was abruptly cut off of her pain medication after being on the same medication , which by the way was very effective at controlling her pain for over 25 years. She never asked for more tablets and was very careful about recording the dose and time she took her medication. She would not take her pills 5 minutes before they were due. During the last month of her life without pain relief, she was in excruciating pain and she only lived 1 month after her pain medications were cut off. I could see she was suffering and felt helpless to do anything to help, this has now had an impact on my mental well being as my last memory of my mother is seeing her crying in pain. I know you believe pain patients are all drug crazed maniacs, however this is truly not the case. Please consider that your misguided and frankly arbitrary guideline have hurt people and destroyed lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff9c86	Anonymous	None	2022-04-05T20:19:07Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-ergs-jpre	False	None	False	2022-04-12 05:37:27.748	[]
3919	CDC-2022-0024-3925	https://api.regulations.gov/v4/comments/CDC-2022-0024-3925	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient for over 10 years now. I've had many MRI'S, CT scans and over a dozen surgeries. Sarcoma cancer survivor, osteoarthritis throughout my body and blood disorders. The pain is real, constant and will not be cured. It is essential that I can get the medication I need in enough quantity for quality of life. The madness and over reach Govt and DEA has put on our Medical providers to prescribe too little pain medication needs to be changed. Most patients use their pain medication as prescribed and shouldn't be punished because of the few irresponsible addicts. Most if us have hard factual medical evidence of our conditions. Pain Patients shouldn't have to be stigmatized, belittled and expect a life of more misery just to get proper relief from pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006484ff9c88	Piontek	None	2022-04-05T20:19:29Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Piontek , Mark	l1m-evqv-y8eg	False	None	False	2022-04-12 05:37:27.990	[]
3920	CDC-2022-0024-3926	https://api.regulations.gov/v4/comments/CDC-2022-0024-3926	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am taking this opportunity to comment on opioid prescribing guidelines because I have several concerns I wish to express. I keep up with news articles about opioid use and misuse because it effects my situation. I know that legal opioids are helpful for chronic conditions, because I have a chronic condition. I also had shoulder surgery, which was very painful and take months to heal, even with physical therapy. Because of my surgery I think that for many situations the allowable number of pills that can be prescribed, such as seven days, for for example, is not enough for many situations. This example of pill count for one cause, which I read about, would not be proposed by anyone that has had surgery and needed relief from pain. They would need more than that I would think.I can understand the reason for opioids being a controlled substance, but from the numerous articles I have read, Fentenal, heroine, and other illegal drugs are by far the main drugs that kill people. I have a chronic situation where stenosis in two areas of my spine cause inflammation and nerve pain. I am in a pain program to treat this. Also I get steroid injections, which helps, but does not eliminate pain. My point is that pain relief medication is necessary for may people and regulations shouldn't be so tight that people can't get the help they need. I am writing as an individual who's been trying to cope with back pain for 50 years. When it first started, no one knew how to treat it and I went to a chiropractor before they were legally licensed and physical numerous physical therapists. Physical therapy methods improved and modern medicine improved. Please improve regulations so that people can get what they need without the process being burdensome, disparaging, or impossible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	0900006484ff9c89	Nichols	None	2022-04-05T20:20:19Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Nichols, Mike	l1m-ex7r-mhvk	False	None	False	2022-04-12 05:37:28.277	[]
3921	CDC-2022-0024-3927	https://api.regulations.gov/v4/comments/CDC-2022-0024-3927	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff9cca	None	None	2022-04-05T20:30:51Z	Spine Intervention Society	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Spine Intervention Society	l1m-evyv-cq44	False	None	False	2022-04-12 05:37:28.514	[]
3922	CDC-2022-0024-3928	https://api.regulations.gov/v4/comments/CDC-2022-0024-3928	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is my second time to tell you how HARMFUL this is caused me. I used to be able to care for myself as I live alone and have no family or friends who are nearby. I'm 64 years old and have endured all types of therapy, injections, surgeries and everything from otc medicine, creams, devices like tens, braces and things I've forgotten about now. I suffered a fall in 2008 that caused great damage. Until last year, I was provided good pain relief and then my doctor suddenly closed permanently. New doctor FORCED TAPERED me without even discussing it with me. I was on a stable dose of 75mme per day without incident. I never abused my medication, passed every drug test and I keep my medications ked even though I've alone, no visitors. I was able to take care of myself, my home and my dog. I did a bit of home maintenance, gardening and crafts. I was doing well, considering how bad my spine is deteriorating. Now I'm on 45mme. My life is so horrible. I have no quality of life, just barely doing the necessities. I'm sad, mad and frustrated with the medical community and the government overreaching. Don't I deserve to be able to do the things that make life bearable?I feel like I'm just sitting here and watching my hopes and dreams just disappearing. I'm begging you to remove the 50mme and ALL mme from your barbaric rules. This is killing the chronic pain patients and it's torture. Nobody deserves to go through this everyday until they die.<br/>Please hear us!!<br/>I've chosen not to include any documents that proves my injuries however I'm on disability and that's proof that you know what my situation is.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484ff9cd9	Gad	None	2022-04-05T20:32:17Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Gad, Kathleen	l1m-fgdg-mzpm	False	None	False	2022-04-12 05:37:28.765	[]
3923	CDC-2022-0024-3929	https://api.regulations.gov/v4/comments/CDC-2022-0024-3929	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I need more pain meds than the government currently allows. There are actually many people struggling with debilitating conditions that require a appropriate amount of meds for us to get through the day. Not everyone on pain meds are abusing them. It doesn't seem fair that we lump everyone under the umbrella of abusing opiods. <br/><br/>Please come up with a system that is fair for all and punitive for all as well. My pain management doctor wants what's best for me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484ff9ce1	Faust	None	2022-04-05T20:32:44Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Faust, Michael	l1m-fpdr-gwja	False	None	False	2022-04-12 05:37:29.033	[]
3924	CDC-2022-0024-3930	https://api.regulations.gov/v4/comments/CDC-2022-0024-3930	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments on 2022 CDC Draft Opioid Prescribing Guidelines<br/><br/>1.<span style='padding-left: 30px'></span>CDC 2022 update removes 90 MME but replaces it with an even lower limit of 50 MME, while admitting the harm caused by the 90 MME limit in the 2016 guidelines, which became state laws, Medicaid hard edits, and is in the SUPPORT act. How does the CDC ensure 50 MME does not become the new limit? <br/>2.<span style='padding-left: 30px'></span>CDC states that 65% “misuse” opioids now for pain vs. 11% to get high and 2% due to being hooked. Doesn’t this suggest that the government’s regulations are causing more problems than they solving? <br/>3.<span style='padding-left: 30px'></span>CDC warns insurers, governments, and others to not use 50 MME or this guideline go set hard limits such as the Medicaid hard edits that were based on 90 MME, but how will this be accomplished?<br/>4.<span style='padding-left: 30px'></span>Sickle cell anemia and palliative should be rewritten as “severe chronic pain” or “intractable pain.” Others have equally painful diseases and should also be excluded. Why not be fair to all?<br/>5.<span style='padding-left: 30px'></span>CDC claims it found only one long-term study while hundreds exist but were not used in creating this document. Why did CDC not consider all available studies dating back 100 years plus?<br/>6.<span style='padding-left: 30px'></span>You advise the use of NSAIDs then advise against its use. Tylenol has become preferred to opioids due to prior CDC guidelines. Why recommend more harmful medicines? Addiction paranoia? <br/>7.<span style='padding-left: 30px'></span>CDC advises against using opioids and sedatives or anti-anxiety drugs. Isn’t this concern stemming from polydrug illicit drug use, and this policy will harm patients with multiple conditions. How can CDC avoid injuring patients who have pain and other conditions?<br/>8.<span style='padding-left: 30px'></span>CDC suggests opioids are not useful in fibromyalgia and osteoarthritis based on very limited data. Many patients have tried other modalities and only function thanks to opioid therapy. Why artificially limit clinician decision-making based on limited studies, and against your advice to individualize care? Why attempt to subterfuge use of opioids in any medical case?<br/>9.<span style='padding-left: 30px'></span>The CDC editors are not trained or experienced in pain management and/or have conflicts of interest and are instead biased by their roles in treating addiction. Why are pain management experts not writing this guideline, rather than addiction specialists? This entire document seems a defense of poor CDC advise continues.<br/>10.<span style='padding-left: 30px'></span>CDC suggests unproven alternative therapies & drugs to which patients often lack access to. How do you plan to make alternative therapies available when you lack the authority to grant access?<br/>11.<span style='padding-left: 30px'></span>You do not have statutory authority to regulate drugs, which belong to the FDA. Why should the CDC be writing these guidelines rather than the FDA who has the authority?<br/>12.<span style='padding-left: 30px'></span>You constantly refer to tapering and imply the default position should be to taper people off their pain medicines as a default position. Why keep harping on tapering? Is it due to your pre-occupation with addiction, which affects only a minority of patients (0.5% to 5%)?<br/>13.<span style='padding-left: 30px'></span>Your guidelines appear to discourage the use of opioids and impose restrictions not only on opioids, but you exceed your charter to cover every facet of pain management and every possible opioid prescriber. Since most overdoses are due to illicit drugs, what is the benefit of this guideline?<br/>14.<span style='padding-left: 30px'></span>How have overdoses declined since the release of the 2016 guideline, and if they haven’t, how is an even more comprehensive and burdensome document going to solve this problem?<br/>15.<span style='padding-left: 30px'></span>Why is this guideline now 229 pages and has expanded from an opioid prescribing guideline into a comprehensive pain management manual, and who authorized you to expand the scope?<br/>16.<span style='padding-left: 30px'></span>Does the CDC honestly expect a 229-page guideline to be useful to busy clinicians? This document is more an anti-opioid political document than a useful clinical decision-making guide.<br/>17.<span style='padding-left: 30px'></span>Why do you emphasize individual care is best left to clinicians and their patients, and yet this entire document attempts to standardize and limit care, resulting in needless suffering?<br/>18.<span style='padding-left: 30px'></span>How many lives has the 2016 guideline cost due to suicides and adverse health effects such as strokes, heart attacks, and other poor outcomes? How many people had to file for disability due to loss of pain care?<br/>19.<span style='padding-left: 30px'></span>CDC constantly emphasizes decisions including choice of opioids, dosages, duration of treatment, etc. should be made by the clinician and warns against misuse of this document as occurred in 2016, which became a weapon. Why not just delete the 2016 guideline and not replace it, especially since overdose deaths have risen while prescriptions have declined, showing you are only causing pain and suffering and not saving lives.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff9d08	None	None	2022-04-05T20:54:10Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1m-8d7q-e70j	False	None	False	2022-04-12 05:37:29.265	[]
3925	CDC-2022-0024-3931	https://api.regulations.gov/v4/comments/CDC-2022-0024-3931	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see the attached PDF	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffa111	None	None	2022-04-05T20:54:38Z	Invitae Corporation	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Invitae Corporation	l1m-fwej-xejt	False	None	False	2022-04-12 05:37:29.613	[]
3926	CDC-2022-0024-3932	https://api.regulations.gov/v4/comments/CDC-2022-0024-3932	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am speaking as a disabled veteran with a degenerative disease that causes the bones in my spine to crush my spinal cord while fusing. I am given no relief for this other than physical therapy. My thoughts: The CDC has no place or position to dictate medication use for terminal or chronic cases. The key to life should be comfort and peace, instead, we sow chaos and restrict the things we need. The US Government is overstepping its bounds on the idea of "we have to keep our people safe". Why can they tell people not to take a horse anti wormer and no one gives a damn, but the CDC tells doctors opioids are bad, don't prescribe, and terminal patients are tapered or cut off? There are over 3,600 comments and it's pretty obvious from your [***] attempt at containing a virus that you will never read this or care. I am just another set of words on a piece of paper in a pointless government meeting.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kent	None	None	0900006484ffa18f	Stone	None	2022-04-05T20:58:30Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Stone, Kent	l1m-gw7v-j59v	False	None	False	2022-04-12 05:37:29.847	[]
3927	CDC-2022-0024-3933	https://api.regulations.gov/v4/comments/CDC-2022-0024-3933	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had a lot of issues with my lower back/sciatica for over 6 years. I have done shots, injections and nerve burning. The last one lasted 4 years which was nothing to cry about. The only issue is that when the pain returns it returns with a vengeance. It was mid October of 2021 and the pain started up again and only got worse with each passing day. Nothing I was taking helped relieve the pain at all. I was so desperate I called my hand doctor, chiropractor, and dentist to see if any of them could help me with an injection. None of them were familiar with this type of thing so I was pretty much out of luck. Getting into a orthopedic was months out. So when my hand Dr. told me about this laser procedure that they were doing I figured why not. I am at anyone's mercy here. The only downfall was that it is not covered by insurance so I had to pay the $700 out of pocket. I find it very sad that an insurance company would rather see patients use drugs or even worse surgery when this is available. Well after 10 visits, I have to say that it has been 4 months and I am moving like a young kid again. I can't believe how much relief this procedure gave me. [name redacted] was amazing. She took the time to make sure that she hit all the spots that were giving me an issue. I have been hiking and biking. My lower back, hip and knee feel amazing! Thank you [name redacted] of [location redacted] for helping me regain my life!!! This really needs to be covered by insurance companies so that it is available to more patients who feel the way I did.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006484ffa190	Dugan	None	2022-04-05T21:00:47Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Dugan, Maria	l1m-gxdc-gkez	False	None	False	2022-04-12 05:37:30.086	[]
3928	CDC-2022-0024-3934	https://api.regulations.gov/v4/comments/CDC-2022-0024-3934	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Attached please find the comments of the American College of Occupational and Environmental Medicine	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffa1be	None	None	2022-04-05T21:05:51Z	American College of Occupational and Environmental Medicine	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from American College of Occupational and Environmental Medicine	l1m-guxm-z9cn	False	None	False	2022-04-12 05:37:30.325	[]
3929	CDC-2022-0024-3935	https://api.regulations.gov/v4/comments/CDC-2022-0024-3935	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for taking my comment.<br/><br/>My issue is chronic neck and back pain, increasing with age. I am 73 years old now.<br/>Many years previously, I was first prescribed a milder (codeine based) medication by my Primary Care doctor.<br/><br/>I was eventually referred to an Orthopedic surgeon, who determined that I had some neck and spinal damage from a traumatic injury. He did a scan of my back, and suspected the damage had occurred years earlier. I'd had a fall from a car at highway speed when very young, and did some motorcycle roadracing in my '20's, with a few high speed crashes. He determined that surgery would not help, and began to proscribe opioids (Norco). This was very helpful. <br/>Then he referred me to a local large Pain Management Clinic.<br/>I have now been with my Pain Management Physician for over 12 years, and my life is so much better. <br/>We have tried many, MANY types of medication, exercise, meditation, etc. I was taking more Norco at the time, and the "Opioid Crisis" started. His practice was limited to the amounts that could be proscribed. This required cutting back on my daily dose, but with some additional medications and exercises, meditation, etc., we arrived at a plan that I have been able to live with for many years now. But I absolutely feel that the Opioids he prescribes have elevated my quality of life immensely. I am required to visit with him every month since we started years ago. I've never missed an appointment, nor been non-compliant.<br/>I feel many of us in pain are hamstrung by the 2016 regulations and the fear it has generated for pain doctors and patients. <br/>Please give some serious consideration to leaving pain care to the qualified physicians, and address the "street" and illegal drugs in some other manner.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006484ff9fc6	Pilgram	None	2022-04-05T21:36:00Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Pilgram, Gary	l1m-i84m-xj0j	False	None	False	2022-04-12 05:37:30.562	[]
3930	CDC-2022-0024-3936	https://api.regulations.gov/v4/comments/CDC-2022-0024-3936	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You are “saving” us to death. The 2016 guidelines led to less prescribing and lower MMEs. Did it lower ODs? No! It led to more ODs. And these “new” guidelines are going to make it worse because of the 50 MME repeated references. This problem has always been a recreational drug use problem. The accidental addict is extremely rare. Addiction is not just exposure. And restrictions on the treatment of pain have led to suffering and death of legitimate patients and recreational drug users.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff9fca	Anonymous	None	2022-04-05T21:36:18Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-ib4p-rjjm	False	None	False	2022-04-12 05:37:30.808	[]
3931	CDC-2022-0024-3937	https://api.regulations.gov/v4/comments/CDC-2022-0024-3937	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>This draft still needs significant revision.<br/>It has many conflicts.<br/>These conflicts are shown by certain statements found in the<br/>document. The draft says “ it is not a replacement for clinical<br/>judgement or individualized , person-centered care….”<br/>In other words, it is a physician/patient care plan.<br/><br/>But questionably, the draft says “Many patients do not experience benefit in pain or function from increasing opioid dosages to ≥50 MME/day but are exposed to progressive increases in risk as dosage increases. Therefore, before increasing total opioid dosage to ≥50 MME/day, clinicians should pause and carefully reassess evidence of individual benefits and risks.” THIS will become a new limit not to be exceeded. So wrong.<br/><br/>It is ridiculous to put a numerical number, such as 50 MME/day, to a risk/benefit outcome when there<br/>is no scientific evidence to support MME's in that statement. Using this specific number is just a continuation<br/>of the folly of using specific MME numbers like the last 2016 Guideline did. Using unvalidated<br/>MME to guide dosing opioid pain meds has in the past led to significant harms to pain patients.<br/>Continued use of MME numbers will cause more harm in the future. Now even more harm<br/>will ensue, now that 90 MME has been removed, many will look to 50 MME as a new LIMIT!!!<br/>Which is totally wrong and not scientifically validated. This will result in more harm<br/>to patients in pain. Remove MME from the finalized version. I am a pharmacist. I have been<br/>involved professionally and personally with pain management since 1995.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joe	None	None	0900006484ff9ff6	Benotz	None	2022-04-05T21:36:52Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Benotz, Joe	l1m-il88-2sz8	False	None	False	2022-04-12 05:37:31.038	[]
3932	CDC-2022-0024-3938	https://api.regulations.gov/v4/comments/CDC-2022-0024-3938	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The whole idea of the CDC writing “Guidelines” for pain management is utterly <br/>“outside it’s lane”. If any agency should be involved, it should be the FDA, not<br/>the CDC. For these Guidelines to even be considered is outrageous. The whole<br/>concept of the previous guidelines or these new proposed guidelines is mostly based <br/>on scientific research articles that are of “fair” or “poor” quality. Past guidelines and the <br/>current draft guideline by the CDC should be abandoned. It should be done by the FDA<br/>or a group of actively practicing physicians, all of whom are experienced in pain management. <br/>NOT “medical professionals” who only do research, only work at universities, and DO NOT<br/>work as alleged experts whom are paid by anti-opioid litigation attorneys.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484ffa02a	Benotz	None	2022-04-05T21:37:45Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Benotz, Joseph	l1m-iy70-q1j6	False	None	False	2022-04-12 05:37:31.279	[]
3933	CDC-2022-0024-3939	https://api.regulations.gov/v4/comments/CDC-2022-0024-3939	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Reducing the daily limits to opioids is not fair to chronic pain patients. I am caretaker for one and child of another. It has been a terrible journey to watch my father live with increasingly more and more pain. To lessen the access of pain meds for relief from this pain is beyond unkind. Please change the regulations to not have a limit for pain management. Thank you [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rhea	None	None	0900006484ffa04c	Levander	None	2022-04-05T21:38:20Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Levander , Rhea	l1m-j774-v58b	False	None	False	2022-04-12 05:37:31.529	[]
3934	CDC-2022-0024-3940	https://api.regulations.gov/v4/comments/CDC-2022-0024-3940	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an Individual that due to injures, failed surgery's and age cannot function without opioid pain medicine. Without it I will be back to being disabled and confined to my bedroom. When I read deeply into the 229 page's of the 2022 opioid prescribing guideline's they sound like they discourage the use of opioid medication's. [name redacted] one of the writer's that authored this update is totally biased against their use. [name redacted] also has admitted to having financial interest yet he remains one of the author's. He should have been removed from the board before this even began. This along with the MME suggestions from the 2016 opioid prescribing guideline's that were misinterpreted causing laws to be made using hard numbers witch contributed to harm and suffering. With this in mind the 2022 update was an attempt to repair some on the damage done. The 50MME will cause even more damages making the harms already done even worse. This 50 MME must be removed if your sincere about helping to give flexibility to decision making by our doctors. Why is the CDC sending doctors pamphlet's with 50 MME recommendation's before the comment period is completed? Is this the intention from the beginning no matter what the people need or want? This will be a disaster, so maybe the 2016 guideline's should just be scraped without replacement! Thank You..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa063	Anonymous	None	2022-04-05T21:39:20Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-jdug-gbuf	False	None	False	2022-04-12 05:37:31.805	[]
3935	CDC-2022-0024-3941	https://api.regulations.gov/v4/comments/CDC-2022-0024-3941	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the [name redacted] at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa09b	Anonymous	None	2022-04-05T21:40:09Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-k0s4-9r99	False	None	False	2022-04-12 05:37:32.048	[]
3936	CDC-2022-0024-3942	https://api.regulations.gov/v4/comments/CDC-2022-0024-3942	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had pain problems since a second neck and low back injury in a car accident, and a bad surgical outcome from a hysterectomy. My primary care doctor handled my needs initially, until my chiropractor recommended that I see a doctor she thought could help me. One of the worst decisions I’ve ever made. Once a patient is under the supervision of a pain management clinic, it’s almost impossible to go back. The current system of doctors being aggressively harassed by the DEA has led to an environment where pain management clinics have been given free reign to order unnecessary appointments and testing, use of spinal procedures/injections that are not approved by the FDA (steroids) and have been shown to cause further harm to patients over time. There is great pressure for costly injections and procedures.<br/><br/>I first went to the pain management clinic in 2016. I used to go quarterly for appointments and be urine tested for compliance once or twice a year. The PA that I used to see called me a ‘star patient’, as I am always in compliance. The group has now decided that all patients must go to a monthly appointment and expect to be tested at each one. What a financial boon for them! The misinterpretation of the 2016 guidelines has now caused me to suffer more pain and financial hardship. Why would an unscrupulous doctor want to write a prescription, which earns them little, when they can basically coerce patients into injections at over one thousand dollars each? They also recently changed my medications, citing that the daily MME was too high (at 40 per day, with the occasional [weekly to bi-weekly] use of a muscle relaxer or anxiety medication, that is primarily for procedures/surgeries), despite my taking all of the very same medications for over a year without issues.<br/><br/>Further, the doctor I saw for many years considered me to be complicated but stable. He recently retired, and with the combination of policy changes and a new doctor, the new doctor has reduced my medication. DESPITE the fact that I have been in treatment for over a year for breast cancer.<br/><br/>In my opinion, the atmosphere created by the 2016 guidelines has allowed the pain management clinics to demand onerous visits, testing, and procedures, or risk losing the medication that has helped me have a somewhat normal quality of life. Without these medications, I am often unable to sit or walk. The pain management clinics are taking advantage of a portion of the population that is already weak and compromised. I always thought that the government was supposed to protect such vulnerable portions of the population even more vehemently than those who are stronger. <br/><br/>Also because of the guidelines, the clinic I go to will only write a prescription for one month. (My problems are mechanical, and will never get better or change without surgery, only worsen over time.) Having a ‘new’ prescription every month has led to me missing an average of ten percent of the medication. That is unacceptable. Would it be OK if only 90% of your roof functioned? Would it be ok if your brakes worked only 90% of the time? I have seen studies cited that chronic pain patients suffer from other mental effects, such as anxiety and depression over time. I contend that it is a result of the uncertainty that is brought about from the circumstances of the interpretation of the 2016 CDC guidelines as listed above. <br/><br/>My recommendation is that the guidelines are not so onerous for doctors, who then coerce their patients into expensive treatment regimes. The new pain management doctor made changes to my medications without access to my full history with their clinic. I believe it was both fear driven and financially driven. In my opinion, my care would be better under my primary doctor, who actually knows me, knows my name and my history.<br/><br/>I recommend that not only should the CDC allow doctors and patients the autonomy to make individual choices for the care that is best for each patient, but also create even more relaxed guidelines for patients with chronic pain, who are relatively stable. (Such as the quarterly visits and prescriptions that I used to have.<br/><br/>Citizens are suffering at the expense of pain management clinics. Do your duty by us, and allow patients and doctors the respect and right to choose what medical care that we decide is best for us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anna	None	None	0900006484ffa0af	Tritschler	None	2022-04-05T21:41:53Z	None	None	1	None	2022-04-05T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Tritschler, Anna	l1m-k6r9-hzgx	False	None	False	2022-04-12 05:37:32.276	[]
3937	CDC-2022-0024-3943	https://api.regulations.gov/v4/comments/CDC-2022-0024-3943	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The arbitrary guidelines set forth by a few doctors within the CDC are causing unnecessary pain and stress. Stress increases pain. The only people that should be involved with treatment are the individual and their doctors. What has been done is egregious and abhorrent. Each individual is different they heal differently and to make blanket guidelines regarding necessary medications is absurd. A handful of "doctors" have literally destroyed people's lives. Do no harm is the oath take by physicians. No one knows their patient better than their doctor who sees them regularly. In my practice the doctors were just lowering everyone to less than 90mg of morphine equivalent regardless of their needs. They also changed the records to say the patient requested to be lowered which was not true. This "guideline" has scared doctors that they will lose their license and has created an environment of subpar care and fraud. It has caused patients to seek street drugs instead of being under the care of their physicians and has led to many suicides. Patients are committing suicide because they are in so much pain. This assault on people with pain has backfired. It is denying people dignity and quality of life which leads to depression. No one should have to live in pain excruciating debilitating pain. You have taken away people's dignity ability to function and become/remain a productive member of society. People like myself require opioid medication to complete activities of daily living to live to function as best they can. You have taken that from me. I have 7 herniated discs, arthritis in my back and both knees, carpal tunnel and tendonitis in both wrists and 2 enormous fibroids the smaller is 6cm the larger is 14cm. I cant have surgery to fix my tumors because I cant be bedridden because that causes more pain. I'm also terrified of the pain I will be in from surgery and will not have proper pain medication so it is a lose lose for me. I'm in constant pain I also have immune system issues. With all of these issues I should be able to have a treatment plan with my doctor that is best for me not for people that have no interaction with me. This site is making it very difficult to write a comment it is constantly asking me to verify I'm not a robot. I'm not surprised that trying to leave a comment is made difficult I'm sure many people just gave up because they were constantly interrupted. I never want to wish anything negative on another person but I really do wish that the doctors and politicians who decided these guidelines would have to endure the same pain and indignity. Please stop the assault on people in pain it is doing much more harm.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa0e8	Anonymous	None	2022-04-06T12:57:55Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-kpe6-9t6u	False	None	False	2022-04-12 05:37:32.523	[]
3938	CDC-2022-0024-3944	https://api.regulations.gov/v4/comments/CDC-2022-0024-3944	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had an implant put in my big toe for bone spurs and arthritis. Several weeks after the surgery I was still having a burning pain and limited movement in my great toe. My Doctor recommended I try laser therapy as an alternative to taking pain medication or having to operate again. The burning pain kept me from being doing the thing I enjoyed like taking walks and hiking. After the first couple treatments I notices I had more flexibility in the joint area and I had NO burning pain. As the treatments progressed I was much more mobile. I did go a few times for "tune ups" if I felt the stiffness return. I have not had the burning pain since.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006484ffa0f7	McNally	None	2022-04-06T12:58:21Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from McNally, Linda	l1m-kvl4-p5kj	False	None	False	2022-04-12 05:37:32.768	[]
3939	CDC-2022-0024-3945	https://api.regulations.gov/v4/comments/CDC-2022-0024-3945	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a spinal injury 12 years ago, and I have been on pain management ever since. Because of the opioid epidemic, government made quite a few strict laws in regards to opioid medications. Unfortunately you took these laws too far, and they are too restrictive when it comes to people who are on long term pain management with pain management doctors. We cannot have refills, so the doctor has to send in 3 different prescriptions at a time, you can only have a 28 day prescription, even though there are 30 days on average in a month, you have to wait 26 days before you can fill the next prescription. It causes MASSIVE headaches for those of us on pain management. Each month I have to call in to the pharmacy to get the next prescription filled. They have to sift through them to find the next one. Then they have to try to fill it in time before you run out of medication. To compound this, pharmacy’s are so backed up they don’t even answer the phones anymore. You have to go in, stand in line for 40min, just to ask them to fill it, and they have to put a rush on it, and all you can do is hope they get to it on time. Then you have to come back in a few days to get it after it’s finally filled. I switched to mail order and it helps tremendously for all but opioid medications. Because there aren’t refills, I have to call in each month, but I have to guess when it’s time to fill it. Then if it’s ok to fill, they fill it, but it doesn’t get to you in time. The doctor actually has to send in a separate 2 week prescription you have to pay for out of pocket, as insurance won’t pay for extra prescriptions, to cover the days you run out of meds. Worse, if the prescription can’t be filled yet, it gets rejected, and you have to call again. It’s the biggest headache ever. Unfortunately people who made these laws never took into account the people who actually need these medications. It should be if you are on pain management with a real pain management doctor, then they can be allowed to send in prescription with refills, that last 30 days, and can be filled a week prior to the end date. All other doctors should be subject to the new laws, but people on real pain management should have more relaxed laws, as they are strictly managed by professionals. Dentists, Primary physicians, and other doctors who don’t specialize in pain management should be held to these more strict rules, but pain management specialists who spent their careers studying pain, and learning to manage it, should be exempt to these laws. I would monitor pain docotrs to make sure they are writing correct orescriptions, as I’m sure there are always one or two who will abuse it for their own personal gain, but 99% of pain management specialist care about their patients and do what is right for them. These ridiculous laws have harmed these doctors and also the patients they care for, which includes me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006484ffa540	McGinnis	None	2022-04-06T12:59:51Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from McGinnis, David	l1m-li6t-6f8b	False	None	False	2022-04-12 05:37:32.981	[]
3940	CDC-2022-0024-3946	https://api.regulations.gov/v4/comments/CDC-2022-0024-3946	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>Docket No. CDC-2022-0024<br/><br/>The CDC has caused serious and irreparable harm with the 2016 guidelines, and the 2022 guidelines, no matter how well-intentioned, must be immediately withdrawn. The CDC is NOT a drug regulating agency, and since less than 5% of legal prescriptions of opioids result in addiction, the CDC has no justification for imposing itself or its "guidelines" upon legal, medical use of prescribed opioids. Public health is damaged by ILLEGAL drugs, not by essential medication legally prescribed by professional medical doctors. You made this mess. The thousands of chronic pain sufferers who can't get medication, who suffer with PTSD, who killed themselves were harmed by the CDC directly. <br/>All CDC guidelines--2016 AND 2022--must be immediately withdrawn. The CDC has NO JURISDICTION.<br/><br/>My son, who was 11 in 2016 and suffers from chronic intractable pain, had the opioid pain medication that he took to make him functional taken from him, resulting in depression and lack of function. He is treated like a drug-seeker just trying to go to the hospital for relief--so he doesn't go. He just suffers. He missed school and could not continue because his pain medicine was taken from him. <br/>Will the CDC find a way to get my son's childhood and teen years back for him? Can the CDC make it possible for my son, who suffers every day in 9/10 pain and lays on the couch 22 hours a day unable to move, his life back? <br/><br/>No one will prescribe him adequate pain medication now. You have DESTROYED HIS LIFE. If you need just one example, here it is. RETRACT your guidelines immediately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484ffa3a1	Kassorla	None	2022-04-06T13:00:42Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Kassorla, Michelle	l1m-lyxn-peod	False	None	False	2022-04-12 05:37:33.198	[]
3941	CDC-2022-0024-3947	https://api.regulations.gov/v4/comments/CDC-2022-0024-3947	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I've been suffering from Restless Legs Syndrome for almost 20 years. I've used a number of meds for this condition. None has been as successful as a low dose 5 mg of Oxycodone each evening to address my symptoms and have a decent night's sleep.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Thank you.<br/><br/>[name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	D.R.	None	None	0900006484ffa3a7	Liston	None	2022-04-06T13:01:56Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Liston, D.R.	l1m-m5ow-844p	False	None	False	2022-04-12 05:37:33.432	[]
3942	CDC-2022-0024-3948	https://api.regulations.gov/v4/comments/CDC-2022-0024-3948	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Give our medications and doctors bad .no more CDC guidelines let doctors have our care back.stop tormenting doctors for helping pain patients.we need help we are suffering and being tortured to death because of being denied our pain medications .we are losing beautiful innocent pain patients to suicide everyday because they can not escape the worst pain imaginable .No MME no 50ME Do not put a cap on medications we are all different and some take lower dose and some a higher dose. You do not give heart patients, diabetes patients the same dose of medications. <br/>Buy putting caps on medications you truly do not care about our lives .so many will continue to suffer in the worst pain imaginable and suicides deaths will continue because they can not take the pain you left us in ..Please show us you care about our lives. Give us back our pain medications that made life possible ...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa3d1	Anonymous	None	2022-04-06T13:02:36Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-mmu7-82qo	False	None	False	2022-04-12 05:37:33.714	[]
3943	CDC-2022-0024-3949	https://api.regulations.gov/v4/comments/CDC-2022-0024-3949	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a 58 year old woman who had to prematurely retire at the age of 53 due to intractable pain. I was working in my dream career, special education, after earning my masters degree at night while teaching during the day. I was a single mom, teaching my self-contained autism classroom at the same school my children attended. I found my calling late in life, and I was good at it. My students made progress with me, which doesn’t always happen in the world of special education. I was a really good teacher.<br/><br/>In 2014 I had my first cervical fusion. I went to a different doctor when I needed a second, who unbeknownst to me performed an “aggressive” foraminotomy. Within months my fusion cracked and I went back in for a revision. My surgeon convinced me he could fix it, and I accept my responsibility in trusting him. During the the third fusion a drill went through my spinal cord. I was back in the OR a few days later for a dura repair. My diagnoses include tetraplegia, Brown Sequard Syndrome, Central Pain Syndrome, and myelomalacia. I have recently been diagnosed with a syrinx in the hole in my spinal cord.<br/><br/>I have been treated for palliative care by my pain management physician for nearly 5 years. We have worked *very hard to establish my current protocol of Gralise (only long acting gabapentin works), Nortriptyline, oxcarbazepine, baclofen and Percocet. I am prescribed 4 Percocet daily, and each day I take it differently depending on how my pain behaves. I do not get high from it. Until the syrinx symptoms, that protocol allowed me to have routines and maintain a quiet life. (The pain from the syrinx has me bedridden).<br/><br/>My physician team (neurologist, new surgeon, internist and pain management) worked very hard to perfect this protocol. It took many medication trials and tweaking. I am a responsible patient, my medications are locked in a safe at all times, I submit to all scheduled and random drug tests as requested. At 90 MMEs my pain was just managed. At anything less, I would be housebound. Nerve pain is like no other and it’s so hard to describe. My entire right side, neck to fingertips and toes, is both on fire and frost bitten 24 hours each day. I am being stung by jellyfish over and over. Clothing hurts, as does feeling air. I can’t feel temperature but an ice cube touch will make me scream in pain. At times it feels like my skin has been torn off, muscles are tightly braided then I’m doused in gasoline and set on fire. My left side is completely normal. The pain gets worse over the course of the day, Percocet brings a little relief. Any relief is a gift.<br/><br/>My pain management Dr knows all of this well. He knows me, and we have a great working relationship for which I’m very grateful. But he is already scared of the guidelines, as are his colleagues. Offices around the country are being raided, physicians arrested, practices closed. These were originally meant to be guidelines, but now are mandates. Reducing those even further will result in under treated patients and practices closing. This will result in patient suicides, and increased fentanyl and heroin on the streets as pain patients seek out an equivalent. <br/><br/>Reducing MME guidelines will NOT reduce the number of pain patients in this country. Please remember how I described my nerve pain. What happened to me can happen to your spouse, sibling, parent, or your child. They would deserve to be able to get through each day at a level 8 or 9 instead of bedridden each day, as do I. Truthfully, we treat our pets more humanely than pain patients who would give anything to be living a “normal” life. Please - trust us and trust our physicians. The greater majority are playing by the rules.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa3df	Anonymous	None	2022-04-06T13:05:13Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-mt02-uwwo	False	None	False	2022-04-12 05:37:33.925	[]
3944	CDC-2022-0024-3950	https://api.regulations.gov/v4/comments/CDC-2022-0024-3950	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The past 6-7 years of the original opioid guidelines(of lies) were put out/acted on as "law" in most states, the opioid epidemic/crisis(rather hysteria), has only gotten worse.<br/>These "guidelines" have NOT made a positive difference at all. Forcing & restricting pain meds(that helped millions have a better quality of life) is just pushing them to illegal street drugs, where they'll become addicted, overdose & probably die. Illegal street drugs are the whole culprit of the opioid crisis/epidemic, in the 1st place.<br/>Over 100,000 deaths & rising from illegal street drugs now, up to unheard of numbers, from restrictions on Rx pain meds cuz of the guidelines. Suicides are way up over 30% now(cuz of doctors forced cut offs/drops too).<br/>WAKE UP! These guidelines have NOT, nor will they(even being updated) help control the opioid epidemic. They haven't helped or made a difference in the past 7 years, they aren't going to now or in the future either. Cuz its NOT prescription pain medicines(never was), its illegal street drugs! WAKE UP!!!<br/>And while you continue to restrict more & more Rx pain meds, they're opening more & more "safe" injections sites for addicts. Tell me that makes sense?<br/>I have multiple injuries/diseases that cause intense pain. I also have a higher tolerance for ANY medicine, I require a higher dose of any kind of medication. Forced down on pain medicine has drastically declined my life. I once was able to do pretty much most things I could when I was younger, on the pain meds. Being forced down to such a low dose now(& its still a higher recommended in your/cdc guidelines) just is not helping enough. I'm now bedbound & cant do anything any more & depressed cuz of it. You can't say that higher doses of Rx pain meds don't help! I'm living proof they do! & I know of many others it helps too. This is just insane! I just want to be a normal functioning person of society, like I was back on the higher dose of Rx pain meds. Why is that too much to ask? That is/should be MY right<br/>The "opioid epidemic" was NOT caused by doctors overprescribing! There's NO law/limit on what doctors can prescribe, so how were they over-prescribing? So thats a big lie & made up! Stop with the lies/false info!<br/>Quit harming people who need & do very well with Rx pain meds. You are taking our lives away from us. STOP!<br/>CDC is supposed to be for infectious disease. Pain/pain meds are NOT an infectious disease! How does the CDC have ANY authority on writing anything for pain? They don't!<br/>CDC needs to be removed from writing anything for pain/pain meds. The original "guidelines'(that have caused hell for pain patients) & these "updated guidelines' need to be revoked/voided! Any laws that came from the guidelines need to be revoked/voided too.<br/>CDC has NO ideas of our medical conditions & pain meds that work best for us, giving back our lives so we can live again. STOP destroying our lives!<br/>The 90's had "pill mills" & docs handing out pain meds. But that has been cleared up for quite a while. Now there's "drill mills", docs forcing invasive/harmful injections/surgeries to receive pain meds that work.<br/>Problems with overdoses/deaths are from illegal street drugs! NOT Rx pain meds. Restricting Rx pain meds, is pushing more & more right to very dangerous illegal drugs. STOP! You're killing more & more people, NOT helping. Its NOT working & it won't!<br/>Ever hear the quote, "Doing the same thing over & over, expecting different results, is the definition of insanity"? CDC's guidelines are insanity! They've had a complete negative effect! Continuing with them, is only going to cause more harm!<br/>The beginning of 200 some pages of "updated guidelines" does seem to correct some of the problems from original. But supporting documents counteract them.<br/>The guidelines need to be withdrawn! & docs told to return patients to last most effective dose before the guidelines.<br/>You cant make 1 size fits all manual for everyone. Thats what these guidelines are. We're NOT all the same! We're ALL different, require different kinds of treatment, different meds at different doses for different amounts of time. That should be determined by Doc & patient. NOT some government group that has absolutely NO idea/understanding of what patient has & needs. <br/>Cuz of CDC's opioid guidelines, docs have been harassed/raided by DEA, using "guidelines" to prosecute them. That is scaring ALL doctors away from prescribing & closing their practices. This is causing patient abandonment! It ALL stems from the CDC's "guidelines". To correct the problems/harm the "guidelines" caused, they need to be removed/revoked/voided completely! Doctors need to be told to return their patients to their last most effective dose of Rx pain meds! Then CDC stay out of docs/patients offices/lives! Give us our lives back!(for those still alive/barely hanging on from the torture you've caused us).<br/>VOID ALL guidelines & return patients to last most effective dose!<br/>Thank you!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	0900006484ffa3e9	Perelli	None	2022-04-06T13:09:22Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Perelli, Catherine	l1m-myy7-12b3	False	None	False	2022-04-12 05:37:34.150	[]
3945	CDC-2022-0024-3951	https://api.regulations.gov/v4/comments/CDC-2022-0024-3951	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	TIME it's measured and finite, Most pain patients are senior citizens close to the end. We've used years of our lives suffering, trying futile remedies, doctors, cures, therapies and the only relief finally, are regulated opioids. The collected data from the Pain News Network and Red Lawhern sites clearly show from gov't data that this current "crisis" is due to illegal fentanyl and the age group is 17-35. The applied MME rules affect ALL ages, all ailments, all patients regardless of illness or chronic condition. I've had debilitating chronic migraines that have derailed my goals somewhat and robbed me of 1/3 of my life. I have pages of all the therapies, interventions, off-label medicines, various specialists over 50 years and finally the only relief are opioids. The stigma is overwhelmingly shameful, yet I've been a professional, tax-payer, parent, aunt, daughter, sister, blood donor and farmer for decades and the one thing that can give the rest of my days relief, is curtailed, questioned, due to a demographic that doesn't fit. The outrage and targeting of pain patients is misguided. IF any rule should apply, it's time. If someone is a senior with a long laundry list of trials and errors in finding relief, then why the MME requirement? Isn't that a specialist's decision? If it's a first time attempt at a solution for an illness, then perhaps MME, start low and see if it works. To curtail and make patients suffer is cruel and inhumane. so please undo the MME requirement for doctors.It's a dangerous and ineffective solution for illegal drug use. It also infringes into a citizen's right for effective, safe care w/ a licensed doctor. I fear I'll die before the CDC understands that medical vs recreational use are 2 distinct things that are driving this DEA interference into doctors' offices, patients' lives and personal medical issues, In this day and age, medical records are easily accessed and show historically long, painful stories spanning decades, of individuals living responsible, safe lives with the aid of opioid pain medications. They're responsible, non-drinkers who just wish to get on w/o another painful day in bed. Why the blanket MME's isn't a scientific fact but a manufactured number by a paid, faux professional, who wasn't a practitioner. Why is this suddenly political? It's HEALTHCARE not security for gov't agents w/ zero expertise of medicine. Quantifying willy/nilly a maximum dosage without science is irresponsible and dangerous.As a 7th generation American and science professional I'm appalled by this nonsense that is passed off as science, shame on the CDC for accepting a random, unstudied number for something they knew little about. MME's need to be erased and instead, historic pain records, age, diagnosis and doctors decide with patient feedback make their medical decisions about appropriate medication plans. What a nightmare this off-the-cuff MME decision has caused for so many.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa412	Anonymous	None	2022-04-06T13:11:10Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-nlbo-6f6l	False	None	False	2022-04-12 05:37:34.418	[]
3946	CDC-2022-0024-3952	https://api.regulations.gov/v4/comments/CDC-2022-0024-3952	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Remote patient monitoring coverage for pain must be expanded and increased given the benefits of reducing overall healthcare expenditure. Better care, safe prescribing, compliance with treatment plans and overall improved doctor patient relationships.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dipan	None	None	0900006484ffa41e	Patel	None	2022-04-06T13:11:21Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Patel, Dipan	l1m-nwep-94ne	False	None	False	2022-04-12 05:37:34.635	[]
3947	CDC-2022-0024-3953	https://api.regulations.gov/v4/comments/CDC-2022-0024-3953	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>Ankylosing spondylitis As well as osteoarthritis also femoral neuropathy and inguial neuropathy I’ve had 29 surgeries and in 2019 I was moving a washer up a flight of stairs from the basement and I was on the bottom and the washer slipped from the dolly knocked me from the stairs and I fell down a flight of stairs landed on concrete and the washer landed on me I broke all the ribs my big toe and scapula on my left side as well as has three holes on the back of my head and had a TBI. My surgeries started when I was 15. I had special shoes and braces and have felt pain since the age of 6. I do not have a working spleen.I have never let it hold me back. I played sports into college worked out into my 30’s when I was told I would do neither. I worked full time into my 40’s but sadly had to finally stop in 2017 when I was working part time. I am mostly titanium now Ive had 3 hip replacements 2 knee replacements and my neck is fused. I had rotator cuff and bicep surgery this year and said that’s it I’m done I can’t do it anymore the fighting with the hospitals and doctors and all it entails I’m done no more surgeries I’m done!!!!  I have had 12 broken bones since 2011 including my right femur because I refuse to give up and this NFL job is my last hurrah I’m 57going on 58 and this disease and pain has taken so much from me I just want one last thing. I need the meds to do it. I have been called drug seeking, and argued with doctors and pharmacists. I am a very guarded person. That is so far from the truth. I am trusting in the CDC to have a heart and help CPP’s<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006484ffa424	French	None	2022-04-06T13:16:11Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from French , Paul	l1m-o0ho-6csb	False	None	False	2022-04-12 05:37:34.847	[]
3948	CDC-2022-0024-3954	https://api.regulations.gov/v4/comments/CDC-2022-0024-3954	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My personal medical records have been tampered with, as an attempt by the people responsible for my chronic LBP, to dissuade my providers to stop medical care. It does indeed sound like a Netflix drama, and maybe it will be.<br/><br/>Outside of my HMO, private providers have advised me of the legal rights of all Americans to receive appropriate medical care for their conditions, not the imaginary conditions of chronic gossipers, who are adept with the same high level legal, and medical skills taught in higher level institutions throughout the world.<br/><br/>I am not advocating drug addiction to treat extreme neurological and bone pain. Perhaps people receiving high level doses of potent legal narcotics should have their blood levels of the opiates assessed in an appropriate and non discriminatory manner, the same way people now receive Covid, and Flu shots.<br/><br/>The problem is an attitude adjustment, not a political one. If the CDC wants to review my personal medical record, I will allow it, for research reasons, but I do not want it published.<br/><br/>I haven't been denied opiates but they were reduced to 85 MME, when 120 MME seemed to reduced my pain .<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa45f	Anonymous	None	2022-04-06T13:17:25Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-oh6x-8xxh	False	None	False	2022-04-12 05:37:35.063	[]
3949	CDC-2022-0024-3955	https://api.regulations.gov/v4/comments/CDC-2022-0024-3955	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am one of the countless chronic pain patients affected by the war on opioids. I am a responsible adult. I am a small business owner and dedicated mother of two wonderful girls. Unfortunately I was diagnosed with Degenerative Disk Disease that caused spinal cord compression and nerve damage. I am active in all recovery methods, treatments and surgery. I am and have been in debilitating pain since 2016. The only relief from the 24 hour agony has been opioid medications. They allowed me to function, work and parent my children successfully. The current regulations have left me unable to work a normal work week and be a successful functional member of society. My every energy now is saved for my children and family. The quality of my life has been severely diminished and most days I’m just surviving. I deserve to be a functional member of society and to contribute to my community. My children deserve a mother who isn’t withering in pain. Legitimate pain patients with medical diagnoses are not getting the pain treatment they deserve and need. I’ve had dear friends that were abruptly tapered or denied their life saving medication turn to the streets and immediately OD because of fentanyl. The real problem is the lack of approximate pain treatment and medical care. Real patients just want to live their lives as fully as possible, work, pay their bills and take care of their families.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	K	None	None	0900006484ffa461	M	None	2022-04-06T13:18:15Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from M, K	l1m-oiqj-tepj	False	None	False	2022-04-12 05:37:35.308	[]
3950	CDC-2022-0024-3956	https://api.regulations.gov/v4/comments/CDC-2022-0024-3956	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006484ffa497	Heinz	None	2022-04-06T13:20:13Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Heinz, James	l1m-pft0-6n14	False	None	False	2022-04-12 05:37:35.528	[]
3951	CDC-2022-0024-3957	https://api.regulations.gov/v4/comments/CDC-2022-0024-3957	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a polio survivor who was doing great on Meperidine for years and then it disappeared - I was told by the manufacture that they no longer manufacture Meperidine because it's not a MONEY MAKER for big pharma. Since then, I've been taking Tramadol which is useless for Post Polio Syndrome and it causes the scariest hallucinations when taken at night & during the day I feel out of sorts. I've read comments similar to mine in doing research about what happened to Meperidine. The newer supposedly better opioids made me sick and one Fentanyl patch nearly killed me. I want the CDC to reconsider bringing back Meperidine in pill form in 100 mgs for those of us who cannot tolerate so many of the other pain medications and are now taking medications that provide little relief and more side effects.. The CDC took away a drug that provided relieve and has fewer side effects that has been around since the 1600's because of money. I used to be active on my bike, swimming and walking. Those activities I enjoyed are no longer an option for the quality of my life and it's depressing. I wonder how long I can go on living with this debilitating chronic pain that you took away from us for money???? Please bring back Meperidine	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terri	None	None	0900006484ffa4c0	Takahashi	None	2022-04-06T13:21:00Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Takahashi, Terri	l1m-qnlu-er57	False	None	False	2022-04-12 05:37:35.742	[]
3952	CDC-2022-0024-3958	https://api.regulations.gov/v4/comments/CDC-2022-0024-3958	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The guidelines for prescribing opioid definitely need to be re-considered, therefore I agree with the Proposed Clinical Practice Guidelines. Since there is no "true" scale to assess pain, providers need to thoroughly assess medical background before prescribing opioid drugs for pain management. An area for improvement in order to minimize risks--like potential overdoses and death--would be to make the guidelines mandatory when considering prescribing opioids. If it is in place as an option for clinicians to think about, they might not follow up with their patients as they need to before prescribing another round or consider another form of therapy. <br/>I agree with these guidelines because it can be an opportunity to help educate individuals on the harm of opioid use. Talking more about the issue, informing, teaching, bringing awareness can help save lives. <br/>Another reason I agree with the proposed guidelines is because it can minimize opioid-related admissions which can be costly to healthcare. It can strain our healthcare system resources and take away from time and energy that can be devoted to other patients in need. <br/>Lastly, re-assessing patients and their pain management can minimize addiction and potential for opioids to end up in the hands of the wrong individuals as they are selling them in our neighborhoods. Unfortunately, I lost my teenage sister to an opioid-related overdose. The Fentanyl-related overdoses and deaths are at an ultimate high. Re-assessing pain levels after pain management therapy can significantly reduce harm to our communities and individuals.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006484ffa4c2	Ramirez	None	2022-04-06T13:22:24Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Ramirez, Nancy	l1m-qs6i-dsmw	False	None	False	2022-04-12 05:37:35.979	[]
3953	CDC-2022-0024-3959	https://api.regulations.gov/v4/comments/CDC-2022-0024-3959	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am deeply concerned that this 2022 draft will have further negative effects for people with painful chronic diseases. Firstly, it is being drafted by some of the same doctors that wrote the 2016 guidelines and whom are known to be anti-opiate. Secondly, while this draft does do away with a cap on MMED, it states very clearly that most people will do well with 50 MMED. The MME calculator was made so doctors could estimate the dosage for a patient when switching from one medication to another. Period. Saying that most people will do well on 50 MMED discounted sex, weight, metabolism, and a number of different things that are crucial to how someone reacts to a certain drug. Would we say that every person with depression would do well with 10 mg Prozac? Of course not! Finally, the 2016 guidelines were made into LAWS in most states and are considered hardfast limits by most insurance companies. The ONLY way to fix this is to redact the 2016 guidelines and leave medicines up to the FDA. I personally have been harmed by the 2016 guidelines, even now while under palliative care for CANCER plus all my other painful chronic diseases due to the fact that my insurance will only allow dosages up to a certain MMED, which by now we know is junk science when dealing with how a person reacts to an opioid medicine. Please, redact the 2016 guidelines and let the FDA govern medicines!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Audrey	None	None	0900006484ffa4c6	Liebl	None	2022-04-06T13:23:05Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Liebl, Audrey	l1m-qzg7-pr79	False	None	False	2022-04-12 05:37:36.192	[]
3954	CDC-2022-0024-3960	https://api.regulations.gov/v4/comments/CDC-2022-0024-3960	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to comment on the proposed 2022 CDC opioid prescribing guidelines. I strongly applaud your response to the call for the need for revision to the 2016 guidelines that added a great burden and resulted in distress and pain for those experiencing chronic pain. The 2022 proposed guidelines are needed to clarify prescribers', insurance companies', and pharmacies' misconceptions and misinterpretations of the earlier guidelines that resulted in distress and patient harm. <br/>I will share one very sad narrative that highlights the narratives of many. An 88 year old woman with severe osteoarthritis, who had been functioning alone at home taking a stable dose of tramadol (50mg po twice daily), was told by her PMD of 20 years that the tramadol would no longer be prescribed because the PMD did not want to have to deal with regulatory oversight. She was unable to find a prescriber in her nearby community who accepted her insurance, so she had to stop the tramadol, and as a result, stopped her usual activity of working in her garden and cleaning her own home.<br/>It is essential that the proposed guidelines clearly state the restrictions that were incorrectly interpreted by insurance companies, regulatory bodies, pharmacies and prescribers in the 2016 version must be abandoned. Situations, such as the one that I described, cannot be encouraged. The CDC needs to be clear about taking responsibility for the inappropriate interpretation of the earlier guidelines and stress that these guidelines are not to be used to dose limit, pill limit, or limit duration of opioid therapies by insurance companies, or pharmacies, and should not be used to penalize prescribers who take the necessary safety precautions to protect their patients and society from opioid related harm.<span style='padding-left: 30px'></span><br/>The proposed guidelines are a great improvement over the 2016 guidelines in stressing that the guidelines are not to be viewed as rigid and inflexible, and that the management of pain requires a patient-centric, individualized approach, with shared-decision making, using multimodal analgesics and nonpharmacological interventions. <br/>I can share many narratives of patients who were abruptly tapered off opioids they had safely and responsibly taken for years because prescribers used the 2016 guidelines as a "way-out" of prescribing, or feared regulatory or governmental penalties. <br/>The 2016 threshold doses failed to acknowledge those patients who were stable on higher doses, appropriately monitored, and enabled to function at their desired level of activity. Instead, many patients were stigmatized and abandoned.<br/>I urge you to remove the carve out for patients with cancer, sickle cell disease or who require palliative care because, fortunately, many people are living long and productive lives with these conditions, and are entitled to the same level of safety and consideration given to anyone requiring long-term opioid therapy. <br/>I support the recommendations for frequent monitoring of patients at initiation of opioid therapy, and during opioid tapering, and urge for appropriate compensation of prescribers who provide such monitoring. <br/>I urge the CDC to support efforts to work with insurance companies and pharmaceutical companies to reduce cost and increase patient access to opioids that are more tamper resistant, and have improved safety profiles. I also urge the CDC's support in increasing access to non-pharmacological therapies such as cognitive behavioral therapies, physical therapies, and mind-body therapies to reduce reliance on opioids and other pharmacological products.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maureen	None	None	0900006484ffa4e2	Cooney	None	2022-04-06T13:24:47Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Cooney, Maureen	l1m-rsly-62gw	False	None	False	2022-04-12 05:37:36.405	[]
3955	CDC-2022-0024-3961	https://api.regulations.gov/v4/comments/CDC-2022-0024-3961	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a Step-daughter, who is totally debilitated because of a severe spinal problem and disc problem she’s went through some surgeries and will not ever be free of the horrible pain that she is made to adore daily. She is not a drug abuser or an addict she has a legit debilitation and yet every month she is forced to fight for a little relief because of these guidelines do you have set forth. It pains my heart to hear her cry and then no the pain that she soon. Two years ago I woke up to a fracture , it just happened . It was severe and lost all control of body functions. I got a taste of the unbelievable excruciating pain that ann has had to Indore for years. One month I went and suffered until I had surgery thank God my surgery help me. And lives with this pain every day and nothing can help her it is my belief that there are certain cases that should be a priority and be recognized that all patients are different and that certain ones need their medication they don’t want to die but they don’t wanna live in the misery that they’re being forced to live in by their meds being lowered or sometimes canceled. I remember working at a hospital and our oncologist took care of the cancer patients but really had no personality or special traits or realization of what he prescribed for each cancer patient and how it affected them he just know he was an oncologist and he would treat the patient until the day arrived that he himself came down with cancer and had to go through what he had prescribed and taken care of patients for years and years a couple months into his treatments he made the statement if I make it through this I will change the way that I take care of my patients from now on because only after going through what I’ve been through with this cancer of my own too I realize some of the misconceptions I’ve had and how I need to change how I treat my patients . I think this is an excellent analogy that could be applied to this group that are causing untold grief for some patients that will live the rest of their lives in agony and pain I think we could do better and we must do better and I appreciate your time	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484ffa903	Goddard	None	2022-04-06T13:25:56Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Goddard, Kathleen	l1m-sf9k-bzfi	False	None	False	2022-04-12 05:37:36.628	[]
3956	CDC-2022-0024-3962	https://api.regulations.gov/v4/comments/CDC-2022-0024-3962	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To who it may concern: I am an individual who has had a L4/L5 spinal fusion back in 2001. Since then I have had non stop chronic pain in my lower back and right leg and was managing it through a pain specialist successfully for years. In 2015 I moved to another state and started seeing another specialist. At the time I still couldn’t work but was able to handle a lot more things like vacations with my family and enjoying life a bit like a normal person. A year or so later I was taken off my meds and put on Norco. It didn’t work as planed so I asked if I could be put back on Percocet. I was told no and from then on was treated with suspicion and extra drug testing. Then the specialist increased the amount of visits which mean more co pays I couldn’t handle. Long story short I had to quit any kind of care and try to manage this other ways. My life is now a nightmare and it’s hit or miss with managing it myself. Something needs to be done about this issue. The majority of people who are overdosing in this so called epidemic are heroine users who don’t know fentanyl has been added to their supply. Percocet now has a stigma on it and it’s the only thing that seems to help me. People I’m my condition are now killing them selves in desperation all over the place. We are suffering because of people’s decision to take hard drugs and this needs to change.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa906	Anonymous	None	2022-04-06T13:26:43Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-si3h-uzqx	False	None	False	2022-04-12 05:37:36.857	[]
3957	CDC-2022-0024-3963	https://api.regulations.gov/v4/comments/CDC-2022-0024-3963	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Https://wamu.org/story/16/01/20/what_happens_to_the_body_and_mind_when_starvation_sets_in/	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa3b9	Anonymous	None	2022-04-06T13:50:47Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-md95-vl60	False	None	False	2022-04-12 05:37:37.103	[]
3958	CDC-2022-0024-3964	https://api.regulations.gov/v4/comments/CDC-2022-0024-3964	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	https://www.practicalpainmanagement.com/pain/other/comorbidities/complications-uncontrolled-persistent-pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484ffa3d3	Young	None	2022-04-06T13:50:53Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Robert	l1m-mn35-38ih	False	None	False	2022-04-12 05:37:37.327	[]
3959	CDC-2022-0024-3965	https://api.regulations.gov/v4/comments/CDC-2022-0024-3965	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	https://blogs.va.gov/VAntage/67708/va-study-uncovers-link-pain-intensity-suicide-attempts/<br/><br/> https://www.practicalpainmanagement.com/pain/other/comorbidities/complications-uncontrolled-persistent-pain<br/><br/> https://www.practicalpainmanagement.com/pain/other/chronic-persistent-pain-can-kill<br/><br/> https://wamu.org/story/16/01/20/what_happens-to_the_nody_and_mind_when_starvation_sets_in_	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484ffa41f	Young	None	2022-04-06T13:50:59Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Robert	l1m-nwnh-t3xt	False	None	False	2022-04-12 05:37:37.538	[]
3960	CDC-2022-0024-3966	https://api.regulations.gov/v4/comments/CDC-2022-0024-3966	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	https://thomasklineme.medium.com/opiodcrisid-pain-related-suicides-associated-with-forced-tapers-c68c79ecf84d<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484ffa452	Young	None	2022-04-06T13:51:07Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Robert	l1m-o7xd-3z40	False	None	False	2022-04-12 05:37:37.779	[]
3961	CDC-2022-0024-3967	https://api.regulations.gov/v4/comments/CDC-2022-0024-3967	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC:<br/><br/>Please stop encouraging physicians to be afraid to properly treat their patients. I am sick to death of hearing stories from my suffering friends, who really do need the help and do not have addiction issues. Please review this proposed update and eliminate anything that would leave doctors without the guidance they need to know it's okay to do their jobs for their patients—and emphasize that states shouldn't be taking CDC guidelines and distorting them into hard-and-fast rules that end up getting patients further disabled or killed through neglect.<br/><br/>This is not acceptable. Please do better with this update.<br/><br/>I refer you to this interview:<br/><br/>https://www.npr.org/2022/04/04/1090919988/pain-patients-and-doctors-worry-the-cdcs-new-opioid-guidelines-may-be-damaging<br/><br/>It is not acceptable to put patients at risk of suffering and death or leave mysterious whether or not it's okay for clinicians to help their patients enough that the help actually works. What if it were you or a loved one going through this? Please put yourselves in patients' shoes when writing guidelines. It's the patients who are the protagonists in all healthcare stories, not regulators or doctors.<br/><br/>[initials redacted]<br/>[city redacted], WA	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa472	Anonymous	None	2022-04-06T13:51:49Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-ospn-vys3	False	None	False	2022-04-12 05:37:37.995	[]
3962	CDC-2022-0024-3968	https://api.regulations.gov/v4/comments/CDC-2022-0024-3968	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First I would like to say that I find it absurd that the CDC is even involved in opioid prescribing as it does not fall within it's designated scope of practice. While I recognize that you track data regarding all manner of deaths, this does not give your agency jurisdiction over all manner of death. That said, I would like the following questions to be considered.<br/><br/>1. CDC 2022 update removes 90 MME but replaces it with an even lower limit of 50 MME, while admitting the harm caused by the 90 MME limit in the 2016 guidelines, which became state laws, Medicaid hard edits, and is in the SUPPORT act. How does the CDC ensure 50 MME does not become the new limit?<br/>2. CDC states that 65% “misuse” opioids now for pain vs. 11% to get high and 2% due to being hooked. Doesn’t this suggest that the government’s regulations are causing more problems than they solving?<br/>3. CDC warns insurers, governments, and others to not use 50 MME or this guideline go set hard limits such as the Medicaid hard edits that were based on 90 MME, but how will this be accomplished?<br/>4. Sickle cell anemia and palliative should be rewritten as “severe chronic pain” or “intractable pain.” Others have equally painful diseases and should also be included. Why not be fair to all?<br/>5. CDC claims it found only one long term study while hundreds exist but were not used in creating this document. Why did CDC not consider all available studies dating back 100 years plus?<br/>6. You advise use of NSAIDs then advise against its use. Tylenol has become preferred to opioids due to prior CDC guidelines. Why recommend more harmful medicines? Addiction paranoia?<br/>7. CDC advises against using opioids and sedatives or anti-anxiety drug. Isn’t this concern stemming from polydrug illicit drug use, and this policy will harm patients with multiple condition. How can CDC avoid once again not injuring patients who have pain and other conditions?<br/>8. CDC suggests opioids are not useful in fibromyalgia and osteoarthritis based on very limited data. Many patients have tried other modalities and only function thanks to opioid therapy. Why artificially limit clinician decision making based on limited studies, and against your advice to individualize care? Why attempt to subterfuge use of opioids in any medical case?<br/>9. The CDC editors are not trained or experienced in pain management and/or have conflicts of interest and are instead biased by their roles in treating addiction. Why are pain management experts not writing this guideline, rather than addiction specialists? This entire document seems a defense of poor CDC advise that continues.<br/>10. CDC suggests unproven alternative therapies & drugs which patients often lack access to. How do you plan to make alternative therapies available when you lack authority to grant access?<br/>11. You do not have statutory authority to regulate drugs, which belongs to the FDA. Why should the CDC be writing these guidelines rather than the FDA who has the authority?<br/>12. You constantly refer to tapering and imply the default position should be to taper people off their pain medicines as a default position. Why keep harping on tapering? How will the CDC ensure that doctors and pharmacist do not continue to just discontinue patients without tapering which has caused thousands of suicides since the 2016 guidelines? And it should be noted that methadone clinics will not see chronic pain patients as they only treat addicts. How will the CDC make methadone clinics change their policies?<br/>13. Your guidelines appear to discourage use of opioids and impose restrictions not only on opioids, but you exceed your charter to cover every facet of pain management and every possible opioid prescriber. Since most overdoses are due to illicit drugs, what is the benefit of this guideline?<br/>14. How have overdoses declined since the release of the 2016 guideline, and if they haven’t, how is an even more comprehensive and burdensome document going to solve this problem?<br/>15. Why is this guideline now 229 pages and has expanded from an opioid prescribing guideline into a comprehensive pain management manual, and who authorized you to expand the scope?<br/>16. Does the CDC honestly expect a 229 page guideline to be useful to busy clinicians? This document is more an anti-opioid political document than a useful clinical decision making guide.<br/>17. Why do you emphasize individual care best left to clinicians and their patients, and yet this entire document attempts to not only limit care but to set standards to be used as norms in all matters of law which increases the ever growing divide between clinicians and their patients' needs.<br/>18. How many lives has the 2016 guideline cost due to suicides and adverse health affects such as strokes, heart attacks, and other poor outcomes? How many people had to file for disability due to loss of pain care?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	0900006484ffa907	P	None	2022-04-06T13:55:07Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from P, Anne	l1m-sj1x-63tn	False	None	False	2022-04-12 05:37:38.212	[]
3963	CDC-2022-0024-3969	https://api.regulations.gov/v4/comments/CDC-2022-0024-3969	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please take away any reference to MME. These 2016 guidelines have harmful impacts to people of the chronic pain community. I spend most of the day in bed because my quality of life has been taken away. I used to have a productive day not anymore. I’m begging for my quality of life back. I have a lot of life left but enjoying life is hard when I suffer with pain day in and out. Please take away Any mention of MME	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephanie	None	None	0900006484ffa921	Meza	None	2022-04-06T13:55:19Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Meza, Stephanie	l1m-t5rj-zqkg	False	None	False	2022-04-12 05:37:38.428	[]
3964	CDC-2022-0024-3970	https://api.regulations.gov/v4/comments/CDC-2022-0024-3970	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in 19 car accidents 17 of which were fault because of seizures and multiple concussions. There were no pain clinics but there were anti opiate treatment centers. So I first started at a methadone clinic which cos a fortune. And after awhile the methadone stopped working. So they switched me to Suboxone. But this is also not a pain clinic but an opiate withdrawal center. I’ve had MRI, CT SCAN, EEG, Sleep study, & a barrage of tests. I have been diagnosed with dozens of problems. I filled disability and of course was denied.most of the time I have to slide around or be pulled by a towel.I’m supposed to be walking with a walker but I’m only 42 so I’m trying to push that back as fas as I can. I’m supposed to have back surgery on 2 different places which I can’t wait for. They need to do pain blocks on both knees but there giving me the run around about that. I’ve written letters to the wonderful attorney in Rhode Island who really seems to care about each and everyone of the suffering patients. Then I wrote a letter to every single legislator in my area that<br/>Signed those bills to punish normal people in pain. Not addicts just regularly people. My tortured soul and all my pain and suffering is on yours and your family’s souls and my blood is drenched all over your fake bodies. Look at Philadelphia where can clinics are gone. That’s the<br/>Results of what you do. You all should be ashamed of yourself and I hope your somewhere changing. I hope your soul is healing. I hope you find your peace falling on your knees… praying. Because this is the last chance killing us. You’ve taken our rights away to our own body and choices now your killing us but taking away our rights to choose our proper healthcare when we know our own bodies. Your disgusting. And the women who voted for these 1800s bills you will burn in hell more than anyone.<br/><br/>Sincerely,<br/>[name and phone number redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Hilary	None	None	0900006484ffa95b	Alexander	None	2022-04-06T13:57:41Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Alexander , Hilary	l1m-u2hi-be85	False	None	False	2022-04-12 05:37:38.695	[]
3965	CDC-2022-0024-3971	https://api.regulations.gov/v4/comments/CDC-2022-0024-3971	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have two major issues with the 2022 Guidance (Draft) <br/><br/>1. [name redacted] amongst others references his own studies multiple times. I consider this a conflict of interest. There should be a clear distinction between those conducting studies and a panel considering these studies when recommending guidance. Surely there are enough professionals available to interpret studies and make recommendations based on them aside from the person creating the study. He references his own research 90+ times. This is a blatant conflict of interest. The second point I take issue with is the references to clinical based guidance when in either the same sentence or immediately thereafter the study states there exists “limited clinical studies.” This document is supposed to guide clinical practice for the entire United States of America. This is shoddy work. Opioid alternatives to acute, post surgical, subacute or chronic pain must be studied in depth before being offered as true options. This is a follow up to the 2016 Guidance. Was anyone besides the authors of this draft conducting studies? My only conclusion is that this is another extremely biased document by individuals completely opposed to opioid treatment for conditions other than cancer, sickle cell disease or end of life palliative care. Shame on the CDC for choosing another group of individuals who would ask all pain sufferers to basically suck it up.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynn	None	None	0900006484ffa5e8	Ackerson	None	2022-04-06T13:58:55Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Ackerson, Lynn	l1m-vvfj-4k3t	False	None	False	2022-04-12 05:37:38.919	[]
3966	CDC-2022-0024-3972	https://api.regulations.gov/v4/comments/CDC-2022-0024-3972	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 73 year-old female who has suffered chronic debilitating pain for more than ten years. Before the CDC Guidelines were revised, and chronic pain sufferers were denied medications legally prescribed by their doctors that actually worked to give the patient a life (in my case, a 100 mcg 3-day Fentanyl patch supplemented as needed with oral Oxycontin tablets), chronic pain sufferers were suddenly classified with drug addicts who obtained such medications illegally and for “recreational” use. The word “criminal” was actually used by one of my doctors.<br/><br/>Now, because I (and others like me) have been denied the medications we need, I have terrible, debilitating, neverending pain 24/7. I have no quality of life. I cannot stand more than 30 seconds without crippling pain, nor can I walk more than a minute. It is extraordinarily difficult and often impossible to cook or do simple household chores. I really do not see any point in trying to continue with the ineffective medications my pain specialist has prescribed, although the doctor has tried her best to help me. Why is the goverment deciding that I should have no quality of life? The very fact that the CDC has issued new guidelines indicates that the federal government recognizes that chronic pain sufferers have been wronged grievously. I would like someone to explain to me how I am better off without the medications I had been prescribed legally that worked and better off without any kind of life at all. I would also like an explanation of why the term “criminal” has been applied to me when I have NEVER used an illegal drug or one not prescribed by a doctor.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006484ffa5ea	Silvani-Lacey	None	2022-04-06T13:59:43Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Silvani-Lacey, Cindy	l1m-vwnq-6hzu	False	None	False	2022-04-12 05:37:39.165	[]
3967	CDC-2022-0024-3973	https://api.regulations.gov/v4/comments/CDC-2022-0024-3973	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm deeply concerned about the new guidelines and the 50 MME limit you put in there. That's going to be all doctors see and get out of these new guidelines. If you insist on putting limits in your guidelines it's going to affect the chronically ill in the same way that the 2016 guidelines have and we'll see even more suicides. The MME limit becomes law and is used to force taper patients off of their much needed pain medication. You saw it with the 2016 guidelines so why are you doing it again and even worse with the new guidelines?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa608	Anonymous	None	2022-04-06T14:00:00Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-wtdr-zl7z	False	None	False	2022-04-12 05:37:39.379	[]
3968	CDC-2022-0024-3974	https://api.regulations.gov/v4/comments/CDC-2022-0024-3974	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain You Know My Name<br/>Losing my pain medication has devastated my life in so many ways. I had Intestinal Cystitis for most of my adult years and was given pain medication for 40 years. I live one day at a time with the pain of Interstitial Cystitis, back, knee and neck. I have gone from being a functional adult to being an invalid woman and wife; it has successfully destroyed my life. I can no longer enjoy my family and friends and this causes emotional problems as well, I think compassion should fit into the CDC regulations, and I have heard you are just waiting to get rid of my generation .You have successfully ruined my life and millions of others. My last days on Earth are going to be agonizing. I was just recently in a car accident and they would not give anything for pain relief.<span style='padding-left: 30px'></span>Thank you for allowing me the opportunity to make these comments. <br/><br/>[name redacted] <br/>[city redacted], North Carolina<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joyce	None	None	0900006484ffa60f	Robles	None	2022-04-06T14:00:54Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Robles, Joyce	l1m-x0z3-h1xu	False	None	False	2022-04-12 05:37:39.593	[]
3969	CDC-2022-0024-3975	https://api.regulations.gov/v4/comments/CDC-2022-0024-3975	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These regulations completely ignore the entire field of Interventional Pain Management and the multitude of procedures that can limit pain and decrease opioid use. Offering patients no options is a strategy that is doomed to failure.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa618	Anonymous	None	2022-04-06T14:03:18Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-x8q5-sbje	False	None	False	2022-04-12 05:37:39.826	[]
3970	CDC-2022-0024-3976	https://api.regulations.gov/v4/comments/CDC-2022-0024-3976	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/>I am close with a person who sadly suffers from chronic intractable severe pain caused by Chemotherapy and several failed surgeries. After unsuccessful allergic responses from several treatments the physician found that Fentanyl helps to mitigate the agony. The current regulations are unnecessarily cruel. The patient is limited to a small prescribed supply that is difficult to refill because of short inventory at the pharmacy. The palliative care doctor understands the legitimate need and at the same time is in fear even though he/she abides by the too strict suicide causing regulations. Please make Fentanyl available in a way that my friend can live the life deserved with pain that is manageable. Please do not be responsible for another senseless suicide. Thank you for your attention.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484ffa61f	Gottlieb	None	2022-04-06T14:03:47Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Gottlieb, Diane	l1m-xgas-240l	False	None	False	2022-04-12 05:37:40.065	[]
3971	CDC-2022-0024-3977	https://api.regulations.gov/v4/comments/CDC-2022-0024-3977	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope you take the time to read these very sincere and honest comments from people living with daily pain.<br/><br/>Also, I hope you at CDC can coordinate with the DEA to prevent them from using the CDC guidelines to <br/>justify arresting good doctors & shutting down pain clinics & leaving the patients in crisis without medical help.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa62f	Anonymous	None	2022-04-06T14:03:56Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-xu5k-an4g	False	None	False	2022-04-12 05:37:40.309	[]
3972	CDC-2022-0024-3978	https://api.regulations.gov/v4/comments/CDC-2022-0024-3978	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Starting with a fall that broke my back my life has never been the same. Even after surgery and a long recovery there was little improvement. The only relief I found was with opiate pain medicine. In 2016 my medication was cut by more than half. Without these medicines I have no life. Long nights with little sleep complicated everything and lead to living confined in my home. Now I fear that with these new guideline's 50MME will become the rule. This must be taken out of this document. At this dose life will become more unbearable. There are many others that suffer besides myself. The rules that went into affect in 2016 have not helped the drug epidemic in our country because RX pain medication is not what is killing people. If my pain medication is not restored I will never be able to return to even a simple life. The stigma that people like myself endure is shameful. How did being hurt come to this? I only want to return to a life where I can rejoin a simple life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa67c	Anonymous	None	2022-04-06T14:04:34Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1m-zqme-kfcm	False	None	False	2022-04-12 05:37:40.571	[]
3973	CDC-2022-0024-3979	https://api.regulations.gov/v4/comments/CDC-2022-0024-3979	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ll make it short and sweet. You have made no change here! As a matter of fact you have made it worse by dropping the MME!! You need to completely get rid of the MME that is kind of saying everyone’s pain is the same across the board and this should help bc it helps someone else. Get rid of all these ridiculous MME recommendations better yet come out and say y’all were WRONG and you should have never lumped legally prescribed pain medications to law abiding citizens were the problem, because they never were. The truth was embellished and now is the time to do what’s right and say you made a terrible mistake and that this guidelines need trashed!! You guys are punishing the most vulnerable people, our Veterans are suffering the most. YOU SHOULD BE ASHAMED!! I beg you CDC to make this right and get rid of these ridiculous guidelines especially the MME recommendation!! Thanks!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffa6ee	Anonymous	None	2022-04-06T14:04:56Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-1u1l-ts0k	False	None	False	2022-04-12 05:37:40.806	[]
3974	CDC-2022-0024-3980	https://api.regulations.gov/v4/comments/CDC-2022-0024-3980	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I AM 1 OF THE MILLION PAIN PTS. THAT WAS DOING FINE WITH SAME PAIN MNGMT. OFFICE AND WAS WITH OUT ANY COMPLAINTS OR PROBLEMS ALL SUDDEN MY DOCTOR WITH OUT ANY RESON HAS NO WAY OF HELPING ME ANY MORE, I HAD TAKEN OPIOIDS OVER 20 YEARS WITH OUT ANY COMPLICATIONS WHAT SO EVER, AND HAD PERFECT ATTENDENCE WITH ANY AND ALL DOCTORS,AND NOW NO PAIN DOCTORS OFFICE WILL EVEN SEE NOR HELP ME WHAT SO EVER, SINCE JUNE 2017 I HAVE NOT HAD NO LIFE WHAT SO EVER, EVEN THOUGH YOU CLAIM NO STUDIES OF LONG TERM USE OF OPIOIDS, I WAS TAKEN 1 OXYCONTIN 45MG. 2 XS A DAY AND 1 OXYCODONE 30MG,IMMEDIATE RELEASE TABLET 4 XS A DAY, AND HAD A SUCCESSFLE QAULITY OF LIFE AND TOOK CARE FAMILY AND 30 YEAR MARRIAGE WAS AWESOME, NOW I SIT HOME SWOLLEN , AND CONSTANT PAIN ,WITH A SLEEP HABIT IN 7 DAY TIME FRAME I SLEEP 3 TO 14 HOURS IN THAT TIME FRAME FROM PAIN ,I HAVENT SLEPT IN MY BED SINCE DISCON, OF OPIOID, IN YOUR NEW GUIDE LINES YOU ALL FELL TO CONVINCE DOCTORS TO KEEP ALL LONG TERM OPIOID PTS. THAT WAS A SUCCESSS?THEY SEEM TO THINK YOU ALL DISAPPROVED ?NOW NO DOCTOR WILL SEE ME? WHAT DO WE DO BESIDES SIT WATCH LIFE GO ON ,AND SIT AND WAIT TO DIE?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484ffa6f3	Hensley	None	2022-04-06T14:05:32Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Hensley, Steven	l1n-2359-zdqf	False	None	False	2022-04-12 05:37:41.044	[]
3975	CDC-2022-0024-3981	https://api.regulations.gov/v4/comments/CDC-2022-0024-3981	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I started taking Opids when I was 67 years old. I'm 74 and still taking the exact dosage prescribed to me seven years ago. Never have I had a problem with trying to take more than the written script until a few months ago when I urged the doctor to increase the number of times I can take an Opid, from 3 10 Mg's a day to 4 10 Mg's a day? The answer was no. <br/><br/>I've been wearing an Aspen back brace for the last three years, which helps. In addition, I recently started using a 10's unit, which sends electrical impulses to the troubled area, which also helps. Regrettably, neither of these devices eliminates the pain but does aid in reducing such pain. <br/><br/>When taking a more thorough look at these devices, there are limitations when using them, much like taking Opids. For example, I can wear the brace at certain times, and wearing the 10's unit is illegal while driving, and the wires will eventually get tangled while sleeping. So those times, especially at night, when trying to fall asleep, that extra dose would help.<br/><br/>In my opinion, the CDC went to the other extreme in their recommendation on prescribing Opids for chronic pain. Some of the comments stated people who obtain the medication for chronic pain weren't abusers. I also believe that doctors should know their patients when prescribing an Opid, as mine does, and know that they won't misuse them. Also, the same should apply to doctors when prescribing for acute and subacute pain but with additional precautions, where extra-strength Ibuprofen for a tooth problem or a post-op procedure would suffice.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484ffb0ea	Ferrari	None	2022-04-06T14:06:33Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Ferrari, John	l1n-66no-ecy0	False	None	False	2022-04-12 05:37:41.287	[]
3976	CDC-2022-0024-3982	https://api.regulations.gov/v4/comments/CDC-2022-0024-3982	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is my honor to provide comments related to the proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids. When developing new and reforming existing clinical guidelines for prescribing opioids, I strongly encourage that the needs of minorities and people of color are taken into better account. Although there is not any reliable data to demonstrate a difference in pain tolerance between people of color and white people, the two groups are treated differently (Mossey, 2011). People of color are less likely to have their pain managed and according to Mossey, represent a disproportionate percent of the population experiencing pain. People of color are often victims of the biases of clinicians that cause minorities to have more unmanaged pain. Not only is the harmful to people of color it also leads to preventable hospitalizations. Preventable hospitalization reduction would create savings and reduce waste in our health care system. I recommend that the guidelines specifically include guidance to clinicians that support their efforts to refrain from perpetrating biases. I also recommend that the guidelines include more strategies and guidance on how to manage acute and chronic pain in older adults. Doctors need a comprehensive education or tool that explain the differences in pain in younger to middle aged adults as well as older adults. Too often, the needs of older adults including pain are dismissed by medical representatives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisbeth	None	None	0900006484ffabfb	Roberts	None	2022-04-06T14:07:03Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Roberts, Lisbeth	l1n-7hnw-ttl4	False	None	False	2022-04-12 05:37:41.522	[]
3977	CDC-2022-0024-3983	https://api.regulations.gov/v4/comments/CDC-2022-0024-3983	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Change the definition of palliative care to those with degenerative, not fixable, diseases and you might just change the lives of a lot of people. Quality of life matters! We are not all addicts! Seems you have made up your mind by posting a pamphlet on 50MME???? Please, we have a drug problem in this country, but it is no longer because of doctors and patients. I am an RN of 22 years.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484ffb11a	Kronus	None	2022-04-06T14:08:51Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Kronus, Lisa	l1n-ch89-apeu	False	None	False	2022-04-12 05:37:41.761	[]
3978	CDC-2022-0024-3984	https://api.regulations.gov/v4/comments/CDC-2022-0024-3984	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Do I truly live in a free country?" I dug a little bit and found your newest leaflet. Said leaflet is talking about a maximum of 50 MME. How on earth are you coming up with these blanket numbers? Blanket pain conditions and individuality matter. The sacred/physician/patient relationship is in jeopardy. You MUST consider the change of the word Palliative Care, so that free and fair treatment may be given to ALL patients, regardless of being at deaths door. I participated in your workgroup. I was the second clinician they spoke with. I guess I went unheard? Circling back - you do not know the patients. The physician does. Why are you dictating how they practice? I use medication - but I also am in my heated pool every single day. I use massage therapy, acupuncture and medical marijuana at bedtime. This is what works for me - I am now staring down the barrel of TWO necessary surgeries. Will they relieve my pain? No, I doubt it. I will have an opened mind to it and be hopeful, but the ACDF, left me disabled and unable to continue on with my dream job of nursing. Are we truly a free country? When overdoses are increasing due to street drugs, and yet, we are still addressing these issues of pain relief? Please focus on the street drugs killing people, get rid of the 50MME pamphlet that has already been made and get out of the physician/patient relationship.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006484ffac50	Kronus	None	2022-04-06T14:09:43Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Kronus, Lisa	l1n-ht6t-ilhh	False	None	False	2022-04-12 05:37:42.007	[]
3979	CDC-2022-0024-3985	https://api.regulations.gov/v4/comments/CDC-2022-0024-3985	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The new Opiod regulations that went into affect a few years ago ruined my life. I have hypermobility Ehlers-Danlos, Fibromyalgia, Severe Endometriosis, Pots, Mast cell activation syndrome, chronic Migraines and Celiac disease. Before when I was able to be have Opiods as part of my daily care, I was able to have a life. I could cook, garden, keep my house clean,travel and even had a small sewing business. I had a cane and walker that were rarely used, anf a shower chair that was required due to Pots. Once Opiods were taken away from my pain management plan, I went down hill quickly. I tried Ketorol injections that didnt work, and have continuously had to keep trying lower class medications to control severe pain. As the medications changed and my pain sored, I went from being active and driving, to needing my spouse to do almost all of the things I did to contribute around the house before in addition to her full-time job. I had to close my business because it was to excrusiating to sit for long periods, and to move my neck in ways I could before. My cane and walker get used more regularly, and to be honest I am just useless. Most of my days consist of reading because that is the only way to try to occupy my mind from the pain. There are several days where I cant get out of bed. To top it off, I was prescribed gabapentin to and naproxene for the pain. The gabapentin caused me to gain 150lb over a couple of months. I have tried reducing the dosage of the gabapentin and was in so much pain I couldnt sit or stand without shooting pain in my spine and joints. <br/>In all honesty, being off opiods has made my life a living hell. I was regularly questioned what is the point in continuing because this is not living. This is torture. Do not be alarmed I take meds I need and have no intention of harming myself. The severe restrictions put on Opiods has robbed me of my independence in so many ways. It would be amazing to get even a small piece of that indepence, self dignity, and some pain free time back. Oh by the way Im only 36 years old.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffb171	Anonymous	None	2022-04-06T14:24:22Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-ih5v-pgh0	False	None	False	2022-04-12 05:37:42.255	[]
3980	CDC-2022-0024-3986	https://api.regulations.gov/v4/comments/CDC-2022-0024-3986	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Patients go to their physicians (and sometimes multiple seeking second/third opinions) and the doctors need to be trusted by the CDC and those that govern them to provide what they feel is best for their patients, they KNOW their situations best, all the dynamics and factors of their medical conditions, and should have complete control to prescribe what is best with no restraint. I’ve asked my pain management clinic straight out what percentage of their patients are responsible with the pain meds prescribed and how many abuse and they said hardly any! I find that to be true from doing research as well. The opioid meds help greatly with pain, little side affects if taken correctly, unlike the Gabapentin, Lyrica, Cymbalta, etc that doctors have to resort to using because there are not many drugs that work well for certain pains (nerve damage pain, neuropathy etc) and they don’t work well! Opioid crisis is due to illicit activity on the street, drug addicts selling laced drugs NOT due to responsible use by responsible patients and I urge the CDC to stop the madness, give doctors back their right to treat their own patients as the see fit! Opioids work great and the part that makes no sense is how dangerous Gabapentin, Lyrica, and all the other drugs that doctors have to resort to instead of what doctors know what works —— the opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	0900006484ffb51c	Duffy	None	2022-04-06T14:27:58Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Duffy, Denise	l1n-jsfa-qe5f	False	None	False	2022-04-12 05:37:42.467	[]
3981	CDC-2022-0024-3987	https://api.regulations.gov/v4/comments/CDC-2022-0024-3987	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS is an extremely disabling disease. It is like being tortured by the agony and pain of not being able to relax and sleep	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	LORI	None	None	0900006484ffb603	FINGER	None	2022-04-06T14:28:07Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from FINGER, LORI	l1n-kd2w-6znl	False	None	False	2022-04-12 05:37:42.678	[]
3982	CDC-2022-0024-3988	https://api.regulations.gov/v4/comments/CDC-2022-0024-3988	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello I want to thank the CDC for altering my life so bad that I cannot work as I want to. Thank you for being a menace to society, and a total nightmare. You have ruined so many lives with nonsense and no experience in pain. The trauma you have caused millions of lives for no reason is so traumatic that I don't think people will ever get over it. I don't know where you think pain comes from or goes but it is real it really needed to be treated and needs to be treated continuously. I have adhesions in my abdomen that means my intestines are glued together so how do you not think that that is not painful sheer idiocracy on your part. THERE IS NO CUTE FOR ADHESIONS!I would like to travel, visit family or friends go to weddings but I'm stuck trying to just live pain free. Since when do you get major surgery done and told to take aspirin, that is plain old crazy! Aspirin do more damage and opioids. At one point it does someone with a little human decency and compassion say I will not allow money to rule my decisions because obviously it's a money thing. You have a lot of blood on your hands I'm suicides and PTSD. You have children living in pain, that affects the family around you. Pain patients have to survive being ostracized at the pharmacy, the doctor's office, and then with family. You have had us painted as drug addicts and seekers when all we want to do is step outside of our house and look around us pain-free. I hope one day this hits home with some of you and there is no opioids to deliver you from the pain I'm not a person to speak bad on someone but it has pushed us to where we want pain-free CDC participants to encounter pain but have no access to opioids, shame on you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joie	None	None	0900006484ffb75a	Canty	None	2022-04-06T14:28:55Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Canty, Joie	l1n-l85u-kvoy	False	None	False	2022-04-12 05:37:42.903	[]
3983	CDC-2022-0024-3989	https://api.regulations.gov/v4/comments/CDC-2022-0024-3989	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Appreciating you for revising the CDC Clinical Practice Opioid Prescribing “Guideline”, which we all know has been taken seriously out of context and has doctors scared and even have had their licenses taken for helping people, but this draft does not address chronic conditions like RLS that are different from chronic pain from cancer. Restless legs syndrome (RLS/WED) is in my case though a chronic lifetime neurological disease with no cure that causes a very urgent need to move the legs and, in my case, other parts of my body such as my arms and torso as well. The symptoms make it impossible to sleep or even to sit for long, which seriously affects every aspect of daily life. I have had RLS {WED) all my life. It became severe when I turned 51 years old. If not for finally a diagnosis I doubt I would still be here. It is that bad!!! However, having taken all of the approved medicines, within a few years I acclimated to them and my severe RLS became even more unbearable. It was not until I was prescribed a cough medicine with a small amount of codeine in it that I accidentally stumbled on some relief. It still took years before I was prescribed Tylenol#3 as you. and most doctors, do not believe it is real and can become so severe. It works most of the time. It brought back my quality of life. But. Once you changed the rules, my dose of T#3 was drastically reduced to the point of me having to decide which nights I had to deal with the agony and no sleep. Not funny since I had advised my doctor to never give me the stronger opioids that the RLS organization advised would work better to get my life back. It is just T#3! I am not an addict! And the fact that I asked for no stronger opioids proves it. I must make a very small amount last me for a month. If you do not have RLS, you cannot possibly understand the agony. And my RLS is so bad I also get pain in my legs. I only ask for the smallest opioid and just enough to sleep without being up all night in agony. My quality of life is so bad I cannot be on a car ride without stopping and getting out to walk often, I cannot go see a movie without missing much of of it without getting up from my seat, definitely have anxiety on a plane, and I dread night time! I take so little of what I have bern allowed to have that I even get it mire than once a nught. Would you like to live this way?<br/><br/>Per RLS foundation, In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure!!! Get that?? A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. As they did in my case. When all other medical therapies fail, ample real scientific research supports the use of low-total-dose opoidds to treat severe RLS. Despite any doctors or professionals that have testified before you. Have real RLS patients testify! <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades, such as I!!! I strongly urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Save a life. I know that is your intent. But, you have not covered all of us! Give us back our quality of life, please.<br/><br/>Thank you for your consideration of these vital issues, and please strongly and humanly consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. We need you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L	None	None	0900006484ffb79f	Harbin	None	2022-04-06T14:30:58Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Harbin, L	l1n-lcim-s81f	False	None	False	2022-04-12 05:37:43.115	[]
3984	CDC-2022-0024-3990	https://api.regulations.gov/v4/comments/CDC-2022-0024-3990	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People in chronic pain should have no restrictions when trying to get pain medication. What does that say about our humanity allowing people to suffer with no medication to ease their pain. When some people who are in chronic pain are still working contributing to society need this medication to survive.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	jayme	None	None	0900006484ffb806	peddycoart	None	2022-04-06T14:31:14Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from peddycoart, jayme	l1n-lm0o-b2sc	False	None	False	2022-04-12 05:37:43.341	[]
3985	CDC-2022-0024-3991	https://api.regulations.gov/v4/comments/CDC-2022-0024-3991	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This painful journey has added to our pain! So sad we are dying in pain for no reason. I hope whoever is getting the money for targeting a group of law abiding citizens and their only problem was they live in pain one day need opioids and can't get them! Shane on the CDC and whomever else had no reason to destroy lives but got the love of money! You have children who's lives you have destroyed and can't play with other children because they have been assigned a life of pain as well as good people. Family and friends are dragged into this world as well because they have to watch family become bedridden and added on medical conditions because the pain is not being addressed therefore breaking down other organs. People who need major surgeries are not being prescribed pain medication AFTER SURGERY,THAT'S OUTRAGEOUS! I have abdominal adhesions so I live with chronic pain, my intestines are glued together and THERE IS NO CUTE! Norcos gave me a life outside of bed. I'm able to work, go to family picnics and just plain old walk in my neighborhood! Shame on whoever decided to do so much damage to the pain community which I can't see any damage control fixing it, shame on you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joie	None	None	0900006484ffb84c	Canty	None	2022-04-06T14:31:44Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Canty, Joie	l1n-lshq-j3jc	False	None	False	2022-04-12 06:38:29.569	[]
3986	CDC-2022-0024-3992	https://api.regulations.gov/v4/comments/CDC-2022-0024-3992	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've been an intractable pain patient for 20+ years. I have a rare genetic disorder, as do my two children, which is known as one of the Top 5 most painful diseases. <br/><br/>I was cared for successfully with a wide variety of treatments that were supported by pain medications for 15 years. My doctor decided under pressure from above to ultra-rapid taper me off of high doses of pain meds in six weeks about 4.5 years ago, and the taper nearly killed me. <br/><br/>My pain is still untreated, and I've now developed high blood pressure, an aortic aneurysm, anxiety and more due to untreated pain. No pain clinic I've visited in the past 4.5 years will prescribe pain meds for me. It has been the most horrific experience of my life and has caused me to lose all faith in medical professionals. It also has completely ruined my quality of life. I can no longer care for my home or loved ones. I can't work, and I spend the majority of my time in bed. <br/><br/>If my pain were properly treated, I could be an asset to my family, friends and community. <br/><br/>The 2016 CDC Guidelines have killed so many in the chronic pain community. The revisions will be far, far worse. The chronic pain community is losing far more people than the addiction community is losing, and everybody seems to be out of their minds about addicts dying. Where is the outrage about policies killing countless pain patients? Perhaps we could start caring more about those of us with horrific medical conditions.<br/><br/>And if you do not stop dictating MME limits, we will lose thousands more pain patients and doctors. If the CDC continues down this path, there won't be any doctors or NPs left in our country. <br/><br/>I've talked with my government officials about this for years, to no avail. I've never personally witnessed such disregard for life. The CDC needs to stand down and let the AMA handle this debacle that the CDC created all on its own. <br/><br/>Just rescind the guidelines. Do the right thing for once.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amber	None	None	0900006484ffb89a	Bullington	None	2022-04-06T14:32:41Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Bullington, Amber	l1n-lyhg-n22w	False	None	False	2022-04-12 06:38:29.778	[]
3987	CDC-2022-0024-3993	https://api.regulations.gov/v4/comments/CDC-2022-0024-3993	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)<br/>Included in my submission is a photo of my father and two of his grandchildren. I believe this image speaks more volume than any words I can write. My dad sacrificed his body for over 35 years doing construction work to support his family. He was a successful business owner and incredibly talented at his craft- tile work. He hauled countless boxes of tile and bags of material for many many years. He started taking oxycontin to help manage his pain in the mid 90's and continues to this day. For him, it's a tool that allows him to function and honestly, survive, to be here with our family. It sickens me that we constantly have to worry about him loosing this tool. The hoops he has to go through are so frustrating. We will do what we have to, to keep him comfortable and functioning. We love our dad. We NEED our dad. Please allow his doctor to take care of him.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Holly	None	None	0900006484ffa953	Dempsey	None	2022-04-06T15:38:56Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Dempsey, Holly	l1m-thsz-mkyq	False	None	False	2022-04-12 06:38:30.009	[]
3988	CDC-2022-0024-3994	https://api.regulations.gov/v4/comments/CDC-2022-0024-3994	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient I have Crohn’s disease I am constantly in and out of the hospital due to horrible flareups where my pain is uncontrolled I am 28 years old I may be young but I do need chronic pain control and what normally works for me is opiates I am not addicted I have never been addicted I have never had issues with the medication in the entire 10 years that I have been diagnosed with the condition I have doctors who treat me like I am more at risk to become addicted because I am young which makes no sense to me considering I have never had an issue I get looked at weird when I go to the ER and need pain control when I go to pain management the doctors try to put me on a multitude of patches that do absolutely nothing for me I get recommended to take tons of Tylenol or ibuprofen which tend to make my Crohn’s even worse I have been suffering on and off for these 10 years and the only thing that I have found that helps me live my life like a normal person in the sense that I can actually work normal hours I can live day today without suffering and being able to actually enjoy life is opiates I know there are tons of attics but I will never be one of them I have an extreme hypochondriac fear of becoming addicted because that’s just a fear in the background of my mind but I know that I will never become addicted because I know that I do not abuse my medication nor would I ever because the people who abuse the medication and the doctors who over prescribe to people who don’t need the medication‘s are the reasons that we end up with the opioid epidemic and people who are actually addicted my family watches me suffer I suffer financially because I cannot go to work when I am in too much pain and I have nothing to take for that pain I consistently watch my husband go to work and work ridiculous hours to try to afford our bills in this economy when we need to income household I have missed family events I have missed spending time with my niece and nephew because I cannot fully participate because of the pain in my body people who have chronic pain whether you are old or young if you know what works for you you should not have a fear of telling your doctor what you know works for you you should not have a fear of your doctor acting like you are just a statistic you should not have a fear of trying to become treated and treated properly you should not have to sit and take medication‘s that absolutely do not work and give you really horrible side effects when you know that there is something that actually works for you and actually helps you get through the day and live your life just like any normal person out in the world I am young but I have chronic pain and I deserve to be heard I deserve to be treated and I deserve to not be looked at funny and treated like I’ll only want pain medication because that’s not what I only want I want a normal life and unfortunately a normal life does not exist without pain control for me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tasha	None	None	0900006484ffa64a	Thiessen	None	2022-04-06T15:44:05Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Thiessen, Tasha	l1m-z5gn-yp4r	False	None	False	2022-04-12 06:38:30.226	[]
3989	CDC-2022-0024-3995	https://api.regulations.gov/v4/comments/CDC-2022-0024-3995	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been gravely affected by the CDC<br/>2016 Guidelines for Opioids. <br/>After a car accident 20 years ago where I was seriously injured. My back was broken, I have several herniated discs in my lower back and my neck with paralysis in my left leg. After two failed operations by top surgeons in Los Angels, CA I was told that nothing more could be done. I was able to function, raise my family and contribute to society for all of those 20 years, although in pan and disabled, with the help of FDA approved Opioid medication. Not once during those years was my dosage increased by my doctor and not once did I ask him to increase my dosage. Once the CDC became involved my whole life ended. I no longer can get ANY PAIN MEDICATION! I have gone to several different doctors and have been refused because they don’t want to get involved with prescribing Opioids. I have MRI’s that show the severe damage and the doctor still refuse. I can no longer function. I wake up in excruciating pain after only three to four hours of sleep average and I am in pain all day long. I no longer participate in family gatherings, I no longer see my friends, I can’t walk my dog, take care of my home or do anything that I once enjoyed. My life is over. <br/>I believe the CDC must undue the damage that has been caused by MAKING A STATEMENT TO ALL PRIMARY CARE PHYSICIAN TO CARE FOR CHRONIC PAIN PATIENTS WITH OPIOID MEDICATION. The guidelines, even if you change them will not undue what you have already done. You have to completely take out ALL GUIDELINES FOR CHRONIC PAIN PATIENTS. My life has been destroyed by your actions and I was NOT an addict and to be a law abiding citizen who is now considered that is horribly wrong. <br/>This is two parts. The second half is that of my children’s father. He committed suicide last year because of the changes caused by the CDC’s guidelines.<br/>He was suffering from throat cancer. He had survived his first battle ten years ago. Unfortunately the cancer returned and as he was going through treatment he was not given adequate pain medication! He begged his doctors and was told that his risk of becoming addicted was too high and that they would not increase his pain medication. He was in horrible pain and NO ONE SHOULD HAVE TO GO THROUGH SUCH PAIN!!! He once again begged for relief from his pain and when his doctors refused he decided it was too much. He ended his own life. My children no longer have a father.<br/>Pain medication should NOT be in the control of the CDC but back with doctors and patients. I think it has been proven that the CDC and the DEA have made horrible decisions and many people have died and many more are suffering. Please end these guidelines NOW!<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ramona	None	None	0900006484ffb111	Karzai	None	2022-04-06T15:45:19Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Karzai, Ramona	l1n-axf1-co4q	False	None	False	2022-04-12 06:38:30.443	[]
3990	CDC-2022-0024-3996	https://api.regulations.gov/v4/comments/CDC-2022-0024-3996	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am caught in the knee jerk reaction of the CDC to the opioid crisis that was created by big pharm drug pushers. Simple as that. I have a 20 yr pain issue from a crippling accident. I broke my hip and pelvis in 32 places. Literally shattered. The first surgery to try and put humpty back together failed miserably they had to do a revision 3 weeks later. They took a biopsy and found that I had a staph infection that quickly turned to sepsis and that all the hardware had to come out and I had to have IV antibiotics, a sucking wound bandage because the incision wouldn’t heal. I was given a 50/50 shot a living because of resistant strains of staphylococcus aureous some antibiotics were useless<br/>Finally found a great surgeon that was willing to try and place an acetabulem in what was left of my hip bone after osteomyelitis had eaten away a good portion of what was left. He did the surgery and 1month later it moved He went back in to fix it. This was in 2002. The second one took and I had it for 17 years until it failed. The trochanter broke lower part of the prothesis was loose so I had a so called revision specialist, thru a referral, do the surgery. He went in and tied the fracture together. His surgery resulted in another sepsis infection. So a repeat of the first time. Take everything out, IV antibiotics, revision. This one seems to have taken but is more painful than the others even 9 months after the last surgery. I can not get any Dr. to prescribe anything but tramadol. A drug which e=was never intended for chronic pain. And at best would not be enough on its own. It barely even takes the edge off my chronic pain. I also have stage 4 arthritis in my left knee damaged in same accident. So there are multiple areas of chronic pain in my body. Now causing undue stress and depression. I am 100 percent disabled and so is my bride. Life sucks, but it sucks worse living with chronic pain, untreated. The war on opiates has caused many people to resort to self medication. Me included. <br/>So now that I have tested positive for cannabinoids I am considered a drug addict and no one will even prescribe tramadol. Causing me to self medicate even more. I have read many of the comments and I can plainly see that I am not alone. Please relax the guidelines for chronic long term pain patients. It is causing more problems than it is solving. Because the problems are spread across lot of people. I call it POST OPIOID CRISIS SYNDROME. I don’t see the need for stopping pain meds so abruptly for the people that really need it so that they are writhing in pain and withdrawing at the same time. Drs and health organizations are scared to death to prescribe real pain meds for the people that need it for fear of being sued. The guidelines have caused some unintended and adverse effects on people with real pain. The don’t call it a controlled substance for nothing. So control it, don’t cancel it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffb173	Anonymous	None	2022-04-06T15:46:15Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-iisu-9iyc	False	None	False	2022-04-12 06:38:30.654	[]
3991	CDC-2022-0024-3997	https://api.regulations.gov/v4/comments/CDC-2022-0024-3997	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Everyone will likely have need for pain control. Post surgery. A fracture. Car accident. Cancer. What is happening now is inhumane. Double mastectomy patients being sent home with tylenol. Sickle cell crisis patients treated as drug addicts. <br/><br/>At 38, I was diagnosed with non Hodgkins 3. Happily I survived that but I'm left with my consolation prize...intractable pain from chemo induced peripheral neuropathy. For the last 22 years I have thankfully had adequate pain control using an opiate. I tried everything. But this one medication allowed me to raise my kids. Be a productive member of society. <br/><br/>Recently, it has become quite difficult to continue receiving this prescription. Harsh "fuidelines" in 2016, a one size fits all approach to pain management, has wreaked havoc, with patients and providers. <br/><br/>I am not a drug addict. I am not a drug seeker. I am a CANCER SURVIVOR with a known side effect of chemotherapy, which is permanent nerve damage and permanent chronic pain. <br/><br/>Individualized treatment is the accepted norm when treating diabetes. Hypertension. Cardiac disease. No limits on medication. Just aiming for acceptable outcomes. <br/>Treating pain must be approached the same way. <br/><br/>I understand there are issues with addiction. This medical condition must be carefully watched for. And treated appropriately. <br/><br/>But. All pain patients do not have the risk of addiction. We must not be approached with that paradigm. <br/><br/>Overdoses are unfortunately on the rise. But information shows the rise in fentenyl in "street drugs" is a major contributor. Prescription medication is Not. Though cutting off a legitimate pain patient can lead to them seeking pain relief wherever they can. <br/><br/>Living with chronic pain since 1998 is not something I'd wish anyone to experience. It has taken away my career (I am an MD) It has taken away my ability to hike, to run, to stand for long periods if time. Pain Medication allows me to function. Not perfectly, as medication does not eliminate pain altogether. My pain is always there. It's my price for cancer survival. <br/><br/>Please. Be realistic about opiates. They can be double edged sword in those prone to addiction. I get it. But. It is merciful and medically necessary to treat pain appropriately. <br/><br/>You are indeed lucky if you've never been in a situation that pain medication would be useful. <br/><br/>I often say about my pain experience that I wouldn't wish this on Anyone. You don't know what it's like until it's your turn to have pain. I hope you never find yourself in that situation. But now. If you or your family or your children are in pain, don't be shocked, angry, if they're offered motrin or tylenol only.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006484ffbe43	Berenfeld	None	2022-04-06T15:49:13Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Berenfeld, Sharon	l1n-n4nd-dp5a	False	None	False	2022-04-12 06:38:30.865	[]
3992	CDC-2022-0024-3998	https://api.regulations.gov/v4/comments/CDC-2022-0024-3998	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m still trying to figure out why the CDC is involved in Drs decisions on patients medical care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffbebc	Anonymous	None	2022-04-06T15:49:23Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-ni54-a44q	False	None	False	2022-04-12 06:38:31.076	[]
3993	CDC-2022-0024-3999	https://api.regulations.gov/v4/comments/CDC-2022-0024-3999	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	South Carolina CDC guidelines are overbearing. In reference to the new proposal; I feel the rules in place now are a direct conflict of interest. Has anyone on the board experienced kidney stone pain or had to be on the opposing end of a hysterectomy or port surgery for cancer patients. The alternative medicine can be bad if not worse. Mind over matter is pain. I feel this to not be true as high blood pressure and heart attacks are on the rise. Many pain patients are withdrawing from surgery because of no available pain medication afterwards. As I know I will be one of them and advocating for myself and my family members who suffer. Please look at it closely. Treating pain in an acute setting is better for the patients and surgeon. Emergency rooms will loose patients as well. Those who abuse are not always the ones in the emergency room. Please stop stereotyping pain and think about it all more clearer. Please we are suffering for the wrong reason.<br/><br/>Respectfully we who are in pain thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lawrence	None	None	0900006484ffbb31	Hall	None	2022-04-06T15:49:54Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Hall, Lawrence	l1n-nnk2-bzlv	False	None	False	2022-04-12 06:38:31.284	[]
3994	CDC-2022-0024-4000	https://api.regulations.gov/v4/comments/CDC-2022-0024-4000	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has been using fentynyl patches for over 10 years for severe nerve damage and pain. He would get gastritis from oral pain meds. He has been functioning very well..working full time with no issues..now his pcp is moving abd NOONE will perscribe him his medication. HE used to use 75 mcg patches but now is down to 37.5mcg and is doing well. Now due to your actions everyone is afraid to give him what he needs. These recommendations as well as the DEA have a job to do but it's greatly impacted way more patients than drug addicts. We are demanding that the CDC and the DEA leave responsibility doctors alone and allowed them to treat thier pts. We have no idea what we are going to do once his doctor actually moves as we can't find anyone to perscribe him what he needs. Zi will continue to fight for him and against these recommendations. EVERYONE is different and you can not blanket doses or meds because people require certain meds for certain reasons..like my husband. I can assure you..more lawsuits are coming as a response to these issues. Pls leave doctors alone! Or stick to getting rid of the doctor mills!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jill	None	None	0900006484ffbb47	Patterson	None	2022-04-06T15:50:19Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Patterson, Jill	l1n-nr64-kqcd	False	None	False	2022-04-12 06:38:31.507	[]
3995	CDC-2022-0024-4001	https://api.regulations.gov/v4/comments/CDC-2022-0024-4001	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	TO OUR GOVERNMENT; YOU HAVE DIRECTLY USED THE 2016 REFORM AND HAVE CAUSE HORRENDOUS FALSEHOODS TO THOSE UNDER THE DISABILITY ACT! CDC AND THE DEA ARE THE MAIN CAUSE OF THE PROBLEM WITH BILLIONAIRES CARTELS AND BLACK MARKET PRODUCTS MAKERS! AND SEEM THE CDC ,DEA, WILL THROWXOUR DOCTORS UNDER THE BUS FOR THEIRCPART OF THE CDC'S PLAN OF THAT CRIPPLING 2016 REGORM! AS YOU THE GOVERNMENT HEALTH DEPARTMENT RIGHTFULLY KNOWS FDA WILL NOT OK EPIDURALS BECAUSE IN GOOD FAITH TO PATIENTS THOSE EPIDURALS CAUSE BLINDNESS, PARALYZED AND EITHER BOTH AND DEATH! AND FDA HAS PLACED THE MEANS FOR PATIENTS TO CHOOSE PAID MEDICATION! AND YOUR CDC AND DEA HAVE PLACED OUR DOCTORS HANDS IN KNOTTS! 2022 REFORM CALLS IT " PAIN ABANDONMENT " AND YOU CAN FEDERAL LEVEL CAN GIVE CHRONIC PAIN PATIENTS EXEMPT ADDED TO THIS FORM. AND PUT THIS CDC ALONG WITH DEA BACK TO DOING THEIR RIGHTOUS JOBS! DEA PLACED TO FIND BILLIONAIRES CARTELS AND BLACK MARKET PRODUCTS MAKERS OUT OF BUSINESS! AND STOP WHAT REALLY IS KILLING OUR AMERICANS! NOT THE PRESCRIPTIONS NEEDED FOR OUR PAIN. AND ALSO OUR MONIES WE HANDLE EVERYDAY IS LOADED WITH CHEMICALS FROM SAID STREET DRUGS. SONMAYBE ALL THOSE URINE TEST ARE FALSE! MY NECK SURGEON SET AN AMOUNT FOR EACH DAY! DOCTOR KNOWS MY MRI'S ARE SHOWING IM IN NEED OF MY PERSCRIPTION! MY SURGEON WAS CORRECT MY DOCTOR IS IN THE WRONG BECAUSE OFCBECAUSE OF THE PRESSURE CDC,DEA ARE GUILTY OF MY QUALITY OF LIFE AND I'M NOT ALONE! SO CORRECT YOURSELF AND PUSHING PAIN PATIENTS TO THE BLACK MARKET PRODUCTS!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Colleen	None	None	0900006484ffc121	Nieve	None	2022-04-06T16:19:25Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Nieve, Colleen	l1n-pkbd-dxro	False	None	False	2022-04-12 06:38:31.725	[]
3996	CDC-2022-0024-4002	https://api.regulations.gov/v4/comments/CDC-2022-0024-4002	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had chronic pain for over 30 years. It has been extremely debilitating for me. I cannot work and cannot do daily activities. It is also depressing to be in pain mentally.<br/>I understand that opioids can be dangerous and are abused by some people. But please remember that they do help a lot of us. That has been the only thing that helps me. I have tried injections, chiropractor, Chinese medicine, physical therapy, meditation and more. <br/>I have degenerative disc disease in my spine. Pain is a medical condition. Please do not take away treatment options that should be between my doctor and me. If opioids are prescribed in a correct and responsible way they do and will help millions of us.<br/>Please stop making it more difficult for doctors to treat chronic pain.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steven	None	None	0900006484ffc130	Duncan	None	2022-04-06T16:19:38Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Duncan, Steven	l1n-ppcq-wk8t	False	None	False	2022-04-12 06:38:31.943	[]
3997	CDC-2022-0024-4003	https://api.regulations.gov/v4/comments/CDC-2022-0024-4003	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my name is [name redacted]. and I am currently being subjected to lack of available pain management doctors. Pharmacist that refuse to fill valid scripts. Even more so since I've moved back to my home state of WV. The only doctors I've ever had that provided me care are in [location redacted], VA. I now have to drive over 800 miles round trip to keep my pain mgmt. providers. Also it's a concierge practice which means I also have to pay a yearly fee out of pocket. Saving up $1500. a year is not easy but it's my only option to receive the health care I need to have any kind of functional life! Because of the guidelines set forth NO doctors will even consider treating pain with opioids in WV. Which is the only medication that provides me any relief. I can deal with pill counts,drug testing, signing contracts and ALL the other hoops I am forced to jump through. But having to drive to another state 4 times a year is ridiculous. PLEASE hear us and give people back the doctors they need without fear of jail time for the doctors doing their job.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Virginia	None	None	0900006484ffc168	Campbell	None	2022-04-06T16:20:55Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Campbell , Virginia	l1n-pxs7-avov	False	None	False	2022-04-12 06:38:32.165	[]
3998	CDC-2022-0024-4004	https://api.regulations.gov/v4/comments/CDC-2022-0024-4004	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop these hurtful laws against chronic pain patients!Exclude us from the cdc mme this is inhumane and against the law!You have taken away our lives to function.Please have mercy on us.We do not want to die but your laws have created severe suffering which causes heart attack,strokes,seizures and suicide.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc183	Anonymous	None	2022-04-06T16:21:21Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-pzv7-bj9a	False	None	False	2022-04-12 06:38:32.385	[]
3999	CDC-2022-0024-4005	https://api.regulations.gov/v4/comments/CDC-2022-0024-4005	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I check a lot of the boxes for not prescribing opiates for long term chronic pain yet I have used them safely for the past 16 years. I got into recovery from a substance use disorder in May 1977 at the age of 20 years old. In 2004 I was seriously injured in an accident that compressed my spine. I have had 3 spine surgeries since and have been diagnosed with a spinal cord injury. Prior to the accident I had 4 herniated discs from construction related injuries. After utilizing every trick in the book to control pain including Tens Unit, spinal injections, anti-depressants, Lyrica, Gabapentin, physical therapy, braces, surgery, etc. I went to see an addictionologist and he prescribed Suboxone for pain management. It worked well for about 7 years and I then developed an allergic reaction to it which caused fluid retention, angioedema and other heart related issues. It became very dangerous to continue using it and I weaned myself off of it. I went back to injections until the physician advised me that he could do no more. I also engaged in years of aerobic conditioning which helped with pain management until it stopped. In the meantime I developed advanced neuropathy from the injury and this became worse by developing diabetes. I have worked with the same internal medicine physician for the past 20 years. He has me on a pain management contract where I am not allowed to be prescribed pain management by anyone other than him. He also completes a yearly urine drug screen and I am not allowed to use marijuana even though it is legal medicinally and recreationally in the state I reside in. Marijuana was my drug of choice many years ago and I wouldn't even consider it now. I have been sober for 45 years this year and I do not abuse the medication I am on. He has prescribed Morphine ER 15mg tablets, one pill twice daily. I generally take one pill per day unless the pain is very severe where I have taken 1-4 if needed from the foot pain, neuropathic pain or spinal cord related pain. I refuse to allow tolerance to develop and I am on the same amount I have been on for several years. I do know that I am physically addicted to the medicine but I never use it to elevate my mood and it is strictly a tool for pain management. There is a saying in the medical community of do no harm. It was harmful to over prescribe which got us into this mess and it is burdensome to not prescribe at all. People have reverted to the streets to take care of chronic pain and, with the mixing of cheap fentanyl to the mix many people have overdosed and died. You cannot treat a dead patient. I still utilize other means to help control my pain levels. I watch what I eat and limit sweets. I also still engage in aerobic conditioning and I use a compounded cream of Lidocaine, Ketamine and Diclofenac to help with the small fiber neuropathy. Having a good physician to work with me is a God send. When he retires I will probably put a gun to my head and end the pain once and for all. And unless you begin to use common sense practices to work with individuals rather than lumping all patients in one category you will continue to have high overdose related deaths or suicides as the quality of life absolutely sucks to be in constant, chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terry	None	None	0900006484ffc1a0	N.	None	2022-04-06T16:22:12Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from N., Terry	l1n-q5xm-2o9j	False	None	False	2022-04-12 06:38:32.598	[]
4000	CDC-2022-0024-4006	https://api.regulations.gov/v4/comments/CDC-2022-0024-4006	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Ehlers Danlos Syndrome. My joints dislocate without a reason. Nerve drugs made me hallucinate and twitch uncontrollably. NSAIDs are why I have a hole in my GI tract that causes me to have blood leave both ends of my body that will never fully heal. Without oxycodone I would never be able to leave my house and I would have no life. I’m 28. I still miss who I was before my genetics took hold in my early 20s, but I’m eternally grateful for my pain management doctor for listening to me. Without my meds I would have no quality of life. Please let the decisions be between the doctors and the patients again. Please.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Erin	None	None	0900006484ffc282	Flannelly	None	2022-04-06T16:22:27Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Flannelly, Erin	l1n-raaz-s3n5	False	None	False	2022-04-12 06:38:33.394	[]
4001	CDC-2022-0024-4007	https://api.regulations.gov/v4/comments/CDC-2022-0024-4007	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached comment from PMRS, Inc.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffa0be	None	None	2022-04-06T17:17:55Z	PMRS, Inc.	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from PMRS, Inc.	l1m-k3u9-1k0g	False	None	False	2022-04-12 06:38:33.623	[]
4002	CDC-2022-0024-4008	https://api.regulations.gov/v4/comments/CDC-2022-0024-4008	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffa49d	None	None	2022-04-06T17:22:00Z	American Society for Pain Management Nursing	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from American Society for Pain Management Nursing	l1m-parf-x5v0	False	None	False	2022-04-12 06:38:33.863	[]
4003	CDC-2022-0024-4009	https://api.regulations.gov/v4/comments/CDC-2022-0024-4009	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This Notice for a new 2022 Guideline is absolutely needed, and long overdue. Pass them. However, adding Sickle Cell will not help patients with the poorly understood Ehlers Danlos Syndrome, which we now know is genetic and clinically documented, but has no cure or clear prognosis. I have EDS. In 2016 the CDC Guidelines and CDC encouraged "Panic Concerning Opiate Use" fueled my state legislature to "prove it was doing enough" by enacting laws that made me voiceless as I begged to remain on a prescription treatment plan that had been stable for over five years. My condition is genetic. It is degenerative. I had to go to a geneticist, even though even geneticists will tell you they do not yet know the markers for each type or version of EDS, nor understand how the condition impacts physiological systems. They can tell you it is real. They now know it is hereditary. You can pass a complex clinical diagnosis. You can see the scars. You can scan the overstretched tendons. You can feel the overload of a constantly swollen lymphatic system. My mother died from Ehlers Danlos Syndrome without a proper diagnosis. Now they know CHF and POTS are related to EDS, so I know it contributed to her death, and she was put on medications that can cause inflammation and flares of pain so intense it can make you speechless, or wake yourself with your own screaming. This happened to me after I was forced to try treatments that caused more damage than good just so my doctor could prove to a rising mountain of agencies, that I actually needed the medication she prescribed. These new guidelines made me wish I had cancer instead of a disorder most doctors have no idea how to treat. I need this 2022 change to survive. No clear diagnosis and comorbidities (like fibromyalgia) means no real prognosis. There is no clear medication or test for multiple forms of EDS. Symptoms are known, but EDS is rare. There is no cure. It is progressive. You lose function. Collagen weakens. Depression can be despair. EDS is an intractable, incurable, degenerative hereditary condition that impacts how collagen is formed and sustained in the body. Collagen is the most abundant protein in the human body, so you cannot ignore it. It is everywhere. It can impact every system. It doesn't go away. Ehlers Danlos Patients often end up in neck braces, back braces, leg braces, disability scooters, wheelchairs, or bedridden in severe isolation. Those all happened to me when state lawmakers followed 2016 guidelines on opiate use and made rights to privacy between my doctors and patient moot, made it extraordinarily difficult to keep me on my stable treatment plan, lead to doctors on my insurance giving up and no longer willing to incur the risk to prescribe opiates, and thousands of doctors force-tapering a desperate and sick population. The CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016 may have been intended to be a "guideline", but the repetitions of this claim, the alterations required to clarify, the need for revision, and thousands of abandoned patients, even more patients "force tapered" off stable prescriptions by doctors more afraid of losing their practices than their patients makes it clear the flaws in the 2016 "Guideline" were taken as mandate. Insurance companies denied physician prescribed, legal prescriptions because they could use the 2016 guideline as back-up. One doctor told me a pharmacy at a major grocery chain called questioning opiate prescriptions for a 98-year-old patient who just wanted to live and not be institutionalized. The 2016 Guideline violated medical intent to "do no harm" as suicides of those suffering chronic pain filled news stories and the radios of police. Please change these policies. Focus on getting addicts help. When you look at research from Johns Hopkins, Human Rights Watch, and newspapers all over the country the vast majority of opiate abuse and overdoses don't come from patients who take opiate medications as prescribed, in concert with their opiate contracts, doctors, and tests. Those of us who take medication as prescribed and monitored by the doctors who were allowed to create a treatment plan are in small minority for overdose and abuse. There myriad reports of increased suicide for patients who had been doing everything right, but were then abandoned or force tapered by frightened doctors. Search Human Rights Watch. Search news stories, and you will see real lives lost because the 2016 Guidelines were written without time for a real impact assessment or with understanding of addiction. Addiction needs to be treated. Many addicts turned to illegal drugs with no help. You cannot take medication and curtail medically educated professionals with blanket knee-jerk legislation, now codified in state laws, and not expect it to harm patients. It damaged the heart of confidentiality, trust, and collegiality needed to go to a doctor for help. Change the Guideline. Stop punishing patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffa90f	None	None	2022-04-06T17:24:34Z	EDS Foundation Member	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from EDS Foundation Member	l1m-sptq-gw4s	False	None	False	2022-04-12 06:38:34.096	[]
4004	CDC-2022-0024-4010	https://api.regulations.gov/v4/comments/CDC-2022-0024-4010	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, <br/><br/>Please see the attachment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006484ffb0e8	Donovan	None	2022-04-06T17:27:42Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Donovan, Kathleen	l1n-5swp-62pw	False	None	False	2022-04-12 06:38:34.325	[]
4005	CDC-2022-0024-4011	https://api.regulations.gov/v4/comments/CDC-2022-0024-4011	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I've read over 50 of these posts, and it's the same thing. Those who are dealing with chronic pain, chronic illness, post surgery etc, see the restrictions one way. Those who aren't are the most critical. We run around this country talking about personal "freedom", yet we are now policing folks medical cabinet. I suffer from chronic pain, recently had my second back surgery. Up until this point, ive had no problem getting my medication, but due to recent changes, it's been a struggle. Now, my doctor has to call in "4" medications, including my pain meds. So, I'm stuck paying $35 for miralx, $10 each for pain med, naprosyn, and axid. $65 to get my pain meds, and this other stuff that I don't use, nor do I need. Opioid abuse is real, and should be addressed, but we are going overboard. If you check the actual overdoses across the country since these barbaric restrictions, they have increased. Where was this faux outcry when Black folks were dying left and right because of Crack? A entire generation was decimated, so many people were locked up because of this. And yet, nothing was done. I take my meds responsibly, and yes I agree barriers should be in place. But, to go overboard the way this country has is disingenuous at best, but asinine in reality.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lei	None	None	0900006484ffbbbf	S	None	2022-04-06T19:46:36Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from S, Lei	l1n-ob6e-qf1t	False	None	False	2022-04-12 06:38:34.542	[]
4006	CDC-2022-0024-4012	https://api.regulations.gov/v4/comments/CDC-2022-0024-4012	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi,I do not like the updated guidelines and especially with the term MME or 50MME in the guidelines.There are 30-50 million intractable pain patients and wounded veterans who are suffering in severe pain from being force tapered like me to reach the limit of 90MME{Morphine Millagram Equivalent }Millions of IPP,S and wounded veterans had their pain managed for decades like myself till March of 2016 when 30-50 million of us were involuntarily force tapered off our medications to reach 90MME to supposedly stop OD DEATHS or Addiction.Since 2016 when millions of us were involuntarily force tapered OD DEATHS increased to over 100,000 caused by fentanyl not diverted prescribed pain medications.The term MME or 50MME should not be added to updated guidelines.In fact the 2016 and the updated 2022 guidelines should be removed and rewritten by the FDA or Pain Specialists,Pain Patients,Advocates or both the FDA,Pain Specialists,Pain Patients and Advocates.It is the FDA,S job and their scientists,pain specialists to write new guidelines on opiod medications not the CDC and psychiatrists from PROP.Since 2016 when I was involuntarily force tapered off my pain medications that I was managed on since 2000 my quality of life declined significantly.My neurosurgeon,PCP,S and myself tried alternatives like PT,Epidural Steroid Injections and the only thing that helped with my severe pain was opiod medication.My neurosurgeon told me after my 3rd surgery I will have severe pain the rest of my life in lower back from severe nerve damage and scar tissue.Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006484ffbce2	Reifsnyder Jr.	None	2022-04-06T20:43:25Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Reifsnyder Jr., Richard	l1n-pahz-w41u	False	None	False	2022-04-12 06:38:34.755	[]
4007	CDC-2022-0024-4013	https://api.regulations.gov/v4/comments/CDC-2022-0024-4013	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is imperative that the newly proposed recommendations must include contemporary literature surrounding many of our opioid-sparing therapies. Please see the letter attached	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Avni	None	None	0900006484ffbcf8	Gupta	None	2022-04-06T20:49:02Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Gupta, Avni	l1n-ozd6-xgo2	False	None	False	2022-04-12 06:38:34.995	[]
4008	CDC-2022-0024-4014	https://api.regulations.gov/v4/comments/CDC-2022-0024-4014	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is so many people in pain , they can not get the help they due to this lie or opiate crisis, this has brainwashed our doctors. I’ve suffered enough it’s time to help us , give us the life not take it away. Big example of brainwashing is COMTREA this place is run on government funds so they are told what they can and can not do , it’s completely unfair to so many , since when is predisone give pain relief? It may work if you have RA in which I don’t . So explain that one . The truth is it’s all ILLICIT FENTANYL, CORRECT USE DOESN’T EQUAL ABUSE	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc305	Anonymous	None	2022-04-06T20:50:31Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-s3sj-xjo5	False	None	False	2022-04-12 06:38:35.209	[]
4009	CDC-2022-0024-4015	https://api.regulations.gov/v4/comments/CDC-2022-0024-4015	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been on the receiving end so much so that the media had myself scared that I was an addict that while going to a pain doctor I seeked help. That doctor prescribed subutex. I have taken that off and on and feel I was better when I was on pain meds. Because my temperament changed I was more agitated. Started back smoking after five years absent. Lost six teeth from which I’ve had implants. I’ve been off Suboxone for a while yet it was so hard to get off almost as bad as coming off gabapentine. With the later my heart would race and skip beats. This alternative medicine has severe side effects. The pain I feel raises my blood pressure and I’m so scared is going to take me out of this life because I have no quality of life. I worked in the medical field. I resigned two years ago after being at this one place ten years. Bad relationship and loss of teeth being main reason.my anxiety over being an addict was the main reason I got off pain meds. Pain doctor did not I always had my bottle count was right I was being told by a family member pain meds are bad. Please revise this and look at acute management. Let the physicians do their job as they took an oath to. I hope I can save one person from not giving up. Less people will begin to not have surgery. I hear of emergency rooms not treating pain with pain meds and being one who has stones I worry. People will get the medicine alternately and end of being pressed. Please help those who suffer in pain. Not everyone is abusing. Not everyone should suffer for those who do.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc111	Anonymous	None	2022-04-06T20:50:44Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-piho-s441	False	None	False	2022-04-12 06:38:35.415	[]
4010	CDC-2022-0024-4016	https://api.regulations.gov/v4/comments/CDC-2022-0024-4016	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Federal Register<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>April 5, 2022<br/>RE: Proposed 2022 Revised Opioid Clinical Guidelines<br/>National Center for Injury Prevention and Control<br/>CDC Docket # CDC-2022-0024<br/><br/>I am a pharmacist and I would like to remind the agency that these recommendations are more than mere suggestions, as insurers are using them to justify not paying for, and thereby restricting access to, opioids.  Unfortunately, insurers  have been rapid and thorough in "following the guidelines"-- many now require prior authorization to fill more than 90 mme/d prescription, or those that are needed for longer than a month, or if more than 2 seven-day acute supplies are needed within 30 (and in some cases up to 60) days. Patients are having to pay larger and larger percentages of the cost out of pocket or wait for PA approval without needed pain coverage.<br/><br/>Surgeons often write small quantity prescriptions (1-3 days) for oxycodone for severe post-operative pain and a prescription for a small amount (5 to 7 days) of tramadol for moderate pain.  Many insurers only allow one acute immediate release opioid to be filled in 7 days. Most patients assume the pain will be intense so they fill the oxycodone--even though the tramadol might have been enough.<br/><br/> If an arthritis patient generally gets by with NSAIDS and APAP, but occasionally has acute exacerbations, the insurers are penalizing them for NOT using opioids by limiting all "initial" fills to a 7 day supply--so either the patient pays a whole copay for 7 tablets of "1 po qhs prn pain" or they have to use it more frequently so the computers will know it's for a chronic condition and allow a larger days supply. Insurers do not allow an override, either.<br/><br/>If the CDC really wants to address the opioid crisis, it should make insurers pay 100% for naloxone nasal spray.  Most don't, or cover less than half.  As a result, most patients refuse to obtain the antidote that could save their life. If insurers were forced to pay for naloxone with opioid prescriptions, there would be more available in the community at large. That may even help with the overdoses of illegal opioids--which are the bigger problem.  <br/><br/>Before a practitioner can dispense an opioid, they have to ask patients not only why they need it, but what else has been tried and failed.  If their profile indicates it, why are they taking a benzodiazepine, a muscle relaxer, an antidepressant, a sleeping pill, or a gabapentinoid, etc? When did they start or stop it?  Have they attempted to wean off of the opioid or the other medication(s)?  No matter how gently or empathetically asked, some patients feel that they are doing something wrong with so many questions--even though the clinician’s intentions are honorable.   When naloxone is recommended in case of emergency—“like a fire extinguisher or insurance"—patients either want it and it's not adequately covered by insurance or they interpret the suggestion as implying they are stupid, irresponsible, or addicted.  (This is usually because a previous provider failed to interact with the patient with tact or compassion.)  <br/><br/>Most of my chronic opioid patients have been maintained on the same dose for years--without misuse or abuse--and to take away the medication that helps them to be mobile and controls their pain is cruel.  Of course dose reduction attempts are good, but even slightly weaning some patients can make a significant reduction in their quality of life.<br/><br/>Yes, there is an opioid problem in the US, but we need to stop criminalizing patients for asking for and doctors & pharmacists who provide help with relieving pain. When all other options fail, opioids are often the last and only resort for people with severe, debilitating pain.<br/><br/>Whatever guidelines you decide, please remember that these are more than just recommendations—they provide justification for insurers to limit—or refuse—to pay for medications that are essential for a decent quality of life for many people. <br/><br/>Thank you for your attention to this matter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006484ffc34c	Montijo	None	2022-04-06T20:51:01Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Montijo, Jane	l1n-sjje-35ot	False	None	False	2022-04-12 06:38:35.632	[]
4011	CDC-2022-0024-4017	https://api.regulations.gov/v4/comments/CDC-2022-0024-4017	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As an interventional pain specialist for 20+ years, I am proud of my specialty and the positive impact we as pain doctors apply to our patients’ quality of life and reduce their reliance on opioids. Unfortunately, CDC has never recognized the real difference Pain Medicine makes in the public safety and well being. It is hard to believe that we have to make efforts to convince CMS and CDC that we are making our patients’ lives better. Opioid guidelines have been helpful but they have also opened the door for more use of opioids by primary care and pain physicians “as long as they prescribe under certain MME. With constant decrease in reimbursement for pain procedures, more physicians use opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kamran	None	None	0900006484ffc926	Koranloo	None	2022-04-06T20:51:10Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Koranloo, Kamran	l1n-uskq-ejoc	False	None	False	2022-04-12 06:38:35.849	[]
4012	CDC-2022-0024-4018	https://api.regulations.gov/v4/comments/CDC-2022-0024-4018	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You are killing people and making the families watch you kill those most important to them. Putting limits on those in chronic pain only makes it worse. It's adding insult to injury. Good people are left to feel like addicts just for needing help to live. Good people are turning to death over life because they are lost in their fight for a shred of pain relief. Taking away doctor and patients rights to the pain relief they need is not right. If the abusers abuse it, well that's their problem and if they lose their life, that choice is on them, but stop restricting those who actually need it to live a quality life. Allow Dr's to Rx opiods to give patients a chance to enjoy life rather than making things difficult on everyone.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc929	Anonymous	None	2022-04-06T20:53:22Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-utwp-auor	False	None	False	2022-04-12 06:38:36.092	[]
4013	CDC-2022-0024-4019	https://api.regulations.gov/v4/comments/CDC-2022-0024-4019	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a 25 year chronic pain patients, been with same Dr same pharmacy for 16 years 22 at pharmacy, things started changing last year all of a sudden the pharmacy cannot get meds it’s a roller coaster ride. Then the DEA and CDC started ur crap. Today I was told here is ur last scrip you them wisely HUM <br/>So now I have no doctor been turn down by at least 20<br/>I had 22 injections last week go for more next week , can no longer to normal things , life is a dark hole , lady at pharmacy that had filled my legal scrip told me she had kids and did not care she was not filling same scrip they filled 4 months in a row , I ask for letter never got it of why, now Doctors office of 16 years tells me I’m not welcome because of my health, I hav had 7 back and neck surgeries 10 other orthopedic surgeries, I’ve lived this way 25 years , you could not kill us in Covid <br/>I guess I will end up in streets as well , I was a Functioning human being until they messed with my medical and took my doctor away from me. My worst fear has come true	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc957	Anonymous	None	2022-04-06T20:53:53Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-ustz-l130	False	None	False	2022-04-12 06:38:36.314	[]
4014	CDC-2022-0024-4020	https://api.regulations.gov/v4/comments/CDC-2022-0024-4020	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. I am one of these people. The only med that helps is Methadone. Yet i am made to feel like a criminal when i get these meds. And if you drop a few on teh floor, anywhere say an airplanes, you can’t get extra to make up for it, so you suffuse severally , no sleep, not Abel even to sit down for days until you get more meds.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jan	None	None	0900006484ffc97e	Sogge	None	2022-04-06T20:56:06Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Sogge, Jan	l1n-vgmu-zf0z	False	None	False	2022-04-12 06:38:36.526	[]
4015	CDC-2022-0024-4021	https://api.regulations.gov/v4/comments/CDC-2022-0024-4021	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2000, I underwent surgery for a fractured bone in my leg. I woke up in the recovery room and knew that something had gone terribly wrong. I looked down at my foot and leg fully expecting them to be engulfed in flames. Much to my surprise, they were not being consumed by flames but by a condition called Complex Regional Pain Syndrome Type 2 (CRPS), an incurable form of nerve damage considered to be the most painful condition known to medicine. <br/><br/>My nerve pain feels like a horrible accident happening over and over and over again. Ever see one of those giant car eating machines with the intertwined metal fingers? The car gets dropped in and is pulled apart by those giant metal fingers, your foot or arm being continuously ripped apart over and over and over. This is CRPS Type 2. The nerve damage pain involves the extremes of every sensory variable from temperature to pressure to sensitivity. My leg/foot is a frozen, paralyzed, painful, useless stump that I drag around with me 24/7/365. <br/><br/>The intensity of pain and the fact that the nerve damage is permanent means that I will suffer from someone’s incompetence for the rest of my life, every second of every minute of every day for the eternity of my life. The majority of the human population has never and will never experience a comparable level or intensity or lifetime duration of pain like CRPS. <br/><br/>CRPS is a debilitating condition. The difficulties it presents are very real for me and my spouse who has taken over most of the household duties as well as taking care of me. Were it not for opioids, I would be 100% house bound, in a wheelchair and totally dependent on my spouse for everything. It is not fair to either of us. After 22 years of using opioids, I have never asked for an increase in dose and have not become an addict. I can live my life.<br/><br/> I have tried every medication, procedure, alternative supplements and therapies offered. Nothing helped this excruciating pain except opioids. They are a miracle drug for many people including myself. Opioids are a legitimate medication used for hundreds of years to treat pain. If they are removed from a physician’s pain treatment arsenal, many more patients will die either from heart attacks or complications of pain or from seeking street drugs to manage their pain. After 22 years of using opioids, I have not become an addict. <br/><br/>Stop punishing legitimate pain patients and witch hunting their doctors. Rescind the 2016 Guidelines and do not republish any updated ones. The Guidelines were based on tainted information, sketchy research and written by unqualified individuals with seriously questionable conflicts of interest. In fact, I strongly believe that the authors of the 2016 Guidelines should be investigated. <br/><br/>These Guidelines need to be removed completely from use because they have been treated like law and many states created their own laws based on them. So the Guidelines are now part of patients’ health records! They are used by NarxCare for risk score algorithms as well as using risk scores to flag doctors who “prescribe out of CDC Guidelines”. <br/><br/>Let doctors treat their patients as they have the knowledge. Young doctors must be re-educated on the use of opioids as a pain treatment. These Guidelines, especially the MME limits helped no one. The “science” behind the limits was very flawed and purposely skewed. There is no legitimate reason that any authority, other than a patient and their doctor, needs to limit dosage or any time frame. There is no science or any double blind clinical studies behind the MME limits to support the opiate to opiate ratios that are "theoretically therapeutically equivalent". The MME system is not FDA approved or even recognized. <br/><br/>We lost dedicated doctors who retired prematurely or switched specialties to avoid being targeted by the overzealous DEA. We’ve lost pain patients to suicide & street drugs because they were cut off or tapered involuntarily from their pain meds. STOP! Enough is Enough! Go after the drug cartels, not patients and their doctors. <br/><br/>Control must be returned to doctors treating pain patients without interference from outside agencies.<span style='padding-left: 30px'></span><br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A.	None	None	0900006484ffc99f	Spector	None	2022-04-06T20:56:22Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Spector, A.	l1n-vpwj-2d14	False	None	False	2022-04-12 06:38:36.735	[]
4016	CDC-2022-0024-4022	https://api.regulations.gov/v4/comments/CDC-2022-0024-4022	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Fellowship Trained Double Boarded Pain Physician. I was sanctioned by the Medical Board for prescribing opioid medication to one patient that the board said I was "over prescribing." The patient had been in the same medication for over 15 years and was highly functional. The patient had Failed back syndrome, fused from T12 to S1, Arachnoiditis and failed all other therapies including Intrathecal Pump, placed by the local university hospital, and Spinal Cord Stimulator placement. I even had a phone conversation with Dr. Giancarlo Barolat about Deep Brain Stimulation and he felt the patient would not benefit from this therapy. The Medical Board used the CDC guidelines as mandates for their case against me. Hence, I do not prescibe ANY medications now. I only do injection therapy as do most Pain Specialist now. The Physician's that are the expert's and have been trained on how to prescribe opioid medication, have been targeted and now refuse to prescribe opioid medication. By the way, the patient that was supposedly being "over-prescibed" , is still on the EXACT SAME medications and dosages that I was prescribing to this day.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc9b3	Anonymous	None	2022-04-06T20:56:39Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-vx4s-9eqt	False	None	False	2022-04-12 06:38:36.951	[]
4017	CDC-2022-0024-4023	https://api.regulations.gov/v4/comments/CDC-2022-0024-4023	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a follow up comment to one previously written..felt the EXTREME need to update EXACTLY WHAT this has done to me and my life!!! I now stay in my apartment all the time. Have COMPLETELY given up on any& all doctors because of my med that had me A FUNCTIONAL member of society, a caring & helpful mother & SADDEST of all,a DOTING GRANDMOTHER , WAS COMPLETELY & INHUMANELY TAKEN AWAY ABRUPTLY (as my previous comment explained!) Now I continue to suffer terribly with my BIOPSY PROVEN (BURNING FEET) NEUROPATHY!! I NO LONGER SEE +/ or speak to anyone in my family (I admit my situation is complicated,SO MUCH MORE TO THIS STORY) but I DON'T, NOR HAVE I EVER ALLOWED MY GRANDCHILDREN TO SEE ME IN THIS MUCH PAIN !! Having previously been SO INVOLVED in every day life with my kids and grands, YOU BETTER BELIEVE that the more recent SO-CALLED PAIN CLINIC DOCTORS I last got out to via rides DID see a VERY UPSET person (and probably just labeled me...as it goes!) But I AM A HUMAN BEING WITH PRIDE who HATES THE STIGMA,ALWAYS HAS ( The stigma isn't new..especially from new doctors I have had to see as well as pharmacists that started to want to REWRITE MY DOCTOR'S PRESCRIPTION!!!!) I admit that I had no idea all this was happening or I would have gotten involved ALOT SOONER..WHILE I WAS STILL FUNCTIONAL!! Now, whether anyone who talked to me in March believed me or not...THIS BROKE ME & I continue in AGONY BUT, as stated I have GIVEN UP FIGHTING NOW..& what happens when that happens to a person??? You guessed it..THIS situation actually brought A VERY STRONG WOMAN TO THE BRINK OF SUICIDE, TWICE!!! Not only was that VERY HARD TO DO(If you knew me!), but for me to be COMPLETELY HOMEBOUND with minimal essentials delivered to me is enough to make ANYONE IN CHRONIC/BURNING PAIN GO PSYCHOTIC & I just CAN'T BELIEVE that hasn't happened yet!! The only thing I now know is that YOUR SOLUTION TO THE PROBLEM HAS TRULY RUINED MY LIFE & I have only one thing keeping me going now and that is TRYING LIKE MY BEST TO FIND A LAWYER TO SUE ANYONE & ALL INVOLVED in the DESTRUCTION of my life !! NOT MANY ( Only people TRULY in my position!) TRULY UNDERSTAND THE PAIN & SUFFERING I have gone through these past months & inside,where there USED to be a very caring,loving, kind LIFELONG CARETAKER...That person is now DEAD INSIDE & ALONE, BUT MORE IMPORTANTLY, IS THIS WAY BECAUSE SHE REMAINS IN CHRONIC, IRRETRACTABLE PAIN that has just 1 simple solution..My previous pain med...But I MUST find that lawyer!! I just hope my inner strength is strong enough to keep looking & fighting. Good luck to everyone else involved who is suffering	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006484ffc6a4	St.Germain	None	2022-04-06T20:58:00Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from St.Germain, Michelle	l1n-wek1-ihht	False	None	False	2022-04-12 06:38:37.160	[]
4018	CDC-2022-0024-4024	https://api.regulations.gov/v4/comments/CDC-2022-0024-4024	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Since the 2016 guidelines were published, I have seen primary care providers stop prescribing opioids, pain clinicians stop taking patients or close down, pharmacies refuse to fill prescriptions. I keep hearing on my Facebook groups of yet another suicide. Full thickness burn patients sent home with NOTHING for pain, even with return to ER and begging for relief. I have heard clinicians slip up and mention getting pain meds for their own family members. Once again, a select few are being treated. I heard a CVS pharmacist talk about her bonus for turning in MY PCP after I stated there was a note on her door ‘Office Closed.’ DEA had come and closed it leaving all of us with no provider for ANY of our care. Of course, after review there were no problems identified but where did that leave all of us, and more sadly, my beloved physician. Did the CVS pharmacist have to return her bonus? I’m sickened by the conflicts of interest among policy drafters who can’t even see COI right in front of them. So yes, any improvement in giving prescribers back their clinical judgement is a much needed improvement. I’m afraid to leave my name with my comments as I have no trust anymore.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc6f9	Anonymous	None	2022-04-06T20:58:12Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-wsn4-im44	False	None	False	2022-04-12 06:38:37.377	[]
4019	CDC-2022-0024-4025	https://api.regulations.gov/v4/comments/CDC-2022-0024-4025	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A few years ago when my Mother was in the hospital dying, we wanted her to be as comfortable as possible. The doctors/nurses didn't want to give her any pain meds. I asked why. Did they think she'd become addicted? They said yes, possibly. OMG! She only had a few days left to live. Come on! She wouldn't have become addicted. But just by a very tiny chance she did, what's the problem? She's dying & fast!<br/>It took A LOT of coaxing to get them to give her .02mg of morphine. Which probably didn't even do anything or much at all. <br/>Then my family came down on me for asking for pain meds for her. I asked them why they were upset. They said pain meds are bad! I said, what do you mean? They said they are highly addicting. Omg, that's SOOOO not true! I told them, for 1 we are in a hospital, controlled environment. For another Rx pain meda are safe/controlled. Its illegal street drugs that are bad/dangerous/addicting. & for another if even by some weird chance she did become addicted in a couple days to that tiny amount(which is unheard of), what's the problem? She's dying!!<br/>I also had a friend who had to have his leg amputated. Something no one ever wants to go through or have happen. They gave him some pain meds in the hospital. But several days after surgery, he was sent home with NO meds for the pain & told to take Tylenol for pain. OMG! You've got to be kidding me. He asked the doctor why he couldn't give him some pain meds for a little. The doc said cuz he wasn't going to put his license on the line/risk loosing his license for prescribing opioids. This is completely absurd!!! Again asking why his license would be put on the line for a few pain meds? & the doc said because of laws from the CDC's guidelines. <br/>For one, the CDC is supposed to be for transmissible infectious diseases. Pain is NOT an infectious transmissible disease. So why does the CDC have ANY authority at all to make ANY guidelines or anything on pain? Or anything other than infectious disease?<br/>ALL the opioid guidelines need to be withdrawn, rescinded, voided as well as any laws or anything else that stems from them. That is the ONLY way they will be able to start to undo all the harm their "opioid guidelines" have caused.<br/>Also doctors need to be told to return their patients to their last most effective dose of pain meds they did well with before the 2016 opioid guidelines were put out! <br/>Please stop & undo the harm & insanity the opioid guidelines have caused. <br/>The new updated guidelines at 1st(the very beginning) seem to try to undo some of the harm they've caused. But as you read further into it, the supporting documents counteract it & will cause even greater harm. We've already seen it happen!<br/>Thats why, ALL the "opioid guidelines" need to be withdrawn/voided. The CDC has NO authority to put these "opioid guidelines" out in the 1st place.<br/>Please please please stop this harm/torture! <br/>The thing is, its not even Rx pain meds that were/are causing any problems. Its illegal street drugs! & by restricting Rx pain meds, its just pushing more & more right to illegal street drugs, & pushing overdoses & deaths to unheard of numbers.<br/>The only way you will get a handle on the overdoses & deaths, is to make illegal street drugs undesirable. Treat addiction individually with what works best for each person. But you also need to treat people in pain individually with what works best for each person too. <br/>Stop taking away/restricting pain medicines that work wonders for people, without their being a replacement that works just as well or better for everyone.<br/>You are fooling yourself if you think you will end the opioid epidemic. You tried restricting Rx pain meds & that went completely downhill. It didn't help at all & only made things worse. So stop doing that. You will keep making things worse!<br/>Please give people in pain back their lives with the help from rx pain meds! Please stop harming them & sending them to illegal street drugs! Please!<br/>The only way now to do that is to remove/void ALL opioid guidelines!<br/>Thank you!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484ffc71d	P	None	2022-04-06T20:59:58Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from P, Marie	l1n-x1e9-kujs	False	None	False	2022-04-12 06:38:37.594	[]
4020	CDC-2022-0024-4026	https://api.regulations.gov/v4/comments/CDC-2022-0024-4026	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a pharmacist who has spent some time working in pain management, and a private citizen who has had first-hand experience with a spouse who died of substance abuse, I am appalled by what I believe to be a hype-and ignorance-driven suppression or "chilling effect" upon proper pain management for patients who suffer. It seems to me that there are many people in positions of authority who are perfectly happy to, through virtue signaling, misguided policy, and political neglect, ignorantly punish people who are honestly seeking pain control in order to function somewhat normally in their day-to-day lives. I believe that this is because of serious governmental ignorance and societal problems that politicians and political policies are unable (or, disconcertingly, often unwilling) to address. This errant attitude is not restricted to the arena of pain management and opiate use, by the way.<br/>I would like to offer a few basic, absolutely not comprehensive suggestions to help this problem:<br/>1. Border security. The failure to do anything truly relevant at our nation's borders to stop the flow of both drugs and drug dealers/transporters is a travesty. Political neglect of this issue is killing people. Control the borders of our country.<br/>2. Fight ILLEGAL drug trafficking. Treat illegal drug distribution like the murderous evil that it is and shut these people down HARD.<br/>3. Treat the addicted with FIRM compassion. More support and research for drug treatment programs is needed. However, I lost my wife to alcoholism, Ii believe in part due to the inability to have her placed in a program that was able to legally keep her there until progress was made. Her physicians constantly expressed concern about her medication regimens and concerns that they could "get in trouble" if they were more aggressive. I do NOT blame them. <br/>My last option was "72 hours in lockdown to de-tox, and after that if she left, they could incarcerate her." Tell me, where does that help a person or their family to get any meaningful help for someone who is suffering from suicidal substance addiction?? I didn't even bother to turn in the paperwork, seeing it as a meaningless and more traumatizing non-option for a person suffering from profound PTSD and depression. SHE DIED LESS THAN A WEEK LATER.<br/>4. Keep trying to figure out how to help people with real pain issues and other LEGITIMATE controlled substance needs receive better care and management without being neglected or stigmatized. <br/>5. Learn, as politicians/media/activists the differences between TOLERANCE, DEPENDENCE, AND ADDICTION. One can be TOLERANT (requiring higher doses for management of an issue to long-term exposure) and DEPENDENT (where the body will suffer withdrawal due to long-term medication use), and YET STILL BE PROPERLY TREATING PAIN (anxiety, depression, etc.) without ADDICTION (the often-compulsive use of drugs to one's detriment). People who self-medicate are very often undermedicated or mis-medicated. Stop blaming patients with real needs for the "opiate crisis" which is a societal problem, more political than medical. Use medical professionals and personnel for your primary sources and please educate those in political positions about pain management. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffc725	Anonymous	None	2022-04-06T21:00:09Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-x363-e6g6	False	None	False	2022-04-12 06:38:37.807	[]
4021	CDC-2022-0024-4027	https://api.regulations.gov/v4/comments/CDC-2022-0024-4027	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have personally suffered from excessive and unnecessary pain as a result of the 2016 CDC guidelines. We all know that they became the defacto standard of care and as a result caused much harm to myself and ten's of thousands of others. I am of the strong opinion,based on my research,that the 2022 guidelines will be worse.They will cause further harm to chronic pain patients and their providers. The CDC along with numerous other government agencies will continue to weaponize these unscientific "guidelines" to the detriment of pain sufferers. The new 2022 and the 2016 guidelines should be retracted. The CDC has no expertise or legal authority to establish these. There was never any legislation giving this authority to the CDC. I am currently in severe pain I am a large person with a fast metabolism who requires more than 50 mme for adequate pain relief.My Doctor is implanting an experimental spinal cord stimulator. I hope this gives me some relief. I am told that it could reduce my pain by as much as fifty percent but not completely. As I move into my old age I am terrified that I face the prospect of inadequate treatment for present and inevitable future pain. I am requesting that my comment be read by the as yet unnamed Peer Review panel. There are ten's of thousands of people like me who are neglected and as a result suffer because of failed pain management bureaucrats.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006484ffc72a	Quinn	None	2022-04-06T21:02:54Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Quinn, Robert	l1n-x6pq-ku2i	False	None	False	2022-04-12 06:38:38.014	[]
4022	CDC-2022-0024-4028	https://api.regulations.gov/v4/comments/CDC-2022-0024-4028	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 69 year old veteran with a squeaky clean record. I had been under pain management for 25 years when the new Trump reductions came in. For no reason I went from 130 MME to 90! For 25 years I was able to work, had no bad habits, my friends were respectable people and the rug was pulled out from under me. I don't drink alcohol, do not smoke pot. <br/> For myself and others, I resent being included in the statistics for those who abuse and take illegal drugs. It is political and ignorant.<br/> October 6th, 2021 I had a MRI of my spine done. Two regions came back as "severe", the worst possible rating. The others were not much better. I have had all that surgeries can offer me and am classified "intractable." In what world does politics belong in my world?<br/><br/>Sincerely,<br/><br/>[name redacted]<br/>[email redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484ffc75a	Eblen	None	2022-04-06T21:04:12Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Eblen, John	l1n-xboo-v5pq	False	None	False	2022-04-12 06:38:38.229	[]
4023	CDC-2022-0024-4029	https://api.regulations.gov/v4/comments/CDC-2022-0024-4029	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2018, Oregon proposed changes to the state opioid policy for chronic pain patients on medicaid in response to the 2016 federal guideline changes. Over 30 states have followed the 2016 CDC guideline by enacting laws limiting prescribing opioids. My comment will address Oregon's proposals for alternate treatments, as it is applicable for my argument that chronic pain patients quality of life needs to be considered by CDC guidelines.<br/><br/>Oregon's Health Evidence Review Commission and Value-based Benefits Subcommittee (HERC and VbBS) proposed changes to Medicaid, intended to discontinue long term opioids for chronic pain patients. All chronic pain patients would be forced to taper their opioid use within a year, no exceptions. Once the year was done there would be NO opioids for these patients.<br/>Instead patients would be replaced with the following ALTERNATIVE treatments:<br/>Cognitive Behavior Therapy (CBT), Mindfulness, Pain Acceptance, Aqua Therapy, Chiropractic Adjustments, Non-opioid medications like NSAIDS, Acupuncture.<br/>These alternative therapies won't to work on their own to replace Opioids as a treatment and will cause some chronic pain patients to commit suicide. Despite a drop in painkiller prescriptions over the years, the drug overdose rate continues to soar. It is clear the 2016 guidelines did more harm than good.<br/><br/>Cognitive Behavior Therapy (CBT) is talk therapy that helps patients learn to identify negative thoughts and behaviors and work to develop skills through structured techniques.<br/>Even if CBT works well for a patient, if they don't have a good therapist it won't be as effective and can turn patients off of seeking treatment. It's important to try to find a good therapist that fits, but sometimes it's easier said than done. Many patients don't have access to more than one therapist, if they are able to work with one at all.<br/>There aren't enough studies with enough empirical data to completely support CBT as a treatment on its own. CBT alone cannot help chronic pain patients, and is often used alongside other methods of pain management, but not every patient has access to a full medical team or the transportation or money or insurance to access such care.<br/>Mindfullness is one of the core parts of CBT, so as an alternative treatment is insufficient. "Pain Acceptance," aka Acceptance and Commitment Therapy (ACT) is just a specialized extension CBT. Studies show that CBT, ACT, and Mindfulness as treatments for chronic pain, particularly fibromyalgia, show "mild to moderate improvements in mood and quality of life, but very small changes in pain severity."<br/>Aqua Therapy is not available to every chronic pain patient. This may be due to location or cost or any other number of variables. So unless states have widespread availability for chronic pain patients to receive aqua therapy it cannot be a reasonable replacement for opioids.<br/>Chiropractic care is steeped in controversy. It's an alternative treatment with both scientific and ethical issues. The same goes for acupuncture, of which studies give varied and inconclusive results. Neither can be considered adequate alternatives to opioids.<br/>NSAIDs are not supposed to be used long-term. NSAIDs can increase the chance of a heart attack or stroke as early as the first couple of weeks of using them, and the risk compounds and increases from there. NSAIDs, when used long term, can cause kidney and Liver damage. NSAIDs are not always an option for patients due to interactions with other medications. <br/>The risk of addiction to opioids makes good headlines, but in chronic pain patients it is less than 5 percent. Many patients would turn to suicide before going to the street to get illicit drugs out of desperation.<br/><br/>Tolerance, Dependence, and Addiction appear to be confusing concepts for many of the lawmakers, so I will define them simply. <br/>Tolerance is a patient's diminished response to medications as the result of repeated use. Tolerance is a PURELY physical effect.<br/>Dependence (not to be confused with addiction) is a PHYSICAL condition in which the patient's body has adapted to the presence of a drug. If a patient stops taking said drug suddenly, they will experience withdrawal symptoms, which is why chronic pain patients are expected to gradually taper their opioid usage over the course of a year.) Addiction is a chronic MENTAL illness. It's an overwhelming urge to use a drug, a compulsion. If a chronic pain patient uses pain relievers to ensure that they can maintain a functional existence, by definition they CANNOT abuse said drugs with responsible usage correctly overseen by licensed medical professionals.<br/>We should not accept pain. Nor should we resign ourselves to it, just for the convenience of those who do not experience it. Chronic pain is different from acute pain and must be handled on a case-by-case basis without penalizing patients or encouraging doctors to turn away chronic pain patients due to being perceived as a hassle.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Morgana	None	None	0900006484ffc7da	Harp	None	2022-04-06T21:06:05Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Harp, Morgana	l1n-xxmy-5jtt	False	None	False	2022-04-12 06:38:38.441	[]
4024	CDC-2022-0024-4030	https://api.regulations.gov/v4/comments/CDC-2022-0024-4030	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/>I [name redacted] am writing this because I suffer from Chronic pain. One of the biggest issues I have is receiving pain control. Due to the statistics stating that one of the most reasons for opioid addiction comes from the misuse of medicine, race and class. It’s almost impossible to get help with pain control as a black woman. This leads to being angry, depressed, and others things that affect your mental health. Now when you go to your next pain appointment angry, crying, anxious or lashing out because your hurting now your an addict. Your an addict due to the actions you display and they’re similar to actions of an addict. Yet they’re really from someone who is living daily in pain crying out to the Dr to help them. That’s a fine line that should be handled with care. It calls for changes on how myself and others can properly get pain control as needed. It shouldn’t be on the state, federal or any other jurisdictions to weigh or set standard on. Pain is a horrible thing to deal with everyday and should be measured person to person.<br/>There’s also a clause you have to sign if you smoke marijuana or take street drugs. I feel like that clause is meaningless because it doesn’t work effectively. I signed it myself because my pain medicine was PRN so in between if I had discomfort I had medical marijuana. I took a urine test and the marijuana showed up with alcohol. All I had was rum cake after Christmas an edible. When I went to my appointment, I told my Dr what I had and the Dr took away my pain medicine due to that. He also knew I was on medications that prohibited me from drinking.<br/>Before this I’ve been on Oxycodone 5mg from failed back surgery for almost a year from July 2020-January 2021. I took all my medicines properly daily as needed. Never had an issue with addiction even when the pain Dr took me off in January 2021. That was a long time yet, I stuck to my script and was fine. So everyone that been on opioids for long periods of time become addicted.I really didn’t drink and I’ve been honest my entire life to my Dr’s. He still cut me off my pain medicine despite retesting, discussing my results or anything. I looked my results up after my appointment myself to see why my pain medicine was cut off. Just because of statistics. I’ve had to live in pain spending most days in bed for the last 2 years. My mental state depleted. I have gained over 80lbs without eating more than 1x a day.I’ve been trying to rebuild my life since. I had to study many statistics and studies to know that my actions I once displayed was like those drug seeking. <br/>Then I’ve read that African Americans are more susceptible to opioid abuse, I’m confused me. I have friends young, older, white and brown/black that became addicted to street drugs from not having their pain controlled by pain doctors. Not from abusing pain meds. The people turn to things like heroine and cocaine because I was told it takes away the pain. We as people who suffer from chronic pain just want to have a comfortable day after physical therapy or going outside for whatever it may be. <br/>So to whom it may concern, please help change the way chronic pain is managed. Sometimes it takes and opioid and sometimes it don’t. Help people like me who just want to be able to go out and enjoy fresh air and know when they get home we won’t be stuck in the bed the next two days from pain. Having a PRN pain medicine to help ease the pains I/we suffered all day trying to enjoy some parts of life would help some.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	LaChelle	None	None	0900006484ffc8c7	Howard	None	2022-04-06T21:08:08Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Howard , LaChelle	l1n-z2hq-wihn	False	None	False	2022-04-12 06:38:38.694	[]
4025	CDC-2022-0024-4031	https://api.regulations.gov/v4/comments/CDC-2022-0024-4031	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 66 year old chronic pain patient for 15+ years. I’ve been to many various doctors to try to understand where my pain is coming from and none of them could put a finger on it. The diagnosis, basically, is nerve damage. I have degenerative disc disease and I had a fusion in 2013 which didn’t really help the situation that much because one of the screws place a doctor put in went through the bone and into the midline of the nurse which could be the culprit that is causing my current pain. As a result, I am dependent on the pain medication to help me have somewhat of a life. Without these pain medication‘s, I, like many chronic pain patients, we consider alternate routes that are end of life situation‘s. There is no hospice for pain patients. We are all at the mercy of Pain Management Doctor she seem to have stringent rules because they do not want to “get in trouble “. The reality of the situation is the doctor does not prescribe enough pain medication to account for breakthrough pain or life situations that require one more pill then as prescribed. I personally feel this is nonsense and that the doctor should trust their patients to lose their prescriptions wisely. I hope there are some new rules that doctors can use that will not get them in trouble and still help their patients. We need a win-win.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monica	None	None	0900006484ffcd07	Myska	None	2022-04-06T21:08:40Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Myska, Monica	l1n-zb53-g3n2	False	None	False	2022-04-12 06:38:38.908	[]
4026	CDC-2022-0024-4032	https://api.regulations.gov/v4/comments/CDC-2022-0024-4032	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings and thanks for the positive, more realistic and compassionate features in the CDC's update on opioid prescribing guidelines. For the record, I am a chronic pain-disabled man of 64 years who for a decade has relied on still-effective, opiate-based pain medication for relative functionality, quality of life, and basic freedoms others enjoy. I've already commented on the background of my physiological afflictions, as well as personal harm and intensified stigma I’ve suffered, stemming from the CDC's prior set of Guidelines; so I'll not repeat all that. For now, firstly, I am gratified that the CDC has apparently listened to we, the patients and providers who've called for leeway in prescribing that's commensurate with individual medical cases, and not some arbitrary one-size-fits-all approach. As you know, many health officials and government agencies applied the 90 mme guideline as an absolute rule to enforce, resulting in immeasurable suffering, effective torture, and skyrocketing suicides in pain communities across America. They also resulted in justified protests from the AMA, and in a Human Rights Watch report calling out the cruelty against patients (not addicts!) unleashed by draconian applications of the prior Guidelines. Your updated Guidelines are in general more humane -- so many thanks for that. However, I beg you to please, please drop the reference to 50 mme in the update! If you don't, the previous harm will likely not just be repeated, but horribly multiplied. As you should have gathered on the first go-around, ANY mention of specific dosages, regardless of context, will be misread, misinterpreted and misapplied, regardless of context. Whether misapplication is maliciously intentional or not, people will read, "blah, blah, blah, 50 mme, blah, blah, blah . . .," and then slash patients' dosages to that level; which, for many, would be no more than a cruel mockery (as 90 mme already is for many, and that includes even cancer patients who’ve been medically abandoned in the opiophobic crusades). Keep the recommendation that patients, with their doctors' oversight and participation, get a level of pain medicine tailored to their unique situation. But, for the love of God and humanity, leave out specific dosage amounts and numerical references -- or else we are heading for more agony, death, and disaster! Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006484ffcd10	Gramer	None	2022-04-06T21:10:32Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Gramer, Joseph	l1n-zdk3-4fp8	False	None	False	2022-04-12 06:38:39.118	[]
4027	CDC-2022-0024-4033	https://api.regulations.gov/v4/comments/CDC-2022-0024-4033	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Executive Summary (please see attached document for full comment)<br/><br/>We in the United States face an epidemic of opioid overdose deaths. This tragic problem receives a great deal of attention in the media and in the national discourse, and rightfully so. However, the dire repercussions of a world where patients have less access to opioids receive little airtime in the conversation about opioids. Clinical use of opioids to treat chronic pain masks the potential for an epidemic of suicides among chronic pain patients. Studies have found that an alarming number of chronic pain patients have experienced suicidal ideation, and that number could surge if access to opioids is made even more restricted. Chronic pain patients already experience numerous hurdles to obtaining opioids—it is imperative that the CDC and other authoritative bodies do everything in their power to make certain that these patients get access to the treatments they need. <br/><br/>Treating patients with chronic pain is difficult and time consuming. Chronic pain patients are not a monolith—each one of us is different, and our cases are complex. The optimal treatment regimen is usually multimodal—opioids are often one piece (albeit a critical piece) of the puzzle. Putting together our pain puzzles takes time, the remuneration for a provider’s efforts is inadequate, and many providers are afraid of the liability associated with opioid prescribing.<br/><br/>The CDC should do everything in its power to address barriers to access, while at the same time encouraging common-sense, reasonable practices for addressing opioid abuse, like monitoring and auditing prescribing patterns. Measures like establishing across-the-board maximum dosing guidelines for opioids significantly impair access to treatment. Dosing limits can give providers cover for effectively kicking severe chronic pain patients out of their practices. If a provider refuses to prescribe the dose of opioids a patient needs because that dose is higher than what the guidelines have established, then that patient is forced to seek care elsewhere. This allows providers to rid their practices of high-maintenance, high-cost, low-profit patients with severe chronic pain.<br/><br/>The CDC should seek to empower physicians to be the arbiters of which opioid treatments their patients receive and at which dose. Physicians should be able to prescribe opioids without fear of professional sanctions or criminal prosecutions (unless they are blatantly running “pill mills”). It is front-line providers who are in the best position to determine which patients should receive opioid treatment, and these providers need adequate time and reimbursement to do their jobs effectively. These providers must manage the difficult balance between the risk of death from opioid overdose with the risk of death from suicide as a result of inadequately treated pain. The best thing the CDC could do to address the opioid epidemic is actively campaign for higher and broader reimbursement for treating chronic pain patients. Providers need more time with their patients to prescribe opioids safely, and widespread availability of multidisciplinary pain clinics should be resurrected. <br/><br/>[name redacted]<br/>[location redacted] CA<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brandon	None	None	0900006484ffcd15	Stauffer	None	2022-04-06T21:16:28Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Stauffer, Brandon	l1n-z1ie-0nk4	False	None	False	2022-04-12 06:38:39.328	[]
4028	CDC-2022-0024-4034	https://api.regulations.gov/v4/comments/CDC-2022-0024-4034	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Five years have gone by since the cdc guidelines changed my pain treatment by scaring my PAIN CLINIC into discontinuing my opioid therapy. I've tried the alternative treatments recommended by my doctors, but here I am in so much more pain because my effective pain medication was taken away for no reason. I've lost my ability to work,and must get help from someone to even keep up my house. I've lost my dignity, my health and my trust in everyone involved. The revision to the 2016 guidelines is not going to help people in pain, if anything they will make it worse. <br/>The CDC needs to admit the harm done to pain patients, and retract all guidelines and not replace them. The CDC has no expertise in writing guidelines for treating pain, no legal mission, and no legislative authority.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffcd2e	Anonymous	None	2022-04-06T21:16:45Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1n-zlrg-8nwy	False	None	False	2022-04-12 06:38:39.539	[]
4029	CDC-2022-0024-4035	https://api.regulations.gov/v4/comments/CDC-2022-0024-4035	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC insists upon wildly and continuously overstepping its bounds. As if the 2016 guidelines weren't damaging enough, it now has brought the MME down even further, from 90 to 50. The CDC hasn't the authority to produce such guidelines to begin with, let alone update them; an entity thats main focus is to control contagious disease has now stepped into the job that belongs to the FDA. All mention of the Morphine Milligram Equivilant simply MUST be removed from this update; these arbitrary numbers will again be weaponized by the DEA, which is yet another agency who has gone rogue. When doctors see that the new guidelines have dropped to 50, many more patients will suffer harms, and our deaths will continue to rise, due to the severe undertreated pain of incurable disorders and diseases. Many deaths are already on their hands since 2016, as a result of a great many patients losing their physicians to the DEA oversight. The biggest question still remains - how is it that prescription opioid prescribing is at a 20 year low, while overdoses, (mostly from illegal fentanyl) are up at least 1000%? The answer is because the problem doesn't stem from patients and their doctors. The threat that drives these overdoses is from the street, as fentanyl busts continue to rise. Until these facts start to become correctly reported by the media, deaths from both sides will continue to increase. Putting the blame where it belongs would be a step to start controlling the numbers. Until that happens, at least removing all MME mention from the entire guideline would be a start. <br/>We are Pennsylvanians for Appropriate Pain Treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffcb87	None	None	2022-04-06T21:16:55Z	Pennsylvanians for Appropriate Pain Treatment	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvanians for Appropriate Pain Treatment	l1o-0jbg-u7b3	False	None	False	2022-04-12 06:38:39.760	[]
4030	CDC-2022-0024-4036	https://api.regulations.gov/v4/comments/CDC-2022-0024-4036	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 72 years old and several years ago I had a knee replacement due to osteoarthritis. My knee was bone on bone. I had the necessary prerequisite injections that the doctors suggested. None of those injections helped except that were incredibly painful and not even done by the doctor. In 2016 suddenly there was an abrupt change that is not based in science. I know this because I take pharmacology in my career and I was appalled to find out it is a result of many dark backroom meetings with a select few so called concerned doctors. We know these doctors are being paid millions in dark money to speak AGAINST opioids. So if my doctor agrees I need pain medication, WHAT THE HECK IS THE DEA DOING COMING BETWEEN ME AND MY DOCTORS OF 20 YEARS? I had to cut back on the hydrocodone that allowed me to live my life without pain. I never took more mme than your guidelines suggested but ALL DOCTORS ARE TERRIFIED OF LOSING THEIR LICENSES because of your proclamation that you and a small group of activists have bestowed in on the American people saying you know better than my doctor of20 years. This is disgusting and appalling. Surely you don't think you can take America back to the dark ages without a court fight. <br/>Three weeks before my mother passed away her assisted living doctors were telling us they woud be taking away her hydrocodone, which gave her relief from the botched back surgery of previous years ( yes, we have proof of this). So taking medication away from 88 year old hospice patients will DEFINITELY NOT STAND WITH ANYONE. <br/>I HAVE KNOWN PEOPLE AND VETERANS WHO HAVE DECIDED TO COMMIT SUICIDE BECAUSE THEY WERE NO LONGER ABLE TO SUFFER WITHOUT PROPER MEDICATION AND THE ONLY MEDICATION THAT HELPED WERE OPIOIDS.<br/>IN MY OWN CASE MY ORTHOPEDIC PHYSICIAN PLACED A KNEE REPLACEMENT THAT ENDED UP TOO SMALL AND IT KEPT SLIPPING OUT. DURING MY RECOVERY THEY TOOK AN MRI AND BECAUSE I WAS IN PAIN THEY PULLED E BY MY SHOULDERS TO GET ME IN THE MRI TABLE. I BEGAN HAVING SHOULDER PAIN AND WAS TOLD IT WAS PROBABLY THE CRUTCHES. IT ONLY GOT WORSE, THEN AFTER ANOTHER MRI ON MY SHOULDER, IT REVEALED A TORN ROTATOR CUFF. I THEN REQUIRED ANOTHER SURGERY. THE NEXT MORNING AFTER ROTATOR CUFF I WOKE UP IN SEVERE PAIN IN THE HOSPITAL AND WHEN I ASKED FOR PAIN MEDICATION THE NURSE SAID THE DOCTOR ONLY SAID I COULD HAVE TYLENOL. I LAID IN BED CRYING IN PAIN AND CLEARLY NO ONE WAS INTERESTED. THIS IS COMPLETELY INTOLERABLE!!!! I WANT TO BE IN THE ROOM WHEN ONE OF YOUR FAMILY MEMBERS ARE SENT HOME WITH TYLENOL AFTER A LEG AMPUTATION OR HIP SURGERY. WE CAN THEN HAVE A CONVERSATION.<br/>ANOTHER ISSUE I FOUND OUT IN MY RESEARCH IS THAT THERE IS PROOF THAT WOMEN WITH HEART DISEASE ARE TAKE MUCH LONGER TO GET A REAL DIAGNOSIS BECAUSE THEY ARE TOLD THEY HAVE A MENTAL ISSUE SUGGESTING THEY ARE MORE EMOTION, ANXIOUS AND NERVOUS. IT IS APPALLING. <br/>I CAN PROMISE YOU YOU NEED TO GET TOGETHER WITH YOUR ASSOCIATES[name redacted] ET AL AND STOP INTERFERING WITH AMERICANS AND THEIR DOCTORS. WE ARE COMMITING SUICIDE DAILY BECAUSE OUR LIVES WENT FROM THE AVAILABILITY OF PAIN MEDICATION TO HELP US LIVE OUR EVERYDAY LIVES TO NOT BEING ABLE TO GET OUR OF BED BECAUSE OF PAIN. MY LIFE IS SO MUCH MORE PRODUCTIVE WHEN I'M NOT IN PAIN. THERE ARE MILLIONS OF US AND I PROMISE YOU WHILE I HAVE STRENGTH I WILL MAKE SURE EVERYONE KNOWS WHAT THE DEA AND CDC have done to American society in the name of self satisfied doctors who think they know my history. I will NOT go without a fight. Social media will catch up with your dark money.<br/>I EXPECT TO HEAR BACK FROM YOU AND TELL ME WHY YOU ARE GIVING YOURSELVES CONTROL OVER OUR BODIES. YOU HAVE CREATED A CLUSTER **** and you need to know this isn't going away. Allow me and my doctor to decide what's best for me. You would think that the provable evidence that you have caused suicides would be enough for you to be mildly concerned..sadly I don't see your interest in lifting a finger to help. I think we all know where each other stands. <br/><br/>[name redacted]<br/>[email redacted]<br/><br/>I WANT THIS REVIEWED AND INSIST A PERSONAL RESPONSE	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jan	None	None	0900006484ffcb8f	Fulton	None	2022-04-06T21:18:27Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Fulton , Jan	l1o-0nml-71hi	False	None	False	2022-04-12 06:38:39.985	[]
4031	CDC-2022-0024-4037	https://api.regulations.gov/v4/comments/CDC-2022-0024-4037	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines for prescribing opioids is a mess that cannot be repaired. The guidelines should be retracted and not replaced by more confusing jargon. The CDC has no expertise on drafting guidelines for treating pain and are biased and highly damaging to people living with pain. How many suicides and deaths are on the heads of the CDC due to their 2016 guidelines. They should be on trial for the murder of innocent people instead of trying to do more harm.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffcb99	Anonymous	None	2022-04-06T21:18:34Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-0pw3-mob4	False	None	False	2022-04-12 06:38:40.202	[]
4032	CDC-2022-0024-4038	https://api.regulations.gov/v4/comments/CDC-2022-0024-4038	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	REMOVE MME LIMITS<br/>Once again, I'm writing to the CDC to beg for humanity and compassion...to be treated at least as well as a beloved pet; though they're suffering now, too.<br/><br/>I'm not going to give you all the facts & numbers, as I know you'll be inundated with this type of info...however, the following does bear repeating:<br/>According to your own information, between 2016-2019 the amount of Rx opioid pain meds, allowed to be manufactured, were cut by upwards of 60%.<br/>During the same time period the OD rate increased by over 1040% & no, that's not a typo.<br/>Also increased were suicides among CPP (Chronic Pain Patients) and their prescribing physicians, by over 40% & suicides among Veterans in pain rose more than 55%....what more is it going to take..?<br/><br/>At first, I was hopeful, reading this latest version, but just when my heart had begun to fill with the unaccustomed feeling of real hope; there it was: "50MME"<br/><br/>Not only have you repeated another hard limit; you've gone even farther & Lowered It!??<br/><br/>You can go on & on about how it only applies to acute, or newly dx'd pts, but we ALL know how that number will be used.<br/>Have you not learned anything from the past 15+ years? Because this didn't start with your 2016 GL, this started with the DOJ & Big Insurance, almost 20 years ago.<br/><br/>I remember [name redacted] & [name redacted], may they rest in peace."The Chilling Effect" shows the first failed attempts and many have been watching ever since.<br/><br/>I know some of you have compassion, but sometimes good intentions pave the road to hell, and that's where myself, & many others like me, are left to crawl, hobble, roll and scrabble along as we desperately try to find relief.<br/>Take a look at my imaging & tell me I don't deserve appropriate treatment!<br/>I haven't showered since June of 2021. I have my hair washed once since then. This is No QOL, this is barely an existence.<br/><br/>I'm literally begging you; please stop adding a limit to the guidelines, no more MMEs! And you're as close to golden & we'll get. Just stop giving the DEA ammunition! Please! I want to live to see my grandkids, but never will if this continues.<br/><br/>Thank you for your time, please make this right. What is stopping you?<br/><br/>Sincerely,<br/>An Intractable Pain Patient	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jessica	None	None	0900006484ffcbac	Minerd-Massey	None	2022-04-06T21:24:38Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Minerd-Massey, Jessica	l1o-0hpy-m6fq	False	None	False	2022-04-12 06:38:40.423	[]
4033	CDC-2022-0024-4039	https://api.regulations.gov/v4/comments/CDC-2022-0024-4039	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The NEW revised 2022 CDC Opioid Guidelines have already failed the chronic and intractable pain patients in this country! CDC needs to remove the hard limits, such as 50MME and not add every pain patient into the same pain level box with the one-size-fits-all! there are going to be thousands of suicidal deaths due to unmanaged pain along with overdoses from chronic and intractable pain patients trying to find pain relief. My Pain Specialist informed me on March 7, 2022 he and every doctor in the Pain Clinic I'm going to, is lowering every patient that is being prescribed opioid pain medication that is above 50MME down to a hard limit of 50MME as recommended in the NEW 2022 REVISED CDC Opioid Guidelines! This is down from the previous hard limit 90MME which was the hard limit dosage recommended in the 2016 CDC Opioid Guidelines! By CDC's own admission, the 2016 CDC Opioid Guidelines caused devastation, loss of function and quality of life for hundreds of thousands if not millions of pain patients! Most of them are trying to live with CHRONIC/INTRACTABLE PAIN. Intractable pain is never mentioned in either of the 2016 or 2022 guidelines, only acute and chronic. FACT: Several states have LAWS defining intractable pain treatment and when permissible to be treated with opioid therapy. The CDC Opioid Guidelines have overridden a lot of those states intractable pain management laws by recommending (mandating) doctors to reduce opioid pain medication down to 90MME in the 2016 guidelines and further down to 50MME in the new revised 2022 CDC Opioid Guidelines! CDC is trying to push a narrative that they, by their own admission, made mistakes with the 2016 guidelines and are now trying to correct them. Just one of the many mistakes made in the 2016 guidelines, is they blamed prescription opioid pain medications for the Nations so called opioid epidemic, as well as overdose deaths and that illicit Fentanyl and street drugs were the main reason for most of the opioid epidemic and overdose deaths. In addition, CDC stated chronic pain patients have suffered enough and it was time to try too give some relief doctors and pain patients by adding some changes into the revised 2022 Guidelines. Changes such as giving doctors more flexibility when prescribing opioid pain medication and prescribing opioids should be done at doctors discretion and with the patient's complete understanding of what opioid medication is and does. CDC did exactly the same thing as they did with the 2016 guidelines by adding hard MME limits i.e. 90MME and now 50MME in the new revised guidelines, How is this helping and not hurting the chronic/intractable pain patients? Even though CDC stated the Opioid Guidelines are only guidelines and recommendations not law, the FACT is the 2016 CDC Opioid Guidelines were made into mandated law and very soon the NEW REVISED Opioid Guidelines are going to be as well! Because CDC said the guidelines are not law and are only recommendations for doctors to use as guide with some direction! At the time my doctor lowered my pain medication down to 50MME from 90MME he told me his "Hands are tied and there's nothing I do can change that"! What a guy! It appears he is being forced to follow the guidelines recommendations! I've heard from dozens of pain patients from other states, they are all saying, their doctors are enforcing the 50MME from 90MME by following the 2022 Revised CDC Opioid Guidelines as standard practice! The FACT is, this is happening in real time, and this is happening before the NEW 2022 CDC Opioid Guidelines have even been released to the public (that we know of)! We thought CDC was admitting to their mistakes and can see the mistakes and the devastation the 2016 Opioid Guidelines caused? Why in Gods name are they doing this again? Only this time it's worse than the 2016 guidelines! Instead of fixing the devastation and horror that was caused to millions of pain patients, CDC is using much of the same language and recommendations (Mandates/Laws) in the new 2022 Opioid Guidelines as they did in the 2016 guidelines, with the hard MME limit formula. A MME formula that does not make sense and does not work! CDC also stated they are leaving out the hard limits because "every pain patient needs to be treated individually and with respect". They also stated they were leaving out the ONE-SIZE-FITS-ALL clause, yet they recommended to "use caution and to pause before prescribing up to 50MME and do not go over 90MME", putting all pain patients, acute, chronic, intractable in the same pain box! Every body is different, with their own individual type of pain and individual way to treat it! There has got to be better and more options for pain patients with chronic/intractable pain! CDC needs to do much, much better than this, in order to HELP THE DISABLED AMERICAN CITZENS IN PAIN, AT NO FAULT OF OUR OWN!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffcbd2	Anonymous	None	2022-04-06T21:25:01Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-12iq-8h1o	False	None	False	2022-04-12 06:38:40.637	[]
4034	CDC-2022-0024-4040	https://api.regulations.gov/v4/comments/CDC-2022-0024-4040	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Injured Workers Pharmacy - Andover, MA Comments	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fefcbf	None	None	2022-04-06T21:30:37Z	Injured Workers Pharmacy	None	1	None	2022-04-06T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Injured Workers Pharmacy	l1e-zrra-4iot	False	None	False	2022-04-12 06:38:40.852	[]
4035	CDC-2022-0024-4041	https://api.regulations.gov/v4/comments/CDC-2022-0024-4041	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff17ca	None	None	2022-04-06T21:31:34Z	National Comprehensive Cancer Network	None	1	None	2022-04-06T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from National Comprehensive Cancer Network	l1f-e9rr-vl55	False	None	False	2022-04-12 06:38:41.066	[]
4036	CDC-2022-0024-4042	https://api.regulations.gov/v4/comments/CDC-2022-0024-4042	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff1dfc	None	None	2022-04-06T21:32:32Z	Millennium Pain Center/National Spine Center	None	1	None	2022-04-06T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Millennium Pain Center/National Spine Center	l1f-kv4x-4eed	False	None	False	2022-04-12 06:38:41.276	[]
4037	CDC-2022-0024-4043	https://api.regulations.gov/v4/comments/CDC-2022-0024-4043	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was on a stable dose of opioid pain medication for a decade with no problems until the CDC guidelines scared my doctor into abandoning me and discontinuing my medication for no good reason. I've tried alternative methods to relieve my pain that either didn't work or I had bad reactions to them. With opioid pain medication I was able to work, and keep up my house, and walk my dogs. I can't do any of those things now and because of this have sunk into depression and despair. My health is actually failing due to lack of exercise, NSAIDs causing intestinal damage and not being able to eat or sleep. It's heartbreaking to discover how many pain patients were affected by the CDCs guidelines and how many good people we have lost. The CDC should be charged with murder, and prohibited from developing ANY guidelines regarding the treatment of pain and use of opioid pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff2052	Anonymous	None	2022-04-06T21:33:03Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1f-p4vf-p1fw	False	None	False	2022-04-12 06:38:41.517	[]
4038	CDC-2022-0024-4044	https://api.regulations.gov/v4/comments/CDC-2022-0024-4044	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff21ae	None	None	2022-04-06T21:34:13Z	Gundersen Health System	None	1	None	2022-04-06T04:00:00Z	None	None	2022-03-31T04:00:00Z	None	None	None	None	None	None	None	Comment from Gundersen Health System	l1f-pd3w-rhuk	False	None	False	2022-04-12 06:38:41.728	[]
4039	CDC-2022-0024-4045	https://api.regulations.gov/v4/comments/CDC-2022-0024-4045	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a sufferer of severe Restless Legs Syndrome for over forty years, I am writing to inform you of how invaluable codeine is to the treatment and relief of my symptoms. I have tried multiple other medications as well and am still on Pramipexole, but as you know, all have side-effects, and Pramipexole has been found to cause augmentation over time. Even though it did cause augmentation for me, it still is the best of my available choices, and so I've been forced to stay on it, but to reduce the dosage and supplement with codeine 30mg x 4 per day. My physician is a brilliant neurologist, specializing in movement and sleep disorders, and I am well-supervised. I am not being overly dramatic when I state that if I could not have codeine, my symptoms are so severe that I would not want to live. RLS has a profound effect on my quality of life even with proper medication. Without it, life would not be worth living. It annoys me tremendously that in reading descriptions of RLS, even on respected medical sites, the symptoms are often described as uncomfortable but not painful. It's a different kind of sensation, not unlike having a cattle prod send shocks up and down your legs, and it IS painful. I urge you, in considering this issue of controlling the availability of opiates and their possible abuse, to consider patients like myself, who use them judiciously and under supervision, and for whom they are critical to our well-being and quality of life. Sincerely, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006484ff2791	Truscott	None	2022-04-06T21:34:28Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Truscott, Wendy	l1f-wis2-qss1	False	None	False	2022-04-12 06:38:41.948	[]
4040	CDC-2022-0024-4046	https://api.regulations.gov/v4/comments/CDC-2022-0024-4046	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	0900006484ff3490	Williams	None	2022-04-06T21:35:02Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from Williams , Steve	l1g-iy4g-owdn	False	None	False	2022-04-12 06:38:42.159	[]
4041	CDC-2022-0024-4047	https://api.regulations.gov/v4/comments/CDC-2022-0024-4047	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached comments from the American Society of Regional Anesthesia and Pain Medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff3c5a	None	None	2022-04-06T21:36:55Z	American Society of Regional Anesthesia and Pain Medicine	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from American Society of Regional Anesthesia and Pain Medicine	l1g-q9te-h6q5	False	None	False	2022-04-12 06:38:42.369	[]
4042	CDC-2022-0024-4048	https://api.regulations.gov/v4/comments/CDC-2022-0024-4048	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see the attached document that serves as a formal comment concerning the proposed Clinical Practice Guideline for Prescribing Opioids. In particular, this response involves the apparent omission of clinical hypnosis an effective and empirically validated treatment intervention for pain conditions. We respectfully encourage the CDC to consider including clinical hypnosis as an evidence-based treatment intervention for pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff4a7e	None	None	2022-04-06T21:37:38Z	Division 30 of the American Psychological Association	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-02T04:00:00Z	None	None	None	None	None	None	None	Comment from Division 30 of the American Psychological Association	l1i-3v0e-j5sb	False	None	False	2022-04-12 06:38:42.577	[]
4043	CDC-2022-0024-4049	https://api.regulations.gov/v4/comments/CDC-2022-0024-4049	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Anyone and everyone involved in this scam of a “guideline” should be jailed. You are directly responsible for the TORTURE of millions of Americans under the guise of a “public health emergency”, which really has more to do with boosting the stock portfolios of those invested in pharmaceuticals. Opioids have been used safely tor THOUSANDS OF YEARS. The only “crisis” is that government involvement in our healthcare decisions. Thousands have already died because they can’t get a SAFE SUPPLY OF PAIN MEDS, and must go to the streets hoping for relief from inevitable human pain, then accidentally overdose on fentanyl-laced pills!!! Our own government is performing human experiments on us without our knowledge or consent, and unfortunately it’s on us ordinary citizens to take our power back, and we WILL. <br/><br/>In time, this period of CDC encroachment on our basic human rights will be seen as one of the darkest periods in human history, and the names of everyone involved in this travesty will be remembered only with deep shame. But what do they care? They’re making millions on our suffering with their useless “treatment centers” and “opioid misuse” drugs. Well, honey, just remember - you can’t take it with you. To all of you profiting from this nightmare forced on hard-working Americans who just need a bit of relief from our lives of toil: when it’s your turn to go, and you see that bright light leading the way to your destiny, it is my hand who will reach out to take you where you need to go. It’s up to you to decide where that will be. <br/><br/>Shame on you all. You embarrass yourselves, and this once great nation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanette	None	None	0900006484ff5f52	Wallis	None	2022-04-06T21:38:50Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Wallis, Jeanette	l1i-stdm-b21f	False	None	False	2022-04-12 06:38:42.817	[]
4044	CDC-2022-0024-4050	https://api.regulations.gov/v4/comments/CDC-2022-0024-4050	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your restrictive weaponized guidelines have ruined my life. I'm a Cancer survivor 35 years of age and in constant agony. Since the 2016 Guidelines I've lost Seven (you counted right 7) Loved ones to Suicide after they were either Force Tapered or Flat-out Cut Off Cold Tukey from their Pain Meds. <br/>Unfortunately for you I refuse to give you and your fellow PROP Cult members what you want. I live to see your karma and I will relish you day in court for 'Strict Liability.' <br/>I was once an acrobatic athlete in top five of my field, herbal medicine maker, and mother of two. Now since my pain is untreated per request of your guidelines I can no longer care for my children; I can no longer work. My home is now my prison, the heartless doctors are my wardens that "get-off" on my suffering and my body the torture device of 365 24/7 Agony. <br/> The DEA has weaponized your guidelines into LAW to persecute any prescribing doctors. Your weaponized guidelines are a violation of 4th, 9th and 14th amendments of the constitution.<br/>the CDC's guidelines are what the DEA uses to VIOLATE:<br/>Amendment IV<br/>The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated, and no warrants shall issue, but upon probable cause, supported by oath or affirmation, and particularly describing the place to be searched, and the persons or things to be seized.<br/>Amendment IX<br/>The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.<br/>an amendment to the U.S. Constitution, ratified in 1868, defining national citizenship and forbidding the states to restrict the basic rights of citizens or other persons.<br/>the 14th Amendment: No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.<br/>this is something both the CDC and DEA have done.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ff6503	Anonymous	None	2022-04-06T21:38:59Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1j-ddgg-8vbs	False	None	False	2022-04-12 06:38:43.026	[]
4045	CDC-2022-0024-4051	https://api.regulations.gov/v4/comments/CDC-2022-0024-4051	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I ask the committee to read the enclosed detailed analysis regarding the proposed 2022 Opioid Prescribing Guidelines. I am the founding president and Executive Director at Chronic Illness Advocacy & Awareness Group dba CIAAG which represents over 8,224,000 members. <br/><br/>This report discusses a number of serious concerns regarding the proposed guidelines and have outlined them for your review and careful consideration. These guidelines will impact the health and well-being of millions of citizens and must be developed with the utmost care. <br/><br/>I am available to discuss any questions or concerns and can be contacted by email at [personally identifiable information redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff623e	None	None	2022-04-06T21:40:22Z	Chronic Illness Advocacy & Awareness Group dba CIAAG	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Chronic Illness Advocacy & Awareness Group dba CIAAG	l1j-kzvz-a8as	False	None	False	2022-04-12 06:38:43.240	[]
4046	CDC-2022-0024-4052	https://api.regulations.gov/v4/comments/CDC-2022-0024-4052	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	MME is junk science and needs removed from any & all documents that are suggestive of prescribing practices regarding any & all medications.<br/><br/>https://t.co/gAjGF9bi66	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ashley	None	None	0900006484ff66d6	Rodgers	None	2022-04-06T21:42:15Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers , Ashley	l1j-p8w2-74zs	False	None	False	2022-04-12 06:38:43.462	[]
4047	CDC-2022-0024-4053	https://api.regulations.gov/v4/comments/CDC-2022-0024-4053	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see the attached document from the American Association of Nurse Anesthesiology	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff3997	None	None	2022-04-06T21:43:13Z	American Association of Nurse Anesthesiology	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-01T04:00:00Z	None	None	None	None	None	None	None	Comment from American Association of Nurse Anesthesiology	l1g-mf7g-05bn	False	None	False	2022-04-12 06:38:43.716	[]
4048	CDC-2022-0024-4054	https://api.regulations.gov/v4/comments/CDC-2022-0024-4054	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	PLEASE REMOVE ANY AND ALL MORPHINE MILLIGRAM EQUIVALENT LAWS FROM THE GUIDELINES.<br/>Furthermore, having NSAIDS and Tylenol both deadly and damaging drugs as the gold standard for pain is detrimental. Neither of these poisons are good for pain at all. <br/>Another request is that the CDC reveal ALL Conflicts Of Interest to the Public this includes the corruption and influence of ALL (Hate Group) PROP members.<br/>These guidelines are no better than the 2016 version. They are biased, unscientific and heavily discriminatory against pain patients. These guidelines are discriminatory against diseases, Veterans, the disabled and discriminatory against women. Women make up the majority who have painful illnesses such as Fibromyalgia, especially after childbirth. <br/>I've left an attachment from The CHRONIC ILLNESS ADVOCACY &AWARENESS GROUP.<br/>REMOVING THIS DOCUMENT WOULD BE FURTHER PROOF YOU ARE HIDING THE TRUTH FROM THE PUBLIC.<br/><br/>If your going to revise the guidelines you should at least have Chronic Pain Patients in the group to be fair instead of stacking the deck against the people who you've deemed "useless eaters". Just like what the Nazi SS did with the T-4 Eugenics Experiment in WW2 to kill of the "undesirables". You like Nazi Germany have deemed all chronic pain patients Disposable or Collateral Damage in your War on Healthcare. <br/>Put yourself in our shoes how would you feel if you were deemed a "useless eater".<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melinda	None	None	0900006484ff62a7	Allder	None	2022-04-06T21:44:33Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-03T04:00:00Z	None	None	None	None	None	None	None	Comment from Allder, Melinda	l1j-rntm-nd19	False	None	False	2022-04-12 06:38:43.931	[]
4049	CDC-2022-0024-4055	https://api.regulations.gov/v4/comments/CDC-2022-0024-4055	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support Dr. [name redacted]'s comments and those of CIAAG. Please see the attached.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Henry	None	None	0900006484ff69f1	Yennie	None	2022-04-06T21:47:47Z	None	None	1	None	2022-04-06T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Yennie, Henry	l1k-o795-v92v	False	None	False	2022-04-12 06:38:44.158	[]
4050	CDC-2022-0024-4056	https://api.regulations.gov/v4/comments/CDC-2022-0024-4056	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	National Center for Injury Prevention and Control, Centers for Disease Control and Prevention<br/><br/>Attn: Docket No. CDC-2022-0024<br/><br/>February 4, 2019 our lives changed forever. I typically love Mondays! That Monday was the Monday-est Monday I have ever experienced. At just 33 years young, the date of February 4, 2019 would be forever etched in my mind. My PCP advised me to file for SSDI and immediately stop working, unless I wanted to speed this monster up and risk paralysis sooner rather than later.... much later, we are hoping. After several excruciating MRIs, I was diagnosed with Adhesive Arachnoiditis. With tears in his eyes, my doctor couldn't stop apologizing. "You just don't even see this in someone who has reached their 80s or 90s...." I couldn't imagine what he was about to tell me. I knew something was terribly wrong but, I didn't have it on paper, yet. We certainly weren't expecting news that would completely turn our lives upside down. This disease isn't as rare as majority may want you to believe. This disease is, most commonly, caused by medical malpractice. I carried and birthed all four of our children, naturally with no pain medication. During labor, with our third little human, I was just about to push when I just gave up and kept stating. "I can't do this. I can't. I need an epidural." Well, we didn't put 2 & 2 together until our fourth baby. Just before my body decides it is time to push, I tell myself and everyone around that I cannot do it anymore. Now, anyone who is a parent should have learned that there is a cut off time for epidurals. First red flag was the anesthesiologist was called while I'm in active labor, just about pushing our baby out. He gets the catheter inserted into my spine and it was time for baby to arrive! I yelled that it was time to push and ended up laboring, on my back, with the catheter still inserted! Our third little miracle was born March 5, 2011. Yes, I have been living with this monster for eleven years. Although, I wasn't diagnosed until February of 2019. Having an invisible disease is the most difficult thing I have ever had to face. This has progressed and is spreading into my hips. There are many direct symptoms but, it also causes other health complications. My joints and tendons (specifically my shoulders, hips and knees) are calcified.... which truly limits my range of motion. The pain is excruciating. I cannot stay in one position for more than ten or so minutes, due to my spinal cord and tendons feeling as if they are frozen stiff. After several years of trial and error with medications I am finally to the point I can function with the help of opioids and my husband. Having to take medicine just to function is a position I never even thought of, prior to this disease. I fully understand where the judgements and stereotypes come from. However, those of us who do not have a choice do not deserve to be treated like garbage. Honestly, those of us that have no choice battle our minds, daily. We battle the fact we have no choice. Please consider those of us who have terminal/permanent illnesses that do not have a choice. Believe me when I state that those of us who are battling illnesses, especially invisible to the eye illnesses, and are given no choice but to take opioids to function... we have exhausted every option, with no relief, before deciding opioids are the best option.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffcbfe	Anonymous	None	2022-04-07T14:20:50Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-1h8b-2hds	False	None	False	2022-04-12 06:38:44.369	[]
4051	CDC-2022-0024-4057	https://api.regulations.gov/v4/comments/CDC-2022-0024-4057	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	thank you for opening up the comment. regarding the latest guidelines. I work hard in daily practice to reduce patient's usage of opioids. Usually patients are referred to my office already taking narcotic medications and our goal is to reduce the reliance on this. In clinical practice, fellowship, residency and in numerous studies these interventional techniques have been shown to be effective in reducing patient's pain. Restricting access to this therapy reduces the patient's options when confronting a future with reduced reliance on narcotic medications. It is imperative that properly trained physician specialists continue to be supported in there role in reducing pain through nonnarcotic means including interventional therapies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	thomas	None	None	0900006484ffcc17	whealton	None	2022-04-07T14:29:04Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from whealton, thomas	l1o-1qrb-yp77	False	None	False	2022-04-12 06:38:44.595	[]
4052	CDC-2022-0024-4058	https://api.regulations.gov/v4/comments/CDC-2022-0024-4058	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The Injury Prevention Division of the Centers for Disease Control is neither qualified to create or implement these guidelines. The harm that has been done as a result of 2016 Guideline has been horrendous, and this document stands to cause even greater harm. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	0900006484ffcc41	Farmer	None	2022-04-07T14:29:28Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Farmer, Karen	l1o-23j6-6e6t	False	None	False	2022-04-12 06:38:44.809	[]
4053	CDC-2022-0024-4059	https://api.regulations.gov/v4/comments/CDC-2022-0024-4059	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing this comment using a cellphone while lying in bed because chronic pain makes it impossible for me to sit at a computer for more than a few minutes at a time. This "accommodation" is just one small example of the multiple ways in which chronic pain has significantly reduced the quality of my life.<br/><br/>In late 1994, I underwent a surgery that resulted in nerve damage. This surgical error has caused me severe, disabling, chronic pain for over 27 years. Over these years, I have tried many, many treatments to relieve the intense burning pain that prevents me from living a relatively normal life.<br/><br/>The only treatment that can significantly reduce my pain has been hydrocodone. On the few occasions that my medication was delivered late, I was forced to lie in bed until I could take my usual dosage. I do not enjoy taking opioids. I have never gotten high on opiods. I am not an addict. I depend on opiods for pain relief, and only for pain relief. If I were to be deprived of this medication, I am certain that my life would become literally unbearable.<br/><br/>There are millions of people like me. Our pain is an illness which must be addressed using the best methods currently available. For intense chronic nerve pain, the best medication currently available is hydrocodone. To refuse this medication to people in pain would be a cruel malpractice. <br/><br/>I am calling on the CDC to address pain as it addresses other illnesses. Today physicians are aware of the dangers of overprescribing. Please trust physicians to treat patients in pain with the best methods currently available. Allow physicians to prescribe opiods in the dosages they deem necessary for the individualized treatment of chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marie	None	None	0900006484ffcc62	Mitchell	None	2022-04-07T15:16:35Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Mitchell , Marie	l1o-2gi1-xxfm	False	None	False	2022-04-12 06:38:45.023	[]
4054	CDC-2022-0024-4060	https://api.regulations.gov/v4/comments/CDC-2022-0024-4060	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am relieved that you are trying to change, clarify or rectify your 2016 Guidelines for Prescribing Opioids for Chronic Pain since they have caused so much discontinuity in care and decreased the quality of life for so many good people suffering needlessly. When you make guidelines that impact so many lives directly and indirectly then you must take the responsibility to make sure all parties involved in prescribing Opioid therapy are crystal clear in how to successfully implement these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffcc97	Anonymous	None	2022-04-07T15:28:04Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-326d-2s2c	False	None	False	2022-04-12 06:38:45.254	[]
4055	CDC-2022-0024-4061	https://api.regulations.gov/v4/comments/CDC-2022-0024-4061	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The current update of the CDC guidelines for opioid prescribing make a few, VERY FEW improvements and/or clarifications to the 2016 guidelines. In order to try to repair the tragic destruction of the patient-doctor relationship, the best and most prudent course would be for the CDC to publicly renounce the original 2016 guidelines and refrain from continued interference in prescription guidelines period. However, as that will never happen as long as organizations such as PROP and zealots such as [names redacted] are allowed unfettered influence in the CDC. Therefor I am asking that a more balanced and realistic portrayal of the benefits of opioid medical use be presented in this guideline, and a more realistic portrayal of the risks, as PROVEN by the CDC’s own records of addiction among pain patients & overdoses caused by illicit versus prescription medication. I also would ask that any and ALL mention of MME, particularly any number associated with MME be completely & totally removed from this guideline & renounced for any use as a dosing guide. <br/><br/>The emphasis on supporting the doctor’s decision making WITH the patient is a wonderful addition to this guideline, however, the CDC with its overall lack of medical training should never be advising a course of treatment for every type of doctor or medical situation. It completely nullifies the goal that you say you have of supporting individualized care & doctor/patient collaboration. <br/><br/>In all, this massive expansion of an already terribly flawed guideline still needs much work to do the job it is supposed to do. If that job is to protect the patients of America. It certainly does not protect anyone from the perils of opioid addiction as written, as it does not address ANY of the actual causes & triggers of addiction. And at the same time it has the huge potential to significantly further harm the millions of acute and chronic pain patients whom are already vastly undertreated for pain. <br/><br/>Sincerely,<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	0900006484ffd148	Train	None	2022-04-07T15:38:31Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Train, Rebecca	l1o-43cg-6368	False	None	False	2022-04-12 06:38:45.468	[]
4056	CDC-2022-0024-4062	https://api.regulations.gov/v4/comments/CDC-2022-0024-4062	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] and I live in my hometown of [location redacted]. I moved back after the 2016 Guidelines (GL) were released and the residual loss of medical treatment left me disabled, unemployed, divorced and without a home. <br/> <br/>Unfortunately the knee-jerk reaction of the 2016 GL was immediate for me. My Rx was cut-off a few months after the GL were released, even though I was a model patient who was under the care of a pain specialist and prescribed a dose well below any CDC “MME threshold”. Weeks later I lost my six figure job which supported 5 ppl. My physician was visibly disturbed that I lost my job due to unmanageable pain so he suggested yet another epidural steroid injection which I could no longer afford without the premium health insurance provided by the job I had just lost. <br/><br/>I have a complex medical history including several spine injuries. I was able to manage the pain until I had an adverse reaction to an implanted medical device (no longer on the market) which caused accelerated bone degeneration, neuropathy & autoimmune issues (among other systemic issues). Pain medication had kept me ‘functional enough’ to keep my job, including significant travel requirements, although it was very challenging to balance the travel demands of my job with strict in-person requirements of a pain contract including; regular follow-up appts, picking up paper scripts monthly, urine screens & epidural steroid injections. However, I quickly found out that I’m mostly bedridden without treatment and medications since I had exceeded my ability to ‘self-manage’ the pain.<br/><br/>My medical records are substantial/lengthy and my health condition is complex due to lack of long term study (and liability related disincentives) regarding the reported/documented damages caused by the medical device. I’ve had several procedures/surgeries to remove fragments and diseased organs/tissue caused by the device, however I have no prognosis or treatment plan so my PCP referred me to pain management for palliative care. <br/><br/>Unfortunately I was completely abandoned by the pain clinic weeks prior to my last major surgery which forced me into disabilty. I’ll never understand why it’s ok that any Rx (in my case, less than 15 MME) would cause an ethical physician to abandon a long-term, compliant patient right before a major surgery without discussion of alternatives or continuity of care. The only reasonable explanation is that the GL has provided a tool for blatant violations of the Hippocratic oath & human/disability rights by implementing an unscientific, deadly drug war policy into healthcare.<br/><br/>Personally, I was raised with holistic alternative medicine and have always advocated for using all legal available tools to manage pain (ice, heat, herbs, OTC, PT, TENS unit, TM/meditation, CBT, etc) however… medical intervention can be critical when all other options are exhausted. The reality is that “FDA approved pain medications are safe and effective (increase function) when used as prescribed and stored correctly” but the GL have generously painted every patient and physician with the brush of addiction stigma which has only caused more harm to both the pain and addiction communities.<br/><br/>That said, I was encouraged to see more patient-centered language in the updated GL draft. It was also good to see transparency about ‘who’ is included in the CDC opioid workgroup. <br/><br/>However, I’m concerned about the lack of public input and still see language implying hard limits which has been weaponized by the DEA to terrorize physicians under the false cover of “public health”. This GL has carried too much weight in the quality (or lack) of care patients are receiving, so it is of upmost importance that any “hard limits” (numbers) or “suggestions” have solid references to scientifically back them up. If there is no solid reference to back up a “medical guideline” then the guideline should be entirely rescinded.<br/><br/>It’s also critical that serious harms/deaths (including suicides) caused by 2016 GL are acknowledged in the updated version. Many disabled patients, like myself, no longer have access to treatment due to the chilling effect it’s had on medical care. The updated GL may reduce these harms by providing assistance to patients abandoned due to the “unintended consequences” of the guideline and have been unable to reestablish care. <br/><br/>Thank you for taking time to hear from one of the “unintended consequences” of the 2016 CDC GL since no one is tracking patient-outcomes. Please don’t forget us this time. <br/><br/>“The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life, the sick, the needy and the handicapped.” - Hubert Humphrey <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristin	None	None	0900006484ffd15f	Reynolds	None	2022-04-07T16:03:58Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Reynolds, Kristin	l1o-48h1-nfnp	False	None	False	2022-04-12 06:38:45.680	[]
4057	CDC-2022-0024-4063	https://api.regulations.gov/v4/comments/CDC-2022-0024-4063	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have both friends and family that need pain meds to have any type of normal living. As we age our bodies are giving out and we stay in constant pain.<br/><br/>Our knees give out, our backs stay in pain..we fall and hurt ourselves. Sometimes serious injuries.. Addicted to pain meds? NO. Necessary for some quality of life? YES<br/><br/>I hope those in pain get much needed pain meds so they can enjoy some quality of life.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Betty	None	None	0900006484ffd1b8	Sander	None	2022-04-07T16:07:32Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Sander, Betty	l1o-4to3-xfhh	False	None	False	2022-04-12 06:38:45.900	[]
4058	CDC-2022-0024-4064	https://api.regulations.gov/v4/comments/CDC-2022-0024-4064	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors not prescribing opioids to me for about a year now, has destroyed my life! I live on $733 disability. I have been on disability since 2011. Now because I cannot get pain medication that works, I cannot work, I cannot clean my house, and my life is a productive human being is over. I don’t know what this point if I will ever find a Doctor Who is willing to prescribe me, pain medication that works. They all want to make money off of me . They want to do injections which do not work for me. I cannot even find an orthopedic surgeon who will help me. I have a fourth herniated discs and scoliosis. And I’m 65 years old. I am too old to fix my scoliosis. And because I have scoliosis no surgeons will help me fix my discs, ordeal with my pain. The CDC made a massive mistake when they decided the only people dying of cancer could receive opioids. I have been taking opioids since 2007 and I have never been addicted. Please do something about this excruciating circumstance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Teresa	None	None	0900006484ffd1be	Welby	None	2022-04-07T16:12:00Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Welby, Teresa	l1o-4vyc-ss02	False	None	False	2022-04-12 06:38:46.165	[]
4059	CDC-2022-0024-4065	https://api.regulations.gov/v4/comments/CDC-2022-0024-4065	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve read the latest research and recommendations. The non pharmacological treatments for pain are great if you are middle to upper class. For most, physical therapy, yoga, acupuncture, laser, psychotherapy, massage… are not obtainable/affordable. (And have you ever been to a community mental health center for services? Yikes!) Anyone on Social Security with no other income or supplemental insurance - the co-pays for 2-3 visits a week PT sessions are impossible to afford. Medicaid recipients Have very limited services available and very limited visits. Doctors make recommendations and write orders without ever asking “can you afford this pain management option? Can you access this option? Is this option available in your area?” I have had many patients call me sobbing because there are no viable resources available for what the doctor has prescribed or recommended. Recommendations and research are great as long as there is a level playing field for access. Otherwise, you are dooming patients to go without pain management or seeking it illegally. I haven’t seen any studies in your findings regarding life expectancy and adverse events related to living with untreated chronic pain. The financial toll must be staggering . I see no studies in your records regarding access to alternative care (non pharmacological treatments ) for pain management . Why are you making recommendations without understanding access? You could have a miracle cure for pain - but if it isn’t accessible , you are merely blowing smoke and setting up a system of failure for clinicians and patients .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffd1de	None	None	2022-04-07T16:17:48Z	Alabama Therapy Center, PC	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Alabama Therapy Center, PC	l1o-560y-oyax	False	None	False	2022-04-12 06:38:46.386	[]
4060	CDC-2022-0024-4066	https://api.regulations.gov/v4/comments/CDC-2022-0024-4066	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Get rid of opiod prescribing "guidelines" altogether. They do not make any sense, since addiction is not caused by treating pain. And the cause of overdose is the restriction on pain relievers that forced addicts into a dangerous fentanyl black market from China and Mexico. You are only making things worse. MME's are stupid, they are not science based and are being treated as law. So this updated "guideline" will now make it illegal to prescribe of 50 MME( whatever that means) to medical boards, doctors, and the DEA/DOJ. So don't. If you want to make things better remove the 2016 "guidelines". Focus on IMF coming from Mexico and harm reduction programs	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	0900006484ffd509	Malik	None	2022-04-07T16:21:13Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Malik, Tammy	l1o-8s5s-866m	False	None	False	2022-04-12 06:38:46.598	[]
4061	CDC-2022-0024-4067	https://api.regulations.gov/v4/comments/CDC-2022-0024-4067	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am currently taking Suboxone and am experiencing dental problems. I have chronic pain and because of my addiction they pushed nerve conjunction and more injections ( I had previously had 5 sets and they just made it worse and I said that) they didn’t care so I completely stopped going to a pain doctor! I was diagnosed at the age 18 with bulging disc’s now at 33 I have spinal stenosis, herniated disc’s , bulging disc’s and degenerative dice disease. This effects my daily life in so many ways. So because of my conditions I am taking Suboxone and gabapentin. Since taking the Suboxone my back teeth have gotten so bad to wear now I’m having to seek a dentist. I wish there was a medication that didn’t have side effects like this. Loosing your teeth is like loosing so much of your self. I find myself in so much pain physically and emotionally from this and just want my experience to be heard that way maybe something could be done!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffd546	Anonymous	None	2022-04-07T16:26:31Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-9a31-m58m	False	None	False	2022-04-12 06:38:46.815	[]
4062	CDC-2022-0024-4068	https://api.regulations.gov/v4/comments/CDC-2022-0024-4068	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi my name is [name redacted] I'm 32 I was taking Suboxone for 3 years maybe longer my teeth became so brittle I I've had to pull several and they starty getting holes at the bottom of my gums I've been needing more pulled but don't have the money..I'm so self conscious my teeth used to be perfect..now Ill have dentures hopefully one day....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amanda	None	None	0900006484ffd5f4	Glass	None	2022-04-07T16:27:56Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Glass, Amanda	l1o-9ulh-cdox	False	None	False	2022-04-12 06:38:47.023	[]
4063	CDC-2022-0024-4069	https://api.regulations.gov/v4/comments/CDC-2022-0024-4069	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted], 19 years ago after having a root canal it was discovered the dentist left a wire in my mouth and traveled up severing the maxilary nerve as it was not found until 6 months later, finally found a doctor and stayed with him for 11 years and suddenly I was told my doses would be lowered. I was compliant and followed all the rules. Never called in meds early or taken more than I should. As my doses were lowered, my quality of life dropped exponentially and am now in bed every day with crippling pain, I brought it up with my doctor and he said he was gonna drop it even lower, that "the less pain medicine I take, the less overall pain I'll have" which is completely not true and does not make sense. I was then told to go for an appointment and was yelled at and my older son was told " be quiet, you are not here to be heard" and was told if I come back then he was gonna drop it as low as medically possible and was told to find a new doctor. Now I can't find a doctor that will help me, please help the people that truly need their medicine this cannot be allowed to happen to someone else ever again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	0900006484ffd5f0	Reyes	None	2022-04-07T16:30:10Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Reyes, Diane	l1o-9r4d-uarp	False	None	False	2022-04-12 06:38:47.240	[]
4064	CDC-2022-0024-4070	https://api.regulations.gov/v4/comments/CDC-2022-0024-4070	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain of osteoarthritis of the knees. Have been using Diclofenac for the pain for a number of years. It helps but does not reduce the pain enough. Have just added Tramadol with Diclofenac. It reduces the pain to a more livable pain. Doctors need a guideline that they can follow and not feel they are going to get in trouble for issuing to much Narcotics.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charles	None	None	0900006484ffd8a4	Walker	None	2022-04-07T18:12:48Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Walker, Charles	l1o-ajxk-59o9	False	None	False	2022-04-12 06:38:47.458	[]
4065	CDC-2022-0024-4071	https://api.regulations.gov/v4/comments/CDC-2022-0024-4071	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree that we must find a solution to the overwhelming epidemic of opioid abuse, but over-regulation of pain meds to legitimate chronic pain sufferers is not the way to go. I have been in the ER and told “my pain was not the right kind of pain to warrant pain relief”. I had a cervical migraine at the time, (pic added of my failed Cervical fusion) along with Fibromyalgia, neuropathy, and arthritis all the way down my spine. I was in horrible pain. The doctor said he “could get in trouble” if he treated my pain with opioids. Treating everyone as if they were addicts is ridiculous. Our histories (mine started in 1998) and records should speak for themselves. Not to mention the drug tests I have to take every month and have NEVER failed. Quit lumping us all in with addicts. True chronic pain patients NEVER misuse their meds, because then we’ll have days without any relief. The majority of us are on the lowest doses possible, and don’t try to make our pain go away, just take the hard edge off it to stay out of the hospital.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006484ffdda9	Mittel	None	2022-04-07T18:14:08Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Mittel, Cynthia	l1o-ar78-u2yn	False	None	False	2022-04-12 06:38:47.663	[]
4066	CDC-2022-0024-4072	https://api.regulations.gov/v4/comments/CDC-2022-0024-4072	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Under CDC "This clinical practice guideline is not"<br/>The last bullet point >Applicable to the following types of pain treatment:<br/>sickle cell disease-related pain<br/>cancer pain<br/>palliative care; or<br/>end of life care.<br/>The next bullet points need to be added <br/>Rare diseases which cause debilitating pain<br/>Veterans who have been injured and suffer debilitating pain<br/>Failed back surgeries whose patients have rods, screws, pins, etc in their bodies that cause pain. <br/>May I Illuminate the fact there are over 7,000 Rare Diseases in the National Organization of Rare Diseases Database. (www.rarediseases.org)<br/>90% of these Rare Diseases have No effective treatment. Opioids are the ONLY treatment for painful diseases that we have that actually reduce pain to tolerable levels. <br/>95. Pain is the signal from our bodies that something is wrong. When we seek healthcare we deserve to know what is causing pain.<br/>Until we find out our doctors need to treat us with the correct medication for pain. Now if we are seeking medical treatment, unless it is at the time deadly, most likely we have already rubbed the ointments on, got our massage, soaked in the tub, taken Tylenol or Advil or maybe alternated them; The label reads to seek medical treatment if pain persists. This is the normal course of action for any adjusted human being. Tylenol, Advil. over the counter medications are for acute, 10 day duration and then we are told to go to doctor for help. The doctor may run tests. He may or may not know for weeks what is wrong. He normally will prescribe RX ibuprofen for inflammation. Neither the patient nor the doctor immediately say let's get on an opioid. This is the real world in which we live. <br/>Eventually, like me at 56 years old you are finally given the diagnosis you have been searching for all your life that caused severe pain. MRI thoracic spine instead of lumbar. X ray of thoracic instead of just assuming you have a rotator cuff tear that physical therapy can cure for $200.00. <br/>I was born with an Omphalocele. I was born, (mri/x ray showed) with Congenital Scoliosis. I have Fibromyalgia that is severe. Fibromyalgia is mentioned throughout these proposed guideline updates like it is no big deal. Fibromyalgia is very painful. Opioids are very effective in treatment. Cymbalta does not help so much. Neurontin for pain has never helped. Only made me fat so weight baring joints can have a more difficult time.<br/>I read these proposed guidelines and CDC is making the same mistake twice in hitting hard suggesting* 50 MME. Speaking of 20MME, etc. <br/>The same will happen with the 50MME that happened with the 90MME. See I was on a 30 MME Lortab dosage plus 2 doses 50mg Tramadol a day. My pain was under control as much as possible. Over the years since 2017 my life has been significantly affected by CDC Guidelines of 2016. When I saw one doctor because my other one went to prison, He stripped me of my tramadol and force tapered me to 10MME. I found a Pain Management Doctor who was not as afraid of CDC, DEA and FBI and he RX me 30MME. I was okay. Tramadol helped my burning pain so much. CDC said I could not have Tramadol anymore though. I just have to suffer with the burning pain. Now that doctor moved on the Doctors who replaced him force tapered me to 20 MME than because of the Opioid Crisis force tapered me again to 15MME. 2 dosages of 7.5 Norco a day. Every 12 hours. These medications are 4-6 hour duration of effectiveness. So I get half of what I need and I suffer every day needlessly because somebody else has a problem with misusing or is an addict? When do my Diseases take precedence over theirs? I need a full dosage in 24 hrs. I am good with 3 dosages a day, if still 7.5. I need my Tramadol back. I can't have it though because my government does not believe that Disabled Americans need pain medications for their diseases. The many, many steroid injections, dry needle injections have not benefited me for more than a few days, if it helped at all. I have an ice pack I use. It is one of those hot water bottles. I have 2 in freezer. Sure Ice helps for as long as I am using it. I am bound to it. I have much rather have help from pain medication so I can move off the couch or out of the bed for hours instead of ice on me, for literally hours. Opioids were introduced to me in late 90's. I have lived with pain all my life. As most people, I did not want to use pain medications. I did what my doctor told me to do and my pain was under control so I could function. I used a Chiropractor then. He made me hurt so much worse, I cried all the way home. I have done everything you all suggest. Life of debilitating pain is not what Anybody asks for. Please add these Rare Diseases under your list. Please add our injured Veterans as well. VA has cut off our Veterans so much so some have committed suicide in parking lots. Please stop Inhumane Treatment. Let Our Ethical Doctors Treat us. Stop the making Doctors afraid to RX.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	B	None	None	0900006484ffe068	KENNY	None	2022-04-07T18:20:18Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from KENNY, B	l1o-c2ri-2s6r	False	None	False	2022-04-12 06:38:47.892	[]
4067	CDC-2022-0024-4073	https://api.regulations.gov/v4/comments/CDC-2022-0024-4073	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My pain medication was stopped and I was told I needed to go on Belbuca. That did nothing for my pain, and has now rotted my teeth. ( I was never told this would rot your teeth… my teeth were perfect before I took Belbuca). When I told my Pain Management Dr I did not want to be on Belbuca any longer, he offered me a patch. I’m sorry, but I don’t want a patch on me that everyone can see.<br/>After that, he said he was letting me go because there was nothing else he could do for me.<br/>Now I’m in pain everyday, and my teeth are a mess from the Belbuca film I was given. My options are basically out, now that doctor’s won’t treat me and I’m living in pain and most days want to die.<br/>Something has got to be done for patients suffering and needing actual help. We’re not drug addicts, we’re just regular people trying to make it through the day without being in so much pain we can barely live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006484ffe0e8	Prescott	None	2022-04-07T18:26:12Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Prescott, Melissa	l1o-cuzq-5ni9	False	None	False	2022-04-12 06:38:48.138	[]
4068	CDC-2022-0024-4074	https://api.regulations.gov/v4/comments/CDC-2022-0024-4074	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Not one medication or type of treatment is good for everyone. As someone well said that if Aspirin is good for everyone then there would not be any ibuprofen, naproxen or plavix. This is true for us as an interventional pain management physician taking care of today’s patients with complex medical problems including increasing geriatrics populations, social and mental issues.<br/>These patients often need interventional pain procedures and surgeries to keep them living independently and in less pain. Other groups are cancer, trauma survivors or have other chronic debilitating diseases with no cure resulting in painful neuropathies who depend on opioid along with other Meds for their simple day to day activities.<br/>Therefore all different modalities including opioid should be available for these patients to manage their pain by physicians trained in their use for safety and to minimize side effects .<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Syed	None	None	0900006484ffd9e6	Nasir	None	2022-04-07T18:27:53Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Nasir , Syed	l1o-enj3-zmr2	False	None	False	2022-04-12 06:38:48.345	[]
4069	CDC-2022-0024-4075	https://api.regulations.gov/v4/comments/CDC-2022-0024-4075	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I find it unbelievable that “experts” in this field were involved/consulted in creating and/or reviewing the new (2016) opioid guidelines, there is no way anyone who knows anything about pain (nerve pain) would knowingly, intentionally make another human suffer so. It’s very clear that some “experts” used clearly have a personal attack against this type of medication, an attack that has caused irreversible damage to thousands or received a hefty amount of gifts to get these guidelines passed. Why else would an expert in pain relieve agree for other meds, meds not even created for pain relieve be used & not use medication that is actually created & used to do exactly what it was created to do relieve pain? Which “expert” is going to Make that make sense to us who have suffered for years now? You either have total disregard for humans or someone is lining your pockets, I guess we need to do some research! Obviously a lot of research needs done! Your attack on the chronic pain community has not only cost us missing precious time with our family but suffer in pain so bad it’s completely inhumane! We have been called/treated addicts, abusers, drug seekers, Dr shoppers from CNA’s to Pharmacists, please tell us this was never your intentions? We sign contracts, abide by all the rules then get told by pharmacies “we’re not filling your medications.” Have you any idea how we feel, not only do we know we’re going to hurt for God only knows how long but our dignity, why, what have we done wrong? Our injuries, diseases & pain didn’t stop because he/she died with a needle in their arm, may they rest in piece but don’t hurt the innocent ones abiding/passing the contract rules. What you experts created should be considered illegal hundreds of thousands lost their life because they turned to the streets for help all for medical help & WE weren’t the ones in the first place overdosing on just opioids! How sad is that? Do you “experts” honestly believe that we would rather be in pain, humiliate ourselves, live in our beds vs have 0 pain, work & enjoy participating in family functions, have quality of life, not to mention $0 Dr bills, seriously? All we want is some quality of life in as little pain as possible! It’s hard to write this without sounding angry but which one of “you the experts” decided you were more competent to treat my diseases & conditions better than the experts who’ve treated me for years & sees me once a month? Do you see now how our “community of pain sufferers” have 0 trust in the abilities of some of you who will be making serious life altering decisions to our lives after the painful mess they already created? It’s not fair & I know that you are all smart enough to know that you don’t have enough knowledge or care to be making such decisions & should do the honorable thing & just step down. I’d also like to add that you probably won’t receive near the responses you deserve to get because a lot of people are in either too much pain & not able to focus or they’re elderly & have no idea how to do this but I guarantee you if you look at the comments on chronic pain groups, certain disease groups or just listen to the people in line at the pharmacy it will bring you to tears hearing these people literally begging for help! Personally I’d like to thank each & every one of you for making the past 6yrs years of pure hell & hold you all accountable, God forbid any of you ever find yourself a chronic pain patient sufferer & end up in this same shape. A huge majority of my life is spent in bed on heating pads, cold compresses, heated mattress pads, special beds & mattresses because my pain is so bad. Where was I on Christmas at home alone in horrendous pain, as I am most days due to Lupus, AS, Osteoarthritis, severe osteoporosis, Diverticulitis (resection), Pancreatitis, Degenerative Disk Disease, Crohn’s Disease, at 55, I’ve done every treatment available to me, spent months in the hospital & would just like to have what little quality l have left with as little pain as possible by my treating physicians who see me regularly & can treat me with medications that were specifically made for chronic pain. I wish this life onto no one but if it would make a difference in helping to understand the pain we battle daily I would gladly volunteer to trade places for a day, if it were only that easy. I’d much rather have my working, golfing, dancing, bowling, playing softball w/my grandkids back than this any day. Thank you for your attention, concerns & considerations in this matter just do better in targeting the right group of people, we should not be clumped together. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffda8c	Anonymous	None	2022-04-07T18:33:32Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-f94x-vhib	False	None	False	2022-04-12 06:38:48.564	[]
4070	CDC-2022-0024-4076	https://api.regulations.gov/v4/comments/CDC-2022-0024-4076	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>My name is [name redacted]. I had a stroke in 2006, at age 26. The stroke caused brain and central nervous system damage. I developed a severe, full body pain disorder called Central Pain, also called Reflex Sympathetic Disorder. The pain is severe, constant, cold, and burning. I searched for 2 years for help, and finally got a diagnosis and found a pain management specialist. The Doctor was very familiar with this disorder. I had tried every non opioid medication available. The only treatment that help me live in low pain are opioids. I am able to live a decent quality of life. Before my Dr and Nurse helped me, I was in so much pain, and I was going to end my life. The pain is unrelenting and I could not exist in my body, it became hell. I am on a dose that is higher than 90 mme. I never feel high, and Im able to function like a normal human being and exist in my body without suffering constantly. Im able to bathe, go on errands, maintain a committed relationship, and run a small internet business. I am currently being tapered to a lower dose, due to my Dr being worried about treating me on a higher dose, due to regulations. My quality of life is already declining. When he retires in a few years, Im very worried I wont find anyone to help me. Please do not lump chronic pain patients in with drug addicts. Many chronic pain patients take their medication responsibly, and just want to live in lower pain. We should not have to suffer because some people choose to abuse drugs. Drug addicts will abuse anything they can get their hands on. Please allow Doctors to care for their patients and not be in fear. PAIN RELIEF IS A HUMAN RIGHT. No living being should have to live in severe pain. Many people have ended their lives due to these restrictions. Please help us. Chronic pain patients need your help and compassion. I would like to try an intracathedral pain pump, but my insurance will not cover it. It would be $50,000 out of pocket, to start. Ketamine treatments are $750-$2000 per treatment. Chronic pain patients have very few choices. Medication is the only option for myself and many others due to lack of income and disability. I love my country, and I hope the government cares about its citizens in severe pain. Please help us. Please allow our Doctors to prescribe medication to responsible chronic pain patients without fear. No living being should live in severe pain. Please, help me. I only want to live a decent quality of life. I cannot live without pain management. I just want to have the pain treated, so I can exist in my body and not constantly suffer. Please, help.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006484ffdafe	H	None	2022-04-07T18:36:49Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from H, Julie	l1o-g16l-skqm	False	None	False	2022-04-12 06:38:48.783	[]
4071	CDC-2022-0024-4077	https://api.regulations.gov/v4/comments/CDC-2022-0024-4077	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Opioid Prescribing Guideline's are contradictive . How can Clinicians use their own judgement using the built in flexibilities. Every type of treatment is laid out for for them. The 50MME cancels out any decision making by physicians, dose, duration, etc. has been laid out in advance. This needs to be amended or removed. The FDA explains that there is no dosage limit as it should be with the proper steps to be taken. NASIDS or Tylenol is recommended over the use of opiate's but many people can't use them any more due to damage already caused or will cause. Also for some types of pain they are in effective. Anti anxiety medication with opioids is discouraged. How ever with some disorders for instance severe anxiety or panic disorder this can be managed and there is no scientific evidence there is a danger when used together under a doctors care they work quit well together. An other issue is that addiction specialist writing the guidelines. There are no Pain management specialist (physician's)participating plus they would not be biased to other options. Another concern is that a 229 page page document is to large and complex as a guide. appears more like a manual. The CDC emphasize the choice of of opioid to be used, time used or duration . This decision is or should be up to the treating Physicians. PS. Pain management Physicians have a greater understanding of pain, pain medicines and should have the flexibility to make these decisions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffdb87	Anonymous	None	2022-04-07T18:38:40Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-gu68-f6fu	False	None	False	2022-04-12 06:38:48.997	[]
4072	CDC-2022-0024-4078	https://api.regulations.gov/v4/comments/CDC-2022-0024-4078	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The safety and security protecting human beings against dangerous health issues Detecting and responding in real time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mr. Jose	None	None	0900006484ffe1e4	Rodriguez,	None	2022-04-07T18:39:25Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Rodriguez,, Mr. Jose	l1o-j6vr-pxx4	False	None	False	2022-04-12 06:38:49.209	[]
4073	CDC-2022-0024-4079	https://api.regulations.gov/v4/comments/CDC-2022-0024-4079	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am concerned about these updates, that they may have unintended consequences of keeping doctors from perscribing opioids to patients who need them. I know it says it is left to doctor judgement, but if they perceive it as frowned upon, or increasing liability, they will see it as too risky and avoid it. Pain is an awful thing and people should be able to get adequate pain relief from a doctor.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharice	None	None	0900006484ffe205	Weimann	None	2022-04-07T18:40:06Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Weimann, Sharice	l1o-jmde-n9gb	False	None	False	2022-04-12 06:38:49.421	[]
4074	CDC-2022-0024-4080	https://api.regulations.gov/v4/comments/CDC-2022-0024-4080	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guidelines have harmed chronic intractable pain patients. It has changed the climate in my doctor's office and completely interfered with my medical care. I can't get the treatment I need because the guidelines has had a domino effect through all the groups who make decisions for patients like me. There is really nothing in the updates that fixes all the harm. They don't go far enough. I am very concerned your repeated mention of 50MME will be grabbed onto as the new "law," so the revisions stand to do even more harm. Please consider patients when you make guidelines that you understand will become law. At this point you can see the drastic effects your 2016 guidelines had, so there's no doubt how much impact the revision will have. If you care to help intractable pain patients, you will have to strongly push against the damage you've already done with the previous guideline. The revisions don't go near far enough.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffe236	Anonymous	None	2022-04-07T18:41:26Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-k8ek-ljfn	False	None	False	2022-04-12 06:38:49.688	[]
4075	CDC-2022-0024-4081	https://api.regulations.gov/v4/comments/CDC-2022-0024-4081	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi, I think you've made some improvements with your proposed revisions, but they don't go far enough. They need a lot more protections for long-term chronic pain patients. I've watched my wife's medical care take a nosedive after the 2016 guidelines. They destroyed her ability to get adequate medication to be involved in our family and interact with me. She was force tapered down to 50MME, in expectation of your revision. She isn't able to play with the kids or go on walks with me like she used to do. Her condition won't get better. She has a degenerative disease. So, how will she function as her condition gets worse? She's already not functioning well, not like she did when she had adequate pain care. When her pain was controlled she had a good quality of life and your revisions won't help. It doesn't address the harm that was already caused. It also mentions 50MME and providers are already reducing to 50 because of it. Please provide protections for patients like my wife.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffe251	Anonymous	None	2022-04-07T18:43:03Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-kl0n-fkkb	False	None	False	2022-04-12 06:38:49.919	[]
4076	CDC-2022-0024-4082	https://api.regulations.gov/v4/comments/CDC-2022-0024-4082	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines have had a tremendously negative impact on my quality of life. I have been a patient with severe chronic pain for over 20 years. I have been going to the same pain doctor for these 20 years. Because of all the media about pain pills and the guidelines, she drastically reduced my dose of pain medicine several years ago and this has had a affect on my ability to function as a happy, active, contributing person. <br/><br/>For many years I was on much higher doses. As my symptoms worsened and as I grew tolerant to doses, my doctor had gradually increased my dose to meet my needs. I still had pain, but it was not so severe that it kept me from sleeping, being able to accomplish my ADLs, and to participate socially, and to be able to do the things I love to do--gardening, sewing, cooking, knitting. With the drastic reduction in the dose of my opioid medication, all areas of my life have been negatively impacted. I am in so much pain that it interferes with my sleep, my ability to complete my ADLs, my desire to be around others because I don't want them to see me in pain, and my ability to enjoy my hobbies. When I was on higher doses, I could participate in ALL of it. My current dose DOES NOT adequately treat my pain.<br/><br/>MY Causes for CHRONIC PAIN:<br/><br/>Severe osteoarthritis of the Cervical and Lumbar, and Thoracic SPINE<br/>Severe Degenerative Disc Disease of the SPINE<br/>SPINAL STENOSIS at Multiple levels of the spine and compression of roots<br/>Severe Osteoporosis with accompanying microfractures<br/>Severe HIP Dysplasia with periacetabular osteotomy and subsequent HIP arthroplasties of both hips, and the right one x2 due to faulty prosthesis<br/>Severe Bilateral KNEE arthritis s/p arthroscopy of both, and subsequent effusion, with removal of over 100mls of blood tinged fluid and steroid injections.<br/>Bilateral SHOULDER arthritis (xray confirmed bone on bone with cysts)<br/>Severe BILATERAL ARTHRITIS of HANDS with edema and stiffiness<br/>s/p BREAST CANCER, surgery and RADIATION with ongoing radiation induced fibrosis, scarring, edema all causing pain and radiculopathy<br/>dx of PSEUDOGOUT crystal deposit in both Knees.<br/>Severe IDIOPATHIC SCOLIOSIS (left rib cage in contact with left anterior iliac spine)<br/><br/>ADJUNCTIVE THERAPY:<br/><br/>physical therapy professional and at home<br/>ice<br/>water therapy<br/>back brace but can only use 3 hours /day or less<br/>wrist supports for short periods of time<br/>exercises (shoulder stretching with equipment that fits over door)<br/>Using CRUTCHES for walking and for standing<br/>Maximum doses of Tylenol and Advil (NSAIDs cause gastritis)<br/><br/>MEDICATION TRIED THAT DID NOT WORK:<br/><br/>Celebrex<br/>Duloxetine<br/>Gabapentins<br/>CBD<br/>Marijuana<br/>Alcohol<br/>(All prescriptions were given chance to reach maximum dose and for 8 to 12 weeks)<br/><br/>MEDICATION THAT WORKS:<br/><br/>OPIODS (I am on both extended release oxycontin and oxycodone for break through relief. THE PROBLEM IS THAT MY PRESET DOSE IS 0.15, AND 0.16 respectively of my previous dosing. It does not adequately treat my pain.<br/><br/>Even on higher doses, I suffered NO UNTOWARD EFFECTS. I was never sedated in anyway, never nauseated, and any mild constipation was effectively treated with stool softener. My pain was under good control on the higher doses. I never abuse my meds, I only take them as directed, I always keep them locked in a safe place. If I wasn't in great pain, sometimes I might have a few doses left over. (but no left overs with this drastically reduced dose). If there is any "down side" I guess you could say that the higher doses were more expensive, but I was more than happy to pay all of it out of my own pocket. I never expected insurance to pay for it.<br/><br/>I HOPE THAT YOUR NEW GUIDELINES WILL TAKE ALL OF THESE THINGS INTO ACCOUNT, ESPECIALLY REGARDING THE DEVELOPMENT OF TACKYPHYLAXIS AND TOLERANCE TO DOSES. OVER TIME PATIENTS MIGHT VERY WELL NEED INCREASING DOSES TO TREAT THEIR PAIN ADEQUATELY.<br/><br/>I only want to HAVE MY LIFE BACK. WITH HIGHER DOSES I was able to enjoy a very reasonable and acceptable quality of life. Even though I still had some pain, it was manageable. On the drastically reduced doses that I am on now, MY PAIN IS NOT MANAGED WELL AT ALL.<br/><br/>I have tried to discuss this with my pain doctor but have received no response except that she is afraid of censure and/or licensure revocation.<br/><br/>Please change the quidelines to reflect the above, and the following:<br/><br/>Patients are individuals with unique needs.<br/>Patients cannot be grouped in bulk.<br/>There are many patients who REALLY suffer with chronic pain, who do not abuse their meds, have no wish to abuse drugs, who are not suicide risks, or overdose risks, and are taking opiods only BECAUSE NOTHING ELSE WORKS.<br/><br/>THANK YOU SO MUCH FOR ALLOWING US TO MAKE COMMENTS.<br/><br/>Sincerely,<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathryn	None	None	0900006484ffe25f	Kartus	None	2022-04-07T18:48:58Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Kartus, Kathryn	l1o-ky4w-57i9	False	None	False	2022-04-12 06:38:50.154	[]
4077	CDC-2022-0024-4083	https://api.regulations.gov/v4/comments/CDC-2022-0024-4083	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern,<br/>I am writing this comment today because I have seen first hand how bad the CDC’s 90 MME has effected the medical community. I am very concerned that if the CDC doesn’t change its policy on opioids soon that we will hit a point of no return. Patients are suffering because no one is prescribing opioids to people who truly need them. I can say first hand that I have seen many many patients suffer even hospice patients who should not be suffering. I work in hospice now and I have to watch people literally suffer and moaning out in extreme pain because the providers are so uneducated on pain medication and the great benefits they offer. They are also scared to death to give them because they believe a dying person will get addicted. They should never be identified as addicted they should be identified as someone getting medical care. Also I want to write because I have lost several friends to overdose deaths. I’m talking about hundreds of friends and not one friend died of prescription overdose. They all were related to illegal street fentanyl probably from China. As I am writing this comment I have a good friend in the icu fighting for his life right now because of and overdose do to illegal fentanyl. I know if pain medication was easier to get prescribed I would have several of those friends still with me today. It’s sad to see that since the CDC first started with the 90 MME it has completely failed and I believe the CDC is more responsible for the increase in overdose deaths now. Please change this failed system and help the people get the help they deserve.<br/>Thanks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dylan	None	None	0900006484ffe270	Riggleman	None	2022-04-07T18:50:53Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Riggleman, Dylan	l1o-l4de-obnw	False	None	False	2022-04-12 06:38:50.383	[]
4078	CDC-2022-0024-4084	https://api.regulations.gov/v4/comments/CDC-2022-0024-4084	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The statistics on opioid overdoses mix illegal and legal options. It is important to break this information down to see that legal, prescribed options are not the problem. People that suffer from chronic pain are being abused. Physicians dictate that chronic pain patients submit to painful injections on a regular basis to continue to receive pain medication that helps them function and participate in life activities. These injections have serious side effects, are not fda approved, and do not treat the underlying condition. Each injection procedure I was forced to endure caused increased pain, leaving me with a permanent higher level of pain. Physicians are forcing patients to also submit to procedures to place stimulators in their body. Regardless of the reports of significant injury, infections, and paralysis. Rarely do any of these procedures help the patient, but they generate a significant income for pain management physicians. Some physicians do their best to treat their patients within the CDC guidelines, but the mme limits across the board do not allow them to treat patients individually. They are forced to limit the opioid medications they prescribe. NSAIDS are a dangerous drug. They cause stomach ulcers, pain, and bleeding. They also cause heart complications. Opiods do not. It is a safe, effective treatment of pain. Opiods prescribed to meet the individual needs of the patient allow patients to participate in life without causing damage like the NSAIDS and the injections. It is inhumane to force a patient already suffering from significant, life altering pain, to submit to painful unapproved procedures that do more harm than good. It is inhumane to force a patient to take harmful medications that damage their organs and have side effects that limit their ability to participate in life. Pain clinics now have their own surgery centers. They have taken advantage of the opportunity the CDC has given them to abuse their patients. Refuse their injections and you will not receive any medication to treat your pain. The pain clinics have shifted from treatment by informed consent to treatment by threats and intimidation. Pain clinics overcharge for simple urine drug screens. A $50 urine drug screen can cost $1200 at a pain clinic. I know, I have seen the charges. Office visit fees are exaggerated and evaluations documented in the chart are not completed. Patients arrive, the staff interrogates them, counts their pills, makes them pee in a cup for the mandatory drug screen, then the physician comes in and tells the patient they will schedule an appointment for injections or there will not be any medications prescribed. Patients are treated like criminals. I had to leave a pain clinic because of their abuse. I have endured 6 back surgeries and one neck. I have had ankle surgery and now need an ankle replacement. I am told to just go on disability. I need a certain level of opiods to move and get through the day. I use the minimum amount of medication I am allowed sparingly. I protect it with my life because my life depends on it. Forcing chronic pain patients to live in excruciating pain, day after day is inhumane. Prosecuting physicians for their treatment of patients in true pain should be illegal. Are their pill mills? Yes, I am sure there are. But I assure you that your policies are harming and killing more patients than the pill mills. The updated guidelines are no better. Even the mention of a MME will bring new standards of care limiting life saving treatment to chronic pain patients. The CDC GUIDELINES have focused on the overdoses of the illegal drug consumers. It is time to focus on the patients that need legal prescriptions to function in daily life. Limiting chronic pain patients medication limits their life and daily activities. Do I take the limited medication during the day so I can function and work? Do I take it in the evening so I am able to move and take a shower? Or do I wait and take it so I can sleep? What about the patients that just can't deal with it anymore? The pain runs their life, the clinics abuse them, and the government treats them like a criminal. All the while the true criminals can get whatever they want on the street. Then they overdose and the world is upset. The criminals are losing their lives by choice. Chronic pain patients don't have a choice. It is time to start taking proper care of chronic pain. There are safe and effective opiods to treat pain. Stop harming the patients and feeling sorry for the criminals. Quit listening to doctors with an agenda. Put our care back in the hands of physicians that care. There should be consequences for physicians that force patients to submit to procedures that harm them. Please look into the abuse chronic pain patients are being put through. Focus on the quality of life of chronic pain patients and quit padding the pockets of these pain clinics. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffe2d4	Anonymous	None	2022-04-07T18:57:03Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-n7n7-6g0l	False	None	False	2022-04-12 06:38:50.591	[]
4079	CDC-2022-0024-4085	https://api.regulations.gov/v4/comments/CDC-2022-0024-4085	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was involved in a car wreck when I was 22 years old in 1997 that nearly killed me. I had a crushed pelvis, damaged neck, broken ribs and lots of surgery. I'm 47 now, and really wish the doctors wouldn't have been bribed with lavish lunches and other gifts to prescribe bushels of opioids. It really harmed people. Some died. I managed somehow to have pretty good doctors who were pretty honest with me, and I'm still plugging along, trying to have a moderately decent quality of life, while being responsible and aware of my surroundings. I think it's important to regulate these types of meds, and hold both doctors and patients accountable. I've been urinating in cups for pain management doctors to test me for my meds, the therapeutic dose of those meds, illicit drugs and other prescription drugs for 20 years. No problems. I get recommended for physical therapy or injections? Not a problem, i just do what they tell me. I do get discouraged when i go to my appointment and hear the dr is clamping down again. I haven't been this uncomfortable since back when the crash happened and strangers telling my doctor what i need is ludacris. I just want to go to my appointment, fulfill my obligations and get some meds to be able to function. If not, a painful life in bed isn't an option.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tiffany	None	None	0900006484ffe40e	Lapp	None	2022-04-07T18:58:30Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Lapp, Tiffany	l1o-vd37-8981	False	None	False	2022-04-12 06:38:50.816	[]
4080	CDC-2022-0024-4086	https://api.regulations.gov/v4/comments/CDC-2022-0024-4086	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ll keep this very simple. <br/>When a patient states he or she does not want a script of opioid, of any kind and any amount, just stop talking and do what they ask of you. <br/>Simple. <br/>Do not argue. <br/>They have a better reason to not take any than you have to provide any…at all.<br/><br/>During COVID the JAMA reported a 25% increase in death due to addiction. <br/>Please understand if either a liquid or solid form, it will kill.<br/><br/>[name redacted]<br/>[contact information redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006484ffe430	Asbury	None	2022-04-07T19:00:05Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Asbury, Michael	l1o-wg3d-998y	False	None	False	2022-04-12 06:38:51.036	[]
4081	CDC-2022-0024-4087	https://api.regulations.gov/v4/comments/CDC-2022-0024-4087	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Recommend that the CDC review and update as required the curricula at medical schools and other training organizations to reflect appropriate prescribing practices for opioids. Let the training facilities train, and the CDC remove itself from publishing theses type of guidelines. Let the doctors do their jobs without fear from other government activities. Let the state health departments monitor and suggest updates to the training curricula as required.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006484fff595	Richardson	None	2022-04-07T19:00:51Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Richardson, John M Richardson	l1o-yfzz-nksg	False	None	False	2022-04-12 06:38:51.249	[]
4082	CDC-2022-0024-4088	https://api.regulations.gov/v4/comments/CDC-2022-0024-4088	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient one of the saddest thing is to live with pain 24/7. Opioids can't take away pain, only helps to control it. The issue with pain is tricky, very difficult to deal with, some days is hell, some other days it is manageable and bearable. It is really bad when you are in severe pain and can't use meds as you need to because you are constantly counting how many pills you have before the next refill. The problem is every case is different and not 2 cases are alike, but it is really a problem when you are so limited on the amount of meds you are given monthly. Now the problem with pharmacies and pharmacist with so much prejudice always treating you as if you were a junkie who is trying to get a fix. Why can people understand we did not choose to live this life! nobody gets up one day and says "hey I'm going to become a chronic pain sufferer" and take pain killers! oh great idea! Please whomever reads these comments, think about how much suffering people like me go thru in life, trying to carry on and not give up, living in pain 24/7 and counting down making sure we don't run out of meds. Please also think and remember that some people lost their lives last year and this year when they were told by their doctors we are NOT prescribing pain medication no more (who are suppose to be the one keeping them alive and healthy) and they when crazy to the point of going out and buying street drugs like fentanyl to later died of an overdose. Please think about the people who are severely and chronically suffering in pain, who sometimes wish to be dead instead of continuing in pain and SO RESTRICTED as to how much pain medication they can get. Yes there most be a serious investigation of those who are not real pain sufferers and the real ones, take them out (they idiots who use just for "fun") but help those who are really having a hard time just going day to day without giving up. Thanks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carlos	None	None	0900006484fff5d1	Barrantes	None	2022-04-07T19:03:07Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Barrantes, Carlos	l1o-yra2-55vo	False	None	False	2022-04-12 06:38:51.496	[]
4083	CDC-2022-0024-4089	https://api.regulations.gov/v4/comments/CDC-2022-0024-4089	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an ACGME fellowship-trained pain management physician with over a decade of experience. Judicious use of opioid medication in conjunction with interventional procedures provide tremendous improvement in quality of life for thousands of my patients. The interventional procedures we do help keep opioid use in a safe range. Please allow these services to continue in order to treat patient who suffer from severe debilitating pain. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484fff607	None	None	2022-04-07T19:04:02Z	Anonymous	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-z4fv-lhu8	False	None	False	2022-04-12 06:38:51.705	[]
4084	CDC-2022-0024-4090	https://api.regulations.gov/v4/comments/CDC-2022-0024-4090	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe, and have extensive clinical and cost-effectiveness data.<br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of Dr. [name redacted]’s own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. <br/><br/>Sincerely, <br/>[name redacted], MD<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Raj	None	None	0900006484fff867	Parekh	None	2022-04-07T19:06:34Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Parekh, Raj	l1p-11ux-9544	False	None	False	2022-04-12 06:38:52.147	[]
4085	CDC-2022-0024-4091	https://api.regulations.gov/v4/comments/CDC-2022-0024-4091	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate the proposed new cdc guidelines for opiates.. perhaps we are arriving at the middle of the pendulum where compassion and safety can coexist!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484fffe52	Anonymous	None	2022-04-07T19:06:50Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-2mu5-mkz9	False	None	False	2022-04-12 06:38:52.369	[]
4086	CDC-2022-0024-4092	https://api.regulations.gov/v4/comments/CDC-2022-0024-4092	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am submitting a comment, while knowing this is extremely outside the scope of the CDC duties. Even knowing this whole thing has no science behind it and knowing its very discriminatory and the cdc does not care. These guidelines need to be resincded, you should not be involved at all in healthcare. This has caused devastation to every single person. From people getting acute pain care, people getting chronic pain care, pwud, literally every person. Again, so outside your scope of practice, i cannot fathom how you are allowed yo do this. I am not going to talk about issues this has caused everyone, because you know. You just dont care. And you have no legal right to even do this. Stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angela	None	None	0900006484fffe84	Dein	None	2022-04-07T19:07:42Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Dein, Angela	l1p-2sqb-4n5l	False	None	False	2022-04-12 06:38:52.598	[]
4087	CDC-2022-0024-4093	https://api.regulations.gov/v4/comments/CDC-2022-0024-4093	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines should be rescinded. There is no reason you should be making guidelines that affect patient care so horrifically that almost no one has care anymore. These are only one of the reasons no one trusts the CDC anymore. This whole charade is not backed by any legitimate science, only people, states, and orginizations that will make money off of these if they are released. How many people have these helped? The over 100,000 dead? All the people who need pain care after surgery? All the people who had lived stable lives on medications that their doctors, who have worked hard to get stable? Not a single person. You have screwed up medical care for millions and should be sued or charged with a crime. You have not only used fake data, unscientific data, made up numbers and tons of kick backs, on the original guidelines you have now doubled down and have in fact made up completely new bogus claims and bogus science. Wow! I cant believe this could get even more ridiculous. But it is the CDC, so yes.....it can. Should this not be done thrpugh the FDA? I know money is your biggest reason behind this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynn	None	None	0900006484ffff08	Colclasure	None	2022-04-07T19:09:07Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Colclasure, Lynn	l1p-39fh-h9h3	False	None	False	2022-04-12 06:38:52.815	[]
4088	CDC-2022-0024-4094	https://api.regulations.gov/v4/comments/CDC-2022-0024-4094	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There are many admirable recommendations within the original 2016 CDC Opioid Guidelines, and this subsequent "update", highlighted by the general "risk reduction strategies" common to almost all pain management guidelines, which demand emphasis. These beneficial efforts include Storage/Disposal of medications education, naloxone education, PDMP review, urine drug monitoring, drug-drug interaction reviews, and the proper diagnosis of pain conditions. These recommendations are not a change, nor an update, yet these two items are:<br/><br/>1. Omission of Morphine Milligram Equivalent (MME) Factors and thresholds.<br/><br/>To have originally instilled an absolute need to calculate and consider MMEs in prescription opioid utilization at all times, and then simply omit as such in an "update", is extremely concerning. This already occurred with SL Buprenorphine originally being published by the CDC (March 2016) as 10, only to then pivot to 30 (Dec 2016, an incredible 300% change), and then to omit the respective MME factor completely from MME resources thereafter in order to avoid a perceived increase in "stigma". What is a clinician to do? To utilize or not to utilize (MMEs), which have been in clinical existence and debate for decades, is what this "update" reverberates with its intended and unintended audiences. Shakespeare would not be proud. Yet, here we are again, with an omission of incredibly important clinical guidance. It is highly recommended to directly address the MME Factor and threshold (although sensationalized to be a "limit") as opposed to simply an omission of guidance.<br/><br/>2. Emphasis on the fact that not every patient utilizing chronic prescription opioid therapy absolutely needs to be tapered, and when a prescription opioid taper occurs, it must be gradual, possibly spanning months and years, not weeks, unless there are higher-risk causations involved (e.g., criminal activity, diversion, lack of prescription opioid in one's system to begin with, possible harm to others, and so on).<br/><br/>This particular update is well received. Perhaps also important to state that "grandfathering" and "initial starts" are different patient care situations.<br/><br/>Overall, perhaps an initial review/list of the actual changes from the 2016 CDC Opioid Guidelines to these 2022 drafted (and eventual published) "update(s)" would serve the intended (and unintended) audience well. After all, us healthcare professionals appreciate comprehensive, dynamic, and succinct information that aims to improve the patient care that we provide, and most will not read another article in this realm (just as in 2016), however, many can appreciate a brief list of the two actual updates (or one update and one omission) from the 2016 CDC Opioid Guidelines. Food for thought.<br/><br/>In the grand picture, one must always realize that ANY extreme of patient care will never work for every patient situation, point blank. Although not intended, any manuscript/guideline author with a pulse had to realize eminent sensationalized "pulling back" on the utilization of prescription opioids in the diverse treatment plan for patients in pain upon publication of the 2016 Guideline. Perhaps the theme of this 2022 "update" can be portrayed as "Welcome Back". Welcome back to a middle ground for my fellow dispensers and prescribers whom went from one extreme (too many prescription opioids) to another (absolute avoidance). How tragic for those in pain. I know, I experienced the same sensationalized irrational attempt at patient care when having nephrolithiasis at the beginning of the COVID pandemic, while waiting in an ER on a gurney for 3 [long] hours in incredible pain without one offer of resolution, nor even an opioid risk screening, which may actually be just as concerning when considering the valuable aspects of the 2016 Guideline and this current attempt at an "update". Welcome back, fellow dispensers and prescribers, to the utilization of prescription opioids only when appropriate and with the deployment of risk reduction strategies when that moment happens, in other words, welcome back to logical, compassionate, strategic, and comprehensive pain management patient care.<br/><br/>In closing, U.S. Drug overdose deaths have drastically increased since the publication of the 2016 CDC Opioid Guidelines. Last Halloween, one of the scariest things observed was a jack-o-lantern reading "Causation from Correlation". Let's address the elephants in the room, by emphasizing the importance of the risk reduction strategies in these (and almost all) pain management guidelines along with the gradual opioid taper considerations, and avoid any omissions (MME guidance). Godspeed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006485000051	Garofoli	None	2022-04-07T19:15:10Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Garofoli, Mark	l1p-4h00-nty5	False	None	False	2022-04-12 06:38:53.044	[]
4089	CDC-2022-0024-4095	https://api.regulations.gov/v4/comments/CDC-2022-0024-4095	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In reference to the opportunity to make public comments on the Clinical Practice Guidelines for Prescribing Opioids, I have a few opinions.<br/>There is obviously a need a baseline reference for when and how to prescribe these already in existence. I think that taking a few more step for monitoring these prescriptions and those prescribing should be considered. For example, although the age of technology has made it easier to track, I believe it is vital that we go back to the nucleus of the action. Let me be specific. A Primary Care Physician should be the nucleus. If a specialist of any kind deems an opioid prescription necessary, a phone call or direct contact to the Primary Care should be required. All physicians should be on the same page at all times and having the family (PCP) at the forefront not only makes it easier for the patient to be cared for but protected as well.<br/>I have seen medication issues even with computer systems involved where the hand and feet and body of each medical institution are not cohesively monitoring or getting correct information.<br/>Clinical Practice Guidelines for Prescribing Opioids should be so aligned that there is no room for error.<br/>This is especially important since we now have more open borders, which in turn, makes the fentanyl risk if patients somehow slip through the accountability and guidance of protecting them. The Primary Care Physician, as the nucleus can assist those with addictive personalities to monitor and deter any abuse that may be in the shadows. Thereby, constant, consistent, and thorough communication is a major key in these clinical guidelines.<br/>As a Certified Prevention Specialist and Health Educator it is vital for a healthy society to maintain high ethical standards relating to prescribing opioids. If we prevent the occurrence of negative issues we can certainly maintain our high goals and standards for longevity and healthy existence.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Catherine	None	None	09000064850000dc	McQuaide	None	2022-04-07T19:23:30Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from McQuaide, Catherine	l1p-4x2y-jlds	False	None	False	2022-04-12 06:38:53.264	[]
4090	CDC-2022-0024-4096	https://api.regulations.gov/v4/comments/CDC-2022-0024-4096	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read the CDC draft, that is open for public comment, in its entirety. <br/>I am a 68 year old that suffers from unceasing, excruciating pain due to several documented issues with my body. I am a breast cancer survivor and went through (2) bone marrow transplants, along with chemotherapy and radiation to save my life. I just want to share with you that, up until the 2016 guidelines, my pain was being well controlled by a pain specialist. Throughout that period, not only was I prescribed opioids but I also had several different procedures, went to physical therapy sessions 500+ times, including aquatic therapy. I was able to go places and enjoy my life and my grandchildren. Immediately after the CDC published the 2016 guidelines, my pain specialist started posting on Facebook that they were going to go down on the morphine milligram equivalent by 10 MME. Every couple of weeks, they continued dropping the MME’s, each time saying that that would be the last drop, but yet it continued until it reached 45 MME. It didn’t matter what level a patient’s pain was, nor their diagnosis, it was dropped across the board...every patient. The reason listed as to why? THE 2016 GUIDELINES. Then in 2019, when the CDC said that the guidelines had been misapplied, nothing changed because doctors were fearful of the Arkansas State Medical Boards and the DEA. I have attended many of our Pain Committee meetings, as well as our Medical Board meetings and have heard, first hand, them threatening physicians for writing 70 MME’s.<br/>This current draft will not change anything for the suffering.<br/> Nothing will change until the government removes themselves from practicing medicine. The overdose deaths are caused by illegal laced<br/>drugs. My quality of life has suffered because of the CDC guidelines and will continue to until they are redacted completely! I am a respectable human, have raised a wonderful family, while I worked for the Railroad. Please help me; help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485000501	Anonymous	None	2022-04-07T19:25:30Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l1p-4z1c-x2lt	False	None	False	2022-04-12 06:38:53.480	[]
4091	CDC-2022-0024-4097	https://api.regulations.gov/v4/comments/CDC-2022-0024-4097	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read the new proposed guideline and do not see how this guideline will discontinue the harm that the CDC has already caused for chronic pain patients. There is mention of being “careful” about going over 50 mme, which the insurance companies, DEA will jump on as another drop in advised mme opioid amount from the 90 mme we have today. The likely result is intractable pain patients will have their meds reduced again. I care for a loved one who is slowing dying from uncontrolled pain. His life will be shortened because of the indifference that the CDC has shown to pain patients that have tried every medical method to treat their pain and opioid was the last method left that helped them lead normal lives. Now those pain patients are left with high blood pressure from untreated pain , chronic insomnia because they cannot escape the pain to get a good nights rest. My loved one is losing his memory, cognition from chronically not sleeping and your answer to help pain patients is to propose a guideline that will make things worse. How inhumane- how about the oath doctors make to their patients to do no harm, and treat to the best of their ability. Even doctors are scared to properly treat their patients out of fear to going to jail. Pain patients are not drug addicts- they have a injury or disease that causes their pain -&; they should not be left to die in misery. Many have chosen suicide because they cannot take the pain anymore. The cdc guideline from 2016 did not help, in fact deaths went up over 100% because prior to that it was drug addicts dying. Now the cdc has added confirmed chronic pain patient to the death list - a sacrifice of true pain sufferers that were doing fine , following the law and taking their medications as their doctors advised are left to die with no treatment and I see the new guideline making it worse. Please do something to stop Americans from dying from untreated pain. Thanks [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	090000648500050b	Lloyd	None	2022-04-07T19:27:42Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Lloyd, Leslie	l1p-51r9-b533	False	None	False	2022-04-12 06:38:53.699	[]
4092	CDC-2022-0024-4098	https://api.regulations.gov/v4/comments/CDC-2022-0024-4098	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached letter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffdaea	None	None	2022-04-07T20:54:00Z	St. Andrew's Presbyterian Church	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from St. Andrew's Presbyterian Church	l1o-fhp7-s4zw	False	None	False	2022-04-12 06:38:53.915	[]
4093	CDC-2022-0024-4099	https://api.regulations.gov/v4/comments/CDC-2022-0024-4099	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Podiatrist licensed in Virginia and Maryland I have had an enormous amount of success in alleviating debilitating foot and ankle pain with use of MLS Class IV laser therapy. It has allowed us to virtually eliminate the use of Opioids in our office. We use it for acute trauma, including post-operatively as well as for chronic foot and ankle pain. There numerous studies that have been done to corroborate its efficacy. Would be terrific if this therapy became an approved and adjunctive therapy in treatment of pain when opioids are being considered.<br/>Your time is appreciated.<br/>Healthy regards,<br/>[name redacted], DPM	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006485000511	Ross	None	2022-04-07T21:20:36Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Ross, Paul	l1p-5360-eek3	False	None	False	2022-04-12 06:38:54.148	[]
4094	CDC-2022-0024-4100	https://api.regulations.gov/v4/comments/CDC-2022-0024-4100	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am begging you to change the CDC guidelines. I am not an addict, or a criminal or a liar. I'm a person who lives in pain that is far beyond tolerable pain. I am afraid to go to sleep every night because I know the pain will be even worse when I wake up in the morning. I'm in a wheelchair after more than 20 spinal surgeries, lots of implants and my back was broken when they tried to put in a pain pump and broke my back in surgery so I could go off of pain medications. The pain I knew prior to this surgery was nothing compared to now. Then they tapered my meds due to the supposed opiod crisis and I ended up on hospice after losing half my body weight due to the pain. The saying, "there are worse things then death" is very true. Although I believe in God, and I'm not suicidal, I have no quality of life other than I love my family. We all suffer because of the guidelines and drs who don't want to prescribe any medications that would help with the pain. I'm asking you to imagine living with this kind of pain every day or watching your loved one suffer constantly. I don't even remember the last time I had a good day. Most days I can't even concentrate. Everyday we have to try to focus on finding someone to help. Please, I'm asking you to help us and stop punishing people for being in horrible pain, stop punishing doctors who took an oath. It's inhumane to allow an animal to suffer yet we allow humans to suffer. Please change this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	090000648500066b	Marbut	None	2022-04-07T21:22:11Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Marbut, Michelle	l1p-69ro-1mj3	False	None	False	2022-04-12 06:38:54.366	[]
4095	CDC-2022-0024-4101	https://api.regulations.gov/v4/comments/CDC-2022-0024-4101	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop making life so much harder for pain patients! I have such a very few good, low pain days each month that eliminating my meds will completely erase any semblance of quality in my life. Please allow my doc to treat me with care, caution, and compassion. Don't accept this version of the guidelines!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cathy	None	None	090000648500075c	Marquardt	None	2022-04-07T21:23:02Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Marquardt , Cathy	l1p-6zbx-pqfc	False	None	False	2022-04-12 06:38:54.608	[]
4096	CDC-2022-0024-4102	https://api.regulations.gov/v4/comments/CDC-2022-0024-4102	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer. I was diagnosed with nerve root compression, bone Spurs & osteoarthritis 2 years ago. The pain from this is not only unbearable but also effects other parts of my body that causes immobility. Without pain medication, I’m stuck in bed. Something as easy as using a hand mixer will set off the pain for days. Cooking, cleaning, laundry Etc need to be sought out and planned along with timing in order for me to be able to them. I am begging you to allow the chronic pain patients get any and all meds as needed with consistent monitoring. I can’t live like this anymore. I’m so tired of the constant pain. The injections (if they work) wear off leaving me in more pain due to not feeling pain from them and overworking my body. Physical therapy does absolutely nothing. The information on Haldol does not list pain but, it is listed as a psychiatric drug. Are you aware of how hard it is to get off of psychiatric drugs? They make opioids seem like Tylenol. Please help us & thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carmela	None	None	0900006485000835	Evans	None	2022-04-07T21:24:22Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Evans, Carmela	l1p-7wvv-on3w	False	None	False	2022-04-12 06:38:54.854	[]
4097	CDC-2022-0024-4103	https://api.regulations.gov/v4/comments/CDC-2022-0024-4103	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines have drastically affected my life. I’ve had to see 3 different pain management drs. The last one had me on 130 mme and at one time reduced me to 90 mme. He put in my chart patient agrees with taper regime. I absolutely did not agree to this. I was sick for weeks. My pm dr had me on methadone and oxycodone and my pain level was at 5-6. I begged him to up my dose but of course he stated the cdc guidelines are the reason for my taper. I ended up going to a methadone clinic and when I saw the addiction dr he refused to let me be a patient there. I was devastated. He told me “we are not a pain clinic” go back to pain dr tell him you need a higher dose. Like my pm dr is gonna increase my pain meds. I ended up going to another clinic an hour away. Please do away with the MME. I have a very hard time trusting drs. I went to the ER for pain. They told me to take Tylenol and ibuprofen. Seriously I suffer from a C1 injury in 2 places. I’m not allowed to work. The CDC has hurt allot of people. Lease reconsider the guideline	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850008ad	Anonymous	None	2022-04-07T21:25:31Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-8emi-4edg	False	None	False	2022-04-12 06:38:55.072	[]
4098	CDC-2022-0024-4104	https://api.regulations.gov/v4/comments/CDC-2022-0024-4104	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to know why I was denied any pain medication for severe radiation burns when I was being treated for cancer of the larynx at Texas oncology. I was left in unspeakable pain and unable to eat, and they denied ANY pain medication to me. I can give names dates.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006485000990	Hull	None	2022-04-07T21:30:55Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Hull, Linda	l1p-97x5-eibk	False	None	False	2022-04-12 06:38:55.294	[]
4099	CDC-2022-0024-4105	https://api.regulations.gov/v4/comments/CDC-2022-0024-4105	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Maybe you should consider the damage you are doing to those of us who suffer with constant pain Journal of medicine chronic pain causes atrophy of the brain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3566164/	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006485000aa3	Hull	None	2022-04-07T21:31:06Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Hull, Linda	l1p-a1bj-qskb	False	None	False	2022-04-12 06:38:55.514	[]
4100	CDC-2022-0024-4106	https://api.regulations.gov/v4/comments/CDC-2022-0024-4106	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>On behalf of my father who died six monthes ago ! The CDC and the State of KY with its guidlines took his function and life away. He no longer could function AT the mmei requird by state or cdc guidlines of 2016. Even his Dr moved, left, retired, quit. The last three days of his life at home under hospice he was still under treated for stage four cancer. Our Goverment is protecting us to death. The whole lot of you should be ashamed. Rest in peace Dad we Love You !!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	09000064850009ed	Bolton	None	2022-04-07T21:31:50Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Bolton, James	l1p-9kmu-s5mw	False	None	False	2022-04-12 06:38:55.735	[]
4101	CDC-2022-0024-4107	https://api.regulations.gov/v4/comments/CDC-2022-0024-4107	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an RN SINCE 1992, I haven't practiced since 2010 due to injury that causes chronic pain. I have been forced tapered at least 8 times b/c the 2016 of CDC opioid prescribing guidelines. the worst was in 2017 after my care was abandoned. i was forced tapered of 75 mcg of fentanyl in 5 days. I was so out of my head that I fell and broke my tailbone and whacked my head giving me a concussion. <br/><br/>I have deep concerns about the 50 MME and 20MME references in the supporting text of the 2022 revision of the 2016 CDC opioid prescribing guidelines. so many people including myself have been harmed by the 2016 Guidelines. these hard limits must be removed. [name redacted] recently stated in Opioid litigation in Washington State that he simply pulled the 120 MME out f thin air based on his practice experience. this is not science. PROP's members including [name redacted] who helped drat the 2016 guidelines are making significant amount of money testifying for Opioid litigation. this is a gross conflict of interest. similarly [name redacted] is on Board of scientific Counselors that drafted the 2016 and anticipated 2022 opioid prescribing guideline while receiving grant money from CDC and opioid litigation money while employed for Oregon health & Science University, Pacific Northwest Evidence based Practice Center. he has been awarded countless research by AHRQ. It's time for the CDC to break out this closed system of research that is riddled with financial Conflicts of Interest. it"s time to restore ethics in healthcare and research. Get PROP's members out of draft revision.<br/><br/>It is also past time that the CDC ignore [name redacted]'s Network and Shatterproof"s donations to CDC Foundation.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janice	None	None	0900006485000ad2	Garland	None	2022-04-07T21:35:03Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Garland, Janice	l1p-a6yy-vcf4	False	None	False	2022-04-12 06:38:55.954	[]
4102	CDC-2022-0024-4108	https://api.regulations.gov/v4/comments/CDC-2022-0024-4108	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am glad to see the CDC has decided to include modifications to the 2016 guidelines based on feedback from the public (described in the "Updated Draft CDC Guideline for Prescribing Opioids Overview of Public Engagement Work"). I would like to add my voice here as a hospice and palliative care physician who prescribes opioids often, to treat severe, intractable symptoms in people with life-limiting illnesses. <br/><br/>Firstly, I have been in medicine for almost 15 years, and have watched public and clinician sentiments about opioids change drastically. As a society we have see-sawed between seeing opioids as risk-free medications that should be used for every little pain, and seeing them as demonic substances that destroy the lives of moral degenerates and the people who love them. As is always the case, the truth is much more complicated. Opioids are extremely useful when used properly by clinicians with sufficient knowledge to do so. And they can and do cause harm when they aren't prescribed properly. No matter who is prescribing them, there is always a remote chance that the person taking them will develop an opioid use disorder. We cannot do away with all risk associated with the medical use of opioids, but nor can we restrict their use beyond reason and punish those who need them. <br/><br/>The CDC's 2016 guidelines were misappropriated and misused by the health insurance industry to limit patients' access to opioid medications. It has made it phenomenally difficult for me to help many of my patients access appropriate relief of pain and shortness of breath with these medications. No matter that I, a highly trained and experienced clinician, know how to safely prescribe and monitor the use of these medications--insurance companies decide for me and my patients what they can be given. My patients who are "too well" to enroll in hospice but suffering enough to need opioids have spent far too much of their limited time, energy, and goodwill on arguing with their insurance companies to obtain medication I have legally, purposefully, and carefully prescribed for them. I have spent far too much time on the phone with insurance companies too, when I should have been caring for my patients. It is an outrage. Health insurance companies are practicing medicine without a license and should be punished accordingly. <br/><br/>On the other hand, I see and recognize the dangers that non-medical use of prescription opioids poses to people and their families. Clinicians who do not routinely prescribe opioids MUST educate themselves appropriately (or consult a specialist like me appropriately) in order to responsibly prescribe them. State medical boards can and do require clinicians to complete continuing medical education on the judicious prescription of opioids. The vast majority of clinicians I come across want to be able to prescribe opioids safely, but have not taken the needed steps to educate themselves and gain more confidence in doing so. They believe it is too difficult, yet it is not. Physicians, especially, are highly educated and constantly learning new skills and improving their own ability to practice evidence-based medicine. There is no reason they cannot learn to prescribe opioids safely without the use of clumsy, arbitrary guidelines. <br/><br/>The CDC guidelines' mention of limits on opioid prescribing, no matter how couched they are in nuance, qualifications, and equivocation, are taken by inexperienced clinicians, health insurers, and pharmacies as "hard limits" that give them permission to inappropriately restrict patients' access to opioids. This is unethical. Like all interventions in medicine, clinicians bear the responsibility of learning how to, and continuing to hone their own effectiveness in, the safe and judicious prescribing of opioid medications. If the CDC wishes to promote this cause, they would find ways to influence and support it beyond simplified "guidelines" that are taken as the word of God by the uninformed. <br/><br/>Safe prescribing and medical use of opioids is complicated. I urge you to give that credence and do better. The 2016 guidelines, as they were written, should never have seen the light of day. They are an understandable--if terribly misguided--reaction to the societal heartache caused by the epidemic of illicit/non-medical opioid use in the United States. But because they were published, my patients and their families have suffered. They die in pain because they are afraid of what opioids might do to them. Hours of my clinical practice are devoted to discussing and assuaging overreactive fears about the harms of opioids, which have been enabled by the CDC's guidelines and media attention to them. When I educated my patients about the benefits and risks of opioids, we do shared decision-making together, and they are able to understand those benefits and risks, and I help them balance them. They then have to fight with their insurance companies to cover the prescription. For shame. <br/><br/>You must do better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Liana	None	None	0900006485000b6e	Eskola	None	2022-04-07T21:39:50Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Eskola, Liana	l1p-aydu-8qi2	False	None	False	2022-04-12 06:38:56.175	[]
4103	CDC-2022-0024-4109	https://api.regulations.gov/v4/comments/CDC-2022-0024-4109	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 54 year old active (as I can be) and not over weight woman with chronic pain due to scoliosis, spondilithiasis, 5 bulging discs, severe nerve compression, bone degeneration, 4 bone spurs, bursitis in both hips, arthritis and so on. I trained and rode horses since I was a child. There is no surgery that will correct my diseases. I do use an inversion table. I swim and I walk. I am active S much as I can be. Pain medication is my only other source of alleviation. The stricken guidelines have disabled me and many like me be of abusers of the medications. It has hampered my abilities to do things I love like hiking, canoeing and such. The CDC has scared doctors from actually taking g care of the people who NEED the medicines to get out of bed in the morning without dropping to the ground in debilitating pain. I cannot sleep properly at night as I wake in pain from lack of the proper medicine. I am being punished because of abusers and it is not right. The CDC has hand cuffed my Doctor who constantly tell me when looking at my MRIs that I have the worst back she has ever seen in her career. I was on heavy doses of medication which I weaned myself off of. In 2010. Now I desperately need a higher dosage and am unable to get it. My quality of life has taken a dramatic downward spiral. Please take this into consideration when putting the recommendations into action. Think of this my pain is such that I plan to move to a state which allows doctor assisted euthanasia because I will NOT live with this kind of pain for the rest of my life because it will only get worse! I wish I could attach my MRI and my X-rays you like my Dr would be amazed that I’m still upright and walking!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	0900006485000b96	Grzymkowski	None	2022-04-07T21:43:18Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Grzymkowski , Melissa	l1p-ayy4-qdb1	False	None	False	2022-04-12 06:38:56.399	[]
4104	CDC-2022-0024-4110	https://api.regulations.gov/v4/comments/CDC-2022-0024-4110	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ive had to take pain meds for like 20 yrs. Seeing many doctors telling me i could not be fixed i finally accepted the hard truth after like 10 yrs & many doctors later. I appreciate what the goal is controlling the opiods ALOT of the wring people have suffered either by doctors taking meds away or reducing.leaving the patient suffering. w/nowhere to turn to. I have chronic pain head, neck, back. 3 surgeries to neck, removal of brain tumor, lung surgery. Had blastimycosis to lungs and brain so twice ive had it. I run into issues w/doctors just because they dont see me bleeding profusely. My doctir had retired and had to find another doctor it was a nitemare. Got lucky & found one that understood but even with that my.meds were cut because of CDC changes. I trued to fund another doctor and my search i found out the following. Doctors were not evaluating me if i needed meds or not. They went with what the new rules were. (Just summarizing) most doctors are no longer recommending what's best for patient. But what the RULES that have been passed down. #2 issue when new rules went into effect they would not let my regular doctor (internist) continue prescribing my meds. I take 3 different opioids. Was forced to find a pain doctor. GUESS WHAT?most pain doctors quit, retired etc. Leaving a handful pain doctors left. Good luck trying to get them to help you.<br/>Lastly: issue#1 most doctors do NOT recommend whats best for patients, but what rules have been set down & what makes it best for them.<br/>Issue#2 pain doctors or clinics are very very scare<br/>Issue#3 people that need help. Are left pain and suffering.<br/>Issue#4 if you require more morphine thats outside whats being REQUIRED, Your SCREWED. it will be interesting to see what problems people have<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	linda	None	None	0900006485000be1	Halterman	None	2022-04-07T21:46:02Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Halterman, linda	l1p-bauq-kxnv	False	None	False	2022-04-12 06:38:56.621	[]
4105	CDC-2022-0024-4111	https://api.regulations.gov/v4/comments/CDC-2022-0024-4111	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have major nerve issues, through out my body. 3 surgeries on neck. 1 on lower back. Thoracic Outlet Syndrome. Diabetes and other conditions I won't go into. Pains in back, arms, and legs. Phantom sensations  - broken bones, tickles, needle pricks, and jolts of electricity in muscles and bones that go on for hours sometimes. They wake me up nightly. Some days I'm writhing, shaking, rolling on the floor for hours. The sensations drive me out of my mind. I'm not suicidal, but it would make my day if I was told I had a terminal illness. <br/><br/>We managed all of this well enough for 10 years, controlling my pain with opioids after an auto accident set everything in motion. I managed to do a challenging job very well. I only took meds as prescribed. Then the CDC put out it's attack on opioids in 2016. My pain was no longer being managed. I was unable to keep my job and lost my ability to work in 2017. 18 months later I was on disability. I know I'm entitled to it, but it's a sharp cut in pay and I hate I'm not making my own living.  Self worth destroyed.<br/><br/>What can I add that others haven't already said? I've read several hundred of the comments. Others have said it all. I won't repeat the same things. NO MME NUMBERS! I don't think you at the CDC have been told much if anything that you don't already know. You know your view is extremely different from nearly all of your peers and you shut out dissenting opinions, but you're convinced you're right. <br/><br/>Pain patients like me and the physicians who treat us are discriminated against with extreme bias. <br/><br/>You're fighting to advance an IDEOLOGY. <br/><br/>"Opioids are bad and they create addicts who will say anything to keep their fix coming. You must save us from ourselves and the misguided physicians who enable us." <br/><br/>Scientific studies, suicides and decimated families, peers that expose the fallacies of your statements  - none of that can change the mind of one who is committed to advancing an ideology. THE IDEOLOGY IS MORE IMPORTANT than all mentioned above. That's been very obvious as you've resorted to "junk studies" that aren't peer reviewed and you've cherry picked quotes from legit studies so that real studies are included (though facts are twisted). Other legit studies that don't fit the mantra were ignored. As a patient who purports that opioids have been helpful, I'm most likely seen as an enemy of sorts. The millions who suffer are collateral damage for the sake of the cause. Besides, you aren't responsible; suffering happens when you become addicts.<br/><br/>My plea to you comes from a different perspective. Is this the right way to promote your ideology? Your initial effort to fight the opioid "epidemic " failed. The DEATHS DOUBLED and while I imagine you don't accept responsibility, nearly everyone else believes you poured gasoline on the fire. Your ability to solve this problem has been questioned - you failed and dead bodies are everywhere to prove it. You have credible opponents who are exposing the lack of integrity in making the initial recommendations, which resulted in more deaths than before and millions of wrecked lives. Most people believe a 180 degree turn from your initial efforts is an imperative. It's quite possible that in the end you will discredit yourselves and the responsibility for making opioid guidelines will be passed to another organization who bring a solution that results in dissolving the epidemic. Your first effort actually makes a strong case for opioid prescribing.<br/><br/>Perhaps there is a more effective way to promote your ideology. Can you not see that the same rhetoric will lead to same results  - failure to dissolve the epidemic and MORE deaths? Your revision has a blatant "anti-opioid" tone, even with the few caveats you threw in to appease. The current stance will eventually discredit you and weaken your ability to affect opinions of others.  Then you will no longer have a voice regarding opioid use. <br/><br/>I'm SURE I won't change anyone's mind. My comments feel like a drop in the ocean. I know my comments will most likely be skimmed over quickly and then disregarded. I included my comments because I want to be counted among the millions who've suffered along with me. My brothers and sisters in pain deserve my effort too. And yes, it makes me feel good to say something. We don't want pity. We want to be believed and understood. We are easy to pick on because most of us are too weak and overwhelmed to fight back. <br/><br/>Thanks for allowing our voices to be posted an allowing mine to be counted. I hope they are read with an open mind and aren't dismissed. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006485000c12	Anderson	None	2022-04-07T21:50:41Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anderson, Mark	l1p-blw9-giy6	False	None	False	2022-04-12 06:38:56.837	[]
4106	CDC-2022-0024-4112	https://api.regulations.gov/v4/comments/CDC-2022-0024-4112	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient with arachnoiditis. This is a progressive painful disease. Without pain meds I am completely house bound. I have to order groceries, etc. I don’t drive. I spend too much time worrying about controlling my pain. The meds I am given are no better than Tylenol (Tramadol). I have tried gabapentin, lyrica, antidepressants, injections, all to o avail. I have a spinal cord stimulator also. <br/> The guidelines were badly written the first time around, and is even worse this time. There is absolutely no reason for capping MME doses every person is different. Why is the CDC involved at all ? I honestly fear that the government is happy just letting us die.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Molly	None	None	0900006485000c24	Kirkland	None	2022-04-07T21:51:39Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Kirkland, Molly	l1p-bo5e-gwi9	False	None	False	2022-04-12 06:38:57.075	[]
4107	CDC-2022-0024-4113	https://api.regulations.gov/v4/comments/CDC-2022-0024-4113	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Proper Pain Medicine prevents Poverty. It’s really that simple. Opioids allow Chronic Pain Patients to be productive members of society. Without Pain Medicine, Patients suffer, but Families bear the burden. Doctors are terrified that their Families will be next. It’s obvious that terrorizing Doctors hasn’t decreased Overdose Deaths. In fact it’s quadrupled them, and created an expanding market for Illicit Fentanyl. Further, the 2019 Statement changed nothing, Overdose continued to increase. With these massive failures I must question why you continue these policies? The 50 MME as I am certain you are aware is already being implemented in Pain Management Specialties, when the 90 MME led the Nation to a fourfold Overdose I cannot fathom the even the suggestion. Middle School Algebra will tell you where this equation will end. May I suggest that Chronic Pain Patients and their suffering Families are allowed the same amount of input into the Guidelines that the Families of Overdose Victims are given. The voice of Chronic Pain Patients and their Families is sorely lacking.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485000c5c	Anonymous	None	2022-04-07T21:53:34Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-c0iw-5fw5	False	None	False	2022-04-12 06:38:57.297	[]
4108	CDC-2022-0024-4114	https://api.regulations.gov/v4/comments/CDC-2022-0024-4114	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in treatment since 2009 at the same doctors office.I respectfully believed I was at most minimul at 765 a day.I did not ask for more ever after that.I worked walked around and tried to move around normally.Not as an athlete but as a normal person who could walk around walk up stairs and not suffer much.After the new laws I was cut down about four times to 210 a day.Since 2017 I have suffered every day.I go to psychal therapy and try to sleep late so not to suffer being awake.Everything I do is a painful ordeal.I have trouble walking and climbing upstairs.If it were not for sitting I would not be able to drive a car.I take two steps to climb one step while climbing up or down the stairs.I played basketball for 15 years year round but I could not play anything now.I yell out walking foreward in the morning when I first get up just by stepping foreward.I have herniated discs in my back and in my neck.My back always hurts and I always feel unsociable including after taking my medication.I have had trouble sleeping every night for 14 years.The dosage I was on enabled me to walk around and live like a normal person.That was before 2017.I am severly tired of suffering and heard about the CDC trying to help give doctors that treat pain patients more discretion to treat them if the patient has been in treatment for more than 6 years.I am glad to see that there are still some humanitarians in our country.I grew up in a humanitarian America but it is not like that now pertaining to people with severe injuries and chronic pain.I talked to my surgeon and he told me that he could not promise that his surgery would solve the problem.I have tried a wheelchair a walker a tens machine heating pads pain pads thick sofened matress pads massage pads diclofenac sodium gel cbd cream vibrating sleeping pads massagers back support belts boifreeze therapitic lounge chair seat cushions 6pack abs electrical machine hyper impact massager an inversion table heated seats I bought a hot tub I have had pain shots epidurals and the shots did next to nothing Relief was very little only temporary while I was using the things I wrote about but never solved the pain suffering.If there is some new legislation about giving pain doctors more discresion in treating their patients for pain I would always be in favor of it.Cutting off or cutting down pain patients only caused more heroin addicts.Two thirds of all deaths from drugs came from fentanyl not a doctors prescription.I would end illegal drugs from coming over the borders by going to the origin where they are grown and produced and use a computer to track what doctors are prescribing.My experience after 2016 has not been a good one.The last five years I have suffered and if there is some new consideration through Congress that doctors can use their discretion on individuals that are permanently injured I am all fir it.Alll of you should be commended for your humanitarism and concern.It gives me hope that there are still individuals like yourselves out there.Thank you for listening to what my experience has been like.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	franklin	None	None	0900006485000c60	hansen	None	2022-04-07T21:57:33Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from hansen, franklin	l1p-c4x8-b9wc	False	None	False	2022-04-12 06:38:57.523	[]
4109	CDC-2022-0024-4115	https://api.regulations.gov/v4/comments/CDC-2022-0024-4115	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is genuine concern about opioid usage and the plain economic motivation that pharmaceutical firms have prioritized over our and our families' well-being. This is not to say that the needs of certain people who are suffering are unimportant. Of course, there should be a means to get essential prescriptions, but as history shows, prescribing opioid pain pills contributed to the creation of a crisis that began with the deception that OxyContin was not addictive. The wheels came off when it went so far as to score hospital certification based on pain as a fifth vital indicator.<br/><br/>Over time, we've discovered that opioids are rarely needed to control pain. The simplicity with which	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850011a4	Anonymous	None	2022-04-07T21:58:25Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-e1y9-s658	False	None	False	2022-04-12 06:38:57.771	[]
4110	CDC-2022-0024-4116	https://api.regulations.gov/v4/comments/CDC-2022-0024-4116	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. Gabapentin does not reduce my RLS symptoms, only low dose methadone works and it works extremely well for me with little side effect. I have been taking this for almost 2 years at night and it knocks out the RLS 99.9% of the time, so I can sleep better. Without it I found I can't sleep more that an hour or two a night and can not function during the day. <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	09000064850012f6	Brown	None	2022-04-07T22:00:14Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Robert	l1p-eue8-hu1g	False	None	False	2022-04-12 06:38:57.987	[]
4111	CDC-2022-0024-4117	https://api.regulations.gov/v4/comments/CDC-2022-0024-4117	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi<br/>I am a chronic pain patient for the last 10 years. I have had 10 back surgeries that did not reduce the pain but tried anything my doctors suggested. I saw the same pain management doctors for 10 years and followed their instructions without issue.<br/>I recently moved to Florida and the nightmare of getting a new doctor and medication has begun. After finally finding a doctor willing to prescribe opioids similar to what I was taking that helped I have difficulties finding pharmacies that will provide the prescriptions. The doctors reduced the medicine that I was taking even though I was not having issues with it just because the government thinks it should be. The doctor agreed that my regime was what he what have prescribed when I was put on the medicine.<br/>Its extremely frustrating when you have been on medicine for years without issue and just because you move to another state you have issues like I am having. I am currently considering a pain pump but I am hesitant. I already have a neurostimulator that does not work. Something needs to be done to address chronic pain patients as currently they are treated like crack addicts and its disgraceful.<br/>People who have had many surgeries should not experience this treatment.<br/><br/>I do understand that their are issues with addiction and problems with the medicine but that can not be the reason that chronic pain patients needlessly suffer.<br/>please help address this issue.<br/>Thanks	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	susan	None	None	0900006485001370	lukowicz	None	2022-04-07T22:02:12Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from lukowicz, susan	l1p-f0ah-8qi2	False	None	False	2022-04-12 06:38:58.202	[]
4112	CDC-2022-0024-4118	https://api.regulations.gov/v4/comments/CDC-2022-0024-4118	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/><br/>As a chronic pain patient with multiple pain disorders. I like many have been negatively affected by the CDC guidelines. It took years to find the right and stable dose for me. Then after the guidelines became law I was forced tapered and eventually lost my doctor because he retired and unable to find anyone to take over my pain. My quality of life is now about zero living life from bed in pain is not living. I so far have refused to try to alleviate my pain from anything illegal so my options are not good. And alcohol is not an option. I’m one of many patients who is an Ultra Rapid Metaboliser so my meds needs differ from a normal or slow Metaboliser. The 90 current MME threshold wasn’t enough for my daily needs along with many others and my retired doctor knew it even after a full taper. He would apologize and wish he could do more but he was afraid of prison for doing his job! Along, with metabolizing my meds quickly I am also allergic to OTC meds and that Suboxone they are forcing on us pain patients but doctors don’t seem to care and still recommended OTC meds at the peril of my own health because they are also afraid of loosing their license or jail. The current and update pending Guidelines will make it even harder on the pain community and anyone else who else who may need surgery or become sick with a painful disease. Most of the OD’s are not from patients under a doctors care but from illegal drugs including stolen medication. We shouldn’t have to suffer from non-patients using illegal drugs. We are not drug addicts only people with real pain looking to have some semblance of life with some pain relief. We take pain pills to relieve pain not to get high. Please stop treating us that way and reconsider the guidelines. Thank you for your consideration regarding this matter.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amber	None	None	09000064850013b4	Christian	None	2022-04-07T22:04:07Z	None	None	1	None	2022-04-07T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Christian, Amber	l1p-f4qd-iqcj	False	None	False	2022-04-12 06:38:58.420	[]
4113	CDC-2022-0024-4119	https://api.regulations.gov/v4/comments/CDC-2022-0024-4119	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffccc4	Anonymous	None	2022-04-08T13:25:28Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-38vi-rjdx	False	None	False	2022-04-12 06:38:58.642	[]
4114	CDC-2022-0024-4120	https://api.regulations.gov/v4/comments/CDC-2022-0024-4120	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To CDC and 2022 guidelines authors:<br/><br/>I am writing you today to ask you to please remove any and all daily MME dosages from your guidelines. Please stop punishing millions of us that deal with daily, horrible pain. Being on pain medication was not first line of treatment, but the absolute last resort. I have gone through years of invasive and non-invasive attempts to lessen (not even trying to completely remove) my pain, and have failed all of them. My pain medication works. I have been on this dosage for a decade and am managing my pain better than NSAIDs and other medications (lyrica, cymbalta, neurotnin, celebrex, tramadol, etc) that I have been on. I also take less mg per dose than what I was taking before and have no side effects like other medications have given me, including liver and kidney problems with NSAIDs and angioedema with Tylenol, etc.. Pain patients are being treated like criminals and it is really heartbreaking to suffer because illegal drug use and overdose deaths they have caused. Pain patients are not addicts and we need to be treated as any other patient is being treated. We did NOT choose this, but are treated like drug seekers, and are drug tested, have to sign contracts, are being scrutinized by pharmacists, etc. This is not ok. If you do not remove the daily MMEs from the new guidelines, more innocent people will suffer more than we already are. Doctors have taken your 2016 guidelines as law and has the DEA. People have chosen to end their suffering permanently by killing themselves because they have been either tapered or cut off completely. Please, I know that these new guidelines are attempting to fix the horrific damage that 2016 ones have done, but if you leave the new MMEs you will sentence more people to suffer needlessly or worse. Please do not allow politics and lobbyists to dictate how doctors treat patients and their pain. Please, please make the 2022 guidelines not be punitive, but have them allow people to have relief from pain and be treated with respect and dignity. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	V	None	None	0900006485001bb6	K	None	2022-04-08T13:50:14Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from K, V	l1p-iq2d-5ktw	False	None	False	2022-04-12 06:38:58.863	[]
4115	CDC-2022-0024-4121	https://api.regulations.gov/v4/comments/CDC-2022-0024-4121	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in Whitewright, Texas and have multilevel disc degeneration, stenosis, nerve impingement, poly arthritis. Doctor's refuse to do anything but give Esi's or facet injections. These do not work for me and made me worse! I used to be very active, worked out daily and now I have trouble walking. It's taken a toll on my mental health and my physical health is also suffering. This is inhumane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	SARAH	None	None	0900006485001c82	UDELL	None	2022-04-08T14:03:47Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from UDELL, SARAH	l1p-j0nc-0yom	False	None	False	2022-04-12 06:38:59.110	[]
4116	CDC-2022-0024-4122	https://api.regulations.gov/v4/comments/CDC-2022-0024-4122	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I applaud you for trying to correct the horrible mistake of the prior "guidelines" that have done so much damage by subverting care. The prior version caused numerous states and agencies to adopt similar guidelines, so that damage is almost irreparable. In addition you have subverted patient care by causing providers and systems to fear prescribing for legitimate established patients, many of which have no alternatives for treatment. This has also caused untold suffering in the chronic pain community through forced medications tapers, which have in turn caused disability, mental and physical anguish, and suicides.changing the guidelines is a small step in the right direction, but this damage is a perfect example of why the government needs to stay out of an individuals health care. I believe it will take a significant effort to reverse the damage and environment that has been created for patients and providers. I am happy to see there have been a number of law suits for deceased individuals who were forcibly tapered of the medications that allowed them to live somewhat normal lives. I can tell you you first hand that the problem is illegal drugs pouring across the border, not legally prescribed opioids. This evidenced by the body count that has continued to sky rocket. This also does not count those driven to suicide or illegal drugs because of the past guidelines, which is another huge number of lives. As a patient and provider I urge you to do everything you can to reverse the immense damage that is still ongoing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roger	None	None	0900006485002079	Skic	None	2022-04-08T14:07:46Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Skic, Roger	l1p-l3j8-59sv	False	None	False	2022-04-12 06:38:59.342	[]
4117	CDC-2022-0024-4123	https://api.regulations.gov/v4/comments/CDC-2022-0024-4123	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had episodic low back pain for 20+ yrs and chronic pain for 12 years since a cervical fusion 12 yrs ago and lumbar fusion 1 yr ago. Initially my PCP was managing my pain meds with Lortab. After my cervical fusion, PCP's in Utah had stopped prescribing opiates. I was referred to a pain management clinic.They did a good job with my pain control as does the pain clinic in NC where I now live. The problem comes when I have to see a provider not associated with the pain clinic on weekends and after hours. I had Lumbar fusion surgery and 10:10 pain after because the surgeon refused to give me anything more due to risk of respiratory depression even though I was on Telemetry and my opiate dose is relatively low (7.5 mg hydrocodone tid). The pre-op plan for oxycodone was ignored. I can't even get cough med unless my clinic is open to approve it. There have been times when I neglected to seek care because I am on a pain contract and knew I would not get anything even though my current meds were not enough. In the 20+ years I have been on hydrocodone, my dosage has never increased except for short periods of exacerbation. Please give prescribers the education and leeway to personalize and adapt when needed. I feel very discriminated against and shamed even though I have followed the rules, but not always had pain adequately controlled.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	0900006485001454	Parks	None	2022-04-08T14:23:29Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Parks , Sharon	l1p-ffdp-o585	False	None	False	2022-04-12 06:38:59.563	[]
4118	CDC-2022-0024-4124	https://api.regulations.gov/v4/comments/CDC-2022-0024-4124	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People have the right to have their pain assessed, and treated. Thousands of people are turning to the streets to get help with pain management, and they are being killed due to Fentanyl. Please treat patients who truly need their medications. <br/>As a doctor, you must take a Hippocratic Oath which states that you are to treat the whole patient. You are not upholding that oath when you withhold, or limit how much medications someone may receive after surgery, chronic pain, or many other reasons. Please make the right choice and allow people to have some relief if they've been dealing with diseases, chronic pain client, and anyone who has had surgery and will need it in order to recover. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kasia	None	None	090000648500164f	Czubiak	None	2022-04-08T14:24:19Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Czubiak, Kasia	l1p-ghjv-y611	False	None	False	2022-04-12 06:38:59.779	[]
4119	CDC-2022-0024-4125	https://api.regulations.gov/v4/comments/CDC-2022-0024-4125	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please ..jelp us get our meds and docoters back its a living hell living with pain remember me when u in pain sonner or later you will.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sam	None	None	090000648500165e	Flores	None	2022-04-08T14:24:44Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Flores, Sam	l1p-gil5-hxvw	False	None	False	2022-04-12 06:38:59.997	[]
4120	CDC-2022-0024-4126	https://api.regulations.gov/v4/comments/CDC-2022-0024-4126	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetinghs. Thank you for reviewing your efforts at the HARM caused by those taking opiates illicitly. I understand the need to addresss that side of it but unfortunately your efforts have simply created a larger customer base for illegal narcotics sellers. Doctors are so terrified of your new regs they simply refuse to prescrribe to anyone,, regardless of legitimate need and immense suffering they are enduring.<br/>If I have to take weekly UAs, undergo more strict monotoring anything is better than turning to the dangers of the cartels who know offer fake Oxy's, Xanex and a host of fake fentynal pills all designeed to fill the gap creayed by doctors abrubtly cutting off paatients however real ytheir pain may be.<br/><br/>Your are sadly creating a huge new profit center for the cartels, forcing oldwer people who wwould never interact wwith these violent drug dealers just to treat their horrible pain.<br/><br/>I know your intentiopns were honorable but the result has created an entirely nre problem as bad or worse then the one it intended to solve.<br/><br/>Hopefully the days of 6 months scripts from pill mills who require patients to only fill at attached pharmacies owned by family members are over. Now if we van return some power and authority to the medical experts to use their training and science baased knowledge to manage chronic pain without fear of suddddenly losing their licenses.<br/><br/>I could tell you of multiple doctors and stories who have chosen to ignore patients pain (at risk of suicide or turning to illegal street drugs) to play it safe and protect their degree they worked so hard to obtain over serving their patients chronic pain issues.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mike	None	None	09000064850016b9	McDermott	None	2022-04-08T14:27:03Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from McDermott, Mike	l1p-gqtt-ixn9	False	None	False	2022-04-12 06:39:00.234	[]
4121	CDC-2022-0024-4127	https://api.regulations.gov/v4/comments/CDC-2022-0024-4127	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Three years ago my life was changed. I had a total ankle replacement at 38 years old. This is very uncommon at my age and I was not prepared for what was yet to come. 6 months after my initial surgery I went under another total corrective ankle replacement. 1 year after that failure I had an ankle fusion due to the two previous surgery failures. All of this took place within 2 years. I saw my life as a full time working mom of 6 completely change. The pain that I've endured throughout the past few years has been unbearable. I have been put on every medication possible, I've had nerve stimulation surgery, acupuncture, dry needling, physical therapy, and in 3 weeks I'll undergo my 7th surgery. I've been left with extreme pain and nothing seems to help except for my pain medication. Due to the CDC regulations I've had doctors tell me that Tylenol was enough, to meditate the pain away, that essential oils should help. My entire world has changed. I lost my job that I'd had for 13 years. I'm a shadow of the wife and mom I used to be. All I'm asking is for you to think of us pain patients that truly do not want to be on these medications but have no other alternatives. My pain medication has not increased at all within these 3 years. I'm not abusing them in any way. Please remember that three years ago I was just like you living a very eventful amazing life. I never thought I would be in this position. Please don't punish pain that we did not chose.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robbin	None	None	0900006484ffd20f	Sisti	None	2022-04-08T14:29:59Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Sisti, Robbin	l1o-5hwe-hmt8	False	None	False	2022-04-12 06:39:00.455	[]
4122	CDC-2022-0024-4128	https://api.regulations.gov/v4/comments/CDC-2022-0024-4128	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	At 53 years old, this is my 45th year with a very rare disease (NKC) and a second one, on top, all with no known cure (NKC), Childhood Onset Cervical and General Dystonias, with tremor, which affect my head, neck, both arms, shoulders, upper body, plus, and, to make all matters worse, I was T-boned (in a MVA), 25 years ago, and suffered a damaged spinal cord, along with a broken lower back, was partially paralyzed (having to learn to walk again and use my left arm again) and dxed with Reflex Sympathetic Dystrophy-Chronic Regional Pain Syndrome! All was dxed at [treatment provider redacted] both pre- and post-MVA and most standard treatments to treat Childhood Onset Cervical and General Dystonia I had been successful with, including all types of Botox, no longer work, I am now immune to or, after 40 plus years, simply do not work any longer! I am not a good candidate for any surgeries, either, being far beyond the 20ish year mark. [treatment provider redacted] stated, along with several doctors, that I would have to be on Narcotic Analgesics for the rest of my life and they were very successful until 2016, when the 2016 CDC Guidelines hit! I fought to stop all of the new law” along with many good doctors, nurses and other patients (going through similar living nightmares, now, knowing people who have died due to being cut or cut back)! I am not an addict, but require these medications, along with sedatives and muscle relaxants, to keep my body from going into spasms, shaking, pulling, pain, tremors, etc. I sometimes call the pentagram of pain!<br/><br/>This is unacceptable, cruel, unusual and inhumane treatment to subject humans to! It is also wrong to persecute doctors, nurses and pharmacists trying to treat us patients! In many attempts to make us look bad, you are showing the intent of the government to commit cruel and unusual punishments! Why? You can say that that is not the intended thing, but from where others sit, seeing my suffering and being cut back” alone, due to the DEA and insurance agencies putting constant pressure on a great fighter and doctor who had to let me go, because he was told to let half go or you lose your license!? I, sadly, understand why he did what he did, keeping a patient, similar to me, but he had known him 10 years longer. He also said, that given that there are only about 5K people like me (there were 10K just 6 yrs ago), that a hospital would take me and study me! Oh yeah, there is one that would allow “outpatient,” but 3-4 hours away?! My Dystonias are also from either side of the family, a type A and B, making mine harder to treat with any surgery, also beyond the 20ish year mark and it would, likely, make me worse! On top, hit in a MVA, caused by someone else? Unbelievable! The surgeons were relieved I would not want to try a, likely, doomed surgery! Narcotic analgesics have worked effectively for 20ish plus years and as I am being cut back, by my neurologist, I am only getting worse! My body is not stabilizing, because it is trying to go back on the “original course,” which, with Childhood Onset Dystonias... is to get worse, with multiple plateaus! This, per multiple doctors and NIH, who tried to get me a doctor to be able to treat me with Narcotic Analgesics, as recently as last year, 2021!<br/><br/>Even in contacting Medicare and Medicaid (who allowed me to use their MD and DO databases), NIH (who tried to find me a doctor in mid-2021, no luck, on their own time), the CDC (yep), the VA Department of Health, my County Department of Health, H and HS, DMRF (because I have had mine for so long, with a few thousand others) and NSTA, which I helped to found with about 25 people, as a teen, and every single doctor and surgeon that I have seen and-or spoken with, over 2021, in particular... agrees!<br/><br/>Stop the torture and genocide and let us take the correct amount of medications that we need, without your interference! The only country to do what is being tried here was China and it was under the rule of Mao Zedong! This is America and now, 1 million deaths of patients plus, later, the fact that there was already a downturn in a small amt of “bad doctors” and “pill mills,” when the 2016 Guidelines came out and should have been pulled, but too many people sided with a few thousand deaths, not thinking of the Millions of chronic pain, plus, patients and how it could affect our lives! The DEA having been given the authority to treat the “guidelines” as law and with the cartels doing what they are doing; It is time to Stop the restrictions and allow doctors and pharmacists to do their jobs and let me, as a patient, see doctors I need to see!<br/><br/>I have a very long, documented medical record and every single MD I have spoken with has said that the Narcotic Analgesics, with sedatives and muscle relaxants, having been tolerated well for for so many years by me, showed so much of an improvement and strong benefit over risk-that I should be on them! Allow us our medications back, at the levels our doctors prescribe!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	090000648500175c	Wiesman	None	2022-04-08T14:35:30Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Wiesman, Gary	l1p-h27h-nkpf	False	None	False	2022-04-12 06:39:00.693	[]
4123	CDC-2022-0024-4129	https://api.regulations.gov/v4/comments/CDC-2022-0024-4129	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The information I am sharing is solely my own experience and what has happened in my life and how these changes to the opioid law has affected me in the past present and future. My hope is to have broader exceptions to the opioid laws for sufferer of chronic pain and find ethical common ground and get rid of the all or nothing changes that have been happening and take a closer look at the gray areas. I understand the tragedies of those who have lost loved ones and the suffering some have experienced as a result of misuse of opioids. My heart goes out to those families. I too have suffered loss but not for the use of opioids but for the lack of use of opioids in certain circumstances.<br/>Thank you for letting me share my story.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006485001895	Brown	None	2022-04-08T14:36:12Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Donna	l1p-hquv-dszn	False	None	False	2022-04-12 06:39:00.982	[]
4124	CDC-2022-0024-4130	https://api.regulations.gov/v4/comments/CDC-2022-0024-4130	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines are still hurting real pain patients all over the US. These are hurting people with cancer and post op also chronic pts. On my dads death bed (w cancer and kidney disease) begging for pain medicine and doc denied it, which is recorded and still haunts me today. Animals at the vet are getting proper treatment, why can’t patients. The illegal drugs are hurting Americans not approved FDA medication. Please listen to what people are trying to tell you. You or a loved one will be affected, it’s just a matter of time, Then you’ll see how it’s affects someone. Nobody wants this to happen to you or your loved one- it’s so sad to watch.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	A	None	None	0900006485001a07	Clark	None	2022-04-08T14:36:53Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Clark , A	l1p-i7ww-r32s	False	None	False	2022-04-12 06:39:01.201	[]
4125	CDC-2022-0024-4131	https://api.regulations.gov/v4/comments/CDC-2022-0024-4131	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The cdc has no authority or business putting out guidelines for pain treatment period. Due to the failure of the 2016 guidelines, this new guidance should not go forward. People that were not "intended" to be affected are. Acute injuries not treated. Cancer, sickle cell right on through hospice are all denied adequate pain relief. <br/>My child has suffered in pain 4 weeks now, acute injury. Told to take Ibuprofen or tylenol. Can not use leg. Can not work. This is not individualized care it is inhumane treatment by a facility afraid to treat pain due to "guidelines " and Dea overreach. Recind the guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Natalie	None	None	0900006485001aa0	B	None	2022-04-08T14:37:32Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from B, Natalie	l1p-ieey-wuci	False	None	False	2022-04-12 06:39:01.425	[]
4126	CDC-2022-0024-4132	https://api.regulations.gov/v4/comments/CDC-2022-0024-4132	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Page 4: Risk could include the population of individuals diagnosed with SUD/OUD. It could be beneficial to see language in this section regarding conversation around treating individuals in recovery who are in pain….and does this population’s diagnosis qualify under their current definition of “risk”	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485000629	None	None	2022-04-08T14:47:36Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-63ji-nhge	False	None	False	2022-04-12 06:39:01.647	[]
4127	CDC-2022-0024-4133	https://api.regulations.gov/v4/comments/CDC-2022-0024-4133	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg.14: "Also in 2020, it is important to note that among those reporting misuse in the past year, 64.6% reported the..."<br/><br/>This is a key data point that could be used as education for a variety of stakeholders, especially in any materials, presentations, tip sheets, etc. for a person-centered approach in treating pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485000652	None	None	2022-04-08T14:47:54Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-67o4-vv8i	False	None	False	2022-04-12 06:39:01.879	[]
4128	CDC-2022-0024-4134	https://api.regulations.gov/v4/comments/CDC-2022-0024-4134	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 20: "While this clinical practice guideline update includes content on pain management for patients..."<br/><br/>It would be interesting for the gap to be addressed. This guidance addresses pain (acute, subacute and chronic) and the onset of it and the guidelines for prescribing….and it refers to ASAM’s guidance for those with OUD and the management of it; however, there’s this gap where individuals start in pain management and potentially develop OUD or are at risk for dependence as a result of their pain management treatment. It would be interesting to see guidance on how to address this gpa….to address how to identify this at-risk/early onset of OUD population by screening and assessment (aka referral for a drug/alcohol assessment).	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500066a	None	None	2022-04-08T14:48:42Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-69op-tdie	False	None	False	2022-04-12 06:39:02.094	[]
4129	CDC-2022-0024-4135	https://api.regulations.gov/v4/comments/CDC-2022-0024-4135	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 23: "Pill counts"<br/><br/>Suggestion of changing “pill counts” to “medication counts” as some medications may change origin from pill to another form (film, liquid, etc.) as time goes on as to not outdate the guidance tool should this change in the near future	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485000683	None	None	2022-04-08T14:49:02Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-6baf-gk4b	False	None	False	2022-04-12 06:39:02.313	[]
4130	CDC-2022-0024-4136	https://api.regulations.gov/v4/comments/CDC-2022-0024-4136	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 24: "Consultation with mental health specialists when mental health conditions are<br/>present or suspected."<br/><br/>Does this include SUD since SUD is housed within the DSM-V or does SUD remain separate from mental health specialty language in this document?<br/><br/>"Co-prescribing of naloxone"<br/>Should this be referencing “co-prescribing” when there are naloxone products now that do not require a prescription? Should this item be more of a ‘conversation/recommendation of naloxone.’ I know this is part of a study, however, maybe a language shift should this take away be used.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	09000064850006a0	None	None	2022-04-08T14:49:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-6de6-ck25	False	None	False	2022-04-12 06:39:02.528	[]
4131	CDC-2022-0024-4137	https://api.regulations.gov/v4/comments/CDC-2022-0024-4137	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 94: "clinicians and patients who set a treatment plan in advance of prescribing will clarify expectations regarding how opioids will be prescribed and monitored with an aim to improve patient safety, health,and well-being."<br/><br/>Yes! If not already there, it could be helpful that where this guidance document is housed, to have resources/examples of what’s outlined in these recommendations. For this item, having a treatment plan example or referencing the key components to a treatment plan could be helpful for outpatient clinical offices to utilize.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	09000064850006a7	None	None	2022-04-08T14:50:13Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-6h5i-hczg	False	None	False	2022-04-12 06:39:02.751	[]
4132	CDC-2022-0024-4138	https://api.regulations.gov/v4/comments/CDC-2022-0024-4138	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 98: "Clinicians should use additional caution with ER/LA opioids and consider a longer dosing interval when prescribing to patients with renal or hepatic dysfunction because decreased clearance of medications among these patients can lead to accumulation of drugs to toxic levels and persistence in the body for longer durations."<br/><br/>Would it be appropriate to include the co-prescribing of naloxone to this item considering the risk that the item infers?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	09000064850006d5	None	None	2022-04-08T14:50:45Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-6iqj-1p69	False	None	False	2022-04-12 06:39:02.994	[]
4133	CDC-2022-0024-4139	https://api.regulations.gov/v4/comments/CDC-2022-0024-4139	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 109: "Clinicians should remain alert to signs of anxiety, depression, and opioid misuse or opioid use disorder (see Recommendations 8 and 12) that might be revealed by an opioid taper and provide treatment or arrange for management of these co-morbidities."<br/><br/>Would arrange for management infer referrals to specialists for either consultation or actual assessments? Specialists such as mental health, behavioral health and SUD treatment providers?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	09000064850006f0	None	None	2022-04-08T14:51:14Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-6knd-1f1l	False	None	False	2022-04-12 06:39:03.206	[]
4134	CDC-2022-0024-4140	https://api.regulations.gov/v4/comments/CDC-2022-0024-4140	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 120: "As an alternative for patients not yet in opioid withdrawal, some authors have<br/>described low dose initiation of buprenorphine to allow for initiation of buprenorphine in patients..."<br/><br/>It might be worth adding (if appropriate) that utilizing Bup for this purpose is not using it ‘off-label’ in case prescribers question off-label practices.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485000701	None	None	2022-04-08T14:51:33Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-6mba-4o2m	False	None	False	2022-04-12 06:39:03.428	[]
4135	CDC-2022-0024-4141	https://api.regulations.gov/v4/comments/CDC-2022-0024-4141	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pg 122: "Clinicians should generally avoid prescribing additional opioids to patients “just in case” pain continues longer than expected."<br/><br/>Yes! This is a vital point as some prescribers will tell patients that they can keep a script on file “in case it’s needed.”<br/><br/>"If opioids are prescribed continuously (around the clock) for more than a few days for acute pain, clinicians should prescribe a taper to minimize withdrawal symptoms on discontinuation of opioids."<br/><br/>Another key point! Especially for patients receiving this around the clock prescribing and are then discharged or released from it without discussions on tapering/titration, what to expect, how to and then follow up with their PCP or outpatient provider.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485000713	None	None	2022-04-08T14:52:17Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pennsylvania Department of Health, Office of Drug Surveillance and Misuse Prevention	l1p-6ofv-z9b1	False	None	False	2022-04-12 06:39:03.643	[]
4136	CDC-2022-0024-4142	https://api.regulations.gov/v4/comments/CDC-2022-0024-4142	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since I was eleven yrs old. I didn't know I had endometriosis until I landed in the hospital after seeing my doctor at the time. She admitted me immediately after seeing the excruciating pain I was in. It was my 1st experience with an autoimmune disease. I chose to have a hysterectomy at 40 to end my year's of suffering. That led to my diagnosis of fibromyalgia. No one really knows what causes it but it's usually trauma related. It turned my life upside down. The pain was constant and I lost the ability to do many of the things I loved to do. I could barely help raise my children. No one understood what I was going through. I have used opiates as a child into my adulthood. I now have several more autoimmune diseases that are very painful. <br/> The CDC guidelines have done nothing but make my provider's afraid to treat my pain from my illnesses. I also use medical cannabis with my opiates. I weaned myself down on the amount of opiates I was being prescribed. No one told me to do it. No one assisted me in doing so. I am 68 yrs old and I cannot believe how chronic pain patient's are being abandoned or cut off by their provider's. The use of MME's is harmful and not backed by science in any way. We are all individuals and a one size fits all in pain management does not work at all! <br/>The DEA has taken the guidelines and are policing our doctor's and provider's. Remove the guidelines and give our provider's the ability to diagnose and treat painful conditions. They have been taken as law by many insurance companies and continue to harm people with serious chronic conditions. Yes, you bear responsibility for the death's of those who were abruptly cut off from medication's that made life bearable. <br/>Do the right thing by millions of people suffering with very painful conditions. Respectfully, I hope you all can be open minded and help us get our medications that treat pain back to people who desperately need it. We are not addict's. We are in severe pain. Thank you for being open to our constructive criticism. People are dying. Commiting suicide...	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lee	None	None	0900006484ffd312	DeFrancesco	None	2022-04-08T14:58:48Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from DeFrancesco , Lee	l1o-7y81-xypb	False	None	False	2022-04-12 06:39:03.859	[]
4137	CDC-2022-0024-4143	https://api.regulations.gov/v4/comments/CDC-2022-0024-4143	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket number CDC-2022-0024<br/><br/>I don’t know what to do anymore to help my mom. I’ve only posted here once before, but this is hard. I think my mom thinks her pain is temporary, and I would also like to believe it is…but it’s not looking that way. I’m in another chronic pain group and someone there commented that if they’ve sent you to pain management it’s because you’re not getting better. I don’t know what to do! I’ve suggested she move in with me and she won’t. I’ve suggested we get a power of attorney set up because I CANNOT advocate for her with her care team if I don’t have one, I’ve asked. She calls me all the time lately crying. Late at night. Drunk. Yes, she is drinking again, which I cannot imagine is great for her considering the amount of pain medication she’s on. Tonight I suggested that she talk to her PCP about getting on an antidepressant and she started yelling at me. She told me she already has such difficulty getting her pain medication that she highly doubts they would ever prescribe her antidepressants. I told her that antidepressants are not classified the way opioids are and that it wouldn’t be difficult to get them. She yelled that she wasn’t depressed she was angry, but I can’t handle being her outlet for this. I am in school to be a social worker, and I am taking 7 classes. I am falling behind in all of them, because at this point I don’t have the mental capacity to be her caretaker and I feel so overwhelmingly guilty about that. I have two kids, two dogs, and my partner works full time so I also have to find time to take care of my house. Being as I know my limits and I know when I’m getting burnt out….I can confidently say I’m getting extremely burnt out. I have SO much compassion for my mom, but she needs help from professionals in the medical community….not me who has zero medical training apart from my old job at an assisted living community. I don’t know what acronyms mean and that seems to be the answers I get sometimes, and I have to look them up online. I just don’t know how much longer I’m going to be able to provide emotional support, and I certainly don’t have the time or energy to be my moms full time caretaker unless she moves in with me and we get an in home nurse. Thank you for letting me vent. I really hope this doesn’t come off as insensitive. I listen every time my mom needs an ear, but truthfully speaking she needs a therapist to talk to about this stuff. I could never tell her that, because she already yelled about the antidepressant thing. I worry, but I’m all she has.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	09000064850020ae	Marin	None	2022-04-08T15:10:01Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Marin, Mary	l1p-l8dl-evtg	False	None	False	2022-04-12 06:39:04.082	[]
4138	CDC-2022-0024-4144	https://api.regulations.gov/v4/comments/CDC-2022-0024-4144	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Up until 2016/2017 I led a pretty normal life. I worked fulltime as an Information System Consultant for the state of WV. At that point I had about 17 years in with the state, all in the technology field as that is what my degree was in. For about 15 of those years I was a chronic pain patient (CPP) and prescribed opiates over and above the new guidelines. I functioned well in my job when my pain was managed. I was a viable employee and also had a good life. I did a lot with my children and than grandchildren such as bike riding, camping, swimming and hiking. Once the CDC regulations came out my pain management doctor started lowering everyone's medicine. I am not going to go into the *** I went through when these medications were taken but let's just say my life was no more. I could no longer function at my job like I had. I could no longer do anything with my grandchildren and they had a hard time understanding what had happened to me and why I could no longer do activities with them. All they knew was that Nan-Nan was in pain and it hurt her to walk. I filed for disability from my career and was declared disabled by the state. Once I left work I applied for SSDI and was approved on the first go round. You see without the medication I needed I was no longer a functioning, productive tax-paying member of society. It was a hard thing to accept. I had worked most of my life. I went to college with two (9 month & 21 month old) babies on my hips. My husband left me because I went to college as he thought I was going to find another man. Thirty some years later I still have not found that man he was afraid of. So I was a single parent with 2 babies on my hips trying to get an education and working part time. It was rough but well worth it. I became disabled about 2 years after I started with the state. My spine was slipping on itself and needed to be stabilized. I was in so much pain that there was not a question of not having the surgery but how soon. Surgery that was supposed to be no more than 3 hours turned into 6 hours. Surgeon said it was the worse back he had ever operated on. He did it laparoscopy and put in a cage, rods and screws. Seven weeks later I was back at work wearing a brace but back working never the less. Lots of people said I should go on disability at that time but I wanted to work and between the surgery and the medication I was able to. I had several promotions and was tasked with creating a program for all retired IT equipment. Dept. Of Ed wanted some of the equipment to put back out in schools. I created all processes, procedures and managed the whole operation. The program saved DOE a million a year and a lot of other agencies money also as they could buy the "used" equipment. I did all this while on a high dose of opiates which managed my pain. Now with a low dose I am a non-functioning member of society. I should still be working and making a difference but without the correct medication to control the pain I am useless. I feel like people consider me a drug addict and that includes doctors. I had total hip replacement recently and was released WITHOUT any after surgery pain medication. To cut someone open, remove a major bone and replace it should rate some pain medication afterwards so the patient can do physical therapy and not be in horrible pain. I have always thought that the CDC dealt with pandemics and odd diseases not medications. I have always thought that was the FDA. Such harm was done with your first set of regulations that instead of revising them they should be done away with completely and let the correct agency do their job. You need to stick with what you know. Pandemics and diseases!!! Please for millions of us chronic pain patients out here please rescind your previous regulations and let the right agency take over and do their job. We are no different than a diabetic who has to have insulin to survive. We need opiates to function and not all at the same level. Thank you for your time and attention to this very important issue and we all are praying you do the correct and right thing and let the FDA take the lead on this as it is in their wheelhouse.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006485002165	Martin	None	2022-04-08T15:17:54Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Katherine	l1p-lnwr-ke53	False	None	False	2022-04-12 06:39:04.313	[]
4139	CDC-2022-0024-4145	https://api.regulations.gov/v4/comments/CDC-2022-0024-4145	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors swear to do no harm. I understand the CDC doesn't have to pledge an oath to do no harm, but your guidelines have caused doctors break their oaths by turning away pain patients and leaving them to suffer and take all quality of life away, because they are afraid of you and the DEA. Too many of my brothers and sisters in pain have killed themselves because they couldn't take it anymore. Others have had to quit their jobs because they can't keep up because of pain and pain management groups are making patients jump through hoops just to get some pain relief. It is shown that steroid injections can create more harm than good and yet pain doctors are demanding that their patients get these shots or no pain meds. This is horrible.<br/>Please change your inhumane guidelines and reach out to doctors across the county and ensure them that they can now treat their patients to the best of their abilities using, when necessary, opiates. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Meggy	None	None	0900006485002522	James	None	2022-04-08T15:22:19Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from James, Meggy	l1p-nfc1-du07	False	None	False	2022-04-12 06:39:04.544	[]
4140	CDC-2022-0024-4146	https://api.regulations.gov/v4/comments/CDC-2022-0024-4146	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter is in constant pain from disease and a. Car wreck, she is not an abuser, but does need pain killers to function. Your guidelines are unreasonable for chronic pain patients. All MME SHOULD BE REMOVED.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006485002740	De Graw	None	2022-04-08T15:24:29Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from De Graw, Carol	l1p-ov5x-p2n0	False	None	False	2022-04-12 06:39:04.762	[]
4141	CDC-2022-0024-4147	https://api.regulations.gov/v4/comments/CDC-2022-0024-4147	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand you all are working on the new cdc guideline for 2022 and it is going to make it even harder to get help with pain .mme is now down to 50 Mme .what are we the pain communities suppose to do now .We are suffering now so now it will be worse .i m just wondering have anyone of you been in pain I not talking about a little pain and then it goes away .i m talking about pain that's there 24_7.with no relief ? Apparently not .or you would not make us suffer so much .i wonder if it was one of your family members that had a disease with pain and no help for them and you are watching them suffer .what would you do ?we are suffering some are taking there own lifes cause there are in so much pain and have been denied pain medication that would help them .why do we have to suffer???	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850027cc	Anonymous	None	2022-04-08T15:25:05Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-pbxy-ysef	False	None	False	2022-04-12 06:39:05.027	[]
4142	CDC-2022-0024-4148	https://api.regulations.gov/v4/comments/CDC-2022-0024-4148	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello to all who read and consider these comments. I am a chronic pain patient and a concerned citizen of this country. I have had intractible pain that I have tried everything that I can, to treat my pain for over 20 years. I have had 45 minutes of direct gamma radiation shot directly at my nerve to damage it so my pain might stop. But it didn't work. I have tried so many anticonvulsant medications and different combos with them that include antidepressants, lyrica, baclofen as well as cymbalta and gabapentin. None of them worked, and some made me very very sick, some made me lose all my short term memory and forget words and the names of my grandchildren and I have not completely recovered from some of those memory problems; but none of them helped my pain. I have what is known as trigeminal neuralgia, atypical trigeminal neuralgia and trigeminal neuropathy. The type of pain everyone thinks doesn't respond to narcotic pain meds, at least everyone but the ones of us who tried everything else but pain medications work for us. This type of pain is very extreme and debilitating and all day long. But pain medicine helps to let me take a shower, lets me brush my teeth, helps me be able to talk and be around my family without having to leave and go home because my face is hurting so bad I could cry out or just sit and rock with my hand over it trying to shield it from any more wind or people's breath. I have other comorbidities that pale in comparison, I have DDD with spinal stenosis, and other arthritic changes that cause pain. Yet I was cut off my pain meds in 2019 and have no quality of life. I rarely am able to shower or brush my teeth because of the pain it causes. I don't get to be with my family because I'm always in pain. * All I do is have pain. Why? Because of your fear of me becoming an out of control addict? Well, that did not happen although I was on a stable dose of pain meds for years. If you aren't going to let doctors prescibe for intractible pain then the least you can do would be suggest we all should have the option . You fully know that no matter how many times you write "these guidelines should only be used as guidance and not laws or regulations" they have been and WILL be used as laws and regulations. Blaming doctors for not prescribing when they have been going to jail for it is wrong. Please know these guidelines will be used against doctors and patients. Let us have a right ** if you are going to insist on us living a life of intractable pain. This is inhumane. Human rights watch has been saying not treating pain patients is wrong and inhumane for years now. I have lost many cpp friends this year alone due to untreated pain. By continuing to write guidelines on pain and using the word risk hundreds of times, you make lawmakers create inhumane laws and doctors unable to be doctors and healers. You, the CDC have made living life a risk like we have not known for many decades. By creating a time when pain medications are frowned upon, and hospitals no longer use them, NO one who knows about these terrible laws and regulations wants to even take the risk of living- you have created fear of being in a world where medical doctors are mandated to be uncaring and cold. Who wants go on a trip or a hike where one might accidentally get hurt when they know they will be left in agony? We accept some risk to enjoy life but because of you, we cannot do those things. You know your guidelines have been weaponized against both patients and doctors. Yet instead of taking them down, you rewrite them and that will not change the laws that hurt doctors and patients alike. Please do the right thing and rescind them. Maybe then, the very people who have made these laws will stop and we can be whole again, we can get care for pain again. Instead of rewriting your guidelines I would suggest you tell all law makers that any laws telling doctors how to treat pain is wrong. Lawmakers are not doctors, they do NOT know the effect their laws are having on people in all kinds of pain. Please do one thing right - make it clear that doctors know how to treat pain and should use their own clinical judgment, as each patient will be different and you know that to be true, each patient with high blood pressure, or diabetes will need different meds and different dosages, and pain patients need different meds and dosages as well, get rid of the MED. Please help make medicine compassionate and well rounded again instead of a one size fits all. If you don't, more blood will be on your hands. Maybe even mine, because I can't access pain care anymore and my rare and intractable pain doesn't seem to be going away. I wish it would. Maybe you don't realize nobody wants to be on pain meds now, they are treated like criminals on parole. Now children are being denied pain care and it's MONSTROUS! How do you sleep at night knowing you caused this?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006485002d02	Peddicord	None	2022-04-08T15:57:33Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Peddicord , Lisa	l1p-q5w9-8u9w	False	None	False	2022-04-12 06:39:05.254	[]
4143	CDC-2022-0024-4149	https://api.regulations.gov/v4/comments/CDC-2022-0024-4149	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why does the CDC felt the need to advise doctors at all about pain treatment when it is clear their advice has not improved the outcome on our overdose crisis? That function should be left to professional experts in the pain management field, anesthesiologists and patient advocates. The war on drugs should not takes precedence over patient welfare, especially when overdoses have almost nothing to do with patients or prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002d0d	Fimrite	None	2022-04-08T16:02:37Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-q6z1-ruo1	False	None	False	2022-04-12 06:39:05.523	[]
4144	CDC-2022-0024-4150	https://api.regulations.gov/v4/comments/CDC-2022-0024-4150	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer. I have dealt with Chronic pain since age 17 in 1989 when I suffered a work related injury and did not get proper care. At age 21 in 1994 I died in a car wreck and have suffered chronic pain since. I did everything I could possibly do to avoid long-term opiod use. Finally in 2014 I decided I was tired of being miserable 24/7 and I started using Vicoden with my doctor's help. At that point I had ben seeing that particular doctor for 6 years. We found the best dose for me was 10/650 but due to the Tylenol over doses we had to go down to 10/325. I have been on that dosage since. We found 5 a day was optimal for relief. Then all this BS on opiod use/abuse came out and suddenly instead of being a patient using medication to control my symptoms I became a drug abuser, especially after my doctor left his practice due to constant drama of lawsuits!! I had to switch doctors three times, just to find one willing to prescribe 4 a day with a contract and the condition that if things change with the insurances or the CDC guidelines any further I Will loose the only medicine that helps at all. Too often well meaning intentions are not well thought ought and good people suffer and pay the consequences. I am an educated woman that made an educated decision with her doctor. I don't turn to the streets or seek stronger drugs. There are millions like me. <br/>Please change the guidelines to stop the craziness that true patients must go thru!! Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DJ	None	None	0900006485002d26	Clonts	None	2022-04-08T16:04:03Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Clonts, DJ	l1p-qemc-436l	False	None	False	2022-04-12 06:39:05.737	[]
4145	CDC-2022-0024-4151	https://api.regulations.gov/v4/comments/CDC-2022-0024-4151	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We have a big mess to clean up after the last guidelines turned healthcare upside down for both patients and doctors. Payers are refusing to cover opioid treatment and doctors are refusing to prescribe. Pharmacies are refusing to dispense. DEA and DOJ continue to arrest and imprison prescribing doctors. Patients are suffering from not getting pain medicine when medically necessary. There is an alarming increase in suicide and patient deaths connected to being abruptly tapered from opioid pain medications. As long as the CDC continues to convince healthcare workers and law enforcement that opioids are poison that isn’t useful for pain, the damage will never stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002d3f	Fimrite	None	2022-04-08T16:05:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-qh5f-9f8v	False	None	False	2022-04-12 06:39:05.993	[]
4146	CDC-2022-0024-4152	https://api.regulations.gov/v4/comments/CDC-2022-0024-4152	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2022 draft guidelines are very much like the 2016 guidelines, biased against opioid prescribing, all about non-opioid treatments while describing chronic pain patients or anyone with severe pain as potential abusers. How is this anymore balanced, less one-sided than before? Does the CDC think that opioids can just be tossed aside, that pain is rarely severe enough to require opioid analgesics? Even though the revision includes warnings against the misapplication of guidelines, the CDC still seems to be doing their best to stop opioid prescribing by over-encouraging the use of unproven, non-evidenced-based, non-opioid pain treatments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002d91	[city redacted]	None	2022-04-08T16:06:13Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-qoir-gow3	False	None	False	2022-04-12 06:39:06.208	[]
4147	CDC-2022-0024-4153	https://api.regulations.gov/v4/comments/CDC-2022-0024-4153	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should throw out all remnants of the 2016 guidelines and start fresh in in 2022 with brand new guideline that describe how to undo the immense harms we’ve seen and experienced first hand. The revision should steer away from advice about how to treat pain all together. The 2016 guidelines harmed millions of acute and chronic pain patients with moderate to severe, high impact pain. The multi-modal non-opioid treatments emphasized in the draft guidelines, are not effective and not scientifically proven.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002ddb	Fimrite	None	2022-04-08T16:07:11Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-quxh-j177	False	None	False	2022-04-12 06:39:06.431	[]
4148	CDC-2022-0024-4154	https://api.regulations.gov/v4/comments/CDC-2022-0024-4154	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 5 principles warning not to misapply the guidelines are great, except for number 3 which should be about flexible patient-centered approaches that include opioids when necessary. Unfortunately these important principles are referred to on only on one out of over 200 pages of the draft guidelines that constantly remind us of the the grave risks of opioid prescribing as well as over-emphasize that opioids may not be needed for pain treatment at all, suggesting they shoudn’t even be considered for many types if pain. There is the caution not to exceed 50 MME on page 100. And on page 99, “The lowest starting dosage for opioid-naïve patients is often equivalent to a single dose of approximately 5 to 10 MME or a daily dosage of 20-30 MME/day.” MMEs shoudn’t be recommended at all by the CDC since they are not evidense based proven science and studies are inconclusive.<br/><br/>We have seen the damage done from 90MME suggested in the 2016 guidelines. Now it appears that the CDC is trying to sneak in suggestions for even lower doses. State laws will follow by even further restricting prescribing based on these numbers despite the suggestion not to translate CDC guidelines into laws with hard limits, insurance restrictions and more doctor arrests. Legislators did it before, and what’s to stop them from doing it again? Our country doesn’t need anymore encouragement in this direction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002e20	Fimrite	None	2022-04-08T16:08:03Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-r2i9-fm46	False	None	False	2022-04-12 06:39:06.646	[]
4149	CDC-2022-0024-4155	https://api.regulations.gov/v4/comments/CDC-2022-0024-4155	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mom (late 70s at the time) was in horrific pain from an infection (actinomychosis) in her jawbone (something all but one of her dentists denied the existence of). <br/><br/>I wasn’t on hand to supervise her opiate consumption for a spell (didn’t realize I needed to be), and she took more of her pills than prescribed; ran out.<br/><br/>She went into a period of extreme (10 level) pain and opiate withdrawal symptoms simultaneously. It was utter hell. <br/><br/>I was unable to find anyone or anything to help. No one dared prescribe more due to concerns about licensure. (l ended up with irritable bowel syndrome myself from the level of “freaked out”.)<br/><br/>Eventually (thank God) I recalled kratom… which got her over the worst of it, and ultimately into better times.<br/><br/>It is inhumane to deny folks who need it, pain relief. Every case is different and should be judged on an individual basis; presumably something a doctor is qualified to do. Thank you.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Noelle	None	None	0900006485002e29	Pollet	None	2022-04-08T16:09:12Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Pollet, Noelle	l1p-r3dm-ocey	False	None	False	2022-04-12 06:39:06.872	[]
4150	CDC-2022-0024-4156	https://api.regulations.gov/v4/comments/CDC-2022-0024-4156	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Our daughter developed severe fibromyalgia about six years ago. She was living, working and going to graduate school in California. She worked with several doctors including rheumatologists and tried a variety of pharmacological and non-pharmacological therapies. None gave her adequate pain relief to continue working until she finally was prescribed oxycodone to assist when experiencing flares. Two years ago she returned to Oregon as my wife and I were getting older and could use her assistance from time to time. She is also our only child. Doctors in Oregon would not prescribe oxycodone because of 2016 CDC guidance and wanted her to retrace all of her previous steps in seeking relief. She has not been able to work nor return to school to complete her MA. She is close to be qualified as a psychotherapist. Sometimes the pain is so bad she has to choose between showering and cooking that day. She is trying to get enough of her life together to return to California hoping her previous doctors will once again be able to help.<br/><br/>We have to give doctors latitude to prescribe for their patients. Chronic pain patients have different needs than those experiencing acute pain from surgery or suffering from near end of life disease. Chronic pain can be so debilitating that life can be seen as hardly worth living. <br/>Please allow physicians, who know their patients best, to appropriately prescribe pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006485002e2c	T	None	2022-04-08T16:10:30Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from T, Gary	l1p-r3do-qwxp	False	None	False	2022-04-12 06:39:07.086	[]
4151	CDC-2022-0024-4157	https://api.regulations.gov/v4/comments/CDC-2022-0024-4157	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a woman and a chronic pain patient. Being a woman had often made life difficult at times because make physicians often assume our issues are hormone related or were just emotional, or making it up, etc. Being in pain was no different. I’m an RN, I understand opioids and their effects as well as side effects. I had been through treatment after treatment, as well as having a male physician get in my face and scream “I will NEVER give you pain medicine!!!” After suffering for years, I was given SSDI for my multiple diseases and disorders. That actually brought with it the credibility to qualify, per se, to get treated with opioids. I finally found a great pain mgmt doctor that I have been with since 2003!! This doctor knows that I have never failed a urine test nor have I run out of meds early. <br/><br/>I had a life. I could do my grocery shopping, clean my house, load my dishwasher, etc. <br/><br/>In 2017 my doctor informed me that he had to take my methadone away and taper me to 60mg of oxycodone per day! Since then I spend most days in bed. I prefer to sleep as opposed to being awake in pain. My quality of life has severely deteriorated and that lies squarely with the CDC and their ONE SIZE FITS ALL approach to opioids. Demonizing pain patients became the new standard of care for hospitals, doctors offices, etc. <br/><br/>I had 4 surgeries since your guidelines came out and my recovery was slower than it should have been because I was in so much pain I couldn’t properly do my PT!!<br/><br/>Your guidelines changed my kids lives so that they had to help me a lot more taking time out of their young adult lives!! My husband had had to take a lot of time off work to help me. My use of NSAIDS has gotten to the point that my kidney function labs are beginning to show decline!!! I have to take protonix 2x a DAY because of the irritation in my GI tract! Opioids NEVER caused my organs harm. Opioids never gave me GI irritation to the point of a possible ulcer!!!<br/><br/>You made me pain mgmt visits ridiculous. “How are you?” “In uncontrolled pain.” “I’m sorry. I can’t raise your dosage” <br/><br/>You need to realize this bs is harming us in many ways. Don’t hurt a group of people because of the actions of a few!!! Give us our doctor patient relationship back. Give us our lives back. PLEASE	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485002e50	Anonymous	None	2022-04-08T16:12:17Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-r76z-5n8h	False	None	False	2022-04-12 06:39:07.301	[]
4152	CDC-2022-0024-4158	https://api.regulations.gov/v4/comments/CDC-2022-0024-4158	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Does our country want to save lives or keep not prescribing opioids while watching more and more people die from illicit drugs? That is where the problem started to begin with. All causal reference for overdose deaths to doctor prescribed drugs should be removed from the guidelines to avoid misapplying CDC data and state honestly that that the majority of overdose deaths are caused by illicit drugs, not prescriptions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002e6e	Fimrite	None	2022-04-08T16:12:59Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-ra3u-vb3l	False	None	False	2022-04-12 06:39:07.528	[]
4153	CDC-2022-0024-4159	https://api.regulations.gov/v4/comments/CDC-2022-0024-4159	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	* Thanks for the chance to express my never-ending hatred for every last one of you there at the CDC!<br/><br/>I have a birth defect of the liver that can't be operated on. It can only be fixed by a liver transplant or treated with pain medication. So, I was put on morphine. I took the same dose of morphine for 20 years, then all of a sudden I was told I couldn't have it anymore.<br/>I have never been in trouble with the law. I've never sold a pill or bought one illegally. <br/>So, WHY ME?<br/>HOW COULD YOU DO THIS TO A 65-YEAR-OLD WOMAN‽<br/><br/>As to your worthless advice > a chiropractor can't fix my liver, I can't do yoga (pressure on my liver can cause internal bleeding), I meditate more than 99.9% of other people, and I'm not allowed to take aspirin or NSAIDs (they can cause bleeding), and Tylenol doesn't work either, no surprise there.<br/><br/>Well, thanks to you, I'm not on any kind of pain medication anymore.<br/>Nor have I been to see a friend, gone to a movie, etc. since this happened.<br/>Instead, I'm lying on my couch .<br/><br/>I don't intend to get a mammogram, colonoscopy, or anything other tests .<br/>I'm not watching my diet anymore either. Now, I eat a lot of eggs and drink whole milk .<br/><br/>Just so you know, I had a child and this pain is way beyond that or I never would have agreed to take morphine in the first place.<br/>.<br/>No one should have to live with pain like this.<br/>You have even managed to make me hate God because he hasn't granted my prayer .<br/><br/>So, this is my truly heartfelt and soul-deep sentiment—** !!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janis	None	None	0900006485002e8e	Fontecchio	None	2022-04-08T16:22:38Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fontecchio, Janis	l1p-rimg-t1tm	False	None	False	2022-04-12 06:39:07.745	[]
4154	CDC-2022-0024-4160	https://api.regulations.gov/v4/comments/CDC-2022-0024-4160	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	A person who has a chronic disease<br/> cancer, lupus chrones, R.A. ect. The gov. has no right taking them off of their pain medicines. These meds that were perscribed helped all of these people. To live with pain everyday when their are meds that can relieve their pain and the gov. is taking it from them is awful. These patients are not abusing them they are just trying to live a life without pain. I for 1 is a patient who you are trying to take my meds from me after years of trying medication after medication to relieve my pain. Their has been numerous shots different meds over the years and therapy Finally with taking Norco along with my other meds, I am finally feeling almost normal, and now you want to take them away from me and thousounds of other people who are suffering, By taking these pills off of people you are making us suffer when we should not have to' Not 1 person I know wants to be in pain daily and not be able to function. Please show some mercy for patients who are getting relief by taking pain meds know one wants to be in pain daily and not be able to try to live a normal life.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	joyce	None	None	0900006485002e6f	lorenz	None	2022-04-08T16:25:23Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from lorenz, joyce	l1p-ra5c-0xc9	False	None	False	2022-04-12 06:39:07.965	[]
4155	CDC-2022-0024-4161	https://api.regulations.gov/v4/comments/CDC-2022-0024-4161	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To balance the revision and help change the course of all those physicians and government officials who continue to misapply the guidelines, opioid benefits should be clarified on every page<br/><br/>The draft guidelines point out on every page and every guideline how critical it is to only prescribe opioids when the benefits outweigh the risks. Good point, but nowhere in the guidelines does the CDC balance that out by talking about the benefits of prescribing opioids for severe pain, which have been proven effective throughout history.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002e8f	Fimrite	None	2022-04-08T16:26:23Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-riov-sqbk	False	None	False	2022-04-12 06:39:08.182	[]
4156	CDC-2022-0024-4162	https://api.regulations.gov/v4/comments/CDC-2022-0024-4162	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m 65 retired. I’ve had chronic pain in my shoulder and upper back since 1982 working at a very physical job. At first I didn’t think it was serious and would go away. Instead it got worse. A couple weeks of pain in a year would in five years become constant and debilitating. I still worked at that job and then a different job in 2001 all the while in severe 10+ pain every day and all night. I’d often go 2-3 nights without sleep and still worked. I saw sports medicine drs, pain, orthopedic, neurological, chiropractic, drs. I’ve had surgery, electrical stimulation device and many many pain meds from morphine, fentanyl, tramadol, psych meds like Wellbutrin, nortryptaline, cymbalta, and many more. I was on Vicodin for nearly 10 years before it stopped working. I then was prescribed Dilaudid and that helped with the big attacks but I couldn’t take it enough to bring down overall pain. Then about 15 years ago I started on Opana. Ive been on it continuously since and with my other “tools” in my pain toolbox (ice, heat, otc pain meds like Advil, and other distractions This was in the days before the Opiod Epidemic. My PCP who I’ve had for 15 years retired and I’ve been working with a new Dr to a least try to come close to the pain therapy program I’ve been that at least works a little and certainly more than any injections, procedures, PT that I’ve had over the decades. The 1990s through the 2010s we’re the worst and it’s only been slowly that I’ve managed to bring th pain down enough that I can be a part of life again. I’m so cut off from the world when I’m having constant severe attacks and I’m scared that now drs are reluctant to prescribe these meds that have helped me live a sort of normal life, now near the end when things should be easier, I’m finding myself back 20 years bu I’m not that young guy anymore. I’m afraid this pain will cause a stroke or heart attack when it gets so bad. I need these meds to keep the pain at a miserable level instead of an unbearable level which it can get. I’m not an addict. If the pain isn’t there I don’t take the stronger breakthrough pain meds. In fact I’ve stopped the Dilaudid completely and will save them only for attacks which fortunately lately have eased. My new Dr has refilled my Opana but says he doesn’t want to be the prescriber so I went to another pain clinic to see if they’d work with my dr. One wouldn’t even see me saying I’ve been on opioids too long for anything else and they won’t prescribe them. One said they would if I gave up medical marijuana and clonazapan and be drug tested all for one prescription. I asked what they recommend to replace the pot and clonazapan and they honestly said that they had nothing. They sympathized with my situation and sent a report to my dr saying my current therapy program seemed to work and they had nothing better but they wouldn’t manage my pain meds without limitations. Why must I bargain about my quality of life? I’ve obviously survived long term opioid use. At this point I’ll probably die of old age before the drugs do. Please don’t take my only means of being a part of my family and enjoy the last part of my life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gary	None	None	0900006485002eda	Kaplan	None	2022-04-08T16:29:25Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Kaplan, Gary	l1p-rqtp-2rop	False	None	False	2022-04-12 06:39:08.403	[]
4157	CDC-2022-0024-4163	https://api.regulations.gov/v4/comments/CDC-2022-0024-4163	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The risks of under-treating pain need to be cited as often as CDC cites the risks of overprescribing. Millions of chronic pain patients have moderate to severe, high impact pain that needs to be managed with opioids. High opioid doses are especially needed to manage unbearable levels of prolonged agony to keep a patient from screaming in pain with dangerously high blood pressure from pain, which could lead to stroke, cardiovascular and adrenal problems, chronic pain, long term disability and death. This kind of severe pain was not mentioned at all in the CDC draft guidelines and was not included in comparison studies showing only small differences between opioid and non-opioid pain relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002f06	Fimrite	None	2022-04-08T16:31:57Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-ruuq-ahqh	False	None	False	2022-04-12 06:39:08.624	[]
4158	CDC-2022-0024-4164	https://api.regulations.gov/v4/comments/CDC-2022-0024-4164	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	More clarification is needed regarding the degrees of pain on a scale from 1-10 which might require opioids.<br/><br/>Countless people have suffered from being under-treated or not treated at all for severe post surgical and acute pain, and now the CDC is emphasizing that non-opioid therapy is even the preferred treatment for most acute pain. They need to emphasize that this doesn’t apply at all to severe acute or post surgical pain. Instead, the CDC recommends nob-opioid treatment for all and constantly emphasizes all the grave risks of opioid over prescribing. <br/><br/>There should be a warning emphasizing on every page of the guidelines that effective doses of opioids need to be made available for moderate to severe pain according to at least a 15 fold variance in patient needs which only treating physicians have the training to determine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485002f3b	Fimrite	None	2022-04-08T16:32:34Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-rzx8-ea3s	False	None	False	2022-04-12 06:39:08.839	[]
4159	CDC-2022-0024-4165	https://api.regulations.gov/v4/comments/CDC-2022-0024-4165	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mother took prescription opioids for 20+ years and was NEVER ADDICTED to this drug. She raised my brother and me alone as a disabled woman. She is a wonderful loving mother who without these FDA approved drugs would not have been able to function after her horrific car accident that left her permanently disabled and in excruciating pain. With the Opioids she was able to function and without them she has become home bound. For the last five years my mother has been able to get pain medication and she had been ridiculed by one doctor after another. She had been called a drug addict. Which she is most DEFINITELY NOT!! The CDC’s Guidelines have destroyed my mother’s life and destroyed our family. <br/>PLEASE ABOLISH THESE GUIDELINES AND ALLOW PAIN MEDICATION TO BE BETWEEN DOCTORS AND PATIENTS ONLY. <br/> Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Benjamin	None	None	090000648500304d	Karzai	None	2022-04-08T16:33:28Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Karzai , Benjamin	l1p-sywv-2jkr	False	None	False	2022-04-12 06:39:09.056	[]
4160	CDC-2022-0024-4166	https://api.regulations.gov/v4/comments/CDC-2022-0024-4166	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mom suffers daily because people chose to mis use prescriptions Sad	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicoke	None	None	090000648500306a	Ladesic	None	2022-04-08T16:34:22Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Ladesic, Nicoke	l1p-t2qd-484a	False	None	False	2022-04-12 06:39:09.278	[]
4161	CDC-2022-0024-4167	https://api.regulations.gov/v4/comments/CDC-2022-0024-4167	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Mvedical societies should set their own guidelines for their own specialties, and not rely on the generic advice of the CDC.<br/><br/>The American Medical Association and 14 other medical societies have released new advice for physicians managing surgical pain.<br/><br/>For patients on long-term opioid therapy, the medical societies urge physicians to continue their patioent’s baseline opioid dose and to provide additional, supplemental analgesia for acute pain after surgery. <br/><br/>Many hospitals are not following this advice. Instead they are misapplying CDC Guidelines and under medicating patients, or even not medicating them at all. Medical Boards continue to support these misapplications, so patients have nowhere to turn when their pain is neglected.<br/><br/>https://www.painnewsnetwork.org/stories/2022/3/10/15-medical-societies-release-new-advice-for-treating-surgery-pain-in-patients-already-on-opioids	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	090000648500308e	Fimrite	None	2022-04-08T16:35:46Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1p-t6y2-uar7	False	None	False	2022-04-12 06:39:09.502	[]
4162	CDC-2022-0024-4168	https://api.regulations.gov/v4/comments/CDC-2022-0024-4168	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had Spinal Adhesive Arachnoiditis for over 20 years now. It was caused by my surgeon during a low back surgery and it has caused me to have chronic, horrible, never ending pain, among many other things and has changed my life for the worst. I could go on and on about that but I won’t. What I want to say is that…I am upset and tired of, trying to find doctors who are willing to even prescribe opioids for my condition. They all refuse because they are afraid of the CDC, the FDA, of losing their jobs, of being sent to jail for prescribing opioids etc. I am upset and tired of the pharmacist telling me that my doctor is going to tell me I have to lower my 90MME per day of morphine, I am sick of the pharmacist telling me he won’t be able to fill my morphine and Percocet prescriptions beginning July 1 because I don’t have cancer pain and I am his only customer taking “that high amount of opioids without having cancer”, and he doesn’t want this to be a red flag to the regulators who might shut his business down if they, the regulators, find out he, the pharmacist is filling my prescriptions!!! This is exactly what my local pharmacist told me today. I have been taking 90 MME’s of morphine per day and 5-325 of Percocet 3-4 as needed per day for over 17 years now plus other prescriptions just to have a life and have never had one issue, have never increased my drugs, never taken anyone else’s drugs, never taken illegal drugs, don’t drink, have passed every single urine test and pill count my pain doctor has given me and yet for some reason I’m told that opioids lead to worse addictions. This is TOTAL BS! I had 2 full bottles of Oxytocin tablets in my house for over 20 years and I never used one of them! I realized at the beginning of my condition that these weren’t for me. I didn’t get addicted to them like everyone claimed to in their multi million dollar lawsuits, I didn’t sell or give the drugs away. I was just a bad housekeeper who didn’t feel good enough to worry about getting rid of them. Not everyone gets addicted from opioids. It is not true!! Especially when you need them for chronic pain! A chronic pain person does not get high on opioids either.<br/>I get upset when the CDC asks for comments and then the CDC doesn’t listen to everyone who presents their comments. I read over and over on reputable websites that Spinal Adhesive Arachnoiditis pain is considered to be as bad as metastatic cancer pain, it is progressive, and it can take 12 years off a person’s life, among many other things. If this is true, which I believe it is, then why doesn’t the CDC include this condition along with cancer, palliative care, and the other conditions that warrant strong opioids?? I also get upset that the CDC supposedly writes “guidelines”, but my pharmacist, my pain doctor, my family doctor and others never look at these as guidelines. They look at these guidelines as “laws to follow”, and then when we the patients ask for a medication increase, we immediately get an answer of NO! NO, can’t increase your opioids because the CDC says so. This is so frustrating. I also get upset every time I hear the word opioid overdoses are at an all time high, opioid overdoses are skyrocketing. For two reasons this infuriates me. In the state I live in, I just read on the CDC’s?? map that our state had 5 deaths per 100,000. I’m sorry but to me that isn’t a lot. But what makes me even more mad is that the government is lumping prescription pills with fentanyl, heroin, etc. but when people hear “opioid”, they immediately think it is morphine, Xanax, OxyContin, oxycodone, etc. or things you get at the pharmacy. I have friends that will say to me that the overdoses are all prescription drugs when the majority are not. <br/>I feel like the biggest thing the CDC could do is step back with some of this prescription oversight and focus should be placed more on the street drugs like fentanyl which is causing the most deaths. Give the doctors back their power so they aren’t afraid of being a doctor. Do some surveys on how many physicians, FNP’s, etc. used to prescribe opioids and how many no longer do?? The doctors and pharmacists know their patients. The government and the insurance companies do not know the individual patients!! Get out of the doctors offices. Are there patients who are druggies? Yes. But the majority aren’t and don’t punish the ones who aren’t. Soooo many of us need these opioids just to have a half normal life. Before my opioid regimen was finally figured out by my pain doctor and in place, I spent every day laying in bed, in horrible pain, depressed, with no hope for anything. I’m starting to feel this way again because my pain doctor practices in a town of approximately 45,000 and he’s the only one I know of who prescribes opioids. When he soon retires I am very scared and worried what is going to happen. I pray the CDC changes things.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristine	None	None	09000064850030b4	Sullivan	None	2022-04-08T16:39:49Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Sullivan, Kristine	l1p-tbdp-wn1y	False	None	False	2022-04-12 06:39:09.724	[]
4163	CDC-2022-0024-4169	https://api.regulations.gov/v4/comments/CDC-2022-0024-4169	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a intractable pain patient I live in severe pain every single minute of my day.<br/><br/>Before the cdc guidelines for opioids I was on a much higher dose that allowed me to not just survive but to live a rich full life. I was able to work, go to concerts travel pretty much anything I had done before I was injured in a MVA On 6/7/2000. <br/><br/>I've underwent 2 spinal fusions and as a result of that I've developed adhesive arachnoditis a extremely painful disease. <br/><br/>I've tried hard to understand why a 65 year old lady has to suffer because of others actions. <br/>I have great empathy for those fighting addiction but unlike me they can choose to be treated. <br/><br/>I never thought once in my entire life that the country I risked my life for would betray me like this country has. <br/><br/>In asking no I'm begging remove all guidelines and let Drs do their jobs. Let patients have some quality of life<br/><br/>I implore you please remove these horrible laws that have come from the cdc opioid guidelines. <br/><br/>The people dying today or those who are using not knowing that their drug of choice is laced with illicit. Leathel poison of non pharmaceutical fentynal pills. That's who the dea needs to go after the drug dealers not drs trying to live up to their oath. <br/><br/>Thank you for your time<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850032ca	Anonymous	None	2022-04-08T16:41:00Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-vev9-q5tl	False	None	False	2022-04-12 06:39:09.944	[]
4164	CDC-2022-0024-4170	https://api.regulations.gov/v4/comments/CDC-2022-0024-4170	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain sufferer. It is almost impossible for me to get my medication. I have been probably labeled as a drug seeker, however I always take my medication responsibly exactly as prescribed. It is an opioid pain medication. <br/><br/>Two years ago, my father had a dental bone graft and the surgeon absoluty refused to prescribe my elderly father any pain medication. He was told to take two Tylenol. It was horrible for me to watch him suffering, as a chronic pain sufferer myself I knew what he was going through. His graft got infected, he was given amoxicillin... Needless to say my father never went back to any doctor, he never completed his bone grafts and implants due to the fear of excruciating pain. <br/><br/>This needs to change! There is an epidemic of people suffering from chronic pain because doctors are not willing too treat their patients pain due to the current prescribing guidelines. <br/><br/>We want relief, please, not suffering!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	0900006485003381	Rossmann	None	2022-04-08T16:41:53Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Rossmann, Michelle	l1p-w8qd-9wc3	False	None	False	2022-04-12 06:39:10.188	[]
4165	CDC-2022-0024-4171	https://api.regulations.gov/v4/comments/CDC-2022-0024-4171	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC - I am begging you to give me back my life !! I am disabled spend most days home because my pain is overwhelming. I have osteoarthritis & spinal stenosis and ruptured disc's. I can't even walk my dog I live on the second floor of my condo. I can't walk up or down the stairs it's too painful. Not only has this effected my life physically I am very depressed ***. When I was taking pain medication ( hence pain medication) I was able to work, grocery shop, cook etc. I can't do anything for myself ..why don't you focus on the illicit drugs people are dying from that's the real problem. I'm currently looking for a pain management ( not to mention it's a huge challenge to get there because I'm in excruciating pain ) the first thing I am asked is to take a drug test ( I'm not a drug addict ) the humiliation and embarrassment makes me feel worthless .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	09000064850034b3	Ornstein	None	2022-04-08T16:46:56Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Ornstein, Donna	l1p-xkpj-299k	False	None	False	2022-04-12 06:39:10.402	[]
4166	CDC-2022-0024-4172	https://api.regulations.gov/v4/comments/CDC-2022-0024-4172	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines have been a complete and utter failure in protecting anyone from overdoses. The number of increasing and record overdoses since the adaptation of these in 2016 speaks for itself. These guidelines are however, responsible for much harm and suffering. I live in constant unrelenting pain due to spinal stenosis. KP will not prescribe narcotic medications to opioid naive patients under any circumstance. I refuse to be victimized and discarded by the medical establishment so I have to look for medications elsewhere. Moreover, As the supply of medications dwindles the rise of more potent and deadly illicit drugs is surging to fill in where there is a demand. The CDC Guidelines for prescribing CANNOT stop this from happening-EVER. That’s one of the reasons they have caused so much more harm than good. Also, these guidelines have destroyed the patient, doctor relationship and have made the medical establishment a place of untold pain and suffering. Leave medical care in the hands of doctors.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006485003c97	Chavez	None	2022-04-08T16:48:19Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Chavez, Maria	l1p-zc5v-1tku	False	None	False	2022-04-12 06:39:10.616	[]
4167	CDC-2022-0024-4173	https://api.regulations.gov/v4/comments/CDC-2022-0024-4173	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband and I are both chronic pain patients for over 20+ yrs. We have been dropped from pain management and took forever to find care due to the2016 guidelines. The harm we suffered was horrific and long lasting. My husband is having trouble working and cannot find pain management. <br/> Pain management needs to be flexible and considerate of each individual case. The morphine milligram equivalent is loosely based on flawed studies and even worse flawed science. Each person experiences pain differently and metabolizes medications differently. Putting each person into molds won’t work and is destined to fail. Who suffers then? The patient, families and friends suffer. <br/> Suicides are on the rise due to untreated and under treated pain. Using non opioid treatments as first line is the first step. Unfortunately requiring these non opioid treatments are unattainable for many due to insurance and costs. If I were to attend physical therapy 3x week I would pay $120.00 per week or $480 per month. If my husband needed message treatment he would not be able to because insurance won’t pay for it. So many people that have chronic pain cannot afford these opioid sparing modalities. <br/> The pain doctors are afraid to prescribe due to fear of governmental overreach and prosecution. These compassionate and caring doctors follow standards of care and fda parameters for prescribing medications for pain. Many pain doctors and family doctors have stopped prescribing still. Many physicians actually tell patients they have to utilize interventional and surgical treatments to continue receiving pain medication therapy. The FDA recently warned against many epidural injections for back pain. They can cause further neurological damage. Some patients are resorting to implanted electronic stimulators which have many problems and bad outcomes. When a patients has trouble with the spinal stimulators sometimes the insurance companies refuse to cover for removal of said devices. Patients can go for years while navigating the insurance companies grievance processes. <br/> I belong to a non-profit group that are advocating for end of life care, veterans, cancer patients and children with incurable diseases and injuries. Children who are loved by their parents and ony ask for freedom from pain. The many hospitals have adopted non opioid guidelines no matter what conditions warrant care. . <br/> Healthcare for chronic pain patients is difficult for so many. I was turned away from palliative care because I need pain medications to sit up at the very leadt. This is discrimination against me for my disability. I reported this to my state Attorneys office. The reply was “We cannot help you”. <br/> Please remove any mention of morphine milligram equivalent from the proposed guidelines. Stay out of the physician/patient relationship. <br/> The overdoses crisis is due to illicit fentanyl and other drugs not prescription opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mrs	None	None	0900006485003cf5	Anonymous	None	2022-04-08T17:00:34Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous , Mrs	l1p-zqv1-h4wb	False	None	False	2022-04-12 06:39:10.840	[]
4168	CDC-2022-0024-4174	https://api.regulations.gov/v4/comments/CDC-2022-0024-4174	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	MLS Laser struck me as a perfect addition to my practice as soon as I verified the research in 2015. A light with no heat emitted makes it seem like a ruse. However, I have patient after patient who could bring positive reviews of impressive pain relief. Shoulders, elbows, wrists, hands, backs, knees, shins, ankles, feet. All pain resolved or greatly improved. I receive acute injuries from multiple high school athletes, and MLS laser has greatly sped their recovery. High ankle sprains typically take 4-12 weeks to improve. I have had three athletes back in play in 1-2 weeks with MLS laser with this same injury. I have undercharged the value MLS laser provides my patients since I began using it because I care about people. The pharmaceutical industry does not share my views of helping people. They want stability. Not resolution. It is criminal to not fully endorse MLS laser for pain relief over harmful and dangerous pharmaceuticals.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Justin	None	None	0900006485003d17	Amaro	None	2022-04-08T17:05:36Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Amaro, Justin	l1q-01ah-zsd1	False	None	False	2022-04-12 06:39:11.062	[]
4169	CDC-2022-0024-4175	https://api.regulations.gov/v4/comments/CDC-2022-0024-4175	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The statement of 90mme being a limit in the 2016 guidelines have led to horrendous needless suffering abuse of patients at the hands of doctors and death from suicide and heart attacks and stroke due to ongoing untreated or undertreated severe pain. You must remove the 50mme statement from the proposed revised guidelines as it clearly will cause even more pain amounng the chronicly I'll. As we saw with a 2016 guidelines your intention was disregarded and the number was used as a finite limit and made law in several states. Any stated amount should be exempt from any stated limits .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006485003efd	Ellis	None	2022-04-08T17:06:11Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Ellis, Jennifer	l1q-282j-1u61	False	None	False	2022-04-12 06:39:11.278	[]
4170	CDC-2022-0024-4176	https://api.regulations.gov/v4/comments/CDC-2022-0024-4176	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC Guidelines were initiated to address the opioid epidemic but in fact were created to fast track opioid litigation and make money for greedy politicians and physicians. It is imperative that the practice of individualized medicine where doctor patient relationships are built on a collaborative relationship which encompasses active listening, removes biasing and generalization of all patients who need opioid therapy for overall quality of life, lies, lack of evidence based medicine be enforced. <br/>s<br/>These guidelines which quotes "This clinical practice guideline is voluntary; it provides recommendations and does not require mandatory compliance" has absolutely been misconstrued and has harmed not only the patients but the physicians that care for their patients. This has been taken to the "letter of the law" so to say, thousand's of healthcare facility post their opioids free hospitals, clinics etc based on their "adhering or following CDC guidelines. Patient are labeled, penalized, financially devastated with monthly pain management visits upwards of $200 dollars a visit with monthly punitive drug tests. They are not being managed by their primary providers which has caused a great deal of medical gaslighting from their providers to the patients and medical PTSD, trauma, suicide and deaths from the patients. To do no harm is not evident and the push for these non FDA treatments such as drill mills, with holding pain medications if patients do not want these painful, harmful injections, nerve ablations or spinal stimulators These are absurd and again financially devastating patients.<br/><br/>The last thing is the actual lack of medications that the DEA/CDC have forced drug companies to discontinue that were effective. For example Zohydro/long acting Hydrocodone is no longer made. Long active Oxycodone is being forced on people and it is very, very expensive. Patients cannot afford or sustain these high cost prescriptions that do not in all actually cost $500 plus dollars to make 60 pills. <br/><br/>anonymous for fear of being hunted down by the DEA made a criminal for wanting a quality of life that I can participate in physically, functionally. For not wanting to become a suicide statistic or disabled statistic. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	anonymous	None	None	0900006485003f32	anonymous	None	2022-04-08T17:07:46Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from anonymous , anonymous	l1q-2eub-qbsw	False	None	False	2022-04-12 06:39:11.496	[]
4171	CDC-2022-0024-4177	https://api.regulations.gov/v4/comments/CDC-2022-0024-4177	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No. CDC-2022-0024,<br/>I'm a multi disease intractable pain pt. I'm not special or different from 100M chronic pain pts, but I'm awake again for the 400th night in a row due to the fire in my leg & foot which is now starting to radiate to my left arm. This was either from a twisted ankle during hurricane prep a few yrs ago, or my many dis states, post chemo & radiation treatments, take your pick. I am dying. I began taking oxycodone 15 mgs in 2012, 4 tabs a day just b4 I moved to a smaller town north of the city I grew up in. My rheumatologist dxd me with sjogrens syndrome in 2017, fibromyalgia dxd in the 80s, neuropathic pain, CRPS dxd by neurologist, post shingles neuralgia (I get shingles every few mo due to a compromised immune system) try living with that 5 or more times a yr) valacyclovir has destroyed my already diseased liver, NAFLD, my kidneys r failing & loads of Advil probaby helped that along, I cant move out of state to live with my children w/an 80 yo husband whose got prostate ca, atage t3c teetering on stage 4, I have breast cancer (we were born xmas eve & day, & dxd with cancer 6 mo apart in 2006, just a side note). I also have psoriatic arthritis & RA every JOINT SCREAMS. He's 80, cant get more than advil for his pain, Dr is afraid to rx, Celebrex raises his BP too high. His spine is so riddled with arthritis, hard to tell metastatic dis from that, so he takes advil 800 mgs a day & will probably die from that b4 the cancer kills him. We also take anxiety benzodiazapine, me for FORTY YEARS for panic atx & cancer sure helps give u thos, my husband since his cancer dx. Now the pharmacist doent feel comfortable rx the xanax w/o a monthly consult with the dr who is livid! Same dose for 40 yrs, PRN. Mostly im blessed thats under control until the govt decides otherwise. Why do we have to live like this?. We r upset & rightfully so that we are 65 & 80, & cant get a few 100 pain pills a mo to manage our pain. Also we never take 1 more pill thab prescribed, we go by the book. We r pain hostages to our bodies, to the govt & to the Drs & pharmacies. Drs fear their licenses more than they want to help us have any QOL & moving to our children? That's just a dream that i wont live to see. I havent seen my son or his new twins, its been almost 3 yrs. Weve never been apart in our whole lives & its the CDC GDLNS TURNED LAW thats keeping us apart. Criminals & drug cartels run this country into the ground & who suffers? We do!. No Dr in the new state will take us on bcuz they're licenses due to DEA & govt overreach prevents them from helping us, & those like us.*. I don't want to sit in this chair 20 hrs a day. I went from 30 yrs advanced yoga to bed bound during the pandemic due to under treated pain. I simply can't go on, I'm weak & recently possibly have hypogammaglobulinemia (waiting for blood tests) which means probably underlying cancer somewhere else. Bcuz of the 2016 & new gdln the oncologist won't rx if I get cancer again either, he's too scared. My friend has metastatic bc & lung ca & she gets 3 10mg Norco. Is that cruel? Is it ultra cruel her pharmacist makes her wait until day 30 to fill it. She can barely walk. How many more vets or chronic pain pts will commit suicide in 2022? This guideline if not rescinded or the cdc keeps taking our comments down, wont help bcuz it already suggests that 50MME is better than 90, 90 is too little, & every BODY is different & it should be left up to DRS to decide, not the cdc. even a certain PROP MEMBER RECENTLY ADMITTED THIS but whose checking? We can't mention that. 100k++ dead from illicit street drugs & now comes the new updated cdc gdln meant to HARM not help. 50mme already implemented by pain drs as LAW. Why is the federal government in our drs ofcs? The drug policy in the US is the worst in the free world. Pls rescind this new version. It won't help anyone. Stop allowing states to sue drug cos, pharmacies to funnel money to unregulated rehabs that end up in the pockets of the owners, the drug adx have a high turnaround that have a revolving door, the drug they push suboxone isn't for pain, it's for adx. We r not addicts, we DEPEND on these meds to have a tiny semblance of life. Stop allowing the states to steal money from legitimately run businesses & stop letting so called orgs like PROP push drugs like suboxone for profit. Their non expert non study backed research has landed us here & 6 yrs later we r worse off, not better. Prescribing down 40%, OD DEATHS UP 1000%. SOMETHING IS GRAVELY WRONG. I'm just a pt in pain. I speak for 100M of us. Please do better. Get qualified research, ask US what we need & help the drug abusers separately. We have no adx. Addiction is in less than 5%, there r actual legitimate studies to back this. Help us. *. Tysm for reading this. It's 3am & another night of despair & pain. I feel none of u have experienced this pain, or we would not be here today.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485003f74	Anonymous	None	2022-04-08T17:13:49Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-2sxt-vh5w	False	None	False	2022-04-12 06:39:11.714	[]
4172	CDC-2022-0024-4178	https://api.regulations.gov/v4/comments/CDC-2022-0024-4178	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please loosen the drs ability to prescribe with out fear of loosing their license. Legitimate pain patients with long term disease are being dismissed and looked at as drug seekers. The 50 mme is not enough for some. Many have tried all other drugs and physical therapy and still are in bed crying everyday. Lost jobs, ability to do laundry or cook. Please help the Legitimate pain patients not be scrutinized as they are. Leaving the hospital in pain from surgery with no pain medication is inhumane. <br/>I went home from a heart attack with extreme anxiety and could not get a prescription for lorazapam. I was so upset and afraid. That is what the medication is for. I had no follow-up with cardiologist as too busy and they change the appointment. Who leave the hospital after a Stent and can't get a follow-up for 4 months! There are not enough pain clinics, not enough primary doctors. Pain patients wait and cry for a year to get diagnosed, tests and relief. <br/>Please..the illegal street drugs are killing people. Stop the fentanal. Give rx to those who take responsibly.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dianna	None	None	09000064850035a3	West	None	2022-04-08T17:17:26Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from West, Dianna	l1q-5gq8-dr3q	False	None	False	2022-04-12 06:39:11.946	[]
4173	CDC-2022-0024-4179	https://api.regulations.gov/v4/comments/CDC-2022-0024-4179	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to take a step back and take the time to realize the harm they are doing to chronic pain patients and the public in general. The CDC continues to make decisions based on faulty information. The opioid crisis is a street drug problem and the guidelines the CDC continue to put forward are NOT stopping overdose deaths, in fact they continue to rise. Our tax dollars would be better spent going after drug dealers who push illegal drugs. You are punishing the wrong people and causing undo pain and suffering to people who struggle daily to have any quality of life. Expecting someone who just had surgery to control pain with NSAIDs or Tylenol is ludicrous! I personally had a surgery where I was denied pain medications after and as a result refuse to have anymore surgeries. I am also a chronic pain patient and know how if feels to lie in bed for days trying to control pain with heat, ice, NSAIDs and/or Tylenol, using a tens unit and still crying because the pain is so bad. I’ve done physical therapy, taken the shots and don’t get me started on the horrors of those injections! Some of us just don’t tolerate steroids of any kind. It is insane and inhumane to make people suffer based on a false narrative!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	09000064850035c1	Bishop	None	2022-04-08T17:20:27Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Bishop, Debbie	l1q-6nrx-hlch	False	None	False	2022-04-12 06:39:12.191	[]
4174	CDC-2022-0024-4180	https://api.regulations.gov/v4/comments/CDC-2022-0024-4180	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a intractable chronic chronic pain patient of 21 years with multiple chronic chronic conditions I am also a patient that has been severely harmed do to forcibly tapered down to the CDC “2016 Supposedly guidelines suggestion” put out by the cdc. Since the beginning of 2016 my pain specialist just decided the care I had received for 21 years was maraculously know a danger to me that I could become addicted. In all the years I have suffered declined and became sicker with more problems. The CDC used there own bias when having these original guidelines written and implemented. The physicians they listened to were all anti opiate physicians. The federal government gave the same physician 2 million of or tax dollars to write multiple articles to do there own bias studies to make the quidelines they they had same doctors who wrote these guidelines.just in the knowledge of knowing these two facts is justification for CDC to be investigated.instead the CDC is again allowed to commit serious harm to 100 million chronic patients and acute patients with writing another seriously flawed chronic pain guideline. Over six years the medical society has heard of patients harmed patients committing suicide patients being forced into tapering there life saving opiate medications.the CDC has known the FDA has known all along way before the guidelines were made that the illegal drug cartels were infiltrating the US with fentanyl laced pills way back in 2015 but did nothing to stop them. This crisis was caused by the cartels and government policies all for money. The CDC implemented the original guidelines and did nothing to document the serious harms that legitimate patients were having. No data at all. This is 2022 not 1500’s the CDC did nothing while millions of sick chronically I’ll patients wrote called told doctors told legislators told the world. I want to know how it is legal for a government agency of the U S has no oversight in this matter. You are a division of HHS who 2019 wrote best practice quidlines that after all our patients wrote and tried to get implemented but they just disappeared. How and who is reasonable for allowing the CDC with all the facts known in 2016 chronic pain guidelines to allow the CDC to rewrite another devastating blow to the chronic pain patients again. After all the harm after all the deaths all the physicians you destroyed allowed any part in writing updated guidelines. You know after six years of hearing from patients you have severely harmed are trying to implement 50mm this is mind boggling. You had an outside team reviewed your guidelines that told the CDC the guidelines will severely harm even more patients and you overrode them and still are adding 50 mm the CDC must take out any mention of mme or more patients will die. I hope someone has the power to investigate this whole CDC guideline disastrous guidelines. Please listen to your patients do no more harm	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485003605	Anonymous	None	2022-04-08T17:23:29Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-8dom-sdtd	False	None	False	2022-04-12 06:39:12.405	[]
4175	CDC-2022-0024-4181	https://api.regulations.gov/v4/comments/CDC-2022-0024-4181	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 54 year old with degenerative disc disease,spinal fusion,spinal stenosis ,curvature of the spine and bone spurs in neck and lower back. I have attempted to manage my chronic pain with every regimen available from the medical industry since age 15. Opioids are the only thing that allows me to manage my chronic pain and have a quality of life. Due to living in a rural area I have to travel 80 miles to find a Dr willing to write opioid prescription and 60 miles to a pharmacy willing to carry the opioid medication. I am willing to do this because opioids are only medication that allows me to manage my chronic pain and maintain a quality of life. <br/>I was very close to a well known business owner who lost his pain management Dr and unable to find one willing to write opioid prescription for his chronic pain. The man turned to alcohol and other things from the street attempting to manage his chronic pain. That man was a productive member of society and is now deceased. <br/>Thank you for allowing me to leave a comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850036c6	Anonymous	None	2022-04-08T17:24:23Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-bagi-d7dh	False	None	False	2022-04-12 06:39:12.627	[]
4176	CDC-2022-0024-4182	https://api.regulations.gov/v4/comments/CDC-2022-0024-4182	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove the CDC guidelines. The harm to legacy pain patients because of this guideline is the worst humanitarian crisis of the 21st century. ADA violations, WHO violations, and civil rights violations. Doctors are already telling patients by end of April we will reduce you to 50 MME. This insanity needs to stop! The FDA has guidelines for opiates there is no need for the CDC to be involved. Congress needs to do an oversite hearing! The chance of addicting is low <1%, if and when we become addicted, well come see an addiction specialist. Until then, our specialists are pain management and rare and painfully disease specialists. Stop “opiate addiction” then stop the illicit drug poisoning crisis. DEA do your job and leave prescribers alone unless truly criminal behaviors are noted. There is a big disconnect between DEA, CDC, FDA, Insurance companies and Medical Boards. Please fix it!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	09000064850037e3	Tuthill	None	2022-04-08T17:25:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Tuthill, Karen	l1q-e2hn-duhw	False	None	False	2022-04-12 06:39:12.840	[]
4177	CDC-2022-0024-4183	https://api.regulations.gov/v4/comments/CDC-2022-0024-4183	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to live my life! The pain I now endure makes it nearly impossible. In 2013 I began to feel the pain that w later diagnosed as spinal stenosis. By the summer of 2014 the pain from the spinal stenosis had become so severe I was prescribed the low dose of 5mg. of Oxycodone. I remained on this dose for 6 years without needing to increase. It helped me to carry on a close to normal lifestyle: normal tasks, grocery shopping, laundry, exercise including walking, going out with friends, concerts, etc. As my doctor discontinued the Oxycodone by February 2021, all of the above activities have been taken away. My pain care doctor has tried about a dozen there pain meds for me. All had side effects for me from vomiting, diarrhea, excessive swelling, constant nausea, dizziness, and I had to be hospitalized twice in one month from trying new pain medications. Being a type I diabetic, I have exercised all my life through when I was still taking the Oxycodone. Now I am currently taking a pain med that does little to control the pain. Therefore when I try to exercise it results in so much pain. I need the exercise for my diabetes and blood sugars and for my body to feel better but the pain is so restricting. At this point in my life my days consist of constant severe pain. I only leave the house to go to doctor's appointments. I cannot do any of the things I enjoyed or the places I used to go. I feel like a shut-in! I find myself hoping that I will fall asleep at night and not wake up in the morning. I am a person who loved my life as it was before this pain made it so intolerable. Please change your guidelines to allow usage by those who benefit and don't abuse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006485002086	Bostad_Etzweiler	None	2022-04-08T17:54:28Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Bostad_Etzweiler, Robin	l1p-l4pc-u9ds	False	None	False	2022-04-12 06:39:13.064	[]
4178	CDC-2022-0024-4184	https://api.regulations.gov/v4/comments/CDC-2022-0024-4184	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	UR G.L. ARE BAD SCIENCE. HOW DOES THE CDC GET BY WITH BAD SCIENCE UR G.L ARE CRUEL IF U DONT UNDERSTAND CRUEL. ITS WILLFULLY CAUSING PAIN OR SUFFERING. DROP THE MME IF U DONT U WILL BE RESPONSIBLE FOR THOUSANDS OF SUICIDES. SO PLEASE DROP ALL MMES.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485000fe5	Anonymous	None	2022-04-08T17:54:43Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-mlgr-kgk4	False	None	False	2022-04-12 06:39:13.293	[]
4179	CDC-2022-0024-4185	https://api.regulations.gov/v4/comments/CDC-2022-0024-4185	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffd97d	None	None	2022-04-08T17:59:35Z	U.S. Pain Foundation	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from U.S. Pain Foundation	l1o-diem-0waa	False	None	False	2022-04-12 06:39:13.513	[]
4180	CDC-2022-0024-4186	https://api.regulations.gov/v4/comments/CDC-2022-0024-4186	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	one of the authors has made a statement 'let them die out ' is this the kind of person that needs to be apart of the new drafted guidelines ? we are humans nothing or no person needs to die .it would be in everyones best intresest if the WHO Analgesic Ladder that doctors was taught in medical school to measure opioids for safe effective care of chronic pain patients .17 years of living in pain come October . my doctor retired but assure you he took care of me at a time when they could call in my meds like 4 or 5 times ,his nurse told after the 5 th call in i would need to come in to office the DEA is starting to crackdown on regulations ,now this was in 2005 ,now i go every month ,take a pea test like im on probation for being a criminal ,lord save us ,these guideliness suggest stay at 50 mme .well i hope not ,i will leave a note to my family to sue for medical malpractice and end my life due to the CDC guidelines that has not fixed uprising in overdose deaths in this country it gets worse year after year ,but if the mme is applied i give up ,let the doctors be the doctors that treat pain .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485003d62	Anonymous	None	2022-04-08T18:02:52Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-zzo0-e209	False	None	False	2022-04-12 06:39:13.729	[]
4181	CDC-2022-0024-4187	https://api.regulations.gov/v4/comments/CDC-2022-0024-4187	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thanks to the 2016 guidelines published by the CDC I am now headed to a wheelchair for the rest of my life. I’ve been on opioids long term for degenerative disc disease and failed back syndrome. Due to the 2016 guidelines, the CDC and DEA have put the fear of God in these providers for helping patients control their pain and to have some quality of life. It’s impossible to find a physician willing to prescribe the medication that actually works but instead forces physicians to do other procedures instead of being allowed to treat their patients as needed when it comes to pain. The guidelines forced my MD to cut my pain medications in half and then when the pain was intolerable i was forced to undergo numerous epidural steroid injections to justify the need for me to be allowed to have opioids to control the pain. Thanks to the injections I now have severe Adhesive Arachnoiditis, which is called the suicide disease because of the relentless pain it causes. My spinal cord is now cinched off in 3 places due to the injections. The progression of this disease will eventually paralyze me from the waist down. It has caused the nerves to be clumped together and now it’s affecting my bladder and kidneys due to the nerve damage caused by the Arachnoiditis, which in turn was forced upon me because the CDC ‘guidelines’ which destroyed my quality of life. Adhesive Arachnoiditis is just one of two diseases that the Social Security Administration sees as automatic approval for permanent disability. I was forced to find a pain management doctor as my PCP or any other of my physicians wouldn’t prescribe the amount of opioids I need to have a minimal quality of life. I have found ONE provider that is compassionate, helpful and understanding the level of pain I have daily. However, thanks to the CDC and DEA and the false 2016 guidelines, I am treated as a drug dealer. In order to receive my monthly medications. I’m required to have a drug test every 30 days so they can make sure I’m actually taking the drugs they’re prescribing and nothing else. I have an appointment every 30 days and must do all this in order to receive my prescription. Currently, after every pain management appointment, I must try and find a pharmacy in town that has my medications in stock and willing to fill the prescriptions. Due to CDC/DEA controlling the amount of opioids produced, its now a challenge to find my medications. I live in a city with half a million people, and still making 5-6 phone calls to various pharmacies every month to find my life saving medications. Would this happen with blood pressure medications or heart medications?<br/>NO it doesn’t, yet I’m bed ridden without any opioids when I had some quality of life when I’m allowed them. The CDCs general guideline of 90 MME which they’re trying to reduce to 50 MMEs is ridiculous and takes the physician away from actually helping their patient. No bureaucratic entity should be telling MY doctor how to treat me when they know nothing of the situation. The opioid crisis is caused by illicit fentanyl but yet the CDC portrays it as chronic pain patients are driving the crisis when that is the farthest thing from the truth!! The government does not belong in my doctors office. The fear of the DEA by these physicians is unnecessary and despicable. Why do I have to jump thru all these hoops forced upon me by the government because the CDC wants to regulate further, prescribed medications? The facade that the CDC is there to protect citizens from harm but the CDC and DEA are the ones causing the crisis with false information and unnecessary regulations. Apparently, these government agencies don’t care if pain patients are treated inhumanely due to the ‘experts’ that are driving the false narrative. Let the doctors prescribe as they are the ones with the degree and above all do no harm. Please stop the ‘regulations’ that are causing unneeded pain and suffering by chronic pain patients and the hundreds if not thousands who have committed suicide due to uncontrollable pain, the medications exists to help patients, why cause more human suffering, it’s that simple. Regulations aren’t necessary and let the physicians do their job. Simple solution.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	090000648500384d	Stidham	None	2022-04-08T18:03:40Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Stidham , Cynthia	l1q-evct-3866	False	None	False	2022-04-12 06:39:13.947	[]
4182	CDC-2022-0024-4188	https://api.regulations.gov/v4/comments/CDC-2022-0024-4188	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am just curious as to when pain was removed from the vital signs. When did addicts who abuse drugs, legal obtained or illegally become more important then law abiding citizens with painful diagnosis? What happened to compassion? What happened to the doctor patient relationship? When you are in daily pain and reach out to the medical community for help, only to be ostracized, what do you expect us to do? There should be no MME, no criminalizing of disabled people by forcing UAs etc. We are American citizens who have jumped through all your hoops just to get the minimum amount of pain relief in our already hard loves.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Monica	None	None	09000064850038be	Mo	None	2022-04-08T18:04:00Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Mo, Monica	l1q-fd59-ibc9	False	None	False	2022-04-12 06:39:14.199	[]
4183	CDC-2022-0024-4189	https://api.regulations.gov/v4/comments/CDC-2022-0024-4189	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient under the care of a pain management doctor. The 2022 changes are good but they don't go far enough. The CDC 2016 changes have impacted those who have help with legitimate chronic pain whi are being treated by pain doctors. Many patients have been totally cut off in getting help because of the 2016 regs. Many pain doctors are afraid to give prescriptions for pain and many have retired from handling pain management. These regs are unfair to patients who use only prescribed opioids and follow strictly to the doctor's instructions. These regs have unfairly put us into the same category as drug users who are hooked on illegal street drugs that they don't use for a legitimate pain condition. Changes need to be made to help those of us who have chronic pain from health conditions. Please have some compassion for us and help all patients who live with pain everyday to have access to opioids to give us a better quality of life!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shirley	None	None	09000064850045b4	Wade	None	2022-04-08T18:04:15Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Wade, Shirley	l1q-gpn8-kz3d	False	None	False	2022-04-12 06:39:14.416	[]
4184	CDC-2022-0024-4190	https://api.regulations.gov/v4/comments/CDC-2022-0024-4190	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain patients are suffering. These changes help but they need to remove any reference to specific MME dosages as local governments and agencies have shown a willingness to distort intent and to latch on to any fixed dosage guidelines and twist it into a hard limit.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Guy	None	None	09000064850045d2	Damrosch	None	2022-04-08T18:04:27Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Damrosch, Guy	l1q-gv7k-5yak	False	None	False	2022-04-12 06:39:14.818	[]
4185	CDC-2022-0024-4191	https://api.regulations.gov/v4/comments/CDC-2022-0024-4191	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic (though only occasional) sufferer of pain that can only effectively be lessened by a small dose of an opioid, I welcome these revisions and urge you to publish revised guidelines soon. It is scandalous that the original guidelines were drafted with so little input from experts on pain management! <br/><br/>While addiction is a serious concern, I'm afraid that the previous guidelines went way overboard, creating something of a witch hunt atmosphere for both people needing this form of pain relief and the doctors willing to prescribe this necessary relief. Many states, including mine, turned the guidelines into too-strict rules regarding dosages, duration of use, and surveillance. Many doctors, upon hearing that I only found relief from an occasional (less than once a week) small (2.5mg) dose, treated me with suspicion assuming, in spite of this very limited use, that I was an addict seeking a "high." One even suggested that my symptoms were due to opioid "withdrawal." I was fortunate enough to find a doctor who took my concerns seriously; I know that other pain sufferers have been less lucky. Some have committed suicide.<br/><br/>Revisions of the guidelines in light of the needs of pain sufferers is long overdue. Please publish revised guidelines ASAP.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	09000064850045f7	Nelson	None	2022-04-08T18:05:29Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Nelson, Julie	l1q-h4tz-w1em	False	None	False	2022-04-12 06:39:15.027	[]
4186	CDC-2022-0024-4192	https://api.regulations.gov/v4/comments/CDC-2022-0024-4192	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/><br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/><br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe, and have extensive clinical and cost-effectiveness data.<br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of [name redacted]’s own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/><br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. <br/><br/>Sincerely,<br/>[name redacted] MD<br/>Board Certified Anesthesiologist and Pain Medicine Physician<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Samuel	None	None	090000648500461c	Luebbert	None	2022-04-08T18:07:18Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Luebbert, Samuel	l1q-h8vi-tw8h	False	None	False	2022-04-12 06:39:15.241	[]
4187	CDC-2022-0024-4193	https://api.regulations.gov/v4/comments/CDC-2022-0024-4193	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<span style='padding-left: 30px'></span>Docket number 2022-0024<br/><br/>I'm a chronic pain patient. The CDC guidelines tell physicians to use the lowest "EFFECTIVE" dose. This isn't happening. Pain is subjective, but it's not being heard. Doctors are terrified because the 2016 CDC guidelines were weaponized, taken by legislators and written into laws. The CDC was wrong about their data, used unscientific MME, and uses IDEOLOGY AND STIGMA! The CDC guidelines both old and new fail to mention the benefits of opioids for pain relief, function and quality of life. It all biased. And it's easy to sit back and judge others when you yourself don't suffer from some incurable painful condition or diease! And that's exactly what is going on here. Not to mention all the $$$$$ from litigation. I have been a chronic pain patient since 2007. The CDC guidelines weren't meant to affect me. But I was forced tapered down to 1/4 the dose of my pain medication. I have been suffering every since. I used to have a life with adequate pain relief medication, but I have been homebound since the CDC 2016 opioid prescribing guidelines came out. I have suicide ideation due to the endless suffering I go through 24/7. I was injured during spinal surgery. That alone cost me my career in the health care industry and it cost me any chance of ever having children. But now since the CDC decided to regulate medications and dictate the "PRACTICE" of medicine. I can't get adequate pain relief. I'm not recieving the "lowest EFFECTIVE dose"! My blood pressure has shot up. I'm only 50 years old. I have been dealing with chronic pain since 2007. I never once experienced stigma until I myself became a chronic pain patient. I had a physician call me a drug addict. He didn't even bother to do any assessment on me. I never felt so humiliated and all alone in my entire life. I was seeking medical help. I suffered injuries and stigma got in the way of me receiving the appropriate medical attention I truly needed. Now because of the stigma getting in the way, I have permanent damage to my body. I'm in pain 24/7, day after day. I'm an intractable pain patient. I know that physicians can't face any legal problems treating an intractable pain patient. But that was before the CDC decided to dictate the practice of medicine. HOW DID PROP BECOME THE EXPERTS? THEY DON'T TREAT PAIN PATIENTS HOW DID [name redacted] become an expert witness and make $500,000.00 to testify against Johnson and Johnson? I would choose suicide over street drugs to end my inhumane and cruel pain and suffering. I can't access legal EFFECTIVE opioids for pain relief, functioning and so I can have a better quality of life. I'm not alone, there are millions of people who are suffering inhumanely and cruelly because they can't access legal opioids for pain relief, functioning, and a better quality of life. No where in the guidelines does it talk about the benefits of opioids. It's all anti-opioid biased IDEOLOGY and unscientific! I used to trust the CDC. But I don't anymore. This is governmental overreach! Not based on SCIENCE. Even your data is wrong. I may not be around, but I can't wait till the day comes that the CDC, and PROP has to answer for its crimes against humanity. The treatment of pain is a basic human right! My regards.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	090000648500473a	Dawn	None	2022-04-08T18:09:07Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Dawn, Kim	l1q-huva-ic8u	False	None	False	2022-04-12 06:39:15.472	[]
4188	CDC-2022-0024-4194	https://api.regulations.gov/v4/comments/CDC-2022-0024-4194	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ff86e3	None	None	2022-04-08T18:28:42Z	American Association of Neurological Surgeons/Congress of Neurological Surgeons	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from American Association of Neurological Surgeons/Congress of Neurological Surgeons	l1l-4kra-l7ks	False	None	False	2022-04-12 06:39:15.679	[]
4189	CDC-2022-0024-4195	https://api.regulations.gov/v4/comments/CDC-2022-0024-4195	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a way of brief introduction, I am the CEO of National Spine & Pain Centers (NSPC), comprised of >120 US board-certified physicians dedicated solely to offering cost-effective, high quality outcomes. We are currently operating in over 110 locations across 13 states. I am a double-board certified physician whose 20+ year career in interventional pain management began treating US Army active-duty service members and their military dependents. Interventional pain management (IPM) as a specialty is dedicated to offering effective image-guided minimally-invasive pain management diagnostic & treatment alternatives to often unnecessary open surgical procedures and to less specific higher risk longer-term opiate dependency.<br/> <br/>As follow-up to President [name redacted]'s State of the Union Address, the tragic and unnecessary opioid overdose death rate has been singled out as one of the four critical challenges we must address as a nation. [name redacted] NSPC CMO is world-renowned in the interventional pain management field. He is the past founder of the Johns Hopkins Pain Department, leads the World Institute of Pain, participated in the original CDC Opiate Prescribing Guidelines, served on Governor [name redacted]’s past White House Task Force regarding the opiate overdose crisis, and most recently played a contributing role in the 2019 HHS bipartisan Pain Management Best Practices Inter-Agency Task Force Report, which advocated for a wholistic approach to chronic pain patients that includes ALL five modalities of Complimentary Medicine, Restorative therapies, Non-opioid pharmacotherapy, Opioids and Interventional Pain Management (see attached). Our specialty is similar to the field of Interventional cardiology that offers both diagnostic and therapeutic options to optimize outcomes and minimize more expensive open cardiothoracic surgeries whenever possible,<br/> <br/>Currently, board-certified pain specialists are often not involved early in the diagnostic and treatment pathway which can lead to unnecessary expense and suboptimal patient outcomes (see The Case for Early Interventional Pain Management (practicalpainmanagement.com) . The government’s position in the newly proposed 2022 CDC Opioid Guidelines, which all but ignored input from the Opioid Work Group (OWG), is also inconsistent with what should be our shared goal of minimizing opiate utilization whenever possible, but for use in safe and effective management settings whenever necessary. To make matters worse, this past year saw the introduction of several increasingly more restrictive LCD policies regarding several well-established cost-effective IPM procedures with a documented track record of quality outcomes as highlighted in the HHS Pain Management Best Practice Guidelines. The very manual which should act as a strategic roadmap to offering chronic pain patients effective & viable treatment alternatives to improved pain control and maximized function is seemingly not being used to make policy adjustments. Finally, there has been a troubling escalation of regulatory audits and chart review inquiries by both governmental agencies, and those commissioned by the government as independent agencies who are incentivized to find any discrepancy and recovery dollars at all cost.<br/> <br/>In the end, this approach seems at odds with a shared goal of avoiding opiates whenever possible, but minimizing the dose in a safe clinically controlled environment whenever necessary. With less than 9,000 board-certified IPM physicians in practice, these undue restrictions & inquiries restricts our ability to provide adequate patient access and to deliver cohesive, coordinated, quality care. Interventional pain management, as pointed out by the HHS Task Force Report, offers effective & viable treatment alternatives to just living in chronic pain. In the interest of public health & safety, all vested partied must agree on and adopt well-researched evidence-based pain interventional therapies, which can play a much larger role in effective pain management with the underlying goal of reducing longer-term opioid related harms in the longer term.<br/> <br/>I thank you for your consideration	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500474f	None	None	2022-04-08T18:30:16Z	National Spine & Pain Centers	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from National Spine & Pain Centers	l1q-hmg4-l8qq	False	None	False	2022-04-12 06:39:15.898	[]
4190	CDC-2022-0024-4196	https://api.regulations.gov/v4/comments/CDC-2022-0024-4196	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attachment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paula	None	None	0900006484ff8702	Berzanski	None	2022-04-08T18:30:35Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Berzanski, Paula	l1l-52y0-2w48	False	None	False	2022-04-12 06:39:16.112	[]
4191	CDC-2022-0024-4197	https://api.regulations.gov/v4/comments/CDC-2022-0024-4197	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See Attachment	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leah	None	None	0900006484ff8dc7	LoneBear	None	2022-04-08T18:33:13Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from LoneBear, Leah	l1l-cyfh-kxq9	False	None	False	2022-04-12 06:39:16.318	[]
4192	CDC-2022-0024-4198	https://api.regulations.gov/v4/comments/CDC-2022-0024-4198	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have read both the 2016 guidelines and this proposed guidelines, and it appears that the research on these proposed guidelines come from on Doctor, if I but his name you redact it in over 100 comments I have looked over. I am not sure why your refusing to disclose this info, the info is on the proposal, but what should be expected from a agency that pushed the original guidelines though with no public comment period, and is tasked with contagious and infectious diseases that when an actual thing in their charter came about they punt it to national allergy. You admit in the first part that the guidelines were misapplied but later your since we went this far lets go lower what the heck. Your are causing grievous injury to legitimate pain suffers, and are to callus to admit it. Why should my spouse suffer and be bed ridden when her old pain meds allowed her to work, and live a life? It would seem as if your agency wants to enact the T4 work of the late 1930's in Germany because they are consumers. People deserve basic rights and these guidelines are a blatant denial of them. <br/>you seem to have forgotten the oath you took as doctors so let me remind you<br/>this is the modern version: <br/><span style='padding-left: 30px'></span><br/><br/>I swear to fulfill, to the best of my ability and judgment, this covenant:<br/><br/>I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.<br/><br/>I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.<br/><br/>I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.<br/><br/>I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.<br/><br/>I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.<br/><br/>I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.<br/><br/>I will prevent disease whenever I can, for prevention is preferable to cure.<br/><br/>I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.<br/><br/>If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.<br/><br/>Medications Save Lives. Stop Pill Shaming!<br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850000ad	Anonymous	None	2022-04-08T18:34:10Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-07T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1p-4d8f-8zqq	False	None	False	2022-04-12 06:39:16.529	[]
4193	CDC-2022-0024-4199	https://api.regulations.gov/v4/comments/CDC-2022-0024-4199	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to ensure the message stresses the importance and availability of pain treatments for patients by a pain specialist and the availability of treatment to include non opioid interventions. Patients need to know that their pain is not discounted despite the opioid crisis. Patients need to know that the CDC cares about individuals and that not everyone is an addict nor should they be grouped as such. Non opioid interventions prevail and should be readily accessible. Pain is a difficult concept to research and study for purposes of efficacy and mostly impossible to quantify. The bottom line is treatments, opioid and non opioid, should be available within reason from a pain specialist	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RICHARD	None	None	09000064850047ff	WEAVER	None	2022-04-08T18:34:46Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from WEAVER, RICHARD	l1q-i9y9-p8aq	False	None	False	2022-04-12 06:39:16.740	[]
4194	CDC-2022-0024-4200	https://api.regulations.gov/v4/comments/CDC-2022-0024-4200	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See Attachment	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leah	None	None	0900006484ff8df4	LoneBear	None	2022-04-08T18:35:28Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from LoneBear, Leah	l1l-dnfp-0ks1	False	None	False	2022-04-12 06:39:16.948	[]
4195	CDC-2022-0024-4201	https://api.regulations.gov/v4/comments/CDC-2022-0024-4201	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	SEE PDF ATTACHED FOR FULL COMMENTS<br/><span style='padding-left: 30px'></span>It is obvious over the past several years that there has been a war on pain management by anti opioid groups and the DEA which in my opinion is mainly being waged to scapegoat physicians for the heroin and illicit fentanyl overdose death crisis. Physician prescribing has had little to no direct relationship to that crisis and the CDC guidelines have been used as a tool to aid those involved in this war. This has had a devastating effect on patients and doctors involved in pain treatment management and there has been no real evidence of benefits as the steady rise in opioid overdose deaths clearly illustrates. Opioid prescribers have rapidly decreased in number. Access to pain. treatment has become critically low. Opioid phobia has become its own epidemic. Cases like mine have frightened many if not most physicians, especially given the fact that if well intentioned prescriptions can be attacked for treating pain patients without any overt criminal intent or behavior, each opioid prescription written places a physician in a Russian roulette scenario. Pain treatment is widely regarded to be a human right and this human right has become increasingly unavailable. The CDC's 2016 pain treatment guidelines played an unintended role in this scenario and any update of the guidelines must be very carefully worded to prevent them from being weaponized and used for Suboxone marketing including the use of MME recommendations. This specifically includes exclusion of MME recommendations and to include the mention that Suboxone has a very limited role for chronic pain treatment and no indication for pain treatment. Otherwise pain treatment and management with opioids will no longer be available as a means to safely and effectively ease the suffering of patients for which it is the best option as determined by the patient and their physician. <br/>[Name Redacted] M.D.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Randy	None	None	0900006484ff86a0	Lamartiniere	None	2022-04-08T18:36:52Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-04T04:00:00Z	None	None	None	None	None	None	None	Comment from Lamartiniere, Randy	l1l-43tw-airj	False	None	False	2022-04-12 06:39:17.158	[]
4196	CDC-2022-0024-4202	https://api.regulations.gov/v4/comments/CDC-2022-0024-4202	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 13-year chronic pain sufferer, I am thrilled that the CDC has updated the guidelines for prescribing opioids. I know the 2016 guidelines were developed in response to the opioid epidemic—in an attempt to protect Americans-- but the truth of the matter is that the 2016 guidelines were extraordinarily harmful to the chronic pain community, and many of us suffered exponentially. Living in daily physical pain is immensely difficult, and villainizing these medications didn’t help those of us who have benefited from them.<br/><br/>That said, solely relying on opioids for pain management is a mistake, and I believe that opioids need to be used in conjunction with a holistic mind-body approach for true efficacy. <br/><br/>I sincerely thank the CDC for taking the time to update these guidelines.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christina	None	None	0900006485004dc0	Chororos	None	2022-04-08T18:41:49Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Chororos, Christina	l1q-j7jp-sj8t	False	None	False	2022-04-12 06:39:17.374	[]
4197	CDC-2022-0024-4203	https://api.regulations.gov/v4/comments/CDC-2022-0024-4203	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Governing agencies for opioid prescriptions and pain management/substance use disorders MUST collaborate on best practice. <br/><br/>As a pain management and addiction practitioner, there absolutely must be more guidance provided, and oversight for prescribing of ALL controlled substances. <br/><br/>Increased education on both pain management and SUD's must be mandatory for all practitioners. The present mandated education is sorely lacking. <br/><br/>We are in the midst of the worst drug overdose epidemic we've seen yet, with a variety of etiologies. <br/><br/>With the number of deaths attributed to opioids, the number of lawsuits against opioid manufacturers, the amount of money spent on both prescribed opioid pain medications and treatment for opioid use disorder we CANNOT relax guidance on opioid prescriptions, and must expand alternative to opioids for pain management options. <br/><br/>I realize people who've had opioid exposure believe opioids are the only thing that "allows them to function" and this is disordered thinking. We should help them recognize this, and treat them individually. Unfortunately they might need opioid pain meds for life; close monitoring should occur with frequent medical visits, UDS, etc... We should work to help them improve function, not necessarily obliterate pain which is unlikely. <br/><br/>Do not start people on opioids moving forward in the sub-acute or chronic pain periods. <br/>Enough already! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	theresa	None	None	0900006485004dfe	miceli	None	2022-04-08T18:42:17Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from miceli, theresa	l1q-je7i-xw5j	False	None	False	2022-04-12 06:39:17.592	[]
4198	CDC-2022-0024-4204	https://api.regulations.gov/v4/comments/CDC-2022-0024-4204	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a caregiver for my husband. He sustained a incomplete spinal cord work related injury 18 years ago. The changes made by the CDC several years ago have had a dramatic impact. Physicians insisting that they would not order any opioids under any circumstances is most inhuman. Though the dosages had been appropriately reduced it still was not an option. The physicians were under strict adherence from their hospital based systems to follow this guideline. The systems desire was to have the individual return to a wheelchair, stay in a corner and not complain about the loss of mobility by the reduction in opioids. This is unethically cruel. Close friends have lost loved ones as a result of these rulings. My fear is that the changes will be limiting and physicians will continue to refuse to order medication appropriately. Physicians will have to comply or loss employment. Congress and the CDC have failed to pass legislation to declassify marijuana and giving patients an alternative to opioids. There are never any statistics given regards the loss of life due to these restrictions. Another failure of our government to respect human life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485004e13	Anonymous	None	2022-04-08T18:42:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-jhhi-y33m	False	None	False	2022-04-12 06:39:17.799	[]
4199	CDC-2022-0024-4205	https://api.regulations.gov/v4/comments/CDC-2022-0024-4205	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485004eb1	None	None	2022-04-08T18:44:26Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from County of Erie Department of Health	l1q-jppl-jred	False	None	False	2022-04-12 06:39:18.021	[]
4200	CDC-2022-0024-4206	https://api.regulations.gov/v4/comments/CDC-2022-0024-4206	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a chronic pain condition called Interstitial cystitis. Unlike many patients with this condition, mine is well controlled most of the time with a low dose tricyclic medication and diet. There are times , maybe once or twice a month, that the pain is excruciating. At these times, the only thing that helps is vicodin. I use these as my "last resort" and use them responsibly. When I need them, I need them. Thankfully, my current doctors recognize that I do not abuse opiates. I live in fear that these doctors will retire and new doctors will refuse to prescribe because of restrictive laws. I am well aware of issues around addiction as I did my dissertation research on the topic and served on the board of an addiction treatment hospital. Hopefully, a balance can be found to reduce abuse but still enable those who truly need pain relief and use the medications responsibly to obtain them. <br/> I will note that some of the medications that might help some patients with IC reduce opiate use are not on insurance formularies and out of pocket cost are extremely high (eg. Urelle, uribel and others in the class). If the goal is to reduce opiate use in patients with interstitial cystitis, these medications would ideally be included on medicare and other insurance formularies.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850075ad	Anonymous	None	2022-04-08T18:47:17Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-rf9m-ksb2	False	None	False	2022-04-12 06:39:18.241	[]
4201	CDC-2022-0024-4207	https://api.regulations.gov/v4/comments/CDC-2022-0024-4207	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I agree that something needs to be done about the opioid problem but what about the many people who are suffering and in pain. Cutting back on their pain medication will cause them needless suffering. My daughter and cousin have fibromyalgia,, lupus and other conditions and being unable to receive the meds they need is causing them a great deal of pain and stress. I am sure that they are not alone and should not be lumped together with drug users. I know that not giving out opioids so freely to patients is needed but the patients that live with constant pain should not be made to spend their lives suffering.<br/><br/>Thank You<br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marilyn	None	None	0900006485007568	Kennedy	None	2022-04-08T18:47:49Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Kennedy, Marilyn	l1q-raxz-n8vu	False	None	False	2022-04-12 06:39:18.449	[]
4202	CDC-2022-0024-4208	https://api.regulations.gov/v4/comments/CDC-2022-0024-4208	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I got RLS when my family responsibilities were at a peak (around age 55). There was no cure. I had great difficulty performing my job, due to chronic sleep loss (months). Therefore I humbly request that professionally managed opioid use be thoroughly evaluated as a possible cure for RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	09000064850074d3	Mullee	None	2022-04-08T18:48:02Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Mullee, John	l1q-qvfd-4wnd	False	None	False	2022-04-12 06:39:18.656	[]
4203	CDC-2022-0024-4209	https://api.regulations.gov/v4/comments/CDC-2022-0024-4209	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to support my Son’s case. He has a rare genetic condition known as Spasmodic Torticollis and cervical & generalized dystonias, childhood onset, that affects his head, neck, shoulders, arms (upper body) that was noticeable around the age of 8, which has no known cure. He has lived with this rare condition for 45 years. Also, at age 27, he was T-boned in an automobile accident which worsened his condition. He was diagnosed by NIH and told he would have to be on narcotic analgesics <br/>along with other medications for life to control his symptoms. He has been declared 100 percent disabled by the Federal Government and can’t work. Since there is no known cure for the spasms, jerking, tremors, cramping and pain, he has been able to control them with medication along with narcotic analgesics, until around the year 2016, when the Federal Government began putting controls on doctors’ prescribing these restricted medications which better controls his symptoms. By not getting sufficient restricted medications to control his condition, his symptoms are getting worse and may not <br/>be reversible. Not being able to get the restricted medications his body needs, he has a great amount of stress and is unable to sleep but a few hours each night. On the proper amount of medications he was able to live independently with some help. We want to keep him living independently.<br/><br/>I support the effort to relax restrictions on opiates for pain reductions. Doctors must be allowed to be doctors to prescribe the necessary medications that work for each patient on an individual basis according to that person’s illness.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	V	None	None	09000064850074d0	Wiesman	None	2022-04-08T18:48:26Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Wiesman, V	l1q-qv8h-tc0f	False	None	False	2022-04-12 06:39:18.903	[]
4204	CDC-2022-0024-4210	https://api.regulations.gov/v4/comments/CDC-2022-0024-4210	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from Restless leg syndrome for 40 years. It may seem like a not so serious condition but it is a debilitation one. I have had several different medications some which have made the condition worse. That is after 6 pm I cannot sit,,sit still, enjoy company sitting, or watching tv, i must stand or walk around till i go to bed. Please consider changing guidelines for this condition, low dose opioids would make my life 100% better. thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	mary	None	None	09000064850074cb	hoyes	None	2022-04-08T18:48:43Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from hoyes, mary	l1q-qulx-0w0g	False	None	False	2022-04-12 06:39:19.143	[]
4205	CDC-2022-0024-4211	https://api.regulations.gov/v4/comments/CDC-2022-0024-4211	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	April 8, 2022<br/>To Whom It May Concern,<br/><br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have personally suffered with severe, refractory RLS for three decades. The designation, “refractory” refers to cases in which severe symptoms persist even after application of all traditional medicinal treatments. In Europe, where low-total-daily-dose opioids have been prescribed to treat this illness for many years, there are countless testimonials from people with my level of severity who became virtually symptom free as soon as they began being treated with this regimen, and who have been able to maintain the regimen for years without any addictive effect or other substantial side effects. Even more pertinent are the findings of Mayo Clinic in the U.S. regarding the effectiveness of this regimen. <br/><br/>Below are links to two published recommendations from Mayo Clinic, the first from January 2018 and the second, revised recommendation from July 2021:<br/>https://www.mayoclinicproceedings.org/article/S0025-6196(17)30825-X/fulltext<br/>https://www.mayoclinicproceedings.org/article/S0025-6196(20)31489-0/fulltext<br/><br/>I urge you to endorse the use of low-total-daily-dose opioids to treat severe cases of RLS like mine.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Thank you.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	09000064850074c8	Wright	None	2022-04-08T18:52:37Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Wright, Thomas	l1q-qhp5-zhsv	False	None	False	2022-04-12 06:39:19.356	[]
4206	CDC-2022-0024-4212	https://api.regulations.gov/v4/comments/CDC-2022-0024-4212	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from Restless Leg Syndrome most of my life. I am now 70 years old and am finally getting relief from taking 10 mg. of methadone every day for the last 5 years. That is a minuscule dose. Without methadone, I would sleep only an hour or so every night. Restless legs is an indescribable condition that causes the sufferer to have to move or kick his legs every few seconds. It is most ruthless when you relax and sit down or lie down. It is exhausting. Please recommend that methadone is a viable treatment for RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ann	None	None	09000064850074c4	Elicker	None	2022-04-08T18:53:11Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Elicker, Ann	l1q-quah-mhts	False	None	False	2022-04-12 06:39:19.576	[]
4207	CDC-2022-0024-4213	https://api.regulations.gov/v4/comments/CDC-2022-0024-4213	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>PERSONAL NOTE: I’ve been suffering from restless leg syndrome for decades now. In the last five years it has become destructively life-changing. I have been put on so many medication regimens. Some of them work for a while and then stops working. Right now, my neurologist has me on a low, low-dose of methadone. It is working wonders. You can’t imagine how important relief from these feelings are. RLS has been pretty much ignored in the research field. More funds need to be allocated for research to find the cause or causes of RLS. In the meantime, low-dose opioids hold a great deal of promise and are effective relief for many people. It’s hard for people who have not experienced RLS to know what we are up against. Thank you for acting to include low-dose opioids in the prescribing guidelines. PLEASE.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Act NOW!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ben	None	None	0900006485007497	McClinton	None	2022-04-08T18:53:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from McClinton , Ben	l1q-qqga-79qo	False	None	False	2022-04-12 06:39:19.804	[]
4208	CDC-2022-0024-4214	https://api.regulations.gov/v4/comments/CDC-2022-0024-4214	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Physicians seem to be increasingly taking steps to protect themselves against liability of opioid overdose in patients, versus wanting to meet patient pain management needs. I feel as if doctors are wanting to avoid any potential lawsuits, fines, license suspension, or penalties connected to opioid dispensing. It seems many doctors are suggesting alternative methods to avoid prescribing controlled pain medications altogether. A few examples suggested to my mother have been, reducing pain medication dose and frequency, pushing "holistic" pain options (acupuncture therapy, meditation, deep breathing, yoga), referring patients to other pain management physicians and specialists, and asking patients to sign indemnification forms. I really feel these suggestions are a way to offload patients to another pain prescribing doctors and/or avoid prescribing controlled substance. The desire to avoid potential liability is beginning to outweigh patient pain management needs. I recently heard of some military veterans being completely denied opioid prescriptions altogether, despite documented painful service injuries. That is so very unfortunate.<br/><br/>I care for my 85 year old mother. We are experiencing the struggles in getting her pain prescriptions. It involves debate and explanation just to get refills on her pain medications. It is becoming a constant struggle. My mother has severe, and chronic osteoarthritis that has invaded her hips, knees, shoulders, hands, ankles, and lower back. Severe pain impairs her ability to walk and do her everyday hobbies when you have bone to bone grinding in your every move. Surgery is not an option due to her having heart issues and adverse issues with anesthesia. Expensive pain specialists have created more issues with invasive and painful steroid injections that disrupt diabetes management. Her only basic pain relief is Tramadol. Tramadol, the drug at the safer end of the spectrum of controlled substance, is being challenged by her primary care physician. This is a physician who has treated my mother for nearly 20 years as a PCP and administered this drug for years, is now requesting "special" forms that need to be signed before Tramadol to be prescribed. (Which we have not done.) This physician has already reduced frequency, which has negatively affected my mother's pain management. This physician also discontinued prescribing Xanax because she fears it is not safe to do both medications together, even though my mother has safely taken both for several years, especially after the death of my father, her husband of 60 years, which was incredibly traumatic for her. <br/><br/>Physicians need to look at each patient and medical case uniquely, instead of trying to be rid of opioid associations, and discharge that care to other sources. My mother does not abuse drugs, and neither does she smoke, nor drink alcohol. She has a regular physician and cardiologist she has seen for 20 plus years. She has documented chronic illnesses and severe arthritis and injuries in her body, proven with X-rays, scans, and exams. She is not a young woman between the ages of 18-28 needing a controlled substance for any minor reason. My mother does not jump from doctor to doctor seeking pain medications. She is under the care of her team of regular doctors that communicate with each other in order to give her the best quality of life she can have at 85 and beyond. Pain management should not be a struggle for people, especially patients with chronic pain. I feel patients with chronic pain are having to constantly explain and justify themselves in order not to be seen as an addict, or an abuser of drugs. I feel primary care physicians are beginning to act in their own interest, and taking it upon themselves to create their own pain medication regulations, in order to protect their livelihoods, perhaps out of fear of liability, but that fear leads to less quality care for their patients. <br/>We understand that opioids can cause addictions, injuries, and deaths, especially amongst younger populations. However, medical communities should have common sense. Doctors need to be observant and vigilant of their patient's needs. Pain management should be carefully considered, but it should not be an accusation of abuse, limited, or "taken away" from patients who have already suffered enough from illnesses that cannot be cured in order for doctors to avoid liability. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lorena	None	None	0900006485007450	Moreno	None	2022-04-08T18:54:17Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Moreno, Lorena	l1q-qq3c-8fhs	False	None	False	2022-04-12 06:39:20.012	[]
4209	CDC-2022-0024-4215	https://api.regulations.gov/v4/comments/CDC-2022-0024-4215	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to comment on the proposed update for opioid use for chronic conditions, especially my chronic condition of Restless Leg Syndrome. Although Hollywood has claimed this Syndrome as a ruse by pharmaceutical companies to increase usage this couldn't be further from the truth. I have endured the jokes, jeers and all around misconceptions for years yet those words do nothing to alleviate the daily issues myself and thousands of others face. <br/>I started going to doctors, including neurologists and a sleep disorder facility over 3 decades ago. Although many drugs have been approved for RLS most do nothing after a while except increase the frequency of my symptoms. <br/>I work with my doctor who monitors my opioid use as the pain drugs are the ONLY relief I get which allows myself the simple pleasures of sitting down be it in my house, driving a car or sleeping. <br/>Unless you have the syndrome it's hard to explain how relentless the urges to move can be. Feeling like you're living in freak show without end is so depressing. Knowing that I have the option of opioid relief has been a godsend. Please consider our plight.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicki	None	None	090000648500744c	Kellum	None	2022-04-08T18:54:31Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Kellum, Vicki	l1q-qovo-y693	False	None	False	2022-04-12 06:39:20.224	[]
4210	CDC-2022-0024-4216	https://api.regulations.gov/v4/comments/CDC-2022-0024-4216	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why does the CDC, FDA, etc. feel that only people who have cancer, have the worst pain imaginable and these people plus the dying are the only ones who deserve opioids for their chronic pain? Other people have horrible, never ending chronic pain that also deserve the right to proper treatment. And it makes me so mad when I read someone’s comment that says chronic pain should not be treated with prescription narcotics because this results in the pain patient moving on to stronger drugs such as fentanyl, heroine, etc. This is so untrue! Perhaps if the person was a drug seeking, street druggy to begin with. But I have taken prescription narcotics prescribed by a licensed pain physician for over 20 years and I have never moved on to anything that my physician did not prescribe to me. My physician also requires me to see him every 3 months. This way he is able to see that I am not abusing drugs and he keeps up with my condition. In 14 years with him I have never missed a 3 month appointment with him even though some days I can barely get out of bed and I have to drive 85 miles round trip to see him. My pain physician also requires me to sign a pain agreement with him once a year, to agree to urine tests and pill counts at random. <br/> I have had the dosage of my narcotics lowered several times. The pain agreement states that if I fail a urine test or pill count, or miss a 3 month appointment, or many other items on the agreement, my physician can drop me as a patient at any time. And I know he has gotten rid of drug seekers. My pain physician also has me go to PT, water therapy, Pilates, walk,try massage, tordal injections for pain which aren’t considered narcotics, ride a bike when I am able for exercise and for my mental state. My pain physician also has me on anti-depressants, anti-convulsants and vitamins. So, when a person REALLY HAS CHRONIC PAIN they are not seeking drugs!! Prescription or otherwise! WE DO NOT GET HIGH FROM OUR PRESCRIPTION DRUGS! We just hope to get out of bed on most days! True chronic pain patients don’t move on to street drugs! We just work with our doctors and listen to their ideas and suggestions to feel better. My pain physician won’t even let me try medical marijuana of any kind because he said it is still illegal at the federal level. If this showed up in my drug test, he could drop me as a patient.<br/>Leave the relationship between the patients and their doctor. They know more than the government.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007398	Anonymous	None	2022-04-08T18:54:49Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-qmbw-o1wx	False	None	False	2022-04-12 06:39:20.431	[]
4211	CDC-2022-0024-4217	https://api.regulations.gov/v4/comments/CDC-2022-0024-4217	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m am 77 years old and have RLS. Have been taking low dose hydrocodone for over 27 years, same dose, never changed. It works great.<br/>Take primarily for bedtime and afternoon rest. If I don’t take it, my legs would work restlessly all night and day. Please don’t change my ability to get my dosage.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacki	None	None	090000648500732d	Snodgrass	None	2022-04-08T18:55:00Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Snodgrass, Jacki	l1q-qih4-9vxm	False	None	False	2022-04-12 06:39:20.644	[]
4212	CDC-2022-0024-4218	https://api.regulations.gov/v4/comments/CDC-2022-0024-4218	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Prescribed opioids are the lowest in history yet 100,000 people died in 2021 of suicide or Illegal drug ODs. Chronic Pain Patients are dying in record numbers now. The damage caused by the 2016 CDC “guidelines” and 90MMES is deplorable. To include 50MMES in the 2020 CDC “guidelines” willfully will cause the tragic and traumatic death of ten of thousands more Chronic Pain Patients. Everyone is one MVA or traumatic event away from becoming a person dependent on effective pain control to remain contributing, productive citizens. STOP PUNISHING CHRONIC PAIN PATIENTS and remove ALL references to MMES!! Any further deaths from systemic collapse after rapid tapping, opioid cessation or denial of opioids, are the responsibility of the CDC. Irrefutable and overwhelming evidence now exists to demonstrate the 2016 CDC “guidelines” are grossly riddled with damning and inaccurate information. The entire 2020 CDC “guidelines” need to be rewritten to include all research supporting effective and ethical treatment of all Chronic Pain Patients. Even one more disillusioned suicide is entirely the CDCs responsibility.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rebecca	None	None	09000064850072c6	Faurer	None	2022-04-08T18:55:21Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Faurer, Rebecca	l1q-qf2l-fbp2	False	None	False	2022-04-12 06:39:20.859	[]
4213	CDC-2022-0024-4219	https://api.regulations.gov/v4/comments/CDC-2022-0024-4219	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>As a person who has augmented on first line drugs, I thought my life was over until my doctor put me on a low dose opioid. I have been on this low dose opioid for many years now and it has allowed me to live a full and normal life. I can’t imagine my life without it.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Act NOW!<br/><br/>[initials redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donnie	None	None	0900006485007192	Kee	None	2022-04-08T18:58:58Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Kee, Donnie	l1q-q6s5-rpml	False	None	False	2022-04-12 06:39:21.069	[]
4214	CDC-2022-0024-4220	https://api.regulations.gov/v4/comments/CDC-2022-0024-4220	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a person who suffers from Restless Legs Syndrome (RLS). I have many much more “serious” conditions, but it is RLS that tortures me the most. I have tried and failed using many pharmaceutical options. I now rely on low dose opioid therapy to help control the symptoms of this very disabling, neurological condition. Without this treatment, I do not know what I would do. <br/><br/> Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, a very important document. Unfortunately, the draft does not address chronic conditions like RLS that differ from chronic pain. RLS is a chronic neurological disease that causes an urgent and incapacitating need to move the legs and, in my case, my arms and back as well. The symptoms make it impossible to sleep or even to sit quietly. It seriously affects every aspect of my daily life for many hours of each day. In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications relieve the symptoms for a while, but over time those same medications can worsen the symptoms. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. I have been on the same dose of narcotics for almost 10 years with no adverse effects.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same dose of opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, using carefully monitored low-total-daily doses.<br/><br/>Thank you for your consideration of these vital issues. Please visit the RLS Foundation website at www.rls.org as a resource for scientifically-based information about RLS, as well as important information for persons with this condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marion	None	None	090000648500712c	Gillen	None	2022-04-08T18:59:24Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Gillen, Marion	l1q-q6n1-llxy	False	None	False	2022-04-12 06:39:21.280	[]
4215	CDC-2022-0024-4221	https://api.regulations.gov/v4/comments/CDC-2022-0024-4221	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am 76 years old and have had RLS for the last 35 years of my life. I would say that it is a very debilitating illness if not treated. I have been taking pramiprexole for the last 35 years and in increasing doses. I currently take 2.0 mg per day. There are times when I first take my dose of pramiprexole that I get sudden severe RLS symptoms. But within an hour or so, my RLS symptoms diminish. This tells me that I might be close to the point were my medication actually starts to cause the symptoms and I will have to stop taking it. At that point my only recourse will be to take opiods. If that avenue for treatment is not available to me, I don't know what I would do. My life would become intolerable. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elaine	None	None	09000064850067e0	Gorham	None	2022-04-08T19:04:08Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Gorham, Elaine	l1q-p6rv-dpte	False	None	False	2022-04-12 06:39:21.491	[]
4216	CDC-2022-0024-4222	https://api.regulations.gov/v4/comments/CDC-2022-0024-4222	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485006823	None	None	2022-04-08T19:06:02Z	SOLVD Health	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from SOLVD Health	l1q-ov7z-evfj	False	None	False	2022-04-12 06:39:21.729	[]
4217	CDC-2022-0024-4223	https://api.regulations.gov/v4/comments/CDC-2022-0024-4223	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless Leg Syndrome is a terrible nerve disease that causes legs to spasm for hours at a time, especially at night. It is hard to describe the suffering of not being able to sleep, or even relax. Mild doses of opioid are the only solution in many cases. I urge the CDC to include a section in the opioid prescribing guidelines that will give physicians the freedom to prescribe opioids in low doses when other medications do not work.<br/><br/>Please consider the RLS Foundation at www.rls.org as a resource for scientificaly based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Albert	None	None	09000064850068ca	Sevcik	None	2022-04-08T19:06:13Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Sevcik, Albert	l1q-pbmn-kiuj	False	None	False	2022-04-12 06:39:21.945	[]
4218	CDC-2022-0024-4224	https://api.regulations.gov/v4/comments/CDC-2022-0024-4224	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	jerry	None	None	0900006485006d42	avila	None	2022-04-08T19:06:37Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from avila, jerry	l1q-pfv3-fqgz	False	None	False	2022-04-12 06:39:22.156	[]
4219	CDC-2022-0024-4225	https://api.regulations.gov/v4/comments/CDC-2022-0024-4225	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an almost 70 year old woman, living independently, & I have RLS. I function well during the day - I walk 4 miles, do exercises, maintain my home & also my garden. Currently during the night when my RLS symptoms are keeping me awake, in addition to prescribed medication I resort to more & more OTC pain relievers to help me get comfortable. Oftentimes I lie fear that I might be harming my liver & kidneys in the process. One low level opioid would quickly provide the same relief, as I know from experience. It seems to be widely understood now that medications should to be rotated over time, or they can gradually lose effectiveness. Please let low level opioids again be a part of the mix to aid in treatment of this extremely frustrating, chronic neurological condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Abby	None	None	0900006485006d45	Field	None	2022-04-08T19:06:49Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Field, Abby	l1q-pg58-zsez	False	None	False	2022-04-12 06:39:22.371	[]
4220	CDC-2022-0024-4226	https://api.regulations.gov/v4/comments/CDC-2022-0024-4226	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/><br/>I have had RLS for 15+ years. It is an insidious disease that directly impacts my quality of life, prevents me from being able to sleep or relax. While the sensations are hard to describe, the impact to my life is as bad as or worse than mild to moderate pain. I took Tramadol for many years and it WORKED, allowed me to sleep and improved my quality of life. When we moved to Florida by new physician was unwilling to continue to prescribe Tramadol because it wasn't "approved" for treatment of RLS. I'm now taking Requip and Neuronton which have more sever side affects, keeping me from being able think as clearly during the day and frankly it doesn't always work. It's also likely that I will need to continue to increase the dosages to relieve my symptoms. (I'm sitting here typing this at 1:33pm and my legs are "going off".<br/><br/>I recently learned that opioids were used for 100's of years to treat RLS symptoms and that in 2016 the CDC changed the guidelines making physicians afraid to prescribe them to treat RLS. <br/><br/>I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006485006e31	Donnell	None	2022-04-08T19:07:08Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Donnell, James	l1q-pkje-hftu	False	None	False	2022-04-12 06:39:22.580	[]
4221	CDC-2022-0024-4227	https://api.regulations.gov/v4/comments/CDC-2022-0024-4227	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>The terminology related to cancer patients shifts through the document and is often not clear. Recommend changing the following lines to add clarity:<br/>Change line<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>from<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>to<br/>33-34<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>cancer pain treatment<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>pain associated with active cancer <br/><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>treatment or active cancer treatment<br/><br/>304<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>cancer paint treatment<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>pain associated with active cancer <br/><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>treatment or active cancer treatment<br/><br/>1368<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>cancer pain treatment<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>pain associated with active cancer <br/><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>treatment or active cancer treatment<br/><br/>3992<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>cancer pain treatment<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>pain associated with active cancer <br/><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>treatment or active cancer treatment<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006485006e37	Walsh	None	2022-04-08T19:07:25Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Walsh, Margaret	l1q-pljl-0jus	False	None	False	2022-04-12 06:39:22.800	[]
4222	CDC-2022-0024-4228	https://api.regulations.gov/v4/comments/CDC-2022-0024-4228	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve suffered from rls for many years and my doctor tried all of the available medications but nothing was effective. We finally tried 15 mg of hydrocodone and I was able to sleep through the nite for the first time. I can’t imagine life without this medication. Rls ia not curable so this is a medication for life. For me. Nothing Else works. Please do not consider limiting my access as my life would be unbearable	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006485006ff9	VanDyke	None	2022-04-08T19:07:38Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from VanDyke, Margaret	l1q-pw88-hy39	False	None	False	2022-04-12 06:39:23.011	[]
4223	CDC-2022-0024-4229	https://api.regulations.gov/v4/comments/CDC-2022-0024-4229	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been plagued with RLS for as long as I can remember. It wasn't until 12 years ago that I was able to get a reasonable amount of relief. It was then that I began treatment with a combination of Methadone and NeuPro patch and it has been a God send. NeuPro alone doesn't provide relief, nor does Methadone alone. However the combination of both provides the best relief I have ever had. I was concerned about the use of Methadone (maximum daily dose is 30mg) at first but have never felt a "high" feeling and wouldn't like that if I did. Without this dosage life it miserable, especially as I have gotten older. Please allow the responsible use of Methadone (an opioid) to treat this Neurological disease. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ralph	None	None	09000064850075b9	Albright	None	2022-04-08T19:08:11Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Albright, Ralph	l1q-rh0l-31x7	False	None	False	2022-04-12 06:39:23.229	[]
4224	CDC-2022-0024-4230	https://api.regulations.gov/v4/comments/CDC-2022-0024-4230	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When pregnant with my daughter who is now in her early 40's, I was told by a neurologist, the discomfort I was suffering in my legs, was Restless Leg Syndrome. Initially I was prescribed Pramipexole. When that drug no longer provided relief, it was followed with a series of various other non-opioid pharmaceuticals with limited success and often an increase of augmentation of symptoms. Approximately 6 years ago, I consulted with a sleep specialist who allowed me to "test" several different opioids to determine a level of relief. It was finally determined a low dose (5mg) methadone was the most successful medication. I am currently taking this prescription of 1 or 2 tablets at nighttime. Rarely do I ever need more than 1 tablet per night. Quality of life with methadone has been a blessing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006485007609	Schaefer	None	2022-04-08T19:08:23Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Schaefer, Pamela	l1q-rsbm-2eau	False	None	False	2022-04-12 06:39:23.497	[]
4225	CDC-2022-0024-4231	https://api.regulations.gov/v4/comments/CDC-2022-0024-4231	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been diagnosed with refractive RLS that no longer responds to other dopamine agonists. I was on the edge of despair. IF this condition continued, or I failed to find a better treatment, I knew it would shorten my life, certainly shorten my quality of life, as sleep is SO SO important. No sleeping pill can make you overcome the almost evil urge to move, kick or jerk. But when I found THANK GOD a doctor not terrified of the DEA, and he prescribed to me, as per the massive study of Mayo Clinic a LOW dose (2.5 mgs/day) I found such relief. No side effects. No "high". No need to up my dose (after a solid year) and I can say I no longer think of suicide, or buying drugs off the street. I found relief. I am supervised and I keep in contact with this blessed doctor who understands the cruelty of this "non-pain" disease. I don't wish it on anyone, EXCEPT those who are in control of how it is prescribed and their reluctance to help those sufferers; I do wish it on them, so they can see how horrible it is, and then, with a simple pill, a LOW DOSE opioid, they can escape the torture of walking, over and over and over, each night. Please, please have some common sense and compassion, for those of us who are not addicts, not looking for a high, we just want to sleep. We just want relief. Please make this easier for doctors to find the right low dosage to help RL sufferers like myself. Thank you for listening. Should this proposal make it easier to help those where NO OTHER OPTION helps, it will be a Godsend, truly. Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	marion	None	None	090000648500673a	Shepley	None	2022-04-08T19:09:11Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Shepley, marion	l1q-p2m1-9unl	False	None	False	2022-04-12 06:39:23.705	[]
4226	CDC-2022-0024-4232	https://api.regulations.gov/v4/comments/CDC-2022-0024-4232	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the husband of a Restless Legs sufferer. My wife has had this disease for over 50 years (our entire marriage) and suffers daily with bouts of sleeplessness caused when RLS either keeps her awake for hours at night time or awakens her during her minimal sleep periods. She often gets les than 3-4 hours sleep per night and thereby suffers additionally from other health related issues (like Covid- from which now she also is fighting "Covid asthma".) We seem to be constantly in Dr's appointments, and even recently emergency rooms for breathing difficulties. Fortunately, we have found the Restless Legs Foundation and wonderful people to help us. One of the only effective RLS medications my wife has been able to tolerate is Methadone in low daily quantities. She finds effective relief at 15-20 mg/day. Without it, we would not know what to do. I believe the RLS Foundation has been doing an important study of the positive effects of Methadone on our disease. We cannot be without it.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dyke	None	None	09000064850065e2	Henderson	None	2022-04-08T19:09:23Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Henderson, Dyke	l1q-otdl-zjd4	False	None	False	2022-04-12 06:39:23.914	[]
4227	CDC-2022-0024-4233	https://api.regulations.gov/v4/comments/CDC-2022-0024-4233	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I wish my RLS doctor could have prescribed a low dose opioid to ease my terrible transition from Mirapex to Gabapentin!!! They are not thinking of the patient when they refuse to allow a low dose. It would have saved me alot of sleepless nights , and me trying absolute anything to get some rest. It forces people to desperate situations to do desperate things. Good sleep quality is so huge in helping with depression and other issues. . Please cinder adding RLS to the list !!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patrick	None	None	090000648500653e	Edward	None	2022-04-08T19:09:37Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Edward , Patrick	l1q-opxi-397v	False	None	False	2022-04-12 06:39:24.124	[]
4228	CDC-2022-0024-4234	https://api.regulations.gov/v4/comments/CDC-2022-0024-4234	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a new member of RLS Foundation. RLS is a debilitating and serious neurological disease and no cure. Along with it, you just cannot sleep, the restless legs keep you awake. I have tried 9 different medications for this disease plus numerous supplements. I have tried medical marijuana (didn’t help with sleep or RLS), Acupuncture and am now trying therapeutic massage. We are not drug addicts and if needed, after numerous tries with various medications that don’t work, I don’t see any harm in prescribing very low doses of opioids. Let me tell you, some people want to commit suicide if they can’t get any relief, and if very low doses of opioids help, then so be it. This disease is hell believe me. Not the end of the world for the FDA to approve very low doses of opioids. We are not the junkies out on the street looking for a fix. We just want to be able to sleep.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	09000064850054de	Koehler	None	2022-04-08T19:09:51Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Koehler, Diane	l1q-omkn-zz1l	False	None	False	2022-04-12 06:39:24.338	[]
4229	CDC-2022-0024-4235	https://api.regulations.gov/v4/comments/CDC-2022-0024-4235	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This document has really hurt my quality of life. Please take out all of the MME suggestions. Let my professional doctor do what he's trained to do. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bobby	None	None	09000064850054d2	Campbell	None	2022-04-08T19:10:08Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Bobby	l1q-olwl-vt4w	False	None	False	2022-04-12 06:39:24.549	[]
4230	CDC-2022-0024-4236	https://api.regulations.gov/v4/comments/CDC-2022-0024-4236	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Shame on those medical practitioners who, for years, have overprescribed opiates. They have done a grave disservice to their patients, as well as throwing current available treatments for RLS, and other chronic disorders and diseases back back decades. Can you really state that there is no effective way to utilize responsible use of low dose opiates? Really?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	0900006485005482	hodge	None	2022-04-08T19:10:20Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from hodge, Anne	l1q-oc5w-594r	False	None	False	2022-04-12 06:39:24.761	[]
4231	CDC-2022-0024-4237	https://api.regulations.gov/v4/comments/CDC-2022-0024-4237	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] and i am an 84 year old with RLS that i have had for many decades. My symptoms were relieved by a small nightly dose of an opioid. Because of a cap being placed on Dr’s ability to Rx these has made my Life so undeservedly miserable. I am very active and was never addicted to any opioid that i took for this and never had to increase my dosage. I understand the sad and real fact that some young adults committed suicide on them. However restricting Dr’s ability to rx them for Chronic pain patients has also driven many to this as well. Withholding a solution to patients with legitimate conditions that are treatable therefore restricting them from living worthwhile pain free lives by prescribing an opioid is barbaric. I beg you to please consider those of us who are responsible tho living with pain by alieviating these restrictions and therefore returning our lives to us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sherry	None	None	090000648500546f	Darnell	None	2022-04-08T19:11:27Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Darnell, Sherry	l1q-o95m-pbm6	False	None	False	2022-04-12 06:39:24.969	[]
4232	CDC-2022-0024-4238	https://api.regulations.gov/v4/comments/CDC-2022-0024-4238	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from restless leg syndrome for many years. In the beginning, I was taking a dopamine pill which helped to get me to sleep; however, like most dopamine pills, there was a rebound effect, which actually exacerbated the symptoms. My neurologist then recommended I take very low dosage of methadone (10mg per day). It has worked to virtually eliminate my symptoms and allow me to get a decent night's sleep. Please allow low dosage opiods to be used for medicinal purposes. My prescription is monitored-I cannot have more than a 30 day supply, and I have to show proof of identity every time it is renewed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eugene	None	None	090000648500544e	Fleishman	None	2022-04-08T19:11:40Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Fleishman, Eugene	l1q-o7yu-n82q	False	None	False	2022-04-12 06:39:25.187	[]
4233	CDC-2022-0024-4239	https://api.regulations.gov/v4/comments/CDC-2022-0024-4239	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered with RLS for many years and have tried all of the medications that helped for a while but now I cannot sleep because none of the medications work anymore. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wyman	None	None	0900006485005427	Harris	None	2022-04-08T19:12:16Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Harris, Wyman	l1q-o32n-5qqc	False	None	False	2022-04-12 06:39:25.395	[]
4234	CDC-2022-0024-4240	https://api.regulations.gov/v4/comments/CDC-2022-0024-4240	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC tried to qualify themselves with a pathetic lack of critical background and a truly disastrous lack of any expertise in this specialized area. They proceeded to invent vicious, so-called guidelines, which created death and destruction of fragile lives, lives which had managed to survive on their prior, properly prescribed drug regimens, but were destroyed by the prior contrived Guideline. This cannot be allowed to continue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dick	None	None	0900006484ffcc5a	Carvelli	None	2022-04-08T19:39:11Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Carvelli, Dick	l1o-2b1t-xwt7	False	None	False	2022-04-12 06:39:25.604	[]
4235	CDC-2022-0024-4241	https://api.regulations.gov/v4/comments/CDC-2022-0024-4241	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had 20 years of decent pain relief from opiates and adjunct therapies. I only started them after all other treatments failed. That should have been enough to keep my treatment but it wasn’t because of the CDC,DEA and PROP. When my meds were lowered to what you consider “safer” I lost function,gained weight,my husband had to retire to care for me and after 4 years of under treated pain I developed high blood pressure. The outcomes should have triggered a return of my meds that had been beneficial but it didn’t. These new guidelines will lead to me being lowered to 50mme. You’re already passing out PR pamphlets to that effect. You’re using recreational drug use and ODs against legitimate patients. The studies you use to dictate treatment for everyone only includes patients with mild pain. We deserve better than this. You need to take any comments on MME out. You need to include that patient outcomes are the deciding factor. And you need to stop putting out PR things saying that these guidelines were made with the input and guidance of pain patients and doctors. You need to pay attention to the long term deadly effects of some alternatives to opiates and the lack of efficacy,insurance coverage and availability of other alternatives. When I contacted the CDC about my situation I was told to “find another doctor”. Like that is a possibility. Between the CDC,DEA and PROP you’ve made it impossible to get decent pain treatment. My doctor knows I’m suffering,that I’ve tried everything else and that the under treatment of my pain has led to loss of function and health consequences. But she is afraid to treat me with anything more and the new guidelines will make it worse. She tried to find me another doctor but no doctors in my area are willing to take a patient like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006484ffcc8c	Anonymous	None	2022-04-08T19:39:24Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1o-2vzt-vpuv	False	None	False	2022-04-12 06:39:25.828	[]
4236	CDC-2022-0024-4242	https://api.regulations.gov/v4/comments/CDC-2022-0024-4242	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Costa	None	None	0900006484ff9f94	Soteropoulos	None	2022-04-08T20:25:37Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from Soteropoulos, Costa	l1m-hfoy-7b7g	False	None	False	2022-04-12 06:39:26.047	[]
4237	CDC-2022-0024-4243	https://api.regulations.gov/v4/comments/CDC-2022-0024-4243	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic dibilitating pain now for over 15 years with medical test proving severe chronic medical conditions causing my chronic dibilitating pain and have been on opioids all these years. I was on a stable high dose opioid for years with no problems what so ever. I never abused my medications and was always compliant. Even after the cdc guidelines came out i had not problem getting my pain medication even when my doctor retired the next doctor kept on same dose as previous doctor did. Then he retired suddenly and then i was FORCED to be cut down by doctor on call who had never seen me and still to this day has never seen me but was filling my medication by me calling in till i could get in to new doctor. I was not consulted about the FORCED cut down, I did not know i was being FORCED to cut down until i got to pharmacy to get my prescription. When I got in to see a new doctor he also from the first visit FORCED me to cut down even more and said i WOULD be cut taken off my pain medication due to the new laws set by cdc. And offered me no alternative to pain management and did not listen or care about what i had to say. I found another doctor and he was and is the same way. FORCED me to cut down even further and saying i would be cut off and not listen to or care about what i had to say. My daughter has tried reaching out to him and he refuses to get back with her. She has even printed off the cdc guidelines and other documentation and left at his office and he still refuses to get back with her. He does not care how this has impacted my quality of life such as I stay in bed all the time and in severe pain 24/7, i can no longer do simple daily things around the house, get dressed by myself ect., go to family functions, have my grandchildren come and visit or stay with me, take a shower or wash my hair by myself, go to the store, go to church, or anything i was able to do prior to being FORCED without my consent to be cut drasically down from my long term stable high dose opioid treatment. Prior to being FORCED to be so drascially cut down even though my opioid treatment did not take away my pain completely it did allow me to enjoy life to the best of my ability with my medical conditions. I had some form of quality of life but that has been ripped from me with being FORCED to this drastic cut down and no alternative to pain management. Most days i think i'd be better offf dead cause this is not living bv no means. I have even went to being able to live by myself to having to live with family do to not being able to do simple things for myself any longer. I am only 55 years old and I should not be FORCED to live this way when I was on a treatment that worked for so many years with no problems. SOMETHING HAS GOT TO BE DONE. This has not only affected myself but my family and loved ones. I am no longer able to be with family and loved ones as i previously was. I have missed holidays, grandkids birthdays, grandkids school programs, weekly family get togethers, ect do to being FORCED to DRASICALLY cut down my pain medicaitons. These new fresh out of school doctors DO NOT CARE AT ALL ABOUT THE PATIENT OR LISTEN TO PATIENT. They do not pay attention to past medical records and treatments that have and have not worked and DO NOT CARE TO HELP THE PATIENTS MEDICAL PROBLEMS ANYMORE WHEN IT COMES TO PAIN. THEY TREAT YOU LIKE YOU ARE IMAGINING THE PAIN AND IT'S ALL IN YOUR HEAD. I can see why so many opt for suicide or street drugs when this happens because i have thought about doing the same and my daughter is the one who has kept me from doing so up to this point. She is constintly stressed over how this has afftected me, her and the rest of my family and loved ones. You are suppose to be able to trust your doctor and know he is going to try to help your medical condition the best he can and not ignore it. But those days seem long gone. It's like finding a needle in a haystack to even find a doctor to see you if you are on an opioid. I am treated lilke a drug addict instead of a patient with a severe chronic debilitating disease that is is severe chronic pain 24/7 that can not get out of bed. A doctor has not addressed my medical conditions or the affects of my medical conditions since my last long term doctor retired. Only thing a doctor has addressed getting me off opioids. They could care less about a persons medical conditions, treatment, or pain if they are on opioids. Never have i had a problem trusting or respecting any of my doctors, and knowing he or she was doing all they could to help what ever was wrong with me up to this point.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	SANDRA	None	None	0900006484ffa617	KENNEDY	None	2022-04-08T20:26:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-05T04:00:00Z	None	None	None	None	None	None	None	Comment from KENNEDY, SANDRA	l1m-x8lp-nyea	False	None	False	2022-04-12 06:39:26.260	[]
4238	CDC-2022-0024-4244	https://api.regulations.gov/v4/comments/CDC-2022-0024-4244	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffbbeb	None	None	2022-04-08T20:35:41Z	Students for Sensible Drug Policy at the University of Michigan	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Students for Sensible Drug Policy at the University of Michigan	l1n-o5pw-lnvs	False	None	False	2022-04-12 06:39:26.476	[]
4239	CDC-2022-0024-4245	https://api.regulations.gov/v4/comments/CDC-2022-0024-4245	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe chronic pain, because of nerve damage caused by surgeries in my lumbar area and have been forced to tapered by my physician, because he is afraid of the DEA and the CDC. He told me he knows I need a higher dose with my nerve damage, but he feels like his license is on the line, and I understand he worked hard for his degree. He fears the DEA will raid his office like they have done to other physicians. He knows I have been a model patient who always passes urine tests and have done everything they have asked of me, yet this isn't enough, I get treated like a drug addict from the pharmacy, other doctors, hospital, all because I am unlucky enough to be suffering from chronic pain. The only thing that gives me any quality of life is opioids, otherwise I spend every waking moment, and very little sleeping moments in bed. It effect my health by giving me diabetes, high blood pressure, headaches, because of the extreme stress to my body from the agonizing pain. Chronic pain saps the joy out of your life, you have no quality of life, I need help with simple chores around the house, when before with higher doses of pain medicine (opioids) I was able to do for myself. I actually had a life. If you have high blood pressure nobody would take away your blood pressure medicine, then why are they taking away opioids from Chronic Pain Patients. Post op, and Cancer patients? Let the doctors be doctors and stop all these guidelines and let the doctors decide and diagnosis not the CDC and the DEA. I seen how my husband suffered after surgery because the doctors were afraid to prescribe enough opioids for his pain, it was heart-breaking what he went through, he could not sleep, I seen tears streaming from his eyes, and he is one tough cookie, this must stop. Why are you making Chronic Pain, Post-op patients, and cancer patients suffer? Can you imagine you are dying and they tell you I can't give you more pain medicine because we are afraid you will be addicted, that don't even make any sense at all. That makes our country and doctors a laughing stock of the world. The DEA needs to focus on the drug cartels not doctors and their patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverly	None	None	0900006485004c3d	Petersen	None	2022-04-08T20:37:21Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Petersen, Beverly	l1q-kmo4-tym0	False	None	False	2022-04-12 06:39:26.691	[]
4240	CDC-2022-0024-4246	https://api.regulations.gov/v4/comments/CDC-2022-0024-4246	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate the opportunity to comment. There are members of my family with incurable - and extremely painful- diseases. Not many years ago, they were able to live an almost normal life and hold a job with the help of certain pain-reducing drugs. Those drugs are no longer available to them. They now languish in their home, usually in dark rooms, barely able to function. We can't let the actions of drug dealers and criminal addicts prevent ordinary folks with debilitating illnesses from getting badly needed medicines. <br/><br/>But that is exactly what is happening.<br/><br/>The Drug Enforcement Agency is intimidating doctors who try to help those patients.<br/><br/>About 45,000 individuals committed suicide last year. How many did it in despair from unrelenting pain that could have been treated?<br/><br/>I fear my family members will follow those 45,000 if changes aren't made to help them get needed medicines.<br/><br/>Please restore a balance so that physicians can use judgement, not just follow a computer algorithm-driven process that flags patient files without first-hand knowledge of patient background.<br/><br/>Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gene	None	None	0900006485004c4c	Morphis	None	2022-04-08T20:37:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Morphis, Gene	l1q-kopb-rkmj	False	None	False	2022-04-12 06:39:26.899	[]
4241	CDC-2022-0024-4247	https://api.regulations.gov/v4/comments/CDC-2022-0024-4247	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was one of the unfortunate ones who was force-tapered off of meds for pain and anxiety and went through tortures ESPECIALLY after being taken off sleep medication (and thankfully put back on.) But how anxiety- producing is it, to live every day wondering when that will be denied again, because my young little PA is scared to death she will recieve censure if she continues to prescribe!!<br/><br/>You really can't base decisions on hearsay from those who maybe knew of someone or someone's child who died of an overdose!! Why would the rest of the stable people recieving benefit from their med regime have to be punished for those who make a decision to abuse drugs???<br/>Everyone has issues in life and some WERE traumatic, but until this emphasis on forbidding meds for pain and anxiety (and sadly sleep) took place, we were able to get assistance from medication. Medical care needs to get back to that!! Antidepressants are being prescribed for everyone, as well as Neurotin and these types of meds which have bad side effects and have tolerance and brain enzyme changes just like the banned opioids and benzos.<br/>Please remember that a MME cannot be mandated because of differences in weight, metabolism and pain tolerances! And certain natural psychological profiles are more prone to react with anxiety, and handle it in different ways, and meds need to be monitored and adjusted accordingly!<br/>As well, let me comment, my 45 year old son, who has family history of severe arthritic degenerative disease, was a productive Architect while on Opioid treatment for disc collapse. Now after surgeries and Suboxone, he is on disability and has lost all his molars from that terrible drug. If you have the ability to change this tragedy that is going on, PLEASE PLEASE DO IT!<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robin	None	None	0900006485005160	Stitt	None	2022-04-08T20:41:08Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Stitt, Robin	l1q-llu8-g4j8	False	None	False	2022-04-12 06:39:27.106	[]
4242	CDC-2022-0024-4248	https://api.regulations.gov/v4/comments/CDC-2022-0024-4248	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Diagnosed with the following: Fibromyalgia in 1989, Interstitial Cystitis 2003-Went through all treatments including DMSO, bladder installations with heparin etc. before prescribed opiates to treat severe pain. Stable dose of opiates allowed me to continue bladder therapy. Pelvic Floor Dysfunction-2004. Hashimotos Thyroiditis 2005, severe adenomyosis 2005, ovarian cyst, Osteoarthritis 6 joints 2005 Full hysterectomy 2007, Left knee replacement 2010 (age 43). Tarlov cyst S2 2011, Type 2 diabetic 2011, Autonomic dysfunction caused by Chronic Lyme Disease 2012, Synovitis 8 joints 2012, peripheral neuropathy 2012, Lyme treatment 2013-14, 2014 left knee replacement failed, right knee end stage osteoarthritis 2020. Officially disabled effective 2011-12. Yes my body failed me and yes I was prescribed pain medication to treat all the conditions that I have listted, but the dpse never changed. I followed every rule & regulation, including drug testing. Since 2016, after the CDC was corrupted by PROP to put forth Opioid Guidelines my quality of life has been affected. Why? Because doctors forced tapered my dose to below 90 mme, inadequate to treat my pain from numerous diseases/conditions. Doesn't matter that I took my medication as prescribed. Since then I have been treated as if I'm an addict, not an unlucky person who didn't ask for a broken body filled with pain every waking moment of the day. Live in my body for a day and you too would need to take pain medication! Any quality of life I had left has been taken away from me due to fear and lies. And yes I fought to the best of my ability, but to do so from my chair or bed is impossible when the entire government is on this rampage. To be ignored and treated badly despite following the rules has destroyed my soul. And to feel powerless to change the course my country decided to take in 2016, is beyond anything I have ever witnessed. No more trust in medical system or my physician who fears his license will be taken away or will go to prison bc he treats pain & prescribes pain relieving medicine? Losing my right for privacy, and filled with anxiety every doctor appt or pharmacy fill date is not how I want to live my life. Worse yet, and despite the harm done to people like me the CDC again decides to put out updated guidelines instead of scrapping the destructive 2016 opioid guidelines??? And to keep/add unscientific 50 mme - 90 mme language within the documentation is beyond comprehension in it's tonedeafness! Haven't you done enough damage to innocent pain patients?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485005167	Anonymous	None	2022-04-08T20:41:44Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-loy2-9z68	False	None	False	2022-04-12 06:39:27.326	[]
4243	CDC-2022-0024-4249	https://api.regulations.gov/v4/comments/CDC-2022-0024-4249	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Regulators	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006485005191	Albertine	None	2022-04-08T20:41:56Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Albertine, John	l1q-lxn1-tpfv	False	None	False	2022-04-12 06:39:27.563	[]
4244	CDC-2022-0024-4250	https://api.regulations.gov/v4/comments/CDC-2022-0024-4250	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My restless leg syndrome would be miserable if I couldn’t take a low dose of methadone. I tried lots of different drugs but none worked. Methadone 5 mg is the only thing that has helped.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Frances	None	None	09000064850051ca	Smith	None	2022-04-08T20:42:07Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Frances	l1q-m3s0-zjjc	False	None	False	2022-04-12 06:39:27.770	[]
4245	CDC-2022-0024-4251	https://api.regulations.gov/v4/comments/CDC-2022-0024-4251	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been suffering from this condition for over 25 years and would have no quality if life without my daily dosage of Tramadol as part of my treatment plan. It has been very difficult in recent years due to the prejudices against people using opioids. Pharmacies have attempted to cut off my medications leaving me in severe pain. My pain is managed through a daily dose of opioids which has not changed over the past 20 years.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	09000064850051db	Kendrigan	None	2022-04-08T20:42:22Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Kendrigan, Cheryl	l1q-m56t-sx0c	False	None	False	2022-04-12 06:39:27.977	[]
4246	CDC-2022-0024-4252	https://api.regulations.gov/v4/comments/CDC-2022-0024-4252	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why has the government gotten involved in our <br/>rights to have pain medication prescribed BY DOCTOR. <br/>OUR DOCTORS make sure what is needed. I have several issues and use zanax <br/>On a daily basis. I do not abuse my medication in fact I requested <br/>That my provider write my perscripscion for less pills that I did have <br/>Because I didn't use them. I don't think that the cdc should be<br/>In charge of our medication. People that are in pain should not be<br/>Governed by a group of people that have no idea what the pain is like.<br/>IF you think these practices will remove street drugs you are severely wrong. This practice the cdc is using is doing nothing but forcing street drug people to manufacture their own pills usually with ingredients that<br/>Will kill...<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	09000064850051e6	Cavanaugh	None	2022-04-08T20:42:33Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Cavanaugh , Debbie	l1q-m6k3-mlo3	False	None	False	2022-04-12 06:39:28.183	[]
4247	CDC-2022-0024-4253	https://api.regulations.gov/v4/comments/CDC-2022-0024-4253	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe RLS that doesn't respond well to any of the medications usually prescribed for this disease. My life with RLS has been a sleepless nightmare. I am now on low dose methadone and it is the ONLY treatment that has helped alleviate RLS. I am writing to request that the CDC include chronic diseases like RLS in the treatment guidelines for prescribing opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mardis	None	None	09000064850051ea	Nenno	None	2022-04-08T20:42:46Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Nenno, Mardis	l1q-m6r5-ivvk	False	None	False	2022-04-12 06:39:28.399	[]
4248	CDC-2022-0024-4254	https://api.regulations.gov/v4/comments/CDC-2022-0024-4254	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67 year old retired nurse who has had Restless Leg Syndrome (RLS) since I was 5 years old. Other members of my family also have RLS including my father and one brother. I am writing today to inform you that opiates are an essential component in the management of my severe case of RLS. I had tried and failed treatment with gabapentin, Lyrica and pramipexole, a dopamine agonist. My RLS symptoms include significant aching and restlessness of both legs and arms. Last year, after developing augmentation to the pramipexole, I was able to sleep only two and a half hours per day. Infact, some days passed with no sleep whatsoever. Needless to say, my mood and functioning plummeted to a low level for the 5 months that I was not sleeping. In early August 2021, a sleep neurologist started me on low-dose methadone which has had a miraculous improvement. Taken along with rotigotine, a dopmine agonist patch, I am able to function at an acceptable level. I continue to experience aching of the limbs and restlessness, but I am able to get at least seven hours of sleep each night. If I no longer had access to the methadone, I would be in the same situation I was in last year, aching, restless and sleepless. If opiates like methadone were out of reach, I would no longer be able to function in society.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary Beth	None	None	0900006485005203	Siegel	None	2022-04-08T20:43:06Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Siegel, Mary Beth	l1q-maqk-dl93	False	None	False	2022-04-12 06:39:28.604	[]
4249	CDC-2022-0024-4255	https://api.regulations.gov/v4/comments/CDC-2022-0024-4255	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	If I should ever suffer augmentation or for any reason, need to stop my RLS medication, I would need something, possibly opioids, to be available to me. RLS is the most horrible feelings to experience. With no relief from RLS a person would consider suicide.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	GENEVA	None	None	0900006485005207	JORGENSON	None	2022-04-08T20:43:23Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from JORGENSON, GENEVA	l1q-mbi5-fyt5	False	None	False	2022-04-12 06:39:28.824	[]
4250	CDC-2022-0024-4256	https://api.regulations.gov/v4/comments/CDC-2022-0024-4256	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe RLS, and it was only by accident I discovered that half a tablet of an opioid oxi-contin prescribed for my husband’s knee surgery worked miracles on occasion for my RLS. Please consider this use of opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ann	None	None	090000648500520f	Rounds	None	2022-04-08T20:43:32Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Rounds, Ann	l1q-mcnz-dfx3	False	None	False	2022-04-12 06:39:29.510	[]
4251	CDC-2022-0024-4257	https://api.regulations.gov/v4/comments/CDC-2022-0024-4257	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Regulators,<br/>I am asking for you to consider the potential unintended consequences of regulations which impact users of low dosage opioids for control of Restless Leg Syndrome (RLS). I am 75 and have suffered from RLS for over 15 years. My treating physician [name redacted] at Johns Hopkins, a researcher in the RLS field), prescribed a variety of other types of medications and they were not effective. The result was a significant degradation of my life as consistent sleep became impossible. When all other options had been exhausted, he prescribed low dosage methadone (a few mg/day). The result was immediate and amazing. For the past 5 years, I have been essentially RLS symptom free and my life returned to normal. This low dosage of methadone has been a life changer. I do not suffer any side effects and do not abuse the medication in any way. Please do not make this medication unavailable during you attempts to accomplish a worthwhile goal of controlling opioids. There are very few things in our lives today that can not be misused. Thank you for considering my comments.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006485005228	Albertine	None	2022-04-08T20:44:17Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Albertine, John	l1q-mfb8-s711	False	None	False	2022-04-12 06:39:29.720	[]
4252	CDC-2022-0024-4258	https://api.regulations.gov/v4/comments/CDC-2022-0024-4258	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485005231	None	None	2022-04-08T20:45:07Z	Interstitial Cystitis Association	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Interstitial Cystitis Association	l1q-m3lo-izyr	False	None	False	2022-04-12 06:39:29.946	[]
4253	CDC-2022-0024-4259	https://api.regulations.gov/v4/comments/CDC-2022-0024-4259	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for considering the Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids. I support putting treatment options back in the hands of doctors and patients. I have seen my brother-in-law, who has Childhood Onset Cervical and General Dystonia, go through a series of pain medication changes because of the CDC guidelines. These changes did not take into account neither his pain nor personal health needs, causing him unnecessary consternation and stress while not providing sufficient pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485005233	Anonymous	None	2022-04-08T20:46:27Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-mghr-1ahe	False	None	False	2022-04-12 06:39:30.199	[]
4254	CDC-2022-0024-4260	https://api.regulations.gov/v4/comments/CDC-2022-0024-4260	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am a 54 year old woman and have been on the same low dose of Oxycodone since I was 38 years old. RLS is pervasive in my family one both sides, but I seem to have gotten a more severe case, one which doesn’t respond well to most medications. Early in my diagnosis, I tried about 7 different medications, yoga, acupuncture, chiropractic care and a number of unusual home remedies did my RLS. None worked. One medication that did seem to have a benefit lead for augmentation and a worsening of my symptoms. Others made me ill. The one medication that consistently and effectively relieves my symptoms is Oxycodone. As I’ve mentioned, I have never needed to increase my dose in all these years. I see a sleep disorders specialist yearly at Mass General and he has saved my life. Before I found this effective treatment for my RLS, I wondered how I would continue to live without sleep. It was excruciating and I considered ending my life. I could not sleep at night, I couldn’t enjoy a movie with my husband, professional conferences were awful because I would have to stand or walk around during them. I am a speech-language pathologist and am so blessed with this rewarding career and a wonderful husband. Without this medication, my life would be over. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laurie	None	None	0900006485005234	Hirst	None	2022-04-08T20:47:11Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Hirst, Laurie	l1q-mgl7-2y0d	False	None	False	2022-04-12 06:39:30.413	[]
4255	CDC-2022-0024-4261	https://api.regulations.gov/v4/comments/CDC-2022-0024-4261	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from RLS for many years. The idea of using opioids to manage the condition is ridiculous in my layman’s opinion. The condition can be managed in many ways, is not life threatening as my physician likes to say, and simply should not be managed with opioids. The cure would be worse than the disease, a condition that does not warrant the extreme of opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ron	None	None	0900006485005247	Cerra	None	2022-04-08T20:47:26Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Cerra, Ron	l1q-mj9m-zqzc	False	None	False	2022-04-12 06:39:30.646	[]
4256	CDC-2022-0024-4262	https://api.regulations.gov/v4/comments/CDC-2022-0024-4262	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am grateful the CDC has taken steps to undo some damage done to those patients/doctors that could be classified as collateral damage by the 2016 Guidelines. I am on stable, long term opioid therapy and I do not intend on living this short time on earth in bed. I enjoy being a productive member of society. I don’t enjoy this feeling of being on parole every time I visit my Dr due to pressure put on him and his organization on what were meant only to be recommendations. Opioid therapy is essential to me, just as essential as my eyeglasses are to see, to participate in other pain mitigation therapies (exercise, therapy, massage).I sincerely hope your organization follows through on dropping what has been molded into a one size fits all approach to pain care. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485005254	Anonymous	None	2022-04-08T20:47:38Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-mk3r-do55	False	None	False	2022-04-12 06:39:30.867	[]
4257	CDC-2022-0024-4263	https://api.regulations.gov/v4/comments/CDC-2022-0024-4263	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, please consider adding opioid options to the RLS list of medications. I am a lifelong sufferer of RLS and because of another problem was put on opioid for pain and the RLS completely stopped. It has made a huge difference in my life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485005286	Anonymous	None	2022-04-08T20:47:48Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-moam-fls8	False	None	False	2022-04-12 06:39:31.076	[]
4258	CDC-2022-0024-4264	https://api.regulations.gov/v4/comments/CDC-2022-0024-4264	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have RLS, up until an opiate was found and worked my quality of life did not exist. As years went on it got worse to the point of being debilitating. It then started to affect my mental health. I am lucky to only live an hour from world renowned Mayo Clinic who had a specialist and he was able to find a very low dose Methadone med that has pretty much taken the RLS away, I have no side effect and have stayed on the same does for many years. Thank you [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Luann	None	None	0900006485005297	Rieber	None	2022-04-08T20:48:20Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Rieber, Luann	l1q-mqut-ppdj	False	None	False	2022-04-12 06:39:31.285	[]
4259	CDC-2022-0024-4265	https://api.regulations.gov/v4/comments/CDC-2022-0024-4265	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I need to have access to opioids ass that seems to be the only thing that helps my condition. I take a very low dose.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stanley	None	None	09000064850052b7	Hoernicke	None	2022-04-08T20:49:23Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Hoernicke, Stanley	l1q-muo5-8gha	False	None	False	2022-04-12 06:39:31.498	[]
4260	CDC-2022-0024-4266	https://api.regulations.gov/v4/comments/CDC-2022-0024-4266	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is so difficult to describe the discomfort and problems caused by RLS - it effects my life on a daily basis. The inability to sit or lie still, with nervous like spasms not only on my legs but arms, shoulders, and often my entire torso prevents me from having a normal daily without medication. Spasms and jerking motions may not sound serious but the feelings far exceed any other pain I have endured. Just two tablets of my medication at bedtime alleviates the problem and allows me to have a normal night’s sleep. Please allow this to be included in the guidelines for prescribing opioids. Without it, I could not have a normal life. Thank you for your kind attention.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rochelle	None	None	09000064850052c1	Skelton	None	2022-04-08T20:49:36Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Skelton, Rochelle	l1q-mwhb-0p1w	False	None	False	2022-04-12 06:39:31.743	[]
4261	CDC-2022-0024-4267	https://api.regulations.gov/v4/comments/CDC-2022-0024-4267	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have RLS (Restless Leg Syndrome) I need an opiod in a low dose as needed to adjust my medications I take on a regular schedule to manage my RLS - i.e. I take Requip 2 mg per evening, sometimes I have to keep elevating this dose to manage the RLS. When this happens a small dose of an opiod allows me to decrease the Requip back to my 2 mg per night. Once I am back at a 2 mg of Requip per night I can stop the opiod. This may happen 4-5x /per yr.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathryn	None	None	09000064850052c3	Young	None	2022-04-08T20:49:51Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Kathryn	l1q-mwmz-iml1	False	None	False	2022-04-12 06:39:31.952	[]
4262	CDC-2022-0024-4268	https://api.regulations.gov/v4/comments/CDC-2022-0024-4268	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have spent the past 20 years struggling with Restless Leg Syndrome (RLS). My treatment with dopamine agonists (Requip) have caused me to suffer augmentation. My quality of life has suffered greatly and it has had profound impact on my family as well. Doctors tried to treat my worsening RLS symptoms with antianxiety and antidepressant medications too. At one time I was taking 4 different medications. Not only did I continue to have RLS symptoms but all of those medications caused significant side effects as well. 2 years ago I was finally able to see a neurologist who specializes in RLS. After gabapentin and Lyrica failed to control my symptoms and each caused serious side effects of their own, he started me on low dose opioids. Now, 2 years later, I can tell you that low daily doses of Methadone has changed my life. I no longer take any other medications for RLS and Methadone has not caused any side effects. Methadone has greatly improved my quality of life. Low dose opioids are an important, perhaps lifesaving, treatment for RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tammy	None	None	09000064850052fb	McKenna	None	2022-04-08T20:50:03Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from McKenna, Tammy	l1q-n31x-feki	False	None	False	2022-04-12 06:39:32.167	[]
4263	CDC-2022-0024-4269	https://api.regulations.gov/v4/comments/CDC-2022-0024-4269	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67 year old retired RN that suffers from chronic pain. Around 10 years ago I could not get out of bed anymore to go to work. The pain and fatigue were overwhelming. Fast forward that year, I received a diagnosis of mitochondrial disease. The pain I had assumed was nurses back turned into so much more. My muscles are weak and do not support my skeletal system in my body. They spasm trying to do the job. I had one massage therapist tell me my back felt like concrete. I was referred to a pain management physician. Luckily we used to work together in the operating room. I never felt like he looked down on me. MRI’s confirmed damage as well. Yes I was prescribed opiates to function. This after prior and continual attempts to improve the quality of my life by trying to reduce the pain through PT which really caused more spasms, tens unit, heat/cold packs, anti inflammatories, massage therapy gels and trigger point injections. He retired and his son originally planned to take over the practice.He chose not to because the government had made it so difficult to treat patients. They were anesthesiologists. After a long stressful search I found a NP. After a few visits we parted ways. His temper was horrible and he was not reliable. Again I had to search for pain management. My primary care doctor covers my meds. during the gaps. I then found a DNP that practiced pain management.. He was very professional and closer to my house. The monthly appointments that are always required can be very difficult especially in winter conditions. I have been with him for a few years and now I have lost him because he is not Medicare approved?? Again I am looking. After multiple phone calls and responses of “we don’t prescribe pills” I will probably have to drive at least 30/40 minutes away. That is in all weather conditions to go to an appointment where nothing much changes and I get urine tested monthly as if I am a criminal. My knee is splinted, my TMJ joints are so painful and yes my back is still a problem.Poor muscle strength affects my whole body. There is no treatment for my disease. We are thinking of Florida for a few months this winter but how will I get my meds? Find a doctor down there for a few months? Remember 30 days only or 60 for a vacation only if your insurance company agrees. 80% of primary care doctors will not deal with long term pain management. Make it easier for us. The guidelines must change. Providers must have more independence to treat their patients-as they see fit.And that means dosages. There should not be different guidelines for cancer patients. Which I also had lung cancer in October. I still have pain from the area where the chest tube was. Pain is pain and I for one am very tired of being demonized for wanting pain relief for my disease that has no real treatment. Opiates allow me to function. Make changes to the 2016 guidelines that made it worse. Please feel free to contact me. Thank you for allowing me to submit comments.<span style='padding-left: 30px'></span>Sincerely, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Terri	None	None	0900006485005314	Schelter	None	2022-04-08T20:50:58Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Schelter, Terri	l1q-n4mk-q8yc	False	None	False	2022-04-12 06:39:32.394	[]
4264	CDC-2022-0024-4270	https://api.regulations.gov/v4/comments/CDC-2022-0024-4270	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have grown increasingly alarmed at the failure of the medical profession, due to its fear of prosecution for alleged overprescribing, to alleviate major postsurgical pain or pain arising from acute conditions. I’ve directly experienced this failure after a hysterectomy as well as during the throes of a kidneystone that required emergency room care. It’s now all too common for doctors to breezily tell patients to take ibuprofen in lieu of prescription medication intended for major pain. I implore the CDC to stop what has accurately been called a war on doctors who prescribe pain medication and, by extension, their patients who legitimately and often desperately need real relief And not just the Band-Aid of Tylenol or Advil.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allison	None	None	0900006485005327	Stieber	None	2022-04-08T20:51:10Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Stieber , Allison	l1q-n6d5-vu1g	False	None	False	2022-04-12 06:39:32.612	[]
4265	CDC-2022-0024-4271	https://api.regulations.gov/v4/comments/CDC-2022-0024-4271	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have dealt with Restless Leg Syndrome since my childhood. In those days, it was “growing pains” and required parents to rub your legs each night when you awakened with leg pain and moving around the bed in your sleep. As an adult, I have continued to suffer with RLS. In the past four or five years, I have finally received care from those who are familiar with RLS, have studied the disease and know how to treat RLS. The use of opioids has totally changed my total health. I take only 5 mg at night have have gained more rest and improved total health. I don’t think the average person understands what it means to have RLS. The pain and frustration with constant movement and no sleep at night. It is important that this is taken into consideration when making decisions on the use of opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathryn	None	None	090000648500532e	Stoddard	None	2022-04-08T20:51:24Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from \nStoddard, Kathryn	l1q-n6ra-6cn5	False	None	False	2022-04-12 06:39:32.835	[]
4266	CDC-2022-0024-4272	https://api.regulations.gov/v4/comments/CDC-2022-0024-4272	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My dad has suffered with RLS for most of his adult life. He is currently on Methadone and Lyrica but he still only sleeps in 45 min increments through the night due to full body twitching from RLS. Without the low dose Methadone, I honestly don’t know how or if my dad would function on a daily basis. As a human, I understand the opioid crisis in this country. As a nurse, I also understand and know that opioids have a place in the treatment of medical conditions and are sometimes necessary long term. Restricting opioids from people with legitimate medical conditions that require them to function would be a gross, uninformed decision with life and death consequences to those that rely on opioids to control and manage their medical condition, like RLS. Furthery, restricting opioids from people that rely on them will not help the opioid crisis.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	090000648500536e	Knox	None	2022-04-08T20:57:05Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Knox, Sarah	l1q-nds8-ze5a	False	None	False	2022-04-12 06:39:33.063	[]
4267	CDC-2022-0024-4273	https://api.regulations.gov/v4/comments/CDC-2022-0024-4273	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. Having a method for treating long term care is needed.<br/>The current medicine stops years of exhaustion and fatigue caused by chronic lack of sleep, but the medicine can only be used for a short period of time before it becomes ineffective. Limited doses of opioids could help to pause chronic sleep deprivation and let people get back to a regular lifestyle again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	090000648500536f	Herbein	None	2022-04-08T20:57:18Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Herbein, James	l1q-ndz3-4mrx	False	None	False	2022-04-12 06:39:33.291	[]
4268	CDC-2022-0024-4274	https://api.regulations.gov/v4/comments/CDC-2022-0024-4274	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>I am one of the nearly 12 million people who suffer from RLS in the United States. There is no cure and while there are a few prescription medications may relieve the symptoms for a while, over time these same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I cannot even begin to explain how hopeless and lonely I have felt in the middle of the night when RLS symptoms are causing severe pain and preventing sleep; especially knowing that there is a safe and effective treatment option (low-total-daily-dose opioids). <br/><br/>I am very cognizant of the need for opioid prescribing guidelines; however, because of the strict language used, many patients with legitimate need are not receiving the care they need. This is unethical and bad science.<br/><br/>Over 300 years ago, Sir Thomas Willis first diagnosed RLS and successfully treated patients using opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Emily	None	None	0900006485005374	Birch	None	2022-04-08T20:57:38Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Birch, Emily	l1q-new6-ec1q	False	None	False	2022-04-12 06:39:33.507	[]
4269	CDC-2022-0024-4275	https://api.regulations.gov/v4/comments/CDC-2022-0024-4275	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm writing as an RLS patient, currently using a daily Neupro (dopamine agonist) patch to control restless legs and periodic limb movements. Only someone with this disorder can understand how debilitating it is, but let me tell you that without adequate sleep, none of us can function in society. Untreated, RLS prevents adequate sleep, which can cause a multitude of follow on problems.<br/><br/>I'm aware of two significant issues with dopamine agonists. First, they make me tired during the day--like narcolepsy, falling asleep while working. It's conundrum that a medication to improve sleep also makes one sleepy. I have to be careful about this and I'm only on a mid-range dose. This is made worse, of course, if I haven't slept well the previous night. Second, these drugs don't work forever. The period of time apparently varies by person, but having been using dopamine agonists for about 3 years, I worry what the future will bring.<br/><br/>In short, knowing that treatment alternatives exist is very important. I understand from my reading on this topic that low dose opioids are a potential treatment option for restless legs and periodic limb movement disorder. Preserving these options is very important to me and to many others who have these debilitating disorders.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	090000648500537d	Laffey	None	2022-04-08T20:57:55Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Laffey, Tom	l1q-ngix-8xzw	False	None	False	2022-04-12 06:39:33.746	[]
4270	CDC-2022-0024-4276	https://api.regulations.gov/v4/comments/CDC-2022-0024-4276	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had restless leg syndrome for 5 years. It can rule your life and leave little room for the rest of life! It has taken all this time to find a treatment regimen that minimizes disruptions ( One is never free of the symptoms jumping out.)<br/><br/>I have had nights where I had a choice between pacing all night or taking a small amount of hydrocodone. The hydrocodone takes the restlessness and discomfort of my leg away and I can sleep again.<br/>Simply, I urge you to rely on the input and expertise of <br/>RLS socialist and make opioids available for treatment protocols for this syndrome.<br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary ann	None	None	0900006485005382	Ambrose	None	2022-04-08T20:58:25Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Ambrose, Mary ann	l1q-ngny-i5ps	False	None	False	2022-04-12 06:39:33.955	[]
4271	CDC-2022-0024-4277	https://api.regulations.gov/v4/comments/CDC-2022-0024-4277	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low dose opioids are a life changing treatment for Restless Leg Syndrome patients. As a Registered Nurse and RLS patient, I can testify to the fact that in the 20 years that I have been treated for RLS, daily low dose Methadone has profoundly improved my quality of life. My RLS symptoms are completely managed without any side effects at all. The dopamine agonists I had been taking caused augmentation as well as countless side effects. <br/><br/>Although I do understand the intense focus on opioid abuse, low dose opioid treatment for RLS needs to be protected from any rules or regulations that may make it even harder to obtain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485005398	Anonymous	None	2022-04-08T20:58:36Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-nklq-j9qj	False	None	False	2022-04-12 06:39:34.161	[]
4272	CDC-2022-0024-4278	https://api.regulations.gov/v4/comments/CDC-2022-0024-4278	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In your recommendations, please make allowances for other uses of opioids, such as for the management of restless legs syndrome (RLS, Willis-Ekbom disease). For many sufferers of RLS, low dose opioid are the only option that works. Because low doses are used, there risks are also lower. <br/><br/>I am lucky. I can manage my RLS mostly with diet, exercise, and over the counter supplements. On bad nights I used to take a half of a hydrocodone or oxycodone (1/4 the dose for pain). I now take requip, which increases dopamine (non-opioid, Rx). Because I only need requip a few days a month, I have not developed augmentation (making RLS worse) and it continues to work for me. <br/><br/>Many other people with RLS are not so lucky. They have developed augmentation and cannot take requip or related medications. For them, low dose opioids are the only option that works. Again, these are effective at doses lower than used for pain, so they are safer. I know several people with RLS who are having difficulty getting the low dose opioid medication they need.<br/><br/>Please, in your recommendations, make allowances for the use of opioids for people suffering with RLS.<br/><br/>Thank you so much for your consideration.<br/>[name redacted]<br/>PhD in Biochemistry<br/>Restless legs syndrome sufferer<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bradford	None	None	09000064850053f6	Fanger	None	2022-04-08T20:59:15Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Fanger, Bradford	l1q-nutc-kk1a	False	None	False	2022-04-12 06:39:34.368	[]
4273	CDC-2022-0024-4279	https://api.regulations.gov/v4/comments/CDC-2022-0024-4279	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Obviously, we’ve had an opioid crisis in this country for years created by the [name redacted] and their illegal business practices and perpetuated by the physicians who were too willing to go along with them. We need accessible and quality rehab care for those who are addicted. Not much more needs to be said about that.<br/><br/>There are, however, millions of people experiencing a variety of chronic pain requiring relief. Some of that relief can come through non-opioids, but there are those who need it to get through their days and nights. I happen to be one of those persons.<br/><br/>I have had Restless Leg Syndrome (RLS) since 2007. As most RLS patients, I was prescribed a Parkinson’s medication, and it worked well for several years. And then it didn’t. My physician kept increasing my dosage, but the RLS was getting worse. Then, I went to a neurologist at George Washington University whose answer was to triple my medicine, and I knew that wasn’t the answer. I believe this is call augmentation — when a drug that once worked ends up making your problem worse.<br/><br/>Fortunately, at the time I lived in the DC area and sought out the expertise at Johns Hopkins University - Sleep Medicine Center. [name redacted] and his team have conducted enormous research on RLS treatment. I had hoped that my iron levels were low enough to get the iron transfusion that works in many patients, but it wasn’t. After trying several other drugs, such as Gabapentin, [name redacted] prescribed 10mg of methadone that I take each evening. It saved my life. <br/><br/>Some people think RLS is not a problem — that it’s made up by drug companies — but I can tell you that it is debilitating and ruins lives. Imagine if you couldn’t sleep every single night, that all you could do was walk around and around your house. There’s a reason why the Restless Leg Association names their publication Night Walkers. So I’m up all night, I have an urge that comes on 10-30 seconds before it happens, and then my leg moves involuntarily. The time before the movement is painful. Sometimes it moves into my arms. Imagine that — your legs and arms flailing and there’s nothing you can do about it.<br/><br/>All this movement and my husband couldn’t sleep in the same room with me. I was lucky to get 2-4 hours of sleep at night, and I had to perform during the day at my job.I had a career. It affected performance at my workplace, relationships, and gave me depression.<br/><br/>Methadone changed my life. It’s almost impossible to get. When I moved to Arizona it took me 12 months to find a doctor who would actually read the data from JHU, and now I have a prescription. But, what happens if my doctor retires? When she went on sabbatical last year, I couldn’t get my prescription refilled. Last year when I went on vacation, it was a HUGE issue to get a few pills in advance since I’d run out on vacation. I’m constantly in fear.<br/><br/>You have the power to do something for me and the other millions who are not addicted to these drugs, who take them responsibly, and need them to survive!<br/><br/>Please do the right thing and help us. Please do it.<br/>Thank you for your attention.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	09000064850053fb	Kelly	None	2022-04-08T21:01:33Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Kelly, Anne	l1q-nw7j-e68l	False	None	False	2022-04-12 06:39:34.582	[]
4274	CDC-2022-0024-4280	https://api.regulations.gov/v4/comments/CDC-2022-0024-4280	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless Leg <br/><br/>Restless Leg Syndrome (RLS) is a complex syndrome with many individual variable. Finding the appropriate medication is a fine art between the patient and the practitioner. I have suffered with RLS for over 25 years. I have been fortunate enough to have found movement neurologists who have adjusted my medications several times during that time. There is not a one-size-fits-all for the duration of the syndrome. Having the additional option for an Opioid in cases where all of the traditional pharmaceuticals have failed, sometimes after many years, would be an important option.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485005412	Anonymous	None	2022-04-08T21:01:43Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-nztj-igh6	False	None	False	2022-04-12 06:39:34.804	[]
4275	CDC-2022-0024-4281	https://api.regulations.gov/v4/comments/CDC-2022-0024-4281	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I take a low daily dose (7.5MG) of Methadone to manage my RLS symptoms. IT HAS SAVED MY LIFE. Before Methadone the only option my doctor would prescribe was Mirapex. I began taking Mirapex in 2001, and while it helped with my RLS symptoms, Mirapex (a dopamine agonist) augments, which means you have to increase the dosage over time in order for it to work. Sadly, one day it stops working all together. Mirapex can also cause severe side effects such as gambling, sex, and shopping addictions. These addictions--specifically gambling and sex--RUINED MY LIFE. But I had no other option to treat my RLS (which, if left untreated, would literally drive me crazy). When [name redacted] took me off Mirapex and prescribed the low dose of Methadone, my addictions disappeared. My RLS is the best it has ever been. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. PLEASE!<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006485005415	Sanders	None	2022-04-08T21:03:15Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Sanders, Joseph	l1q-o0go-adpv	False	None	False	2022-04-12 06:39:35.015	[]
4276	CDC-2022-0024-4282	https://api.regulations.gov/v4/comments/CDC-2022-0024-4282	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Today my pharmacy informed me they would no longer fill my perscriptions because they exceeded the 50mme level.Where does this stop? I've been fortunate to be able to live a productive life because my pain has been controlled. I fear for my future and my quality of life. Please don't continue to harm so many of us to the extent that some have chosen suicide.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500541d	Anonymous	None	2022-04-08T21:03:29Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-o19g-yhe3	False	None	False	2022-04-12 06:39:35.246	[]
4277	CDC-2022-0024-4283	https://api.regulations.gov/v4/comments/CDC-2022-0024-4283	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been dealing with RLS all my life (79 years old). I don't use a lot of opoids, but when I need them, they are a godsend as nothing else works. I currently have trouble getting the doctor to order enough. I use 2 tramadol.50mg daily. I have been out for 2 weeks and get no response when I call the office, consequently I have had to use more of my hydrocodone/apap than normal<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485005422	Anonymous	None	2022-04-08T21:03:41Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-o2ni-ghxj	False	None	False	2022-04-12 06:39:35.458	[]
4278	CDC-2022-0024-4284	https://api.regulations.gov/v4/comments/CDC-2022-0024-4284	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless leg syndrome is a relentless neurological problem that has no cure. The medications prescribed for it now either have many negative side effects, require increasing dosages and often don’t work at all. I am on gabapentin currently and my doctor has continually increased the dosage which is effective for a short time but needs to be frequently adjusted upwards. It also takes 2-21/2 hours to take effect. Being able to take a small dose of opioids, even PRN would be a blessing. I’ve used a half tablet of Vicodin as needed in the past and this allows me to get a good night’s rest. However my neurologist is hesitant to prescribe it. ( I use the tablets from a previous surgery). Please consider allowing the use of opioids for this disease. I believe studies have shown sufferers of RLS are unlikely to suffer addiction issues.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marcia	None	None	0900006485005426	Geraghty	None	2022-04-08T21:04:12Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Geraghty, Marcia	l1q-o2zc-vy5i	False	None	False	2022-04-12 06:39:35.677	[]
4279	CDC-2022-0024-4285	https://api.regulations.gov/v4/comments/CDC-2022-0024-4285	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from RLS for 56 yrs, since I was 21. It gets progressively worse, meaning my legs, trunk and firearms tingle ALL NIGHT, EVERY NIGHT. OPIATES (methadone & slow release morphine) and the ONLY medications that provide relief > I’ve tried them ALL. Without opiates, my life is not manageable because I would never have nighttime relief. PLEASE have mercy and keep access available.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Margaret	None	None	0900006485007bc1	Johnston	None	2022-04-08T21:04:47Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Johnston, Margaret	l1q-wtrm-56fe	False	None	False	2022-04-12 06:39:35.885	[]
4280	CDC-2022-0024-4286	https://api.regulations.gov/v4/comments/CDC-2022-0024-4286	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with RLS for 30 years. It is very frustrating trying to find an effective med. regimen.Initially, I was treated by my PCP with gabapentin, cloazepam, and ropinolol. That was helpful, but not a solution.<br/>Based on my experience, I don't think there is a solution. It is a very difficult condition to try to deal with. It makes it nearly impossible to sleep. It often happens when I am at the movies or on an airplane. My friends and family don't understand it. They suggest herbal remedies, etc. It is socially awkward.<br/>For nearly two years I have been seeing a neurologist that specializes in sleep disorders. He eliminated the clonazepam and prescribed doxepin and increased the gabapentin. He said I should take iron and vitamin B12 supplements daily. That didn't help. I tried alcohol or marijuana, but that wasn't helpful. When you have this condition, you become quite desperate for relief and a good night's sleep. Recently, lorazepam ( 0.5 mg at bedtime) has been added to the gabapentin and ropinolol. It is helpful, but again, not a solution.<br/>At a minimum, I think opiods would be very helpful when the effectiveness of the ropinolol subsides (augmentation ); usually a week or two before you're able to get back on a low dose of ropinolol.<br/>For years I have dreaded going to bed at night because it means hours of tossing and turning at the mercy of RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Marydale	None	None	0900006485007bb5	Stevens	None	2022-04-08T21:05:12Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Stevens, Marydale	l1q-wsfq-wywt	False	None	False	2022-04-12 06:39:36.095	[]
4281	CDC-2022-0024-4287	https://api.regulations.gov/v4/comments/CDC-2022-0024-4287	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am 66 years old and was diagnosed with RLS in approximately 1996. I was treated with Klonopin, which caused me to experience severe clinical depression. It stole my life for 3 years. Then other drugs were tried, Requip, Mirapex, etc., etc. I had life-altering side effects on every one of them. Finally my neurologist said he had only one thing left and that was Methadone. I said let's do it. I have been taking two 5 milligram tablets before bedtime for over 10 years now with no need for an increase in dosage. I have had NO side effects from this drug. And it has resolved my restless legs BETTER than any of the drugs specific to the issue! In my opinion this should be the FIRST medication attempted for RLS and should be prescribed to everyone who has no addiction issue or other specific issue which would preclude its use.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	MARLA	None	None	0900006485007ba3	FISHER	None	2022-04-08T21:09:02Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from FISHER, MARLA	l1q-wqnp-88kt	False	None	False	2022-04-12 06:39:36.316	[]
4282	CDC-2022-0024-4288	https://api.regulations.gov/v4/comments/CDC-2022-0024-4288	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I live in Oregon. The state of Oregon has weaponised the GLS & is actively forcing pain patients to taper to 50 MMEs against their will. <br/>Please stop forcing pain patients to suffer. <br/>I have PTSD from undertreated pain & I am also being forced into disability, when the right medication could allow me to work.My life is automatically shortened because I have no income. The CDC GLs are putting my life in danger in multiple ways. If I should need more than 50 MMEs and I cannot endure the pain I am increased risk of suicide. My MD may fire me if I need more pain medication. If my MD I have now moves, quits or I lose my insurance I most likely won't be able to find a MD willing to take me since my medical conditions are all pain causing conditions. I have so much pain that I may have a stroke, heart attack & am at risk of suicide because my medical conditions are so painful they increase my risk to 10x or more than that of someone who doesn't have my pain condition. <br/>These are very cruel policies that fail miserably. <br/><br/>Please throw out and redact the CDC GLs. Please stop these harmful policies. <br/>The CDC GLs have failed epically please NO MORE! Please stop making medical patients endure this dred human experiment.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007b75	Anonymous	None	2022-04-08T21:09:39Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-wjl9-bspu	False	None	False	2022-04-12 06:39:36.524	[]
4283	CDC-2022-0024-4289	https://api.regulations.gov/v4/comments/CDC-2022-0024-4289	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a 57-year-old male who suffers from a severe case of restless leg syndrome for several decades. I've tried nearly every treatment in the books and some that were not in the books. Low doses of methadone (and some other opioids) as a treatment for RLS has changed my life forever. When taken as prescribed by a knowledgeable doctor, nothing has been more effective at treating RLS. Not a lot of doctors are sufficiently educated about RLS, and the ones who are typically avoid prescribing opioids because of the stigma attached to it. Even correctly writing the prescription can be very tricky because of the way they are supposed to be written. Doctors need to be able to write for opioids when appropriate for many RLS cases. Some patients have no other option for effective treatment. As opioid tolerances increase (as far as "getting high"), RLS treatment effectiveness remains strong. Usually, Parkinsons medications are the first line of treatment for RLS, which can lead to augmentation and refractory RLS. Opioids do not have that problem. Opioids should be the first line of treatment for RLS so as to avoid augmentation and refraction altogether.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	0900006485007b52	Stroker	None	2022-04-08T21:10:06Z	None	None	1	None	2022-04-08T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Stroker, David	l1q-wehj-cnee	False	None	False	2022-04-12 06:39:36.948	[]
4284	CDC-2022-0024-4290	https://api.regulations.gov/v4/comments/CDC-2022-0024-4290	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I've had RLS since I was a child, I am now 55. The only way to describe RLS is that it is like being tortured. The feeling hits me, most nights at the end of a long day as I am relaxing or in bed. It feels like maggots are crawling under my skin in my thighs and are wiggling under the skin and in the muscle. The need to move them is overwhelming. Without medication, this feeling can go on for hours. Many RLS patients end up in a very dark place mentally if this continues for nights and weeks. A low dose opiod helps many of us get some relief. It doesn't completely eleviate the symptoms, but does reduce the symptoms.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Matthew (Matt)	None	None	090000648500529a	Hill	None	2022-04-09T17:15:44Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Hill, Matthew (Matt)	l1q-mry1-2lh5	False	None	False	2022-04-12 06:39:37.169	[]
4285	CDC-2022-0024-4291	https://api.regulations.gov/v4/comments/CDC-2022-0024-4291	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I currently take 2 medications (Mirapex 0.5 x’s 2 twice a day, Horizant 600MG x’s 2 once a day, and Neupro Patch 3MG 24 hours daily). If there is a better remedy I feel its your obligation to help us suffering from extreme cases of RLS. I’m 65 yrs old and have been suffering since I was 15 yrs old. Why won’t you help? It not only affects my life but my husbands as well. [name redacted] NY	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeanne	None	None	0900006485007617	Cavanaugh	None	2022-04-09T17:21:17Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Cavanaugh, Jeanne	l1q-ruxh-htwm	False	None	False	2022-04-12 06:39:37.394	[]
4286	CDC-2022-0024-4292	https://api.regulations.gov/v4/comments/CDC-2022-0024-4292	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good day,<br/> My true statement MUST be heard, so please allow me to show who I am, and how prescribed opiates have made my life livable. <br/> I am 69 years old, a former high school athlete that played multiple contact sports, and weightlifted. I was often injured during my school contact sports career, but remained very active through my 2 years of college. My fulltime work career began immediately after leaving college, in a physical position. As I gained experience and knowledge of my chosen field, after approximately 10 years, I was promoted to the bottom supervisory rung of a large governmental operation. This position was more sedentary, yet provided enough hands on old fashioned work, to keep me moderately fit. As I gained additional knowledge and experience, I was repeatedly promoted to the point of gaining a position within the top 5% level of management. Our Federal Government entrusted me to coordinate multifaceted operations that managed employees, a fleet, and facilities that provided Service to our Country. I was proud of my contributions. When I retired, I continued to work in a more sedentary part time position, with much less "Stress" that was part and parcel of my prior Management position. In my time off, I coached my son's Little League teams from 8 to 18 years old. I have told you all this to try and paint a picture of who I am, what I have done, and the impact of what my current Opiate Provider is putting me through. <br/> Approximately 2 years after I retired from my fulltime position, I began to have lower back pain. I saw my Primary Doctor, who after recommending Physical Therapy, heating pads, etc., and I followed through, but my pain increased. I was referred to Pennsylvania's [health facility name redacted] Rehab Hospital Pain Specialists, who examined me, took x-rays, and an MRI of my lower back. What they found was spinal curvature, degenerative disease of my lumbar spine, including Ankylosing Spondylitis. <br/> Their help was complicated by my Renal Insufficiency that prevents my ability to take NSAIDS. This is when I introduced to assistance from Tens units, multiple steroid injections and Opiates. My pain was finally under control, I could sleep at night. This was approximately 10 years ago. <br/> I continue to receive either steroid injections and or Radio Frequency Ablations on at least 6 locations of my lumbar back, as I continue opiate prescriptions.<span style='padding-left: 30px'></span><br/> My use of opiates increased as my pain became unbearable. After these 10 years, my current opiate provider has stated that because I am "at your max of 90 MME's" they could NEVER approve any additional opiates, and suggested multiple Opiate Releasing Implants as .."the only additional way I can help". It appears to me that the provider was SURE that 90 MME's was a ROCK SOLID MAXIMUM, that anything more may NOT be approved, that any additional pain I may encounter for the rest of my life be handled by insertion of multiple devices for each area of pain generation, that I DO NOT WISH IN MY BODY. For me personally, it appears I will need at least 6 such implants. I find that to be unacceptable. <br/> When I asked my current fantastic Interventionalist about these Opiate Releasing Implants, he told me he has 12 patients currently using them, and 2 like them, the rest hate them, because for them they don't work very well. He wasn't a fan of these implants.<br/> When I heard about this outreach from our Federal Government, and I read over the associated information provided, it appears my opiate provider has been directed by their "higher ups" to stay well clear of that 90 MME threshold, because I was told, "to keep the government off our back"...<br/> So, what is it...Is it a HARD number, or do providers have options of individualizing opioid pain management?<br/> Opioid therapy has allowed me a richer, more fulfilling life. A case in point was when there was a human error by my pharmacy, when they issued me hydrocodone rather than prescribed oxycodone. Within a day or so, my pain became unbearable. I was living in my bed, and needed my walker to get from my bed to the couch 25 away, and the bathroom, another 25 feet away. I could NOT even step outside, due to the pain. This went on for about a week. When the prescribing error was found, and after verification, the proper dosage and opiate was finally taken, within a day, I was able to resume my normal activities. With proper meds, I am able to mow and edge my lawn, go fishing, take moderately long car trips, take walks of well over a mile, play with my Great Dane, and practice softball with my granddaughter. <br/> Please insure prescribers KNOW they have the option to individualize opioid prescriptions, rather than comply with a ridged, governmental mandated maximum. <br/><br/> <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	al	None	None	0900006485007624	testa	None	2022-04-09T17:22:58Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from testa, al	l1q-rwfe-53fb	False	None	False	2022-04-12 06:39:37.604	[]
4287	CDC-2022-0024-4293	https://api.regulations.gov/v4/comments/CDC-2022-0024-4293	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC, as a chronic pain patient for nine years, I can tell you how to improve your guidelines for pain patients: tear them up and butt out. You have done nothing but promote the financial welfare of anti-opiod interest individuals and groups for the last five years. You have made my life and the lives of countless others living hells and sold us out to politicians for a sound bite. You have caused untold suicides. <br/><br/>Prior to 2018, I was able to take Opana (4 per day) for my main pain and Hydrocodone (up to 6 per day) for my breakthrough pain. They were prescribed by my GP, an excellent doctor who knew my conditions and was able to coordinate my care.<br/><br/>That changed in 2018. At urging from YOU and the anti-opioid interests who "counseled" you, politicians passed over 500 laws to take away the only truly effective medication for pain we have. Within months, my excellent doctor left for another state. Now, I was left to the care of overworked doctors in a clinic who had no real interest or time in my care and who were not allowed to prescribe pain medication. No, for that I had to go to a special pain clinic, overwhelmed, with no knowledge of my background and no time to hear or read my medical history. I now have to pee in a cup like a prisoner and submit to idiotic questionnaires about my mental health whenever I limp through their doors. My Opana was yanked off the market by political witch hunts and nothing was given to me to make up for it. It was not tapered; one day it was there and the next it wasn't and nobody gave a rodent's furry posterior of what that did to me. My Hydrocodone was taken away, too, by a doctor (without reading my medical history and told me not to talk) who told me, "You're getting old and will just have to get used to pain". I was finally able to get 4 tablets back, the most they could give me, at the pain clinic.<br/><br/>I no longer talk to my brother, because in 2018 he was convinced by your simplistic anti-opiate propaganda, that I was now a drug user, no better than a heroin dealer.<br/><br/>But the worst thing that happened was the pain, the dreadful and overwhelming pain that face every day. I get up in pain, crying, every day. I take a Hydrocodone that only takes the edge off of the pain (does not get rid of the pain, just makes it almost tolerable) for four, not six hours. Instead of leading a normal life, I am trapped inside on a chair or bed. I can no longer take walks because of the pain. I am never out of pain, never comfortable.<br/><br/>I am very angry that you, the CDC, and politicians, now prescribe. I am very angry that you treat me no differently than a drug addict. You aren't taking addicts off the street (as if that is even your perview, which it is not), when I look around at the waiting room of my clinic, I see primarily woman over 45; you are making grandma a criminal. <br/><br/>You have ruined my life, but at least I am still alive to tell my story. Not so many are that lucky. You have created a system that ignores pain and sweeps the suicides under the rug. If you really want to do something, admit this is none of your business and tell the Federal government to rescind their pain Nazi laws. Let doctors alone do the prescribing and stop trying to manage them and their patients.<br/><br/>If you need a cause, how about stairs? Tens of thousands of people die from stairs every year more than opiates, yet I have never heard of a "war on stairs". I look forward to it.<br/><br/>I hope there really is kharma in the world, because the CDC deserves some really nasty kharma to make up for the persecution of pain patients. And that's what it has been for us, political persecution by righteous zealots, some of which are laughing as they bank their profits from Suboxone and high dollar anti-opioid clinics. The CDC is a despicable tool of anti-opioid interests, with us, the people in pain, paying for your political gain. Kharma on you and your loved ones!<br/><br/>Before 2018, I was able to still go for walks and still lead an almost normal life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006485007638	Check	None	2022-04-09T17:24:21Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Check, Pamela	l1q-rx6d-6ipg	False	None	False	2022-04-12 06:39:37.822	[]
4288	CDC-2022-0024-4294	https://api.regulations.gov/v4/comments/CDC-2022-0024-4294	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Doctors over-prescribing opioids did not cause our drug crisis. According to CDC's data, nearly half of all overdoses don’t involve prescribed opioids at all. Among the remaining drug-related deaths in 2017, half involved illicit fentanyl and heroin. Only about 18,000 deaths involved a prescription opioid, and most of those also involved multiple illegal drugs and alcohol.<br/><br/>The National Institute on Drug Abuse says most addicts begin to abuse drugs in their teens or early 20s. Contrast that with pain patients on opioid therapy, the majority of which are over age 55. Seniors are prescribed opioids three times more often than youth under age 18, yet somehow seniors have the lowest overdose rates of any age group, and youth overdose six times more often. Prescriptions aren’t the problem.<br/><br/>Restricting pain medication to pain patients won’t stem the tide of illicit fentanyl and heroin overdose deaths. Forcing pain patients off the only medications that work, providing no alternatives, and driving those same patients to street drugs and, increasingly, to suicide won’t help either.<br/><br/>Lawmakers must direct their attention to the real problem--the rising tide of illicit street drugs--and stop persecuting pain patients, the most vulnerable among us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	0900006485007643	Deitrick	None	2022-04-09T17:24:47Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Deitrick, Kimberly	l1q-ryac-aaku	False	None	False	2022-04-12 06:39:38.069	[]
4289	CDC-2022-0024-4295	https://api.regulations.gov/v4/comments/CDC-2022-0024-4295	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered with RLS symptoms for 15 years, most of that time with full body symptoms, which continue today. Other medications caused irreversible symptom augmentation. Before my doctor prescribed low dose opioid treatment for me, I was only able to sleep intermittently for a few hours a night - my ability to work and participate in activities and my relationships were suffering. With proper treatment, I have been able to work to support my family and put 2 children through college. Low dose opioid treatment has literally been life changing for me and my family.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RLS	None	None	0900006485007655	Patient	None	2022-04-09T17:25:20Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Patient, RLS	l1q-s13f-p5eh	False	None	False	2022-04-12 06:39:38.298	[]
4290	CDC-2022-0024-4296	https://api.regulations.gov/v4/comments/CDC-2022-0024-4296	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You have no idea how bad RLS can affect your over-all health and your every day life if you haven't had RLS. I've tried all the over the counter pills and creams to no avail. Maybe if you just have Mild symptoms, they might work. But my symptoms are so severe that even prescription drugs aren't helping anymore. My legs literally jump up in the air when I try to go to sleep. So, YES, I approve of someone using Opiods if that's what will help. I'm willing to try anything to have just one night without my legs jumping and creepy crawling feelings that keep me up all night. I do think that the Opiods should be followed very closely though to assure that they're being used properly and not being prescribed to someone without them trying all else that could be prescribed for their situation. And just have the patient be monitored closely. And not given to anyone with a prior addiction to them. I think that if they're used safely, they can be a Huge help for anyone who suffers like I do. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nichola	None	None	0900006485007670	Lugris	None	2022-04-09T17:25:32Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Lugris, Nichola	l1q-s7xh-9u21	False	None	False	2022-04-12 06:39:38.529	[]
4291	CDC-2022-0024-4297	https://api.regulations.gov/v4/comments/CDC-2022-0024-4297	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from many painful chronic illnesses and have been horribly mistreated by the medical community by way of the CDC opioid prescribing guidelines. I have in recent years developed PTSD. My PTSD is from having to be involved in the current medical system in order to manage my pain. Based on thousands of comments by patients in pain support groups, I know that PTSD from medical mistreatment is spreading like wildfire among the chronic pain community. Consequently, we are seeing and will continue to see: a rise in pain-induced death from medical collapse, more pain patient suicides (which in the current environment may well be labeled “accidental overdose”) and an increase in chronic pain sufferers seeking relief outside of the medical system. <br/><br/>In the face of pain patients, most doctors have abandoned their oaths to “do no harm” either out of fear of the rogue DEA or as a result of propaganda-style misinformation from our now highly politicized medical schools and media. Under similar oaths, I assume, nurses and pharmacists have also become negligent and outright cruel to pain patients. It is systematic abuse of the disabled.<br/><br/>The CDC needs to correct the immense amount of damage these prescribing guidelines have done by withdrawing all opioid prescribing guidelines! This flagrant abuse of human rights has got to stop, and we know the new 2022 opioid prescribing guidelines are going to cause even more damage to the lives of the disabled! THE CDC MUST OPENLY AND AGGRESSIVELY PUSH TO GIVE THE POWER BACK TO THE DOCTOR’S. THE DEA FEARMONGERING AND BLATANT ABUSE OF POWER NEEDS TO STOP. THEY SHOULD SPEAK OUT PUBLICLY ON THE SIDE OF THE 50 MILLION CHRONIC PAIN PATIENTS! Somehow, in a culture that defines itself as a champion for the exploited, everyone has benefitted but those most in need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500767b	Anonymous	None	2022-04-09T17:26:05Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-s8u3-7s7d	False	None	False	2022-04-12 06:39:38.751	[]
4292	CDC-2022-0024-4298	https://api.regulations.gov/v4/comments/CDC-2022-0024-4298	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC Guideline for Prescribing Opioids has caused immeasurable harm, pain and suffering for patients diagnosed with chronic pain. The 2022 proposed Guideline will only compound the harms already institutionalized by near universal misapplication of the 2016 guidelines. The 50 MME/day caution will be understood to mean the new hard limit. Clearly, CDC's 2019 press release “CDC Advises Against Misapplication of the Guideline for Prescribing Opioids for Chronic Pain” has had no effect in curbing “hard limits”, “abrupt tapering” or “sudden discontinuation of opioids”, with and without patient consent. Why would the CDC now expect a different outcome?<br/><br/>The American Medical Association (AMA) has criticized the CDC Guideline in a letter to CDC, June 16, 2020:<br/>“The nation no longer has a prescription opioid-driven epidemic”<br/>“The CDC Guideline has harmed patients”<br/>“The CDC Guideline has been misapplied as a hard policy threshold by states, health plans,pharmacy chains, and PBMs”<br/>“While the AMA understands that the apparent goal of the CDC Guideline was to reduce opioid prescribing, we believe the proper role of CDC is to improve pain care (emphasis added). It follows that a dedicated effort must be made to undo the damage from the misapplication of the CDC Guideline.”<br/><br/>The CDC process has been contaminated with secrecy, conflicts of interest and methodological bias from the outset. Not until the Washington Legal Foundation (WLF) threatened legal action due to CDC’s failure to follow Federal Law did CDC open the process to public scrutiny. In the WLF’s November 17, 2015 letter to CDC they write “CDC’s secrecy and it’s apparent indifference to conflicts of interest by those likely to support new restrictions on opioids, have led many to conclude that CDC is uninterested in conducting administrative proceedings that give all interested stakeholders an equal opportunity to influence the agency’s decision making.” That influence has permeated the entire process with ideological bias.<br/><br/>Equally troubling is the incestuous nature of the funding of the “evidence-based” research upon which the Guideline relies, in particular, the relationship between the Agency for Healthcare Research and Quality (AHRQ), the Pacific Northwest Evidence-based Practice Center (EPC), Oregon Health and Science University (OHSU) and a co-author of the 2016 and 2022 Guidelines. That same co-author:<br/>1. has publicly advocated restrictions on opioid prescribing since at least 2011<br/>2. contracts with AHRQ to conduct reviews of opioid studies<br/>3. is employed by OHSU, which has received $500,000 in funding from AHRQ to conduct opiate studies<br/>4. is Director of EPC, which is a program within OHSU which conducts the studies, which said co-author then reviews and then cites as clinical evidence as co-author of the draft Guideline<br/>5. is cited more than one hundred times in the 2020 Proposed Guideline as author or co-author of the reviews which comprise the “systematic clinical evidence” supporting the Guideline’s recommendations<br/>6. is a member of the Board of Scientific Counselors which has oversight responsibility, including final approval of the Guideline.<br/><br/>Health is a human right and to be free of pain is integral to that right. If a patient is informed of the risk and benefit associated with taking an opiate analgesic, that decision should be made between physician and patient, without CDC and DEA overreach. As the AMA has stated, “The nation no longer has a prescription opioid-driven epidemic” and “While the AMA understands that the apparent goal of the CDC Guideline was to reduce opioid prescribing, we believe the proper role of CDC is to improve pain care. It follows that a dedicated effort must be made to undo the damage from the misapplication of the CDC Guideline.”	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	09000064850076c2	Smith	None	2022-04-09T17:29:31Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, David	l1q-sj7p-4q10	False	None	False	2022-04-12 06:39:38.976	[]
4293	CDC-2022-0024-4299	https://api.regulations.gov/v4/comments/CDC-2022-0024-4299	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Good Afternoon, I am grateful your agency has decided to revisit and potentially undo some cross fire damage done to patients/doctors from the initial guidelines. I have been on stable, long term opioid (and low dose benzodiazepine) therapy for many years. I would be bedridden if not. I am an active member of society with these, and they allow me to participate in alternative therapies as well. I hope your agency follows through on the updates as proposed. It is obvious that some behind the anti-opioid agenda (not all) have concerns that don’t stray from the dollar sign. This is my second comment, I am unsure if my first was successfully posted.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850076e8	Anonymous	None	2022-04-09T17:29:48Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-su6z-r69o	False	None	False	2022-04-12 06:39:39.200	[]
4294	CDC-2022-0024-4300	https://api.regulations.gov/v4/comments/CDC-2022-0024-4300	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While we are grateful for the revision of the CDC Clinical Practice Opioid Prescribing Guideline, the draft does not address chronic conditions like RLS which vary from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have had primary RLS for over 28 yrs and began secondary RLS approx five years ago. I’ve been on opioids, a small dose, for approx 12 years after trying multiple medications without help or with horrible side effects. Now my RLS is worsened with the secondary RLS, but the doctors are reticent to order any more due to “controlled substance”. Have had problems when admitted to hospital with Drs not wanting to order my opioid, even though it’s only one pill. I would only wish people making the laws preventing those of us with RLS from getting the medications that help, could experience RLS for themselves for several days to see how the quality of their life is affected. Then multiply this night after night for years! Many RLS websites list the suicide prevention hotline number at the top of site as people with this disease can be driven to taking their lives to get some kind of relief. Made to feel like a drug abuser when I go to pharmacy to pick up med or when I have to sign documents at Drs office that I won’t sell my medication. Why would I do that when I need it?? Made to feel like a drug addict (although I’ve had NO increase in meds for 12 years) when I go to Dr to seek help. Am guessing many other people who have cancer pain, etc, are being treated the same so they can get some relief. It’s shameful that in this country our Drs don’t have freedom to treat their patients the way they KNOW would help them. Need to use CPAP but can’t use much due to be up every hour to two hours for hours which is affecting my health. <br/><br/>My understanding is the regulation changes occurred due some in society who have abused opioids. This leads me to feel alcohol should be regulated or restricted then, as many more murders, car accidents, beatings occur due to the prevalence of alcohol usage. Perhaps even lawsuits against alcohol manufacturers. It seems to make as much sense as what is being done to those of us looking for any kind of relief for sleep. And, unlike alcohol which is NOT necessary for life, our opioids afford us the only relief we can get for sleep. Sleep deprivation creates many health problems. Long term lack if sleep increases risk of obesity, diabetes, and heart and blood vessel (cardiovascular) disease, GI issues, decreased ability to fight infectious diseases, not to mention psychological issues such as depression, memory issues, inability to make plans as we don’t know “how the night will go and how exhausted we will be to do anything the following day.”<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>I understand I’ve been very wordy in this document. Hard to not want to explain all the angles as this affects my quality of life SO MUCH. Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007707	Anonymous	None	2022-04-09T17:30:31Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-svkm-hzrq	False	None	False	2022-04-12 06:39:39.415	[]
4295	CDC-2022-0024-4301	https://api.regulations.gov/v4/comments/CDC-2022-0024-4301	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75 year old retired physician (Professor Emeritus Medicine, [medical school name redacted] . I was struck 3 years ago with severe painful restless leg syndrome. Maximum doses of gabapentin did not help. I was down to 2 hours of sleep each night. My MD decreased my gabapentin to 600 mg tid and added methadone. I have been on a stable dose of methadone 10 mg for 2 years. This medication made my life livable. I am now able to get between 7 and 8 hours of sleep each night. When I began taking methadone I went through a real circus trying to get my insurance company to cover this medication. The cost of the drug is small; I now copay $2.00. However, not having the insurance automatically approve the drug complicated my getting a monthly refill of the drug for almost half a year--each time my getting the drug would be delayed and I would then pay out of pocket to get the 30 day supply. This whole process was humiliating--I was made to feel like a junky. Thankfully, my insurance is approving the drug now. Having opioids as an approved practice guideline would really help RLS sufferers such as me. Thank you for this opportunity to comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeffrey	None	None	090000648500770b	Jones	None	2022-04-09T17:31:09Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Jeffrey	l1q-sx19-5n8y	False	None	False	2022-04-12 06:39:39.628	[]
4296	CDC-2022-0024-4302	https://api.regulations.gov/v4/comments/CDC-2022-0024-4302	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include RLS in the Opioid prescribing guidelines, I am 66 years old and I have Refactory RLS, I've suffered with RLS for over 30 years, my legs and left arm ache and jerk around terribly!!! I have even considered hurting myself because there is no relief!! Until I started taking 5mg of Methadone and that is the ONLY medication that has helped ! I haven't had any symptoms for about 6 or 7 month's now, it is vitally important, PLEASE help as much as you can...Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006485006c1c	Gustovich	None	2022-04-09T17:31:16Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Gustovich, Mark	l1q-t8tp-xhe3	False	None	False	2022-04-12 06:39:39.840	[]
4297	CDC-2022-0024-4303	https://api.regulations.gov/v4/comments/CDC-2022-0024-4303	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for considering putting RLS on the opioid list. I have suffered with it for about 50 years. My mother and sisters also suffer, with my mom and I being the worst. I tried the dopamine agonists for many years but they had to keep increasing my dosage until finally I was on 4 mg of requip plus Horizant, and then tried Neupro patch. I had augmented and NOTHING helped. I honestly thought I was going to lose my mind. You see, RLS affects your sleep so drastically and also your way of living. Travel is out of the question. Sleep is practically non-existent and will drive you to insanity. I finally found a sleep specialist/neurologist who prescribed a low dose of methadone. This doctor changed my life!!! I thank him every chance I get. <br/><br/>On the other hand, my mother is 77 years old. She has had hip and knee replacements, a rod in one ankle and has suffered terribly. In addition to these issues, she has severe RLS. Her GP has tried everything he knows and it doesn’t work. She cries. She walks the floors all night. She doesn’t sleep. She is pitiful and I am terribly worried that she may do something drastic! Something has to be done! I’ve talked to so many people who have considered suicide because this condition will drive you to it! I know how hopeless one can feel. <br/><br/>Please help us by adding RLS to the list!!! It only takes a low dose but it changes lives.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janice	None	None	0900006485006c27	Kotouch	None	2022-04-09T17:31:37Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Kotouch, Janice	l1q-taj8-cekb	False	None	False	2022-04-12 06:39:40.052	[]
4298	CDC-2022-0024-4304	https://api.regulations.gov/v4/comments/CDC-2022-0024-4304	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person that has had chronic pain and other symptoms from a permanently and excessively sensitized central nervous system (CNS), I would like to make everyone aware that tramadol (an opioid), has been very efficient in suppressing symptoms for me when other medications I take (often) fail. <br/><br/> I've taken small doses of tramadol regularly for over 20 years and never had any need to increase dosage, nor have I become addicted or felt any "high." Though I don't take tramadol everyday, I need it because often nothing else works to calm my CNS. I feel I shouldn't be made to go through the humiliation of convincing doctors I'm not lying and not an addict simply to get a prescription for a medication that makes a fairly normal life possible for me. <br/><br/> In recent years however, I've had an increasingly hard time getting doctors to prescribe it for me. And even with a prescription, I am forced to make multiple trips to the pharmacy because I cannot get more than a few pills at a time. I would like to be able to get a 60-pill supply all at once-- like the other medications I need. <br/><br/> Tramadol calms my nervous system without drowsiness as nothing else does:<br/> It stops my interstitial cystitis bladder pain that results from consumption of a glutamate (or glutamate-enhancing) additive in restaurant food. <br/> In spring, when pollen inflames my sinuses, antihistamines and anti-inflammatories don't work without tramadol. That's because a localized, nasal allergic reaction sets off a body-wide nerve response that includes severe skin itching, excruciating middle ear pain, and migraines. <br/> Gentle exercise and an oral antidepressant keeps my fibromyalgia in check usually, but if I overdo it the muscle pain can be severe. Nothing stops the pain so quickly as a small dose of tramadol.<br/> But worst of all, because of CNS-provoked symptoms triggered by my various medical issues, I can't sleep. Sleep deprivation, I understand from many studies, can sensitize the CNS or exacerbate its sensitization to stimuli. Tramadol calms my nervous system so I can sleep despite a flareup of whatever is the issue at the moment.<br/> For me, tramadol is a necessity like food and water. Please loosen the regulations so people like me can easily get what we need. <br/><br/> And by the way, here's a suggestion for a national solution: why not have some nationwide licensing/permitting/accreditation process that individuals with long-term chronic conditions can get (kind of like a gun permit)?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverley	None	None	0900006485006c7d	Laumann	None	2022-04-09T17:32:06Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Laumann, Beverley	l1q-tlqk-rx36	False	None	False	2022-04-12 06:39:40.283	[]
4299	CDC-2022-0024-4305	https://api.regulations.gov/v4/comments/CDC-2022-0024-4305	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been on 8mg Suboxone for 2 years and my teeth are already rotting away. I’m only 22 and have a lot of dental work ahead of me. I only make about 30k a year so it’s been extremely difficult to get my teeth fixed on top of all the other costs of living. I need multiple root canals and I’m dealing with a ton of pain. I’ve also had multiple infections/abscess from my rotting teeth and the infections will keep coming back until I get them fixed. I’ve never had dental problems like this until I was prescribed Suboxone and I was never warned about these negative side effects. I know I’m not the only one with this issue, we need relief and we deserve relief. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joshua	None	None	0900006485006c8c	Adams	None	2022-04-09T17:32:19Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Joshua	l1q-tnyt-hr80	False	None	False	2022-04-12 06:39:40.535	[]
4300	CDC-2022-0024-4306	https://api.regulations.gov/v4/comments/CDC-2022-0024-4306	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For more than a decade I have lived with someone who is in chronic pain due to degenerative disc disease. His pain was under control until the disastrous 2016 CDC guidelines led to a forced tapering of his opioid medication. <br/><br/>His quality of life diminished significantly, and we have watched in horror as countless others in chronic pain have suffered, died and even committed suicide due to untreated chronic pain. Some patients have been abandoned medically, and doctors persecuted for trying to honor their oaths to do no harm. The CDC itself has recognized the 2016 guidelines were misinterpreted and misapplied. Numerous credible news reports have documented how those in chronic pain have paid the price and continue to pay an awful price for this.<br/><br/>Now we are faced with another set of guidelines on pain management that will result in more unnecessary suffering and misguided medical treatment for those who live with complex medical conditions, and are in chronic pain. <br/><br/>I join others who respectfully request that these guidelines be withdrawn completely. They were made without any real or meaningful input from specialists in pain management and from physicians and others who are on the front lines treating people with chronic pain. The CDC Injury Prevention Center, which created the new guidelines, does not have the professional expertise, knowledge, or qualifications to write such a prescriptive guideline.<br/><br/>Further, evidence showing the benefits of opioid therapy and the widespread harm of forced tapering were excluded from the draft guidelines. Based on these, and multiple other problems with these guidelines, I join the many individuals and organizations that object to these guidelines and request that they be withdrawn immediately. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006485006c8e	R	None	2022-04-09T17:32:44Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from R, Sarah	l1q-to7t-n4ae	False	None	False	2022-04-12 06:39:40.748	[]
4301	CDC-2022-0024-4307	https://api.regulations.gov/v4/comments/CDC-2022-0024-4307	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was injured by a DRUNK DRIVER (12/13/09, broken back L3-L5, left hand, mandible, & teeth) and the 2016 CDC CPG made my life a lot harder because I am playing by the rules, I work a job, have a family, and do not receive disability or unemployment. The 2022 CDC Clinical Practice Guideline does not improve mine nor any other legitimate pain patient. If anything, these need to be repealed immediately! The government does not have the right to step into people's personal care, that's for the physician and the patient. I was hurt by a person on alcohol, I was 1.1miles from my job that morning when I was hit while waiting for a red light to change. I should not be treated like a criminal simply because I am seeking help for my severe pain. The doctors should not be afraid to help me or another patient out of the fear of losing their license or worse. Being in pain is not a crime!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nathan	None	None	0900006485006c95	Gee	None	2022-04-09T17:32:57Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Gee, Nathan	l1q-tqoh-6dcn	False	None	False	2022-04-12 06:39:40.964	[]
4302	CDC-2022-0024-4308	https://api.regulations.gov/v4/comments/CDC-2022-0024-4308	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC:<br/><br/>This is my second comment and I had to cut this one down to fit here. The first one had an attachment that was completely redacted so I would like to summarize the content of the attachment, leaving out the names of the not so innocent.<br/><br/>My attachment was an appeal letter to my insurance company, who shall remain unnamed, sent in 2017 when I received notice that due to new guidelines I could no longer continue getting prescription coverage for two medications I was taking for my chronic pain. I would immediately have to taper OxyContin by 90% in one month and stop taking Diazepam. The decision by the insurance company to deny my appeal was apparently made by a registered pharmacist who also made the initial decision to deny my prior approval and my doctor’s taper plan that I sent with my appeal. I would think a pharmacist would have known the dangers of tapering off either OxyContin or Diazepam too quickly, or at the same time. Patients should have been given a reasonable amount of time to taper safely and the CDC should have known and recommended that. <br/><br/>I had been taking OxyContin 3x daily for years because my pain management doctor said it only lasts 8 hours, which I can attest is correct. It did dull my pain some at that more frequent higher dosage but that would no longer be allowed and now it had to be only every 12 hours and I would be required to go from 80 mg. 3x daily to 10 mg. 2x daily. Think about that! I haven’t been the same since and it took over two years to taper down safely to that point. The Diazepam is something I’ve been using since my first spine surgery back in 1998 and it’s the only thing that makes me able to tolerate any opiates without violent vomiting. Nothing else works, not even newer chemo drugs. <br/><br/>All of this increased pain began because of the CDCs new guidelines released in 2016. The insurance companies jumped on board as fast as they could because it saved them a lot of money and they didn’t care who it hurt. When I went to pick up the first month’s prescriptions that were no longer covered (I had to keep using them long enough to taper safely and not die in the process) the cashier at the pharmacy said she almost had a heart attack when she rang up the nearly $1000 charge for one medication. The other has been generic and costs a pittance comparably. So that went on for two years, until I was tapered long enough and safely by my doctor, who was still afraid he’d lose his medical license for prescribing the lowest dose made by the manufacturer.<br/><br/>But aside from the money, there is the suffering. Those of us in chronic pain are not abusing our medications and never were. Somehow the CDC came up with the idea that if they took away our pain medication the addicts on the streets would suddenly disappear, or stop dying. Well, it didn’t work! Actually over the years since the CDC made it so difficult for doctors to prescribe and patients to not be in pain, there were more drug overdoses and illicit drug sales than before and still chronic pain patients suffer.<br/><br/>My long time, sympathetic, caring doctor has since retired, really sick of the runaround and rules he as a doctor had to follow, and being a nice guy he hated seeing his patients in needless misery. We live in a very rural medically underserved area with one federally subsidized clinic, so I’ve now had seven doctors in less than two years. It’s very hard to gain anyone’s trust in a few months, maybe seeing them two or three times maximum before they are replaced by another temporary doctor. All the doctors are reluctant to prescribe even the low doses of medication my retired doctor said I should probably take indefinitely, like forever. This will take time to rectify, even if you change your guidelines so doctors can prescribe much needed pain medications for their patients. Meanwhile we’re still suffering. Do you care? If you’re a doctor, or a medical professional of any kind, please remember your oath which is one of the oldest binding documents in history. It was written by Hippocrates and is supposedly still held sacred by physicians: “Treat the ill to the best of one’s ability”. Please!<br/><br/>[name redacted]<br/><br/>My attachments were not allowed as added files but I'll try to post them here. They're important and should be considered.<br/><br/>https://coloradopaincare.com/chronic-pain-and-heart-disease/<br/><br/>https://www.health.harvard.edu/heart-health/chronic-pain-linked-to-higher-risk-of-heart-attack-and-stroke<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006485006cc9	Lyford	None	2022-04-09T17:34:26Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Lyford, Nancy	l1q-txhi-ji8v	False	None	False	2022-04-12 06:39:41.180	[]
4303	CDC-2022-0024-4309	https://api.regulations.gov/v4/comments/CDC-2022-0024-4309	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Have you read some of the comments submitted? Painful to read, the human suffering created by well intentioned meddling from government agencies. I wonder how many more deaths have occurred once prescribers were overtaken by the regulatory narcophobia and cut off chronic opiate users who then went to “unlicensed corner pharmacists” or just committed suicide due to uncontrolled pain and loss of quality of life and loss of hope vs. unintended overdoses from those patients receiving prescription opiates.<br/>I am a physician with over 40 years of clinical experience. I have practiced through the period when physicians were being sued for not managing pain aggressively enough and are now being monitored and threatened by regulators for over-prescribing. The well publicized war on opiates has lead to an unfounded and severely detrimental narcophobia for the majority of medical providers.<br/>Patients who have been functioning members of society, living with chronic pain, managed with opiates have been cut off with the exceptionally ignorant logic that now after years of use they are at risk of overdose...really, why now, because some government functionary has deemed it so.<br/>Faced with loss of regulated and monitored pain relief these patients have turned to much more dangerous sources of illicit pain relief frequently with disastrous results.<br/>I am presently practicing as a palliative and hospice provider but also care for rehab patients. Both groups have legitimate need for opiates, doses and duration of therapy is individualized to the patient. There is no ceiling opiate dose, there is no "correct" duration of therapy. The physician/provider and patient are the only legitimate arbiters of these parameters. Guidelines are fine but as a long practicing physician, I have treated innumerable patients that do not fit into the "usual" care paradigm. We have palliative patients with cancer, spinal cord injuries or other disabling conditions that, with proper pain management, begin to thrive on our inpatient unit to the point that they can occasionally be discharged to continue life in the community. My fear is that when they return to the community, providers there will refuse to prescribe the established opiates and other medications for fear of regulatory scrutiny and sanctions...leaving the patient with no relief, deterioration in quality and frequently duration of life as a result.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bradley	None	None	0900006485007905	Buckhout MD	None	2022-04-09T17:50:26Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Buckhout MD, Bradley	l1q-u4xp-oss9	False	None	False	2022-04-12 06:39:41.411	[]
4304	CDC-2022-0024-4310	https://api.regulations.gov/v4/comments/CDC-2022-0024-4310	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why are responsible legit pain patients being target by taking away or limiting their pain RX. The drug over doses are and have been by illegal street drugs for the most part. I am currently being WEANED OFF my pain RX as I type this, not fair. I won't have access to a RX that has worked for 30 years, same RX same dose for 30 years. THINK ABOUT THAT 30 years of living a somewhat normal life is about to CHANGE for me. <br/><br/>I have never abused my meds, doctor hopped, tested dirty or abused my RX in any way. I don't drink, smoke or use anything illegal. <br/><br/>I will be suffereing like many Americans who are being taken of meds. I will no longer be able to visit my grandkids who live in 2 different states who the parents serve in the military. <br/><br/>As of right now I am able to take 1 RX to deal with my pain, RLS (Restless leg syndrome) and IBS (Irritable Bowls syndrome). 1 RX works on all three of my ailments, where as before I was on 3 different RX and not all were working. I'm able to eat finally and not have food go straight through me, I was down to 102 pounds until I started taking pain RX at the time it wasn't prescribed for IBS but was a miracle drug for me. My pain was not gone but was controlled which was why I was prescribed and then to realize I could sleep through the night and not suffer from RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	0900006485007913	Klein	None	2022-04-09T17:50:46Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Klein, Katherine	l1q-u8f0-qrxg	False	None	False	2022-04-12 06:39:41.639	[]
4305	CDC-2022-0024-4311	https://api.regulations.gov/v4/comments/CDC-2022-0024-4311	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think this is my second submission. I'm not an addict. I have been in chronic pain since 1993. I'm not an addict. I have been over exposed to radiation at age 3 (1956) Trial and error on a 3 year old. I l9st my right kidney but suffered the aftermath. The extreme radiation burnt/scared my mid spine wrapped around my right hip and my abdomen. My right hip.is shrunk and my side caved in. 66 years have passed. From the "over exposure" I had a right abdomen hemicoltomy leaving much scar tissue. My right hip was totally replaced as the bone had died. My gallbladder has shrunk into my liver and I had gallstones that had to be drained and stented. If the stones return I need to have my gallbladder removed at a transplant hospital. I was very productive and independent until a work related accident. Due to spinal scoliosis after lifting a client I destroyed T 10 11 12 thoracic dics along with 2 lumbar. I had over 4 spinal surgeries losing 5 dies. My back at 69 is collapsed along with fractures and osteoporosis. The collapsed back is causing my radiatiated/shrunk stomach.A surgical rod popped through my radiated/burn mid spine and left me with an egg size wound since 2018. I see a Micro surgeon but the wound won't close. Before 2016 being on a dose of Morphine/OxyContin therapy I came alive. I had a church/social life, took care of my hygiene, cooked, shopped and worked in my flower garden. After 2016 with a reduction in pain meds I'm Useless. I have no life. I'm dependent on my crippled husband to pull up my pants every time I get dressed and go to the bathroom.Not a liveable life. I have never absolutely never missed my pain meds. I have always had my pill count and passed all urine test. I pray this never happens to you or your loved ones. I also pray y next year when I turn 70 my pain meds can go back to 2016 so I can live my 70's independent and happy. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary C	None	None	0900006485007914	wright	None	2022-04-09T17:51:23Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from wright, Mary C	l1q-u8lj-aujh	False	None	False	2022-04-12 06:39:41.864	[]
4306	CDC-2022-0024-4312	https://api.regulations.gov/v4/comments/CDC-2022-0024-4312	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>April 8, 2022<br/><br/>Dear Committee Members,<br/>The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe, and have extensive clinical and cost-effectiveness data.<br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of Dr. Chou’s own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. <br/>Sincerely, <br/><br/>[name redacted], MD<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	0900006485007925	Martin	None	2022-04-09T17:52:34Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Thomas	l1q-typ6-n8wp	False	None	False	2022-04-12 06:39:42.079	[]
4307	CDC-2022-0024-4313	https://api.regulations.gov/v4/comments/CDC-2022-0024-4313	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Remove the guidelines and give our provider's the ability to diagnose and treat painful conditions without the interference of the CDC and DEA.<br/><br/> Pain meds are not causing overdoses it's illicit fentanyl & heroin, not prescription opioids. <br/><br/>The guidelines have caused an enormous amount of harm. Doctors are afraid to help their patients, and some doctors are bullying patients into procedures in order to get a little bit of opioids. It isn't just chronic intractable pain patients being harmed anymore, it is many different types of patients that are left in horrendous pain like surgical, cancer, end of life, sickle cell and others.<br/><br/>Please remove the guidelines and stop the suffering and abuse.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	090000648500794c	James	None	2022-04-09T17:52:47Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from James, Tom	l1q-uhkl-dmuv	False	None	False	2022-04-12 06:39:42.299	[]
4308	CDC-2022-0024-4314	https://api.regulations.gov/v4/comments/CDC-2022-0024-4314	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a practicing interventional pain physician I face the opioid epidemic in our country every day. Luckily for some patients interventional pain procedures, including accurate injections or more advanced treatments such neuromodulation, radiofrequency ablation, vertebral augmentation, minimally invasive surgeries can dramatically decrease pain and improve function. The vast majority of patients DO NOT want to take or be reliant on opioid or other pain medications to get through their work and daily activities. I have seen the success of interventional pain management therapies in helping patients decrease or come off completely on opioids or other pain medications with unwanted side effects. I support guidelines helping us tackle the opioid epidemic on multiple fronts but we cannot handcuff other effective pain treatments!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eduardo	None	None	090000648500795e	Icaza	None	2022-04-09T17:53:03Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Icaza, Eduardo	l1q-ujtu-sr48	False	None	False	2022-04-12 06:39:42.512	[]
4309	CDC-2022-0024-4315	https://api.regulations.gov/v4/comments/CDC-2022-0024-4315	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2000 I was diagnosed with restless leg syndrome. My neurologist prescribed mirapex because Pfizer said it was a new miracle drug with fewer side effects then Levodopa. Over the years I needed dosage increases which we now know is augmentation. I began to gamble a little. After a dosage increase in 2010, I gambled compulsively for 3 years and lost over $2,000,000. My son figured out the dopamine agonist was causing the gambling OCBD and urged me to see my doctor. I've tried many medications but none work very well. I take Levodopa once again. My new neurologist wants me to try opioids but I want to try all other options before I go there. My life has been a disaster since 2010. If I eventually have to take opioids to control my RLS symptoms it is essential the option is available. I would hate to have to move out of the country to get opioids if I desperately need them. I am running low on options though. Please leave opioids on the table for RLS sufferers like me. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathryn	None	None	090000648500797e	Gillette	None	2022-04-09T17:53:22Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Gillette, Kathryn	l1q-upep-maiy	False	None	False	2022-04-12 06:39:42.724	[]
4310	CDC-2022-0024-4316	https://api.regulations.gov/v4/comments/CDC-2022-0024-4316	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to comment on opioids for people like me with RLS (Restless Leg Syndrone)<br/>I have been taking low doses of Oxycodone (15 mg/day) for over 15 years. This has been a life saver for me.<br/>I suggest doctors need to be able to prescribe these drugs in low doses for long periods of time. I have tried many (15 or so) RLS drugs and none work as well as Oxycodone (Methadone, codeine, and many non opiates)<br/>Please consult with doctors who specialize in treating RLS<br/><br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wayne	None	None	0900006485007994	Plu	None	2022-04-09T17:53:35Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Plu, Wayne	l1q-uuzw-ydgo	False	None	False	2022-04-12 06:39:42.940	[]
4311	CDC-2022-0024-4317	https://api.regulations.gov/v4/comments/CDC-2022-0024-4317	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS is a neurological disease that causes an URGENT need to move the legs and other parts of the body as well. It makes it impossible to sleep, to sit down quietly to read a newspaper or book, to go to the symphony, church, to get your teeth clean, get a hair cut, to get a manicure/pedicure. It is a horrible …dreadful disease. When all other RLS therapies fail… there is much scientific research supports the use of low daily dose of Opioids to treat RLS. Which will help the lives of millions of people. <br/>I tell you this because I am a victim of SEVERE RLS with movement in my arms. I have been on every RLS Medication there is…been with Mayo doctors … on and on. My RLS was so horrible (I sadly say this…) that I did contemplated taking my own life. I was miserable…unbearable. Please…CDC…include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require Opioid therapy as a last resort …and being monitored carefully.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jo	None	None	09000064850079de	Plunkett	None	2022-04-09T17:53:53Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Plunkett, Jo	l1q-v48h-to95	False	None	False	2022-04-12 06:39:43.184	[]
4312	CDC-2022-0024-4318	https://api.regulations.gov/v4/comments/CDC-2022-0024-4318	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a lifelong RLS suffered where every single medication for treatment has failed to treat my severe symptoms,except opioids, PLEASE include RLS as a diagnosis for acceptable use for opioids. Research has repeatedly shown opioids to be highly effective for treatment of refractory RLS such as mine. The low dose of opioids that are effective for RLS have also been shown to not lead to addiction. <br/><br/>RLS is a very serious condition. The sleep deprivation, anxiety and pain associated with the symptoms in severely effected patients such as myself effect all aspects of our life including shorter life expectancy due to cardiac risks, poor work performance, failed relationships, and suicide ideation. Please help us make proper treatment more accessible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006485007a32	Smith	None	2022-04-09T17:54:06Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Pamela	l1q-vk76-62mr	False	None	False	2022-04-12 06:39:43.407	[]
4313	CDC-2022-0024-4319	https://api.regulations.gov/v4/comments/CDC-2022-0024-4319	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. <br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I’ve had RLS my entire life. When it grew worse as I got older, I found low-total-daily dose opioids to be the only effective therapy for me. Without it, I am unable to sit down and watch television in the evening, read a book, attend live performances without fidgeting in my seat and kicking the seat in front of me, sit comfortably in an airplane, or sleep soundly at night. When I first requested opioids for my restless leg syndrome, my primary care physician expressed real concern about the possibility of losing her medical license if she prescribed opioids for me. I joined the RLS Foundation five or six years ago when it became clear that tightening federal and state regulations intended to protect people from becoming drug addicts during the opioid crisis also threatened to take away the one drug therapy I rely on to control RLS. Not everyone who uses opioids becomes a hard-core drug addict.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. <br/>Thank you for considering these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diana	None	None	0900006485007a3e	Tonnessen	None	2022-04-09T17:54:35Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Tonnessen, Diana	l1q-vmox-cvn5	False	None	False	2022-04-12 06:39:43.635	[]
4314	CDC-2022-0024-4320	https://api.regulations.gov/v4/comments/CDC-2022-0024-4320	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to tell you that my life is completely rewened by your guidelines. I was prescribed 180 mg oxycodone /oxycontin for 24 years. It worked great for me for my pain. Then my good dr <br/>of 10 years retired . I went to several doctors and they are completely terrified to prescribe me my medicine of 24 years. My life has been turned upside down. I had a good life before and now I just cry all the time and I really don't want to live like this. It has also effected my daughter , my grandsons , my 85 yr old mother . You have the doctors so scared to loose their lisence if they help a person in pain. Im so angry. I want my medicine and my life back . I didnt do anything wrong. I want to die. Thanks to you. Sincerely, [name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shawna	None	None	0900006485007a69	Stockman	None	2022-04-09T17:55:06Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Stockman, Shawna	l1q-vsuf-iuun	False	None	False	2022-04-12 06:39:43.861	[]
4315	CDC-2022-0024-4321	https://api.regulations.gov/v4/comments/CDC-2022-0024-4321	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC, please, please, please allow for prescription for low dose opioids for the treatment of RLS. If you only knew the hours of suffering through restless legs episodes every night so that I cannot get to sleep until 1 or 2am and then try to function the next day you would be merciful on the tens of thousands of suffers of this affliction. I know the small dose prescription of an opioid really helps because after surgery for a knee replacement or a rotor cuff repair which I had both of, my symptoms of RLS were relieved for one or two nights. Please help us, the suffers, some help in order to live better lives.<br/>[name redacted]<br/>[email address redacted] <br/>[phone number redacted] <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006485007a6c	Montcalm	None	2022-04-09T17:55:52Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Montcalm, Robert	l1q-vt3r-r5rc	False	None	False	2022-04-12 06:39:44.087	[]
4316	CDC-2022-0024-4322	https://api.regulations.gov/v4/comments/CDC-2022-0024-4322	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is very disheartening when you go to a doctor for help, specifically a pain management doctor and you get told “I won’t be prescribing you anything for pain.” Simply it comes down to everyone being afraid of being “raided” or losing there licenses because of the way the guidelines are written. There are many people in this world who absolutely need to have there pain managed, but it is so hard to find a doctor who’s willing to treat your pain - some people just give up and end up choosing other means to have there pain treated because the ones who can treat pain patients absolutely refuse to because they’re always “afraid”. Not everyone is a “drug-seeker”, and if prescribers have that mindset 24/7 what is the point is even being a physician? Individuals shouldn’t be afraid to tell there doctors that they’re in pain, that they’d like something for pain, or that they want/need something for pain. Not everyone needs to be red-flagged for drug seeking, addictive behavior when they’re simply looking for proper help. I’ve seen physicians for pain management and was told “there’s no studies supporting that opioids work for pain.” or “I’ve seen studies with lab rats, and it wasn’t supportive of opioids for pain management” or “Your problem is the pain medication “ - that is a FALSE NARRATIVE. <br/><br/>If you have pain before ever taking opioids, how does that make any sense to blame the problem is pain medication? <br/><br/>Physicians are 100% “MEDICALLY GASLIGHTING” patients because they are to scared to HELP people who need help. <br/><br/>Nobody wants to live in constant pain, nor does anyone deserve too. These regulations/guidelines need to be changed, to help people, that’s what these medications are designed for. They should be used for pain - if there is a legitimate reason for having them - use it. <br/><br/>Why are these medications created for pain, if they’re NOT going to be used/prescribed for pain? <br/><br/>I personally had a MACI cartilage transplant, and a tibial tubercle osteotomy (TTO) on my left knee. Following the procedure I was refused adequate pain management, and I was forced to suffer for weeks, begging in a hospital bed for help, something for the pain, it was pain that I could not handle. - I was refused medication because of all of this - I had my leg cut in half and then had screws/plates out in and I was told “it doesn’t hurt that bad”.<br/><br/>If you’ve never experienced chronic pain, or even severe acute pain do not pass judgment on others who need the help with medications designed specifically for that. Everyone reacts differently to pain, and just because one treatment plan works for someone else doesn’t mean it’s going to work for everyone else. Everyone should be treated differently - and have there pain treated adequately. I find no reason to have people suffer when the help/treatment is readily available to everyone. <br/><br/>Things needs to change, we deserve to have our pain treated & for any physician/prescriber that is “scared” then they simply shouldn’t be in the position they’re in to help people. <br/><br/>PRESCRIPTION USE DOES NOT EQUAL ABUSE!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007a85	Anonymous	None	2022-04-09T17:56:44Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-vwos-191o	False	None	False	2022-04-12 06:39:44.303	[]
4317	CDC-2022-0024-4323	https://api.regulations.gov/v4/comments/CDC-2022-0024-4323	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I sincerely hope the that CDC will take the public comment's seriously while structuring the 2022 opioid prescribing guidelines. I am hoping this is not just a formality. For myself the out come will make the different's between having a life or (not) . When your life depends on a set of rules like these what they say is a concern. The majority of pain patients are not drug addicts, they depend on there medication for a quality of life without agonizing pain. This is our reality unfortunately. Try to keep this in mind when writing the new opioid prescribing guideline's. This is not a great way of life but it's life. Thank You!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007a98	Anonymous	None	2022-04-09T17:56:56Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-vzfy-8hyo	False	None	False	2022-04-12 06:39:44.523	[]
4318	CDC-2022-0024-4324	https://api.regulations.gov/v4/comments/CDC-2022-0024-4324	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered with RLS most of my life and have been treated with Pramipexole for several years but I have had to increase my dosage due to augmentation. Because of this I would like to get off of this category of drug eventually but life is so miserable without it, I would need opioids to treat my chronic medical condition. To deny me and other patients this medication is unbelievably CRUEL and without any scientific reason. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006485007aaf	Reed	None	2022-04-09T17:57:22Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Reed, Carol	l1q-w1po-s1fr	False	None	False	2022-04-12 06:39:44.758	[]
4319	CDC-2022-0024-4325	https://api.regulations.gov/v4/comments/CDC-2022-0024-4325	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 73 and have MS. My sleep issues are RLS and regular insomnia. I get side feeds from most drugs. <br/>I am 73 years old and have MS. My sleep issues are RLS and insomnia. I get side effects from most drugs that are worse than loss of sleep. I’ve tried cannibis but it only works for a few days then loses its effectiveness. I would really like to try the low dose opiates and see if it can help with sleep issues.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diana	None	None	0900006485007aba	Bjel	None	2022-04-09T17:57:37Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Bjel, Diana	l1q-w2qf-7fu2	False	None	False	2022-04-12 06:39:44.980	[]
4320	CDC-2022-0024-4326	https://api.regulations.gov/v4/comments/CDC-2022-0024-4326	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have been taking oxyneo for nearly 3 months. A low does and has given back my life. The sensation in my legs at night has gone away. I have been to many doctors and tried many medications over the last two years. At times I was so desperate and thought I losing my mind. I am thankful to the doctor who has prescribed this to me! <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	0900006485007ac7	Penney	None	2022-04-09T17:57:54Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Penney, Leslie	l1q-w4fe-zmrj	False	None	False	2022-04-12 06:39:45.248	[]
4321	CDC-2022-0024-4327	https://api.regulations.gov/v4/comments/CDC-2022-0024-4327	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Use of opioids in moderate doses are a way forward for folks like me with RLS. Period. Poor sleep is a contributor to heart disease and Alzheimer's among others. RLS is poorly understood - please, please give us at lease one decent option. Please help us!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tim	None	None	0900006485007ac9	Sheffelin	None	2022-04-09T17:58:07Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Sheffelin, Tim	l1q-w50k-idlp	False	None	False	2022-04-12 06:39:45.488	[]
4322	CDC-2022-0024-4328	https://api.regulations.gov/v4/comments/CDC-2022-0024-4328	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain sufferers and the doctors who prescribed them are NOT the problem. It's rules and regulations such as these that forces people to buy them illegally. It's rules and regulations like these that force patients to do anything for relief and sometimes that is killing themselves. Pain sufferers should not be punished for being in pain. Don't you think they would rather live a pain free life without pills if they could? Pain is not a choice, but making people suffer is. We know our bodies better than anyone and if we are in pain we shouldn't be made to feel like addicts because we need e tra help living a quality life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007acd	Anonymous	None	2022-04-09T17:58:20Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-w5go-xofj	False	None	False	2022-04-12 06:39:45.702	[]
4323	CDC-2022-0024-4329	https://api.regulations.gov/v4/comments/CDC-2022-0024-4329	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for your attention, this has a profound impact on my quality of life.<br/><br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>[Tell your own experience with RLS in a short paragraph.]<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Norman	None	None	0900006485007b04	Basham	None	2022-04-09T17:58:38Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Basham, Norman	l1q-w8ma-4yqu	False	None	False	2022-04-12 06:39:45.923	[]
4324	CDC-2022-0024-4330	https://api.regulations.gov/v4/comments/CDC-2022-0024-4330	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have refractory restless legs syndrome. The Mayo Clinic Proceedings for treating this suggests low dose methadone on an ongoing basis. For over six years, I have searched for a doctor who understands this disease and is willing to treat it according to the Mayo Clinic Protocol. I live in Florida where it is very difficult to find a doctor who is willing to prescribe low dose methadone. Finally, at the beginning of 2022, I was allowed to start using a low dose 5 mg methadone daily tablet. This is a miracle for me. I can finally sit comfortably and enjoy a play or concert without being in agony and just waiting for intermission so I could stand up. I can now sit through dinner or even a movie or tv show without the need to stand and walk around. This chronic pain is unlike what is treated at pain management clinics. People with the chronic pain of refractory restless legs syndrome only need a low dose and do not need to increase it as time passes. I have suffered needlessly for many years because it is so difficult for chronic pain patients like me to have access to this standard treatment. I understand that there is a severe opioid crisis but, please, don't lock out patients like me from having access to this drug that makes my life more worth living. Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	VIRGINIA	None	None	0900006485007bff	ENGLAND	None	2022-04-09T18:01:04Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from ENGLAND, VIRGINIA	l1q-x3u8-jbfv	False	None	False	2022-04-12 06:39:46.145	[]
4325	CDC-2022-0024-4331	https://api.regulations.gov/v4/comments/CDC-2022-0024-4331	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I sporadically suffer from RLS (Restless Leg Syndrome.) It is a real condition, folks; it is not just in your head. It can make your night (and day) time life miserable. <br/><br/>Some sufferers have had relief on a daily, low-dose, carefully monitored regime of opioids. Please include provisions in the legislation under consideration for opioid therapy for RLS as a chronic health condition. <br/><br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Martha	None	None	0900006485007c63	Littlefield	None	2022-04-09T18:01:21Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Littlefield, Martha	l1q-xhhf-biyf	False	None	False	2022-04-12 06:39:46.380	[]
4326	CDC-2022-0024-4332	https://api.regulations.gov/v4/comments/CDC-2022-0024-4332	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a long known, chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, especially at night, which seriously affects every aspect of daily life. <br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>Over the last 2 decades, my problems with RLS were controlled with various medications for a period of a year or two each, as new medicines came out, until augmentation made them worse (a common outcome with other approved medications). For 8 years now I have been well controlled with once a day, taken an hour before bedtime, low, same dose of hydrocodone. This has been life changing.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. <br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. Attached is one of many scientific articles on the topic.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007c81	Anonymous	None	2022-04-09T18:04:10Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1q-x70i-iox8	False	None	False	2022-04-12 06:39:46.656	[]
4327	CDC-2022-0024-4333	https://api.regulations.gov/v4/comments/CDC-2022-0024-4333	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from RLS and have had it since I was 40. I am doing everything I can to deal with this condition. I will require as I get older an opioid to control my RLS. Please make this available to me in the future.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	bette	None	None	0900006485007cbc	zimm	None	2022-04-09T18:04:19Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from zimm, bette	l1q-xt11-2f62	False	None	False	2022-04-12 06:39:46.874	[]
4328	CDC-2022-0024-4334	https://api.regulations.gov/v4/comments/CDC-2022-0024-4334	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My RLS has progressed over 30 years to the point where I would be suicidal ion I had no treatment. I have tried a litany of pharmaceutical and homeopathic treatments including Sinemet, Ropinirole, Mirapex, Lyrica, Horizant and Gabapentin. to no avail. Each drug had initial limited success and became less and less effective over a year. Finally I found relief with a small dose of opioids - 10-20 mg of hydrocodone daily at night. I have tracked my usage for over 5 years and my dose has remained constant and the treatment remains effective. Note too that the opioids are 1/10th the cost of the drugs I mention above. I am followed closely by a qualified Neurologist. Access to these drugs by my physician for this disease are vital to me and the many other sufferers who get similar relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	0900006485007cc7	Rochester	None	2022-04-09T18:04:35Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Rochester, Paul	l1q-xtwp-vail	False	None	False	2022-04-12 06:39:47.116	[]
4329	CDC-2022-0024-4335	https://api.regulations.gov/v4/comments/CDC-2022-0024-4335	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Clinical Practice Opioid Prescribing Guideline is most welcome, but RLS is a chronic condition very different from chronic pain. This important difference is not addressed in the draft guidelines. Restless Legs Syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. <br/><br/>There is no cure for RLS, a chronic disease that affects nearly 12 million adults and children in the U.S. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have taken the same small daily dose of methadone for over a decade, neither experiencing side effects nor increasing my dose of 10 mg daily. Before being prescribed opioids I had “augmented” symptoms from my previous drug. I was taking more and more with less and less effect. RLS was moving from my legs into my arms. Symptoms occurred earlier and earlier in the day. I was unable to attend any function at night, not a movie, not a concert, to fly on a plane, or drive in a car without unbearable discomfort. The word “discomfort” does not cover the effect, but there is no scale for RLS symptoms as there is for pain. If there were, I would have been at the top. My small daily dose of opioid makes my life possible.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. <br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006485007cd5	Secretan	None	2022-04-09T18:08:36Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Secretan, Linda	l1q-xvzh-tl9t	False	None	False	2022-04-12 06:39:47.344	[]
4330	CDC-2022-0024-4336	https://api.regulations.gov/v4/comments/CDC-2022-0024-4336	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Esteemed Members of Congress:<br/>The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/>The guidelines should call for a multidisciplinary approach to chronic pain that includes multiple modalities incorporating the role of interventional pain management for diagnosis and treatment.<br/>1.<span style='padding-left: 30px'></span>Interventional pain management techniques are safe, and have extensive clinical and cost-effectiveness data.<br/>2.<span style='padding-left: 30px'></span>With extended mandate and mission creep, the CDC guidelines are becoming mandatory for standard of care even though they have not reviewed appropriately all other therapies. <br/>3.<span style='padding-left: 30px'></span>A transparent assessment without inclusion of Dr. [name redacted]’s own studies, which have a dominant role in the preparation of these guidelines, will show the appropriate real-world evidence for interventional techniques including epidural and facet joint interventions, spinal cord stimulation, intrathecal infusion systems, interspinous prosthesis, and multiple other techniques.<br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies. <br/>Sincerely, <br/>[name redacted] NP-C	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006485007d05	Somers	None	2022-04-09T18:09:44Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Somers, Barbara	l1q-y8s4-uxqy	False	None	False	2022-04-12 06:39:47.556	[]
4331	CDC-2022-0024-4337	https://api.regulations.gov/v4/comments/CDC-2022-0024-4337	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Clinical Practice Opioid Prescribing Guideline does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. There are only three classes of medication that are used in the treatment of RLS. Number one is dopamine agonist drugs. While these drugs can work fairly well, over time they will make the disease worse, and as such are no longer prescribed by knowledgeable practitioners. The second class of drugs is anticonvulsant medications. These drugs do not cause the worsening of RLS over time, however most patients with moderate to severe RLS receive little to no benefit from this class of medication. The third treatment class is opioids. Opioids work very well for RLS and cause no worsening of the disease. Typically, patients will need a lower dose than most chronic pain patients.<br/>This leaves opioids as the only viable treatment option for most patients. Unfortunately, due to over regulation by the State and Federal government, doctors are afraid to prescribe these essential medications. This has caused some chronic pain and RLS suffers to buy their medication online, use street drugs to relieve symptoms, and some have committed suicide due to being under-treated. Patients shouldn’t be killing themselves due to inadequate medical care in the most advanced country on earth. The blood from their deaths lies solely on the hands of the government bureaucrats that continue to uphold these harmful policies.<br/>Thank you for your consideration of this vital issue, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me. Please try not to butcher this like you did with Covid-19.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Taylor	None	None	0900006485007d41	White	None	2022-04-09T18:10:15Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from White, Taylor	l1q-yo1v-tkuy	False	None	False	2022-04-12 06:39:47.776	[]
4332	CDC-2022-0024-4338	https://api.regulations.gov/v4/comments/CDC-2022-0024-4338	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please don’t make it any harder than it already is to get my medications that ALLOW ale to live my life. Without these medications I would be in bed not raising my kids, not cooking them dinner not helping with homework. This is so unfair. I have a valid reason for being on these medicines. I can’t believe they are making it harder to get them. Please don’t do this to me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Charlotte	None	None	0900006485008653	Bodine	None	2022-04-09T18:11:01Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Bodine , Charlotte	l1r-a889-vx7r	False	None	False	2022-04-12 06:39:47.986	[]
4333	CDC-2022-0024-4339	https://api.regulations.gov/v4/comments/CDC-2022-0024-4339	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is my second attempt to submit a comment. Apparently telling the truth gets your comment erased so I won’t mention how deeply the removal of my meds has impacted me emotionally b/c apparently the people of the CDC do not want to hear it. The loss of my meds is not the first time I’ve come face to face with the pain of being without proper pain control. I watched my father go through 9 brain surgeries on only Tylenol. I won’t tell you what it’s like to find your loved one tied to a chair after brain surgery because the VA ran out of beds. I was 14 at the time & I had no idea 30 years later I’d be in pain too. I did everything right growing up. I never smoked, did drugs, and I never even had a drink of alcohol. It doesn’t matter. I’m questioned, made to pee in a cup, and when my PTSD came back with a vengeance because of the loss of my home, the death of my grandmother, physical threats from another family member, and an I’ll mother, I found myself being made to choose between treatment for my PTSD and pain care. How do you choose your psychological well-being or being able to walk work care for an elderly parent. I couldn’t even leave the house b/c I couldn’t stop shaking. So PTSD meds it was and by by pain care which, by the way I’d spent 20 yrs trying to get. I’m now $14000 in debt from paying for alternative therapies and trying to exist. 3 years ago when I finally got care I thought God has finally heard my prayers. But now I am homebound. I can barely walk & I have no help. I wish I’d never been given pain meds b/c now I know what it’s like to be “normal.” To not live afraid. What do I have to live for now but a future that will include homelessness and ever increasing pain. I did everything asked of me and nothing NOTHING mattered. I am being punished again because I was punished as a child. This is no life. My father was the head of several hospitals and he & his colleagues would NEVER have agreed to treat patients the way you are asking drs to treat us. Never.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500863d	Anonymous	None	2022-04-09T18:13:59Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-a0g3-w8tt	False	None	False	2022-04-12 06:39:48.217	[]
4334	CDC-2022-0024-4340	https://api.regulations.gov/v4/comments/CDC-2022-0024-4340	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support the RLS Foundation facts whicjh begin with:<br/>'I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.'<br/>For the last eight years I have used Methadone and it as been a life saver. For some years Ropinirole controlled mty RLS, but in time 'augmentation' set in. RLS was with me permanently. At meetings I had to stand behind a chair to get some relief. Night times were spent pacing the bedroom or house, even hitting my head on the wall to try and knock me out. The sufferigis unbearable. On a fight to <br/><br/>England I spent 18 hours pacing the isles because I couldn't sit. I'd tried every drug available. <br/>Dr [name redacted] kindly wrote to me nine years ago, recommending opiod use. Since then I got approval and use 1.8 mg Methadome with a titrateddose of Ropinirile up to 2mg. This takes one year and I then use 1.2 mg Methadone only for a reset of Ropinirole, recommencing Ropinirole at 0.25 mg. This has worked exceptionally well for over eight years, with no changes to Methadone usage. <br/>It is quite likely that I would not be writing this today wwithout Methadone, because suicidal impulses were so strong without it.<br/>Unfortunately Doctors will rarely prescribe it, and even at the hospital pharmacy I'm looked at like a lepper. My own GP is afraid to prescribe it as some have been struck off for prescribing Methadone. <br/>I urge you to respect RLS jn the same way as severe pain, and allow prescriptions of low dosage opioids to be made reasonably available for RLS sufferers.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	RONALD	None	None	090000648500863c	BONE	None	2022-04-09T18:15:06Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from BONE, RONALD	l1r-9z2l-1ml6	False	None	False	2022-04-12 06:39:48.443	[]
4335	CDC-2022-0024-4341	https://api.regulations.gov/v4/comments/CDC-2022-0024-4341	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve been taking low doses of methadone for the past 2 years to treat my chronic RLS. It has changed my life and that statement is not hyperbole. I’ve taken other medications but none have provided the relief that the methadone has. I realize that the name of this disorder, Restless Leg Syndrome, doesn’t necessarily convey its seriousness but it is debilitating. Please allow this low dose use of opioids to continue.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Rosiland	None	None	0900006485008616	Krumm	None	2022-04-09T18:15:19Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Krumm, Rosiland	l1r-9ey2-cd2b	False	None	False	2022-04-12 06:39:48.655	[]
4336	CDC-2022-0024-4342	https://api.regulations.gov/v4/comments/CDC-2022-0024-4342	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel lab rats are treated with more dignity than myself. With failed back surgeries and still no relief the only thing a Dr could do was manage my pain and that was taken away. I'm sorry Jonny got drugs from across the border but why punish us all. If you only had an accurate count of those that decided to no longer live with chronic pain and stop the suffering the only way they could I'm glad I want have to answer for so many lives lost. <br/><br/>Let the Dr help people don't scare them with arrest. <br/><br/>May God have mercy on so many souls that died before there time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Troy	None	None	0900006485008615	Edwards	None	2022-04-09T18:15:34Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Edwards, Troy	l1r-9e7q-l8ql	False	None	False	2022-04-12 06:39:48.900	[]
4337	CDC-2022-0024-4343	https://api.regulations.gov/v4/comments/CDC-2022-0024-4343	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I know and have experienced the difference between acute and chronic pain. I've broken both legs and ankles separately, a toe, a finger and had all my top teeth removed at age 15 with only novacaine, all acute pain, very painful, but never given a narcotic for any of that, nor did I ask for any. The body heals faster when we're young. In 1991 I herniated a disc at T 11-12, didn't know it was herniated until an MRI in 1993. The pain is a burning/throbbing of my spinal cord. Had spinal fusion in 1993 and got ZERO pain relief. By December 1994 I could no longer work. I had one bulging disc in my neck also by that time. I now have 12 bulging and/or herniated disc throughout my spine. With scoliosis, which I never had prior to my 1993 surgery, a spine surgeon will not operate on the herniated discs at L1-S1, and he said don't let any other surgeon operate on it. I also have a torn labrum in my right hip. Two hip surgeons will not operate to repair it because they said people over 30 do not get good results, I am now 66. I have been on opioids since 1993 and soma muscle relaxer. After the 2016 Guidelines my Pain Doctor immediately abandoned me. Spinal injections given to me by two different pain doctors do not help at all. Nerve ablations do not help. Since 2016 I have only been able to get about 1/4 of the opioids and ZERO soma that I received before 2016. I need to be back on extended release opioids, fast acting opioid for breakthrough pain and soma, the only muscle relaxer that ever helped me. I used to be able to walk a 1/4 mile down the beach to a restaurant to eat and walk 1/4 mile back with medications, now I can not. I have no quality of life left. I went from seeing a pain doctor 2-4 times a year to 12-16 times a year. No wonder Medicare is going broke. My BC/BS PPO should also be complaining. I used to get my RX's through Caremark 90 day mail order w/ 1 refill. Now I have to go to local pharmacy every 30 days and not one day earlier. I have great insurance and still can't get what I need. I fear for the pain patients w/o insurance who are gambling with their lives desperately seeking relief on the streets. How many of them were part of the 200,000 who overdosed on street drugs laced with fentanyl? How many overdosed on purpose? I had a heart attack in 2014. My cardiologist told me just last week that it's not good for my heart to be in pain 24/7. The CDC and DEA needs to concentrate on getting fentanyl and cocaine off the streets and let doctors, all doctors not just pain doctors, get back to treating their patients. The politicians in my state of Florida took the CDC Guidelines for Primary Care Doctors and codified them into law also applying them to Pain Management Doctors. Getting that law reversed will be difficult. I should be able to receive whatever RX in whatever doses that allows me to have a quality of life. I should be able to schedule doctor appointments around my life, not my life around doctor appointments. I should be able to get 90 day RX'S with a refill from my 90 day mail order pharmacy as I did for over 20 years. As I have exhausted pain management and surgical options my insurance should not have to pay for me to see a specialist- pain management. After I get stabilized on RX's under new Guidelines I should be able to get RX'S from my Primary Care Doctor like I did in the past and only need to see a doctor twice a year. If I don't get relief by the end of this year I'm DONE. I shouldn't have to live a life in misery. Also, I pay too much for medical insurance to not get my needs met. Have some compassion. For the ones who think opioids don't help chronic pain, you are so wrong. Imagine as I feel, someone has my spinal cord between their thumb and index finger and are squeezing and rubbing it back and forth 24/7, is my reality. Some say opioids don't really help they just change the way your brain feels pain. I say great, please, change the way my brain feels pain. I need opioids and soma to live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006485008610	Beck	None	2022-04-09T18:17:15Z	None	None	1	None	2022-04-09T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Beck, Sandra	l1r-9dbm-yiql	False	None	False	2022-04-12 06:39:49.119	[]
4338	CDC-2022-0024-4344	https://api.regulations.gov/v4/comments/CDC-2022-0024-4344	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My RLS started in the gulf war in 1991. I was first prescribed Sinemet, moved on to Mirapex, Requip , Neupro, Gabapentin even Codeine, then combinations of those meds. After 20 years of treatment nothing would control the symptoms anymore. What used to be evening torture turned into 24-hour torture. No matter how high the dosages of medication. Eventually I traveled standing up in the airplane (RLS does not let you sit) from Florida to California to seek out a specialist. I was prescribed Methadone. I was able to fly back home sitting down. Looking back 10 years later, I have to say it saved my life. Opioids need to be controlled, but people that need opioids cannot be deprived of them either. A lot of docs are not willing to prescribe Methadone for my RLS and treat me like a drug seeker. They are right, I am seeking out Methadone, because it is the only drug that helps me. RLS is a terrible disease, I don't wish it on my worst enemy. Methadone should be listed as the first line of treatment for this condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Billie	None	None	0900006485007bfb	Gifford	None	2022-04-10T18:06:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Gifford, Billie	l1q-x2ge-x2n1	False	None	False	2022-04-12 06:39:49.349	[]
4339	CDC-2022-0024-4345	https://api.regulations.gov/v4/comments/CDC-2022-0024-4345	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>RLS was identified as periodic limb movements when I went for a sleep test. Sleep test was requested because I was falling asleep while driving. As I continued to get treatment it was noticed that the CPAP machine was not providing a good results. It was then determined RLS was keeping me awake. Because I am a Substance Abuse Counselor for 40 years I refused opioid medication. I tried requip and another medication without any success. I am now on 3 mg of Neupro. Which has helped tremendously. As a substance Abuse Professional I know there are people who drink and use opioid medications responsibly and those who will become addicted. RLS is physical and becomes a mental health disorder. Please consider responsible use of opioid medications as a treatment for RLS.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sally	None	None	0900006485007d7f	Langland	None	2022-04-10T18:10:49Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Langland, Sally	l1q-yxn1-5yzi	False	None	False	2022-04-12 06:39:49.568	[]
4340	CDC-2022-0024-4346	https://api.regulations.gov/v4/comments/CDC-2022-0024-4346	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a Chronic Pain Patient who has been disabled since 1997. I was on a regiment that let me have quality of life. Since the 2016 guidelines I have NO quality of life. 90 MME is bad enough but 50 MME is incomprehensible. My anxiety medication was totally taken away and with more extreme pain now it causes much more anxiety and depression. I have multiple conditions that I will have for life. Since the guidelines I can no longer cook (which I used to love), clean, and bathe & dress myself. My life and my health has deteriorated drastically. Please consider us and our Doctor's experience when making decisions that could affect our lives forever.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	0900006485007dae	Wall	None	2022-04-10T18:11:08Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Wall, Pamela	l1q-z756-gcmr	False	None	False	2022-04-12 06:39:49.781	[]
4341	CDC-2022-0024-4347	https://api.regulations.gov/v4/comments/CDC-2022-0024-4347	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Restless Legs Syndrome has to this point in my life, been the worst thing that has EVER happened to me. Days upon days I would go without sleep. Then a Neurologist prescribed Requip, the Parkinson's drug that the FDA repackaged as an RLS drug. Good news, it helped, not cured, but helped my RLS. Bad news, it can cause Obsessive Compulsive behaviors. For me, it was compulsive eating. I gained almost 50 lbs in roughly 6 months. I would be standing in the kitchen in the middle of the night, not hungry at all....and eat a tray of Oreos and a bag of Doritos. Then I got on Ultram, which helped the RLS, but I required more and more of it for it to work. The fancy MD's call this "Augmentation". At the end of my dance with Tramadol, I was taking 600-1000mg of it a night. I would order it from three different sources oversea's (Philippines usually)...and pay in wire transfers from Western Union. I never EVER thought I would see the day that I answered one of those shady texts or emails online trying to sell me black market meds. But a lack of sleep will make you do funny things. It was not until I found Dr. [name redacted] , through the RLS society's website that my battle with RLS was over. I had won. Because Dr. [name redacted] prescribed me 5mg per night of Methadone. I literally cannot tell at all that it is even in my system. I have not had one night of RLS since. And I have never needed to take more than 5mg for it to work. I need SOMEONE, ANYONE to tell me where the harm is in having this drug available for RLS patients. Especially compared to all of the terrible alternatives I described above??? I take a quarterly urinalysis to prove I am not increasing the dosage. And the govt limits the prescriptions to not be filled but every 30 days. Where is the risk or downside? There is none. But the upside is IMMENSE. If you make these drugs unavailable, the patients will do what they must to find them. Only it will be in the grey/black market. Going without sleep is not an option. Would you not rather it be done under the supervision of a physician?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006485007db8	Moore	None	2022-04-10T18:13:22Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Moore, Michael	l1q-z85z-wytn	False	None	False	2022-04-12 06:39:49.997	[]
4342	CDC-2022-0024-4348	https://api.regulations.gov/v4/comments/CDC-2022-0024-4348	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cross refer to tracking number l1l-52y0-2w48. Corrections and Revisions made.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paula	None	None	0900006485007df1	Berzanski	None	2022-04-10T18:16:12Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Berzanski, Paula	l1q-z668-ne1d	False	None	False	2022-04-12 06:39:50.253	[]
4343	CDC-2022-0024-4349	https://api.regulations.gov/v4/comments/CDC-2022-0024-4349	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids<br/>Docket No. CDC-2022-0024<br/>Document Citation: 87 FR 7838<br/>Document Number: 2022-02802<br/><br/>Thank you for the opportunity to provide input on the use of opioids from the chronic pain patients' point of view. As a person who suffers from chronic pain, I can tell you firsthand how difficult it is to live a productive life. I have listed the procedures I've undergone over the past 18 years to provide background. <br/><br/>In the past 18 years, I have had six surgeries to correct problems with my cervical spine. The last to were complete cervical revision surgeries from level C2 – T4, where the placed hardware was placed to keep my head upward. (See Below)<br/><br/>•<span style='padding-left: 30px'></span>June 2004<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>Disk Fusion C6 – C7 Neck (Anterior)<br/><br/>•<span style='padding-left: 30px'></span>March 2007<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>Disk Fusion C5 - C6 Neck (Anterior)<br/><br/>•<span style='padding-left: 30px'></span>May 2008<span style='padding-left: 30px'></span><span style='padding-left: 30px'></span>Disk Fusion C4 - C6 Neck (Posterior)<br/><br/>•<span style='padding-left: 30px'></span>December 2011<span style='padding-left: 30px'></span>Disk Fusion. Removal of failed C4 – C5 (Posterior) fusion, replaced with C3-C4 (Anterior)<br/><br/>•<span style='padding-left: 30px'></span>January 2, 2018<span style='padding-left: 30px'></span>C2 – T3 Revision Surgery (not completed) stopped after removal of old hardware. Spinal cord bruising prevented completion of surgery. Completion TBD.<br/><br/>•<span style='padding-left: 30px'></span>February 5, 2019<span style='padding-left: 30px'></span>C2 – T4 Cervical reconstruction surgery.<br/><br/>Two revision surgeries were necessary because they bruised my spinal cord during the first one in 2018, and had to stop the procedure immediately to give my spine time to heal. This injury made my body numb from the chest down, leaving me with little sensation in my body except for pain. They replaced all the hardware during the second surgery in 2019 and raised my neck by 26 %. <br/><br/>Approximately two weeks after the last surgery, I realized that I was no longer in pain. Granted, I was on high doses of morphine, but for the first time in 15 years, I was no longer suffering. We gradually began tapering off my pain medication, and this was going well; however, once we reached a certain point, the pain became unbearable again. Today, I typically remain at a level 5 on a pain scale of 1 to 10, and although pain is relative, I have a much higher tolerance for pain than most people. When your average pain level is a five, there is very little room before it becomes unmanageable. <br/><br/>The current CDC guidelines are insufficient to control pain for every chronic pain sufferer. Doctors are afraid to go beyond those limits regardless of how much pain their patients experience. The quality of life for people like me is drastically reduced. Your choice between going out for a cup of coffee, and feeling intense pain afterward, compared to staying home, the choice is obvious. That is not living.<br/><br/>Limiting doctors on what they can prescribe based on an arbitrary number, with no idea of the individual patient's background, is overreach. Let doctors who specialize in pain management work with their patients on quality pain control. I understand that clinicians have overprescribed opioids culminating in the current crisis, but you have gone too far in the other direction. It would be best to leave these decisions to doctors specializing in pain management and know their patients' individual circumstances.<br/><br/>Attachment:<span style='padding-left: 30px'></span>Excel spreadsheet showing downward titration of opioids from January 2019 to 2021. No personal information is included. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JAMES	None	None	0900006485007e05	RIGGLE	None	2022-04-10T18:18:19Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from RIGGLE, JAMES	l1q-zea8-9204	False	None	False	2022-04-12 06:39:50.472	[]
4344	CDC-2022-0024-4350	https://api.regulations.gov/v4/comments/CDC-2022-0024-4350	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In full disclosure, I work for a company that provides toxicology services but they don't know I'm supplying a comment. I don't understand why these services are vilified by many commenters. Toxicology helps the doctor know if the patient is potentially using drugs in a way that is dangerous. If a patient is using drugs the way they say they are, they shouldn't have a problem with the test result. <br/><br/>This is particularly true with fentanyl, which is increasingly mixed with cocaine and even marijuana, often without a person's knowledge. One of the pain experts I work with tells a story about a patient who admitted to using cocaine to the doctor when the tox report came back. The test result also showed fentanyl -- but the patient had no idea and was horrified (because they understand that while cocaine is dangerous fentanyl combined is particularly threatening). <br/><br/>I feel tremendous sympathy for patients grappling with unresolved pain. Some of the stories are soul crushing. If they need opioids for pain relief because nothing else will work, there should be mechanisms to get this access. Periodic toxicology screens are an obvious tool for checking that the patient who is prescribed an opioid is not mixing it with other drugs or not using it at all (signifying possible diversion). If the patient is prescribed an opioid and their tox results show a pattern of inconsistencies the patient can't account for, the physician may have adequate basis to modify or discontinue treatment and/or refer them to a substance use disorder treatment clinic. <br/>Others argue that it makes them feel like a criminal. I understand that, too, particularly if I have never misused a drug. But is this a good enough reason not to do it? I dislike that my doctor wants me to get blood tests every year and do a visit every 6 months to get a certain medication (not a controlled one). But I do it because that’s her policy, which is designed to ensure quality care (even if I think it is ridiculous). <br/><br/>Some argue that toxicology research is lacking. I am all for science, but sometimes the devotion of policy makers to randomized, prospective controlled trials conflicts with common sense. I don't need a randomized study to tell me wearing a parachute when I jump out of an airplane is probably a better idea than jumping without one. A tox test can show if a drug was taken, combined with other drugs, or not taken at all. Nothing else at the doctor's disposal can match this level of insight. We all know that patients are prone to lie to doctors about matters affecting their health, from exercise habits to number of sex partners to, yes, drug use. <br/>With 100,000 people dying a year -- many of whom started off on a Rx opioid -- why is the value of a medical tool that can provide insight into actual drug use up for debate?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006485007e27	Bost	None	2022-04-10T18:19:18Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Bost, Wendy	l1q-zwm9-ltee	False	None	False	2022-04-12 06:39:50.689	[]
4345	CDC-2022-0024-4351	https://api.regulations.gov/v4/comments/CDC-2022-0024-4351	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband started 2.5mg of methadone after years of no sleep and painful living... he initially was put on ropinirol but he augmented quickly and his condition became worse... days after starting the low dose opiod he is symptom free and can finally sleep	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	rosa	None	None	0900006485007e29	amir	None	2022-04-10T18:19:35Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from amir, rosa	l1q-zxfd-rmhz	False	None	False	2022-04-12 06:39:50.906	[]
4346	CDC-2022-0024-4352	https://api.regulations.gov/v4/comments/CDC-2022-0024-4352	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment. Working as a palliative care pharmacist over the past 25 years, I have found these guidelines to have impacted those I serve negatively. Although the CDC guideline published in 2016 state "The guideline is intended to apply to patients 18 years and older with chronic pain outside of active cancer treatment, palliative care and end-of-life care", the zealous response to this guideline has resulted in the development of numerous policies negatively impacting patients it was not originally intended for. We, as a palliative care team, have seen frail elderly patients with stage 4 metastatic cancer abruptly discharged by providers no longer willing to prescribe opioids for severe cancer pain causing these patients to present to emergency rooms not only in a pain crisis but exhibiting signs/symptoms of opioid withdrawal. We have also seen patients lingering in pain for weeks/months prior to enrollment into our palliative care clinic severely impacting their strength and ability to undergo treatment options. The policies born out of this guideline have not only negatively impacted patients, but also providers. Although the premise of palliative care is to assist with symptom management, the fervor of regulations has made caring for cancer patients with pain burdensome for both providers and patients including frequent face to face appointments and trips to the lab. Over the previous 5 years, young providers/pharmacists have little exposure of how to utilize opioids safely and effectively; thereby, negatively impacting their training and ability to utilize this important tool correctly which only serves to increase the risk of potential error when an opioid is utilized. I hope in the new guidelines, it will be made very clear (restated throughout the document rather than stated only once) that those with pain related to cancer or cancer treatment are to be excluded and the decision to use opioids will be left to those who are experts in this field. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Micki	None	None	0900006485007e51	Martin	None	2022-04-10T18:22:15Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Micki	l1r-04vc-msu2	False	None	False	2022-04-12 06:39:51.122	[]
4347	CDC-2022-0024-4353	https://api.regulations.gov/v4/comments/CDC-2022-0024-4353	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a retired University Educator from Illinois, who taught Respiratory Care, nursing, paramedics & oriented physicians in the critical care on ventilators. I practiced for 20 years & then taught for 18 years. I loved teaching, but was forced into early retired because of migraines and GI issues. I am on disability & still guest lecture sometimes. In 2016, I had two emergency abdominal surgeries for a decal valvulus. I was given a 20% chance to live. After 3 months in the hospital and several episodes of sepsis, I was released. I’m thankful to be here. But my surgeon discontinued the 3 mgs of morphine after 6 months, because he was afraid I’d become addicted. My quality of life continues to decrease. I’ve seen 17 different Neurologists for migraines & was an inpatient at headache specialty clinic in Chicago. The medications either had terrible side effects or they quit working. I’m on Medicare and can only get the one med that seems to help somewhat and half the recommended frequency. I am forced to pay out of pocket for that. After years of trying every new medication that comes on the market, my savings are taking a hit. My PCP finally gave me Fiorinal #3 to help the migraines & it does. But he just retired & the new doctor is afraid I’ll become addicted. I never ask for medicine early, take exactly as prescribed & would never share. I know better after working years in healthcare. Why must I suffer? My quality of life is decreasing and these should be my “golden years.” I have several concerns about what the 2016 guidelines did to chronic pain patients like me & I’m not impressed with the proposed 2022 guidelines either for several reasons. I believe the proposed guidelines will be worse than those of 2016 & make my quality of life even worse. I believe the way they are written they are unfairly biased against opioid treatment and ain in any form, whether acute or chronic. A majority (7 of it’s 12) recommendations are Category A recommendations are based insufficient evidence. Both the 2016 new 2022 guidelines are organized around MEq day we limitations of Morphine. Where’s the data to support this? I honestly believe the 50 MEq will become the new hallmark for DEA to persecute doctors who do nothing wrong. Let’s face it. The number one f opioid prescriptions has significantly decreased over the last several years. The problem the DEA should be addressing is the illegal & extremely deadly importation of Fentanyl! That’s the culprit in the “so called opioid epidemic.” Until affordable new medications are widely available and proven to be better than opioid prescriptions, the CDC should repudiate both guidelines. I deserve to have a quality of life that allows me to interact with others and be with my grandchildren, family and friends. Every time I talk to a doctor they put me in a category of a drug seeker. What do they expect when I’m in constant pain. Many of us have turned to street drugs or suicide because of the stigma associated with opioid prescriptions. It’s not right & should not be tolerated. Would you want your loved ones to suffer needlessly, when there are drugs available to treat their pain. Please reconsider.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynda	None	None	0900006485007e5f	Hillebrenner	None	2022-04-10T18:23:16Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Hillebrenner, Lynda	l1r-09lk-egmx	False	None	False	2022-04-12 06:39:51.337	[]
4348	CDC-2022-0024-4354	https://api.regulations.gov/v4/comments/CDC-2022-0024-4354	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids are a vital link in the management of pain care. My husband suffers from chronic back pain which was at least moderated enough with opioid prescriptions to be able to function on some level day to day. When the regulations changed we went through hell dealing with specialized "pain practices". They finally found an excuse (a technicality in their very extensive pain contract) to stop prescribing to him. He ended up in the Emergency Room with withdrawals. He lives in excruciating pain and dreams of the day when he can "get his medicine" back. There are a large number of legitimate pain sufferers who would benefit by revision of the Opioid Guidelines. Please help end their suffering!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007eb2	Anonymous	None	2022-04-10T18:33:35Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-0t7p-8bo0	False	None	False	2022-04-12 06:39:51.606	[]
4349	CDC-2022-0024-4355	https://api.regulations.gov/v4/comments/CDC-2022-0024-4355	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I have had Restless Leg Syndrome since 1972. Please take note this is 50 years. I have been under a doctor's care for RLS since 1997 again please note this is 25 years. Through out the decades I have tried natural remedies and traditional treatments offered by the medical community. My symptoms have grown worse as the years have passed. My RLS is considered severe based on how long I have been affected, the increased symptoms, the severity of those symptoms, and the lack of relief that I and my doctor's are able to achieve. My neurologist offered me Opioid therapy in 2017 as an addition to the treatment plan I was already on, because of augmentation and in order to reduce the amount of dopamine agonist medication. <br/><br/>I have had significant relief in MY personal RLS journey and RLS symptoms in the last 5 years since the addition of opioid therapy to my treatment regimen. I was carefully selected for this treatment because my severe RLS that has not been able to be effectively managed with other therapies. Opioids are not the only treatment for severe RLS, but are absolutely an integral part of an appropriate treatment therapy program for patients who are in the severe category of this disease. <br/><br/>We as a RLS community are not expecting complete repression of all symptoms, but what we do expect and demand is the right to be treated, cared for appropriately by our medical professionals, and allowed to live our best lives. If this treatment plan requires opioid therapy then we should have it. Allow our trained medical professionals to practice medicine, to heal, or at the very least help us find our best life. I have been blessed with a long life and should not be told that it can not be my best life.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007eb9	Anonymous	None	2022-04-10T18:33:53Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-0wi1-kb0g	False	None	False	2022-04-12 06:39:51.817	[]
4350	CDC-2022-0024-4356	https://api.regulations.gov/v4/comments/CDC-2022-0024-4356	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have worked as a Geriatrician and Palliative care physician for last 15 years. I started my practice when pain was considered a 5th vital sign and physicians were penalized for inadequately treating pain. Pendulum swinging to the other extreme with strict opioid restrictions, is causing harm to a lot of patients with true pain, which could be best managed with opioids. We hope new guideline is more clear about the targeted population, more supportive of role of "clinical determination".	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007ebc	Anonymous	None	2022-04-10T18:34:06Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-0xjj-behu	False	None	False	2022-04-12 06:39:52.036	[]
4351	CDC-2022-0024-4357	https://api.regulations.gov/v4/comments/CDC-2022-0024-4357	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007eee	Anonymous	None	2022-04-10T18:40:35Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-0rkf-g4ra	False	None	False	2022-04-12 06:39:52.249	[]
4352	CDC-2022-0024-4358	https://api.regulations.gov/v4/comments/CDC-2022-0024-4358	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had RLS in severe form for the last 7 years or so.I am a 73 year old male. During this period I ran into numerous MD's who did not have a lot of experience with RLS. They all tried to help and thank God I eventually I was referred to a Neurologist at Kaiser in Northern Ca who saved me from the torture that RLS sometimes brings but is not often understood well by medical people or the general public. During this last 7 year period my treatment has been as follows: 1/17/2014<span style='padding-left: 30px'></span>I started ropinirole which lasted 7 months. Then 7 months of Mirapex when the ropinirole stopped working.Then concurrently gabapentin. During this I had iron infusions. I also started taking methadone in 2017 as well as oxycodone for breakthrough pain. My RLS is under control now but there are unpleasant side effects: constipation, sedation. I feel fortunate in that I have read everything written by people like Dr. [name redacted] and i have a good neurologist _Dr. [name redacted]_who understands how miserable it is to live every day with this disease and physicians afraid to prescribe opiates which often are the ony things that work. Thanks [name redacted] <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerald	None	None	0900006485007f05	Brack	None	2022-04-10T18:41:29Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Brack, Gerald	l1r-1981-xqa6	False	None	False	2022-04-12 06:39:52.482	[]
4353	CDC-2022-0024-4359	https://api.regulations.gov/v4/comments/CDC-2022-0024-4359	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a friend afflicted by a chronic pain condition, and worried about the unnecessary difficulties they have faced in seeking treatment. One size doesn't fit all, and ethical doctors should have the authority to deliver a customized treatment plan for patients based on their personal needs and medical specifications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007f0d	Anonymous	None	2022-04-10T18:41:45Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-1aqc-a3ca	False	None	False	2022-04-12 06:39:52.706	[]
4354	CDC-2022-0024-4360	https://api.regulations.gov/v4/comments/CDC-2022-0024-4360	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings. I am writing to request that you include a section for the use of low-dose opioid therapy for those people, such as myself, who suffer from severe refractory Restless Legs Syndrome in the forthcoming revised CDC Clinical Practice Opioid Prescribing Guideline. Altogether different from chronic pain situations, Restless Legs Syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. Dopamine agonist prescription medications have traditionally been the first line medications of choice, and they indeed relieve the symptoms for some (they didn't work at all for me) but over time those same medications can make the symptoms worse, a phenomenon known as augmentation. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. <br/><br/>Now 54, I have suffered from this disorder for as long as I can remember...as a young child I used to refer to it as 'crazy legs'. I was unable to sit through a nighttime movie, and very rarely got a full night's sleep. It's an almost impossible sensation to describe to someone that's never experienced it...the best I've come up with is electrified pipe cleaners internally both shocking and tickling your legs (and for some, arms as well.) It's utterly miserable, and for those with severe cases, it makes sleep virtually impossible. Nights become, without hyperbole, an endless torture. When, in my early 30's, my RLS had become unbearable and was making normal life virtually impossible, I finally reached out to an expert at a top sleep disorder clinic in Los Angeles, where I was then living. After trying the standard first and second line medications to no avail, my doctor recommended a trial of a nightly very low-dose opioid. I was naturally initially leery, being aware that such medications can be potentially addictive. But as I was getting 2 hours of sleep between nonstop agonizing bouts of this crazy sensation in my legs, I was ready to try anything. The first night I used it was nothing less than astonishing. It was like a switch had been pulled, entirely shutting off this source of lifelong nighttime torment. I had the first RLS-free night of sleep in memory, and I awoke with an incredible sense of relief and renewed hope for the future. A future that now included SLEEP. I have used it since, without ever needing to increase dosage, any loss of efficacy, etc. It's mechanism of action in treating RLS is ENTIRELY different from that of chronic pain...it's extremely rare for the sort of tolerance and/or opioid misuse disorder issues to manifest with RLS users. Low-dose nightly opioid therapy has allowed me to live a normal life for the 20 plus years I've been taking it, and without it, I'm not entirely certain I'd still be around to be typing these words. As a member of the Restless Legs Foundation, I'm privy to the terrible fact that we lose members to suicide every year, innocent victims of a biological disorder that can be almost universally resolved with low-dose opioid treatment who happen to unfortunately live in parts of the country without experts in sleep disorders and particularly RLS and thus cannot get a doctor to prescribe them. They are almost always professional, productive, middle age or older folks who's RLS has gotten progressively worse, and they simply cannot take it any longer. They leave shattered families behind. It's heartbreaking in it's total unnecessariness, in it's root cause being based upon perspectives and policies put in place to fight a very serious public health crisis that without question needs to be dealt with, but that has nothing whatsoever to do with them. It is truly an apples/oranges scenario in the usage of these medications. I plead with you to listen to personal stories of severe RLS sufferers such as myself, look at the current body of clinical study and evidence, including the latest Mayo Clinic recommendations for the treatment of RLS (attached) and to include a section in the 2022 Opioid Prescribing guidelines to address and create a carve-out for chronic severe RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored, and prescribed by experts. I can personally assure you it is an essential, potentially life-saving option to have in a sleep disorder or neurologist's toolkit when working with a patient with severe refractory RLS. <br/><br/>Thank you so much for allowing my comment on this most vital issue, and for the incredible work you at the CDC do. The RLS Foundation at www.rls.org is an excellent resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alexander	None	None	0900006485007f11	Naegle	None	2022-04-10T18:43:32Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Naegle, Alexander	l1r-10vv-4emb	False	None	False	2022-04-12 06:39:52.919	[]
4355	CDC-2022-0024-4361	https://api.regulations.gov/v4/comments/CDC-2022-0024-4361	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t believe these guidelines leave ample room for the thousands, possibly millions, of Americans suffering from intensive chronic pain, who have undergone a myriad of psychological and medicinal alternatives, any room for treatment. The majority of people like me would like an avenue to allow us to receive the care we need to return to contributing members of society. We don’t want to be on disability. The pain, along with the emotional and social side effects, are not only exhausting but also traumatizing and demoralizing. There has got to be some consideration for people with painful conditions, ones where there is a medical consensus that the conditions are painful and ultimately debilitating if that pain is not addressed in conjunction with their other symptoms. There is real suffering not only in this population, but also in their children, families, and caregivers. Why does someone, who is in pain enough to require hospitalization, given medication to help the nausea caused by the pain, but left to suffer with the pain itself? We have our pain either dismissed, are told that we are drug seeking due to the stigma brought on by restrictions and reaction to the opioid crisis, or have our pain legitimized but are told by our medical teams that their hands are tied. We should no longer be a blind spot. We shouldn’t have to live on the sidelines. There has got to be more wiggle room.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Samantha	None	None	0900006485007f55	Fulmer	None	2022-04-10T18:43:53Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Fulmer, Samantha	l1r-1x42-f3re	False	None	False	2022-04-12 06:39:53.144	[]
4356	CDC-2022-0024-4362	https://api.regulations.gov/v4/comments/CDC-2022-0024-4362	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a doctorate in Molecular Genetics, spent my career in the biotech-pharma industry developing breakthrough diagnostics such as HPV testing as well as clinical development of novel therapies such as Epogen (recombinant erythropoietin) and have suffered life-long from Ehlers-Danlos Syndrome. I starting experiencing RLS as a child but only sought treatment for it in recent years. <br/><br/>LI was put on low dose ropinarole and have had to discontinue the drug because it caused augmentation of RLS and I found myself needing higher doses within a year or so.<br/><br/>What did I do to manage the severe RLS symptoms? I read about the use of low dose opiates and fortunately, already receive a monthly opioid prescription for the chronic pain associated with Ehlers-Danlos Syndrome. I adjusted my dosage, with my pain management specialist’s approval, so that I take 1/2 Percocet at bedtime and keep 2 more half tablets by my bedside in case I’m awakened in the night by RLS symptoms. After several months, I am delighted to have RLS AND pain at night better managed. I am fully aware of the issues and concerns surrounding opioid medications, but it is a travesty to deny this medication under well-controlled circumstances (I see my pain management doctor monthly; no automatic refills), to patients who do not demonstrate additive tendencies. Opioids work, period. They should be included in treatment of RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006485007f82	Fuller, Ph.D.	None	2022-04-10T18:44:12Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Fuller, Ph.D., Cynthia	l1r-26g4-12o4	False	None	False	2022-04-12 06:39:53.356	[]
4357	CDC-2022-0024-4363	https://api.regulations.gov/v4/comments/CDC-2022-0024-4363	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My sister has RLS and has suffered for many years. The low dose opioid she takes is the only thing that brings relief. She has experienced shame and stigma for needing to take this but it has been life changing for her and I don’t know what she would do if this treatment option was not available.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485007ffd	Anonymous	None	2022-04-10T18:44:21Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-36f4-dvh1	False	None	False	2022-04-12 06:39:53.599	[]
4358	CDC-2022-0024-4364	https://api.regulations.gov/v4/comments/CDC-2022-0024-4364	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have given my daughter permission to write on my behalf. I had terminal Neurosarcoidosis and thanks to the CDC guidelines I was treated like a drug addict while terminal. I was forced tapered off the lowest doses of Xanax and Tramodol while terminal. All the doctors were obsessed over was I needed low-dose Xanax to cope with Sarcoidosis of the Prostate. I took my medication for 25 years without increase or deviation and was treated like a criminal degenerate while terminal. I was obviously showing symptoms of end stage brain disease but the doctors were only concerned about taper me off of Xanax and Tramadol. I went without any pain or suffering medication until my daughter took me out of the CDC brainwashed ruthless NYC medical system who refused to give me a hospice consult after labeling me a drug addict. I was forced to go to a physical rehab while terminal. I was denied any pain or suffering medication while forced exercise while terminal. The obsession with narcotics due to the CDC [name redacted] PROP [names redacted] is so infused the hospital didn’t bother to call any of my doctors and was taking off of life-saving heart medication until I was drowning in my own fluid. My daughter [name redacted] got me home and where I became can catatonic. I lived another nine days in extreme agony since hospice could not catch up with my pain. I was so advanced my daughter had no time to set up home health care and had to do duties no daughter should be forced. I have done everything right my entire life. I served my country, I worked hard, I raised a family, I was a law abiding exceptional citizen. The CDC labeled me a criminal in the last years of my life. My insurance company exploited me over your guidelines, my doctors abandoned me, I was mocked and tormented for the crime of dying. In the last weeks of my life I was treated worse than an animal. The damage you have done to the medical system cannot be reversed with your revised guidelines. The CDC with help from PROP and cohorts took away dignity in my death. The CDC refuses to acknowledge Sarcoidosis exists and further decided people who are afflicted with this agonizing disease need to be tortured even while terminal. My daughter still alive and the CDC is doing everything to ensure she is slowly tortured to death too. It’s bad enough that she has been traumatized by having to witness her father being tortured to death by instructions of the CDC but she must know they will do the same to her but unlike me she will have no devoted child to remove her from the torture trap the CDC has forced the medical system to become. Your agency is filth.. You hire filth. The only hope civilized society has is complete disbandment of the CDC and your enforcers at the DEA. My daughter read that one of your original anti-narcotic zealots [name redacted] is now deceased like me. I’m assuming unlike me he received adequate pain and suffering relief. All of you are do as I say not do as I do. I believe that every single author, designer, architect, creator should be forced to endure the pain that I had to endure in the last years and especially last weeks of life. I represent all the people that the CDC has tortured to death over your choice of experts who have all proven to be arrogant, bigots, elitist, greedy, sadistic psychopaths. I was robbed of my end of my life dignity forced to be tortured without adequate pain and suffering relief because of the CDC. I will not get a second chance to die and the CDC will forever be held responsible for making what should’ve been a dignified end to a dignified life a unconstitutional cruel and unusual death. Your revise guidelines are as worthless as your agency. I would like [name redacted] to know that taking terrorizing our medical system to force taper a terminal human being off of all pain and suffering medication including medication that keeps him alive like Eliquis and Lasix over their obsession with narcotics he personally drummed up will definitely kill them. He would rather instruct the medical system to torture the terminal to death over his ridiculous fear mongering of potential harm.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Edmund	None	None	0900006485008017	Rosenberg	None	2022-04-10T18:47:26Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Rosenberg , Edmund	l1r-330d-44ha	False	None	False	2022-04-12 06:39:53.812	[]
4359	CDC-2022-0024-4365	https://api.regulations.gov/v4/comments/CDC-2022-0024-4365	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My grandma,mom,brother means daughter all have/had RLS. I used quinine when it started in my early 20s but really think it started in childhood as teachers would say “ keep your legs still”. RLS has been mocked mercilessly, but it is so real. I’ve tried thing until I have a rebound effect. The thing that works best for me now is Mirapex 75 mg. Tried going back to Requip, didn’t help. I had to practically beg for klonipin to take at night with the Miripex, sometimes it works sometimes it doesn’t. They will only allow a very low dose 5 mg. I ration it. I can’t take anything with Benadryl, drink any alcohol before bed or eat any sugar as it all makes it worse. If I didn’t have pramipexole ( Mirapex)to at least help a little -the alternative would be a horrible life if life at all. I’m glad doctors are at least getting more educated on this but I wish they were even more educated because this disease can cause so many sleepless nights that yes at leads to depression yes at leads anxiety BECAUSE YOU CANT SLEEP. So instead of a low dose of an opioid you’re giving a ton of other medicines that cause a lot of other problems. Ambien did help me until my DR was hesitant about that too. And God forbid I have a few bad nights where it leads to a shortage of mirapex at end of the month, then I just say to myself “ ok 2 more sleepless nights of pacing the floor til I get a refill”. It is no way to live. I wish we had more drs really were educated in restless legs. It is REAL. [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheryl	None	None	090000648500804a	Wierenga	None	2022-04-10T18:48:05Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Wierenga, Sheryl	l1r-3tvm-gcvh	False	None	False	2022-04-12 06:39:54.039	[]
4360	CDC-2022-0024-4366	https://api.regulations.gov/v4/comments/CDC-2022-0024-4366	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I personally have struggled with severe RLS for many many years. I was initially prescribed dopamine medicines which eventually made my condition worse. I went through several doctors and no one seemed to know what to do to help me. I finally found a doctor who diagnosed me properly and after trying several other medications, prescribed oxycontin. I finally had some relief from a horrid neurological disorder. It still does not give me 100 % relief but it is manageable. A psychiatrist I know said people commit suicide over severe RLS. It can be that bad. <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	090000648500807b	Wolf	None	2022-04-10T18:48:40Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Wolf, Susan	l1r-4bc0-mv2j	False	None	False	2022-04-12 06:39:54.263	[]
4361	CDC-2022-0024-4367	https://api.regulations.gov/v4/comments/CDC-2022-0024-4367	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Endometriosis required me to have six major abdominal surgeries over a 20 year period, with the long-standing protocol of opioid dosing for each and every procedure, which tapered as I healed without incident and went years between the surgeries or need for any medication.<br/><br/>My spine is severely contorted and twisted with degenerative scoliosis, which is a result of a decade of an FDA med that now has a black box warning for severe osteoporosis and my spine is one of the examples that would be the postmarket studies.<br/><br/>I can’t sit long enough to eat a meal. Without pain Rx, I am immobile and losing more bone mineral density every day. <br/><br/>I was taking a generic med that is the mildest formulation in the lowest opioid dose available and still it was taken, as my doctor said she was “uncomfortable prescribing because of the CDC guidelines“.<br/> <br/>For11 years I was getting 5 mg, four per day. <br/><br/>Now for 18 months I’m confined to my bed 90% and hope my pain care is restored before I am beyond the ability to regain my strength and functioning. Complications of reflux an ever-increasing weakness are resulting from this immobility.<br/><br/>Disabled since 2011, I don’t know why this is happening to me. I have no hope of ever traveling to see my children and my mother, – as I need pain relief to pack and travel.<br/><br/> I have done not one thing wrong as my doctor noted prior to discontinuing my pain meds at the end of my last follow up. <br/><br/>Please restore reason and compassionate care to America’s disabled citizens and abolish these guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006485008083	DeGeorge	None	2022-04-10T18:49:06Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from DeGeorge, Susan	l1r-4ggl-wnqw	False	None	False	2022-04-12 06:39:54.476	[]
4362	CDC-2022-0024-4368	https://api.regulations.gov/v4/comments/CDC-2022-0024-4368	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having Restless Leg Syndrome for more than 35 years, since I was 40, I am currently 76. <br/>Opioids, Methadone 12.5 mg daily, taken daily 3:30pm 5mg and 10:30pm 5.5 mg. Began the Opioids after Dr's referred me to [healthcare facility name redacted] Sleep Department, because my RLS was extreme and Chronic.<br/><br/> In the early years I started on a medication called Mirapex, it lasted for 10-15 years, until I augmented. Then on a series of different meds, sometimes taking up to 5 at a time. As I aged, the RLS got worse , more intense. Stanford was the lifesaver. Their Dr put me on Oxycodone, it worked for a year, then I started 12.5 mg of Methadone. It was the only thing keeping my legs still, in movies, car rides, at work m, in bed. <br/>I've lost several relationships and 2 divorces, the men could not deal with my terrible disease. <br/>I retired 3 years ago , almost caused a very bad accident on a curvy road, coming home from my work. I was tired and fell asleep at the wheel. It woke me up more ways than one. <br/><br/>I can not imagine living without this drug. I am NOT an abuser of drugs. I don't drink, because alcohol interacts with the Opioid. <br/>If the CDC puts regulations on this drug, I have no idea what may happen to me. I may go insane, or entertain Suicide. It is that debilitating. <br/><br/>Please, consider my story. I do NOT use Methadone for pain, I use it to keep my legs quiet, so I can sleep. I go to my pharmacy once a month, must request a new prescription every month. My Dr can only give one months supply. See attached picture of the pill bottle no more than 75 pills are given at a time. I have to sign for the medication, with picture identification. There are many Doctors at Kaiser, who will not prescribe Methadone, because of the power of this drug and the implications. <br/><br/>I am telling my story, so the CDC understands how desperate this community of RLS sufferers and how they survive in our world. It is not easy. <br/>I beg you not to regulate this medication, please! It must stay available to the people who actually Benefit from the drug. <br/>Thank you for your consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Molly	None	None	090000648500808f	Mcgarvey	None	2022-04-10T18:49:58Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Mcgarvey, Molly	l1r-4a9q-8d1q	False	None	False	2022-04-12 06:39:54.694	[]
4363	CDC-2022-0024-4369	https://api.regulations.gov/v4/comments/CDC-2022-0024-4369	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello I want to comment on this ..I sat down today and went through alot of these comments on this and I feel the need to say something to the ones that are against changing the guidelines.one day they will get sick and need opioid therapy and because of these guidelines they won't receive them .alot of sick people are out here suffering because of these guidelines ..u got your proof u can clearly see that pain meds were not causing the over dose problems.it was the illicit fentynal and heroin.please restore the guidelines and take all mme out of them .u agreed to take out the 90 mme but u left the 50 mme and now drs are cutting people down under 50 mme .this is insane. There are so many chronic pain patients taking their own life every day because they can't get pain relief if u don't take out all mention of mme u will see way more people killing them self .I feel the CDC should not have no say so in opioids pain meds period.it should be between the Dr and the patient..it should be up to the Dr PC and pm .this suffering has to stop .u have the power to fix it .u have people that are working at the CDC her name is [name redacted] that says she will make sure that the guidelines will stay the same and will not get better ..how come it seems like this was well planned out .I mean u take away the 90mme but leave the 50 mme and u had to know that Drs were going to go under the 50 mme .for God sake cancer patients our veterans our palliative care patient s are all suffering now pharmacy s are going by the 50mme and now pharmacy s are saying we can't fill out of state scripts even tho I'm only 12 miles out of state .my Dr office is out of state why cause WV don't have no pain Dr that will wite a script ..please ripped all these guidelines up .please .if u can about the American sick people u will remove all of the guidelines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	09000064850080b9	Rice	None	2022-04-10T18:51:35Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Rice, Melissa	l1r-54lr-y425	False	None	False	2022-04-12 06:39:54.910	[]
4364	CDC-2022-0024-4370	https://api.regulations.gov/v4/comments/CDC-2022-0024-4370	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Now the truth has come out that the doctors from PROP qnd the lawyers who sued the pharmaceutical companies were doing this qll for the money The government and lawyer and experts witnesses (PROP member) would make tons of money from pharmaceutical companies and these addiction specialist would have plenty of new business. Meanwhile the only thing you have done has cause suicide for chronic pain patients to go up 400% and millions of people suffering worse then ever. People are having major heart surgery and being denied opiates. That pain just stresses the heart. Of course a hospital probably make $20k for a code blue these days. But now some insurance companies are paying doctors more not to prescribe any opiates. You have ruin healthcare. Now you are in pain you are just seen as a drug seeker. It is like your doctor feels it his job to play cob, than to treat health problem as a patients. Something li,like, 60% of doctors will not even take a patient on opiate for chronic pain. How is this not discrimination since many of are disabled? Why would anyone go into a ER and wait for 8 hours for a shot of morphine and then have a 10k bill when they can buy Fentanyl down the street for $10.00. The state have made these guideline into laws and you need to have them change them back where a doctor is not responsible for what a patient does once they leave the office. Do you charge every car dealer when someone cause a crash and kills themselves? Of course not, but you are doing the same thing and the point where doctor do not trust their patient and patient do not trust there doctors. After surgery the surgeon knows what is best to prescribed, not some addiction specialist who thinks everyone get addicted to everything. The mme recommendation need to go because many long pain patients ar being just stop off there medication when there old doctor retires. Also opiate does is highly individualized and what some one who has had chronic pain and taking opiate for 30 years is going to need a much higher dose that many years later.. Many patients need increase of medication as there condition worsen. Patient who are on opiates for chronic pain should be allowed on them as long as the benefits out way the risk. Also the guideline must talk about proper tapering. Most of these doctors do not even tell there patient and the patient does not find out until they pick up there medication and he is giving them 30% of what there were on the past 20 years. I am a 100% service connected Veteran and they have been no help and because of your unstudied policies and money hungry scabs, they feel Veteran with chronic pain do not need any opiates. This includes outside doctors who care for patients in Veterans homes. Chronic pain kills and their are plenty of studies have said that. While other alternative may help they usually do not help enough to help someone with severe back issue and severe chronic pain like myself. I have chronic pain because I service my country. Medical care has become like the torture chambers in the 1800's and the CDC guideline are totally at fault. The people responsible for these guidelines should be charged with manslaughter for every patient who was taken off their medication and committed suicide because of their severe pain. Crimes against humanity and causing undo suffering. Please get rid of the guideline. Meanwhile why is the federal government keeping all the money?`Or was that the point since the pharmaceutical companies were following the guidelines for the time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jenifer	None	None	09000064850080ba	Markoe	None	2022-04-10T18:52:46Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Markoe, Jenifer	l1r-5536-jh2q	False	None	False	2022-04-12 06:39:55.125	[]
4365	CDC-2022-0024-4371	https://api.regulations.gov/v4/comments/CDC-2022-0024-4371	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help stop the punishment of people in pain by stopping the DEA from threatening legitimate doctors and pain suffers from access to pain medicine. Like myself who suffer from sciatic nerve damage, spinal stenosis, and hip pain from related injuries, I was taken off my meds because my doctor was 'afraid to go to jail.' The office she works at was visited by the DEA and so was the pharmacy, I have been treated previously by a board certified pain management doctor out of [healthcare facility name redacted] and I continued that treatment here in Michigan but have been since left to be in pain rather than receive treatment. I don't want others to go through what I've gone through because doctors are afraid to 'go to jail' if they prescribe something to help their patients not be in pain 24/7. It's a crime to take away medication that is helping people live a life semi normal and sentence them to hellish pain. Please take into consideration people like myself who have done nothing wrong, like abusing medications or selling, but still suffer the consequences of what others do. I've witnessed pain patients screaming in pain and doctors refusing to give opiate pain meds because they're afraid of the DEA. Please stop this criminal action.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brooks	None	None	09000064850080c2	Bray	None	2022-04-10T18:53:41Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Bray, Brooks	l1r-59yt-9qul	False	None	False	2022-04-12 06:39:55.354	[]
4366	CDC-2022-0024-4372	https://api.regulations.gov/v4/comments/CDC-2022-0024-4372	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm writing on behalf of the chronic or refractory Restless Leg Syndrome (RLS) sufferers (a.k.a Willis Ekborn Disease), myself included. I first began to have mild RLS symptoms in my early 20's which in a couple years became chronic and I was already experiencing debilitating sleep deprivation. I went the old route of being prescribed Dopamine Agonists which worked wonders until they didn't and I endured Augmentation. This brings me to opioids. Something I never imagined myself needing, but after trying 10+ different therapies for RLS, I saw an Nationally recognized RLS specialist who is able to prescribe me Methadone and it's the only way i was able to reclaim my life and my career. In my late 30's and a father to a young son, it's imperative I'm able to have this prescription, I even fly out of state to see the Doctor annually to maintain the patient relationship and remain eligible for prescription refills.<br/><br/>I just would like it to be more commonly understood that RLS can be so severe, and the other medications, like DA's, Gabapentin, even other opiates don't work for everyone, and methadone won't work for everyone either, but life is truly unlivable with refractory RLS and getting just one hour of sleep a night and without this medication I'm not sure I'd be typing this today. Ironically we have very real issues with opiates in our society yet they can also be a life saver for many. Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	09000064850080ca	Weatherson	None	2022-04-10T18:53:58Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Weatherson, James	l1r-5b43-fkal	False	None	False	2022-04-12 06:39:55.573	[]
4367	CDC-2022-0024-4373	https://api.regulations.gov/v4/comments/CDC-2022-0024-4373	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have suffered from RLS for over 50 years now and have progressed to Methadone (5mg/night) as a last resort treatment. The other alternatives have caused augmentation and are not longer suitable for use by myself. Do not fool yourselves, this is a horrible disease and there is no cure. Opiates are used as a last resort and should stay that way. Taking the last resort away from RLS sufferers condemns them to a living Hell (Please excuse the language, but it is appropriate) and will shorten their lives. Think well and long on this one. Sleep well...we do not.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	09000064850080eb	Langlois	None	2022-04-10T18:54:31Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Langlois, Michael	l1r-5lsc-697v	False	None	False	2022-04-12 06:39:55.787	[]
4368	CDC-2022-0024-4374	https://api.regulations.gov/v4/comments/CDC-2022-0024-4374	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to support allowing use of daily total low dose opioids to treat severe Restless legs syndrome (RLS). RLS is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>Nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am 62 years old and have been suffering with Significant RLS for 7 years. I need to take nightly Gabapentin and Requip in order to sleep at night. I initially started on a low dose of Requip (0.25) 1 hour prior to bed and over the years am now taking 600-900 mg of Gabapentin and 1-1.25mg of Requip every night in order to fall asleep. It I decrease my medication by 25% or more I will not be able to sleep or may only get 2-3 hours of interrupted sleep. I will eat trying to help relieve the symptoms, which helps temporarily but has caused me to gain weight slowly these past 7 years. I do not want to take any opioids for fear of getting addicted, but need to every so often just to wean my dose of Requip to reduce Augmentation and increasing the Requip which causes OCD like symptoms (ie the eating). I know at some point in my future I will need to take daily low dose opioids. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Sincerely,<br/><br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	090000648500850a	Cook	None	2022-04-10T18:55:16Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Cynthia	l1r-61tm-euv0	False	None	False	2022-04-12 06:39:56.003	[]
4369	CDC-2022-0024-4375	https://api.regulations.gov/v4/comments/CDC-2022-0024-4375	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please let the public know what the measure of success is for these Guidelines for Prescribing Opioids. The rate of overdoses keeps climbing. In the meantime, people are being denied humane pain relief as evidenced in the comments from patients on this very platform. It seems that these policies are hurting many people on many different fronts. Your researchers are pushing these cruel and inefficient policies and fail to acknowledge that the illicit drug market becomes a viable alternative to people seeking relief when denied care at the doctor's office. Moreover, not the CDC Guidelines or any other force on Earth will stop the force of supply and demand. Ever. Denying opioid medications has turned people to the very dangerous and unregulated illicit drug market as also evidenced by some people commenting on this very platform. The restriction of less harmful drugs has given way to the illicit production of more deadly and poisonous substances, like illicit fentanyl, which could explain the rise of overdoses since the adaptation of these guidelines in 2016. Again, I ask that you make clear to the public what is your measure of success in pushing these guidelines onto the medical establishment? Is your measure of success simply reduction in opioid prescribing? what about patient outcomes? What about a patient's quality of life? What about patient's function? Where are the numbers that these guidelines are helping anyone? and in which ways? I want common sense and humane medical care to return to the practice of medicine. These Guidelines have proven to be an antithesis to patient well being as evidenced in patient comments on this very platform.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850085ad	Anonymous	None	2022-04-10T18:55:40Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-7zmb-szz0	False	None	False	2022-04-12 06:39:56.229	[]
4370	CDC-2022-0024-4376	https://api.regulations.gov/v4/comments/CDC-2022-0024-4376	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm asking you guys please put the prescribing medcine back in the hands of our Doctors. They are train <br/>professionals that know best how to treat pain. To many of us have suffered because of these guidelines,<br/>and people are turning to street drugs and committing suicide because doctor are afraid to treat their pain. Please turn this back to over to our Doctors ..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	09000064850085a3	Davidson	None	2022-04-10T18:55:58Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Davidson, James	l1r-7wh6-a4u0	False	None	False	2022-04-12 06:39:56.442	[]
4371	CDC-2022-0024-4377	https://api.regulations.gov/v4/comments/CDC-2022-0024-4377	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of dailIy life. <br/>I have severe chronic RLS and have been taking low dose Methadone for about 3 years. Before I started Methadone, I tried approximately 20 different drugs to help with my symptoms. I also tried acupuncture and other types of alternative medicine with no help. Before Methadone I had a very poor quality of life. Most days I was nauseous from being terribly sleep deprived. I was miserable. I currently take 12.5mg Methadone with good results. I can now enjoy life.<br/>Thank you for your consideration regarding prescribing opioids for RLS.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	090000648500857d	Mack	None	2022-04-10T18:56:23Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Mack, Barbara	l1r-7dak-2imp	False	None	False	2022-04-12 06:39:56.663	[]
4372	CDC-2022-0024-4378	https://api.regulations.gov/v4/comments/CDC-2022-0024-4378	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain is a constant companion. I have had 9 back surgeries and have multiple rods and screws holding my spine. together. I have degenerative disc disease as well as mixed connective tissues diseas. I have multiple organ involvement. GI and pancreases. Multiple joint problems. I only get 10 mg of long acting oxy twice a day. This doesn’t bigan to give me enough relief. I struggle every day to dress myself and tend to my basic needs. By the end of the day I’m so exhausted I can barely make it into bed. There are days I go to bed in my clothes becase I don’t have the strength to change into my PJs. If I had better pain control I woild be able to funtion much better. I’m not a candidate for injections or bone stimulators. I can’t take NSAIDs due to only having 50% of my kidney function. I lost the other 50% from long term use of NSAIDs. So I’m begging you to u to revamp these guidelines and make it clear that chronic pain patients can obtain adequate pain relief so that my quality of life will be bearable. I worked for over 40 yrs as an RN. I’ve taken care of hundreds of patients. I always made a pint of helping them to be comfortable and functioning to their best. Please give us chronic pain patients the ability to have a decent quality of life. Otherwise it’s not worth living. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006485008562	Long	None	2022-04-10T18:57:16Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Long, Barbara	l1r-6oht-qdbq	False	None	False	2022-04-12 06:39:56.883	[]
4373	CDC-2022-0024-4379	https://api.regulations.gov/v4/comments/CDC-2022-0024-4379	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Much harm has been caused to my well-being and safety due to these harmful 2016 CDC Guidelines. Three years ago, I began unbearable pain that left me unable to work, walk or sleep. I went to the hospital thinking that my pain would be relieved but I was given 1 ibuprofen while I was there and discharged without a prescription for any medications. I was referred to pain management and to physical therapy. I also did 5 sessions of accupuncture and got no relief of my symptoms. The pain management doctor prescribed anti depressant after antidepressant and more gabapentin , Tylenol and more ibuprofen. I felt like I was being poisoned and still no relief of my debilitating pain. After a year of this inhumane struggle, I began to contemplate suicide as a way out of my misery. By this point, the doctors said they could do nothing else for me only dangerous spinal injections. I was not ready to have this dangerous procedure performed. Two people close to me have lost their ability to walk due this very invasive procedure. 1 1/2 years into my ordeal, I was pretty much abandoned by the medical establishment. I decided that they would not victimize me like this and so I had to leave the country to get humane medical care. I was given opioids for my pain and my pain subsided so much that I began to cry because I had not been able to get feel this kind of relief for so long. I could walk and I could sleep again! It was wonderful to have my life back! These guidelines are so increadibly harmful and have made healthcare in the United States and beyond, a place of torture and suffering. They must be rescinded. Too may people, including children have been harmed and are being harmed. Why is the CDC comfortable with hurting people? Additionally, the overdose rate keeps rising. What is your measure of success? Torturing people? Because this is the only thing you've accomplished.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Maria	None	None	0900006485008551	Rodriguez	None	2022-04-10T18:57:38Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Rodriguez, Maria	l1r-6v6q-0459	False	None	False	2022-04-12 06:39:57.100	[]
4374	CDC-2022-0024-4380	https://api.regulations.gov/v4/comments/CDC-2022-0024-4380	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should be more cautious when prescribing opioids as pain medication. Approximately 21-29% of patients given opioids for chronic pain end up misusing them (National Institute on Drug Abuse). As we are aware of, the opioid crisis has only worsened over the course of the pandemic. While stricter precautions would be ideal, the timing of this expansion in the guidelines is terrible. The speed at which a doctor will offer opioids to a patient is appalling. I remember at the age of 9 I broke both my wrists. They brought me into urgent care and immediately offered me a highly addictive opioid for my pain. There were so many things wrong with this especially because I was so young. Thankfully my parents were aware of the dangers and gave me Tylenol instead- which worked just fine. Needless to say, there are some situations where simple nonaddictive medications fall short, I am simply saying that we need to be more cautious with the rate at which we dole out opioids for situations where it can be avoided.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500851d	Anonymous	None	2022-04-10T18:57:59Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-6c0w-xddi	False	None	False	2022-04-12 06:39:57.329	[]
4375	CDC-2022-0024-4381	https://api.regulations.gov/v4/comments/CDC-2022-0024-4381	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Suffering with scoliosis. Every day in pain. I can’t even get rest from sleep. Being in pain I have lost my happy personality. I’ve lost other things for enjoyment of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jen	None	None	090000648500851a	Brody	None	2022-04-10T18:58:07Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Brody, Jen	l1r-6bax-d7ob	False	None	False	2022-04-12 06:39:57.544	[]
4376	CDC-2022-0024-4382	https://api.regulations.gov/v4/comments/CDC-2022-0024-4382	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Twenty years ago, I was diagnosed as having RLS. I have a relentless, unbearable, intolerable urge and need to move my legs and have a difficult time sitting while trying to watch television, read a book, enjoy a concert, fly on a plane, or have dinner with my friends. Most of the time I have to get out of my seat to stand, stretch and/or walk around or find something to do, which re-focuses my mind from my legs to whatever it is that I am doing. I have taken 3 different types of drugs to try to alleviate the symptoms. I took Requip for 6 years, after which my symptoms worsened and I had to stop taking due to issues of “augmentation”. I then took a second type drug, Gabapentin, for several months, but reached a point where the drug was no longer effective. I then started the third type drug, opiates, and have taken 15-20 mg OxyContin nightly for almost 8 years. For the first time, I am able to manage my symptoms well enough to get some quality sleep and to be able to participate in activities. I do not and will not abuse my use of this drug, as I am well aware of the impacts from abuse. There is no cure for restless legs syndrome. But for me my low dose of OxyContin helps to abate or lessen the symptoms so that I can function better. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850085b8	Anonymous	None	2022-04-10T18:59:41Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous, Anonymous	l1r-8463-4yz3	False	None	False	2022-04-12 06:39:57.763	[]
4377	CDC-2022-0024-4383	https://api.regulations.gov/v4/comments/CDC-2022-0024-4383	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a spinal fusion when I was 13 & started taking Oxycodone in 2009 because my back has been impacted by the rod that was put in. Because of the CDC guidelines in 2016 my pain management has been impacted. I have had to fight against Dr.'s who were so afraid of what could happen to them if they didn't follow the guidelines resulting in my meds being cut back or taken away. I was misdiagnosed as a "over sedation" in the ER until I flat lined and they found I had massive pulmonary embolism. I have seen the reaction of people when they find out that I take Oxy for my pain. The CDC needs to change the way they think about chronic pain. The Opioid epidemic is not caused by the people who use their meds as prescribed it caused by people who are buying street drugs that contain fentanyl. I'm tired of being put at risk because of my chronic pain. Do something to change to chronic pain management in a positive way and stop demonizing us.in the media!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Denise	None	None	09000064850085b1	Fisher	None	2022-04-10T19:00:00Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Fisher, Denise	l1r-80xv-03jg	False	None	False	2022-04-12 06:39:57.979	[]
4378	CDC-2022-0024-4384	https://api.regulations.gov/v4/comments/CDC-2022-0024-4384	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Agency: Centers for Disease Control and Prevention <br/><br/>Docket No. CDC-2022-024<br/><br/>I am submitting these comments in regard to the CDC Clinical Practice Guideline for <br/>Prescribing Opioids—United States, 2022<br/><br/>I am supporting the softening of guidelines for U.S. doctors prescribing oxycodone and other opioid painkillers.<br/><br/>I am a chronic pain patient. Since the 2016 CDC recommendations my life and the lives of others like me have changed dramatically. We have suffered needlessly as it is so difficult to get the medicine we need to relieve pain and lead normal lives. <br/><br/>It is hard for most people to imagine what it is like to live with severe pain flare-ups due to medical conditions and some of us have to live with serious pain on a daily basis. On top of that is the daily fear of not being able to get the medicine needed to control the pain - the feeling of hopelessness. The severe anxiety. <br/><br/>Pain patients are treated like common criminals when trying to get care. I have had doctors and nurses roll their eyes at me and pass me from doctor to doctor and clinic to clinic as if I’m the enemy. They drain my pockets with medical bills without offering treatment. Some doctors and nurses fear if they treat me with the opioids that work to relieve pain it will jeopardize their jobs. When they do actually prescribe, the medicine is in the lowest strength and quantity.<br/><br/>Doctors prescribe anything but pain medicine for chronic pain patients usually making the patient worse. The current fad is to prescribe gabapentin instead of opioids. Gabapentin is a seizure medication that is the equivalent of prescribing Ivermectin for COVID. It makes the patient worse. They hand this out in huge quantities instead of giving us what we actually need. I was given a prescription for 180 pills which I took for three days and was so sick I couldn’t continue. I’ve heard chronic pain patients call gabapentin punishment for being in pain. They are right. There is no miracle cure or therapy and no non-narcotic pain medicine that works. <br/><br/>It is no wonder that Reuters reported in 2018 2018 that “Nearly one in ten suicide deaths in the U.S. occurs in people with chronic pain, a new study indicates.” For us, not getting the relief we need, many times results in this last resort.<br/><br/>Chronic pain patients are not causing the drug problem. We are just trying to live our lives. When people keep pushing to eliminate opioids we are the ones who suffer. <br/><br/>The announcement that the CDC may soften guidance on opioid prescriptions offers us a glimmer of hope. Please do not disappoint us as hope is a rare thing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850085eb	Anonymous	None	2022-04-10T19:01:27Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-8slx-g8he	False	None	False	2022-04-12 06:39:58.217	[]
4379	CDC-2022-0024-4385	https://api.regulations.gov/v4/comments/CDC-2022-0024-4385	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have taken Opioids for pain for years, taking them mostly during the day. I have never taken more than the prescribed amount. In the last few years I have developed really bad Restless Legs Syndrome (RLS). I have tried every medication prescribed for RLS, even trying some twice in hopes that they would work when I had changed other meds. None of them did. I read an article about Opioids being prescribed for RLS. One evening when I woke up with horrible Restless Legs I took a Hydrocodone. Wow, I could actually lie down and sleep! My Restless Legs progressed to even worse and I ended up taking most of my prescription in the evening and early morning hours to ve able to sleep. I have never taken more than prescribed and have been taking them for more than 10 years. I do not believe many of the regulations concerning Opioids are really all that helpful, and can make things very difficult for those of us who do not abuse them. I am not hard hearted, I had a student who I met with regularly to mentor, die from an overdose, but not from prescribed Opioids, but from some he got on the street when he was going to have to wait a couple of days to get his prescription refilled (Unfortunately he had lived in a rough neighborhood and went back to it to get the drugs). Only allowing a person to get their prescription from a specialist in a financial hardship costing me $600 a year (having to see the specialists every two months) while if I could get it prescribed from my GP it would only cost me $300. Spending money on cutting off the sources of illegal Opioids, getting dealers off the streets and drug counseling would be far more helpful than telling physicians what they can prescribe for what and having them spend a great amount of time with the "paper-work" now associated with prescribing Opiods. When the new computer system came into play that the doctors and pharmacies had to use for prescribing Opioids I went several days, even a couple of weekends without my meds because of computer issues. The pain was not pleasant (an understatement) but not being able to lie down for three nights because of my RLS was a living hell. Please, enact rules and guidelines that actually might help both the addict and the responsible user, and not just what might look good politically.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Greg	None	None	09000064850085e0	Siegfriedt-Wilson	None	2022-04-10T19:01:55Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Siegfriedt-Wilson, Greg	l1r-8jms-jyg0	False	None	False	2022-04-12 06:39:58.436	[]
4380	CDC-2022-0024-4386	https://api.regulations.gov/v4/comments/CDC-2022-0024-4386	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic disease patient. I have been severely harmed by the CDC's inhumane 2016 CDC, Clinical Practice Guideline for Prescribing Opioids. The 2022 CDC draft "revision" doubles down on the torture show unleashed in 2016. Therefore the CDC should Rescind, not 'update' it's 2016 opioid guideline.<br/> <br/>Because of the unscientific, unethical and tortuous 2016 CDC "Guidelines" I am in severe undertreated pain, which limits my ability to walk, sleep and perform basic activities of daily living. I suffer from the painful diseases of inflammatory osteoarthritis and autoimmune disease and require these medications to survive.<br/><br/>As a direct result of the Guidelines I have been medically abandoned once, force tapered twice, and denied fulfillment of my prescriptions at two pharmacies. Leaving me with life threatening sudden withdrawl.<br/><br/>I worked as an RN in the critical care and operating room arenas for 35 years. I am proud of the compassion I showed my patients. <br/>Since 2016, the CDC has deliberately stoked hysteria over the supposed "opioid crisis", and behaved like an authoritarian regime. Relying on the police state tactics of the DEA. <br/><br/>The revision gives lip service to "Individualized PERSON centered care" to further distance CDC from the intentional HARM inflicted on VULNERABLE PATIENTS! CDC's opioid prohibition is extended in the 'draft' to include: lower MME amounts, diagnoses, age limits, among other arbitrary criteria. The Guidelines and draft are unscientific, cruel, discriminatory and unethical. <br/> <br/>The document's “evidence” is weak and scientifically unsound (MME MAX), and amounts to mere opinion, based on weak evidence. Much of the cited “evidence” was created by the opiophobic author of the “guidelines", who has Conflicts of Interest. (see doc. #!).<br/><br/> The 50 MME maximum alert will cause mass forced "tapers"(cut off), patient torture, use increase use of illicit fentanyls and deaths, as lawmakers adopt it as the law. <br/><br/>CDC must revoke, not update the Guidelines. The biased anti-opiate views will continue to actively harm and likely kill me due to complications of untreated pain.<br/><br/>Attached are four excellent research articles, breaking down the flawed 2016 CDC data:<br/> <br/>1.https://www.pallimed.org/2021/09/roger-chous-undisclosed-conflicts-of.html<br/> https://pubmed.ncbi.nlm.nih.gov/31327624/#:~:text=Misperceptions%20include%20the%20number%20of,opioid%20use%20and%20heroin%20initiation.<br/><br/>2.file:///Applications/59-475-1-PB.pdf<br/><br/>"For a long time already, it was doubtful that opioids causing accidental death in the United States originated from medications prescribed to pain patients. However, insurance companies, politicians and authorities, including the USA Centers for Disease Control (CDC) and the Drug Enforcement Administration have<br/>been blaming pain patients and their prescribers for causing the crisis. They did not distinguish between<br/>actually prescribed medications and medications intended for prescription, and also not between the medication fentanyl, illicitly produced fentanyl, and its more potent illicit derivatives (‘fentanils’), of which many<br/>do not have any medical or veterinary use and which are only available on the illicit markets. Because<br/>the mechanisms behind the many lethal opioid intoxications in the United States were not well analysed,<br/>the responses were also not an answer to the problems and therefore, cannot revert these<br/>Because of this, pain patients were gradually denied access to opioid pain relievers. Human Rights Watch announced to investigate the United States for torture with this respect ([name redacted] 2018).<br/>Finally, it was recognized by the CDC that the epidemic is not driven by opioids prescribed to pain<br/>patients ([name redacted] et al. 2017). Moreover, the CDC admitted in 2016, that they have historically categorized ‘all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic<br/>opioids, regardless whether they originate from licit or illicit sources) as “prescription opioid overdoses”’<br/><br/>The situation in the United States has much been conflated by erroneous data. For instance, the Centers for<br/>Disease Control and the anti-opioid organisation Physicians for Responsible Prescribing reported that the US<br/>per capita consumption of opioid analgesics is 1.7–4.1 times higher than the actual consumption reported<br/>officially by the US Drug Enforcement Administration to the INCB ([names redacted] 2016a). <br/><br/>3.https://www.dovepress.com/getfile.php?fileID=79642<br/><br/>I urge all CDC and PROP members who contibuted to the torture, suffering and death of innocent patients to turn in your medical licences.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500864f	Anonymous	None	2022-04-10T19:05:54Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-a6c5-0lmc	False	None	False	2022-04-12 06:39:58.647	[]
4381	CDC-2022-0024-4387	https://api.regulations.gov/v4/comments/CDC-2022-0024-4387	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The update on prescribing opioids has some interesting omissions, including the failure of the CDC to accept responsibility for creating a self-made Public Health Crisis involving at least twenty million High Impact Chronic Patients being forcibly taken off their opioids.<br/> Opioids are still the gold standard for the treatment of moderate to severe pain regardless of duration. When use correctly, opioids are safe and well-tolerated.<br/> The evidence for long-term opioid therapy is very strong anecdotally but essentially lacking in good evidence-based studies. Cochrane reports back this conclusion. There is some reasonable confirmation that LTOT works.<br/>I have spoken with other MPs who agree with me that the artificial limits are nonsense and must be based on the patient and doctor-patient team and objective results.<br/> The opioid OD spike is caused by Chinese fentanyl and Mexican heroin, not by prescription opioids. The DEA and other agencies must be more involved with this problem.<br/> May we please stop the moral panic that has caused a gross overreaction to all opioids, especially fentanyl. It's time for reasoned physicians to guide practices involving the treatment of pain to a much better place.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	090000648500865f	Falzone	None	2022-04-10T19:06:51Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Falzone, Joseph	l1r-ahjj-9zfn	False	None	False	2022-04-12 06:39:58.871	[]
4382	CDC-2022-0024-4388	https://api.regulations.gov/v4/comments/CDC-2022-0024-4388	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guidelines, but the draft does not address chronic conditions like Restless Legs Syndrome that are different from cronic pain. RLS is a chronic neurological disease that causes an urgent need to move legs and sometimes other parts of the body. This makes it impossible to sleep or even quietly, which seriously affects every aspect of life.<br/><br/>I have been taking tramadol for over twenty years started off very slowly and have increase very slowly, but with guarded care am able to continue to get relief from it (contrary to every other type of treatment that I have tried). <br/><br/>I urge the CDC to include a section in the guidelines to address chronic medical conditions like RLS that require taking opioid therapy as a last resort, in low-total daily doses, carefully monitored.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donna	None	None	0900006485008675	Morgan	None	2022-04-10T19:07:00Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Morgan, Donna	l1r-aruz-rtj2	False	None	False	2022-04-12 06:39:59.091	[]
4383	CDC-2022-0024-4389	https://api.regulations.gov/v4/comments/CDC-2022-0024-4389	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The restriction of opioid painkillers for chronic pain patients causes far more harm than good. When people are denied legal, readily available pain management, they WILL turn to self-medication, leading to overdose and death. If they don't go this route, they may take their own lives. All of this posturing about "we're saving people" is fairly blatantly repackaged hysteria, and it punishes disabled people. I understand wanting to be cautious, but caution that causes more harm than it solves is itself, harmful. Reverse the decision, issue new guidelines that actually take into account that people need pain RELIEF and not just dampening, and stop causing disabled people to live in misery.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006485008676	R	None	2022-04-10T19:07:36Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from R, J	l1r-asqc-33ks	False	None	False	2022-04-12 06:39:59.495	[]
4384	CDC-2022-0024-4390	https://api.regulations.gov/v4/comments/CDC-2022-0024-4390	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter-in-law has been severely and negatively effected by these regulations. Her quality of life is poor as well as difficult, much more difficult than a young woman should have to go through. She is in constant pain. Please ease up opiate restrictions in order for her, as well as thousands of other people with fibromyalgia as well as EDS to have a chance at a normal life. She deserves no less. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006485008694	Kent	None	2022-04-10T19:07:52Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Kent, Cynthia	l1r-bc1v-22z3	False	None	False	2022-04-12 06:39:59.709	[]
4385	CDC-2022-0024-4391	https://api.regulations.gov/v4/comments/CDC-2022-0024-4391	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, however the draft does not address conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease which creates a need to move the legs and, sometimes, other body parts. The symptoms make it difficult sleep, which seriously affects every aspect of daily life.<br/><br/>Many people suffer from RLS. There is no cure. Some prescription meds give temporary relief, but then after a time make the symptoms worse. When other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I am helped by low-total-daily-dose opioids, without any addiction issues or negative side effects.<br/><br/>When RLS was diagnosed more than 300 years ago, it was successfully treated with opioid therapy. But in 2016, the CDC Opioid Prescribing Guidelines made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS, even some who had been on the same low-total-daily-dose opioid therapy for decades. I strongly encourage the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of this issue. The RLS Foundation (www.rls.org) is a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008695	Anonymous	None	2022-04-10T19:08:28Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-08T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-bc3v-1txr	False	None	False	2022-04-12 06:39:59.930	[]
4386	CDC-2022-0024-4392	https://api.regulations.gov/v4/comments/CDC-2022-0024-4392	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered chronic pain since a car accident In 1994 at the age of 38. I went from being a busy, active, healthy, mom and nurse, to someone who was often bedridden with days that showering or getting dressed was too painful and exhausting. Opioids gave me a bearable quality of life, with a few hours of functioning each day, and the capacity to sleep instead of suffering in raging pain all night. That ended, in 2016, my dr. Discontinued my medications, according to his interpretation of the CDCs recommendations. My quality of life has plummeted and if not for my grandson and adult children, I would have no will to live like this. It’s hard enough to be disabled, but to have pain every day, is torturous and it’s impossible to sleep with uncontrolled pain. The pain clinics refuse to prescribe my precious medications that were so helpful and it’s cruel and barbaric to force people to endure constant pain and refuse to treat them. A whole population of patients is driven to despair, and I’m now embarrassed of the medical field I used to be so proud of working for. I urge the CDC to make the distinction between “addiction” and “relaince”on pain medications and get acknowledge that there are patients who do not abuse their medications and require them for functioning and quality of life. So much of the previous data used was flawed and biased, and due to the “war on opioids” doctors have abandoned pain patients and left them suffering. Prescribed medications must be available to the population of people tormented in pain who require them and use them responsibly and the benefits must be weighed with the risks. The current situation is destructive and cruel, and disregards a patients right to be treated and pain alleviated. Doctors who are willing to treat pain should not be persecuted or intimidated, this is what the pain experts do, and opioids are considered the last alternative for those who respond favorably to them and nothing else provides relief. Please let the addiction specialists work with addicts and Pain specialists work with chronic pain sufferers, The damages of the CDCs faulty policy has caused so many to suffer needlessly and will take years to undo the propaganda, I hope you completely scratch the policy and work with actual experts on pain management to proceed with a policy that includes and respects the needs of the millions suffering from chronic pain, and the beneficial role opioids play, when used as they were meant to be used, to relieve iretractable pain and recovery from painful procedures.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	09000064850084f1	Kelley	None	2022-04-10T19:09:05Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Kelley, Linda	l1r-gkc5-yf1p	False	None	False	2022-04-12 06:40:00.150	[]
4387	CDC-2022-0024-4393	https://api.regulations.gov/v4/comments/CDC-2022-0024-4393	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with fibromyalgia at 16. Immediate anti-depressant. I am now in my late 40’s and the pain and fatigue are sometimes unbearable, as I work full time, much<br/>of it is on my feet<br/>I have tried everything it seems. Medication, PT, yoga- I’ve tried it all. My evenings and weekends are spent in a hot bath and bed. <br/>I have not been to pain management, because of the nightmare stories people have of going that route. I am exhausted, I can’t hold up to someone acting like I’m a drug addict, which is what this last ruling caused. Doctors terrified to prescribe adequate pain relief. I need to pain relief to live my life. I have taken Advil several times a day for the last ten years. It doesn’t touch it most days. <br/>But I can’t go to pain management because there you have to sign a contract- they require you to sign a contract and they would be in charge of my ADHD meds. I literally can’t work without them. <br/>Every story I read, pain management doctors get targeted by the DEA and then they lower their patients doses or cut them off. <br/>But opioids do help. Being able to have them occasionally for pain would be amazing for me and my family. But I can’t have them that way in pain management. And I could be seriously affected by my pills just taken away. <br/>I’ve read so many stories, including a cousin in a wheelchair that shot herself, because they wouldn’t prescribe adequate relief over fear of the DEA. The suffering people have endured because of this nightmare guidance must be rectified. Patients need adequate relief, not a suicide option because they can’t live in pain: <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008d04	Anonymous	None	2022-04-10T19:09:24Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-hfr1-os4j	False	None	False	2022-04-12 06:40:00.367	[]
4388	CDC-2022-0024-4394	https://api.regulations.gov/v4/comments/CDC-2022-0024-4394	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am praying that the 2016 CDC guidelines for prescribing opioids to chronic pain patient is abolished. The real problem is FENTANYL and heroin addiction, not opioid prescriptions. Everyone is blaming the doctors for prescribing the opioids, but for chronic pain patients, it is the only way to have a somewhat normal and functional life. The 2016 guidelines punished those who suffer from chronic pain. The doctors started cutting dosages and for some, just denied them meds all together. Now even having surgery, hospitals are refusing pain meds and sending patients home with Tylenol or ibuprofen!!! We are talking major surgery and agonizing pain. Animals are treated better than humans in that aspect and it is WRONG and CRUEL!! If I had to survive only on over the counter medications I would not have any quality of life. Even on opioid pain medication, I have had days of agonizing pain. If I had to live the rest of my life knowing that I would t have relief from the pain, I would most likely kill myself. There are so many people that I know and have heard about that have been refused pain medication and they committed suicide. You cannot tell me that since the 2016 guidelines were implemented that it helped the “opioid crisis”. The addiction rate has increased by 400 percent. FOUR HUNDRED PERCENT!! And the people dying are being POISONED with fentanyl. They are not OVERDOSES. An overdose is when you take too much of something, drug dealers are intentionally poisoning people. A doctor takes a Hippocratic oath to do no harm. And restricting pain medication to those suffering daily is animalistic, cruel and inhumane! The guidelines should be retracted immediately and LET THE DOCTORS TREAT THEIR PATIENTS!! No one person is the same and this is not something the CDC should be butting into period! Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Veronica	None	None	0900006485008d05	Fitz	None	2022-04-10T19:09:45Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Fitz, Veronica	l1r-hihl-fv3o	False	None	False	2022-04-12 06:40:00.578	[]
4389	CDC-2022-0024-4395	https://api.regulations.gov/v4/comments/CDC-2022-0024-4395	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I know that you probably will not read most of these comments that come from patients & you will read the ones from drug clinics that will say the opiate crisis is only getting worse & they will be happy if you lower the MME! But if I am blessed & very lucky & you do choose to read my comment I thank you in advance! So I am 76 years old & untill 5 years ago I had only taken pain medication a few times & then it wasn't longer than a few weeks but 5 years ago I had neck surgery that went bad & I ended up with MRSA which almost killed me; I spent almost a year in the hospital & had 3 surgeries to try to repair the damage; & now the only thing that I can take to keep me from laying in bed crying is pain meds I take a total of 6 a day which may sound like a lot but I am right at the 90MME & actually I had been on 140MME until 6 months ago when my Dr of 5 years said he wanted to take me down in fear the CDC will make it impossible for me to get the pain meds I need to truly live; I take monthly urine test & do monthly pill count & have for 4 years straight & not 1 time in either have I had any issue; & not one time have I abused my meds; I have never went to the streets to sell or buy pain meds; so why oh why are you Punishing people like me? I worked till I was 68 I never broke the law; I actually was a police woman for 27 years in Dallas! So I am a good person & I just don't understand why you can do this to people that truly need the medications! I understand the opiate crisis trust me I worked hard to keep drugs off the streets for many years but do you know must of the drug problem is the illegal drugs coming in from Mexico & then the homemade fake drugs being made! The problem isn't somebody suffering from Cancer; Lupus; RA: or someone just like me that has had failed surgeries! So I come to you asking you to please re-think changing the opiate MME & truly know you will only be making the illegal drugs get more popular & your going to send good people looking to the streets even more when you take away what works for them that a DR gives them! Thank you for your time!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006485008d20	Stockton	None	2022-04-10T19:10:13Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Stockton, Linda	l1r-iqee-nqof	False	None	False	2022-04-12 06:40:00.799	[]
4390	CDC-2022-0024-4396	https://api.regulations.gov/v4/comments/CDC-2022-0024-4396	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m 81 years old and have suffered with Restless Keg Syndrome all my life. That life has been circumscribed by the disease that doesn’t allow me to sleep. Low dose tramadol for the last 12 years has allowed me some measure of normalcy. Without it, I would take my life because it would be intolerable. Don’t throw out the baby with the bathwater when you define availability parameters.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barb	None	None	0900006485008d5b	Shave	None	2022-04-10T19:10:26Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Shave, Barb	l1r-mjwa-iab8	False	None	False	2022-04-12 06:40:01.008	[]
4391	CDC-2022-0024-4397	https://api.regulations.gov/v4/comments/CDC-2022-0024-4397	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Congratulations! You have taken so many lives away, including my own. <br/>At 1 time I had a bucket list of seeing a castle. Now I just want to be able to take a short flight to see my grandson & take him to the zoo. Unfortunately, even that is probably gone for me. You see, because of the ridiculous "guidlines" my provider is now afraid to prescribe even though I have VERY well documented diseases and structure problems. I'm 54 and hope to not live in this pain much longer. <br/>My question is why? Why are your grandchildren entitled to you? Why are your children entitled to have you? Why are your parents entitled to you? Why are only the healthy entitled to qualify of life? Why are my parents & children & grandson not entitled to me? Just why? I'm nearly homebound now. Not that long ago I still had quality of life because I was medicated properly. Unless of course this is about population control. Is it? Since CPP suicide has increased 470% it would make a lot of sense that it is indeed. The "opiod crisis" is due to ILLICIT FENTANYL not legal prescription overdose. But somehow the power of this government is to destroy lives NOT better them. If I had diabetes I could be medicated. If I had high blood pressure I could be medicated. Hell, we are finally trying to treat depression in this country, thank goodness!! But not if a person is in pain. <br/>So congratulations! You have so much blood on your hands & until you fix your mess MORE PEOPLE ARE GOING TO KILL THEMSELVES!<br/>But remember, not you or your children or your parents are immune from illness, injuries or old age. The day may come that YOU are begging for pain meds. <br/>You MUST remove all mention of MME from your new "guidelines"!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006485008ad1	Green	None	2022-04-10T19:11:03Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Green, Jennifer	l1r-o3lc-5lqi	False	None	False	2022-04-12 06:40:01.221	[]
4392	CDC-2022-0024-4398	https://api.regulations.gov/v4/comments/CDC-2022-0024-4398	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Treat pain first. Do not withold or reduce pain medicine unless there is an adequate replacement. Never use placebos for long term pain control. Believe patients first. If doctors cannot help a patients underlying cause, they still have a moral obligation to treat the pain. Doctors should be held accountable for failure to treat pain. Pain management needs to be a priority, not an inconvenience. Law enforcement has zero business involving themselves in medical issues unless there is direct evidence of specific criminal activity. Patient rights need to be enumerated in no uncertain terms and they need to be respected and protected. Part of this is recognizing and acknowledging how patient rights are being violated, up to and including unreasonable searches (urinalysis). How is it that I have to subject myself to have my biochemistry be forcibly searched regularly for access to a class 4 controlled substance? How is it I am have been in uncontrolled pain since 2017 yet doctors have deliberately ignored this fact and thus deliberately fail to treat it? Current interpretations of the policy are specious at best, and have resulted in torturing chronic pain patients. As such, you need to proactively protect chronic pain patients and stop demonizing one of the most effective tools we have until there is something better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michael	None	None	0900006485008aed	Geist	None	2022-04-10T19:11:20Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Geist, Michael	l1r-pf8o-gogd	False	None	False	2022-04-12 06:40:01.438	[]
4393	CDC-2022-0024-4399	https://api.regulations.gov/v4/comments/CDC-2022-0024-4399	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I was diagnosed with RLS at 30 years of age - I am now 55. I have been sleep deprived for the last 25 years. The symptoms of RLS are simply stated as HORRIBLE. There is no getting use to it and if you try to fight it - the symptoms get worse - the feeling of ants crawling inside your legs and arms. I have fallen asleep while driving and by the grace of God - I have not hurt anyone or gotten into an accident. I now do not drive. RLS can also be very painful especially if you are unable to move to alleviate the pain. I live in NYC and if I am on a crowded subway and an RLS episode comes on - I start to jerk my body to alleviate the episode - these body movements look very disturbing to an outsider which in turn causes high level of anxiety making the episode worse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diana	None	None	0900006485008af5	Lumley	None	2022-04-10T19:12:20Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Lumley, Diana	l1r-q06u-byy4	False	None	False	2022-04-12 06:40:01.652	[]
4394	CDC-2022-0024-4400	https://api.regulations.gov/v4/comments/CDC-2022-0024-4400	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My 76 year old mother suffers from excruciating chronic pain from Rheumatoid arthritis and severe osteoarthritis which has destroyed all the cartilage in her hip and knees. Despite this, she is unable to get pain medication to properly manage her pain, even through a pain clinic. Because of sepsis in her hip replacement due to decades of immunosuppressants, she is not a candidate for further joint replacement surgery. She has finally has been able to receive small doses of Tramadol, which is really unable to control her pain. Because of the opioid crisis and the overreaction of the CDC and medical community, instead severe chronic pain patients like my mother instead sit in pain, barely able to take themselves to the bathroom because it hurts so much to walk.<br/><br/>Yes, opioids were handed out improperly - I was once offered them for pain when diagnosed with bronchitis at a quick clinic that I suspect was an opioid mil. But denying patients with severe chronic pain the relief they so desperately need isn't a solution to that problem- instead it destroys other lives. My mother sits in a recliner all day now, unable to do any of the things she enjoyed. Her garden is gone, she is unable to see her grandson, a brilliant oboiest, play at concerts. She is instead confined to a small apartment, faculties muddled by pain rather than age. The guidelines under consideration still are too restrictive on chronic pain and do not acknowledge the real harm being done to patients in real chronic pain who genuinely need pain medication in order to have any semblance of a normal life. The guidelines should provide guidance for this as well, as opposed to a narrow focus that opioid are bad and should not be used for anything other than extreme short term use after surgeries. Lives are being ruined by that approach. This is not a black or white situation; it is fraught with shades of gray, and individuals like my mother sit in the shadows, silently suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006485008b08	Flowers	None	2022-04-10T19:12:52Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Flowers, Lisa	l1r-qibs-ha90	False	None	False	2022-04-12 06:40:01.896	[]
4395	CDC-2022-0024-4401	https://api.regulations.gov/v4/comments/CDC-2022-0024-4401	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please suspend these guidelines, while they may have been we'll intentioned they have caused more harm than good. Chronic Pain Patients have been cut off from medications or had them cut back to levels that are not helpful at all. Please suspend these guidelines do not amend.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chuck	None	None	0900006485008b10	Dixon	None	2022-04-10T19:13:04Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Dixon, Chuck	l1r-qoor-e1xr	False	None	False	2022-04-12 06:40:02.112	[]
4396	CDC-2022-0024-4402	https://api.regulations.gov/v4/comments/CDC-2022-0024-4402	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low-Level Laser therapy is very effective in reducing pain. I have experienced of patients <br/>reporting significant improvement in pain after therapy.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485008d76	None	None	2022-04-10T19:13:13Z	CWSF	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from CWSF	l1r-s15f-aeb3	False	None	False	2022-04-12 06:40:02.326	[]
4397	CDC-2022-0024-4403	https://api.regulations.gov/v4/comments/CDC-2022-0024-4403	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Thankfully, I have not reached the point where I require opioids. As my RLS progresses, I hope that the option will be available to me and to others that suffer. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Thank you for hearing my concern.<br/><br/>With best regards,<br/>[name redacted]<br/>[city redacted] , VA	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	0900006485008daa	Osborne	None	2022-04-10T19:13:56Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Osborne , Cheryl	l1r-t6iq-gzan	False	None	False	2022-04-12 06:40:02.538	[]
4398	CDC-2022-0024-4404	https://api.regulations.gov/v4/comments/CDC-2022-0024-4404	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been taking opioids since 2016 & they do work. I take 2x 50mg & pregabailn 300mg at night, if I miss a dose then RLS kicks straight away!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	June	None	None	0900006485008de1	Jones	None	2022-04-10T19:14:08Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones , June	l1r-tva1-7gww	False	None	False	2022-04-12 06:40:02.743	[]
4399	CDC-2022-0024-4405	https://api.regulations.gov/v4/comments/CDC-2022-0024-4405	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006485008e1c	None	None	2022-04-10T19:15:37Z	US Pain Foundation	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from US Pain Foundation	l1r-ub6b-8rwe	False	None	False	2022-04-12 06:40:02.959	[]
4400	CDC-2022-0024-4406	https://api.regulations.gov/v4/comments/CDC-2022-0024-4406	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please add RLS to list of chronic diseases for low dose opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	0900006485008e23	sweeton	None	2022-04-10T19:16:19Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from sweeton, Deborah	l1r-uub0-6j6m	False	None	False	2022-04-12 06:40:03.176	[]
4401	CDC-2022-0024-4407	https://api.regulations.gov/v4/comments/CDC-2022-0024-4407	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>---I have used low level opioids for several years now with no negative effects.--Oxycodone (1) 5mg tab and (1) 10 mg tab taken 8-10 hours apart.--the low level opioids along with (2) .25 mg Ropiniroles daily enable me to have a reasonable quality of life.--Unfortunately the Ropinirole meds are losing their effectiveness which is expected over time.--I have used several other RLS meds and they don't work for me.--I have severe RLS symptoms every day for most of the day.--The opioids help to ease the discomfort. Without the opioids I can neither sleep or rest in a chair. Think about that please.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	F	None	None	0900006485008e48	Kautz	None	2022-04-10T19:16:43Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Kautz, F	l1r-v8z1-zgvr	False	None	False	2022-04-12 06:40:03.404	[]
4402	CDC-2022-0024-4408	https://api.regulations.gov/v4/comments/CDC-2022-0024-4408	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm am a medical professional and my life has completely taken away and clearly stated. I was told because of the CDC.guidelines I would have to be weaned extremely down. I was on approximately 340mme for 15 years. I was a high functioning CPP. I've nearly died in withdrawals. I have 15 bulging or herniated disc from 6 ATV and MVA as a teenager.Then ICU became my passion but working bedside meant pulling, pushing and holding on up to 400lb patients. Nero surgeon said if he operated on one area obviously the other area are gonna continue to hurt and it would be years to operate on all. Surgery wasn't a viable option for me. So that when I started with pain management. I was treated so well and continued to function well until guidelines. I fear I'm gonna end up in the streets homeless. I have no living relatives to help in any shape or form. The guidelines continue to harm so many people. Please help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Krissie	None	None	0900006485008e53	Cook	None	2022-04-10T19:17:00Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Krissie	l1r-vg0u-j5ms	False	None	False	2022-04-12 06:40:03.616	[]
4403	CDC-2022-0024-4409	https://api.regulations.gov/v4/comments/CDC-2022-0024-4409	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] from [city name redacted], New Brunswick, Canada. At 78 years of age, I have had restless legs for about 15 years. My neurologist prescribed Requip which I have now topped out on. Due to an ulnar nerve injury, I was prescribed Gabepentin ... 9 tabs a day which is the medication my neurologist has suggested would be the addition to my Requip. I have been able to reduce this to 4 tabs a day but not successful reducing to 3 tabs or less. Those of us with Restless Legs need help to manage this affliction for we literally cannot sleep a wink without help. Our fear is that the medications will not work but with the addition of an opoid, we have a chance to live with sleep. Please help us. Sincerely, [name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Patricia	None	None	0900006485008e6c	Trail	None	2022-04-10T19:17:46Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Trail, Patricia	l1r-vnqd-kfmc	False	None	False	2022-04-12 06:40:03.838	[]
4404	CDC-2022-0024-4410	https://api.regulations.gov/v4/comments/CDC-2022-0024-4410	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC's job is infectious disease, not pain management. The CDC has been infected by an insidious parasite known as PROP and the side effect is corruption. The irony of it all is rather disturbing. The "Fix/Cure" is to RESCIND THE GUIDELINES that were written by PROP.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ruth	None	None	0900006485008e73	Ard	None	2022-04-10T22:23:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Ard, Ruth	l1r-vqua-f5pd	False	None	False	2022-04-12 06:40:04.142	[]
4405	CDC-2022-0024-4411	https://api.regulations.gov/v4/comments/CDC-2022-0024-4411	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to request that you please consider changes to the current CDC Clinical Practice for Prescribing Opioids for pain. I am 62 years old and have acute pain in my leg. It has not been diagnosed, because the 3 doctors I have consulted with do not see anything in my X-rays. The insurance company makes it mandatory that I have 6 sessions of physical therapy, before any other tests can be performed to find the source of my severe pain. I have tried physical therapy but it is so painful I am not able to do anything while I am working with the therapist. Nor can I do anything at home. I need some kind of relief from the pain so I can thrive while having treatment and assessments. My doctors will not prescribe pain medications because of the current law. It is beyond my comprehension why responsible adults who do not want to take drugs to escape reality have to be punished for those who abuse freedom. So, I am asking you to consider a change that would make pain medications available to seniors suffering with acute pain and need relief while attending physical therapy. I know physical therapy works, but there are times when a patient needs help with the pain to begin the sessions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dina	None	None	0900006485008ea8	Giddens	None	2022-04-10T22:24:32Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Giddens, Dina	l1r-wegf-0iwt	False	None	False	2022-04-12 06:40:04.388	[]
4406	CDC-2022-0024-4412	https://api.regulations.gov/v4/comments/CDC-2022-0024-4412	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a patient of pain management. I followed all the rules and did everything right. I was finally authorized for a spinal cord stimulator with the end goal to be lower doses of pain meds. Had a prescription stolen, filed a police report, told the doctors I got pain meds from my other surgeon. Got dropped like a hot potato and the doctor refuses to continue with the stimulator that could save my life. There is no tapering here, or empathy. The current guidelines make pain patients nothing but a liability and we're treated as such. There is a band of opiate hating dea fearing doctors standing in the path to some relief for us. We're the ones dying out here. We're the ones who have to choose to live this way or die this way. You're giving us no chance to live.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008f25	Anonymous	None	2022-04-10T22:24:46Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-xqf3-zjkm	False	None	False	2022-04-12 06:40:04.604	[]
4407	CDC-2022-0024-4413	https://api.regulations.gov/v4/comments/CDC-2022-0024-4413	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for causing me to be bedridden. Thank you for basically ruining my life. Thank you for misinformation. Thank you for threatening and intimidating medical professionals. You make me sick and have no business doing what you are doing. If I suicide myself that will be because of you. God be with you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008f38	Anonymous	None	2022-04-10T22:26:49Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-xz5i-gre4	False	None	False	2022-04-12 06:40:04.823	[]
4408	CDC-2022-0024-4414	https://api.regulations.gov/v4/comments/CDC-2022-0024-4414	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC warns insurers, governments, and others to not use 50 MME or this guideline go set hard limits such as the Medicaid hard edits that were based on 90 MME, but how will this be accomplished?<br/><br/> Sickle cell anemia and palliative should be rewritten as “severe chronic pain” or “intractable pain.” Others have equally painful diseases and should also be included. Why not be fair to all?<br/><br/> You advise use of NSAIDs then advise against its use. Tylenol has become preferred to opioids due to prior CDC guidelines. Why recommend more harmful medicines? Addiction paranoia?<br/><br/>CDC suggests opioids are not useful in fibromyalgia and osteoarthritis based on very limited data. Many patients have tried other modalities and only function thanks to opioid therapy. Why artificially limit clinician decision making based on limited studies, and against your advice to individualize care? Why attempt to subterfuge use of opioids in any medical case?<br/><br/> You do not have statutory authority to regulate drugs, which belongs to the FDA. Why should the CDC be writing these guidelines rather than the FDA who has the authority?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shealyn	None	None	0900006485008f42	Heritage	None	2022-04-10T22:27:09Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Heritage, Shealyn	l1r-y43j-g2qb	False	None	False	2022-04-12 06:40:05.036	[]
4409	CDC-2022-0024-4415	https://api.regulations.gov/v4/comments/CDC-2022-0024-4415	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC 2022-0024 Proposed guideline for Rx opioids<br/>I am a person with interstitial cystitis(IC) www.ichelp.org<br/>For many years, I suffered with pain that felt like a lit match was in my urethra. I used to sit on the floor and hit my head against the wall, thinking that if my head hurt badly enough, my pelvic pain would be better. Did not work. I wanted to die but did not want to leave my young children. I had a good doctor but he could not help. I was told to go to a pain dr but my insurance company DID NOT HAVE ONE. I finally got permission to go to any pain dr and they would pay. I got relief. My story is one of millions. A very kind pain doctor told me "People who are addicts take narcotics to get high, people in pain take them to get normal." He also treated cancer patients who were going to die. His reasoning was that though they certainly deserve to be comfortable, so do people in pain who are NOT going to die. Why can't we live our lives in comfort instead of pain. We can't work, go on Medicaid, lose custody of children, our spouses leave us. You don't stop giving penicillin because a few people are allergic. You don't stop treating people in pain ---it is inhumane. Please realize chronic pain is a disease and needs to be treated. There are of course other ways, which helped me. But one of my doctors told me "You don't need these" but I did!! Until I found other ways to get the pain under control. Please help people in pain. I personally know people who could not get the pain under control with this disease who killed themselves.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006485008f58	Salin	None	2022-04-10T22:27:34Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Salin, Linda	l1r-ye3g-ou4y	False	None	False	2022-04-12 06:40:05.255	[]
4410	CDC-2022-0024-4416	https://api.regulations.gov/v4/comments/CDC-2022-0024-4416	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You have to track chronic pain patients' suicide numbers if you want this report to be truly 'evidence based '<br/><br/>No one tracks this. No one cares.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Holly	None	None	0900006485008f5e	Goodwin	None	2022-04-10T22:27:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Goodwin, Holly	l1r-ygpu-s9kx	False	None	False	2022-04-12 06:40:05.487	[]
4411	CDC-2022-0024-4417	https://api.regulations.gov/v4/comments/CDC-2022-0024-4417	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a physician - a general internist, who suffers with moderate to severe restless leg syndrome. This condition causes an extremely uncomfortable sensation which is only momentarily relieved with movement. It mostly occurs in the evening, however at its worst it may occur for an entire night, preventing any restful sleep. I take Lyrica, which helps, however the symptoms vary considerably from day to day, and there are times when it does not provide relief, even with a high dose. I no longer take Requip, as it caused augmentation, which is symptoms anytime during the day, or in other parts of my body, or even my entire body. I have been using tramadol, as needed, which offers some relief, although the most effective medication for me, at times of severe symptoms, is hydrocodone. I have been very reluctant to request this from my physicians because of the stigma associated with the use of opioid medications.<br/><br/>Restless leg syndrome can be torture - after a night of symptoms, and an inability to get an adequate amount or quality of sleep, I have difficulty functioning at work the following day. At one point it caused me to become severely depressed.<br/><br/>Please consider codifying the role of low dose opioids for Restless Leg Syndrome, recognizing the limited number of available, effective medications for those of us with moderate to severe symptoms. Thank you!<br/><br/>[name redacted] M.D.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mark	None	None	0900006485008f64	Lentz	None	2022-04-10T22:28:22Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Lentz, Mark	l1r-yj74-nhdb	False	None	False	2022-04-12 06:40:05.745	[]
4412	CDC-2022-0024-4418	https://api.regulations.gov/v4/comments/CDC-2022-0024-4418	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patients are the last unprotected class of citizens in the United States. Our government has singled us out as if we are undeserving of relief for our medical conditions. Every chronic pain patient is classified as a potential criminal first, legitimate patient second. We must defend ourselves to our physicians, pharmacies & insurance companies. No other patient in the United States receives so little compassion, empathy or care for such life-altering conditions.<br/><br/>My journey: Under direction from my internist, I begin treatment at local major hospital pain center for arachnoiditis - please learn what this is. I attend monthly appointments for refills. Meds control pain to level 6-7. I take meds exactly as directed, no overuse, compliant patient. I attend P.T., use recumbent bike to keep leg strength, remain active w/family and friends. Interviewed as ‘life survivor’ for local radio station, commended for my positive attitude. <br/><br/>More importantly, I’m asked to volunteer as a patient role model at this pain clinic. I partner with staff, hold advisory role. This lends an additional sense of purpose to my pain.<br/><br/>After 2 years no issues at pain center, covid situation yields anxiety, sleeplessness. I take ½ of 1 Valium pill prescribed by internist to help me sleep. I tell clinic staff next appointment, urinalysis confirms. <br/><br/>What happened: The once-supportive staff confronts me angrily. I have violated a rule, took a drug that clinic didn’t prescribe. I show that internist prescr. med for anxiety, I personally owned the medication-filled at a local pharmacy. All is ignored, I’m forced to defend myself. Appointment cut short. No understanding, no increased supervision, no trial period of medication review. Instead, I receive one 30 day refill, immediately completely cut from pain center care, no weaning/tapering support. <br/><br/>I walk out of clinic in shock, tearful, worried about my future care. I’m no longer can attend this pain clinic. My internist is prohibited by his practice from prescribing any opioids, so I have absolutely nowhere to turn for help.<br/><br/>I petition clinic for a review based on prior commended work with committee. Clinic staff employs no empathy I’m seen as a risk to clinic’s license. No attempt at a probation.Staff is patronizing, suddenly exhibiting a superior, hostile, confrontational attitude, use regulations against me.<br/><br/>I immediately cut activities to avoid pain. The journey I’m on now is too long to detail here. <br/><br/>What I’ve learned: As an outcome of severe regulations, doctors, pharmacies, & insurance companies fear government litigation & license removal. These restrictive guidelines yield them a false sense of power over patients that is harmful at the least, deadly at the worst. Their employers force them to put their own survival over the care of their patients, denying them any medication that they see as a risk. <br/><br/>These drug regulations take patient care out of hands of patient’s own PCP. Doctors who know the patient the most & understand their pain are completely removed from the process. The regulations are over-reaching, not patient specific, do not allow care by patient’s own PCP. Innocent, pain-ridden patients are denied pharmaceutical assistance when they need it the most. It is cruel. If the CDC director could experience life with arachnoiditis without medication for 24 hours, these regulations would be dropped. <br/><br/>Less than 10% of ER visits for drug overdose are patients who were prescribed opioids by a physician. The rest are overdosing on street drugs, not physician-prescribed opioids. Instead, they overdose on fentanyl laced street drugs. Heroin & fentanyl bought on the street laced with other drugs from China do not find their way into the hands of legitimate pain clinic patients. <br/><br/>Yet continually CDC lumps us into drug statistics with the term ‘opioid overdoses’ as if we are the problem. Why are we putting severe limits on helpful prescriptions for law-abiding, legitimate patients suffering from chronic life altering pain conditions, when we know they are not the problem? These punitive regulations allow the CDC to appear as if they are doing something to defeat overdoses when in fact they are not solving the problem at all.<br/><br/>We all know this is the truth. You created a new problem rather than eliminated an old one.<br/><br/>Please remove these overly restrictive regulations to allow physicians autonomy with their patients, allowing patients the empathy and support they deserve. Chronic pain patients are some of the strongest warriors I know. Every day they fight against the pain they feel just so they can live a life with some degree of happiness. <br/><br/>Please respect the pain legitimate patients suffer with. Allow them the care and medication they require. Drop these regulations. Give chronic pain patients the chance to live the best life they can - they deserve it. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M. Den.	None	None	0900006485008f7d	Dep.	None	2022-04-10T22:29:13Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Dep., M. Den.	l1r-yort-qo43	False	None	False	2022-04-12 06:40:06.004	[]
4413	CDC-2022-0024-4419	https://api.regulations.gov/v4/comments/CDC-2022-0024-4419	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The reason that opiates were used so much for pain was because they work for most people for most pain,were available,relatively cheap,covered by insurance and didn’t require huge amounts of time off work for therapy. Many people in rural areas didn’t have good access to alternatives. Many people that were low income couldn’t afford to spend a fortune on failed treatments or time to do them. The idea that the alternatives available are replacements is naive. At least not for moderate to severe pain. I know because I did try them and still use some even though they don’t lower the pain. I may be wrong, but weren’t the RX deaths last year under 17,000 and included methadone,Buprenorphine (used mainly for addiction treatment) and poly pharmacy? What were the NSAID deaths? Around 16,500? The people ODing on RX are not taking them as directed but the NSAID deaths usually are. Your new guidelines actually come out worse by mentioning 50mme and tapering patients that are stable. The poor understanding of this situation is leading to the suffering and deaths of legitimate patients and the ODs are getting worse every year. If these go into effect the new limit will be 50mme. And legitimate patients will have no choice but to suffer and have their function, health and mental health decline, buy illicit drugs with the risk of death or to kill themselves. These guidelines make it seem like all the people with chronic pain have mild issues but that’s not true. These guidelines exclude a whole subset of patients with degenerative conditions. The idea that not being ok with tapering is a sign of addiction is cruel and illogical. We didn’t take higher doses for the heck of it. We took them because they helped us function,to have decent pain relief and decent lives. These guidelines will lead to more suffering and death amongst legitimate patients. It will also do absolutely nothing for the addiction and OD crisis. Addiction isn’t just exposure. Until you focus on the reasons for abuse you will never help this problem.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008f90	Anonymous	None	2022-04-10T22:29:43Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-yuj1-jx89	False	None	False	2022-04-12 06:40:06.243	[]
4414	CDC-2022-0024-4420	https://api.regulations.gov/v4/comments/CDC-2022-0024-4420	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered for many years with Restless Leg Syndrome (RLS). At this time I am not taking an opioid medication. My symptoms are reasonably well-controlled with Gabapentin. However, having suffered with RLS for over 30 years and being aware of the trickiness and progressiveness of this condition, I am concerned that at some point I may need an opioid to control the pain and muscle spasms associated with this condition. In fact, Gabapentin is the third drug that I have used over the years to deal with RLS. So it is my hope that your agency will approve the use of opioids for the treatment of RLS. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Howard	None	None	0900006485008f93	Herrnstadt	None	2022-04-10T22:30:00Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Herrnstadt, Howard	l1r-yv9s-bf6d	False	None	False	2022-04-12 06:40:06.459	[]
4415	CDC-2022-0024-4421	https://api.regulations.gov/v4/comments/CDC-2022-0024-4421	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. When my primary care doctor stopped prescribing opioids for my pain in 2014 I suffered every single day. My pain had been under control for years and then it came back with a vengeance. After 2 years of great suffering I found a pain management specialist sho actually listened to me and gave me the medication I needed to get through the pain. This does not entirely stop the pain, but I am able to walk, shop, do a little housework and just get through the days without being in agony. I have been on the same dose since 2016. I would NEVER take more than what has been prescribed for me. I follow the rules, whenever I see a new specialist I immediately inform him/her that I am in pain management. I thank God for my pain management specialist.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008f97	Anonymous	None	2022-04-10T22:30:17Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-ywex-26e2	False	None	False	2022-04-12 06:40:06.671	[]
4416	CDC-2022-0024-4422	https://api.regulations.gov/v4/comments/CDC-2022-0024-4422	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have tried many medications to help manage my severe RLS, and either they didn’t help or made my symptoms worse. I have been taking Suboxone, a low-dose opioid, for a few years and it greatly improves my symptoms.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wendy	None	None	0900006485008fad	Riethmiller	None	2022-04-10T22:30:35Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Riethmiller , Wendy	l1r-z8r6-poh2	False	None	False	2022-04-12 06:40:06.888	[]
4417	CDC-2022-0024-4423	https://api.regulations.gov/v4/comments/CDC-2022-0024-4423	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an intractable chronic pain patient from VA. I have been in pain due to back and neck injury for many years. Because of the cdc guidelines, I have had tremendous difficulty finding a physician willing to treat my pain with Opiate medication. I have failed any and all alternative treatment possibilities and have no alternative treatment options available in Virginia. I am unable to locate even a primary care physician as I am labeled and prejudiced against as a chronic pain patient.<br/>I am not able to work, drive, care for myself, or participate in any activity without pain medication. I live a life of imprisonment in my body, not functionable, with no option of relief, due to the 2016 cdc guidelines.<br/>The MME that have been placed need to be removed, throughout the entire document. I am an individual, and the strength/amount of medication needed is different for every person.<br/>Please remove throughout the entire document the guidance for amount of days that I can be treated for with opiates, for acute treatment. Individuals recover at different rates and should be treated accordingly.<br/>These guidelines need to be updated with a plan on how to reimpliment them. The 2016 guidelines were supposed to be just a guideline, but states have now taken them as law. I have lost several physicians as they have felt pressured to follow these guidelines or lose their license. They have retired early or left medicine all together as they cannot practice their life's purpose to the best of their ability. These guidelines have caused my doctors undue anguish as they watch their patients suffer.<br/>These guidelines have brought life altering consequences to myself. I only want to live my life just like everyone else, and the 2016 guidelines have taken this option from me. Please trust that my doctor knows whats best for me. I am an individual in the United States of America, and these guidelines have created a situation where I'm treated as a nameless faceless entity who is treated the with no regards to individuality.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008fbb	Anonymous	None	2022-04-10T22:31:07Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1r-zgak-t8zt	False	None	False	2022-04-12 06:40:07.101	[]
4418	CDC-2022-0024-4424	https://api.regulations.gov/v4/comments/CDC-2022-0024-4424	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patient here. I have tried absolutely everything under the Sun (including spine surgery) to no avail. Fortunately, my pain specialist is willing to prescribe the pain medication that works. However, the copays, procedures, and tests (no urine) are expensive. I wish that, after a period of time, that my primary doctor could prescribe my pain medication. She knows me best and is a fraction of the cost of the pain specialists. <br/><br/>I’d bet dollars to doughnuts that the misuse, and overdoses are not actual pain patients. However, it is pain patients that suffer the consequences. Certainly we can come up with a better plan than scaring our doctors into practicing defensive medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	0900006485008fc1	M	None	2022-04-10T22:31:26Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from M, John	l1r-zikp-e3hc	False	None	False	2022-04-12 06:40:07.328	[]
4419	CDC-2022-0024-4425	https://api.regulations.gov/v4/comments/CDC-2022-0024-4425	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	How could you folks not understand that mass drug testing of American citizens is one of the leading causes of our overdose epidemic? You don't have to go any further than the bias the drug test creates towards alcohol use to see that it's counterproductive and a huge mistake. If you add in all the other drugs with shorter detection times than the safest drug (THC) you get a real good idea of how we ended up in our overdose epidemic. It's really simple. The safest drug (THC) that you can't fatally overdose has by far the longest detection time which creates a bias towards drugs with shorter detection times that are far more dangerous and can be fatally overdosed, especially alcohol. The Federal Aviation Administration (FAA) has a toxicology database on all general aviation (non-drug tested) pilot fatalies over the last 30 years and that database proves that their drug test not only doesn't work but is actually amazingly counterproductive. It doesn't matter if it's a chronic pain patient or an employee. The drug test works the same way and creates the same bias. I can prove to anyone in 30 minutes using the government's own data that their drug test not only doesn't work but it's amazingly counterproductive and absolutely contributes to our National Disgrace of fatal drug poisonings. If you actually care about the citizens in this country then you'll contact me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tom	None	None	0900006485008fe4	Rector	None	2022-04-10T22:31:54Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Rector, Tom	l1s-01h0-dqpq	False	None	False	2022-04-12 06:40:07.547	[]
4420	CDC-2022-0024-4426	https://api.regulations.gov/v4/comments/CDC-2022-0024-4426	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I want to say unless you have experienced chronic pain 24 7 everyday you don't understand what CPP go through and to say anyone needing opioids for pain has opioid use syndrome is unscientific and a total outright fabrication, and abuse of people in power. I believe they are making these falsehoods up to get patients to take suboxone and other drugs like this. I have yet to read any studies supporting their theories and the majority of deaths caused by opioids are caused by heroin and fentanyl, not prescription drugs. As far as making it more hard to get opioids what do they want all the chronic pain patients dying off, oh wait, didn't they say that, or cancer patients screaming in pain before they die, or no pain medicine for post-up patients, nobody will want to have surgeries? Even before opioids they gave you whiskey and a stick to bite on. It is hard to believe how cruel the CDC and these guidelines are and would you want one of your loved ones suffering in pain for the rest of their lives, without any relief? Of course you wouldn't!<br/><br/>Dr.[name redacted] is a doctor who specializes in addiction not pain management, why is he representing CPP? If opioids are not good for chronic pain, show me the research that you read or researched and proved, you know (facts) to come to this conclusion? You take care of patients who are addicted not CPP, totally different. CPP are not pawns for the big pharmacies, we are human beings who live every day in agonizing pain and need relief to have a life, doesn't everyone deserve the pursuit of life, liberty and happiness? <br/><br/>Don't Chronic Pain Patients deserve relief from their pain?<br/><br/>The government should not have their noses in patient and doctor relationships! Stop all these guidelines and leave it up to the doctors not government agencies who are making CPP, Post-op and cancer patients suffer, even dogs get better pain relief. It has been proven in America Prohibition only makes things worse and puts alcohol and opioids in the hands of criminals. Stop the DEA from raiding doctors who are trying to help CPP, don't they do this kind of thing in a third world country? You know terrorize people into doing want they want.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Aidan	None	None	0900006485008b63	Zachary	None	2022-04-10T22:32:46Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Zachary, Aidan	l1s-0fdy-1yrw	False	None	False	2022-04-12 06:40:07.767	[]
4421	CDC-2022-0024-4427	https://api.regulations.gov/v4/comments/CDC-2022-0024-4427	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been in so much pain cause I was cable cut off of pain meds. I know have no job, can't handle the pain and working. I have no quality of life, I can do the things I have enjoyed. I'm just of the pain, no relief has given me bhave ad anxiety. There shouldn't be a mme cut off. So many people need highamounts. Injections made things worse for me, ended up in the hospital at stroke level bp afterwards. I just want to at least be able to cook and .clean my house. Please don't treat 7s like addicts	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Audrey	None	None	0900006485008b67	Hickey	None	2022-04-10T22:33:05Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Hickey, Audrey	l1s-0gsf-hg0y	False	None	False	2022-04-12 06:40:07.997	[]
4422	CDC-2022-0024-4428	https://api.regulations.gov/v4/comments/CDC-2022-0024-4428	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had an accident at age 14 that left me with a bone-on-bone Left knee. It would be 40 years before it could be replaced. By then my Right knee was worn to bone on bone, as well as ALL my Vertebrae, both hips, ankles.I have dealt with chronic pain my entire adult life! I have had 3 major joints replaced and face more in the near future. I would LIKE to move to a warmer climate to ease some of the pain BUT I am AFRAID I won't be able to find a new Doctor who will prescribe the Hydrocidobe I need to do basic life functions. I only take 4 per day.Sometimes when the pain is extreme I have to take more than 4 per day but on days with light activity I may take only 3 per day. I DON'T crave this medicine. I REQUIRE it to function! I couldn't go up & down ANY steps without it. Do you have any idea of the fear a person like me feels due to the limitations of getting basic pain medication that's been available on this planet for CENTURIES. And now I can't even consider moving out of this state of Iowa with extreme temperature variations is very unfair that you put such fear in physicians that a person like me can't even move! I don't agree with those crazy "Pill-Mill Dr's" and that's what you need to regulate.People like me should not have to face an entire lifetime of extreme chronic physical pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jill	None	None	0900006485008b6d	Stevens	None	2022-04-10T22:33:28Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Stevens, Jill	l1s-0ilq-ao0b	False	None	False	2022-04-12 06:40:08.215	[]
4423	CDC-2022-0024-4429	https://api.regulations.gov/v4/comments/CDC-2022-0024-4429	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was in a bad car accident 7 years ago with lasting complications. I now have chronic pain. Due to the erroneous CDC guidelines I found it very hard to get prescription Opioids. The only thing that helped me with any quality of life. I couldn't get out of bed nor tend to my daily tasks. In the last year alone I've been subject to meds like Belbuca, Buprenorphine, and Suboxone which is great for some but the doctor I saw only gave me my pain meds after I tried every dose of Belbuca. Then I was forced to at least try Buprenorphine but the side effects were horrible and finally onto Suboxone, that made me feel like an addict. I have been forced to taper. They claim I'm too young. It's not like I asked for the accident to happen. Ever since the accident happened I have had issues with my meds but not as much as the past year.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stacey	None	None	0900006485008b7e	Woods	None	2022-04-10T22:33:44Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Woods, Stacey	l1s-0qh9-luyk	False	None	False	2022-04-12 06:40:08.434	[]
4424	CDC-2022-0024-4430	https://api.regulations.gov/v4/comments/CDC-2022-0024-4430	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I responsibly take an opioid for my RLS symptoms which gives me relief from pain and able to lead a productive life. I only take the prescribed amount and do not in any way feel addicted. I urge you to include them in the practice guidelines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	catherine	None	None	0900006485008b83	boehme	None	2022-04-10T22:33:58Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from boehme, catherine	l1s-0rmo-7wge	False	None	False	2022-04-12 06:40:08.675	[]
4425	CDC-2022-0024-4431	https://api.regulations.gov/v4/comments/CDC-2022-0024-4431	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who has been dealing with chronic pain since an auto accident resulted in subsequent surgeries. It has impacted every aspect of my life. The pain is constant which causes problems with everything I do. I am on disability for my chronic pain and have gone through any and all procedures do try and alleviate my pain. Unfortunately nothing has helped me return to my previous status. I have tried all medications for the pain but the only thing that allows me some resemblance of normal is my Vicodin. Without my pain medication I am basically in bed all the time throwing up due to the severity of the pain. It’s no way to live. Now my doctor is so afraid of properly caring for me and I’m being forced into a reduction of my meds. My pain is worse now and no matter how much I beg my doctor doesn’t want to even discuss giving me my higher dose. My life is dramatically worse now and I’m unable to do so much just to have some quality of life. You are playing with peoples lives and it’s hurting innocent people. What goes on between my doctor and I shouldn’t be restricted to the point it’s causing me more pain. My doctor shouldn’t be afraid of going to prison or losing his license because the government is trying to keep him from prescribing the very medications that truly save peoples lives more than destroy. What you are doing is forcing people to look elsewhere for pain relief and are dying because they are taking dangerous street drugs to try and make their pain go away. That’s killing more people than have meds that are truly safe and effective prescribed by the person who knows them best. Please make things easier for us who suffer every minute of every day. All I ask for is the ability to not suffer and get back the quality of life that I had prior to all these inappropriate regulations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Debbie	None	None	0900006485008b87	Saraceni	None	2022-04-10T22:34:26Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Saraceni , Debbie	l1s-0vrw-na6n	False	None	False	2022-04-12 06:40:08.889	[]
4426	CDC-2022-0024-4432	https://api.regulations.gov/v4/comments/CDC-2022-0024-4432	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a chronic pain patient and have been for almost 15 years. I was on stable medication for 10 years.. I’ve got a long list of diseases and complications that make any sort of treatment complicated in ways that most doctors don’t understand. . I can function and work on a dose that is UNDER the recommended limit and yet there is not a single doctor out there willing to even consider pain medication even when they all agree I’d probably find more benefits on it than off but their licenses aren’t worth the risk. How is this healthcare? My life is in your hands.. literally.. and you have no consideration for that? I’m waiting on long term disability just solely because I can’t do anything else to manage the symptoms and no job will keep someone sick. What are you answers here?? You meddled in healthcare and tried to make it one size fits all and now you don’t want to hear about the consequences? Get out of doctors offices and stay in your lane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008b91	Anonymous	None	2022-04-10T22:34:45Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-11c0-520d	False	None	False	2022-04-12 06:40:09.103	[]
4427	CDC-2022-0024-4433	https://api.regulations.gov/v4/comments/CDC-2022-0024-4433	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a 53 year old chronic pain patient I have been made to feel like a leper, no doctor wants to touch me. At 17 years old I suffered a lower back injury while skiing added to that Rheumatoid arthritis in my 30s, I have been dealing with chronic pain most of my life. <br/>In 2012 I was very fortunate to have a doctor work very closely with me for several years until I had over half of my functionality back. I was able to work 8 hours a day every other day and have a life worth living. During this short time it seemed like everything started improving in my life significantly.<br/>It wasn’t long after that the 2016 CDC guidelines put an end to being able to function when the state of Maine effectively made all their doctors and healthcare subsidiaries force people off their chronic pain medications. I don’t drink alcohol or smoke and have never abused drugs. When I was on large doses of oxycodone I felt absolutely no desire to take more than prescribed. The medication was a godsend, it just worked with no appreciable side effects. <br/>Now instead of getting the help I need for chronic pain, my life is full of constant pain and anxiety over weather I will be ever be able to receive the meds that allow me to function again. The last five years I’ve spent most of my time in bed thinking about all the things I need to be doing and want to be doing. I’ve been shuffled around to see many various doctors and specialists to retry all the old things I’ve already tried to improve my chronic pain. Simply put when every bit of your body is fighting against you, no amount of talk therapy is going to get you up and moving.<br/>It wasn’t like the first time I went to see a doctor about pain they instantly prescribed me opiates. The pain meds were simply the last thing that was tried when nothing else would work and unfortunately they seem to be the only thing that truly works. <br/>Now I believe we’ve come too far and stigmatised these life restoring pain medications is too much that people who suffer from chronic pain will never truly benefit from opiates again. Just 10 years ago I really believe that I had been given a life worth living back after I was prescribed oxycodone for my chronic pain however thanks to the 2016 CDC guidelines and people who abuse these medications I feel as though I have no real future worth living.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Todd	None	None	0900006485008b9a	Underwood	None	2022-04-10T22:35:18Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Underwood, Todd	l1s-14uv-mv7c	False	None	False	2022-04-12 06:40:09.310	[]
4428	CDC-2022-0024-4434	https://api.regulations.gov/v4/comments/CDC-2022-0024-4434	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I support allowing physicians having the ability to decide which treatments, including opioids, are appropriate for an individual’s care. Many patients with chronic pain have been hurt by restricting access to these medications. Regulations take away an important aspect of decision making between physicians and patients. People with rare diseases are often collateral damage because physicians don’t understand their symptoms, society doesn’t understand or care and specialists that do understand are few and far between so patients are left often for years or decades in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	P	None	None	0900006485008ba1	Day	None	2022-04-10T22:35:31Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Day, P	l1s-17lx-my9l	False	None	False	2022-04-12 06:40:09.527	[]
4429	CDC-2022-0024-4435	https://api.regulations.gov/v4/comments/CDC-2022-0024-4435	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for reviewing/revising these guidelines. I have always been a physically active outdoors person, a respected professional and an active member of my community. <br/>When a compassionate doctor prescribed hydrocodone 5 mg to be used for my worst pain after I could no longer take ibuprofen due to bleeding problems, my quality of life improved in ways I hadn’t known were lacking because I had grown so accustomed to accepting a daily level of pain as part of life. <br/>In 20 years of using hydrocodone, I never asked for a higher dose or increased number of pills. I was always so grateful to be able to do the things I love, things that gave my life meaning. <br/>Since being abruptly discharged from my harried, frustrated physician’s practice, because of her fear of the 2016 (you can call them guidelines, but they are, in practice, rigid punishing rules), my quality of life has taken a steep decline. It has been discouraging to see that my sacrifice has not resulted in the decrease in opioid overdoses it was supposed to create. I don’t discount the harm a certain pharmaceutical company did, but it is unfortunate the hysterical, wholesale reaction was to throw all chronic pain patients on the fire you used to avoid the hard work of nuanced recommendations. <br/>Your 2016 guidelines are draconian and cruel, both to good physicians and responsible patients. They have done immense harm without resulting in the hoped for societal good. <br/>Please be bold in turning back your rules and allowing physicians, not politicians or insurance executives, to use their training and judgment to provide appropriate individualized care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008bab	Anonymous	None	2022-04-10T22:36:20Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-11ie-qemr	False	None	False	2022-04-12 06:40:09.790	[]
4430	CDC-2022-0024-4436	https://api.regulations.gov/v4/comments/CDC-2022-0024-4436	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from a multitude of dental problems. There is seemingly nothing I can do to prevent the abscesses and endless surgeries that are very expensive and quite painful. I always got the pain medication prescribed in advance so that I had it at home and ready for me as soon as I needed it. It was usually 20 tablets of Vicodin, 10 mg. Now I'm told to take Tylenol and Advil. Massive doses of those two drugs can't be good for me. More importantly, they don't help! What is the harm in prescribing 20 pain pills after an extremely excruciating surgery? Why should I suffer when I'm not an addict?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kellye	None	None	0900006485008bad	Pikul	None	2022-04-10T22:36:36Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Pikul, Kellye	l1s-1emf-lkf8	False	None	False	2022-04-12 06:40:10.003	[]
4431	CDC-2022-0024-4437	https://api.regulations.gov/v4/comments/CDC-2022-0024-4437	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please don’t mess around with opioids that actually provide us some significant relief from RESTLESS LEG SYNDROME, I respectfully ask!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006485008bc6	Hash	None	2022-04-10T22:36:45Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Hash, Richard	l1s-1s7x-15w5	False	None	False	2022-04-12 06:40:10.221	[]
4432	CDC-2022-0024-4438	https://api.regulations.gov/v4/comments/CDC-2022-0024-4438	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have rheumatoid arthritis, osteoarthritis, fibromyalgia and diabetic neuropathy. I have had a knee and a shoulder replaced. Every minute of my life I hurt. I go to a pain clinic. My pain was always a 9 or 10 now it is 5 6 or 7 depending on my activity. Before my doctor at the pain clinic there was no activity just PAIN!!!!! I pray you consider patients like me when you make your decisions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006485008bcd	Gort Gossett	None	2022-04-10T22:36:57Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Gort Gossett, Linda	l1s-1trp-65wu	False	None	False	2022-04-12 06:40:10.434	[]
4433	CDC-2022-0024-4439	https://api.regulations.gov/v4/comments/CDC-2022-0024-4439	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My mom has spine pain stemming from malpractice following a ruptured disc. She has had to take me contin, 230 mg 2xday for at least 25 years. The struggle she has had with her current doctor retiring and no other at the practice being willing to prescribe has been insane. She has been through so many different pain tests, drug screens, medication managements, etc., and nothing has worked to any high level (including the MS Contin!) that new guidance must be put in place for this. It is heartbreaking to hear her response that dr so and so can see her, only to find out they want to try something she already tried. It is my hope that pain management can evolve to help her, but at this point, the medication she is on is the only thing that keeps her functional. It does not bring her quality of life in any way, just the ability to get up occasionally. I hope that we can fund pain management before she is gone from us, but in the meantime, can we please make it easier for her to find some relief from it?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	0900006485008bd0	Sams	None	2022-04-10T22:37:13Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Sams, Sarah	l1s-1v9m-jfpe	False	None	False	2022-04-12 06:40:10.650	[]
4434	CDC-2022-0024-4440	https://api.regulations.gov/v4/comments/CDC-2022-0024-4440	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain is a very personal experience. No two people experience pain in exactly the same way. Some people are very sensitive and can be incapacitated by the slightest discomfort. Other people, people like me, who live with pain every day, have a tolerance for pain that would bring other people sobbing to their knees. My case is punctuated by four herniated or ruptured discs, Ankylosing spondylitis, arthritis and small fiber neuropathy. I suffered silently for as long as I could until the pain kept me bed bound. In 2014 I recognized that this wasn't a life anymore and sought medical treatment. The first doctors I saw didn't know the causes of my pain, they kept testing me and scanning me and eventually a vague outline of my suffering appeared. But relief never came because just as the doctors were figuring out how to manage my pain the new guidelines came along and made my conditions untreatable. I spent years on my couch in so much pain I was unable to move. I would wake up every day unsure if I would be able to get out of bed, let alone walk, and no one was willing to help me. The pain doctors I went to would give me Naproxen or tell me to "just take some Tylenol", as if I wasn't already taking the maximum daily allowance of both. It wasn't until 2018 that I found a pain doctor who was willing to prescribe any kind of opioid. As soon as I started taking Hydrocodone, my life felt like it was mine once again. I could walk, I could move, I could leave the couch and tend to my own needs. It was a miracle drug that made me feel like I could be a person once again. But it was a brief respite. I started with three pills and by the end of the year I was up to four. I went to five pills the next year and held steady there for another year. The problem was that each pill started out giving me about four hours of relief. But that time contracted slowly over the weeks until the period of relief was less than three hours. I needed a pill for each set of hours that I was awake, unable to take any at bedtime because they gave me insomnia and I couldn't sleep. By the time the period of relief had dwindled to about two and half hours, the quality of relief had similarly waned. The doctor reluctantly gave me the next higher dose but, curiously, even though he knew that higher dose wouldn't last any longer, he took away one of the pills. Now I had to get through my day with one less pill and, no, I couldn't. My pain doctor recognized that increasing the dosage and taking away one of the pills didn't make any logical sense and indicated that it was these guidelines that forced him to send me back into pain for three extra hours a day. Its the illogic of this situation that feels so cruel. If each pill only gives me, at this point, two hours and eighteen minutes of pain relief, then diminishing my dosage due to some arbitrary guidelines designed for someone who is NOT me certainly seems to run counter to the Hippocratic Oath. You absolutely can't promise to "do no harm" and yet capriciously be more invested in a guideline than a patient. As we've recently seen with the CDC's uncertain vacillations during the COVID pandemic - this organization is placed on a pedestal to provide guidance but it is not an organization who's guidance is respected as suggestion but seen as unassailable law. Any guidelines the CDC offers will be read as concrete and inviolable; this means that even the most rudimentary of those guidelines will need to be written for the most egregious cases and the CDC will not do that, as it didn't in 2016. It painted with a wide-brush based on faulty data about a very specific portion of the population that weren't even part of the national discussion. The opioid "epidemic" was not, is not, and has never been about people who have chronic pain and need opioid pain medication prescribed to them by licensed, trained, and educated doctors. The CDC needs a hands-off approach to this topic that begins and ends with a patient-based philosophy. Let the doctors determine the particular needs of their patient and prescribe for that patient. This organization is not protecting us from "over-prescription" or "overdose", it is only stopping us from being able to live our lives like a real person. It is the most ableist of ableism to diminish the quality of our lives for a political metric.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicholas	None	None	0900006485008bd7	Holbrook	None	2022-04-10T22:38:01Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Holbrook, Nicholas	l1s-1yut-iam1	False	None	False	2022-04-12 06:40:10.863	[]
4435	CDC-2022-0024-4441	https://api.regulations.gov/v4/comments/CDC-2022-0024-4441	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering from intractable migraines, SLE and degenerative disc disease for nearly 40 years. I've been placed on opioids then removed from them at least a dozen times. In 2008, I was inpatient at [health facility redacted] in the Psychiatric Ward for 3 weeks due to suicidal ideation caused by constant pain. This was my third stay in a Psych Ward for this issue. I was in unbearable pain and had already seen 5 of the top 10 migraine specialists in the Country, all of whom eventually gave up on me and put me back on opioids. I even went so far as having my top right cervical rib and scalene muscles removed to "help my migraines" as well as many other painful medical procedures. When I was discharged from [health facility redacted], I had an action plan from 5 departments, including Pain Management. Once again I was put on a low dose of methadone daily (10 mg) with 20 dilaudid per month for "breakthrough pain". With all of this documented I managed to find an Internal Medicine Doctor willing to take me as a patient. I followed the [health facility redacted] plan for over 10 years, never once breaking my Pain Agreement, even when I had broken bones. Three years ago I developed an allergy to Methadone and was discontinued cold turkey. At this point I had worked my way down from 20 dilaudid per month to 15 every two months, by my request. Yet despite being called a "model pain patient", my doctor who I've been seeing for over 10 years refused to replace my daily pain medication and was "too afraid" to increase my dilaudid number any higher than the 15 every two months. My kidneys are failing and I'm no longer allowed to take any NSAIDS at all. All other drug groups have failed. There is no hope for me. I've become a shut in who avoids light, noise, crowds, even leaving my house. My life isn't worth living and I think of suicide every single day. I've been suffering for over 40 years now, and I don't believe anyone will help me. I actively search for ways in which I can kill myself without making my loved ones suffer. It's only a matter of days, maybe months before I succeed. I truly believe that a large percentage of "overdoses" are actually suicides by people who can no longer bear the pain they live with every day. I haven't been able to get more than 3 hours since my very awful withdrawal from methadone. I am very bitter toward the CDC and blame you for my pain. I'm very angry toward the people who abuse medicine and have made my life so miserable. I tell my husband that more than anything I want to sue some the Government for ruining my life. All of this is true and from my heart. I would not repeat this to anyone, but I believe so strongly that the CDC is to blame I couldn't resist commenting.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cindy	None	None	0900006485008be9	Westgard	None	2022-04-10T22:42:24Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Westgard, Cindy	l1s-28nj-9d1k	False	None	False	2022-04-12 06:40:11.083	[]
4436	CDC-2022-0024-4442	https://api.regulations.gov/v4/comments/CDC-2022-0024-4442	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not deprive doctors and patients from opioid pain relief options. Having suffered chronic pain monthly for almost 40 years I can attest to the usefulness of specific opioids in restoring me from excruciating pain to an almost functional human, and I never became addicted. It was trial and error to find one that worked. Limiting doctors options to help their patients pain is cruel. I fear for women like me who might not now get the relief they deserve, and will forced to suffer unecessarily for many years. People will find relief one way or the other, so this opioid alarm fad - which will pass just like prohibition did - is just furthering suffering and creating an unsafe black market.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	C	None	None	0900006485008bfe	M	None	2022-04-10T22:42:40Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from M, C	l1s-2j2b-d8kk	False	None	False	2022-04-12 06:40:11.301	[]
4437	CDC-2022-0024-4443	https://api.regulations.gov/v4/comments/CDC-2022-0024-4443	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain meds (opioids) are very important to me. They keep me alive, literally. They allow me to participate in life and not be dependent or anyone else. <br/><br/>The 2016 Guidelines must be changed or better yet, dumped entirely. They serve no purpose except to torture people who are already living tortured lives. <br/><br/>What was the worst pain that you've ever experienced and for how long did you experience this pain?<br/>Was your hand slammed in a car door? Amputation? Did you give birth with no anesthesia? Gunshot wound? Ever been in a car accident and your face or head go through a windshield? Ever fall from a roof and splintered your spine? Many people have had horrible accidents that change their lives but usually, those events will pass and your body will heal and your pain will subside. <br/><br/>Now imagine you live in “Bizarro World” 24/7/365, slamming that car door on your hand over and over again, giving birth to that baby over and over, slamming your head or face into that glass windshield over and over or falling from that roof over and over to hear your bones crack as you smash into the hard ground. This is the only way that I can describe my 22 years with Complex Regional Pain Syndrome, Type 2 (CRPS) where nerves are permanently damaged. It is considered to be the most painful condition known to medicine and I can attest to this fact. Every single second of every single minute of every single day of every year for the rest of my life, I have to live with this excruciating pain. The thought is absolutely terrifying. <br/><br/>If I get cut off from my pain meds, the quality of my life will be nonexistent. The quality of my spouse’s life will also be awful because all of life’s responsibilities including now caring for me will be on my spouse. It is not fair to punish people with chronic or intractable pain. Come live my life for a day. You wouldn’t survive and neither will I if my meds are cut off or tapered to meet MME limits. Please stop punishing people with intractable or chronic pain issues. We didn’t ask for this pain. We aren’t drug addicts and don’t need opioid tapering. We are responsible people taking medication prescribed by a licensed physician for a legitimate medical condition. We just want to be able to live our lives and not be a burden to our loved ones or society.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008c44	Anonymous	None	2022-04-10T22:43:16Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-3dpp-f3i7	False	None	False	2022-04-12 06:40:11.531	[]
4438	CDC-2022-0024-4444	https://api.regulations.gov/v4/comments/CDC-2022-0024-4444	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 49-year-old woman who started treatment for chronic pain in 2012. When the 2016 CDC guidelines were published, my doctor told me she was scared to continue prescribing the 5-10 MMEs per day I needed to function and sleep. I consulted 5 surgeons, and 4 out of the 5 recommended treatment for pain and physical therapy. My treatment is conservative and appropriate. The causes of my pain are well documented, and I was referred to my current pain specialist in 2018. I searched for a cure, but there is no cure. Now, I live in fear because there is only one doctor in my area who will manage and treat chronic pain with opioids, due to the 2016 CDC guidelines. In fact, a large area hospital sends their patients to my doctor after surgery because they are now "opioid-free". <br/><br/>When my GP retired in 2019, I struggled to find a doctor who would take me because I have an opioid on my medication list. Even though I have a pain specialist now and never ask another doctor for pain medication, I had two doctors tell me I am "too complicated" and they refused to take me. My cardiologist finally recommended a doctor who agreed to accept me as a patient after months of searching. I just need somewhere to go if I get strep throat! Thank goodness none of my specialists have had a problem with my medication list. <br/><br/>My pain specialist has offered to help the CDC, but he was turned down. He rotates my medications to keep my tolerance low, so the medications remain effective, and it works! Opioid therapy for chronic pain works very well. I do not understand why the CDC promoted the fallacy that a patient must take more and more and more medication to treat their pain. I do not understand the lie that all chronic pain patients have opioid use disorder. I am a wife and mom of 4 who has never used a "street drug" in my life and pain management has helped me to keep working and to function and do the physical therapy I need to stay mobile. I am far from unique.<br/><br/>I do not understand why patients and doctors are not consulted in the creation of this policy. You are asking for comments after the document is created, but I highly suspect you are not reading them. Doctors and patients protested the 2016 CDC guidelines, but those warnings were ignored. The 2016 guidelines have created an impossible situation for people living with chronic pain, or even those with acute pain now. I had two 1mm kidney stones in 2010 and the hospital offered morphine. In 2018, I had a 3mm kidney stone and was offered Advil. There are many like me and we are ignored, neglected, and now, in some cases, even denied medical care of any kind. Please, stop this madness. Your war on effectively treating pain is killing people.<br/><br/>A very good friend of mine died in January 2021, and he spent his last week in the hospital in terrible pain. The hospital knew his cancer was killing him, but they would not treat his pain. He gave up treatment, moved to hospice and died the next day. He was able to get pain medication in hospice and his last day he was able to sleep and talk with friends. Why did he have to suffer for an entire week, his last week? The CDC guidelines from 2016 have inspired hospitals to limit pain medication for everyone now, even cancer patients. What is the fear? My friend is not an addict, he is dead and had to discontinue treatment that might have given him more time with his family because he could not stand the pain.<br/><br/>The CDC is responsible for opioid-free hospitals, patient suicide and suffering, and an astronomical increase in deaths due to tainted drugs on the streets while the DEA focuses on prosecuting innocent doctors. These doctors now have a case before the Supreme Court asking that they be able to do their job and treat patients in real pain. The 2016 CDC guidelines have inspired draconian laws from politicians who do not know better, tying doctors' hands and torturing patients with both acute and chronic pain. Since 2016, chronic pain patients are treated like criminals. I fear these new guidelines will inspire more problems for doctors, pharmacists, patients and their families as lawmakers and the DEA use 50MMEs as a hard limit, just as they have done with 90MMEs. I respectfully request that the entire proposed document be withdrawn. The CDC Injury Prevention Center, which created this document, does not have the professional expertise, knowledge, or qualifications to write such a prescriptive Guideline.<br/><br/>Finally, ask yourself, would submit to a hip replacement, double mastectomy, back surgery, or limb removal with only Advil to treat the pain? If you had cancer, would you want help with your pain as you undergo treatments? Please, have some compassion and consider both chronic and acute pain patients. We deserve pain treatment and quality of life without being subjected to useless injections, spinal cord stimulators that can do more harm than good, and expensive medications that do not work to treat our pain. <br/><span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	0900006485008c4c	Whitty	None	2022-04-10T22:44:20Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Whitty, Jennifer	l1s-3k8c-7fp5	False	None	False	2022-04-12 06:40:11.743	[]
4439	CDC-2022-0024-4445	https://api.regulations.gov/v4/comments/CDC-2022-0024-4445	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When these guidelines went into effect I was on long standing opioid therapy with as much success as was possible with my many conditions and I showed up for a clinic appointment seeing a sudden uptick in my pain and instead of the slow increase and subsequent taper we usually successfully completed during a particularly bad pain flare I was instructed to head to the ER where they had called ahead and was told they were going to check me in under the equivalent of an impromptu pain program but the next week was a HELL that started directly with them yanking me off all my opioids, no taper, no nothing, just suddenly no more and they literally watched me rapid detox and be ABSOLUTELY miserable with now a pain flare and heavy withdrawal symptoms all based on these new guidelines. I cried until I had no more tears, vomited until there was nothing left in my stomach and despite begging endlessly they said I had to completely ride out the withdrawal before we could even address the main reason for my initial appointment -a now MASSIVE pain flare-only to find the Butrans patch(essentially is supposed to take away everything but the pain relief) that they tried me on wasn't covered by my insurance, was going to cost $295 for each 12 hour patch and I ended up having an anaphylactic reaction to the first one I stuck on so could even use the 2 others they suggested we self pay for at the hospital pharmacy. After that initial bad experience I got smart and found a new pain doctor but even that was a MONUMENTAL task as no one wanted to take on any new patient who had previously been on long standing opioid therapy. During that search I had no where to turn but ER during months of search for pain doctor who would see me and the minute I came in saying I was a chronic pain patient I had terrible experiences in the ER- one doctor was so skeptical and thought I was a drug seeker he made me take a urinalysis in the lobby bathroom of the ER waiting room before he would even let me back. I was diagnosed with depression at facing massive pain with no help and it all happened so fast due to simple guidelines. I didn't have high Quality of Life before even with the meds just due to my ongoing conditions but once these guidelines hit my QoL was in the toilet and no one wanted to help because they were afraid of getting their licenses yanked. If there had been at the very least a split guideline for those of us on documented long-term opioid therapy I think the chronic pain community wouldn't have suffered nearly as much as I know many of us did. Please keep in mind that many people were pushed to seek more illegal forms of pain relief who would've normally stuck with a doctor monitored rx only because of tremendous pain so gatekeeping them out of the method of treatment that they've found to work only pushes more individuals to deal with non monitored and possibly deadly cut drugs out of desperation, all I ask is you keep chronic pain patients in mind this time around.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008c5f	Anonymous	None	2022-04-10T22:44:55Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-3thu-1nud	False	None	False	2022-04-12 06:40:11.958	[]
4440	CDC-2022-0024-4446	https://api.regulations.gov/v4/comments/CDC-2022-0024-4446	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As we all know, the guidance put out by the CDC in 2016 has resulted in many doctors simply ceasing to prescribe opioids. In one particular case that is very personal to me, my mother who is elderly, was faced with a sudden termination of her ability to receive prescriptions for the opioids that she had taken for a very long time for relief from chronic pain associated with back issues that have come with her old age because her doctor informed her that he would no longer be writing such prescriptions for anyone. The amount of scrutiny applied to doctors that do write them has become unbearable for the doctors, and while I understand that I also know that the CDC is not blameless in bringing the scrutiny about. The end result is that my mother went through withdrawal without medical assistance even being offered for that process. At this time she see's doctors that would be willing to write prescriptions of opioids but chooses not to take them for fear such a thing could happen again, so she lives in pain and it is undeniable that this was born of the CDC putting out their guidance in 2016. The CDC can take the position that their guidance was misapplied all they want to but that leaves me asking why it has taken them seven years to stand up and make such a statement.<br/><br/>As we also know the previous guidance has resulted in insurers having carved in stone policies on what opioids they will cover and if at all how much. This further diminishes the doctor's ability to make such determinations because if the insurer will not cover a medically necessary prescription because of the stigma created by the CDC guidance then in many instances the patients are unable to obtain the relief that would have been provided had they been able to get such prescriptions filled. It's as if the insurers are practicing medicine and the doctors can only do what the insurer tells them is OK. Case in point, in January of 2022 my insurer provided a prior authorization for my wife to have hip replacement surgery. That procedure involves the doctor literally fileting the hip from the upper thigh to the waste, using saws to cut the femur and pelvis to get the old hip removed, then installing an artificial joint consisting of steal and ceramic. The patient was discharged and sent home less than 24 hours after the procedure, and the insurance company who approved of the procedure being performed then would not cover post procedure pain medications. Fortunately I am in a position to come out of pocket for such without it completely bankrupting me so she was ultimately afforded the relief those medications could provide but not because my insurance company was willing to cover it. It is undeniable that this was born of the CDC putting out their guidance in 2016. The CDC can take the position that their guidance was misapplied all they want to but that leaves me asking why it has taken them seven years to stand up and make such a statement.<br/><br/>Subtle changes to the previous CDC guidelines are unlikely to have any wide range or sweeping changes to the fallout that has already taken place, which involve not only policy changes on the parts of doctors and insurers but also laws that have been passed based on that earlier guidance. I don't know what, if any, appreciable difference this updated "guidance" will actually have. My reality is that the CDC is just trying to put it on record that they didn't mean to cause harm when the reality is that they did. What I believe the CDC should be doing is finding a way to put the toothpaste back in the tube, un-ring the bell or something. Damage has been done.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	0900006485008c61	Camp	None	2022-04-10T22:45:48Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Camp, James	l1s-3uha-i392	False	None	False	2022-04-12 06:40:12.190	[]
4441	CDC-2022-0024-4447	https://api.regulations.gov/v4/comments/CDC-2022-0024-4447	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket no. CDC 2022-0024 is concerning to me because it gives too much choice. I have seen one family member who was known to have mental health issues, kidney disease, and alcoholism being given opiods repeatedly in the hospital and upon going home after cancer surgery. This was in response to saying his pain was a five. His kidney disease progressed rapidly, and he died of end stage renal failure. Worse, another family member was given opiods for back pain, started going to several doctors and pharmacies in three states, upping her doses, was found out, and one doctor continued prescribing and increasing her dosages, even though he suspected that numerous falls and increased pain were done purposefully. She ended up with failing kidneys and was on dialysis as opiods were increasing, and dialysis was not working. Her nephrologist attempted to intervene because she had no other health issues. Her doctor continued prescribing, she stopped dialysis, and committed suicide by intentional overdose. Saying that the prescribed dosage can be made according to the patient's and doctor's values is unethical and utterly ignorant. I have chronic pain which never goes below a "3 or 4" and I take acetaminophen. I may not be exceptionally active, but I survive just fine. Efforts need to be placed in finding other means of treating pain. It's one thing if it's a burn patient, and it's another for a sore back. These guidelines encourage doctors to bypass their oath: First do no harm.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lisa	None	None	0900006485008c37	Payeur	None	2022-04-10T22:46:39Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Payeur, Lisa	l1s-36ky-vkfg	False	None	False	2022-04-12 06:40:12.414	[]
4442	CDC-2022-0024-4448	https://api.regulations.gov/v4/comments/CDC-2022-0024-4448	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The opioid crisis, driven by greedy pharmaceutical companies, who were not ACTUALLY penalized, only patients who suffer have been penalized. Reckless doctors and misusers/abusers ruined care for those who are truly suffering and just want relief. Why are medicines that can help relieve pain, poison that can be so intense that one would rather die than feel the pain any longer. As mental illness gains more awareness, chronic pain sufferers who also have comorbidities of serious mental health issues, are at the greatest risk of suicide due to the difficulty of obtaining prescriptions. The United States does NOT regulate guns or bullet sales as strictly as pain medication and other life-saving medications are. The public outcry for gun restrictions falls on deaf ears, but opioids and other controlled substances, are over-regulated, how does this make sense? I'm commenting as a disabled person who suffers from chronic/complex-PTSD, chronic pain, and I'm a registered nurse who has worked in the hospital, patient-bedside care. Years before I became a nurse, I was prescribed opioids. Opioids should not be the first line of treatment, and often patients were not warned of potential serious side effects by prescribing physicians (severe constipation, risk of bowel blockage). Even so, healthcare providers should explain ALL risks of using opioids, so better educated healthcare providers and patients should be the goal. Perhaps there should be more mandatory training. I feel the prescribing guidelines issued in 2016 should be done away with and the CDC's new recommendation should focus on education, not prescribing recommendations. People of every profession, socio-economic status, race, creed, etc. will ultimately choose to do right, or do wrong. I don't think prescribing recommendations will change this. All it will do, is continue to restrict access for those in grave need. Statistically, I'm supposed to die by suicide. I fight everyday to not, for my family. It's so much harder when not only am I constantly suffering mentally, throw in a day my pain flares up to 10/10. Those are some of the most dangerous days for my life. One suicide can have a domino effect on so many lives. I know, because my mother took her life when I was a child. Thirty-two years later, those effects still ripple through the family. My mother did become addicted to pain pills after breaking her coccyx, seven years later, dead by gunshot. Focus more on mental health, there will be less addicts, and better health outcomes. If someone is suffering mental health issues, it's very difficult to be medication compliant, whether the other medical issues are pain related, heart disease, or diabetes. Please consider these matters before submitting your updated recommendations, as what your propose will affect legislation across the country. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	0900006485008c66	Farr	None	2022-04-10T22:47:41Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Farr, J	l1s-3uie-4t75	False	None	False	2022-04-12 06:40:12.624	[]
4443	CDC-2022-0024-4449	https://api.regulations.gov/v4/comments/CDC-2022-0024-4449	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please put the power to prescribe back in the hands of doctors, where it should be. I was diagnosed with DDD, stenosis and a host of other issues in my back and neck that cause a lot of pain. I am thankful for my pain doctor prescribing Tramadol to help alleviate the pain. I worry for my future, as my disease is degenerative in nature. It’s only going to get worse. If the ability to use opioids is taken away from my doctor who will help me? I’m only 55 years old and have to work another 10 years. There are days the Tramadol doesn’t do enough to ease the pain and I have to miss work. As my symptoms get worse my doctors hands will be tied and I won’t be able to work any longer. <br/><br/>I’ve tried over 16 weeks of physical therapy. I learned 3 really good exercises that help alleviate the pain under certain circumstances but that’s not enough. I’ve tried several injections and they don’t help enough either. <br/><br/>Please remove any and all MME restrictions from any guidelines put forth and allow our doctors to treat us effectively. Life must go on and in this day and age NOBODY should suffer needlessly when there are many medications that can help. My dog is on a daily pain/inflammation medication. Don’t humans deserve the same?!? <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anna	None	None	0900006485008c7e	Bearinger	None	2022-04-10T22:48:25Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Bearinger, Anna	l1s-48r5-cwh2	False	None	False	2022-04-12 06:40:12.849	[]
4444	CDC-2022-0024-4450	https://api.regulations.gov/v4/comments/CDC-2022-0024-4450	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello my name is [name redacted], I was diagnosed with RSD also referred to as the suicide disease because of the pain it causes. I was diagnosed in 2005. I had Ulnar nerve decompression and relocation surgery on my left arm. I was started on opioids in 2005. I have always taken my meds responsibly and have never asked for a higher dose. I have never failed a drug test to date. My doctor's office has been taken over by a federally funded hospital and now want to wean me off my pain meds. I live in Maine and it is very hard to find pain doctors here. I will have to drive many miles to go to one of the few places that still prescribe pain management. This will cause me more pain in my arms if i can even make it that far or i will have to rely on the kindness of others to drive me there. I don't even know if the new place will be open in the future as they are all closing in the state of Maine. This uncertain future scares me and causes me great stress further aggravating my condition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008c95	Anonymous	None	2022-04-10T22:49:04Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-4j0i-j8sw	False	None	False	2022-04-12 06:40:13.058	[]
4445	CDC-2022-0024-4451	https://api.regulations.gov/v4/comments/CDC-2022-0024-4451	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been dealing with the results of multiple failed back (and other) surgeries for over 20 years, and other medically induced misadventures, taking opioids, always under the care of or supervision of a physician. I have tried every recommended alternative remedy (injections, RFA, spinal cord stim, ad nauseum) offered by numerous physicians, all to no effect. The little relief I get from opioids is counterbalanced by the stigma I feel for having to take opioids. I took myself off all opioids for about eight months and found no change other than I could barely get out of bed.<br/><br/>Physicians have gone on vacations leaving me with no pain control, one came back and told me I would only be on a half dose then. I am fed up with all this. I worked in the medical environment for 30 years, and now to be told I just "don't matter" is a phrase I just can't hear anymore. I will be one of the patients who just goes to bed and never gets up again. Despair, abandonment, knowing no one cares is just too much to handle, and I can't keep loading this on my husband of nearly 50 years. Shame on you for treating honest patients in this manner. Shame on you!<br/><br/>I don't smoke, drink alcohol or even coffee, and it irks me that you still find fault. It is devastating to think all involved in making decisions regarding pain meds feel we are 'addicts'. I shouldn't have to feel guilty for trying to get the meds I need to try to have a normal life. Going to a pain doctor shouldn't be about peeing in a jar or pill counts. It should be about my health care.<br/><br/>Your primary physician, the one that knows you best, should be able to prescribe the pain meds needed. Your guidelines should accommodate greater latitude in strength and potency of opioids prescribed. The pain clinics, that didn't exist before the guidelines, do not know you as a person; they only have a punchlist to complete to comply with guidelines. (The county we live in has NO pain clinicians, I have to travel 40+ miles for one.) There is NO need for people to be treated like this or suffer like this.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	b	None	None	0900006485008c98	murphy	None	2022-04-10T22:49:44Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from murphy, b	l1s-4jbn-2lt2	False	None	False	2022-04-12 06:40:13.271	[]
4446	CDC-2022-0024-4452	https://api.regulations.gov/v4/comments/CDC-2022-0024-4452	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 "Guidelines"<br/><br/> Have made it next to impossible to get any HELP with SEVERE INTRACTABLE PAIN. Any pain really. <br/> When ones Pain Flares Up the pain gets TO be too much, Overwhelming to the point of Not being able reduce the Pain you call for help, The Sherriff and medical crew comes to stop you from Killing ONESELF. The paramedics then take you to the ER. BY WAY OF AMBULANCE. I have been MANY MANY TIMES IN THE LAST FEW YEARS. <br/><br/> THEN NO MATTER HOW MUCH PAIN YOU ARE IN. NO MATTER HOW OBVIOUS IT IS... YOU GET THE "WE CAN NOT TREAT CHRONIC PAIN IN THE ER" BLOOD PRESSURE OFF THE CHARTS, VOMITING, CRYING, FULL ON VISIBLE PAIN. WITH ALL THE SIGNS OF BEING IN SEVERE PAIN. Then your told "WE CAN NOT TREAT CHRONIC PAIN IN THE ER" <br/><br/> SO YEAH... I AM STILL ALIVE, THAT IS IT. <br/><br/> "SORRY" Just doesn't do much for Severe Pain. ANY PAIN for that matter. The Pain DOESN'T SEEM TO CARE WHAT IS SAID, Like "It must be Frustrating" "I'm sorry there is nothing I can do" LIKE A RECORDING THEY MEMORIZED FOR INTRACTABLE PAIN PATIENTS. They then pass you onto the NEXT Provider that basically says and does the same, OVER AND OVER AGAIN AND AGAIN. WITH NO REGARDS TO ONE'S HEALTH WHAT SO EVER. It is just mind boggling to actually believe that this is happening NOW IN 2022. It is like instead of progressing and moving forward. You want to do the exact opposite. The only reason, can be, you people want Chronic Pain Patients to KILL THEMSELVES. THERE IS NOTHING ELSE THAT CAN EXPLAIN, WHY, YOU ARE DOING THIS TO FELLOW HUMAN BEINGS.<br/> What I have been through trying to "HANG IN THERE" ALL THIS TIME, WITH ALL THIS PAIN DAY AFTER DAY, WEEK AFTER WEEK, MONTH AFTER MONTH, YEAR AFTER YEAR... I don't know WHAT TO DO ANYMORE. I CANNOT KEEP GOING LIKE THIS. <br/><br/> I do not want to be a statistic. "ANOTHER VETERAN PATIENT COMMITTED SUICIDE" WE SAW IT HAPPENING HE HELD ON FOR A LONG TIME. SUPRISINGLY HE HELD ON AS LONG AS HE DID. WE TRIED TO MAKE HIM QUIT MUCH SOONER THAN THIS. WE REFUSED TO HELP HIM FROM THE START.<br/><br/> AS MUCH AS I DO NOT WANT TO DIE. I DO NOT WANT TO KEEP LIVING EITHER. THE PAIN GETS TO BE TOO MUCH. I HAVE LOST ALL FAITH IN HUMANITY. Well not all humanity. When I have to leave the house. For anything. The People go out of their way to help me, whether it be waiting for me to open a door for me, getting a product off the shelf in the grocery store, Really anytime I am out, people will go out of the way to assist me in any way they Can.<br/><br/> IT IS NOT RIGHT. YOU WANT US TO KILL OURSELVES. REFUSING PROPER PAIN MANAGEMENT. YET. I HAVE ASKED FOR HELP. BEEN REFUSED HELP. <br/><br/> THEN ALLOW ME TO DIE WITH SOME DIGNITY. EUTHANIZE ME. DO NOT MAKE ME TAKE MY LIFE FOR SOMEONE TO FIND ME, IN WHO KNOWS WHAT LEVEL OF DECOMPOSITION AND MESS LEFT BEHIND, BECAUSE THERE ARE NO DOCTORS LEFT. Only Providers that just want to PAY OFF THEIR STUDENT LOANS, NOT BEING ABLE TOO GET A JOB AT A REAL HOSPITAL OR PRIVATE PRACTICE BECAUSE THEY JUST ARE NOT ABLE.<br/><br/> There was a Day when Doctors wanted to help people. That is why they became Doctors. Nowadays people want to be a provider for the money Chasing the BIG DREAM OF EVERLASTING MONEY.<br/><br/> LIKE ANYTHING. TO BE A TRUE ASSET AND WORTH THE MONEY. You have to put forth a REAL effort and Commitment to be the Best that you can, This is not a prerequisite at the VA HEALTH CARE SYSTEM. <br/><br/> <br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006485008cc2	Young	None	2022-04-10T22:50:44Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Young, Robert	l1s-54oe-g6d1	False	None	False	2022-04-12 06:40:13.489	[]
4447	CDC-2022-0024-4453	https://api.regulations.gov/v4/comments/CDC-2022-0024-4453	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This clarification to the opioid guidelines is essential for those of us living with severe chronic pain. I’ve suffered from CRPS (Complex Regional Pain Syndrome) for over 35 years. With a score of 42, the McGill pain index rates it as the most painful form of chronic pain that exists today. CRPS should also have an exception similar to sickle cell anemia, cancer or palliative care. It’s only with sufficient opiates that I can have some quality of life. Having had to severely cut back, I have no life at all. I spend my days isolated in my home, just trying cope with the pain. I fully appreciate why CRPS is nicknamed the Suicide Disease. <br/><br/>I understand the need to regulate opiate prescriptions to curb abuse. But exceptions need to be recognized. It’s time to allow doctors to determine their patients’ needs when prescribing the dosage of opiates.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006485008cc3	Thompson	None	2022-04-10T22:51:03Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Thompson, Nancy	l1s-55na-a1bt	False	None	False	2022-04-12 06:40:13.702	[]
4448	CDC-2022-0024-4454	https://api.regulations.gov/v4/comments/CDC-2022-0024-4454	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who has been prescribed Hydrocodone, Valium, and Flexiril among other meds to manage what are excruciatingly painful migraines and multiple other medical diagnosis’ that have made it impossible to work (I owned my own business for 5 years) and now I am on a Hickman port receiving TPN for nutrition. I have a small brain tumor, have lost the ability to walk unaided, and my stomach is full of strictures and my esophagus is paralyzed now. It’s getting worse by the day, and yet I keep going. <br/><br/>I cannot express my level of anxiety and fear that I will be labeled as a drug seeker when what I’m trying to do is just be barely functional enough each day so that I might be still in my kids’ lives (now diminished to once a week instead of full time due to my health). I’ve lost everything, and now as of this week, my health insurance, too. <br/><br/>I am appalled that despite my medical history clearly showing half a dozen autoimmune and other conditions that cause severe pain, I can still be a accused of being an addict when the sect opposite is the truth. I am hyper vigilant about not using more than one dose a day, I never mix certain meds (opioids and benzos) EVER, self-report what I am using and how much to the people around me, communicate often with my care team and have everyone and every chart connected, and use my pain meds only after I’ve breached every other method I have for managing pain (mindfulness, baths, sleep, meditation, acupuncture, chiropractic care, frozen hats for migraines, heating pads, journaling, eating, not eating, anti-nausea meds, whatever). I cannot take NSAIDS or SNRIs, so a number of other pain relief options are not available. I see a therapist for trauma, and a psychiatrist, plus the pain clinic I finally got accepted in to provided access to a therapists who’s specifically there to address medical trauma. I understand the mind/body connection. <br/><br/>I am very afraid that one day the small emergency scripts I have will be taken away for whatever reason, because I get trigeminal migraines (‘suicide’ migraines), complex headaches, and hemiplegic (stroke like) migraines, ulcers, and have worked out with my care team after dozens and dozens and dozens of ER trips what exact combo works to break them so don’t have to go to the hospital each time. This has saved my family tens of thousands of dollars in ER trips now that I’m simply prescribed exactly what they would give me there. <br/><br/>I have considered suicide when my pain exceeds 11/10 and I think I might actually die from the level of pain I’m in. This is why I will never own a gun, too. This is not a normal way to life or be day to day, waiting for migraine might actually be a stroke or not and also worry about the meds being taken away because our system can’t tell the difference between an addict lying and an actual chronic pain patient. Now we’re all lumped together with no discuto croon and doctors are cutting off their patients cold turkey everywhere. <br/><br/>I am not an addict. I have never bought or traded or sold my meds, or given them to anyone else. I lock them in a safe, and the key is hidden. I take the privilege of having these meds very seriously, and do not take it lightly that they can be taken away at any moment. <br/><br/>There has to be a more fair system to alllow humane pain management to exist without patients being labeled as addicts or attention seekers. We just want relief and to return to our lives. I hope my testimony here and that of others may help with finding a more reasonable middle ground where people aren’t driven to suicide or ordering potentially lethal pills online if their scripts are cut off suddenly, or they’ve been fired by their primary care teams, or any number of the stories I hear about online. <br/><br/>Please, please help those of us who really need it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tanya	None	None	0900006485008ccd	Luz	None	2022-04-10T22:55:56Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Luz, Tanya	l1s-5agb-5t9k	False	None	False	2022-04-12 06:40:13.913	[]
4449	CDC-2022-0024-4455	https://api.regulations.gov/v4/comments/CDC-2022-0024-4455	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For a long time restless legs was described as "...an irresistible urge to move one's legs." Eventually, the description included the words "may be painful." As someone who has lived with severe restless legs since I was a young child, believe me when I say the pain associated with RLS can be terrible and debilitating. I have been fortunate to have physicians willing to prescribe daily morphine for this terrible condition but many others suffer with no relief. Please educate yourself about RLS and pray you never have to personally experience the dreadful pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	KATHLEEN	None	None	0900006485008cd1	DICKENS	None	2022-04-10T22:56:17Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from DICKENS, KATHLEEN	l1s-5cmy-i8tl	False	None	False	2022-04-12 06:40:14.122	[]
4450	CDC-2022-0024-4456	https://api.regulations.gov/v4/comments/CDC-2022-0024-4456	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] and i live in the state of Maine. Maine is a big state with very few pain management offices and fewer doctors that will prescribe opioids. I have degenerative disk disease in my neck and back,arthritis,spinal stenosis,lumbar spondylosis,and lumbar facet joint syndrome. I'm in great pain every second of the day and it has only gotten worse with age. My pain started at age 17 from a sledding accident and now I'm 55 years old. I hate taking pills and have resisted taking pain pills until i couldn't stand it anymore. I started taking opioids july 2018 and have never failed a drug test and take my pills exactly as prescribed. I'm terrified that any day i could walk into my doctor's office and be told they are taking my pain pills away. I don't know what i will do if that happens. This causes me great stress.thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485008cdf	Anonymous	None	2022-04-10T22:56:53Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-5mra-y7oa	False	None	False	2022-04-12 06:40:14.336	[]
4451	CDC-2022-0024-4457	https://api.regulations.gov/v4/comments/CDC-2022-0024-4457	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	2022-0024 Revised CDCguidelines for prescribing opiates. <br/>My husband was a patient at a VA hospital for a month last year during a NO VISITOR policy. I understand their attempts to keep the community and staff safe. I hope they understand the impact it had on patient care. <br/>I am a retired RN with Dystonic Parkinsons. It’s a very painful condition. I seek help from a chronic pain clinic with a Doctor that did a fellowship in palliative care. He is tired of the battle as am I. I feel hopeless at this point. My primary Care Physican has left his practice as well. I want to do what my husband asked. He asked me to care for our granddaughter who we’ve had custody of for 4 yrs. Her mother left her alone and she kept describing diabetic needles she was finding at home. <br/>The intent of my comment is to allow you to know how the CDC guidelines have affected individuals. <br/>My husband died miserably in a hospice almost 200 miles from our home. I was allowed to visit him during the 32 hours he was there before his death. I made the best decision I could to transfer him to hospice rather than a med/surg floor. He had lack of attention on a med/surg floor at the VA facility and told me he was crawling to the bathroom. When he was discharged home by ambulance I didn’t recognize him. He smelled bad had a full beard and mustache and was 50 lbs lighter. He was only home for a few days before lack of pain medication prompted another hospitalization. A decision to transfer him to hospice or a med/surg floor had to be made. I chose hospice. I had been with a number of patients at end of life and recognized that he wasn’t coming home again. When he left I said he would never be home again and I was right<br/>He was having continuous bloody diarrhea and even though he had on a 75 mcg fentanyl patch and was receiving 5 mg of oxycodone every 4-6 hrs he was having terrible pain. I understood why after he died a Doctor called me to discuss my complaint about his care. Even though he was on high flow oxygen his skin was cold and he wasn’t perfusing tissues. He wasn’t absorbing the medication. He had stage 4 colon cancer. I witnessed death as a nurse but his haunts me now. <br/>I helped to draft pain management standards for the hospital I worked at during 1986-2001. I am familiar with reviewing medical records, collecting data and submitting it. I hope the process has improved. I don’t trust data as scientific evidence no matter how it is presented. I have my own issues now with pain management. No primary care physician is prescribing opiates in this rural area currently. I’ve tried surgery and interventional procedures to help me cope with pain but nothing has been effective. I dont say that opiates are a cure for anything but it helps me to function and provide care to my 9 yr old granddaughter. I told my husband I would and I’ve tried but now my prescription cannot be obtained from the distributor. I asked the doctor to change me from a fentanyl patch because of the bad reviews it was getting and not being able to get it from the distributor. My doctor had me call all local pharmacies to see if they had my dose in stock. The nurse said write down what they say. I had responses of not being able to get it from the distributor to being hung up on and told they couldn’t give that information out over the phone. One pharmacy told me it was because of the CDC guidelines and strict ordering and reconciliation of narcotics. My sister is struggling with stage 4 ovarian cancer and is having difficulty in getting pain medications. She is so scared that her death will be painful. I know how she feels. I am bent forward at the waist and lean to the right. My spine is curved severely in the thoracic area. I am having difficulty feeling my legs and I am incontinent. I want palliative care but if has different definitions and the services are not in place in this rural community. My memory is failing me and I have begun having hallucinations. I am in bed a lot but I can run bath water, do light housekeeping and help with homework. Last yr I taught 3rd grade at home due to COVDiD. You know your guidelines were misapplied in 2016 and before. I don’t understand how all this medication is being diverted to those that don’t need it when I can’t even get a prescription. I don’t think you can fully experience the effect your guideline has on patients until you are truly in need. This is not how I want to spend my time. I’d rather have comfort so I can care for myself and my granddaughter. Your war on drugs is affecting those patients that need medication desperately. Please consider patients with life limiting diseases such as MS, parkinsons, cancer and other diseases that affect their length of life and quality of life. Pay attention to the language to state that those that need it will get it without difficulty. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006485009102	miracle	None	2022-04-10T22:58:29Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from miracle, Barbara	l1s-5v5j-yllf	False	None	False	2022-04-12 06:40:14.566	[]
4452	CDC-2022-0024-4458	https://api.regulations.gov/v4/comments/CDC-2022-0024-4458	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Although these changes are not enough, I very much appreciate the recognition that current regulation of opioids for chronic illness are more harmful than helpful. I am 71 years old, have had Rheumatoid Arthritis since the age of 17. I have Swanson implants in my hands, an artificial hip, six foot surgeries, and many joints are now bone on bone. I am in pain every day, with my opioids being the only reason I can function. I have worked since the age of 16, and still run my own company: The Financial Valet, Incorporated. I am a mother and a wife. I have never abused my pain killers, in fact I believe they are the only reason I am still alive today. However the struggle to get prescriptions is often difficult, especially when faced with a relatively young doctor afraid of "getting in trouble". In many cases the doctor's self preservation comes before the needs of their patient.<br/><br/>Please consider different guideline for those, like me, with chronic illnesses. We are just trying to survive an incurable disease, while being productive people in society. The thought process that people who take opioids will only want more and more while becoming addicted is arcane at best. I've been on Norco for well over 30 years and, as I mentioned, it has allowed me to function. I ask no more than that.<br/><br/>Thank you.<br/>[initials redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joni	None	None	0900006485009111	Holinger	None	2022-04-10T22:59:01Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Holinger, Joni	l1s-60a0-a7xv	False	None	False	2022-04-12 06:40:14.797	[]
4453	CDC-2022-0024-4459	https://api.regulations.gov/v4/comments/CDC-2022-0024-4459	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain patient since 2008. I was in a motor vehicle accident with over 2 dozen fractures and much soft tissue damage. What ended up being the worst was the compression of 5 thoracic vertebrae. I have since been on very slowly increasing levels of morphine. The initial "guidelines" published by the CDC years ago caused my insurance company to randomly refuse to cover whatever opioid I was taking at the time without notification. I learned to contact my Doctor asking for an alternative. Later they refused completely. I was very lucky that my insurance administration was changing and I merely waited a few days and asked the pharmacy to try again. This is just one of the many was chronic pain patients are abused and neglected. I am very lucky to have a medical practice that stands by my side, others are not so lucky and they should not need to be.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500912f	Anonymous	None	2022-04-10T22:59:19Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-6dgv-z5lu	False	None	False	2022-04-12 06:40:15.028	[]
4454	CDC-2022-0024-4460	https://api.regulations.gov/v4/comments/CDC-2022-0024-4460	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There should be separate guidelines for patients already using opioids and those being prescribed for the first time. My loved one is a long time sufferer of chronic pain and does not deserve to be subjected to the indignity that he has over the last several years as providers have cowered due to the 2016 guidelines. He is just one of many people who desperately need these drugs and who use them responsibly. They should not suffer simply because others have been irresponsible or doctors are afraid to uphold their sworn duties.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009133	Anonymous	None	2022-04-10T22:59:31Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-6gga-uya2	False	None	False	2022-04-12 06:40:15.248	[]
4455	CDC-2022-0024-4461	https://api.regulations.gov/v4/comments/CDC-2022-0024-4461	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My understanding is that the proposed CDC Clinical Practice Opioid Prescribing Guideline is a practical and welcom addition, but unfortunately the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or sometimes even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>In my personal experience, a general practitioner originally diagnosed my RLS, which had transitioned from a "nuisance" to interfering with me getting enough sleep. My doctor prescribed Requip, which initially was like a magic bullet and my symptoms disappeared. Over the course of a year, my symptoms gradually worsened and required more Requip to keep them at bay. Eventually, the symptoms worsened in spite of the medication, which led me to see one of the nation's top authorities on RLS, Dr. [name redacted]. He told me that Requip almost always causes augmentation over time, so I had to go "cold turkey" for about three weeks. During that time, I often couldn't get to sleep until 5 or 6 a.m. and had to stand up and march in place for an hour or two in the middle of some nights. Once the Requip was cleared from my system, I began trying every conceivable treatment (both medications and alternative treatments). The only thing that worked for me was opioids, though some caused insomnia and itching. Finally, we found that methadone worked best for me and allowed me to get 6-7 hours of sleep. While I'm prescribed 5 mg of methadone per night, I'd say that on 2 out of 3 nights I only take 2.5 mg. On some nights, I supplement with Carbodopa-Levodopa, which like Requip is a dopamine agonist, for a maximum of three nights per week to avoid augmentation. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. Because RLS patients like me take such small doses, there is almost zero chance of addiction unless the medication is abused. As a multi-company CEO and now a board member, getting sufficient sleep is absolutely vital to me. Without methadone, I would probably have become unemployed 5-8 years ago. I'm very concerned that policies intended to reduce opioid abuse will inadvertently prevent people like me from receiving life-changing treatment. As it is, I already experience some pharmacists in other states who won't fill prescriptions from my doctor in California and, because I can never get more than 30 days' of medication, I am constantly faced with the risk of not being able to refill. <br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Allen	None	None	0900006485009142	Bucknam	None	2022-04-10T23:01:04Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Bucknam, Allen	l1s-6szt-ztv9	False	None	False	2022-04-12 06:40:15.476	[]
4456	CDC-2022-0024-4462	https://api.regulations.gov/v4/comments/CDC-2022-0024-4462	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for revising the guidelines for prescribing Opioids for Chronic Pain. Please consider carefully, Chronic Diseases like Restless Legs Syndrome in Opioid Prescribing Guidelines. I have suffered from RLS for over 60 years and have lived with physical, emotional, neurological pain and severe sleep deprivation throughout these years. Being treated with combinations of prescription medications provided intermittent relief from symptoms, however, I was seldom able to sit through a complete theater performance, sustain lengthy travel, study or work without standing, marching in place or walking. In the past 2 years, as I suffered with surgical procedures, while providing long term care for a family member, I found that living with RLS was no longer tolerable UNTIL my physician prescribed a very low dose of an opioid taken one time daily. The relief I have found is dramatic. I live many days without symptoms, and sleep uninterrupted 6-8 hours/night.<span style='padding-left: 30px'></span><br/><br/>I urge the CDC to include a section in the 2022 Opioid Prescribing Guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low total daily doses, carefully monitored.<span style='padding-left: 30px'></span>Thank you for your consideration of this vital issue.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sheila	None	None	090000648500914c	Connolly	None	2022-04-10T23:01:22Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Connolly, Sheila	l1s-6uhi-kxqa	False	None	False	2022-04-12 06:40:15.689	[]
4457	CDC-2022-0024-4463	https://api.regulations.gov/v4/comments/CDC-2022-0024-4463	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The ileocecal valve of my domestic partner, who has Crohn’s Disease, was non-functioning/damaged after her third bowel resection in 2011. Since then, she has been subject to painful spasming. Nothing but small doses of immediate-release painkiller stop the spasms. For a few years, pain-management doctors prescribed opioids, albeit at the cost of frequent appointments and condescension. Although my partner was ABD (All But Dissertation) in a Ph.D. program in New York City until Crohn’s and Major Depression ended her career, and although she clearly had/has a disability caused by Crohn’s Disease, she was treated like a drug addict. Then, I suppose it must have been around 2016, things got worse. Despite her track record of NOT misusing, more frequent appointments were necessary and office visits became unprofessional and insulting in the extreme. Shortly thereafter, doctors refused to offer any painkillers. A cycle of diarrhea, dehydration and spasming has been her fate ever since. She spends a great deal of her life in pain in the bathroom. My respect for pain-management doctors is nil. They are a disgrace to the medical profession.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	greg	None	None	0900006485009155	hohman	None	2022-04-10T23:01:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from hohman, greg	l1s-6y16-tv31	False	None	False	2022-04-12 06:40:15.973	[]
4458	CDC-2022-0024-4464	https://api.regulations.gov/v4/comments/CDC-2022-0024-4464	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	1st off I understand there was a real problem with overprescribing/unnecessary dispensing of opioids leading to addictions and overdoses. Some regulation is necessary. Bu the original 2016 CDC recommendations left no pathway for chronic pain patients that really need them, even in large doses. That opened the floodgates for other agencies and lawmakers to mercilessly slash when and how much people like me can receive them. I have a condition called Tethered Spinal Cord Syndrome. I have had it since birth, but it wasn't diagnosed until I was 50 years old when the pain started. It took almost a year to have it diagnosed and another six months to obtain a surgeon experienced with the detethering surgery. Two caveats were stressed before surgery. One, the operation would not take away the level of pain I was experiencing every minute of the day but would help stop the pain from getting worse. Second, there is always a chance of retethering. About five years later, I did retether. During the second surgery, the surgeon could not completely untether my spinal cord from the rest of my spine without leaving me paralyzed. For the last 14 or 15 years, my pain has slowly, relentlessly increased. I have excruciating pain in most of my back, both hips, and down the inside of my left thigh. I also had arthritis pain in both hips, but the pain has decreased very little despite having both hips re-placed. It is very difficult to make someone else understand how bad the pain is unless they have felt it. The closest I can come is if someone has a bad toothache. So strong that you beg the dentist to take care of it right away. The pain area is very small and at the very end of a nerve. Fortunately, a dentist can kill the nerve ending to eliminate that pain without creating more problems done further on the nerve. Imagine that amount of pain covering deep into an area that includes most of the back and both hips. Every second of every day of your life. My pain did not start out that strong, but it has increased to that point over more than 19 years. Over that time, various surgeons, family doctors and pain management specialists have prescribed just about every pain medication there is from tylenol through fentanyl. The only one that afforded me any relief is oxycodone. I have also tried physical therapy, internal and external electrical stimulators. Medical marijuana makes me sick. I have tried hypnosis and herbal remedies. Nothing reduces my pain, that I have tried, except oxycodone. Why that works and other opiates like vicodin don't is a mystery to me, but everybody is different. Over the years, my dosage has gone up, as the pain did, from about 10 mg 4 times a day to 60 mg 4 times a day. This did not completely take away my pain, but I could still function with a cane. In fact, for the first ten years, I still worked full time. Then the pain increased to the point I had to retire. But I still had a limited, but functional life. Then 2016 hit. Immediately, my dosage was cut in half to 30 mg 4 times a day. Then it was lowered again to 30 mg 3 times a day. My pain doctor has warned me for some time that that may be lowered again, depending on the lawmakers in Michigan. As it is I spend about 20 hours a day in a recliner. (I cannot tolerate the increase in pain caused by lying down,) I have to hire people to clean my house, take care of my yard and house repairs, and grocery shop for me. Even to take out the trash. I have to force myself to go to a seniors' club a couple hours twice a week. I do that because the depression. and loneliness is almost too much to bear on top of the pain. There isn't a day that goes by that I don't contemplate ending my life to finally end my pain. In fact, the only reason I haven't already done so is the birth of my only grandchild 4 years ago. Unfortunately, my son and his family moved to Texas a year ad a half ago,, for work. Since then I had planned to move down there near them once they were settled and I could sell my house, etc. Now that hope has been taken away from me. My pain management doctor was going to a national convention and I asked him if he could ask around to find out what the opioid restrictions are in Texas. Even though the conference had to be held virtually, he did manage to connect with a few doctors in my son's area. It was not good news. Apparently, the limitations are even stricter there than in Michigan. In fact, he described them as draconian. There is no way I can survive on less than I am receiving now. I cannot even be near my only reason for living through this pain. I know that a year or so ago, some doctors from the CDC issued statements that the 2016 limitations were never meant to apply to chronic pain patients who truly need the medicine, but the evil genie was out of the bottle. Laws were passed. There needs to be a legal channel for true chronic pain patients to get the drugs we need.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009174	Anonymous	None	2022-04-10T23:02:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-7ck6-fiya	False	None	False	2022-04-12 06:40:16.182	[]
4459	CDC-2022-0024-4465	https://api.regulations.gov/v4/comments/CDC-2022-0024-4465	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC guidelines are harming people and stealing lives. Chronic Pain Patients are not drug abusers, they need this medications to help live a reduced pain life. It sickens me to see som many people made to suffer in such cruel ways. Please stop making people suffer more.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alicia	None	None	090000648500917f	Zwieg	None	2022-04-10T23:05:04Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Zwieg, Alicia	l1s-7ls9-xhs4	False	None	False	2022-04-12 06:40:16.389	[]
4460	CDC-2022-0024-4466	https://api.regulations.gov/v4/comments/CDC-2022-0024-4466	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please explicitly state that chronic pain patients who lost access to opioids can now have access, at whatever dose and for whatever period of time the provider deems appropriate. The current draft is a good start but needs to go further in restoring access to pain medication for those with legitimate need. I work as an aide to patients in a retirement home and there are a number of people who spend all day every day in agonizing pain because doctors are currently unwilling or unable to prescribe opioids for them. No one should have to live like that.<br/><br/>Many states, like WA where I live and work have enacted their own draconian restrictions on the prescribing of opioids. They exist, at least in my state, as an ineffective, cruel, and misguided attempt to solve the opioid crisis. The new federal regulations must supercede state restrictions and establish a nationwide right to adequate pain management and opioid therapy when determined necessary by doctors and other healthcare providers. Lawmakers and the DEA have no business telling prescribers how to practice medicine except perhaps in extreme cases, and even then only if they are doctors themselves.<br/><br/>The harm and suffering to patients caused by the 2016 guidelines must end now.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006485009192	Denato	None	2022-04-10T23:05:24Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Denato , Robert	l1s-7tsv-9jkd	False	None	False	2022-04-12 06:40:16.603	[]
4461	CDC-2022-0024-4467	https://api.regulations.gov/v4/comments/CDC-2022-0024-4467	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>For example, I have had RLS since early childhood, but only started receiving medical treatment in the 1970's. I couldn't get any sleep for being restless all night needing to get up every hour or two "to go to the bathroom." I have been on every medicine FDA approved for RLS since. Each worked for some time, but I would eventually develop "augmentations" meaning that my symptoms of twitchiness and spasms running through my legs every 20 seconds with each lasting for 4 seconds would happen during the day as well as at night. At its worst, my RLS manifested itself also in my arms and sometimes in my torso. As a therapist needing to sit with patient groups for an hour at a time it became more difficult to sit through a session without standing up and walking around or having my whole body squirm in my seat with my total attention focused only on myself instead of on my patients. I started each new RLS medicine, have it work for awhile [having to anticipate how long it would take to be effective for those hour long sessions], then would need to raise the dosage to the point when taking it no longer worked [not being able to sleep and feel rested or be able to sit very long], just to start on a different approved medicine. When I started taking low dose Methadone in 2014 I found it to be the saving grace. I have been on the same dosage of 20 mgs Methadone per day since then [5mgs at 2PM, 5mg at 7:30PM and 10mgs at 9:30PM]; no need to continually raise dosage or change medicines every so often. I am now able to sit in the car for hours on end, or sit through a concert without having to stand up behind the last row of the concert hall or leave entirely, and I can do Reiki on clients who use my quiet, warm hands to quiet themselves down and rechannel their own energy system. I finally can give off the sense of calm, patience and full attention. <br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia	None	None	0900006485009193	Barnard	None	2022-04-10T23:06:10Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Barnard, Cynthia	l1s-7v9m-nov3	False	None	False	2022-04-12 06:40:16.820	[]
4462	CDC-2022-0024-4468	https://api.regulations.gov/v4/comments/CDC-2022-0024-4468	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I personally have delt with chronic back pain for 30+ years. The idea that Dr.’s can no longer prescribe as they deem necessary for a patient is ludicrous. The abusers of the narcotics, including physician’s should be the ones punished. If you have ever experienced chronic pain you would change your mind instead of impacting those who suffer. I appreciate your willingness to review current policies and allowing Dr.’s to manage patient care as they deem fit.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jo	None	None	090000648500919f	Bromwell	None	2022-04-10T23:06:24Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Bromwell, Jo	l1s-80wl-s3x2	False	None	False	2022-04-12 06:40:17.043	[]
4463	CDC-2022-0024-4469	https://api.regulations.gov/v4/comments/CDC-2022-0024-4469	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC should not be involved in any fashion with how opiates are prescribed. Too many members have connections with PROP and other anti-opiate zealots who stand to benefit financially from such ridiculous "guidelines". The CDC was warned repeatedly by the AMA, doctors, advocates and patients that these horrid "guidelines" would cause thousands of suffering patients and suicides. The CDC ignored all of these warnings and imposed the "guidelines" anyway. The conflict of interest at the CDC is appalling. The CDC should be banned from having any oversight whatsoever in the practice of pain medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850091a2	Anonymous	None	2022-04-10T23:06:40Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-81h8-uap2	False	None	False	2022-04-12 06:40:17.256	[]
4464	CDC-2022-0024-4470	https://api.regulations.gov/v4/comments/CDC-2022-0024-4470	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain from 2 traumatic accidents. Since 1999 I’ve been suffering. It is insane what the DEA/ government and insurances have done. I feel dogs get treated better than me. My doctor was shut down 7 + years ago. He cared about me so much. He evaluated me and helped me a lot! Stop the all regulations! I cannot even get a decent muscle relaxer that helps me! Doctors aren’t allowed to prescribe it! I have metal in 3 places and the surrounding muscles often get in a lot of pain. I could go on disability or the government could let the doctors treat me. Don’t let addicts that abused the system ruin the life a of person in chronic pain! It’s not right! Now a days doctors prescribe gapapentin/ neurontin for every type of pain or anxiety. It doesn’t make sense. Remove the RED TAPE.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850091ae	Anonymous	None	2022-04-10T23:06:56Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-84v2-0zhz	False	None	False	2022-04-12 06:40:17.479	[]
4465	CDC-2022-0024-4471	https://api.regulations.gov/v4/comments/CDC-2022-0024-4471	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern. I have been a sufferer of refractory Restless Legs Syndrome (RLS), AKA Willis-Ekbom disease, for more than 13 years. This disease has greatly impacted the quality of my life. My symptoms are currently under control through the use of gabapentin enacarbil and a nightly low-dose opioid. Regarding the use of opioids in the treatment of RLS I would like to quote from the research article in The Mayo Foundation for Medical Education and Research 2018; 93(1);59-67 titled The Appropriate Use of Opioids in the Treatment of Refractory Restless Legs Syndrome. (Please, find article attached in its entirety) "RLS is a distinct disorder, differing from chronic pain in many ways. Refractory RLS is characterized by unresponsiveness to dopamine agonists or alpha-2-ligands due to inadequate efficacy, augmentation, or adverse effects. This may result in severely impaired quality of life, profound insomnia, and suicidal depression. Opioid therapy is a mainstay in the management of these patients." In summary, the article states, "In summary, a number of opioid medications in low dose appear effective in refractory RLS. The risks of opioid use are relatively low, taking into account the much lower doses used for RLS compared with those in patients with chronic pain syndromes. As long as reasonable precautions are taken, the risk-benefit ratio is acceptable and opioids should not be unreasonably withheld from such patients." This article also discusses the opioid pathophysiology in RLS. This particular article contains more than 52 references regarding this subject. I am trusting that in the efforts of the CDC to protect those with the problem of opioid addiction that the CDC does not, at the same time, condemn persons like me to an intolerable existence of restlessness and disabling insomnia. The word restlessness used in the RLS diagnosis does not begin to describe the condition from which we suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lindy	None	None	09000064850091b1	Munoz	None	2022-04-10T23:08:54Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Munoz, Lindy	l1s-7tlo-0c38	False	None	False	2022-04-12 06:40:17.701	[]
4466	CDC-2022-0024-4472	https://api.regulations.gov/v4/comments/CDC-2022-0024-4472	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have tried numerous medications physicians use for managing RLS. (Note there is no cure.) Some of these medications, which seemed miraculous at first, eventually made the symptoms worse. Some had undesirable side effects, typically mental, including cognition declines. I suffer from significant, long-time sleep deprivation. I required special accommodations that allowed me to stand at work. I cannot attend movies or events in a concert hall or auditorium without worrying if I can sit still through the performance. Travel on an airplane is too arduous to even consider. Low dose codeine and methadone have been the answer for me. Yet, due to government regulations, my physicians have had difficulty easily obtaining these for me. I stopped taking them a few years ago at my doctors' request. Just recently I have persuaded a "new" doctor to prescribe codeine. To make it easier for him to manage, he is prescribing Tylenol 3.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Carol	None	None	0900006485009053	Van Nuys	None	2022-04-10T23:15:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Van Nuys, Carol	l1s-95bo-qxm2	False	None	False	2022-04-12 06:40:17.944	[]
4467	CDC-2022-0024-4473	https://api.regulations.gov/v4/comments/CDC-2022-0024-4473	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	ee attached file(s) Please, it took months to prepare and want to share my thoughts concerning "my" pain. After being on a working management plan for pain for over 20 years, you have systematically destroyed what little quality of life I had with your new "regulations". My new physician refused to prescribe the medications that I utilized to live due to your recommendations. For 20 years I had no problems with medication management, abuse, nor did my doctor. Now I live in pain daily with having to choose between pain and sleep. Additionally, after a mastectomy for breast cancer, I was sent home with one script of hydrocodone and told to substitute Advil for the pain. The pain was horrific in the hospital and at home, they said they could not give any more pain meds due to the "law". Two years later I still have massive pain in the cancer area, in addition to my other chronic medical conditions. Advil, and other OTC meds cause more harm than good and don't work. I feel I am not being treated for my chronic illness and have been abandoned by the medical community because of my pain. "Illegal" drug use and suicides have increased since 2016, as have overdoses since your guidelines were revised. Drug addicts get treatment and are treated better than those of us with legitimate chronic pain and disease. Look at the facts. It has nothing to do with LEGITIMENT and LEGAL medication use. I have tried physical therapy, aqua therapy, anti-depressants and other medications (Lyrica, gabapentin, etc.), meditation, feedback, exercise, therapy groups, cremes, lotions, CDB, OTC and everything under the sun to get through the day and none of these have helped me and some made my health worse. Cost and availability are major issues with the alternative care options in your guidelines: time, travel, cost, transportation issues, no local availability for other treatment, and some do not help and can exacerbate your pain and cause financial hardships. Paying for the alternatives is costly, when a low-cost prescription would do. Doctors are scared to prescribe most anything due to regulations and that only hurts the patients that need these medications to live. Doctors cannot and most will not take the risk to treat their patients now with the new guidelines. Hydrocodone and Benzodiazepines can be used in a safe and effective manner. I had done this for 20 years with absolutely no issues until 2020. It worked for me, and we are all different. One size doesn't fit all. Now my conditions are not managed, and I suffer daily. Revisions need to be made to the guidelines and to instruct physicians, insurance companies, and pharmacies, that they are only guidelines and patients should be put first and treated accordingly. What works for one person may not work for another. So many people in pain and are suffering, many I know turned to alcohol to help ease the pain. Pain changes you and not for the better. Not treating pain is criminal in my opinion and we are given no other option than to suffer.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009057	Anonymous	None	2022-04-10T23:17:27Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-8u1s-hqf7	False	None	False	2022-04-12 06:40:18.154	[]
4468	CDC-2022-0024-4474	https://api.regulations.gov/v4/comments/CDC-2022-0024-4474	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello,<br/>I am a 44 year old chronic pain patient who has had ankylosing spondylitis since age 21 and have been on a variety of pain medications both controlled and non.<br/>I have gone through just about every treatment, counseling, and therapy possible and available within the range of affordability - sometimes beyond what is reasonably affordable.<br/>For my entire working life I have been in the medical field. I have been an EMT, home health care aid, as well as working with severely brain injured clients.<br/>I then worked nearly 15 years as a certified surgical technologist where I excelled at every possible surgical speciality. The last 6 years in the OR I was a surgical first assistant in the open heart surgical suite which was physically and mentally challenging, but something that I immensely enjoyed and worked very hard to be as competent and reliable at as possible.<br/>I was on biologic TNF meds as well for the AS, but the efficacy was waning after being on them for close to 6 years at the time.<br/>I was VERY stable on opioid medications up until the 2016 guidelines emerged. At the time I was able to transition from opioids (Tramadol) to Suboxone even though I had no history of abuse, overuse, nor was I taking high dosages of opioid medications. The relief I was able to maintain from Suboxone was very short lived as the insurance company also changed their guidelines to fit within the poorly written and frequently misinterpreted 2016 guidelines. I was told I had one week worth of medication available to me - reasons cited, Suboxone is not for pain, but the pain medications I was taking were no longer being offered by the clinic I attended due to the erroneous guidelines. <br/>I fell into quite a terrible pain spiral, was forced to go on medical leave as I was no longer able to be a reliable member of the heart team, was in incredible amounts of acute and chronic pain, as well as mental anguish brought about by the inhumane one week taper off opioids. After the acute withdrawal period where I received very little supplemental help, was embarrassingly looked down upon as some kind of "junkie" because I asked - not for opioid pain meds, but for something to help with the withdrawals. I was unable to sleep, function, even open bills that came in the mail because I now had terrible and unrelenting anxiety like I have never in my life experienced. I was incredibly incapacitated and in constant terrible pain that was completely and utterly unnecessary.<br/>I found another pain clinic and was again looked down upon as some kind of abuser, which was entirely incorrect and a disgusting bias perpetuated by the 2016 CDC guidelines.<br/>The alternative prescription NSAID pain medications and non-controlled medications (like Clonidine) to supposedly help were utter failures. <br/>I went to counseling and even asked that I try Seroquel an antipsychotic because the anxiety was unrelenting - it did not work either.<br/>My PTO and PML ran out. I was forced to try and return to work and it was quickly clear that I was no longer able to do my job or be a reliable worker.<br/>I lost my job after too much missed work. I went on Medicaid as I also now lost my insurance and any way to pay my bills or take care of myself - because of these idiotic guidelines!<br/>For close to two years I suffered greatly physically, mentally, and spiritually. I was unable to play with my son, be a good spouse, be much of anything...even taking care of myself was a huge chore.<br/>That is time I will never get back and I am incredibly disheartened with feelings of guilt even to this day.<br/>I was put on IV Remicade only to have awful side effects that made me constantly ill with sinus and upper respiratory infections. I applied for disability. I was immediately approved and several of the physicians remarked how I should have and could have done this years before. <br/>I didn't need to do it years before though, because I was a stable, working person, who was on low to moderate doses of opioid medications that allowed me to be functional and behave as a "normal" person. <br/>Yes, my disease had progressed, which I would think would more so warrant the use of opioid pain medications...but it was impossible to even start back on a reasonably small dose of such medications.<br/>Once I was approved for disability and was able to get Medicare, I was able to find a clinic that once again allowed me to take opioid medications. This was around 6 years ago.<br/>I have not increased my dosage, I have not abused my meds, and have been living still with a great deal of chronic pain. To equate a person like me to those abusing and overdosing illicit drugs on the streets is insulting and detrimental to the lives of many people.<br/>These guidelines sent me down a pain spiral that left me disabled years earlier than I needed to be.<br/>Did far greater harm than good, and I would love to sue the CDC's asses off for all the excruciating pain and suffering I was unnecessarily put through.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500909f	Anonymous	None	2022-04-10T23:18:44Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-a28h-gq81	False	None	False	2022-04-12 06:40:18.368	[]
4469	CDC-2022-0024-4475	https://api.regulations.gov/v4/comments/CDC-2022-0024-4475	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Denial of adequate pain medication can also result in other problems, see.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6730296/ I was left suffering daily because of laws being made to ban doctors or cause them to fear giving us pain medications, I was denied anything for pain by [health facility name redacted] on [address redacted] Texas while I was being treated for cancer of the larynx. I had severe radiation for burns in my throat, and they would not prescribe me anything for my pain. I was unable to even talk and a relative called pain doctors going down the phone book directory, and they told me they were never treated so rudely by pain clinic..even hanging up on them, when they asked if they could give me some pain medication for my cancer pain saying we do not prescribe pain medications to anyone, and hung up, or we don't treat cancer pain. I suffered so horribly, you just cannot imagine the pain I had to endure. Not only that, but I was going to discontinue the treatments as my throat was burned so bad from the radiation, toward the end... like someone put a lit blow torch down my throat. I was unable to talk or eat, I lost about 40 pounds within a few months and toward the end of the treatments I looked anorexic. My brother was so worried about my discontinuing the radiation, and he finally found a pain doctor who was willing to treat me, after he told him this. He gave me some type of fentanyl spray for my throat and when I went to get the prescription filled it cost 2000 dollars for a month supply, so I was unable to get it filled, so then he prescribed Suboxone, same issue it cost 700.00 a month so unable to get it filled. I do not have part D on my Medicare, as I dropped it.. I have other medical problems, also and so many times when I was given medications by other doctors for other issues Medicare would deny it, saying it's not on their formulary and even when it was, after so many months of them paying 800 dollars per prescription they would deny and saying the reason being because I am catastrophic. I do not understand them saying this is a reason to deny covering my medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	09000064850090a8	Hull	None	2022-04-10T23:20:04Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Hull, Linda	l1s-aav4-5mfo	False	None	False	2022-04-12 06:40:18.585	[]
4470	CDC-2022-0024-4476	https://api.regulations.gov/v4/comments/CDC-2022-0024-4476	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless Legs Syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life. <br/>In the U.S. nearly 12 million adults and children suffer from RLS. There is no cure. a few prescription medications may relive the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS. I have had severe RLS for the past 30 years, I am 66 yrs old now, and have tried other medications but the only one that lets my legs be at peace is the low-total-daily dose opioids that my Doctor has been willing to prescribe for the last 5 years. I only take two 5 mg Oxycodone tablets per day that I cut in half and take 2.5 mg at 12 pm, 4 pm, 8 pm and 2 am. These have saved my sanity! <br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully6 monitored which is what my Doctor and I have been doing. <br/>Thanks you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Betsy	None	None	09000064850090ba	Collins	None	2022-04-10T23:20:26Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Betsy	l1s-apl2-dhc0	False	None	False	2022-04-12 06:40:18.796	[]
4471	CDC-2022-0024-4477	https://api.regulations.gov/v4/comments/CDC-2022-0024-4477	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please listen to all the people and their stories and their pleas. You see us, you know we are here suffering because you think we are drug seekers. You are hurting and killing medicine seekers. Relief seekers, life without pain seekers. Please see how much damage you are doing by taking away peoples medicine. The addiction is no longer a reason to deny good people life without pain. Stop punishing good people. Please, we are begging you to stop the tapering when people need it. You’re causing more stress and panic.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850090bb	Anonymous	None	2022-04-10T23:20:42Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-aq94-tzjy	False	None	False	2022-04-12 06:40:19.006	[]
4472	CDC-2022-0024-4478	https://api.regulations.gov/v4/comments/CDC-2022-0024-4478	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband, like so many other people is suffering. He has nerve damage causing constant pain, numbness, burning and stinging in his feet, legs, hands and arms. He tried dozens of non opioid medications for years with no relief until he was started on opioids about 15 years ago. He had some quality of life, was able to walk short distances, visit with family and friends and enjoy some time with low levels of pain. Since the CDC issued their fatally flawed "guidelines" in 2016 he has been caused to suffer. Month after month his doctor, who is a board certified pain management specialist, is being FORCED to reduce his medication dosage. He now spends 23.5 hours a day in bed, much of it screaming in pain and wishing to die so the pain would stop. And just last month his doctor's office was taken over by Synovation and they cut off his medication and refused to help him at all. People are going to die needlessly without changes. Pain patients are not drug addicts and we are sick and tired of being treated like street level druggies. PLEASE GET RID OF THE GUIDELINES THAT HAVE BEEN ADOPTED AS LAW BY INSURANCE COMPANIES, PHARMACIES AND SO MANY MORE.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pauline	None	None	09000064850090c3	Richards	None	2022-04-10T23:21:03Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Richards, Pauline	l1s-axtr-ldpy	False	None	False	2022-04-12 06:40:19.262	[]
4473	CDC-2022-0024-4479	https://api.regulations.gov/v4/comments/CDC-2022-0024-4479	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please revoke the inhumane and unscientific 2016 “guidelines “. The 2022 draft is a horror show that doubles down on the catastrophic damage already leveled on the sick and disabled. Apologize to the patients, doctors and family members you have harmed and killed.<br/>Millions of Americans are waiting. We will not be silenced.<br/><br/>dove press.com/get file.pho?fileID=79642<br/><br/>PROP’s dirty tricks exposed. Research article.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009774	Anonymous	None	2022-04-10T23:21:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-r54b-7rg9	False	None	False	2022-04-12 06:40:19.488	[]
4474	CDC-2022-0024-4480	https://api.regulations.gov/v4/comments/CDC-2022-0024-4480	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Let me sum up your 2016 and 2022 "guidelines" and "update"<br/><br/>Premeditated manslaughter.<br/>With extreme indifference. Suffering, then Unlawful wounding/inflicting of Unlawful GBH/<br/>Intended murder but loss of life expectancy by decades...<br/><br/>Revoke the 2016 Guidelines. Apologize for the torture and deaths you have caused. Far too many of what the #CDC calls ‘unintended consequences’ are marked by headstones now.<br/><br/>Get your opiophobes from PROP to pack up their prison bags. There is a cell waiting.<br/><br/>Real research articles:<br/><br/>https://www.dovepress.com/getfile.php?fileID=79642<br/><br/>Misinterpretation of the “Overdose Crisis”<br/>Continues to Fuel Misunderstanding of the Role<br/>of Prescription Opioids<br/><br/>https://www.pallimed.org/2021/09/roger-chous-undisclosed-conflicts-of.html<br/><br/>https://pubmed.ncbi.nlm.nih.gov/31327624/#:~:text=Misperceptions%20include%20the%20number%20of,opioid%20use%20and%20heroin%20initiation.<br/><br/>file:///Applications/59-475-1-PB.pdf<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850093a8	Anonymous	None	2022-04-10T23:25:09Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-qlqq-uir8	False	None	False	2022-04-12 06:40:19.700	[]
4475	CDC-2022-0024-4481	https://api.regulations.gov/v4/comments/CDC-2022-0024-4481	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 58 yo woman who has had an idiopathic inner ear disease for the last 19 years. I need pain relief to have any quality of life. I have had 3 holes drilled into my skull, lost my hearing in that ear AND lost my eardrum. I have NEVER misused my medication. Your policies are driving people to get them off the streets (not me, I just suffer). Bring back Percocet. It works better. The only time I don't want to live is when I am in unbelievable pain with no relief in sight. I would rather live a quality of life, then quantity. In 19 years I have tried everything!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850093a4	Anonymous	None	2022-04-10T23:25:23Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-q9a0-vs14	False	None	False	2022-04-12 06:40:19.912	[]
4476	CDC-2022-0024-4482	https://api.regulations.gov/v4/comments/CDC-2022-0024-4482	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi I am a 46 yr old woman I've been threw 2 accident first one when I was 15yrs an lose my upper eye lid an some head trauma an my second accident I was shot in the face an lose my jaw was scattered an I've been in more then 20 surgeries an know they can do no more for me I have a metal an screws in my face where my jaw is I have so much pain when I talk eat sleep on my face when it hot my face feels like it's on fire because if the hardware in my jaw an when it cold the pain unbearable I've been going to pain management an I was on pain meds that help me where i was finally able to control my pain I have a family I gotta be there for them The pain meds help me to do thing I need to do like help my kids an cleaning our home cooking talking an able to do other things but since they change the rule it been real hard I can do things like i use to because of the my pain always there I try my best but there are times I cant because I'm in so much pain an my faimly suffer because I'm the mom . my pain doctor retired an it was hard find one but I found one an my pain meds are get lower an lower so it been hard I'm in so much pain everyday an night I hope the rules can change I always followed the rules an I know I'm not the only one that going threw this hopefully my statement help <br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500939d	Anonymous	None	2022-04-10T23:25:56Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-q2du-77pg	False	None	False	2022-04-12 06:40:20.124	[]
4477	CDC-2022-0024-4483	https://api.regulations.gov/v4/comments/CDC-2022-0024-4483	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I tried all the conventional treatments and unconventional treatments as well. Vitamins and supplements, quinine, marijuana, low-dose Parkinson drugs etc. I started with hydrocodone over 20 yrs ago and found I was able to sleep 4 hrs at a time! I still suffered in the daytime though and regularly beat on my legs and got up from my desk job every couple of hours to walk around. I began low dose hydrocodone during the day with very positive results and no negative side affects. My PCP has treated my for over 25 years and we monitor my use very carefully. I supplement with gabapentin which allows me to reduce the hydrocodone but I hate the side affects. I understand the need to make it more difficult to get opioids because of the abuse and harm it does to millions of Americans but feel that has also led to people obtaining opioids on the street which is now laced with deadly fentanyl and is doing even more damage. I urge you to consider making opioids available as a treatment for RLS for people like me.<br/>Regards<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	WILLIAM	None	None	0900006485009399	ISBELL	None	2022-04-10T23:26:16Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from ISBELL, WILLIAM	l1s-pz67-596n	False	None	False	2022-04-12 06:40:20.339	[]
4478	CDC-2022-0024-4484	https://api.regulations.gov/v4/comments/CDC-2022-0024-4484	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please address the concerns about CDC's integrity raised in this article.<br/><br/>https://medium.com/the-shadow/scrutiny-of-cdc-overdose-death-data-yields-explosive-results-3b9910151ef3	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009393	Anonymous	None	2022-04-10T23:26:27Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-ppii-dzf3	False	None	False	2022-04-12 06:40:20.569	[]
4479	CDC-2022-0024-4485	https://api.regulations.gov/v4/comments/CDC-2022-0024-4485	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted] and I am from Missouri. In April of 2002 the life I knew came to an end. I woke up one morning throbbing in every joint and being so sensitive over every inch of my body that I couldn't stand to be touched. I went to every kind of doctor and specialist, and no one could help me. By the end of that first summer, I didn't even want to wake up in the morning. After 4 years of being basically bedridden, I was then offered pain meds. They helped, but I knew I'd never be the same. I continued on my own to find a cure with diets,supplements, masssage therapy, physical therapy, hormone replacements, acupuncture, meditation, etc. My family has spent 10s of thousands over the years trying to help me. In 2015 my pain doctor precribed Nucynta at a fairly high dose. It was like a miracle! It helped my pain so much that I started getting stronger, remembering who I used to be and that I used to be passionate about things. I lost weight and started a business! In 2018 I was forced off of Nucynta and put on 60mg of Oxycodone. It just doesnt work as well, so I had to cut my business and just struggled along. My insurance wouldn't cover the Nucynta which I could never afford, it being about $1200 a month. Then the final straw was last year my pain doctor stopped giving pain meds (I was his patient for 15 years) and I had to change doctors. I got called a doctor hopper because Ihad to find a new doctor. I have been treated like an addict and a criminal ever since the CDC guidelines. In order to get a new doctor I had to drop to 40 mgs a day. I closed my business and I have struggled this past year terribly with never any true relief. This past year broke me. No one that doesn't have chronic pain should EVER be able to tell another person how much they should have to suffer. There is no other sickness or malady for which a doctor would WITHHOLD the correct amount of meds. Only pain. There is no longer any meaning to FIRST DO NO HARM. Now I'm just struggling through life waiting to die. My life is as important as yours, and I shouldn't have to BEG for the proper medication. What has been done to pain patients is criminal, and this little paragraph can't possibly express the Hell I've gone through since the CDC guidelines.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	0900006485009384	Barkley	None	2022-04-10T23:27:27Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Barkley, Susan	l1s-pgis-h3v7	False	None	False	2022-04-12 06:40:20.801	[]
4480	CDC-2022-0024-4486	https://api.regulations.gov/v4/comments/CDC-2022-0024-4486	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I speak today on behalf of myself as a chronic pain patient for over 35 years and the wife to a husband who has been a chronic pain patient now for 6 years. In addition, as a supporter of those who deal with chronic pain every day, and as a patient myself who has considered suicide on several occasions in which chronic pain has played a major part in. <br/>I have Fibromyalgia, Small Fiber Neuropathy, Interstitial Cystitis, Irritable Bowel Syndrome, Pudendal Neuralgia, Occipital Neuralgia and Degenerative Disc disease among other things. My husband has Small Fiber Neuropathy, Migraines, Back pain, Functional Neurological Disorder. All of these can conditions can and do cause severe pain. I personally have taken opioids in the past short term, but I have never taken them on a regular basis, nor would I say they were a good fit for me. My husband on the other hand has suffered for 6 years now and would not function if it weren't for opioids. He tried many other medications before opioids however none were helpful. The thought of his pain medication being discontinued is a fear he has lived with since all the changes with prescribing have taken place. <br/>It is not fair, nor humane, to not consider and treat each patient as an individual and provide relief for those who truly need it. My husband is monitored very closely, he has random drug screenings and is very careful with his medications and I believe this to be true for most patients who suffer chronically and take opioids. Doctors and patients should not have their hands tied when they are in the profession of helping others. <br/>Many in the support groups that we belong to also rely on these opioids in order to have any quality of life. I have read so so many posts from chronic pain patients who have had their medications just stopped abruptly or cut in a half. This is and was not a humane thing to do and the definitely the wrong way to go about it for some in the medical profession. Without these medications some patients, my husband included, would NOT be able to live a life where they find any relief and that's when the chance of suicide greatly increases. Unfortunately, it is my understanding from the groups that many chronic pain patients have committed suicide due to these circumstances and their increase in pain. These people are mainly the patients who have tried everything else before relying on opioids. Being a chronic pain patient in and of itself is not an easy thing to live with, but also extremely depressing and not only affects you but also family and friends. Believe me when I say none of us wants to live like this. I speak for myself and my husband when I say never would either of us think this is how our lives would have turned out. But we take every day as a new day and do the best we can. <br/>Another point I would like to bring up although not directly related to prescribing opioids is the access to alternative treatments. I personally find this to be extremely frustrating. Medications for me do not provide much relief. I take antidepressants to help with my depression and anxiety. For me, myofascial release, cupping, dry needling and massage are my go to treatments. Medicare restricts how much PT/OT therapy a person can have regardless of the condition, has a cap on the amount of the PT/OT benefit payable and does not provide for any maintenance alternative care to help keep pain levels stable. Medicare will however cover daily medication, some extremely expensive, that are taken for years or maybe even forever. In addition, Medicare covers mental health benefits for as long as a patient needs it, which again, when dealing with chronic pain therapy could be for a lifetime. For chronic pain patients, keeping stress and anxiety in check is very important. Not doing so can and will for many cause increased pain. If patients had the financial resources to afford the alternative treatments that do help many chronic conditions, this could result in a decrease in the need for pain medications, a reduction in depression and anxiety symptoms or possibly a decrease in both physical and mental symptoms. It can also help some to have better quality of life which could also decrease depression and anxiety. <br/>I really hope that at some point alternative treatments become an option for treatment and is covered by insurance in the same way that medications and mental health benefits are. Every person is an individual and should be treated as such.<br/><br/>Thank you for allowing me to comment and for reading. <br/>[name redacted], Chronic Pain Patient<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kelly	None	None	0900006485009374	Cerulli	None	2022-04-10T23:28:39Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Cerulli, Kelly	l1s-oz78-n5p5	False	None	False	2022-04-12 06:40:21.017	[]
4481	CDC-2022-0024-4487	https://api.regulations.gov/v4/comments/CDC-2022-0024-4487	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife lives with debilitating chronic pain due to a genetic disorder. Our lives were upended by the 2016 guidelines. Prior to 2016 she had a medicine regiment (including opiates) that allowed her to have a life. She could drive, do volunteer work, walk our dog, go out with friends, etc. Once the guidelines went into effect, doctors began treating them as law. Her pain management doctor very rapidly force-tapered her to a dosage that provided only minimal pain relief, leaving her effectively bedridden. We have not recovered since.<br/><br/>The priority of doctors shifted to avoiding legal penalties instead of providing the dosage of medicine they knew was effective for the given patient. Please create guidelines that give the control back to the pain management specialists. Please create an environment that places patient health above all else. Please remember the chronically ill are not drug addicts to be punished but rather people who are hurting and in search of relief.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	0900006485009370	K	None	2022-04-10T23:28:54Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from K, Brian	l1s-ow52-term	False	None	False	2022-04-12 06:40:21.235	[]
4482	CDC-2022-0024-4488	https://api.regulations.gov/v4/comments/CDC-2022-0024-4488	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been severely harmed by the 2016 CDC “Opioid guidelines”. <br/><br/>In the last 6 years, as a direct result of the CDC guidelines, I have been medically abandoned twice, and nonconsensually force tapered three times. On numerous occasions the practitioners cited "regulatory pressure and fear of the DEA', along with the "CDC Guidelines".<br/>I was also refused a valid prescription to be filled by Walgreens and Walmart , despite a clear history of safe and responsible use of opioids.<br/> <br/>I was accused (erroneously) of being an “addict”, and lied to by doctors, pharmacists, and P.A.’s, in an effort to eliminate me as a patient and potentially kill me as a result of maltreatment and negligence. I was in agony, yet I was ignored and left to die.<br/><br/>Diagnosis: 12 year history of: End stage Inflammatory Osteoarthritis, Total Knee Replacement with complications.<br/><br/>The CDC should revoke, not 'update' it's 2016 opioid guideline. The 2022 update doubles down on the unscientific MME cap, making 50 MME the new 'high' dose. Weak evidence and opiophobia with skewed "research" is again present. Written by [name redacted], a rabid anti-opiate extremist and PROP member. The author himself has numerous, well documented, conflicts of interest. https://www.pallimed.org/2021/09/roger-chous-undisclosed-conflicts-of.html<br/><br/> What the CDC, PROP, and DEA have done to the sick, in pain and dying, all vulnerable patients, is criminal. You must be held accountable and stopped. <br/><br/>More references/unbiased science:<br/><br/>https://www.dovepress.com/getfile.php?fileID=79642<br/><br/>https://pubmed.ncbi.nlm.nih.gov/31327624/#:~:text=Misperceptions%20include%20the%20number%20of,opioid%20use%20and%20heroin%20initiation.<br/><br/>file:///Applications/59-475-1-PB.pdf<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009366	Anonymous	None	2022-04-10T23:29:55Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-onc3-lmv2	False	None	False	2022-04-12 06:40:21.444	[]
4483	CDC-2022-0024-4489	https://api.regulations.gov/v4/comments/CDC-2022-0024-4489	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, the arms and other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have suffered from RLS in my legs and arms for around 50 years and have used many of the non-opioid drugs typically prescribed for it. All of those medications were problematic for me. After taking them for a while, I always needed to be prescribed higher doses, beyond the FDA recommended dosages, to get relief from the symptoms, and those medications also resulted in many debilitating side effects. <br/><br/>Just over two years ago, I saw a different RLS specialist who diagnosed me as having severe dopaminergic augmentation, due to the effects of those drugs, and switched me to a daily dose of 10mg of Methadone. I have been taking the same 10mg dose of Methadone for just over two years and for the first time in my life I no longer suffer needlessly from RLS symptoms and the side effects of the typical RLS medications. <br/><br/>Also, as I understand, clinical studies indicate that those who take a low-dose opioid to control RLS symptoms don't usually build up a tolerance to the prescribed opioid and can remain on the same low dose for years. A daily dose of 10mg of Methadone is considered to be a very low dose. I cannot feel any effect from taking it and it completely eliminates RLS symptoms 24/7.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	0900006485009339	Brown	None	2022-04-10T23:31:36Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Joseph	l1s-nikk-btgo	False	None	False	2022-04-12 06:40:21.890	[]
4484	CDC-2022-0024-4490	https://api.regulations.gov/v4/comments/CDC-2022-0024-4490	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	All that is ever reported in the media is about the people who abuse the system and opioids. But what about those who suffer from sever chronic pain injuries, diseases, and/or cancer. This war on opioids has impacted those patients too. They are treated as if they are the 'dirty addicts' looking to get high, when they are just trying to live somewhat of a normal life with an injury/disease that has caused them debilitating pain that they didn't ask for.<br/><br/>My sister is a chronic pain patient for over 20 years due to an accident. These guidelines have had a huge impact on her life. She struggles every day with chronic pain, minimal support, complying with all the random tests, signing waivers giving up all her rights in order to get treated and going to every doctor appointment fearful that she might be told, again, that due to regulations, they are cutting her back on another medication. Her medical history has been heavily watched, documented, tested and NOT once has there EVER been an indication that she is doing anything illegal, but she is still treated as a 'dirty addict' because she takes pain medication for a condition she didn't ask for. She doesn't want to get “high”, she just wants her life back. <br/><br/>Just like my sister, the pain patients who truly need the pain medication just to be able to live life are paying the higher price because they are the ones who are suffering, everyday. Doctors are not allowed to treat their patients the way they deserve to be treated for fear of jeopardizing their lifetime dedication to human lives. I have seen and heard stories about pain patients that are dropped by their doctors as they don't want to treat them for fear of loosing their licenses which results in losing loved ones to suicide. Rather it be them taking their own life because it has become unbearable or taking the wrong street drugs because again, meds have been drastically cut back/taken away.<br/><br/>Why is the CDC setting these regulations? Isn't the CDC'S job infectious diseases? Here is a thought...as part of writing these guidelines, the authors should be required to undergo major surgery with a regular strength Tylenol. Then, for a brief moment, they will understand one minuscule moment of what a pain patient goes through...hopefully.<br/><br/>The CDC should abolish these guidelines as they are killing people under the guise of helping addiction.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nicole	None	None	0900006485009338	Phillips	None	2022-04-10T23:32:02Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Phillips, Nicole	l1s-nhal-y8q5	False	None	False	2022-04-12 06:40:22.188	[]
4485	CDC-2022-0024-4491	https://api.regulations.gov/v4/comments/CDC-2022-0024-4491	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I appreciate the important work the Center for Disease Control is doing regarding revision the CDC Clinical Practice Opioid Prescribing Guideline policies. I am a 70-year-old male and a longtime sufferer of Willis-Ekbom disease, commonly known as Restless Leg Syndrome (RLS), a chronic neurological disease that causes an urgent need to move the legs; in my case, the disease also affects areas throughout my body, including arms, hands, and torso. There is no cure. The suffering caused by extreme cases of RLS is difficult to describe to those who have not experienced it, and while the sensations are not the same as those of people who suffer from other kinds of chronic pain, they are intense, miserable, and debilitating.<br/><br/>The CDC policies directly impact the medications that I and so many others with severe RLS need to manage this disease. For me, that is an opioid prescription. Under the care of my primary doctor, neurologists, and sleep care physicians, I tried for years to get a handle on my condition with dopamine agonists and several other drugs that the majority of RLS patients respond to favorably. Nothing worked. The final option was opioid meds. For two years now I have been taking methadone, 10-15 mg daily , and it’s no exaggeration to say that it has given me my life back. I can’t stress how grateful I am to have this medication to control my condition (as is my family). I continue to take the same dosage as initially prescribed with excellent results.<br/><br/>My understanding is that the draft of the CDC guidelines under revision does not address chronic conditions like RLS. An abundance of scientific research supports the use of low-total-daily-dose opioids to treat severe RLS when all other medical therapies fail. As I’m sure the CDC is aware, the 2016 CDC Opioid Prescribing Guidelines have unfortunately often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions such as RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored. <br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>Respectfully submitted,<br/><br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	090000648500932d	S.	None	2022-04-10T23:32:45Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from S., Steve	l1s-n9v7-4g17	False	None	False	2022-04-12 06:40:22.413	[]
4486	CDC-2022-0024-4492	https://api.regulations.gov/v4/comments/CDC-2022-0024-4492	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider chronic pain patients who follow the rules. I have been suffering with chronic pain for 9 years and doctors are afraid to prescribe opiods. I drive 1.5 hours each way once a month to a Dr who listens and prescribes my opiod medication. A few times I have had to go days without my opoids because I am not allowed to refill them until the day I run out and the pharmacy is out of stock and has to order them. I have always taken my meds as prescribed and I have to do all of this to be treated. I live in a highly populated area and I shouldn't have to suffer while driving 3 hours total to see a doctor for 10 min to prescribe my opiods. A few days overlap for filling opiods scripts would be life changing so I don't have to go without because of something I can't control. There are so many rule following patients who are deeply suffering because of the way things are now. Please think of us and help us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Meredith	None	None	0900006485009307	Martin	None	2022-04-10T23:32:57Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Martin, Meredith	l1s-m5fz-e2eb	False	None	False	2022-04-12 06:40:22.665	[]
4487	CDC-2022-0024-4493	https://api.regulations.gov/v4/comments/CDC-2022-0024-4493	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had scoliosis at age 13 requiring me to have a spinal reconstruction, taking bone from my hip to fuse T2-L3 while adding a Harrington rod. Twelve years later I had to have the rod removed, hoping for pain relief. There was a 17” incision for each surgery. Five years later I had L4/5 fused and a partial discectomy, hoping for pain relief. I had tried “alternative therapies” before ever taking an opioid. Those “therapies” and various procedures didn’t help the pain. The only effective modality for pain relief was the right combination of medications, along with other therapies. I’ve never had addictive tendencies.<br/><br/>The 2016 guidelines made me lose my continuity of pain care, causing me to lose daily function. This resulted in me having to quit my job and file for disability. I’m now only functional about 4 hours per day. The disability process was excruciating and I had to switch all of my doctors. I had to go to 4 pain clinics before I found one that would accept me as a patient. The others would not take on a person who didn't respond to procedures and alternative therapies and required only medication management. I've been suicidal and suicide is still an option. Several doctors told me bluntly, they were going to strictly follow the guidelines and they weren’t willing to risk imprisonment, fines, fines to their employer or losing their licenses by prescribing “high amounts” of opioids as defined by the guidelines. Unless I had cancer or required palliative care, my medications were going to be cut to 50 MME’s. I read the guidelines, printed them and explained to my doctors the “guidelines” said to review each person individually and higher amounts of MME’s were allowed. I explained the 50 MME’s was for patients newly prescribed opioids, not existing chronic pain patients. They ignored what I said. I had been taking opioids and benzodiazepines for years. I had to pick one. I picked opioids. Then, they cut my MME’s 25% in one month. Later my opioids were reduced over 50%.<br/><br/>When I explained to my doctor that suicide was an option, she explained since I hadn’t attempted it, I wasn’t serious. She had no idea I had just hired an attorney, filled out my will and said goodbye to my loved ones. I’m barely holding onto life now.<br/><br/>The current guidelines were created by a biased panel of experts, violating the Federal Advisory Committee Act (FACA). Immediately after the 2016 guidelines were implemented, Congress notified the CDC of their violation yet, the current revisions were handled the same biased (anti-opioid) way. Pain management clinicians and patients were not included in the creation of these revisions in any significant way. The current guidelines and proposed revisions are intentionally written to be used by state medical boards as “regulations” (de facto laws), bypassing the FDA. They are used as weapons against doctors and patients to move our country to becoming opioid free. This is being achieved by groups such as PROP by thought leaders such as [name redacted] . Mr. [name redacted] has said on record he wants no opioids in the US, even for cancer or palliative care patients. After the FDA told Mr. [name redacted] opioids where in fact an effective modality for chronic pain and his assertions were not supported by long-term controlled studies, he then went to his friend, the CDC director in 2015 and created these anti-opioid “guidelines”. He then worked with agencies such as the DEA, CDC, DHS, HHS to implement the MME’s. This was done so law enforcement had something “legal” to show if doctors were prescribing “too high” of doses of opioids.<br/><br/>The Morphine Milligram Equivalent (MME) is completely subjective, and not based on any clinical evidence. These were created by psychiatrists with no input from pain management specialists or patients.<br/><br/>Public comments during the 2016 guideline open comment period had public comments “accidentally” deleted or system errors didn’t allow comments to be posted. This is happening again for these revised guidelines. Of the comments posted, they were completely ignored<br/><br/>The CDC is a private organization that is bypassing the FDA, which is the correct governing entity for medication management. The CDC needs to remove themselves from the doctor/patient relationship.<br/><br/>The current guidelines should be abolished, not revised. If they are going to be revised, they cannot and should not be written by a biased, anti-opioid group of authors.<br/><br/>These guidelines have been used effectively to transition diagnosis from actual “physical pain” to nebulous “mental pain”. This is because the authors are psychiatrists and they view problems through a myopic lens. Since they only know how to use a hammer, they make every problem a nail. These guidelines are intentionally written and weaponized by anti-opioid zealots, some of which have undisclosed conflicts of interest. Shame on them!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dan	None	None	09000064850092f5	Bateman	None	2022-04-10T23:34:53Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Bateman, Dan	l1s-loih-rmyb	False	None	False	2022-04-12 06:40:22.882	[]
4488	CDC-2022-0024-4494	https://api.regulations.gov/v4/comments/CDC-2022-0024-4494	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	THANK you for making it so difficult and confusing to leave a comment..<br/>NOT that I think you'll read it...as executive secretary am I allowed to know how much money you earn in a year...just would like to know how much we pay you to make my son's life a living hell !!! has it ever accured to you that when back surgery was performed for scoliosis 20 years ago they didnt have the knowledge they have today....my son has suffered for years because of it....patients with cancer suffer with horrible pain because of your decisions and actions....who made you God !!?<br/>what are you going to do if you are ever diagnosed with such terrific illness....maybe you can spend all your free time trying to get the CDC to care....who are you, a government agency that has the right to be involved in my son's doctor office visits and recovery....<br/>DISSOLVE the CDC....ALLOW THE DOCTOR to do what years of education have taught him to do...<br/>patient care should be between the doctor and the patient....NO PLACE FOR THE LONG ARM OF GOVERNMENT.....AGAIN !!!!<br/>please live with my son for 2 weeks...be him for 2 weeks....YOU CANT.....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850092d8	Anonymous	None	2022-04-11T01:00:14Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-l39l-jb83	False	None	False	2022-04-12 06:40:23.100	[]
4489	CDC-2022-0024-4495	https://api.regulations.gov/v4/comments/CDC-2022-0024-4495	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a long term sufferer of chronic high pain levels I am dedicated to advocating for reasonable and needed administration guidance for prescribing opioids. The final decision on levels and prescribing specifics should be left with a physician that is knowledgeable and familiar with the patient. Not all patients respond to medications at levels that are lower than the average. There should always be a process and the patient should be able to communicate what levels are working and what levels are not. This should not be left up to the CDC or other governmental agency, but the physician treating the individual patient.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melodi	None	None	09000064850092c4	Connor	None	2022-04-11T01:00:39Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Connor, Melodi	l1s-ksju-8apx	False	None	False	2022-04-12 06:40:23.315	[]
4490	CDC-2022-0024-4496	https://api.regulations.gov/v4/comments/CDC-2022-0024-4496	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC 2016 Guidelines need to abolished. Pain medication belongs with doctors and patients NOT with the government. I think with all the suicides, the accidental deaths with street drugs and the many abandoned chronic pain patients it is extremely clear the CDC’s Guidelines have caused nothing but suffering. <br/>Thank you.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mons	None	None	09000064850092b2	Karzai	None	2022-04-11T01:01:01Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Karzai , Mons	l1s-kgmi-ou7r	False	None	False	2022-04-12 06:40:23.597	[]
4491	CDC-2022-0024-4497	https://api.regulations.gov/v4/comments/CDC-2022-0024-4497	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	According to a June 2021 report published by the Congressional Research Services,the United States continues to far over prescribes opioids in comparison to all G7 nations.<br/><br/>That report can be found at:<br/><br/>https://crsreports.congress.gov/product/pdf/R/R46805<br/><br/>According to the CDC in a November 2021 report:<br/><br/>"Provisional data from CDC’s National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.<br/><br/>The new data documents that estimated overdose deaths from opioids increased to 75,673 in the 12-month period ending in April 2021, up from 56,064 the year before..."<br/><br/>Why is it that ALL G7 companies prescribe fewer opioids than the United States?<br/>Why apparently are their pain management practices relying on far less use of opioids? Are their pain management techniques more or less effective than ours?<br/>Certainly, their death rates from opioid abuse are lower than in this country.<br/><br/>As a father of a daughter who died of an opioid overdose, I object to any attempts to ease or expand prescriptions of opioids.<br/><br/>The United States needs less not more opioid use and abuse.<br/>And the penalties imposed on Purdue Pharma and the Sacklers are vastly insufficient. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	09000064850092af	Burgess	None	2022-04-11T01:01:41Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Burgess, Robert	l1s-kfk4-ouv3	False	None	False	2022-04-12 06:40:23.813	[]
4492	CDC-2022-0024-4498	https://api.regulations.gov/v4/comments/CDC-2022-0024-4498	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	hank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I use low dose Tramadol (50 mg) to help me sleep at night so I can work in the daytime without the need for excessive naps.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850092a5	Anonymous	None	2022-04-11T01:02:07Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-k7w5-1fkz	False	None	False	2022-04-12 06:40:24.034	[]
4493	CDC-2022-0024-4499	https://api.regulations.gov/v4/comments/CDC-2022-0024-4499	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I forgot to put the docket number on my coment.<br/>It is docket #CDC-2022-0024.<br/>My comment is that I want you to revise the opioid prescribing guidelines.<br/>People like me need prescription pain medication in order to live a decent, productive life.<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	090000648500928d	Bernhardy	None	2022-04-11T01:02:20Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Bernhardy, Karen	l1s-jvbb-jzgw	False	None	False	2022-04-12 06:40:24.267	[]
4494	CDC-2022-0024-4500	https://api.regulations.gov/v4/comments/CDC-2022-0024-4500	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please revise the prescribing guidelines for opiates.<br/>I am a Chronic Pain Patient. I have Ankylosing Spondylitis and Multiple Sclerosis and both are extremely painful. I was on prescription pain medication for years without any problems. In fact, the medications gave me a quality of life that I no longer have now that I've been tapered back so far on my pain medication. My diseases will not go away. They are both progressive and painful. Please revise your guidelines on the prescribing of opiates so that myself and others like myself can be treated with appropriate pain medication so that we may lead productive lives.<br/>Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	090000648500927c	Bernhardy	None	2022-04-11T01:02:33Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Bernhardy, Karen	l1s-jgnv-9yoz	False	None	False	2022-04-12 06:40:24.486	[]
4495	CDC-2022-0024-4501	https://api.regulations.gov/v4/comments/CDC-2022-0024-4501	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 71 years old and have had Restless Legs Syndrome for around 20 years. I was on a dopamine for years but still suffered with RLS symptoms. I was up and down for so many years until an accident 7 years ago when I was prescribed an opioid for pain. I was amazed at how much my RLS symptoms evened out and I felt so much better. My legs felt so much better; the electric current feeling lessened. My neurologist then prescribed only 10 MG of hydrocodone to be taken only 5 days per week along with gabapentin as my new regimen for treating RLS. My life changed so much and my symptoms lessened and were much better managed. My dosage of the opioid did not change until last year when my RLS disease advanced into one of my arms. At that time, my opioid prescription dose was increased a little. It gives me a lot of relief to take hydrocodone mid-day to control the arm and leg movements. I am quite uncomfortable and miserable when I have a day when I take no opioid; my arm jerks all day long starting when I first wake up. An opioid greatly helps with my RLS symptoms making it so that I can live a more normal life feeling somewhat comfortable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	0900006485009262	Keele	None	2022-04-11T01:02:58Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Keele, Linda	l1s-iyxe-s64l	False	None	False	2022-04-12 06:40:24.703	[]
4496	CDC-2022-0024-4502	https://api.regulations.gov/v4/comments/CDC-2022-0024-4502	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please let the doctors prescribe what they think, I just had surgery	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jill	None	None	090000648500923b	Cohen	None	2022-04-11T01:03:24Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Cohen , Jill	l1s-i4cb-1qqn	False	None	False	2022-04-12 06:40:24.973	[]
4497	CDC-2022-0024-4503	https://api.regulations.gov/v4/comments/CDC-2022-0024-4503	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had hip a replacement in late January, 2022. I was in a pain management program for several months prior to my procedure. After my surgery my insurance BC/BS Federal refused me any opioid based medications. My pain initially was extreme. I was forced to pay out of pocket since it was deemed either unnecessary or “abuse” by my insurance. I guess they were ok with the surgeon fileting my hip (37 subsequent staples) and recommended Tylenol. Tell me, what’s wrong with this picture.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	090000648500923a	McDermott Camp	None	2022-04-11T01:03:42Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from McDermott Camp, Kathleen	l1s-i2mg-4fcl	False	None	False	2022-04-12 06:40:25.189	[]
4498	CDC-2022-0024-4504	https://api.regulations.gov/v4/comments/CDC-2022-0024-4504	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have tried pill imaginable.....I have an 84 year old husband to care for, NOBODY around to help me with this...<br/>I have been taking 3 norco a day....NO MORE than 3 a day....if I do not take them....both of us will be in trouble....<br/>If I have unusual rougher days that usual...I will take otc pain pills with Norco to ease this pain.....I have O.A....I have<br/>herniated disks...there is NO way I can have surgery....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	judy	None	None	0900006485009668	beaver	None	2022-04-11T01:04:13Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from beaver, judy	l1s-hapb-yiop	False	None	False	2022-04-12 06:40:25.408	[]
4499	CDC-2022-0024-4505	https://api.regulations.gov/v4/comments/CDC-2022-0024-4505	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove all reference to MME. If you urge providers to be careful about increasing doses above 50 MME doctors will use 50 MME as a maximum threshold. Patients currently at 90 MME will be reduced to 50 MME arbitrarily because doctors are afraid to even appear to exceed CDC guidelines. This will additionally increase patient's pain, suffering and suicides. <br/><br/>I am a chronic pain patient. Without appropriate dosage my life becomes unbearable. Due to your initial guidelines many pain management facilities closed out of fear. Currently my husband must drive me 3 hours each way monthly to see my pain practitioner. The long drive adds to my current pain level. With less restrictive guidelines from the CDC, hopefully other pain practitioners will not be afraid to reopen up facilities. <br/><br/>Thank you for your time and consideration in removing all reference to MME dosage.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Suzanne	None	None	0900006485009667	Ausili	None	2022-04-11T01:04:29Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Ausili, Suzanne	l1s-h9gc-et7e	False	None	False	2022-04-12 06:40:25.659	[]
4500	CDC-2022-0024-4506	https://api.regulations.gov/v4/comments/CDC-2022-0024-4506	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	People with injuries and chronic pain need these medications to keep their will to live. Doctors/prescribers just need to do their due diligence to make sure of misuse versus debilitating pain if the CDC is so worried about over prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500965d	Anonymous	None	2022-04-11T01:04:41Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-h113-mxam	False	None	False	2022-04-12 06:40:26.388	[]
4501	CDC-2022-0024-4507	https://api.regulations.gov/v4/comments/CDC-2022-0024-4507	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The main emphasis of the 2022 draft guidelines seems to be on lowering prescribing by promoting non-opioid multi-modal treatments which may help mild pain, but are laughable in the face of the kind of severe pain opioids are meant to treat. The next emphasis is on the risks of opioid prescribing and the warning not to over prescribe pain meds. These risk warnings can be found on over 200 pages. One page is enough. The last emphasis is on allowing doctors to make their own treatment decisions using patient centered, individualized pain treatment along with a warning early in the draft guidelines, to avoid misapplication by not using them to set hard limits on prescribing. Limit opioid use because they are too dangerous to use in most cases, but allow doctors to use their own judgement while practicing iimiIndividualized care? Avoid opioids and use non-opioid multi-modal treatments wherever possible, but use a patient centered approach and don’t set hard limits? There seem to be some contradictions here.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	090000648500964b	Fimrite	None	2022-04-11T01:05:16Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Fimrite, Deborah	l1s-gpuq-12wb	False	None	False	2022-04-12 06:40:26.612	[]
4502	CDC-2022-0024-4508	https://api.regulations.gov/v4/comments/CDC-2022-0024-4508	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Get rid of the 90 mme, you all have made people suffer, prescription opiods were never the problem, fentanyl and heroin are, stop making people suffer and put that Dr's need to take care of their patients and that Dr's need to have the say so in treatment plans! The government needs to stay out of the Dr's Healthcare decisions! You have made fentanyl overdoses and suicides come to an all time high. Right your wrong here.<br/><br/>Dr's are scared of getting their lifes ruined by the dea!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Destin	None	None	0900006485009648	Slaughter	None	2022-04-11T01:05:29Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Slaughter, Destin	l1s-gmxf-uy0a	False	None	False	2022-04-12 06:40:26.835	[]
4503	CDC-2022-0024-4509	https://api.regulations.gov/v4/comments/CDC-2022-0024-4509	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opioids have help chronic pain patients for decades now. Why we are going backwards, I don't understand. To have this scientific knowledge to relieve pain, but not allow chronic pain patients access to science, is going back to the dark ages.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500962d	Anonymous	None	2022-04-11T01:05:54Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-g5vn-8i63	False	None	False	2022-04-12 06:40:27.067	[]
4504	CDC-2022-0024-4510	https://api.regulations.gov/v4/comments/CDC-2022-0024-4510	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I feel the guidelines are vital to control overdose deaths, by protecting pain patients from leaving medical care to purchase street opioids. We have lost the war on drugs, miserably. Opioid use disorder sufferers may as well be offered medical grade heroin now as well. The fentanyl and fentanyl analogs have opened Pandora's box. The DEA and all other drug enforcement entities cannot stop the flood of these drugs. Not now, not ever. Chronic pain patients will die, addicts will die, loved ones, will die. The ever increasing deaths we are seeing now, are obvious signs. Ignore them, at all our families peril. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Laura	None	None	090000648500961d	Cornwell	None	2022-04-11T01:06:09Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Cornwell, Laura	l1s-fppq-eamn	False	None	False	2022-04-12 06:40:27.288	[]
4505	CDC-2022-0024-4511	https://api.regulations.gov/v4/comments/CDC-2022-0024-4511	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a 1 in 75000 rare bone disease called polyostotic fibrous dysplasia in my legs and skull. I’ve had many surgeries and live in constant pain at the age of 28. I have to lay in my bed all day. Even with my thoroughly documented condition, many doctors are too scared to prescribe me anything. Getting into a new pain clinic takes 3-4 months and many pain management doctors won’t even prescribe medication, instead trying to push fentanyl and steroid spinal injections all the time. I can’t live like this much longer. I can’t imagine another year with this quality of life, much less 30-40.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	09000064850095da	Baggett	None	2022-04-11T01:06:31Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Baggett, Daniel	l1s-fc1c-gmyn	False	None	False	2022-04-12 06:40:27.509	[]
4506	CDC-2022-0024-4512	https://api.regulations.gov/v4/comments/CDC-2022-0024-4512	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear Government Regulators,<br/><br/>I am asking you to consider the potential unintended consequences of regulations which impact users of low dosage opioids for control of Restless Leg Syndrome (RLS). I have used one quarter of lowest dose possible just before bed for the last six years. I have tried many things under the guidance of my MD Family practitioner and the only thing that has worked is my once a night .25 of the lowest dose tablet. To deny me the use of Oxycodone would bring absolute misery to my life, ie. no sleep no quality of life.<br/><br/>Thank you,<br/>[initials redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	R Scott	None	None	09000064850095d8	Roy	None	2022-04-11T01:07:15Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Roy, R Scott	l1s-fbef-4bc0	False	None	False	2022-04-12 06:40:27.726	[]
4507	CDC-2022-0024-4513	https://api.regulations.gov/v4/comments/CDC-2022-0024-4513	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I run a chronic pain group. It's real important. We find a way to help these people who are in constant pain. I know the disadvantages of opioids but I also know there are no other good drugs on the market right now. I am all for getting rid of opioids. If you can find something else to administer to us that will keep us with less pain as the quality of our life matters. Please somebody advocate for the people who are the silent minority suffering in day after day pain. Horrible to be sick when we are young and horrible to be sick even when we're old. Health is a priority and quality of life is most important. I urge you to listen to those who are living in pain	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amelia	None	None	09000064850095af	Dock	None	2022-04-11T01:07:32Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Dock, Amelia	l1s-ey3c-ynrl	False	None	False	2022-04-12 06:40:27.946	[]
4508	CDC-2022-0024-4514	https://api.regulations.gov/v4/comments/CDC-2022-0024-4514	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife suffers from a debilitating condition called Complex Regional Pain Syndrome (CRPS) due to a botched operation on her knee that occurred 22 years ago. She has tried everything under the sun (short of being put into a ketamine coma to try and reset her nerves) to relieve her peripheral nerve damage and the only thing that truly works out of everything she tried are Opioids. She has been on the same dosage of Opioids for 22 years. She has never abused this life saving drug and she is not addicted. This drug is saving her life and mine too because we can have a life.<br/>The bottom line is that Opioids are not bad when prescribed and used properly. In fact, they are a lifesaver for someone living with chronic pain and can be the only solution for many. Without opioids, the only alternative for many pain patients is suicide. The powers that be need to stop showboating and conflating numbers with the illegal drugs on the market. Opioids have a very legitimate use for a chronic pain patient using the drug legally under a doctor’s care. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L	None	None	09000064850095a9	Hansen	None	2022-04-11T01:07:56Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Hansen, L	l1s-ete1-2avs	False	None	False	2022-04-12 06:40:28.163	[]
4509	CDC-2022-0024-4515	https://api.regulations.gov/v4/comments/CDC-2022-0024-4515	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Considering the risks to individual and society from opioid medications, ideally we would apply<br/>evidence-based standards to direct pain treatments. At this time the evidence does not favor<br/>opioid use, therefore it should be reserved only for special circumstances of refractory pain<br/>when all alternatives including interventional therapies have been exhausted. That is of course<br/>with the exception of specific acute pain scenarios, cancer pain, or palliative care end-of-life<br/>situations.<br/>The Pacific Spine and Pain Society sincerely thanks the CDC for the opportunity to comment on<br/>the recently proposed Opioid Prescribing Guidelines. What these organizations share is a deep<br/>commitment & passion for the health of our country’s citizens. We are optimistic that the CDC<br/>will share our resolution to allow medical evidence and the science of medical practice lead the<br/>charge in designing the optimal treatment of chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009582	Anonymous	None	2022-04-11T01:09:03Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-eagt-bygb	False	None	False	2022-04-12 06:40:28.383	[]
4510	CDC-2022-0024-4516	https://api.regulations.gov/v4/comments/CDC-2022-0024-4516	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have very close personal experience with someone suffering from severe RLS, my father in law. He has had the disease as long as I’ve known him and he has tried every dose and every combination of medication out there for RLS. He finally was tried on methadone at very low doses and it does seem to help him during his augmentation periods as well as controlling his symptoms overall. His quality of life is significantly impacted by RLS, including countless sleepless nights which affects his daily life significantly. Again, I have seen some improvement in his symptoms with methadone and believe that it should be something that is researched further and is added to the treatment regimen for severe RLS. I am a practicing internal medicine physician myself so I have a very good understanding of the disease process and treatment and wouldn’t be writing this if I didn’t feel strongly about it!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenden	None	None	0900006485009559	Brunner	None	2022-04-11T01:09:31Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Brunner, Brenden	l1s-d9m0-2cvh	False	None	False	2022-04-12 06:40:28.600	[]
4511	CDC-2022-0024-4517	https://api.regulations.gov/v4/comments/CDC-2022-0024-4517	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I completely agree with the need to get people off opiates , they are very addictive . But we need to find an alternative that gives people a chance of quality life . My wife is in chronic pain and the medicine she is on does not give her good quality of life . Most days she cannot get out of bed and the few good days she has , she over do’s herself trying to get all the things done she wasn’t able to do the previous weeks. D Then she is basically done for the next few days<br/>My other gripe is how people treat people who have an opiate addiction even when they are doing the right thing and not taking this medication. I can say this , having worked in healthcare for almost 40 years. The staff see it in the patients chart ,speak about it outside headshot of the patients , and basically treat the patient as if they have the plague. They ignore the patients , assume they are lying about everything, even other health conditions. They walk right past the patients room, pretending not to hear the patient calling out for help. So they do not receive the treatment they need. And then people wonder why these patients chose not to come to the hospital , or get very upset when they are a patient or relapsing into their addition and seek opiates. We need to treat all patients with care and compassion . Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009544	Anonymous	None	2022-04-11T01:10:25Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-cpjr-97x8	False	None	False	2022-04-12 06:40:28.817	[]
4512	CDC-2022-0024-4518	https://api.regulations.gov/v4/comments/CDC-2022-0024-4518	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Any doctor who withholds pain meds for a legitimate reason like severe pain,chronic pain,post op pain etc should lose his or hers liscense.They took an oath to help not harm,I cannot fathom having surgery with no pain meds it's barbaric,asinine and downright cruel	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009510	Anonymous	None	2022-04-11T01:10:47Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-c8qh-g18t	False	None	False	2022-04-12 06:40:29.037	[]
4513	CDC-2022-0024-4519	https://api.regulations.gov/v4/comments/CDC-2022-0024-4519	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please let dr's treat there patients as they see necessary because all you do with more regulations a scaring them so they can't treat there patients like they need to. Thank you<br/>Go after the illegal drugs <br/>and leave dr's alone	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	09000064850090fa	Edward	None	2022-04-11T01:11:03Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Edward, John	l1s-buh5-horw	False	None	False	2022-04-12 06:40:29.251	[]
4514	CDC-2022-0024-4520	https://api.regulations.gov/v4/comments/CDC-2022-0024-4520	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am the father of a 53 year old son who has suffered from a very rare disease known as childhood onset cervical and general dystonias, with tremor, for 45 years now, and there is no known cure. To make matters worse, he was diagnosed with Chronic Regional Pain Syndrome, after being hit in an automobile accident. After having tried multiple treatments, non-opioid and opioid medications along with non-medication related treatments, he was told by NIH and multiple doctors that opiates would work best for my now, disabled son. He had been doing better, was able to do more for himself, is not an addict, had a better quality of life and now is getting worse, being cut from the opiate part of his regimen. Being over 80 years old now, I can no longer help him the way that I did when I was able to and simply want him to have continued access to all of the medications that work for him, at the levels he requires and that doctors and pharmacists should be able to use to treat him with, so that he can have his quality of life back and be better able to take care of himself, again, that he was able to do before the CDC Guidelines began to take effect after 2016. I support these new guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Franklin	None	None	09000064850090c4	Wiesman	None	2022-04-11T01:11:54Z	None	None	1	None	2022-04-10T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Wiesman, Franklin	l1s-ay9t-zz2n	False	None	False	2022-04-12 06:40:29.477	[]
4515	CDC-2022-0024-4521	https://api.regulations.gov/v4/comments/CDC-2022-0024-4521	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a diagnostic MRI in 1996 and the contrast media came apart in my legs causing the heavy metal gadolinium to cause chaotic scarring of my feet and legs. My tendons and ligaments have become hard and brittle so that when I walk, they start working through my skin. My legs swell terribly if I don't spend a lot of time with them elevated. I have been treated with oxycontin since 1996 and have slowly required more medication to be able to do minimal daily activities and have a minimal quality of life. In 2017, my pain Dr. was forced to substantially decrease the amount of medicine she prescribed to her patients. She referred me to another Dr. who turned out to be more interested in insurance fraud than patients. He was shut down a few months later and I was one of those patients who couldn't find a pain management Dr. due to the efforts of the DEA and state medical boards to destroy the lives of chronic pain patients and their Doctors. The 2016 guidelines were released by a committee that had members who had clear conflicts of interest and, of course, they did exactly what the CDC wanted. They claimed opiates weren't proven to be effective for long-term use. Nothing else has ever worked as well but the people who take them are subjective just like those who want to see them prohibited, so they can make more money with agonist/antagonists and trigger point injections and other interventional therapies. The latter group fit better into the governments plans so their viewpoints were given precedence and the guidelines were released without any comment period for the first time ever. They were then used by state medical boards and state legislatures to create a horror story for people with chronic pain and those who tried to help them. So many decent people were unnecessarily caused to suffer pain with inadequate pain relief due to the pogrom against chronic pain doctors and their patients. It's mostly about the money, however much the anti-opiate group wants to claim the moral high-ground. The lies and misinformation from those working against opiates has been despicable. Claims by [name redacted] that people shouldn't need opiates because their endorphins should be enough are pure hogwash. NSAIDS at high doses damage peoples kidneys. Insurance companies didn't want to pay for pain prescriptions. Politicians didn't want to pay for pain prescriptions and they wanted the money insurance companies were paying to lobby for more efforts to destroy the pain management industry. The [name redacted] family had really deep pockets and our politicians are still working to get their hands on more of it. I knew the [name redacted] greed would end badly when they were raising the price of Oxycontin by over a 100% per year often. It was disgraceful but greedy people are not uncommon. Greedy politicians can really ruin your life though. I would imagine most of them get plenty of pain meds when they need them. The sadistic nature of those holier than though folks is really difficult to tolerate. When they can't eat or sleep because the pain is so awful, they might see what they have done. Probably not though, because people can rationalize anything, as evidenced by Trump supporters. We have turned our medical professionals into people who care more for money than anything. And many don't care much about patients at all. How was it that they so easily assisted the medical boards and DEA in dismantling the pain management industry. They were so frightened of drawing the attention of the regulators that they gladly threw patients under the bus. So much for the Hippocratic oath.<br/>I just hope there is some semblance of humanity left in these guidelines so that individualized patient care isn't lost entirely. I hope the pendulum swings back toward a less frightening future for those with painful conditions. I am very worried about my ability to get adequate pain relief. It seems arbitrary reduction in my meds is likely to be an ongoing issue. Why is it that politicians think they are better able to determine what is best for their constituents pain treatment than if their constituents work together with a pain management doctor? It's because they think that those who have the gold should be making all the rules and right and wrong shouldn't enter into it. Just like [name redacted] .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850090db	Anonymous	None	2022-04-11T12:16:38Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-bfza-ujqr	False	None	False	2022-04-12 06:40:29.697	[]
4516	CDC-2022-0024-4522	https://api.regulations.gov/v4/comments/CDC-2022-0024-4522	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been practicing in the field of pain medicine for the past 15 years. It has truly been a privilege to be able to change people's lives for the better with interventional procedures, medications, and lifestyle changes. I applaud the CDC for making a concerted effort with its updated guidelines to acknowledge that the human experience with pain is quite complex and there really is no "one size fits all" approach to pain management. <br/><br/>With regards to the ethics of prescribing opioids, it really is a different scenario when you inherit a patient that has been on high dose opioids for years versus someone who has just begun opioid therapy at a low dose. I think the 2016 guidelines have been helpful in giving clinicians pause on escalating doses of medications to levels that pose significant dangers including death to patients. That said, following these guidelines rigidly has increased suffering for people who have become used to functioning with opioid medications at higher doses. One must balance the risk of high dose opioids in these patients with the risk of decreased function, depression, and potentially suicide. This can be quite complex for practitioners, particularly in states where providers face scrutiny and lengthy, expensive state board investigations based on prescription drug monitoring data that gives limited information on each clinical scenario. <br/><br/>Opioids are often treated in public discussion across the board as all carrying the same risks for dependence, addiction, and death. This is not true. There are some molecules such as buprenorphine and tapentadol are classified as opioids, greatly relieve pain but carry lower risks for abuse and negative outcomes. Unfortunately, I have often prescribed these medications only to be told that they are not covered by insurance companies which will cover medications with much higher abuse potential. <br/><br/>Last, I was very disappointed in the paucity of information on interventional pain procedures. We have been able to reduce the opioid dosage on thousands of patients over the years with these procedures and improve their quality of life. With the introduction of some of the newer procedures for lumbar stenosis the arsenal we have to address traditional chronic pain issues is only expanding. I was disappointed that section of the guideline was addressed by a physician who was not a pain management specialist. Hopefully, the CDC will allow a voice to specialists in the field of pain management on this topic in future guidelines. It would give the guidelines more credibility. <br/><br/>With our aging population, there are millions of Americans that will need all of the help they can get with chronic pain to finish out their working careers. This will include medications, physical therapy, psychological intervention, interventional pain procedures, and surgery. We need to evaluate the risks versus the benefits of all of these modalities for each individual patient and tailor the treatment to him or her that is most appropriate. <br/><br/>J[name redacted] MD<br/>[health facility name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeremy	None	None	090000648500953a	Scarlett	None	2022-04-11T12:17:47Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Scarlett, Jeremy	l1s-cmez-zqu5	False	None	False	2022-04-12 06:40:29.915	[]
4517	CDC-2022-0024-4523	https://api.regulations.gov/v4/comments/CDC-2022-0024-4523	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[Docket No. CDC–2022–0024]<br/>Proposed 2022 CDC Clinical Practice<br/>Guideline for Prescribing Opioids<br/>AGENCY: Centers for Disease Control and<br/>Prevention (CDC), Department of Health<br/>and Human Services (HHS).<br/>ACTION: Notice with comment period.<br/><br/>Opioids has been a major problem in the United States since the 90’s, in other words, we have been dealing with this epidemic for well over 30 years. It is absurd that until this day in age we haven’t had a solution to fix this addiction problem and it is a shame that we’ve had a couple of waves and we are still talking about this. Hhs.gov stated that only in the year 2019 there were about 71 thousand deaths of overdose and over 10 million of misusage (Assistant Secretary of Public Affairs (ASPA). (n.d.). Now, is it the patient’s fault from requesting something strong? Is it the practitioner’s fault for prescribing knowing the repercussions of this drug? Or is it the manufacturer fault for pushing sales and making or using the active addictive ingredient? <br/>It has been years since the CDC and other entities has said that they will reassess or reconsider or even come up with something that could decrease this epidemic but to my research, it looks like things have not been delivered. <br/>My suggestion is, get rid of it. There are other methods as stated in the proposal that could easily be implemented. There is already opioid addiction treatment which falls under drug addiction, and there are other pain killers that are not opioids. <br/>There has been initials trials and research, but more research needs to be done, the results has been consistent for the following quote. “Trials identified subsequent to the earlier report largely support previous findings—namely that exercise, multidisciplinary rehabilitation, acupuncture, CBT, mindfulness practices, massage, and mind-body practices most consistently improve function and/or pain beyond the course of therapy for specific chronic pain conditions.” ([name redacted] (2020). <br/>We already know the problem, let’s consider getting rid of it instead of reinventing other similar drugs. Invest in noninvasive treatments that will work better, permanent, and effectively instead of covering the pain with opioids temporarily, just so they can request for more.<br/><br/>Assistant Secretary of Public Affairs (ASPA). (n.d.). What is the U.S. opioid epidemic? HHS.gov. Retrieved April 9, 2022, from https://www.hhs.gov/opioids/about-the-epidemic/index.html <br/>[names redacted] (2020). Noninvasive nonpharmacological treatment for chronic pain: A systematic review update.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angela	None	None	0900006485009553	Espinal	None	2022-04-11T12:18:47Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Espinal, Angela	l1s-d6nl-rxab	False	None	False	2022-04-12 06:40:30.136	[]
4518	CDC-2022-0024-4524	https://api.regulations.gov/v4/comments/CDC-2022-0024-4524	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not tie our doctor’s hands when it comes to treating those of us who live in chronic pain. They have gone to school for many years to understand what we are going through and how to help us. Most doctors try everything imaginable before writing a script for pain medication. I have had more needles jabbed in my head, neck and back than most people get shots in a lifetime. My chronic back and neck pain started when I was in my early 30’s. At this time I was riding children and was willing to go through anything necessary to be ABLE to be there for my children. At age 40, ALL nerve blocks and pain/steroid injections STOPPED giving me any pain relief. At this point, I was sent into pain management for prescription medication. I am 5 years into that. The meds do provide enough pain relief for me to get a few hours sleep. Some people are really in severe chronic pain. Most of us do not take these meds for the high, the thrill or whatever you may think. I wish every person who is trying to limit pain medication could live just one week in my body and feel all the pain that I must live with. You do not know anything about pain until you are up, sitting on your toilet, crying in pain in the middle of the night, because you absolutely can not sleep when you are in this much pain, but at the same time you 1. Do not want to awaken your family members who HAVE to function the next day and 2. Don’t want to see the pain and concern on your spouses face, knowing they love you, but there is absolutely NOTHING they can do to help you. <br/>I beg of you, please let our doctors make the decisions when it comes to our health. THEY are the ones with YEARS of education and experience dealing with pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kristie	None	None	0900006485009554	Truett	None	2022-04-11T12:19:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Truett, Kristie	l1s-d6us-hkcr	False	None	False	2022-04-12 06:40:30.361	[]
4519	CDC-2022-0024-4525	https://api.regulations.gov/v4/comments/CDC-2022-0024-4525	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your guidelines, both past and future, are an abysmal failure. Written prescriptions for opioids has decreased by 42% since 2012 with the biggest decrease being after 2016. This has left nearly 2000 HCP indicted and too frequently incarcerated, and millions of patients being tortured by uncontrollable pain. The attack on HCP has become tyrannical and your guidelines fueled the ammunition of the DEA/DOJ against the medical community. Meanwhile, overdose deaths are at an all time high, killing over 100,000 people in the past year alone. How long before you admit not only your failure but your inhumane harm? What you have done and are doing, is causing harm to legitimate pain patients, harm to the medical community and harm to all people living in America. You are restricting legitimate pain patients from being prescribed the very medications that have successfully controlled their pain for months, if not years, leaving then to have an unbearable, tortured life unless they resort to the street drugs that are responsible for killing 100,000 people living in the US. The best answer to our opiate “crisis” is not further decreasing legitimate pain medications for those who need them. The best answer is to end the prohibition and legalize all drugs while making MAT available to all of the 1% of our population who are addicted. Stop your nonsense. Stop believing that doing the same thing again will lead to a different result which defines insanity. Stand up to our very corrupt government and speak the truth to them. Your guidelines will escalate the attack on HCP by the DEA/DOJ which means no HCP will be willing to write any prescriptions for chronic pain medications, the most effective of which are opiates. This will leave millions of fellow Americans including our veterans with no means to control their pain- a life of torture which unfortunately too often leads to suicide. Imposing your guidelines will do nothing to reduce overdose deaths either though it will undoubtedly increase the suicide rates. I’m sure you know that.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009580	Anonymous	None	2022-04-11T12:19:36Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-e6jm-tcbo	False	None	False	2022-04-12 06:40:30.581	[]
4520	CDC-2022-0024-4526	https://api.regulations.gov/v4/comments/CDC-2022-0024-4526	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted], I have been seeing the same pain dr. for about 7 years. Before her I was with my last Dr. for 10 years. I only switched because I lost my insurance and she would let me pay out of pocket. <br/><br/>Before all the new guide lines I was on a mix of Long and short acing. I was doing great. I was on a regiment of meds that actually helped. Then I got pregnant and all the new guild lines were set and so I can't get the meds I need to function on a daily basis. I get just enough SHORT acting to not be in pain all day HOWEVER I can't do ANYTHING! If I do anything more then sit on my couch I'm in so much pain I can't get ahead of it unless I take more then I am supposed to and if I do that, then I run out early & I cant do that or I get sick in withdrawals. <br/><br/>I can't even take my son to the arcade unless my husband/his dad comes with us so that I can sit down 10 minutes in to being there. Not being able to function like a normal person is taking its toll on the relationship with my son.<br/> <br/>If i were able to be on 1-2 long acting a day plus my break threw short acting I would be able to live a normal life at 35. Instead I live the life of a 80 year old women who can't do ANYTHING or i am in agony for DAYS!! I can't work & its SO hard to get on disability. I'm not trying to get more as a drug addict. I just want to be able to function like a normal 35 year old mom. But because of the guidelines, I can't. <br/><br/>People who don't love in pain, don't understand what a struggle it is EVERYDAY to just get out of bed because of the pain. It hurts to try and move just 1 inch closer to the edge of the bed. then I have to make my son breakfast. That is just as painful standing in the kitchen because standing for mote then 3-5 minutes puts me in more pain then I can even begin to explain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	shelly	None	None	090000648500958a	Brewer-Bissell	None	2022-04-11T12:20:29Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Brewer-Bissell, shelly	l1s-eb0z-awpy	False	None	False	2022-04-12 06:40:30.798	[]
4521	CDC-2022-0024-4527	https://api.regulations.gov/v4/comments/CDC-2022-0024-4527	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	First of all,how could any of you so called "experts" on pain that are having these mtgs.to decide how to manage pain with opiates truly know what a person who has chronic pain know what it's like to write yet another guideline for physicians. No one person knows what it's like to suffer their own complex type of pain.And we need not judge them and call everyone addicts.How does anyone truly know what it takes to stop the throbbing of a fractured hip, disc herniations.incessant migraines, or ongoing pain from arthritis/Ra.<br/>Granted, there are the nsaids, aspirins and Tylenol of life,but who wants to continually endure the bleeding stomach that comes from the first two ripping your gut open,not to mention emergency surgery for perforations from nsaids.<br/>Yes there are those options of epidurals and physical therapy, but when that doesn't work,then the only option are opiates. Doctors need to use their best judgement in prescribing for those with chronic paine especially for the elderly who are riddled with back troubles not to mention hip fractures from osteoporosis and persistent arthritis.<br/>So I am very pleased after watching my sister suffering from ulcerations of the legs chronic back pain and cellulitis that there are opiates to help her sleep. She certainly didn't plan on her latter years to suffer with all of this and be bedridden for 7 years now, unable to walk from looking like a rottweiler chewed on her legs.So in making the last draft to accomodate patients it should be of everyone's concern to alleviate and help those that suffer have see quality of life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009591	Anonymous	None	2022-04-11T12:21:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-edyp-qph8	False	None	False	2022-04-12 06:40:31.033	[]
4522	CDC-2022-0024-4528	https://api.regulations.gov/v4/comments/CDC-2022-0024-4528	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain for almost 3 decades. During that time, I have always taken medication prescribed as it was prescribed. I have tried or attempted to try pretty much everything my current pain doctor has suggested. I've done everything with the exception of a stimulator surgically implanted in/on my spine. I've had two separate injections which provided zero relief and cause extremely high blood sugars requiring an Emergency Room visit after each injection. While my initial medication was in my opinion riduculous (Oxycontin at what I considered a high dose. I believe they were 10s) I refused and the physician changed the prescription to a Loratab 10 4x a day. As with most medication, after a while, you need more to control the pain. The doctor then added Fentanyl to the regime. From there about 10 years ago or so, the practice was a 25mg Fentanyl patch changed every 3 days along with a generic percoset 10, and a muscle relaxer. When my doctor became unwilling to provide what was working because of the initial law, things started to go downhill. My doctor at that point lowered the percoset to 7.5s. At the appointment before the last he switche me to loratab 7.5s which did less than the percoset 7.5s and I was having trouble moving. Walking became a chore. I could no longer do the things I normally could. Seriously considered requesting a home health aide to help with laundry, cooking, cleaning. The last appointment, we did switch my meds to Fentanyl patch changed every 3 days and Percoset 5s. My daughter is now looking for a walker to make it so I am at least a little bit mobile. There is little pain relief. Not even enough to take the edge off. If things don't change, I believe I will be in a wheelchair relying on someone else to take care of my most personal needs. I will be regulated to staying in the house going nowhere but the doctors. I am terrified, both of the pain and the seclusion that will come of my needs not being met medically. <br/><br/>I take my medications with a prayer. Praying to God that this will stop soon. I'm a good person. I don't use the meds incorrectly. I don't sell them. I'm writing this on the small chance that someone in charge will read it and will consider the outcome of the choices made. Please don't let me continue to live like this.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	0900006485009592	Ryan	None	2022-04-11T12:21:40Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Ryan, Barbara	l1s-efw8-wxbo	False	None	False	2022-04-12 06:40:31.256	[]
4523	CDC-2022-0024-4529	https://api.regulations.gov/v4/comments/CDC-2022-0024-4529	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Like so many others who are suffering from chronic pain at the cost of our government and big pharma who are now pushing other compound drugs for pain pumps and stimulators that don’t help those of us who have multiple conditions that were caused from a simple surgery in my testicle that became abscess and had to be opened back up and then ended up getting Fourniers Gangrene which caused an emergency surgery and when I woke up I couldn’t believe at how much damage was done in less than 24hrs. I lost a testicle, a large area of my left groin area including some areas of my penis and the pudendal nerve is damaged, sciatica nerve damage, and down my whole left leg which is discoloring and swells every so often. I’m always in a few types of pain and I’m now disabled with only Medicaid which I can’t find many Drs to take and all the ones who do I have to drive at least an hour up to 4 hours now as I keep expanding my circle of Drs who keep saying they can’t help and since my damage crosses into several specialties, it’s an easy excuse for one specialist to say I need to see another one, to where none of my Drs even help try to locate Drs for me anymore. My primary told me to call the news and see if they’ll do a report like that is what I need. <br/>I was on meds until the laws started changing around 2019 and had Drs flat out lying to me saying “ the new laws say I can’t write any opiates…..” and other lies to where I had to call the DEA who sent me to Floridas website that listed the actual laws and told to print the sheet out and give to the Drs and I did many. <br/>I’m a grown man and they are Drs who took oaths and lied to my face. I can handle the truth, don’t lie to me. <br/>But I did end up having to get a pain pump implant and it hasn’t helped and imaging was done that shows the catheter isn’t near the pudendal nerve and that’s why I’m feeling no relief and there’s a needle under the pump also. This was discovered 10/2020 and I still can’t find any type of dr to adjust the catheter and the pain is only getting worse as is my health since I live in bed 90% of the time and the simplest chore feels like I’m going to die. But I’ve gained a lot of weight, my blood pressure is high and on 2 meds for it, my cholesterol is bad and on meds for it, my liver numbers are in the 90’s and none of the images show why, I’m on meds for it, my kidneys are starting to hurt me worse and I’m to see a dr about them, I also have a hernia, scar tissue, and swollen lymph node in my left groin area which hurts me so bad. <br/>I don’t sleep, I do doze here and there and take naps. Every 3-4 weeks I’ll just crash and get a good 5 hour sleep and then I’m woke by pains, cramps, spasms. I’ve never cried so much and have only been to the hospitals 3 times and one told me not to come back over this and the other told me they can’t help, so I just cry and wait until I can administer a bolus and take any muscle relaxer which they stopped writing. I don’t think I’ll make it through this year and all I think about is dying in my sleep. I’m afraid to attempt suicide, but I did look into a few states that have laws passed called Death with Dignity, but the diagnoses has to be terminal and then you get a RX and the pharmacy gives you meds that you take at home and I guess fall asleep and all the pain is gone forever. <br/>I’ve already been disconnecting with my family and friends the past couple years in hopes that when I do go it won’t hurt them as bad as if we were as close as we used to be just a few years ago. <br/>I used to be close and call my sisters daily and visit often. Outdoors and traveling around the country and able to build my dream B&B in south Florida and almost got to see it open, but then it all changed due to a blood clot removal going wrong and having 16 surgeries in a 5 month window catching a gangrene that if left alone one more day would have killed me. <br/>I think that might’ve been best overall and at least I wouldn’t be suffering and my family could’ve possibly sued the surgeon and got to move into the 6 bed/bath B&B and lived it up in paradise. <br/>Attached are graphic pics after the gangrene was removed and I had over 40 titanium sutures that were in 3 months and a few ripped out because they were pulling my penis so he just took them all out early. I never thought I’d experience orgasms that cause me to cry, but over time I still have to tend to that although it’s less and less. <br/>I just know this can be managed because I had a shot that gave zero pain for 3 hours before I lost my insurance and became disabled. I miss having a life, and I’ve struggled so hard these past 4yrs, and just turned 40. This is as far as I’ll make it if someone don’t help somehow. I’m tired of everyone apologizing and saying at least I’m alive like that helps. This ain’t a life to have. To get fat in bed as I feel my body failing me. Addressing my pain will address the rest.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Russell	None	None	0900006485009593	Bowles	None	2022-04-11T12:22:36Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Bowles, Russell	l1s-ehna-kwdb	False	None	False	2022-04-12 06:40:31.472	[]
4524	CDC-2022-0024-4530	https://api.regulations.gov/v4/comments/CDC-2022-0024-4530	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 55 year old woman who has experienced the pain caused by people addicted to opiods both prescribed and later obtaining illegally. I have worked in legal field and experienced many clients who have become addictive to pain medication. I am not a doctor. I have personally lost everything due to my son and daughter in laws addiction and then my granddaughter being born addicted for which I cared and raised for 14 months and left my career to care for her. On the other end I reside with my friend and her boyfriend who has almost overdosed multiple times due to his addiction to prescribed opiods. He is 60 years old and left employment after being fired. The family suffers as they continue to get them prescribed. My friends boyfriend had back surgery years ago and continued receiving pain meds without any continued therapy. I can only state I see him doing home repairs on side, sitting at computer all day never getting up due to pain or having to lie down throughout day due to pain. Additionally he drinks every day. I am afraid he will die and the family will find pills when he runs out because he becomes unbearable due to withdrawal. The sad thing is I called his doctor following episode she thought he died due to overdose. He continues to get them prescribed. Pain medicine following surgery with no continued Physical therapy or new pain therapy leads to continued reliance on these medicines. They are only meant for short term. So many families pick up pieces and hide or enable (which I did). I did go to many programs to help me see and understand my faults. As communities struggle, we must stop them from being prescribed too much. Cancer and life ailing treatment are closely monitored. I see need for abuse extremely sad and crimes are lessened for drug and alcohol when they should be worse because it should be jail or treatment. Special jails for recovery and programs to lead lives to let them become successful. More help to children born addicted. I see hospitals limit or deny pain meds and that is wonderful. I can say my son became addicted following hernia operation at 16. That was introduction. Finally, he and family are doing well but continue recovery every day. My experience has been over prescribing and continued prescribing. Everyone got rich by these drugs and now its time for them to accept the liability if they continue prescribing. I plead to you to limit doctors prescribing and family doctors should not be able to prescribe with continued therapy by patient. Checking pain meds randomly or seeing patient before just calling in scripts. Check bloid levels to be certain they are not abusing or mixing if they prescribe. Also, pharmacy should also listen if someone living in residence advising of abuse. Pharmacy says if doctor prescribes they fill. I tried to help without putting myself at risk to help because it is easier to let someone abuse drugs when they are in denial or no one wants to confront person addicted. I am a pennsylvania resident. I pray for change in limit or removal of these drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anita	None	None	09000064850095f4	Arndt	None	2022-04-11T12:23:23Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Arndt, Anita	l1s-ffnh-8vxf	False	None	False	2022-04-12 06:40:31.698	[]
4525	CDC-2022-0024-4531	https://api.regulations.gov/v4/comments/CDC-2022-0024-4531	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC:<br/><br/>In addition to the despondence and difficulty of living with chronic pain, there is also the danger of heart problems. It’s now been shown that the heart can be affected by intense pain. Long term chronic pain can produce severe stress and anxiety, which in turn can elevate blood pressure and pulse rate. <br/><br/>I had a heart attack four months into my forced rapid taper in 2017, after your revised guidelines on opiates made it impossible to continue on the level of pain medications that had been helping me function. I had no prior heart problems. The most common causes of pain are spinal disorders, arthritis, and headaches. I live with all three, plus fibromyalgia and many more conditions. "During intense pain there is a release of adrenalin which elevates the heart rate and blood pressure. In some chronic pain patients {like myself} long-term pain can produce chronic tachycardia ~ a pulse rate greater than 100 heart beats per minute.”(ColoradoPainCare) This is apparently commonly found among severe fibromyalgia pain patients. My pulse rate now stays at about 130, which is way too high. A recent Holter heart monitor showed my heart rate now rarely goes below 100 bpm. An increased heart rate over a sustained period of time can damage the heart leading to cardiac arrest, stroke or death. <br/><br/>So who do I thank or blame for this, and what now? Do I continue to live in fear of another heart attack, or a stroke, more pain, no help? Will I ever be able to increase the pain medication that almost makes my life tolerable? No one even listens anymore. My mantra has become “nobody listens; nobody cares”. Isn’t that sad?! Chronic pain is defined as pain lasting for more than three months. Try more than a third of a century, close to half of my life. I often wonder why I even try to stay here. Is it worth waiting it out to see if I can catch a fleeting moment of some quality of life?<br/><br/>Please do the right thing and change your guidelines to respect the needs of both chronic pain patients and their physicians.<br/><br/>Thank you,<br/><br/>[name redacted ]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006485009646	Lyford	None	2022-04-11T12:24:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Lyford, Nancy	l1s-gm34-e9y9	False	None	False	2022-04-12 06:40:31.918	[]
4526	CDC-2022-0024-4532	https://api.regulations.gov/v4/comments/CDC-2022-0024-4532	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The opioid prescribing guidelines are creating a much larger disabled community by removing legal access to opioid pain medication and it’s contributing to the opioid crisis. Cutting people off and removing access to legal opioid medications is driving them to search for medication on the streets. It’s been reported that one of a the reason’s why people turned to illegal drugs (heroin, fentanyl & fake pills) in the first place is when doctors stopped writing opioid prescriptions. It’s obvious why there was a sharp opioid overdose increase in 2021; surely the CDC understands as well. Overdoses can’t be blamed entirely on the pandemic. This is history repeating itself. The only difference is the current wave of overdoses aren’t addicts looking for a high, a good feeling. No, these are medical patient’s with legitimate pain issues searching for pain relief. For some reason there are medical providers who believe if opioid medication is reduced the pain condition will go away. That is a ridiculous way of thinking. The 90 MME and 50 MME need to be removed from the opioid guidelines and doctors need to be allowed to prescribe opioid medication to pain patients when required, especially chronic pain patients who have been on long term opioid therapy. For those pain patients who have lost access, their access to opioid medications needs to be reinstated. All without the threat of DEA. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	T.	None	None	0900006485009653	Tate	None	2022-04-11T12:25:07Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Tate, T.	l1s-gslt-39hj	False	None	False	2022-04-12 06:40:32.133	[]
4527	CDC-2022-0024-4533	https://api.regulations.gov/v4/comments/CDC-2022-0024-4533	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on pain medication for 16 years, after nearly being crushed to death in a horrific vehicle accident. But prior to taking those meds on a consistent basis, I tried all the options one could try, including all forms of injections, acupuncture, other types of medication, consulting surgeons, many months of physical therapy, etc. When there was nothing left to try, I was referred to a pain clinic. There, I finally found enough relief from pain through the use of opiates to have a somewhat normal life. When the strict guidelines were put out by the CDC in 2016, I tried to tell my provider at the time that they were merely guidelines, not laws. His answer to that was that their clinic would stand out and likely would be looked at or targeted. Because of that fear, my inexperienced physician put me through the horrible experience of withdrawals by immediately stopping my medication and exchanging it for another. I was then subsequently released from that clinic for voicing my displeasure and objections. Now that the CDC has realized the 2016 guidelines were too far reaching, many providers still remain reluctant about prescribing anything over the 90 MME. They are still trying to group all patients into that number regardless of each persons unique situation; my provider included. This has caused me to be extremely anxious and depressed, not to mention, in much more pain. So unless the CDC makes it abundantly and definitively clear that each situation is unique, should be mutually decided upon between both doctor and patient, and that it is just as deadly to deny a pain patient the medication they need as it is to overprescribe, my fear is that nothing will change. I do so much appreciate the CDC allowing this public forum to give a voice to the many pain patients throughout the country. <br/><span style='padding-left: 30px'></span><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009658	Anonymous	None	2022-04-11T12:25:35Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-gw1y-fw1p	False	None	False	2022-04-12 06:40:32.351	[]
4528	CDC-2022-0024-4534	https://api.regulations.gov/v4/comments/CDC-2022-0024-4534	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>My name is [name redacted] <br/><br/>I have suffered with RLS for 18 years. I was diagnosed with RLS in 2004. My doctor prescribed numerous FDA approved medications for RLS over a 14 year period. None of them worked for me. I was miserable because I didn’t sleep well and I also struggled with restless legs during the day, so sitting for long periods was impossible. Riding in a car for more than an hour became impossible. In 2018 I read an article on RLS.org that claimed doctors were successfully treating restless legs with opioids. I was skeptical about using opioids because of the addiction problems. I contacted one of the doctors listed on the RLS.org website; [name redacted], MD PhD at Johns Hopkins Hospital. At my first appointment on August 18, 2018, Dr [name redacted] and I decided to try Oxycodone 5mg to treat my RLS. To my surprise, it worked so well! I could finally get a good night sleep and go on long car rides. My quality of life improved so much! I thank God every day for this medication!<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Christy	None	None	090000648500966a	Millard	None	2022-04-11T12:26:32Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Millard, Christy	l1s-hchd-3fsq	False	None	False	2022-04-12 06:40:32.566	[]
4529	CDC-2022-0024-4535	https://api.regulations.gov/v4/comments/CDC-2022-0024-4535	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The MMEs are unscientific, harmful and punitive. Show me the blind studies, which can't be done because there are none.After a forced, imposed taper, I then asked for a steady, over time taper. I figured being in control and knowing what was to come was better than the anxiety of not knowing. I have a complicated migraine disorder that steals an average of 2 weeks of my month since 1968. It has been a struggle, to. say the least. It can come on at any time, affect various body systems; digestive, nervous, muscular, etc.I tried EVERY known remedy, to name a few of the 3 pages:magnesium, exercises, 2 surgeries, 1 MRI, biofeedback, psychologist,diets, geographic moves to different climates, all to no avail. I've taken epilepsy drugs, which had an awful effect. I was a lab rat. Triptans and Peptide disruptors help but it's not enough and the dosage is limited, so there's breakthrough pain, which opioids ameliorate effectively. I am much more mobile and effective taking 90mg. per day average, but that is NOT allowed. I'm below the 90mme, which doesn't really do the job. Now, neurologists want to jab injections into patients, which I'm not on board for doing. When the 5 yr. trial is over, I'll read the results. Being a test subject doesn't work for me. I'm a fully grown, well-read, highly educated and informed, retired professional. I prefer to make my own decisions with my doctor about what is effective for an enjoyable life. I don't need to be managed by a misguided attempt by the DEA to quell the illegal fentanyl crisis affecting teens and young adults. They need to talk to the cartel about that, oh wait, they're armed, criminals and dangerous. Pain patients and doctors are compliant, old and easy to shame, plus the DEA agents look effective by bullying the medically infirm and doctors, showing decreased use of opioids, meanwhile overdoses on illegal fentanyl in the young are going upward.As a 7th generation American taxpayer, I'm appalled that gov't agencies have become so lazy. SHAMEFUL! I'm OLD. There aren't any children in my home except me, but regardless, like a child, I'm required to stock Narcan. Shaming me and the rest of the chronic sufferers seems petty and cruel. This shaming and curtailing is ignorance and bullying at it's worst. Please respect patients who are older, at their wits end for relief and stop this shaming and nonsense.All of this information has been researched and can be verified by [name redacted] , and the Pain News Network.and The New York Times. Nobody wants be managed as if they are addicts. The CDC and DEA bear the shame of this crisis in the medical care of pain sufferers in the U.S..	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850091fd	Anonymous	None	2022-04-11T12:27:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-hf1k-oomj	False	None	False	2022-04-12 06:40:32.785	[]
4530	CDC-2022-0024-4536	https://api.regulations.gov/v4/comments/CDC-2022-0024-4536	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Current opioid guidelines have left patients like myself with no consistency in pain management. Doctor prescriptions of tramadol which has much worse withdrawal symptoms. Or pushing Gabapentin in extremely high doses which has negative effects on patients memory. I was prescribed Duloxetine or. Amitriptyline, but I couldn’t get ZTlido Lidocaine patches or other brands because they were deemed to expensive. So instead of clearly explaining how to use an opioid, and closely monitoring patients, Doctors push Psychotic drugs, and insurance companies won’t support simple lidocaine patches because they are more concerned with costs than patient health. Before the existing guidelines I was able to manage my pain with a conservative mix of Naproxen or Celebrex, taken with a 5mg/325mg opioid/Acetaminophen pill. I knew to limit the opioid to only very painful events or only 3 consecutive days. There was no high effect and I knew not to expect one. I also learned of Voltaren Gel and bought my own Lidocaine patches to alternate to help keep my body from getting use to a consistent amount of pain medication. This is called pain management. Until science discovers new and effective medicines to combat pain like antibiotics, there aren’t many choices for patients like myself. Especially since I’m sensitive to Meloxicam, and piroxicam, celebrex is the strongest I can tolerate. All the meds I have listed can be abused, denying the many based on potential abuse is not good patient centered medical care.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	0900006485009235	Peterson	None	2022-04-11T12:27:58Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Peterson, Stephen	l1s-i04d-6jk3	False	None	False	2022-04-12 06:40:33.006	[]
4531	CDC-2022-0024-4537	https://api.regulations.gov/v4/comments/CDC-2022-0024-4537	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 73 year old disabled RN with severe cervical and thoracic spinal stenosis, and osteoarthritis in my lumbar spine. <br/>I also suffer from Fibromyalgia,Lyme,Sjögren’s,and Colitis. At age 13 I spent five months in a body cast after having eight thoracic vertebrae fused for scoliosisThe chronic pain in my neck and middle back from pressure upon nerve roots is excruciating and totally debilitating. <br/>Throughout my life I have chosen holistic medicine but no “natural” treatments touch my pain; neither do the CDC’s recommended alternatives for pain treatment ,such as Tylenol and NSAIDs,nor have my weekly acupuncture or physical therapy, massage,or Trager helped.The ONLY treatment that relieves my terrible pain is opioid medication.<br/>I used to be a teacher of Tai Chi for Arthritis as endorsed by the American Arthritis Association, and also took water exercise classes and loved to take walks, garden with my husband, play with our grandchildren,and play music. But since I have been drastically tapered down to only 80 MMEs I can no longer even get a night’s sleep without waking up in pain. Trying to get pain relief has become the focus of my existence, and whereas I used to be a well respected RN in my community, I have felt humiliated and judged by the present medical establishment. Added to the loss of adequate opioid prescribing , I’ve been on a forced tapering to zero of Klonopin, which helped my CPTSD and muscle spasms both , without any alternative (yes I have been in talk therapy off and on for decades). This has led to frequent nightmares;reliving past traumas; and panic attacks plus what feels like electric shocks in my feet and legs.<br/>I cannot see how the CDC could possibly claim that these draconian tapers are helping patients who really need opioid prescriptions. I was started on them in 1994 by an orthopedic surgeon, and until the 2016 guidelines I enjoyed a very active professional and private life . Now I am bedridden. Because my level of 24/7 pain has forced me to become isolated from most of my old friends and family (who live several hours away), I only have my elderly husband to help me and he has his own health problems. I live in fear now of what will happen as I continue to deteriorate and become too much of a burden to everyone. A nursing home where I’ll be warehoused and beg to die while all our hard earned resources are lost ? I already think of suicide often but I fear considering it). Now my pain management doctor says the goal is to get me to an even lower dose of only 50 MMEs! I cannot tolerate such pain!<br/>I don’t think that CDC has a place in taking over a doctor’s role . I am in too much pain,depression,and fatigue to sit up and write anymore now.It will take a lot to fix the severe damage already done, and these new guidelines will not empower doctors and pharmacists to stop being terrified of losing their licenses and/or going to prison for treating us pain patients humanely.<br/>What happened to “First do no harm”?<br/>Even the AMA and other respected medical bodies have spoken out against the restrictions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Francisca	None	None	09000064850092d6	Scofield	None	2022-04-11T12:29:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Scofield, Francisca	l1s-l2ny-wpwr	False	None	False	2022-04-12 06:40:33.258	[]
4532	CDC-2022-0024-4538	https://api.regulations.gov/v4/comments/CDC-2022-0024-4538	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RESCIND all OPIATE GUIDELINES. THEY CANNOT BE FIXED, PERIOD.<br/><br/>During checkout for my last spinal fusion surgery, I brought my DNA paperwork it to the hospitalist’s attention. I am an ultra-rapid metabolizer of several drug classes, not just opiates. In my case, this means my body burns through a dose too rapidly, leaving my system before the next dose is due. There were lots of hours that my pain was not covered and the muscle spasms made every worse. After my return home, I involuntarily screamed out loud with every movement, about 2 dozen times per day. This had never happened before, and this was my sixth spine surgery. My surgeon had gone on vacation and his PA refused to help me, treating me EXACTLY as did the hospitalist.<br/><br/>Both the hospitalist and my surgeon’s PA gave me nearly identical anti-opioid speeches, including “I DON’T CARE about your genetic circumstances, that’s all you’re getting.” Medical providers say this over and over again: THEY DON'T CARE.<br/><br/>With chronic and extreme pain we don’t expect to be pain-free; we are not naive. We just want to be able to leave our beds and FUNCTION. We want to be useful and pull our own weight. Our disabilities were not our choice. Many, in fact, are due to birth defects and other genetic factors, as well as medical mistreatment.<br/><br/>One of the profound results of a home-bound, bedridden, pain-filled life is not only the isolation in general and the limitations of such a life, is what I am missing with my family. This especially affects my relationship with my grandchildren. I cannot sit on the floor to play with them; I cannot stand at the kitchen counter to bake cookies with them; I cannot sit at the table to do craft projects with them. I cannot drive to go visit them. I cannot lift them. It’s an extreme struggle to attend their school events. I knew long ago that my grandparenting would have limitations, but I never thought my ability to function at all due to under-treatment would reach such a low level. All because of deliberate discrimination against a class of medication. I had thought that discrimination against the disabled was illegal, but response to the original CDC 2016 guidelines has proven otherwise. These guidelines have produced more suffering and more deaths since their adoption, and the number of deaths due to ILLEGAL narcotic overdoses continues to skyrocket.<br/><br/>My primary sources of pain:<br/>Early Onset inherited Degenerative Disk Disease of the spine, along with sciatica, arthritis, bone spurs, ruptured disks, damage from spine procedures.<br/>Adhesive Arachnoiditis, caused by an epidural steroid injection, 2004, diagnosed 2012.<br/>RSD/CRPS (Reflex Sympathetic Dystrophy/Complex Regional Pain Syndrome) of both feet and lower left leg, diagnosed in 2017.<br/>Atypical Parkinson’s Disease; causes severe dystonia/muscle spasms/muscle spasticity, 2020<br/>6 spine surgeries (non-spine surgeries are not listed here):<br/>Lumbar laminectomies x2: 1990 and 1991<br/>Spinal Cord Stimulator Implant 2010<br/>Cervical spinal fusion, C4-C6 January 2013<br/>Lumbar spinal fusion, L4-S1 June 2013<br/>Spinal Cord Stimulator Explant 2014<br/>Lumbar spinal fusion extension with new hardware to include L3-S1 December 2019<br/><br/>The ONLY answer to both the 2016 and 2022 CDC opiate guidelines is to completely RESCIND them. The original guidelines cannot be fixed. The proposed guidelines will only create more prohibition and more suffering, harm, and deaths by medical mistreatment and/or suicide due to constant unrelieved pain. Did you think we wouldn't see the NEW proposed MME (built on junk science) of the much lower 50MME??? After rescinding both the current guidelines and the proposed changes, there needs to be a speedy reversal of all other legislation that is causing harm to pain patients. These are all Fruit of the Poisonous Tree [Principles of Sound Reasoning] and must be stopped. These further guidelines differ by state and have increased harm, both to pain patients and to the addiction community (different diseases, different treatments). Concurrent with rescinding and reversing, patients who have survived so far should have their appropriate medication returned to them without fear of retribution to either the patient or the provider.<br/><br/>The CDC itself should have been completely eliminated once their experiments on the Tuskegee Airmen were revealed. https://www.cdc.gov/tuskegee/timeline.htm<br/><br/>The CDC should NEVER have created these guidelines. Because AK was laughed at and refused by the FDA, [initials redacted] circled his wagons and later proposed these guidelines to the CDC, who unfortunately believed [initials redacted]. The CDC is for COMMUNICABLE diseases! People cannot catch addiction, so the CDC should not be involved.<br/><br/>Alcohol prohibition was an extreme failure and also caused an increase in deaths. Prohibition only causes harm and never help. RESCIND all OPIATE GUIDELINES. THEY CANNOT BE FIXED, PERIOD.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lauri	None	None	09000064850092d9	Nickel	None	2022-04-11T12:31:48Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Nickel, Lauri	l1s-krtg-ioqa	False	None	False	2022-04-12 06:40:33.480	[]
4533	CDC-2022-0024-4539	https://api.regulations.gov/v4/comments/CDC-2022-0024-4539	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been living with Psoriatic Arthritis for over 20 years. This is a progressive, degenerative disease that affects the skin and joints. In my case, it affects my feet, hands, tailbone and low spine the most. Over the past 20 years, my ability to function has slowly declined. I used to be a very athletic person who participated in many sports such as skiing, hiking, and running. I can no longer do any of those cherished hobbies. There are new medications that help autoimmune diseases, such as Humira and others, but despite those medications, pain has been a part of my daily life since this started.<br/><br/>I have been fortunate to have doctors who understand that pain control is as important as the medications that slow the progression of my disease. I have been on morphine daily for the past 17 years. During that time I have never requested an early refill, I have never gone to different doctors, I have never failed a urine drug test, I have never gone to different pharmacies. <br/><br/>I do not crave morphine and I don't get a high off it. It takes the edge off the constant pain I live with every day and allowed me to work in my career for many years. It allows me to do my chores, go grocery shopping, and do a few fun activities at times. If this prescription was taken from me, I would become bed-ridden due to pain. I would lose my appetite from severe pain, and I'm not sure where my life would go from there.<br/><br/>There are thousands of people like me who have conditions that cause chronic pain. We just want to function as much as we can. We don't abuse our meds, we take them so that we can work, go to school, take care of family, volunteer in the community. Not getting high, not abusing them. <br/><br/>Please remember that the decisions that are made will have a tangible impact on my life and others like me. We aren't on the news because we're just trying to live our lives. It doesn't make for dramatic news stories. But these medications are vital to our ability to function, they are not for fun, or optional. I would give anything to have my health back and to never need a pain medication again.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850092e8	Anonymous	None	2022-04-11T12:32:20Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-lg46-z592	False	None	False	2022-04-12 06:40:33.702	[]
4534	CDC-2022-0024-4540	https://api.regulations.gov/v4/comments/CDC-2022-0024-4540	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm presently 60 years old and suffer from arthritis, neuropathy, and degenerative disc disease. I have had multiple failed spine surgeries including two on my cervical spine in 2010 and 2012. The most recent surgeries relieved most of the pain radiating into my arm, but I still have chronic, debilitating headaches. My neck is no longer a good surgical option, so I have been in pain management. I tried all the conservative methods as well as injections to no avail and was subsequently placed on opioid therapy.<br/><br/>My pain has been well-managed with essentially the same dose for the last 10 years, and I’m able to have a reasonable quality of life and continue to work. Sometime during the course of my treatment, the country became faced with an opioid crisis. I found myself caught in the crosshairs even though I had nothing to do with it. Pain management physicians have come under greater scrutiny and been given more red tape to deal with while trying to help patients. I do agree that some doctors need to more closely monitor patients receiving opioid therapy, but this has been taken to the extreme.<br/><br/>Now, because many doctors are fearful about prescribing opioids, they have started forcing more patients to have injections and other procedures done. I think some may believe they are required to do those things before they can prescribe. Unfortunately, many realized that they also make more money doing these procedures than simply writing a prescription. And so, the nightmares of going through painful, unnecessary, and even dangerous procedures begins, just so a patient can continue the medication that works.<br/><br/>Your regulations are tying everyone’s hands. Physicians can’t practice in the patient’s best interest and patients are left with no option but to blindly try anything that’s offered. Someone who’s just had surgery or who has cancer pain is allowed relief, but we’re forced to keep our pain with no relief. I didn’t do anything to cause my pain anymore that another person caused themselves to get cancer. Patients with chronic pain are also quite vulnerable because we just want the pain to stop so we can play with our kids and go to work instead of being bitchy and sleep deprived all the time.<br/><br/>I was recently dismissed from my pain management doctor of these last 10 years over the phone, with no good reason given and no transfer of care. I did nothing wrong, and I was also never given a letter of dismissal as required by the Ohio Administrative Code. Now I’m faced with the daunting task of finding a new doctor. Without that letter, doctors tend to assume the worst about my dismissal; that I did something illegal. I have a very legitimate need, yet I’m being treated like an addict because of all the stigma surrounding opioid use.<br/><br/>The first pain management doctor I saw said he didn’t prescribe opioids. The next one I saw wanted to do epidural injections and “maybe try a spinal cord stimulator”; neither of these are FDA approved methods of treatment for my condition. I also received a very harsh lecture on the evils of opioids but was at least given a prescription for the time being as I was out of medication at that point. I felt like I’d made a deal with the devil as I accepted it. His office then called a few days later wanting money for an injection they said I was to schedule, even though I had explained that they don’t help, and I’ve had adverse reactions to them.<br/><br/>I’ll soon be seeing yet another doctor in hope of a better fit, but I’m afraid of trying any more after that for fear I’ll be labeled a “pill seeker”. These restrictions have caused patients like me to now live in fear as our quality of life is being regulated into non-existence, and I’m honestly beginning to understand why so many people have turned to the streets in search of relief. It’s all just become a tangled mess of pain, despair, and fear, with nowhere to turn and no one to trust.<br/><br/>As more pain management doctors close shop or scare away patients with inappropriate, expensive, and dangerous treatments, you will see an increase in deaths from street drugs from this new group. Patients need regulated and safely sourced medications. Medication that is needed to simply maintain some quality of life. As more patients get pushed to the streets for relief because it’s no longer attainable in a clinical setting, they will die. Others will simply no longer want a life filled with pain and may die at their own hand.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	H	None	None	09000064850092ed	B	None	2022-04-11T12:33:01Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from B, H	l1s-lhic-qb3u	False	None	False	2022-04-12 06:40:33.919	[]
4535	CDC-2022-0024-4541	https://api.regulations.gov/v4/comments/CDC-2022-0024-4541	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2016, 1 in 5000 people died from an overdose from any drug. ANY DRUG! Once evidence began to surface of discrepancies, some began to research it and found out that the CDC has used a ‘traditional method’ to calculate overdoses and that once it was calculated correctly it was discovered that the overdose deaths that had any type or amount of opioid, legal or illicit, was around 43,000; and without heroin and illicit fentanyl (but without regards to how it is obtained or what other drugs are found WITH the prescription medicines) the number is around 17,000(6). Then it was discovered that while there are an average of 6 substances in a toxicology report at autopsy, some of those deaths have been counted as 6 separate deaths. Shame on them for inflating those numbers and playing on people heart and purse strings and allowing everyone to continue using these numbers in order to place blame instead of correcting them! Do you think the media and policy makers have not been told about the drastic correction, of course they have been told, but they have chosen not to correct it because telling the American public that it is a crisis of epidemic proportions when the numbers have not changed in a century does not make for a good story or encourage outrage. So the truth is, 1 in 5,000 Americans die of ANY DRUG overdose, and around 1 in 20,000 Americans die from overdose of prescription pain medications with or without other substances (alcohol, other class of drugs, and on purpose to commit suicide due to pain).<br/><br/>Less than 1% of patients ever become addicted to their prescription pain medications despite the false narrative put for by anti-opioid litigation "experts" more like grifters affiliated with [organization name redacted] the FBI definition of a hate group.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850092f1	Anonymous	None	2022-04-11T12:34:21Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-ll0y-bmfl	False	None	False	2022-04-12 06:40:34.140	[]
4536	CDC-2022-0024-4542	https://api.regulations.gov/v4/comments/CDC-2022-0024-4542	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 57 year old female chronic pain patient with fibromyalgia and several other chronic illnesses. My life is very limited by these things. I’m homebound and I need help with basic personal care tasks. I've had episodes of pain so severe I could not walk. I’ve been reduced to crying and screaming and passing out from pain. I take 50 mg of tramadol 4 times daily as part of my chronic pain careplan. My pain management goal is to take just enough medication to be able to function at my current level while hopefully slowly rehabilitating myself. Previously I was in so much pain all the time that it was unbearable to do anything and I spiraled farther and farther downhill physically. I have been stable on my treatment plan for several years under the long term care of a PCP who recently left my health network. I have already had one PCP refuse to take me as a new patient because of my medication. <br/><br/>I understand the risks of taking opioid medications and I dislike taking them, but I have been closely monitored and am very careful with them. I also realize that doctors need to be very cautious with these medications and that addiction is a serious problem for many people. That does not mean that patients like me should be castigated, shamed, treated like criminals, and live with the possibility that I could be forced to live in agonizing pain again. My doctor used to give me a 6 month prescription with 5 30 day refills. This is still the legal prescribing level in my state according to 2 pharmacists. But since opioid addiction and overdose has become a huge issue, guidelines in my health network have become extremely tight. My doctor could only prescribe 1 30 day no refill supply at a time and I received an absolutely degrading letter from the network that restricted so many areas of my life not necessarily related to my medication. Then my insurance company started a policy where they would only fill 10 days at a time of my prescription which I could only order 1 day in advance. With Covid most pharmacies in my area are severely understaffed and it would usually take them 3-8 days to fill these prescriptions. The end result being that I got about 18 days of medication for a 30 day period. I was forced to tell the pharmacy to fill the full 30 days and pay out of pocket for 6 months. When my PCP tried to get authorization for 30 day prescriptions she was given the run-around and never did receive the promised documentation. Thankfully this decision has since been reversed, for now. I considered the 10 day policy to be discriminatory against people with disabilities. As a person who can’t drive I needed to send someone else 3 times as often to pick up a prescription in the middle of a pandemic. It took more time, work, resources and risk for everyone involved and left me without proper treatment.<br/><br/>Going forward my departing PCP was able to hand my case off to the lead doctor at her clinic and he has agreed to take over my treatment in the short run while things get sorted out. They are sending me to a pain specialist for a consult. I have since discovered that my health plan’s policy is that there are now more advanced alternative treatment techniques and they will not prescribe opioids for chronic pain. I had already tried these treatments before starting on tramadol - chiropractic, massage, myofascial release, neuromuscular technique, physical therapy, warm-water pool therapy, restorative yoga, acupuncture, reiki, bio-feedback, breath work, meditation, individual and group mental health therapy, and a chronic illness coaching/support group. While many of these modalities certainly are helpful, they are not enough alone. And unfortunately I can no longer do some of them as they are either contraindicated by other chronic conditions or beyond what I’m currently able to do. Also many of them cost $1000's out of pocket as insurance considers them non-medical. How can these things be both non-medical and the only acceptable, most advanced medical treatments at the same time?<br/><br/>I am always open to trying new treatments and want to take the least amount of medication necessary. No one would be more eager than me to take my tramadol to the nearest pharmacy for safe disposal and never see it again. But I have serious reservations about the upcoming pain consult. The scheduling nurse very rudely informed me out of the blue that they did not allow doctor-hopping and that all of the doctors were in agreement on the same approach to pain treatment. If this cookie cutter approach to medicine worked for me I wouldn’t need a pain specialist or be listed as "very high" complexity on my referral. If all of these doctors are automatically taking opioids completely off the table, how can they provide individualized, full spectrum medical care? The medical system is so rigid and sometimes downright abusive that sensible, rational, compassionate, solution-oriented, skilled treatment is very hard to find.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850092f2	Anonymous	None	2022-04-11T12:35:17Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-09T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-llb2-d2k9	False	None	False	2022-04-12 06:40:34.364	[]
4537	CDC-2022-0024-4543	https://api.regulations.gov/v4/comments/CDC-2022-0024-4543	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Ask any doctor, nurse, medical specialist, therapists for chronic pain patients and chronic pain patients themselves and you will receive a nearly unanimous response that the 2016 CDC Guidelines have caused cruel and unbelievable harm to millions of people. There is no patient who is as closely monitored as a chronic pain patient. Monthly appts for each refill, digital monitoring of any prescription, constant drug screening, detailed paperwork at all levels. And yet chronic pain patients are somehow the reason for an entire societal issue of drug crimes and addiction? Chronic pain patients are not addicts - they are in pain and therefore are dependent on opioids to live any quality of life. How those opioids affect the patient is individual - science knows this based on research and empirical evidence so the daily MME is deceitful and inhumane at this point. <br/>The CDC has been corrupted by big pharma companies who peddle Suboxone (not an analgesic for pain) or Intrathecal Pain Pumps as an alternative to oral opioids when oral opioids are absolutely more affective for pain and in most cases far more safer. <br/>Pain related prescriptions must be returned to the purview of the sacred relationship between doctor and patient. Pain must be returned as the 5th vital sign. Chronic pain patients must be given all viable options for treatment, especially the option that has worked fine for them for years, long term opioid treatment at whatever daily MME is effective. If the CDC, DEA and FDA are truly concerned about the “Opiate Crisis” then finding better rehabilitation services and social services should be prioritized. To scapegoat compliant and suffering chronic pain patients instead of addressing addiction due to illicit street drugs is corruption and cruelty combined. For shame CDC! <br/>There will be more suicides, injuries, suffering and desperation overdoses CAUSED by the guidelines if they are not immediately and fully revoked. I personally blacked out from pain due to lack of access to opioids and now have a “severe nerve compression” on my last MRI. I have always tested clean on my drug tests, pristine CURES report, always compliant, have a genetic incurable painful disease but your guideline prevents me from now getting the opioids I need to the point I blacked out and permanently injured myself. You CDC are harming people. Blood is on your hands and you have an opportunity to fix it. Do not waste anymore time. Have integrity. Revoke the 2016 guidelines on opioids. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009790	Anonymous	None	2022-04-11T12:36:38Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-rrg7-xxxv	False	None	False	2022-04-12 06:40:34.587	[]
4538	CDC-2022-0024-4544	https://api.regulations.gov/v4/comments/CDC-2022-0024-4544	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 75 year old woman who has suffered with Restless Leg Syndrome for about 20 years. I have been on 10 mg, low dose, Methadone for about 18 months and it is absolutely so necessary for me to control the horrible leg jumping and nerve agitation. I have been on many different drugs. Ropinerole, which is a drug for RLS served me well for about 13 years but eventually I was on a higher dose than is recommended and still having increasing problems. My doctor tried other things but it was not until I was finally placed on Methadone that I was able to have some peace and feel like I could live a normal life. It is so very important that you do not do anything that will make taking low dose opiates any more difficult than it is. My doctor only prescribes one month at a time, no automatic refills and I have random urine tests to be sure I am not doing other drugs, apparently. I am seen every three months just to monitor how I am doing on the Methadone. It has saved my sanity. Please, keep these vital, low dose opiates available to those with severe, uncontrolled Restless Leg Syndrome.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dale	None	None	0900006485009791	Talley	None	2022-04-11T12:36:53Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Talley, Dale	l1s-rrv0-dgtv	False	None	False	2022-04-12 06:40:34.844	[]
4539	CDC-2022-0024-4545	https://api.regulations.gov/v4/comments/CDC-2022-0024-4545	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	They could give us more free time in between visits its not an emerency. After 12 years of shots 7 times a year and less and less medicine ; I can't even make it through the procedure without help. I think we've really been tested to our limits. The fact is the pain is uncurable and the medicine has helped the most because it was the tried and true method and the substitutes have all caused trouble. I dont want to be punished for other people's mental health problems anymore.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009793	Anonymous	None	2022-04-11T12:37:05Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-ruil-n3oz	False	None	False	2022-04-12 06:40:35.080	[]
4540	CDC-2022-0024-4546	https://api.regulations.gov/v4/comments/CDC-2022-0024-4546	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Why are you sending these to hospitals promoting 50 mme is “safer.” As you know MME idea is non scientific and bias. It doesn’t take into acct metabolism and so many other issues. <br/><br/>I attached the pamphlet you’ve sent to hospitals. Hospitals are suppose to be exempt from these “guidelines.” Dying in a hospital with a painful disease/condition but you send this to a hospital warning them not to prescribe above 50mme! Why? So they can live in agony minutes longer? To prevent addiction in the afterlife? It’s so cruel! It’s appalling!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M	None	None	09000064850097a6	Lg	None	2022-04-11T12:37:47Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Lg , M	l1s-s2fr-vfzw	False	None	False	2022-04-12 06:40:35.302	[]
4541	CDC-2022-0024-4547	https://api.regulations.gov/v4/comments/CDC-2022-0024-4547	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am comnmenting mainly as to the wrongful expansion of the jurisdiction of the CDC into this matter that is even attempting to in any way advise on the prescription details of these pain medications. These pain medications do not in any way act to control disease spread nor are they curatives of any contagious disease, ergo the CDC should in no way be involved in guiding their use. <br/><br/>Furthermore I object to the oxymoronic attempted expansion of the legal authority of the CDC with this guidance and the claim that this guidance will not be used for legal purposes, as they already are for so many other matters which are just officially listed as recommendations but are enforced regularly with armed guards and police personnel. Please cease in these continued ever expanding overreaches of authority and return these decisions to the preview of individual medical teams and patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beth	None	None	09000064850097a8	Grundfest- Frigeri	None	2022-04-11T12:38:02Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Grundfest- Frigeri, Beth	l1s-sfhe-1ilw	False	None	False	2022-04-12 06:40:35.521	[]
4542	CDC-2022-0024-4548	https://api.regulations.gov/v4/comments/CDC-2022-0024-4548	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop trying to act like you understand pain. You did harm to the Lyme community and now to chronic pain patients. How about you just open your hearts and minds and realize there is more going on with people and they need help. Stop micro managing others lives. There will come a day you or a loved one will need help, but won't be able to get it if you go through with this. Have some compassion for human life and allow chronic pain patients the help they need to live and enjoy life. It is not your place to say how much medicine a patient needs. Not everyone needs the same amount or type. Realize everyone is different and opiods ate the only help for some.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850097b6	Anonymous	None	2022-04-11T12:38:13Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-t3ht-w76j	False	None	False	2022-04-12 06:40:35.738	[]
4543	CDC-2022-0024-4549	https://api.regulations.gov/v4/comments/CDC-2022-0024-4549	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to request the CDC to acknowledge the AMA’s criticism of the 2016 opioid guidelines as being incredibly harmful- and the many other doctor and scientist organizations who have spoken against it. I am asking that the unscientific and arbitrary daily MME not be capped but be returned to the discretion of the doctor and patient. I am asking that Pain be returned as the 5th vital sign. I am asking that age and class not be qualifiers for access to opiates. I am asking that stable and compliant chronic pain patients be treated with the basic human right of having access to life saving and life changing opioid medications. <br/> “Cruel and Inhumane” treatment is exactly what the CDC guidelines created. It forced doctors to choose between their license and the health of their chronic pain patients. It forces chronic pain patients between an unlivable life or relief through death or illicit drugs - something No One should be forced to think of by their own government. How I have not chosen the latter two is only a miracle but I do not blame the hundreds of thousands who have chosen it. <br/>Ehlers-Danlos Syndrome is incredibly painful and most drs are not well versed in it. If you insist on not revoking these guidelines fully then please include EDS (Ehlers-Danlos) and other “rare” or “rarely diagnosed” illnesses that are painful as exceptions to your “guidelines” which we all know are now state laws, insurance rules, social stigma, threats to licenses etc and not a “guideline” at all. Ehlers-Danlos is a genetic condition that causes a collagen defect - it is incurable at this time. One of the main diagnostic criteria is chronic and acute pain. I suffer from it daily. As do others in my family. Every one of us needs a different regimen of medication but we are now not allowed to have a choice about what we are putting in our own bodies for pain. Our drs do not have a choice either. Only a mysterious unscientific group across country can decide. It’s Kafka-esque, Orwellian. Corrupt honestly. <br/>Please return the decision making process of pain management to the sacred relationship between doctor and patient, without fear of punishment. <br/>CDC has a chance now to honor the chronic pain patients who chose suicide due to intractable pain because of your 2016 guidelines. CDC can prevent further death and suffering right now by doing what is best for the patients, doctors and families. Revoke this unscientific and absurdly cruel “guideline” in full and immediately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850097b8	Anonymous	None	2022-04-11T12:38:55Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-t6ta-fgog	False	None	False	2022-04-12 06:40:35.961	[]
4544	CDC-2022-0024-4550	https://api.regulations.gov/v4/comments/CDC-2022-0024-4550	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024<br/><br/>I am a former Registered Nurse who is appalled by what the CDC has done to pain patients. I've been an pain advocate for over 30yrs. Never would I have believed the torture Healthcare has been forced or bamboozled to do to patients. While many may critize the 5th vital sign, it finally gave pain patients a voice. It gave patients a voice AND more appropriate & compassionate pain management. Maybe that's why so many really didn’t like it? The better we control patients pain acutely, the less likely they'll develop chronic pain. <br/><br/>This is what I've seen since the 2016 CDC Guidelines came to be -<br/>Nurses (& other HCW) Crying because their pts in excruciating pain & they're often forbidden to provide appropriate pain relief. Too many facilities won't allow any intervention. Or the dosage is so meager it's not really worth receiving & doesn't help much.<br/><br/>Nurses & doctors are leaving/retiring - the stress is unbearable watching this - and this was way before covid.<br/><br/>Younger undertreated & untreated pts in uncontrolled pain are dying of associated issues ie heart attacks & CVA's, again pre-covid. <br/><br/>Under/untreated pts in uncontrolled pain are talking about taking their own lives because they can't stand the pain one more minute or one second longer. Too many are succeeding at suicide. <br/><br/>Outcomes aren't near as good post surgical recovery when pts are forced to do therapy with uncontrolled pain levels.<br/><br/>Illicit OD deaths have skyrocketed, but rx med OD's have remained steady & low. <br/><br/>Pain patients are suffering across the board - this is wrong on so many levels. None of us took an oath to do this harm. <br/><br/>New draft guidelines recommendations- <br/>You had a workgroup review your work , then almost completely ignored their recommendations - use their recommendations. Ex 7/12 CDC recommendations are still a category A , against your OWG & studies provided. <br/><br/>Dr [name redacted] has serious conflicts of interest that would not be tolerated by the science/medical community anywhere else yet he's an author of said revision- Any study or writing he was involved with needs completely removed & investigated. Also investigated by a Congressional Hearing. <br/><br/>"Risk" is mentioned 300 times eventhough we have an illegal drug problem, not a prescription rx OD problem - remove them & words like "risk." <br/><br/>50MME remains even after thousands upon thousands of pts/caregivers/HCW & your own workgroup have explained repeatedly - this is a ridiculous dosage, the FDA webinar proved how unreliable MME's are, there shouldn't be any limit or mention of any× number & it goes against promoting individualized care - it needs completely removed. <br/><br/>You still allow PROP members to continue to be involved with these Guidelines eventhough they're adamantly against pain relief in the form of opioids & have to many conflicts to mention - this is highly unethical, remove their complete access to the process. <br/><br/>Write in the revision that the revision replaces the 2016 version that will be rescinded.<br/><br/>If you can not do all of these things plus what others have suggested, then I respectfully request you rescind BOTH the 2016 & 2022 CDC Guidelines.<br/><br/>Thank you for this time to comment. <br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Former	None	None	09000064850097c3	RN	None	2022-04-11T12:40:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from RN, Former	l1s-tnuo-5xfi	False	None	False	2022-04-12 06:40:36.179	[]
4545	CDC-2022-0024-4551	https://api.regulations.gov/v4/comments/CDC-2022-0024-4551	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain for more than 2 decades and I am in CONSTANT FEAR that I will not be able to access the medication I NEED. I need my medication to just have a semblance of a “normal life”. And to be honest, my life is far from normal at this point. Please try to take into consideration what people are dealing with on a daily basis. This is not the life I dreamed of or would wish on anyone. To have to worry about whether or not my pain medication will be available is an unnecessary worry on top of everything else I need to deal w. I am pleading for you to increase the minimum amount that you currently have set so more people that Ned their medication can receive them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850097c4	Anonymous	None	2022-04-11T12:40:28Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-tnvp-ecav	False	None	False	2022-04-12 06:40:36.400	[]
4546	CDC-2022-0024-4552	https://api.regulations.gov/v4/comments/CDC-2022-0024-4552	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 77 year old woman who suffers from chronic pain due to a variety of reasons. I have been diagnosed with Fibromyalgia (first time in 1986), osteoarthritis, bursitis and problems with my feet, legs and back that cause nearly debilitating pain from time to time, but more often than not as the years have passed. When OTC pain killers stopped working more than 20 years ago, I was first prescribed Oxycontin and then later Fentanyl patches withHydrocodone for breakthrough pain as needed. Over the years, I have reduced the amount of Fentanyl and Hydrocodone in particular substantially , but I also got blessed with Restless Legs Syndrome which becomes more severe when I try to further reduce the amount of Fentanyl in my patches. When I say severe, I really mean severe to the point where I can't sit or sleep because the legs keep kicking and I have to be walking or marching to make them stop. In spite of the fact that I take medication for RLS, it's only the Fentanyl that gives me any relief. I have never exceeded the amount of drugs that my doctor prescribes, nor have I tried to acquire more from any source other than my doctor. Like most people, many of them senior citizens like me, who experience chronic pain, I don't want to be cut off from the pain medications that I really need to live what's left of a somewhat normal life because there is a segment of the population who has chosen to take and then accidentally overdose on drugs they usually acquire illegally for "recreational" purposes. My doctor has been diligent in his efforts to get me off opioids because of the threat of restrictions that may be placed on his ability to prescribe them, maybe sooner than later, but my life won't be worth living when that happens.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850097c7	Anonymous	None	2022-04-11T12:41:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-tvrp-ms04	False	None	False	2022-04-12 06:40:36.618	[]
4547	CDC-2022-0024-4553	https://api.regulations.gov/v4/comments/CDC-2022-0024-4553	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC Clinical Practice Opioid Prescribing Guideline for prescribing Opioids: It doesn't address chronic conditions like Restless Leg Syndrome (RLS). That is a completely different from chronic pain. Restless Legs are a nightmare. I am 70 years old, and have had Restless Legs Syndrome for many, many years. When I was in my late 40s, restless legs became more of a problem that increases as I get older. In my 50s, I dealt with restless legs nearly every night, it became a nightly problem severe enough to require medications to try to help control the symptoms. It is documented that RLS becomes more severe as we age. It is also documented that opioids are a very effective method of treating RLS, with little augmentation (where the medication eventually makes symptoms worse) in most cases. <br/>Logically, I understand the following facts: RLS is a neurological sensory-motor disorder with symptoms that are within the brain, affecting more than 12 million of Americans. It disrupts sleep, robs victims of the ability to work and live normally, and can put RLS victims at risk for developing heart attacks, strokes, and even Alzheimer’s disease. RLS is NOT a chronic pain condition; opioids are used to treat the underlying neuropathology issues, not a sensation of pain. It is a life-long disease. There is no cure, and treatments are imperfect. The doses of opioids in RLS treatment are substantially lower compared to the doses used in managing pain or in drug dependency. Addiction and dependence are not common complications for affected RLS individuals, since the total daily dose of opioids used to manage RLS is quite low. (Mayo Clinic, Restless Legs Foundation)<br/>In 2007 I had back surgery for a disintegrating ruptured disk, and a spinal fusion in 2013. Opiates were prescribed for a short time for pain, but the doctor and I realized that it also relieved my restless legs symptoms. As I tapered off the opioid during the day, I was allowed to keep taking a small dose at night for the restless legs. I have been taking an opiate every night since. The dosage has increased only slightly over 15 years. One year ago, the doctor at the Sleep Center, Mayo Clinic increased to 15 mg per night due to severity of symptoms. It creates no “high”, but gives relief from restless legs.<br/> The urge to move my legs is unbearable, and sitting still, much less lying down to sleep, is impossible, no matter how tired I am. Symptoms can begin early to late afternoon if I’m doing something that requires sitting still like in church, at a computer desk, a hair salon, movie theater, restaurant, concert, school program, car or airplane. Relaxing at home, watching TV, reading sets it off. When it starts, I literally cannot sit still. It is relentless, and will not stop until I can stand up and move my legs. The symptoms are now being exacerbated by my disk above my fusion that has now slid forward. My RLS doctor at the Sleep Center, Mayo Clinic has found that spinal problems very commonly causes the worsening of RLS. <br/>I have tried many prescriptions in classes of drugs that are used often to control RLS symptoms over the years, but every single one either had severe side effects, or caused augmentation, where the symptoms actually became worse the longer I was on the drug. This seems to be a common thread in all those medications. Except opiates. <br/>I have had the same primary physician for 14 years prescribing opioids for me for restless legs. My nightly dose was 10 mg each evening for 10 years. It increased to 15 mg a year ago. All of it is carefully monitored by my doctor, my insurance company, and my pharmacy. Restless Leg sufferers do not deserve to have the “war on drugs” take away one of the very few medications that allow us to have a life. Please consider the needs of patients who rely on regular use of opioids to manage RLS, and long-term pain as well. <br/><br/>I’m asking the CDC to include a section in the 2022 Opioid Guidelines to address chronic medical conditions like RLS, and other medical conditions, as well as pain, that require needed opioids. Thank you. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Linda	None	None	09000064850097cf	Frideres	None	2022-04-11T12:41:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Frideres, Linda	l1s-u1c3-9y9v	False	None	False	2022-04-12 06:40:36.831	[]
4548	CDC-2022-0024-4554	https://api.regulations.gov/v4/comments/CDC-2022-0024-4554	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern: <br/>I have watched my Mom, who is terminally ill with cancer, suffer immensely, due to the current regulations in place for pain medications. She has a gastric tube, and due to her stomach, intestines and bowels being eaten up with cancer ( Oncologists actual discripttion after 2nd extensive surgery of 9+ hours in 9/11/2018) she can't tolerate her Gtube being clamped. So any medications she receives only gets 30-70% absorption. It has been absolute hell trying to get the medication she needs and actually HAVE PAIN CONTROL. I've read studies that the clamp down in 2016 released by the CDC did NOT stop excessive use & od's, in fact they went up from 60,000 deaths to over 100,00 after the guidelines where put in place. It's absolutely heartbreaking, watching your hero, the most important person in your life, suffer needlessly. I understand and believe there should be other options besides opioids for a lot of other pain situations but for her particular situation..there is absolutely no excuse. She is a warrior she is the most beautiful strong capable intelligent woman I've ever known..and she should not have to go through this. Cancer is a horrible disease. And other people with chronic pain and illness long-term chronic pain and illness should not have to suffer either. I understand if there is a moderate injury there should be a specific amount of time range that a doctor should figure out between he and his patient or she in their patient the best plan for them to effectively treat the pain and to not become addicted to opioids or any other narcotic. The doctor patient relationship has really hit a low with the amount of restrictions that have been put in place. Our doctors are doctors to heal and to protect their patients...they are not effectively able to do so with these restrictions! We need change. Thank you so much for taking the time to request and review testimonials. I want to give my mom some good news soon about her pain control. Blessed Be.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deana	None	None	09000064850097de	Walker	None	2022-04-11T12:42:26Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Walker, Deana	l1s-uqw0-izmv	False	None	False	2022-04-12 06:40:37.048	[]
4549	CDC-2022-0024-4555	https://api.regulations.gov/v4/comments/CDC-2022-0024-4555	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm lucky enough not to suffer with chronic pain, but I have had to watch loved ones deteriorate because they are no longer prescribed the medication they need to function daily. Their medication wasn't discontinued because of anything they did, their prescribers became so worried that they would be punished for prescribing opiates that they chose to let their patients suffer needlessly while pushing costly procedures that were useless at best, and harmful at worst. These procedures may provide relief for some, but for many they do not. These people have become shells of their former selves, no longer able to do the things they love, and often not even being able to get out of bed. One very dear friend is now contemplating end of life options because life is no longer worth living when there's no hope in sight. <br/>On the other side of the spectrum, i have had a loved one die from a fentanyl overdose. The drug wasn't prescribed by a doctor, and it wasn't supplied by a patient. It was manufactured in a clandestine lab in a foreign country and then smuggled into the US. <br/>Refusing to provide humane treatment to patients who are actually in pain will do nothing to decrease the number of overdoses or the amount of opioids available to and from unscrupulous people, stopping drugs form illegally coming into the country will. I also fail to see how leaving people with no option for relief other than suicide is better than the miniscule chance that they'll die of overdose.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500943d	Anonymous	None	2022-04-11T12:42:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1s-wqbg-uq5v	False	None	False	2022-04-12 06:40:37.272	[]
4550	CDC-2022-0024-4556	https://api.regulations.gov/v4/comments/CDC-2022-0024-4556	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 67yo male. I have been a chronic pain patient with a hospital-based pain clinic since 2000. Before that, I had been seen by Orthopedic Surgeons, Neurosurgeons, Neurologists, and my Primary Care doctor. Since entering the Pain Clinic program I've again been seen by Neurosurgeons, Orthopedic surgeons, and pain specialists. Throughout my adult life, I'd always worked in the blue collar fields which landed me in hard, strenuous jobs and some unfortunate accidents/injuries. I've had five surgeries, the last being a Laminectomy at L5-S1 in 1996. <br/>I've been prescribed various opioids throughout this time and when I was referred to the Pain Clinic I had been taking Oxycodone and OxyContin for a few years. During the years that followed my entering the Pain Clinic, I was continued on the OxyContin and Oxycodone prescriptions. I was prescribed 9-40mg OxyContin ER and 7-30mg. Oxycodone IR per day. That's 570mg PER DAY for about 15 years. I was closely monitored by the Pain Clinic, given urine screens, phsyche evals, was seen in the office every three months, and NEVER had a single issue with my doctors and they never had a single issue with me. This was in addition to my Primary Care doctor's regular check-ups, drug screens, and blood tests. I never had any types of side effects other than constipation, which I overcame with regular doses of Senna-Plus. I'm as regular as I was in my 20's. At every visit with my Pain Clinic I would ask if there were any new procedures or surgical options that could help me. I was told, every time, that there was not and that I would be at that level of medication for the rest of my life. This is all documented. Please keep in mind that I was able to function clearly. I was NOT a zombie. I was NOT getting "high" when I took the medicine. This is so foreign to me when I hear these claims of people taking these drugs to "get high". I don't see what they get out of it other than pain relief. Of course, I always took the medicine as directed, orally and not how I heard that some had used them. At one point I was considering returning to work in some capacity. I had a good quality of life. <br/> <br/>When the CDC came out with their "Guidelines", everything started changing. My Pain doctor announced his retirement. I think he got out because he saw the writing on the wall, so to speak. I was transferred to his colleague and co-founder of the clinic. He immediately started reducing my medications stating that he "had to" due to the new CDC Guidelines. This lasted for about a year and a half and then he also retired. Now, I'm on my third pain clinic doctor and this one's even more determined to remove me from Chronic Opioid Therapy. Since this started, the doctors don't ask about my pain or offer more than steroid injections. They are simply there to take me off the opioids and cover their behinds. There is no "care" in that clinic. <br/><br/>I am now at 3-20mg OxyContin ER and 3-30mg Oxcodone IR per day (135mg per day) with plans to cut me again this coming month. These past three years have been removed from my life. The way I once lived with a quality of life is gone. The past year HAS BEEN HELL! Not because of withdrawals. Because they only took the medicine. They didn't take the pain. The pain that was masked all those years is still there. And now it's all I have. Pain all day. Pain all night. I can't walk 50 feet anymore. I have to use an electric cart if I go to the store. Because of the lack of aerobic exercise like simple walking, I have gained weight which just makes things worse. This whole thing is spiraling. I can say without a doubt that after I was lowered from 3-40mg ER and 3-30mg IR per day my ability to function was severely limited. <br/><br/>My hope is that the CDC will carefully review it's procedures on issuing "guidelines" in the future. Doctors are running scared and retiring. There are so few options for REAL pain patients. I have told them repeatedly that I'm willing to be thoroughly studied, reviewed, and questioned to any degree that is desired to show that my pain is REAL. My X-rays, scans, everything is all on record. I'm afraid this is shortening my life due to not being able to be active anymore. At 67yo I know it's important to stay active, as I have been all my life. Please don't let this happen again. This shouldn't happen to anyone.<span style='padding-left: 30px'></span>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Craig	None	None	09000064850097f8	Richardson	None	2022-04-11T12:43:30Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Richardson, Craig	l1s-ys56-uv35	False	None	False	2022-04-12 06:40:37.512	[]
4551	CDC-2022-0024-4557	https://api.regulations.gov/v4/comments/CDC-2022-0024-4557	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a cbronic pain patient. I object to the proposed guidelines because they do nothing to protect people like me who need REAL paib relief to function. Since being cut off from my meds (the dreaded oxycontin and MS Contin) in 2016, I have been unable to work because sitting for hours triggers paralyzing nerve pain. Gabapentin, a seizure medication is currently prescribed in hopes that one of its unintended consequences (allagedly alleviating nerve pain) will manifest. It is a joke. I have aged 20 years in five. I used to ride my bicycle everywhere, hold down a demanding job in the legal profession and travel on weekends. Since losing my pain meds, I have gained 30 lbs. I spend my days laying down and reading or watching TV. I have had to.take early retirement at age 62. I feel like my life is over and on days when my pain is extreme, I think about suicide. All because some greedy people i don't know gave opiates to drug addicts, some of whom died. They say I could get addicted and I'm meant to believe that is a worse than death. I take blood pressure meds everyday without which I'm told I could die. Nobody worries about my dependence on those.drugs. My need for that drug isn't called an addiction even though stopping it could actually kill me. Stopping my pain meds made me feel like dying but I guess that's more dangerous? Please don't be part of the chronic pain patient's problem.<br/> (See attached files which are my MRI reports. They corroborate my pain.)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	09000064850097fa	Sickman	None	2022-04-11T12:44:28Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Sickman, Elizabeth	l1s-ys0t-44bu	False	None	False	2022-04-12 06:40:37.733	[]
4552	CDC-2022-0024-4558	https://api.regulations.gov/v4/comments/CDC-2022-0024-4558	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 56 years old, I have Osteoarthritis and Degenerate Disc Disease, total knee replacement both knees, suture anchors in my right shoulder and hip, my fingers are becoming deformed, left shoulder subluxation and L4L5 have lost height. I lost my PCP because she decided to move to hospice care, due to the new guidelines I wasn't able to find a doctor that would prescribe and monitor my pain medication and I can't even be referred to a pain management doctor because they don't accept Medicaid, another problem caused by HHS, my quality of life has been impacted in a negative way, perhaps if those of you making these regulations had to live with the pain we live with you would be more sympathetic to our needs, I was like to point out the number of overdose's in 2020 majority were from fentanyl!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	090000648500945e	Lee	None	2022-04-11T12:45:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Lee, Melissa	l1s-zixv-84a5	False	None	False	2022-04-12 06:40:37.951	[]
4553	CDC-2022-0024-4559	https://api.regulations.gov/v4/comments/CDC-2022-0024-4559	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please include Restless Leg Syndrome (RLS) in your 2022 CDC Clinical Practice Guideline for Prescribing Opioids. The name of the disease may sound silly, but it is no laughing matter. Imagine trying to fall asleep only to have someone shake you awake constantly to the point that it affects your physical and mental health. That is RLS, only instead of being shaken, your legs or arms or both, become uncomfortably restless to the point that you can not fall asleep or it wakes you up, out of a deep sleep. You feel like you have to get up and walk, or stretch, which relieves the symptoms, until you lay down again and they just come back. RLS is a a real thing and affecting millions all over the globe. I believe the statistic is that one in ten people have it.<br/><br/>I have been a victim of this disease for over 2 decades. I have tried most of the drugs out there to control it, along w/homeopathic remedies. Nothing works as well as low dose opioids each night. As a matter of fact, there are drugs out there that are commonly prescribed for RLS that cause augmentation after using them for a few months, making the disease worse. I know. I was a victim of that also. Low dose opioids do not cause augmentation. They also do not lead to increased tolerance and addiction. Given the current laws as well as the oversight by insurance companies, you can only receive your prescribed amount for the month so you can not stockpile or divert this drug. Without it, my life would be miserable. And lastly, when I take this drug, the dosage is so low, there is no euphoric effect associated w/it. I hate taking drugs. But I HAVE to take this one.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jay	None	None	090000648500946c	Moroso	None	2022-04-11T12:46:06Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Moroso, Jay	l1t-0ms9-tavh	False	None	False	2022-04-12 06:40:38.170	[]
4554	CDC-2022-0024-4560	https://api.regulations.gov/v4/comments/CDC-2022-0024-4560	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern:<br/>Please abolish you Guidelines! Do you understand the damage you have done to people who live with pain every day? Do you understand that you could easily be someone who lives with pain every day too. All it takes is one car accident. And you could be left dealing with pain that their is NOTHING YOY CAN DO, NOTHING BUT TAKE PRESCRIPTION PAIN MEDICATION!!!!<br/>Please, pain medication should not be a decision that the government makes. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mona	None	None	0900006485009472	Doss	None	2022-04-11T12:46:22Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Doss, Mona	l1t-0u91-475d	False	None	False	2022-04-12 06:40:38.388	[]
4555	CDC-2022-0024-4561	https://api.regulations.gov/v4/comments/CDC-2022-0024-4561	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your guidelines have had the net effect of doing great harm, and caused many a suicide. For me, it has crossed my mind more than once. It has also caused me to be unable to properly treat my cancer.<br/>I went from being able to get my pain treated in my primary care dr's office to him refusing. I was sent to pain management. I was kicked out of there. I had to learn how to live with fibromyalgia and no pain meds. I had been on them for 15-20 yrs at that point. (I also wasn't even tapered off them, just kicked out of the practice).<br/>Then, I got cancer. I had pain from fibromyalgia still, of course, but now I had pain from chemo and surgeries. I was undermedicated for my pain throughout, including waking up screaming and shaking from multiple surgeries, one being a double mastectomy. <br/>I was then told I couldn't have ANY pain meds for the pain caused by the long term cancer meds. I went to oncologist after oncologist to get help. I am on oncologist number 4 who is giving me all the tell tale signs that he is about to drop me from pain meds again. (Oncologist number 1 gave me 5 mg oxy for a short period of time while on chemo, grossly insufficient and then stopped entirely, oncologist 2 and 3 refused pain meds outright). <br/>The pain in my hands from these medications is so bad I can't open cans or bottles. I had to buy those devices old people use. (This is ON pain meds, although a lower dose than I really need). I walk like I am 90 for the first 4 hours each day (I am 50). When he kicks me off these, I will once again stop taking my anticancer drugs due to being unable to deal with the pain they cause. (I already stopped one drug I should have been on for the cancer, and couldn't deal with the pain and other symptoms it caused-this was while under oncologist number one's care).<br/>I almost quit chemo due to the symptoms and let cancer take me. I started feeling suicidal DURING CANCER TREATMENT.<br/>I then found out I had a heart condition and needed heart surgery. I was undermedicated and woke up during surgery. I ended up needing a second surgery, and a pacemaker. My pacemaker hurts me thanks to my fibromyalgia. I get zero help for that pain. I woke up undermedicated for the heart surgery, and was in ICU for a week, where I was undermedicated the entire time including a time when the dr outright refused to answer the nurse's calls. I was in constant pain, and no one cared. <br/>You have caused absolute chaos in medicine. You have helped absolutely no one with your guidelines. You have instead helped lawmakers put a vice grip on drs, insurers, and pharmacies working together to deny the right to be without pain.<br/>Even the addicts you think you are helping are dying because they now can't get the meds, and go to the street. (Some of them are pain patients, and some are not).<br/>Your guidelines should swing as violently as possible back to where things were as the net effect of what you have done is absolutely devastating. YOU ARE DESTROYING LIVES. Mine in particular. You have no idea of what it is like to be in pain now and try to get help. NO IDEA	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julie	None	None	0900006485009473	Turek	None	2022-04-11T12:47:00Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Turek, Julie	l1t-10sq-d1gx	False	None	False	2022-04-12 06:40:38.606	[]
4556	CDC-2022-0024-4562	https://api.regulations.gov/v4/comments/CDC-2022-0024-4562	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic daily migraine with a constant headache. I couldn’t even get out of bed for weeks, but I was able to get a shorter term amount of oxycodone, which has now been tapered down to 2 a day at 5 mg (only oxy, not the added aspirin). It has allowed me to function. It was hard to get anyone to prescribe the oxy to begin with, but luckily I’ve had the same PCP for years, and she knows I can be trusted. However, I am getting ready to have to move, and I fear I will soon go back to not functioning if I can’t get a new doctor to prescribe it. Additionally, the guidelines now seem unnecessary in my situation. For example, I have to be seen in person every 3 months to continue, and there are no refill options so the script is only for 1 month at a time. Living with chronic pain is bad enough. Being made to feel like a junkie just for wanting to be able to function for me and my kids, just plain sucks.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009475	Anonymous	None	2022-04-11T12:47:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-1la2-pte5	False	None	False	2022-04-12 06:40:38.827	[]
4557	CDC-2022-0024-4563	https://api.regulations.gov/v4/comments/CDC-2022-0024-4563	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make it so primary care doctors feel like they can prescribe opioids for chronic pain my mom is in severe pain and gets no help ,she is 81	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brenda	None	None	0900006485009476	Fugitt	None	2022-04-11T12:47:24Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Fugitt, Brenda	l1t-26zm-aykc	False	None	False	2022-04-12 06:40:39.053	[]
4558	CDC-2022-0024-4564	https://api.regulations.gov/v4/comments/CDC-2022-0024-4564	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	RLS is a typical example of a disease that can be helpedby low dose opoids. Please. Ease my dis ease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500948d	Anonymous	None	2022-04-11T12:47:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-3576-j5bm	False	None	False	2022-04-12 06:40:39.286	[]
4559	CDC-2022-0024-4565	https://api.regulations.gov/v4/comments/CDC-2022-0024-4565	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am glad to know your going to be taking some of the restrictions off on the prescription by docs of pain medications. It has gotten so bad in my once Mayberry like town due to docs cutting a lot of folks off that had lived in pain and unfortunately people who were on lortab once who held good jobs owned houses and were productive working members of society now are like zombies or in jail. I don’t think docs should be giving someone who broke their arm OxyContin no in no way do I mean that. That was crazy but cancer paitients I think are people who need the heavier stuff. I just heard today if a young man with colon cancer and is ok so much pain the docs are giving him basically ibuprofen he’s dying it makes no sense. What started out as understandable became ridiculous. No one should be prescribed hard core pain medicine like OxyContin unless they are a cancer paitient or dying but lortab? I never heard of anyone robbing folks or killing their babes taking that but now after those laws taking away normal pain meds from hard working people did nothing but cause folks to turn to hard street drugs. Now my once peaceful town where everyone worked had nice homes and worked hard has become a crazy murderous place where methed out people who turned to the drugs like that after docs stopped seeing them lost their homes couldn’t work then got in herione or meth. We have had murdered in our town that are too horrible to talk about. I worked in mental health and social services working with foster children last twenty years and our case loads tripled when u did it. We didn’t have enough foster homes to hold them all and I personally heard it from so many families that “when their doc cut off pain medicine they turned to hard street drugs”. This is ridiculous I saw more people stop working due to pain sign up for disability due to chronic pain. What were the people who linked “opioid epidemic”snd normal pain medication together. If a person died of herione or fentyl that is not due to pain pills. I’m not saying give the stuff away like candy but they made a huge mistake and now we have more suicide by young and older people who could t live with pain or got on meth and turned became zombies. This “pain pill prohibition” is gonna be looked back on one day and looked at like the prohibition of alcohol. Did you really think it was gonna help? Did u not expect folks to be cut of and having lived somewhat normal lives with less pain to just be ok? I have seen too many things since these rules got to be so crazy. People on meth don’t die they live forever they are like the walking dead. People who used to be respected. Now a shell of who they once were. I had a neighbor 15 years great neighbor he had back issues from accident he took I think lortab never see him crazy acting for the time he was having his pain lessened. Well he got cut off he’s lost his home kids got on methadone and did meth which makes no sense but it happened. He has been arrested will be going to prison soon for attempted Robbery. The murders in the last 10 years have gotten so bad people murdered old people being stabbed then burned in their homes for 100 dollars so these Idiots can get their meth. One young man stabbed everyone in his family he was on meth I’m saying these things wouldn’t be happening like this if they didn’t take pills away so they could work. We have a mess I hope you can turn it around. Give them back their pills so they can work and have as normal lives as possible. The physical pain in all these people I mentioned were verified cases of no prior arrests -the people had back surgeries didn’t work or car accidents almost killed them and took normal pain pills like lortab nothing crazy but when taken off they become monsters. Think about what ur doing the world is crazy enough. If you don’t help relieve pain especially now with Covid things are gonna just get worse. Oh I heard my friend tell me her son terminal colon cancer 31 years old he’s dying in pain after surgery they gave him one 5 mg I think she said hydrocodone oil called norco -gave him one a day 5 milligrams he just had surgery. What I’m the world have u done 1hes suicidal from pain and knowing he’s gonna die this time adjust first surgery. I told her about hospice care they didn’t know what is available I worked in fields where I could set up those things but our medial health professionals are dealing with so much then u tell them to lay off the pain meds but I can’t imagine you would tell them<br/>Not to try to ease the suffering of a dying young man. You have docs who don’t wanna take that chance because their scared of getting in trouble. I hope you all can fix this because their is too much suffering. Pain pills and hereon are not the same thing so stop letting people think they are when u hear in news the aboit how many people died delegate the illegal and legal drugs get awareness out there	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500981c	Anonymous	None	2022-04-11T12:48:43Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-4lyq-r75z	False	None	False	2022-04-12 06:40:39.505	[]
4560	CDC-2022-0024-4566	https://api.regulations.gov/v4/comments/CDC-2022-0024-4566	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is absolutely imperative that low level opoids be prescribed for RLS. IT IS OFTEN THE ONLY THING THAT HELPS A PERSON SUFFERING FROM RLS.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500981d	Anonymous	None	2022-04-11T12:49:00Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-4mhh-8x54	False	None	False	2022-04-12 06:40:39.734	[]
4561	CDC-2022-0024-4567	https://api.regulations.gov/v4/comments/CDC-2022-0024-4567	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have visited pain management docs because I have been diagnosed with Trigeminal Neuralgia. Docs throw prescriptions at me but I need to find out the cause! Mayo Clinic has declined me because I appear to be w complicated case. <br/>We need cures not just meds that deal with symptoms- and do so poorly.<br/>[name redacted]<br/>[email address redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kay	None	None	0900006485009832	Mazzetta	None	2022-04-11T12:49:32Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Mazzetta , Kay	l1t-6z8z-gnei	False	None	False	2022-04-12 06:40:39.960	[]
4562	CDC-2022-0024-4568	https://api.regulations.gov/v4/comments/CDC-2022-0024-4568	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please revise these guidelines, my life was upended with the last guidelines. I had a great Dr that helped my pain but due to the guidelines, he stopped, suddenly. I went to pain management and they demanded I get injections that didn't help, they made me worse. When I told them.so, they told me I either get the injections that hurt me or be discharged from treatment. I had 3 other practices tell me the same. I lost my quality of life, my job and my family because of this. I have little to no enjoyment in my life. I had been on a stable dose for over 5 years with no increase in dosage no dirty UAs, never running out of meds. I had a good quality of life.. I worked,, had hobbies and loved my life. Now I'm on disabilityand can't even take care of myself. .. these new guidelines are left as written, my life will be over. I can't take anymore pain and the CDC is behind it. Please stop passing guidelines that kill us. Most ODs are from street drugs, not from chronic pain patients. I fully knew the risk when started on opioids. They have been the only effective treatment. I will try anything for relief. But many alternate treatments aren't even covered by insurance. <br/> At least there were very effective before the guidelines took them away. I have had multiple drs off me suboxone. I'm not a drug addict, nor have I ever been. I've been told by a few that's it's all they can give. When in a disabled person treated worse than addicts...now, in the US. Pain patients get worse treatment and no dignity. drug addicts receive more compassion, care and dignity. Sadly pain patients are having to lie to go get medications for pain at drug facilities and some drs are advising they to just lie and say its not for pain, but for addiction. This is a travesty. I'll never lie and say I'm an addict to get pain relief. I guess I'd die first. It appears the CDC wants chronic pain patients dead. There's no other way to explain their actions. Their actions have been proven to cause suffering and death, now guidelines are even worse. Lowering 90mme to 50mme. . . Now some abandoned patients seek relief in the only way possible, suicide or street drugs. Chronic pain patients deserve safe, ethical treatment. I exhausted all other means of treatment before being started on opioids. Please remove the 50mme limit. Let our drs treat us, not the CDC. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	090000648500984b	Perry	None	2022-04-11T12:50:09Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Perry, Pam	l1t-8cwj-5lir	False	None	False	2022-04-12 06:40:40.178	[]
4563	CDC-2022-0024-4569	https://api.regulations.gov/v4/comments/CDC-2022-0024-4569	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC needs to RETRACT their 2016 Guidelines to Opioid Prescribing, and apologize for even writing the guidelines. You have caused suffering, increase in deaths, and government interference with the sanctity of the dr/patient relationship. The disease is the overgrowth of government and the invasion of healthcare. We should have the right to life, liberty and pursuit of happiness. <br/><br/>Pull the 2016 Guide to Prescribing Opioids, apologize, and stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	090000648500986c	Cremer	None	2022-04-11T12:50:21Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Cremer, Mary	l1t-9p8x-entd	False	None	False	2022-04-12 06:40:40.401	[]
4564	CDC-2022-0024-4570	https://api.regulations.gov/v4/comments/CDC-2022-0024-4570	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have chronic pain that’s successfully managed with tramadol. When the 2016 guidelines came out, my primary care physician refused to prescribe tramadol for me and I had to find another provider. Tramadol is a mu-opioid and was an unscheduled drug from its initial US approval in 1995 through 2014 because it has strikingly low abuse and dependency potential. It does not generate euphoria in patients. However, in 2014, under pressure due to international abuse, primarily in Africa where massive doses were fed to malnourished farm animals, the FDA classified it as a Schedule IV drug. That action combined with the CDC’s excessively restrictive 2016 policy, changed that medication from a convienient, safe, and effective treatment option for pain, to an overly restrictive, excessively burdensome and unjustifiably difficult to manage pain control option, both for the provide and the patient. <br/><br/>This policy should include a carve-out for Tramadol until the FDA reverses its Schedule IV policy decision.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	James	None	None	09000064850098d9	Auvil	None	2022-04-11T12:50:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Auvil, James	l1t-b1ti-h11h	False	None	False	2022-04-12 06:40:40.633	[]
4565	CDC-2022-0024-4571	https://api.regulations.gov/v4/comments/CDC-2022-0024-4571	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016,and current CDC draft for Opioid prescribing , has left the Chronic pain community trying to find their much needed pain relief-as MDs are leaving the field of Pain Management in droves! Why? Because in more than 38;States-these Guidelines became LAW! Also, the DEA were targeting Pain doctors who prescribed more than 90 MMEs per day. With the threat of their controlled substance prescriptions being taken away,, Doctors did not want to prescribe these life-saving pain meds. Instead, patients were harmed by being “ force tapered off these pain meds. “. I was force tapered off my pain meds and were “ harmed” by these CDC guidelines!. Yet, in its draft: it still mentions the daily MMEs, which now is mentioned in the current draft. Now, it is only 50 MMEs per day! These CDC guidelines need to be destroyed! Start OVER! I know that there is NOT one legitimate paper written about the harms of opioid patients. I am a perfect example. For 30 years !I have been a law abiding person who took her meds as prescribed.. I never overdosed, or had respiratory depression. I offered to be in a study about pain, yet that did NOT happen.<br/>I suffer from a birth defect. I was born without ANY hip socket, and spent 3 Months in the Hospital, age 8 years old. It was a huge surgery, with lots of bone pain. The Surgeon removed half of my pelvis-in order to use that bone to create some semblance of a hip socket. I was on crutches for a year-and had to learn how to walk again. Bone pain is horrible. Plain Tylenol for post-op pain is un acceptable! We have the means to treat pain, but-if you are an anti-opioid zealot-you should NEVER decide to work with pain patients! I feel that some PROP members are invested in the drug called-Suboxone. Suboxone is a med used for opioid use dis-order. Now, they are trying to give it to the abandoned pain patients right to prescribe Suboxone. We are tired of having to deal with Insurance companies, pharmacies-because the pain patient is now labeled as a drug addict. How humiliating! There are thousands of us-who obey the LAW, but are labeled as drug seekers. Please give the MDs the right to prescribe our lifesaving pain meds. They give the pain patient the ability to get out of bed, do tasks, socialize, and have a better quality of life. Help patients who suffer burns, broken bones, trauma, birth defects, and multiple other immune diseases ( without a cure), the ability to function, and have a LIFE! The “ benefits of opioid therapy “ outweigh “ the risks/ or harms! Taking a legacy pain patient,,off these meds is extremely harmful! I know some patients suffer high blood pressure,tachycardia ( rapid heartbeat ) , and some have had seizures. <br/>CDC , you need to only be concerned with communicable diseases. Bring healthcare back, and give the Hospitals the much needed opioids to treat all types of pain! [name redacted], RN ( retired).	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	0900006485009923	Clark	None	2022-04-11T12:51:39Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Clark, Kathleen	l1t-betc-8rtx	False	None	False	2022-04-12 06:40:40.850	[]
4566	CDC-2022-0024-4572	https://api.regulations.gov/v4/comments/CDC-2022-0024-4572	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a cancer patient, I was using opiates for pain. Upon the enactment of the 2016 policy, my doctor had me change to suboxone.<br/>Although this medicine worked for minor pain, when I was admitted to the hospital for surgery none of the opiate medications would work. The first time was 2 weeks of suffering with no relief. The second time was a week. The 3rd time was again a week. We have to be able to acess these opiate pain medicines forbthose of us with chronic pain and cancer pain aswell as other serious debilitating diseases. It is unfair to make those of us who abide by the rules suffer because of those who do not. Tired of being in pain.<br/>Please allow our doctors to decide and untie their hands. We as a nation need to re evaluate these rules and regulations for those of us in need. Please allow the doctors to do their jobs.<br/>That is why we do not practice medicine on ourselves. Leave it to those who know. I am not as worried about addiction as I am about dying in pain. Please stop the irrational outlawing of prescribing these medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	0900006485009942	Gilbert	None	2022-04-11T12:52:31Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Gilbert, Richard	l1t-bkb7-xsas	False	None	False	2022-04-12 06:40:41.071	[]
4567	CDC-2022-0024-4573	https://api.regulations.gov/v4/comments/CDC-2022-0024-4573	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 37 year old woman. Diagnosis of Ankylosing spondylitis, hidrandenitis, and fibromyalgia. I am a single mother to 3 children and a caregiver to both of my severely disabled parents. People don't understand what living with true, chronic daily pain is like. We must allow doctors to take care of people the way they see fit. <br/><br/>The cries of pain going on in my house are beyond anything I've ever imagined could happen to myself and my family. We dedicated our whole lives to farming, providing for our communities, and paying our share as American citizens. Why are we being forced to suffer in such a way? It's wrong, unjust, inhumane and un-American. We know there is an opioid crisis. People are dying on overdoses of street drugs and chronic pain patients are being martyred. It isn't right. Imagine what life would be like if you couldn't stand long enough to cook, clean, or spend quality time with your family. Imagine what it would be like if you couldn't function from pain. Imagine what it would be like to be unable to walk, sit, stand or even lay down without excruciating pain. Imagine what it would be like to lay down at night, wondering if you can make it through another day.<br/><br/>We've got to remember that there is a big, HUGE difference between addiction and being dependent upon a federally approved medication to maintain a quality of life. Please allow doctors to use their best judgements and prescribe these life saving medications to the people who truly NEED them in order to live a somewhat productive and less painful life. We are begging, screaming, and crying from the bottom of our hearts and souls, to just be allowed to live. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009950	Anonymous	None	2022-04-11T12:52:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-bm69-wxl8	False	None	False	2022-04-12 06:40:41.325	[]
4568	CDC-2022-0024-4574	https://api.regulations.gov/v4/comments/CDC-2022-0024-4574	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient who has not been able to receive pain medication. I've been suffering for many years. Never in my life have I abused any medications or substances, but with the guidelines the way they are, everyone is treated as an addict. This is hurtful and harmful for patients like me. I have numerous chronic health conditions, proven by imaging and testing. Even going to a Pain Management facility doesn't work- they offer invasive procedures, like cauterizing nerves in the spine, this is terrifying and unnecessary. <br/>I hope the new proposed guidelines are passed, so that physicians can return to treating patients, rather than insurance companies forging the way. <br/>Thank you for modifying the guidelines to better help patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katalin	None	None	09000064850099a4	Miklos	None	2022-04-11T12:53:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Miklos , Katalin	l1t-c4qb-cr70	False	None	False	2022-04-12 06:40:41.540	[]
4569	CDC-2022-0024-4575	https://api.regulations.gov/v4/comments/CDC-2022-0024-4575	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife has had four bulging discs in her spine for over ten years. She was also diagnosed with rheumatoid arthritis three years ago. Finally, she has PTSD and depression from abuse as a child. She is unable to get any pain management medication because of the current restrictions put on opiod prescribeding by the government, insurance companies and ultimately doctors. Even pain management doctors refuse to prescribe pain medications because she suffers from depression. <br/><br/>Her inability to get pain medication prevents her from having a job and having a normal life. Living in pain on a daily basis is a death sentence. As a result, she is on disability, has low self esteem and feels like a burden to society. She just needs relief from the pain so she can live a normal life.<br/><br/>Please change the current guidelines so that she may return to a normal life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bill	None	None	09000064850099fd	Smutny	None	2022-04-11T12:53:17Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Smutny , Bill	l1t-ct3a-tt24	False	None	False	2022-04-12 06:40:41.783	[]
4570	CDC-2022-0024-4576	https://api.regulations.gov/v4/comments/CDC-2022-0024-4576	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am a United States Marine Corps veteran. I live in South Dakota. I am 67 years old. Prior to the Guidelines I was a happy healthy active woman who loved baking, horseback riding, spending time with friends and just living my life as I choose. I get my healthcare at the VA. In about August of 20116 the VA started tapering me off my pain meds to end up forcing me off the pain meds in April of 2016. Now my life is just an endless existance of pain and more pain. My body continues to deteriorate as the years go by. I now spend my days in bed. Unable to do anything that brings me joy. I am supposed to be going to a horse show my niece is in today but pain will not let me. I moved home to be close to family for support but now I am unable to do that very often because of untreated pain. I used to take care of my house but now I am unable to do the simpliest things to keep it up. I have had extremely high blood pressure since the VA began tapering me. I am ignore at the VA for any and all concerns. The VA is now my #deathcare. My overall health has been affected by the untreated pain. The saddest thing is knowing I have no where to go for ANY health concerns I may have. Sad, really. I will not go to an ER, the VA or any doctor because of the way I have been treated. I know have PTSD from healthcare which is worse than the PTSD I have from being gang raped in the Marines by fellow Marines. Yes, I know. This is one of the reasons I am denied pain relief. My health records are full of lies, inaccuracies, judgments, opinions but little real healthcare. I have been abused by the VA and other healthcare systems simply because I have chronic pain from several issues in my back. I have tried everything possible to relieve this pain but nothing helps!! I am suicidal everyday. When I hear of someone dying, I am jealous. The CDC has ruined the healthcare in this country. Why is the CDC in charge of this anyway when we have the FDA?!?! My life is over. Why is my country trying to kill me off? What the CDC and this government are doing is passive murder. All behind the false narrative of the opiod overdose crisis is caused by prescription medications. When, in fact, it is from the illegal drugs in this country. Time to tell the truth America!! Get the CDC/DEA out of our doctors offices!! Let doctors practice medicine. They are trained to do this Bring back the doctor patient cooperative. Save lives. Don't destroy them. I only hope, if this happens, I will still be alive to see it happen. I WANT THE PEER GROUP TO TO READ THIS!! That is my right. Remove the guidelines and put no more in place. Stop the torture of innocent people in pain. And remove all mention of MME as it is not scientIfic. Please live in reality. Our lives depend on it. PLEASE DO THE RIGHT THING. You are my\our only hope.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandra	None	None	0900006485009a20	Emery	None	2022-04-11T12:54:23Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Emery, Sandra	l1t-d4on-7dkd	False	None	False	2022-04-12 06:40:42.001	[]
4571	CDC-2022-0024-4577	https://api.regulations.gov/v4/comments/CDC-2022-0024-4577	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please remove the MME limitations. They've been utterly harmful and destructive to both patients and clinicians. Government needs to stay out of the doctor/patient relationship and let the doctor who sees the patient and their whole medical history and such determine what's best when it comes to amounts written. Every patient is an individual and not one person is like the other. How can you set hard rules when this is the case? You've stricken fear into all doctors who now are afraid to prescribe because of your guidelines and the MME and the DEA. Get Government out of the patient/doctor relationship, please!! Thank you for your time.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brittney	None	None	0900006485009a2e	West	None	2022-04-11T12:54:37Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from West, Brittney	l1t-d7qe-a3l2	False	None	False	2022-04-12 06:40:42.223	[]
4572	CDC-2022-0024-4578	https://api.regulations.gov/v4/comments/CDC-2022-0024-4578	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like this committee to consider th use of opioids for RLS. this is a condition I personally have had to deal with for over 50 years. When I first discovered opioids would control this condition it was over 10 years ago. Then all the regulations came in and now I average 2-4 hours of sleep per night. I cannot go to a movie, take a plane trip or long ride in a car. I have to watch TV standing or walking around the room. I cannot stay overnight with friends or family because of the disruption it takes on their lives. Then I was allowed opioids, my dosage increased only slightly over a 10 year period. At no time did I crave or abuse this drug, because it worked. When the drug is prescribed correctly, it isn't a problem because it is doing the job it was intended for . Sadly, way too many Dr s are not educated on RLS and successful treatments. Please take a look at the many people who suffer without opioids on any facebook group regarding RLS. There are way too many who suffer without the option of opioids. <br/>Sleep is one of the most important needs for our body and when you have RLS, Sleep is almost none existent.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jan	None	None	0900006485009a6b	Chavez	None	2022-04-11T12:54:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Chavez , Jan	l1t-dm2l-roa8	False	None	False	2022-04-12 06:40:42.442	[]
4573	CDC-2022-0024-4579	https://api.regulations.gov/v4/comments/CDC-2022-0024-4579	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	FDA/CDC comment re: revised oppid prescribing guidelines.<br/><br/>As a patient with complex spine and joint conditions, I have benefited from the class II opioid Tramadol as a part of managing pain. My doctor has monitored the Klippel-feil related severe osteoarthritis I have had for many years. After a referral to a Rheumatologist, I was recently diagnosed with spondyloarthritis, a disease that is often under diagnosed and delayed in women. I believe this was missed because I had no medical insurance or regular medical care when I was younger. By the time I was seen, I already had advanced osteoarthritis. I offer these details to illustrate that in medicine, one size assuredly does not fit all.<br/><br/>For years, I took small amounts of nsaids, first over the counter, then in prescription form, until lower gastrointestinal bleeding made it unsafe to take these any longer. I have had spinal fusion surgery, foot surgery for foot deformities, and extensive physical therapy. These have all helped me maintain function, as does the Tramadol. I am able to walk everyday, spend time with family, including my grandchildren.<br/><br/>My doctor, who knows me really well, has recently retired. On my last telehealth appointment, she told me that the younger doctors in the medical center family practice don't believe opioids should be prescribed at all. She said they may prescribe Suboxone instead of the Tramadol, even though I take only two or three tablets a day, considerably less than what is prescribed for acute pain.<br/><br/>When I looked up Suboxone, I learned this is used for addiction. I recently saw on my chart, under medical conditions: Long term Opioid Use. It feels like a scarlet letter! What isn't there is the context: gastrointestinal bleeding risk/nsaids contraindicated, that would help to explain why a small amount of Opioid is appropriate.<br/><br/>I try to be positive and proactive about managing my health. I hope the guidance revision can correct the tendency to stereotype patients, which only adds to the stress of dealing with chronic illness.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	S	None	None	09000064850097fd	C	None	2022-04-11T12:56:08Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from C, S	l1s-z57e-4mew	False	None	False	2022-04-12 06:40:42.673	[]
4574	CDC-2022-0024-4580	https://api.regulations.gov/v4/comments/CDC-2022-0024-4580	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This document has hurt me terribly. I was electrocuted in 1986, had 60 surgeries. Please, please completely undo this Document that hurt so many people who a trying to have some quality of life !!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	0900006485009ac0	Campbell	None	2022-04-11T12:56:18Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Robert	l1t-eevl-9o22	False	None	False	2022-04-12 06:40:42.890	[]
4575	CDC-2022-0024-4581	https://api.regulations.gov/v4/comments/CDC-2022-0024-4581	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines continue hurt and harm my husband and other people in the burn Community. Let the trained professional doctors do their job. Keep politics out of health situations. This guideline from the beginning was so one sided from PROP, no people who suffer with chronic pain were even allowed to be interviewed in this secret process.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lynn	None	None	0900006485009ad8	Campbell	None	2022-04-11T12:56:30Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Lynn	l1t-eou3-049u	False	None	False	2022-04-12 06:40:43.108	[]
4576	CDC-2022-0024-4582	https://api.regulations.gov/v4/comments/CDC-2022-0024-4582	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please take out these ridiculous MME limits. My father who suffers from chronic pain, is 220lbs. He requires more meds then a smaller person. We all metabolite things in different ways and times. STOP THE ABUSE OF INNOCENT PEOPLE who are already suffering enough !!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jaden	None	None	0900006485009af3	Campbell	None	2022-04-11T12:56:39Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Campbell, Jaden	l1t-exy1-olwi	False	None	False	2022-04-12 06:40:43.324	[]
4577	CDC-2022-0024-4583	https://api.regulations.gov/v4/comments/CDC-2022-0024-4583	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain patients have used opioids for eons because they block nerve pain and are the only relief for millions of pain sufferers. I herniated my L4 disk over ten years ago. The wound pinches the nerve going down the front of my left thigh. My wound created a contusion in my spine, and the pain crippled me for months. Pain sufferers need pain relief, and addicts need medical and psychological care to become well. NSAIDS shrink swelling and come with the potential side effect of ulcers. <br/>My back doctor advises surgery for my condition with the caveat the surgery may or may not offer pain relief. I would rather continue my opioid therapy during days with intense pain. The last thing pain sufferers need are government regulations that make it difficult for doctors to prescribe appropriate medicine that blocks nerve pain without worry the Drug Enforcement Agency may shutter their practice.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keith	None	None	0900006485009af6	Ensminger	None	2022-04-11T12:56:56Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Ensminger, Keith	l1t-eyoa-jmx9	False	None	False	2022-04-12 06:40:43.548	[]
4578	CDC-2022-0024-4584	https://api.regulations.gov/v4/comments/CDC-2022-0024-4584	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Pain patients have used opioids for eons because they block nerve pain and are the only relief for millions of pain sufferers. I herniated my L4 disk over ten years ago. The wound pinches the nerve going down the front of my left thigh. My wound created a contusion in my spine, and the pain crippled me for months. Pain sufferers need pain relief, and addicts need medical and psychological care to become well. NSAIDS shrink swelling and come with the potential side effect of ulcers. <br/>My back doctor advises surgery for my condition with the caveat the surgery may or may not offer pain relief. I would rather continue my opioid therapy during days with intense pain. The last thing pain sufferers need are government regulations that make it difficult for doctors to prescribe appropriate medicine that blocks nerve pain without worry the Drug Enforcement Agency may shutter their practice.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Keith	None	None	0900006485009af7	Ensminger	None	2022-04-11T12:57:07Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Ensminger, Keith	l1t-eyoa-kq9z	False	None	False	2022-04-12 06:40:43.780	[]
4579	CDC-2022-0024-4585	https://api.regulations.gov/v4/comments/CDC-2022-0024-4585	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines that were released in 2016 have increased drug overdoses and have caused the suicide rates to significantly increase among chronic pain patients. The 2016 and current guidelines should be eliminated. The CDC and DEA have destroyed the doctor/patient relationship. I am a chronic pain patient who uses opiates to help decrease my pain level. Prior to using opiates I went to physical therapy, a chiropractor, tried multiple antidepressants, beta blockers, neurontin, acupuncture, meditation, low impact exercises, tens unit, heating pad, lidocaine patches, ibuprofen, naproxen, Celebrex and much more. Pain medication helps get my pain level down enough so that I can do everyday activities such as get dressed, shower, laundry, cooking and chores around the house. Pain medication also makes it possible to do aquatic exercise, yoga, walking through out the week. I also use the following to help decrease my pain level as well, because when you deal with chronic pain you need a multitude of tools in you toolbox to survive and combat pain and pain flares; tens unit, heating pad, epson salt bath, stretching, aquatic exercise in a therapy pool, yoga, meditation, physical therapy, lidocaine patches, supplements, turmeric, orgasm, massage when I can afford it. Out of all of these tools I have found pain medication helps the most so I can live a somewhat normal life. There is only so much one can afford on a fixed income. Health insurance companies need to make alternative therapies covered as well such as ketamine infusions, lidocaine infusions, massage therapy, medical marijuana (I don't like the psychoactive affects), stem cell therapy, hyperbaric oxygen chamber, psychedelics, etc. to help those combat chronic pain. Another option should be the right to die and not live in pain. Chronic pain patients are not responsible for those overdosing on drugs who want to escape life. Pain patients want to be able to participate in life and enjoy spending time with our families, spouse, friends, etc. Due to the DEA my doctors office was shut down by the DEA. I was forced tapered off my pain medication by another pain management doctor until I was able to find a doctor who was willing to let me stay on a much lower dose of medication than I was used to getting. It has been some very difficult years trying to get to where I am currently at, leading a somewhat stable life where I want to live. I feel we are punished, because we suffer from chronic pain. The hoops we must jump through to get our pain medication is enough to make you not want to live. We must see pain management doctor every 28 days, urine drug test screening each month, pill counts, pharmacy can only fill early one time a year for a vacation override so if you have three children like me who live in a different state you need to plan everything around getting your medication and doctor visits(which are not the same day each month since medication must be at least 28 days from last fill), this does not include if you want to visit other family out of state, a funeral or if your doctor decides to do a surprise pill count you must get to the doctors office that day or your dropped as a patient. This is insane to put this amount of pressure on the sick and disabled. Not to mention I was forced off Klonopin which I only used for panic attacks. The anxiety and fear I have every month prior to going to pain management that I will be told he can no longer prescribe my pain medication and when that is okay I the anxiety and fear I feel prior to taking my prescription to the pharmacy that the pharmacist will refuse to fill my medications or they won't have the medication in stock is a horrible way to live every four weeks it is a nightmare of its own. I must get all my medication filled at one pharmacy and can not shop around for cheaper drug prices or the pharmacy will not fill my pain medications. Medicare does not cover prescriptions so I am paying a lot of extra money I could save by going to different pharmacies to get the cheapest drug price. This is so wrong on so many levels. Despite your guidelines and all of these rules overdoses are way up and you only count the ones who die. I have followed the rules all my life, never broke the law or been arrested. I do not use illicit drugs. I have many painful illnesses and I should not have to bare the responsibility and punishment for those who wish to escape life chasing the next high. Those using illicit drugs need help with what they are trying to escape in life. I wish I knew the answer to how to fix it. I do know I am not the problem. I worked hard to raise my kids right, to love them and give them the self confidence to be productive members of society. I worked hard to be a productive member of society until I became disabled in 2015. My mom taught me I needed to work hard in life for what I wanted which makes it much harder to accept being disabled.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	090000648500a915	Manik	None	2022-04-11T13:11:50Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Manik, Deborah	l1u-2i8n-wity	False	None	False	2022-04-12 06:40:43.996	[]
4580	CDC-2022-0024-4586	https://api.regulations.gov/v4/comments/CDC-2022-0024-4586	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic pain for 11 years. I have a titanium plate in my neck, attached to 3 discs. I have a 7 inch strip of titanium along with wire and 10 screws in my upper right arm. now, I am going to need surgery on my right knee. I cannot express the pain level I live with every minute of every hour of each day. some days, it is hard to be alive. I thank God and my husband for getting me through each day. I also have 3 compressed discs in the thoracic area and 3 ruptured discs in my lower back along with a number of other things wrong with my back. It would be easier to state what is not wrong. When my pain management doctor told me he had to lower my amount of pain medication,I didnt know what I was going to do. How do I live with even more pain? I was told I was put in an age group which only allows me a certain amount of pain medication. I could not understand this. My pain is more than others and less than some. How could I not get individual pain treatment? this did not make sense to me because not everybody's pain is the same. Pain leads your life. Pain tells you what you can and cannot do. My quality of life is not good because I can't get pain medication strong enough to ease my pain. If I could, I could get around better and be a little more active like I need to be. I understand about some meds being prescribed to people who may not need such a strong pain med. I go to pain management, I sign a contract and do drug screenings. I am doing what I'm suppose to do in order to receive pain medication. but when the CDC changed guidelines,grouped me according to my age and lowered my pain medication, I felt like I was paying for the mistakes of others who abused their pain medication. I deserve the right to have individual treatment and to have a better quality of life!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	pam	None	None	090000648500a925	polk	None	2022-04-11T13:12:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from polk, pam	l1u-2qb8-15ys	False	None	False	2022-04-12 06:40:44.222	[]
4581	CDC-2022-0024-4587	https://api.regulations.gov/v4/comments/CDC-2022-0024-4587	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with type ii Scheuermann's disease. Everything I have read about my condition minimizes what I have endured. After years of useless therapy and mostly NSAIDS an Opiate was added. Some years later surgery was attempted to repair ruptured and herniated disc and to help minimize the discomfort. After a lengthy recovery it was some years later I became Fairley stable by comparison? Starting with the 2016 Opioid Prescribing Guideline's created a opioid pain medication prohibition, my life was destroyed, no one was willing to prescribe an opioid. This group Prop. and now the CDC have ruined this country's pain management in our Heath Care System. Having the only pain medication that helped taken away is criminal. The stress an anxiety and aggravation these guideline's have caused is unethical and unacceptable. The FDA has the only congressional authority over controlled substance given to them by the United States Congress. I fail to understand why doctors need these guideline's. The CDC has a whole other function in our society?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a1e4	Anonymous	None	2022-04-11T13:13:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-tr5b-b764	False	None	False	2022-04-12 06:40:44.438	[]
4582	CDC-2022-0024-4588	https://api.regulations.gov/v4/comments/CDC-2022-0024-4588	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment on the upcoming revised prescribing guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	SCOTT	None	None	090000648500a1e7	DEDDO	None	2022-04-11T13:22:48Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from DEDDO, SCOTT	l1t-tetd-qmxx	False	None	False	2022-04-12 06:40:44.868	[]
4583	CDC-2022-0024-4589	https://api.regulations.gov/v4/comments/CDC-2022-0024-4589	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guideline has been an unmitigated disaster because:<br/><br/>One size (or dose) does not fit all. <br/>It discriminates against elderly patients who only want to function somewhat normally.<br/>It focuses on the wrong end of the problem. Most opioid overdose deaths DO NOT involve a patient with a current, legal prescription. They involve fentanyl and/or illegal street drugs. <br/>It ignores the paramount importance of the doctor patient relationship; individual treatment for the patient, without fear of repercussions for ethical, medically sound care.<br/>It has had a deleterious effect on the ability of patients with legitimate prescriptions to obtain needed medications in a timely and reliable manner.<br/>It has diverted focus from the real problem with drugs in the country- fentanyl and methamphetamines from other countries. <br/>It has inflated the cost of pain management for Medicare because the same doctors who are reluctant or afraid to prescribe opioids when appropriate will instead direct patients to any number of expensive treatments, some of which are laughably ineffective in dealing with chronic and intractable pain. (Cui bono?).<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Paul	None	None	090000648500a1ef	Skonberg	None	2022-04-11T13:25:06Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Skonberg, Paul	l1t-twrk-9d7s	False	None	False	2022-04-12 06:40:45.085	[]
4584	CDC-2022-0024-4590	https://api.regulations.gov/v4/comments/CDC-2022-0024-4590	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Daily I hear about People overdosing on Illicit & illegal synthetic opioids to relieve their pain. I am a legacy pain patient I’ve suffered with pain most of my life. I developed Salmonella, which was misdiagnosed for 2 weeks and turned into thyroid fever. Once diagnosed, a miracle,8 days in icu.My teen years I developed a stomach pain that doctors couldn’t figure out. I missed a lot of school because of those episodes & there were many. The pain would come & I would drop! I would be in agonizing pain for hours to days. Tried everything thing nothing worked. At 19 I developed arthritis in my right knee. It progressively got worse. By the time I was a mother of two, I was struggling to keep up. My back started giving out.The otc pain meds did very little, I do mean little. Natural methods such as acupuncture, chiropractic, none of those worked.I Sought the treatment of a Dr. They tried me on pain meds. Finally some relief!Then I got the worse news, I had cancer! I was misdiagnosed with that too. The chemo was aggressive and painful along with the multiple surgeries. They seem to manage the pain at the time, but after they took my breast and botched up a few surgeries, I was left in daily pain. Pain is a 365 day job, that I didn’t apply for & cannot quit. Once My pain was managed properly my quality of life gave me the ability to learn how to swim, teach my children, be a wife & take care of my parents. One died of cancer. It’s part of my genetic makeup. With bricks as breast, RA & other chronic illnesses, a stomach issue, opiate therapy was the only thing that got me back to living. My mother died in pain in hospice!It saddens me that the guidelines lines have driven people to suicide.These medications that have been used for over 4000 years are now being withheld from us, striping us of a QOL!<br/>Suicides have increased yet the writing of prescription opiates have decreased by 60+ percent. The problem is not with the law abiding pain patients that are using their prescriptions properly, it’s the dope pushers on the corners that are killing people with illicit drugs. It’s seems as though the CDC would rather people turn to illegal/synthetic opiates to relieve pain.Why not get help for them instead of hurting the chronic pain community? Pain is relentless pain is there all the time in a chronic pain patients life. They depend on the medication for QOL.I was on my regimen for 17 yrs & 10 surgeries & never went up on my medication.Now being forced to taper has disrupted our household. One of the most enjoyable parts of my life is maintaining healthy relationships, being in so much pain has forced me into isolation. I have had suicidal thoughts because of the pain which saddens me. <br/>Everyone is made differently. It’s not a one size fits all!My body happens to metabolize pain medication greater than most people. My pain regimen allowed me to go on my first honeymoon in 20 years of marriage n 2018.<br/>These meds give people the ability to work, to travel and to be active in their community. Denying proper pain management with opiates, when they are the only thing that works is similar to denying people of water!<br/>Dr. Should not feel afraid of loosing their license because they are treating their legacy pain patents. <br/>The doctor &the patient should work together. Relationships with a PCPs Are lacking!The FDA guidelines state that the taper or lack there of should be patient driven not provider driven. Yet we are forced to taper & have our lives completely ripped from underneath our feet.<br/>Illicit fentanyl and other illicit drugs like heroin, those are the drugs that you should be seeking to cease. Why go after the veteran, the cancer survivor, they have went through the war and now they are suffering the consequences of it. Treat them humanely that is all we are asking. We should not have to suffer because people overdosed on-Illicit drugs, drugs that were not prescribed by a doctor.<br/>Doctors are so afraid that they are turning away chronic pain patients. This did not work in the prohibition and this is not working now. How many lives have to be lost before you get it right? <br/>Women especially women of color have their pain dismissed and that Has to stop! Any drug can be misused or overused why focus on opiate pain medicine that gives people back their lives?<br/>We also need to get rid of doctors postdating pain medication prescriptions. There is no other drug that they post date why single out those medications. It’s as if you’re telling the patient I don’t trust you which can be very traumatic. Women suffer from chronic pain more because of all of the hormones that we deal with and the complexity in which We were made. My life now consists because of the forced taper, to the ER to be treated for my severe pain. This leads to unnecessary costs & wasted time. This can be prevented if PCP would treat & not force taper. Proper use does not equal abuse! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kizzy	None	None	090000648500a1f5	Kistulinec	None	2022-04-11T13:32:21Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Kistulinec , Kizzy	l1t-tm0m-8sww	False	None	False	2022-04-12 06:40:45.297	[]
4585	CDC-2022-0024-4591	https://api.regulations.gov/v4/comments/CDC-2022-0024-4591	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a person who was just diagnosed with a condition that will most likely cause me chronic pain for the rest of my life I would appreciate not being treated like a drug addict. I had to sign a pain management contract that basically requires me to see a specialist every month to renew my nonopioid medicine and have a drug urine test done. Every time I see my pain management doctor I have a copay, I should be able to have some refills for my medicine without having to make an appointment monthly, pay a copay, and take time off of work to get a refill. It’s demoralizing and dehumanizing. Please take this into account when passing guidelines for chronic pain management. I shouldn’t have to feel like less than a human because I have pain that requires treatment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alicia	None	None	090000648500a93e	Hatfield	None	2022-04-11T13:34:22Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Hatfield, Alicia	l1u-38g5-zz1l	False	None	False	2022-04-12 06:40:45.511	[]
4586	CDC-2022-0024-4592	https://api.regulations.gov/v4/comments/CDC-2022-0024-4592	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm sorry but I have to leave my opinion on this .I see this is coming to a close as of tomorrow .I just want to say that pharmacist needs to stay out of the Drs business.they tried to act like the Dr and say they know what's best for the patient which is not true my Dr know s what s best for me..alot of pharmacist are against opioids pain meds.because of the lies they been told as well because of the 2016 CDC guidelines..we are asking u to throw the whole guidelines out.so this will stop .to many people are suffering.and has suffered way to long .please do the right thing here .I have lost alot of friends because they took their own life because they can't handle the pain....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melissa	None	None	090000648500a940	Guthrie	None	2022-04-11T13:34:53Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Guthrie , Melissa	l1u-3a1p-ko4p	False	None	False	2022-04-12 06:40:45.729	[]
4587	CDC-2022-0024-4593	https://api.regulations.gov/v4/comments/CDC-2022-0024-4593	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was successfully prescribed opioids from the V.A for 10 years. I have multiple permanent spinal issues that put me on Social Security Disability a few years before I was prescribed opioids. My quality of life along with physical and mental health have suffered since the V.A discontinued all opioid medication in favor of chiropractic care,yoga and mindfullness.<br/> I've been complaining for 7 years that I've gained 15 lbs, my BP has to be controlled with medication now, I have PVC'S caused by their improper tapering and my service connected depression increased 20% because of my chronic pain and lack of the life I had with my pain controlled.<br/>The [location redacted] V.A has been totally incompetent in my medical treatment since the CDC changed guidelines on opioids.<br/>Accupunture and tai chi don't help kyohosis, spondylosis, herniated and degenerative discs and stenosis. The V.A says no pain medication so your so called primary care can't prescribe opioids even if they want to. No doctor is going to risk his license to help you I was told.<br/>Chronic pain patients need help...make the guidelines apply to us...and make the V.A follow them	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kirk	None	None	090000648500a941	Jones	None	2022-04-11T13:36:07Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Kirk	l1u-3a65-fsdm	False	None	False	2022-04-12 06:40:45.975	[]
4588	CDC-2022-0024-4594	https://api.regulations.gov/v4/comments/CDC-2022-0024-4594	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello! I guess I will start by saying I just want somewhat of a life back. The opioid fear from doctor's because of regulations) pressure has made my life a living hell each day! I have severe chronic pain in my body from injures etc/severe gout pain as well. The only thing given to me now is a low does of tramadol which barely helps because not given the dose needed(I am on half the recommend dose). I also have very severe anxiety, depression/mood issues,ocd,add,and most severe tourettic ocd/tics. I have been on pages of meds I can list that have made the issue way worse or did nothing.But most commonly it did usually the opposite of what it was supposed to do. I also had two Brain injuries when I was 4 & 8 which may have caused some of my issues. I have binders I made of research that has evidence based information that some atypical opioids do help these issues in some individuals, especially the tourettic ocd & tics. I'm 37 years old and feel the worst I've ever felt. There was a few opioids/atypical opioids (mostly hydrocodone)that almost makes the ocd/tics non-existent and my mind the most normal I've felt in a long long time. It basically made me the person people once knew and a somewhat normal life. It allowed me to think clearer and help with the add/attention issues, it helps so much with the pain, and most importantly controlled the tourettic OCD and tics to make them mostly non-existent & the urges to do certain tick and OCD things virtually not there. I'm not saying you take a pill when everything is 110% great but all I'm saying is we want a chance to have access to medication that will allow us to control our issues like that and pain to just have a life again and to have it considered by doctors and have them not look at you like you are just a pill seeker and give you something else that just makes things worse. I've begged & pleaded for many doctors to please, please, just listen to me and can this just be tried and evaluated to just see the positive impact it would have, but they just look at you like just another junkie, or I've had doctors say it looks like it could have a positive impact on you since we tried everything else but we're so afraid they would lose their license.I was willing to do anything. I just beg you to please consider your regular pain and special circumstances patients that we have a say and don't have to continue a life we can never fully live. I think all plans will continue to fail as long as patients such as myself and other chronic pain & special circumstances patients who have been successfully treated by opiates for many years are not part of this story.There are thousands of us who are able to lead a somewhat functional life because we have/had access to opiates. We show no signs of addiction -stealing pills, seeing multiple doctors, faking pain, losing our jobs,money,cars,homes,family,etc. We don't live in our cars or on the streets where we contract and carry diseases as we turn to shooting up drugs. And we won't die from purchasing and injecting illicit fentanyl or heroin cut with it. Our lives don't look like that at all! Please, consider everyone who needs access to opiates to get some of their lives back. Please don't take this away from us for no point at all except including responsible prescription patients with people who use these drugs in a clandestine way. We are two very distinct groups of people and deserve to be treated as such. I am 100% in favor of doing whatever we can to end are opiate issues that is taking our valuable people, but that help does not have to come at the expense of law abiding patients, doctors, and pharmacists. Lastly I agree that all treatment modalities should be made available to those who are trying to control pain but most of those are done at our inexpense cause insurance does little to nothing. Please let's make a change of favors all of us there is a way to serve both of these crises without any more harm to each of these groups that have already suffered enough. Thank you for your time and hopefully when you are making your decisions you will keep a lot of this in mind because a lot of the normal things we would like to do we are missing out on and being discriminated against when us the patient and sometimes the right doctors know what works for us but do not have it access to it. Thank you for your time! [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jarred	None	None	090000648500a942	P.	None	2022-04-11T13:39:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from P., Jarred	l1u-3ahi-kjng	False	None	False	2022-04-12 06:40:46.186	[]
4589	CDC-2022-0024-4595	https://api.regulations.gov/v4/comments/CDC-2022-0024-4595	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am submitting these comments in support of revising the 2022 CDC Clinical Practice Guideline for Prescribing Opioids to include the use of low-dose opioids for Restless Leg Syndrome (RLS). I am an 81 year-old male who has been taking 10 to 15 mg (47 to 70.5 MME) of methadone daily for the past 12 years (since June 2009) for RLS after other medications (dopaminergic agents, dopamine receptor agonists, anti-convulsants, alpha-2-delta ligands, and others) failed to provide long-term relief and often caused augmentation that made my symptoms worse than before I started taking the medicine. Methadone has controlled my symptoms for the past 12 years without augmentation and has allowed me to live a normal life.<br/><br/>I initially developed RLS symptoms at age 58 and have required constant treatment since age 61. Without treatment, I am unable to sleep because my legs jerk the moment I fall asleep; waking me. I have participated in the [name redacted] National RLS Opioid Registry since 2018 and recommend that you contact them for their opioid use data. I also recommend the [name redacted], Vol 93, Issue 1 article: "The Appropriate Use of Opioids in the Treatment of Refractory Restless Leg Syndrome" by [name redacted]. Every 12 months, my prescribing physician has to fill out and submit significant paperwork to my pharmacy to get a "Prior Authorization" for my methadone prescription. It would help significantly if RLS was a prescribed on-label use of low-dose methadone and other low-dose opioids. Please consider my beneficial experience with low-dose methadone as you revise the CDC Opioid Prescribing Guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a958	Anonymous	None	2022-04-11T13:50:09Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-3jt1-4so7	False	None	False	2022-04-12 06:40:46.400	[]
4590	CDC-2022-0024-4596	https://api.regulations.gov/v4/comments/CDC-2022-0024-4596	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	090000648500a1f9	Barnes	None	2022-04-11T13:52:36Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Barnes, Kim	l1t-tmny-3230	False	None	False	2022-04-12 06:40:46.644	[]
4591	CDC-2022-0024-4597	https://api.regulations.gov/v4/comments/CDC-2022-0024-4597	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was and am on long term opioid therapy. I was stable, working, and most of all my pain was managed and quality of life highly impacted for positive. Since the 2016 CDC guidelines started being implemented in the draconian and dangerous manor that it was the harm,hopefully,unintentionally that has been done Is profound. Many many have died from being abruptly tapered off perfectly legitimate,widely used, opioids for many physical conditions and chronic pain conditions. Now people are on non therapeutic low doses because of a non scientific MME guideline? I’m on an a much lower amount of a medication that allowed me to have a life and participate in activities that I’m not able to. Dr.s in my experience know opioids are addicting but they also know they are important medications that are safe when used appropriate, No matter the mg dose , that should not be in any guideline. Many know the folks that are responsible for the [name redacted] debacle in the 2016 and even now the junk science is making its way into the 2022 guidelines that were supposed to put things back to having access to legal prescription opioids that are NOT what’s killing people from overdose. You know it’s the fentanyl analogues and it’s so bad I don’t think you know how bad it is going to get. Don’t ad to it by creating a new customer for these dangerous substances because they can’t get a Dr. to prescribe because not if worries of addiction or overdose but because of fear of DEA or local law going after licenses? He rid of the MME from the 2022 guidelines. And allow long term opioids for severe pain conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	090000648500a961	David	None	2022-04-11T13:53:21Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from David, David	l1u-3mdg-hx2z	False	None	False	2022-04-12 06:40:46.854	[]
4592	CDC-2022-0024-4598	https://api.regulations.gov/v4/comments/CDC-2022-0024-4598	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife has had several surgeries involving a metal plate. She has lumbar and thoracic conditions that are not operable,leaving the only option of opiate pain medication. The opiates were helping her live a better quality of life. The doctor chose the strength by looking at her MRI's,talking with her and discussing with about her pain level. then the government guidelines caused her level of pain medication to be lowered. This has left her much less functional and suffering constantly. Please put the call back in the doctors hands and forget this insane peer level B.S. away from politicians who have only hurt legitimate pain patients. This has done nothing to stop the majority of O.D.'s which are from illegal street drugs. My wife is 60 now and monitored well. [name redacted]<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	DAVID	None	None	090000648500a97c	POLK	None	2022-04-11T14:02:46Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from POLK, DAVID	l1u-3z19-88es	False	None	False	2022-04-12 06:40:47.066	[]
4593	CDC-2022-0024-4599	https://api.regulations.gov/v4/comments/CDC-2022-0024-4599	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a208	None	None	2022-04-11T14:04:09Z	Minnesota Acupuncture Association	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Minnesota Acupuncture Association	l1t-tr5j-opj8	False	None	False	2022-04-12 06:40:47.282	[]
4594	CDC-2022-0024-4600	https://api.regulations.gov/v4/comments/CDC-2022-0024-4600	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has suffered with RLS for many years. He currently takes oxycodone at night to help him sleep and it works!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	robert	None	None	090000648500a219	botelle	None	2022-04-11T14:04:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from botelle, robert	l1t-uak4-im7p	False	None	False	2022-04-12 06:40:47.513	[]
4595	CDC-2022-0024-4601	https://api.regulations.gov/v4/comments/CDC-2022-0024-4601	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines must be repudiated! Too many patients were harmed by the original guidelines. The 90 MME limit harmed thousands of patients. The new revisions inaccurately state higher risks after 50 MME, thus creating a new, lower limit that will harm even more patients. The CDC denies the 1st guidelines were used to harm patients yet it is clear that the CDC Opioids Guidelines did harm thousands of patients. The CDC was warned about these harms and ignored them. The CDC also chose to not include pain management doctors and pain patients to get accurate information. Knowing the previous guidelines were both intended to harm patients and weaponized to beyond their claim to be only for primary care doctors yet applied to hospitals, post surgical patients, even cancer patients, even end of life patients-it is clear that all CDC guidelines should be repudiated!<br/>The CDC also refused to follow up and investigate harms to chronic pain patients. The amount of intentional unethical behavior is serious and improper. It is government malfeasance. Nothing written under these circumstances can be trusted! the 2016 Guidelines and this revision Must be Repealed!!<br/>The 90 MME Guideline in the 2016 version caused serious harm to patients. The 50 MME reference in the revision will harm more innocent patients!! MMEs have serious flaws in the science behind them! Set limits do not respect patient needs!<br/>The claims of prescribed opioids being “highly addictive” also have serious flaws. Multiple studies show less than 2 percent possible correlation to addiction. Despite over approximately 100,000 people being prescribed opioids annually for decades and the addiction rate remaining a constant low number, and rising overdoses connected to illegal drugs, the CDC continues to lie and say prescribed opioids both cause addiction and are “highly addictive” when the evidence is against this. If prescribed opioids were so “addictive” the number of addictions would grow by tens of thousands annually- which is has not. <br/>The CDC knows that most overdoses have 5 or more substances, that prescribed opioid deaths are rare, and even rarer as the solo cause. Illegal drugs overwhelmingly cause overdoses. The CDC’s own Wonder Database shows this. It also shows that 1 person’s death with 5 or more substances is counted as up to 25 deaths in the data as each drug and combination is counted as a separate entry. Yet instead of cleaning up the data, they are fully aware of these gross inflations and used these inflated numbers to create a false narrative blaming prescribed opioids. The CDC was also aware that illegal fentanyl was a serious contributor to ODs yet chose to ignore that essential information. <br/>Patient harms and suicides increased after the 2016 Opioid guidelines. ODs from illegal drugs increased 1040%! There were zero positive outcomes from the 2016 Opioid guidelines for patients, for addicts, or for anyone- unless only the money from the opioid lawsuits is counted. The lies in the 2016 CDC Opioid guidelines were weaponized for the Opioid lawsuits. <br/>In fact, they appear created just to be used for the Opioid lawsuits rather than helping patients. The harm done to patients since the CDC Opioid Guidelines has been documented in multiple sources: increased disability claims, increased ER and hospitalizations, increased harms, increased relationship problems, decreased function, decreased ability to work, decreased income, and most critical- increased suicides. Also ODs from illegal drugs increased 1040 percent since the CDC Opioid guidelines even though prescribed opioids decreased significantly giving more evidence that prescribed opioids are not related to the increased ODs. <br/>As patient harms increased, opioid lawsuits wins against pharmaceutical companies increased. As if, only the lawsuits mattered rather than the patients. <br/>The CDC Guidelines, original and revised MUST BE REPEALLED! Doctors and patients should make medication and treatment decisions; not the government! The government should be fighting the real problem, illegal drugs. Evidence clearly shows illegal drugs, especially illegal fentanyl is causing the increasing ODs. Yet even though data clearly shows this, and that prescribed opioids have no causation or correlation with increased ODs or addictions, and that MME’s are based in flawed science, and that “increased harm” at “higher MMEs” is exceedingly low- almost the equivalent of multiplying by zero, 0.04 in fact. A number far too low to use to base any harm risk off of. The initial study re MMEs is riddled with unfounded assumptions, spurious correlations, and poor methodology. This is true of almost all studies used by the CDC to create a false narrative that prescribed opioids are “highly addictive” and “causing” increased OD’s and addiction. With significant numbers of studies and data confirming prescribed opioids are not highly addictive.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a982	Anonymous	None	2022-04-11T14:06:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-406z-ddm5	False	None	False	2022-04-12 06:40:47.768	[]
4596	CDC-2022-0024-4602	https://api.regulations.gov/v4/comments/CDC-2022-0024-4602	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Scrap this trash! No MME limits for patients! Too many patients have been harmed! <br/><br/>90 MME already caused too much harm!! Saying doses above 50 MME will cause greater harm will create a new lower limit that harms many more patients!!<br/><br/>All CDC guidelines should go! But since government cronies have allowed the lies of the previous draft, at least make this one truly better- NO MME LIMITS!!! <br/><br/>No MME LIMITS!!<br/><br/>Not 50 MME, NOT 90 MME! <br/><br/>NO MME LIMITS!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a98d	Anonymous	None	2022-04-11T14:07:10Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-496b-g2p8	False	None	False	2022-04-12 06:40:48.003	[]
4597	CDC-2022-0024-4603	https://api.regulations.gov/v4/comments/CDC-2022-0024-4603	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a chronic Pain patient who suffers from Nerve Damage iny left Sciatic Nerve. This means that I'm in constant pain 24hrs a day,7 days a week,365 days a year. I'm obviously on SSDI as I can't work anymore. The only thing that has givee relief from my constant pain is the Methadone my Doctor prescribed me. Now I'm a big guy and have a very efficient liver. Because of this I generally require more medication than others. This wasn't an issue in the 90s.My doctors figured out how much I needed then prescribe it. It started that way with Methadone. I started at 10mg 3x/day but a few years later I went up to 4x a day. No Problem. Them 2016 came. The state of Maine,like many other states,had decided to adopt this MME garbage and bought into the fear mongering. Some saw this for what it was,a way to expand the "recovery"Industry and jumped on. Some were bleeding hearts who bought the propaganda. Whatever they were they ruined the lives of thousands of Mainers,most of them elderly,by cutting their medication to "protect"them from becoming addicts! Many had been SAFELY taking those does for years,but the government didn't care! They tried to cut mine to LESS than what I started at! However there's a tiny loophole; if your predicted to have the condition until death it qualifies for a Palliative Care Exemption. So my Doctor Fought for me to get one,and was successful. However there were many who's doctors either didn't know about the exemption,or didn't want to fight the state for it who've suffered since then. That's when they turn to the streets and OD! Out of desperation! Others just gave up hope and committed suicide. Suicide due to untreated pain is skyrocketing amongst Vets right now,as well as the general public. The answer wasn't to attack opiates with ridiculous standards that can't possibly fit everyone! You should concentrate on Fentanyl, particularly the illegally imported stuff that they're mixing into...well everything! Because it's cheap. Stop that trade and provide people with adequate pain relief and you'll END your Opiate Crisis in a few years. Continue to crack down on patients and this is going to get worse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Stephen	None	None	090000648500a994	Cody	None	2022-04-11T14:08:55Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Cody, Stephen	l1u-4awz-mxyb	False	None	False	2022-04-12 06:40:48.228	[]
4598	CDC-2022-0024-4604	https://api.regulations.gov/v4/comments/CDC-2022-0024-4604	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	193.<span style='padding-left: 30px'></span>Page 108 – why does CDC feel the need to advise against unnecessary dose increases? Does the CDC have the medical charts and studies to show doctors routinely prescribe unnecessary dose increases? “Clinicians should generally avoid unnecessary dosage increases.” What practical value does such a statement really add?<br/><br/>194.<span style='padding-left: 30px'></span>Page 108 – contradicts prior advice that suggests dose increases are unnecessary. “Although there is limited evidence to recommend specific intervals for dosage titration”. As most pain expert textbooks document, dose titration is indeed necessary due to tolerance effects, but not a word is mentioned in this guideline about opioid rotations to mitigate the effects or use of NMDA agonists to help defeat such tolerance effects. Why not?<br/><br/>195.<span style='padding-left: 30px'></span>Page 108 – again CDC attempts to limit all patients with a one size fits all limit without regard to the multitude of factors that require individualized dosing which CDC first recommends then constantly contradicts with 50 MME over and over again, learning nothing from the harm created in the 2016 guideline’s poorly determined 90 MME limit. Remove it and all references to single dose limits or dose limits period. “Before increasing total opioid dosage to ≥50 MME/day, clinicians should pause, given that dosage increases to more than 50 MME/day are unlikely to provide significantly improved pain control for most patients” Also this is flat out untrue for millions of chronic pain patients and fuels misinterpretation and misapplication of your guidelines as you admit occurred with 90 MME. Millions of patients take significantly higher dosages and have been stable for decades on 200 to 1000 MME. Why keep violating your own advice about individualized care and clinician decision making?<br/><br/>196.<span style='padding-left: 30px'></span>Page 108 – this statement lacks any supporting evidence and attempts to control clinical decision making with government imposed limits subject to misinterpretation and misuse by government agencies (DEA), state governments, insurers and Medicaid/Medicare hard edits. “Additional dosage increases beyond 50 MME/day are progressively more likely to yield diminishing returns in benefits relative to risks to patients.” Remove all references to 50 MME. Otherwise, how will ensure what happened with 90 MME in the 2016 guidelines cannot occur in any organization or entity in the United States?<br/><br/>197.<span style='padding-left: 30px'></span>Page 108-109 – CDC gives further reasons why 50 MME/Day is wrong and needs to be removed in every reference in this document. “decision to increase dosage based on individualized assessment of benefits and risks and weighing factors such as diagnosis, incremental benefits for pain and function relative to risks with previous dosage increases, other treatments and effectiveness, and patient values and preferences.” <br/><br/>198.<span style='padding-left: 30px'></span>Page 109 – CDC cites a specific instance where is stated in 2019 its 90 MME had been taken out of context and imposed as a strict limit, which has also been advised against in this document. Why cite a state limit built on a mistake, and what is CDC going to do to correct such state level mistakes that were based upon CDC’s 90 MME? This is a vivid example of why any reference to a 50 MME or any other limit is dangerous, subject to misinterpretation, and harmful to patients and physicians and needs to be removed completely. Some states require clinicians to implement clinical protocols at specific dosage levels. For example, before increasing long-term opioid therapy dosage to >120 MME/day, clinicians in Washington state must obtain consultation from a pain specialist who agrees that this is indicated and appropriate (State of Washington Department of Health, 2019). Clinicians should be aware of rules related to MME thresholds and associated clinical protocols established by their states. The AMA has repeatedly called upon the CDC to correct this mistake being made over again in this draft, and we’ve identified the multitude of reasons that a one size fits all limit is both unscientific and harmful. How can the CDC work to reverse the damage it has done by the 2016 guidelines and best ensure state guidelines based on what CDC stated was a gross misinterpretation and out of scope of its 2016 guideline?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa7e	None	None	2022-04-11T14:11:47Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-c2if-6i8v	False	None	False	2022-04-12 06:40:48.693	[]
4599	CDC-2022-0024-4605	https://api.regulations.gov/v4/comments/CDC-2022-0024-4605	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While the proposed guidelines are an improvement from the last guidelines published in 2016 , they continue to be extremely problematic for patients with legitimate chronic pain disorders who depend on opioid therapy to reduce their pain and improve their quality of life. <br/><br/>The CDC's 2016 guidelines have unfortunately led to extremely harmful consequences for patients with chronic pain. They were used as the backing for huge policy decisions, with many states adopting laws and regulations that limited opioid prescribing. Similarly, many health insurances based policies on those guidelines. Many doctors have stopped prescribing opioids at all because it is seen as such a huge risk to their license. Some doctors will not take on new patients who take opioids to treat their pain. Many pharmacies will not fill patients' prescriptions. As a result, patients with chronic pain who have legitimately and safely taken opioids to control their pain for years now have to jump through herculean obstacles to obtain their prescriptions every month.<br/><br/>The proposed guidelines do not balance discussing the known risks of opioids with the benefits of continuing opioids for chronic pain when a patient has failed other treatment options. The guidelines also do not take into account the incredible harms of poorly managed chronic pain, which include physical distress, mental agony, inability to hold a steady job, and suicide. There needs to be stronger language against abandoning patients who depend on opioids for their pain. Additionally, citing specific doses can be interpreted as giving a hard ceiling, which makes it nearly impossible for patients who have safely depended on higher doses of opioids for years to obtain the medication needed for them to function on a daily basis. Physicians need to be trusted to use their judgement to decide which medications are safe and beneficial for their patients, and at what doses.<br/><br/>It is understandable that the CDC is hoping to reduce drug overdose deaths. However, while opioid prescriptions have decreased by over 40% in the last decade (helped in large part by the 2016 CDC guidelines), annual drug overdose deaths in the U.S. have increased during the same time period. The problem is clearly not with the prescribing of opioids- illicit street drugs are primarily driving the increase. There is therefore no reason to unfairly target chronic pain patients who are just trying to treat their pain with the permission and medical recommendations of their doctors.<br/>As an example, my good friend is a 40 year old woman with chronic pain that resulted from the treatments needed to save her life when she was diagnosed with cancer as a young adult. She has tried countless other modalities to treat her pain including numerous non-opioid medications, procedures, injections, 2 implanted spinal stimulators and much more. After nearly 20 years of trying other options, the only thing that she has found that provides relief from her excruciating daily pain is opioids. Her doctor has been prescribing opioids to her safely for years. She is at low risk for overdose and would never sell or give away her medication. She doesn't get "high;" she simply needs it to reduce her chronic pain so she can function. Unfortunately, due to all the of red tape which now surrounds opioid prescribing and dispensing, she now most of her time trying to obtain the medication that her doctor feels is most beneficial and safe for her. And most months out of the year, the red tape is so incredibly obstructive that she ends up running out of her needed medication, leading to sudden tapering, extreme pain, and her being unable to function. And if her current doctor were to retire, it would be virtually impossible for her to find another doctor willing to take her on as a new patient and continue the opioid medications that she has safely depended on for many years. <br/>My friend, like thousands of other chronic pain patients around the country, are depending on the CDC to take back much of the harmful language that was detailed in the 2016 guidance. The CDC needs to replace the prior language with more appropriate statements that respect the benefits that many chronic pain patients receive from taking opioids and that acknowledges the incredible harms that come from limiting dosing, suggesting medically unnecessary tapers and making it so incredibly difficult for patients to obtain the medication that their doctor has decided is best for them.<br/>One set of proposed changes that takes the needs of chronic pain patients into account was written by [redacted] and [redacted] [redacted]. I think that these proposed revisions are a great start and should be strongly considered by the CDC.<br/>Thank you for your consideration. The lives of chronic pain patients are literally in your hands.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aa80	Anonymous	None	2022-04-11T14:13:41Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-c4at-hgov	False	None	False	2022-04-12 06:40:48.923	[]
4600	CDC-2022-0024-4606	https://api.regulations.gov/v4/comments/CDC-2022-0024-4606	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline, but the draft does not address chronic conditions like RLS that are different from chronic pain. Restless legs syndrome (RLS) is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/>I have severe refractive genetic RLS. It causes me jerk both my legs and arms all night long and even walking does not stop it. I didn’t know why until I heard the TV advertisements for the first RLS drug. My primary care Dr tried all the dopamine agonist drugs until I augmented during a 2:00 pm meeting. We then tried all the off-label drugs sch as tricyclic anti-depressants, etc. with no real benefit. After receiving hydrocodone for pain after a hip replacement, I found that it completely quieted the RLS so I sleep. For 15 years, everything was fine until the State of Virginia instituted strict opioid laws. My primary care doctor cut me off with 2 weeks’ notice. Why? Because the rumors of physicians arrested for prescribing too many opioids were scary, when there were no definitions of how much was too many. Even my orthopedist told me he wasn’t prescribing opioid pain medications after my knee replacement surgery. I went to a pain management doctor, and they gave me a list of dispensaries for CBD. I was supposed to take a totally unregulated supplement with no real scientifically based research behind it instead of well documented drugs with a long history of pain relief. <br/>I tried 3 sleep specialists in VA who refused treatment, saying they were afraid of the law. I ended up at [name redacted] in [location redacted], MD. [name redacted] assigned one doctor to see all out of state patients, but he was excellent. He immediately switched me to methadone, which was a godsend, completely relieving my RLS symptoms and with the 15 hours duration, I wasn’t waking up in the middle of the night to take another 4 hour dose of hydrocodone or oxycodone. <br/>I’ve had numerous joint replacement surgeries in the last 5 yrs, but fortunately at the [name redacted], [location redacted], VA, where the surgeons understand the need for post-op pain medications. (I have genetic QA,12 surgeries so far). However, the Virginia laws are still scaring doctors. Last year I dislocated my elbow in a fall, tearing all the ligaments and crushing part of the bone. The ER Dr in the [name redacted] wrapped it up, told me to see an orthopedist on Monday, and I found out at the pharmacy that he had only prescribed OTC ibuprofen. The dosage was completely inadequate for level 10 pain. I started taking aspirin and was so mentally out of it with pain that I didn’t keep count. I ended up in ICU for 5 days and 5 more in a regular room for aspirin overdose. I had gone into kidney failure but fortunately came out of it. Isn’t that funny, Virginia is so afraid of opioids that I end up with aspirin overdose. <br/>This delayed my elbow surgery for 3 weeks and led to being so frail that I fell and dislocated my hip the day I was released. I had both hip revision and elbow surgery within 5 days. Because of the delay, the elbow surgery was unsuccessful as the bones had softened too much. After two more surgical attempts at correcting the elbow, my orthopedist says I now must have an elbow replacement. My point is, NONE of this would have happened (6 surgeries total and near kidney failure) IF the ER doctor had given me reasonable opioid pain medication instead of prescribing OTC dosage of ibuprofen. He simply created a cascade of disastrous health consequences that I will carry for the rest of my life.<br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-dose opioid therapy for decades. I urge the CDC to include a section in the 2022 Opioid Prescribing guidelines to address chronic medical conditions like RLS that require opioid therapy as a last resort, in low-total-daily doses, carefully monitored.<br/>Thank you for your consideration of these vital issues, and please consider the [name redacted] at www.rls.org as a resource for scientifically based information about RLS, as it is for members like me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	090000648500a997	Hayes	None	2022-04-11T14:13:58Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Hayes, Deborah	l1u-4b3t-7t20	False	None	False	2022-04-12 06:40:49.142	[]
4601	CDC-2022-0024-4607	https://api.regulations.gov/v4/comments/CDC-2022-0024-4607	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	199.<span style='padding-left: 30px'></span>Page 109 - The following entire statement should be modified to communicate that in some cases patients at high dose opioids should not be decreased and may need to be increased due to tolerance, and/or opioid rotation should be employed, but in any case any decisions about dose increases or decreases or no change should be at the sole discretion of the clinician and patient. Care must be individualized for the reasons outlined many times in other comments, such as differences in prior opioid exposure, drug metabolism, drug absorption, body weight, age, disease state, pain severity, etc. “For patients already receiving higher opioid dosages, clinicians should carefully weigh benefits and risks and exercise care when reducing or continuing opioid dosage. If risks outweigh benefits of continued opioid therapy, clinicians should optimize other therapies and work closely with patients to gradually taper to lower dosages or, if warranted based on the individual clinical circumstances of the patient, to appropriately taper and discontinue opioids. Unless there are indications of a life-threatening issue, such as warning signs of impending overdose, e.g., confusion, sedation, or slurred speech, opioid therapy should not be discontinued abruptly, and clinicians should not abruptly or rapidly reduce opioid dosages from higher dosages (recommendation category: B, evidence type: 4). “ State“if benefits outweigh risks, maintain established dosages and increase as necessary based on individual patient needs and/or consider opioid rotation to maintain analgesic efficacy and aggressively treat pain, since most patients who are on long term high doses of opioids are Intractable Pain Patients.”<br/><br/>200.<span style='padding-left: 30px'></span>Page 109 - Clinicians should consider tapering to a reduced opioid dosage, or tapering and discontinuing opioid therapy, and discuss these approaches with patients prior to initiating changes, when risks outweigh benefits (potentially including avoiding risks of tapering) of continued opioid therapy. CDC should also note that the vast majority of overdoses occurs due to street drugs and that physicians should treat pain in order to prevent patients from having to resort to much more dangerous street drugs for pain relief and confess the 2016 guidelines have driven patients to street drugs. How many times can you express your anti-opioid bias, and don’t you realize it destroys the credibility of this guideline?<br/><br/>201.<span style='padding-left: 30px'></span>Page 109 – 110: State that patients who do not agree with dosage reductions should not be forced to undergo reductions, especially merely to comply with any provision or statement of this guideline, and that dosage decisions should be at the sole discretion of clinicians and their patients, based on each individual medical case, as needed to optimize patient function and reduce pain. “For patients agreeing to taper to lower opioid dosages as well as for those remaining on higher opioid dosages, clinicians should establish goals with the patient for continued opioid therapy (see Recommendations 2 and 7) and maximize pain treatment with nonpharmacologic and nonopioid pharmacologic treatments as appropriate (see Recommendation 2). <br/><br/> <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa81	None	None	2022-04-11T14:13:59Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-c5sl-6cxo	False	None	False	2022-04-12 06:40:49.389	[]
4602	CDC-2022-0024-4608	https://api.regulations.gov/v4/comments/CDC-2022-0024-4608	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	202.<span style='padding-left: 30px'></span>Page 110-111 demonstrates a bias against opioids, and this multitude of bullets seems designed to push the very patient abandonment you suggest should not happen. Tapering encouraged like this leads to patient abandonment! In total, the word “taper” occurs 201 times in this 226 page document, but “individualized” occurs only 21 times. You would punish the 99.5% of patients who do not become addicted to opioids. “Clinicians should collaborate with the patient on the tapering plan, including patients in decisions such as how quickly tapering will occur and when pauses in the taper may be warranted. Clinicians should follow up frequently (at least monthly) with patients engaging in opioid tapering. When opioids are reduced or discontinued, a taper slow enough to minimize symptoms and signs of opioid withdrawal (e.g., anxiety, insomnia, abdominal pain, vomiting, diarrhea, diaphoresis, mydriasis, tremor, tachycardia, or piloerection) should be used. Tapers can be completed over several months to years depending on the opioid dosage and should be individualized based on patient goals and concerns. Longer durations of previous opioid therapy might require longer tapers. Tapers of 10% per month or slower are likely to be better tolerated than more rapid tapers, particularly when patients have been taking opioids for longer durations (e.g., for a year or longer). Significant opioid withdrawal symptoms can signal the need to further slow the taper rate. At times, tapers might have to be paused and restarted again when the patient is ready and might have to be slowed once patients reach low dosages. Tapers should not be reversed without careful assessment of benefits and risks of increasing opioid dosage or without maximizing nonopioid treatments for pain and addressing behavioral distress. Once the smallest available dose is reached, the interval between doses can be extended. Goals of the taper may vary—some patients might achieve discontinuation; others might attain a reduced dosage. If the clinician has determined with the patient that the ultimate goal of tapering is discontinuing opioids, opioids may be stopped when taken less frequently than once a day. Clinicians should access appropriate expertise if considering tapering opioids during pregnancy because of possible risk to the pregnant patient and to the fetus if the patient goes into withdrawal. Clinicians should advise patients that there is an increased risk for overdose on abrupt return to a previously prescribed higher dose, caution that it takes as little as a week to lose tolerance, provide opioid overdose education, and offer naloxone. Clinicians should remain alert to signs of anxiety, depression, and opioid misuse or opioid use disorder (see Recommendations 8 and 12) that might be revealed by an opioid taper and provide treatment or arrange for management of these co-morbidities. Clinicians should closely monitor patients who are unable to taper and who continue on high- dose or otherwise high-risk opioid regimens (e.g., opioids prescribed concurrently with benzodiazepines) and should work with patients to mitigate overdose risk (e.g., by providing overdose education and naloxone—see Recommendation 8). Clinicians can use periodic and strategic motivational questions and statements to encourage movement toward appropriate therapeutic changes and functional goals. Clinicians have a responsibility to provide or arrange for coordinated management of patients’ pain and opioid-related problems, including opioid use disorder. Clinicians should not abandon patients.” <br/><br/>203.<span style='padding-left: 30px'></span>Page 111 - CDC attempts discourage misapplication that occurred with this statement below, but in reality misapplication to is likely to continue as the draft is currently written in 2022. CDC knows the source of the nation’s addiction crisis is due to street drugs, predominantly illicit, not medical fentanyl, which if anything the 2016 CDC guidelines made worse, not better. “Payers, health systems, and state medical boards should not use this clinical practice guideline to set rigid standards related to dose or duration of opioid therapy, and should ensure that policies based on cautionary dosage thresholds do not result in rapid tapers or abrupt discontinuation of opioids, and that policies do not penalize clinicians for accepting new patients who are using prescribed opioids for chronic pain, including those receiving high doses of opioids.” This statement cannot guarantee misapplication won’t continue without drastic action taken, and the 226 page long document is only going to make matters worse and lead to even more misunderstanding and misapplication due to the myriad number of contradictions.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa84	None	None	2022-04-11T14:14:24Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-c7zj-15bp	False	None	False	2022-04-12 06:40:49.667	[]
4603	CDC-2022-0024-4609	https://api.regulations.gov/v4/comments/CDC-2022-0024-4609	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	204.<span style='padding-left: 30px'></span>Page 111 - CDC is encouraging misapplication of its own guidelines by extending the scope of a recommendation: While Recommendation 5 specifically refers to patients using long-term, high-dose opioid therapy for subacute or chronic pain, many of the principles in these implementation considerations and supporting rationale, including communication with patients, pain management and behavioral support, and slower taper rates, are also relevant when discontinuing opioids in patients receiving shorter durations and/or lower-dosages (see also Recommendations 6 and 7). Continuation of therapy must be an option. Why is continuant not listed as an option, since CDC knows full well 12 million Americans have no other choice but to continue opioid therapy or suffer a major degradation in quality of life and ability to function and contribute to society.<br/><br/>205.<span style='padding-left: 30px'></span>Page 111 – add “nor force mandated dose reductions”. “Clinicians should not abandon patients.” Every sentence of this guideline should reinforce this point and not contradict it.<br/><br/>206.<span style='padding-left: 30px'></span>Page 111 – CDC should listen to its own advice and reflect upon how the 2016 damage caused this exact outcome and realize the vast majority of the 2022 draft violates this principal. “Payers, health systems, and state medical boards should not use this clinical practice guideline to set rigid standards related to dose or duration of opioid therapy.” Listing 50 MME as a suggested limit and 5-10 MME as starting doses are rigid standards! Why keep such a limit knowing the harm 90 MME caused in 2016 through misunderstanding, out of scope, and misapplication?<br/><br/>207.<span style='padding-left: 30px'></span>Page 111 – How does CDC plan to guarantee its 2022 guideline does not result in this outcome? “policies do not penalize clinicians for accepting new patients who are using prescribed opioids for chronic pain, including those receiving high doses of opioids.” What realistic steps with teeth could you add to this document to ensure this does NOT happen?<br/>• <br/>208.<span style='padding-left: 30px'></span>Page 112 – Most overdoses occur at low dosages. CDC stated 98 MME. Higher doses are not inherently more dangerous especially in long term chronic pain where patients are titrated slowly over years or decades to offset tolerance effects. “Patients receiving long-term, high dose opioid therapy for chronic pain are at increased risk for adverse events including overdose mortality (Bohnert et al., 2011; Dunn et al., 2010; Gomes et al., 2011; 2467 K. S. Gordon et al., 2020; Kaplovitch et al., 2015).” Please make this clear and as noted.<br/><br/>209.<span style='padding-left: 30px'></span>Page 112 – This study proves that harm exceeds benefit since the hazard ratio is higher for causing a mental health crisis than an overdose. Also the 1.09 hazard ratio for overdose is very low and we know most overdoses are caused by illicit street drugs or prescription drugs stolen and misused for recreation. “One observational study found that among adults prescribed stable higher opioid dosages (mean ≥50 MME/day) long-term, increasing maximum monthly dose reduction velocity by 10% was associated with an adjusted incidence rate ratio of 1.09 for overdose (95% CI, 1.07-1.11) and of 1.18 for mental health crisis (95% CI, 1.14-1.21) (Agnoli et al., 2021).” Emphasize that for many patients maintaining their current dose may be the best course of action, and that decision should rest entirely on the clinician, not via manipulation of a federal agency, intimidation by the DEA, and taking cherry picked statements out of this document to weaponize it to justify anti-opioid bias.<br/><br/>210.<span style='padding-left: 30px'></span>Page 113 – who are these alleged experts and what is their background? This sounds like addiction psychiatrists not pain management specialists, who should have been at least included with a 50/50 representation in editing this guideline. “Some experts were concerned that over-emphasizing risks of tapering could increase harm from continued high-dosage opioid use.” <br/><br/>211.<span style='padding-left: 30px'></span>Page 113 – this statement demonstrates why the multitude of references to tapering in this document are prejudicial, biased and risk patient harm. “Because tapering opioids can be harmful in some circumstances, benefits of continuing opioids in patients who have already received them long term might include avoiding risks of tapering and discontinuing opioids.”<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa88	None	None	2022-04-11T14:17:01Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-c9kr-7kuh	False	None	False	2022-04-12 06:40:49.898	[]
4604	CDC-2022-0024-4610	https://api.regulations.gov/v4/comments/CDC-2022-0024-4610	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	On March 23rd 2022 I was in the hospital due to severe pain in my abdomen and a fever of 104. I was diagnosed with chronic intestinal inflammation that had been going on for years, but this particular day it became terribly inflamed and is now diverticulitis. I was told there is no cure and it can flare at any time. I have also suffered kidney stones in the past and the pain still lingers with any new trauma or illness. The doctor administered 50 mg Tramadol to help with the fever and pain in the hospital and a prescription to take home. Leaving the hospital in pain, I went to the pharmacy and my insurance company refused to cover the Tramadol pain medication. The reason was they wanted me to try something else first, such as over the counter medication, but never stated what the replacement drug should be. I ended up using my own funds and other partial coverage to get the medication, but I am disabled on limited income and this was a horrible inconvenience to me and the doctor. The doctor made it very clear that over the counter medication was unreasonable for me to try to gauge and I would have to take too many of them at out-of-pocket cost to get the same pain relief. I don't believe any insurance company should have the right to over rule any doctor. <br/><br/>Recommended change to “CDC Clinical Practice Guideline for Prescribing Opioids–United States, 2022 “ <br/><br/>Line 1532: Medicare/Medicaid or uninsured patients must be allowed leniency to receive physician perscribed opiate medication for a maximum of 7 day period. In this time patient should receive compassionate care while doctor resolves medical concerns with insurance company while closely monitoring patient's health. A social worker or outreach worker should be assigned to patient to help bridge communications and work to resolve acute pain needs regardless of financial qualifications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tee	None	None	090000648500a999	Lewis	None	2022-04-11T14:17:02Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Lewis, Tee	l1u-4br7-3crs	False	None	False	2022-04-12 06:40:50.118	[]
4605	CDC-2022-0024-4611	https://api.regulations.gov/v4/comments/CDC-2022-0024-4611	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	212.<span style='padding-left: 30px'></span>Page 113 – 114: The introduction of this study you cite here states the vast majority of cases used in reaching this conclusion are poor quality, as stated “Study quality was good for 3 studies, fair for 13 studies, and poor for 51 studies.” Why base such a recommendation on a majority of poor studies? (https://www.acpjournals.org/doi/full/10.7326/M17-0598) “However, following slow, voluntary reduction of long-term opioid dosages, many patients report improvements in function, quality of life, anxiety, and mood without worsening pain or with decreased pain levels (Frank et al., 2017).” This is the exact opposite from the truth we are hearing from a myriad of chronic pain patients who have suffered from dose reductions, including many who were forced from being a tax paying contributor to society to being a drain on the US government financial system, and a lot of these people would love to return to work if they were given proper and sufficient analgesics and pain management.<br/><br/>213.<span style='padding-left: 30px'></span>Page 114: This needs to be a recommendation and be more emphasized or you’ll repeat the same mistakes of 2016 and cause more patient harm and more physician attrition. “Clinicians should not insist on opioid tapering or discontinuation when opioid use may be warranted (i.e., when benefits of opioids outweigh risks) (Kroenke et al., 2019; U.S. Department of Health and Human Services, 2019a).”<br/><br/>214.<span style='padding-left: 30px'></span>Page 114: Statements like this lead to forcing patients to choose between treatment for anxiety or insomnia or pain, and cause harm. This is especially dangerous because anxiety and pain can be mutually reinforcing. The entire basis for such a statement is reports from overdose data taken mostly from overdoses that combine 4 or more illicit substances taken in dosages far in excess of prescription levels. “Some patients using more than one respiratory depressant (e.g., benzodiazepines and opioids) might require tapering one or more medications to reduce risk for respiratory depression.” Care needs to be individualized and not dictated by a federal agency. Why punish patients with multiple severe health conditions, when they do not increase overdose risks unless medicines are taking not as directed or for getting high?<br/><br/>215.<span style='padding-left: 30px'></span>Page 114: This statement is unnecessary and reflect the anti-opioid bias of the editors of this document “Patients who are not actually taking opioids (such as patients who are diverting all opioids they obtain) do not require tapers.” This insinuates and falsely accuses people for diverting opioids, which the DEA cites as so low a number as to be statistically insignificant. Why do you falsely incriminate pain patients in this regard?<br/><br/>216.<span style='padding-left: 30px'></span>Page 115: This statement indicates a bias against opioid use because when in doubt you are saying to stop opioid therapy rather than give patients benefit of the doubt. Remove this statement “The patient has been treated with opioids for a prolonged period (e.g., years), and current benefit-risk balance is unclear (e.g., decreased positive effects due to tolerance, symptoms such as reduced focus or memory that might be due to opioids). In fact millions have successfully used opioids for many years, and even decades without these side effects. <br/><br/>217.<span style='padding-left: 30px'></span>Page 115: This statement could be used to deny pain treatment to anyone who ever struggled with OUD in the past and needs to be removed “There is current evidence of opioid misuse.”<br/><br/>218.<span style='padding-left: 30px'></span>Page 115: This is not a valid reason to taper patients off opioids, and encourages the practice of patient abandonment, and forces patients who have terrible serious physical and mental diseases to be treated by one or the other, which has a negative impact on both because often such conditions are mutually reinforcing. Remove this: “The patient is receiving medications (e.g., benzodiazepines)”<br/><br/>219.<span style='padding-left: 30px'></span>Page 116: CDC is once again pressing dosage reductions and ignoring its own advice that clinicians should make decisions not federal agencies and that dosages should be individualized. “Clinicians should empathically review benefits and risks of continued high-dosage opioid therapy and should offer to work collaboratively with the patient to taper opioids to safer dosages.” You are telling industry to get people off opioids as if the illicit fentanyl crisis will be solved by heeding these words, which the data from CDC simply contradict. Why the constant emphasis on tapering?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa89	None	None	2022-04-11T14:17:30Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-cauq-f70q	False	None	False	2022-04-12 06:40:50.369	[]
4606	CDC-2022-0024-4612	https://api.regulations.gov/v4/comments/CDC-2022-0024-4612	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	220.<span style='padding-left: 30px'></span>Page 116: CDC repetitively suggests tapering regardless of individual circumstances as outlined in these comments, and by doing so is implying that people who are stable on long term doses should even be tapered, and such needs to be removed : “If the current opioid regimen does not put the patient at imminent risk, tapering does not need to occur immediately, and clinicians can take time to obtain patient buy-in (Dowell & Haegerich, 2017).” You should not imply that long term patients need to be tapered whatsoever. Why do you do this and not leave it to clinicians and patients to make individualized choices?<br/><br/>221.<span style='padding-left: 30px'></span>Page 116: CDC is suggesting that physicians deceive patients because there are millions of patients who have successfully had their severe pain treated for many years, and it is very doubtful that most do not experience worsening from pain from the witness of millions of patients. “Patients should be advised that overall, following voluntary reduction of long-term opioid dosages, most patients report stable or improved function, anxiety, and mood without worsening pain.” This statement is either a result of a bias against opioid use or is not based on robust high quality data from multiple studies, such as the ongoing studies across the country including Stanford University, and this can result in patient harm.<br/><br/>222.<span style='padding-left: 30px'></span>Page 116-123: “Pain management during tapering”, “Behavioral health support during tapering”, “Tapering rate”, “Management of opioid withdrawal during tapering”, “Tapering when patients have opioid use disorder”, “Other challenges to tapering” all reveal a bias against opioids and emphasis on tapering that is very likely to result in patient harm, abandonment, and use by federal agencies to eliminate physician choice and decision making and should left to the physician and patient to decide, not the federal government. Especially considering prescriptions are down by historic proportions yet overdoses have continued to climb.<br/><br/>223.<span style='padding-left: 30px'></span>Page 123 – this statement defies expert level textbooks that document even high dose patients will eventually need increases due to tolerance effects and such increases do not clearly increase the risk of overdoses. Your own analysis earlier in this document proves that most overdoses occur at low doses of opioids, again usually taken for non-medical reasons by those who are opioid naïve. The real problem not addressed at all by this guideline is the intentional doping of illicit fentanyl into almost every street drug now being sold on our streets. Remove this: “Increasing opioid dosage in patients already receiving high dosages is likely to be associated with diminishing returns for pain relief and increased risks for adverse effects and should be avoided.” High dose is a relative term and thus gives no useful advice, besides being untrue. Why not remove this generic statement entirely rather than attempt to manipulate clinicians into dose reductions, which this appears to do?<br/><br/>224.<span style='padding-left: 30px'></span>Page 123-124 – How does CDC plan to ensure this statement is heeded? How does CDC inform the DEA to back off its enforcement of 90 MME? Why mention 50 MME then contradict that suggestion here, which should remain and 50 MME should be removed? “Payers and health systems should not use this clinical practice guideline to set rigid standards related to dose or duration of opioid therapy”. How will you guarantee this will not happen, especially given the strong anti-opioid bias of this guideline?<br/><br/>225.<span style='padding-left: 30px'></span>Page 124 – this statement should be the first one made in this document, along with the emphasis on individualized care, and that this document in no way is a substitute for clinician decision making and should never be the basis of government or insurance policy. “Care should be taken to ensure that policies do not penalize clinicians for accepting new patients who are receiving opioids for chronic pain. Patients prescribed opioids but unable to access ongoing care (Lagisetty et al., 2019) may be at risk for abrupt opioid discontinuation and may miss opportunities to receive life-saving interventions, including monitoring for and management of mental health and substance use co-morbidities.”<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa8c	None	None	2022-04-11T14:17:55Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-ccc0-8x6j	False	None	False	2022-04-12 06:40:50.604	[]
4607	CDC-2022-0024-4613	https://api.regulations.gov/v4/comments/CDC-2022-0024-4613	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	226.<span style='padding-left: 30px'></span>Page 124 – considering all the variables noted above with regard to 50 MME: “When opioids are needed for acute pain, clinicians should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids”. Again, clinicians and patients should decide this, and we do not need the federal government warning against “no greater quantity” which will drive up refills which in turn drives up medication costs due to insurance copays and quantity price breaks in volumes. It is a false assumption that unused opioids will wind up diversion risks. The vast majority of patients are not criminals, and you are implying they are with this statement. Simply advise patients to dispose of unused opioids.<br/><br/>227.<span style='padding-left: 30px'></span>Page 124 – a special emphasis such as bold lettering needs to be given to the final statement of this paragraph, shown here underlined:. “Opioids are sometimes needed for treatment of acute pain (see Recommendation 1). When the diagnosis and severity of acute pain warrant use of opioids, clinicians should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. For many common causes of nontraumatic, nonsurgical pain, when opioids are needed, a few days or less are often sufficient, and shorter courses can minimize the need to taper opioids to prevent withdrawal symptoms at the end of a course of opioids. However, durations should be individualized based on the clinical circumstances of the specific patient. <br/><br/>228.<span style='padding-left: 30px'></span>Page 124 - If the goal is truly individual care as determined by clinicians, based upon their medical education, clinical experience, and relationship with their patients, why is there any guidelines beyond the FDA drug guidelines that already include dosage information in the prescribing guidance? “For postoperative pain related to major surgery, procedure-specific opioid prescribing recommendations are available with ranges for amounts of opioids needed (based on actual use and refills and on consensus). <br/><br/>229.<span style='padding-left: 30px'></span>Page 125 – why does the guideline attempt to address socioeconomic differences and disparities? Isn’t this more political than medical information, and amounts to implying that clinicians are racists? “In particular, clinicians, practices, and health systems should ensure all patients can access and afford additional evaluation and treatment, as needed, to minimize disparities across patients based on access to and affordability of care and refills.” <br/><br/>230.<span style='padding-left: 30px'></span>Page 125 – where does 2 weeks come from? Why should the re-evaluation period not be left to the clinician’s judgement instead of the federal agency’s advice? “Patients should be evaluated at least every 2 weeks if they continue to receive opioids for acute pain.” <br/><br/>231.<span style='padding-left: 30px'></span>Page 125-126: This makes any 2 week period or 50 MME limit contradictory to your own findings (and hence both should be removed): “Some patients (17.8%, ranging from 11.7% to 30.0% depending on the acute pain condition) obtained at least one refill within 30 days after their initial opioid prescription, suggesting that while for most patients, these durations might have been sufficient or more than necessary, there is likely to be variation across diagnoses and among patients in time to recovery.” Indeed, one sizes does NOT fill all. Why cite such numbers in this document? <br/><br/>232.<span style='padding-left: 30px'></span>Page 127: states “There is also evidence of variation in opioid needs across patients undergoing the same procedures based on individual factors including pain at discharge and prior opioid use (Mallama et al., 2021). One study found that while a majority of patients used no or few (less than a total of 50 MME during their entire postoperative course) opioids, some patients required opioids for up to 15 days after surgery (Thiels et al., 2018).” Again, this statement affirms that a single 50 MME limit or 2 week time frame or 5-10 MME starter dose are all meaningless, unscientific, and highly likely to lead to unnecessary human suffering because the anti-addiction bias of the editors chose to ignore its own findings. Again, this statement adds no value to the guideline, and seems a mere attempt to justify the anti-opioid bias and addiction focus of the editors, and is not balanced with pain management and care of pain patients because most of this document represents only the addiction and not the pain management side of the opioid debate.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa8e	None	None	2022-04-11T14:18:16Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-cdqs-kbwv	False	None	False	2022-04-12 06:40:50.853	[]
4608	CDC-2022-0024-4614	https://api.regulations.gov/v4/comments/CDC-2022-0024-4614	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 65 and have used Oxycodone at the same dose for approximately 10 years, for chronic pain from various medical issues. I have also tired other pain therapies. I do not nor have I been tempted to abuse my medication. The Oxycodone does not eliminate the pain, but it does help dull it. Insurance and Doctors refuse to do need surgery because of weight and smoking. Loosing weight and stopping smoking is a double edge sword. The more pain you are in the more you smoke and the less you are able to physically move. Don't I deserve some quality of life? What ever happen to first do no harm? Living in severe pain is not only harmful it is cruel. I am sorry for those who abuse their medication but why should I be punished and forced to live in pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	090000648500a9b4	Cobb	None	2022-04-11T14:19:30Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Cobb, Cheryl	l1u-4edf-0k41	False	None	False	2022-04-12 06:40:51.073	[]
4609	CDC-2022-0024-4615	https://api.regulations.gov/v4/comments/CDC-2022-0024-4615	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	233.<span style='padding-left: 30px'></span>Page 127: This statement is false and misleading and reflects the anti-addiction prejudice and bias of the authors of this document who lack training and experience in pain management: “Opioids prescribed for surgery and other acute pain conditions that go unused (Bartels et al., 2016; Bicket, Long, Pronovost, Alexander, & Wu, 2017; Mallama et al., 2021; Neuman, Bateman, & Wunsch, 2019) are a potential source for misuse and diversion”. Very few if any opioids are truly diverted, a fact backed up in DEA production quota statements that affirm that less than 0.5% are diverted. As pain experts have cited in expert pain management textbooks, this opioid-phobia harms patients. What studies validate that unused drugs end up being misused and diverted, and not simply safely stored for a use when medications cannot be refilled thanks to the DEA quotas that have bottlenecked supply chains and caused patients to suffer withdrawals while they were forced to wait on refills due to the government’s over-emphasis on minimizing diversion rather than ensuring pain is treated humanely?<br/><br/>234.<span style='padding-left: 30px'></span>Page 127: The decision again should be based on the physician and patient, not a remote federal agency, especially one that lacks regulatory authority and expertise in pain management, with a known addiction bias and political agenda. “Therefore, limiting duration of opioids prescribed can minimize the need for a taper to prevent distressing or unpleasant withdrawal symptoms.” Remove this sweeping generalization due to the potential for harm and low potential for benefit. Why keep repeating taper, taper, taper?<br/><br/>235.<span style='padding-left: 30px'></span>Page 128: Again we see in your own guidelines that contradict 50 MME and 7 day limits you impress elsewhere: “Certain circumstances (e.g., severe traumatic injuries) might require use of opioids for durations greater than 7 days. Durations should be individualized based on the clinical circumstances of the specific patient.” Doesn’t this last sentence suggest there is no need for a CDC guideline at all?<br/><br/>236.<span style='padding-left: 30px'></span>Page 128: Why does the University of Michigan seem to be emphasized? Is it due to their anti-opioid bias? “For postoperative pain, procedure-specific opioid prescribing recommendations are available with ranges for amounts of opioids needed (based on actual use and refills and on consensus) (Michigan Opioid Prescribing Engagement Network, 2020; Overton et al., 2018) (Thiels et al., 2018).” Doesn’t this also suggest there is no universal guideline for all patients, all conditions, all factors included? Shouldn’t such decision making be made based on clinician-patient judgement and not some academic study done retrospectively and subject to selection and other bias and prejudice? Don’t such prescribing guidelines become based on overdoses in a certain region, and why should overdoses due to street drugs drive anti-opioid fears when most overdoses are due to illicit street drugs and recreational drug use? How does this guideline solve the illicit drug overdose in the United States, and what is the correlation between opioid prescriptions and overdoses? Isn’t the relationship inverse – the fewer the prescriptions, the more the overdoses?<br/><br/>237.<span style='padding-left: 30px'></span>Page 128: You suggest that access to low-cost opioids or alternative therapies are difficult for many Americans to receive due to insurance or health care limitations, but then you make statements as if all such problems are solved knowing this is a very unlikely scenario and completely unrealistic. Why do you make suggestions that will harm patients? “in the event that pain continues longer than expected, it might be challenging for some patients to successfully navigate the healthcare system (e.g., clinician and pharmacy contact, transportation, need for assistance) to obtain additional medication as needed, leading to potential disparities in treatment.” You are creating the very disparities you advise against. Isn’t that a bit hypocritical, and violates other principals of this document?<br/><br/>238.<span style='padding-left: 30px'></span>Page 128: Isn’t this a statement of a political objective of a single payer government run health system, and what purpose does it have in this document? “In particular, clinicians, practices, and health systems should ensure all patients can access and afford additional evaluation and treatment as needed to minimize disparities across patients based on access to and affordability of care and refills”. How does CDC propose that all patients can access and afford evaluation? Doesn’t this reveal an agenda to drive for universal payer/socialized healthcare, that on average the US Citizen does not want, and given the CDC 2016 guidelines, should not trust government to manage healthcare?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa90	None	None	2022-04-11T14:20:36Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-chkx-42c8	False	None	False	2022-04-12 06:40:51.303	[]
4610	CDC-2022-0024-4616	https://api.regulations.gov/v4/comments/CDC-2022-0024-4616	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	239.<span style='padding-left: 30px'></span>Page 129: states “When patients are discharged from the hospital following surgery, opioid dosages needed during hospitalization and prior to discharge can help predict tapering needs to prevent withdrawal (Hill, Stucke, Billmeier, et al., 2018; Joo et al., 2020; Tamboli et al., 2020).” Again this is another anti-opioid addiction fear mongering statement designed to under-treat pain and risk harming patients. Why the insistent occupation with tapering throughout this document? It seems such tapering could be summarized in a single page, removing many pages of this document as excessive bureaucratic paper waste of taxpayer funding? If so, ensure that tapering should be at the sole discretion of the clinician and not per this guideline.<br/><br/>240.<span style='padding-left: 30px'></span>Page 130: Isn’t this best removed and deferred to clinician judgement? “Clinicians should evaluate benefits and risks with patients within 1 to 4 weeks of starting opioid therapy for subacute or chronic pain or of dose escalation. Clinicians should evaluate benefits and risks of continued therapy with patients every 3 months or more frequently (recommendation category: A, evidence type: 4). “<br/><br/>241.<span style='padding-left: 30px'></span>See questions on the 50 MME limit cited earlier and then remove this section “Clinicians should consider follow-up intervals within the lower end of this range when ER/LA opioids are started or increased, given increased risk for overdose within the first 2 weeks of treatment, or when total daily opioid dosage is ≥50 MME/day. (Note: Overdose risk is doubled across multiple studies for dosages of 50 to <100 MME/day relative to <20 MME/day - see Recommendation 4”).<br/><br/>242.<span style='padding-left: 30px'></span>Page 130: Delete 50 MME and assess the value of the rest of this statement without the one size fits all value: “In initial follow-up interval closer to 4 weeks can be considered when starting immediate-release opioids at a dosage <50 MME/day.”<br/><br/>243.<span style='padding-left: 30px'></span>Page 130: Given that most opioids are not refillable, is CDC now suggesting that Schedule II substances be allowed 2 refills? This may be the first useful suggestion in this document, but it is evidence that the editors are not aware of the practice of pain management to which this document attempts to regulate. “Clinicians should regularly reassess all patients receiving long-term opioid therapy, including patients who are new to the clinician but on long-term opioid therapy, at least every 3 months.”<br/><br/>244.<span style='padding-left: 30px'></span>Page 130: Isn’t the implicit goal of pain reduction all that is sufficient, and why does the federal government feel compelled to advise doctors about how to make such rudimentary aspects of pain management? “Clinicians seeing new patients already receiving opioids should establish treatment goals for continued opioid therapy (see Recommendation 2). Don’t you think every physician understands the goal is to reduce pain, and if possible, increase function? Why does this statement need to be made?<br/><br/>245.<span style='padding-left: 30px'></span>Page 130: This statement is claiming that everyone with any form of mental health or depression is somehow more subject to opioid use disorder. Clinicians should re-evaluate patients who are at higher risk for opioid use disorder or overdose (e.g., patients with depression or other mental health conditions, a history of substance use disorder, a history of overdose, taking ≥50 MME/day, or taking other central nervous system depressants with opioids) more frequently than every 3 months. Again, see comments on 50 MME as a one size fits all limit and the risks it brings of repeating the same disaster caused by the 90 MME reference in 2016.<br/><br/>246.<span style='padding-left: 30px'></span>Page 130: Another idealized political statement that has no benefit in a guideline such as this, but does seem to suggest the political bias towards government controlled socialized one payer medicine: “To minimize unintended impact on patients with challenges in accessing or affording follow-up visits, practices, and health systems should work to ensure all patients can access and afford follow-up evaluation.” Why make such political statements when this is beyond a clinician’s control? <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa92	None	None	2022-04-11T14:20:49Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-cjag-aus3	False	None	False	2022-04-12 06:40:51.517	[]
4611	CDC-2022-0024-4617	https://api.regulations.gov/v4/comments/CDC-2022-0024-4617	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	247.<span style='padding-left: 30px'></span>Page 131: Why do you contradict yourself by warning against use of medicines for mental health conditions such as anxiety and insomnia and they advise clinicians to treat these orders? In fact, you should not be suggesting any aspect of mental health care in this document, especially harmful ideas such as you propose elsewhere. Many if not most patients with chronic pain suffer from anxiety or other conditions that are mutually reinforcing and forcing patients to choose to treat one and not the other harms millions of patients. The following is right and your references to not treat chronic pain and anxiety, insomnia, etc. is wrong: “Clinicians should ensure that treatment for depression, anxiety, or other psychological co-morbidities is optimized”. Why do you warn about combining pain management and mental health tools then state here (correctly so) that both should be treated? Is it purely based on the unfounded belief that benzodiazepines and opioids “MIGHT” lead to overdoses, and do you have clear studies that demonstrate this that differentiates street drug users who combine many substances from patients under physician care that have long been under management for multiple conditions and never had any problems in decades of being treated with both benzodiazepines and opioids? Aren’t you contributing to the problem instead of solving the problem?<br/><br/>248.<span style='padding-left: 30px'></span>Page 131: See comments regarding 50 MME alone and when combined with benzodiazepines. You state: “dosages ≥50 MME/day or opioids combined with benzodiazepines]”. Millions of patients have safely used dosages of 1000 MME/day combined with multiple benzodiazepines when under a physician care successfully without incident for decades, disproving this alleged heightened risk of overdose. Your bias against combined use comes solely from overdose reports that are driven by illicit drug use, and include other drugs such as heroin, alcohol, cocaine, etc. You should not make statements like this that result in patients being forced to choose between having pain or mental health managed. Both should be managed without your advice or input and left to the decision making of the clinician and patient. The federal government needs to stop dictating how patients are treated.<br/><br/>249.<span style='padding-left: 30px'></span>Page 131 recommends unproven and often unavailable modalities and should include opioid therapy in this statement as an equally viable option. “Clinicians should maximize pain treatment with nonpharmacologic and nonopioid pharmacologic treatments as appropriate (see Recommendation 2). Again this seems more anti-opioid rhetoric. Why does the CDC seem so preoccupied with eliminating opioids when they have been safely used for centuries, and are often the last resort to give patients some semblance of quality of life? Shouldn’t adults have the freedom to choose to be treated, and that treatment should not be dictated by a federal agency who lacks the patient’s records or insight into their susceptibility to the very low risk of addiction?<br/><br/>250.<span style='padding-left: 30px'></span>Page 131: This statement is untrue and could lead to bad decisions and cause patient harm. The problem may be the wrong opioid is being prescribed and another opioid might be more effective. Again, care should be individualized and not dictated by a federal agency, especially one without statutory authority or clinical expertise to write these guidelines. “Patients who do not have pain relief with opioids at 1 month are unlikely to experience pain relief with opioids at 6 months.” How many studies demonstrate this and cite those studies, vs. the experience of millions of US citizens who have been treated with opioids for decades successfully for very painful conditions? How do you prevent insurers, the DEA, and other federal agencies from mis-interpreting this 6 months as a limit on the duration of opioid therapy, and the resulting harm including risk of suicide to the public health?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa93	None	None	2022-04-11T14:20:59Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-ckl4-e11h	False	None	False	2022-04-12 06:40:51.738	[]
4612	CDC-2022-0024-4618	https://api.regulations.gov/v4/comments/CDC-2022-0024-4618	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	251.<span style='padding-left: 30px'></span>Page 132: You claim “Although evidence is insufficient to determine at what point within the first 3 months of opioid therapy the risks for opioid use disorder increase, reassessment of pain and function within 1 month of initiating opioids provides an opportunity to modify the treatment plan to achieve pain treatment goals, minimize risks of long-term opioid use by tapering and discontinuing opioids among patients not receiving a clear benefit from these medications, and additional evaluation within the first three months might provide opportunities to identify and mitigate risks for opioid use disorder and overdose.” You admit to not having any data then proceed to make recommendations on time periods even when you have no basis in making those, so without data, what is the basis for this suggestion, and why not leave decisions to clinicians and patients? Don’t all Americans deserve to have their pain treated, or do we need a constitutional amendment to guarantee our freedom to be treated for pain? Don’t you realize all the needless suffering you have caused, without benefit, since prescriptions are down over 70% yet overdoses have continued to climb?<br/><br/>252.<span style='padding-left: 30px'></span>Page 132: The CDC states there is limited data for this statement but then grades it a level A recommendation: “Experts noted that although there is little evidence for specific follow-up time frames, the recommendation was reasonable and reflects common practice and therefore supported both the recommendation and the category A designation.” In addition, what experts are you referring to, the 5 editors with an addiction background? Whose common practice? Did you survey every pain management doctor in the United States?<br/><br/>253.<span style='padding-left: 30px'></span>Page 132: See previous questions about 50 MME references and remove this: “Clinicians should consider follow-up intervals within the lower end of this range when ER/LA opioids are started or increased, given increased risk for overdose within the first 2 weeks of treatment (Miller et al., 2015), or when total daily opioid dosage is ≥50 MME/day, given overdose risk is doubled across multiple studies for dosages of 50 to <100 MME/day relative to <20 MME/day (see Recommendation 4).” In addition, this statement is so poorly written that it will only add confusion and harm patients. Are you not saying longer term use of opioids is safer?<br/><br/>254.<span style='padding-left: 30px'></span>Page 133: Again, why does one specific author who is also one of five of the editors tend to be the most cited in this document, and one who was a primary contributor to the problematic 2016 guidelines, someone without training or expertise and possible conflict of interest, seem to be the most relied upon source in this entire document, and doesn’t that make the entire document one man’s opinion, and that man is not a pain management specialist? In analyses of placebo-controlled trials, the clinical evidence reviews found that effects of opioids on mean improvement in pain and in function were greater at 1 to 3 months than at 3 to 6 months (Chou et al., April 2020).<br/><br/>255.<span style='padding-left: 30px'></span>Page 133: Claims “taking other central nervous system depressants with opioids) more frequently than every 3 months. To minimize unintended impact on patients with challenges in accessing or affording follow-up visits, practices, and health systems should work to ensure all patients can access and afford follow-up evaluation.” Why the insistent occupation with tapering throughout this document? How does a clinician ensure all patients can access and afford follow-up evaluation? Isn’t that a matter for taxpayers and their representatives to decide, not a federal agency? Such political statements ruin the credibility of this guideline.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa95	None	None	2022-04-11T14:21:17Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-cmr7-bpiw	False	None	False	2022-04-12 06:40:51.961	[]
4613	CDC-2022-0024-4619	https://api.regulations.gov/v4/comments/CDC-2022-0024-4619	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	256.<span style='padding-left: 30px'></span>Page 133: What does paid time off have to do with opioid prescribing? The majority of the US is fundamentally against socialized / federal control of health care, yet CDC writes this guideline with such political aspirations, and should be removed due to the inherent bias it pushes. “In addition, policymakers should minimize 2980 barriers to care (e.g., through promotion of paid time off).” If anything, CDC has made a great case against any future federal control of medicine.<br/><br/>257.<span style='padding-left: 30px'></span>Page 134: Where does the CDC think it gets the authority to impose any percentage of improvement to deem therapy beneficial? Should such goals not be better left to physicians and patients, and not the federal government? Again this is a one size fits all limit like 50 MME. “defined as a 30% improvement in scores for both pain and function (Ostelo et al., 2008)” Define where this 30% comes, and how is such determination to be made? Isn’t relief of pain sufficient reason to continue treatment of pain?<br/><br/>258.<span style='padding-left: 30px'></span>Page 134 contains a good statement but CDC contradicts it in warning against combining analgesics and anti-anxiety medicines, which should be determined by clinicians and their patients. Especially considering since publication of the 2016 guidelines, overdoses have only increased, while prescriptions have dropped over 70%, patients have been force tapered and/or abandoned, and DEA has constantly pressured pain doctors into limiting prescriptions to no more than 90 MME. Exactly how can clinicians accomplish this advice given all the contradictory statements elsewhere in this document? “Because depression, anxiety, and other psychological co-morbidities often coexist with and can interfere with resolution of pain, clinicians should use validated instruments to assess for these conditions (see Recommendation 8) and ensure that treatment for these conditions is optimized.” The truth is you recommend elsewhere to not use the best medications for pain and mental health conditions together, and yet here you correctly surmise that all conditions should be treated to improve patient care and outcomes. Why not leave such decisions to the clinician and patient?<br/><br/>259.<span style='padding-left: 30px'></span>Page 134 makes a reasonable statement that is contradicted by its incessant reference to 50 MME, 4 weeks, and other single one size fits all statements throughout this document. Isn’t this statement more important than all your wasted attempts to define limits for doctors and their patients? “Clinicians should ask patients about their preferences for continuing opioids, given their effects on pain and function relative to any adverse effects experienced.” <br/><br/>260.<span style='padding-left: 30px'></span>Page 134 - Given that as recently as 2002 or later, 200 MME/day was the borderline for what ws deemed “higher dose opioids, why is the CDC consistently pressing for 50 MME/day as a limit? See questions elsewhere as to why 50 MME appears in this document or any limit at all due to the myriad of variables that make any single number impossible for everyone. “if patients are taking higher-risk regimens [e.g., dosages ≥50 MME/day” <br/><br/>261.<span style='padding-left: 30px'></span>Page 135 states “clinicians should work with patients to reduce opioid dosage or to discontinue opioids when possible, using principles from Recommendation 5. Clinicians should maximize pain treatment with nonpharmacologic and nonopioid pharmacologic treatments as appropriate (see Recommendation 2).” Again this is an opioid prescribing guideline whereby CDC is recommending against using opioids and risking the public health all out of the fear of addiction being driven by use of illicit street drugs. Why have opioids been used for hundreds of years and are known to be effective and due to the nations illicit fentanyl crisis these guidelines are being written to punish patients while not helping addicts? Prescriptions are down 70% and overdoses are higher than ever, proving the 2016 guidelines only caused harm.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa96	None	None	2022-04-11T14:21:36Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-culr-c575	False	None	False	2022-04-12 06:40:52.205	[]
4614	CDC-2022-0024-4620	https://api.regulations.gov/v4/comments/CDC-2022-0024-4620	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	262.<span style='padding-left: 30px'></span>Page 136 states that “Clinicians should avoid prescribing opioids to patients with moderate or severe sleep-disordered breathing when possible to minimize risks for opioid overdose.” Can’t patients be given SpO2 monitors who have such conditions so they too can be treated safely for pain? Why deny pain care to someone with sleep apnea?<br/><br/>263.<span style='padding-left: 30px'></span>Page 136 states “For pregnant people with opioid use disorder, medications for opioid use disorder 3048 (buprenorphine or methadone) have been associated with improved maternal outcomes and 3049 should be offered (see Recommendation 12). “ If methadone is acceptable for use for OUD, why deprive pain patients the same level of care? Methodone can be managed by a trained physician. Isn’t training simple enough to do for both OUD and pain doctors?<br/><br/>264.<span style='padding-left: 30px'></span>Page 136 states “Clinicians should use PDMP data (see Recommendation 9) and toxicology screening (see Recommendation 10) as appropriate to assess for concurrent substance use that might place patients at higher risk for opioid use disorder and overdose.” Does CDC back the position that use of PDMP and/or toxicology screening should only be required for those at higher risk of OUD or overdose, and not required of everyone being treated with opioids? This makes a lot of sense especially for toxicology screening.<br/><br/>265.<span style='padding-left: 30px'></span>Page 136 states “Although substance use disorder can alter the expected benefits and risks of opioid therapy for pain, patients with co-occurring pain and substance use disorder require ongoing pain management that maximizes benefits relative to risks. “ Indeed even those with substance use disorder deserve compassionate care of pain. How can CDC help stop the practice of denying anyone with OUD on the records from receiving medically necessary pain treatment including use of opioids through close monitoring and supervision, so they are not denied care altogether?<br/><br/>266.<span style='padding-left: 30px'></span>Page 137 states “If patients experience nonfatal opioid overdose, clinicians should evaluate for opioid use disorder and treat or arrange treatment if needed. Clinicians should work with patients to reduce opioid dosage and to discontinue opioids when indicated (see Recommendation 5) and should ensure continued close monitoring and support for patients prescribed or not prescribed opioids.” Why should a one-time accidental nonfatal opioid overdose warrant a dosage reduction or discontinuation rather than counseling and closer monitoring?<br/><br/>267.<span style='padding-left: 30px'></span>Page 137 states “The clinical evidence reviews found evidence too limited to determine effects of patient demographics and comorbidities on risk of opioid-related harms (Chou et al., April 2020).” If there is lack of evidence of harm, why do we need guidelines at all? Isn’t this merely an over-reaction to the overdose crisis that we now know is primarily dominated by illicit street drugs, especially illegal fentanyl analogs?<br/><br/>268.<span style='padding-left: 30px'></span>Page 137 – “higher dosages of opioids (e.g., ≥50 MME/day),” Remove all references to 50 MME/day for the reasons cited above, and answer the questions given. Who decided 50 MME/day constitutes higher dosages when for decades the limit was 200 MME/day and why?<br/><br/>269.<span style='padding-left: 30px'></span>Page 138 – “Clinicians should avoid prescribing opioids to patients with moderate or severe sleep-disordered breathing, whenever possible, to minimize risks for opioid overdose.” Again why not have SpO2 monitors with alarms for such people rather than deny treatment of their pain?<br/><br/>270.<span style='padding-left: 30px'></span>Page 140 – “Clinicians should use additional caution and increased monitoring (see Recommendation 7) to minimize risks of opioids prescribed for patients with renal or hepatic insufficiency, given their decreased ability to process and excrete medications, susceptibility to accumulation of opioids, and reduced therapeutic window between safe dosages and dosages associated with respiratory depression and overdose (Goodman and Gilman’s The Pharmacologic Basis of Therapeutics, 9th ed, 1996)”. Doesn’t this make a good case for why 50 MME/day is not a good idea as a one size fits all threshold?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa97	None	None	2022-04-11T14:21:54Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-cx6i-aadx	False	None	False	2022-04-12 06:40:52.422	[]
4615	CDC-2022-0024-4621	https://api.regulations.gov/v4/comments/CDC-2022-0024-4621	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	271.<span style='padding-left: 30px'></span>Page 141- “medication-related behaviors that increase risk such as saving unused medications.” What studies prove that saving unused medicine increases risks? Given the shortages and difficulty obtaining opioids since release of the 2016 guidelines, don’t you expect more people are less likely to dispense with their unused opioid due to all the barriers to getting opioids that CDC has created, both intentionally and unintentionally, and how can you eliminate those barriers so patients again are willing to dispense of unused medicines?<br/><br/>272.<span style='padding-left: 30px'></span>Page 141 – “Persons aged ≥65 years can be at risk for inadequate pain treatment” is a true statement, but you go on to assume step functions occur at a specific age and even mention 55 years old, when the science proves there is no step function and the decline is mostly linear or logarithmic. Why make such singular age statements when they are not backed by medical evidence as being step function points?<br/><br/>273.<span style='padding-left: 30px'></span>Page 142- “high acute suicide risk precludes the safe use of self-administered long-term opioid therapy”. In fact many patients have been driven to suicide due to discontinuation of opioid therapy, so isn’t this a very dangerous recommendation to make? Why not?<br/><br/>274.<span style='padding-left: 30px'></span>Page 142-143 states “For treatment of chronic pain in patients with depression, clinicians should consider using tricyclic or SNRI For treatment of chronic pain in patients with depression, clinicians should consider using tricyclic or SNRI antidepressants for analgesic as well as antidepressant effects if these medications are not otherwise contraindicated (see Recommendation 2)”. Why does this guideline now delve into making specific psychiatric drug recommendations, and based on what studies or data that shows these are more effective than other medicines, such as SSRIs? Doesn’t the FDA regulate drugs and not CDC?<br/><br/>275.<span style='padding-left: 30px'></span>Page 143 claims “patients with histories of substance use disorders are more likely than other patients to receive long-term opioid treatment for chronic pain (Edlund et al., 2010).” While this may have been possible 12 years ago, do you have more recent data in the last 2 years demonstrating this is still the case, and if so, what data?<br/><br/>276.<span style='padding-left: 30px'></span>Page 143-144 states “Non-prescribed drugs (e.g., heroin, illicitly manufactured fentanyl, cocaine, methamphetamine) (Gladden, O'Donnell, Mattson, & Seth, 2019) and alcohol (Jones, Paulozzi, & Mack, 2014) are listed as contributory factors on a substantial proportion of death certificates for prescription opioid-involved overdose deaths. Since this proves what AMA and other organizations have been saying all along, that prescription opioids alone are not the major cause of overdoses, then why do we need a CDC opioid prescribing guideline at all in 2022?<br/><br/>277.<span style='padding-left: 30px'></span>Page 144 claims “For example, the question “How many times in the past year have you used an illegal drug or used a prescription medication for nonmedical reasons?” (with an answer of one or more considered positive) was found in a primary care setting to be 100% sensitive and 73.5% specific for the detection of a drug use disorder compared with a standardized diagnostic interview (P. C. Smith, Schmidt, Allensworth-Davies, & Saitz, 2010).” Is CDC really so gullible as to believe even a majority of people would answer this question affirmatively? It really brings into question the credibility of the CDC to assume with such confidence that people answer honestly.<br/><br/>278.<span style='padding-left: 30px'></span>Page 145 states “Patients with co-occurring pain and substance use disorder require ongoing pain management that maximizes benefits relative to risks. “ Does CDC know that many people now in methadone clinics are simply pain patients who lost access to pain treatment and faked being an addict to get any form of pain care, and how can CDC reverse this trend, since OUD treatment is not designed for pain, and is rather ineffective due to dosing intervals? <br/><br/>279.<span style='padding-left: 30px'></span>Page 145 claims “Yet, a cohort study of commercially insured patients found that opioids were dispensed to 91% of patients after an overdose, and a substantial percentage experienced a repeated opioid overdose, with a cumulative incidence at 2 years of 17% among patients receiving 100 or more MME/day, 15% among those prescribed 50 to 100 MME/day, 9% among those prescribed <50 MME/day, and 8% among those prescribed no opioids (M. R. Larochelle et al., 2016).” Isn’t this really a small percentage to have a second overdose and not a valid reason to deny pain care to these people? You stated earlier that most overdoses involved illicit drugs, so isn’t it likely these percentages reflect non-prescription based overdoses as well?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa9a	None	None	2022-04-11T14:22:12Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-cyd9-d21t	False	None	False	2022-04-12 06:40:52.634	[]
4616	CDC-2022-0024-4622	https://api.regulations.gov/v4/comments/CDC-2022-0024-4622	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	280.<span style='padding-left: 30px'></span>Page 145 states that “Clinicians should work with patients to reduce opioid dosage and to discontinue opioids when indicated (see Recommendation 5)” in discussing people who have overdosed, whether accidental, or intentional, or due to prescription opioid or polydrug use including street drugs. Shouldn’t all these factors be weighed before reducing opioid dosages, and that decision left to the clinician? Can’t this become a misinterpreted justification to cut everyone off pain treatment who might accidentally overdose even once?<br/><br/>281.<span style='padding-left: 30px'></span>Page 147 – “Ideally, PDMP data should be reviewed before every opioid prescription for acute, subacute, or chronic pain. This is recommended in all jurisdictions where PDMP availability and access policies, as well as clinical practice settings, make this practicable (e.g., clinician and delegate access permitted). “ contradicts an earlier statement whereby only high risk patients should be required to have a PDMP check. Which is it? Do such PDMP checks violate HIPAA rights?<br/><br/>282.<span style='padding-left: 30px'></span>Page 147 – “Clinicians should review PDMP data specifically for prescription opioids and other controlled medications patients have received from additional prescribers to determine whether a patient is receiving high total opioid dosages or combinations (e.g., opioids combined with benzodiazepines) that put the patient at high risk for overdose. Opioid and benzodiazepine risk should not be discouraged as many patients have multiple conditions and not treating both cause worsening of the other condition. Why make such an alarmist claim when millions of patients have been successfully treated without overdose or incidence for decades? Many people have been forced to choose to have pain or anxiety treated as a direct result of such statements made by the CDC in 2016. Why continue to fail the public and mislead clinicians?<br/><br/>283.<span style='padding-left: 30px'></span>Page 147 makes a valid point. “Clinicians should not dismiss patients from their practice on the basis of PDMP information. Doing so can adversely affect patient safety, could represent patient abandonment, and could result in missed opportunities to provide potentially lifesaving information.” What further steps can CDC take to prevent this from happening?<br/><br/>284.<span style='padding-left: 30px'></span>Page 148 attempts to correct the idea that opioids and benzodiazepines can both be necessary, but it still places an over-emphasis on the risk. Use extreme caution when prescribing opioids and benzodiazepines concurrently, appreciating that some patient circumstances warrant prescribing of these medications concomitantly. Why punish people with multiple health conditions like this?<br/><br/>285.<span style='padding-left: 30px'></span>Page 148 – “ Buprenorphine should not be counted in the total MME/day in calculations given its opioid partial agonist properties that confer a ceiling effect on respiratory depression.” Isn’t it illegal or unethical to coerce clinicians into using a specific opioid? Does this drug work for every patient?<br/><br/>286.<span style='padding-left: 30px'></span>Page 148 makes an important point about false test results, yet many patients have been thrown out of pain clinics and lost access to pain care over one result. “A negative toxicology test for prescribed opioids might indicate the patient is not taking prescribed opioids, although clinicians should consider other possible reasons for this test result, such as false negative results or misinterpretation of results (see Recommendation 10).” How can CDC further emphasize this point and avoid harm to patients?<br/><br/>287.<span style='padding-left: 30px'></span>Page 149 claims “overdose risk is further increased among patients receiving these treatments from multiple prescribers rather than one prescriber”. Is it not safer for a patient to see a pain specialist for opioids and a psychiatrist for anxiety, thus making this claim false? If both are reviewing the PDMP, why is such a claim being made by CDC?<br/><br/>288.<span style='padding-left: 30px'></span>Page 149 claims “most participants felt that PDMPs improved opioid prescribing by decreasing opioid prescription amounts.” Why should a decision to decrease opioid amounts be made based solely on a PDMP review as stated here? Didn’t you say PDMP has not proven to be effective as a tool, and if that is true, why use it as a weapon to force patients to lower doses?<br/><br/>289.<span style='padding-left: 30px'></span>Page 149 states “Special attention should be paid to ensure that PDMP information is not used in a way that is harmful to patients. For example, PDMP information has been used to dismiss patients from clinician practices (Irvine et al., 2014), which might adversely affect patient safety and result in untreated or undertreated pain.” CDC is admitting the danger of PDMPs, yet only a paragraph above used it as a basis to lower dosages. Why not eliminate the direct tie between PDM review and decreasing opioid amounts?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aa9b	None	None	2022-04-11T14:22:29Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-czw9-emdp	False	None	False	2022-04-12 06:40:52.863	[]
4617	CDC-2022-0024-4623	https://api.regulations.gov/v4/comments/CDC-2022-0024-4623	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	290.<span style='padding-left: 30px'></span>Page 149-150 states “Experts noted concern about PDMP risk scores or other algorithmic interpretations from software platforms that can lead to distrust between clinicians and patients and stigmatization, particularly for patients with conditions such as opioid use disorder.” How can CDC avoid this distrust when it is encouraging use of the PDMP? Since you admit it is an unproven tool, why not simply stop the practice of using PDMPs, with no clear benefit and a clear risk?<br/><br/>291.<span style='padding-left: 30px'></span>Page 150 states “these algorithms may disparately impact women, people of color, and people who live in poverty (J. Oliva, 2021). Importantly, while one PDMP-generated risk measure has shown fair 3391 concurrence with the WHO Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), these scores have not been externally validated against clinical outcomes (Cochran et al., 2021) (J. Oliva, 2021). Such risk scores should not take the place of clinical judgment.” Isn’t this more proof that the use of PDMPs should be discarded? If retained, how can CDC lead the elimination of all these problems and risks with PDMPs? Has CDC done a cost/benefit analysis since nothing is free and PDMPs consume physician time?<br/><br/>292.<span style='padding-left: 30px'></span>Page 150 contradicts the facts you just made clear “Ideally, PDMP data should be reviewed before every opioid prescription for acute, subacute, or chronic pain.” Why should PDMP data be used when it is known to be biased, racist, inaccurate, and subject to misuse?<br/><br/>293.<span style='padding-left: 30px'></span>Page 151 presents an important point “Clinicians should not dismiss patients from care based on a toxicology test result because this could constitute patient abandonment and could have adverse consequences for patient safety, potentially including the patient obtaining opioids or other drugs from alternative sources and the clinician missing opportunities to facilitate treatment for substance use disorder.” But how does CDC plan to ensure this is prevented?<br/><br/>294.<span style='padding-left: 30px'></span>Page 152 – another key point “Clinicians should explain to patients that toxicology testing will not be used to dismiss patients from care and is intended to improve their safety”. How can CDC help make this happen and be sure patients are not dismissed on one test result that might be a false positive or negative? <br/><br/>295.<span style='padding-left: 30px'></span>Page 153 – states “The clinical evidence reviews did not find studies evaluating the effectiveness of toxicology screening for risk mitigation during opioid prescribing for pain.” Then why require such expensive tests? Also, when tests are actually required such as an overdose situation, government should mandate that insurance pays for the cost and not the patient. Some patients have been forced to pay thousands of dollars per test which is not right.<br/><br/>296.<span style='padding-left: 30px'></span>Page 154 – states “In addition, testing costs would have the greatest consequences for patients with the least ability to pay.” In consideration of this fact, should toxicology tests only be done based on clinician judgement and not on some fixed periodic basis? People may be unable to get their pain treated because they cannot afford to pay for expensive testing.<br/><br/>297.<span style='padding-left: 30px'></span>Page 155 – this is very true but does not reflect current reality because it is used exactly as CDC advises against. “Clinicians should explain to patients that toxicology testing will not be used punitively (e.g., will not be used to dismiss patients from care) and is intended to improve their safety.” How can CDC help reduce this problem?<br/><br/>298.<span style='padding-left: 30px'></span>Page 156 – another key point “Restricting confirmatory testing to situations and substances for which results can reasonably be expected to affect patient management can reduce costs of toxicology testing, given the substantial costs associated with confirmatory testing methods.” How can CDC add emphasis to this, and provide guidance on when to require such testing, such as following an actual overdose situation or other unusual circumstances? And how can CDC help drive insurers to pay for these tests? It is discrimination and possibly a constitutional violation of equal rights under the law for poor people without insurance to be forced to take such tests, especially done without any motivation other than a time period having passed.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aaa0	None	None	2022-04-11T14:22:47Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-d1lw-beka	False	None	False	2022-04-12 06:40:53.079	[]
4618	CDC-2022-0024-4624	https://api.regulations.gov/v4/comments/CDC-2022-0024-4624	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	299.<span style='padding-left: 30px'></span>Page 157-158. This wording is too strong. Many patients need a combination and it is safer than an ultra-high dose of opioids to treat each condition appropriately. Prior exposure and duration of treatment should establish a given regimen is safe, if a patient has taken such a combination for years without incidence, as is often the case. This should be made clear so that patients on long established combinations are not subject to being cut off from any treatment that has been long established for at least a year or even a decade. “Although there are circumstances when it might be appropriate to prescribe opioids to a patient who is also prescribed benzodiazepines (e.g., severe acute pain in a patient taking long-term, stable low-dose benzodiazepine therapy), clinicians should use extreme caution when prescribing opioids and benzodiazepines concurrently. In addition, clinicians should consider whether benefits outweigh risks of concurrent use of opioids with other central nervous system depressants (e.g., muscle relaxants, non-benzodiazepine sedative hypnotics, potentially sedating anticonvulsant medications such as gabapentin and pregabalin).” Why not clarify that patients well established on a regimen for years should be left alone? If a patient is alerted to the risks, why should he or her not be willing to take that risk, since it is that patient’s life and not the CDCs? Is the USA not the land of the free, where we have individual accountability, and not a communist government that dictates every facet of decision making such as Russia?<br/><br/>300.<span style='padding-left: 30px'></span>Page 158 - Why not emphasis this more? “In specific situations, benzodiazepines can be beneficial, and stopping benzodiazepines can be destabilizing.” For example, anxiety often worsens the perception of pain, and pain worsens anxiety. Spell out some examples. Insomnia causes lack of sleep and sleep lowers pain tolerance.<br/><br/>301.<span style='padding-left: 30px'></span>Page 158 – why not include chronic pain in this statement? “Buprenorphine or methadone for opioid use disorder should not be withheld from patients taking benzodiazepines or other medications that depress the central nervous system.” Why do those with OUD get this special exception but not chronic pain patients with terrible pathologies who did not cause their own problems?<br/> <br/>302.<span style='padding-left: 30px'></span>Page 159 states “Due to these considerations, several experts felt recommending extreme caution with concurrent prescription of opioids and benzodiazepines was more appropriate than a recommendation to avoid prescribing opioid pain medication and benzodiazepines concurrently and that category B would be more appropriate than category A for this recommendation.”. What is the practical difference in Category A vs B recommendations? Do clinicians consider A and ignore B category recommendations? While it might humor academians, what is the tangible value of different category levels?<br/><br/>303.<span style='padding-left: 30px'></span>Page 160 states “Clinicians should check the PDMP for concurrent controlled medications prescribed by other clinicians (see Recommendation 9) and should consider involving pharmacists as part of the management team when opioids are co-prescribed with other central nervous system depressants.” Without access to the patient’s medical records or treatment history, what value is there in involving pharmacists? How many drug studies test combinations of more than 2 substances taken simultaneously, and isn’t software programs commonly available to check for interactions? It is not those pharmacists don’t have value, but the US medical system does not really equip them to have a key role in treatment decisions, and while that might be a fundamental flaw with US health care, it is nonetheless a reality. Adding them in this decision loop only presents added bureaucratic risks and unjustifiable exposes pharmacists to liabilities beyond their control due to their lack of access to needed records.<br/><br/>304.<span style='padding-left: 30px'></span>Page 161 provides a very fundamental point that a patient’s needs or desires should drive treatment decisions of course with clinician input. “Clinicians should communicate with mental health professionals managing the patient to discuss the patient’s needs, prioritize patient goals, weigh risks of concurrent benzodiazepine and opioid exposure, and coordinate care.” Why do we need CDC guidelines at all, given prescriptions are down 70% and overdoses continue to increase, and patients and their clinicians are both superior to this document and CDC even emphasizes this document is not a substitute of clinician judgement and care should be individualized? Why isn’t the better course to repeal the 2016 guidelines instead of replace them?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aaa1	None	None	2022-04-11T14:23:03Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-d3e1-7mkd	False	None	False	2022-04-12 06:40:53.293	[]
4619	CDC-2022-0024-4625	https://api.regulations.gov/v4/comments/CDC-2022-0024-4625	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 33 year old who has had health issues my whole life. They have gotten worse as i have gotten older and now the only reason i am able to participate in society is because of my pain medicine. Honestly i cant imagine having to live with out it and i dont want to. Unfortunately this has been a constant fear for me since the 2016 guidelines and i fear the new guidelines will only make this fear more of a reality. it is so hard to possibly face losing the last of my independence. I am not able to take steroids or nsaids because of my health conditions. Opioids are my only option. I am treated with distrust and discrimination even though i am disabled and have a clear medical need for my medication. I live in the bay area of California. There are a lot of doctors here and yet it is still nearly impossible to find any who prescribe Opioids. Most have a clinic policy that prohibit their doctors for prescribing for any reason for fear of the government intervening even though rheyve done nothing wrong. The doctor i currently get them from considered stopping for this reason and asked me to see if i could get them through any of my other doctors and specialists. I asked them all and they all said that i needed them but couldn't prescribe because of clinic rules and fear of the government taking their license. After this my doctor who is a good doctor and believes in "doing no harm" and her responsibility for patients agreed to continue my prescription. I have been to pain specialists who have further agreed i need this medication. It is wrong that the government wants to put limits on dosage and prescriptions on doctors wjo clearly know better then the government what their patients need. This is especially true because of the faulty science and reasoning behind these cut offs. These limits have also caused my insurance to no longer cover my medication as it is above the 2016 mme recommended limits. The new limits are even lower. How can the insurance go against all of my doctors on what i need? The pharmacy keeps less medication on hand so that i often have trouble even filling my prescription if other people in the area recently filled theirs. I am not a drug addict i just want to be part of society abd not suffer in constant pain. Research shows chronic pain patients and their prescriptions have no relationship to the illegal fentenyl and heroin epidemic. I have known 3 people who have died frkm illegal Opioids and not one of them ever had a prescription for Opioids. Why is nothing being done to save people like them and so much being done to punish people like me? There should be NO recommended limits in the new guidelines. They will inevitably be misconstrued and will harm patients just like last time. Doctors know what their patients need. It is very hard to currently be okayed for a prescription in the current times. Those of us that have already been under so much scrutiny are not a risk to the public or ourselves. Prescriptions are at there lowest point while illegal drugs are still killing people. Our doctors clearly have enough descretion and there is enough monitoring already we do not need mme cut offs. Please take these restrictions that have led to so much suffering out of the guidelines. If the government wants people to be independent and able to work preservr patients rights to the medication they need. Please help save the lives and independence of people who have no other options. Save my life because my future is in your hands.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anita	None	None	090000648500aaa2	Glasser	None	2022-04-11T14:23:35Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Glasser, Anita	l1u-d3kt-xrlu	False	None	False	2022-04-12 06:40:53.510	[]
4620	CDC-2022-0024-4626	https://api.regulations.gov/v4/comments/CDC-2022-0024-4626	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC guidelines do not apply to patients in a realistic way. The guidelines appear as repetitive nonsense to justify the writers and associates to continue the same self-benefiting business that is a true conflict of interest. During this, millions of ill and disabled Americans who are living in pain are suffering to death while being ignored by those who are supposed to be their representatives. It would seem as if this entire scenario were deliberate for all that has resulted. Also, it looks like it is intended to continue with the mention of the ridiculous threshold of 50 MME. Like the CDC, the doctors are not concerned with the individual needs of the patient's condition but only the number threshold stated in the guidelines. Also, like the CDC, the doctor ignores the patient's account of pain experience from their condition and will only rely on the words of the "experts" as not to appear biased and be in compliance. Perhaps someday after enough people have died, maybe millions of them, and after the addiction business has made enough billions of dollars then maybe the senate will decide to assign patient care back to the doctor and allow the doctor once again to prescribe proper pain medication to the surviving pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a9c9	Anonymous	None	2022-04-11T14:24:27Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-4qgw-7tfq	False	None	False	2022-04-12 06:40:53.752	[]
4621	CDC-2022-0024-4627	https://api.regulations.gov/v4/comments/CDC-2022-0024-4627	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guidelines were a complete failure. The revised guidelines are even WORSE! You let PROP members write the first guidelines, and sadly here they are again. The revision must not be put out with a mg cap. In fact the MME should be tossed too. It’s only served to come after doctors and patients. The FDA even said there arey no valid studies supporting any cap as people are all different. They metabolize meds differently. There’s also genetic differences. One size fits all is false. <br/><br/>Prescriptions of opioids are down, WAY down, but instead of lowering overdose rates they’ve more than doubled. It’s clear the assumption that RX meds are driving the “opioid crisis” is false. <br/>Since PROP likes to take data from one state and use it for the nation, hear this; only 1% of fentanyl overdoses are in patients with a valid prescription. The recent statement that NSAIDs work better than hydrocodone was from one study of young people having wisdom teeth removed. The US is not the #1 user of opioids, we are 8th. <br/><br/>The lies and PROPaganda must stop. Innocent people are suffering and dying! Drug abuse hasn’t slowed down, it’s worse, or at least more deadly. People with painful diseases aren’t fueling this problem. Bootleg fentanyl is killing record numbers! The drug trade rolls right along. Guidelines don’t apply to them. You’ve ignored the real problem while persecuting innocent patients and doctors. Do not allow any recommendation to taper a patient who is doing well on a stable dose. Forbid switching them to buprenorphine unless they are true addicts. It is NOT FDA indicated for pain. It’s a treatment drug for addicts. Pain patients are not addicts just because they are still in pain or take opiate or opioid meds. Very few pain patients abuse their meds. 3% max, not 25%! The misinformation is appalling. The guidelines have destroyed Dr/patient trust. Drug approval and recommendations is what the FDA does. <br/>The CDC and DEA should be working with the real addicts. Stopping the bootleg fentanyl. Helping addicts and funding treatment. That’s the only way to really bring deaths down. <br/><br/>Patients are already being tapered to 50 mme in anticipation of these updates. You must put a stop the carnage that is sure to happen if this update is finalized as is. Knowing this and doing nothing is criminal neglect! Please, listen to the few patients begging for mercy! You don’t limit blood pressure meds or anti depressants. You don’t tell a diabetic that can only have SOME of the insulin they need. Alcohol kills many more than opioids every year, but anyone of age can buy and consume it. It doesn’t make sense and it’s highly unethical. <br/><br/>The best thing to do is announce research has shown cutting patients meds has had the opposite effect intended. Make it crystal clear the guidelines caused unwanted harm and are recalled as faulty. Never allow PROP an opportunity to cause such a great injustice again. Ensure patients pain treatment returns to the level of medication needed to allow a humane existence. The off label use of a variety of meds and procedures is just causing worse problems. This is the real crisis. You have an opportunity to make life better for millions. I urge you to do so. Innocent lives depend on you, <br/>I am an Ehlers Danlos Syndrome patient. My life has been turned upside down due to forced tapers and under-treated pain. I also have anxiety and insomnia that are no longer treated. I took meds for those conditions for over 10 years. If they’re so deadly, why am I alive? Because I didn’t abuse them. I never took Oxycontin, but I’m still paying the price for those who abused it, or took multiple drugs (often with alcohol). That’s not me! This is so very cruel to disabled and vulnerable patients. I feel like a cross between a lab rat and a whipping boy. Please, this is torture. Get out of the way of doctors that are trained in the field of pain, not just addiction experts. The OWG had valid concerns, but were just given lip service and the writers just threw in more of their misleading evidence, it’s NOT OK! It’s a disaster waiting to happen! You’ve been warned by experts. Please leave pain patients and their doctors to do what’s right for each individual.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aaa3	Anonymous	None	2022-04-11T14:24:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-cqym-zd3i	False	None	False	2022-04-12 06:40:53.963	[]
4622	CDC-2022-0024-4628	https://api.regulations.gov/v4/comments/CDC-2022-0024-4628	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	There is a significant population of people in our country that suffer from constant debilitating pain that makes life impossible without properly administered effective pain management. Any federal regulations that hamstring the ability of competent doctors to humanely treat the patients legitimately falling into this category should not be created.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Fred	None	None	090000648500a9d3	Van Riper	None	2022-04-11T14:25:22Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Van Riper, Fred	l1u-4sj1-kclg	False	None	False	2022-04-12 06:40:54.175	[]
4623	CDC-2022-0024-4629	https://api.regulations.gov/v4/comments/CDC-2022-0024-4629	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	305.<span style='padding-left: 30px'></span>Page 164 – since suboxone is excluded from this list, why is it being pushed so hard by the US government, including being mis-prescribed for chronic pain, for which it is not indicated? “FDA-approved medications indicated for the treatment of opioid use disorder and/or the prevention of relapse include buprenorphine, methadone, and naltrexone.”<br/><br/>306.<span style='padding-left: 30px'></span>Page 170 – this very statement reflects why many chronic pain patients have resorted to faking addiction in order to retain some degree of pain care, which is a direct result of the 2016 CDC guidelines, and further evidence of why this guideline should be killed rather than expanded. “Importantly, opioid dosage thresholds for caution in the treatment of pain are not applicable to opioid agonist treatment of opioid use disorder (Houry, 2018) as recommended dosages of methadone and buprenorphine for opioid use disorder (American Society of Addiction Medicine, 2020) differ from those for pain management. There is no recommended duration limit for treatment of opioid use disorder with buprenorphine or methadone, and discontinuation is associated with risks for relapse and opioid overdose (American Society of Addiction Medicine, 2020).” Is this what we would expect from a group of editors comprised solely of addiction specialists? Why was no pain management expert included of equal representation on the editor group of five for this document? Doesn’t that make this only applicable for treatment of Opioid Use Disorder?<br/><br/>307.<span style='padding-left: 30px'></span>Page 174 – Again, why was no pain management expert included in the editorial board of this guideline? Is this merely because CDC has become so focused on PROP’s input that it has largely neglected the 12-25 million Americans who suffer from severe or chronic pain? “Based upon these reviews, an update to the CDC 2016 Guideline was warranted.”<br/><br/>308.<span style='padding-left: 30px'></span>Page 175 – the entire basis of this update hinges on a study done in Portugal, and even that study is of poor quality evidence. How can you claim to have updated this guideline when you only considered a single cherry picked study, when in fact a number of individuals have submitted over 10 long term studies that proved long term efficacy of opioids that you created rules to ensure those studies would not be considered? It seems CDC has learned nothing from the 2016 update including the April 10, 2019 letters from FDA and CDC Director [redacted]. The evidence reviews that informed this clinical practice guideline affirmed the appropriateness of the recommendations included in the 2016 CDC guideline for using opioids to treat chronic pain.<br/><br/>309.<span style='padding-left: 30px'></span>Page 175 – since you suggest that this document is no substitute for clinician judgement and that care should be individualized, doesn’t that make this entire update based on one foreign study of chronic pain relatively a worthless document, wasting millions of dollars in taxpayer money, driving many pain specialists out of business, torturing millions of pain patients, and driving thousands of pain patients to resort to suicide due to the poorly written 2016 guidelines, in which legacy you seem determined to continue? Specifically, the clinical practice guideline outlines how clinicians and patients should work together in assessing the benefits and risks of continued opioid use and if or when to taper opioids to a lower dosage or discontinue opioids all together in accordance with the HHS Tapering Guide (Dowell, Compton, & Giroir, 2019; U.S. Department of Health and Human Services, 2019a).”<br/><br/>310.<span style='padding-left: 30px'></span>Page 175 – Again you discriminate against dozens of equally if not more painful disease categories by excluding sickle cell anemia. “There are 4 key domains covered by the updated clinical practice guideline for prescribing of opioid pain medication for patients 18 and older for pain outside of sickle cell disease-related pain management, cancer pain treatment, palliative care, and end-of-life care.” How do you justify excluding only sickle cell disease and not other equally painful diseases? Why not simply waive these burdensome and frankly ignorant and poorly written guidelines for all victims of intractable pain?<br/><br/>311.<span style='padding-left: 30px'></span>Page 176 – says all this document needs to say. The rest should be turned into a guideline for treating opioid use disorder, since that is the expertise of the 5 editors who wrote this guideline: “The care provided needs to be individualized and person-centered (U.S. Department of Health and Human Services, 2019b). Clinicians and patients should work together to identify treatment goals and tailor an approach that considers both the benefits and risks of available options (U.S. Department of Health and Human Services, 2019b).”<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aaa6	None	None	2022-04-11T14:26:11Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-d5sv-as4n	False	None	False	2022-04-12 06:40:54.415	[]
4624	CDC-2022-0024-4630	https://api.regulations.gov/v4/comments/CDC-2022-0024-4630	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 59 years old. I have severe rotational scoliosis. My back not only has the S curve, it is also like a screw that is continuously tightening. It is extremely painful. I have been on Percocet 10/325 for more than 15 years. I see my primary care doctor twice a year to check my pain status. This decision should be between the doctor and patient. The last time the CDC made an adjustment, my doctor had to prescribe MORE than I needed (4 a day). At present, I can get the 3 per day I need. My doctor can prescribe only what is necessary. That’s a GOOD thing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a9e2	Anonymous	None	2022-04-11T14:26:42Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-52th-8add	False	None	False	2022-04-12 06:40:54.628	[]
4625	CDC-2022-0024-4631	https://api.regulations.gov/v4/comments/CDC-2022-0024-4631	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	311.<span style='padding-left: 30px'></span>Page 176 – says all this document needs to say. The rest should be turned into a guideline for treating opioid use disorder, since that is the expertise of the 5 editors who wrote this guideline: “The care provided needs to be individualized and person-centered (U.S. Department of Health and Human Services, 2019b). Clinicians and patients should work together to identify treatment goals and tailor an approach that considers both the benefits and risks of available options (U.S. Department of Health and Human Services, 2019b).”<br/><br/>312.<span style='padding-left: 30px'></span>Page 177-178 gives a guiding principal that is constantly contradicted throughout this draft document. “Special attention should be given to avoid misapplying this updated clinical practice guideline beyond its intended use or implementing policies purportedly derived from it that result in unintended consequences for patients (Dowell, Haegerich, et al., 2019). This includes being inflexible on opioid dose and duration, discontinuing or dismissing patients from a practice, rapidly and non-collaboratively tapering patients who may be stable on a higher dose, and applying recommendations to populations that are not a focus of the clinical practice guideline such as patients with cancer, sickle cell disease, or during end-of-life care (Dowell, Haegerich, et al., 2019).” Add intractable pain to this list.<br/><br/>313.<span style='padding-left: 30px'></span>Page 178 - CDC caused a lot of damage in the 2016 guidelines as Director [redacted] tried to correct in his April 10, 2019 letter, that seems to have been forgotten along with the letter from the HP3 organization letter signed by [redacted] that represented the input from over 300 experts in pain management. As FDA noted, a lot of people were driven to suicide do to patient abandonment, loss of pain medication, and access to anyone who would prescribe above CDC’s “out of thin air” 90 MME number that you now rescind but replace with an even worse 50 MME “suggestion”. How can you claim success when you yourselves have admitted to the widespread misinterpretation and misapplication of the 2016 guidelines? Despite a 70% drop in prescriptions, overdoses are higher than ever. In almost every meaningful measure, CDC has failed the public health and caused more damage than good, and the 2022 draft guidelines are even worse. “The uptake and widespread utilization of the 2016 CDC guideline hinged on its successful dissemination.” How can you make such a false claim?<br/><br/>314.<span style='padding-left: 30px'></span>Page 179 – this seems to be a complete and utter false statement: “This clinical practice guideline updates and expands upon the recommendations in the 2016 CDC Guideline and is based on the best available evidence as interpreted and informed by expert opinion and attending to the values and preferences of patients, caregivers, and clinicians.”<br/><br/>315.<span style='padding-left: 30px'></span>Page 181 – You claim – “In closing, the principle aim of this clinical practice guideline is to ensure people have access to safe, accessible, and effective pain management that improves their function and quality of life while illuminating and reducing risks associated with prescription opioids, and ultimately reducing the consequences of prescription opioid misuse and overdose. Lessons learned from the development of the 2016 CDC guideline informed the process used to generate this update.” The CDC has done more damage to the practice of pain management in the United States and has gained a negative return on investment. Overdoses are spiraling higher. Patients are resorting to street drugs. And this guideline is so full of contradictions and conflicting statements that we request a hearing before the US Congress on how CDC has failed the public, harming pain patients while failing to reverse or even slow down the rate of overdoses in the United States.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aaa7	None	None	2022-04-11T14:27:11Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-d76j-jb7m	False	None	False	2022-04-12 06:40:54.861	[]
4626	CDC-2022-0024-4632	https://api.regulations.gov/v4/comments/CDC-2022-0024-4632	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	No one is addressing the real reason this forum is here. Drug overdoses have predominantly been by younger adults. Now there is an entire new group of people dying from prescription drug overdoses. They are older adults. Adults that are in terrible pain and can no longer get there prescription medications due to new laws imposed by our government. These adults are turning to unknown online websites. The medications they are receiving have probably been made in someones basement or garage, and cut with who knows what, but mostly Fentanyl. And they are dying. Our government has failed its people. They have taken overdose deaths that were approximately 85-90% caused by heroin, cocaine, alcohol, and other prescription pills and blamed the entire cause of those deaths on doctors and opioids. It just isn't so. All of these street drugs are coming across our borders on a daily basis. According to border resources, it is thousands of pills, pounds of Fentanyl, heroin, cocaine, and now methamphetamine. We don't hear a word about addressing that problem except blame it on the doctors and take away the only medication that helps people suffering from actual pain. The problem isn't just the doctors not prescribing the medications, pharmacies will not fill the prescriptions. I don't know how the government can turn this around, but please read some of these comments. People are considering suicide because they cannot deal with the pain. They cannot leave their homes because they can no longer function due to pain. Please do something.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joy	None	None	090000648500a655	Smith	None	2022-04-11T14:27:41Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Joy	l1u-554x-l8rt	False	None	False	2022-04-12 06:40:55.082	[]
4627	CDC-2022-0024-4633	https://api.regulations.gov/v4/comments/CDC-2022-0024-4633	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife has suffered from RLS for years and she would not be able to function were it not for her ability to use small dose methadone. Please consider people like her who rely on opioids to function.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	090000648500a659	Hayes	None	2022-04-11T14:27:55Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Hayes, Steve	l1u-55mm-ox9g	False	None	False	2022-04-12 06:40:55.302	[]
4628	CDC-2022-0024-4634	https://api.regulations.gov/v4/comments/CDC-2022-0024-4634	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Noted citations:<br/><br/>“But [redacted] highlighted several concerns that remained from the draft guidelines on which the AMA submitted comments. “We remain concerned about the evidence base informing some of the recommendations; conflicts with existing state laws and product labeling; and possible unintended consequences associated with implementation, which includes access and insurance coverage limitations for non-pharmacologic treatments, especially comprehensive care; and the potential effects of strict dosage and duration limits on patient care,” she said.<br/>“We know this is a difficult issue and doesn’t have easy solutions,” [redacted] said. “If these guidelines help reduce the deaths resulting from opioids, they will prove to be valuable.”<br/>https://www.ama-assn.org/delivering-care/opioids/what-physicians-are-saying-about-new-cdc-opioid-guidelines<br/>Provisional data from CDC’s National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.<br/>The new data documents that estimated overdose deaths from opioids increased to 75,673 in the 12-month period ending in April 2021, up from 56,064 the year before. Overdose deaths from synthetic opioids (primarily fentanyl) and psychostimulants such as methamphetamine also increased in the 12-month period ending in April 2021. Cocaine deaths also increased, as did deaths from natural and semi-synthetic opioids (such as prescription pain medication).<br/>https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm<br/>Opioids were widely prescribed in the United States during the late 1800s for pain, headaches, asthenia, cough, diarrhea, and other complaints.<br/><br/>More recent studies that have evaluated large numbers of medical patients are reassuring. They suggest that there is a very low incidence of iatrogcnic opioid addiction among patients with no history of prior addiction; for example. one study documented four cases of addiction among 11,822 patiens treated with opioids. and another found no cases of addiction in over 10,600 patients treated with opioids.<br/><br/>It is well documented that acute pain and cancer pain have been undettreated in this country for much of the past century.<br/> <br/>[redacted]<br/>Source: https://www.jpsmjournal.com/article/0885-3924(95)00202-2/pdf<br/><br/>We describe 100 patients who were chronically given opioids for treatment of nonmalignant pain. Most patients experienced neuropathic pain or back pain. We used sustained-release dihydrocodeine, buprenorphine, and sustained-release morphine. Pain reduction was measured with visual analogue scales (VAS), and the Karnofsky Performance Status Scale was used to assess the patient's function. Good pain relief was obtained in 51 patients and partial pain relief was reported by 28 patients. Only 21 patients had no beneficial effect from opioid therapy. There was a close correlation between the sum and the peak VAS values (r = 0.983; p < 0.0001) and pain reduction was associated with an increase in performance (p < 0.0001).<br/><br/>Journal of Pain and Symptom Management - February 1992<br/>Source: https://www.sciencedirect.com/science/article/abs/pii/088539249290116Y<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aaa8	None	None	2022-04-11T14:28:05Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-d95q-s8dy	False	None	False	2022-04-12 06:40:55.519	[]
4629	CDC-2022-0024-4635	https://api.regulations.gov/v4/comments/CDC-2022-0024-4635	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Patients reported here are functioning quite well after 10 or more years in opioid treatment. The vast majority can care for themselves and even drive. Opioid dosages have generally remained stable for long periods without significant escalation. Given the findings here, there is no obvious reason to discourage opioid use or encourage pain patients to cease opioids.<br/><br/>[redacted]<br/><br/>Source: https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/opioid-treatment-10-year-longevity-survey-final-report<br/><br/>A minority of carefully selected and monitored patients with chronic low back, diabetic polyneuropathy and osteoarthritis pain profit from LTOT, even for years. These findings cannot be extrapolated to other CNCP syndromes such as other neuropathic pain syndromes, fibromyalgia syndrome or chronic visceral pain syndromes. The number of patients which remain in a LTOT decreases with time. The findings of the review support the recommendations of European Pain Federation position paper on appropriate opioid use in chronic pain management that opioid therapy can be conducted in properly selected and supervised patients within a multicomponent approach (O'Brien et al., 2017).<br/>https://onlinelibrary.wiley.com/doi/full/10.1002/ejp.1496<br/>In a study examining more than 2,900 fatal overdoses in Massachusetts, researchers found that only 1.3 percent of decedents had an active prescription for the opioid detected in their system on the day they died.<br/>Toxicology reports revealed that 61.4 percent of victims used heroin on or near the date of their overdoses, followed by fentanyl at 45.3 percent, according to the study, published in Public Health Reports. Of the 491 decedents who had at least one active opioid prescription, commonly prescribed painkillers like buprenorphine, oxycodone and methadone were frequently undetected in screenings, according to the study's authors.<br/>The report highlights a growing divide between public health experts and the federal government.<br/>https://www.newsweek.com/study-finds-less-2-percent-overdose-victims-prescriptions-opioids-1467035?fbclid=IwAR0oy_i1HCOYW1dxDwdyEVWthZqa_qIWDMg3Bb6BivXfpu4s0-YapxQXxok<br/>NEW YORK (Reuters Health) - The novel mu-opioid-receptor agonist NKTR-181 appears to provides long-term pain relief in patients with chronic low-back pain (CLBP), according to results from the uncontrolled, open-label SUMMIT-08 LTS study. [redacted], and colleagues tested the safety, tolerability and, as a secondary outcome, effectiveness of six different doses of NKTR-181 (ranging from 100 mg to 600 mg twice daily) in a 52-week study of 638 patients with CLBP (93%) or other chronic noncancer pain conditions.<br/>Overall, 37% of participants discontinued early: 73 withdrew, 67 had adverse events, 32 were lost to follow-up, 27 had protocol deviations, and 21 withdrew for other reasons. About half of the patients (47%) had one or more drug-related treatment-emergent adverse events (TEAEs), most commonly constipation (24%) and nausea (9%), the researchers report in Pain Medicine, online July 30.<br/>Ten percent of patients discontinued treatment due to TEAEs, and none of the serious TEAEs (reported in 5% of patients) were deemed related to NKTR-181. <br/>The mean pain intensity decreased from 4.6/10 at baseline to 2.7/10 at the end of the titration period. Reduced pain intensity was maintained for the duration of treatment once a stable dose of KNTR-181 was reached.<br/><br/>SOURCE: https://bit.ly/33SHW19<br/>Pain Med 2019.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aab0	None	None	2022-04-11T14:29:10Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-dawn-238b	False	None	False	2022-04-12 06:40:55.731	[]
4630	CDC-2022-0024-4636	https://api.regulations.gov/v4/comments/CDC-2022-0024-4636	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We reviewed 26 studies with 27 treatment groups that enrolled a total of 4893 participants. Twenty five of the studies were case series or uncontrolled long‐term trial continuations, the other was an RCT comparing two opioids. Opioids were administered orally (number of study treatments groups [abbreviated as "k"] = 12, n = 3040), transdermally (k = 5, n = 1628), or intrathecally (k = 10, n = 231). Many participants discontinued due to adverse effects (oral: 22.9% [95% confidence interval (CI): 15.3% to 32.8%]; transdermal: 12.1% [95% CI: 4.9% to 27.0%]; intrathecal: 8.9% [95% CI: 4.0% to 26.1%]); or insufficient pain relief (oral: 10.3% [95% CI: 7.6% to 13.9%]; intrathecal: 7.6% [95% CI: 3.7% to 14.8%]; transdermal: 5.8% [95% CI: 4.2% to 7.9%]). Signs of opioid addiction were reported in 0.27% of participants in the studies that reported that outcome. All three modes of administration were associated with clinically significant reductions in pain, but the amount of pain relief varied among studies. Findings regarding quality of life and functional status were inconclusive due to an insufficient quantity of evidence for oral administration studies and inconclusive statistical findings for transdermal and intrathecal administration studies.<br/>Many patients discontinue long‐term opioid therapy (especially oral opioids) due to adverse events or insufficient pain relief; however, weak evidence suggests that patients who are able to continue opioids long‐term experience clinically significant pain relief. Whether quality of life or functioning improves is inconclusive. Many minor adverse events (like nausea and headache) occurred, but serious adverse events, including iatrogenic opioid addiction, were rare.<br/>The findings of this systematic review suggest that proper management of a type of strong painkiller (opioids) in well‐selected patients with no history of substance addiction or abuse can lead to long‐term pain relief for some patients with a very small (though not zero) risk of developing addiction, abuse, or other serious side effects. However, the evidence supporting these conclusions is weak, and longer‐term studies are needed to identify the patients who are most likely to benefit from treatment<br/>Cochrane Systematic Review - Intervention Version published: 20 January 2010<br/>Source: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006605.pub2/abstract<br/>Study: https://doi.org/10.1002/14651858.CD006605.pub2<br/><br/>Refer to these additional citations:<br/>https://docs.google.com/document/d/1RzQDSppUKhjiAsEmhW2WbTXlP5V8vJ4M_vBPQLKhK_8/edit?fbclid=IwAR0tlDlD2It4KJzxxr9cSqAA_JARaa1GgAJN2tgiKFNMSQGEzSjTGPCDK_U<br/>https://www.cdc.gov/media/releases/2019/s0424-advises-misapplication-guideline-prescribing-opioids.html<br/>https://static1.squarespace.com/static/54d50ceee4b05797b34869cf/t/5caf661d7f312b0001bac1b8/1554998814907/Alford+Final+.pdf<br/>http://freepdfhosting.com/0dc0977cdd.pdf<br/>https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes<br/>https://www.usatoday.com/story/news/health/2019/04/24/opioid-pain-pills-crackdown-doctors-prescriptions-cdc-fda/3562373002/?fbclid=IwAR1ZRyedTjKJUUW1csNE5ismHoksduErdAobpu7IO8JwwXMwz-0xU8cdj6k<br/>https://reason.com/2018/04/09/medicare-agency-retreats-from-arbitrary/<br/>https://video.foxnews.com/v/6024911665001?fbclid=IwAR05Sbn1cYqnSaTYRpxc0_3ZU7JG2cEcWUKHQZ6YYzp87za0kK09ehWYHcc#sp=show-clips<br/>https://reason.com/2018/05/14/opioid-death-rates-are-not-correlated-wi/<br/>https://www.cato.org/blog/cdc-researchers-state-overdose-death-rates-prescription-opioids-are-inaccurately-high<br/>https://www.practicalpainmanagement.com/resources/news-and-research/cdc-opioid-overdose-death-rates-over-reported-half<br/>https://www.dovepress.com/efficacy-of-opioids-versus-placebo-in-chronic-pain-a-systematic-review-peer-reviewed-fulltext-article-JPR<br/>https://www.dovepress.com/articles.php?article_id=74212&s=04&fbclid=IwAR1lL161ws8L6mdckJu_YiyWrYhQ7fwazuAdtDIKl3v7TOrihf8ARDOOZJw#cit0013<br/>https://ballotpedia.org/Opioid_prescription_limits_and_policies_by_state?fbclid=IwAR1e8CoEuIYEZcRyz7BWnl_VatXaelSXVwLL7gv071D3bfolcpSpfiltxdk<br/><br/>https://www.dovepress.com/articles.php?article_id=74212&s=04&fbclid=IwAR2IbET7oSvL8MfEcBbnaOa__TqpQrkNBmH4R99fCr_r72o2NhEptrbgdbY#cit0013<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500aab3	None	None	2022-04-11T14:29:39Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-dcg5-i8s1	False	None	False	2022-04-12 06:40:55.959	[]
4631	CDC-2022-0024-4637	https://api.regulations.gov/v4/comments/CDC-2022-0024-4637	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	While I understand and support guidelines for prescribing opioid medications, The CDC guidelines have effectively eliminated necessary treatment for many, many chronic pain patients, and as we have seen, done virtually nothing to eliminate the risk of abuse and death because those risks are associated with ILLEGAL STREET DRUGS, and not those medications prescribed by pain management physicians to chronic pain patients. The greatest risk of death for severe chronic pain patients now, is suicide intended to end suffering that is no longer managed by reductions of prescribed opioid medications. I am on of those patients whose care was greatly, negatively impacted by the CDC's position and recommendations on opioid prescribing, and while I won't go into the reasons I need medication to manage severe chronic pain, I will say that my physician, a pain management specialist, became more concerned with the ramifications of prescribing opioid medications for his patients than with the needs of his patients. I was, prior to the CDC recommendations, prescribed approximately four times the pain medication I am currently prescribed. My current opioid prescription medications were decreased to fall within the CDC guidelines. However. this had nothing to do with my care or what was in my personal best interest. It was solely based on the CDC recommendations, intended for primary care physicians, nurse practitioners, emergency rooms and dentists, coupled with my physician's fear of negative ramifications for prescribing opioid medications. I suffered with the reduction of medication; both with withdrawal from opioids and great increase in the pain I experienced in decreasing those medications. This was unnecessary and done despite decades of drug screenings showing no misuse of prescribed medications or other substances. One thing I would like to see incorporated into the care provided by my specialist would be to discuss with patients any concerns with other medications or substances that are identified on drug screenings, rather than my physician's current policy of immediately discharging any patient whose drug screenings show substance use outside those medications he prescribes to patients. I do appreciate the CDC's stance on addressing medically any concerns in this area. It's my hope that the CDC will take a clear stance with pain management physicians that chronic pain patients who have been prescribed pain medications exceeding the CDC recommendations, should not have medications withheld based solely on those guidelines. As patients we should not automatically be treated like addicts because of high levels of opioids these very same physicians have prescribed. To be frank, our health and quality of life is more important than anyone's license to practice medicine. The CDC has untold deaths on their hands, and those deaths are directly due to the suffering caused by the withholding of necessary pain medication. I suffered with severe unremittent pain for over two years and I can assure you there is a limit to the level and duration of severe pain anyone can endure. You should advocate for the care of chronic pain patients, who were prescribed legal medications from specialists and now find themselves without adequate pain control, because CDC recommendations have created unnecessary fear and panic among physicians. For many, patient care has become inadequate to an inhumane degree. This should become a primary focus of CDC policy. Your recommendations should be clearly and specifically communicated to pain management specialists, who should be more concerned with patient care than they are of the possibility of negative ramifications for prescribing legitimate pain medication. The CDC has an obligation to make correction to the policies that have harmed chronic pain patients.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tara	None	None	090000648500a65c	Pfuhl	None	2022-04-11T14:29:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Pfuhl, Tara	l1u-57dx-6dem	False	None	False	2022-04-12 06:40:56.208	[]
4632	CDC-2022-0024-4638	https://api.regulations.gov/v4/comments/CDC-2022-0024-4638	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 74 yr old woman I have osteoarthritis,spinal Stenosis and neuropathy in my feet and hands all chronic pain When I was 15 I came down with Juvenile RA hospitalized on and off for about a year was given all kinds of pain med codine darvon would not take it made me feel horrible.As I got older the Ra went away I lived on Motrin 6 to 8 a day 2 Drs.told me I had to stop because I have high blood pressuure and motrin creates protien in my kidneys.So fourteen years ago I went to the Dr. I am seeing now She put me on Hydrocodone 7.5/325 2 to 3 a day I did not know what it was I was skeptical to my surprise it relieved most of my pain because I was more active with less pain but had no weird feeling felt fine.First of all I am not an addictive person don't smoke or drink in the fourteen yrs I have been on this opoid I have never taken any more then was told did not need to the only reason the third one was taken sometimes is because the neuropathy is so bad it feels like torches are burning my feet at night.My Dr. has all of a sudden decided decided that I have an addiction and has tapered me to a quarter of what I was taking now I must decide what part of the day I would like to be pain free or if I want to sleep at night.That same Dr I had a wonderful repore with has become so vicious I cant even talk to her anymore.I have a 47 year old son with cerebral palsy cannot walk He has lymphedema with sores on his feet I must wash wrap and unwrap his feet and legs wash them creme his legs down clean his sores out takes about 3 hours twice a week I cant even stand when I am finished I now walk bent over because of the severe spine and thigh pain I am afraid I am going to fall because of the pain and when the sciatica hits I just stay in bed and cry and I am also taking Motrin again be dammed about anything but they don not help anyway It is not fair for honest to goodness chronic pain suffererss to be punished like drug addicts when all we are trying to do is to live somewhat of a normal life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dolores	None	None	090000648500aab7	Corbett	None	2022-04-11T14:32:42Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Corbett, Dolores	l1u-dnao-irx7	False	None	False	2022-04-12 06:40:56.467	[]
4633	CDC-2022-0024-4639	https://api.regulations.gov/v4/comments/CDC-2022-0024-4639	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see my attached comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	090000648500a22d	Sabo	None	2022-04-11T14:33:09Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Sabo, Kathleen	l1t-u7xc-0ip7	False	None	False	2022-04-12 06:40:56.680	[]
4634	CDC-2022-0024-4640	https://api.regulations.gov/v4/comments/CDC-2022-0024-4640	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hi, I don't know what all to say. My name is [redacted]. Lol, you've probably seen me on Twitter, pushing for change for years. What more can I say, let doctors treat their patients... please !!! <br/> <br/> Since I have become disabled from work damage and Rheumatoid Arthritis(or some auto-immune disease). Non-insertional Achillies Tendonitis, Bulging L5, pinched nerves in hips and spine, pinched nerves from C3-C7, bone chips in both elbows, carpool tunnel in both hands. Also almost blind (Ocular Albinism). <br/><br/> I needed pain medication to keep moving. I don't mind some level of pain, that's life... I am talking about the ability to keep moving (some level of functionality). Being able to move to get food, sleep more than a few hours, socialize without having a pained face, grooming, etc etc. Many many horrible days and experiances- because of being refused pain treatment. Last time I tried to pain doctor (pa), "Pain medications are not indicated for Chronic Pain". By policy, set by the office manager. I yelp in pain all the day. I could go on and on. <br/><br/>I think you all know why pain medication is sometimes needed. Not choice "A", but otherwise it's ungodly pain and no quality of life. Pain relief is not guaranteed, but to block it is wrong ! Please stop this !!! <br/><br/>---Suggestions---<br/><br/>P.S. (1) Where do we go now ? I can't go back to the former doctors, can't trust them to look out in their patients best interest (I). Even if you decide to help, how ? Not just I, many. I'm screwed and getting worse. Physically, waking each day is a freaking nightmare... pain !!! We do we the patients go ... now. <br/><br/>(2). Don't block opioids because cannabis was prescribed (damage and RA). My states doctors use this a am excuse not to prescribe opioid pain medication. If your pain worsens and your using cannabis, you are not allowed to take opioids. From experience, Arizona 2019 to today. Cannabis stays in system for months, no pain medication will be prescribe until THC (maybe).<br/><br/>(3) Every state needs a system to advocate for patients to find pain relief. Independent of state medical boards. There is currently to where to go for help or accountability. <br/><br/>I could write for hours of hells the 2016 CDC Guidelines caused, but whats the point. Not going to give s sob story, just fix it. What is happening now... is just wrong !!!<br/><br/>It's amazing how much pain a person can learn to accept, and not.<br/>Have a great one !!! <br/><br/>[redacted]<br/> <br/><br/> <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chris	None	None	090000648500aabf	Morgan	None	2022-04-11T14:33:27Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Morgan, Chris	l1u-e6lh-wq6m	False	None	False	2022-04-12 06:40:56.890	[]
4635	CDC-2022-0024-4641	https://api.regulations.gov/v4/comments/CDC-2022-0024-4641	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 1968, I enlisted in the U.S. Army to respond to my country’s call to service. During my basic training I fell more than 30 feet to the ground while completing an exercise known as the “slide for life”. Although I eventually recovered enough to serve almost six years in Vietnam, the resulting injury left me with a lifelong legacy of back and leg pain.<br/>When I was younger, I was able to get away with taking over-the-counter NSAIDs to dull the non-stop pain. As I became older, it became apparent that long-term use was not an option. In 2005, I was rushed to the hospital with stomach bleeding that was the result of excessive use of over-the-counter NSAIDs. I was then prescribed tramadol as an alternative pain reliever to avoid having another episode that would land me in the hospital. <br/>Now in my twilight years, age-related arthritis coupled with my stenosis and spondylosis began to affect everything. Exercise, physical therapy, acupuncture, visits to the chiropractor only seemed to make my pain worse. The only thing that seemed to make a modicum of difference was the tramadol. <br/>Then, in 2014, there was a sudden shift. My physician suddenly started to restrict their prescribing of tramadol and became suspicious of my answers to her questions regarding my pain level. I was referred to endless pain management appointments, prescribed the gambit of drugs in an effort to wean me off my tramadol prescription and treated like a guinea pig. Although I was receptive to finding an alternative, it became clear that this was an exercise in futility. <br/>Pain management doctors would prescribe drugs with horrible side-effects that did not provide any relief. I was forced to go to physical therapy which only exacerbated the pain I was already experiencing. Specialists would try to pressure me into agreeing to surgery, despite my repeated refusals. If my doctors were already refusing to treat the pain I currently have, what guarantee would I have on pain relief after being operated on. No procedure ever has a 100% guarantee; what if the operation made things worse? Would the doctors abandon me as they have now?<br/>I understand and sympathize with the thousands of individuals who were affected by the opioid crisis. However, I am not a drug user. I have never abused drugs and certainly have never abused anything I was prescribed. Despite multiple doctors indicating that my prescription was a low dosage to begin with, I have been treated little better than a drug seeking patient. I’m not asking for anything exorbitant; I am asking for relief and assistance in improving my quality of life. I answered my country’s call to service, so in my time of need, I would appreciate it if my country responded in kind. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aac1	Anonymous	None	2022-04-11T14:33:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-egc9-dh2k	False	None	False	2022-04-12 06:40:57.136	[]
4636	CDC-2022-0024-4642	https://api.regulations.gov/v4/comments/CDC-2022-0024-4642	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 1968, I enlisted in the U.S. Army to respond to my country’s call to service. During my basic training I fell more than 30 feet to the ground while completing an exercise known as the “slide for life”. Although I eventually recovered enough to serve almost six years in Vietnam, the resulting injury left me with a lifelong legacy of back and leg pain.<br/>When I was younger, I was able to get away with taking over-the-counter NSAIDs to dull the non-stop pain. As I became older, it became apparent that long-term use was not an option. In 2005, I was rushed to the hospital with stomach bleeding that was the result of excessive use of over-the-counter NSAIDs. I was then prescribed tramadol as an alternative pain reliever to avoid having another episode that would land me in the hospital. <br/>Now in my twilight years, age-related arthritis coupled with my stenosis and spondylosis began to affect everything. Exercise, physical therapy, acupuncture, visits to the chiropractor only seemed to make my pain worse. The only thing that seemed to make a modicum of difference was the tramadol. <br/>Then, in 2014, there was a sudden shift. My physician suddenly started to restrict their prescribing of tramadol and became suspicious of my answers to her questions regarding my pain level. I was referred to endless pain management appointments, prescribed the gambit of drugs in an effort to wean me off my tramadol prescription and treated like a guinea pig. Although I was receptive to finding an alternative, it became clear that this was an exercise in futility. <br/>Pain management doctors would prescribe drugs with horrible side-effects that did not provide any relief. I was forced to go to physical therapy which only exacerbated the pain I was already experiencing. Specialists would try to pressure me into agreeing to surgery, despite my repeated refusals. If my doctors were already refusing to treat the pain I currently have, what guarantee would I have on pain relief after being operated on. No procedure ever has a 100% guarantee; what if the operation made things worse? Would the doctors abandon me as they have now?<br/>I understand and sympathize with the thousands of individuals who were affected by the opioid crisis. However, I am not a drug user. I have never abused drugs and certainly have never abused anything I was prescribed. Despite multiple doctors indicating that my prescription was a low dosage to begin with, I have been treated little better than a drug seeking patient. I’m not asking for anything exorbitant; I am asking for relief and assistance in improving my quality of life. I answered my country’s call to service, so in my time of need, I would appreciate it if my country responded in kind. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aac2	Anonymous	None	2022-04-11T14:34:02Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-egcd-x54j	False	None	False	2022-04-12 06:40:57.357	[]
4637	CDC-2022-0024-4643	https://api.regulations.gov/v4/comments/CDC-2022-0024-4643	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please stop regulating opioids with your Opioid Prescribing Guidelines. <br/>My sweet husband takes Methadone for his hip pain. He has had it cut by 50%.<br/>It still enables him to work, thank God, what little he receives. According to what I have researched online, he is at 90 Mme.<br/><br/>He is about to retire and we are wanting to move to Tennessee.<br/>I am thinking we will not find another doctor willing to prescribe him his Methadone, even at 90 Mme. <br/><br/>What the 2016 guidelines have done to chronic pain patients in this country is a crying shame.<br/>Why are people in pain being punished??<br/><br/>And why is the CDC now pushing for 50 Mme??<br/><br/>PLEASE consider the pain that these people are enduring every day.<br/> <br/>Sincerely, <br/> <br/>[name redacted] RDH	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lanora	None	None	090000648500a230	Hubbard	None	2022-04-11T14:34:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Hubbard, Lanora	l1t-umid-zj60	False	None	False	2022-04-12 06:40:57.596	[]
4638	CDC-2022-0024-4644	https://api.regulations.gov/v4/comments/CDC-2022-0024-4644	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[redacted]<br/><br/>To whom it may concern,<br/>I am writing to you regarding the Opioid Recommendations that went into effect in 2016.<br/><br/>I am a Registered Nurse, (disabled), who practiced for a total of 28 plus years in Med/Surg, as well as Behavioral Health. I am married to my husband of 30 plus years. In 1998, he sustained a back injury, that despite multiple interventions, left him in chronic pain. We consulted an Orthopedic Surgeon as well as a Neurosurgeon, and both of these physicians stated that Surgical Intervention would not help. He underwent countless back injections, and IDET, Physical Therapy, and even was referred to and was treated by a Physiatrist.<br/><br/>Despite these years of interventions, nothing helped his severe pain. He subsequently was referred to a Pain Management Specialist, and after finding the right fit for him, Physician wise, has been a client of the office since 1999. <br/><br/>In addition, my husband also suffered fractures of his ankles at different times, and had to have his right ankle fused as it did not heal correctly. He still has considerable pain from these incidents. <br/><br/>His Pain Management Physician prescribed him originally Morphine and Fentanyl Lozenges, but eventually his pain became so severe he ended up on Fentanyl Patches with Oxycodone for breakthrough pain. His Fentanyl Patches eventually were titrated up to 100 mcg. <br/><br/>This allowed my husband, while no longer able to work, a fair quality of life. We could for example, occasionally go out to restaurants, or go to a Bookstore and then get Pizza, on Birthdays and Christmas, for example. He could tolerate sitting in his recliner in the living room to watch TV, almost daily. He could go out shopping to buy Christmas and Birthday presents for his family, as well as visit his parents. The pain would be worse with activity, but in a day or so he'd recover back to his baseline. When his parents needed him he could help them.<br/><br/>This continued until 2016, when his Pain management Physician of 17 years told us he was retiring. His new Pain Management Physician informed us that the Opioid Prescribing Guidelines were changing, and that my husband was going to have his pain medications drastically tapered. I actually remember protesting saying that I had in fact read the guidelines, and told this Physician that, that was what they were, Guidelines, and not Law, and that for a patient with Chronic pain who had never once had a “bad” urine specimen, nor had any evidence of addiction or misusing his pain medications, to taper his medications would be cruel, an leave him in agony! Nevertheless, my husband's medications were drastically weaned down to a mere 25% of what he was previously prescribed. <br/><br/>This left my husband in abject agony almost every day. He is now limited by pain, to mostly staying in bed, sleeping on his right side. His quality of life is absolute shit. Sitting in the living room in his recliner for perhaps 3 hours hurts him so bad that he can maybe do this 1-2 times per week, and has to go back to bed for the rest of the day, or go soak in a scalding hot bath to try to get some relief, and then go to bed. In addition now he has to drive us to pick up medications and groceries, as I now have medical issues that make it unsafe for me to drive. So, as you might imagine, he hurts worse than ever. <br/><br/>He is stoic, and considering the amount of pain he lives with every day, most people would be unable to function at those levels. When I was still able to work, I would almost cry knowing as I gave my hospital patients IV pain meds, such as Morphine, and Dilaudid, my husband was at home, suffering, and there was nothing I could do for him. This breaks my heart, not only as a Wife, but as a Nurse, to see such suffering in the man I love, and not be able to help him. <br/><br/>I beg of you to not only reconsider the Opioid recommendations for my husband's, sake, but for every other person who has had to suffer so much pain, depression, and hopelessness. How many people have hurt so long, without relief, or hope of relief, that they took their own lives? Our Duty to our patients is, “First Do No Harm”, I ask of you How Is Inadequate Pain Management, No Harm?!<br/><br/>Regretfully, and Sincerely, <br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amiee	None	None	090000648500aac3	KELLEY	None	2022-04-11T14:35:01Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from KELLEY, Amiee	l1u-egqi-bf6d	False	None	False	2022-04-12 06:40:57.817	[]
4639	CDC-2022-0024-4645	https://api.regulations.gov/v4/comments/CDC-2022-0024-4645	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted] and I reside in Missouri. I have sickle cell disease and my genotype is sickle cell anemia and I live with sickle cell pain and chronic pain daily. I am a Sickle Cell Disease Patient Advocate and I am on the Community Leadership Council for the National Pain Advocacy Council and I also sit on the board of Uriel E Owens Sickle Cell Disease Association of the Midwest. I am personally vested in the success of these guidelines and getting them right for the safety and health of not only myself but for so many others so that they can have the quality of life they deserve to live, but the sad truth is that for many the harms done by the 2016 guidelines are irreversible because many of those people are no longer here. I hope by using my voice and others, we can help change things for the future. In the draft for the updated guidelines, I appreciate that it focuses on the disparities in pain care because that is a vital component in barriers to care when it comes to Sickle Cell Disease and in other chronic conditions affecting People Of Color. I also like that the draft acknowledges the harm that resulted from previous 2016 guidelines, tapering, medication discontinuation, etc. <br/>As a Sickle Cell Patient and a SCD and Pain Advocate, I have seen the widespread harm caused by the 2016 guidelines. Many pain patients, chronic pain patients, sickle cell patients and several other patients, have been force tapered off medications that are lifesaving for them, medications that greatly improve their QOL and keep their pain levels as low as they possibly can be without hospital intervention. Many have been turned away by their doctors, told they couldn’t see them anymore due to strict opioid guidelines that they had to adhere to now. And even though we as sickle cell disease patients are exempt from the guidelines, we are Not untouched by the harms of the 2016 guideline. There have been many more barriers SCD patients have faced since the ongoing opioid crisis and the 2016 guidelines didn’t help at all, racism, longer ER wait times, mistreatment and under-treatment in the hospital. <br/>As a SCD patient who is on daily pain medication, I am in constant fear of when the same things will happen to me, will my Doctor force taper me off opioids, will I go to the pharmacy one day and have the pharmacist use their own bias and tell me they are unable to fill my prescription for opioids and will I go to the hospital and be given Tylenol instead of the usual proven morphine I get for my sickle cell pain. The opioids that I take daily for pain are the only thing standing between me and several trips to the ER and days and days of non stop sickle cell pain. No, the medication does stop All pain, nothing does, but it helps enough so that I am able to live my life, go grocery shopping, drive a car and do everyday things without being in constant pain. At one point it kept me out of the hospital for over 10 years, now I am up to 3 years out. Opioids play a big part in my pain management plan along with music therapy, and heat therapy. I think many people have the wrong perception of opioids and think automatically that if you’re using them more than occasionally then you must be either addicted or a drug seeker or both, but that is not true in several cases. Sickle cell patients are often mislabeled as drug seekers when we try and seek help in the ER for pain and it has gotten so much worse since the opioid crisis and the guidelines, whether we are exempt or not, have not helped. We STILL face multiple barriers to care in the emergency room, to getting prescriptions filled, and in all other aspects of our health care. Please recognize that opioids DO work for many people in pain and oftentimes a combination of opioids and other treatments are what can work for some patients, force tapering is NEVER ok, there is not one type of pain and Every single patient is different and many of us have lived with these diseases, disorders, conditions, this pain, for most of our lives and even like myself, from birth, and we know what works best for us and what helps us live semi comfortable lives and for many, that is treatments with opioids. In the new guidelines, Please work on focusing on flexibility and individualized care for patients and work with policymakers and others to rescind the supply and dosage thresholds from your previous policies. Thank You for listening.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jemela	None	None	090000648500aac7	Williams	None	2022-04-11T14:36:04Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Williams, Jemela	l1u-erwe-squt	False	None	False	2022-04-12 06:40:58.045	[]
4640	CDC-2022-0024-4646	https://api.regulations.gov/v4/comments/CDC-2022-0024-4646	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for giving me the opportunity to comment on your revisions for the 2016 guideline for treating Chronic Pain with opioids. As a person who lost my LIFE because of them, I ask you to concentrate on viruses and other contagious illnesses and stop the same people with the same COI’s and financial benefits from opioid litigation, from doing further damage to innocent Americans. <br/><br/>FDA approved opioids are the safest, most effective best solution, when taken as prescribed and stored correctly, for treating chronic pain and especially high impact patients that have tried every other treatment there is, for myself many times. These medications have been used for centuries for pain relief. The [name redacted] says Pain Relief is a Human Right but it’s not possible in the USA anymore. The CDC needs to pull the revision and leave the treatment of people with NOT CONTAGIOUS documented incurable conditions that cause pain to the FDA who approves our treatment, including LTOT, and our DOCTORS who know us and our needs, who know how to properly manage pain with many root causes. Legacy patients should have our medications back that gave us the ability to function. I WANT to help myself. You’re stopping me. <br/><br/>The MMED is unscientific in that multiple versions are available, none of them giving the same results for the same medications and dose. The fact that everyone responds differently to different medications at varying amounts IS scientific. MMED is totally flawed and neither the 90 MME or now 50 MME should be a part of any revision. What works for one person won’t work for another. THAT is scientific. Stop experimenting on me without my consent and forcing me to suffer and be totally disabled, unable to do simple OR complex tasks, when pain relief is readily available. <br/><br/>Stopping “co-prescribing” of opioids and Benzodiazepines is a huge mistake, as millions have taken these medications simultaneously without overdose or adverse events. I’d taken both since about 2003 and for many of those years, I was able to continue doing physical labor in a factory, take care of my family, be involved in my daughter’s extracurricular activities and had a good quality of life. I’m a responsible 59 year old woman who shouldn’t have to suffer for the CHOICES of others. For myself, the BENEFITS from my medications FAR outweighed the RISKS, which are none, because I used my meds responsibly. Buprenorphine is not created for pain relief and is very destructive to your TEETH, just like real heroin. Narcotics do NOT destroy your teeth. Acetaminophen is not good for the liver LONG TERM and ibuprofen is not good for the stomach LONG TERM. Narcotics / opioids do not damage organs or teeth. <br/><br/>When I had my medications, I was able to be much healthier because I was able to exercise regularly and keep my weight in check. That’s not possible now, with my pain not well managed. Among other things, I have Degenerative Joint Disease which has made it impossible to even walk through the house with my right hip being bone on bone. I’m forced to spend the time in bed or my recliner. In April of 2019 I had a right TKR which never healed probably without adequate pain relief, that makes my entire leg feel like lightning is raging through it ALL THE TIME. My Benzodiazepine helped my nerve damage and muscle spasms tremendously, no longer possible. Again IF there’s a risk, let ME take that risk. I didn’t CHOOSE this. I should be treated ethically. <br/><br/>The facts are that opioid prescribing is at 20 year LOWS and deaths are at all time HIGHS are proof that prescribed medications, for THAT PERSON, are NOT driving the “opioid crisis” but illicit drugs ARE. The illicit fentanyl will poison you with a tiny bit. THAT IS RISKY. There is NO BENEFIT from it. Pain medications enabled me and lack of adequate pain relief took my abilities away. There’s no “excess opioids” out there. <br/><br/>Lastly, for anyone to believe they can “stop addiction,” you’re highly mistaken. You cannot stop human behavior. During the horrific riots of 2020, when cities were burning and destruction was everywhere, [name redacted] said “people are going to do what they do” and threw her hands up in the air. That’s the only time I’ve ever agreed with her. The addiction rate for chronic pain patients is under 1%. We don’t abuse them because they are our lifeline. <br/><br/>An estimated 95,000 people (approximately 68,000 men and 27,000 women) die from alcohol-related causes annually, 15 making alcohol the third-leading preventable cause of death in the United States. The first is tobacco, and the second is poor diet and physical inactivity. 16<br/>https://www.niaaa.nih.gov/.../alcohol-facts-and-statistics<br/><br/>Where’s the “alcohol crisis?” Stop keeping people from ethical medical care and let us have whatever our Doctors say we need, NOT unelected bureaucrats that don’t answer to the taxpayers that are forced to fund them.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bev	None	None	090000648500a65e	Minich	None	2022-04-11T14:36:08Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Minich, Bev	l1u-598m-85kk	False	None	False	2022-04-12 06:40:58.296	[]
4641	CDC-2022-0024-4647	https://api.regulations.gov/v4/comments/CDC-2022-0024-4647	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been suffering with severe car accident injuries & painful arthritis for so long and I have been denied any medication/help because of this “epidemic”. I don’t understand why I am being denied medication, it is the only way I can live a normal life. I have lost all quality of my life when they stopped prescribing medications. I urge you to lift these restrictions because it is not a drug, it is medication that people like me need to live a normal life. To be in pain every day of my life is absolutely the worst situation I’ve ever experienced. Any medication in this world can be abused but that should not mean people like me should have to suffer because there are addicts/abusers in the world that cannot handle medication. Thank you and I sincerely hope you will consider lifting these prescribing restrictions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lauren	None	None	090000648500aad3	Marcello	None	2022-04-11T14:36:13Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Marcello , Lauren	l1u-fl01-tlb8	False	None	False	2022-04-12 06:40:58.510	[]
4642	CDC-2022-0024-4648	https://api.regulations.gov/v4/comments/CDC-2022-0024-4648	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This is a continuation of my previous comment tracking # 11u-b1qs-vfwe <br/> These CDC Guidelines need to be removed with all due respect. If doctors need these type of opiate guidelines for prescribing opiate pain medication then they have no business prescribing any type of medication, much less being doctors at all if they cannot use the medical education an degree they've received in the first place, as I am sure they were taught how to prescribe opiate pain medications responsibly. I have 17 yrs of medical documentation consisting of MRI's, X-ray's, and have already tried alternative pain relief such as physical therapy, Chiropractors, epidural steroid injections, my nerves being burnt- Radio Frequency ablations, minimally invasive treatments so most of us chronic pain patients are way past that point and have already experienced failed and extremely invasive surgeries and or traumatic injuries from accidents that are irreversible leaving us in a severely traumatic condition that can only be treated with high mg opiate medications. Trust me we don't crave some stupid pill that gives us side effects such as being constipated constantly, and tired...etc....I don't get some sort of high that people think we do but we get relief from a tormenting pain that you cannot understand unless your in our shoes. The relief that I get with opiate pain medication allows me the basic functions like being able to go to the store, pick up my daughter from school, cooking....etc. but these last years since the 2016 cdc guidelines on opiate prescribing have left me bedridden 24/7, waking up in the middle of the night of tormenting pain, exhausted and unable to take care of myself in the simplest ways, watching my daughters grow up from a distance without me , missing out on school plays, family outings or trips and not to mention that my family suffers along with me as they have to see me in this condition always in constant agony,.... as my wife has to carry the whole burden financially as I'm unable to provide financially but it would at least be nice for them if I had adequate pain relief that I could have a quality of life that I could smile and enjoy time spent with them instead of being in a bed 24/7 dying a slow death from constant tormenting pain. Opiate pain medication does not cause addiction to us legit chronic pain patients, yes physical dependence in which are 2 different things, our pain is never going away either and we are being given alternative pain medications such as lyrica & gabapentin or suboxone & belbuca in which causes way more harm like brain damage from the lyrica, and extreme damage to our teeth like in my case from the belbuca that the FDA just recently announced and admitted too. PLEASE completely remove the MME from the guidelines or them as a whole completely. Its not like everything is gonna just go back to normal that fast anyways these doctors, pharmacies and insurance company's have already been conditioned and traumatized by the DEA, 2016 CDC guidelines in such a way that has victimized us Chronic pain patients in so many ways that we have been left out to die literally, treated in a in-humane manner and as you stated "it was not your intention to hurt anyone" well then I sincerely petition you to remove the 2016, 2022 opiate guidelines and or the MME in its entirety as enough damage has already been done. This is the little hope that we and our families have left, that we could have at the very least... somewhat quality of life. We will continue to always have and battle the never-ending TOREMENTING chronic pain but with the proper mg of opiate medication we can receive enough relief that would allow us to live at the very least a quality of life that every human being deserves. For myself with the proper opiate medication I could have extended relief around the clock with immediate relief during flare-ups as I try to live an active life with my wife, 3 daughters, and grandson attending school functions, traveling, going for walks in the evening, doing physical therapy , and exercise and lose weight as I use to love running and jogging in which i could do again at a small pace, I would try to work a part time job to earn money for my family. I have so many hobbies that I miss so much like metalworking and classic car restoration. All this being said, that with the proper medical pain management with the use of opiate and high dose opiates in severe cases such as mine you will be giving us our lives back at the very least, and the Hope to live again. Instead of seeing and feeling a dead end in life ( physically inhumane never ending suffering ) many pain patients will be saved from commiting suicide. I could go on and on as our minds are constantly and only thinking about pain that we are truly overwhelmed with agony beyond belief. You see we are truly seeking Relief from Torment and if the the opiate pain medication gives us that relief then we need our opiate pain medication.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	cruz	None	None	090000648500aad6	Hill	None	2022-04-11T14:36:40Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Hill, cruz	l1u-fn78-d535	False	None	False	2022-04-12 06:40:58.724	[]
4643	CDC-2022-0024-4649	https://api.regulations.gov/v4/comments/CDC-2022-0024-4649	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[redacted]<br/>SECOND COMMENT WITHOUT IDENTIFYING INFORMATION, AND THE ONE BAD WORD.<br/><br/>To whom it may concern,<br/>I am writing to you regarding the Opioid Recommendations that went into effect in 2016.<br/><br/>I am a Registered Nurse, (disabled), who practiced for a total of 28 plus years in Med/Surg, as well as Behavioral Health. I am married to my husband of 30 plus years. In 1998, he sustained a back injury, that despite multiple interventions, left him in chronic pain. We consulted an Orthopedic Surgeon as well as a Neurosurgeon, and both of these physicians stated that Surgical Intervention would not help. He underwent countless back injections, and IDET, Physical Therapy, and even was referred to and was treated by a Physiatrist.<br/><br/>Despite these years of interventions, nothing helped his severe pain. He subsequently was referred to a Pain Management Specialist, and after finding the right fit for him, Physician wise, has been a client of the office since 1999. <br/><br/>In addition, my husband also suffered fractures of his ankles at different times, and had to have his right ankle fused as it did not heal correctly. He still has considerable pain from these incidents. <br/><br/>His Pain Management Physician prescribed him originally Morphine and Fentanyl Lozenges, but eventually his pain became so severe he ended up on Fentanyl Patches with Oxycodone for breakthrough pain. His Fentanyl Patches eventually were titrated up to 100 mcg. <br/><br/>This allowed my husband, while no longer able to work, a fair quality of life. We could for example, occasionally go out to restaurants, or go to a Bookstore and then get Pizza, on Birthdays and Christmas, for example. He could tolerate sitting in his recliner in the living room to watch TV, almost daily. He could go out shopping to buy Christmas and Birthday presents for his family, as well as visit his parents. The pain would be worse with activity, but in a day or so he'd recover back to his baseline. When his parents needed him he could help them.<br/><br/>This continued until 2016, when his Pain management Physician of 17 years told us he was retiring. His new Pain Management Physician informed us that the Opioid Prescribing Guidelines were changing, and that my husband was going to have his pain medications drastically tapered. I actually remember protesting saying that I had in fact read the guidelines, and told this Physician that, that was what they were, Guidelines, and not Law, and that for a patient with Chronic pain who had never once had a “bad” urine specimen, nor had any evidence of addiction or misusing his pain medications, to taper his medications would be cruel, an leave him in agony! Nevertheless, my husband's medications were drastically weaned down to a mere 25% of what he was previously prescribed. <br/><br/>This left my husband in abject agony almost every day. He is now limited by pain, to mostly staying in bed, sleeping on his right side. His quality of life is absolute Feces. Sitting in the living room in his recliner for perhaps 3 hours hurts him so bad that he can maybe do this 1-2 times per week, and has to go back to bed for the rest of the day, or go soak in a scalding hot bath to try to get some relief, and then go to bed. In addition now he has to drive us to pick up medications and groceries, as I now have medical issues that make it unsafe for me to drive. So, as you might imagine, he hurts worse than ever. <br/><br/>He is stoic, and considering the amount of pain he lives with every day, most people would be unable to function at those levels. When I was still able to work, I would almost cry knowing as I gave my hospital patients IV pain meds, such as Morphine, and Dilaudid, my husband was at home, suffering, and there was nothing I could do for him. This breaks my heart, not only as a Wife, but as a Nurse, to see such suffering in the man I love, and not be able to help him. <br/><br/>I beg of you to not only reconsider the Opioid recommendations for my husband's, sake, but for every other person who has had to suffer so much pain, depression, and hopelessness. How many people have hurt so long, without relief, or hope of relief, that they took their own lives? Our Duty to our patients is, “First Do No Harm”, I ask of you How Is Inadequate Pain Management, No Harm?!<br/><br/>ANY MEDICAL RECORDS YOU REQUIRE WE WILL GATHER AND PROVIDE AS FURTHER EVIDENCE.<br/><br/>Regretfully, and Sincerely, <br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amiee	None	None	090000648500aadc	KELLEY	None	2022-04-11T14:37:29Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from KELLEY, Amiee	l1u-fu3l-ds71	False	None	False	2022-04-12 06:40:59.005	[]
4644	CDC-2022-0024-4650	https://api.regulations.gov/v4/comments/CDC-2022-0024-4650	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope you will finally listen to the cries of those begging you to do the right thing and help them! I wrote a submission to the one two years ago about my son who is disabled and in daily chronic pain. It’s just disgusting this is all still going on. If all the decisionmakers were in as much pain as all these pain patients are, I am quite sure this all would’ve been overturned long before now and doctors would again be able to prescribe whatever a patient needs which is the way it should be! <br/>For every 1 submission you get, there’s at least 1000 more with similar issues who would respond if they could. You won’t hear from the majority as they are in too much pain to compose a response, first off. Secondly, the millions that might could are terrified of retaliation and losing the little bit of help they might be getting from a doctor. Most don’t want to get cutoff completely from doctors or have their doctors offices closed down, licenses revoked and doctors possibly locked up by the DEA.. it’s happening every where. The balance you won’t hear from are the people that were in overwhelming pain and are now dead because of it.. so sad but true. Two of them were dear friends of mine. The blame for these deaths lie with the government as the government is responsible for this nightmare!<br/>People are scared to open up and with good reason. You want to know the horror stories that are the peoples lives? Sign up with private pain support groups. There are lots out there with many thousands of members who only open up to each other for support and comfort because of the privacy protections in place. <br/>One that I know of has over 25,000 members alone. A tremendous amount of people in chronic pain don’t even get online even if they are at all able. <br/>People shouldn’t be scared of what else their government will do to hurt them and destroy their lives but they are because that’s what has been happening for so long. They’ve suffered for so long at the hands of government bureaucracy and overreach, corruption, etc., and it just keeps getting worse. <br/>All people of this earth should have access to all things available.. not just what the elites deem fit. Nothing should be illegal or limited but everyone should be responsible for what they do or don’t do with what they access. I could go into a long spiel on alcohol but this is already long enough. <br/>There never has been and never will be a one size fits all for anything and each individual should have the right to choose what works best for and helps them the most. There should be no limits or drug testing.. these people have real pain for gosh sakes. And especially there should be no “we’ll only give you a little pain medication if you take these shots” which should not even be allowed.. it’s been proven how much worse off the shots make people. But if you think that most people don’t know to “follow the money”, think again. The government’s involvement should be limited to things like making sure all things are manufactured properly so that they’re safe for the people at a reasonable cost, etc. <br/>Many more people have died over the years from untreated and undertreated pain and terrible “pain management” practices than any “opioid crisis” that mostly involves illegal drugs with the majority being shipped in from other countries. Pain patients have no control over that and clearly the government is not doing a very good job in keeping them out.. probably because all they can seem to focus on is locking up innocent doctors and leaving innocent pain patients to suffer even more. They already get treated in a less than humane way which is unconscionable and needs to stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lois	None	None	090000648500aadd	Luesing	None	2022-04-11T14:37:43Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Luesing, Lois	l1u-fufq-vqk7	False	None	False	2022-04-12 06:40:59.222	[]
4645	CDC-2022-0024-4651	https://api.regulations.gov/v4/comments/CDC-2022-0024-4651	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I hope you will finally listen to the cries of those begging you to do the right thing and help them! I wrote a submission to the one two years ago about my son who is disabled and in daily chronic pain. It’s just disgusting this is all still going on. If all the decisionmakers were in as much pain as all these pain patients are, I am quite sure this all would’ve been overturned long before now and doctors would again be able to prescribe whatever a patient needs which is the way it should be! <br/>For every 1 submission you get, there’s at least 1000 more with similar issues who would respond if they could. You won’t hear from the majority as they are in too much pain to compose a response, first off. Secondly, the millions that might could are terrified of retaliation and losing the little bit of help they might be getting from a doctor. Most don’t want to get cutoff completely from doctors or have their doctors offices closed down, licenses revoked and doctors possibly locked up by the DEA.. it’s happening every where. The balance you won’t hear from are the people that were in overwhelming pain and are now dead because of it.. so sad but true. Two of them were dear friends of mine. The blame for these deaths lie with the government as the government is responsible for this nightmare!<br/>People are scared to open up and with good reason. You want to know the horror stories that are the peoples lives? Sign up with private pain support groups. There are lots out there with many thousands of members who only open up to each other for support and comfort because of the privacy protections in place. <br/>One that I know of has over 25,000 members alone. A tremendous amount of people in chronic pain don’t even get online even if they are at all able. <br/>People shouldn’t be scared of what else their government will do to hurt them and destroy their lives but they are because that’s what has been happening for so long. They’ve suffered for so long at the hands of government bureaucracy and overreach, corruption, etc., and it just keeps getting worse. <br/>All people of this earth should have access to all things available.. not just what the elites deem fit. Nothing should be illegal or limited but everyone should be responsible for what they do or don’t do with what they access. I could go into a long spiel on alcohol but this is already long enough. <br/>There never has been and never will be a one size fits all for anything and each individual should have the right to choose what works best for and helps them the most. There should be no limits or drug testing.. these people have real pain for gosh sakes. And especially there should be no “we’ll only give you a little pain medication if you take these shots” which should not even be allowed.. it’s been proven how much worse off the shots make people. But if you think that most people don’t know to “follow the money”, think again. The government’s involvement should be limited to things like making sure all things are manufactured properly so that they’re safe for the people at a reasonable cost, etc. <br/>Many more people have died over the years from untreated and undertreated pain and terrible “pain management” practices than any “opioid crisis” that mostly involves illegal drugs with the majority being shipped in from other countries. Pain patients have no control over that and clearly the government is not doing a very good job in keeping them out.. probably because all they can seem to focus on is locking up innocent doctors and leaving innocent pain patients to suffer even more. They already get treated in a less than humane way which is unconscionable and needs to stop.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Lois	None	None	090000648500aadf	Luesing	None	2022-04-11T14:37:54Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Luesing , Lois	l1u-g1n5-1ldx	False	None	False	2022-04-12 06:40:59.448	[]
4646	CDC-2022-0024-4652	https://api.regulations.gov/v4/comments/CDC-2022-0024-4652	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My pain has been successfully managed by my pain specialist for over a decade with opioid therapy and an integrated pain management program facilitated by that opioid therapy. With the medication levels he prescribed I am able to function and be productive. Without the medication I suffer severe pain that is incapacitating, and leaves me bedridden and unable to care for myself. I cannot see the value in living a life that is so completely filled with pain that the experience of pain overwhelms my ability to function or even to think about anything other than seeking respite from the intense pain I experience without sufficient opioid medication.<br/><br/>I am a full body CRPS intractable pain patient who like millions of others have lost all quality of life and function, including the use of both hands, rendered housebound and bedridden disabled as a direct consequence of misapplied CDC guidelines, which have made life unlivable. This is despite 23 years of CRPS, being well-managed, without any problems or increases in medication since being titrated (after 8 years bedridden as I was determined to avoid medication and it was asked all alternative methods for the first eight years of disease).<br/><br/>The largest problem with this is that it seems to be based on the theories of the controversial CDC guidelines, flawed by CDC's own data and admission, and the huge amount of papers and subsequent studies by eminent pain specialists and organizations, even the American medical Association deeming that that methods in the CDC guidelines are dangerously flawed.<br/><br/>Basing new regulations CDC guidelines, dangerously replicated here, on cherry-picked science at the expense of patient care will only further profoundly exacerbate the problem, in every direction, harming both harming both patients and the drug addicts the CDC claims to want to help.<br/><br/>As has been demonstrated, limiting supply and prescriptions has only caused immense suffering to a population and demographic that had little to do with the addiction problem and illicit drug crisis.<br/><br/>Overdoses continue to skyrocket as it is not the same demographic.<br/><br/>The proposed changes also assume that the 2016 CDC guidelines on opioid prescribing are a correct basis for pain management practice—they aren't.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aae7	Anonymous	None	2022-04-11T14:38:07Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-geat-fv8d	False	None	False	2022-04-12 06:40:59.667	[]
4647	CDC-2022-0024-4653	https://api.regulations.gov/v4/comments/CDC-2022-0024-4653	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Greetings-I I'm a 63 year old male engineer who was mostly pain free until an auto accident in June of 2017. Within 2 days my pain level was awful. In the past 4.6 years I have been to 200+ mechanical treatments at doctor's requests and went through heck trying to get out of pain. Meds are about 1/2 as much as I need presently (my guess on the 1/2 part). I haven't been able to work because of the pain the last 2.5 years. Beef the auto accident, I was able to bicycle 85 miles a week and planned on retiring at 70. Now, I can't sit in a chair for more than a few minutes, I have issues walking limiting the length to mostly in my home. I'm couch ridden 22 hours a day. The 60 mg of oxy is enough to calm my crying for a few hours a day. Never 1x have I gotten a buzz from the meds...even at prescribed amounts of 300 mg daily. I've had probably 20 spinal injections and 2 operations...and, just in the past month the docs have zeroed in on the cause...and it looks like I'm going to need another 2 surgeries to help with the pain. I've been refused prescriptions at [name redacted] because the manager thought my doc wasn't doing enough to get me off of the medication. Please make it less strict to write prescriptions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	John	None	None	090000648500a665	Cichon	None	2022-04-11T14:38:24Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Cichon, John	l1u-5dwg-fsgu	False	None	False	2022-04-12 06:40:59.903	[]
4648	CDC-2022-0024-4654	https://api.regulations.gov/v4/comments/CDC-2022-0024-4654	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	When I read this update to the 2016 CDC Opioid prescribing document, I realized that these authors have been so involved in the Overdose Opioid department of the CDC and in drug addiction treatment that they have lost sight that chronic pain patients are not addicts, they are dependent on prescription opioids to control physical pain, do not feel high, just physical pain relief, and that it may be more dangerous to quickly taper a chronic pain patient who has been on the same dose for decades.<br/><br/>The authors keep writing, “These are only Guidelines.” Guidelines should not state that a doctor can only prescribe 50 MME/day, which means 30 mg of Oxycodone/per day. These low doses are NOT "responsible prescribing." Please remove this directive. Why:<br/><br/>1. If millions of patients are prescribed the same dose and the same opioids, there won't be enough tablets available for sale at the pharmacies; the DEA has limited the number of tablets and capsules that the drug companies are allowed to produce.<br/>2. Milligrams/day need to be adjusted for each individual's pain levels. Some people have a low tolerance for physical pain, some have high tolerances. <br/>3. One drug does not fit all, one dose does not fit all, find the right drug for the individual, and then adjust the dose.<br/>4. In medical school, doctors were taught to prescribe opioids as the last result after everything else was tried.<br/>5. The FDA has stated that there is no top dose limit.<br/>6. There is no ceiling level dose as there is with buprenorphine, which was originally developed for drug addiction treatment, not pain management.<br/><br/>Pregabalin and gabapentin are both stated by the CDC document as preferred non-opioid pain relievers. They have side effects which make them highly sought-after drugs for teenagers and drug addicts. Pregabalin causes severe vertigo/ dizziness, and gabapentin causes mental confusion in most people; teenagers think they are getting high. <br/><br/>I suggest that pregabalin (Lyrica) and duloxetine (Cymbalta) should be prescribed with care and not to people over 65 years old, because of the side effects causing similarity to senile dementia. I based this statement because of what happened to my male friend who was 67 when he was prescribed both pregabalin and duloxetine. Pregabalin gave him severe vertigo, caused him to forget what he had recently read, he repeated what he had already said, he gained twenty pounds, and was sleepy, but had difficulty sleeping because of pain and leg cramps. Shortly after taking his duloxetine medication, he became extremely hot and sweaty and could not express his thoughts (into words) which made him upset. A year after starting those medications, black dots began erupting on his skin which became itchy red rashes all over his body, as well as, developing bubbly clear blisters on his skin. It was all super itchy. Uncontrolled scratching left deep, bloody, gashes on his arms, shoulders, and upper back. His ankles had large purple bruises. It was very painful. He yelled out that the “pain is worse than cancer.” He did some research and realized it fit the description for what could have been Stephen-Johnson's disease. It was an allergy reaction to those drugs. Stopping both drugs cleared the disease. It took six months to get the pregabalin out of his system and feel better. He still has black scars on his legs. <br/><br/>Please remove the 50 MME/day limitation for certain, specified, clinicians. It doesn't make sense. Why cherry-pick who can prescribe higher doses than another? If the PhDs had gone to medical school and attended three-year residencies, they would understand the hard work and skills the internists and family medicine doctors developed to practice medicine. Many clinician types were not mentioned, such as general practitioners, who only completed the first year of residency (internship); PAs; NPs; and DOs. An internist is a primary care physician, but S/he/? can be, at the same time, an ER clinician, a pain management specialist, infectious disease specialist, hospitalist, or the hospital's cardiologist reading EKGs or doing pulmonary function tests.<br/><br/>An added note: I was very disappointed in the format of this document. Footnotes do not go in the middle of the page-they are numbered and go to the bottom of the page or go to the back of the document. Chapter breaks didn't make sense. Why are there references to the Coronavirus in a document on opioid dosing, because the lead author is the head of the Coronavirus department? <br/><br/>Done	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barbara	None	None	090000648500aaf2	Jenke	None	2022-04-11T14:38:28Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Jenke, Barbara	l1u-h18m-4gcj	False	None	False	2022-04-12 06:41:00.122	[]
4649	CDC-2022-0024-4655	https://api.regulations.gov/v4/comments/CDC-2022-0024-4655	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please do not force those in pain to suffer even more under your regulations.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a75b	Anonymous	None	2022-04-11T14:38:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-hmop-rwla	False	None	False	2022-04-12 06:41:00.346	[]
4650	CDC-2022-0024-4656	https://api.regulations.gov/v4/comments/CDC-2022-0024-4656	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It began with a gunshot wound in 1983 which resulted in many surgeries to correct but in the process I over produced adhesions in my abdomen which have caused actually obstructions and now seem to only cause partial obstructions which are incredibly painful, also the bullet hit and pushed my spine out of place and with age backpain has cropped up that is mind shattering. luckily these 2 things were happening only once a year or so in my younger years but now in my 50's they have dramatically increased and need pain med therapy.<br/><br/>At age 30 i was given renal tubular acidosis and medullary sponge kidney from my late mother who also suffered and in the early years i got 1-2 stones a year but now again in my 50's i create and hopefully pass 5-10 stones a month while also having to have surgery for stones every 2 or so years.<br/>I began opioid meds around my early 30's with PRN Demerol which at the time worked ok because i didn't need it much but over the years the stones have increased like I said and my need for opioids increased.<br/>I should say that the kidneys and the stomach cannot at this time be "cured" but only managed...since my spinal problems have become unbearable I am looking at surgical options but specialist appointments take time, I didn't look at spinal surgery in the past due to many spinal surgeries causing more pain than they relieved but now I am at an impasse and will see what they have to say.<br/><br/>In my 40's I started on a 24/7 365days a year Morphine regime, over the years doctors have offered increases or changes in the prescribed drug and I have always come back to Morphine due to lack of side effects and ability to NOT feel high in anyway so therefore the ability to have a "life"<br/><br/>Started at 90mg long acting 2x day with 30mg fast acting for Breakthru<br/>PAIN SPEC! increased to 150mg 2x day + previous Breakthru<br/>PATIENT (myself) decreased back to previous med level due to I didn't feel the need for the increase<br/>PAIN SPEC! changed me from Morphine to Hydromorphone (cant remember dose)<br/>PATIENT requested reversal back to Morphine due to side effects after only one month<br/>ER DOCTOR/GP changed me from Morphine to Fentanyl patch (25mg) due to bowel loss and digestion concerns<br/>PATIENT insisted on reversal after 3 days use due to side effects<br/><br/>Also of note is I have NEVER-<br/>Double doctored- even refusing scripts from ER doctors because of fear of double doctoring<br/>Abused meds- Never injected, snorted, used street drugs, drink, smoke or anything of the like<br/><br/>BUT I have been -<br/>Forced to wait in ER for no reason (in agony) because they believed i was shopping for meds<br/>Forced against my will and knowledge to have my meds tapered even though i met with doctor after the fact and disagreed vehemently<br/>Forced to have meds tapered a 2nd time again without my knowledge or consent<br/>Having my doctor get frustrated and angry with me and the situation because he feels he is being forced to HARM his patients<br/>Having my doctor get frustrated and angry a 2nd time for same reason<br/>Seeing many many doctor offices with signs stating they will NOT prescribe narcotics to ANYONE which is a form of discrimination<br/><br/>Where is the CARE? COMPASSION? The HYPOCRATTIC OATH? <br/>What happened to DO NO HARM?<br/><br/>I do see a need for doctors and regulators to reduce and remove opiates from people that are abusing them BUT also don't need them (abuse and need can happen at the same time.) It's interesting that it was the Pharmacy Companies and the Doctors that caused this crisis when they created millions of "street addicts" as well as FORCING addiction on people against there will when prescribed meds for non-med worthy causes or over prescribing for real short term causes.<br/>But instead of TAPERING the guilty Pharmacy Companies or the OVER PRESCRIBING Doctors we the chronic pain sufferers are vilified and tapered and sometimes even taken off them completely, even though most studies show that non-consent tapering or 100% removal can cause SUICIDE and or DRUG OVERDOSE (when a patient turns to street drugs for pain relief). <br/><br/>The CDC MUST realize that there is a relatively small percentage of patients that NEED these meds and sometimes even in "scary" doses (compared to a "normal" person) but just because there is an opioid crisis and things like CHINESE/MEXICAN Fentanyl are killing people every day but that is not a reason to TORTURE patients and forget the oath of "DO NO HARM" when it pertains to Chronic Pain Sufferers.<br/><br/>I cannot speak for all the sufferers out there but for myself I have no problem with random drug tests to prove I'm not using street drugs or drinking alcohol as well as "pot", I have no problem with having meds dispensed weekly to help avoid problems as well as bubble packs to help for same reason. Many people say a GP doctor should not be prescribing and that patients should be going to pain clinics for such things but the problem I see for myself and here in my city is that the clinics are doing the exact same thing.<br/><br/>STOP THE TORTURE!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brent	None	None	090000648500a760	Moffatt	None	2022-04-11T14:38:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Moffatt, Brent	l1u-ias8-2mxs	False	None	False	2022-04-12 06:41:00.568	[]
4651	CDC-2022-0024-4657	https://api.regulations.gov/v4/comments/CDC-2022-0024-4657	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was born with a genetic disease called elhers danlos syndrome where my body can't properly make collagen. My body is missing the "glue" that hols it together. This leads to chronic pain, frequent dislocations and broken bones, fragile skin, organ ruptures, and problems with any part of the body made from collagen. I'm told I won't live to see 50. I've been completely bedridden for the past 8 years, on a good day I can get up and go to the bathroom and kitchen twice a day, and on a bad day I can't sit up, walk, speak or chew food. The pain gets so intense I vomit or pass out. I can't find one dr who's willing to put me on pain medicine because of the stigma of pain patients being addicts. The CDC guidelines had a lot to do with the stigma. A dr put me on palliative care but insurance won't pay for it. I keep getting denied disability benefits. Im still young, only in my 30's and I've never gotten to enjoy my teens and 20's because of illness and medical neglect. You guys have no idea what it's like to be dying with pain levels at a 10 and be completely neglected by those who took an oath to help and not harm. Chronic pain patients are committing suicide in massive numbers because of the neglect. I'm asking you to find whatever humanity you might have left and stop making it difficult for chronic pain patients to get medicine. Research shows only 5 percent of the opioid epidemic is caused by prescription opiates, the rest is from street drugs. After the last edition of the CDC guidelines the use of street opiates went up 20 percent. You know what happens when patients with severe pain are neglected by the system? They try to find it recreationally. Statistics show these guidelines aren't helping stop addiction, they're just increasing street use of opiates. So you want to help stop the opiate crisis? Stop making it so difficult for chronic pain patients to get medicine. We're not addicts, we have real pain and deserve to have a better quality of life. There's ways to help stop the opiate crisis without neglecting and killing those who need this medicine the most. Please have some humanity.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sara	None	None	090000648500a76c	Draffen	None	2022-04-11T14:39:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Draffen, Sara	l1u-ip2d-f8u0	False	None	False	2022-04-12 06:41:00.918	[]
4652	CDC-2022-0024-4658	https://api.regulations.gov/v4/comments/CDC-2022-0024-4658	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 64 year old woman with multiple painful illnesses and injuries. What I have been through in the last few years has been incredibly difficult for me. I have been tapered down from my normal dose of pain medication. This has caused me to be almost completely bedridden this is totally unfair to me and the doctors taking care of me. CDC and the DEA have both targeted me and my prescribing doctor from taking optimal care of me. The experimental mandates that you have put into place have caused major harm to me not only physically but also emotionally. It has affected my relationships with my families and friends and has made people around me feel like I’m a criminal because I have painful conditions. I have been targeted by doctors pharmacies and denied care. I have proven to the government that I am disabled yet here I am fighting with the same government to get proper care. One size pain medication protocol does not fit another person’s medication protocol you need to drop the MME equivalent. I have done all of the therapies medical interventions and alternatives to pain medication before I got to this place of taking pain medication. Now that I have been tapered my blood pressure is out of control most of the time because my pain is out of control. I have never been on the wrong side of the law yet you wanna demonize me as being a person on the wrong side of the law this has to stop. You need to get qualified physicians that have an ongoing relationship of treating people with Painful illnesses. My painful conditions are not caused from an illness in my brain my painful condition is caused from physical injuries and one of my medical condition is called Cushing’s syndrome let me explain what that means in my life Cushing syndrome breaks down your bone endings and rebuilds them incorrectly so that they’re not smooth there’s no amount of mindfulness that’s going to fix this condition. I want my quality of life back the one I had before you made my doctors taper me off of my medication and I may need more than what was prescribed plain and simple. Stop playing doctor grow up stay in your lane if you wanna play doctor go back to school get your degree in medicine until then get out of my doctors office and leave me alone let me live my best life without you trying to tell me what that is.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Susan	None	None	090000648500a77b	B	None	2022-04-11T14:40:08Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from B, Susan	l1u-jgog-r6o7	False	None	False	2022-04-12 06:41:01.129	[]
4653	CDC-2022-0024-4659	https://api.regulations.gov/v4/comments/CDC-2022-0024-4659	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have a friend , similar to many individuals with chronic pain, who benefits from responsible use of prescribed opioids. Indeed, these are the only interventions to significantly help her quality of life. She and many others are relying on the CDC to have a more person-centered approach that is likewise grounded in research. Therefore , the CDC is encouraged to utilize language affirming the life-changing and even life-saving care that many people with chronic pain have from taking opioids , and that emphasizes the impactful challenges that can result from hindering access to medication. Thank you for your time and consideration.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a78a	Anonymous	None	2022-04-11T14:40:38Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-kf5j-wgwk	False	None	False	2022-04-12 06:41:01.355	[]
4654	CDC-2022-0024-4660	https://api.regulations.gov/v4/comments/CDC-2022-0024-4660	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines should not have a 50 mme limit. We have lost many chronic pain patients to suicide with just the arbitrary 90 mme limit. Why suggest a useless 50 mme? People are overdosing on street drugs, not Vicodin! Get rid of cruel limits on wonderful opiates that relieve suffering and misery for millions. No other drug is capable of what opiates do for pain. No other drug is as beneficial.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Germ	None	None	090000648500a7a6	Pugh	None	2022-04-11T14:41:01Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Pugh, Germ	l1u-l166-4g08	False	None	False	2022-04-12 06:41:01.586	[]
4655	CDC-2022-0024-4661	https://api.regulations.gov/v4/comments/CDC-2022-0024-4661	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Having suffered from back and neck pain for many years, suffering with RLS for at least 26yrs, times when lack of sleep and continuously being in pain , I have seriously considered ending my life, if it wasn’t for my family I would have.Although I would have preferred to stop the pain naturally, it was impossible, opioids are the only thing that gave some relief, not full relief but made it possible to carry on, they must be available for people when all else fails, and pain is unbearable.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beverley	None	None	090000648500a7af	Loseby	None	2022-04-11T14:41:10Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Loseby , Beverley	l1u-lcf6-mzm2	False	None	False	2022-04-12 06:41:01.806	[]
4656	CDC-2022-0024-4662	https://api.regulations.gov/v4/comments/CDC-2022-0024-4662	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to relate to incidents that I personally went through and had to deal with over the past two years 2021/2022.<br/><br/>The first and worst tragedy involved a person who I had become a caregiver to. He was a forty year old honorably discharged veteran. A former 1st Lieutenant in the United States Army. An Executive Officer of a Company of Combat Infantry in Afghanistan. His name is [redacted]. He had just had his leg amputated in a civilian hospital. They sent him home with a joke of a supply of hydrocodone. They were gone in less than a week. I think they were meant to last two weeks. As a VA patient it was near impossible to get a doctor to prescribe opiates long before the last CDC guideline turned prescribing them to patients by doctors into a potentially arrestable offence. Asking a VA doctor for them became damn near an excercise in futility. I know this first hand being a disabled veteran myself. You see [redacted] had undergone four horrible surgeries prior to amputation in an attempt to save his leg. He had already used up the CDC guidelines threshhold and then some before his amputation. The short of it is this. Some low life SOB sold this man who was suffering in desperate pain some pain pills one night. [redacted] was dead the next morning. [redacted] should have been given four times the amount of legal pain medication that he was given when they discharged him home from the hospital. He would be alive today if they had.<br/><br/>The second incident is one I am still dealing with. [redacted], a young man in his mid twenties had a serious accident on a snow board here in Colorado. He had been on legally prescibed opiates for years before suddenly having them taken away by his doctor being unwilling to prescribe them anymore. Thanks to the CDC guidlines. His life went downhill. He eventually lost his job and then his home. In desperation from his being homeless and in pain he turned to heroin managing to survive for two years on the street. I took him in and convinced him to see a local doctor who was well known to addicts. That doctor got him on methodone. So far [redacted] is doing quite well. None of what he went through living on the street for two years smoking whatever that nasty black stuff is they call heroin need ever have happened. In fact the young man need never have been forced to be dependent on methodone either.<br/> <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomas	None	None	090000648500a7b1	Almond	None	2022-04-11T14:42:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Almond, Thomas	l1u-ldll-p32q	False	None	False	2022-04-12 06:41:02.018	[]
4657	CDC-2022-0024-4663	https://api.regulations.gov/v4/comments/CDC-2022-0024-4663	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello and thank you for giving those who suffer 24/7 with uncontrolled pain that drains a person of quality of life a chance to voice their concerns on opiods for pain management its taken five years to do so. For years all you would get for answers to understand facts that backed such guidelines when you search for info all you get was the sound of crickets .As a person who is unfortunately suffering with chronic pain that is a result of overuse of my body doing hard work and tons of heavy lifting daily for 38 years until it resulted in spinal fusions and hardware to try to correct damage done while trying to provide for my family.With being diagnosed with Lumbosacral Spondylosis,Lumbar Radiculopathy,Rapid Lumbar Disc Degeneration,and Myalgia Myositis which has reaked havoc on my quality of life totally ended any ability to enjoy any outdoor activitys and put me in a economic dark place.So when a person destroys their body and health while being a hard working citizen in america to contribute to society with the end result of a all my hard work im being called a drug addict because my pain requires me to have to seak medication to help relieve some of my pain, its so demoralizing when i have to basically beg for medication and all along being labeled addicted when the facts are being dependent is the correct label I should have be given.Please tear down the WALL between the ones who are medically diagnosed by their medical Doctor as per needing opiods for relief of their pain we are all so tired of the mine field we have to navigate to aquire medication for our much needed demoralized way of life to be allowed proper medication for pain relief based on medical evaluation from your Medical Doctor.Please get out of my doctors office let him do what he has been to school for and First Do No Harm Comes Into Play thanks again for giving me the opportunity to beg for proper medication while having to be dependent on them just like the ones who are dependent on meds for being diabetics . God Bless You And may God Bless all Who Are Having To Suffer In PAIN....	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a7ba	Anonymous	None	2022-04-11T14:43:10Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-ljw2-76b6	False	None	False	2022-04-12 06:41:02.241	[]
4658	CDC-2022-0024-4664	https://api.regulations.gov/v4/comments/CDC-2022-0024-4664	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m writing this for a friend who is 42 years old and has survived colon cancer. She lost all of her large intestines her bladder and has had complete hysterectomy. She wears two collection bags. She was ravaged by the cancer but suffering she endures daily now is worst. I watch her suffer in pain every day she beat cancer but your regulations have taken all of her quality of life away from her the two stomas that she has bleed and are raw daily. She can’t eat without it’s coming out of her to the point she’s in tears from the pain your 90 MME equivalent has reduced her to rolling in pain every day she wants to die every day because her doctors can’t give her more pain medication because of what you have done. Why because she might become addicted? She been though so much she deserves proper care and you have taken that away from her. Your methods have tortured her. One more thing my 89-year-old mother broke her shoulder and because of your mandates and the doctors fears of you coming to get them or her becoming an addict really she was dying. My mom died in ungodly pain for what because some addict goes out on the street and sticks and needle in their arm. Stop making people suffer give everyone access to legal drugs so we don’t have to lose anyone to addiction or overdoses	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a7bd	Anonymous	None	2022-04-11T14:43:27Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-lmbz-i1b7	False	None	False	2022-04-12 06:41:02.466	[]
4659	CDC-2022-0024-4665	https://api.regulations.gov/v4/comments/CDC-2022-0024-4665	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Myself and three of my doctors have been harmed by the 2016 opioid prescribing guidelines, my primary care physician who does not agree with the CDC was forced to taper my opioid medications by [name redacted], this drove him baddie as I couldn't take it anymore and he sent me to my old pain management doctor, saying he had more leeway. My pain management doctor seen how bad I was and left me where I was at for approximately 8 months, then because of the CDC guidelines insurance company started calling him a drug dealer, pharmacies wouldn't fill his prescriptions, he then turned into dr. Jekyll and mr. Hyde, yelling at me, lying to me about the guidelines, then he gave up his practice of 35 years. My podiatrist, who is a surgeon couldn't get his prescriptions filled at pharmacies after amputating his patients feet.<br/><br/>I suffer from painful diabetic neuropathy of the legs, feet and hands. I also have Crohn's disease, stress fractures in my lower back, bacteria in my upper back bones T5 and T6, several other comorbidities developed from undiagnosed Crohn's disease. My pain medication has been cut by over 2/3 leaving me bedridden. The CDC has destroyed the last five and a half years of my life and for what, because junkies want to get high.<br/><br/>It's pretty clear to me the 2022 update is not an improvement and will reliably make my life worse. The CDC is still lying, manipulating or not telling the whole story of benefits achieved by using opioids, the CDC is still using unsupported and or unreliable data, unfairly biased against opioid therapy and against Pain Care generally. 7 of its 12 recommendations are effectively mandatory (category a), and at least five recommendations are based on very weak or cherry-pick evidence. Opioids saved my life, after three years of trying to find another way to control this pain so I could keep my career in aviation, I finally went on opioids and found some relief from constant horrible pain, suicide thoughts and deep despair.<br/><br/>Both guidelines are organized around morphine milligram equivalent dose limits. MMED are considered in the medical community to be junk science, with no consistent definition and no valid data on equivalency. You have no further to looked then the [name redacted] for that verification. There is at least a 15 to 1 range in minimum effective opioid dose between individual patients, everyone metabolizes opioids differently, ie one person could take 10mg where the other person would need 50 to control their pain. None of this is addressed in the guidelines. It's clear the CDC does not have the expertise to be writing guidelines of any kind for pain management. There is plenty of evidence out here that clearly shows the CDC is directly responsible for thousands if not tens of thousands of suicides by pain patients and or dying of medical conditions related to too much pain. The CDC has known this 4 years, yet did absolutely nothing to help us . The people dying are elderly, disabled, rare disease patients and Wounded Warriors . So I must ask the question. What is the difference between what the CDC has done and what [name redacted] is doing in [location redacted]?<br/><br/>There is only one ethically, morally and scientifically appropriate course for the CDC to take now: they must be entirely repudiate their published guidelines on opioids, withdraw them and not replace them. Practice guidelines are the proper mission of Professional Medical academies and societies whose members actually treat pain -- NOT public hacks who never have. Likewise, since 1986 we already HAVE a guideline for the use of opioids. It's called the [name redacted] Analgesic Ladder, and it's been taught widely in medical schools. But it's utterly unmentioned in the CDC guidelines. <br/><br/>I support all of [name redacted] work on treating patients with opioids and I am a member of [name redacted], [name redacted]<br/><br/>Please stop The Killing and torturing of pain patients, we had nothing to do with the drug epidemic in this country and are not the ones od'ing and dying, never have been. The DEA must be told to stand down and leave our doctor's alone. If this country and the CDC was serious about stopping people from od'ing and dying, one would think they'd be advocating for shutting down the southern border and all the nasty drugs walking across it. Perhaps we should think about stopping people from shooting up on city streets with immunity, how many times do they OD before they actually kill themselves, 3,5,10 times? The CDC has to know that about 70% of every OD and death in this country has illegal fentanyl in their system.<br/><br/>Thank you for your time<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	David	None	None	090000648500a66c	Cole	None	2022-04-11T14:43:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Cole, David	l1u-5hco-7bvn	False	None	False	2022-04-12 06:41:02.678	[]
4660	CDC-2022-0024-4666	https://api.regulations.gov/v4/comments/CDC-2022-0024-4666	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been going to doctors for almost a year. I have had to change doctors 4 times because they are refusing to prescribe medication for pain that is effective. I currently have 2 collapsed discs in my lower discs. They are collapsed pinching my sciatica. When my sciatica stops receiving signal then I get bacterial infections internal in my sciatica. Problem number 1. Doctors are treating patients like junkies and refusing to prescribe effective medicines. I have tons of paperwork. We shouldn’t be treated this way. I had to turn my own mri in because my pain clinic wouldn’t request my file. He was very rude and disrespectful to me. Claimed he couldn’t just prescribe pain medicine to me. I changed doctors. A month and a half later I still didn’t have a appointment so I called the new doctor and the still haven’t sent my mri file. They are refusing. This is unacceptable. Uploaded is my newest X-ray. The other file is the location of the doctor who shouldn’t be allowed to practice anymore. He is very rude to the less fortunate. As you can see they don’t do there job. I’m in so much pain I don’t sleep and I vomit every time I get up. I haven’t worked in over two years. Tons of paperwork. Listen you scared the crap out of these doctors. You need to straighten this out. Please. This is inhumane. Abuse of power. Under assumption. Doctors aren’t even doing there job yet they sure are getting paid for those visits. Also this has been a 10 year battle also. I have done all treatments except surgery and pain medicine. I paid 2 different occasions for a medical marijuana card in the state of Georgia which resulted in a illegal raid on my house. I have never committed a felony until this. This state is out of control. I can’t take it anymore. I’m changing to pain medicine because nothing else has been effective.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jerry	None	None	090000648500a7cf	Standridge	None	2022-04-11T14:44:38Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Standridge, Jerry	l1u-lopl-g48x	False	None	False	2022-04-12 06:41:02.898	[]
4661	CDC-2022-0024-4667	https://api.regulations.gov/v4/comments/CDC-2022-0024-4667	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The original CDC guidelines have caused egregious harm This new draft appears to double down. People who once worked, raised families are now stuck in bed. Please stop interfering in our health care. Please, we're human beings. We're not responsible for illicitly manufactured fentanyl causing 85% of overdoses.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a7f1	Anonymous	None	2022-04-11T14:44:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-mju2-q8iy	False	None	False	2022-04-12 06:41:03.111	[]
4662	CDC-2022-0024-4668	https://api.regulations.gov/v4/comments/CDC-2022-0024-4668	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	You must reconsider the threshold of 50mme. Look what happened when you put threshold of 90mme?<br/>Most dea, Dr's, insurance , pharmacists went crazy to 50mme. <br/>At 50mme, they will go to zero. <br/>So many won't even comment believing you won't listen to pain patients anyway. <br/>How many more suicides will take place over inadequate pain relief. Or purchase illicitly manufactured Fentanyl unknowingly or possibly even knowingly these days.<br/>Some will say it's better than nothing. <br/>Pain patients don't abuse their meds. Its their line to live f with some type of quality ofof life. Most had some type of life prior to 2016 guidelines. Even [redacted] himself was quoted saying these are guidelines, they were never meant to be "law". But, they have been turned into laws, and Dr's are afraid to prescribe at all. <br/>Don't you think if more pain patients had access to some pain relief some could go back to workforce? Or help watch grandchildren so those parents could go back to work. <br/>This must all be reconsidered. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a7fd	Anonymous	None	2022-04-11T14:45:28Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-mpur-ufip	False	None	False	2022-04-12 06:41:03.320	[]
4663	CDC-2022-0024-4669	https://api.regulations.gov/v4/comments/CDC-2022-0024-4669	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	In 2000 my wife had a botched lower back fusin. The dr at the time shut down and left her with svere scaring. In 2015 she was finally diagnosed with RA . She was doing well on opiod therapy. Work and living. Since they took them away she doesnt go anywhere and most days dont get out of bed. Its hard to watch her dieing slowly and numerous times which she was dead. I cry for her alot. This is not a life. This is inhumane. Barbaric! The fda just released their report. The main cause of overdose and death is due to herion and illegal fentanyl. We knew that and dont even have a degree! Wth is wrong with this. Stop the insanity and give my wifes life back!.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Julius	None	None	090000648500a804	Rocha	None	2022-04-11T14:45:48Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Rocha, Julius	l1u-myw9-ckge	False	None	False	2022-04-12 06:41:03.537	[]
4664	CDC-2022-0024-4670	https://api.regulations.gov/v4/comments/CDC-2022-0024-4670	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC wants to put in place specific care plans for adults over 18 with acute, subacute, and chronic pain (excluding sickle-cell or pancreatic cancer). I believe this is a crucial and necessary rule. Opioids are truly a crisis in America and it is far too easy to be prescribed into an addiction, especially from a young age. Purdue and the other Big Pharma around them are incredibly detrimental to many people, as all of these medicines are for-profit and are SOLD rather than PRESCRIBED, as medication should be. These can lead to horrible addictions to even worse drugs, like heroin or cocaine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a811	Anonymous	None	2022-04-11T14:45:57Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-n3ds-1fho	False	None	False	2022-04-12 06:41:03.780	[]
4665	CDC-2022-0024-4671	https://api.regulations.gov/v4/comments/CDC-2022-0024-4671	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pelvic pain patient for 13 years. I’ve been on low doses of various opioids this entire time. Pelvic pain is not well understood and few doctors understand how to treat it, but it is horribly life-altering. I’ve had multiple procedures, types of physical therapy, medications, etc., and nothing has resolved the issue. Pelvic PT helped but insurance cut me off. I can no longer run. I can’t sit for very long. I’ve lost the will to socialize and enjoy most things. <br/><br/>13 years of my life and counting.<br/><br/>Without access to opioids, it’s possible I would have committed suicide by now. <br/><br/>There have been several times I’ve found myself below the line on bearable life. Only access to opioids has stopped me from the unthinkable, because the bit of pain relief I get is just enough to dull the stabbing rectal and vaginal pain that feels like sitting on a knife-embedded golf ball. It is excruciating. And I have to smile and pretend all is well. I am likely alive today because of opioids.<br/><br/>Until doctors have a treatment for pelvic pain and insurance covers it, no one should suffer this horror. It comes with shame, inability to communicate the depths of daily despair. I still work and do daily activities, but I am not the same, but I am alive. Insurance covered some pelvic pain therapy but cut me off because I “didn’t make progress fast enough.” Even the insurance company doctor agreed with my doctor that I should continue, but the insurance “algorithm” said no, and I was cast aside. <br/><br/>Until the medical profession takes chronic intractable pain patients seriously, especially pelvic pain, and works to understand and treat these conditions, we must have access to opioids. Opioids don’t make the pain go away, but it does saw the sharpened points off the knives in my internal organs. If I could get rid of the pain I would cold-turkey opioids - I’d press the button that forever stops the prescription. I don’t want to be in this pain. <br/><br/>I am a very productive member of the federal government, in FDA in fact. No one knows about my pelvic pain issues. I suspect I am not alone. But without access to medication, I cannot sit to work, I cannot concentrate to work and live. Even with medication it is hard, but it is possible.<br/><br/>Stop making doctors think these guidelines are the law. My doctor changed my meds in 2017 because she said it was “against the law for her to prescribe fast acting opioids.” Of course I did not contradict her, because it’s impossible to find a new pain doctor. CVS Pharmacy magically doesn’t have my monthly meds in stock. CVS shorts my prescription two months in a row and now I’m forced to ask for recounts..and they make ME feel like the drug addict. I’m required to purchase Naloxone (not covered by insurance) by my doctor even though I am well below 50 MME/day and have none of the risk factors listed. I AM NOT A DRUG ADDICT. STOP TREATING ME LIKE ONE! I have many CVS stories - I can feel my blood pressure rise every time I go into that store now. It’s always something. <br/><br/>Stop using urine tests as the absolute cut off for medication and consider the entire person and their medical history and years of past compliance. After 10 years, I failed a urine test (opioid not detected) because I am on a low dose and the dose had just been lowered…but I was accused of diverting and told if I failed again, I would be let go. After 10 years of compliance and proof of reduced dose just prior to the failed test. Now I carefully save up and time my meds for every doctor’s appointment in case I am urine tested because my low dose means I run the risk of being let go as “non-compliant.” We are treated like potential criminals who they are just waiting to “catch.”<br/><br/>Don’t punish me because the medical system doesn’t know how to treat chronic pelvic pain.<br/><br/>You will kill me. <br/><br/>Keep us safe from street medications, because that’s where we’ll have to turn, running the risk of Fentanyl deaths. Look at all the older folks having to turn to heroin, god I am so afraid of ending up like that!<br/><br/>Fix the illegal Fentanyl problem. Middle-aged women struggling with horrible pelvic pain…we are not the problem. <br/><br/>Fix medical care. Make insurance pay for pelvic PT. Do research to cure pelvic pain! Help us heal so we can leave opioids behind because we no longer need them.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L	None	None	090000648500a812	Simone	None	2022-04-11T14:46:28Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Simone, L	l1u-n3j3-9daz	False	None	False	2022-04-12 06:41:04.100	[]
4666	CDC-2022-0024-4672	https://api.regulations.gov/v4/comments/CDC-2022-0024-4672	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm a chronic pain patient with Crohn's disease, osteoarthritis, failed back surgery, hiddradinitis ect.. I've had over 40 surgeries for these conditions. My chronic illnesses have taken everything from me. My ability to have children, go to college,have a career,ect. I'm in pain mgmt and am currently on over 90MME opiate medication. This medication has allowed me to live a somewhat normal life for the past 11 yrs. Due to your 2016 and revised 2022 guidelines my pain mgmt Dr. is forcing me to get an invasive pain pump because they're afraid of repercussions from the DEA. I have no choice but to get this pain pump. I find it disturbing that instead of keeping me on my current regiment of medication I've been stable on for the last 11 yrs that I'm not given a choice but to get this extremely invasive,expensive,disfiguring device put inside my body. I've tried finding another pm doctor but nobody will take me because I'm on over 90ME. They won't even give me an appointment. This is all due to your guidelines.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heidi	None	None	090000648500a827	Jones	None	2022-04-11T14:46:38Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Heidi	l1u-ndti-rqpx	False	None	False	2022-04-12 06:41:04.329	[]
4667	CDC-2022-0024-4673	https://api.regulations.gov/v4/comments/CDC-2022-0024-4673	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whome It may concern:<br/>It has been my expierence that over 20 years in Pain Managment that the population that is beening served is highly scrutinized so much so that they, pain management patients are a vulnerable population. They at times are not treated fairly or completely and are discriminated against by what medicatons they are prescribed or treatments they undergo.<br/>The CDC must strongly advocate for multidisciplinary care, personalized for each individual patient. This includes behavioral therapy, restorative therapy, complementary medicine pharmacologic therapies, and Interventional Pain Management (IPM) strategies.<br/> The 2016 CDC opioid guidelines were aimed at primary care providers, but many state boards mandated them by law, resulting in tremendous needless suffering and exacerbating the illicit opioid epidemic with causation of needless deaths. These guidelines not only restrict opioid prescriptions, but also have restricted almost all interventional techniques to reduce access and sending patients to the streets for illicit opioids. With the new guidelines, these unintended consequences, including overdoses, deaths, and access limitations will continue.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Indra	None	None	090000648500a845	Ramdayal, DNP	None	2022-04-11T14:47:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Ramdayal, DNP, Indra	l1u-nkgc-23un	False	None	False	2022-04-12 06:41:04.561	[]
4668	CDC-2022-0024-4674	https://api.regulations.gov/v4/comments/CDC-2022-0024-4674	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have responded over and over again to your requests for comments, yet nothing has improved since the 2016 GL’s came out.<br/><br/>I have ALWAYS used my medications as directed, but today I feel like a drug addict for the way I am treated. My PAIN MANAGEMENT DOCTOR was finally starting to get me on doses that were starting to help my pain when the GL’s came out, then I was dropped to 90MME—no tapering, just cut in half. Then my PCP refused to continue my .05mg of Xanax—because I took opioids. Suddenly, medications I took for years without issue was too dangerous for me to take.<br/><br/>You know what I have learned from all of this? You all really have no clue what you are doing, and we’re nothing but game pieces to you.<br/><br/>I’m so angry that I trusted you all with my life, for what? Gaslighting and mistreatment? I was forced to read up on my symptoms and diagnose myself because I couldn’t find doctors with the cajones willing to test me for the diseases I turned out to have—only because I finally (was able to) fired them them and hire new doctors who, within six months, tested and diagnosed me because someone finally LISTENED to me! If you saw the comments from past doctors that I crossed paths with, you would see how much I had to fight just to get a diagnosis. And now, the fighting continues just for basic treatment. Especially opioids. <br/><br/>Opioids have literally been the only thing that I noticed helped my symptoms (obviously pain). Not my DMD’s, not the vitamins, not the myriad of prescriptions my doctors tried on me over the years. The opioids. Yeah, I know how it sounds, but it’s the truth. <br/><br/>I “survive” on 90MME, but barely. I’m not able to do things like I was able before the GL’s, but I’m grateful I have at least something to help with my pain. It would be nice if my levels were more like 3-4 on the pain scale, rather than a constant 8-10, but I guess beggars can’t be choosers. Right?<br/><br/>You are telling us that our pain, our lives, doesn’t matter. Right? Prove me wrong.<br/><br/>Since the GL’s came out, my appointments are more about whether I took my prescription to the same pharmacy, or that I’m not “doctor shopping”, rather than what we should do to improve my pain. I have gotten to the point that I just answer their questions rather than tell them about my pain. Because they don’t care anymore about my pain—especially since I am not able to accept injections anymore! <br/><br/>So yeah, I’m mad! Fix this!!!<br/><br/>Bit.ly/Chronic-Hell	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandie	None	None	090000648500a66f	Jones	None	2022-04-11T14:47:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Jones, Sandie	l1u-5iqy-s53z	False	None	False	2022-04-12 06:41:04.771	[]
4669	CDC-2022-0024-4675	https://api.regulations.gov/v4/comments/CDC-2022-0024-4675	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	[redacted] should be banned from receiving federal money for failure to treat pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Robert	None	None	090000648500ab51	Coble	None	2022-04-11T14:47:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Coble, Robert	l1u-nojj-47eg	False	None	False	2022-04-12 06:41:04.982	[]
4670	CDC-2022-0024-4676	https://api.regulations.gov/v4/comments/CDC-2022-0024-4676	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t understand why patients who have established, working pain management and have been under their doctors care for years are being put through phsycial and mental torture. There should be laws to protect the pain patients quality of life . PCP’s who leave or retire , why are pain patients living in fear of finding a doctor ? This is absolutely crazy . It’s wrong on an ethical level . Give these people their lives back . Please. They’ve been through enough .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a670	Anonymous	None	2022-04-11T14:47:50Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-5jgd-rl3b	False	None	False	2022-04-12 06:41:05.198	[]
4671	CDC-2022-0024-4677	https://api.regulations.gov/v4/comments/CDC-2022-0024-4677	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 62 years old and have Rheumatoid Arthritis. I would love for you to chane the CDC guidelines to help not hurt Chronic Pain patients. We need medicine to have a chance at life. We want to to be able to get ip and enjoy our family and.do things that make us feel human again. I understand the the problem with odrugs but there has to be away to help us. I have put off having knee surgery because im afraid of the pain of surgery. Please help us	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kim	None	None	090000648500ab53	Collins	None	2022-04-11T14:47:52Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Kim	l1u-npkh-dxxc	False	None	False	2022-04-12 06:41:05.442	[]
4672	CDC-2022-0024-4678	https://api.regulations.gov/v4/comments/CDC-2022-0024-4678	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please allow already established long term chronic pain opiates users to continue their quality of life by stopping the 90 MME and other imposed restrictions. Call off the witch-hunt that has Doctors terrified to keep us on our years long dosages that were allowing for a semi productive life. We have suffered long enough. Since your forced reduction the illegal opiate problem has gotten much worse so if that was your goal you've succeeded. I suffer every second of the day now and I am but a drop in the ocean of your induced misery.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500ae44	Anonymous	None	2022-04-11T14:48:06Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-ob07-1qfb	False	None	False	2022-04-12 06:41:05.703	[]
4673	CDC-2022-0024-4679	https://api.regulations.gov/v4/comments/CDC-2022-0024-4679	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please help me, till 2016/2017 I had a productive life with my adhesive arachnoiditis spinal stenosis spinal back arthritis protruding disc in lower spine . I was on the same opioids same dose for over 22yrs then I was forced off. I thought what did I do ?!? My painful journey is millions and millions of others yet I have never met or spoken with them. Why would you the CDC take millions of patients like myself off of our opioids?!? I as millions of others do so many other treatments with YES my opioids but now I am not seeing my grandkids or my grandkids activities not volunteering for the [name redacted] not working part time not planting a garden barely even be able to get out of bed now. How do you know what MMEs work for me and my chemistry!?! You DO NOT. My doctor and myself know what works best for me. Please I miss my productive life,	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a672	Anonymous	None	2022-04-11T14:48:41Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-5ktu-ea34	False	None	False	2022-04-12 06:41:05.913	[]
4674	CDC-2022-0024-4680	https://api.regulations.gov/v4/comments/CDC-2022-0024-4680	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a nurse of 31 yrs-when pain was made the fifth vital sign it was the beginning of the end for people with acute and chronic pain-were we judged and held to a standard they had allowed so many people to become addicts because we wanted satisfied customers. pain-we all live with some pain each and every day-it’s unrealistic to think we as medical professionals can make patients 100%pain fre but that what it did-made the public think we could do that!!<br/>Now over 200 of our citizens are dying every day-overdoes and poisonings-this is unacceptable and you have the power to stop it.<br/>No more families should ever have to find a loved one dead because they became addicted and volume not obtain prescription pain meds and had to resort to unreliable or unknown street drugs.<br/>I’ve seen it first hand many times and it sickens me and I pray that my family will come out unscathed but the odds are not I. My favor at the rate this epidemic is progressing <br/>Sincerely [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Vicki	None	None	090000648500b018	Dugan	None	2022-04-11T14:49:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Dugan, Vicki	l1u-pyaa-q5on	False	None	False	2022-04-12 06:41:06.138	[]
4675	CDC-2022-0024-4681	https://api.regulations.gov/v4/comments/CDC-2022-0024-4681	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m both a patient and an RN. I understand the opioid crisis and the severity of it and its implications to society. However, allowing people to live in a constant state of overwhelming pain is nothing short of cruel. I believe every situation should be looked at individually. When I need pain meds, I mix them with NSAIDS until the NSAIDS work well enough alone and begin to space out and end the taking of prescription pain meds as soon as I can. I don’t want to become dependent and because I know what I’m doing, I don’t. I also don’t have an addictive personality so am much less likely to become an addict. There are many of us whom are responsible and take the pain medication in a way that doesn’t become a problem. Allowing people whom are in significant pain to be in such pain where they cannot sleep nor rest to heal due to pain is an unreasonable expectation which will lead to doing anything to remove the unchecked pain. I believe unsupervised self-medicating is much more risky than considering each case individually and providing reasonable pain management.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Dottie	None	None	090000648500a679	Fisher	None	2022-04-11T14:49:26Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Fisher, Dottie	l1u-5t6t-lb05	False	None	False	2022-04-12 06:41:06.356	[]
4676	CDC-2022-0024-4682	https://api.regulations.gov/v4/comments/CDC-2022-0024-4682	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I don’t even know where to begin with this whole pain journey…. <br/><br/>To say that I’m mad, bitter and resentful would be a massive understatement. <br/><br/>I lost nearly a decade of my life to pain because of cdc incompetence. It’s an insult that our tax dollars are spent on biased research from the likes of [redacted]. <br/><br/>It’s disgraceful that your guidelines are the cause of such immense suffering. People like me with spinal stenosis, people with ptsd and sexual assault history, black Americans with sickle cell treated like drug seekers, ccp’s, women with hysterectomies and even heart surgeries with no pain meds. You people are literally the worst humans on the planet to torture people with these idiotic guidelines. And your mme revised guidelines are worse than the 2016 guidelines. <br/><br/>Your false narrative of an opioid crisis when your policies helped create the mess are a travesty and nothing short of tyranny.<br/><br/>I was denied pain meds because my dog took phenobarbital for more than a decade. Denied pain meds because I had a history of trauma. I was denied pain meds because of some BS chicken little theory that I might be at risk for overdose despite the fact that I have had zero substance abuse issues, no arrests, nothing to cause a legitimate concern. I was in intractable pain. Unable to work or finish school in a timely manner such that now after surgery by caring and willing to prescribe providers at UCSF I'm timed out on my medical classes and can’t use my credits to apply to schools. <br/><br/>I want everyone of you to recognize that I hold you personally responsible for the years of pain and suffering, loss of my personal freedoms, income, happiness and those of my husband. <br/><br/>Pain is tyranny.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ramona	None	None	090000648500b01c	Cavanaugh	None	2022-04-11T14:49:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Cavanaugh, Ramona	l1u-q0vg-qxso	False	None	False	2022-04-12 06:41:06.577	[]
4677	CDC-2022-0024-4683	https://api.regulations.gov/v4/comments/CDC-2022-0024-4683	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My pain Mg doctor forced me off Hydrocodone and onto Belbuca films. I went from paying $10 for the opioid to paying $196 for the Belbuca, with insurance. I’m disabled and on SSDI. I cannot afford the Belbuca. This is wrong.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	090000648500a680	Sanders	None	2022-04-11T14:49:56Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Sanders, Pamela	l1u-5xgv-tsmo	False	None	False	2022-04-12 06:41:06.810	[]
4678	CDC-2022-0024-4684	https://api.regulations.gov/v4/comments/CDC-2022-0024-4684	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Take away all MME comments!! The science on MMEs is seriously flawed! It is inaccurate, does not accurately compare medications or allow for patient differences or patient needs. The [name redacted] has spoken against MME limits, many doctors have spoken out against MME limits. The supposed risk at above 50MME is not a true risk. The study used is seriously flawed! And the risk found was 0.04 percent- doubling, tripling, even ten times that is not a serious risk!! <br/><br/>The true facts are obvious to many of the public and medical community. About MMEs, about the way tapering harms patients, about the ways the CDC opioid guidelines have been weaponized against patients, about how illegal fentanyl is the true problem leading to Overdoes increasing. <br/><br/>Take away MMEs, take away all limits! Let doctors and patients decide treatment options. The CDC should focus on illegal fentanyl which is really the problem! <br/><br/>https://umpersiststudy.org/?fbclid=IwAR3xMk1KWBvbc7CQFi9QHIkPPx5aWebK8JMTlivOdokHvMCIqic2804KXzU<br/>https://www.ajpmonline.org/article/S0749-3797(21)00277-4/fulltext?rss=yes<br/>https://www.theguardian.com/society/2021/jul/07/when-the-pain-isnt-all-in-your-head<br/>https://www.vnews.com/Strafford-woman-navigates-chronic-pain-and-cancer-treatment-40394165<br/>https://www.painnewsnetwork.org/stories/2021/7/6/ama-cdc-opioid-guideline-still-harming-pain-patients<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987740/<br/>https://dspace.mit.edu/handle/1721.1/107321<br/>https://www.linkedin.com/posts/john-hsu-md-300a8b2a_opioid-alternative-pain-meds-present-unique-activity-6817515351287447553-hwM8<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752089/<br/>https://link.springer.com/article/10.1007/s11606-019-05301-2<br/>https://www.cato.org/blog/lawmakers-really-want-follow-science-they-will-repeal-codified-opioid-guidelines<br/>https://www.google.com/amp/s/www.practicalpainmanagement.com/amp/22563<br/>https://www.healio.com/news/hematology-oncology/20210702/roswell-parks-opioidrestricting-postoperative-protocol-reduces-use-safely-substantially?utm_medium=social&utm_source=facebook&utm_campaign=sociallinks<br/>https://www.theguardian.com/australia-news/2021/jul/01/i-suffer-from-three-chronic-conditions-the-worst-part-is-knowing-my-pain-could-have-been-prevented<br/>https://www.ama-assn.org/press-center/press-releases/ama-backs-update-cdc-opioid-prescribing-guidelines<br/>https://www.endocrineweb.com/professional/resource-centers/clinicians-guide-talking-patients-about-obesity?ap=818&pb=Facebook_Mobile_Feed&aid=Custom_Saxenda+HCP+Obesity+Guide_FB_All_March+2021&sec=Saxenda+HCP+Obesity+Guide_All_Dynamic_NPI+lookalike&sid=6244532147372&fbclid=IwAR3eS5LHUoUbDpx4Taw2Muvrveng0QXPezWigLIVlhpy1QgcFB4nFoPufBA<br/><br/>https://rheumatoidarthritis.net/living/secondary-gain-chronic-pain?fbclid=IwAR0kNX-on1MwW6b-TCb1PvYIQza_nJ-wF1h4Nxs-_1qqGd56sUd1yqC37q0&utm_campaign=RInvoqPJ&utm_confid=sovh8wut7&utm_medium=promoted&utm_source=facebook.com<br/>https://filtermag.org/pain-patients-opioids-fear/amp/<br/>ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254657/<br/>https://www.painnewsnetwork.org/stories/2021/7/16/advisory-panel-warns-cdc-revised-opioid-guideline-ignores-risk-of-undertreating-pain<br/>https://www.acsh.org/news/2021/07/19/2020-drug-deaths-spiked-30-and-pain-pills-had-nothing-do-it-15669<br/>https://pubmed.ncbi.nlm.nih.gov/34261978/<br/>https://stefankertesz.medium.com/an-opioid-quality-metric-based-on-dose-alone-80-professionals-respond-to-ncqa-6f9fbaa2338<br/>https://www.ihconline.org/initiatives/ambulatory/opioid-stewardship-program/educational-events?fbclid=IwAR0wA2YJ7Yj2GkKSWs7ZHYezZv-w6nur_Xy4NINVtlp6AyqDtuNjErlFjl8<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356472/#__ffn_sectitle<br/>https://chronicpainallianceofwest.org/2021/07/26/cdc-opioid-guideline-review-2016-healthcare-under-fire/<br/>https://ascopubs.org/doi/abs/10.1200/JCO.21.00476#.YPw1YcIDkpQ.facebook<br/>https://www.marieclaire.com/health-fitness/a36905887/the-high-price-of-chronic-pain/?utm_source=facebook_ign&utm_medium=cpm&utm_campaign=ign_healthandwellness&fbclid=IwAR2IR1_luWCdW33HafLSVzzZ_3BpcLCB3QKyhJ1IJB9PaGAPvc4ETw6ewN0<br/>https://doctorsofcourage.org/hfpp-part-1-organized-collaboration-against-doctors/<br/>https://www.painnewsnetwork.org/stories/2020/9/4/nearly-85-of-us-overdose-deaths-blamed-on-street-drugs<br/>https://medium.com/swlh/where-is-the-outrage-for-the-disabled-elderly-americas-people-dying-in-pain-fd0ad6e7b6a7<br/>https://apnews.com/article/business-health-coronavirus-pandemic-opioids-3879fc0bccf1021f1410cbbc2cf33a7a<br/>https://www.medscape.com/viewarticle/955230?src=soc_fb_share<br/>https://www.ama-assn.org/press-center/press-releases/ama-backs-update-cdc-opioid-prescribing-guidelines?utm_source=twitter&utm_medium=social_ama&utm_term=5205422460&utm_campaign=Advocacy&utm_effort=FBB009<br/>https://www.statnews.com/2020/12/02/misguided-medicare-rule-harm-people-chronic-pain/<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a690	Anonymous	None	2022-04-11T14:52:10Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-688k-6wif	False	None	False	2022-04-12 06:41:07.067	[]
4679	CDC-2022-0024-4685	https://api.regulations.gov/v4/comments/CDC-2022-0024-4685	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am concerned over the CDC GL of 2016, because there was a 90 MME daily limit of prescribed opioid meds for established chronic pain patients. The new draft of 2022 mentions caution in prescribing more than 50 MMEs per day. As a legacy pain patient of more than 30 years, I had my Doctor and myself create a plan of pain treatment which worked for me! The prescribing of LEGITIMATE opioid meds is a trust between Doctor and patient. The CDC stated that these guidelines - would be just that. Well, wait a minute! The CDC GL became LAW in approx. 39 States. MDs were being investigated by the DEA, and some were “ jailed for prescribing high dose pain meds!” So, we have MDs running scared. Some MDs had their schedule II ( controlled substance license) removed. I have been harmed by the CDC and their “ supposed guidelines.” I was “ force tapered off my pain meds to a level where I was NOT getting the relief from pain meds”. No explanation was given, & I was forced to seek another PM facility. I still am not getting proper pain relief. My benzodiazepine med was also drastically cut-from 60 tabs per Month to 10 tabs per Month. I suffered from a birth defect. I was able to walk as a child, but I limped terribly. I went into the Hospital for 3 Months. I had to be in skeletal traction to bring down my femur bone-so it would be at ny hip level. I was born with NO hip socket! My left hip is very abnormal. The Surgeon removed half of my pelvis-in order to use my own bone to help construct a hip. <br/>I walked with crutches for 1 year. As an adult, I had to endure a primary total hip replacement surgery, at age 25. At the time of Surgery, I had severe osteoarthritis/ osteoporosis. Having Ortho surgery on my femur bone was highly painful! I have a metal rod hammered into my femur bone, and goes from my left hip until my knee. I have lots of metal, screws, and nails which can’t be removed. I also endured more than 4 hip revision surgeries, because any foreign body has a shelf life, and my body wore out the prosthesis-due to mechanical failure. So, the MMEs need to go! Get rid of them. Start over, because too many pain patients have nowhere to go.Doctors don’t want to treat pain., and hundreds of abandoned patients ( who are law-abiding citizens) have committed suicide. But, the news media, does NOT want to let the public know that pain patients are committing suicide! We can’t ALL fit in a one size approach to treating pain. MDs are being driven out of the Medical field-all due to these so called guidelines. The trust between Doctor/ patient has been fractured. It all has caused a domino effect from the PM facility, to the Pharmacist, and to health insurance. Lawmakers do NOT understand chronic pain. Instead, the [name redacted] Doctors who drafted these Guidelines, also have a conflict of interest. They are addiction specialists who want to push the medication called Suboxone. <br/>Now, pain patients who cant get a Doctor to manage their pain-well, guess what? They will give a pain patient “Suboxone”. This now means, that a pain patient has “ opioid use disorder”. So, basically, patients are desperate to get relief-and some register as being addicts-in order to get Methadone for their pain. There is NOT one paper that says you will die by taking opioid meds. I always said-use me as an example at how lifesaving these opioid meds are! They relieve suffering from pain, they definately take care of post-op pain. Yet, the CDC talks about the benefits vs. the risks of opioid meds. There is NO risk when taken as prescribed. Now, the CDC wants to not use opioids at all! This is crazy. Plain Tylenol does NOT work for post-op pain, Cancer pain, ER pain, etc. it would be criminal, if MDs were getting paid big amounts of $$$$ for NOT prescribing pain meds! It is the ILLICIT drugs which are causing the massive drug overdoses. It’s drug dealers who are giving out these deadly drugs laced with illicit Fentanyl. <br/>What are pain patients supposed to do? Many pain patients like myself, tried every non opioid treatment-like cognitive behavioral therapy, hypnotherapy, acupuncture,heat, ice, etc. The opioid meds have been SAFELY used for thousands of years. Government and legislators need to srep away-and let MDs treat pain. Get educated. Hear from chronic pain patients. We only have approx. 1% who become addicted. Please see the movie called : Pain Warriors. Stop prosecuting our Doctors, and stop the DEA from arresting them. The REAL danger lies in the streets. Please do NOT make the word OPIOID to be evil. NSAIDS are not the answer either. They cause aGI bleeding, ulcers, etc. I am a former RN , who had to retire early due to my own disability. I would never allow patients to suffer! [name redacted] ( retired).	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kathleen	None	None	090000648500a691	Clark	None	2022-04-11T14:55:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Clark, Kathleen	l1u-68gr-a8s9	False	None	False	2022-04-12 06:41:07.285	[]
4680	CDC-2022-0024-4686	https://api.regulations.gov/v4/comments/CDC-2022-0024-4686	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It seems as though the new narrative is focused properly on illicit fentanyl in regards to overdose deaths. However, the damage has been done with the careless and thoughtless guidelines passed originally by the CDC. If there were ever truly a "crisis" let's look at something most people use...alcohol. An estimated 95,000 people die per year from alcohol and yet the height of deaths from opioids haven't even come close to that number. An even further discrepancy if you take out the illicit fentanyl deaths. Opioids are MEDICALLY NECESSARY and alcohol is not, yet you find a liquor store on every corner in America. I have heard horror stories from chronic pain patients. I have lost friends from suicide because their pain was uncontrolled. Hospital's are only interested in keeping their opioid numbers down while putting lives in danger and needless suffering. It's truly disgusting and disgraceful. This crisis has been manufactured and misrepresented. Each and every person in this country is a car accident or nasty fall down the stairs away from needing necessary medication that would allow comfort. With the current state of hysteria we have suffering. Suffering because of agenda pushing without the data to back it. This medicine has been used safely for thousands of years and people who are responsible and reasonable, which is 99% of Americans should be able to have access to this medicine if their doctor deems it necessary without fear of stigma or law troubles. I pray that the pendulum swings back to a reasonable approach. That one fits all guidelines are done away with and that you come out and apologize to the citizens and doctors that have been harmed by the original guidelines. Focus on illicit fentanyl and get out of the doctor's office and hospital rooms.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L. Shane	None	None	090000648500a69c	Erwin	None	2022-04-11T15:00:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Erwin, L. Shane	l1u-6eaw-kczi	False	None	False	2022-04-12 06:41:07.506	[]
4681	CDC-2022-0024-4687	https://api.regulations.gov/v4/comments/CDC-2022-0024-4687	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Get rid of the CDC Guidelines! Patients and doctors should determine treatment!<br/>No Tapers!<br/>No MME<br/>No medication limits<br/>No forbidding Rx opioids and benzodiazepines<br/><br/>https://www.acsh.org/news/2017/09/18/tylenol-isnt-so-safe-least-it-works-right-11827<br/>https://www.academia.edu/35612995/Evidence_Based_Policymaking_Whats_Absent_from_the_Opioid_Crisishttps://truthout.org/articles/the-war-on-drugs-comes-to-the-doctors-office/<br/>https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13898<br/>https://www.bostonherald.com/2021/07/07/steidler-recovering-from-washingtons-fumble-on-opioid-epidemic/<br/>https://www.painnewsnetwork.org/stories/2021/7/6/the-war-on-drugs-comes-to-the-doctors-office<br/>https://umpersiststudy.org/?fbclid=IwAR3xMk1KWBvbc7CQFi9QHIkPPx5aWebK8JMTlivOdokHvMCIqic2804KXzU<br/>https://www.ajpmonline.org/article/S0749-3797(21)00277-4/fulltext?rss=yes<br/>https://www.theguardian.com/society/2021/jul/07/when-the-pain-isnt-all-in-your-head<br/>https://www.vnews.com/Strafford-woman-navigates-chronic-pain-and-cancer-treatment-40394165<br/>https://www.painnewsnetwork.org/stories/2021/7/6/ama-cdc-opioid-guideline-still-harming-pain-patients<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987740/<br/>https://dspace.mit.edu/handle/1721.1/107321<br/>https://www.linkedin.com/posts/john-hsu-md-300a8b2a_opioid-alternative-pain-meds-present-unique-activity-6817515351287447553-hwM8<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752089/<br/>https://link.springer.com/article/10.1007/s11606-019-05301-2<br/>https://www.cato.org/blog/lawmakers-really-want-follow-science-they-will-repeal-codified-opioid-guidelines<br/>https://www.google.com/amp/s/www.practicalpainmanagement.com/amp/22563<br/>https://www.healio.com/news/hematology-oncology/20210702/roswell-parks-opioidrestricting-postoperative-protocol-reduces-use-safely-substantially?utm_medium=social&utm_source=facebook&utm_campaign=sociallinks<br/>https://www.theguardian.com/australia-news/2021/jul/01/i-suffer-from-three-chronic-conditions-the-worst-part-is-knowing-my-pain-could-have-been-preventedhttps://truthout.org/articles/the-war-on-drugs-comes-to-the-doctors-office<br/>https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13898<br/>https://www.bostonherald.com/2021/07/07/steidler-recovering-from-washingtons-fumble-on-opioid-epidemic/<br/>https://www.painnewsnetwork.org/stories/2021/7/6/the-war-on-drugs-comes-to-the-doctors-office<br/>https://umpersiststudy.org/?fbclid=IwAR3xMk1KWBvbc7CQFi9QHIkPPx5aWebK8JMTlivOdokHvMCIqic2804KXzU<br/>https://www.ajpmonline.org/article/S0749-3797(21)00277-4/fulltext?rss=yes<br/>https://www.theguardian.com/society/2021/jul/07/when-the-pain-isnt-all-in-your-head<br/>https://www.vnews.com/Strafford-woman-navigates-chronic-pain-and-cancer-treatment-40394165<br/>https://www.painnewsnetwork.org/stories/2021/7/6/ama-cdc-opioid-guideline-still-harming-pain-patients<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987740/<br/>https://dspace.mit.edu/handle/1721.1/107321<br/>https://www.linkedin.com/posts/john-hsu-md-300a8b2a_opioid-alternative-pain-meds-present-unique-activity-6817515351287447553-hwM8<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752089/<br/>https://link.springer.com/article/10.1007/s11606-019-05301-2<br/>https://www.cato.org/blog/lawmakers-really-want-follow-science-they-will-repeal-codified-opioid-guidelines<br/>https://www.google.com/amp/s/www.practicalpainmanagement.com/amp/22563<br/>https://www.healio.com/news/hematology-oncology/20210702/roswell-parks-opioidrestricting-postoperative-protocol-reduces-use-safely-substantially?utm_medium=social&utm_source=facebook&utm_campaign=sociallinks<br/>https://www.theguardian.com/australia-news/2021/jul/01/i-suffer-from-three-chronic-conditions-the-worst-part-is-knowing-my-pain-could-have-been-preventedhttps://truthout.org/articles/the-war-on-drugs-comes-to-the-doctors-office/<br/>https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13898<br/>https://www.bostonherald.com/2021/07/07/steidler-recovering-from-washingtons-fumble-on-opioid-epidemic/<br/>https://www.painnewsnetwork.org/stories/2021/7/6/the-war-on-drugs-comes-to-the-doctors-office<br/>https://umpersiststudy.org/?fbclid=IwAR3xMk1KWBvbc7CQFi9QHIkPPx5aWebK8JMTlivOdokHvMCIqic2804KXzU<br/>https://www.ajpmonline.org/article/S0749-3797(21)00277-4/fulltext?rss=yes<br/>https://www.theguardian.com/society/2021/jul/07/when-the-pain-isnt-all-in-your-head<br/>https://www.vnews.com/Strafford-woman-navigates-chronic-pain-and-cancer-treatment-40394165<br/>https://www.painnewsnetwork.org/stories/2021/7/6/ama-cdc-opioid-guideline-still-harming-pain-patients<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987740/<br/>https://dspace.mit.edu/handle/1721.1/107321<br/>https://www.linkedin.com/posts/john-hsu-md-300a8b2a_opioid-alternative-pain-meds-present-unique-activity-6817515351287447553-hwM8<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752089/<br/>https://link.springer.com/article/10.1007/s11606-019-05301-2<br/>https://www.cato.org/blog/lawmakers-really-want-follow-science-they-will-repeal-codified-opioid-guidelines<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a6a8	Anonymous	None	2022-04-11T15:01:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-6kv5-023g	False	None	False	2022-04-12 06:41:07.736	[]
4682	CDC-2022-0024-4688	https://api.regulations.gov/v4/comments/CDC-2022-0024-4688	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom this may concern.<br/>I would like it interduce myself. I am a widowed 67 yr old male who is currently on medication to help control my chronic pain. I became disabled due to severe Osteoarthritis, inflammatory joint which has severely affected my spine and caused several surgeries. I also have spinal stenosis causing a great deal of pain. This all began about 16 yrs ago when I was working as a manufacturing engineer <br/>specializing in the design and assembly micro electronics systems. I had the honor of working on advanced subsystems for advanced military aircraft military. I have 3 patents<br/>in this field. <br/>I loved my work, however, had to take an early retirement because of my condition. Fortunately I was granted Social Security Disability and had also done some financial planning for the future which is why I live well and can get by with all my medical cost. I have tried just about every method to control my pain known to current science in an effort to curb the use of Opiates. Up until 2016 I was able to maintain and control my pain issues. I do chiropractic therapy which does help. I have done nerve obligation which burns the nerve in my spine (no help and is a very painful and dangerous). I have also done joint injections which proved to be some help but are only recommended twice a year and has severe side effects. <br/>I have been examined by 2 very good surgeons and both had said, there is to much arthritis and would take to long under the knife which could prove dangerous. Back in 2016 my doctor drop my medication abruptly by 45%. He explained to me he would continue to treat me, however, had no plans to be arrested and or confined to a jail cell. It had been explained to him by an attorney that if he were not to comply with the new CDC guidelines there would be a chance he may fall under investigation and potentially tried for over prescribing and face imprisonment. <br/>That action on his part has made my life more difficult. As I stated before, I was widowed for 12 yrs with all the household chores falling on my shoulders. I was recently re married to a wonderful woman that has taken on me and my disabilities. She is of great help but cannot fix my daily pain. <br/>I am writing the CDC to let them know what it's like to endure this damn pain everyday. Unfortunately most do not understand the impossibility of living a life in daily pain and could only wish the people that hand out these guidelines like there is little to no ramifications. Well I can say this suggested guideline of 2016 had a big impact on me! My sleep has been reduced to naps, my weight dropped by 30 lbs. and mental well being is on edge. recently I had to undergo carpal tunnel surgery with some other details performed. I woke up in post op with searing, pounding pain at the site of the surgery. The who was taking care of me gave me an injection of Tylenol for post op comfort. That is how insane this the guidelines have affected pain treatment. I not be able to control my emotions got in a very heated discussion on pain control. I exclaimed to him that I was scheduled to have the other wrist done and will be canceling it. As a matter of fact I refuse to have any other surgery performed unless it's life threatening period. This is our healthcare now that a group of people has deemed it so and from what I see some seem to be unqualified to make such decisions. I will make have to cut this short because I am in terrific pain in my upper spine and neck. I have taken my 90 MME for the day and hope to get some form of sleep tonight which is another big issue that I live with. This measurement of milligrams per day is a total falsehood in my opinion. Here's my point. I am allowed 20 mg of Oxycontin a daily plus 10 mg of Oxycodone daily. Recently there has been a shortage of Oxycontin ER 20mg. I was forced to switch to 30mg of MS Contin daily. Not only do I have a slight allergy to Morphine but it does not address the pain as much as the 20mg Of Oxycontin ER. So in my body the MME equations means nothing.<br/>I am eagerly awaiting the committees favorable decision. If this decision in my case proves not favorable I intend on moving somewhere whether it be in this country or not where I can get competent and compassionate health care. I am so disappointed that I have to live on the edge of pain and anxiety and will no longer stand being treat like criminal! Furthermore, I refuse to pay the price for a Illegal Fentanyl Epidemic that is being exasperated with Illegal open Boarders allowing this poison to freely flow into our country. I will no longer mention this unfortunate political criminal act but it's about time people suffering in pain stop paying for these criminal act's and get some relief and justice. We have a illegal drug problem not! A pain pill problem. We are dying out here and the CDC's guidelines are literally killing us.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Joseph	None	None	090000648500a6ad	Allio	None	2022-04-11T15:05:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Allio, Joseph	l1u-6oi4-8bxu	False	None	False	2022-04-12 06:41:08.180	[]
4683	CDC-2022-0024-4689	https://api.regulations.gov/v4/comments/CDC-2022-0024-4689	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for this opportunity to speak. I am an advocate with the [name redacted]. On behalf of the 100 million Americans who suffer chronic pain, 20 million of which require daily opioids to manage their intractable pain, I thank for the critical work you have done to help chronic pain patients. Chronic pain patients have been targeted and traumatized for the past 3 years and are desperate for sensible policies that allow them to receive the medication they require to live and function. <br/><span style='padding-left: 30px'></span>Patients are somewhat heartened to see the beginnings of this with the recent CDC and FDA announcements and the Task force draft report. However, given that these are still based on the known and proven misinformation regarding prescription opioids causing rising overdoses and the inaccurate statements regarding lack of evidence for opioid therapy for chronic pain, patients are skeptical that true progress has been made. It is well known that the CDC egregiously misreported their overdose numbers and that they misrepresented the research on opioids and chronic pain as well. Many experts, research, medical records, and evidenced based medicine support this. Until a clear statement acknowledging these errors is made and the 2016 CDC guidelines are eliminated, chronic pain patients will continue to be targeted, traumatized, abandoned, and killed. <br/><span style='padding-left: 30px'></span>30 years ago, ADHD medications were reported as over prescribed resulting in catastrophic consequences for millions of children that are still present today. 42-77% of children with ADHD do not receive treatment, medication avoidance is a primary reason. This negatively affects their life time growth with serious negative outcomes such as addiction, jail time, and vocational difficulties. <br/>not only can be used, but should be used Chronic pain patients face much higher risks: increased pain, health problems, mental health problems, loss of employment, family, and death. Already millions of patients have been abandoned, patient anxiety and PTSD has risen, and suicides have risen dramatically. Quite frankly, with zero exaggeration-patient lives are on the line. Without firm and clear action this will not change. More patients will be traumatized, tortured, and die.<br/><span style='padding-left: 30px'></span>I stand here today to genuinely thank you for your efforts. And to also say, it is not enough, nowhere near enough. I ask you, the members of the task force, and everyone in the room- What else will you do to ensure the safety, well being, and medical needs of chronic pain patients will be met? What else will you do to ensure errors are corrected and that accurate information is used in policy and treatment decisions? Most importantly, what will you do to ensure that ALL providers know that prescribed opioids are an appropriate tool that not only can be used, but should be used for many patients? What will you do to ensure that chronic pain patients are no longer targeted, traumatized, that they no longer feel that suicide is the only option? We must ensure that chronic pain patients are not subject to decades of harm because of the inappropriate misinformation and propaganda towards prescribed opioids. We depend on you to be the leaders for that effective, and immediate change. Both as task force members and community members. Thank you.<br/><br/>https://rheumatoidarthritis.net/living/secondary-gain-chronic-pain?fbclid=IwAR0kNX-on1MwW6b-TCb1PvYIQza_nJ-wF1h4Nxs-_1qqGd56sUd1yqC37q0&utm_campaign=RInvoqPJ&utm_confid=sovh8wut7&utm_medium=promoted&utm_source=facebook.com<br/>https://filtermag.org/pain-patients-opioids-fear/amp/<br/>https://medium.com/@opioidhysteria/no-the-sacklers-did-not-kill-more-americans-than-covid-19-476c418a0e48https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254657/<br/>https://www.painnewsnetwork.org/stories/2021/7/16/advisory-panel-warns-cdc-revised-opioid-guideline-ignores-risk-of-undertreating-pain<br/>https://www.acsh.org/news/2021/07/19/2020-drug-deaths-spiked-30-and-pain-pills-had-nothing-do-it-15669<br/>https://pubmed.ncbi.nlm.nih.gov/34261978/<br/>https://stefankertesz.medium.com/an-opioid-quality-metric-based-on-dose-alone-80-professionals-respond-to-ncqa-6f9fbaa2338<br/>https://www.ihconline.org/initiatives/ambulatory/opioid-stewardship-program/educational-events?fbclid=IwAR0wA2YJ7Yj2GkKSWs7ZHYezZv-w6nur_Xy4NINVtlp6AyqDtuNjErlFjl8<br/>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356472/#__ffn_sectitlehttps://truthout.org/articles/the-war-on-drugs-comes-to-the-doctors-office/<br/>https://theoncologist.onlinelibrary.wiley.com/doi/10.1002/onco.13898<br/>https://www.bostonherald.com/2021/07/07/steidler-recovering-from-washingtons-fumble-on-opioid-epidemic/<br/>https://www.painnewsnetwork.org/stories/2021/7/6/the-war-on-drugs-comes-to-the-doctors-office<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a6b1	Anonymous	None	2022-04-11T15:07:43Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-6qt7-u83p	False	None	False	2022-04-12 06:41:08.394	[]
4684	CDC-2022-0024-4690	https://api.regulations.gov/v4/comments/CDC-2022-0024-4690	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	i am a 23 year old that has been dealing with smas for 5 years before they found it and it resulted in permanent nerve damage and have not been able to receive pain management care since i can not do any nerve blocks since i have other nerves in the way and can not recieve any type of pain medication. Even when they found the source of my pain it was still hard to get medication even with years of proof and countless doctors. all i heard is im to "young" to be in real pain. everytime i have a kidney stone i can get pain meds, but when i have even worse pain that i had to quit working years ago from pain, now im just supposed to "deal with it" and go to physical therapy which does nothing but hurt me and i already had surgery which also did not affect pain at all. this isnt even i pill problem anymore its just a fent problem that we have to turn to since we cant recieve the care we need so people would rather die then live like this, therapy wont help if the cause of it all is needing pain meds. would rather pass a kidney stone a day then keep living with constant nerve pain. should be this hard to recieve care with 1000 pages of proof and turning to pain management as a last resort. we go to pain management to get sent elsewhere to help the pain and it doesnt work:(.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	justin	None	None	090000648500a6b2	diaczyk	None	2022-04-11T15:08:24Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from diaczyk, justin	l1u-6qvk-43nl	False	None	False	2022-04-12 06:41:08.609	[]
4685	CDC-2022-0024-4691	https://api.regulations.gov/v4/comments/CDC-2022-0024-4691	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The oath that a physician is to live by is "do no harm". That is exactly what they aren't doing when the group of chronic pain sufferers are only allowed the 90MME. Doctors are saying that everyone can only take this amount of medicine and that their body will all react the same. Nothing could be farther from the truth. I am a patient who has been on pain medications for the past 10 years. Been treated by either Pain Management or by Family Physician. I have been accused of selling and trading medicine because my urinalysis came back too high for Morphine, when I wasn't even on it. I had to have a genetic test that proved with a medication type that my liver converted it to Morphine. I was threatened that my care would be terminated until the test showed otherwise. I have been treated like a drug seeker, when my genetic disposition leads to Degenerative Disc Disease. My body is only laughing at the amount of medicine I am told to take what I have been given and to grin and bear it. Nothing can be done otherwise to prescribe the actual medicine I need to function. In the very near future (one week) I will have my 2nd cervical revision fusion C-3 to T-1 and my 3rd lumbar revision fusion T-11 to S-3 4 months. Past surgeries have occurred over a 4 year time span. I am in constant pain with little relief because of the 90MME limit and being put into the same box as everyone else is. Stop treating a patient like a leper and let the Doctors do what is needed to treat and medicate their patients to be able to at least function as a normal human being. At some point my fusions will meet and my whole spine will be fused. I pray that this is figured out that by that time I will have some source of relief. <br/><br/><span style='padding-left: 30px'></span>At some point, I figure I will need a total revision up and down my	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a6b3	Anonymous	None	2022-04-11T15:10:56Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-6rbt-vzc4	False	None	False	2022-04-12 06:41:08.850	[]
4686	CDC-2022-0024-4692	https://api.regulations.gov/v4/comments/CDC-2022-0024-4692	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Sirs,<br/>How many of the people that decided on the 2016 "guidelines" actually suffer from chronic pain or a debilitating condition? <br/>I wonder if any of you have considered the harm that had been caused by these "guidelines"?<br/>These "guidelines" have done nothing to stop opiod deaths. In fact it has caused many CPP to take their own lives. Those of us who are suffering realize that this opiod crisis is actually an illicit fentanyl crisis. <br/>Physical dependency and addiction are completely different and you know it. If you don't know it then please educate yourselves on the difference. Please understand that those of us whose life depends on the use of FDA approved opiods for any quality of life have tried everything else and our meds are the last choice. We have tried surgeries, injections, ablations, cremes, patches, essential oils, diet, exercise, physical therapy, mental therapy, electrical stimulators, acupuncture, massage therapy, water therapy, dry needling and any other thing you can possibly think of. <br/>Please remember that your children, your parents, your spouse, not even yourself are immune from illness, injury or old age. The day may come that you have to watch someone you love suffer to death in pain that could be controlled by opiod therapy. <br/>This madness needs to stop. You must let Healthcare providers do their jobs and let them treat their patients humanly without the fear of prosecution.<br/>I beg of you to remove all mention of MME from your new "guidelines". Let us have some quality of life back before its too late.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a6b9	Anonymous	None	2022-04-11T15:11:48Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-6un3-xekf	False	None	False	2022-04-12 06:41:09.063	[]
4687	CDC-2022-0024-4693	https://api.regulations.gov/v4/comments/CDC-2022-0024-4693	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 CDC guidelines have caused incredible harm and suffering to responsible long term chronic pain patients and the doctors that prescribe opioid medications to them. The current guidelines limit access to the medications that ease our suffering. We have lost our quality of life, which is nominal to begin with. We have lost the jobs that pain medications enabled us to do previously. We have lost the ability to occasionally participate in family milestones. Most importantly, we have lost hope in our ability to return to the, albeit limited, degree of self sufficiency that we achieved prior to the current guidelines.<br/> As a result of the guidelines, many physicians who had treated our pain management for years, and knew us well, have stop prescribing or left medicine all together to avoid the unnecessary hassle that comes with being an opioid prescriber.<br/> Current doctors often speak about feeling powerless to provide the care that their patients need when they have to lower dosages and increase office visits, not because it is best for the patients, but because they now fear scrutiny from the CDC, DOJ, etc. and the loss of their licenses. Healthcare decisions need to be back in the hands of medical professionals providing patient care and to the patients they treat.<br/> The individuals who influenced the CDC guidelines were either unqualified to set standards, posed conflicts of interest, or both. There was never a crisis for responsible pain patients on opioids! There was an Oxycontin crisis caused by unscrupulous practices by Big Pharma in misleading physicians and patients. I am glad that has, and is, being addressed. However, the vast majority of us are responsible patients who require our pain medication to function. Our pain medications are the difference between being able to attend to ourselves in a bathroom, bathe ourselves, drive a car, hold down a full or part time job, manage everyday life, attend holiday gatherings, go to religious services, maintain community connections, and keep a healthy mental state.<br/> The CDC guidelines have ‘thrown the baby out with the bath water’. Those with post operative pain, chronic pain, pain during palliative care, etc. should have access to the medications they need, and have used responsively in consultation with their doctors. Now, because of the guidelines, many do not. Instead, they are treated like criminals, required to navigate expensive medical obstacles, change to medications they know from experience will not work in order to prove the doctor tried opioid alternatives…again, and accept invasive treatments they have tried before to no avail, just to gain access to the only thing that works.<br/> Many will have to go on public assistance and disability programs because they can no longer function at the same level, or do the jobs (albeit often only part time) that they were able to do with their pain medication. The majority of pain patients that are now being scrutinized and having dosages decreased (or completely denied) have years of proven responsible use and know the medication that works for them. Proper use of opioids have helped us. Restriction is disabling us. Proper use is not abuse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sherry	None	None	090000648500a6ba	Warner	None	2022-04-11T15:31:58Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Warner, Sherry	l1u-6uw2-mipt	False	None	False	2022-04-12 06:41:09.289	[]
4688	CDC-2022-0024-4694	https://api.regulations.gov/v4/comments/CDC-2022-0024-4694	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have had the privilege and the misfortune to know several people affected by opioids for various reasons. I have family and friends who have subjected themselves, for whatever reason, to abusing opioids in different ways. Some of them claim that an injury getting treated by opioid use started the path towards abuse and addiction. Others were looking for ways to get high or get away from themselves emotionally. I also have family and friends that take, as prescribed, opioids for pain control to assume day to day tasks that they otherwise could not. My mother has trigeminal neuralgia, which has been referred to as a suicide disease because the pain can be so intolerable, that one turns to suicide to get away from the pain. The new rules for pain control have caused her to lose the ability to have access to proper pain management, and I am scared that she too may turn to suicide if she can’t find a way to get relief from her condition. She is not alone in struggling to get help through prescription medication, because doctors are scared to prescribe opioids due to the new regulations for opioids. The people that I know that have abused opioids in the past, have turned to other drugs that are now easier to obtain. Drugs that contain fentanyl, heroin, meth, etc are still available to addicts and are still killing addicts everyday. So they have a way to still get high, party, play and abuse a substance regardless of your regulations and recommendations. However, people that are in need of pain management are the ones that do not have a safe way to get help, and are the only ones that I see are being affected in any way by these constraints. So, is the goal of the opioid laws to veer people that abuse drugs toward more dangerous drugs. Is the goal to hurt people who have terminal illness or daily pain? Is the goal to put the lives of innocent pain patients to the side and focus on drug addicts that find another way to get high? If so, then hats off to you, you have succeeded! If that is not the goal of your recommendations. then you need to reconsider how you word your literature and how you portray pain management. People that are in need are suffering, at the expense of people that chose to party. why would the life of someone that chooses to abuse outweigh the life of someone who is trying to simply live without pain. Save one addict. and a cancer patient, or a veteran, or another innocent person may end their own life to get out of their painful situation, when it could have been avoided by proper pain management. My mother is not an addict, but she is looked at like one when she seeks help or treatment. She has been told that it is in her head, she has been told that she is an addict. neither apply. She is currently not on any pain medication because of the exhausting process that she would have to undertake to get help. She does talk of suicide frequently and I am completely taken at how the doctors have turned on her since she was first diagnosed. I’m the beginning, she had no problems getting treatment, doctors seemed to understand what she was going through and wanted to help any way they could. Now they are scared of a lawsuit, or losing their career because of the way things have turned out with opioids. Why would we want to punish those in need to save the lives of those who play? I don’t know anyone who was addicted to opioids that have stopped taking drugs. They look for and find something to keep partying. People still die of overdose on all kinds of other drugs. So the outcome of these laws have only punished pain victims and made them feel like there is no hope for them, when there is a way that they could get help. This situation is appalling. I would not want my loved one to die of overdose, but having access to prescription pain meds does not make a person take it. I have a pistol, doesn’t mean I am a murderer. People use guns to commit homicide, suicide everyday. If we made guns illegal, evil people would still have guns and innocent people would have no way to defend themselves against them. Take opioids away from people, drug addicts are still going to find ways to abuse drugs, but innocent people are going to suffer through their life. It’s a nice concept thinking that lessening opioids will save lives, and it may save a few, but at what expense? Innocent people living through pain and suffering until they die? I think we are worrying about the wrong demographic here! Take care of people with real world problems, if someone chooses to abuse, that is on them. They will do it regardless! I hope that none of you have to watch a loved one suffer because a bad person made a bad choice, but that is exactly what is happening and you all are the reason! We have a way to get people relief, but it can be abused, so we don’t use it to help? There has to be a way to still treat pain, those people are worth it! I think you should reconsider your approach to this situation, for everyone!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	090000648500a6c5	Peddicord	None	2022-04-11T15:40:53Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Peddicord , Brian	l1u-76t5-yzzq	False	None	False	2022-04-12 06:41:09.510	[]
4689	CDC-2022-0024-4695	https://api.regulations.gov/v4/comments/CDC-2022-0024-4695	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The American Board of Pain Medicine (ABPM) commends the Center for Disease Control for undertaking a comprehensive review and revision of its 2016 Guideline for Prescribing Opioids for Chronic Pain and appreciates the opportunity to comment on the proposed 2022 Clinical Practice Guidance for Prescribing Opioids.<br/><br/>ABPM Diplomates are pain medicine specialists trained to utilize a multi-disciplinary and team-based approach to pain care and number over 2,300 physicians across all 50 states.<br/><br/>Pain medicine specialists and their patients are experiencing first-hand the ramifications of restrictive policies that limit access to a wide range of pain treatments, including both opioid and non-opioid care. Most of these policies are based on the misapplication of the 2016 Guideline which included an inflexible application of recommended dosage and duration thresholds and policies that encourage hard limits and abrupt tapering of drug dosages. <br/><br/>To improve pain care, and the accurate interpretation and application of the 2022 Draft Guideline, ABPM offers comments and recommendations in the attached document. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	09000064850094ee	None	None	2022-04-11T16:35:40Z	American Board of Pain Medicine	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from American Board of Pain Medicine	l1t-ewd4-ho78	False	None	False	2022-04-12 06:41:09.731	[]
4690	CDC-2022-0024-4696	https://api.regulations.gov/v4/comments/CDC-2022-0024-4696	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered with chronic pain for 40+ years..after a bad head on car crash ...im 57 yrs old..now....for 25 years ..chiropractors and other non opioid therapies helped me control my pain...in 2003 i had a another bad accident..resulting in 5 major spinal surgeries...then INTRAC SPINAL PAIN developed after a total neck replacement...which crushed my whole spine...opioids are the ONLY thing that is able to control this severe level of pain...i have been STABALLY on opioid therapy for 8 years until CDC 2016 guidelines tapered my longtime opioid therapy away...i was left...abandoned by Dr.s to die...hypertension rate BP..severe dehydration...prolonged diarea was blood...sleep deprived..the extreme spinal nerve pain was so intense...EVERY waking conscious part of my body was affected!!...my husband brang me to ER hospital s and Dr s...with no help!..everytime..i was labelled a 'drug seeker'..even thou i had ALL current MRI s..Spine specialists from TOP spine Dr diagnosis s...and recommedations which were to control the pain with opioid therapy.....i had to turn to desperate measures...to save my life!...i am now bedridden!!!..no quality of life...suicide constantly on my mind...with these low...limited mme doses our gov/CDC has set into "guidelines"...i am UNABLE to find a Pain Management Dr to prescribe proper dose of opioid meds to control my severe INTRAC pain...due to the 50mme suggested limit..n...not over 90mme...which are being TOTALLY misapplied and set into LAW!!...our government/CDC NEEDS to let Pain Management Specialists prescribe what is NEEDED WITHOUT these limits...people who take opioids for severe pain...take them to function and be able to live...NOT TO GET HIGH.....without opioids...i would of had a heart attack....PLEASE...REMOVE government over reach from our PAIN SPECIALISTS...i beleive ONLY PAIN SPECIALISTS should be able to prescribe opioids longterm...there is a need for longterm opioid therapy....PLEASE listen to people and pain specialists (with many years of experience)....MORE innocent ppl will die if these strict guidelines are NOT PROPERLY REVISED!....our overdose and addiction epidemic is from ILLEGAL DRUGS......thank you!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	09000064850094f9	Anonymous	None	2022-04-11T16:36:00Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-fckz-7hv8	False	None	False	2022-04-12 06:41:09.944	[]
4691	CDC-2022-0024-4697	https://api.regulations.gov/v4/comments/CDC-2022-0024-4697	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached document. Thank you for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a233	Anonymous	None	2022-04-11T16:37:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-ucko-zfuc	False	None	False	2022-04-12 06:41:10.169	[]
4692	CDC-2022-0024-4698	https://api.regulations.gov/v4/comments/CDC-2022-0024-4698	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I know you are trying to fix the horrible problems that stemmed from the 2016 Guidelines. I am a 40 year old maintenance worker. I was cut off in 2019. I can barely work now. Thank goodness I am self employed. I struggle with daily hygiene and I cannot keep up with my daily chores. When I am not absolutely suffering at work, I am at home in bed suffering. I had to give up my hobbies, friends and time with family. Being a Chronic pain patient under your guidelines is a FULL TIME JOB! The Chronic pain patient is required to go to endless Doctors appointments, labs, counseling, pain clinics, specialists, Acupuncture, Chiropractor, Physical Therapy, Injections, wait times at Pharmacies, pill counts, random UA’s, injections, spinal procedures, recovery of treatments, spinal stimulator’s and adjustments, etc. We are Chronically suffering every single minute every single day and you want me to juggle the normal life I should lead with a career of going to way to many appointments so I can be a guinea pig. I know what works for me. It is impossible to juggle all of the red tape, stigma, and rejection. Let alone have a quality of life. You make Doctors and patients want to give up. Doctors giving up on us and patients want to give up on life itself. Suffering from pain is bad enough but all of these rules and guidelines cause useless stress and devastation. The purpose of us using opioid therapy is to have a quality of life not just make it to the next appointment to prove ourselves once again. Please admit to everyone that you have done more harm than good. You have exacerbated the black market. Yet when the numbers are broken down the deaths are caused by street drugs heroin and fentanyl – not legally prescribed medications taken under the care of a doctor. According to a Cochrane Review on “Opioid Prescribing for Chronic Pain” less than 1 percent of those who were screened for drug problems developed new addictions during pain care. Additionally, the “Cohort Study of the Impact of High-Dose Opioid Analgesics on Overdose Mortality” found the drug related death rate for people who take opioids prescribed for them is 0.0022 per 1,000. That’s lower than the mortality rate for people who take blood thinners. There is no quality control on the streets. Us pain patients are suffering while addicts are overdosing. People are committing suicide due to untreated or under treated pain. Maybe you think you are/were doing a good thing back in 2016 but, now you know the unrepairable damage you have done. Please I am begging you to redact and refute all opioid guidelines. Stop the Doctors from being terrorized by the government and DEA. Help to restore the Doctor patient relationships. Inform all law makers that you have made a mistake. There is so many benefits to longterm Opioid Therapy but you only echo the risks throughout your guidelines. They could still be miss applied. The wording comes across as biased against opioids. Please help by just admitting that prohibition or extreme rules and regulations just make things worse. Let us have personal responsibility. I would be more than happy to sign something that would absolve my Doctor of any wrong-doing due to opioid prescribing to me by them. That should be enough.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a240	Anonymous	None	2022-04-11T16:41:22Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-ussn-2ng8	False	None	False	2022-04-12 06:41:10.426	[]
4693	CDC-2022-0024-4699	https://api.regulations.gov/v4/comments/CDC-2022-0024-4699	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This guidelines have caused unnecessary pain, suffering and misery to chronic pain patients due to not being able to receive the adequate medication to diminish the excruciating pain that our conditions causes. It is cruel and inhuman to be treated like a drug addict because we need this medication to live a functioning life.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a25b	Anonymous	None	2022-04-11T16:41:52Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-v13d-2qqf	False	None	False	2022-04-12 06:41:10.640	[]
4694	CDC-2022-0024-4700	https://api.regulations.gov/v4/comments/CDC-2022-0024-4700	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To the CDC:<br/><br/>The chronic pain I live with has increased exponentially since your 2016 guidelines forced me to taper my pain medications significantly. My pain comes from many sources, including nine spine surgeries over twenty years ago with instrumentation in my cervical and lumbar spine, degenerative disk disease, a current thoracic spine compression fracture, spondylitis, neuropathy, fibromyalgia, arthritis, osteoporosis, COPD, coronary artery disease, along with other problems.<br/><br/>My pain is constant. It never takes a break, not for one second. The pain is aching, burning, stabbing, agonizing, incessant. Most of it occurs in my neck which radiates to my skull, jaw, clavicles, and shoulder blades. I have zero range of motion and am unable to turn my head. If I try my pain level surges and I can hear the grinding and crackling of my bones and metal plates loudly in my ear. The sound is like a ratchet, but louder. https://www.youtube.com/watch?v=eA0NdANR2ek But then there’s the pain from the pressure. Fibromyalgia makes it impossible to be touched or to lean on anything. I only sleep on my back because my sides, arms, and legs can’t have any pressure on them or the pain increases. It always amazes me that my pain can actually get worse when I think it’s reached its peak. But it does. <br/><br/>Sleep is transient and very difficult to get in any sufficient amount. I have a bolster pillow under my knees to keep from extending my lower back, and a small pillow under my feet because my heels burn from the neuropathy if they touch the bed. Then there are two slanted down pillows under my head to cradle my neck and keep it supported. I have an oxygen cannula on my face. There is no way I can move. My elbows get raw from lying in one spot on the bed. Sleep only comes from sheer exhaustion. I go to bed two hours after my husband so I can hopefully fall asleep but it still generally takes at least an hour or two. He gets up an hour before I do but I’m not sleeping, just laying there thinking about all the things I’d like to get done, but none of them ever happen because once I’m up it’s too painful to do much of anything. I’m lucky to get four hours of sleep each night and the pain is with me throughout.<br/><br/>Once I rise it’s hard to make it from one side of the bed to the other. My body trembles from pain, my heart races, and I have trouble catching my breath. I try to straighten the covers and go to the living room to sit in my recliner. It’s then time to get on my computer, a half hour before my inhalers are due, along with my heart medications and the little bit of pain medication I’m still allowed. I look at the clock and agonize over the next 18+ hours I have to be upright and how I’m going to get through it.<br/><br/>Without my computer I’d have no contact with the outside world. I can no longer drive and don’t leave my house except for doctor appointments or medical tests. My husband has to drive me anywhere I need to go. He does the errands, grocery shopping, and other outside tasks. I don’t see anyone but him and I’m often irritable and petty toward him. The pain makes me that way and I try to explain it to him, but he doesn’t really understand, even though he’s been here through it all. So how can I make you understand? I was once a dancer, a hiker, a swimmer, a bodybuilder, a social worker, a friend, a volunteer, an employee, a happy person.<br/><br/>Before you changed your guidelines regarding opiates in 2016, forcing me to lower my pain medications, I had some quality of life. I went out, did errands, had friends I socialized with, went to concerts and dances, had some fun, and a life. Now it’s pure monotony and pain. I’m just waiting for it to end. Sad!<br/><br/>As you’re updating your guidelines to "support safe and effective pain care options" please show some compassion toward those of us who are suffering and allow us to obtain the opiate medications that were helping us prior to your 2016 changes.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	090000648500a261	Lyford	None	2022-04-11T16:48:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Lyford, Nancy	l1t-v51p-exmz	False	None	False	2022-04-12 06:41:10.856	[]
4695	CDC-2022-0024-4701	https://api.regulations.gov/v4/comments/CDC-2022-0024-4701	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	my son had severe back pain from a sports injury. He could not get proper treatment in prison and when released had no access to pain relief or treatment. He started using street pills and later heroin to treat his pain - self medicating. He is dead now from fentynol laced drugs. You are so worried about people overdosing on prescribed pills that you have caused people to go to the streets for drugs to treat their pain. You are responsible for my sons death.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	heide	None	None	090000648500a2a3	Fossum	None	2022-04-11T17:21:39Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Fossum, heide	l1t-v9h3-cp7d	False	None	False	2022-04-12 06:41:11.072	[]
4696	CDC-2022-0024-4702	https://api.regulations.gov/v4/comments/CDC-2022-0024-4702	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please make it clear that the doctors and their patients can decide on dosage, frequency, etc. People are suffering and unable to get much needed relief. It has caused a hardship for honest patients with chronic pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a2d7	Anonymous	None	2022-04-11T17:41:48Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-w6af-crf0	False	None	False	2022-04-12 06:41:11.291	[]
4697	CDC-2022-0024-4703	https://api.regulations.gov/v4/comments/CDC-2022-0024-4703	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Chronic pain patients like myself with fibromyalgia feel like there no hope as we face pain everyday. Doctors should not feel pressured to give prescription that can help with pain. There is a difference between addiction and dependency. Pain patients are not addicts.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a2da	Anonymous	None	2022-04-11T17:42:12Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-w821-gjmy	False	None	False	2022-04-12 06:41:11.520	[]
4698	CDC-2022-0024-4704	https://api.regulations.gov/v4/comments/CDC-2022-0024-4704	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The very condensed facts. I'm 56 y/o and in chronic intractable pain since 1994. I exclusively used holistic treatments from 1994-2008 because I preferred not to medicate. ALIF surgery in 2008. Pain management from 2008-2019. Fully compliant with all requirements (1 doctor, 1 pharmacy, random drug screens, monthly pill counts) yet forced to leave after issues arose with a PA due to 2016 "guidelines". I had previously voluntarily requested and completed a reduction prior to that time. Under care of my DO since 2020 when I was refused to even be seen by 10 other pain management offices once I mentioned that I was previously given a Rx for oxycodone. When I had adequate pain medication, I was able to function and care for my mother, who recently turned 101, keep my house tidy, and assist physically limited friends and family. In the past 3 years my house has become cluttered and unclean, I have no patience to care for others, and have no desire to care for myself. If not for the love of my animals, I'd never leave my bed. I was once a very outgoing and happy person, even in spite of my physical limitations. Without sufficient pain control, I'm depressed, angry, and have no semblance of a life. I did nothing wrong to cause my pain. This was simply my lot in life. I followed all the rules of my pain management doctor and yet, I was punished for the sins of others. Those others are still getting their illegal drugs, and still dying. And they are treated with more respect by being given free drugs, so they don’t suffer withdrawal, and free, clean needles to keep free from infection. It's just like the criminals running the streets with illegal firearms and the law abiding, licensed, registered gun owners being blamed for their deadly actions. You will never be successful in stopping the "opiate crisis"(caused by illegal fentanyl and heroin, NOT by responsible, legal, monitored, Rx use) when you're turning innocent people into criminals out of desperation for relief. No one ever talks about the rate of suicide among innocent pain patients and the devastation it causes their loved ones, but the media is flooded with stories of addicts OD'ing and the pain felt by theirs. Patients in pain have nothing to do with the illegal fentanyl and heroin that is responsible for those deaths. Addicts choose their way of life, no one forced it on them. We are forced to live a life of pain and suffer the consequences for the actions of others. It seems that once the pharmaceutical companies were no longer allowed to offer perks to physicians to push their medication, they didn't feel that pain patients needed relief so much anymore. Many pain management physicians now own interests in surgery centers, and the care for actual pain management lessened further. If you don't agree to frequent injections and procedures that they can bill much more for, then you don't get any pain medication at all. Most of these modalities are very temporary at best, and many are useless, not to mention costly and financially devastating to pain patients who survive on barely livable incomes. It's time to care about patients in pain who follow the rules and simply want to make it through what little life they have left in as little pain as possible. I leave you with these paragraphs taken from a letter from the AMA - that link, and a few significant others, is below:<br/><br/>“In addition, the guideline did nothing to stem the drug overdose epidemic sweeping the country. In fact, the epidemic has become more lethal despite the CDC restrictive guideline due to illicitly manufactured fentanyl, fentanyl analogs, heroin, methamphetamine and cocaine.<br/><br/>“States and insurers have turned the guideline into laws and unbending regulations, preventing physicians from treating patients as individuals with specific needs. The AMA outlined its concerns and recommendations (PDF)in 2016 and 2020 to the CDC. For the nearly 40 states that have codified the guidelines—as well as the insurers and pharmacy chains that have policies based on the guideline—the new draft guidance is good place to start with overhauling policies and laws.<br/><br/>https://www.ama-assn.org/press-center/press-releases/report-shows-decreases-opioid-prescribing-increase-overdoses<br/><br/>https://pubmed.ncbi.nlm.nih.gov/3310496<br/><br/>https://www.psychologytoday.com/us/blog/nation-in-pain/201511/chronic-pain-and-the-risk-suicide<br/><br/>https://www.foxnews.com/health/as-opioids-become-taboo-doctors-taper-down-or-abandon-pain-patients-driving-many-to-suicide<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Alison	None	None	090000648500a2e9	Katla	None	2022-04-11T17:48:02Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Katla, Alison	l1t-wcm9-nnmu	False	None	False	2022-04-12 06:41:11.730	[]
4699	CDC-2022-0024-4705	https://api.regulations.gov/v4/comments/CDC-2022-0024-4705	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines are going to make life even worse for chronic pain patients. It is sick that the CDC, PROP, and [name redacted] are hellbent on making things worse for people in pain. Without my meds I couldn't leave the house or work.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sandy	None	None	090000648500a2ef	White	None	2022-04-11T17:48:31Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from White, Sandy	l1t-wdmu-gpoy	False	None	False	2022-04-12 06:41:11.949	[]
4700	CDC-2022-0024-4706	https://api.regulations.gov/v4/comments/CDC-2022-0024-4706	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was diagnosed with Chrinic Regional Pain Syndrome (CRPS) in 2021. Since I have been diagnosed I have learned much about the 2016 CDC guidelines that many states have used as a rule instead of a guideline.<br/>I have had a severe reaction to all medications that I have tried that are for nerve pain. This list includes (but is not all inclusive) gabapentin, lyrica and cymbalta. The only medication that is currently helping me with the pain is Tramadol. <br/>Imagine my surprise when I found out that in order to receive this medication I would be required to take drug tests on a regular basis and sign a contract with my medical provider.<br/>I feel that these "guidelines" do not allow for proper treatment for my condition. In addition, I feel that I am being punished for having a serious medical condition.<br/>I am old enough to remember when options were prescribed for every condition. I understand that this issue must be addressed but not at the cost of someone with a serious medical condition who is in constant pain.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Danielle	None	None	090000648500a2f6	Smith	None	2022-04-11T17:49:31Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Danielle	l1t-wfag-6j8h	False	None	False	2022-04-12 06:41:12.164	[]
4701	CDC-2022-0024-4707	https://api.regulations.gov/v4/comments/CDC-2022-0024-4707	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have suffered from chronic, debilitating pain since August 2000. I have been under the care of licensed physicians specializing in pain management since then with the exception of a six month period in Las Vegas where I felt I had been referred to a doctor who cared only for profit and was a pill distribution operation. It was my choice to try [name redacted] d<br/><br/>I have suffered from debilitating, chronic pain for 22 years, the result of scar tissue from 3 spine surgeries forming along my sciatic nerve, compressing it into my spine and causing excruciating pain. I have completed innumerable rounds of various therapies to help alleviate the pain with minimal use of medications. Unfortunately the therapies were unsuccessful in controlling my pain and the only effective way of relief became opiates as prescribed by a legally licensed, highly trained and ethical physician. Unfortunately this was also the time the Opioid Crisis began and the nightmare of living a life in constant, excruciating pain became a reality for many thousands. The CDC wrote Guidelines for the prescribing of opiates that quickly became absolute rules of dosages based on a person’s height, weight, duration of time being medicated, with no consideration given to the reason/severity/origin of the pain being experienced. Our Doctors are no longer being allowed to treat their patients. Strangers within the CDC are telling our doctors what medications they are to prescribe. This is illegal because the Guidelies state that patients must BE SEEN by their doctors prior to receiving medications. Our doctors are being denied their prescribing privileges and being prosecuted for breaking laws that aren’t even laws for prescribing, just guidelines. Those of us suffering needlessly from pain that can be significantly relieved when LEGALLY and PROPERLY treated are now considered criminals because we need opiates to maintain a somewhat pain free life. Why is one group of people being treated as felons? There are no felonies being committed. It is time for the complete overhaul of the CDC Opiate Prescribing Guidelines. Compassionate care of persons suffering from chronic pain should be of utmost importance. Hard, limited guidelines for dosages, types of medications, duration of treatments should NOT be a part of any type of “compassionate” law. Doctors who know their patients should be treating their patients, not being made to stand on the sideline while a person who is looking at a piece of paper about a stranger in pain “treats” his/her patients. Compassion, not punishment, should be the objective of a complete overhaul of new opiate prescribing guidelines for those who legally and responsibly use opiates to maintain a moderately comfortable life while at the same time addressing the tragic ramifications of the Opioid Epidemic. A “One Size Fits All” solution to address legal and illegal opioid use is not only irresponsible on behalf of all whose lives have been impacted, positively or negatively, by opiates, but cruel to those being forced by complete strangers to experience needless suffering	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Amy	None	None	090000648500a2f9	Anderson	None	2022-04-11T18:08:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anderson, Amy	l1t-wgc9-ruws	False	None	False	2022-04-12 06:41:12.394	[]
4702	CDC-2022-0024-4708	https://api.regulations.gov/v4/comments/CDC-2022-0024-4708	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We as pain patients should not be treated as criminals by using things like Narxcare, PDMP, Lab testing UA’s. They make our interactions with our Doctors nothing but worrying about possible addiction. There is not enough time in an appointment to cover dissecting a patients past and family history. Using people’s history of suffering sexual or physical violence against them receiving opioid therapy for their pain. Our Doctors don’t have time to be a detective and an addiction counselor and be a Doctor. We are pain patients not criminals. Maybe you could look for a DNA marker that lets you know who might be prone to addiction. Then you could help those people monitor their use of opioids for pain. Many people drink alcohol that do not become alcoholics. Those that do need help have many options for treatment if they choose so. You do not put everyone who drinks on probation just because they might become an alcoholic. We pain patients deserve the same respect. Heavy regulations and of course probation do not work. We are adults and can take personal responsibility. There is no one fits all solution. We are all individuals who need different things. That’s why I believe guidelines do not work for things like this. You can warn us of the dangers but, you cannot tell us when where and how. That should always be our rights as citizens of the United States of America land of the FREE! We are using our medications to live some sort of quality of life. Not for self destruction.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a307	Anonymous	None	2022-04-11T18:20:52Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-wlqv-y5ho	False	None	False	2022-04-12 06:41:12.610	[]
4703	CDC-2022-0024-4709	https://api.regulations.gov/v4/comments/CDC-2022-0024-4709	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	1. To the extent there is an "opioid crisis" that warrants Government policy/guideline intervention, it relates to ilicit opioid use, addiction, and the associated continual increase in year-over-year overdose deaths. By that definition, the "opioid crisis" falls into the CDC's area of responsibility, but it has now been proven indisputably that opioid prescribing is not correlated to or driving that crisis.<br/><br/>2. In creating and releasing the 2016 guideline on opioid prescribing, it is apparent that the the CDC chose to operate outside of its area of expertise and scope of responsibility. That is presumably what led to the 2016 guideline being such a disaster that it now needs to be repudiated.<br/><br/>3. There is no scientific basis for any MME limit. Human bodies and their pain and diseases that require treatment are not uniform. Publishing a guideline that references any MME limit can only harm chronic pain patients and their providers, as has been proven beyond any doubt by the 2016 guideline.<br/><br/>4. The CDC should ensure it is operating in a transparent and unbiased manner, which has not happened to date, either with the 2016 guideline's creation or with this revision. It should ensure that those involved in this revision are able to operate without bias or conflict of interest, which means without even the appearance of those things.<br/><br/>5. In attempting to have a positive impact on illicit opioid addiction and overdose deaths, the CDC is seemingly operating with positive intentions. But what ever happened to non-maleficence being a fundamental pillar of medical ethics? Non-maleficence says that if a treatment causes more harm than good, it should not be considered.<br/><br/>Immense harm has been done to millions of Chronic Pain Patients (CPP), pain practitioners, and pharmacists who have literally had nothing to do with illicit opioid addication and/or overdose deaths. Meanwhile, illicit opioid use, addiction, and overdose deaths continue rising every year.<br/><br/>There is no question the 2016 guideline has caused more harm than good. This is indisputably proven by the CDC's own data.<br/><br/>6. It is long past time for a completely different approach. I implore everyone involved to rethink the current approach and adjust to one that appropriately separates efforts to combat illicit opioids from legitimate opioid prescribing.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	090000648500a30a	Teer	None	2022-04-11T18:26:38Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Teer, Brian	l1t-wnbt-7fqu	False	None	False	2022-04-12 06:41:12.839	[]
4704	CDC-2022-0024-4710	https://api.regulations.gov/v4/comments/CDC-2022-0024-4710	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing to support the nuanced changes to the Clinical Practice Guideline for Prescribing Opioids. For too long, patients who have legitimate healthcare needs have not been able to access their pain-relieving and life-saving medication because of a moral panic around opioid use. While many have suffered from addiction, our policies must not criminalize those who require safe access to opioids, or doctors who believe in their professional judgement, that such medication is necessary. Over the last few years I have seen a close friend suffer enormous physical, psychological, and emotional anguish because she has been unable to get safe prescriptions for the medications. As a uniquely bright, creative, caring person who has worked for much of her life to stand for those who are unjustly incarcerated and are victims of human rights abuse, she found herself in her late 30s, largely isolated from friends and family, in part because of her debilitating physical condition, in part because of the stigma associated with her medical needs. None of this had to be. As we continue to grapple with a pandemic, we need a society that can trust in its doctors and its healthcare system. Please revise the draconian and counter-productive policies around opioids that have done undue harm to so many.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Brian	None	None	090000648500a30b	Dolber	None	2022-04-11T18:28:20Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Dolber, Brian	l1t-wnd2-tcon	False	None	False	2022-04-12 06:41:13.053	[]
4705	CDC-2022-0024-4711	https://api.regulations.gov/v4/comments/CDC-2022-0024-4711	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on schedule 2opioids for a shattered knee and disc compression fractures at T12 in my back and C6 in my neck. Today I cannot find a prescriber to get the pain relief I need and deserve . Can anyone help me? Thanks [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ronald	None	None	090000648500a30c	Evancho	None	2022-04-11T18:29:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Evancho, Ronald	l1t-wnjl-42yh	False	None	False	2022-04-12 06:41:13.266	[]
4706	CDC-2022-0024-4712	https://api.regulations.gov/v4/comments/CDC-2022-0024-4712	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 66 years of age. I have sever pain issues that cannot be addressed by my physician for a long amount of time. I’m on my own for finding medication that can help me. I can scout bad neighborhoods or online pharmacies to get proper medication that will help me, but it’s to risky. I’ve given up much of my life by staying in bed or doing absolutely nothing. BORING. My doctor has been my doctor for 20 plus years. She knows me very well. She knows my issues but is unable to HELP me. I don’t believe the elderly is going to become addicted. WE just need some help. No shame in this. Please reconsider the elderly who unfortunately needs help. For a doctor not to be able to help their patients is absurd. Can’t even prescribe the lowest milligrams of opioids. Now can anybody become addicted to that. Put your faith in doctors. They know us. They can help us. My viewpoint. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a319	Anonymous	None	2022-04-11T18:30:20Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-wsj3-2yg4	False	None	False	2022-04-12 06:41:13.501	[]
4707	CDC-2022-0024-4713	https://api.regulations.gov/v4/comments/CDC-2022-0024-4713	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The war on opioids has been taken to extremes and has now become a war on pain relief. I have seen and heard a lot of anecdotal evidence of chronic pain sufferers who need them and being denied, as well as doctors wanting to wean people off opioids who have been on them for years with no issues. The easy answers and modalities being offered are absurd. Yoga? Biofeedback? Acupuncture? For real, substantial chronic pain issues, these modalities will only work for those who are prone to the placebo effect. The studies claiming the non-opioid solutions work were surely done with a bias and a predetermined conclusion was baked in. Take it from a chronic pain sufferer who knows others in the same boat.<br/><br/>I was recently in the pain management clinic at the VA, and they are dead set against me having anything stronger than Tramadol, which I've been on for years with no issues. Just not working so well anymore. Even worse, a few years ago another doc there told me I should get off Tramadol, and that "studies" show that opiates don't really work. I said "Tell that to the chronic pain sufferers I work with, in blue collar work, who could not function without them." Fortunately, a more senior doc allowed me to stay on the Tramadol, but it just goes to show you how the younger, less-experienced doc was all too anxious to get me off a mere synthetic opiate like Tramadol because of all the hysteria and directives equating opiates with addictions/death.<br/><br/>Here's the simple fact of the matter: The VAST majority of opioid deaths are NOT chronic pain people who are taking the meds as prescribed by their doctors. The deaths are mostly amongst addicts and partyers, usually younger people, who are getting tainted heroin, fentanyl, and such off the street. Garbage coming out of Mexico and China. I have seen the stats, but don't have links to present. Again, the deaths are largely not legitimate pain sufferers abusing their meds. So we legitimate pain people are being denied good meds due to idiot addicts and partyers. Wonderful.<br/><br/>May the people who have initiated and hyped the "war on opioids" one day themselves, or someone they love, have chronic pain and not be able to get adequate relief. That's called Karma.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Shon	None	None	090000648500a31a	Kelly	None	2022-04-11T18:34:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Kelly, Shon	l1t-wudu-aun6	False	None	False	2022-04-12 06:41:13.727	[]
4708	CDC-2022-0024-4714	https://api.regulations.gov/v4/comments/CDC-2022-0024-4714	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please give doctors the freedom to provide care for their patients without fear of reprisal. Prohibitions affecting prescriptions to patients with pain is not the best, and has proven wholly ineffective, means to reduce illegal drug overdoses.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Broken	None	None	090000648500a331	Spine	None	2022-04-11T18:35:32Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Spine, Broken	l1t-x0m3-487e	False	None	False	2022-04-12 06:41:13.944	[]
4709	CDC-2022-0024-4715	https://api.regulations.gov/v4/comments/CDC-2022-0024-4715	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	CDC 2022 Guidelines <br/><br/>Hello, I am a 78-year-old Mother of 5 and Grandmother of 12. I started an apartment building business 22 years ago. I rent to low income and fixed income persons desiring a safe and clean home. This was going successfully until in 2011 when I injured my spine while shoveling a huge drift of snow. After 3 years I was finally diagnosed with Severe Spinal Strenuous a lifetime unmendable condition. This is where my spine had separated into 2 pieces. This causes acute and constant pain that drains one of all one’s strength just bearing up with the constant pain. This resulted in almost complete shutdown of all my life’s activities. <br/><br/>I was finally given Tramadol 5mg for the pain. <br/><br/>Because of some relief I was able to walk again. I even got strong stomach and back muscles to hold up my teetering spine and was able to walk 3 to 5 miles a day. I again began to carry on my Family activities and my business life. <br/><br/>In 2016 I was immediately taken off my acute chronic pain medication for no reason or explanation. Ever since I have been in constant debilitating pain. This requires all my energy to just endure the pain. My business is now too difficult for me to run, and I must sell. Retirement looks like one long painful hell with constant suffering and no meaningful activity with my family. Just managing to endure the pain is all I can do. I feel like I am in a prison camp being tortured. <br/><br/>I do not know why I was taken off medication that had such a world of benefits to me to only end up with a meaningless life filled with pain and no benefits. I was found guilty without a trial. <br/><br/>My doctor is too terrified to assess my “risk verses benefits” for fear of unreasonably harsh reprisals. He no longer wants to see me and is afraid that I may ask for help. So, all he talks about is pain medication when I do not even come to see him for any help in that area. He has stopped doing his job as a doctor. <br/><br/>Today’s problems are not caused by doctors. Pharmaceutical companies have created safe and beneficial drugs to hep humankind and doctors are trained to watch over safely administrating them. Do not take control away from these already proven successful safeguards. These structures are the best safeguards for a minimal risk of addiction. <br/><br/>If you want to help, look to our unbalanced social structure of the unequal distribution of wealth. Do not destroy the Middle Class by tying down their ability to be productive. Do not demonize medications that have so long proven a benefit. Instead, help mend society's ills and the drugs will end up being the blessings that we need to continue to go forward. <br/><br/>Who is to say that what has already worked in the past is not better than these new untested requirements. The results so far are more harmful than the past. Where did the term risk even come from. I can see a connection between drugs an addiction if one skews the data. However, I have not seen a proven connection between a cause and effect of drugs causing addiction. <br/><br/>It is a risk to have an untrained third party determining my health care. It is a risk having to go in for additional experiments that have not proven to work. It is a risk to go in for additional unproven testing when I cannot even get to somewhere unsafe to even be seen to be tested. It is a risk to go in for additional testing when I am too hurt to even go there. Why go about reducing risk when there was no risk in the first place. The Guidelines do not reduce risk. These Guidelines should be removed forever. <br/><br/>Sincerely, <br/><br/>Suffering Chronic Pain Patient	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a332	Anonymous	None	2022-04-11T18:49:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-x0xp-y6gu	False	None	False	2022-04-12 06:41:14.179	[]
4710	CDC-2022-0024-4716	https://api.regulations.gov/v4/comments/CDC-2022-0024-4716	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Denying people in pain pain-relief is akin to torture. While I have had only minimal need for opioids for the past 15 years, denying anyone simple, safe, inexpensive relief from pain is immoral. Yet today many doctors will not prescribe any narcotics for any reason. I am generally healthy, white, educated, and therefore have the privilege I need to go through the hoops necessary to receive the prescriptions I require to remain a fully functioning member of society. But this wasn't always true. Fifteen years ago I developed a severe migraine syndrome which lasted about three years. Injections, pills, intravenous drips of prescription concoctions, ER visits, treatments of all sorts (I tried everything), did not keep the migraines from coming. But narcotics usually kept the pain from becoming intolerable. I was regularly incapacitated for three years in almost every way. Too often I could not think, I could not drive, often I could not care for my children, sometimes I could only crawl. I could never have jumped through the hoops patients have to jump through today to get the care they require. For example, asking me to go to yet another doctor, every month, in person, then to the drug store myself, would have been an insane request. I was simply too sick. It is evil to require extreme effort from the sickest and most vulnerable people. (Please ask a sick person about what a sick person can actually do before making new rules!) At that time, suicide was an ever present option. Without any relief from the pain, there is no way I would have made it. I know I am lucky in some ways - after 3 years, when the syndrome began to lessen and my need for pain relief decreased, I simply took less and less without concern or issue, as most people do.<br/><br/>I do have sympathy for those who become dependent or addicted, and I am furious at the few doctors who write the vast majority of medically unnecessary prescriptions, but surely there is a way to both protect against unwise and harmful use and allow for reasonable and compassionate care through pain relief for those who medically require it. I do understand the complications inherent in the term "who medically require it". <br/> However, the sick, injured, and helpless should not be forced to suffer agony needlessly; to demand that they do so by withholding pain relief is barbaric and inhumane.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karin	None	None	090000648500a336	Duval	None	2022-04-11T18:54:17Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Duval, Karin	l1t-x7by-pem8	False	None	False	2022-04-12 06:41:14.399	[]
4711	CDC-2022-0024-4717	https://api.regulations.gov/v4/comments/CDC-2022-0024-4717	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for these new dosing guidelines. Under the current guidelines, my mother is unable to receive a dosage adequate for her pain management needs and her quality of life has greatly suffered. She has severe spinal stenosis, has had 3 hip replacement surgeries and is trying to wait as long as possible before having a knee replacement for arthritis in her knee. <br/><br/>For years, she was able to access the medications she needed to manage her pain and continue with the activities she loves -- gardening, cooking and traveling in order to be an active part of her grandchildren's lives. But the dosing guidelines, combined with state regulations, forced her doctor to reduce her prescription so much that she spends most of every day in severe pain. <br/><br/>Activities she could do several years ago now come at great cost -- pain, exhaustion, frustration and grief -- simply because her doctor has reduced her dosage to miniscule levels compared to what she was taking before. She has never demonstrated any signs of addiction, but her doctor does not feel she has the freedom under the current guidelines to give my mother the dosage she needs. <br/><br/>I heard about the new guidelines on [name redacted] and was filled with hope and joy that my mom might be able to finally get back to her previous dosing levels and enjoy a renewed quality of life. I hope these guidelines will be approved, and that the CDC will give state boards and doctors the training, education and tools they need to implement them safely for the patients they are meant to serve.<br/><br/>Thank you for taking the time to consider my comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heidi	None	None	090000648500a6e5	Hess	None	2022-04-11T18:56:38Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Hess, Heidi	l1u-7rpu-ndyv	False	None	False	2022-04-12 06:41:14.616	[]
4712	CDC-2022-0024-4718	https://api.regulations.gov/v4/comments/CDC-2022-0024-4718	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I used to be stable on a higher dose. I worked a full time job and have for the last 47 years. I have adhesive Arachnoiditis. I had to take medical disability after I was tapered down to a 4th of what abnormally take.. Now no quality of life and mostly Bed ridden. I have had this since I was 12 years old and now in my 60s. 2016 guidelines made my life and pain excruciating. Is there, has to be exceptions for all the chronic pain patients. I am in too much pain now to do any type of physical therapy. I wish I could just wash the dishes. Thank you for listening	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	EM	None	None	090000648500a6e6	BIDART	None	2022-04-11T18:56:59Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from BIDART, EM	l1u-7seo-662w	False	None	False	2022-04-12 06:41:14.841	[]
4713	CDC-2022-0024-4719	https://api.regulations.gov/v4/comments/CDC-2022-0024-4719	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 50MME limit on opioids needs to be eliminated. Doctors will take this suggestion as a hard limit on prescribing opioids. This happened with the 2016 guidelines which suggested a upper limit of 90MME. <br/><br/>There is an incorrect statement(s) that opioids are not effective for chronic pain. This is absurd and not supported by the pain management literature.<br/><br/>The guidelines should be eliminated and a new body consisting of proper experts from all pain related fields should be organized.<br/><br/>The CDC actually has no authority to regulate individual medical practice in the US.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a6ec	Anonymous	None	2022-04-11T18:57:13Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-7u7q-xtcb	False	None	False	2022-04-12 06:41:15.058	[]
4714	CDC-2022-0024-4720	https://api.regulations.gov/v4/comments/CDC-2022-0024-4720	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	50MME must be `removed from the 2022 guidelines, this mention of a number will be viewed as a limit by insurers, law makers from states or even county's. this number will be miss interpreted by any one looking for what appears to be a maximum dose. If this is your intention 50MME is much to low and will harm many patients already be being treated. A reduction of medication can have a negative effect unless it is needed.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Roger	None	None	090000648500a701	Holland	None	2022-04-11T18:57:35Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Holland, Roger	l1u-8dy6-p8cu	False	None	False	2022-04-12 06:41:15.270	[]
4715	CDC-2022-0024-4721	https://api.regulations.gov/v4/comments/CDC-2022-0024-4721	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC,<br/><br/>It's come to my attention that strange things are going on with the comments processing, and any references to [name redacted] are being censored and removed. He's a major author of this guideline and the last, it seems silly to erase commentators' credible concerns about his involvement. <br/><br/>The social media output and comments made by your scientists as of late have given me less confidence to trust your word on your intentions for this draft of the opioids guidelines. I hope I am wrong, but it seems like the organization is playing certain games with the American public. Writing one thing in the description section, such as saying there should be no MME limits on prescribing, and then submitting an MME formula in the notes section indicating the NCIPC does indeed support prescription limits; is duplicitous and wrong.<br/><br/>That is my professional opinion. Here are my personal feelings on the matter.<br/><br/>I am praying that the CDC will be blessed with wisdom and a strong moral compass, that your organization will be able to do the right thing to save the lives of so many abandoned patients like myself. There are now too many like us to count. The strategy to punish patients to stop overprescribing has failed, please move on and save some lives. Please don't punish the innocent for the sins of others.<br/><br/>Sincerely,<br/>[name redacted]<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	peter	None	None	090000648500a70b	pischke	None	2022-04-11T19:00:27Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from pischke, peter	l1u-8nok-ciuc	False	None	False	2022-04-12 06:41:15.487	[]
4716	CDC-2022-0024-4722	https://api.regulations.gov/v4/comments/CDC-2022-0024-4722	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a physician who treats Restless Legs Syndrome (RLS) patients, I support the use of opioids in the treatment of severe RLS refractory to other treatments. Many professional organizations have endorsed the use of opioids for RLS under these circumstances in their standards and practice guidelines including the [name redacted], the [name redacted], the [name redacted], the [name redacted] and the [name redacted]. Based upon a large double blind study, the opioid oxycodone in combination with naloxone is the counterpart of FDA approved for use in refractory RLS throughout most of the countries in Western Europe.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Arthur	None	None	090000648500a713	Walters	None	2022-04-11T19:02:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Walters, Arthur	l1u-8uth-4l4t	False	None	False	2022-04-12 06:41:15.706	[]
4717	CDC-2022-0024-4723	https://api.regulations.gov/v4/comments/CDC-2022-0024-4723	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Being a intractable pain patient for 21 years I've had my life turned upside down with the 2016 cdc opioid prescribing "guidelines".The CDC KNOWS that for many people including myself life has become nothing but torture. Taking a person's life quality away is and always will be torture. The CDC has effectively destroyed not only my life but millions more. Where once I could work, travel, enjoy my life is now filled with agony. The CDC GUIDELINES NEED TO BE ABOLISHED. Illicit phentynal coming across our borders daily yet drs and their pain patients have been targeted by government both state and federal The DEA going after Drs who are trying to do their job. <br/><br/>The pill mill days are long gone we have a national man made disaster of people being tortured cruelly denied medicine that gives us quality of life. We are targeted by the cdc and dea and it must STOP. PLEASE REPEAL THE CDC GUIDELINES	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a71a	Anonymous	None	2022-04-11T19:03:21Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-8zrd-0u5j	False	None	False	2022-04-12 06:41:15.927	[]
4718	CDC-2022-0024-4724	https://api.regulations.gov/v4/comments/CDC-2022-0024-4724	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As has been demonstrated, limiting supply and prescriptions has only caused immense suffering to a population and demographic that had little to do with the illicit drug crisis, while overdoses continue to skyrocket.<br/><br/>The highest number of overdoses are in the youngest population, a population at least prescribed opioids. The population most prescribed opioids has the lowest overdoses. This is because those are under the care of a physician, not illicit street drugs.<br/><br/>Less than 1% is the risk of addiction, with an opioid nave overdose risk of 0.025%. There are no cases of an overdose and non-addicted patients.<br/><br/>Around 3% of overdoses shared in 2016 by the CDC were found to have a legitimate doctors prescription. Leading cause of death is heroin and illicit fentanyl analogues, not medications prescribed by physicians.<br/><br/>Now there’s even more are suffering based not on medical science or patient care. This is not only cruel when there are safe, efficacious medical solutions, but goes against the tenets of medicine. Intractable pain is not simply a physical nuisance but a physiological calamity, increasing risk of multiple complications, shortening lifespan and affecting every bodily system, while simultaneously removing all quality of life and function.<br/><br/>The reason there are limited long research studies (though even these were excluded from the CDC guidelines) is because it is considered inhumane to knowingly not treat a person's severe pain for a prolonged period.<br/><br/>It is also important to note that the lack of longterm evidence for opioids in chronic pain is matched by a lack of evidence for any treatment for chronic pain, also due to problems in conducting studies. Despite this, recommendations based upon the lack of evidence were deemed sufficient evidence for other non-opioid pain management modalities. This goes against scientific analysis.<br/><br/>MME: It should be noted that morphine equivalent calculators don’t account for interacting medications or specific characteristics of an individual, e.g. P450 cytochromes.<br/><br/>Many pain specialists have criticised a one size fits all protocol as it rarely applies to pain patients and has no scientific basis. It is also a guideline intended for use by clinicians evaluating new opioid-naive patients, not those successfully managed on long-term opioid therapy.<br/><br/>I am a full body CRPS intractable pain patient who like millions, have lost all quality of life and function, including the use of both hands, rendered housebound and bedridden disabled as a direct consequence of misapplied CDC guidelines and the flaws therein, which have made life unliveable. This is despite 23 years of CRPS, prior to this being well-managed, without any problems or increases in medication since being titrated. <br/><br/>The only successful co-healing modalities, such as physical therapy, used as part of a integrative pain management program, I already practiced every day but they are not possible without the medication. Centralised pain is Constant and severe.<br/><br/>As evidenced by years of successful opioid therapy under the care of a pain specialist, illicit recreational drug use and addiction has nothing to do with pain care; to conflate to wildly different demographics is to harm both.<br/><br/>The largest problem is that it seems to be based on the theories/opinions of the initial controversial 2016 CDC guidelines, flawed by CDC's own data and admission, and the huge amount of papers and subsequent studies by eminent pain specialists and organizations, even the American medical Association deeming that that methods in the CDC guidelines are dangerously flawed.<br/><br/>Basing new regulations on flawed science that has been conducted with monetary incentive and numerous other political incentives at the expense of patient care will only further profoundly exacerbate the problem, in every direction.<br/><br/>The mistaken belief that the benefits of not taking opioids medication outweigh the risks is harming patients from whom constant intractable pain is a greater risk, with consequences such as cardiac complications as a result of unrelenting severe pain. It also removes productive members of society, rendering them to a life of pain without purpose, solitude and suffering. Please help make this right. Thank you for reading.<br/><br/>I have also read and I wish to endorse the comments of [name redacted] PhD, [name redacted] MD, [name redacted] MD as submitted to the Federal Register. Please help stop this inhumane suffering and patient suicides by allowing pain specialists to practice medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jo	None	None	090000648500a343	Malby	None	2022-04-11T19:04:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Malby, Jo	l1t-wygk-febf	False	None	False	2022-04-12 06:41:16.150	[]
4719	CDC-2022-0024-4725	https://api.regulations.gov/v4/comments/CDC-2022-0024-4725	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for rewriting these and taking comments, however, a reference to 50 mme will still cause patients to be under treated or not treated at all. It will likely cause hesitancy by doctors to write anything over 50 mme.<br/><br/>Many people w/ different conditions have been able to get their lives back at much higher doses. They are not addicts, nor should they be treated as such. And they need doctors willing to carefully titrate their dosage up-not down to an ineffective dosage.<br/><br/>Pain mgmt is not one size fits all and may times takes a mix of different meds. While people are human, what helps one person may be completely different from another regardless of their condition(s). People are complex individuals.<br/><br/>Please remove references to specific conditions not being helped by opioids because whatever studies you referenced do not reflect those who are really being helped by them in real world practice. Perhaps a survey sent to those in the PMP system would better reflect this?<br/><br/>Please remove the commentary about those above age 65 needing less than 50 mme as this is also inaccurate.<br/><br/>Please allow telemedicine visits for established patients.<br/><br/>Please allow early refill of meds (sometimes you are too sick to go out or are snowed in or at the mercy of a hurricane).<br/><br/>Please stop insurance companies and pharmacies from meddling with pill count, number of days allowed, or dosage, under the guise that they are preventing addiction. They are not the treating physician.<br/><br/>Please stop the DEA harassment of doctors. They need to be able to write out the correct prescription with the correctly titrated dosage without fear of going to jail or losing their license.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Judy	None	None	090000648500a728	Gibson-Combs	None	2022-04-11T19:05:11Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Gibson-Combs , Judy	l1u-9bgq-dop3	False	None	False	2022-04-12 06:41:16.368	[]
4720	CDC-2022-0024-4726	https://api.regulations.gov/v4/comments/CDC-2022-0024-4726	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My wife is a chronic pain patient who was doing very well for many years treating her severe pain due to a disease with prescribed opiate medication per pain management after other treatments and medications failed to provide relief. In 2016 when the CDC guidelines were published her prescribing doctor immediately discontinued one of her medications and forced her to taper down on her opiates, which caused her increased pain, less function and reduced quality in her life. I noticed she was experiencing more and more pain, unable to do as much, was becoming depressed and spent more time inside just resting and watching TV. This was unlike her prior self while on adequate opiate therapy which allowed her to garden, shop for antiques, travel to see our children and grandchildren and be quite active. <br/><br/>As time went on, her doctor continued to force unreasonable tapers in regard to her opiate medication despite her greatly increasing pain and we were told he must adhere to the CDC practice guidelines for all opiate prescribing morphine milligram equivalents, which were substantially lower than her established prescription for many, many years. She was now also experiencing issues with our Pharmacy and insurance carrier refusing fills of her prescribed opiate medication and/or making her wait until she was out of medication to get more. When we inquired about this we were told it was in compliance with the CDC guidelines for opiate prescribing. This was worrisome, as she was becoming more and more disabled so I had to take time off work to drive her now twice per month to her pain management appointments which were not really managing her pain anymore and then to the Pharmacy in hopes they would fill without imposed holds and judgements that were very hard on her and often compromising to my employment.<br/><br/>This situation of forced tapers generating her growing pain, depression and disability was extremely concerning, but things got worse when her doctor abruptly discontinued all her medication and discharged her as a patient. His reasoning was, "The CDC practice guidelines for opiate prescribing." I went to that appointment with her and could not believe the CDC would make guidelines doctors must enforce, which actually inflicted pain and compromised health. We were also told the CDC guidelines no longer recommended opiates to treat chronic pain because they didn't work longterm. We were shocked because we knew this was untrue per her past longterm success with opiate pain management. We just could not imagine the CDC would take stable chronic pain patients receiving good pain relief, improved function and increased quality of life via individualized opiate medication doses and destabilize them, to increase their pain, reduce their function and very much limit any quality of life, but that is exactly what the CDC guidelines were doing, harm. <br/><br/>Her soon to be ex-doctor also told us the CDC guidelines were to protect patients and to lessen the overdose and addiction epidemic caused by prescription opiates. This too seemed unreasonable, as the guidelines were doing harm and my wife was proof of such, as we later found out the guidelines harmed many and caused deaths by suicide of pain patients made to suffer from now unmedicated pain. The overdose and addiction epidemic data shows it is not from legal prescription opiates for chronic pain, yet illegal Fentanyl found in street drugs. Apparently my wife and other chronic pain patients are now being made to suffer based on unproven opinions, theories and limits on the opiates they took responsibly that greatly reduced their pain. Why is this allowed to continue? My wife followed all the rules, never had any issue with addiction, took her medication responsibly, used only one doctor and one Pharmacy, doesn't smoke, doesn't drink alcohol, yet she is being labeled an addict or potential addict by the CDC and her medically necessary opiate medication was forcibly reduced then abruptly stopped.<br/><br/>My wife went through a terrible withdrawal and needed to be hospitalized while her pain grew so severe she could no longer care for herself and wanted to die. By a miracle after many doctors refused to even see her because she required opiate pain management therapy above the limits the CDC had imposed in their guidelines we finally found a doctor who will treat her although only at the dose imposed by the CDC guidelines, but at least it buys us some time, as we await necessary changes in the CDC 2022 revision. The CDC must remove limits on opiate doses and choose individual therapy over the present one size fits everyone rule they have imposed. The CDC 2022 revision should also remove time limits imposed on opiate treatment and clarify long term can indeed be effective. We await the CDC 2022 revision in hopes it will correct the prior guidelines which caused harm and death to many innocent chronic pain patients just seeking legitimate relief from suffering.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a729	Anonymous	None	2022-04-11T19:07:16Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-9cis-ejh5	False	None	False	2022-04-12 06:41:16.583	[]
4721	CDC-2022-0024-4727	https://api.regulations.gov/v4/comments/CDC-2022-0024-4727	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am grateful that the CDC has decided to revise the Opiod prescribing guidelines and I pray that it will help reverse the harm done to Chronic Pain Patients like myself however I believe more changes are necessary. For one I propose increasing the list of diseases/conditions that are to be exempt. Currently it includes cancer, sickle cell and palliative care. There are a number of others that should be considered exempt which would allow pain management doctors to treat their patients. One of these is CRPS which I’ve had for 17 years as a result of accidental electrocution. It is listed as 42-46 ( depending on source) and is considered one if not the most painful disease known to modern medicine. It list higher than terminal cancer pain,which is currently exempted from the guidelines. <br/>From a personal perspective I want to firmly state that I wish I never had to take another opiod again but the sad truth is I require them to remain a productive member of society and for any quality of life. Before the accident I wouldn’t even take allergy medication until my wife begged me to. I’ve never tried ANY illegal drug and I was totally against prescription pain medication and tried to cope with dangerous levels of Advil because it wasn’t a “pain pill”. The sad fact for me and thousands of other was I needed something to knock down the non relenting pain. I’ve exhausted all currently know treatments and now along with opioids, other meds, two Spinal Cord Stimulators and a Dorsal Root Gangalion Stimulator have fair pain control. I’ve had hundreds of drug screens done and have never once been flagged for non-compliance. Over the years I’ve voluntarily and I my request have reduced my pain meds to the lowest levels I could manage. I’m the type of patient you hurt with the guidelines. Know all patients on opioids are labeled as drug seekers by many practices and Emergency Departments. I’ve been to the ED once during this due to migraine causes by a spinal fluid leak from a procedure. It took hours to convince them I didn’t want pain meds I wanted treatment for the spinal fluid leak. The stereotype created has dangerously left myself and others unwilling to seek ED treatment even when needed and will cause deaths. I for one I’m tired of the stigma associated with opioids. If the CDC can provide me another solution ( and I’ve tried all that suggested in the guidelines) I will gladly never take another.<br/>Please give long and hard consideration to those like myself who live in horrible, constant pain that just want to get up each, go to work and take care of their family. I don’t take these for a high and can’t understand why someone would. Give doctors back the ability to help us without fear or threat of losing their liscense. The doctor I credit with getting me out of a wheelchair gave up and went into hospice care due to these guidelines as she couldn’t bear watching her patients suffer at the restrictive limits. I know the argument is it wasn’t law just guidelines but many doctors, pharmacies and especially Insurance companies took it as such. I’m now forced to paid for a large portion ($500 a month) of my pain medication out of pocket each month due to my insurance company stating they would not pay above the the 50 Morphine Equivalent siting your guidelines as the justification. Thankfully I’m in a financial position where I can absorb this cost but many aren’t and are suffering due to this. <br/>Please give us law abiding and complaint pain patients back our dignity and better quality of life. I’ll close with this, could you bear to see a love one struggle with intractable pain while taking 90 Morphine Equivalent would you insist the doctors not increase beyond that level of better pain management and quality of life be achieved. If your answer is No then please don’t ask or strongly suggest to doctors that they must for others.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aa3f	Anonymous	None	2022-04-11T19:11:39Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-9mvs-fgpn	False	None	False	2022-04-12 06:41:16.799	[]
4722	CDC-2022-0024-4728	https://api.regulations.gov/v4/comments/CDC-2022-0024-4728	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom it May Concern<br/><br/>I am an 82 year old Vietnam combat veteran. I am writing to you in regards to my daughter. She is only 55 and nearly homebound. Not that long ago she was a vibrant woman but that is gone. She used to be full of smiles, always laughing and would do anything for anyone. Since the rules changed a few years ago her pain mgmt was cut in half. She can no longer work and is permanently disabled. She has had 5 neck surgeries just to mention a few & is fused from the bottom of her skull to in between her shoulder blades. She has 1 of the worst cases of scoliosis I've ever seen. She has broken her illiac crest 2 times and had to have 3 surgeries on that. <br/>I'm asking you to throw out your previous guidlines and give my daughter back her life. I probably won't be in this world much longer but I hope she is. I worry that I'll lose her before then because God knows a person can only take so much pain before they do something to relieve it, permanently. <br/>Again, I'm asking you to remove all of your previous rules and guidlines not only for my daughter but for everyone else's children. You can correct this runaway train wreck that you've caused. <br/><br/>Sincerely <br/>[name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aa41	Anonymous	None	2022-04-11T19:12:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-9p9r-jv49	False	None	False	2022-04-12 06:41:17.029	[]
4723	CDC-2022-0024-4729	https://api.regulations.gov/v4/comments/CDC-2022-0024-4729	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This situation has both affected me personally at great expense to my physical health and ability to live a normal life, and has affected hundreds of patients I worked with through my volunteer work with other rare disease patients like myself after I was forced out of my allied healthcare career and onto SSDI, Medicare, and Medicaid waiver with round-the-clock nursing and aide and residential/family supports. I have seen healthcare intimately from both sides and somehow policy (and “guideline”) makers, hospitals, doctors, the majority have managed not only to not help the opioid crisis AT ALL because of tone deafness or cowardice towards proven measures like clean injection kit distribution, making narcan entirely non-rx and distributing that widely, opening safe use centers, making sure drug testing kits can’t be used by police for paraphernalia charges, etc. <br/><br/>At the same time, you, [name redacted], lawmakers, so so many have contributed to the climate of outright hostility toward people who genuinely need pain medications and other scheduled drugs. [name redacted] in particular has characteristically just piled on red tape and nonsensical rules. Keeping NS flushes out of patient rooms isn’t stopping addicts; it’s keeping squirt guns away from sick children and eye drops from the rest of us. And why are we tracking neuroleptics like they’re meth? It would be so much better to have a tracking system where docs can scan in drug tests, log drug holidays, and other indications that a patient is less likely to abuse controlled substances (returnning unused rxs, wasting unused medicine, showing interest in dose lowering or drug holiday, concurrent use of non pharmacological pain mgmt strategies (TENS), seeing a pain psychologist or attending a pain education seminar/clinic. If a patient has decades of positive history with benzos, ADHD/narcolepsy meds, and opiates, it seems they’re a much lower risk. And high risk people still need humane treatment. You’re not going to tell someone in the burn unit their intractable pain can’t be treated because they’ve had a drug problem. But where is that line? There needs to be specific rules because right now it’s like Russian roulette when you go to the ER or have outpatient surgery (I was offered a Tylenol after a surgery-not a procedure-but a genuine surgery with incision and digging around inside me and stitches)-and I’m on a fentanyl patch so they knew darn well that Tylenol was not appropriate for surgery severity breakthrough pain with my tolerance. But the hospital has a policy of nothing but otc pain meds for outpatient surgery recovery, at least in IR. <br/><br/>Frankly your biggest problem is that many hospitals decided it would be less legal trouble to go out of the outpatient pain care business. And these are highly ranked, university teaching hospitals where the sickest patients with the worst pain have to go for treatment. But I have to go through a completely different hospital system for pain management. I had to get paper copies of my urine tests from pain mgmt, because never an ER doc has actually called them about me. Instead they make assumptuons, accusations, or just say “I don’t do opiates” the moment they walk in the room. I took an hour long ambulance ride while septic and with a subluxated/dislocated hip [Ehlers Danlos Hypermobile] with soft tissue impingement. I wasn’t medicated by the sending hospital, and receiving ER had zero interest until days later inpatient when ortho finally saw me and made recommendations. It ended up I needed a muscle relaxer rather than opiate in that case (I requested “pain medicine” or a local anasthetic or nerve block, not opiates per se), but two separate doctors failed to try a muscle relaxer or consult ortho or PT or sports med more promptly because this “no opiate” mindset has become a “your pain and your suffering isn’t real nor meaningful to me so I see no reason to address or acknowledge it at all.” I have been gaslighted, threatened, harassed, and even physically assaulted by physicians (none of those were only one doctor/one incident). I don’t believe, I KNOW firsthand that you have a much much bigger problem than pain and opiates. An appalling proportion of doctors have no respect for their patients.This is a symptom of that. It’s no wonder so so many patients are disillusioned with healthcare. Which is great for when a pandemic strikes and you need to give public health guidance. We in the rare disease, immune compromised communities got the raw deal there too. Y’all screwed up but we’re the ones that have to die for it. Thanks for opening everything up. Screw this part of the disabled community; we don’t have a right to continue being alive. Not if it infringes on someone’s right not to be inconvenienced by public health measures…when they’re in public spaces. Well, off to continue enjoying the formidable pain of my long covid.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heather	None	None	090000648500aa44	Kramer	None	2022-04-11T19:17:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Kramer, Heather	l1u-9tgv-1zn1	False	None	False	2022-04-12 06:41:17.241	[]
4724	CDC-2022-0024-4730	https://api.regulations.gov/v4/comments/CDC-2022-0024-4730	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm extremely angry at what the CDC has done to chronic pain patients as I am one of them! It has destroyed my life in every way possible. I am a wife & mother My marriage is on the verge of divorce due to my husband having to do EVERYTHING, my relationship with my children has been severely effected. They don't understand why thier mother can't do anything with them anymore! All I do is sit in a recliner, I even have to sleep in the recliner! I'm supposed to be sleeping in a bed with my husband all of which has been taken from me due to your guidelines! I went to the same pharmacy I've gone to for 16yrs. The pharmacy manager was on maternity leave. Whatever pharmacist I got was evil! She refused to fill my meds due to your 90mme recommendation! She called my pain Dr, which I had for the past 7yrs & threatened him with calling the DEA. He immediately tapered my pain medications that I've been on for the past 15yrs, in a month & a half! I was on Fentanyl the minimum taper for the dose I was on & for how many yrs I was on it, was 6 months! It has wreaked havoc on my whole life. I'm on way more medications then I've ever been & my health has depleted since this all happened. It is not healthy to not be able to move at all! Then if a person has depression & anxiety due to what you have done to our lives, it's a red flag. This is beyond inhumane at this point. I was to the point I wanted to commit suicide. Sitting in a chair everyday is no kind of life to live. I don't think the government should have even gotten involved. There is NOT an opioid epidemic, it's called illicit drugs on the streets. Worry about that, not people who were being treated by reputable Dr's, taking FDA approved pain medication, not illicit drugs & were living a normal life, until you ripped our lives away from us. I read the new guidelines & nothing is going to change. The mme's need to be removed COMPLETELY! There is absolutely no scientific evidence regarding mme's. Further more I wasn't on a dose anywhere near 90mme's. 90mme's wouldn't even touch the pain I live with on a daily basis. I also don't think acute & chronic pain should be put in the same catagory. There is no comparison of Acute pain that lasts 7 days or so vs chronic pain that can last a lifetime. Also the new guidlines have several comments about reducing & removing patients from opioids. Nothing about how they can & do benefit people's lives. Also the Pdmp should be abolished! It's a violation of our rights and hippa! I've tried to make appointments with several pain Dr's after the one I was with & because of the PDMP they wouldn't take me on as a patient due to the meds I was on. The missapplication 2016 guidlines and the 2022 guidlines are going to continue to adversely effect patient care! I don't believe in OUD. What evidence is there to support that? Also death associated with long-term opioid therapy, where's there scientific evidence of that? More deaths have occurred since your 2016 guidlines! Also according to the CDC, the proposed guidline is a clinical tool meant "to improve communication between clinicians and patients, empowering them to make more informed, person-centered decisions related to pain care together." This has destroyed Dr & patient care! Dr's go through schooling for a reason! They don't need to be told by anyone how to practice medicine! Then it states, opioids should not be the 1st line therapy for several conditions, which includes dental pain. Has anyone making these decisions ever had to deal with dental pain??? Dental pain is ONE of the most excruciating pains that any person can suffer! When dental pain is that bad it is due to an infection & NO over the counter medication can help relive the pain. The CDC needs to remove all guidlines. After all the havoc you wreaked on people's lives from the 2016 guidlines, will last & be extremely hard to reverse to begin with. There doesn't need to be guidlines regarding opioid prescribing. Then the DEA is mentioned in a small part of the guidlines. Due to your guidlines, the DEA is a HUGE problem with opioid prescribing. They are the ones going into Dr's offices & placing them in jail! If you read what I just wrote, it's absolutely pathetic that Dr's treating & helping their patients to live a normal life are being raided & put in jail! What has happened to this country? The DEA also SHOULD NOT have access to any patient medical information! Why do we even have hippa if the government can do whatever they want, with no penalties. The death rate from drugs has dramatically increased since 2016 & your still worried about FDA approved opioid prescriptions? They are at an all time low. I think it would be a great idea to put all this effort into street drugs & illicit Fentanyl, not FDA approved Fentanyl. Another thing our boarders are basically open, which allows for drug smuggling to get in easier then ever before. The DEA should shift their attention to that, leave Dr's alone!Pls remove guidlines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nichole	None	None	090000648500aa4a	Dubinski	None	2022-04-11T19:20:31Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Dubinski , Nichole	l1u-a58o-8koa	False	None	False	2022-04-12 06:41:17.458	[]
4725	CDC-2022-0024-4731	https://api.regulations.gov/v4/comments/CDC-2022-0024-4731	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please! If I were YOUR family member...or YOU, in severe constant agony, wouldn't you fight for relief??<br/>We; The pain patients need YOUR help!!<br/>Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bram Judy	None	None	090000648500aa4b	Cast	None	2022-04-11T19:20:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Cast, Bram Judy	l1u-a8j0-dqnp	False	None	False	2022-04-12 06:41:17.673	[]
4726	CDC-2022-0024-4732	https://api.regulations.gov/v4/comments/CDC-2022-0024-4732	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Docket No. CDC-2022-0024<br/>1. I was hoping the revisions were going to be fair. Unfortunately, bias is again dominant. I wish I had more time & space to comment but much of what I want to say just won't make it. I implore you to read the following articles that contain everything I would like to say here but can't (esp the 1st one): https://www.frontiersin.org/articles/10.3389/fpain.2021.721357/full and also: https://www.pallimed.org/2021/09/roger-chous-undisclosed-conflicts-of.html.<br/><br/>2. FDA should be writing guidelines, not CDC (if at all). This is only in the FDA's wheelhouse plus they have the knowledge to see through & not allow the bias including most of these "studies" found throughout the approx. 226 pgs. The CDC has been fooled, beginning with the original guidelines & since that time, the number of "studies" done by anti-opioid biased individuals & organizations has exploded & has buried the ones that are legitimate, unbiased & actually peer-reviewed (the majority of the biased studies are done by 9 organizations/individuals that received indirect funding from the CDC Foundation). The FDA also wouldn't allow those who admit a financial COI to play a central role in every aspect of these revised guidelines. You are redacting his name in public comments but I'll name him anyway. [name redacted] & not only is he one of the co-authors of the original guidelines but also is the person responsible for approving/adding to the revised guidelines, despite the fact the CDC said they wouldn't allow the bias or those with a significant COI. We are all aware of the devastation caused by the bias in the 2016 guidelines to doctors, patients, their families and caregivers. The CDC & FDA tried to clarify the guidelines & stop their misapplications, but it was too little, far too late & no one listened. All of those unintended consequences were caused by the propaganda & bias published as scientific evidence in those guidelines. This is why the revised guidelines were needed! Get it right!<br/>3. All 226 pgs (approx), are loaded with that same propaganda & bias! The CDC said the bias & conflict of interest wasn't going to be allowed for the revisions! In the opening statements, telling people/organizations, not to misapply the revised guidelines, isn't going to stop it from happening all over again, nor will it fix the harm already done! The revised guidelines are worse than the original because they are again filled with so much bias, cherry-picked "studies" that are done by those with strong anti-opioid bias! Those "studies" are poorly done, not peer-reviewed and from the same people who caused such destruction in 2016 (plus a few others with the same view on opioids). What happened to only using scientific evidence? This is not scientific or evidence. The work group advised the CDC that the guidelines were too heavily focused on opioid risks with not enough attention to benefits for many pain pts. They were also concerned about the bias throughout the document. Go back & listen to them, then make changes BEFORE these are published!<br/>4. The revised guidelines are now for all prescribers. The CDC nor, anyone else except maybe 1 work group member, has expertise in pain management using opioids so why is the CDC publishing guidelines for anyone who prescribes for pain? It has taken much time to finally get changes made so they need to be RIGHT! PLEASE don't make this situation worse by overstepping the CDC's purview & this includes anyone else making recommendations or writing guidelines - especially when the person given the authority to decide what is & isn't included in the revised guidelines has such a strong anti-opioid bias, financial COI & proved this in the 2016 guidelines!<br/>5. The CDC categorized most OD's as caused by Rx opioids when they were d/t illicit street drugs, poly-drug abuse & esp. illicit Fentanyl, but Rx opioids were blamed & the 2016 guidelines came about. Chronic pain pts aren't overdosing! Credible resources claim the risk of addiction is 0.3-5% yet the guidelines focus on risk of addiction vs relief. In fact this document is all about addicts, not pain pts.<br/>6. MME: While the 90MME recommendation is gone from the 12 here, it's now worse because most of the supporting evidence recommends 30-50MME & pushes 50! This will become the new hard limit unless removed entirely!<br/>7. The revised guidelines must be purged of ALL bias/propaganda/biased "studies". Start over or don't do them at all & rescind the 2016 guidelines! Don't make this worse for those suffering every single day & dying because they can't tolerate living with daily intractable pain. Please press pause on the releasing of these revised guidelines until they can be done the right way and without bias!<br/>8. There is no credible evidence showing anti-anxiety meds or muscle relaxers are dangerous when co-prescribed by a responsible doctor. Even those with seizure disorder have had their seizure meds taken away!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Angela	None	None	090000648500aa4e	Willis RN	None	2022-04-11T19:24:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Willis RN, Angela	l1u-afms-rj2r	False	None	False	2022-04-12 06:41:17.901	[]
4727	CDC-2022-0024-4733	https://api.regulations.gov/v4/comments/CDC-2022-0024-4733	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My daughter has a brain tumor but her medication was tapered regardless of her condition. Physicians are scared to treat legitimate patients! Can’t get a primary Dr. that will actually treat her because of the judgement of her taking pain medication !!! The DOJ making statements about Doctors and many others not taking OUD patients! That’s where the money is…. rehab and suboxone ; that’s why you want to help OUD ppl!! There are too many people that are being harmed by CDC and WHOEVER helped write the 2016 opiate guidelines they have given misinformation and fraudulent research documentation . These guidelines must be removed! HIPAA guidelines are being ignored to honor the Persecution of our physicians.!! I endorse [name redacted] and echo his comments and FACTS. My daughter keeps thinking she is being tortured in her sleep because of her pain. I can’t count the ibuprofen midol Excedrin migraine medication she goes through. I know it’s effecting her liver. Her eyes are bleeding internally her pressure so high and no cure, caused by an IUD . Many women effected…. Ruins their life. The corn syrup In our food that our liver can’t process that’s making us all sick . Cigarettes are killing ppl but you guys chose opiates . Please stop this Madness DONT PUNISH PAIN .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	L	None	None	090000648500aa50	Hillard	None	2022-04-11T19:27:21Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Hillard, L	l1u-aj5y-oupf	False	None	False	2022-04-12 06:41:18.137	[]
4728	CDC-2022-0024-4734	https://api.regulations.gov/v4/comments/CDC-2022-0024-4734	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Suicide rate is at an epidemic high, yet those in chronic pain are pushed off opioids at rates above the CDC guidelines for titration onto medications with known elevated adverse event rate of suicide, such as pregabalin, and this is combined with the suicide risk involved in chronic pain and other long term illness <br/><br/>As the baby boom generation gets older this problem will only increase. Insurance companies actually receive a windfall when patients with chronic health problems commit suicide. Doctors rarely receive discipline for underprescription, for suicide risk increase for patients, or for poor titration. What is the CDC doing to prevent this adverse incentive? It appears to be nothing. I have seen this specifically with Kaiser Permanente which underfunds their pain management department, per their own doctors. <br/><br/>Older people are also highly affected by suicide generally. What consultation has the CDC had with representatives [name redacted] and [name redacted], personally affected by the suicide epidemic? <br/><br/>Thank you, <br/>a concerned citizen who represented the Florida Department of Health Prosecution Services Unit as a Senior Attorney during our initial crackdown on the "pill mills" and who has seen opioid deaths increase under the CDC's guidance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	George	None	None	090000648500a25e	Black	None	2022-04-11T19:35:58Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Black, George	l1t-v32p-cyb8	False	None	False	2022-04-12 06:41:18.350	[]
4729	CDC-2022-0024-4735	https://api.regulations.gov/v4/comments/CDC-2022-0024-4735	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	0900006484ffcd13	None	None	2022-04-11T19:42:34Z	American Academy of Addiction Psychiatry	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from American Academy of Addiction Psychiatry	l1n-z1c3-gpd9	False	None	False	2022-04-12 06:41:18.563	[]
4730	CDC-2022-0024-4736	https://api.regulations.gov/v4/comments/CDC-2022-0024-4736	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	<br/>10.<span style='padding-left: 30px'></span>CDC states that 1 in 5 US adults had chronic pain in 2019, and you admit to (undertreated or untreated) chronic pain “causing poor mental health, reduced quality of life, and contributing to substantial morbidity and disability each year.” You admit on page 7 that “suicide ideation also is common among patients with chronic pain, underscoring the importance of adequately treating and caring for people with pain, but your actual guidelines will likely have the opposite effect, causing undertreatment or non-treatment of pain, patient abandonment, loss of access to pain medications, and use of street drugs, or suicide. How can the guidelines be rewritten to prevent unintended outcomes or patient harms to include under-managed pain?<br/><br/>11.<span style='padding-left: 30px'></span>Page 9 states that “a foundation of trust between patients and clinicians are important”, but these very guidelines undermine that relationship by imposing government ideas on what can and cannot be treated and to what limits and on what terms and for what diseases you believe are worth treating. You then go on to encourage non-pharmacological treatments which many pain patients have already tried had and found them unsuccessful, and many others lack access to some of the recommended alternatives, and we rely on the very medicines you say you want to be controlled by physicians, but your document attempts once again to limit physicians, but to 50 MME rather than 90 MME. How can you rewrite the guidelines to rebuild trust that the 2016 guidelines destroyed, and how do you prevent this guideline from having the safe effect?<br/><br/>12.<span style='padding-left: 30px'></span>Page 9 also states that there is a shortage of pain management specialists. Is the CDC not aware that you caused much of this shortage by driving these specialists to quit, retire, or lose their license? Wouldn’t the better course be to trust pain management experts and not a federal agency? Doesn’t a patient’s own physician have better access to individual patient health information than a federal agency?<br/><br/>13.<span style='padding-left: 30px'></span>Page 10 states there is “very limited evidence to support long term (opioid> 1 year) benefits, with most placebo-controlled trials shorter than 6 weeks in duration”. How many studies have you performed to fill this gap that AHRQ identified in 1996? <br/><br/>14.<span style='padding-left: 30px'></span>Page 10 claims in reference to opioids, that “these medicines carry risks due to their potential for diversion and nonmedical use among individuals to whom they are not prescribed”. The public has witnessed unsubstantiated DEA production quotas, and each time the DEA reduces quotas by double digits, yet consistently describes less than 1% are being diverted. How can CDC help stop these harmful practices of opioid quota reductions by the federal government, all tied back to the 90 MME?<br/><br/>15.<span style='padding-left: 30px'></span>You recommend individualized care and say you want clinicians to make decisions, yet on Page 11 contains you state “opioids increasingly prescribed at higher doses and for longer durations – prescribing patterns associated with opioid use disorder and overdose.” Such statements cause harm to pain patients and danger to physicians who prescribe legitimate patients with severe pain and chronic incurable health conditions and need to be removed. Addiction rates are 0.5% according to most sources and at most 10% per the CDC. Remove this false statement.<br/><br/>16.<span style='padding-left: 30px'></span>Also on page 11, you state “underscored the importance or reducing inappropriate prescribing” yet your April 2019 update stated virtually everyone was misinterpreting the guidelines and causing patient harm. Again, you pressure physicians to keep prescribing low by the force of government “guidelines”, to serve as a weapon against chronic pain patients. Why does CDC want to appear to be making the situation better for pain patients so they can regain lost pain management care, then you make statements like this with great potential to harm?<br/><br/>17.<span style='padding-left: 30px'></span>Page 11 tries to lay the blame for the 2016 guidelines on “input from experts and from the public”. In 2016, the press recorded CDC overdose numbers that were initially 72,000, then 48,000, then finally 17,087 overdoses. The press further documented quality problems with the CDC Wonder database, which further eroded public confidence in overdose numbers given to the public. Why should the public and policy makers trust the CDC to get this guideline right given all the prior deceptions and inaccuracies in your data?<br/><br/>18.<span style='padding-left: 30px'></span>As an example of how you harmed the entire United States, on page 12 you admit how “a central tenet of the 2016 Guideline was the recommendations were voluntary and intended to be flexible to support, not supplant, individualized, patient centered care.” Then on page 13, you state , “in fact, been notably inconsistent with the 2016 CDC guidelines and have gone well beyond its clinical recommendations.” How is CDC going to prevent the same problem recurring with these 2022 guidelines?<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a6da	None	None	2022-04-11T19:48:03Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-7kfj-7vdn	False	None	False	2022-04-12 06:41:18.778	[]
4731	CDC-2022-0024-4737	https://api.regulations.gov/v4/comments/CDC-2022-0024-4737	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments 99 to 109<br/><br/>99.<span style='padding-left: 30px'></span>Page 77 - How does one “minimize unintentionally initiate long term opioid use?” Why not just say never use opioids like you imply over and over again throughout this long guideline? Because the majority of your 226 page document lobbies against opioids as some modern evil, when in fact they have been used successfully to treat pain for thousands of years.<br/><br/>100.<span style='padding-left: 30px'></span>Page 77 - Again statements like this can be interpreted as a ban on use of opioids so why is it included given the harm to patients that the 2016 guideline caused? “Clinicians should maximize use of nonopioid pharmacologic”<br/><br/>101.<span style='padding-left: 30px'></span>Page 77 even suggests a dosage limit and specifies a specific opioid/APAP combination. This needs to be removed “hydrocodone 5 mg/acetaminophen 325mg, one tablet not more frequently than every 4 hours as needed for pain” Why include such a specific medication and dose in this guideline?<br/><br/>102.<span style='padding-left: 30px'></span>Page 77 even implies no one should take opioids long term, yet over 12 million Americans do exactly that and many more need them. Why continue to harm patients with statements like these “opioid taper if opioids will be taken around the clock for more than a few days”?<br/><br/>103.<span style='padding-left: 30px'></span>Page 77 – does the CDC/federal government really need to spell out concurrent medical conditions? “Clinicians should consider concurrent medical conditions, including sleep apnea, pregnancy, renal or hepatic insufficiency, mental health conditions, and substance use disorder, in assessing risks of opioid therapy.” Such statements have been used to force patients to choose either to have their pain treated or have a mental health condition such as anxiety treated, when both are mutually reinforcing and not treating one can cause worsening of that condition. Again you risk harm to patients with more than one condition, and such decisions should be made by the physician, not dictated by a federal agency.<br/><br/>104.<span style='padding-left: 30px'></span>Page 77 – how does checking a database prevent overdoses? Isn’t the clinical judgement of the treating physician superior to any government grading scale, and isn’t each human being valued and deserve individualized care, rendering such grading harmful and wasteful? “check the PDMP database to ensure a new opioid prescription will not contribute to cumulative opioid dosages or medication combinations that put the patient at risk for overdose”. Also doesn’t this violate the intent of HIPPA?<br/><br/>105.<span style='padding-left: 30px'></span>Page 78 - This statement implies that any recovered addict should be denied pain relief. “for opioid use disorder, and should use nonpharmacologic and pharmacologic treatments as appropriate to manage the patient’s pain.” Why label someone for life with OUD and make statements like this which will deny them pain medication, causing many to avoid treatment for OUD in order not to be labeled and then blocked for life from using pain medicines?<br/><br/>106.<span style='padding-left: 30px'></span>Page 78 – More anti-addiction statements that have great potential to harm pain patients “strategies that minimize opioid use should be implemented for both opioid-naïve and opioid tolerant patients with acute pain when possible” and are based on a single study from a foreign country as noted elsewhere in this guideline. Why base an entire guideline on a foreign country’s single study when dozens of other studies of long term use exist and were submitted to AHRQ?<br/><br/>107.<span style='padding-left: 30px'></span>Page 78 - Education is good, but the decision to use opioids and how much and when should be individualized, not regulated as this guideline attempts to covertly accomplish. “Patient education and discussion before starting outpatient opioid therapy are critical so that patient preferences and values can be understood and inform clinical decisions.”<br/><br/>108.<span style='padding-left: 30px'></span>Page 79 - This phrase keeps being repeated almost as if it were a goal that in doing so no one would use opioids to treat patients. “discuss an opioid tapering plan when opioids will be used around the clock for more than a few days”. This is also not helpful to keep repeating: “working toward planned discontinuation of opioid use as soon as feasible”<br/><br/>109.<span style='padding-left: 30px'></span>Page 79 - This statement insults the intelligence of physicians who are much better trained than the CDC in managing pain patients “Limiting opioid use to the minimum needed to manage pain (e.g., taking the opioid only when needed if needed less frequently than every 4 hours and the prescription is written for every 4 hours as needed for pain) can help limit development of tolerance and therefore of withdrawal once opioids are discontinued. “ It is false that opioid therapy leads to tolerance and withdrawal on a majority of patients.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a6fc	None	None	2022-04-11T19:56:15Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-88ok-c2c7	False	None	False	2022-04-12 06:41:19.066	[]
4732	CDC-2022-0024-4738	https://api.regulations.gov/v4/comments/CDC-2022-0024-4738	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To whom it may concern, I am a chronic pain patient with 7 herniated disc surgeries, a hip replacement and several other issues that cause me pain. Since 2016 getting a prescription for my chronic pain was possible, but each and every time has left me feeling like I am the bad guy despite my 15 years of being on a 90mg per day dose and never, overdosing, diverting or miss using my prescription. I am now 5 weeks post op, from yet another herniated disc with pretty decent pain down my leg. I have been told by my primary care physician to call back in 3 months and see here I am. I have been through this. Why do I have to suffer for months? This is now having a huge impact on my quality of life. The surgeons office has a hard and fast rule of nothing after 6 weeks. I can't fathom why this is an issue. I am a 42 yo male that has been gainfully employed and very happy for years. This kind of pain is life changing and definitely life altering (including my ability to make a living) if not treated properly for pain control. <br/><br/>Please have some regular for whon these guidelines effect. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	JEFFREY	None	None	090000648500a34d	FADDIS	None	2022-04-11T19:56:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from FADDIS, JEFFREY	l1t-xg56-e4fa	False	None	False	2022-04-12 06:41:19.306	[]
4733	CDC-2022-0024-4739	https://api.regulations.gov/v4/comments/CDC-2022-0024-4739	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Agency: Cuyahoga County Medical Examiner’s Office <br/>Docket No. CDC-2022-0024 <br/>Non-opioid pharmaceuticals such as SNRI antidepressants, pregabalin/gabapentin (anticonvulsants) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are recommended as an alternative to opioid therapy in the new purposed CDC opioid prescribing policy. However, evidence reviewed highlights that there is a small to moderate improvement in chronic pain and function.1 Anticonvulsants such as gabapentin have a poor documented efficacy in relieving chronic pain, and thus are questionable for long term use. In recent years, gabapentin has been utilized for many off label uses such as acute and chronic musculoskeletal pain, and anxiety without FDA approval.2,3 This has resulted in an increase in gabapentin prescribing nationwide. Within our jurisdiction there has been a ten-fold increase in gabapentin seizures as an illicit drug and in detection of gabapentin in fatal overdoses. Drug seizure data gives a general understanding of the make up of the illicit drug market in the US,4 and the increased presence of gabapentin is an indicator of diversion of prescribed gabapentin. This trend is concerningly similar to that of oxycodone over prescription and the subsequent diversion in the early 2000s. <br/>Most of the fatal overdoses involving gabapentin occurred in association with fentanyl, likely of illicit source. The high prevalence of fentanyl in gabapentin-involved fatal overdoses represents a missed intervention opportunity to identify and discuss a possible opioid dependence with a healthcare provider. It suggests a convenient implementation of a poorly documented pharmacologic intervention instead of exploring non-pharmacological options such as physical therapy, acupuncture etc. If the best available documentation for this approach does not indicate much benefit, maybe anticonvulsants such as gabapentin should be de-emphasized or discouraged, and more support be given to non-pharmacological interventions. This policy shift would be an important one for encouraging funding and research to determine efficacies of non-pharmacological therapies to treat chronic pain, a debilitating condition for many Americans. It would also preclude the potential emergence of long-term deleterious effects which may yet be unrecognized. <br/><br/>References:<br/>1.<span style='padding-left: 30px'></span>CDC Proposed Opioid Prescribing Guidelines 2022, https://www.regulations.gov/document/CDC-2022-0024-0002 <br/>2.<span style='padding-left: 30px'></span>[names redacted]. "Gabapentin for off-label use: evidence-based or cause for concern?." Substance Abuse: Research and Treatment 12 (2018): 1178221818801311.<br/>3.<span style='padding-left: 30px'></span>[names redacted. "Examination of the evidence for off-label use of gabapentin." Journal of Managed Care Pharmacy 9, no. 6 (2003): 559-568.<br/>4.<span style='padding-left: 30px'></span>[names redacted] (2022). Association between law enforcement seizures of illicit drugs and drug overdose deaths involving cocaine and methamphetamine, Ohio, 2014–2019. Drug and alcohol dependence, 232, 109341.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500d62f	None	None	2022-04-11T20:01:17Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Cuyahoga County Medical Examiner's Office	l1v-4zgz-xbm3	False	None	False	2022-04-12 06:41:19.519	[]
4734	CDC-2022-0024-4740	https://api.regulations.gov/v4/comments/CDC-2022-0024-4740	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We live in Bonita Springs, Florida. We are here because no other doctors in the three previous states, where we were attempting to live, wanted to take me on as a new patient. My niece vouched for me and got an appointment with her pain specialist. I have been seeing him for 9 years, since we have been in Florida. [The CDC guidelines had a grave impact on my life.] My doctor has involuntarily reduced my pain dosage by 60%, citing the CDC guidelines as the law. I told him that the 'guidelines' don't apply to "pain management", specifically, but it. didn't matter, as the D.O.J is prosecuting doctors regardless.The D.E.A. is going after doctors based solely on "how many opioids they prescribe". They have no idea what conditions these patients have. The D.E.A. is destroying doctors and patients' lives based on one quantitative assessment only. Suicides have increased 440%. The CDC needs to remove any mention of Morphine Milligram Equivalency.<br/>I have Intractable Pain Syndrome. I have several autoimmune diseases, as well as: scoliosis and degenerative disc disease. I have had 4 spinal surgeries. Currently, I am facing an extremely complicated spinal reconstruction surgery to correct my spinal deformity, then a complete knee replacement. I have medical P.T.S.D.from having both of my shoulders replaced. During my 24 hour stay, the hospitalist withheld my long-term opioid medication, as well as not giving me anything stronger than I.V. Tramedol. My pain was so severe that my blood pressure became elevated to 189/85. I called my pain management doctor and explained what happened. He told me to check myself out, and when I got home, to take my regular prescribed pain medication. This seems to be the state of hospitals and many other medical treatments today. I am not living, only surviving.<br/>Currently, I am terrified, as I am facing two major surgeries; one is a knee replacement, the other is an extremely complicated spinal reconstruction. <br/>Hospitalists and surgeons have stopped treating post-surgical pain. I was shocked to experience and learn that my hospitalist had the power to override the surgeon's orders.<br/>I have lived with chronic pain for over 30 years with ever-increasing pain and disease progression. I don't have any "quality of life". I pray continuously to God, asking him to take my life. My mornings start early, as I can't sleep through the night. My doctor reduced my extended-relief medication to twice daily rather than three-a-day. As soon as my eyes open and I try to roll on my side, the pain is horrible as I scream out while trying to sit upright. The nerve pain is paralyzing. The morning are the worst. Sharp, 'electric' pain shoots down both my legs and hips as I stand. I wake up and feel the dreadful pains. I gasp for breath as the pain is horrible and takes my breath away. I take a deep breath and get out of bed. Then, as I stand up, nerve pain shoots down both of my legs and knees. As I try to walk to the bathroom, the pain increases. Sometimes, the pain is so unbearable to stand, that I crawl to the bathroom. I take my medications and wait for some relief.<br/>We are the real warriors, who fight daily to live with limited pain relief. We know that we will never get our old dosages of opioids back. To have the government punish doctors, pharmaceutical companies, and patients who are in life-altering pain, intensified by the threat of forced tapers or actual, is both unethical and immoral and I believe will be seen as the largest civil rights violation in our history. Please rescind the entire 2016 C.D.C guidelines. <br/>consequences from these "guidelines" are catastrophic. Surgeons are not prescribing post surgery pain medication. Doctors don't want to treat patients who are taking narcotics. In fact, many are outright refusing patients who have intractable pain and take opioids. Chronic pain patients are some of the most venerable people in society. Most don't have any money left after paying copay, hospital bills, surgery, and physical therapy. The courage that it takes to continue living when all you want is to die. We should be treated with compassion, understanding and kindness. Instead, we are treated like criminals, who are subjected to urine tests and pill counts. Please consider the magnitude of suffering that has resulted from the "guidelines" and rescind them immediately. Chronic pain patients lives matter! Sincerely, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sharon	None	None	090000648500d62e	Rose	None	2022-04-11T20:02:22Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Rose, Sharon	l1v-4z75-y7be	False	None	False	2022-04-12 06:41:19.737	[]
4735	CDC-2022-0024-4741	https://api.regulations.gov/v4/comments/CDC-2022-0024-4741	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 78 year old active woman afflicted with severe Restless Leg Syndrome (RLS). My disease prevented sleeping longer that 2 hour segments at best, when I’d need to get up and pace the house, often for hours at a time. I became so sleep deprived that I would be weeping, waken my dear spouse who tried to comfort me. I eventually was unable to sit still in a one hour evening meeting. A couple years ago I received a prescription from the experts at the [healthcare facility name redacted] for methadone, which has helped me tremendously after trying many other prescription options without change. I now take 7.5 mg once daily and sleep soundly most nights. It has greatly improved my quality of life.<br/>Therefore I urge you to consider this therapeutic use of an opioid when writing guidelines and legislation.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Karen	None	None	090000648500d602	Small	None	2022-04-11T20:07:16Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Small, Karen	l1v-4wv0-5xwb	False	None	False	2022-04-12 06:41:19.963	[]
4736	CDC-2022-0024-4742	https://api.regulations.gov/v4/comments/CDC-2022-0024-4742	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a female patient with Chronic pain. I've had problems with my entire back for decades, that have become progressively worse with age. I was able to have access to hydrocodone for pain relief through most of that time, on and off. I eventually needed pain relief on a regular basis, which was possible until laws in Texas changed, and that became impossible. I never asked for anything stronger than that, as I have much to do. I've had no pain relief at all for about a year and a half. As such, my quality of life has spiraled downhill, with pain that restricts me from having any kind of normal life. I've always been an independent person. I presently live alone, and have for over a decade. I own my own place, so there is much work to be done. Yet, I cannot function well at all. I do things very slowly, and having to sit down often. I simply cannot keep up. The hydrocodone helped me more than I realized. Nothing takes all pain away, of course. The drugs they offer me now, being Tramadol or Tylenol #3, simply do not work. As an "alternative" to having pain medication, A doctor has done injections to my lower back twice, and my neck once. Actually, I thought that might help. Yet, that didn't help at all, after going through all that. And, it was difficult for me to get a ride to those appointments, at that. I usually drive myself to the various doctor appointments, and for tests. Anyway, with this particular doctor who did the injections, I suffered greatly with the injections to my neck with NO anesthetic! I don't know what happened there. There was supposed to be some local anesthetic, but there was none, as the very deep injections went into the joints inside my cervical spine! I screamed, & could not believe all that. - - I've had spinal cord surgery - twice in my life, to have a tumor removed from it. That's the thoracic spine, that threatened me with paralysis. I injured my cervical spine when I fell out of a swing backwards as a 10 year old child. I probably injured my lower back when working as a construction laborer in my 30s, trying to support my child on my own. I've had a hard life, with some abuse. All my joints hurt, and I don't know why. I've been to many doctors. My shoulders and knees and hips all hurt as well. My arms & legs have neuropathy, and my wrists have carpal-tunnel syndrome. I am scared of having any more surgery. A surgeon removed my gallbladder, & I've had chronic bile gushing ever since. That surgery was in 2006. It destroyed my digestive system. Nobody warned me about that. I was lied to, and told "everything will be fine." It has been far from "fine." Anyway, I need INDEPENDENCE, especially living alone. I need to function, as everything is up to me here at my place, and in my life. I have no one to depend on, really, and I hate asking anyone for help. Most of my friends and family are dead now, anyway. I am 68 years old. I have one daughter, but she travels with her work, and is simply not around. I think that it is very cruel of laws against opioid use that effect people in chronic pain, or any pain, who need relief. This has caused much misery in my life - more than I can actually describe. I need help, and I need it as soon as possible. I am struggling to survive, which I think is needless suffering. At least I got some help before. Now, I can't even get that. I know I'm not the only one. We need HELP! Quit punishing those of us in great pain, because some people abuse some drugs.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melanie	None	None	090000648500d5e5	Tennison	None	2022-04-11T20:07:43Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Tennison, Melanie	l1v-4v6t-s87t	False	None	False	2022-04-12 06:41:20.176	[]
4737	CDC-2022-0024-4743	https://api.regulations.gov/v4/comments/CDC-2022-0024-4743	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Dear CDC officials-<br/>Thank you for taking public comment on this important topic.<br/>I have had chronic pain for >20 years after being attacked by a rapid onset inflammatory arthritis which over time morphed into fibromyalgia and chronic fatigue as well. When I got sick in 2001, I went from being an active RN, runner and fitness instructor to not being able to peel an orange, open a can or climb the 6 stairs to my bedroom without severe pain. My PCP told me to plan for a life in a wheelchair, but I found 2 concerned and open- minded physicians who treated me and helped me get my life back somewhat and a low dose of hydrocodone helped with that. As my joint pain improved, I developed the achy fatigue and constant sore muscles of fibromyalgia which continues to this day. I was able to transition to tramadol on a daily basis ( before it became a controlled substance), with hydrocodone PRN for really bad days. My Dr trusted me to know when to use each and I so appreciated that he allowed me to make judgements based on my daily needs. I went back to work, started volunteering again and slowly regained some level of fitness routine which helped with the deep depression I felt while incapacitated. Not once did I ever misuse the meds that were prescribed which allowed me to become a productive human again, rather than disabled and in a wheelchair as my PCP had predicted.<br/>Then, my tramadol became a controlled “ opioid” ( don’t get me started on that!) and things started to change. My doctor felt horrible but was under pressure as a prescriber and first he said I had to choose between the tramadol and the prn hydrocodone ( 30 -5 mg tablets lasted me 4-6 months). I couldn’t have prescriptions for both. I chose the tramadol, but things went downhill from there. With no way to treat more severe acute pain when it occurred, my fibromyalgia grew worse. I signed contracts, gave urine samples to show I was taking it and nothing else, and was subjected to frequent refills when previously I had gotten 90 day supplies with refills via mail. My doc was always respectful and sympathetic but felt he was being scrutinized. Then he retired and I had to find a new prescriber. My new PCP was uncomfortable prescribing but held me over until I could find someone, which was very difficult. I wasn’t even taking the full daily dose of tramadol, but I was treated with suspicion and treated as though I was a criminal, with disdain. It was humiliating. I only want to keep being a productive human, but being treated this way was so demoralizing. The new doc made you jump through hoops to get your prescription each month. He would not refill it until the day it ran out, so if it was a weekend or you had to travel on that day you were made to go without until his office got around to filling it. This causes great anxiety and pain and I started having feelings of wanting to die rather than go through this every 30 days. It seemed so cruel.<br/>I put up with the new doc for 1 year. I met with another rheumatologist who refused to prescribe at all. He too made me feel like less than a human. I’m not even on a real opioid!! My fibromyalgia is out of control. I barely have the energy to work and my quality of life is 0. I recently found a compassionate rheumatologist who thinks this is nonsense for a non- opioid. I still have to refill every month but at least he treats me with compassion and respect. <br/>I know people commit suicide daily due to the kind of treatment I received from physicians. <br/>I know this comment period is for true opioids but please consider the damage to those of us taking tramadol. We get heaped in there with those needed oxycodone, morphine, dilaudid and such.<br/>Please, please revise these guidelines so physicians can prescribe as they feel the patient warrants. As a HCP myself I know the devastation of the opioid crisis, but please know how much damage these strict guidelines have done to people like me who take our prescribed meds responsibly.<br/>Thank you for reading my story and please make the necessary changes to keep from inflicting undue suffering by doctors on people who are already suffering greatly. <br/><br/>I do not feel comfortable providing my name as I work on a CDC contract, but I am a real person who just wants to live a healthy, productive life as best I can, with the hand I have been dealt. Doctors are supposed to help us, but “ First, do no harm” has gone out the window under the current guidance.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a34e	Anonymous	None	2022-04-11T20:15:18Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-xh1t-ng2q	False	None	False	2022-04-12 06:41:20.400	[]
4738	CDC-2022-0024-4744	https://api.regulations.gov/v4/comments/CDC-2022-0024-4744	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband is allergic to NSAIDs, has multiple allergies and comorbidities. Because of the CDC guidelines, he is unable to get the opioid treatment he SAFELY used for years. Now, I don't have a husband, my children don't have a father, and he is bed ridden in agony 24/7. Be that as it may, we HAVE NOT turned to the streets to get illegal substances. Real pain patients don't do that. So, why have you ruined all of our lives? I hope this reaches a sensible person, who is authorized by this agency to use their critical thinking skills. If you don't loosen your restrictions or you make them worse, prepare for suicide to go up. Those deaths are on your hands, as our suffering is now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anon	None	None	090000648500d573	Anon	None	2022-04-11T20:18:56Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anon, Anon	l1v-4pcu-gf9q	False	None	False	2022-04-12 06:41:20.615	[]
4739	CDC-2022-0024-4745	https://api.regulations.gov/v4/comments/CDC-2022-0024-4745	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Opiates should be titrated to functional results. Patients can give informed consent and then receive treatment with minimal gatekeeping. Forced tapers should be illegal. My civil rights have been violated thanks to the implementation of the guidelines. MME has to go, people metabolize differently and have different needs for analgesia. These guidelines are going to continue to harm patients who are treated like criminals. I have been denied treatment and am near bedridden as a result. Opiates are safe when used correctly. Pain patients are not the problem.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Candace	None	None	090000648500d560	Mercer	None	2022-04-11T20:19:05Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Mercer, Candace	l1v-4ovb-0md7	False	None	False	2022-04-12 06:41:20.833	[]
4740	CDC-2022-0024-4746	https://api.regulations.gov/v4/comments/CDC-2022-0024-4746	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have personally been impacted by the 2016 Clinical Practice Guideline for Prescribing Opioids. Looking at the 2022 version, I have significant concerns that my ability to access medical care which allows me to control my pain and live a productive life.<br/><br/>I understand the seriousness of substance abuse in the United States, the Guidelines have unfairly targeted providers and patients while actually exacerbating the so-called “Opioid Crisis”. As I’m sure you are aware, deaths due to overdoses has actually increased since the Guidelines were introduced.<br/>While the Guidelines are supposed to be “optional”, my state (Virginia) has actually passed laws and Department of Health regulations based on them. This has caused my pain management provider to close and It is all but impossible to find a provider willing to prescribe effective medication.<br/><br/>Due to lack of proper care, it is all but impossible for me to sit for an extended period of time and subsequently I have had to turn down several employment opportunities that require me to be on-site. I do not wish to be forced to request disability benefits should remote work no longer be available in the future! In any case, my profession career has been impacted and my quality of life deteriorated.<br/>The specific and most important points I would like to address in the 2022 version are the following:<br/><br/>1.<span style='padding-left: 30px'></span>Remove the Morphine Milligram Equivalents (MME) from the guideline all together. The 90 MME limit from the 2016 guidelines, while purportedly a “recommendation” has been taken as a hard limit in many regulations just as the 60 MME will considered gospel in spite of the mitigating language in the rest of the document.<br/><br/>2.<span style='padding-left: 30px'></span>Remove the limit of “a few days” or “7 days” from anywhere in the text. Again, legislators and state medical boards have been codifying these arbitrary numbers into laws, regulations and provider mandatory training.<br/><br/>I would also like to ask the commission to take a hard look at the organizations and professionals contributing to both versions of the guidelines and review the motivations for requesting the initial and current restrictions. I would like the CDC to ask is these groups are genuinely motivated by public health or are in any way profiting from reduced opioid prescribing and targeting of legitimate providers.<br/>Specifically, I feel that groups or individuals that have participated as paid “expert witnesses” in lawsuits against opioid manufacturers, those associated with alternative invasive therapy firms/providers and those who might stand to profit by patients referred to the mental health system as a result of chronic pain. While such activities are legal and should not automatically preclude participation in the discussion, blatant conflicts of interest should certainly be taken into account and reviewed.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d4ff	Anonymous	None	2022-04-11T20:19:53Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-4k27-d56a	False	None	False	2022-04-12 06:41:21.059	[]
4741	CDC-2022-0024-4747	https://api.regulations.gov/v4/comments/CDC-2022-0024-4747	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See Attached	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Richard	None	None	090000648500cfcd	Wood	None	2022-04-11T20:20:08Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Richard J. Wood	l1v-5nfe-gozd	False	None	False	2022-04-12 06:41:21.287	[]
4742	CDC-2022-0024-4748	https://api.regulations.gov/v4/comments/CDC-2022-0024-4748	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been on pain medication for over 20 years after having multiple surgeries , physical therapy , acupuncture treatments , herbs in multitude , tens units , and I have bought so many different types of so called "miracle gadgets to help pain " , none of which worked ! Years of trying everything , until I was told I could no longer have surgery because my dieing bones could no longer hold implants ! At that time I was told agressive pain management was my only hope . I went to a pain management doctor who tried me on so many medications until he found what worked enough to give me some assemblance of a life back . I was finally able to do things again , take trips do house work ,go swimming in our pool . I had a life I was able to be with my family and friends and laugh , just feeling alive in what time I had . Until the CDC 2016 guidelines came out and my medication started being cut !? And not being told why or what else could replace what was being taken away . My life start getting worse and now because of the CDC guidelines and the false statements on mme's I have had one of my medications just stopped cold and it caused me terrible illness , my other medications I've been force tapered off almost every one that gave me a life I could live with , now all I can do is lay on the couch and do nothing but keep off my legs I'm unable to travel unable to drive , unable to shop for groceries, <br/>my family and friends no longer visit because I'm always in pain , some days it's all I can do to get out of bed because my pain is so severe throughout my entire body I lay and cry praying God will take me soon!!! My husband is my advocate who drives me to all my doctor appointments and lab appointments and all the surgeries I had to have he took me and stayed with me ! Some of which I'm still going through for my breast cancer reconstruction repairs ! The CDC has taken my life and my husband's life away from us with the unjustified inhumane treatment I have received because of the 2016 guidelines and their 2022 supposedly changing will continue to cause the same treatment to all chronic pain sufferers like myself . If the CDC and the DEA don't take out ALL mention of mme's in any reference anywhere nothing will change ! Also stop telling doctors how to prescribe to patients they no nothing about most importantly with mme's that there are no truth in the morphine measurement, as they have admitted . Please drop your guidelines or at least the remarks you have put throughout your underlying commits about mme's.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary	None	None	090000648500d4e1	Goddard	None	2022-04-11T20:20:10Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Goddard, Mary	l1v-4ijm-ark3	False	None	False	2022-04-12 06:41:21.509	[]
4743	CDC-2022-0024-4749	https://api.regulations.gov/v4/comments/CDC-2022-0024-4749	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	M.	None	None	090000648500a947	Dunning	None	2022-04-11T20:21:01Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Dunning, M.	l1u-2zef-w7w7	False	None	False	2022-04-12 06:41:21.746	[]
4744	CDC-2022-0024-4750	https://api.regulations.gov/v4/comments/CDC-2022-0024-4750	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am mother of a 50-year-old son who has been disabled and has severe rhematoid arthritis, osteoarthritis of both his knees, and was able to work until his medicine was cut from 300 MME to 90 MME in 2017. His doctor said everyone in his clinic was being cut to 90 MME because the clinic was not taking the risk of a DEA raid after hearing of doctors losing their medical licenses. You turned a high paid manufacturing engineering manager who paid a lot of taxes into someone who has been getting disability and Medicare. He wants to return to work but he cannot due to the level of pain he is in and inability to get the medicine he needs. He has been to at least 50 different doctors trying to get medicine in three different states and everywhere its the same story - 90 MME. In fact, he has been warned his clinic will be soon cutting everyone 50 50 MME due to this new CDC "guideline". How many people have you caused to go onto disability and what is the net cost in lost taxes being paid and disability and Medicare payments being sent out? <br/><br/>As I understand it, overdoses have never been driven by patients taking their own medicines, but came from illegal street drugs taken to get high or from stolen medications taken with multiple substances such as alcohol and xanax. Has these guideilnes reduced the number of overdoses in the United States? I think the answer is NO. If so, why expand upon your mistake and make things even worse by lowering the suggested level to 50 MME? You are costing taxpayers a fortune, causing people to suffer in agony. I need a hip replacement but I am unwilling to go through with surgery given the current state of pain management, and half of my Sunday school class is in the same boat as me. We need surgery but thanks to the CDC we cannot be sure we'll have humane post op pain care.<br/><br/>You need to stop trying to practice medicine and let doctors make their decisions. Do they go through 4 years of college, 4 years of medical school, and years of residency only to be told by a federal agency that they cannot prescribe over some made up limit?<br/><br/>You should all be ashamed of the damage you have caused.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d47c	Anonymous	None	2022-04-11T20:23:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-4f29-pdgk	False	None	False	2022-04-12 06:41:21.960	[]
4745	CDC-2022-0024-4751	https://api.regulations.gov/v4/comments/CDC-2022-0024-4751	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m so frustrated today. We need to keep the guidelines In order to control and regulate the number of opioids brought into homes and in the hands of teenagers!! Is the CDC forgetting how the epidemic started? The numbers of prescription drug overdose deaths decreased ( although still high ) but at least the prescribed opioid deaths haven’t increased since the guidelines took place. I understand people with severe pain need help. There are non additive alternatives. It’s not too late if you feel the same as I do, please write in your comment today! We can’t let this happen!! There will be more opioid related deaths, heroin deaths and Fentanyl deaths.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d475	Anonymous	None	2022-04-11T20:24:13Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-41x9-8i5k	False	None	False	2022-04-12 06:41:22.173	[]
4746	CDC-2022-0024-4752	https://api.regulations.gov/v4/comments/CDC-2022-0024-4752	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC must incorporate the current literature, and the Best Practices 2019 recommendations requested by OWG, AAFP, AMA, and Academic and Private practice Pain doctors.<br/> <br/>Adopt well-researched interventional pain guidelines – Evidence-based pain interventional therapies can and must play a larger role in effective pain management and efforts to reduce opioid related harms. A thorough data analysis will demonstrate robust clinical evidence supporting interventional therapies ability to reduce pain, improve function and reduce oral medications. Even for neuropathic pain, the NNTs for non-opioid pharmacotherapies are poor, and they are being forced upon patients with mixed/nociceptive pain ((e.g. chronic neck and LBP). This is consistent with the field of Interventional cardiology that offers both diagnostic and therapeutic options to optimize outcomes. The AAFP believes that the Strong recommendations in the CDC guidelines were not based on clinical evidence. Opioid Prescribing (aafp.org). (We need to collate and categorize this and submit with the letter, as there has been significant progress in the field in the last 6 years, much of which is not cited in the proposed 2022 CDC Guidelines). <br/> <br/>Expand CDC educational materials for non-opioid treatments – Updated patient and clinician resources are necessary to improve AWARENESS of FDA approved non opioid options. Even CBT can be offered virtually now. The patients and the treating primary providers are not aware of the full complement of diagnostic and therapeutic options in managing pain. If the guidelines were to be adopted as written, most patients will try non opioid and non-invasive therapies (medications, complementary medication, physiotherapy etc. ) and then transition to opioids for their neck and LBP, having never really known the true source of their pain, let alone be offered all the options. <br/> <br/>Encourage earlier patient referrals to pain specialists – Currently, specialists are often not involved early enough in DIAGNOSING and TREATING pain syndromes, which can lead to suboptimal patient outcomes. The Case for Early Interventional Pain Management (practicalpainmanagement.com). The progress in our literature now justifies moving IPM therapies higher up (earlier) in the treatment algorithm, as was pointed out by [name redacted] et al and the HHS Best practices report. <br/> <br/>Include HHS Pain Management Best Practices Inter-Agency Task Force recommendations from May 2019, particularly section 2.4 Interventional Procedures in CDC guidelines –which recommends early referrals of Chronic pain patients for Comprehensive Pain Management evaluation with a physician versed in the diagnostic and therapeutic interventional armamentarium. <br/> <br/> <br/> <br/>Simultaneously, our patients whose pain and function has improved IPM must voice their opinions directly to the CDC. 1000s of positive stories bubble up both in the media simultaneously, and they should write their congressional members. Share the link where they can comment: Federal Register :: Proposed 2022 CDC Clinical Practice Guideline for Prescribing Opioids<br/> <br/> <br/> <br/>State Medical Boards have enacted the original 2016 CDC guidelines, making what was a voluntary guideline meant for the primary guideline in to a mandatory standards for ALL physicians. Now the proposed CDC 2022 guidelines are applicable to ALL Outpatients care of chronic non cancer pain (with few exceptions). The States should revise its stance and be more inclusive of the DIAGNOSTIOC and THERAPEUTIC IPM options. Otherwise, the vast majority of Chronic high impact pain patients will continue to suffer with or with out opioids. CME that includes IPM would also help define the full range of options.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Katherine	None	None	090000648500a350	Travnicek MD, FIPP	None	2022-04-11T20:24:40Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Travnicek MD, FIPP, Katherine	l1t-xhmk-i3a3	False	None	False	2022-04-12 06:41:22.386	[]
4747	CDC-2022-0024-4753	https://api.regulations.gov/v4/comments/CDC-2022-0024-4753	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been responsibly using prescribed opioids under the advice of doctors for ten years. I need them for chronic pain. I have never abused them. Please don't punish people like me.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a359	Anonymous	None	2022-04-11T20:25:02Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-xkyw-j589	False	None	False	2022-04-12 06:41:22.606	[]
4748	CDC-2022-0024-4754	https://api.regulations.gov/v4/comments/CDC-2022-0024-4754	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a caregiver for a CRPS patient I have witnessed a great deteriation in their condition with the pressure of ill considered reduction in medication without any benefit, Little alternative working therapy and medication being unavailable. Options are the only lifeline to a iimited functionality due to the biased administration of these useful medications. I believe any reduction in the availability of the necessary medication will result in torturous existence of constant pain, when the present relief is already available.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a35b	Anonymous	None	2022-04-11T20:25:40Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-xncf-6h1m	False	None	False	2022-04-12 06:41:22.820	[]
4749	CDC-2022-0024-4755	https://api.regulations.gov/v4/comments/CDC-2022-0024-4755	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I'm writing today to address the changes being proposed to the prescribing of opioid medication to manage chronic pain. I am a chronic pain patient of over 10 years. The strict restrictions on certain pain relief has left me in a cycle of very little life enjoyment. Im unable to take care of my home or participate in life events. My pain is sometimes unbearable. I understand the need for regulation but we have to keep in mind that many people won't be able to live fulfilling lives without the help of opioid pain control. I know its very hard to imagine daily pain if you are not a pain patient but for many of us it is a reality that has real effects on our lives and the people in our lives. Proper use does not equal abuse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d41e	Anonymous	None	2022-04-11T20:27:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-4anz-5bad	False	None	False	2022-04-12 06:41:23.033	[]
4750	CDC-2022-0024-4756	https://api.regulations.gov/v4/comments/CDC-2022-0024-4756	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Stay away from people who really need these pain meds like people with Multiple Sclerosis for example. If someone has a legitimate need for pain medication please give it to them. Do not hold them to the same standards as someone who doesn’t have a chronic disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Deborah	None	None	090000648500d3f8	Trent	None	2022-04-11T20:27:44Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Trent, Deborah	l1v-49e5-a1a5	False	None	False	2022-04-12 06:41:23.623	[]
4751	CDC-2022-0024-4757	https://api.regulations.gov/v4/comments/CDC-2022-0024-4757	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I understand why the changes to opioid prescription prescribing were originally made in light of the opioid epidemic. They had been prescribed too freely for too long. But when they were changed we over corrected, we made it too hard for legitimate pain patients to get there medication to horrific affect for many of us. These days your regulations are doing more to harm patients than protect them as most use is of illicit drugs by people who weren’t prescribed incorrectly. Meanwhile we suffer and struggle to find doctors willing to take us on. Abiding by the regulations become even more difficult when drug shortages and supply chain issues become a large problem. Please find a middle ground.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jacquelyn	None	None	090000648500d3e3	Dropek	None	2022-04-11T20:27:53Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Dropek , Jacquelyn	l1v-47m5-gced	False	None	False	2022-04-12 06:41:23.836	[]
4752	CDC-2022-0024-4758	https://api.regulations.gov/v4/comments/CDC-2022-0024-4758	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am submitting my statement as an appeal to this disastrous, unjustified proposal, because it goes too far! The 2016 guidelines have literally wrecked my life and the lives of hundreds of thousands of people who are stuck with lifelong, debilitating pain from so many different conditions that are no fault of our own. Most of us are in dire need of opiates, just to maintain some semblance of a quality of life that enables us to practice self care and activities of daily living. Mankind has been using “milk of the poppy” for thousands of years and it is often, a life bringer. But your panel of “addiction specialists” has declared prohibition on this most necessary medication. You pseudo experts are here to get rich by making a name for themselves and you repeatedly cite the same unscientific studies over and over throughout your document. There is no real science behind the arbitrary measure of MMEs, which are opinion based, and not formulated by pain management experts. You simply must eliminate any mention of MME thresholds from this fatally flawed exercise! 90 MMEs were bad enough, but now you’re suggesting 50 MMEs as a one size fits all approach. And you know quite well, that many states enacted 90 MMEs into law, hamstringing doctors and patients around the country. This is flawed science, and I dare say that the CDC is outside of it’s element here. Then, bringing the DEA into clinics for the sole purpose of intimidating and threatening Doctors, is scandalous. Proven scientific evidence shows that most chronic pain patients, especially, older and elderly, are at very low statistical risk of developing an Opioid Use Disorder, because WE are so desperate for relief and conscientious, that we would not dare to overuse or otherwise jeopardize that vital lifeline! If the DEA focused it’s efforts on the cartels and the smuggling of illicit drugs into this country, we would have a better grip on the opiate crisis, but they’re focusing on soft targets, and so many people have completely lost their access to essential pain management, many committing suicide, in the tens of thousands. And the concurrent use of these hard thresholds are now impacting people who are having major surgeries, including radical orthopedic surgeries, and being denied treatment for acute post operative pain care, which is barbaric and a FIRST for Medicine, entirely. At my age of 65, I have a need for a knee replacement and cervical spine surgery, but after the past 13 years following my failed Lumbar Spinal Laminectomy and Fusion, I have decided that the current surgical management of post operative pain is absolutely not worth the risk and horrors of not being treated appropriately. I will take my grinding knee to my grave because it’s not worth the risk of unnecessary suffering. I can only hope that God brings me home within the next decade, and when I ask myself if I can live with my chronic pain for 10 more years, I don’t have an answer to that. I would rather not live in this vacuous hell hole that I’m living in now, for 10 more years! But I am convicted Christian and I still have enough fight in me to get up every morning and put one foot in front of the other. But you know, as well as I do, that the 50 MME threshold will be interpreted as hard law, which would devastate my life beyond measure. There is also an unnecessary trend in restricting cancer patients from the compassionate end of life care that they so deserve. This also frightens me. Pain management must be individualized, patient centered care and NOT measured against arbitrary formulae that were created by people, beyond their expertise. If you do not throw out these new guidelines and start over, with new, qualified experts and go back to the drawing board, you will be doing humanity a very grave injustice. I personally implore you to reconsider this egregious injustice and begin again, and choose your experts wisely. Our very lives are dependent on that. Thank you for considering my testament.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Thomasina	None	None	090000648500d39a	Ferguson	None	2022-04-11T20:28:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Ferguson, Thomasina	l1v-43ob-36l6	False	None	False	2022-04-12 06:41:24.051	[]
4753	CDC-2022-0024-4759	https://api.regulations.gov/v4/comments/CDC-2022-0024-4759	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I became disabled after enduring 5 spinal surgeries, ending with Failed Back Syndrome. I sought out a specialist clinic for my debilitating chronic pain. At the clinic, I received psychiatric treatment, physical therapy, and opioid pain medicine. I was able to perform the Activities of Daily Living and function as best I could given the situation. When the new CDC Guidelines were published in 2016, my insurance company immediately began reducing the care I received from the pain specialist, and demanded I reduce or completely stop taking opioid medicine, citing the CDC guidelines as hard and fast rules that permitted the insurance company from providing the care that helped me function as best I could. After being forced to drastically reduce my medication, my ADL's became more and more of a challenge. I am now completely home bound, and unable to work, travel, shop, enjoy hobbies, etc. The insurance company continues to harass and bully me into stopping all medication, without providing any other options or alternatives. My doctors, nurses, and other healthcare professionals continue to vote the CDC Guidelines as a restraint to providing the care that will allow me to rejoin society and enjoy life again. My insurance company should not be dictating the care I receive. The CDC should not be used as a justification to deny care. <br/>The other issue that is pervasive is the lumping together of professionally managed pain specialist patients and those on heroin and other illicit opioid abusers. The patient that receives care from a specialist undergoes rigorous oversight and control, which leads to positive outcomes in majority of cases. The abuser that uses unprescribed medicine, and/or street drugs, constitutes the vast majority of overdoses and deaths. The two groups cannot be equated.<br/>Thank you so much for revisiting the guidelines. It will make the world a better place.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d377	Anonymous	None	2022-04-11T20:28:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-41y3-ap7v	False	None	False	2022-04-12 06:41:24.267	[]
4754	CDC-2022-0024-4760	https://api.regulations.gov/v4/comments/CDC-2022-0024-4760	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	LISTEN!! PLEASE LISTEN!! I'm a 61 year old, God-fearing, honest working citizen and I'm ashamed to say that I've been out on the streets trying to find pain medicine. There aren't any!!! You can find cocaine, heroin, meth, but NO OPIOIDS!!! You should read up on how people are getting addicted to other more serious, harmful substances because they are in PAIN!! I know of some elderly people who order pain meds from other countries. So many are bedridden because of tremendous pain and can't live their lives. What kind of life is that?? Human beings should NOT have to endure such lunacy!!<br/>Unless you've experienced how ludicrous the laws are concerning pain management, you cannot possibly comprehend the ordeal people in pain have to go through in order to get a little relief. You go to your primary care doctor and, of course, he can't help, says to go to your specialist. The specialist says to go to your primary care doctor or a pain clinic. Go to a pain clinic, they won't help, says to go to your specialist. Round and round it goes. The pain is so immense to the point you're throwing up, so off to the emergency room. Six hours later, you finally see a doctor. They only give you enough for 3 days and says to contact your primary care. REALLY??!! Yes, I've thought of suicide along with 33% of the people who kill themselves due to PAIN!!! <br/>I recently encountered a retired congressman, who was instrumental in passing the 2016 CDC CP Guidelines. Then when he had knee surgery, guess what? Yes, it happened to him. He was in extreme pain and could not get any assistance whatsoever. He truly regrets voting for the 2016 CDC CP guidelines. Please, I'm begging, make the change!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Melody	None	None	090000648500d36d	Grant	None	2022-04-11T20:29:03Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Grant, Melody	l1v-41hl-g5o1	False	None	False	2022-04-12 06:41:24.487	[]
4755	CDC-2022-0024-4761	https://api.regulations.gov/v4/comments/CDC-2022-0024-4761	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My pain has been successfully managed by my pain specialist for over a decade with opioid therapy and an integrated pain management program facilitated by that opioid therapy.<br/><br/>With the medication levels he prescribed I am able to function and be productive. Without the medication I suffer severe pain that is incapacitating, and leaves me bedridden and unable to care for myself. I can I have longer work, care for myself much less loved ones, function is so profoundly affected it becomes a worsening loop, requiring more medical care, more support, caregiving when possible (or simply going without that care, productivity, purpose, life).<br/><br/>I cannot see the value in living a life that is so completely filled with pain that the experience of pain overwhelms my ability to function or even to think about anything other than seeking respite from the intense pain I experience without sufficient opioid medication.<br/><br/>I am a full body CRPS intractable pain patient who like millions of others have lost all quality of life and function, including the use of both hands, rendered housebound and bedridden disabled as a direct consequence of misapplied CDC guidelines, which have made life unlivable. This is despite 23 years of CRPS, being well-managed, without any problems or increases in medication since being titrated (after 8 years bedridden as I was determined to avoid medication and it was asked all alternative methods for the first eight years of disease).<br/><br/>The largest problem with this is that it seems to be based on the theories of the controversial CDC guidelines, flawed by CDC's own data and admission, and the huge amount of papers and subsequent studies by eminent pain specialists and organizations, even the American medical Association deeming that that methods in the CDC guidelines are dangerously flawed.<br/><br/>Basing new regulations CDC guidelines, dangerously replicated here, on cherry-picked science at the expense of patient care will only further profoundly exacerbate the problem, in every direction, harming both harming both patients and the drug addicts the CDC claims to want to help.<br/><br/>As has been demonstrated, limiting supply and prescriptions has only caused immense suffering to a population and demographic that had little to do with the addiction problem and illicit drug crisis.<br/><br/>Overdoses continue to skyrocket as it is not the same demographic.<br/><br/>The proposed changes also assume that the 2016 CDC guidelines on opioid prescribing are a correct basis for pain management practice—they aren't.<br/><br/>The other unplanned consequence is that chronic pain patients are committing suicide. Being in pain with no hope of it getting any better is dibilitating and depressing. One can only take so much of that before all hope is lost. the CDC guidelines are in essence causing indirect deaths. Please modify those guidelines so that doctors can accurately treat pain and not be afraid to care for patients.<br/><br/>Please consider the science (outside of the cherry picked influence of PROP), please let doctors do their jobs, please stop punishing legitimate patients and torturing them with these guidelines. Please, stop DEA scaring doctors into not practicing their profession and treating their patients based on individual needs, because one size (dosage/treatment) does NOT fit all. While there are people that do abuse opioids, majority of them are NOT pain patients.<br/><br/>Additionally, no one wants to take medication every day to function, but when it becomes the only option to function, it’s that or pain and not living. heartbreakingly, the latter is what guidelines are forcing millions of pain patients into, removing that choice. Thank you for reading.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a379	Anonymous	None	2022-04-11T20:29:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-xuw1-0rn7	False	None	False	2022-04-12 06:41:24.712	[]
4756	CDC-2022-0024-4762	https://api.regulations.gov/v4/comments/CDC-2022-0024-4762	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a chronic pain patient. Have been for 20 years. I am still able to get the medication I need. My issue is that all this is because of illicit fentanyl. The opiate crisis was a lie from the start. This crisis started from addicts getting street drugs and overdosing. This crisis is not from a doctor prescribing a pain pill to a patient who really needs it to function in life. I need this medication to be able to work and not have to file for disability. It allows me to enjoy time with my friends and family. My medication allows me to play with my 4yr old grandson. Without my pain medication I will not have the same quality of life. This crisis was not because of cpp taking their prescribed meds. Prescribed Opiates do work long term. I am on almost the same dose as when I started back in 2000. I personally know 6 people who have a prescription for pain medication and none of them abuse it. They are also responsible and do not let anyone else access it.. When your in chronic pain you just want to be out of pain and have a good productive day. So many people are forced to take injections that don't help or gabepentin with its many horrible side effects.. and bupe just rots people's teeth out. I have been force by law and insurance to use a long acting opiate that must be taken with a high fat meal. It has raised my cholesterol and I have gained weight on it. It is also very expensive. But I never had an issue with the medication I was previously on. CPP have all been treated like lying drug addicts who can not control our actions. We also are being restricted to certain mme thresholds. Every person is different and every person should be treated individually. Under treated pain is just as bad as not treating pain. CPPS may be dependant on our medication but this does not mean we are worthless addicts. The treatment options we had before were affordable generics that many are no longer accessible for us. Just please give us and our doctors back control over our Healthcare and what works best for us. We don't need narcan, we don't as cpps need bupe. We just want our quality of life back.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pam	None	None	090000648500a388	Stephens	None	2022-04-11T20:31:51Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Stephens, Pam	l1t-y0rp-r7ps	False	None	False	2022-04-12 06:41:24.926	[]
4757	CDC-2022-0024-4763	https://api.regulations.gov/v4/comments/CDC-2022-0024-4763	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	This proposed revision to the 2016 Guidelines does a lot to fix all of the unforeseen consequences regarding concerns with “overprescribing” opioids. However, it does not go far enough. Attempting to prevent addiction is a noble endeavor. However, continuing to focus only on addiction and nothing else is leading to more problems than before. There should be an equal focus on benefits and risks of NOT being prescribed these critical medications. Even the Americans with Disabilities Act addresses the importance of pain management and providing everyone that is suffering from a medical affliction a Quality of Life. Continuing to concentrate on one possibility will continue to contribute to patient suffering, failure to heal and function properly and losing their ability to live their life with as much quality as possible. <br/>There are a couple of ways that would help provide better lives to anyone that is in need of these critical medications. Eliminating MME limits and placing the focus on promoting education and improving rehabilitation services should be the focus on approving Addiction and Mental Health issues as a whole. <br/>All mentions of MME limits are continuing to further the problem that these Guidelines are attempting to fix from the consequences of the 2016 Guidelines. MMEs are arbitrary numbers and focusing on a particular MME as a measure for safety will continue to prevent appropriate pain management. Additionally, absorption and metabolism vary greatly in individuals making these limits even more arbitrary. Limits placed on prescribing is now in all inpatient settings – including the ER and ICU - and all outpatient settings, regardless of how serious the diagnosis. Continuing to mention any MME limits in these guidelines will continue to result in: patients not healing properly, with many acute issues turning into chronic ones; patients being prescribed other medications that have a plethora of horrible side effects - while not providing pain relief, patients self-medicating, patients finding alternatives outside of the medical system and patients committing suicide. <br/>Also, these MME limits are continuously being weaponized against medical professionals by law enforcement and regulatory agencies. Medical providers are being intimidated and threatened, and as a result, are refusing to prescribe anything at any dose because of this. Too many patients are being abandoned, dismissed and mistreated. Unfortunately, this is leading to many becoming desperate enough to go to the streets and obtain un-regulated and increasingly dangerous drugs, leading to more overdoses and deaths. Also, way too many patients are giving up and committing suicide. The benefits of being on these safe and regulated opioids greatly outweigh any risks from not being prescribed these critical medications. <br/>Limiting or refusing to provide pain control even to someone that is at high-risk for addiction is not helping either. By not providing adequate – or any - pain control that is well-regulated and from a safe supply will most likely lead that individual to immediately self-medicate and obtain relief through illicit means. <br/>Providing more education to medical providers and patients alike will yield better outcomes than any prohibitive measure ever could. Providing more education and resources for rehabilitation services will also yield better results. Especially now that this country is facing an illicit Fentanyl crisis that is more dangerous than anything experienced before. The medical community must come together and start treating patients like patients again and try to prevent as much suffering as possible. NO more blanket policies for a field where individualized treatment is the focus.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Victoria	None	None	090000648500d473	Romano	None	2022-04-11T20:37:09Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Romano, Victoria	l1v-4eov-162z	False	None	False	2022-04-12 06:41:25.145	[]
4758	CDC-2022-0024-4764	https://api.regulations.gov/v4/comments/CDC-2022-0024-4764	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a patient with long term chronic pain issues your guidelines will influence my life intensely. I have 5 fully functioning discs in my spine, bone on bone cartilage free knees, rheumatoid arthritis and osteoarthritis in more joints than I want to list. I’m elderly, I don’t drink or do illegal drugs. I do depend on pain medication to be able to function at all. What little quality of life I possess is due to opiates. Please do not terrify doctors into not being able to write prescriptions for fear of losing their licenses. Do not make my remaining years be years of misery. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mary P	None	None	090000648500aa5a	Simons	None	2022-04-11T20:37:55Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Simons, Mary P	l1u-auwo-zo2u	False	None	False	2022-04-12 06:41:25.362	[]
4759	CDC-2022-0024-4765	https://api.regulations.gov/v4/comments/CDC-2022-0024-4765	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain sufferer, the negative impact of the harsh restrictions of opioids has had a huge impact on my life and the lives of others who are in pain. I used to be able to work full time, take care of my children and live a somewhat functional life. Then one day my doctor said he could no longer prescribe opioids due to pressures to stop prescribing them. He was actually fearful of prescribing them. I went off of my pain medication and have fought so hard to stay active, to not let the pain keep me from having any joy, but the fight can sometimes feel overwhelming. I don’t like taking medications but am now stuck taking medicines that make me tired, depressed, and only diminish the pain a fraction of what opioids did. Opioids didn’t get rid of the pain completely either but they are still more effective than anything else I have tried. I now also take Motrin and Tylenol at high doses daily which is having negative impacts on other parts of my body. The medications I take now cause much more harm then opioids ever did. <br/><br/>Another aspect in which those of use who suffer from chronic pain have to face is the discrimination and lack of care. When I sought out a pain management specialist, I was told they do not prescribe opioids under any circumstances before they ever saw me. Why would they deny a medicine which is proven effective for some conditions without ever seeing the patient? That is not good care. If there is a better solution to opioids that worked that would be great but unfortunately there is not at this time. <br/><br/>At the end of the day, the hardest part is that it is so inhumane to let those of us in chronic pain suffer when we are not the ones abusing these medicines. It is cruel. We are paying the price for something we are not responsible for and it is costing us our lives. Pain patients and doctors should not be used as a scapegoat for a larger problem in society.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aa5c	Anonymous	None	2022-04-11T20:38:09Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-awnv-ra6t	False	None	False	2022-04-12 06:41:25.575	[]
4760	CDC-2022-0024-4766	https://api.regulations.gov/v4/comments/CDC-2022-0024-4766	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am A 63 year old female who has suffered from chronic debilitating fibromyalgia for the last 15 years I was once on 240 mg of morphine plus a day and that just got me out of bed! I am in the one percent of people who have this type of debilitating pain and without morphine I would have been dead many many years ago! To limit the amount of morphine should be between the physician prescribing and the patient! Those of you who sit and make new guidelines are not capable of realizing the importance this and other opiates can do to increase the quality of life! We need this and other opiates to stay alive and participate in daily activities with our loved ones! I am a Registered Nurse who has spent many of my nursing years in the ICU: Medical, surgical, neurological and cardiac units. If anyone would have told me I would someday be on OVER 200 mgs of morphine JUST to get me out of bed I would have said I’d be dead! I simply would not have believed them! I once gave a patient of mine 15 mgs of oral morphine and I watched him like a hawk my entire shift! I no longer work as a Registered Nurse, all my dreams came to a screeching halt in 2007. I woke up feeling achy and thought it was the flu. Well, that “flu” never went away, it got worse with an increase in overall pain that brought me to the fetal position day after day all I could do was lay there and cry! I have had debilitating fibromyalgia for 15 years and my pain is “exactly what it was 15 years ago when it started on February 5th and without morphine and other opiates I know I would be dead! The pain is indescribable! When you have a flare you pray to God to take you! I have thought about suicide more times than I care to admit! Please trust me when I say it is the most awful, extremely disabling pain one would ever experience! I have felt like I was possessed by the devil a couple of weeks ago and without opiates to quell the pain I seriously don’t know what I would have done! I am now on SSD and I long for those days when I could help people! As many would tell you I was a “kick [vulgar language redacted]” nurse. I truly believe you NEED people who have been diagnosed with debilitating fibromyalgia to sit in with you when you make these regulations. I want you to know that I have been on several medications for my <br/>fibromyalgia but none of them took away the pain like morphine and other opiates. Please consider allowing the primary care physician to write scripts for morphine and other opiates for more than one month. I live in a very rural town and making the trip to the pharmacy once or twice a month causes hardship on me and my family. Thank you for reading my story. I can only hope that you will have listened to me and your regulations will be modified to help those of us who need morphine to a) get out of bed b) enjoy life like others c) be somewhat comfortable without that gawd awful pain day after day after day!!! Added note: the McGill’s Pain Scale lists fibromyalgia directly under childbirth for being the most painful conditions a person can endure! In closing, thank you for reading my story. I trust you will make the best decision for me and all the other people who are forced to deal with worst pain God has made known to man! Most sincerely, [name redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Elizabeth	None	None	090000648500a38b	Rodgers	None	2022-04-11T20:38:18Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Rodgers , Elizabeth	l1t-y264-woto	False	None	False	2022-04-12 06:41:25.790	[]
4761	CDC-2022-0024-4767	https://api.regulations.gov/v4/comments/CDC-2022-0024-4767	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was denied effective pain relief for spinal stenosis. The doctor told me that due to CDC Guidelines, he could no longer prescribes opiate pain medication. The alternative treatments and medications that are being offered to me are not relieving my pain and have caused me many intolerable side effects. I am very depressed and desperate for pain relief. I have been harmed by the CDC Guidelines for opioid prescribing and I believe they should be rescinded. The comments on this forum by so many others that have been harmed should be enough evidence to rescind these guidelines immediately.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500aa5e	Anonymous	None	2022-04-11T20:38:18Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-ayx2-irux	False	None	False	2022-04-12 06:41:26.009	[]
4762	CDC-2022-0024-4768	https://api.regulations.gov/v4/comments/CDC-2022-0024-4768	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC Guidelines should not be revised but revoked. The CDC intentionally inflated the data on Opioid deaths. The also willfully inflated opioid deaths from prescribed opioids. The CDC intentionally chose anti-opioid zealots and operated in secret for the initial opioid guidelines. The CDC violated the guidelines for creating policy. <br/><br/>The CDC also cherry picked data for the 2016 Guidelines, unethically ignoring important data that conflicted with the narrative the CDC wanted to propagate. Some of that cherry picked data was written by people who authored the CDC Guidelines, yet this was not disclosed. Government funds were used for those studies, from which the author benefitted from and then used for the 2016 CDC Guidelines. These studies experimented on human subjects without proper consent or ethical procedures to protect patients from harm. Instead patients were seriously harmed and left harmed. The study authors, government officials, and the CDC were aware of this harm and allowed it. <br/><br/>The CDC’s false narrative about prescribed opioids has intentionally ignored the very real dangers of illegal fentanyl. The CDC’s false narrative influenced the DEA, DOJ, and other politicians. The DEA and DOJ have attacked innocent doctors and patients. The DEA has ignored serious increases of illegal fentanyl pouring into the country and directly causing the true increases in OD’s, clearly proven through data. The real dangers of illegal fentanyl have been clear prior to the 2016 guidelines yet were ignored before and after. The dangers of illegal fentanyl are ignored in this revision as well. Yet illegal fentanyl has caused a 1040% increase in overdoses! Higher and higher numbers of illegal fentanyl flood into our country. The CDC’s false narrative against prescribed opioids has caused the DEA to also ignore illegal fentanyl. Between the CDC and DEA choosing to ignore the dangers of illegal fentanyl, they have caused the increased overdoses. <br/>In summary, the CDC has intentionally lied, misused data, chosen to flagrantly disregard proper procedure for policy making, ignored experts, willfully cherry picked data that relied on human experimentation without consent and is riddled with methodological flaws. The CDC willfully chose anti opioid zealots for their authors of the CDC Opioid Guidelines while also intentionally avoiding actual pain management doctors and pain patients on the panel to determine policy for pain patients. The CDC knows its own data is grossly inflated and the further inflated it to create a false narrative blaming prescribed opioids rather than the true cause illegal drugs. The CDC knows MMEs, claims of “highly addictive” prescribed opioids are based on research riddled with poor methodology. The CDC’s false narrative influenced the CDC, DEA, and other government agencies to ignore the dangers of illegal fentanyl, directly causing significant increased over doses. All of this highly unethical behavior cannot be ignored. The CDC’s original guidelines and this revision must be repudiated!!! <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a951	Anonymous	None	2022-04-11T20:42:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-33yl-q7x8	False	None	False	2022-04-12 06:41:26.222	[]
4763	CDC-2022-0024-4769	https://api.regulations.gov/v4/comments/CDC-2022-0024-4769	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have commented about my rls - for which there is no cure which leaves me writhing in pain for several hours a day because Dr is afraid to prescribe sufficient pain relief because of cdc persecution of doctors. I've commented about how we can't move from omaha to Minnesota where my kids and grandkids live because we are afraid we will not be able to receive pain relief in that state and if we attempt to find a Dr that will prescribe hydrocodone we will be branded in the state and interstate tracker as drug seeking. I've talked about my son seeking pain relief for his back on the streets and dying of fentynol laced drug OD. I've talked about [name redacted] and other governors who refuse to allow medical mj that perhaps could be used for overnight pain to reduce use of opiods. What I have not talked about is that because of medical bills my husband and I both work 2 jobs. I am 63 and he is 74. We will have to work this way another 5 yrs. My husband has a bleeding fragile bladder from radiation burns. He cries out when he pees; he says it feels like he's peeing razorblades. The meds his pain relief Dr will prescribe is 80mg. It's not enough but better than nothing. From his job he has developed severe chronic carpal tunnel - he has to have bilateral surgery. Directly following his surgery despite that his pain relief Dr approved additional pain meds surgeon wouldn't prescribe them. He said my husband was on plenty enough meds and let him just use extra from what he is already prescribed. I had a yelling match with him in the post op meeting room and told him that's not how chronic pain patients meds are used. I told him if he was going to make my husband suffer he would not have his other hand done by him. Thank God he changed his mind - as it was I spent the night listening to my husband cry from pain and that was with the additional meds. He is so fatigued by chronic pain that the idea of risking accute pain from something like surgery recovery is traumatizing to him. He also has to get steroid injections for spinal stenosis. This poor 74yo man has a very physical job. He is a manager of a dollar type store and many weeks of the year has to work 7 days a week or several times a month has to work double shifts because low pay prevents attracting assistant managers. He is barely surviving with his pain and what does it matter about if he were to leave this earth at age 80 or 82 from too many pain pills? Instead you make him suffer all his years - dreading waking up or going to the bathroom. This all boils down to mercy and common sense. Your guidelines and mishandling of opiods, mental health and addiction have created a scenario where people are avoiding procedures or surgeries because surgeons won't provide pain relief. Additionally people are unable to work or function normally causing depression, dread, seeking of street drugs and suicide. You all need to rethink this and consider how we feel - why should we want to even go on living with the daily suffering?	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heide	None	None	090000648500a38d	Fossum	None	2022-04-11T20:42:43Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Fossum, Heide	l1t-xpw3-divq	False	None	False	2022-04-12 06:41:26.439	[]
4764	CDC-2022-0024-4770	https://api.regulations.gov/v4/comments/CDC-2022-0024-4770	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello. I am a sixty five year old man that suffers constantly from chronic pain after twenty surgeries, all orthopedic. The pain meds that I used to get helped me have a semi normal life. Now however I’ve been cut back seventy five percent from what I used to receive. Now I can barely function every day and I’m in severe pain most of the day. I cannot do things with my family or friends that we used to do and my life is not at all good. I try to do things but it’s nearly impossible and for the most part I am now crippled because of lack of enough medication to control my pain. <br/>I recently had to have another surgery on my back and for the first time in my experience in the recovery room I have heard the patients crying and begging for some relief from post surgical pain. It was the worst experience of my life and now I’m scared to death about getting my next operation that my doctor has said to be essential.. All of the doctors are afraid to give out scripts for pain meds and it’s been extremely difficult to get what I desperately need. <br/>Also after my surgery my pain doctor abandoned all of her patients and left us all scrambling to find another doctor which was a psychological nightmare!<br/>I really want to be back the way I was before these regulations went into effect. I don’t know how much more I can hold onto the hope that this situation changes. My life is what I now consider to be over but I’m only here now because of my family. <br/>Please change the rules that limit how much medications myself and many others receive so that we can at least partially enjoy the time we have left. We need your help now.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Donald	None	None	090000648500d6de	Peterson	None	2022-04-11T20:47:31Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Peterson , Donald	l1v-58jd-chrt	False	None	False	2022-04-12 06:41:26.668	[]
4765	CDC-2022-0024-4771	https://api.regulations.gov/v4/comments/CDC-2022-0024-4771	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I think it's cruel and unjust to deprive people in terrible pain medicine that will help them live a somewhat normal life. No medicine totally cures my pain but oxycodone in small doses allows me to not spend my days and nights crying in pain and not being able to do daily things that normal people do... like clean, shop for groceries, etc. Last year my PCP decided she didn't want to prescribe it any more because she was afraid of losing her license for making some little error. She sent me to pain management where the PA interviewed me and told me they couldn't prescribe me anything until I saw the doctor in a month. I left there bawling my eyes out. Because of these laws they sent me home without anything for pain for a month. I have been taking oxycodone for years and have ne+ver asked for it to be increased. As it wore off and I experienced withdrawal with no medicine to help, I felt deserted. I am 75 years old and have never broken the law in any way... not even a ticket and didn't even get the courtesy of something for withdrawal like the worst drug addict gets and still deaths from non-prescription opioid increases. Don't law abiding citizens deserve more than this; especially, it seems like older people. It seems to a lot of the elderly that the medical profession thinks that we don't feel pain anymore, like they do infants. This has detrimentally affected people in pain worse than anything in my lifetime there has got to be a better way!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	J	None	None	090000648500a95e	B	None	2022-04-11T20:47:41Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from B, J	l1u-38f3-dwb6	False	None	False	2022-04-12 06:41:26.881	[]
4766	CDC-2022-0024-4772	https://api.regulations.gov/v4/comments/CDC-2022-0024-4772	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The American Dental Association is pleased to submit the attached comments on the Proposed 2022 Centers for Disease Control and Prevention Clinical Practice Guideline for Prescribing Opioids.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500d6ce	None	None	2022-04-11T20:48:07Z	American Dental Association	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from American Dental Association	l1v-4uuy-w8l0	False	None	False	2022-04-12 06:41:27.106	[]
4767	CDC-2022-0024-4773	https://api.regulations.gov/v4/comments/CDC-2022-0024-4773	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For the reasons described in the letter here (https://docs.google.com/forms/d/e/1FAIpQLSfY6RvEHNdy544nscUHGIISCY82DTvGVdOZQYnQ9EZVfGfVpA/viewform), the CDC must withdraw these draft guidelines. For too long, the CDC and other American institutions have tried to address addiction issues by scapegoating or sacrificing pain patients. My wife has a chronic pain disorder; she has been on the same, tiny dose of a mild opioid for more than a decade, with enough doses per month for 20, roughly 4-hour periods of reduced pain. In concert with treatment for the disorder itself, this has allowed my wife to transition from being fully bedridden to obtaining a 2-year degree, working a full-time job, and working toward her 4-year degree (on top of the job!). Having the option of making the near-constant pain she lives with go away (or significantly decrease) when it gets to be too much has made an incredible impact on my wife's mental health; for her and many others, one of the worst things about chronic pain is that it just keeps going, even after you've reached the limit of what you can handle.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bridget	None	None	090000648500a965	Stith	None	2022-04-11T20:48:22Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Stith, Bridget	l1u-3qgb-gkgk	False	None	False	2022-04-12 06:41:27.355	[]
4768	CDC-2022-0024-4774	https://api.regulations.gov/v4/comments/CDC-2022-0024-4774	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	We are in the midst of several challenging epidemics. In addition to the Covid-19 pandemic, we are waging an information war against both the Overdose Crisis & a Suicide Crisis due in large part to undertreated & untreated severe pain. We don't have an opioid crisis. We have e an illicit fentanyl poisoning Crisis. Even if we stopped prescribing opioids altogether, we'd see opioid overdoses climb precipitously. We've witnessed those numbers skyrocketing over the past 6 years, with barely a dent made since 2016. Surely the CDC can see their efforts are fostering the opposite intended. We can no longer refer to the hundreds of abandoned pain patients as "unintended consequences". The CDC & everyone affiliated with P.R.O.P. knew exactly what would happen if the 2016 guidelines were adopted. [redacted] stated very plainly: We're going to have to wait for this generation (of opioid users) to die off before we see the ^opioid crisis^ come to an end.<br/><br/>The deaths won't stop if the CDC continues to allow anti-opioid zealots, DEA Agents, lawyers, & politician to dictate medical care. We are in a new crisis of the CDC's own making: the Pain Care Crisis. <br/><br/>My wife stands on the precipice herself, never knowing if she's allowed to continue a life without weeping in agony. She is NOT alone. Anywhere from 50 to 100 million Americans share her situation.<br/><br/>I believe that the CDC opioid guidelines contributed to illicit fentanyl deaths by reducing the safe supply that could be overseen by actual physicians and nurses. Reducing prescriptions means reducing the numbers of unpoisoned drugs out there. We're at a point where prescribed opioids with safe, predictable dosages would save countless lives. I'm flummoxed by the CDC's stubborn insistence to reduce prescribing. The CDC's actions are deadly & everyone knows it.<br/><br/>The CDC pulled the rug out from under pain patients & their doctors in 2016 by attempting to publish MME limits & time limits. These MME limits carry the force of law & were further weaponozed by the DOJ, the DEA, Medicaid, Medicare, all insurance companies, & pharmacies. The Revisions to the 2016 guidelines will enshrine a NEW limit: 50 MME. This is NOT progress & will kill nore patients.<br/>Any patient needing more than the smallest dose of opioids will suffer & be denied appropriate medical care.<br/><br/>Let me be clear: opioids ABSOLUTELY do work for long-term pain. My wife is living proof of that fact. Some will call my evidence ^anecdotal^ & therefore immaterial, but she isn't alone in this. Thousands of pain patients say the same thing. My question is this: how many patients will the CDC knowingly harm & kill before the CDC & the other Governmental Agencies will cease & desist their campaign against American patients, especially patients with chronic illness & intractable pain? When will they stop? <br/><br/>If these Revisions become the new Guidelines, millions of patients will suffer & the deaths will be incalculable. I worry my beloved wife might not survive it. I fear she would choose MAID or Death With Dignity if she is unable to control her severe spinal pain. It is uncivilized & goes against all Human Rights to deny patients appropriate analgesia. <br/><br/>She cannot eat properly as uncontrolled pain makes her nauseous. At it's worst, the pain causes her to vomit. She loses weight & becomes gaunt & hopeless. I get to watch helplessly, knowing I can't fix it for her. I can't even do much to make it better for her. It's a MISERABLE existence. She cannot sleep well because the pain grinds away all night, often causing her to pass out after finally becoming totally exhausted.<br/><br/>Don't force my wife into a life of contant misery. Don't sentence patients in intractable pain to be tortured for the balance of their lives. She is one of millions! I'm not sure I can convince her to choose to continue living if you plan to publish these guidelines. Rescind them entirely if you really want to save lives.<br/><br/>You have the chance to save millions from the torturous fate I just described. You have the power to immediately reduce the numbers of sudden death, suicide, & drug overdose. Please choose the compassionate, fact-based path, otherwise the deaths will continue, unabated.<br/><br/>The government needs to stay OUT of the practice of medicine altogther.<br/><br/>Thank you.<br/><br/>[redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Gerrit	None	None	090000648500d6bd	Peacock	None	2022-04-11T20:48:56Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Peacock, Gerrit	l1v-56nf-rbbn	False	None	False	2022-04-12 06:41:27.593	[]
4769	CDC-2022-0024-4775	https://api.regulations.gov/v4/comments/CDC-2022-0024-4775	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines were misconstrued by doctors and pharmacists. My husband has been in chronic pain since 2008 and has been taking oxymoron since that time. He cannot move or function without this medication. Right now because of the 2016 CDC guidelines his medication was cut back and he cannot get relief. He just recently had to find a new pain management doctor and this doctor prescribed him 15mg oxycodone after taking 30mg oxycodone for the past 12 years. Are you kidding me! He has 5 herniated discs in his back and 5 herniated discs in his neck and this is the best this new doctor can do?! I call BS on this! My husband is suffering due to the 2016 CDC guidelines that were voluntary, but doctors took as that was how they had to operate! My husband is not the only one suffering like this! I wish there was something I could do to relieve his pain but there is nothing I can do. All I can do is watch him suffer and be in constant pain because these doctors don't care. They are more worried about their license than their patients. Some doctors won't even prescribe opiods if a patient has a medical marijuana card. Unbelievable! There is no rule anywhere that says this! Please consider redacting the 2016 CDC guidelines and giving relief to patients like my husband who really need the medications.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Michelle	None	None	090000648500d68c	Furr	None	2022-04-11T20:49:27Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Furr, Michelle	l1v-53nq-1hsc	False	None	False	2022-04-12 06:41:27.823	[]
4770	CDC-2022-0024-4776	https://api.regulations.gov/v4/comments/CDC-2022-0024-4776	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please see attached from the Patient Quality of Life Coalition.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500d61a	None	None	2022-04-11T20:49:56Z	Patient Quality of Life Coalition	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Patient Quality of Life Coalition	l1v-4lbp-1b8q	False	None	False	2022-04-12 06:41:28.037	[]
4771	CDC-2022-0024-4777	https://api.regulations.gov/v4/comments/CDC-2022-0024-4777	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [redacted]. I have submitted comments previously. I was a wife and am a mother of two young adults with PRSS1. My husband passed when his disease progressed to pancreatic cancer. My kids had an AITTP which failed and now struggle with various chronic issues including chronic pain. My daughter may have to have a pancreas transplant. As I have said in previous comments for input as well as to when CDC did an 'independent' survey to gather information on how the CDC opioid guidelines of 2016 impacted individuals, my kids have been greatly harmed. I also am co-founder of National Foundation for Childhood Pancreatitis and I get calls on a regular basis of how opioids are withheld from children when they are in a pancreatitis flare. These guidelines were not even meant for pediatrics yet are being As an organization and as an independent advocate our concerns align with NPAC and NCIL.<br/><br/>I do want to share some of the calls I have received from parents whose children have pancreatitis or another acute pain condition where relief was denied to them. Again, the 2016 guidelines were not directed at pediatrics. yet they have been used to justify opioids being withheld. The most recent call I received was from a mother. Her child has hereditary pancreatitis, she was hospitalized during a flare. Her condition acute not yet chronic. In order to address pain, the pain team had her attempt to do meditation. While I believe meditation has its place, not during a pancreatitis flare. The hospital was not a rural hospital but a large teaching hospital 'knowledgeable' in the area of pancreatitis. I receive many of these calls. I absolutely believe in a multi-facetted approach to pain based on the individual needs BUT leaving a child in incredible pain is harmful. I don't have to be a researcher to understand this. Many of these children where pain was not addressed are older now and many avoid doctors at all cost even though they have chronic conditions. When you ask them why many often talk about how their pain was ignored or not addressed or they were sent to a psychologist or pain clinic to be treated. Again, I absolutely agree that care addressing pain should be comprehensive AND individualized but many of these children were left in pain by physicians at the justification of the CDC 2106 Opioid guidelines. You may say, 'that is not our issue', yet the information that flooded physicians offices through various government and non-governmental agencies purporting the 'evils' of opioids caused a great deal of harm. You had individuals that were very obviously anti-opioids sit on your committee. They were given authority because the involvement on the committee and utilized it to discourage utilization of opioids. Your agency was used and I believe is still being used to support an anti-opioids campaign. So many have been harmed yet the CDC seems to remain quiet. Never were we invited to the table as you did with the disabled community when they raised concern about COVID. My kids are disabled as well as many on LTOT yet, we have not been invited to the table. Opioids have assisted my kids to live life more fully, however, they have been stigmatized due to being on opioids. Further more in 2019, the clinic my son went to for pain management [redacted] in North Dakota pulled all individuals off of opioids. Their basis, the 2016 guidelines. In my opinion you have allowed these misperceptions. They 'expanded' their care by hiring a pain psychologist (in placement of opioids). <br/>I have concerns about the 50 MME. Although no MME is suggested in general text it is in supporting documents. This will be used and it will be harmed. Also, I have seen information already out supporting the changes in the CDC guidelines (or based on the recommended changes - and they are not out) this is inclusive of the 50 MME so we KNOW it will happen. <br/>Again, I support the information outlined in NPAC and NCIL, however wanted to share that I am seeing harm continue and I fear the revisions more or so attempted to placate instead of truly righting a horrible wrong. <br/>These guidelines have not gone far enough. Those on LTOT are often disabled, this is an issue that truly is a barrier in living a better quality of life. The 50 MME will be weaponized and this weaponization will come from some of those sitting on your committees. I was so hopeful that the revisions would be genuine. Yet, there seems to be efforts aligning with other governmental agencies again to reinforce efforts of opioids being harmful (instead of being a neutral entity that could at times benefit). CMS's goal at one point along with VA was the reduction of opioids NOT the individualized outcomes of people. I sit on a few entities at state level and I see warning signs that this again will occur. HHS and Medicaid have brought up references that make me concerned about the 2022 guidelines if not further revised. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Beth	None	None	090000648500d353	Larson-Steckler	None	2022-04-11T20:51:37Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Larson-Steckler, Beth	l1v-3zll-ybsb	False	None	False	2022-04-12 06:41:28.263	[]
4772	CDC-2022-0024-4778	https://api.regulations.gov/v4/comments/CDC-2022-0024-4778	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a975	Anonymous	None	2022-04-11T20:52:24Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-3k1i-lr88	False	None	False	2022-04-12 06:41:28.481	[]
4773	CDC-2022-0024-4779	https://api.regulations.gov/v4/comments/CDC-2022-0024-4779	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m a 59 year old woman that’s been battling RA/severe generative disc disease/botched foot surgery with severe consequences(ie extreme pain & mobility issues)/bi-polar...<br/> When the CDC issued its “guidelines “.. I, like millions of other chronic pain sufferers that were Already on oxycodone management, was thrown through a loop! I’m luckier then most, as I have a Wonderful GP that didn’t yank all my pain meds.. but they were cut in half..& my life has been forever changed..<br/> I worked closely with my doctor and took my prescription as directed, pill checks, and urine tests ect..& still do....the feeling of being punished is at times overwhelming.. the pain at times.. unbearable..<br/> I have had 3 major surgeries since these new “guidelines “ came out..& I’m here to tell u.. being a person that’s been on opioid therapy for 10+ years..& trying to just survive the Added pain on a 5 a day,10mg limit was nothing less then pure Torture.. legal torture!.. it’s hard to heal when when you’re wracked with pain So intense.. it makes you see black spots and pass out from the pain..& the swollen shut eyes from sobbing.. I need to have more surgeries..& ..quite frankly.. I’m a tough person.. but I just can’t do that again.. it makes me suicidal..<br/> I’ve watched friends dive into street drugs when the were “cut” off..Completely! I’ve watched friends dieing from cancer.. try to make it on there 5 a day “limit”.. and the suffering?... this has Got to stop! We are Not the enemy!.. I think you are.. personally..<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	090000648500d24d	Smith	None	2022-04-11T20:52:29Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Kimberly	l1v-3me6-uv07	False	None	False	2022-04-12 06:41:28.698	[]
4774	CDC-2022-0024-4780	https://api.regulations.gov/v4/comments/CDC-2022-0024-4780	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing on behalf of myself o the CDC regarding their revision of the 2016 Opioid Prescribing Guidelines. I'm aware that, at face value, this guideline revision of 2022 looks to be less harsh on chronic/intractable pain patients. However, having looked closer, I've become aware that the revision is in fact NOT less harsh on the aforementioned group. It leaves us in a state of untreated or undertreated pain.<br/><br/>Having looked into the issue from a legal standpoint, the CDC should not have implemented guidelines (which have since been adopted into law by many states) which cause countless harms and even death to the disabled intractable and chronic pain patient community. [redacted], in his piece entitlted, "Evidence-Based Policymaking: What's Absent from the Opioid Crisis", clearly explained the realities of ADA law as it applies to public policy and the disabled pain community:<br/><br/>"The disabled person who uses prescribed medication to ameliorate Disabling Intractable Pain, is thus exercising a protected right under 42 USC Ch 126. Public entities including states, counties, cities and their agencies may not discriminate against disabled persons in the provision of services. 42 USC Ch 126 Subchapter II Part A. (The FDA is exempt in it's rule-making functions from 42 USC Ch 126, and it's non-rulemaking functions are goverened by an earlier federal law, §504 of the Rehabilitation Act. State agencies attempting to implement guidelines issued by the CDC do not enjoy this exemption and are at risk of being sued under ADA, for any resulting harm)."<br/>Found here: https://www.academia.edu/35612995/Evidence_Based_Policymaking_Whats_Absent_from_the_Opioid_Crisis<br/><br/>This is incredibly important to acknowledge for several reasons, including but not limited to the spike of pain-related deaths and suicides since the inception of the 2016 CDC Opioid Prescribing Guidelines. Simply Googling "pain patient suicides" results in pages and pages of the reality of the pain/suicide correlation, an indisputable fact.<br/><br/>As an advocate and patient myself, I see detailed reports from people daily who are being subjected to nothing short of medical neglect and barbarism. Treatment for pain is in severe decline across the country, from acute pain to post-surgical pain to end of life pain care. People are being sent home from amputation surgeries with no medications. People are being left to die in hospice situations because of the ill-conceived thought of addiction and illegal drug distribution. One such patient was told that her grandmother could not receive end of life pain management because, according to the attending physician, "We can't risk those pills ending up on the streets". Her grandmother, in hospice, was 92 years old. <br/><br/>This complete lack of care and humanity flies in the face of the UN's (and multiple other human rights agencies globally) stipulation that human beings have the right to be free from cruel, inhuman and degrading treatment. According to "Access to pain treatment as a human right" written by [redacted]:<br/><br/>"The right to be free from torture, cruel, inhuman and degrading treatment or punishment is also a fundamental human right that is recognized in numerous international human rights instruments [69–75]. This right creates a positive obligation for states to protect persons in their jurisdiction from torture, cruel, inhuman and degrading treatment or punishment. In a letter to the Chairperson of the 52nd Session of the Commission on Narcotic Drugs, the UN Special Rapporteur on Torture, Cruel, Inhuman and Degrading Treatment and Punishment and the UN Special Rapporteur on the Right to Health noted that governments' failure to take measures to ensure the accessibility of pain treatment threatens this fundamental right [75]."<br/>Found here: https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-8-8#:~:text=Pain%20treatment%20and%20the%20right,instruments%20%5B69%E2%80%9375%5D.<br/><br/>According to the Human Rights Watch's "Denial of Pain Treatment and the Prohibition of Torture, Cruel, Inhuman or Degrading Treatment or Punishment" written by [redacted], <br/><br/>"In interviews with Human Rights Watch in half a dozen countries around the world, people with severe pain often expressed a sentiment similar to that of traditional torture victims: They would do anything to stop the pain. 20 We have documented numerous cases of suicidal ideation among such patients, as well as various cases of suicides and attempted suicides. "<br/>Found here: https://www.hrw.org/sites/default/files/related_material/2011.12%20InterRights%20Bulletin%20Article_only.pdf<br/><br/>As a disabled intractable pain patient with an incurable illness, I can say that pain treatment is critical to my functionality and, without it, my quality of life disappears into nothingness. Please consider all of this, all of us, in your revisions and lift the MME caps. They have caused undue death and suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Mikki	None	None	090000648500d24b	Ingram	None	2022-04-11T20:53:37Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Ingram, Mikki	l1v-3m8o-j6gm	False	None	False	2022-04-12 06:41:28.944	[]
4775	CDC-2022-0024-4781	https://api.regulations.gov/v4/comments/CDC-2022-0024-4781	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is with a heavy heart that I come here today to leave this comment on the revised CDC opioid guidelines. I don’t have much faith that- literally- pained pleas of the thousands of us who have commented here will be taken seriously by anyone at the CDC but I guess I have to try.<br/><br/>It appears that the CDC allowed a man and his (money making) organization to drastically influence both the last and the current versions of these guidelines, A man who has no experience as a general internist or a pain specialist or a surgeon AT ALL but whose entire practice is to treat substance abuse was the loudest voice to influence these guidelines? HOW is that possible? How did the CDC not include patient perspectives? Why is PROP and its founder, AK, the primary influence on this subject when he isn’t even an expert and, in fact, stands to gain financially when more and more people with painful illnesses and injuries are forced off of legitimate prescriptions for opioid analgesics and onto the medication HE makes money on? (HOW is that not a conflict of interest?) I have little hope that this entire process is broken, that you all have abdicated your roles and sold us out for some corrupt agenda that I can't begin to understand but if you are listening and if you care at all here’s what I am hoping for.<br/><br/>REMOVE any mention of MME. <br/>You say that this revision was necessary in part because the previous version was so terribly misapplied and that patients were harmed. WELL. Very obviously by throwing out and even lower (50mme) number which gets printed in your revised GLs over and over and over again you are doing the very same thing as last time. Doctors are already lowering patients from 90mme to 50mme. YOu know this, right? The 90mme ‘suggestion’ became LAW and policy post haste and damaged literally hundreds of thousands of people’s lives and now in your-so-called-effort to fix things a bit you’re going to make things even worse. PLEASE remove discussion of MME as a cap or a suggestion of a cap or in reference to some diseases but not other diseases. You are hurting us. <br/><br/>People are all different. Our responses to injuries and illnesses are different. Our tolerance for different medications is different. Pain from cancer isn’t more important or more painful than other pain. Some people metabolize drugs fast, some slowly. <br/>Putting ONE SIZE ‘rules’ in your guideline only harms people by getting in between us and our Doctors. <br/><br/>Prohibition doesn’t work. <br/><br/>Hey, I’m guessing you all are aware that MORE people have died of overdoses while LESS prescriptions have been written. The street drug supply is being poisoned with illicit fentanyl and variations of it that are far more deadly than anything that was available from a dr years ago. <br/>The crisis you’re trying to fix has little if anything to do with US. The percentage of people who take meds for legitimate long term pain who go on to become addicts is LESS THAN 1%. So you see, again you’re not helping us your hurting us and other people.<br/><br/>I’m too exhausted to say anything else.I wish I could keep going but seriously this much typing has been exhausting for me and now I have to rest. <br/><br/>PS Please get the DEA out of our Doctors appointments. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Heidi	None	None	090000648500d236	O'Donnell	None	2022-04-11T20:54:04Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from O'Donnell, Heidi	l1v-3kkx-wojg	False	None	False	2022-04-12 06:41:29.158	[]
4776	CDC-2022-0024-4782	https://api.regulations.gov/v4/comments/CDC-2022-0024-4782	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These guidelines have already started destroying pain treatment. My last appointment the nurse warned me that if I don’t lie and say the dosage I was tapered to (320mme for 20 years without issues,then 120mme with increased pain and functional loss,to 60mme and total loss of function and extreme increase in pain and health decline) is enough for my pain and function then it will be taken away. I’ve tried other doctors and they all said they couldn’t help me. I contacted the Methadone clinics in the area but they aren’t taking pain patients. These guidelines have left me with the choice of lying and only getting 1 point reduction in pain (that means I live between 7-10) or risk buying drugs online (with the chance of pain relief and the risk of death) or just ending it. You are “saving me” to death. Congratulations on making it worse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d235	Anonymous	None	2022-04-11T20:54:14Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-3kjm-4zbc	False	None	False	2022-04-12 06:41:29.375	[]
4777	CDC-2022-0024-4783	https://api.regulations.gov/v4/comments/CDC-2022-0024-4783	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For the last several weeks, I think I’ve read more than a thousand of these comments about the opiate guideline revisions. A common running theme has been how so many patients feel that they’ve been horribly wronged by the original 2016 guidelines. It’s glaringly obvious that the original attempt to control opiates has horribly back-fired.<br/>I actually cried over several of these comments because they were so personal and tragic. I personally witnessed so many of these scenarios chronic pain patients have described. I worked directly in the pain management field so I know what I’m talking about. The discrimination, the downright disregard and neglect, the uncaring, the ignorance, the obvious greed are just some of the frequent comments made.<br/>The new proposed guidelines will not move the football any further down the field and will continue to sink us further into this opiate quagmire. In my opinion, the new guidelines will push doctors further away from their patients and push patients further away from their doctors. I’m not convinced at all that there is any conciliatory gesture to the patient in these guidelines. All the guidelines do is ease things up for the doctors. Drawn out treatments will put a patient through a circus act of questionable therapies and I think this will prove to be a huge turnoff to the patient. This will push many more to the illicit market for their pain relief, guaranteed.<br/>The authorities have now come up with a new scarlet letter for all of us prescribed opiate users. We will now carry the moniker “Opioid Use Disorder” (OUD) wherever we go. Instead of being viewed as a legitimate pain patient, we will now be labeled OUD. People will look past our chief complaint and convince themselves that we really have an OUD issue. Their judgements will be clouded and I believe a lot of patient’s problems will be overlooked and neglected. This is already happening and it will certainly continue. <br/>No other patient is treated like we are. Pain patients have been put through the ringer because opiates are suddenly a problem we can’t seem to fix. By going after the prescribed opiate channels, we thought it could cure a problem for the long term. As we now see, that blew up like a powder keg and now we really have much bigger problem. <br/>Prescribed opiates are not necessarily the gateway drug to the harder stuff. This faulty battle cry is prevalent because the narrative on opiates has been hijacked. This voice is seriously lacking the truth and it continues to harm the chronic pain patient in innumerable ways. I think we have a mental health crisis, so let’s focus on that and stop using opiates as some excuse for it all. Face up to yourself, dear leaders, and stop hiding behind half-truths and stop the shell game you are playing.<br/>When we can send a young man or woman into the dangers of war, but we can’t seem to find sympathy when they’re trying to live with a battle injury, we truly do have a serious problem in this country. How many veterans have been jerked around over this hyped-up paranoia over opioids? How many have been just cut off from a pain-relieving pill? Is that how we now treat our heroes in this country? It never used to be like this but I guess this is the new future. <br/>It seems no one really understands pain until it afflicts them. Then and only then will that person recognize the suffering of others. One thing I’ve observed is that most people really don’t understand the complexities of pain. It’s like the autism spectrum with an infinity of different possibilities. Pain can occur in so many forms. Just look at a person’s spine with its 364 points of articulation and you can imagine the infinite sources of pain. The alternative treatments to opiates are hit and miss regarding their efficacy and this must be recognized by authorities and should certainly be taken into consideration when making policy decisions. Opioids should continue to be part of the treatment plan because of this. <br/>Again, everyone, these are “guidelines” and they are not law. So, it will be business as usual and the suffering patient will be further marginalized. I don’t see anything getting better and these agonized voices will only continue to add up as the corporate assets stack up. <br/>I hold out hope that this opiate problem does get fixed for the long term but if it continues as it has, we will continue to wallow in this current mess. I myself, at the age of 60 years old, will be looking at turning to the streets because I will not participate any further in these alternative treatments. I’ve spent an enormous amount of money and have gotten very little relief if any. I refuse to support something that proves no benefit and will not be played a fool any longer. Opiates, up to this point, have been my only sanctuary from intractable pain and I will not give them up. <br/>It's time the patient be heard!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jeff	None	None	090000648500d230	Cook	None	2022-04-11T20:54:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Cook, Jeff	l1v-3k9i-3l2t	False	None	False	2022-04-12 06:41:29.586	[]
4778	CDC-2022-0024-4784	https://api.regulations.gov/v4/comments/CDC-2022-0024-4784	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an ER nurse. I have seen patients suffering from pain and unable to obtain relief because of these new guidelines. I also see many overdose patients - but not one of them used prescription opioids. They ALL used either heroin or illegal fentanyl. <br/><br/>Because of my physical workload I have suffered from an unrepairable back injury. I can do very limited work. I can be more functional and have a better quality of life if I am prescribed appropriate opioid and muscle relaxing prescriptions. However, Physicians do not want to prescribe these medications for fear of fines, monetary sanctions and DEA involvement because of these new guidelines. <br/><br/>These guidelines do not help an “opioid crisis.” The crisis is due to illegal street drugs and not from physician prescribed opioids. Please help the millions of chronic pain patients live a fair and equitable life free from suffering.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d21b	Anonymous	None	2022-04-11T20:54:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-3hqo-tsqe	False	None	False	2022-04-12 06:41:29.803	[]
4779	CDC-2022-0024-4785	https://api.regulations.gov/v4/comments/CDC-2022-0024-4785	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Thank you for the opportunity to comment on the 2022 CDC Proposed Opioid Guidelines<br/>The addition and the definitions for acute and subacute provided helpful clarification. However, we wanted to note areas of concern in the practicality of providers implementing these new guidelines. It will be challenging for providers to ensure that the discussions recommended in these guidelines occur in the allotted appointment time, in addition to the assessment and discussions of the patient’s other acute/chronic medical conditions. In addition to the actual discussion with the patient, the documentation regarding the pain management plan and discussion will add even more time necessary to address these guidelines. <br/><br/>In addition, we have concerns regarding the removal of explicit thresholds or benchmarks, such as the MME standards and requirements for specific duration of acute opioid prescriptions (3 to 7 days). With less specific guidance, this makes it more difficult, especially for the inexperienced provider or busy provider, to know when certain modified processes or prescribing practices would be applicable. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500d1b9	None	None	2022-04-11T20:55:09Z	Mercy Medical Center	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Mercy Medical Center	l1v-3b94-lph3	False	None	False	2022-04-12 06:41:30.017	[]
4780	CDC-2022-0024-4786	https://api.regulations.gov/v4/comments/CDC-2022-0024-4786	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing with comments on the proposed CDC Guideline for Prescribing Opioids for Chronic Pain. While the proposed guidelines are an improvement from the last guidelines published in 2016 , they continue to be extremely problematic for patients with legitimate chronic pain disorders who depend on opioid therapy to reduce their pain and improve their quality of life. <br/><br/>As I'm sure you are aware, the CDC's 2016 guidelines have unfortunately led to extremely harmful consequences for patients with chronic pain. Although the guidance may not have been intended as a rigid set of rules, they were used as the backing for huge policy decisions by governments, insurance companies, and professionals from doctors to pharmacists. Many states have adopted laws and regulations that limited opioid prescribing. Similarly, many health insurances based policies on those guidelines. Many doctors have stopped prescribing opioids at all or minimize what they will prescribe despite patients’ documented needs because it is seen as such a huge risk to their license. Some doctors will not take on new patients who take opioids to treat their pain. Many pharmacies will not fill patients' prescriptions even when of record due to the increasing regulatory burden. As a result of this, patients with chronic pain who have legitimately and safely taken opioids to control their pain for years now have to jump through herculean obstacles to obtain their prescriptions every month.<br/><br/>The proposed guidelines do not balance discussing the known risks of opioids with the benefits of continuing opioids for chronic pain when a patient has failed other treatment options. The guidelines also do not take into account the incredible harms of poorly managed chronic pain, which include physical distress, mental agony, inability to hold a steady job, and suicide. There needs to be stronger language against abandoning patients who depend on opioids for their pain. Additionally, citing specific doses can be interpreted (as it was in the 2016 guidelines) as giving a hard ceiling, which makes it nearly impossible for patients who have safely depended on higher doses of opioids for years to obtain the medication needed for them to function on a daily basis. Physicians need to be trusted to use their judgement to decide which medications are safe and beneficial for their patients, and at what doses.<br/><br/>It is understandable that the CDC is hoping to reduce drug overdose deaths. However, while opioid prescriptions have decreased by over 40% in the last decade (likely in large part caused by the 2016 CDC guidelines), annual drug overdose deaths in the U.S. have increased during the same time period. The problem is clearly not with the prescribing of opioids—illicit street drugs are primarily driving the increase. There is therefore no reason to unfairly target chronic pain patients who are just trying to treat their pain with the permission and medical recommendations of their doctors. We do know that as legal prescriptions have lowered and overdoses have increased, suffering, disability, and suicide among those who suffer with chronic pain has risen steadily. <br/><br/>A chronic pain patient myself, I and thousands of other chronic pain patients around the country, are depending on the CDC to take back much of the harmful language that was detailed in the 2016 guidance. The CDC needs to replace the prior language with more appropriate statements that respect the benefits that many chronic pain patients receive from taking opioids and that acknowledges the incredible harms that come from limiting dosing, suggesting medically unnecessary tapers and making it so incredibly difficult for patients to obtain the medication that their doctor has decided is best for them.<br/><br/>One set of proposed changes that takes the needs of chronic pain patients into account was written by [redacted] (https://www.practicalpainmanagement.com/treatments/pharmacological/opioids/commentary-how-fill-holes-cdc-opioid-prescribing-guideline-revisi). I think that these proposed revisions are a great start and should be strongly considered by the CDC.<br/><br/>Thank you for your consideration. The lives of chronic pain patients are literally in your hands.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500d1a8	Anonymous	None	2022-04-11T20:55:50Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-39pp-um0n	False	None	False	2022-04-12 06:41:30.253	[]
4781	CDC-2022-0024-4787	https://api.regulations.gov/v4/comments/CDC-2022-0024-4787	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Anyone in pain after / before medical treatments should have access to pain medication. [redacted]	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Diane	None	None	090000648500ccc2	Launderville	None	2022-04-11T20:56:36Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Launderville , Diane	l1v-2rjz-wjgo	False	None	False	2022-04-12 06:41:30.643	[]
4782	CDC-2022-0024-4788	https://api.regulations.gov/v4/comments/CDC-2022-0024-4788	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a chronic pain patient for over 30 years, I had a primary care doctor that was able to prescribe opioid medications. During that time, I was able to carry on a fairly normal life with work. After a knee surgery, 3 ankle surgeries, 4 shoulder surgeries, I had to go out on disability. I have seen pain management and interventional spine doctors for treatment. They do not want to prescribe opioids either. For the past 4 years, I have not been able to ambulate without use of a walker. I cannot take any NSAID's due to chronic kidney disease. I have tried medical marijuana and that didn't help. I can understand why people have thought of suicide or have gone to the streets for drugs. That is where the opioid crisis is, not in the doctor's office.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jennifer	None	None	090000648500ccb5	Hinkle	None	2022-04-11T20:56:46Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Hinkle, Jennifer	l1v-2qof-szcl	False	None	False	2022-04-12 06:41:30.853	[]
4783	CDC-2022-0024-4789	https://api.regulations.gov/v4/comments/CDC-2022-0024-4789	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The CDC can no longer defend its interference in the practice of medicine with these unscientific practice standards which don't even include appropriate stakeholder input, and which utilize low and no evidence studies to justify its recommendations. <br/><br/>The data CDC's claims are based on don't and never did support the interpretations this agency popularized via media campaigns using an undisclosed amount in taxpayer money. Namely, that the United States is experiencing a "prescription opioid and addiction crisis." CDC's own overdose statistics simply don't support that conclusion and if one considers that CDC has never separated deaths from diverted prescription opioids vs. deaths from prescription opioids actually prescribed to decedents, the agency was never justified in popularizing such interpretations. The data never supported those conclusions. The National Survey on Drug Use and Health (NSDUH) puts prescription painkiller abuse considerably below 1% for the last 20 years.<br/><br/>There was an almost 56% increase in deaths involving synthetic narcotics in 2020 with over 57,000 deaths for this one drug category (T40.4) which is dominated by illicitly manufactured fentanyl (IMF). By comparison, there were just over 14,000 deaths from prescription opioids (T40.2), the bulk of which are likely due to prescription drugs diverted to the black-market. According to Protenus, up to 77% of drug diversion incidents take place in a healthcare setting by healthcare staff.<br/> <br/>Further, there are several replicated results proving that patients rarely abuse or overdose on their prescribed medications. Less than 1% of patients without a diagnosed substance use disorder abuse pain killers according to a meta-analysis conducted by [name redacted]. In a recent study of overdose decedents in Massachusetts, researchers found that only 1.3% had an active prescription at the time of death. These results could be widely representative. The fact that no one has yet looked at how many patients have overdosed on their prescribed medications nationally is incredible considering how much taxpayer money is going to the continued restriction of these life-saving medications in the medical setting.<br/><br/>Until there are studies with a national focus utilizing the Prescription Drug Monitoring Program (PDMP) to separate deaths from diverted drugs vs. deaths from patients with a legitimate medical need for prescription opioids, CDC should recuse itself from any further effort to interfere and in fact, never should have had the authority to interfere in the first place. The fact that the CDC continues to despite its failure to bring down overdose poisoning deaths in the wake of its first guideline should be evidence enough to show that CDC is focusing on the wrong demographics and the wrong markets, complicating the overdose crisis, and introducing secondary and tertiary compounding crises to the mix.<br/> <br/>With between 9.6 and 11.5 million individuals on long-term opioid therapy (LTOT) in general as of 2014 and 4.3 million patients on LTOT for chronic non-cancer pain (CNCP) in 2015, a sizeable population stands to experience continued harm with CDC’s 50MME recommendation. According to the American Board of Pain Medicine’s (ABPM) 2021 survey, “72% of pain medicine specialists said that they—or their patients—have been required to reduce the quantity or dose of medication they have prescribed.” Publishing an updated guideline with an even lower MME recommendation will only worsen the lack of access patients are already facing, a problem created by CDC's first guideline, and it will further complicate the overdose poisoning crisis and continue driving deaths up. <br/><br/>It’s time to take a different approach. Considering CDC has already failed once to appropriately diagnose the problem or effectively impact the overdose death rate in a meaningful way, it’s time the CDC began taking heed of popular demands to rescind the first guideline and withdraw from any further efforts that put American lives in danger.<br/><br/>Regards,<br/><br/>D.S. Nelson \| Founder<br/>National Advocacy Awareness Clinic<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a97d	None	None	2022-04-11T21:08:59Z	National Advocacy Awareness Clinic	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from National Advocacy Awareness Clinic	l1u-3mcd-knaq	False	None	False	2022-04-12 06:41:31.065	[]
4784	CDC-2022-0024-4790	https://api.regulations.gov/v4/comments/CDC-2022-0024-4790	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines were rejected by the FDA in a public letter, saying not only were the guidelines not based in science or evidence, but they’re based on opinion & could have real lasting harm to chronic pain, cancer, & hospice patients. And that’s exactly what happened, because in 2016 the CDC looked at all prior overdose deaths with any opiate in their system, & idiotically combined heroin & illicit fentanyl (both are opiates), & prescription opioids, but didn’t mention heroin or illicit fentanyl causing 87% of the overdoses, & only blamed prescriptions. Thousands of doctors have lost their licenses for no reason by the DEA, abandoning pain patients. <br/>100,000 chronic pain patients have killed themselves to escape the horrific pain, or gone to the street for illicit fentanyl or heroin, OD & die because they didn’t know the dosage. <br/>Millions have lost their jobs, spouses have left them & they’ve lost custody of their kids because they can’t get out of bed to drive them to school because the pain debilitates them so badly. <br/>Had the guidelines not gone into effect, 100,000 people would be alive today, & millions would be functional members of society & involved with their families.<br/>Have the guidelines done anything to stop overdose deaths? No. <br/>They have skyrocketed & prove the CDC & the doctors that work with them are incompetent, responsible for 100,000 lives lost, & are a danger to society. <br/>They should stay in their lane, stay out of medications, & leave that to the FDA. <br/>The new guidelines say without citing any actual evidence that 50mg MME should be the cutoff, down from 90mg MME. Which they know states will adopt that as a hard line limit just like 90mg MME was in 2016. <br/>Revoke the CDC’s ability to put out any guidelines on medications & repeal the ones from 2016 & the ones that will be out tomorrow. <br/>If these guidelines go through, another 100,000 lives will be lost to suicide, millions will become bedbound & waste away & cancer & hospice patients will die in agony, like many have over the last 6 years for NO reason. <br/>For people who aren’t in chronic pain, you & your children will be affected as well. <br/>The CDC is now saying opioids should never be given in an ER setting for acute pain & to give anything other than opioids. <br/>If your kid breaks their arm in half, no pain meds for them. If you get in an car accident & shatter your pelvis? Tylenol for you. <br/>Opioid free surgeries are now the trend as well, double mastectomies, C-sections, open heart surgery, brain surgery, full hip & double knee replacements, etc, all opioid free and people have shared their horror stories. <br/>Many have said when they were writhing in pain, begging for pain meds, they were given Haldol, an antipsychotic known as “chemical handcuffs.” So many have been given Haldol for their pain (it’s not indicated for pain & the FDA hasn’t approved it for pain either) they said once they get the shot (they’re being lied to & told it’s pain meds), they’re unable to move or speak, & the pain is still there. So all it does is make you stop screaming in pain which is what the doctor and nurses want so they don’t have to deal with you. <br/>It’s barbaric & doctors & hospitals are getting paid billions of dollars in kickbacks to NOT prescribe or give out opioids. <br/>And they’re getting billions from the maker of Haldol as a paid partnership. <br/>Hospitals see they can make billions of dollars from this, & they’re desperate for money after Covid because many nurses have quit for better pay elsewhere. So to them, this is the perfect solution to stay open & pay their employees & the doctors can buy new boats. <br/>But the patients suffer. <br/>When hospitals got rid of pain being a vital sign, it used to be where patients were asked to rate their doctors for how they managed their pain, & doctors were paid accordingly. <br/>Now that doesn’t exist anymore, so the doctors can do whatever they want & get paid even more to harm patients. <br/>The pendulum has swung too far & now the entire population of this country will be affected by these new guidelines which will be turned into law by the states. <br/>Rescind all guidelines, revoke the CDC’s ability to say anything regarding medications, & I also implore the Biden Administration to revoke the DEA’s ability to go after doctors because doctors are too scared to prescribe any opioids anymore & patients suffer, are at risk of suicide, & overdose. <br/>DEA: focus on illicit fentanyl coming from Mexico instead of prescriptions by doctors because prescriptions aren’t the problem & never was. <br/>CDC: your studies were over ten years old & only one study was cited for 80% of the data, wasn’t peer reviewed & isn’t acceptable science.<br/>It’s great the courts are now seeing the other side & are holding people accountable that are contributing to the unnecessary deaths caused by the CDC, DEA, DOJ, & the anti opioid doctors who collude with the CDC to put out data that has zero basis in science.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anne	None	None	090000648500a99a	Hochhalter	None	2022-04-11T21:14:21Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Hochhalter, Anne	l1u-3z0r-bt6r	False	None	False	2022-04-12 06:41:31.276	[]
4785	CDC-2022-0024-4791	https://api.regulations.gov/v4/comments/CDC-2022-0024-4791	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Don't punish people with severe medical issues to stop addicts from being addicts. https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154 The CDC MUST rescind/revoke the 2016 guideline and withdraw the 2022 guidelines... because both are based on a MME system that has no science and/or double-blind clinical studies behind it.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kendra	None	None	090000648500a397	Cuyler	None	2022-04-11T22:54:20Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Cuyler, Kendra	l1t-y8s8-oa1v	False	None	False	2022-04-12 06:41:31.496	[]
4786	CDC-2022-0024-4792	https://api.regulations.gov/v4/comments/CDC-2022-0024-4792	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Hello, I’m from Kentucky. I have Osteoarthritis in almost every joint in my body. I am disabled. I can not take NDSAIDS due to causing nose bleeds, and I have CHF. I have tried Neurontin 3 times, and can not tolerate this drug. I have been given Tramadol for my pain, so I can have some quality of life. My Rheumatologist that prescribes this is closing his practice due to family issues. With all the discussions about how hard it is to find a Physician to treat chronic pain. I am so scared. I don’t know what will happen. I hope to find a doctor to continue my regimen, since I am so stable on this medication. If not, my quality of life will very much be affected. I will no longer be able to help my children with their children at times. This very much saddens me. As for know, I don’t know what will happen. But, as a chronic pain patient I don’t feel I should have such a worry about this issue. Please keep us in your prayers, we only only want some quality to our lives. Thank you for your time. I may update as go through this journey for continued pain control.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a398	Anonymous	None	2022-04-11T22:57:13Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-y9vu-3gxk	False	None	False	2022-04-12 06:41:31.703	[]
4787	CDC-2022-0024-4793	https://api.regulations.gov/v4/comments/CDC-2022-0024-4793	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	These regulations kill people. Stop taking pain meds away because people need help for their MENTAL ILLNESS. In what other speciality does my medical care rely on what an addict does? This is ridiculous. May the pain that is created by these guidelines fall solely on your head.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a399	Anonymous	None	2022-04-11T22:57:34Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-yakj-dyf1	False	None	False	2022-04-12 06:41:31.927	[]
4788	CDC-2022-0024-4794	https://api.regulations.gov/v4/comments/CDC-2022-0024-4794	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please refer to the attached correspondence.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Bradley	None	None	090000648500a3a6	Percell	None	2022-04-12T00:23:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Percell, Bradley	l1t-y438-av01	False	None	False	2022-04-12 06:41:32.134	[]
4789	CDC-2022-0024-4795	https://api.regulations.gov/v4/comments/CDC-2022-0024-4795	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a board certified Hospice and Palliative Care physician. I treat many people with pain and I prescribe opioids, sometimes in very large quantities. Previously, when I was a primary care physician, I am no longer in that role, I had a large panel of chronic pain patients managed on chronic opioid therapy. I have always prescribed opioids rationally, with caution, and with exercise of medical judgment. <br/><br/>I find that the twelve guidelines in the Draft Prescribing Opioids--United States 2022 to be straightforward, to exercise common sense, and to be an improvement over the guidelines in Prescribing Opioids for Chronic Pain--United States 2016. However, the references to specific "MME/day" levels following guidelines 7 and 8 should be removed before they cause additional harm to individuals living with pain.<br/><br/>It is well known that the MME/day levels cited in Prescribing Opioids for Chronic Pain--United States 2016, were misinterpreted as absolute limits, adopted by health systems, pharmacy benefit managers, and in many cases enacted into state laws limiting opioids. This has caused harm to individuals who were stable and functional on higher doses of opioids and were forced to taper or stop their therapy altogether. Harms including loss of function, loss of employment and income, loss of family life, and in some cases suicide. <br/><br/>The new Draft Prescribing Opioids--United States 2022, when it is finalized, will undoubtedly have the same effect on health systems, pharmacy benefit managers, and state legislators as Prescribing Opioids for Chronic Pain--United States 2016 did. They will not read the text which says clinicians should consider shorter follow up periods and consider co-prescribing naloxone for patients on >50 MME/day, just like they did not read the text stating that clinicians should carefully justify doses >90 MME/day in the 2016 guidelines. <br/><br/>If these references remain in the final draft, the continuing atmosphere of moral panic about opioid prescribing will lead to 50 MME/day becoming the Maximum dose allowed in many circumstances. Not only will this cause a new wave of suffering for people with pain, it will take the decisions about dosing out of the hands of those of us best qualified to make those decisions, rational, licensed clinicians with many years of study, practice, and continuing education in pain management. <br/><br/>[name redacted], MD, HMDC<br/><br/>P.S. Everyone knows opioid prescribing is at the lowest rate in 15 years and has been falling since 2012. Prescription opioids are not driving the overdose epidemic. The CDC National Center for Injury Prevention and Control must focus on controlling illicit production, importation, and sales of fentanyl and other opioids, rather than overstepping the medical judgement of those in the legitimate practice of medicine.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Daniel	None	None	090000648500a3b5	Harris	None	2022-04-12T00:26:41Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Harris, Daniel	l1t-ylwf-xret	False	None	False	2022-04-12 06:41:32.371	[]
4790	CDC-2022-0024-4796	https://api.regulations.gov/v4/comments/CDC-2022-0024-4796	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. This is very important because beginning in 2016 with the release of your first guideline, you introduced yourselves to me in a most unsettling manner. I and tens of thousands of lives you have "introduced " your way into in the name of safety and concern could be no more in the name of "science" is in truth completely baseless and nothing short of many terms this savagery has been called. <br/>My history in brief.<br/>13 years of 100% compliance while utilizing opioid medications. <br/> 13 years of documented spinal failures beginning with a degenerative disc diagnosis that quickly escalated into 2 surgeries in less than 3 years and my final and last surgical intervention in 2018 Jan. <br/>I was encouraged to provide documentations to support my comment to provide you with a chance to allegedly make sound decisions on how " dangerously addictive and destructive" or is there truly a BENEFICIAL way these medications can be utilized. <br/>Your 2016 abomination preceded any chance I had at a normal functional life on Nov [day redacted],2021. I was abruptly discontinued from my medication regimen of 13 years and thrown in turmoil as a DIRECT result of the misapplication of your first edition. <br/>The discrimination I have faced from doctors who were refusing me treatments because the vilification of the meds that ultimately gave me legitimate functionality only serve to frighten physicians into fear and freedom conserving unfounded self preservation and protection decisions that result in DIRECT patient harms. <br/>You only need to listen to us but you don't. Now you claim to want to help even more by releasing your current revision which have already proven to be nothing more than a continued assault on innocent patients who don't fit your claimed narratives of falsely supported insinuations on "addiction" and furthermore your unneeded OPINIONS on the claims of risk versus benefit analysis. <br/>I was asked to use supporting documentation. I don't need it because you have refuted your own selves dozens of times through your very statistical compilations you publish. But even with that the ignorance of truth and the lack of humanity in the name of self proclaimed societal savior status is none short of barbarism. Please refer to your "work" for your references.<br/>The very notion that lives are not benefitted through the use of opioid medications because of false predications of addiction is in itself as dangerous as it gets. I have been in active and VERY SUCCESSFUL RECOVERY for my own personal reasons and my medications were never abused, diverted, misused, or otherwise used improperly. EVER !!!! <br/>I didn't need your "help" nor did I give any reason that I am somehow hopelessly addicted and labeled, now medically coded ICD 9 and ICD 10 both of which are substance and opioid use disordered in the kangaroo court of public opinion scenarios your " suggestions" have placed now untold THOUSANDS OF PATIENTS into defenseless positions that have resulted in suicides and suffering.<br/>This narrative that was used to justify the insufferable and continuing harm I am experiencing by being stigmatized as an "abuser" I completely and unequivocally prove to be FALSE by my own successful history.<br/>I have suffered severe and potentially life threatening and ultimately fatal increases in blood pressure, gastric issues without the use of NSAIDS that you claim are more effective than the meds I was taking. I was fully aware of the catastrophic side effects of acetaminophen and Ibuprofen and counseled by my physician to avoid outside of its complete ineptitude as an analgesic to begin with.<br/>The claims that the new suggestions that prescribers should not exceed doses greater than 50 MME in your current revision is supported by junk science, lack of suitable and substandard studies that were undertaken in the first half of last century.<br/>Your claims that this is only for opioid naïve patients in a first time prescribing primary care setting is nothing but a lie. <br/>I WAS a legacy patient in long term SUCCESSFUL opioid treatment for multiple advanced intractable conditions, but alas, I am now a VICTIM of your indiscriminate and agenda driven abyss of misery and non function. Why did you do this to me ? <br/>Ask yourselves if you find that appalling. Ask yourselves again how could you not.<br/>The complete repudiation of your 2016 and now current revisions are long overdue.<br/>I went from healthy, happy and functional to a state of chaos the likes of you could never ever comprehend. You told us this wont happen to legacy patients, another lie. You told us we would not be harmed. More lies. <br/>How many of us have to die before you finally see that what you have done is nearly irreparable at this point. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Barton	None	None	090000648500a3c0	Carey	None	2022-04-12T00:33:59Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Carey, Barton	l1t-ysad-zgck	False	None	False	2022-04-12 06:41:32.586	[]
4791	CDC-2022-0024-4797	https://api.regulations.gov/v4/comments/CDC-2022-0024-4797	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I would like to support the patients with extreme pain issues who receive opioids and that they are not denied access to such drugs based on demographics, race, financial abilities etc.Further, there is a dire need for caregivers to address the real needs of such patients without inherent judgements or preconceived prejudices.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Wanda	None	None	090000648500a3c6	Norris	None	2022-04-12T00:34:22Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Norris , Wanda	l1t-ytvj-591k	False	None	False	2022-04-12 06:41:32.810	[]
4792	CDC-2022-0024-4798	https://api.regulations.gov/v4/comments/CDC-2022-0024-4798	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’m commenting on this guideline from the view of one who has been dealing with chronic pain over the past two decades and amongst two healthcare systems. One is within the Veterans Health Administration (VHA) and the other through healthcare in the private sector. Most of my experience has been through both of these medical systems in Idaho. I, however, have recently moved to Arizona where much of my care has mimicked to what I have received in Idaho.<br/><br/>Attached is the entirety of my comment.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Yancy	None	None	090000648500a3e8	M	None	2022-04-12T00:46:20Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from M, Yancy	l1t-z023-2v9x	False	None	False	2022-04-12 06:41:33.023	[]
4793	CDC-2022-0024-4799	https://api.regulations.gov/v4/comments/CDC-2022-0024-4799	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have severe chronic pain from Ankylosing Spondylitis and Ulcerative Colitis/Chron's. For over 30 years I've been in pain. Since the so-calked opioid epidemic, I've had a difficult time finding a doctor to prescribe pain meds. I've been off opiods for 6 years now and am completely debilitated by pain. I can't work, sleep, socialize, do hobbies, prepare nutritious food or function. I've had a pain stimulator, many steroidal injections and nerve ablation. I've hadcsevere reactions from Gaba. Other current meds do nothing for pain and sedate me to a zombie state. <br/>I need surgery but refuse because I won't be given pain medications afterwards. <br/>People in pain deserve to be treated with proper pain killers. <br/>I am in intractable pain every second if every hour of every day, every week, year. For pain patients, adequate pain medication relieves enough pain so we can function. We don't use those meds to achieve zero pain, nor do we use those meds to get high or escape life. Just The opposite. Pain meds give us our lives back. We can work, take care if our children, and enjoy the simple things like sitting at a picnic. <br/>The opioid overdose epidemic is a LIE!<br/>One percent of chronic pain patients become addicted and overuse. <br/>The deaths are from ILLECIT drugs. The number of deaths has not decreased. The number of people abusing substances has nor decreased during this war on opiods. The policy does not work. Pp<br/>I am treated like a criminal when I ask what can be done for my pain. Pharmacists routinely refuse to fill prescriptions for pain killers despite a valid prescription. <br/>Why has chronic pain been demonized? <br/>This is the time to set the record straight. <br/>This is the time to avail people proper treatment fir intractable pain. <br/>This is the time to give me and my fellow pain patients hope for a day in the near future with enough pain relief to participate in our lives. <br/>This is the time to stop suicides of chronic pain patients who cannot continue to exist in unimaginable suffering. <br/>Pain has no moral value. <br/>Why does treating pain have moral overtones?<br/>I am suffering. My fellow pain patients are suffering. People needing routine and emergency surgeries are suffering. <br/>Doctors are refusing to treat appropriately for pain because they're misinformed about ILLicit drug abuse and overdoses. Litigation has led the false narrative. <br/>Revise the guidelines to allow Doctors to prescribe opiods fir pain. <br/>Prescribed opiods are not the reason for drug abuse. <br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cheryl	None	None	090000648500a3f0	Murray	None	2022-04-12T00:49:46Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Murray , Cheryl	l1t-zh68-hlmx	False	None	False	2022-04-12 06:41:33.252	[]
4794	CDC-2022-0024-4800	https://api.regulations.gov/v4/comments/CDC-2022-0024-4800	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am 30 years old and living with chronic pain from Ehlers Danlos Syndrome, Chronic (Daily) Migraines with aura, Psoriatic Arthritis, Endometriosis, Small Fiber Neuropathy, craniocervical instability, and occipital neuralgia. I haven’t been able to work for the past 4 years due to my health and limited treatment options. My muscles have been deteriorating because I spend many days bedbound from the debilitating pain. I am fortunate to have access to some of the best doctors in the world for some of my most disabling conditions, but I often am unable to make it to appointments because I’m in too much pain to leave my house. I haven’t been able to go to the emergency room multiple times when I was told I needed to go because I am in too much pain to get myself there and the pain becomes so disorienting that I can’t function well enough to call 911. <br/>I’ve had multiple doctors recommend pain management programs to me, but I have hesitated to see any pain specialists. During my brief career as a mental health case worker, I accompanied some of my clients to pain management appointments so I have an understanding of how these programs work. I also live in a state where we have been greatly impacted by the “opioid epidemic” and subsequent regulation changes; the hospitals here all have very strict policies surrounding these programs. Drug testing is routine in order to stay in a pain management program, which can be very problematic given the inaccuracy of some of these tests, especially for those taking multiple medications and supplements. (https://pubmed.ncbi.nlm.nih.gov/20689123/ )<br/> My biggest fear is being prescribed a medication like an opioid, which could actually provide enough pain relief consistently to allow me to return to some normal level of functioning, only to have it taken away due to these restrictions. I’ve seen this happen to some of the clients I used to work with, and I don’t think that I would be able to handle the devastation of losing my ability to function all over again. <br/>This also has a very negative impact on doctor-patient relationships which are often already strained for many people with chronic illnesses and chronic pain due to the barriers to receiving adequate care in our healthcare system. The strict policies have left no room for doctors to trust their patients and little room for them to believe that what their patients are reporting is true. This can be especially difficult for people, like myself, whom have invisible illnesses and appear to be young and healthy or capable. After growing up with chronic pain, it can be difficult to express how much pain you feel everyday because you spend a great deal of time and effort hiding how much you’re hurting. It can also be very hard to find doctors you can trust after years of being doubted, and many chronically ill patients or chronic pain patients give up on getting any help from healthcare professionals entirely. <br/> My pain levels are only going to get worse. I will continue to try any new medication options that can help me, but as I am already experiencing with the new anti-CGRP migraine medications, they can stop working at any point and leave me with no options and no hope. At my age, I am very scared of what my future holds, to say the least.<br/><br/>I know that addiction is a huge concern, and I’ve seen the devastation it can cause those suffering from substance abuse problems and their families. But as we have seen during the pandemic, substance abuse rates continued to climb even as access to health care providers became more scarce. ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8896880/ ) Substance abuse is a mental health issue and needs to be addressed as such. Restricting access to pain relief to prevent misuse by those with mental illnesses is greatly hurting those of us in pain from physical illnesses or injuries. This has a huge negative impact on our mental health, as well as our quality of life. <br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a400	Anonymous	None	2022-04-12T00:54:35Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-zn6f-7gni	False	None	False	2022-04-12 06:41:33.461	[]
4795	CDC-2022-0024-4801	https://api.regulations.gov/v4/comments/CDC-2022-0024-4801	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a rheumatologist I see patients with chronic pain every day. Due to local referral patterns I see a very high percentage of chronic pain that is inflammatory in origin but has been misdiagnosed for years as fibromyalgia or other chronic pain syndromes. I believe that this misdiagnosis and subsequent inappropriate treatment is a direct contributor to our current opioid crisis. Through recognition of inflammation as a source of chronic pain, a more comprehensive, individualized treatment plan could be developed. This would involve a multi-pronged, interdisciplinary approach including lifestyle changes, mental health treatment and, when indicated, biologic disease-modifying antirheumatic drugs. <br/> <br/>The inflammatory mechanisms contributing to chronic pain are not well recognized by the general medical community however there is robust pre-clinical data implicating inflammation as a source of chronic pain, both peripherally as well as potentially in the context of sensitization/centralization. An overlooked yet important manifestation of peripheral pain is enthesitis, or inflammation at the entheses which is defined as the transition between tendon/ligaments/joint capsule and bone. There is a paucity of literature on this in general but over the past several years it has been increasingly recognized as an early manifestation of inflammatory arthritis. I believe that enthesitis is a key player in chronic pain syndromes, and that increased recognition of this entity would allow for appropriate management of chronic pain syndromes, and ultimately favorably impact the opioid crisis.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Andrew	None	None	090000648500a40b	Lewandoski	None	2022-04-12T00:56:56Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Lewandoski, Andrew	l1t-zqvn-0w8w	False	None	False	2022-04-12 06:41:33.687	[]
4796	CDC-2022-0024-4802	https://api.regulations.gov/v4/comments/CDC-2022-0024-4802	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I thank you for revising the CDC Clinical Practice Opioid Prescribing Guideline. Please note, however, the draft does not address chronic conditions like restless legs syndrome (RLS) that are different from chronic pain. RLS is a chronic neurological disease that causes an urgent need to move the legs and, in some cases, other parts of the body as well. The symptoms make it impossible to sleep or even to sit quietly, which seriously affects every aspect of daily life.<br/><br/>According to the Restless Leg Syndrome Foundation (RLSF), to which I am a member, In the U.S., nearly 12 million adults and children like myself suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>I have tried a number of drugs to address my RLS since I was first diagnosed in 2013. I have spent many a night driven out of bed because of RLS, walking around the house to all hours of the night. Some drugs worked for some periods pf time, some had side effects, and some were in effective. Some drugs acclimate and you have to try another. Drugs I haqve used include pramipexole, gabapentin, CBD, Tylenol 2, Tylenol 3, and oxycodone HCl (5 mg). Now I am having some success staying a sleep with clonazepam. From communicating with other patients I have learned there is no single remedy that works for everyone. Everyone with the help of their medical professional is constantly trying different options for relief and needs to be able to have access to alll available options.<br/><br/>The first physician to diagnose RLS more than 300 years ago treated it successfully with opioid therapy. Ironically, the 2016 CDC Opioid Prescribing Guidelines often made physicians afraid to prescribe opioids for any reason, even for patients with severe, unrelenting RLS who had been on the same low-total-daily-<br/>In the U.S., nearly 12 million adults and children suffer from RLS. There is no cure. A few prescription medications may relieve the symptoms for a while, but over time those same medications can make the symptoms worse. When all other medical therapies fail, ample scientific research supports the use of low-total-daily-dose opioids to treat severe RLS.<br/><br/>Thank you for your consideration of these vital issues, and please consider the RLS Foundation at www.rls.org as a resource for scientifically-based information about RLS, as it is for members like me.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	William	None	None	090000648500a40f	Burch	None	2022-04-12T01:38:58Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Burch, William	l1t-ztfx-brhy	False	None	False	2022-04-12 06:41:33.914	[]
4797	CDC-2022-0024-4803	https://api.regulations.gov/v4/comments/CDC-2022-0024-4803	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Your proposed guidelines have already trickled down. I benefited from opiate therapy for 20 years. When the first guidelines came out I was lowered to around 120mme and lost some function and a lot of pain relief. My doctor retired and my new doctor lowered me to 60mme. I lost function completely, I ended up in the hospital 4 times with suicidal ideation, I gained weight from inactivity and after 4 years of suffering I developed high blood pressure. Last week I went to the doctor. They told me if my pain isn’t controlled by this dose it may be taken away. Your guidelines are wrong. Just because someone doesn’t have complete pain relief from 50mme that doesn’t mean they won’t benefit from a higher dose. People metabolize meds differently. I guess I should be happy you haven’t decided every Med has a standard dose and if the person doesn’t benefit from that dose they don’t deserve care. I am also require higher doses of blood pressure meds and antidepressants. These guidelines are going to lead to more deaths. I held on for 5 years now hoping that the government would come to its senses and realize that the OD crisis wasn’t caused by us. And that they were “saving us” to death. The dramatic increase in ODs,suicides and medical collapse of legitimate patients should have clued you in by now. I won’t make it if they don’t return my dosage to a level that works. But I’m beginning to think that our deaths are the “intended” consequences.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	0900006485009cee	Anonymous	None	2022-04-12T01:52:04Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-ru3e-qrc2	False	None	False	2022-04-12 06:41:34.142	[]
4798	CDC-2022-0024-4804	https://api.regulations.gov/v4/comments/CDC-2022-0024-4804	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Help!! I’m a chronic pain patient and your guidelines make it extremely difficult to get care. They keep wanting to do injections that don’t help. It’s up to you to right the wrongs you implemented in the prior guidelines. Guidelines have become absolute law. Help the millions who go without pain medication whether it’s surgical, disease or skeletal disease.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Janis	None	None	0900006485009ced	Refior	None	2022-04-12T01:52:15Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Refior, Janis	l1t-rthl-2qmr	False	None	False	2022-04-12 06:41:34.353	[]
4799	CDC-2022-0024-4805	https://api.regulations.gov/v4/comments/CDC-2022-0024-4805	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It’s so egregious that since the CDChas stepped in the middle of Dr. Pain prescribing deaths are up 400% and written prescriptions are BARELY written anymore. It’s now so out of control women can’t get anything for pain after mastectomies?!?! WHAT are you going to do when it’s YOU or your loved one suffering. This must be turned around, this barbaric narrative you’ve written is SO COMPLETELY out of control. Somebody fix this at the CDC!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Jane	None	None	0900006485009cde	Die is Suffering	None	2022-04-12T01:57:52Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Die is Suffering , Jane	l1t-rjqz-45nc	False	None	False	2022-04-12 06:41:34.559	[]
4800	CDC-2022-0024-4806	https://api.regulations.gov/v4/comments/CDC-2022-0024-4806	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My husband has a history of chronic pain medicated with methadone and oxycodone starting in 2004. He had some increases over the years and had been adequately served using methadone 10 mg qid and oxycodone 15 mg qid prn. He hadn't had any increases for over 4 years at the time he was informed by his PCP that he no longer would receive narcotic prescription of any kind. They offered to refer him to a methadone clinic for continued treatment of his pain which speaks either to the ignorance or negligence of this office.<br/>He tried very hard to find a prescribing physician that would continue his regimen but none could be found.<br/>He has never been diagnosed with a substance related disorder and has been absolutely compliant with all medical requirements.<br/>His pain is due to both nerve pain and extensive spinal arthritis. He is, as of 2012, a quadriplegic with one leg amputated above the knee in 2021.<br/>The only option for pain medication in [city redacted], Oregon and environs is a pain clinic. His doctor has attempted to force him onto bupenorphine. In his clinic's intake packet it is made clear that if a patient transitions to bupenorphine they will no longer be considered or treated as a pain patient but will be considered as being treated for a substance related disorder! He has resisted bupenorphine substitution which has done nothing to create a positive doctor patient relationship. The doctor has forced tapering of the methadone to half of what he presented as taking. This has been reduced at 30% per month with two one month stoppages at my husband's request Both times the request was grudgingly granted. Both times the doctor threatened that if he continues to resist being tapered off methadone he will be dropped as a patient. The next taper is a 50% reduction to 10 mg a day. The doctor's goal is to maintain my husband on the oxycodone 15 mg qid prn.<br/>I have observed the effects of the tapering. It has been both physically and psychologically detrimental to my husband. I am his caregiver as well as his spouse by the way. I have witnessed several occasions where simply talking about pain and the forced tapering has raised his blood pressure to very dangerous levels. I have observed a steady increase in his spasticity in his entire body and increased contracture in his knee and fingers. I have observed new twitching or jumping of his ams. I have observed symptoms of early withdrawal and a marked increase in his complaint of pain in his hips and back which did not cause pain before the reduction to 20 mg qid.<br/>Our experience has been doctor driven, doctor controlled. The 90 MME is a limit that is not open to discussion. The bias towards bupenorphine is obvious. The speed of the tapering off of methadone has been slowed down but this always is accompanied by threats of being dropped as a parent. His pain doctor is the head of the local hospital monopoly's pain clinic. If this doctor drops him alternatives may very well not exist. His current PCP cannot prescribe narcotics at this time because he attempted to continue to treat his existing pain patients. Some over the 90 MME. He has been disciplined by the board for trying to help his patients and to follow the 2016 guidines which state a doctor may prescribe above 90MME at their discretion with proper documentation and justification. Oregon apparently has followed others in misinterpreting the guidelines to the detriment of both doctors and their patients.<br/>I believe a new set of guidelines is vital! However, this draft likely will prove insufficient to change current prescribing behavior. Within the draft detrimental effects of opioids is still the primary focus. I believe this coupled with the repeated appearance of the 90 MME rule will result in inadequate change. It seems that two distinct set of guidelines should be published by the agency. A separate and distinct document for doctors treating patients with a history of successful opioid treatment would go further to prevent harmful outcomes. It is historically clear that pain management treatment tends from one end of the pendulum swing to the other. Everything should be done that can be done to ameliorate the negative consequences for compliant chronic pain patients. Any area where doctors and others could again misinterpret, misunderstand and misapply CDC guidelines should be given careful focus. <br/>Given the damage already done to patients and doctors the new guidelines should be written with as little ambiguity as possible. More emphasis on patient participation and agency should be included. Perhaps more emphasis on the shifting to illicit drugs by patients who cannot receive narcotic prescription medication at adequate levels should be made. This phenomenon puts these people at more risk of overdose due to drugs adulterated with fentanyl and other contaminants than they were when treated adequately by a physician.<br/>I sincerely hope you will find usefulness in my comment. I fear the damage may be irreversible.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Nancy	None	None	0900006485009ccd	Henderson	None	2022-04-12T01:58:55Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Henderson , Nancy	l1t-reey-1kp8	False	None	False	2022-04-12 06:41:34.768	[]
4801	CDC-2022-0024-4807	https://api.regulations.gov/v4/comments/CDC-2022-0024-4807	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I was injured in an automobile accident in n1997. I underwent 4 unsuccessful Cervical Spinal Surgeries within the next 10 years as I ended up with Titanium Rods, Plates and Screws in my Cervical Spine. I have Radiculopathy in both my hands. I was then diagnosed in 2010 with a Bone Disease, Avascular Necrosis, caused by Prednisone use all my life for a history of Asthma. I had to have both of my hips replaced, needing my right hip replaced again because of metal toxicity. I will have to have all of my Joints replaced in my Body at some point in my life. I was just diagnosed with Lupus, why I have Severe Neuropathy in my Feet. I've been a Pain Patient since my car accident in 1997 which was not my fault, someone hit me from behind. Took my nursing career from me. <br/>The 2016 CDC Guidelines restrict the Pain Management Physician's ability to treat their Patients conditions adequately and Providers are afraid of loosing their licenses. The use of MME's is harmful and not backed by science at all. We're all individuals and a one size fits all in Pain Management doesn't work at all. <br/>The DEA has taken the Guidelines and are policing our Physicians. Remove the guidelines and give our Providers the ability to diagnose and treat painful conditions. <br/>Chronic Pain Patients are not Addicts! Pain Patients are Dying, committing suicide because they are in such severe pain!!!! Do the right thing by millions of people suffering with painful conditions.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Natalia	None	None	0900006485009cc1	Zylich	None	2022-04-12T01:59:47Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Zylich, Natalia	l1t-rc3e-efa8	False	None	False	2022-04-12 06:41:34.981	[]
4802	CDC-2022-0024-4808	https://api.regulations.gov/v4/comments/CDC-2022-0024-4808	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a 61 year old female and I was born with birth defects that resulted with my having 30 surgeries between the ages of 1 year and the last surgery at age 13. Due to the type of surgeries that I had I have been living with debilitating chronic pain for a long time. I was very fortunate to find a pain management specialist that truly cares about his patients and for the past 17 years has always kept me informed and educated me about pain meds and treatments. I was able to keep working for 5 years longer than I expected thanks to the pain medications (opioids), and now I am able to keep my independence and care for myself at home and have a quality of life. Without these meds I wouldn't be able to function I would be bedbound in a nursing home. I am rarely without pain but when my pain is at a level 10 on the pain scale the medication brings it down to a level between 3 and 5 which enables me to keep moving and care for myself and have a quality of life. With all I have been through in my life what I most want is to be able to stay home and not end up in a nursing home. Not all pain is the same and not everyone has the same tolerance for pain. Please let the pain management Dr's do their jobs. They have gone to school many years and have been trained in this specialized field of medicine. You cannot paint everyone with the same brush, or broadly decide what dosage everyone should not exceed, this should be left to the professionals that have been trained to treat each patient individually.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Leslie	None	None	0900006485009c9b	Collins	None	2022-04-12T02:00:40Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Collins, Leslie	l1t-qvoj-gd1o	False	None	False	2022-04-12 06:41:35.189	[]
4803	CDC-2022-0024-4809	https://api.regulations.gov/v4/comments/CDC-2022-0024-4809	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a173	None	None	2022-04-12T02:01:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Colorado Society of Oral and Maxillofacial Surgeons	l1t-s3op-lj1g	False	None	False	2022-04-12 06:41:35.407	[]
4804	CDC-2022-0024-4810	https://api.regulations.gov/v4/comments/CDC-2022-0024-4810	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I’ve had pain for 38 years. I was injured in 1983 before they treated with opiates. I am worse because of the treatment I received before opiates but did have 20 years of decent pain relief and function from opiates and adjunct therapies. I’ve still do PT exercise/stretches,biofeedback, hypnotherapy, mindfulness, meditation, cognitive Behavioral Therapy and guided imagery. That and the 75mme my doctor begrudgingly gives me. I use distraction constantly to cope and I sleep 1-2 hours at a time at night before the pain wakes me. This isn’t a life anymore. I’ve tried massage,chiropractic, osteopathic manipulation, ganglion blocks, trigger point injections, facet injections, epidural injections, intersegmental traction, steroid dose packs,joint injections, Botox injections, topical lidocaine, capsaicin and menthol,Gabapentin,individual therapy, occupational therapy, group therapy,ketamine infusions, capsules and nasal spray,acupuncture, acupressure, yoga, exercise including Pilates,every diet,supplement and detox treatments mentioned for pain,inversion therapy,Kratom,MJ, CBD, nerve ablation, multiple electric stimulation therapies (tens, equiscope,biowave),multiple surgeries including total joints,braces,oral splints, Myofascial release,reiki,magnetic therapy,crystals, deep breathing,Buprenorphine,LDN, TMS, Buprivacaine and pain pump. The opiates helped the most and cost the least. The push against opiates isn’t going to help the OD problem because it isn’t about the treatment of bodily pain. The issue has to do with kids trying to treat emotional or psychological pain. Unfortunately opiates don’t work for that the way it does bodily pain. You have managed to make the OD problem much worse while torturing and killing the disabled, elderly and Vets. There is no way you can look at your statistics and not realize this is a big mistake.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a178	Anonymous	None	2022-04-12T02:02:54Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-shyg-1ppi	False	None	False	2022-04-12 06:41:35.620	[]
4805	CDC-2022-0024-4811	https://api.regulations.gov/v4/comments/CDC-2022-0024-4811	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a17c	None	None	2022-04-12T02:08:42Z	Physicians for Responsible Opioid Prescribing (PROP)	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Physicians for Responsible Opioid Prescribing (PROP)	l1t-s6ld-b57z	False	None	False	2022-04-12 06:41:35.861	[]
4806	CDC-2022-0024-4812	https://api.regulations.gov/v4/comments/CDC-2022-0024-4812	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been thinking about the actual guidelines for opioid prescribing put forth by the CDC now in 2022 and from 2016. I was wondering what are the actual risks and benefits of the guidelines themselves. They have and will cause harm to everyone along the way.<br/><br/>Risks of having Opioid Prescribing Guidelines <br/><br/>* They have/will destroyed Doctor patient confidentiality and trust.<br/>* Gave Doctors and patients alike PTSD.<br/>* Turned Doctors into fearful police against patients and their fellow colleagues.<br/>* Caused many suicides and will cause more in the near future.<br/>* Caused Doctors to go to prison and lose their practices, assets, reputations.<br/>* Turned patients into test subjects with awful invasive procedures and Non FDA approved treatments and medications.<br/>* Endless cocktails of meditation with horrible side effects.<br/>* They have helped fuel the black market.<br/>* Has caused the DEA to not pay attention to the illicit fentanyl flooding thru the country.<br/>* Pushed law abiding citizens to the streets out of desperation.<br/>* Caused almost all Doctor appointments to be nothing but talking about addiction and not about symptoms.<br/>* Caused unnecessary suffering of chronic pain, acute pain, recovery from surgery.<br/>* Caused more people to stop working or contributing to society due to suffering.<br/>* Been a massive distraction to communicable diseases like Covid.<br/>* Has seen the highest levels of overdoses in history despite having low prescribing rates by doctors.<br/>* Mass confusion in the medical community.<br/>* Fear of opioids all together.<br/>* Unnecessary End of life suffering.<br/>* 365 24/7 Unnecessary Chronic pain suffering.<br/>* Children and victims of horrible of crimes will continuously be excluded from proper pain control. Due to saving them from possible addiction.<br/>* Wasting money on UA’s and needless appointments.<br/>* Making it almost impossible for patients to travel.<br/>* Makes it hard to find doctors that specialize in your particular illness without being labeled as a doctor shopping, drug seeker, or addict.<br/><br/>The list of consequences could go on…<br/><br/>Benefits of having Opioid Prescribing Guidelines <br/><br/>* I’m trying so hard to think of one positive. Sadly I cannot.<br/><br/>The guidelines were influenced by biased people that do not know about pain. The statistics were padded with street overdoses where there is no quality control or oversight of street drugs. They are not showing the numbers of legal opioids prescribed by doctors deaths.<br/>It’s easy to lie with statistics.<br/>Please admit that you made a grave mistake by writing guidelines in the first place. Please Redact and Refute all Opioid Prescribing Guidelines. Let the medical community know that you made a mistake. Please the Risks of your guidelines outweigh the benefits!<br/><br/>I am a 40 year old self-made business woman. I live in Minnesota. I will have to stop working and sell my business if this suffering is to continue. I was cut off in the fall of 2019 of my opioid medication because of my Doctors fear of the government interference in my Doctor patient relationships. I have no Doctor. I am absolutely terrified to find another one. I can only barely work now. The rest of the time I have to lie down. I had to give up on friends and relationships. Loss of time with family. Hobbies, what’s that? Charity work days are long gone. I have so much more to give if only my cries weren’t falling on deaf ears. I live my pain 365 24/7! My life depends on you!<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ms.	None	None	090000648500a180	Brown	None	2022-04-12T02:09:49Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Brown, Ms.	l1t-skk6-o908	False	None	False	2022-04-12 06:41:36.076	[]
4807	CDC-2022-0024-4813	https://api.regulations.gov/v4/comments/CDC-2022-0024-4813	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I request that the CDC rescind/revoke the 2016 guideline and withdrawal the 2022 guidelines... because both are based on a MME system that has no science and/or double blind clinical studies behind them and in support of them.<br/><br/>https://www.acsh.org/news/2022/03/01/true-story-morphine-milligram-equivalents-mme-16154	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kerrie	None	None	090000648500a188	Murray	None	2022-04-12T02:10:01Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Murray, Kerrie	l1t-sms4-an0g	False	None	False	2022-04-12 06:41:36.284	[]
4808	CDC-2022-0024-4814	https://api.regulations.gov/v4/comments/CDC-2022-0024-4814	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Cdc-2022-0024-0001 (cdc revised 2016 guidelines) I am one of the patients who have been affected by the 2016 CDC Guidelines. After finally finding what works for me, after trying everything else (Physical Therapy, chiropractor, massage, acupuncture, Lyrica (which put me in the hospital), gabapentin, etc. - I am sensitive/allergic to many medications, etc.) out there I finally found a set of opioids that work for me. I was able to take care of my self and function (do dishes, laundry, drive short distances, walk short distances) etc. I was told by my PM doctor that they wished all of their patients were as good as me (never had a bad urine test, always did exactly what I was told to do by my doctors). Years later when the guidelines came out my pain management doctor told me that they have to cut all of their patients back. I was forced tapered, with no choice. So they cut one of my two (2) prescriptions in half (the higher one), and I was told that in 2 months that I would be cut in half again. I lost all function (I was bed ridden, not able to drive, not able to walk, I lost all function do to the pain and my husband has dementia, so I need to take care of him). I called around trying to find a new PM doctor. One doctor kept telling me to “shut up” every time I tried to ask a question and told me that he would put me on “Bube”. Well I did not choose him (he would not let me talk). One of the doctors I went to (my current PM doctor) took me, since my primary doctor (who has retired) referred me to him. This PM doctor switched me back to my original opioids, and like clock work I was back to where I was before I was forced tapered. Please stop all of the CDC revisions and also remove the original 2016 guidelines. All it has done is hurt the pain patient community. The MME calculations are not based off of real science, and just hurts the pain patients. If you want to write guidelines then they should be written by all pain management doctors with only one addition specialist. Not created by psychiatrists and addition specialists. I ask you to please help us. I have never abused my medications and I swear that I have PTSD, because every time I have an appointment with my PM doctor, I stress that when I walk in that I will be forced tapered again or that he will retire and the I will not be able to find a PM doctor who will work with me and keep my on the same medications. If you go through with this revision, then all the doctors will be using the 50 MME, which will just hurt us more. I beg you to please help us!!!! I am an individual not being paid by anyone/company.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ruth	None	None	090000648500a190	Koznecki	None	2022-04-12T02:11:42Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Koznecki , Ruth	l1t-srca-4r36	False	None	False	2022-04-12 06:41:36.493	[]
4809	CDC-2022-0024-4815	https://api.regulations.gov/v4/comments/CDC-2022-0024-4815	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Allow people to be treated with the medication that has been proven to work for them and all other treatment options are unsuccessful. How and why would you force people to taper if it’s taking away their quality of life? The MME “cookie cutter” formula is a joke. Everyone is made different. People metabolize medications differently. If all appropriate measures are taken, a shelf life approved prescription of narcan for the patient, and they have a profound chronic condition then continue their regimen that worked for them under qualified doctors supervision. Proper use isn’t the same as abuse.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Taylor	None	None	090000648500a1ae	Kistulinec	None	2022-04-12T02:15:36Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Kistulinec, Taylor	l1t-t63m-b5lh	False	None	False	2022-04-12 06:41:36.707	[]
4810	CDC-2022-0024-4816	https://api.regulations.gov/v4/comments/CDC-2022-0024-4816	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Tell me why I have to live in pain everyday. I've run the game of injections, PT, OT, Electro-therapy, yoga, Rieki, OTC meds. For 16 years after a horrible car accident that left me with 5 surgeries,and chronic back pain I am now having to begging for help. Now that I am fighting AML the pain has increased and no one wants to treat my pain. My primary says the increase pain. Is cancer related and my Oncologist should prescrib, my Oncologist says the pain is a chronic ic issue and my primary should deal with it. So I'm going to ask you, why did you not take into consideration the millions of people like me who are impacted on a daily basis. How do you all sleep at night knowing that some have had enough and just end their lives because dying was preferable to living in pain. Say that last sentence again. Some would rather end their lives than live another day in pain, pain that could be completely treatable. So who's buying you off, Prop? [name redacted]? As a place of disease control, addiction is still raging despite the cruel "recommendations" Do better.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Kimberly	None	None	090000648500a1c5	CLARK	None	2022-04-12T02:17:00Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from CLARK, Kimberly	l1t-tgdc-efeu	False	None	False	2022-04-12 06:41:36.929	[]
4811	CDC-2022-0024-4817	https://api.regulations.gov/v4/comments/CDC-2022-0024-4817	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The cdc guidelines of 2016 forced all chronic pain patients off opiods or the lucky ones still got the 90mme limit. I became totally bedfast and I've been suffering just over 4 years now. The doctors in washington state want to do nothing but cut people off their meds. My doctor used the promise of increasing my meds if I'd do the sleep study which was excrciating for me to get through and after I completed it she jerked the rug out from under me and I'm still suffering and about to give up as the pain is too much to bear with several spine injuries and totally worn out knees .. the ostio dr told my primary care dr that I should be put back on the meds that allowed me to function but both the pain management and primary care refused to do so.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Tim	None	None	090000648500a1c7	Smith	None	2022-04-12T02:17:12Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Smith, Tim	l1t-tgrq-sujf	False	None	False	2022-04-12 06:41:37.138	[]
4812	CDC-2022-0024-4818	https://api.regulations.gov/v4/comments/CDC-2022-0024-4818	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am a sixty year old physician. I have chronic pain due to an accelerated, congenital form of degenerative osteoarthritis which affects my spine and small joints. My condition started in my early twenties during the second year of medical school. I’ve been on some type of NSAID’s since then. I’ve had spine surgery, shoulder surgeries. The spine pain became intractable in my early forties. My rheumatologist recommended I start opiods. I resisted because I trained at a time when narcotics were only an option for end of life care. I resisted for several years. I sought a second opinion. I saw specialists at prestigious university hospitals. But after years of dealing with the pain, my mental health suffered. I felt hopeless and fatigued trying to cope and although suicide was never an option, the thought of death was not unwelcome. I had wonderful physicians who I always felt had my best interests at heart. <br/><br/>It all began to change when the “opiod crisis” became a national headline. Since then opiods and the treatment of pain has become part of a national discourse that has played out on talk shows, by folks who have no business speaking about health matters. It made for catchy political ads from politicians. We as physicians have remained mostly silent. We have allowed others to speak for us whether out of fear or apathy. We have allowed policies to be created that harm patients. Yes, opiods should be the last alternative for folks like me who suffer from a debilitating condition. But they should be part of the armamentarium available to physicians who treat patients like me. A patient’s health and well being should not be guided by fear of reprisals for the prescribing physicians. I was “dealt a bad hand” was what my rheumatologist told me twenty years ago. As the opioid crisis unfolded, he assured me that he would always advocate for me. But as time passed I could see from the strain in his face that it was getting harder. I was more fortunate than most because I had continued care. The opiod crisis is not a problem created by patients who suffer from chronic pain. As a patient I feel abandoned and stigmatized. As a physician, I am ashamed that we have allowed it to get this far.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a1d4	Anonymous	None	2022-04-12T02:17:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-tjxe-n4zv	False	None	False	2022-04-12 06:41:37.359	[]
4813	CDC-2022-0024-4819	https://api.regulations.gov/v4/comments/CDC-2022-0024-4819	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am an RN and i was tough that pain is one of the vital signs since I’ve learned how pain impacts all aspects of life. I work in mental health and many of these patients aging with true health problems are not being treated properly causing them to give up or go to the streets then OD because they got ahold of something that wasn’t safe but they were desperate and didn’t want to die by giving up. We all need to put ourselves in other peoples shoes and although monitoring and pain controls are important and should be enforced we cannot leave human beings to suffer like this. This could end of being you or you’re loved one and when it is you may see the real impact up close. Overdoses from these street drugs, other high addictive problems such as alcohol use, smoking and even eating and mental health disorders including disability rates are a problem too but people often go to anything that will help them feel better. We all know some will become addicted but most who are screened and monitored only become dependent on the med for quality of life. There is a real problem when pain is not treated or doctors can’t make professional calls for their patients for pain because of fear of the government. There is a problem when some doctors judge because of the stigma on pain and therefore don’t treat. We all experience pain differently and you can’t always see it either. Labs, tests don’t catch everything in the beginning of some disease processes so we need to know our patients and give them a chance to be responsible with contracts to see if they improve and re-evaluate this regularly. People don’t want to live this way and deserve to be happy so please try to understand that. I’ve seen too many times in my specialty suffering agony and often suicide and it all started because their pain was ignored especially with labels of mental health, even though we are told not to stigmatize. People can only tolerate so much and if they are not usually going to become addicts, care should be individualized. Pain causes so many problems too so please know that opiates while not being the only thing have a place and a purpose. One size doesn’t fit all. Let’s take care of each other because it’s pretty obvious that more serious overdoses and other problems in society have gotten worse not better since these opiate mandates were put in place with so many restrictions causing doctors to not be able to treat pain appropriately. I advocate for proper pain relief and the use of opioids when effective and used properly with contracts, education and monitoring is in place without a limit. Doctors should use their own education, experience and know their patients so let them take care of them. I truly believe this could turn many problems around in our communities and while there will still be some addiction and misuse of medication most will be safer then what’s happening now. Thank you and god bless!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a1d6	Anonymous	None	2022-04-12T02:18:48Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-tkk5-mege	False	None	False	2022-04-12 06:41:37.567	[]
4814	CDC-2022-0024-4820	https://api.regulations.gov/v4/comments/CDC-2022-0024-4820	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Do you know what it’s like to walk around all day saying “it’s just pain it doesn’t mean anything” or “you’re ok”? I do. It’s called self talk, part of CBT. Does it make the pain better or increase function? No! But I do it. Do you know what it’s like to have to do PT stretches,even though they are extremely painful, just to be able to move,walk,eat and talk? I do. It’s what I have to do because the CDC,DEA and PROP decided to take what pain relief I used to function because of a flawed belief that the treatment of pain was responsible for the addiction and ODs of young people. The new guidelines are pushing the idea that non pharmaceutical treatments are all that’s needed for pain. I have much experience with these treatments. I’ve not experienced decent pain relief with any of them. PT is helpful but doesn’t relieve my pain. Massage and Myofascial release didn’t help and is painful in my face. Electric stimulation therapies (tens units,equiscope,biowave) cause muscle spasms for me. Acupuncture and acupressure did a little while it was being done. Chiropractic and osteopathic manipulation didn’t help and caused pain when done on my neck. The psychological therapies (CBT, mindfulness, meditation, biofeedback, hypnotherapy , guided imagery,individual therapy, occupational therapy and group therapy) helped to cope emotionally but did nothing for the pain. Reiki,laying on of hands, crystals and magnetic therapy did nothing. Intersegmental traction and inversion therapy didn’t help. Braces and splints didn’t help. Heat and ice do a little but only while it’s being applied. These are the ones I consider non pharmaceutical. But there are many others I’ve tried that you may consider like injections and ablations which had their own problems attached and not good pain relief. I need treatment and you are denying what worked for me for 20 years. You are not saving me, you are killing me. These guidelines will finish the job.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a416	Anonymous	None	2022-04-12T02:29:18Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1t-zx4u-81m7	False	None	False	2022-04-12 06:41:37.779	[]
4815	CDC-2022-0024-4821	https://api.regulations.gov/v4/comments/CDC-2022-0024-4821	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Here I am, crawling to accomplish something I should have already done.  Pain is a constant barrier in my life, especially since the CDC decided to get involved in the "War on Drugs" with their Opiate Prescribing Guidelines in 2016.  I have been forced off of my Oxycodone dose of about 80-100 mg/day.  Unfortunately, I live in a state that has adopted the 50 MME/day limit, and have been told, admittedly, by THREE different pain medicine physicians at three separate practices that 30 mg/day of Oxycodone is insufficient to alleviate my suffering, but their hands were tied by the CDC.I think it is inappropriate for the CDC to interfere with my doctor patient relationship, especially when the data used to do this is completely flawed.  The idea of MME's has been debunked over and over throughout the years, yet the CDC continues to tout it as Gospel.  I feel that any mention of MME's in the 2022 guidelines should be stricken and the 2016 guidelines be rescinded.  Consideration needs to be given to those of us that have certain genotypes that do not allow us to metabolize our pain medication as well as others. <br/> Many patients do require an increase in their opioids over the course of their lifetime because they are afflicted with progressive, degenerative diseases that only get worse with time. Imagine today as the worst day of your life as you struggle to do the basic activities of daily living. Then, realize that this will probably be the best day you will have for the rest of your life because it is only going to get worse from here. The sense of hopelessness is overwhelming, especially when one has lived a purpose-driven life such as me. I have lost my 30-year career as a RN because I was unable to perform my duties. I lost my husband because I was no longer able to be a wife to him. I no longer have any friends. Even my family has forgotten about me. People call and invite you on outings and visits, but when you constantly have to decline because of inadequate treatment for a very painful condition(s), they stop calling. Then you become the Forgotten One. I was the one at work that was playfully dubbed "The Social Director" because I was constantly arranging outings, lunches, vacations, and huge parties for the staff, so no, I was not always this way. I worked during high school and nursing school/college. After becoming a RN, I worked as much overtime as I could and held a second job for several years. I had taken the Master Gardener's course in 2003 and put in many volunteer hours that benefitted poor homeowners and a local hospice house by beautifying the surroundings. I spent at least 10 years in animal rescue, opening my home to hundreds of abused and neglected dogs, rehabilitating them, and finding compatible forever homes for them. Now I am basically housebound using delivery services. <br/>Chronic pain is different from acute pain because you know it will never get better, much less go away. It needs to be treated for life, just like many other conditions requiring lifelong treatment with medications. We are not addicted. We are dependent on these drugs, just like someone that suffers from chronic depression. It would be inconceivable to deny a depressed person their antidepressants or a diabetic their insulin. I was force-tapered from my pain medication, and yes, I had symptoms of withdrawal, but I NEVER craved the drug. This is what separates us from those that have an OUD. Chronic pain sufferers take drugs for physical reasons, not mental.<br/>The CDC must admit that its attempt to wage a war on drugs has been unsuccessful and devastating. The statistics prove this. The vast majority of overdoses are not the pain patients that go to a qualified physician, get evaluated, get their prescription and go to a pharmacist to have them filled. It is the illegal drugs coming across our borders and people taking them for recreational purposes that are overdosing. The number of prescriptions has fallen dramatically since 2016, yet the number of overdoses has risen. <br/>In closing, I ask you to please stop this madness and harming of innocent people that did not ask to be in horrendous pain on a daily basis by rescinding the 2016 guidelines and especially erasing any mention of MME's. It was my honest intent to include statistics and a bibliography, but the pain and inability for me to sit at a computer for any length of time precluded this. If you have any question or comments, please feel free to contact me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	CHERYL	None	None	090000648500a425	HENKEL	None	2022-04-12T02:30:12Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from HENKEL, CHERYL	l1u-03az-2bjl	False	None	False	2022-04-12 06:41:37.998	[]
4816	CDC-2022-0024-4822	https://api.regulations.gov/v4/comments/CDC-2022-0024-4822	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	For those of us with chronic pain these medications our blessing in the form of lowering the level of pain for a period of time so that we can function just because there are people who improperly use them or acquire them is not justified to stop people who do need it desperately nobody can know the pain that you feel and the only way to get any relief is through these medications.<br/>They may need to stop the people misusing them but not jeopardize the people who don't who literally take it and need it<br/>Thank You	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Reenie	None	None	090000648500a431	Jenness	None	2022-04-12T02:30:25Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Jenness, Reenie	l1u-06u3-flhy	False	None	False	2022-04-12 06:41:38.210	[]
4817	CDC-2022-0024-4823	https://api.regulations.gov/v4/comments/CDC-2022-0024-4823	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I am writing specifically about patients with intractable chronic pain who are in dire need of relief. What’s urgently needed is new Federal CDC guidelines with latitude for doctors to treat their patients as individual people rather than as a group of people with differing needs. It’s also very important that the new guidelines are uniform across the country. This would allow for transferability from one state to another if a patient relocates. This should work for doctors as well if they change residences from one state to another.<br/><br/>My adult daughter has been suffering with intractable chronic pain from fibromyalgia for a few years. After trying various pharmacological and non pharmacological remedies, the only medication that has given her relief during almost unbearable pain flare ups has been oxycodone. This drug has allowed her to almost complete a masters program in psychotherapy and work professionally in clinics as a senior counselor. Having relocated to a different state, she has not been able to find a doctor who would prescribe oxycodone for her chronic pain. The 2016 CDC guidelines have not been helpful. Her pain became so intractable that she was forced to interrupt her education and profession for the past couple of years. <br/>It is a terrifying for one in her 30s to have a significant part of her life being put on hold along with a much reduced quality of life. The pain from fibromyalgia has rendered her disabled at times.<br/><br/>There’s a category of chronic pain patients for whom carefully prescribed and properly monitored doses of oxycodone or oxycontin are the only therapies that allow them to live some semblance of a normal life. For them, where nothing else brings relief, it is literally life saving. <br/><br/>These are powerful drugs and must be prescribed with sound medical knowledge and caution. It is unethical and just plain wrong for chronic pain sufferers to be made to suffer because of blanket and inadequate guidelines that tie doctors’ hands. <br/><br/>I hope that the CDC partners with other appropriate Federal, and State Medical Licensing Agencies, and appropriate others including pain patients themselves across the country and formulate sensible and practical public policy with rules and guidelines. These guidelines should include a measure of latitude for doctors to treat their patients as individual people, with individual needs, effectively, and with well informed thoughtfulness on the part of both doctor and patient. I believe this is the kind of humane care, caution and latitude utilized by anesthesiologists in the operating theater. There’s the recognition that one size doesn’t fit all, and the anesthesiologist must decide on the type of anesthesia and dosage, and monitor the patient closely for a successful outcome. <br/><br/>So, as with the anesthesiologist, a doctor prescribing powerful opiates must be required to be medically educated about the drugs, and carefully monitor their patients. Patients also need to become well informed about these drugs and should be encouraged to participate actively with their doctors and pharmacists as a team for effective healing outcomes. <br/><br/>Doctors need to have clear rules and guidelines regarding their responsibility to their patients; as an example, identify backup doctors to treat their patients in their temporary absence.<br/><br/>The CDC now has an amazing opportunity to listen, and really hear what chronic pain sufferers are saying and do right thing. They only want a life. In my daughter’s case it is to complete her graduate program - just two more courses - and resume her profession in mental health therapy. <br/><br/>I am anticipating practical, responsible and humane rules and guidelines that would alleviate suffering of intractable chronic pain patients and save lives.<br/><br/>Thank you for this opportunity to comment.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a437	Anonymous	None	2022-04-12T02:31:04Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-0a2w-8zrp	False	None	False	2022-04-12 06:41:38.419	[]
4818	CDC-2022-0024-4824	https://api.regulations.gov/v4/comments/CDC-2022-0024-4824	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The cdc guidelines that were put in place and tied the hands of pain management doctors have caused more harm than good. These doctors are specialists in the field and provide some quality of life for people in chronic pain. It has also opened a black market for fentanyl laced pills which is where the majority of your overdose deaths come from. They are not coming from the legitimate pain patients who seek proper care thru the proper channels. Why punish people in chronic pain? Why attack these doctors and pharmacists? Let them do the job they are qualified to do and remove an arbitrary cutoff. One size doesn’t fit everyone especially when referring to chronic pain. There are so many factors that should be reviewed and processed by the pain management specialists.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a447	Anonymous	None	2022-04-12T02:31:18Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-0ejh-nq5i	False	None	False	2022-04-12 06:41:38.631	[]
4819	CDC-2022-0024-4825	https://api.regulations.gov/v4/comments/CDC-2022-0024-4825	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	To Whom it May Concern:<br/><br/>I've been looking back over the last 5-10 years as a Chronic Pain Patient. I've witnessed a lot of changes, most of them not positive. It seems that ever since the CDC began telling doctors how to prescribe (although they have no expertise in this area), it's been a downhill ride. <br/><br/>To begin with, [name redacted] was the lead author of the guidelines, yet it's a known fact that he has a conflict of interest. He has admitted to this:<br/><br/>“I'm present. Uh … I do have a conflict. I receive funding to conduct reviews on opioids, and I'll be recusing myself after the um, director's, uh, um, um, uh… update.”<br/><br/>- [name redacted], Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.<br/><br/>Ever since these "guidelines" were implemented, doctors became afraid to prescribe pain medications for fear of prosecution by the DEA, an organization with a questionable past - and present. I understand there were some "bad actors", doctors who would prescribe far to many narcotics under questionable circumstances. But they represent the minority, NOT the majority. "Although prescription drug misuse is common in the United States, the majority of people (87.2 percent) who take prescription pain relievers do not misuse them. Understanding the prevalence of and reasons for prescription drug misuse has major public health implications." ([names redacted] - SAMHSA, 2017<br/><br/>Suicides by pain patients are up dramatically, because their pain is now basically untreated. This all came about because of the "overdose crisis" which the media mistakenly called "the opioid crisis". Hell, "opioid" wasn't even a real word until a few years ago (we've always referred to them as "opiates"), and there was NO SUCH THING AS AN "MME". Comparing one narcotic to another is like comparing apples to oranges. Anyone involved in psychopharmacology will tell you that (if they're honest, that is). <br/><br/>So why is the CDC, an organization created to help monitor infections diseases, involved in this at all? Has their interference resulted in a drop in opiate overdoses? No. <br/><br/>As a result, I would ask the following:<br/><br/>"1) The CDC should immediately rescind the most harmful or misapplied portions of the 2016 Guideline. This should include renouncing and rescinding arbitrary dosing thresholds, commonly referred to as MME, by health insurers, state and federal governments and pharmacies. It should also include a ban against involuntary opioid tapers.<br/><br/>2) The CDC should announce its strong commitment to balanced opioid policy, including individualized care for patients with chronic pain, explicitly acknowledging that some patients with chronic pain – especially those with serious illness – may benefit from treatment of opioid analgesics when medically appropriate.<br/><br/>3) The CDC should suspend indefinitely any plan to implement its 2022 Guideline, which are currently expected to be published in the Federal Register in late 2021. <br/><br/>In addition to these measures, we call on the United States Congress or the U.S. Department of Justice to investigate [name redacted], PROP and the Centers for Disease Control to determine whether they violated any federal laws or policies when creating either the 2016 or the expanded 2022 Opioid Prescribing Guidelines. We also encourage legal scholars to examine the harms inflicted upon patients with chronic pain as result of the 2016 Guideline, or from their misapplication, to determine whether these harms could be remedied through litigation. Undoing the ongoing harms of the CDC’s Opioid Prescribing Guideline for Chronic Pain and preventing further harms from the expanded 2022 Guideline - which were drafted with all the same ethical conflicts of the 2016 Guideline yet will affect even more patient populations - is an imperative for all invested in public health and the treatment of pain. Undoing the harms of the CDC Pain Guidelines represents a critical step in restoring balanced pain policy, which must include access to judiciously prescribed opioid analgesics, to the millions of Americans living with chronic pain every day of their lives."<br/><br/>Sincerely,<br/><br/>Another Chronic Pain Patient harmed by the CDC's interference in the practice of Pain Management	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a45e	Anonymous	None	2022-04-12T02:33:13Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-0nh9-m78g	False	None	False	2022-04-12 06:41:38.837	[]
4820	CDC-2022-0024-4826	https://api.regulations.gov/v4/comments/CDC-2022-0024-4826	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have been a chronic pain sufferer since 2007. My Dr's worked closely with me as I had never taken more than Ibuprofen for pain and was Leary of pain medication. I didn't want to live life, "high". I do not like the feeling at all. My Dr's very slowly increased, changed, address, took away, made recommendations etc. when it came to my pain/ pain medication. As we tried medications and/or discovered what worked, what didn't, which doses were elective etc. We finally reached a dose and a pain level that I could live with! No, I'm never pain free but I do have a life again. Over the past 15yrs I have only had a couple of increases and choose to increase the mildest of pain controlling medications over the Opioids. Before medication, my pain wasn't my only symptom. WITH pain relief came clarity, energy, a better attitude, a desire to live each day fully. I do not/have never liked Opioids. I don't have a choice. A 16 inexperienced driver took that from me, I was 42 years old and was left physically and mentally disabled. Medication had enabled me, though still in pain as I'll only take what's needed, to live instead of just existing. They're still a lot I can't do but I'm so grateful for what I can do thanks to Dr's who helped me to get to where I am today! My life is nowhere near where I had envisioned/meant it to be at this age but I'm alive and I can accept where I am because at least I had Drs who really listened and helped me work out the treatment that I specifically needed and could live with. Again, I wanted to live and experience everything each day as fully as I can, with a pain level that I can live with, not be "high" and unaware of my surroundings. As soon as the new guidelines were STRICTLY ENFORCED by JOHN'S HOPKINS, it happened swiftly without warning, my medications were IMMEDIATELY reduced by 25%. It was like being blindsided by a truck! A month prior my Dr advised me that he had excepted a new position and would be leaving. My new Dr reduced my medications, informed me that Hopkins would no longer prescribe Opioids and advised me to find a pain specialist. It took me a few months to digest everything and find a pain specialist. Upon doing so and talking to the office specialist, he informed me of the CDC guidelines. I told him that my understanding was that those guidelines were merely suggestions and that I thought it was at his discretion to treat patients individual needs as he sees fit. He informed me that they rules were in fact demand and that he feared losing his medical license. I believe that is the consensus among JOHN'S HOPKINS Drs as well since they have opted not to prescribe OPIOIDS at all. No great area. I now believe this was the belief of my Dr who left HOPKINS. I've had other people tell me that their Drs too are afraid of losing their licence as well and they too are agreeing to strict guidelines. Drs are absolutely afraid and feel threatened, so much so that they are choosing their careers as opposed to their oathes and their patients suffering. It's inhumane to have the means to help people who are suffering but choose not to. Every health professional I've approached and asked if the guidelines are a recommendations or law, all age with the latest choice and are afraid of losing their careers or facing prosecution. DRS ARE AFRAID TO TREAT THEIR PATIENTS. This is VERY CONCERNING AND WRONG. The fact that they are being forced to choose, to me, is UNCONSCIONABLE. There are protocols put in place to ensure patients are following rules. Those who are following rules shouldn't be penalized. If someone is intent on risking their lives, using drugs inappropriately, NO law is going to stop them. Now people suffering who did the right thing, followed protocols and rules, who were compliant are being forced to the streets for drugs that WILL/ARE killing them because their pain is not being managed. Why are all of these Drs fearing that their medical careers are being threatened over recommendations/guidelines? Why do they feel like they have to choose compassion/right over losing career/licences? Something does not add up here and the only ones suffering are chronic pain patients. It's not right and it is INHUMANE. Thank you.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a45f	Anonymous	None	2022-04-12T02:33:50Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-0nsb-77cg	False	None	False	2022-04-12 06:41:39.043	[]
4821	CDC-2022-0024-4827	https://api.regulations.gov/v4/comments/CDC-2022-0024-4827	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I do not think specific illnesses should get green light for opioids I am glad they get help<br/>There are many rare painful illnesses I have Dopamine Responsive dystonia about 1 in 2 million/billion <br/>It responds to parkinson meds but they trigger horrible vomiting and headaches<br/>I will never have a cure no research I will have it until I die and it is <br/>The pain is so terrible feels like bones breaking<br/>Dystonia standard care opioids and benzodiazepines. I lost my career<br/>my spouse my financial independence and I decided<br/>not to drive anymore Why would anyone want loose all this ? I do not <br/>mind peeing in cups travel by ferry and bus to go into<br/>office Medicare refuses pay for the hydromorphone suppositories which work better do to chronic nausea. They were here prior to FDA <br/>Now that palliative care and hospice are separated <br/>a rare illness that causes pain and no hope cure should not be denied help pain<br/>I also have scoliosis from this dystonia and no surgery can be done as I continue get more crooked<br/>because the rods would pop right out per surgery consult. I go on extra steroids if <br/>dystonic spasms or severe headaches from meds (Sinemet) get bad The overdoses<br/>are from stolen meds illicit fentenal not prescription<br/>pain meds and everyone is different so dosage should be what patient needs not <br/>random dose limit .	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Ellen	None	None	090000648500a467	Johnson	None	2022-04-12T02:34:17Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Johnson, Ellen	l1u-0qoa-c7q6	False	None	False	2022-04-12 06:41:39.252	[]
4822	CDC-2022-0024-4828	https://api.regulations.gov/v4/comments/CDC-2022-0024-4828	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	As a Mother sitting and watching her Daughter who was diagnosed with Ankylosing Spondylitis,Spinal Stenosis, Rheumatoid Arthritis, among other severe issues not being treated , and being told she’s just DRUG SEEKING by staff in EMERGENCY ROOMS who don’t even want to take time to look at her she has lost over probably 125 Lbs she can’t eat, sleep,or do anything because she can barely move , as a Mother it’s GUT WRENCHING not one person willing to help what happened to OATH YOU TOOK AS DOCTORS??? What happened to your compassion?I had to tell my sister that her only son HUNG HIS SELF because after his Dr’s put him on pain meds after a fall instead of doing a surgery he would have rather had they just took away his meds no trying to change treatment plans nothing well now he’s dead my family torn apart, and they won’t give my daughter anything for pain and you wonder why the SUICIDE #’S are up I truly hope that everyone who makes these decisions has to hear the SCREAM OF ONE OF THEIR FAMILY MEMBERS GETTING THAT NOTIFICATION I ALSO HOPE THAT YOU ALL GET DEGRADED AND FEEL AS UNWORTHY AS YOU HAVE MADE MY FAMILY FEEL AND HOPEFULLY YOU’LL BE THERE TO CATCH THEM WHEN THEY DROP TO THEIR KNEES YOU PEOPLE ARE RESPONSIBLE FOR NEEDLESS HUMAN SUFFERING!<br/>I worked in the Medical Field for almost 30 years the decline in patient care over those 30 years is unbelievable to me patients are no longer patients they are numbers these organizations that claim to do the work of JESUS TO HELP THEIR FELLOW HUMANS WELL YOU NEVER KNOW MAYBE THEY DENIED AN ANGEL BECAUSE IT DOES SAY IN THE BIBLE YOU COULD BE ENTERTAINING ANGELS .<br/>And I cannot comment on what happens when my child doesn’t get her meds because NOBODY WILL GIVE HER ANY!!!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Genevieve	None	None	090000648500a46a	Adams	None	2022-04-12T02:35:00Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Adams, Genevieve	l1u-0sby-nh9a	False	None	False	2022-04-12 06:41:39.465	[]
4823	CDC-2022-0024-4829	https://api.regulations.gov/v4/comments/CDC-2022-0024-4829	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Low total daily dose opioids are a helpful treatment for Restless Legs Syndrome. I have tried many different medications and have side effects from other medications and need to use Hydrogocodone Acetamin 5-325 at times to manage my symptoms.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Eileen	None	None	090000648500a46b	Piwowar	None	2022-04-12T02:35:10Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Piwowar, Eileen	l1u-0sq0-dn3g	False	None	False	2022-04-12 06:41:39.680	[]
4824	CDC-2022-0024-4830	https://api.regulations.gov/v4/comments/CDC-2022-0024-4830	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The 2016 guidelines changed my life. As I was able to enjoy my life due the opioids I was taking for my horrific neuropathy pain, I was cut back by 60% due the 2016 CDC Guidelines. While I was not completely bedridden it made life very difficult for me and I was in tremendous pain much of the time. After reading the new guidelines I believe it is crucial to get rid of any mention of mme. Each person is different and it should be up to The doctor as of what dosage we should be on. We are all different. We are all different sizes and our pain is all different. I am a big guy in tremendous pain and I need to be on more dosage than I am on now. Being cut back 60% has basically ruined my life. I am hoping that we can get back to having our doctors make the decision on what kind of dosage we should be on. I believe that any mention of MME mention should be taken out of the new guidelines. I am looking forward to the day when I can be on the dosage that my doctor believes is best for me. I can get back to the day when I can live a full life without being bedridden and without being in so much pain. The guidelines have destroyed peoples lives. I know they were supposed to be just guidelines but everybody took them as law !! Doctors are scared to prescribe it’s going on all over the country including at the pain management place where I go. Please please read these letters and take our advice so we can get back to being treated by our doctors. Thank you	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a470	Anonymous	None	2022-04-12T02:35:35Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-0ulz-d1a4	False	None	False	2022-04-12 06:41:39.894	[]
4825	CDC-2022-0024-4831	https://api.regulations.gov/v4/comments/CDC-2022-0024-4831	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Please consider the many individuals who use opioids responsibly to obtain a better quality of life. It is inhumane to cause undue suffering to this population.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a478	Anonymous	None	2022-04-12T02:35:45Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-0wm6-asu5	False	None	False	2022-04-12 06:41:40.102	[]
4826	CDC-2022-0024-4832	https://api.regulations.gov/v4/comments/CDC-2022-0024-4832	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I have Multiple Sclerosis, Spina Bifida Occulta, Emphasema, Titanium Plate w/6 Screws, Degenerative Joint Disease of Spine, Stenosis, and Migraines. I have been on opioids since my diagnosis of MS in 2002. I have never been addicted or misused my medication. I treat it with utmost respect and know dangers. I can't live without my pain medication. Nor should I have to. It makes all the difference in my quality of life. I have stayed living independently, I'm all about living in spite of MS having highest suicide rate of any disease. If I have no quality of life because I'm in so much pain it makes life unmanageable. Itis why suicide is the option for so many people with MS. Not everyone is same, maintenance pain medication for some people is the only way to have some quality of life. People who want to do drugs always find a way. Some doctors were pumping society with opioids, laws were changed. Now people have turned to Fentenyl, and they are dying just like opioids. People having legitimate pain from disease (s) shouldn't have to lose their quality of life because people abuse. Doctors are able to detect abuse by way of blood or urine tests. Please don't let a non abuser pay the price for abusers, big Pharma, doctors, and patients. Please think and protect a patients right to live pain free. It is cruel to keep a human in pain. We don't even do that for members of our families, cats, dogs, and horses. Thank you for your consideration and my opportunity to be heard. I look forward to your decision.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Cynthia Huether	None	None	090000648500a4d8	Burger	None	2022-04-12T02:38:37Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Burger, Cynthia Huether	l1u-1zyv-l50e	False	None	False	2022-04-12 06:41:40.315	[]
4827	CDC-2022-0024-4833	https://api.regulations.gov/v4/comments/CDC-2022-0024-4833	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	The attached file clearly demonstrates that the MME system has no science nor double blind clinical studies behind it. It is inaccurate, unreliable and unpredictable... producing results that are unethical, immoral and inhumane. The MME system is not referenced in any FDA approved professional prescribing information. The proposed guidelines is - in my professional opinion - is the only treatment for any acute or chronic disease that starts out proposing dosing limits and does not focus on optimizing a pt's quality of life. The 2016 CDC opiate dosing guideline was "weaponized" starting with the DEA and VA. and causing untold number of chronic pain pts to have their pain meds reduced to such a level that they end up living/existing in a torturous level of pain and being home, chair, bed comfined and even many committing suicide because they can not long endure living in a torturous level of pain. I have attached a chart showing the complication of comorbidity issues from under/untreated pain. I have also attached a article describing a 7 million dollar verdict on a pt that committed suicide after his pain clinic cut his opiate meds by 55%.. A pt that was a paraplegic and wheelchair bound for 10 yrs. Our Founding Fathers guaranteed us the freedom of life, liberty and the pursuit of happiness and the 2016 CDC opiate dosing guideline revoke that privilege of many of our citizens suffering from intractable chronic pain. Any guidelines published reference the MME system as its corner stone... will be challenged as being unconstitutional and the CDC did not have the statutory authority to create and publish such guidelines	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Steve	None	None	090000648500a47c	Ariens	None	2022-04-12T02:45:16Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Ariens, Steve	l1u-0l99-4xs5	False	None	False	2022-04-12 06:41:40.522	[]
4828	CDC-2022-0024-4834	https://api.regulations.gov/v4/comments/CDC-2022-0024-4834	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments on 2022 CDC Draft Opioid Prescribing Guidelines Comments 1-9<br/><br/>1.<span style='padding-left: 30px'></span>The guideline update removes 90 MME but replaces it with an even lower limit of 50 MME which patients have already been getting cut to by their doctors. You cannot put down any number in the update or insurance companies, the DEA, and CMS will latch on and use that limit as you yourself admitted occurred in the CDC notice from Director Redfield on April 10, 2019. <br/><br/>2.<span style='padding-left: 30px'></span>Your guideline excludes those in “palliative care” but most states consider that to be hospice and not the CDC’s definition, so unless you have a way to enforce a national definition of palliative to be used by every state, you should replace “palliative” with “intractable pain patients” for exclusion.<br/><br/>3.<span style='padding-left: 30px'></span>The authors who wrote this update include two MDs, one pharmacist, and two public health people. Not one of the authors has any pain management training or experience in anesthesiology or pain management. Don’t experts in anesthesiology and pain management have much more training and experience than the authors of this guideline? Why are none included as editors, and doesn’t their exclusion result in over-emphasis on addiction concerns?<br/><br/>4.<span style='padding-left: 30px'></span>Why does the CDC insist on any guideline when the overdose problem is street drugs not prescriptions, and most of that Is and fentanyl analogs made in China and brought in through Mexico and sold on streets? In addition, overdoses that were deemed “prescriptions” often were determined to be someone else’s stolen medicine. Prescriptions are down over 70% and overdoses have continued to rise since 2016. If anything, the 2016 CDC guidelines made matters worse as people were driven from controlled and professionally monitored medical care to resorting to street drugs, worsening the overdose fatalities instead of reducing them. Why not pursue ways to reduce demand for illicit fentanyl instead of continuing unsuccessful measures to reduce supply?<br/><br/>5.<span style='padding-left: 30px'></span>How does the CDC plan to undo all the damage already done by what you admitted was due to your 2016 guidelines? How do you correct the SUPPORT act which specifies hospital records of any patient receiving more than 90 MME which is a direct connection to your now removed 90 MME limit, and unless you remove the 50 MME limit, how can you guarantee it won’t be misapplied the same as the former 90 MME limit? How can you help state health boards remove MME limits and led redaction of state laws that based hard limits on the 2016 90 MME guideline, and further, how would you ensure 50 MME does not become the new mandated limit?<br/><br/>6.<span style='padding-left: 30px'></span>Why is one disease, sickle cell anemia, excluded but not others such as people with autoimmune disorders that are equal or more difficult to treat and manage, or neurological disorders? Why not just waive everyone with intractable pain rather than being selective to one single disease? Doesn’t everyone deserve pain relief, not just sickle cell anemia patients?<br/><br/>7.<span style='padding-left: 30px'></span>This guideline update constantly contradicts itself. All through the document you refer to patients “deserving individualized care”, consistent with the Congressionally chartered Pain Management Task Force Final Report authored by Dr. [name redacted], you still retain a 50 MME criteria. Page 5 states you want to “be flexible to support, not supplant, clinical judgement” then you recommend a new lower 50 MME limit, that contradicts the very thing you propose on page 5 to be doing? You state on page 5 that “this clinical practice guideline should not be applied as inflexible standards of care across patient populations by healthcare professionals, health systems, pharmacies, third-party payers, or state, local, and federal government or entities” and yet you give a 50 MME limit and you broaden the entire guideline to extend to every possible prescriber?<br/><br/>8.<span style='padding-left: 30px'></span>CDC’s draft 2022 guideline indicates that a single study of long-term use was the basis of this draft update’s recommendations on chronic long term opioid use. AHRQ published a report in 1996, that indicated they had no studies or data to support or oppose opioid use, and here we are 26 years later and all you found was one study from Portugal, which by the way decriminalized all drugs and REDUCED their overdoses while our CDC issued a guideline that more than doubled overdoses. What long term studies were excluded and why? What was the criteria for inclusion and who determined the criteria?<br/><br/>9.<span style='padding-left: 30px'></span>Why does the CDC suggest immediate release analgesics over long term analgesics, when long term analgesics have superior anti-abuse anti-tamper properties? Don’t short term analgesics result in more spikes in blood plasma levels? What data suggests they are in fact safer?<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a6d5	None	None	2022-04-12T02:45:28Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-7gj7-1hm6	False	None	False	2022-04-12 06:41:40.737	[]
4829	CDC-2022-0024-4835	https://api.regulations.gov/v4/comments/CDC-2022-0024-4835	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I had a life for 20 years with opiates and other therapies. But the CDC guidelines stopped that. These “new” guidelines only lower the mme and push more for tapering legacy patients. They will make my already horrible situation worse. The way you put it you think we are all just taking opiates for no reason and when the meds were lowered or stopped that we were better off. That’s not true. We didn’t have some wonderful remission like the addicts you base your studies on. We still have extreme pain and we aren’t receiving a replacement treatment that works. My husband shouldn’t have had to retire to care for me. My grandkids should be able to spend more than 20 minutes at a time with me. I should be able to shop, cook and clean my house. I should be able to go out to eat with family and friends. I should be able to sleep more than an hour at a time. I should be able to have an intimate relationship with my husband of 25 years. You are not saving me. You are hurting me and my family. If you want to take opiates from pain management then you need to replace them with a decent alternative. The problem is there aren’t any. I know, I’ve tried all of them all.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a490	Anonymous	None	2022-04-12T02:46:11Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-16yl-qgyx	False	None	False	2022-04-12 06:41:40.953	[]
4830	CDC-2022-0024-4836	https://api.regulations.gov/v4/comments/CDC-2022-0024-4836	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	I suffer from chronic pain. My pain management doctor was indicted for insurance fraud late last year. There are no other doctors within driving distance that would accept me as a patient since I had been using pain medications. They all require me to follow the standard procedure of exercise and physical therapy that I have attempted over the years that I have been suffering. I couldn’t achieve core strength 20 years ago and I am unable/unwilling to try again at age 64. <br/>I was unaware that I have scoliosis until recently. My spine is twisted terribly. I also have ruptured discs, spinal stenosis, and arthritis. Apparently I am not eligible for the spinal pain implant because my depression is not managed and Medicare will not authorize. So, I am not going to get any help. <br/>I confess that, when my pain medication supply was nearly gone, I attempted suicide in January. I was afraid of having to learn to cope. Now, my life is spent in bed. I can’t stand for more than 10 minutes. I only leave the house for doctors appointments. <br/>This is what the current guidelines have done for me.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Pamela	None	None	090000648500a49f	Blocker	None	2022-04-12T02:46:55Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Blocker , Pamela	l1u-1d80-p9k8	False	None	False	2022-04-12 06:41:41.161	[]
4831	CDC-2022-0024-4837	https://api.regulations.gov/v4/comments/CDC-2022-0024-4837	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My life has dramatically changed since the cdc got involved. I was once able to go to my children's games and debates. Attend gymnastics tournaments and volunteer too. Watching your children excel at things they take interest in is a Remarkable advantage. Going on vacations, helping with homework, dancing and just being a family, friend and co wocker is apart of living. My quality of life has been taken away without just cause. I've tried other Modalities,yet opiate therapy was the one that worked and didn't effect my mind. I was able to focus and not be drowsy. The antidepressants made me not feel. I wasn't myself. Respecting Each one's unique differences is the way we Come together. Overdoses have drastically increased as opiate prescriptions have drastically decreased. This is because of the illicit Illegal street drugs such as fentanyl and heroin that people are overdosing on. The chronic pain community is suffering and losing hope on life because their Quality of life is nil.life is being taken away. Wife & mother of 3 and I cannot do the things that I once was able to do. Cooking, baking entertaing has ceased. tapering against my will has Sent me to the hospital to get relief from my chronic pain. The pain is so Atrocious that suicidal thoughts go across your mind.People have chosen suicide rather than to live in pain every second of the day. I want my life back! I want to teach & travel w/ my family. The CP community is canceled out. Meds that gave us a sense of independence are now making us dependent on others we are shamed for depending on it. We are not addicts,don't want to escape life,but get back into it and out the bed!.stop drug shaming. Stop dismissing my intractable pain that was managed for over 20yrs. Portugal does not do that. Lowest overdose in history!similar to, tobacco, alcohol and Marijuana, people are going to get them. Let law abiding citizens, that dont abuse have a quality of life!I want to parent and be a wife. The stigma around opiates has to stop. Putting fear into people that know what works for them just leads to disaster.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500a4a2	Anonymous	None	2022-04-12T02:51:41Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1u-1ea4-zuhf	False	None	False	2022-04-12 06:41:41.373	[]
4832	CDC-2022-0024-4838	https://api.regulations.gov/v4/comments/CDC-2022-0024-4838	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	Comments 90 to 98<br/><br/>90.<span style='padding-left: 30px'></span>Page 74-75. There is anti-opioid bias and overfocus on addiction so evident in the draft 2022 CDC guidelines in statement such as this “Compared with NSAIDs or acetaminophen, opioids were associated with increased risk of short-term adverse events, including any adverse event, nausea, dizziness, and somnolence ([name redacted] et al., December 2020).” How can nausea, dizziness and somnolence be considered more dangerous than liver poisoning, gastrointestinal bleeding, stroke and heart attacks that NSAIDs and or acetaminophen cause? <br/><br/>91.<span style='padding-left: 30px'></span>Page 75 cites that “Observational studies found opioid use for acute low back pain or postoperative pain was associated with increased likelihood of long-term opioid use ([name redacted] et al., December 2020).” Why list the editor and not the actual study authors?<br/><br/>92.<span style='padding-left: 30px'></span>Page 75: Isn’t this a rather silly to claim that compared with not taking any opioids, taking opioids had a higher rate of long-term use? “For example, one study found that compared with no early opioid use for acute low back pain, the adjusted odds ratio was 2.08 (95% CI 1.55 to 2.78)?” Why would the hazard ratio not be infinite if the comparison is made to a group not taking any opioids? How often are early opioid prescriptions greater than 450 MME? “an early prescription totaling ≥450 MME/day ([name redacted] et al., 2007)?” How often do patients get 450 MME/day as their starting opioid or “early” dose?<br/><br/>93.<span style='padding-left: 30px'></span>Page 75: Likewise, this assessment seems rather ridiculous “Serious adverse events were uncommon for opioids as well as for other medications, but studies were not designed to assess risk of overdose, opioid use disorder, or long-term harms ([name redacted] et al., December 2020).” So essentially opioids are deemed safe but some anti-addiction doctor without training in pain management finds excuses to consider them unsafe due to lack of study design?<br/><br/>94.<span style='padding-left: 30px'></span>Page 75: Doesn’t this suggest the harm CDC has caused by the poorly written 2016 guidelines, and a good reason to not publish an update, but instead residing it altogether? “The American Dental Association recommends NSAIDs as the first-line therapy for acute pain management (see Nonopioid medications for acute pain) (American Dental Association, 2020).” Why did dentists otherwise only decide to make such a proclamation in 2020 and not in the 100 years before, since opioids have been literally used for thousands of years? Can’t the CDC see how dangerous and misleading the 2016 guidelines have been interpreted beyond its self-defined scope, which is now being intentionally expanded to every possible prescriber of opioids? Including all these external references seems to be saying “CDC was right all along because everyone else agreed with us after they bought into our misunderstood guidelines,” a rather self-serving selection bias evident throughout the 2022 draft update.<br/><br/>95.<span style='padding-left: 30px'></span>Why continually reference other organizations that emphasize not using the very medication this guideline update is written to guide? Each reference usually only cites a single study to back up the evidence. “The American Headache Society recommends against prescribing opioid or butalbital-containing medications as first-line treatment for recurrent headache disorders ([names redacted], 2013), and the American Academy of Neurology recommends against use of these medications for treatment of migraine, except as a last resort ([names redacted] et al., 2013).<br/><br/>96.<span style='padding-left: 30px'></span>Again, why does CDC contstantly promote equal if not more dangerous NSAIDs repeatedly throughout this guideline for opioids? Again we see the CDC’s addiction-centric bias. “Given equivalent or lesser effectiveness for pain relief compared with NSAIDs and risks of long-term opioid use after using opioids for acute pain, opioids are not recommended as first-line therapy for many common acute pain conditions.” Is this document a guide for opioid use for pain or a doctrinal decree against use of opioids out of unjustified addiction concerns? The anti-opioid bias is so overwhelming that any physician, like the state of Oklahoma, may forbid use of CDC guidelines, rendering them useless at best and potentially harmful as with the 2016 guidelines<br/><br/>97.<span style='padding-left: 30px'></span>Page 76 - Given the severity of kidney stones, why does this guideline on page 76 state that opioids are not recommended? How does the CDC decide what is “only mild postoperative pain?” Isn’t that best left to the physician and patient to decide and not the federal government? Aren’t patients individuals and should be treated like such?<br/><br/>98.<span style='padding-left: 30px'></span>Why include statements like this from page 77 that are one size fits all and how does the federal government decide how long severe pain can be expected without having examined a patient and reviewed his or her clinical records? “no longer than the expected duration of pain severe enough to require opioids”<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500a6f9	None	None	2022-04-12T02:51:47Z	CPP (Chronic Pain Patients) News Source	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from CPP (Chronic Pain Patients) News Source	l1u-86m7-2cvj	False	None	False	2022-04-12 06:41:41.607	[]
4833	CDC-2022-0024-4839	https://api.regulations.gov/v4/comments/CDC-2022-0024-4839	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My family has been directly harmed by the 2016 guidelines elevation of potential harms of treating pain over the harm of pain itself.<br/>I live with chronic pain due to rheumatoid arthritis and fibromyalgia. I also have an eye condition that has necessitated repeated invasive surgeries since 1998. I am allergic to a medication that is used to keep the eye muscle still after surgery. This causes me to be in excruciating pain during the recovery period which can last several weeks.<br/>The 2016 guidelines have prevented eye surgeons from giving me appropriate pain-controlling medication after surgery that has been done with cutting instruments on my eye, resulting in loss of my ability to contribute to household duties and my part-time work environment due to my need to sleep in order to cope with pain.<br/>My rheumatologist has treated me for over 15 years and is aware of my use of support networks and other mechanisms to monitor my compliance with prescriptions for controlled substances. Over-the-counter remedies are ineffective at managing severe pain caused by arthritis, fibromyalgia or invasive eye procedures, especially when these conditions co-occur. Use of steroids to manage arthritis pain has caused extreme weight gain and resulted in my developing prediabetes and inability to manufacture stress hormone, further limiting my ability to recover properly from surgeries. properly monitored use of opioids has allowed me to safely manage pain, maintain control of prediabetes, and hold part-time employment. It <br/>As both a patient and a member of the clergy, I speak personally and professionally to the importance of of the doctor-patient relationship be considered in establishing these guidelines. Individual factors contribute to the success of pain management, and success of pain management contributes greatly to the mental health and spiritual well-being of patients with chronic pain.<br/>Please ensure that guidelines and training materials respect the individual nature of patients' needs and the importance of doctor-patient collaboration in decision-making.<br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Sarah	None	None	090000648500a4ef	LaRose	None	2022-04-12T03:02:33Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-10T04:00:00Z	None	None	None	None	None	None	None	Comment from LaRose, Sarah	l1u-26aw-6hd5	False	None	False	2022-04-12 06:41:41.819	[]
4834	CDC-2022-0024-4840	https://api.regulations.gov/v4/comments/CDC-2022-0024-4840	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	With one in four persons experiencing chronic pain and the aging of the population with concomitant increase in osteoarthritis, I feel that these guidelines are missing two key points:<br/><br/>1) Some persons are unable to take NSAIDS due to acute gastritis, ulcers and/or perforation. This should be noted in the medical record as an adverse response and considered when looking for alternative medication when Tylenol is not sufficient to control pain. It is one reason why opioids must be considered.<br/><br/>2) To maintain functionality, the opioid medication prescribed may be used intermittently for flare ups for chronic pain. When the focus is only on the prescription, rather than on the actual usage, the information about use can be misinterpreted. If the filling of the prescription is verified, along with validation in the PDMP database of the lack of abuse and ER visits, the patient should not penalized for appropriate use of the opioid medication. It is easier to check refills than do a pill count.<br/><br/>	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500f511	Anonymous	None	2022-04-12T03:03:37Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-k4qy-caml	False	None	False	2022-04-12 06:41:42.026	[]
4835	CDC-2022-0024-4841	https://api.regulations.gov/v4/comments/CDC-2022-0024-4841	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	See attached file(s)	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Chad	None	None	0900006484ffd174	Kollas	None	2022-04-12T03:09:11Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-06T04:00:00Z	None	None	None	None	None	None	None	Comment from Kollas, Chad	l1o-3yo7-opfi	False	None	False	2022-04-12 06:41:42.234	[]
4836	CDC-2022-0024-4842	https://api.regulations.gov/v4/comments/CDC-2022-0024-4842	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	It is well established that untreated pain is correlated with poor mental health outcomes, including suicide. Please consult your subscription to PubMed for the evidence. It's there, if it hasn't been scrubbed yet. This means that this huge, uncontrolled experiment that the CDC has instigated is actually causing poor mental health and the resulting suicides. And the first thing the CDC needs to acknowledge that it is causing suicides, in addition to medically induced PTSD,<br/><br/>Since you're asking for suggestions, here are mine:<br/><br/>1)<span style='padding-left: 30px'></span>Immediately<span style='padding-left: 30px'></span>repeal the CDC<span style='padding-left: 30px'></span>Guideline for Prescribing Opioids for Chronic Pain--United States,<span style='padding-left: 30px'></span>2016. This document has caused untold misery and has cost thousands<span style='padding-left: 30px'></span>of lives to suicide. It is irretrievably flawed.<br/><br/>2)<span style='padding-left: 30px'></span>Do what you can<span style='padding-left: 30px'></span>to keep the DEA out of our doctor's offices. It is unconscionable<span style='padding-left: 30px'></span>that because of the actions of the CDC, federal agencies now have<span style='padding-left: 30px'></span>the power to come between my doctors and myself.<br/><br/>3)<span style='padding-left: 30px'></span>Revoke the license of anyone who performs surgery and refuses to address the<span style='padding-left: 30px'></span>pain they inflict.<br/><br/>4)<span style='padding-left: 30px'></span>Make emergency<span style='padding-left: 30px'></span>room doctors and primary care providers legally liable for the pain<span style='padding-left: 30px'></span>and suffering of their patients,<br/><br/>5)<span style='padding-left: 30px'></span>Acknowledge that opioid therapy has had a beneficial effect on people with pain<span style='padding-left: 30px'></span>for thousands of years.<br/><br/>6)<span style='padding-left: 30px'></span>Acknowledge that people with PTSD or anxiety have a right to equal attention to their pain. Instruction on drug interaction is sufficient, denying them pain medication is life threatening and cruel.<br/>.	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	Anonymous	None	None	090000648500f533	Anonymous	None	2022-04-12T03:09:57Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Anonymous	l1v-kb8w-pcp1	False	None	False	2022-04-12 06:41:42.448	[]
4837	CDC-2022-0024-4843	https://api.regulations.gov/v4/comments/CDC-2022-0024-4843	0900006484f67412	CDC-2022-0024-0001	None	None	CDC	None	None	My name is [name redacted]. I am a MH Activist. My son was killed by Big Pharma, The FDA, N.I.H., A.M.A. & C.D.C. that started with Oxycontin. I was also thrown into this trap after surgeries. The story is quite extensive. Yesterday, the World was put on notice that I am not tolerating anymore of the corruption. Please contact me for input. I have had to find alternate ways to cope with the neverending pain my CNS has succumb to daily by all the deadly chemicals the government has been pumping the citizens with since The [name redacted] in the early 1800's. There will be no more putting PROFITS over human life and harming everyone for personal gain. Please contact me asap. A huge spotlight is going up! I have much more to share with you all. Note, it's deep and no one is going to be happy if I go into further detail publicly. See news - [name redacted]<br/><br/>Thank you very much for your time and energy. Have a fantastic week!	None	[{'name': 'pageCount', 'label': 'Page Count', 'tooltip': 'Number of pages In the content file'}]	None	CDC-2022-0024	Public Submission	None	None	None	None	None	None	None	None	090000648500b923	None	None	2022-04-12T03:11:16Z	None	None	1	None	2022-04-11T04:00:00Z	None	None	2022-04-11T04:00:00Z	None	None	None	None	None	None	None	Comment from Harvest Healing Foundation	l1u-uf3p-v1u5	False	None	False	2022-04-12 06:41:43.185	[]